Migraines and persistent vasomotor symptoms jointly associated with greater risk for CVD, stroke: Study

USA: A recent study published in Menopause has revealed a joint association of migraines and persistent vasomotor symptoms (VMS) with a greater risk of stroke and cardiovascular diseases, although the risk attenuates with adjustment for traditional CVD risk factors.

Catherine Kim, Departments of Medicine, Obstetrics and Gynecology, and Epidemiology, University of Michigan, Ann Arbor, MI, and colleagues conducted the study to examine whether vasomotor symptoms and migraine headaches, hypothesized to be vasoactive conditions, are associated with greater risk for cardiovascular disease events including strokes.

For this purpose, the researchers performed a secondary data analysis of a subset of women (n = 1,954) in a population-based cohort, the CARDIA study, which began data collection at 18 to 30 y of age. They examined whether migraine headaches and VMS trajectories (characterized as minimal, increasing, and persistent) at CARDIA year 15 examination were linked with a higher risk of stroke (both ischemic and hemorrhagic) and CVD events using Cox proportional hazards regression models and adjustment for traditional CVD risk factors (cigarette use, age, and levels of systolic and diastolic blood pressure, high- and low-density cholesterol, fasting glucose, and triglycerides) and reproductive factors.

Based on the study, the researchers reported the following findings:

  • Among women with minimal VMS (n = 835), increasing VMS (n = 521), and persistent VMS (n = 598), there were 81 incident CVD events, including 42 strokes.
  • Women with histories of migraine and persistent VMS had a greater risk of CVD (hazard ratio [HR], 2.25) after adjustment for age, race, estrogen use, oophorectomy, and hysterectomy compared with women without migraine histories and with minimal/increasing VMS.
  • After adjustment for CVD risk factors, these associations were attenuated (HR, 1.51).
  • Women with histories of migraine and persistent VMS had a greater risk of stroke (HR, 3.15), but these associations were attenuated after adjustment for CVD risk factors (HR, 1.70).

“Migraines and persistent vasomotor symptoms jointly associate with a greater risk for cardiovascular disease and stroke, although the risk is attenuated with adjustment for traditional CVD risk factors,” the researchers wrote.

Reference:

Kim, Catherine MD, MPH1; Schreiner, Pamela J. PhD2; Yin, Zhe MS3; Whitney, Rachael PhD4; Sidney, Stephen MD, MPH5; Ebong, Imo MD6; Levine, Deborah A. MD, MPH4. Migraines, vasomotor symptoms, and cardiovascular disease in the Coronary Artery Risk Development in Young Adults study. Menopause ():10.1097/GME.0000000000002311, February 13, 2024. | DOI: 10.1097/GME.0000000000002311

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Intravenous Tirofiban Reduces Neurological Deterioration in Acute Noncardioembolic Stroke: JAMA

Researchers have found that intravenous tirofiban, administered within 24 hours of stroke onset, decreases the risk of early neurological deterioration in patients with acute noncardioembolic stroke compared to oral aspirin. The study’s findings suggest that tirofiban may be an effective alternative to traditional antiplatelet therapy without increasing the risk of symptomatic intracerebral hemorrhage. This study was published in JAMA Neurology. The study was conducted by Wenbo Zhao and colleagues.

Acute ischemic stroke remains a significant health challenge globally, and antiplatelet therapy is a cornerstone of its management. However, patients continue to experience neurological deterioration despite recommended treatment, which can lead to poor clinical outcomes. Investigators aimed to evaluate whether intravenous tirofiban could prevent early neurological deterioration in patients with acute noncardioembolic stroke compared to oral aspirin.

This multicenter, open-label, randomized clinical trial enrolled 425 patients aged 18 to 80 years with acute noncardioembolic stroke within 24 hours of onset. Patients were assigned randomly to receive either intravenous tirofiban (n = 213) or oral aspirin (n = 212) for 72 hours. All patients received oral aspirin afterward. The primary efficacy outcome was early neurological deterioration (increase in National Institutes of Health Stroke Scale [NIHSS] score ≥4 points) within 72 hours after randomization. The primary safety outcome was symptomatic intracerebral hemorrhage within the same timeframe.

The key findings of the study were:

  • Early neurological deterioration occurred in 4.2% of patients in the tirofiban group compared to 13.2% in the aspirin group (adjusted relative risk [RR], 0.32; 95% CI, 0.16-0.65; P = .002).

  • No patients in the tirofiban group experienced symptomatic intracerebral hemorrhage.

  • At 90-day follow-up, mortality rates were similar in both groups (1.3% in the tirofiban group and 1.5% in the aspirin group).

  • Median modified Rankin scale scores at 90 days were comparable between the groups (1.0 for both groups).

The study demonstrates that intravenous tirofiban may provide a significant benefit in reducing early neurological deterioration in patients with acute noncardioembolic stroke. The lack of increased risk for symptomatic intracerebral hemorrhage suggests that tirofiban is a safe option for early stroke intervention.

In patients with noncardioembolic stroke seen within 24 hours of symptom onset, intravenous tirofiban decreases the risk of early neurological deterioration without increasing the risk of symptomatic intracerebral hemorrhage or systematic bleeding. This treatment may offer an alternative to the current antiplatelet regimen for acute ischemic stroke management.

Reference:

Zhao, W., Li, S., Li, C., Wu, C., Wang, J., Xing, L., Wan, Y., Qin, J., Xu, Y., Wang, R., Wen, C., Wang, A., Liu, L., Wang, J., Song, H., Feng, W., Ma, Q., Ji, X., Ding, J., … TREND Investigators. (2024). Effects of tirofiban on neurological deterioration in patients with acute ischemic stroke: A randomized clinical trial. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2024.0868

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Finasteride or Minoxidil, what is better for hair regrowth in female pattern hair loss?

Canada: A first-of-its-kind network meta-analysis (NMA) published in the Journal of Cosmetic Dermatology has shed light on the relative effect of monotherapy with 5-alpha reductase inhibitors and minoxidil for female pattern hair loss (PHL). For both agents, the efficacy appeared to be considerably dose-dependent.

“Our findings can improve clinical guidelines and help dermatologists manage female pattern hair loss more optimally with the available options,” Mesbah Talukder, School of Pharmacy, BRAC University, Dhaka, Bangladesh, and colleagues wrote in their study.

Female pattern hair loss is a distressing condition affecting millions of women worldwide. While it shares similarities with male pattern hair loss (MPHL), its underlying mechanisms and treatment responses differ. Among the various therapeutic options, monotherapy with 5-alpha reductase inhibitors (5-ARIs) and minoxidil is widely used, however, evidence on the relative effectiveness of these drugs is far less for women than for men.

To fill this knowledge gap, the researchers performed an age-adjusted NMA to determine the comparative efficacy of monotherapy with the three agents—in any dosage and administrative route—on PHL in adult women.

For this purpose, the researchers systematically reviewed the peer-reviewed literature to obtain data for the NMA. The outcome measure for the NMA was a “change in total hair density.” The regimen was referred to as an “agent and its dosage;” Bayesian NMA estimated regimens’ surface under the cumulative ranking curve (SUCRA) values and pairwise relative effects.

The NMA used data from 13 trials—across which the following ten regimens were identified (in decreasing order of SUCRA): 5 mg/day finasteride for 24 weeks (SUCRA = 95.7%), 5% topical minoxidil solution twice daily for 24 weeks (SUCRA = 89.5%), 1 mg/day minoxidil for 24 weeks (SUCRA = 78.1%), 5% topical minoxidil foam 1 half capful/day for 24 weeks (SUCRA = 66.5%), 3% topical minoxidil solution 1 mL twice daily for 24 weeks (SUCRA = 45.1%), 2% topical minoxidil solution 1 mL twice daily for 24 weeks (SUCRA = 44.6%), 5% topical minoxidil solution 1 mL/day for 24 weeks (SUCRA = 41.7%), 0.25 mg/day minoxidil for 24 weeks (SUCRA = 35.5%), 1.25 mg/day finasteride for 24 weeks (SUCRA = 24.8%) and 1 mg/day finasteride for 24 weeks (SUCRA = 4.3%).

“To our knowledge, this is the first report of an NMA in female androgenetic alopecia (AGA) comparing the relative efficacies of oral minoxidil (1, 0.25 mg/day), oral finasteride (5, 1.25, 1 mg/day), and topical minoxidil (5% and 2% each applied twice daily) in total hair regrowth. The efficacy demonstrated a possible dose-dependent effect for oral finasteride and topical and oral minoxidil,” the researchers concluded.

Reference:

Gupta, A. K., Wang, T., Bamimore, M. A., & Talukder, M. (2023). The relative effect of monotherapy with 5-alpha reductase inhibitors and minoxidil for female pattern hair loss: A network meta-analysis study. Journal of Cosmetic Dermatology, 23(1), 154-160. https://doi.org/10.1111/jocd.15910

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Oral Antibiotics Effective in Treating Uncomplicated Appendicitis: JAMA

Recent findings from the Appendicitis Acuta II (APPAC II) trial indicated that treating uncomplicated acute appendicitis with just oral antibiotics may not be inferior to a combined regimen of intravenous and oral antibiotics. This study published in the Journal of American Medical Association offers critical look at the potential of antibiotic monotherapy to replace more traditional treatments that involved surgery.

This research was conducted across nine university and central hospitals in Finland and involved a substantial cohort of 599 patients. This secondary analysis evaluate the effectiveness of oral antibiotic monotherapy against a combined approach of intravenous and oral antibiotics in the patients with computed tomography (CT)-confirmed uncomplicated acute appendicitis. The participants included in the trial were between 18 to 60 years and were administered either oral moxifloxacin or a combination of IV ertapenem followed by oral levofloxacin and metronidazole.

Over a three-year follow-up period, the primary measure of success was defined by the resolution of appendicitis symptoms, discharge without the need for surgical intervention and the absence of recurrence. At the year 3 mark, the data revealed a slight difference in treatment success rates of 63.4% for the oral monotherapy group and 65.2% for the individuals who received combined therapy.

The noninferiority margin was not definitively exceeded, as the difference in treatment success rates between the two groups was marginal at -1.8 percentage points. Based on the individual patient scenarios and healthcare provider discretion, this indicates that oral antibiotics alone might still be a potential alternative to more invasive methods, despite being slightly less effective.

The study observed no significant differences in secondary outcomes such as late appendicitis recurrence, treatment-related adverse events, quality of life, hospital stay duration or length of sick leave. These findings suggest that both treatment protocols are similarly safe and tolerable for patients.

The results did not robustly demonstrate the noninferiority of oral antibiotic monotherapy when compared to the combined therapy approach. This calls for further investigations to solidify the role of oral antibiotics in treating uncomplicated appendicitis with the potential benefits of avoiding surgery and its associated risks. These findings imply that the need for surgical interventions in uncomplicated appendicitis cases potentially reduced and shifting the treatment towards a less invasive approach.

Source:

Selänne, L., Haijanen, J., Sippola, S., Hurme, S., Rautio, T., Nordström, P., Rantanen, T., Pinta, T., Ilves, I., Mattila, A., Rintala, J., Marttila, H., Meriläinen, S., Laukkarinen, J., Sävelä, E.-L., Paajanen, H., Grönroos, J., & Salminen, P. (2024). Three-Year Outcomes of Oral Antibiotics vs Intravenous and Oral Antibiotics for Uncomplicated Acute Appendicitis. In JAMA Surgery. American Medical Association (AMA). https://doi.org/10.1001/jamasurg.2023.5947

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Hormone replacement therapy tied to decreased utilization of sinus surgery in older women with chronic rhinosinusitis: Study

USA: A recent study published in The Laryngoscope has shed light on the effect of hormone replacement therapy (HRT) on chronic rhinosinusitis (CRS) management.

Analyzing data from over 65,000 women aged 55 or older, the study found that those undergoing HRT were significantly less likely to require endoscopic sinus surgery (ESS) for chronic rhinosinusitis treatment versus those not on HRT (OR: 0.28). This effect was particularly pronounced in patients with nasal polyps. However, hormone replacement therapy was associated with higher antibiotic utilization.

Chronic rhinosinusitis is a disease that represents a significant health burden, estimated to affect 1.0–12.1% globally. CRS patients have been found to have worse quality-of-life scores versus those with chronic obstructive pulmonary disease and congestive heart failure. Kevin Hur, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA, and colleagues aimed to investigate whether hormone replacement therapy impacts healthcare resource utilization in the management of chronic rhinosinusitis in older women.

The study included women 55 years or older with a diagnosis of CRS using the TriNetX US health record database and followed for three years. The cohort was stratified into two groups: women who received HRT at the beginning of the study were compared to women who did not receive HRT.

The groups were matched by race, age, history of asthma, ethnicity, and history of nasal polyps. Outcomes included whether the patient underwent endoscopic sinus surgery and the frequency of antibiotic use. Kaplan–Meier analysis, measures of association, and cohort descriptive statistics were calculated.

The researchers reported the following findings:

  • Of the 65,400 women included, the mean age was 66.9 years. 27.0% and 3.6% of patients had a history of asthma or nasal polyps, respectively.
  • 2.0% of CRS patients underwent ESS, with the HRT group less likely to undergo ESS [OR: 0.28] versus patients who did not receive HRT.
  • When stratified by polyp status, HRT patients with nasal polyps had a greater decrease in ESS rates compared to control than HRT patients without nasal polyps.
  • The HRT group had a higher mean number of antibiotic prescriptions compared to the non-HRT group.

In conclusion, postmenopausal CRS patients concurrently receiving hormone replacement therapy are less likely to undergo endoscopic sinus surgery but receive more antibiotic prescriptions.

CRSwNP-HRT patients when stratified by polyp status have a greater decrease in ESS rate versus patients with CRSsNP-HRT.

“There is a need for further research investigating potential immunologic mechanisms behind this effect and how menopause itself may affect disease burden to improve care within this population,” the researchers wrote.

Reference:

Herrera, K., Parikh, M., Vemula, S., & Hur, K. Effect of Hormone Replacement Therapy on Chronic Rhinosinusitis Management. The Laryngoscope. https://doi.org/10.1002/lary.31433

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Prenatal opioid exposure increase long-term impact on immunity in pediatric population: JAMA

A recent retrospective study published in the Journal of American Medical Association unveiled a concerning association between prenatal opioid exposure (POE) and the alterations in the fetal immune system that potentially affect the long-term health of exposed children. This study encompassing health records of a vast cohort of 401,462 children born between 2003 and 2018 in the Western Australia, sheds light on the impacts of opioid exposure during pregnancy.

During the study period from August 30, 2022 to February 27, 2023, the study investigated the link between POE and subsequent risks of hospitalization and emergency department visits for immune-related conditions. The outcomes indicated that neonates with POE, constituting 0.4% of the cohort, exhibited a higher likelihood of preterm birth, low birth weight, and co-exposure to cigarette smoke.

Perinatal opioid exposure was associated with a 62% increased risk of perinatal infection and an astonishing 11.91 times higher risk of eczema and dermatitis compared to non-exposed neonates. Neonatal abstinence syndrome resulting from opioid withdrawal in newborns was linked to a nearly threefold increase in the risk of both perinatal infection and eczema/dermatitis.

Prenatal opioid exposure was also found to be linked to a 44% increased risk of childhood asthma. But, no significant associations were observed with allergies, anaphylaxis or autoimmune conditions. By differentiating between opioids prescribed for pain and those used to treat opioid use disorder (OUD), the study observed that while POE from pain-related opioids to increase the risk of infection, OUD-related opioids were linked with a higher risk of childhood eczema and dermatitis.

These findings underscore the need for further research into the impact of opioid-induced changes on the immune system during pregnancy. Understanding the mechanisms behind opioid-induced immune dysregulation could be important to develop interventions to reduce the long-term health risks in children exposed to opioids in utero.

Reference:

Kelty, E., Rae, K., Jantzie, L. L., Wyrwoll, C. S., & Preen, D. B. (2024). Prenatal opioid exposure and immune-related conditions in children. JAMA Network Open, 7(1), e2351933. https://doi.org/10.1001/jamanetworkopen.2023.51933

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Secukinumab may significantly alleviate symptoms of psoriatic arthritis, finds research

Researchers have found that a dose of 300 mg of secukinumab can significantly alleviate symptoms of psoriatic arthritis (PsA) compared to placebo, according to a new study published in Rheumatology and Therapy. The study demonstrates that secukinumab provides better clinical outcomes for patients with PsA. This study was condiucted by Alan J. Kivitz, MD, from the Altoona Center for Clinical Research/Altoona Arthritis and Osteoporosis Center and colleagues.

Psoriatic arthritis is a chronic autoimmune disease linked to reduced quality of life, physical function, and work productivity. Prior research has indicated that secukinumab, a selective inhibitor of interleukin 17A, improves PsA symptoms and has a favorable safety profile. This study aimed to compare the efficacy and safety of secukinumab versus placebo in US patients with challenging-to-treat PsA.

The study pooled data from phase 3 FUTURE 2-5 trials, excluding FUTURE 1 due to its use of an intravenous loading dose not approved by regulatory agencies. A total of 2,147 patients were randomized in the trials, but the current analysis focused on 279 US patients who had harder-to-treat PsA. Participants received secukinumab 300 mg, secukinumab 150 mg with or without a loading dose, or placebo.

The key findings of the study were as follows:

  • Patients on secukinumab 300 mg showed significantly greater ACR20 response rates (59.7%; P < .0001) at week 16 compared to placebo.

  • Secukinumab 150 mg with a loading dose also demonstrated higher response rates (43.4%; P < .0001).

  • Patients receiving secukinumab 300 mg experienced greater improvements in PASI75/90/100 scores, indicating a reduction in psoriasis severity.

  • The safety profile of secukinumab was comparable to placebo, with similar rates of treatment-emergent adverse events across all groups.

  • Patients on all doses of secukinumab showed significant improvement in health-related quality of life and reduced nail disease.

The study found that secukinumab, particularly at a dose of 300 mg, is effective in rapidly improving disease activity and quality of life for patients with PsA. The loading-dose regimen for secukinumab 150 mg also appears to be beneficial. Researchers emphasized the importance of optimal dosing to achieve the best outcomes in PsA treatment. The researchers acknowledged limitations such as not adjusting for logistic regression analyses, nominal P values, and variability in baseline scores. Further studies may be needed to address these limitations.

Reference:

Kivitz AJ, Kremer JM, Legerton CW 3rd, Pricop L, Singhal A. Efficacy and Safety of Secukinumab in US Patients with Psoriatic Arthritis: A Subgroup Analysis of the Phase 3 FUTURE Studies. Rheumatol Ther. Published online April 16, 2024. doi:10.1007/s40744-024-00666-1

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FDA fast tracks investigational gene therapy for heart failure

The US Food and Drug Administration (FDA) has granted Fast Track designation to invesigational gene therapy AB-1002 for treatment of congestive heart failure (CHF).AB-1002 is an investigational one-time gene therapy designed to inhibit the action of protein phosphatase 1, which has been linked to heart failure.

Inhibiting the function of this protein, which is linked to congestive heart failure (CHF), could potentially lead to a therapeutic effect on the heart.

“The FDA Fast Track Designation for AB-1002 is an important accomplishment for the clinical development of this program and highlights our goal of potentially bringing effective treatments to patients with advanced congestive heart failure,” said Canwen Jiang, MD, PhD, Chief Development Officer and Chief Medical Officer, AskBio. “We look forward to completing our Phase II GenePHIT clinical trial, which is currently enrolling patients with severe heart failure, and are committed to exploring the full potential of AB-1002 for the treatment of this devastating disease.”

The FDA Fast Track Program is designed to facilitate the development and expedite the review of new therapeutics that are intended to treat serious conditions and fill unmet medical needs. The purpose of the Program is to get important new therapeutics to patients earlier. Therapeutics that receive this designation benefit from eligibility for more frequent meetings with the FDA to discuss the development plan and, if relevant criteria are met, eligibility for Accelerated Approval and Priority Review.

“The Fast Track Designation for AB-1002 emphasizes the need to rapidly advance new therapeutic modalities such as gene therapy for people living with congestive heart failure,” said Christian Rommel, PhD, Head of Research and Development at Bayer’s Pharmaceuticals Division. “This designation underpins the potential of AB-1002 to address currently high unmet medical need, and we are excited about the opportunity to accelerate its development.”

AB-1002 is an investigational gene therapy that has not received marketing authorization, and its efficacy and safety have not been established or fully evaluated. AskBio is currently enrolling patients in the Phase II GenePHIT (Gene PHosphatase Inhibition Therapy) trial of AB-1002 (also known as NAN-101) for the treatment of CHF.

About GenePHIT

GenePHIT is a Phase II adaptive, double-blinded, placebo-controlled, randomized, multi-center trial to evaluate the safety and efficacy of the one-time administration of AB-1002, via antegrade intracoronary artery infusion, in males and females age >18 years with non-ischemic cardiomyopathy and New York Heart Association (NYHA) Class III heart failure symptoms. Subjects are randomized into one of three treatment groups in a 1:1:1 fashion to either low dose, high dose, or placebo. Primary outcome measures include cardiovascular related death and change from baseline in NYHA classification, left ventricular ejection fraction (LVEF), peak oxygen uptake (pVO2), and Six Minute Walk Test (6MWT). For more information, please visit clinicaltrials.gov or visit askbio.com.

About Congestive Heart Failure

Heart failure occurs when the heart cannot pump blood efficiently enough to meet the body’s needs, including providing sufficient oxygen to the organs. Congestive heart failure results in the slowing of the blood flow out of the heart, which causes the blood returning to the heart through the veins to back up. This causes congestion in the body’s tissues. Symptoms include swelling in the legs and ankles. Sometimes, fluid collects in the lungs and interferes with breathing. Approximately 26 million people worldwide are living with congestive heart failure.

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Patients of autoimmune liver disease treated with immune suppressants have lower prevalence of apical periodontitis: Study

Patients of autoimmune liver disease treated with immune suppressants have a lower prevalence of apical periodontitis suggests a study published in the Journal of Endodontics.

Autoimmune liver diseases (ALDs) are chronic conditions generated by an immune-mediated auto-aggressive inflammatory reaction in genetically susceptible individuals. The purpose of this study was to evaluate the prevalence of apical periodontitis in patients suffering from ALDs, in treatment with the immune-suppressants glucocorticoids, azathioprine, and/or ursodeoxycholic acid. The Autoimmune liver diseases group included 46 patients (11 men and 35 women, average age: 57.9 ± 11.8 years) and 1186 teeth. The control (C) included 50 healthy patients (15 men and 35 women, average age: 58.6 ± 10.4 years) and 1251 teeth), under no medications. Demographic data, and medical, pharmacological, and dental history, were recorded. Dental and radiographic examinations were performed, presence of apical periodontitis, periapical index score, DMFT, quality of restoration, and root canal treatment were evaluated. The influence of the medications assumed by the patients on the prevalence of apical periodontitis was also tested. Results: The prevalence of apical periodontitis was significantly lower in Autoimmune liver diseases than in C, at patient (p=.019), and tooth level (p=.005). (p=.015). Smoking and age were associated with a significant increase in apical periodontitis in cases and controls (p=0.045, and p=0.001). In both groups, endodontically treated teeth showed a higher prevalence of apical periodontitis. Considering all the limitation due to the observational nature of the study, the patients affected by autoimmune liver diseases, and in treatment with immune-suppressors (often associated with immune-modulators), were found to exhibit lower prevalence of apical periodontitis.

Reference:

Ideo F, Niazi S, Chessa L, Miglianti M, Bardini G, Mannocci F, CottiDDS E. Prevalence of apical periodontitis in patients with autoimmune liver diseases under immune suppressants and immune modulators: a cross-sectional study. J Endod. 2024 Mar 23:S0099-2399(24)00165-1. doi: 10.1016/j.joen.2024.02.026. Epub ahead of print. PMID: 38527610.

Keywords:

Patients, autoimmune, liver disease, immune suppressants, lower prevalence, apical periodontitis, study, Journal of Endodontics, Ideo F, Niazi S, Chessa L, Miglianti M, Bardini G, Mannocci F, CottiDDS E

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Bond policy issue raised at NHRC meeting, Is abolishing likely?

New Delhi: The issue of Bond policy was raised during the meeting held today by the National Human Rights Commission (NHRC). In the meeting, the National Medical Commission (NMC) officials including the Chairman Dr B Gangadhar and Secretary Dr B Srinivas were also present and the Commission expressed its plans regarding the bond policy in India.

The NHRC meeting was conducted to discuss the issues of mental health and mental well-being of medical students across the country. 

Speaking about the session, the National Chairman of the Federation of All India Medical Association (FAIMA), Dr. Rohan Krishnan, who also participated in the meeting, told Medical Dialogues, “The major statement that was made was that NMC is planning for a bond-free India. FAIMA has worked very hard on this for several years. FAIMA demanded that the bond policy should be revised and the States where there is a scarcity of doctors, in those States also bond policy should be reconsidered. All these things were discussed in the meeting.”

Meanwhile, notifying about the meeting, NHRC mentioned in an X (formerly Twitter) post, “NHRC core group meeting in hybrid mode on health and mental health begins. It focuses on discussing issues of bonds in medical colleges, the rights of patients, the rights of doctors, and problems in disbursal of stipend to doctors.”

Also Read: Breaking News: NMC Asks States to do Away with Seat leaving Bond

Apart from the NMC officials, the meeting was also attended by the stakeholders from the Health Department, Health Secretary, Chairman of NHRC, representatives of the Indian Medical Association (IMA), Federation of Resident Doctors Association (FORDA), representatives from the United Doctors Front Association (UDFA).

Dr. Rohan Krishnan informed that issues like bond policy, patient welfare, healthcare structure of the nation including what will happen in the future- all these things were discussed in the meeting.

Commenting on the issues, Dr. Rohan Krishnan told Medical Dialogues, “Mental health of the medical students across the country should be of prime concern right now, considering the fact that so many young doctors and MBBS students commit suicide being unable to deal with the immense pressure of studies and work.”

“Doing away with the seat-leaving bond can be a stepping stone in lessening the mental burden on the medical students and we appreciate the efforts of NMC in this regard,” he further added.

In an X post, Dr. Krishnan mentioned, “Took part in a meeting Organised by @India_NHRC Glad to Hear that @NMC_IND Chairman wishes to abolish bond policy pan India. Also, NMC has taken a positive stand on Stipend given to interns,PGs. However, I have again raised the issue of improvement in various aspects of healthcare for *Mental Health and Mental well being of UG and Pg Residents.”

Medical Dialogues had previously reported that earlier this year, taking cognisance of the issue of seat-leaving bond policy, NMC wrote to the Principal Secretary of Health and Medical Education of all States and Union Territories and asked them review the said policy and preferably do away with the same.

The Apex Medical Commission issued this direction after the Anti-Ragging Committee of NMC held a meeting on 9th January 2024 to address the mental health concerns of PG medical students and recommended the State/UT to review the seat leaving policy in medical colleges and to do away the same.

As an alternative, NMC recommended that the States may consider debarring the students for admission in their States for the next one year.

Also Read: Put a Stop to Seat Leaving Bond Penalty: Maharastra Resident Doctors Urge NMC

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