Hyderabad, June 15: Doctors at the Nizam’s Institute of Medical Sciences (NIMS) treating Satyam scam accused B Ramalinga Raju have stated that he needs continuous medical attention due to side-effects of a drug being administered to him as part of the treatment of hepatitis-c. The doctors submitted the report the special CBI court dealing with the case.
The court posted the next hearing to June 16.
The report stated that Ramalinga Raju needs to take four more weekly injections as part of the 24-week treatment. The 20th injection was given on June 8. The report also said Raju needs to undergo a second phase of treatment involving yet another 24 injections — once per week — if the first phase produces satisfactory results.
“If the virus remains positive, the treatment has to be stopped as chances of a cure will be negligible and it will be labelled as non-responsive.
If negative, another course of 24 injections are to be administered,” Dr Ajit Kumar, the gastroenterologist treating Raju said in the report.
The report said that the hepatitis count has markedly reduced from 90 lakh before commencement of treatment to 50,000 after administering 12 doses of the injection — which is a “satisfactory” response.
His vital counts will be rechecked after completion of 24 injections as per international guidelines.
The report further said Raju’s condition deteriorated after the 17th dose and developed leucopenia, a decrease in the number of white blood cells in the blood.
Raju’s counsel argued that the cases in all the chargesheets were similar and not separable. So far the CBI has filed three chargesheets in the Satyam case and is set to file a fourth.
In the first chargesheet, the investigating agency alleged that Raju and others inflated invoices, incomes and falsified income tax returns.
The defence counsel argued that the cases should be clubbed as 23 witnesses out of 26 were the same. Defence also argued that the question of video linkage for the trial comes only after the court decides on the clubbing of cases.
what’s wrong with raju?
NIMS docs believe that Ramalinga Raju’s health parameters require further supervis ed treatment
Complaints at present
Excessive weakness since start of therapy five months ago *Nailbed swelling and infection for 3 months * Blood in stools on and off for 3 months *Loss of appetite, breathlessness on exertion for 3 months * Burning eyes for the past one week Examination report * Heart rate slow: 60/min * BP 120/84 mm Hg (normal) *Temp-Afebrile *Respiratory rate: 24/min, increased.
Swelling of finger nails, skin rashes and roughness of skin noted at places.
Anaemia. No Jaundice/Edema of feet/ Cyanosis/Lymphadenopathy, etc.
Cardiovascular system, chest & central nervous system: Normal.
Abdomen: Spleen just palpable. No other organ enlarged. No Ascites.
Investigations
S. Cretinine 1.1 mg% (normal).
WBC count: 2100-2800 (normal range: 4000-11,000/cmm). High risk for infections.
Haemoglobin: 10.1-11.1 gm % (normal >14 Gm%)
Platelets: 8500-100,000/Cmm (normal range: 1,50,000-4,50,000/cmm). High risk for bleeding
ECG : Slow heart rate. Rest normal.
Comments about present condition
*Raju was given 20 injections of Peg Interferon 180 mcg/weekly along with Tab Ribaverin 1000 mg/daily till date.
*Injection Mircera 100 mcg given fortnightly to improve haemoglobin count and injection Neupogen for improving the WBC count as and when required.
*Vitamins, iron, haemoglobin, calcium, Crocin for fever and other medicines that cardiologists prescribed were given.
*He requires two courses of antibiotics and continuation of treatment for blood in stools.
*May require blood transfusion if bleeding aggravates and haemoglobin goes down.
Response to treatment
*Hepatitis C virus count reduced from 90 lakh to 50,000 after 12 doses of injection, which is a satisfactory response.
*If virus remains positive at 24 weeks of treatment, the treatment has to be stopped, as the chances of cure will be negligible.
Advice
*Requires continuous supervision due to critical sideeffects of medicine requiring frequent changes of medications, which may become life-threatening at times.
*It is unethical to give treatment unsupervised when his blood parameters are at a critical juncture.
*It is advisable to provide treatment under supervision for at least the critical first phase of treatment, ie, 24 injections.
——–Agencies