Rise in diabetics forced to go for amputations due to foot ulcers, finds study

A recent study conducted by the Christian Medical College, Vellore, has uncovered a concerning trend among diabetes patients in India: a rising number of toe and foot amputations due to diabetes-related sores. Published in the peer-reviewed journal Science Direct, the study reveals that the risk of subsequent amputations triples after the first procedure, underscoring the severity of the issue.

In India, diabetic foot ulcers (DFU) tend to present as larger wounds compared to global standards, leading to higher rates of amputation. The study, led by the Department of Endocrinology, Diabetes, and Metabolism at Christian Medical College, Vellore, found that over a 10-year period, mortality rates among patients with DFU range between 25% and 30%, with heart-related issues and sepsis infections being the primary causes of death.

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How Can Govt Fix Uniform Rates for Procedures in Private Hospitals? Supreme Court asks Centre

New Delhi: The Supreme Court has asked the Central Government how it could fix uniform rates in private hospitals across the country when market forces should ideally drive such matters.

Such observations were made by the Supreme Court bench of Justices BR Gavau and Sandeep Mehta while considering the plea by All India Ophthalmological Society, which challenged the government regulations on uniform rates for ophthalmological procedures across India.

Issuing notice to the Government, the Apex Court bench asked “How can there be uniform rates even in private hospitals? It all depends on market forces. What if there was uniform fees for lawyers appearing here?”

Filing the plea, the petitioner association argued that the rates for procedures conducted by the specialists could not be the same in metropolitan cities and small remote villages.

Earlier, the top court bench had issued only a limited notice to the Attorney General and listed the matter for further consideration on April 17. Back then, Justice Dhulia had remarked, “But can you challenge a policy like this? You see, for example health care rates in northeast are very affordable and it will get affected.”

The matter was tagged on Monday with an already pending case seeking directions to the Union Government to notify hospital treatment rates in line with rules under the Clinical Establishments (Registration and Regulation) Act, 2010.

Also Read: Either Govt fixes standard rates for private hospitals or we will implement CGHS rates: Supreme Court issues Ultimatum

Earlier, the counsel for one of the parties, Senior Advocate Dushyant Dave had said that the rules were “completely out of hand”. Attorney General for India R Venkataramani represented the Union Government and Senior Advocate Maninder Singh represented the Indian Medical Association (IMA). Further, Senior Advocate Harish Salve appeared on behalf of a group of private hospitals. 

As per the latest media report by Bar and Bench, earlier this month, while hearing a similar matter, a co-ordinate Bench had lamented how private hospitals set up on lands purchased at subsidised rates were renting on their commitment to reserve some of their beds for the poor.

Back then, the top court bench of Justices Sudhanshu Dhulia and Prasanna B Varale had remarked, “All these private hospitals they say, when getting subsidised land, that they will reserve at least 25 per cent beds for Economically Weaker Sections but it never happens. We have seen it many times.”

Meanwhile, earlier this year, the Supreme Court had slammed the Union Government for its failure to fix a range of rates of services at private healthcare facilities.

Even though Rule 9 of the Clinical Establishment (Central Government) Rules, 2012 mandates that the Government shall determine the rate of fee chargeable from the patients at private hospitals and clinical establishments, it has not been enforced till now.

Issuing directions to the Union Health Secretary to hold a meeting with the State Counterparts and come up with a concrete proposal before the next date of hearing, the Supreme Court bench had warned that if the Government fails to comply with the directions, the Court would consider issuing CGHS rates instead.

Medical Dialogues had earlier reported that concerned with the Supreme Court’s directions to the Union Health Ministry to specify a range of rates for availing services at private hospitals and clinical establishments, the private hospitals had opined that the move would be “catastrophic” for the industry and would also affect the quality of healthcare.

The Association of Healthcare Providers (AHPI) had decided to take up the issue and concerns of the healthcare industry before the Supreme Court bench.

Also Read: Standardising rates will be catastrophic, affect healthcare quality! Private Hospitals express concern over SC intervention, AHPI to move Court

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NEET SS 2024 may not be held this year: NMC

The National Eligibility-cum-Entrance Test for admission to Super Speciality courses – NEET SS may not be held this year, recent minutes of the meeting of the National Medical Commission (NMC) have revealed.

NMC shared the minutes of the meeting dated 23.02.2024 with the social and political activist Dr Vivek Pandey, who had sought the details of the NMC meeting when the decision to prepone NEET PG 2024 was taken.
For more information, click on the link below:

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Health Bulletin 29/ April/ 2024

Here are the top health news for the day:

NEET SS 2024 may not be conducted this year
Recent minutes of the National Medical Commission (NMC) meeting have revealed that the National Eligibility-cum-Entrance Test for admission to Super Speciality courses—NEET SS—may not be held this year.
NMC shared the minutes of the meeting dated 23.02.2024 with the social and political activist Dr Vivek Pandey, who had sought the details of the NMC meeting when the decision to prepone NEET PG 2024 was taken.
For more information, click on the link below:


Spices safe, no notice from Hong Kong, Singapore: MDH

Amid row over the alleged presence of carcinogenic ethylene oxide, a form of pesticide, in its select spice packs, MDH (Mahashian Di Hatti) has called such claims untrue and lacking any substantiating evidence. The company said that it has not received any communication on the topic from regulatory authorities of Singapore or Hong Kong. The over-100-year-old brand said that it does not use ethylene oxide at any stage of storing, processing or packaging its spices. “MDH’s statement is further supported by the fact that nodal regulatory authorities such as the Spice Board of India and FSSAI have not received any communication or test reports from Hong Kong or Singapore authorities regarding this matter.

Horlicks drops ‘Health Label’, now classified as ‘Functional nutritional drink’

In response to directives from the Union Ministry of Commerce and Industry, Hindustan Unilever has rebranded its ‘health food drinks’ category, renaming it as ‘functional nutritional drinks’ (FND). This decision, prompted by concerns over categorization on e-commerce platforms, affects prominent brands like Horlicks and Boost. Ritesh Tiwari, the company’s chief financial officer, stated that this rebranding reflects a more accurate depiction of the products. The move also aligns with efforts to tap into the underexplored market potential of the category.

Hindustan Unilever aims to expand its consumer base, usage, and benefits within the FND segment. Additionally, the company is observing promising growth in its premium offerings, particularly those tailored for diabetes management and women’s health. The initiative comes in light of the National Commission for Protection of Child Rights’ observation that there is no defined category for ‘health drinks’ under the Food Safety and Standards Act 2006. Further, the Food Safety and Standards Authority of India (FSSAI) has cautioned against misleading categorizations such as labeling dairy, cereal, or malt-based beverages as ‘health’ or ‘energy’ drinks on e-commerce platforms.

Why did NEET PG 2024 get preponed? NMC responds to RTI

Seeking clarification on the reasons why the National Eligibility-cum-Entrance Test Postgraduate (NEET PG) 2024 examination got preponed, an application under the Right to Information (RTI) Act has been filed before the National Medical Commission (NMC).Activist Dr. Vivek Pandey filed the RTI application before the Apex Medical Commission after receiving requests from the aspirants…
For more information, click on the link below:

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NBE Invites Online Applications For FMGE June 2024, Know how to apply

New Delhi- The National Board of Examination in Medical Sciences (NBEMS) has invited applications for the Foreign Medical Graduate Examination- FMGE June 2024. For candidates appearing for FMGE, NBE has also released an information bulletin detailing the instructions to fill out the online FMGE application form for June 2024.

FMGE for June 2024 will be conducted on 6th July 2024 on the computer-based platform at various testing centres across the country. The candidates can submit the application form for FMGE June 2024 online from today i.e. 29th April 2024 on the official website of NBE, valid till 11:55 pm on 20th May 2024.

IMPORTANT DATES

S.NO

PARTICULARS

DATES

1

Online Submission of Applications.

29th April 2024 to 20th May 2024 (Till 11:55 PM).

2

Edit Window for All Payment Success Applications (Any information/documents can be edited except Name, Nationality, Email, Mobile number and Test City).

24th May 2024 to 28th May 2024.

3

Final Edit Window to rectify Deficient/Incorrect Images (No further opportunity shall be given)-

1 Photograph.

2 Signatures.

3 Thumb Impression.

7th June 2024 to 10th June 2024.

4

Opportunity to rectify deficiencies related to documents uploaded in the application-

1 Primary Medical Qualification Certificate (PMQC).

2 Apostille/Attestation of PMQC by the Indian embassy concerned.

3 Eligibility Certificate or Admission Letter.

4 Proof of Citizenship.

Through Online Deficient Document Submission Portal.

The portal will be closed on 14th June 2024 at 11:55 PM.

5

Final opportunity to rectify deficiencies related to documents uploaded in the application (A list of such candidates will be published on the NBEMS website).

21st June 2024 (11 AM onwards) to 24th June 2024 (Till 11:55 PM).

6

Issue of Admit Card.

1st July 2024.

7

Examination Date.

6th July 2024.

8

Declaration of Result.

By 6th August 2024.

INSTRUCTIONS TO FILL ONLINE FMGE APPLICATION FORM

NEW USER REGISTRATION

All candidates desirous of applying for the FMGE June 2024 session shall be required to create an online profile of themselves to generate a UserID and Password.

APPLICANT LOGIN

1 This User ID and Password so created will allow the candidate to log in as an applicant for the FMGE June 2024 session and register for an online application. The “Go To Application” link will allow the applicant to continue with the application submission immediately after user creation.

2 If the Login password is lost, it can be retrieved by clicking “Forgot Your Password”.

NAME OF CANDIDATE

Please mention the full name as in the Primary Medical Qualification Certificate. The name as entered by the candidate while creating his/her User ID shall be reflected in a non-editable format in his/her examination application form. No change in the name shall be permissible under any circumstances after the submission of an application. The candidate shall be required to produce his/her Government-issued ID proof bearing the same name at the test centre on the test day to seek entry. In case of a Mismatch in name between the admit card and Photo ID proof shown, entry to the test centre shall not be allowed. It is strongly advised not to submit an application with an error in the candidate’s name as it shall not be allowed to be edited after application submission. If the user has entered his/her name wrongly while registering the user, please create another user with the correct name.

Also Read: NBE releases tentative exam calendar for forthcoming Exams

GENDER AND DATE OF BIRTH

Indicate your gender and the Day, Month & Year of your birth. Please enter the correct date of birth carefully while registering the user.

NATIONALITY

Please choose your nationality amongst the options given: Indian, Non-Resident Indian (NRI), Overseas Citizen of India (OCI) and Foreign Nationals. Indian Citizens who are not NRI should choose Indian. An Indian Citizen should choose a non-resident Indian if he/she is an NRI. If you are a Foreign National but also an Overseas Citizen of India (OCI), please choose OCI. As per Screening Test Regulations, an Indian Citizen/NRI or an Overseas Citizen of India (OCI) alone are eligible to apply for FMGE (Screening Test). Foreign Nationals (other than Nepalese) who are not an OCI are not eligible to apply for FMGE. If you are a citizen of any country other than India or Nepal and not an OCI, you are NOT eligible to apply for FMGE.

EMAIL ID

1 The email ID chosen by the candidate shall be verified through a system-generated OTP for user creation. The same email ID can not be used for the registration of any other user concurrently. Please note that all email correspondence with the candidate shall be done at this email ID only. Email chosen by the candidate shall be the primary means to communicate with the candidate for examination purposes. Information related to examinations shall be sent to this email ID. Candidates shall also be able to communicate with NBEMS through this registered email only. Correspondence received from any other email ID of the candidate shall not be entertained. Therefore, candidates are advised to choose the email ID carefully.

2 The UserID/Application ID and password so generated shall be sent to the registered email ID of the candidate for future records.

Also Read: NEET PG 2024 on June 23, FMGE rescheduled: NBE releases tentative exam calendar for forthcoming exams, All details here

MOBILE NO

1 A unique mobile number is necessary for receiving Examination-related communications sent through SMS. The mobile number chosen by the candidate shall NOT be the primary means to communicate with the candidate for examination purposes.

2 Furthermore, the candidate shall be required to provide information as asked under various heads. It is strongly recommended to keep the required information handy before start filing the application. Some of the salient heads in the application form are as under-

DETAILS OF IDENTIFICATION

1 PASSPORT NUMBER AND VALIDITY- Mention details of the Passport issued by Govt of India if you are an Indian Citizen. Mention details of passport of your country of citizenship if you are an OCI; An OCI shall be asked to provide an OCI Card Number also.

2 ANY OTHER GOVT OF INDIA ISSUED ID PROOF- Providing details shall be mandatory for a Nepalese Citizen or an Indian Citizen who does not have a valid Indian Passport.

3 Marks of Identification.

4 Correspondence and Permanent Address in India.

5 Subjects studied in 10+2 and Percentage/Grades obtained.

6 Details of Primary Medical Qualification:

a Date of Starting and Completing the Course

b NAME OF INSTITUTE- To locate your medical school in the application form in the drop-down list, please refer World Directory of Medical Schools beforehand for easy identification of the name of Country, City and medical school.

Also Read: Applications for eligibility certificate for FMGE invited by NMC

ROLL NUMBER OF LAST FMGE TAKEN

Please mention the Roll number of the latest session of FMGE (out of December 2023, June 2023 and December 2022), if you were issued an admit card for it.

ELIGIBILITY CERTIFICATE (EC)

The candidate can be asked to provide the status of the issuance of EC to you by MCI/ NMC. If EC is applicable in your case, you shall be required to upload the same under the document upload section. If you took admission during the period when obtaining EC from MCI was not required/was exempted by the Govt of India, you shall be required to upload a copy of the admission letter confirming the exact date of admission to the primary medical qualification in lieu of EC. The candidate shall be required to upload a Score Card for qualifying NEET-UG in lieu of EC if admission in Primary Medical Qualification has been obtained on or after May 2018.

UPLOAD OF PRESCRIBED DOCUMENTS & IMAGES

The candidate shall be required to upload scanned copies of the following original documents at indicated places-

1 Primary Medical Qualification Degree certificate/ Provisional Pass Certificate duly attested by the Embassy of India in the country from where the qualification has been obtained/apostilled in accordance with the requirements of the Hague Convention of 5 October 1961 abolishing the requirement of legalisation for Foreign Public Document (Apostille Convention). Apostille/Embassy Attestation uploaded MUST belong to the document which has been uploaded as proof of qualifying Primary Medical Qualification. If it is detected that the uploaded Apostille/Embassy attestation does not pertain to the said proof of qualifying Primary Medical Qualification, this shall be treated as resorting to the use of an Unfair Means and dealt with accordingly. The uploaded document shall be treated as unattested/uncertified and the candidature of the candidate shall be cancelled for FMGE June 2024 irrespective of issuance of admit card, appearance in examination and/ or being declared qualified for the examination.

2 The Degree Certificate/Provisional Pass Certificate of Primary Medical Qualification must confirm that the result of the final examination for the said primary medical qualification was declared on or before 30th April 2024.

3 PROOF OF CITIZENSHIP- One of the following documents must be uploaded:

a INDIAN CITIZEN/NRI- Valid Passport issued by Govt of India (Front Page and Last Page of valid passport).

b OVERSEAS CITIZEN OF INDIA- OCI Card + Valid Passport of the country of Citizenship (Front Page and Last Page of valid passport).

c NEPALESE CITIZEN- One of the Govt of India Issued Photo IDs such as PAN Card, Voter IDs, and Driving Licenses. Indian Citizens who have obtained their Primary Medical Qualification from Nepal and have not been issued passports by Govt of India can also upload this. Migrants from other countries to India shall be required to upload a Certificate of Registration for Citizenship of India issued by MHA, Govt of India

Also Read: NMC Invites Applications for Eligibility Certificate for FMGE, details

PHOTOGRAPH, SCANNED SIGNATURES AND THUMB IMPRESSION

Please refer to Image Upload Instructions available at the NBEMS website and at the end of this information bulletin for details of specifications for uploading photographs, signatures and thumb impressions. Images which are not as per prescribed specification shall not be considered and may lead to rejection of the application. Please ensure that the uploaded photograph is a RECENT photograph and in any case, should have not been taken more than 3 months before the date of application submission. Uploading a photograph which is not a recent one or that is not as per prescribed image upload guidelines as detailed in this information bulletin and/or failure to rectify the same in the final edit window shall invite rejection of the application.

Candidates who have appeared in the Foreign Medical Graduate Examination in the past and have been declared unsuccessful and have submitted their documents to NBEMS on an earlier occasion are also required to submit their scanned documents as detailed above while applying for the FMGE June 2024 session. Submission of documents in the previous session(s) of FMGE, or issuance of admit card in any previous session of FMGE and/or declaration of result in any previous session(s) does not confer any rights for eligibility towards FMGE June 2024 session. Applications of candidates who fail to submit the documents prescribed in the information bulletin or fail to rectify the deficiencies in the document as communicated by NBEMS shall be rejected.

Candidates who fail to submit duly completed applications for FMGE June 2024 with requisite documents and/or fail to rectify the deficiencies in their applications by the last date prescribed (i.e. 24th June 2024) for rectification shall be declared ineligible. Admit Card shall not be issued to candidates who are declared ineligible before the conduct of the examination. In such cases, the entire fee will be forfeited. Issuance of an admit card in any previous session(s) of FMGE shall not be a ground to issue an admit card for FMGE June 2024 as well for such candidates who are declared ineligible for FMGE June 2024 due to incomplete applications.

ACKNOWLEDGEMENT OF APPLICATION SUBMISSION

An acknowledgement email shall be sent to the registered email ID confirming the submission of an application by the candidate. Submission of the application shall be completed only after successful payment of the examination fee. Candidate should confirm the status of payment in the application form PDF where ’S’ would stand for “Successful” and “F” would stand for “Failed”.

Also Read: Amidst demand for release of FMGE Answer key, NBE cites privacy of question bank must be maintained: Report

EDIT WINDOW

1 Candidates who have successfully submitted payment for their application during the Application Submission window shall only be allowed to edit their applications from 24th May 2024 to 28th May 2024. No new application can be registered during the edit window or payment can be made during the window. Any information/document can be changed/corrected during the edit window except for Name, Test City, Nationality, mobile number and Email ID. Information can be edited any number of times before the closure of the window. The last submitted information will be saved in the records.

2 Information entered in the application form can be changed during the “Edit Window”. However, the following fields in the application form shall remain non-editable:

a Name of the Candidate.

b Email ID.

c Mobile number.

d Nationality.

e Test City.

3 No editing of information provided shall be permissible in the application form, once the edit window is over.

4 NBEMS disclaims any liability that may arise due to incorrect information provided by the candidate during online application form submission.

5 NBEMS does not edit /modify/alter any information entered by the candidates at the time of online submission of the application form under any circumstances.

FINAL EDIT WINDOW

1 The corrections in images uploaded (i.e. Photographs, Signatures and Thumb impression), if required, shall be communicated through emails at the registered email ID of the concerned candidates only. and same can be corrected during the final edit window i.e. 7th June 2024 to 10th June 2024. Only those images which require corrections shall be editable during this final edit window. No further opportunity shall be given to make corrections. Candidates are advised to submit the images in their application as per the prescribed image upload guidelines. Failure to submit images as per guidelines and/or failure to rectify the images shall invite rejection of the application.

2 Deficiency related to documents uploaded (Proof of possessing Primary Medical Qualification, attestation of Primary Medical Qualification certificate by Indian Embassy concerned/apostille, Eligibility Certificate/Admission Letter, Identity Proof of Citizenship etc) can be rectified by 14th June 2024. NBEMS shall publish a list of candidates on its website who would fail to rectify the deficiencies in their documents even by 1st June 2024 and shall open an online window from 21st June 2024 to 24th June 2024 giving a FINAL opportunity to submit documents which are deficient in the application. No further opportunity will be given.

Also Read: Around 78 percent of Candidates Fail in FMGE December 2023 exam

ONLINE DEFICIENT SUBMISSION PORTAL

1 The deficiency, if any, in document(s) uploaded by the candidates in the application form (such as EC, Passport, Proof of Passing etc) shall be communicated through an Online Deficient Document Submission Portal. Documents CAN NOT be submitted through any other mode such as in-person to the NBEMS office or through Communication Web Portal or email. Documents submitted through any mode other than the “Online Deficient Document Submission Portal” shall not be entertained.

2 The Online Deficient Document Submission Portal can be accessed through the link, which is mentioned in the information brochure.

3 Candidates can access the deficiencies communicated by NBEMS by entering the information asked on the portal. The portal would allow to respond to queries as well as to upload documents, if so asked.

4 Candidate may kindly note that the following documents may also be asked by NBEMS to be submitted at any time if any doubt arises during the determination of eligibility of the candidate-

i Copy of Address Proof (PAN Card/Voter ID/Passport/ Driving License/ Aadhar Card).

ii Latest Passport-size Photographs.

iii Copy of Date of Birth Proof (Certificate of Matriculation).

iv Copy of 10+2 passing certificate.

v Copy of 10+2 mark sheet.

vi Copy of internship certificate (if done abroad).

vii Copy of failed certificate/ result for Ex-candidates.

viii Proof of Category (SC, ST, OBC etc).

ix EQUIVALENCE CERTIFICATE- From the Association of Indian Universities (for candidates who have done 10+2 abroad).

Meanwhile, the following sequence shall be observed while filing the online application form:

i Fill out the user registration form to generate the User ID/Application ID and Password.

ii User ID and Password will be sent through SMS and Email.

iii Complete the application form and upload your Photograph, Scanned signature, Thumb impression & Prescribed documents.

iv Choose your Test City and pay the Examination Fee.

v Agree to the declaration and Submit the Application.

vi Take a printout of the filled Application form with Transaction ID printed on it and payment status mentioned as “S” (Successful) for records.

Also Read: NBE notifies on Distribution of Pass Certificates to FMGE December 2023 candidates, details

IMPORTANT POINTS

1 Indicate names of four test cities of your choice amongst the test cities offered where you would like to appear in FMGE. You may be allotted the test centre for FMGE in any of these four test cities indicated as preferred choices. The order in which these choices are indicated shall not be treated as your preference order.

2 After the selection of the test city, the candidate shall be required to pay the prescribed examination fee online. The fee can not be paid through any mode other than the payment gateway available in the online application form.

3 Candidates shall be prompted to preview the entire application before submission to make any corrections if so required. They shall be required to submit the application after agreeing to the “declaration”. This shall complete the entire process of application submission.

The application submission process can be completed either in a single sitting or in multiple sittings, as per the candidate’s choice, during the application submission window. However, once an application is successfully completed & submitted, it shall be available for editing certain fields only during the “edit window”.

Candidates are advised not to complete & submit their online application in haste to avoid any errors in providing information. Request for making any changes in the date of birth, name or any other information provided in the application shall be summarily rejected. NBEMS does not edit/modify/change any information provided by the candidates in their applications of its own. Candidates have the option to make corrections to any information except name, nationality, test city, mobile number and email ID during the edit window.

To view the information brochure, click the link below

https://medicaldialogues.in/pdf_upload/nbemsjpg-237140.pdf

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People with opioid use disorder less likely to receive palliative care at end of life, finds study

Compared with people without opioid use disorder, those with opioid use disorder were less likely to receive palliative care in clinics and in their homes, and were dying at younger ages of causes other than opioid use, according to new research published in Canadian Medical Association Journal.

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More doctors can prescribe a leading addiction treatment. Why aren’t more people getting help?

It’s easier than ever for doctors to prescribe a key medicine for opioid addiction since the U.S. government lifted an obstacle last year. But despite the looser restrictions and the ongoing overdose crisis, a new study finds little change in the number of people taking the medication.

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Stress Hyperglycemia Ratio Predicts Cardiovascular Mortality in Triple-Vessel Disease Patients: Study

Researchers have found that the stress hyperglycemia ratio (SHR), a measure of acute hyperglycemia in response to stress, can predict cardiovascular mortality in triple-vessel disease (TVD) patients with acute coronary syndrome (ACS). A study involving TVD patients with ACS from two independent centers observed a strong association between high SHR levels and an increased risk of cardiovascular mortality. This study was published in the journal Cardiovascular Diabetology by Yu Zhang and colleagues.

Risk assessment in TVD remains a challenge due to the complexity of the disease. Stress hyperglycemia, an acute response of glucose metabolism during stress, can offer insights into the patient’s true acute hyperglycemic status. This study aimed to evaluate the prognostic value of SHR in TVD patients with ACS and its role in risk stratification.

A total of 3,812 TVD patients with ACS were included in the study. Baseline SHR measurements were collected, and the patients were followed up for a median of 5.1 years. The study’s primary endpoint was cardiovascular mortality. Cox regression analysis was used to evaluate the association between SHR and cardiovascular mortality. The study also used the SYNTAX II (SSII) model as a reference to assess the incremental predictive value of SHR.

The key findings of the study were as follows:

  • Out of the 3,812 TVD patients with ACS, 219 (5.8%) suffered cardiovascular mortality during the follow-up period.

  • High SHR levels were associated with an increased risk of cardiovascular mortality (adjusted hazard ratio 1.809, 95% confidence interval 1.160–2.822, P=0.009), displaying a J-shaped pattern.

  • The prognostic value of SHR was primarily observed in patients with diabetes rather than those without diabetes.

  • Model Improvement: Adding SHR to the SSII model improved the model’s ability to predict cardiovascular mortality in TVD patients with ACS.

The study confirms that high levels of SHR are linked to long-term cardiovascular mortality risk in TVD patients with ACS. Moreover, SHR adds incremental predictive value beyond the standard SSII model. Assessment of SHR may help improve risk stratification in TVD patients under acute stress and provide better personalized treatment approaches.

Reference:

Zhang, Y., Guo, L., Zhu, H., Jiang, L., Xu, L., Wang, D., Zhang, Y., Zhao, X., Sun, K., Zhang, C., Zhao, W., Hui, R., Gao, R., Wang, J., Yuan, J., Xia, Y., & Song, L. (2024). Effects of the stress hyperglycemia ratio on long-term mortality in patients with triple-vessel disease and acute coronary syndrome. Cardiovascular Diabetology, 23(1). https://doi.org/10.1186/s12933-024-02220-3

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Patients with thicker epicardial adipose tissue and HFpEF at higher risk of coronary artery disease: Study

China: A recent study has revealed that epicardial adipose tissue (EAT) is correlated with coronary artery disease (CAD) in patients with heart failure with preserved ejection fraction (HFpEF). The findings were published online in the International Journal of Cardiology Cardiovascular Risk and Prevention on February 1, 2024.

“This retrospective study revealed that patients with thicker epicardial adipose tissue and HFpEF were more likely to present with coronary artery disease, independent of their BMI and other known risk factors of CAD including age, hypertension, smoking, and type 2 diabetes,” the researchers reported.

Heart failure with preserved ejection fraction presents as a clinically heterogeneous syndrome, and developing therapies for this condition has been limited in success. The presence of coronary artery disease is a common complication in HFpEF, with the incidence ranging from 47 % to 68 % in different cohorts.

The epicardial adipose tissue lies between the pericardium’s visceral layer and the myocardial surface and is suggested to play a role in the development of atherosclerosis and CAD. Previous studies have shown that EAT is closely associated with the pathophysiological processes of HFpEF. However, whether EAT raises the risk of CAD in HFpEF patients remains unknown.

To determine if EAT increases the risk of CAD in patients with HFpEF, Fengling Peng, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China, and colleagues conducted a retrospective cohort study of 112 HFpEF patients hospitalized in the First Affiliated Hospital of Chongqing Medical University from 2021 to 2022, who underwent at least one coronary artery examination.

EAT thickness was measured by echocardiography. Multifactorial binary logistic regression was used to analyze the correlation between EAT and coronary artery disease.

The study led to the following findings:

  • Compared to patients without CAD, EAT thickness was noticeably higher in patients with CAD.
  • Spearman correlation analysis showed that CAD and Gensini scores (r = 0.334) positively correlated with EAT thickness.
  • After adjusting for age, body mass index, gender, hypertension, smoking history, type 2 diabetes mellitus, and a part of biochemical indexes, EAT thickness was associated with CAD (OR ranged from 1.450 to 1.472).

The study limitations were: firstly, study analysis did not occur in a diverse and heterogeneous cohort including a multi-ethnic population and only in homogenous Asians; secondly, echocardiographic measurement was safe, noninvasive, and economical, but quantification of EAT is difficult; thirdly, the retrospective nature of the study; and lastly the selection bias.

“A grand-scale investigation is needed to reveal the association between EAT and CAD in HFpEF patients,” the research team concluded.

Reference:

Zhao, J., Xie, J., Liu, Z., Duan, Q., Gao, L., Peng, F., & Sun, M. (2024). Epicardial adipose tissue: A marker of coronary artery disease in patients with heart failure with preserved ejection fraction. International Journal of Cardiology Cardiovascular Risk and Prevention, 200243. https://doi.org/10.1016/j.ijcrp.2024.200243

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New generation Artificial sweetener has potential to damage gut, reveals study

New research has discovered that neotame, one of the new generation of artificial sweeteners, is capable of damaging the human intestine and causing illness.

The study is the first to show that neotame can cause previously healthy gut bacteria to become diseased and invade the gut wall-potentially leading to health issues including irritable bowel syndrome and sepsis-and also cause a breakdown of the epithelial barrier, which forms part of the gut wall.

The research, which is published in the journal Frontiers in Nutrition and was carried out at Anglia Ruskin University (ARU), demonstrates that neotame can damage the intestinal epithelium directly, by causing the death of epithelial cells, and indirectly, by damaging bacteria commonly found in the gut.

The in vitro study identified a range of pathogenic responses following exposure of E. coli (Escherichia coli) and E. faecalis (Enterococcus faecalis) to neotame, which is found in drinks, foods and chewing gums, including biofilm formation and increased adhesion to and invasion of cells by diseased bacteria.

Some of the newest artificial sweeteners have a 1,000-fold sweeter taste compared to sugar, reducing the amount needed to be added to food and drink. Despite the smaller quantities used, the impact of neotame on the epithelium-microbiota relationship has the potential to cause poor gut health, which in turn could lead to metabolic and inflammatory diseases such as irritable bowel disease or insulin resistance.

This new research into neotame builds on previous work by Dr Havovi Chichger of Anglia Ruskin University (ARU), which discovered that saccharin, sucralose, and aspartame, some of the most widely used artificial sweeteners, could cause similar damage in the gut.

Artificial sweeteners can play a role in helping with weight loss and aiding individuals with glucose intolerance and type 2 diabetes. However, this new study, led by Dr Aparna Shil, of Jahangirnagar University in Bangladesh, and Dr Chichger highlights the need for further research into the toxic effects of some of the artificial sweeteners that have been developed more recently.

Dr Chichger, Associate Professor in Biomedical Science at Anglia Ruskin University (ARU) and senior author of the study, said: “There is now growing awareness of the health impacts of sweeteners such as saccharin, sucralose and aspartame, with our own previous work demonstrating the problems they can cause to the wall of the intestine and the damage to the ‘good bacteria’ which form in our gut.

“This can lead to a range of potential health issues including diarrhoea, intestinal inflammation, and even infections such as septicaemia if the bacteria were to enter the blood stream. Therefore, it is important to also study sweeteners that have been introduced more recently and our new research demonstrates that neotame causes similar problems, including gut bacteria becoming diseased.

“Understanding the impact of these pathogenic changes occurring in the gut microbiota is vital. Our findings also demonstrate the need to better understand common food additives more widely and the molecular mechanisms underlying potential negative health impacts.”

Reference:

Aparna Shil, Luisa Maria Ladeira Faria, Caray Anne Walker, Havovi Chichger, The artificial sweetener neotame negatively regulates the intestinal epithelium directly through T1R3-signaling and indirectly through pathogenic changes to model gut bacteria, Frontiers in Nutrition, https://doi.org/10.3389/fnut.2024.1366409.

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