Archive for month: January, 2024

New Delhi: The newly notified Post-Graduate Medical Education Regulations (PGMER) 2023 has specified that post-graduate medical students will get a minimum of 20 days of paid leave (casual leave) per year. Apart from this, under these new regulations, doctors will also be allowed weekly holidays. Further, they will be given maternity leave and paternity leaves as per Government rules and regulations. 

There are also provisions for paid leaves for the PG medicos. However, the National Medical Commission (NMC) has clearly specified in the new PGMER 2023 that if a candidate avails leaves more than the permitted number of days, his/her term shall be extended by the same number of days to complete the training period.

Concerning the eligibility to appear in the examination, the regulations mentioned that the candidates can appear in the examination with 80% attendance.

Clarifying that all Post-graduate students will work as full-time resident doctors, the regulations further mentioned that they will work “reasonable” working hours and will be provided “reasonable time for rest in a day”.

Medical Dialogues had earlier reported that the final Post-Graduate Medical Education Regulations, 2023 (PGMER 2023), which were published in the official Gazette on 29.12.2023, lay down the rules and regulations regarding admission, counselling, and other details related to the postgraduate medical courses.

Leave Rules for Post-graduate Students:

As per the regulations, the following leave rules will be followed:

a. Every post-graduate student will be given minimum 20 days of paid leave (casual leave) per year.

b. Subject to exigencies of work, post-graduate students will be allowed one weekly holiday.

c. Female post-graduate students shall be allowed maternity leave as per existing Government rules and regulations.

d. Male post-graduate students shall be allowed paternity leave as per existing Government rules and regulations.

e. In addition to 20 days’ paid leave, the candidates will be allowed academic paid leave of 5 days per year.

Further, the regulations mentioned that if a “candidate avails leave in excess of the permitted number of days, his/her term of course shall be extended by the same number of days to complete the training period. However, one shall be able to appear in the examination if one has 80% (eighty per cent) of the attendance.”

As per the Gazette notification, the training period for different Postgraduate medical courses shall be as follows:

List of PG Medical Qualifications and Durations:

“The period of training, including the period of examination, shall be two years for the students, who possess a recognized two-year post-graduate diploma course in the same subject,” it mentioned.

A cancer drug currently in the final stages of clinical trials could offer hope for the treatment of a wide range of inflammatory diseases, including gout, heart failure, cardiomyopathy, and atrial fibrillation, say scientists at the University of Cambridge.

In a study published today in the Journal of Clinical Investigation, the researchers have identified a molecule that plays a key role in triggering inflammation in response to materials in the body seen as potentially harmful.

We are born with a defence system known as innate immunity, which acts as the first line of defence against harmful materials in the body. Some of these materials will come from outside, such as bacterial or viral infections, while others can be produced within the body.

Innate immunity triggers an inflammatory response, which aims to attack and destroy the perceived threat. But sometimes, this response can become overactive and can itself cause harm to the body.

One such example of this is gout, which occurs when urate crystals build up in joints, causing excessive inflammation, leading to intense pain. Another example is heart attack, where dead cell build up in the damaged heart – the body sees itself as being under attack and an overly-aggressive immune system fights back, causing collateral damage to the heart.

Several of these conditions are characterised by overactivation of a component of the innate immune response known as an inflammasome – specifically, the inflammasome NLRP3. Scientists at the Victor Phillip Dahdaleh Heart and Lung Research Institute at Cambridge have found a molecule that helps NLRP3 respond.

This molecule is known as PLK1. It is involved in a number of processes within the body, including helping organise tiny components of our cells known as microtubules cytoskeletons. These behave like train tracks inside of the cell, allowing important materials to be transported from one part of the cell to another.

Dr Xuan Li from the Department of Medicine at the University of Cambridge, the study’s senior author, said: “If we can get in the way of the microtubules as they try to organise themselves, then we can in effect slow down the inflammatory response, preventing it from causing collateral damage to the body. We believe this could be important in preventing a number of common diseases that can cause pain and disability and in some cases can lead to life-threatening complications.”

But PLK1 also plays another important role in the body – and this may hold the key to developing new treatments for inflammatory diseases.

For some time now, scientists have known that PLK1 is involved in cell division, or mitosis, a process which, when it goes awry, can lead to runaway cell division and the development of tumours. This has led pharmaceutical companies to test drugs that inhibit its activity as potential treatments for cancer. At least one of these drugs is in phase three clinical trials – the final stages of testing how effective a drug is before it can be granted approval.

When the Cambridge scientists treated mice that had developed inflammatory diseases with a PLK1 inhibitor, they showed that it prevented the runaway inflammatory response – and at a much lower dose than would be required for cancer treatment. In other words, inhibiting the molecule ‘calmed down’ NLRP3 in non-dividing cells, preventing the overly aggressive inflammatory response seen in these conditions.

The researchers are currently planning to test its use against inflammatory diseases in clinical trials.

“These drugs have already been through safety trials for cancer-and at higher doses than we think we would need – so we’re optimistic that we can minimise delays in meeting clinical and regulatory milestones,” added Dr Li.

“If we find that the drug is effective for these conditions, we could potentially see new treatments for gout and inflammatory heart diseases – as well as a number of other inflammatory conditions-in the not-too-distant future.”

The research was funded by the British Heart Foundation. Professor James Leiper, Associate Medical Director at the British Heart Foundation said: “This innovative research has uncovered a potential new treatment approach for inflammatory heart diseases such as heart failure and cardiomyopathy. It’s promising that drugs targeting PLK1 – that work by dampening down the inflammatory response-have already been proven safe and effective in cancer trials, potentially helping accelerate the drug discovery process.

“We hope that this research will open the door for new ways to treat people with heart diseases caused by overactive and aggressive immune responses, and look forward to more research to uncover how this drug could be could be repurposed.”

Reference:

Baldrighi, M et al. PLK1 inhibition dampens NLRP3 inflammasome-elicited response in inflammatory disease models. JCI; 1 Nov 2023; DOI: 10.1172/JCI162129.

A new study published in The Lancet Regional Health found that among older adults aged 75 years or above who were initially healthy, elevated levels of high-density lipoprotein cholesterol (HDL-C) were linked to a higher likelihood of experiencing all-cause dementia.

A retrospective analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial, a double-blind, placebo-controlled study involving daily low-dose aspirin in healthy older individuals, was conducted. ASPREE enrolled 16,703 participants aged 70 years and older from Australia and 2,411 participants aged 65 years and older from the US between 2010 and 2014. The participants had no diagnosed cardiovascular disease, physical disability, dementia, or life-threatening illness at enrollment, and they were cognitively healthy (3MS score ≥78).

The primary trial endpoint was all-cause dementia, determined by DSM-IV criteria. Cox regression was utilized to examine hazard ratios for dementia across HDL-C categories (<40 mg/dL, 40–60 mg/dL as the reference, 60–80 mg/dL, and >80 mg/dL), and nonlinear associations were assessed using restricted cubic spline curves. Data analysis spanned from October 2022 to January 2023.

Out of the 18,668 participants, 850 cases (4.6%) of new-onset dementia were documented over a span of 6.3 years (with a standard deviation of 1.8 years).

Individuals with elevated HDL-C levels (>80 mg/dL) faced a 27% increased risk of developing dementia. Analyses stratified by age revealed a higher risk of incident dementia in participants aged 75 years or older compared to those below 75 years.

These associations remained statistically significant even after adjusting for various covariates, including age, sex, country of enrollment, daily exercise, education, alcohol consumption, weight changes over time, non-HDL-C, HDL-C-PRS, and APOE genotype.

In summary, the heightened risk of dementia linked to elevated HDL-C levels seemed unrelated to conventional dementia risk factors such as physical activity, alcohol consumption, education, diabetes, or smoking.

Source:

Hussain, S. M., Robb, C., Tonkin, A. M., Lacaze, P., Chong, T. T.-J., Beilin, L. J., Yu, C., Watts, G. F., Ryan, J., Ernst, M. E., Zhou, Z., Neumann, J. T., & McNeil, J. J. (2023). Association of plasma high-density lipoprotein cholesterol level with risk of incident dementia: a cohort study of healthy older adults. The Lancet Regional Health. Western Pacific, 100963, 100963. https://doi.org/10.1016/j.lanwpc.2023.100963