Thursday, October 10, 2013

Do not use Metformin : Worst Pills, Best Pills




Metformin, The life pill for diabetes patient was perhaps most delayed drug for approval in USA. You may surprise that once upon time in America , the most prescribing anti diabetic drug came in list of worst pill. In 1995, due to fear of lactic acidosis the consumer advocacy group Public
Citizen issued the warning: “Do not use Glucophage”. Glycophage is brand name of Metformin. 

Tuesday, April 2, 2013

Latest case in drug patent infringement,2013 : Glenmark launches generic version of Merck’s Sitagliptin


As reported by Rupali Mukherjee of Times of India, in a move which will transform the landscape of the Indian pharma industry, Glenmark has launched a cheaper generic version of pharma multinational Merck’s blockbuster anti-diabetes drug Januvia (Sitagliptin phosphate). The generic vs. innovator battle earlier restricted to anticancer and anti-retroviral meds has now entered uncharted territory; just when you thought things couldn’t get any murkier! 

Image from here


Numbers and market dynamics: 

Owing to obesity and lifestyle changes, India has acquired the dubious distinction of becoming world’s diabetic capital followed closely by China. Emerging markets like India offer huge untapped potential and opportunity for anti-diabetic drug launches. According to this IMS report, the market for non-insulin diabetes treatments has experienced strong growth over the last decade, averaging 9.5% over the past five years. 

Traditionally, therapies for Non-Insulin dependent diabetes was dominated by relatively old and off- patent drugs primarily comprising biguanides(metformin) and sulfonylureas. For majority of type II diabetics, since medications have to be taken daily to achieve glycemic control, drug resistance is a major challenge. Thus there is a therapeutic void which generates demand for novel anti-diabetic product classes. Dipeptidyl peptidase-4 inhibitors (DPP-4) or what is known as “gliptins” offered a new alternative in the treatment pathway. 

Among the DPP-4 inhibitors/gliptins, Merck’s Januvia (Sitagliptin) and Novartis’s Galvus (Vildagliptin) are India’s first patented oral anti-hyperglycemics. In India, Merck’s Januvia was launched in April 2008, few months before Novartis’s Galvus was launched in Sept 2008. Merck and Novartis also partnered with domestic pharma companies to take advantage of local sales force to increase market penetration. Novartis joined forces with domestic generic USV to promote Galvus. Under an India-specific agreement, Merck partnered with Sun Pharma to launch local brand Istamet .In addition Merck also continued to market Sitagliptin in India under the Januvia brand. Januvia is touted as the undisputed leader among the gliptins with the brand accounting for about 80% of worldwide sales for anti-diabetic monotherapy. In India the gliptins market share is estimated at about 500 crore! 

Patent status and launch of generic version by Glenmark 

A very cursory patent check (IPO) reveals that Merck’s Januvia is protected by two patents in India viz. IN209816 and IN219148. IN209816 is a product patent which specifically covers Sitagliptin. IN219148 claims process intermediates used in the manufacture of Sitagliptin. Apart from this, Merck had filed a patent application 5948/DELNP/2005 covering the phosphate salt form and enantiomers of Sitagliptin, but this patent application was abandoned following a pre-grant opposition. Apart from this, Merck is pursuing two patent applications which specifically cover Janumet extended release (sitagliptin+metformin combo). 

According to the Times of India article, a Glenmark official confirmed the launch of generic version of sitagliptin and said “"Glenmark is a responsible company and has launched the products after due diligence and research. Like other branded generics, Glenmark's Zita & Zita-Met are also branded generics." Further according to the article, Glenmark states that its product is “non-infringing” on Merck’s drug. 

First of all, the question of infringement should be evaluated against patent claims and not against innovator’s products. Also, one wonders how one can be non-infringing to a product patent? 

Pricing scenario: 

Januvia and Janumet are once daily prescription pills. As per CIMS Asia, a strip of 7 tablets of Januvia (strengths 50mg and 100mg) is priced at Rs. 300. That works out to around Rs. 43/day. Merck has adopted tiered/differential pricing and launched Januvia in India at one fifth of its US price, less than a dollar a day. According to the TOI article, Glenmark has priced its generic version around 30% cheaper than Merck’s Januvia and the overall savings to the patient could be around 5000 Rs./year.Going by the some of the tremendously steep price reductions we have seen for some anti-cancer drugs recently, I would say that the price reduction offered here is modest.Also, as reported here, many experts assert that Metformin, a 50 year old drug still works best for diabetics and has the least side effects. With many alternate efficacious and affordable therapeutic options available for diabetic patients; I wonder whether the “public interest” factor will feature in this case. 

Conclusion: 
Merck was upset with the generic launch and an official was quoted as saying “We are disappointed in Glenmark's decision to introduce products that directly infringe upon our intellectual property. We believe our patents for Januvia and Janumet are valid and enforceable and will vigorously defend them.” Coup de grĂ¢ce for Big Pharma? Another patent war on the cards? Only time will tell. 

Source: 

Monday, November 26, 2012

Indravadan Modi (I.A. MODI), the father of pharmaceutical industry in India and founder of "Cadila" passes away at 87years.

A very famous pharmaceutical industrialist dies on Monday (26/11/2012) near by 5:00 pm in a private hospital in ahmedabad. The 87 year old pharma tycoon was suffering from some respiratory disorder.


This Bioentrepreneur have started pharma business in 1952 with few thousand rupees and today Cadila pharma is  of 800 crore and is one of largest privately held companies in India. He was come in headline in 1959 due to his anti tuberculosis product ISOPAR.

He has started company name under Cadila laboratories with partnership of Ramanbhai patel. Partner ship come end in 1995 end and Cadila pharmaceutical formed which is IA modi's part and Ramanbhai patel's group started under the name of Zydus cadila or Cadila healthcare (Listed in bombay stock exchage in 2000). Zydus cadila currently run by Mr. Pankaj patel (son of late Ramanbhai) and cadila pharmaceutical is run by Mr. Rajiv I.A.Modi

Cadila pharm is also owner of famous brand Poly Pill which combine five medicine including anti hypertensive, Lipid lowering drug and aspirin for prevention of heart attack.

The Indian Pharma Industry will miss this veteran pharma entrepreneur. 

Friday, October 19, 2012

Myths vs. Facts in diabetes: misconception regarding food in diabetic patient


Myth v/s truth in diabetes:

Myth: If you are overweight or obese, you will eventually develop type 2 diabetes.
Fact: Being overweight is a risk factor for developing this disease, but other risk factors such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.

Myth: Fruit is a healthy food. Therefore, it is ok to eat as much of it as you wish.
Fact: Limit your fruit intake. Contrary to common belief, fruits are not that great for diabetics. Most fruits, especially the sweet ones, are loaded with natural sugar and usually cause marked elevation in blood sugar in diabetics. Restrict the amount of fruit to one fresh fruit a day. When blood glucose is under control, 100gms of fruit with a low glycemic index (e.g. Papaya, sweet lime, orange, guava etc) allowed daily. Certain fruits are worse than the others. Avoid bananas, grapes, oranges, watermelons and mangoes. Whole fruits are recommended rather than fruit juices.

Myth: Diabetics should not eat the food containing fat.
Facts: Diabetics are often low in HDL cholesterol (the good cholesterol). Fat phobia in patient has further worsened this problem. We need good fats. These good fats are found in olive oil, corn oil, cod liver oil, avocado, salmon, other fat fish and nuts. Eat plenty of raw nuts such as almonds, walnuts, pecans, cashews, pine-nuts, pistachios and macadamias. Nuts are also excellent source of vitamins and minerals such as vitamin E and magnesium.
HDL cholesterol and triglyceride level serves as an extremely useful test to diagnose Insulin Resistance Syndrome.  If your HDL is low and/or your triglyceride level is high, you have Insulin Resistance Syndrome. Moreever, A 1% increase in HDL cholesterol is associated with a 3% decrease in risk of heart disease.

Myth: Sun flower oil/ safflower oil contain zero cholesterol while others do not.
Facts: All commoly used edible oil (peanut oil, cotton seed oil etc.) contain zero chlolesterol. One should look at the choleserol lowering ability of oil i.e. unsaturated fatty acid content and omega -3 fatty acids level.

Myth: Sun flower oil/ safflower oil reduces the cholesterol level in the patient other oils do not. Patient can eat saffola or sun flower oil without fear.
Facts: The major misconception regarding oil consumption was  that  the  use  of  polyunsaturated  oils,  like sunflower  and  safflower  oil,  was  good  for  health. Unrestricted use of these oils is known to be harmful.  Recent studies suggest that groundnut oil and gingelly oil have more of omega -3 fatty acids, compared to sunflower or safflower oils. 3). Not more than 0.5kg of fat, per person, per month, is recommended.

Some interesting facts about Diabetes:
  • ·         Researchers found that every two hours spent watching television was associated with a 14% increase in diabetes risk
  • Don't watch TV while eating. Many people overeat because they get too involved in watching a TV show or reading a newspaper and don’t keep track of their food intake.
  • ·         The human body is equipped with 60,000 miles of blood vessels and wired with 100,000 miles of nerve fibers. Diabetes often blocks the cardiovascular system and deadens nerves, causing 80% of deaths among patients with diabetes
  • ·         India has the world’s highest diabetes population with over 35 million people with diabetes. By 2025, this number is expected to swell to 70 million, meaning every fifth diabetic in the world would be Indian
  • ·         A class of chemicals (phthalates) found in personal-care products such as soaps, nail polishes, perfumes, and moisturizers may contribute to type 1 and type 2 diabetes. A study of 2,350 women found that those with higher levels of phthalates in their urine were more likely to have diabetes. Those with the highest concentration of two main phthalates in their urine had nearly twice the risk of diabetes as those with the lowest levels of the chemicals.
  •  

Friday, September 28, 2012

List of drugs which likely to be included in new Drug Price Control Order (DPCO)-2012 (latest dpco 2012)

Report By Vishal Goyani, 28/09/2012.


The Government of India proposed to put 348 drugs in National List of Essential Medicines of India- 2011 (NLEM-2011) under the Drug Price Control Order (DPCO) on 29th September, 2012. Once these drugs come under the DPCO list, they can sell only at lower price then that set by the government.

National Pharmaceutical Pricing Authority (NPPA) is responsible for setting the prices of drugs under DPCO list will set price once these drugs come under the DPCO.

This will give the benefit to the people of India, who will get drugs at lower price than it was previously. On other site this drugs having total market of 29000 crore INR (almost 60% of Total Indian market), so the Pharma companies have to suffer from huge loss.

Download new DPCO-2013 from this link:
http://pharmaceuticals.gov.in/DPCO2013.pdf
http://vishalgoyani.blogspot.in/2013/03/amul-milk-comparison-know-nutrition.html

The barrier of Maximum price will be on some combination formulation and some of new class of medicine beside existing control on the various categories like TB drugs, sedative, Lipid lowering drugs, steroid, pain killer etc.

Some new category of drug cover will be:

1. some commonly used anti-AIDS

2. Some commonly used anti-cancer drugs


New combinations formulations will come under New DPCO list are:

  1. Dexamethasone with combination (anti-inflamatory), 
  2. Multivitamin with vitamin c (vitamin supplement) 
  3. Insulin formulations 
  4. Aspirin with Rosuvastatin (cardiovascular), 
  5. Vitamin C with combination (vitamin c supplement and antioxidant), 
  6. Vitamin E (tocopheryl) (vitamin e supplement), 
  7. Streptomycin with penicillin (antibiotic), 
  8. norfloxacin (antibacterial), 
  9. Cefotaxime (antibacterial), 
  10. Chlorpromazine with combination (antipsychotic), 
  11. Sulphadoxine with combination (antimalarial), 


The World Health Organization in 1977 has introduced concept of essential medicines. It has been adopted by many countries including India. As per this concept India has released NLEM 2011, which contains list of 348 essential drug molecules contained in 489 formulations, including 16 fixed dose combinations.

List of Medicines in NLEM 2011 as per Alphabetical order (Which likely to be under NEW DPCO-2012 DRUG LIST) is as per follow:

(Source and Copyright WHO web site: http://apps.who.int/medicinedocs/documents/s18693en/s18693en.pdf)

1. 25% Dextrose

2. 5-Amino salicylic Acid

3. 5-Fluorouracil

4. Acetazolamide

5. Acetyl Salicylic Acid

6. Acriflavin+Glycerin

7. Actinomycin D

8. Activated Charcoal

9. Acyclovir

10. Adenosine

11. Adrenaline Bitartrate

12. Albendazole

13. Albumin

14. Allopurinol

15. Alpha Interferon

16. Alprazolam

17. Aluminium Hydroxide + Magnesium Hydroxide

18. Amikacin

19. Amiodarone

20. Amitriptyline

21. Amlodipine

22. Amoxicillin

23. Amoxicillin+Clavulinic acid

24. Amphotericin B

25. Ampicillin

26. Anti-D immunoglobin (human)

27. Antitetanus Human immunoglobin

28. Artesunate (To be used only in combination with

Sulfadoxine + Pyrimethamine)

29. Ascorbic Acid

30. Atenolol

31. Atorvastatin

32. Atracurium besylate

33. Atropine Sulphate

34. Azathioprine

35. Azithromycin

36. B.C.G Vaccine

37. Barium Sulphate

38. Beclomethasone Dipropionate

39. Benzathine Benzylpenicillin

40. Benzoin Compound

41. Benzyl benzoate

42. Betamethasone

43. Betamethasone Dipropionate

44. Betaxolol Hydrochloride

45. Bisacodyl

46. Bleaching Powder

47. Bleomycin

48. Bromocriptine Mesylate

49. Bupivacaine Hydrochloride

50. Busulphan

51. Calamine

52. Calcium carbonate

53. Calcium gluconate

54. Calcium Ipodate

55. Carbamazepine

56. Carbimazole

57. Carboplatin

58. Cefixime

59. Cefotaxime

60. Ceftazidime

61. Ceftriaxone

62. Cephalexin

63. Cetrimide

64. Cetrizine

65. Chlorambucil

66. Chloramphenicol

67. Chlorhexidine

68. Chloroquine phosphate

69. Chlorpheniramine Maleate

70. Chlorpromazine hydrochloride

71. Ciprofloxacin Hydrochloride

72. Cisplatin

73. Clindamycin

74. Clofazimine

75. Clomiphene citrate

76. Clopidogrel

77. Clotrimazole

78. Cloxacillin

79. Coal Tar

80. Codeine phosphate

81. Colchicine

82. Condoms

83. Co-Trimoxazole (Trimethoprim + Sulphamethoxazole)

84. Cryoprecipitate

85. Cyanocobalamin

86. Cyclophosphamide

87. Cyclosporine

88. Cytosine arabinoside

89. D.P.T Vaccine

90. Dacarbazine

91. Danazol

92. Dapsone

93. Daunorubicin

94. Desferrioxamine mesylate

95. Dexamethasone

96. Dexchlorpheniramine Maleate

97. Dextran-40

98. Dextran-70

99. Dextromethorphan

100. Diazepam

101. Diclofenac

102. Dicyclomine Hydrochloride

103. Didanosine

104. Diethylcarbamazine citrate

105. Digoxin

106. Dihydroergotamine

107. Diloxanide Furoate

108. Diltiazem

109. Dimercaprol

110. Diphtheria Antitoxin

111. Dithranol

112. Dobutamine

113. Domperidone

114. Dopamine Hydrochloride

115. Doxorubicin

116. Doxycycline

117. Efavirenz

118. EMLA cream

119. Enalapril Maleate

120. Enoxaparin

121. Erythromycin Estolate

122. Esmolol

123. Ethambutol

124. Ether

125. Ethinylestradiol

126. Ethinylestradiol + Levonorgesterol

127. Ethinylestradiol + Norethisterone

128. Ethyl Alcohol 70%

129. Etoposide

130. Factor IX Complex (Coagulation Factors II,VII, IX, X)

131. Factor VIII Concentrate

132. Famotidine

133. Fentanyl

134. Ferrous Salt

135. Filgrastim

136. Fluconazole

137. Flumazenil

138. Fluorescein

139. Fluoxetine hydrochloride

140. Flutamide

141. Folic Acid

142. Folinic Acid

143. Formaldehyde IP

144. Framycetin Sulphate

145. Fresh frozen plasma

146. Furosemide

147. Gemcitabine hydrochloride

148. Gentamicin

149. Gentian Violet

150. Glibenclamide

151. Glucagon

152. Glucose

153. Glucose with sodium chloride

154. Glutaraldehyde

155. Glycerin

156. Glyceryl Trinitrate

157. Griseofulvin

158. Haloperidol

159. Halothane with vaporizer

160. Heparin Sodium

161. Hepatitis B Vaccine

162. Homatropine

163. Hormone Releasing IUD

164. Hydrochlorothiazide

165. Hydrocortisone sodium succinate

166. Hydrogen Peroxide

167. Hydroxychloroquine phosphate

168. Hydroxyethyl Starch (Hetastarch)

169. Hyoscine Butyl Bromide

170. Ibuprofen

171. Ifosfamide

172. Imatinib

173. Imipramine

174. Indinavir

175. Insulin Injection(Soluble)

176. Intermediate Acting(Lente/NPH Insulin)

177. Intraperitoneal Dialysis Solution

178. Iodine

179. Iopanoic Acid

180. Ipratropium bromide

181. Iron Dextran

182. Isoflurane

183. Isoniazid

184. Isosorbide 5 Mononitrate/Dinitrate

185. Ispaghula

186. IUD containing Copper

187. Ketamine Hydrochloride

188. L- Asparaginase

189. Lamivudine

190. Lamivudine + Nevirapine + Stavudine

191. Lamivudine + Zidovudine

192. Leflunomide

193. Levodopa+ Carbidopa

194. Levothyroxine

195. Lignocaine

196. Lignocaine Hydrochloride

197. Lignocaine Hydrochloride + Adrenaline

198. Lithium Carbonate

199. Lorazepam

200. Losartan Potassium

201. Magnesium sulphate

202. Mannitol

203. Measles Vaccine

204. Medroxy Progesterone Acetate

205. Mefloquine

206. Meglumine Iothalamate

207. Meglumine Iotroxate

208. Melphalan

209. Mercaptopurine

210. Mesna

211. Metformin

212. Methotrexate

213. Methyl Cellulose

214. Methyl Ergometrine

215. Methyldopa

216. MethylPrednisolone

217. Methylrosanilinium Chloride (Gentian Violet)

218. Methylthioninium chloride (Methylene blue)

219. Metoclopramide

220. Metoprolol

221. Metronidazole

222. Miconazole

223. Midazolam

224. Mifepristone

225. Misoprostol

226. Mitomycin-C

227. Morphine Sulphate

228. Multivitamins (As per Schedule V of Drugs and

Cosmetics Rules)

229. N/2 Saline

230. N/5 Saline

231. N-acetylcysteine

232. Naloxone

233. Nelfinavir

234. Neomycin + Bacitracin

235. Neostigmine

236. Nevirapine

237. Nicotinamide

238. Nifedipine

239. Nitrofurantoin

240. Nitrous Oxide

241. Norethisterone

242. Normal Saline

243. Nystatin

244. Ofloxacin

245. Olanzapine

246. Omeprazole

247. Ondansetron

248. Oral Poliomyelitis vaccine (LA)

249. Oral Rehydration Salts

250. Oxaliplatin

251. Oxygen

252. Oxytocin

253. Paclitaxel

254. Pantoprazole

255. Paracetamol

256. Penicillamine

257. Pentamidine Isothionate

258. Permethrin

259. Pheniramine Maleate

260. Phenobarbitone

261. Phenylephrine

262. Phenytoin Sodium

263. Phytomenadione

264. Pilocarpine

265. Piperazine

266. Platelet Rich Plasma

267. Polygeline

268. Polyvalent Antisnake Venom

269. Potassium Chloride

270. Potassium Permanganate

271. Povidone Iodine

272. Pralidoxime Chloride(2-PAM)

273. Praziquantel

274. Prednisolone

275. Prednisolone Acetate

276. Prednisolone Sodium Phosphate

277. Premix Insulin 30:70 injection

278. Primaquine

279. Procainamide Hydrochloride

280. Procarbazine

281. Promethazine

282. Propofol

283. Propranolol hydrochloride

284. Propyliodone

285. Protamine Sulphate

286. Pyrazinamide

287. Pyridostigmine

288. Pyridoxine

289. Pyrimethamine

290. Quinine sulphate

291. Rabies immunoglobin

292. Rabies Vaccine

293. Raloxifene

294. Ranitidine

295. Riboflavin

296. Rifampicin

297. Ringer Lactate

298. Ritonavir

299. Salbutamol sulphate

300. Salicylic Acid

301. Saquinavir

302. Sevoflurane

303. Silver Sulphadiazine

304. Sodium Bicarbonate

305. Sodium Iothalamate

306. Sodium Meglumine Diatrizoate

307. Sodium Nitrite

308. Sodium Nitroprusside

309. Sodium Stibogluconate

310. Sodium Thiosulphate

311. Sodium Valproate

312. Specific antisnake venom

313. Spironolactone

314. Stavudine

315. Stavudine+Lamivudine

316. Streptokinase

317. Streptomycin Sulphate

318. Succinyl choline chloride

319. Sulfadoxine + Pyrimethamine

320. Sulfasalazine

321. Sulphacetamide Sodium

322. Sulphadiazine

323. Tamoxifen Citrate

324. Terbutaline Sulphate

325. Testosterone

326. Tetanus Toxoid

327. Tetracaine Hydrochloride

328. Thiamine

329. Thiopentone Sodium

330. Timolol Maleate

331. Tramadol

332. Trihexyphenidyl Hydrochloride

333. Tropicamide

334. Tuberculin, Purified Protein derivative 335. Urokinase

336. Vancomycin Hydrochloride

337. Vecuronium

338. Verapamil

339. Vinblastine sulphate

340. Vincristine

341. Vitamin A

342. Vitamin D (Ergocalciferol) NOT vitamin D3

343. Warfarin sodium

344. Water for Injection

345. Zidovudine

346. Zidovudine+ Lamivudine+ Nevirapine

347. Zinc Oxide

348. Zinc Sulfate



Currently following 70 drugs are under Drug price control order.

List of Price Controlled Drugs (DPCO 1995)

1. SULPHAMETHOXAZOLE

2. PENICILLINS

3. TETRACYCLINE

4. RIFAMPICIN

5. STREPTOMYCIN

6. RANITIDINE

7. VITAMIN C

8. BETAMETHASONE

9. METRONIDAZOLE

10. CHLOROQUINE

11. INSULIN

12. ERYTHROMYCIN

13. VITAMIN A

14. OXYTETRACYCLINE

15. PREDNISOLONE

16. CEPHAZOLIN

17. METHYLDOPA

18. ASPIRIN

19. TRIMETHOPRIM

20. CLOXACILLIN

21. SULPHADIMIDINE

22. SALBUTAMOL

23. FAMOTIDINE

24. IBUPROFEN

25. METAMIZOL (ANALGIN)

26. DOXYCYCLINE

27. CIPROFLOXACIN

28. CEFOTAXIME

29. DEXAMETHASONE

30. EPHEDRINE

31. VITAMIN B1 (THIAMINE)

32. CARBAMAZEPINE

33. VITAMIN B2 (RIBOFLAVIN)

34. THEOPHYLLINE

35. LEVODOPA

36. TOLNAFTATE

37. VITAMIN E

38. NALIDIXIC ACID

39. GRISEOFULVIN

40. GENTAMICIN

41. DEXTROPROPOXYPHENE

42. HALOGENATED HYDROXYQUINOLINE

43. PENTAZOCINE

44. CAPTOPRIL

45. NAPROXEN

46. PYRENTAL

47. SULPHADOXINE

48. NORFLOXACIN

49. CEFADROXYL

50. PANTHONATES & PANTHENOLS

51. FURAZOLIDONE

52. PYRITHIOXINE

53. SULPHADIAZINE

54. FRAMYCETIN

55. VERAPAMIL

56. AMIKACIN SULPHATE *

57. GLIPIZIDE

58. SPIRONOLACTONE

59. PENTOXYFYLLINE

60. AMODIAQUIN

61. SULPHAMOXOLE

62. FRUSEMIDE

63. PHENIRAMINE MALEATE

64. CHLOROXYLENOLS

65. BECAMPICILLIN

66. LINCOMYCIN

67. CHLORPROPAMIDE

68. MEBHYDROLINE

69. CHLORPROMAZINE

70. METHENDIENONE

71. PHENYL BUTAZONE

72. LYNESTRANOL

73. SALAZOSULPHAPYRINE

74. DIOSMINE

75. TRIMIPRAMINE

76. MEFENAMIC ACID *


dpco 2013 list...coming soon.

20 pharmacy students at NIPER to sit on fast today - Indian Express

20 pharmacy students at NIPER to sit on fast today - Indian Express