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tenchlifesciences · 4 days
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bhagwatipharma · 3 years
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SHREE BHAGWATI GROUP Manufacturing Process Equipment and Packaging Machineries
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Shree Bhagwati Group of Companies Wishes You Merry Christmas, may the New Year 2022 bring you more happiness, success, love and blessings!
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Bhagwati is Pioneer in Sticker Labelling Technology
With more than 25 years of experience, Shree Bhagwati is a pioneer company in sticker labelling technology and has highest number of installations in India as of today. With commitments towards customer service and continuous R&D, Bhagwati has kept up the blistering growth and its leadership position in India.
A front and back panel label will be applied with a semi-automatic labeller or a completely automatic labeling system. Applications embrace bottles, shampoo bottles, cases, cartons, cans Etc.
Bhagwati's Labelling Machines widely used in industries like Pharmaceutical, Food & Beverages, Distilleries & Breweries, Cosmetics & Toiletries, Lube & Edible Oil, Automobile, Agriculture & many more. We also provide manufacturing of Self Adhesive Sticker Labels, as a supporting activity for our customers as that is the most important input for the labelling machine.
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We are not ordinary Labeling Machine manufacture
Shree bhagwati’s technologically superior labeling machines.
Automatic Labeling Machine Innovation
Best Automatic Labeling Machine You Can Purchase
Servo labeling machines.
Your satisfaction is 100% guaranteed.
The Double Side Labelling Machine from Bhagwati is a world class product which can take care of your single and double side labelings for your products. Bhagwati’s double side labelling machine are designed keeping convenience in mind making it easy to operate and maintain. Powered with the latest digital servo technology, our Double Side Labelling Machine can label up to 300 containers per minute with precision and accuracy. Exceptional features for product handling, tool less operations, and safety makes it the go to choice for thousands of brands around the world.
Our Portfolio Includes World’s Most Innovative Machinery For Productivity:
Filling Lines for all types of Liquid Filling / Injectable Filling / Powder Filling / Paste, Tube Filling
Process Plants for Ointment, Oral Liquid, Shampoo Etc.
Industrial Storage Tanks & Vessels as per CGMP Standards
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Just share your query with us and we will be ready with a great solution for your smart factory.
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Our Customers
Our worldwide customer base consists of Blue Chip companies across a broad spectrum of markets and industries, including among others Pharmaceutical, Agro, Food & Beverage, Dairy, Oil Industry, Hair oil, Edible / Mustard, / Lube & Cooking, Healthcare, Toiletry and Cosmetics, Personal Care, Logistics, E-Liquid/Vaping, Medical Device and many more for different application of wrap around labeling machine, sleeve shrink labeling machine and front back labeling machine,Wrap and Multi-Panel Applications, Top/Bottom, C-Shape and Full 360 Degree Banding Ampoule, Tube, Vial, Round Bottle, Jar, Cans, Square Bottle, Jar, Cans, Flat Bottle, Bucket, Carton/Box/Container, Carton/Box/Container labelers machine, label applicators systems, Sticker Labelling Machine.
Besides Packaging Equipment, our other divisions include: Printing of Self Adhesive Sticker Labels in Roll Form, Induction Liner / Wads, Printed Shrink Sleeves, Shrink Rolls, Foils.
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Mr. Arjun Rao
CEO Of Shree Bhagwati Group of Companies
+91-9898070475 +91-9898070475
+91-9898070475 +91-9898070475
www.bhagwatipharma.co.in https://www.bhagwatipharma.com/
[email protected]@bhagwatipharma.com
Head Office: Plot No : 2802, Road No 4 E, G.I.D.C, Phase 4, Vatva, Gujarat 382445, India.Head Office: Plot No : 2802, Road No 4 E, G.I.D.C, Phase 4, Vatva, Gujarat 382445, India.
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orbemnews · 4 years
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The World Needs Syringes. He Jumped In to Make 5,900 Per Minute. BALLABGARH, India — In late November, an urgent email popped up in the inbox of Hindustan Syringes & Medical Devices, one of the world’s largest syringe makers. It was from UNICEF, the United Nations agency for children, and it was desperately seeking syringes. Not just any would do. These syringes must be smaller than usual. They had to break if used a second time, to prevent spreading disease through accidental recycling. Most important, UNICEF needed them in vast quantities. Now. “I thought, ‘No issues,’” said Rajiv Nath, the company’s managing director, who has sunk millions of dollars into preparing his syringe factories for the vaccination onslaught. “We could deliver it possibly faster than anybody else.” As countries jostle to secure enough vaccine doses to put an end to the Covid-19 outbreak, a second scramble is unfolding for syringes. Vaccines aren’t all that useful if health care professionals lack a way to inject them into people. “A lot of countries were caught flat-footed,” said Ingrid Katz, the associate director of the Harvard Global Health Institute. “It seems like a fundamental irony that countries around the world have not been fully prepared to get these types of syringes.” The world needs between eight billion and 10 billion syringes for Covid-19 vaccinations alone, experts say. In previous years, only 5 percent to 10 percent of the estimated 16 billion syringes used worldwide were meant for vaccination and immunization, said Prashant Yadav, a senior fellow at the Center for Global Development, a think tank in Washington, and an expert on health care supply chains. Wealthier nations like the United States, Britain, France and Germany pumped billions of dollars of taxpayer money into developing the vaccines, but little public investment has gone to expand manufacturing for syringes, Mr. Yadav said. “I worry not just about the overall syringe manufacturing capacity but capacity for the specific types of syringes,” he said, “and whether syringes would already be in locations where they are needed.” Not all of the world’s syringes are suited to the task. To maximize the output from a vial of the Pfizer vaccine, for example, a syringe must carry an exact dose of 0.3 milliliters. The syringes also must have low dead space — the infinitesimal distance between the plunger and the needle after the dose is fully injected — to minimize waste. The industry has ramped up to meet demand. Becton Dickinson, which is based in New Jersey and a major syringe manufacturer, said it will spend $1.2 billion over four years to expand capacity in part to deal with pandemics. Updated  March 5, 2021, 5:03 a.m. ET The United States is the world’s largest syringe supplier by sales, according to Fitch Solutions, a research firm. The United States and China are neck and neck in exports, with combined annual shipments worth $1.7 billion. While India is a small player globally, with only $32 million in exports in 2019, Mr. Nath of Hindustan Syringes sees a big opportunity. Each of his syringes sells for only three cents, but his total investment is considerable. He invested nearly $15 million to mass-produce specialty syringes, equal to roughly one-sixth of his annual sales, before purchase orders were even in sight. In May, he ordered new molds from suppliers in Italy, Germany and Japan to make a variety of barrels and plungers for his syringes. Mr. Nath added 500 workers to his production lines, which crank out more than 5,900 syringes per minute at factories spread over 11 acres in a dusty industrial district outside New Delhi. With Sundays and public holidays off, the company churns out nearly 2.5 billion a year, though it plans to scale up to three billion by July. Hindustan Syringes has a long history of supplying UNICEF immunization programs in some of the poorest countries, where syringe reuse is common and one of the main sources of deadly infections, including HIV and hepatitis. What You Need to Know About the Vaccine Rollout In late December, when the World Health Organization cleared Pfizer’s vaccine for emergency use, Robert Matthews, a UNICEF contract manager in Copenhagen, and his team needed to find a manufacturer that could produce millions of syringes. “We went, ‘Oh, dear!’” said Mr. Matthews, as they looked for a syringe that would meet W.H.O. specifications and was compact for shipping. Hindustan Syringes’ product, he said, was the first. The company is set to begin shipping 3.2 million of those syringes soon, UNICEF said, provided they clear another quality check. Mr. Nath has sold 50 million syringes to the Japanese government, he said, and over 400 million to India for its Covid-19 inoculation drive, one of the largest in the world. More are in line, including UNICEF, for which he has offered to produce about 240 million more, and Brazil, he said. Inside the company’s Plant No. 6, machines coated in yellow paint hum as they squirt out plastic barrels and plungers. Other machines, from Bergamo, Italy, assemble each component, including needles, monitored by sensors and cameras. Workers in blue protective suits inspect trays full of syringes before unloading them into crates that they hand carry to a packaging area next door. To increase efficiency, Mr. Nath relies on a syringe design by Marc Koska, a British inventor of safety injections, and its ability to produce all of the components in-house. Hindustan Syringes makes its needles from stainless steel strips imported from Japan. The strips are curled into cylinders and welded at the seam, then stretched and cut into fine capillary tubes, which machines glue to plastic hubs. To make the jabs less painful, they are dipped in a silicone solution. The syringe business is a “bloodsucker,” Mr. Nath said, where upfront costs are astronomical and profits marginal. If demand for his syringes drop by even half in the next few years, he will lose almost all of the $15 million he invested. It’s clearly a frugal operation. The blue carpet in Mr. Nath’s office looks just as old as his desk or the glass chandelier by the stairs, fixtures his father put in place in 1984, before he handed over the company to Mr. Nath and his family. A family business is exactly how he likes it. No shareholders, no interference, no worries. In 1995, when Mr. Nath needed money to increase production and buy lots of new machines, he sought private capital for the first time. Had that been the case today, he said, he wouldn’t be able to follow his gut and produce his syringes at this enormous scale. “You have a good night’s sleep,” Mr. Nath said. “It’s better to be a big fish in a small pond.” Source link Orbem News #jumped #minute #Syringes #World
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bbcbreakingnews · 4 years
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From factory to faraway village: Behind India’s mammoth vaccination drive
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KORAPUT: Reena Jani rose early, finished her chores in the crisp January cold and walked uphill to the road skirting her remote tribal hamlet of Pendajam in eastern India. Riding pillion on a neighbour’s motorcycle for 40 minutes through hillsides dotted with paddy fields, the 34-year-old health worker headed for the Mathalput Community Health Centre. Jani’s name was on a list of 100 health workers at the centre, making her one of the first Indians to be inoculated against Covid-19 earlier this month, as the country rolls out a vaccination programme the government calls the world’s biggest. But she had heard rumours of serious side effects and worried about what would happen were she to get ill. “I was frightened because of my son and daughters. If something happens to me, what will they do?” Jani told Reuters, visibly relieved after the injection produced no immediate side effects. The vaccine she received had travelled much further. It was taken by plane, truck and van some 1,700 km from the factory to the clinic where Jani waited, and it had to be kept cold the whole way. Its safe arrival in Koraput district, where leftist guerrillas wage a low-level insurgency amid rolling hills and thick forests, was testament to detailed planning and groundwork by authorities in the state of Odisha. But officials acknowledge this is just the tip of the iceberg. The 1.5 million vaccinated so far, mainly targeting key workers like Jani, are a tiny first phase of a vaccine programme that India hopes will eventually protect its 1.4 billion people from the coronavirus. Only when the much larger third phase is launched, aimed at 270 million people deemed vulnerable, will the government know if its plan to distribute shots across sometimes hostile terrain and amid high temperatures will succeed. “The problem will start from the third phase when the public will start coming,” said Madhusudan Mishra, Koraput’s district collector. “That will be a real challenge.” Supplying vaccines is one thing. Convincing people to take them is another. Scepticism about the safety and efficacy of Covid-19 shots is high in India, particularly in rural areas, officials say, and misinformation via social media platforms and word-of-mouth could undermine the effort. The Covid-19 vaccine Jani took was developed by AstraZeneca and Oxford University. India is also using another developed by Bharat Biotech. The deployment comes as the number of coronavirus cases in India approached 11 million and deaths exceeded 150,000. ‘MOST AWAITED VACCINE’ Manufactured in the western city of Pune by the Serum Institute of India, the world’s largest vaccine maker by volume, some 40,800 vials of the AstraZeneca shot were flown on a commercial airline into Odisha’s capital city on Jan. 12. A fire last week at the Pune plant killed five people but officials said vaccine production would not be affected. India has distributed 16.5 million doses of the two approved vaccines to its states and territories, which dispersed them using an army of drivers and an infrastructure established for existing vaccination programmes but bolstered for the pandemic. In Odisha, after a delayed start on Jan. 13, government staff at the vaccine centre pulled out vials from a cavernous refrigerator and carefully counted them, before packing them into insulated boxes with ice packs to keep them at between 2-8 degrees Celsius for up to three days. Then it was over to veteran health department driver Lalu Porija. He drove his delivery van all night to reach the site, and now had to truck the vaccines 500 km (310 miles) back to Koraput with an armed policeman in plain clothes for company. “I am feeling a little tired,” said Porija, as he stopped to sip tea late that evening after a traffic jam delayed the trip by several hours. Negotiating cows, debris, thick fog and hairpin bends, and fighting fatigue, Porija drove nearly 24 hours within three days to collect and deliver the vaccine shots to Koraput town. On Jan. 15, at Koraput’s main vaccine store, healthcare workers counted, packed and loaded smaller quantities for the district’s five vaccination sites, including the Mathalput Community Health Centre some 30 km away. A small white van drove out at noon, kicking up dust on narrow countryside roads, for a delivery run to multiple sites. Again, an armed policeman sat inside. “The most awaited vaccine,” a healthcare worker at Mathalput said to colleagues, as a box of shots was unloaded. CHALLENGES LOOM India has mapped out a plan to vaccinate around 300 million people by July-August. In the first phase, which got underway earlier this month, the target is 10 million healthcare workers, including Jani. Next are 20 million essential services workers, followed by 270 million people deemed susceptible to the coronavirus. Beyond that there is no clear road map, although the government has said every Indian who wants or needs the vaccine will get it. In Koraput, a team of officials spent months putting together a local Covid-19 vaccination plan, officials said. With much of the district lacking internet access, they chose vaccination sites with good connectivity and conducted dry runs, said Koraput’s top health official Dr Makaranda Beura. And where mobile coverage was patchy, like Jani’s Pendajam village, health workers were called to meetings to inform them of vaccination plans, followed by visits from supervisors to people registered to be inoculated. Despite initial glitches, particularly with CO-WIN – a centralised digital platform to roll out and track India’s mammoth vaccination programme – officials in Koraput said the system would suffice for the first two phases. For the much bigger third phase, district collector Mishra said he anticipated deploying the entire local police force to manage crowds as well as acquiring additional vehicles to support staff working in far-flung areas. But moving the vaccine deep into the interiors, where Maoist insurgents are known to operate, also requires police to work with paramilitary troops and special forces, said southwest Odisha’s police chief Rajesh Pandit. “We have to take extra care,” Pandit said. RUMOURS AND HESITANCY Jani became an accredited social health activist (ASHA) community health worker, a lynchpin of India’s rural healthcare system, around seven years ago. She monitors pregnant women in her village of 500 people, helps with malaria tests and doles out basic medication for fever and diarrhoea. The main breadwinner for her family of five, Jani draws a monthly salary of 3,000 rupees ($41), helping put her two daughters and one son through school. When she first learned she was to be vaccinated, Jani said she wasn’t worried. Then she heard a rumour. “Someone told me that people are fainting, they are developing fever and some are dying after taking the injection,” she said. “That is why I was frightened.” In a survey conducted by New Delhi-based online platform LocalCircles, 62% of 17,000 respondents were hesitant to get vaccinated immediately, mainly due to worries over possible adverse reactions. The fears are rife among health workers too, prompting India to appeal to frontline workers not to refuse vaccines after many states failed to meet initial vaccination targets. Dr Tapas Rajan Behera, the medical officer in charge of the Mathalput Community Health Centre, said authorities were aware of possible reluctance to take the vaccine and had instructed health workers to allay fears over safety. A jittery Jani eventually received her shot, partly vaccinating her against Covid-19: one tiny step in India’s mission to beat the pandemic.
source https://bbcbreakingnews.com/2021/01/25/from-factory-to-faraway-village-behind-indias-mammoth-vaccination-drive/
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adwaitcoherent · 4 years
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At a CAGR of 9.8%, GCC Syringes And Needles Market To show exponential growth
US$ 381.5 Mn in 2018, By 2027, GCC Syringes And Needles Market To Surpass US$ 961.7 Mn
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Description:
Syringes and needles are collectively known as a “sharps” and are the most widely used medical disposables across the globe. Syringes and needles are defined as hollow devices made from glass, metal or polymer, and a nozzle and piston for sucking in or injecting fluid or liquid in a thin stream into the patient or vial.
 Statistics:
 GCC syringes and needles market is estimated to account for US$ 434.6 Mn in terms of value in 2018 and is expected to reach US$ 961.7 Mn by the end of 2027.
 GCC Syringes and Needles Market: Drivers
 High prevalence of chronic diseases is expected to propel growth of GCC syringes and needles market over the forecast period. For instance, according to the World Health Organization, Saudi Arabia recorded 24,485 new cases of cancer and 10,518 deaths due to the disease in 2018.
 Moreover, increasing number of hospitals and other healthcare institutions is also expected to aid in growth of the market. For instance, the Government of Saudi Arabia plans to double the number of qualified Saudi nurses by 2020 and increase the number of licensed medical facilities from 40 to 100 by 2020 under Vision 2030 and the National Transformation Program.
 Kingdom of Saudi Arabia (KSA) held dominant position in the GCC syringes and needles market in 2018, accounting for 73.6% share in terms of value, followed by UAE.
 GCC Syringes & Needles | Coherent Market Insights
 GCC Syringes and Needles Market: Restraints
 Reuse of disposable syringes is expected to hinder growth of GCC syringes and needles market over the forecast period. Syringes and needles are majorly used for the applications such as injection, infusion, and blood collection. For the aforesaid applications, disposable syringes are used repeatedly due to less awareness about patient health and safety and spread of diseases and cost effectiveness, which can ultimately hamper growth of the market.
 Interaction of prefilled syringes with drugs and its diluents is a major concern as it creates stability issue with regards to drugs. In prefilled syringes, interaction between chemicals of drugs and physical properties of the materials used to manufacture syringes such as polymer and glass materials may adversely affect the actual properties of drugs and result in harm to the end user. This in turn may adversely impact growth of the market.
  GCC Syringes and Needles Market: Opportunities
 Increasing self-administration of medication is expected to offer lucrative growth opportunities for players in GCC syringes and needles market. Patients are preferring self-administration of drugs, due to ease in self-administration of drugs using prefilled syringes.
 Availability of disposable sterile syringes and needles to patients through vending machines for self-administration of drugs, where access to syringes and needles through vendors is difficult 24X7, can also emerge as an opportunity for market players.
 GCC Syringes & Needles | Coherent Market Insights
 Hypodermic segment in GCC syringes and needles market was valued at US$ 381.5 Mn in 2018 and is expected to reach US$ 873.2 Mn by 2027 at a CAGR of 9.8% during the forecast period.
 Market Trends/Key Takeaways
 Plastic syringes are increasingly preferred over glass syringes as plastic syringes are easy to use, are highly resistant to breakage, and are more economically priced compared to glass syringes. Moreover, plastic syringes are easy to transport due to their light weight and the probability of accidental injuries is less while handling plastic syringes compared to glass syringes.
 Demand for single use prefilled syringes and needles is significantly increasing due to simplicity in administration. Moreover, single use prefilled syringes and needles are suitable for home use.
 Value Chain Analysis
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 GCC Syringes & Needles | Coherent Market Insights
 GCC Syringes & Needles | Coherent Market Insights
 Various industry stakeholders are involved in the value chain of GCC syringes and needles market such as raw material suppliers, manufacturers, importers, distributors, wholesalers, and retailers
GCC countries rely on imported syringes and needles, owing to lack of manufacturing facilities for such products in the region to meet demand for syringes and needles from end users
“Value chain-1” has become the shortest and profitable value chain due to less intermediates
Irrespective of unfavorable conditions, few local manufacturers are involved in manufacturing activities in the GCC as represented by “value chain-2”, which is less preferable, owing to less profit margin as compared to “value chain-1”
GCC Syringes and Needles Market: Competitive Landscape
 Major players operating in GCC syringes and needles market include, Becton, Dickinson and Company (BD), Nipro Corporation, Baxter International Inc., B. Braun Melsungen AG, Terumo Corporation, Medtronic plc., Smiths Group plc., Abu Dhabi Medical Devices Company,  SAAPP (FZC) LLC., and IBN Sina Medical Factory.
 GCC Syringes and Needles Market: Key Developments  
 Major players in the market are focused on launching new products to expand their product portfolio. For instance, in February 2020, Fresenius Kabi launched Glucagon Emergency Kit, which includes Glucagon for Injection 1 mg and a prefilled glass syringe with 1 mL of Sterile Water for Injection, USP.
 In November 2018, Baxter International Inc. launched the Tisseel Prima syringe at the 2018 American Association of Gynecologic Laparoscopists (AAGL) meeting.
 August 2019: Morimoto Pharma launched new prefilled syringe product, the Morimoto S.A.F.E. Syringe Kit
 August 2018: Credence MedSystems raised US$ 12.8 million in financing through a series B round for expanding manufacturing of its injectable drug delivery devices
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roberthill687-blog · 5 years
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Caspofene Market 2020 – Global Industry Analysis, Size, Share, Growth, Trends
Caspofene Market report delivers rational insights alongside historical and forecast data to benefit in better understanding of the Global Caspofene Market. The report provides a comprehensive analysis of key factors that are expected to drive the growth of the Caspofene Market.
CaspofeneMarket competition by top manufacturers/ Key player Profiled:
DSM Sinochem Pharmaceuticals
JSN Chemicals Ltd
Brightgene Bio-Medical Technology
Jiangsu Shengdi Pharma
Suzhou No.4 Pharmaceutical Factory
Get a sample copy of the report @http://www.360marketupdates.com/enquiry/request-sample/14592048
The statistic scope is caspofene API in this report.
The global Caspofene market was valued at xx million US$ in 2018 and will reach xx million US$ by the end of 2025, growing at a CAGR of xx% during 2019-2025.
This report focuses on Caspofene volume and value at global level, regional level and company level. From a global perspective, this report represents overall Caspofene market size by analyzing historical data and future prospect.
Regionally, this report categorizes the production, apparent consumption, export and import of Caspofene in North America, Europe, China, Japan, Southeast Asia and India.
For each manufacturer covered, this report analyzes their Caspofene manufacturing sites, capacity, production, ex-factory price, revenue and market share in global market.
Caspofene Market Segment by Type covers:
High Purity
Low Purity
Caspofene Market Segment by Applications can be divided into:
50 mg (base)/Vial Injection Product
70 mg (base)/Vial Injection Product
Single Dose Vials Injection Product
Others
Fill the Pre-Order Enquiry form for the report @https://www.360marketupdates.com/enquiry/pre-order-enquiry/14592048
Regional analysis covers:
North America (USA, Canada and Mexico)
Europe (Germany, France, UK, Russia and Italy)
Asia-Pacific (China, Japan, Korea, India and Southeast Asia)
South America (Brazil, Argentina, Columbia etc.)
Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa)
Key questions answered in the report:
What will the marketgrowth rateof Caspofene market?
What are thekey factors drivingthe global Caspofene market?
Who are thekey manufacturersin Caspofene market space?
What are themarket opportunities, market risk and market overviewof the Caspofenemarket?
What are sales, revenue, and price analysis of top manufacturers of Caspofene market?
Who are the distributors, traders and dealers of Caspofene market?
What are the Caspofene market opportunities and threats faced by the vendors in the global Caspofeneindustries?
What are sales, revenue, and price analysis by types and applicationsof Caspofenemarket?
What aresales, revenue, and price analysis by regionsof Caspofene industries?
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Key Benefits to purchase this report
Major countries in each region are mapped according to individual market revenue.
Comprehensive analysis of factors that drive and restrict the market growth is provided.
The report includes an in-depth analysis of current research and clinical developments within the market.
Key players and their key developments in the recent years are listed
The next part also sheds light on the gap between supply and consumption. Apart from the mentioned information,growth rateof Caspofene market in 2025is also explained.Additionally, type wise and application wise consumptiontables andfiguresof Caspofene marketare also given.
Table of Contents
Market Overview 1.1 Caspofene Introduction 1.2 Market Analysis by Type 1.3 Market Analysis by Applications 1.4 Market Analysis by Regions 1.5 Market Dynamics 1.5.1 Market Opportunities 1.5.2 Market Risk 1.5.3 Market Driving Force 2 Manufacturers Profiles
3 Global Caspofene Market Analysis by Regions
4 Global Caspofene Market Competition, by Manufacturer
5 Sales Channel, Distributors, Traders and Dealers
Continued…
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newstfionline · 8 years
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Turning the Tide Against Cholera
By Donald G. McNeil Jr., NY Times, Feb. 6, 2017
SUNDARBANS NATIONAL PARK, BANGLADESH--Two hundred years ago, the first cholera pandemic emerged from these tiger-infested mangrove swamps.
It began in 1817, after the British East India Company sent thousands of workers deep into the remote Sundarbans, part of the Ganges River Delta, to log the jungles and plant rice. These brackish waters are the cradle of Vibrio cholerae, a bacterium that clings to human intestines and emits a toxin so virulent that the body will pour all of its fluids into the gut to flush it out.
Water loss turns victims ashen; their eyes sink into their sockets, and their blood turns black and congeals in their capillaries. Robbed of electrolytes, their hearts lose their beat. Victims die of shock and organ failure, sometimes in as little as six hours after the first abdominal rumblings.
Cholera probably had festered here for eons. Since that first escape, it has circled the world in seven pandemic cycles that have killed tens of millions.
Artists of the 19th century often depicted it as a skeleton with a scythe and victims heaped at its feet. Outbreaks forced London, New York and other cities to create vast public water systems, transforming civic life.
Today cholera garners panicky headlines when it strikes unexpectedly in places like Ethiopia or Haiti. But it is a continuing threat in nearly 70 countries, where more than one billion people are at risk.
Now, thanks largely to efforts that began in cholera’s birthplace, a way to finally conquer the long-dreaded plague is in sight.
A treatment protocol so effective that it saves 99.9 percent of all victims was pioneered here. The World Health Organization estimates that it has saved about 50 million lives in the past four decades.
Just as important, after 35 years of work, researchers in Bangladesh and elsewhere have developed an effective cholera vaccine. It has been accepted by the W.H.O. and stockpiled for epidemics like the one that struck Haiti in 2010. Soon, there may be enough to begin routine vaccination in countries where the disease has a permanent foothold.
Merely creating that stockpile--even of a few million doses--profoundly improved the way the world fought cholera, Dr. Margaret Chan, secretary general of the W.H.O., said last year. Ready access to the vaccine has made countries less tempted to cover up outbreaks to protect tourism, she said.
That has sped up emergency responses and attracted more vaccine makers, lowering costs. “More cholera vaccines have been deployed over the last two years than in the previous 15 years combined,” Dr. Chan said.
The treatment advances relied heavily on research and testing done at the International Center for Diarrheal Disease Research, known as the ICDDR,B, in Dhaka.
Although Dhaka may not be the first place one might look to find a public health revolution, the center is famous among experts in gut diseases.
While its upper levels are quiet and scholarly, the center’s ground floor is the world’s largest diarrhea hospital. Its vast wards treat 220,000 patients a year, almost all of whom recover within 36 hours. Doctors there save hundreds of lives a day.
The ICDDR,B was originally the Cholera Research Laboratory, founded in 1960 by the United States as part of that era’s “soft diplomacy.” Research hospitals were built in friendly countries both to save lives locally and to act as sentinels for diseases that might threaten America.
The ICDDR,B wards contain long rows of “cholera cots.” Each has a plastic sheet with a hole in the middle. A bucket beneath the hole catches diarrhea and another is placed next to the cot for vomit. An IV pole completes the setup. Usually, the only patients who stay long in the hospital are malnourished infants.
Defying expectations, the ward smells only of the antiseptic that the floors are constantly mopped with.
Patients with severe watery diarrhea arrive around the clock, many of them carried in--limp, dehydrated and barely conscious--by friends or family. A nurse sees each one immediately, and those close to death get an IV line inserted within 30 seconds.
It contains a blend of glucose, electrolytes and water. Cholera spurs the intestines to violently flush themselves, but it does not actually damage the gut cells. If the fluid is replaced and the bacteria flushed out or killed by antibiotics, the patient is usually fine.
Within hours, patients start to revive. As soon as they can swallow, they get an antibiotic and start drinking a rehydration solution. Most walk out within a day. The techniques perfected here are so effective that the ICDDR,B has sent training teams to 17 cholera outbreaks in the past decade.
Usually, the only patients who stay long in the hospital are infants so malnourished that another bout of diarrhea would kill them. They live for up to a month in a separate ward with their mothers, who are taught how to cook nutritious porridges from the cheapest lentils, squash, onions, greens and oil.
Only about 20 percent of the patients at the center have cholera. The rest usually have rotavirus, salmonella or E. coli. The same therapy saves them all, but the cholera cases are more urgent because these patients plummet so precipitously toward death.
“I thought I was dying,” Mohammed Mubarak, a gaunt 26-year-old printing press worker, said one afternoon from his cot. His roommates had carried him in at 7 that morning, unconscious and with no detectable pulse.
Now, after six liters of intravenous solution, he was still weak but able to sit up and drink the rehydration solution and eat bits of bread and banana.
Mr. Mubarak had first fallen ill at about 2 a.m., a few hours after he drank tap water with his dinner. “Usually I drink safe water, filtered water,” he explained. “But I drank the city water last night. I think that is what did this.”
Cholera, born in the swamps, arrived long ago in Dhaka. The city is home to more than 15 million, and a third of the population lives in slums. In some places, water pipes made of rubbery plastic are pierced by illegal connections that suck in sewage from the gutters they traverse and carry pathogens down the line to new victims, like Mr. Mubarak.
Vibrio cholerae travels from person to person via fecal matter. In 1854, the epidemiologist John Snow famously traced cases to a single well dug near a cesspit in which a mother had washed the diaper of a baby who died of cholera and convinced officials to remove the well’s pump handle.
Because cholera is a constant threat to hundreds of millions of people lacking safe drinking water in China, India, Nigeria and many other countries, scientists have long sought a more powerful weapon: a cheap, effective vaccine.
Now they have one.
Injected cholera vaccines were first invented in the 1800s and were long required for entry into some countries. But many scientists suspected they did not work, and in the 1970s studies overseen by the ICDDR,B confirmed that.
In the 1980s, a Swedish scientist, Dr. Jan Holmgren, invented an oral vaccine that worked an impressive 85 percent of the time. But it was expensive to make and had to be drunk with a large glass of buffer solution to protect it from stomach acid.
Transporting tanks of buffer was impractical. Making matters worse, it was fizzy, and poor Bangladeshi children who had never tasted soft drinks would spit it out as soon as it tickled their noses.
In 1986, a Vietnamese scientist, Dr. Dang Duc Trach, asked for the formula, believing he could make a bufferless version. Dr. Holmgren and Dr. John D. Clemens, an American vaccine expert who at the time was a research scientist for the ICDDR,B, obliged.
“This isn’t an elegant vaccine--it’s just a bunch of killed cells, technology that’s been around since Louis Pasteur,” said Dr. Clemens, who is now the ICDDR,B’s executive director.
He and Dr. Holmgren lost touch with Dr. Dang, largely because of Vietnam’s isolation in those days. But seven years later, Dr. Dang notified them that he had made a new version of the vaccine. He had tested it on 70,000 residents of Hue, in central Vietnam, and had found it to be 60 percent effective.
Although his was not as effective as Dr. Holmgren’s, it cost only 25 cents a dose. If enough people in an area can be made immune through vaccination, outbreaks often stop spontaneously.
In 1997, Vietnam became the first--and thus far, only--country to provide cholera vaccine to its citizens routinely, not just in emergencies. Cases dropped sharply, according to a 2014 study, and in 2003 cholera vanished from Hue, where the campaign focused most heavily.
But Dr. Dang had not conducted a classic clinical trial, and Vietnam’s vaccine factory did not meet W.H.O. standards, so no United Nations agency was allowed to buy his vaccine.
Because no pharmaceutical company had an incentive to pay for trials or factories, his invention languished in “the valley of death”--the expensive gap between a product that works in a lab and a factory-made version safe for millions.
In 1999, Dr. Clemens approached what is now the Bill & Melinda Gates Foundation, which was just getting organized.
“They were literally operating out of a basement then,” he said. “I got a letter from Bill Gates Sr. It was very relaxed, sort of, ‘Here’s $40 million. Would you mind sending me a report once in a while?’
“But without that,” Dr. Clemens continued, “this wouldn’t have seen the light of day.”
With that money, Dr. Clemens reformulated Dr. Dang’s vaccine, conducted a successful clinical trial in Calcutta and found an Indian company, Shantha Biotechnics, that could make it to W.H.O. standards.
Rolled out in 2009 under the name Shanchol, it came in a vial about the size of a chess rook, needed no buffer and cost less than $2 a dose. Even so, there was little interest, even from the W.H.O.
The vaccine lacked the publicity campaign that pharmaceutical companies throw behind commercial products, and “cholera ward care” was saving many lives--when it could be organized. The new vaccine was not used in a cholera outbreak in Zimbabwe in 2009, or initially in Haiti’s explosive outbreak in 2010.
The “valley of death” lengthened: Without customers, Shantha could not afford to build a bigger factory. The impasse was broken only when Dr. Paul Farmer, a founder of Partners in Health, which has worked in central Haiti since 1987, began publicly berating the W.H.O. for not moving faster.
The agency approved Shanchol in 2011, and since then, the vaccine has slowly gained acceptance. In 2013, an emergency stockpile was started, and the GAVI Alliance committed $115 million to raise it to six million doses.
The vaccine is now used in Haiti, and has been deployed in outbreaks in Iraq, South Sudan and elsewhere. A second version, Euvichol, from South Korea, was approved in 2015.
And later this year, Bangladesh--where it all began--hopes to begin wiping out its persistent cholera. A local company has begun making a domestic version of the vaccine, called Vaxchol. Dr. Firdausi Qadri, a leading ICDDR,B researcher, estimated last year that success there would require almost 200 million doses.
The world finally has a vaccine that, with routine administration, could end one of history’s great scourges. But what will happen is still hazy.
With 1.4 billion people at risk, the potential cost of vaccination in cholera-endemic countries is enormous. And the disease tends to move, surging and vanishing among the many causes of diarrhea.
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