Through a public notice, the National Testing Agency (NTA) has announced the reopening of the registration window for the National Eligibility-cum-Entrance Test for (Undergraduate) courses- NEET UG 2024.
Powered by WPeMatico
Kozhikode: In a distressing incident reported in Kozhikode, a retired doctor fell victim to a marriage scam orchestrated by a gang of four who duped him of Rs 6 lakh, a phone and a laptop.
The doctor, who had advertised his interest in marriage through a newspaper, was targeted by individuals identified as Irshana, Rafi, Majeed, and Sattar, hailing from Kasarkot Kanhangad.
According to the doctor’s complaint filed with the Nadakavu police, the accused contacted him after seeing his advertisement and engaged him in numerous discussions, gradually gaining his trust.
Also read- Karnataka Doctor Loses Rs 16.5 Lakh To Fraudster Posing As Delhi Police Official
At first, the doctor was not interested in the marriage proposal brought up by the group but eventually, he agreed. Consequently, the group showed the woman from Kasargod and the doctor liked her.
As per a Kaumudi news report, the doctor had a liking for the woman, so the gang booked a hotel room close to Kozhikode railway station. Some people, presented by the gang as the woman’s family, also stayed at the hotel. Eventually, a wedding was organized, and separate rooms were assigned to the ‘groom and bride’ in the hotel.
To dupe the doctor, the gang informed the doctor about some monetary assistance as the gang would look for a rented house in the city so that the doctor and the woman could stay after marriage.
The group took an advance of Rs 6 lakh claiming that they had arranged a house in Nadakkavu and the money would be given to the house owner. The doctor immediately handed over the money to the gang.
On the way to visit the new house, the doctor asked the group to look after his belongings as he wanted to enter a Mandir. Taking the opportunity, the gang took his bag which contained a phone and laptop and fled away from the spot.
Realizing he had been deceived, the doctor attempted to contact the fraudsters multiple times to no avail. Subsequently, he reported the incident to the police, prompting them to register a case of fraud against the four fraudsters.
The police investigation is ongoing, with efforts underway to locate and apprehend the perpetrators.
Also read- Pune Doctor Duped By Fraudsters In Drug Parcel Scam, Loses Rs 1 Crore
Powered by WPeMatico
UK: A coronary sinus reducer (CSR) implant showed a symptom alleviation benefit for people with stable coronary artery disease and refractory angina, according to a small placebo-controlled ORBITA-COSMIC trial.
“The number of self-reported daily angina episodes shifted downward significantly among people randomized to the Neovasc Reducer intervention instead of a sham procedure (OR 1.40),” the researchers reported at the 2024 American College of Cardiology (ACC) conference. The findings were published in The Lancet.
However, despite the purported mechanism of benefit of the device, there was no improvement in myocardial blood flow in ischemic segments with the coronary sinus reducer over placebo (difference 0.06 ml/min/g).
The coronary sinus reducer is an hourglass-shaped stainless-steel mesh percutaneously implanted in the coronary sinus to reduce angina. It is the only antianginal therapy that acts on the cardiac venous circulation and is proposed to reduce angina in patients with stable coronary artery disease by improving myocardial perfusion.
Michael J Foley, Imperial College Healthcare NHS Trust, London, UK, and colleagues aimed to measure the efficacy of CSR implant, compared with placebo, on myocardial ischemia reduction and symptom improvement.
For this purpose, the researchers conducted the ORBITA-COSMIC trial at six UK hospitals. Patients aged 18 years or older with angina, ischemia, stable coronary artery disease, and no further options for treatment were eligible. Before entering a 2-week symptom assessment phase, in which patients reported their angina symptoms using a smartphone application (ORBITA-app), all patients completed a quantitative adenosine-stress perfusion cardiac magnetic resonance (CMR) scan, symptom and quality-of-life questionnaires, and a treadmill exercise test.
Patients were randomly assigned in a 1:1 ratio to receive either CSR or placebo. Following the CSR implantation or placebo procedure, patients entered a 6-month blinded follow-up phase in which they reported their daily symptoms in the ORBITA app. All assessments were repeated at six months.
The study’s primary outcome was myocardial blood flow in segments designated ischaemic at enrolment during the adenosine-stress perfusion CMR scan. The primary symptom outcome was the number of daily angina episodes.
Following were the study’s key findings:
· Between May 26, 2021, and June 28, 2023, 61 patients were enrolled between 2021 and 2023, of whom 51 (86%] male) were randomly assigned to either the CSR group (n=25) or the placebo group (n=26). Of these, the intention-to-treat analysis included 50 patients (24 in the CSR group, and 26 in the placebo group).
· 57% of 800 imaged cardiac segments were ischaemic at enrolment, with a median stress myocardial blood flow of 1·08 mL/min per g.
· Myocardial blood flow in ischaemic segments did not improve with CSR compared with placebo.
· The number of daily angina episodes was reduced with CSR compared with placebo (OR 1·40).
· There were two CSR embolization events in the CSR group, and no acute coronary syndrome events or deaths in either group.
ORBITA-COSMIC trial did not confirm the prespecified hypothesis that CSR’s mechanism of action consists of an increase of perfusion in ischaemic myocardial segments. However, the imaging data suggested a possible redistribution of perfusion towards the subendocardium in ischaemic segments.
The CSR, however, produced a clear reduction in angina frequency reported by patients, which developed gradually over weeks.
“These data provide evidence for CSR use as an antianginal therapeutic option for patients with refractory angina, myocardial ischemia, and stable coronary artery disease,” the researchers concluded.
Reference:
Foley MJ, et al “Coronary sinus reducer for the treatment of refractory angina: a randomised, placebo-controlled trial (ORBITA-COSMIC)” ACC 2024.
Powered by WPeMatico
Lucknow: The Department of Sports Medicine at state-run King George’s Medical University (KGMU) has introduced a minimally invasive surgical technique to address a rare and debilitating hip condition known as hip synovial chondromatosis. Affecting only one in a lakh individuals, this condition causes severe pain and mobility limitations.
This innovative approach, a first for the city, promises to spare patients the risks associated with traditional open surgery, according to experts.
Recently, the department successfully performed an arthroscopic procedure on a 20-year-old patient named Himanshu Singh, who had been struggling with the condition for three years. Despite seeking consultations with orthopaedic specialists previously, Singh’s condition had remained undiagnosed.
Also Read:KGMU to kickstart its kidney transplant programme, once again
Sports medicine faculty, Prof. Abhishek Saini said that the hip joint’s lining, the synovium, typically secretes fluid to lubricate the joint and facilitate smooth movement. However, in synovial chondromatosis, the synovium malfunctions, leading to the growth of abnormal cartilage, which can break loose and make pebble-like structures, reports IANS.
Patients afflicted with this condition often encounter abrupt joint locking, excruciating pain, and difficulties performing routine activities such as sitting cross-legged or walking.
Unfortunately, conventional X-rays may not always detect this condition, resulting in a misdiagnosis.
Furthermore, traditional open surgery for this ailment may jeopardise the hip’s blood supply, potentially necessitating joint replacement in the future.
According to an IANS report, Saini explained, “Arthroscopy allows surgeons to visualise and operate inside the joint through small incisions. It is an effective method for removing loose cartilage fragments and other aberrant tissues, thereby alleviating pain and enhancing joint mobility”.
The introduction of this minimally invasive technique underscores KGMU’s commitment to advancing medical care and providing innovative solutions for complex orthopaedic conditions, ultimately enhancing the quality of life.
Powered by WPeMatico
China: A 24-week, phase 3 trial has shed light on the safety and efficacy of bexagliflozin versus dapagliflozin as an adjunct to metformin in Chinese patients with type 2 diabetes mellitus (T2D). Bexagliflozin and dapagliflozin are sodium-glucose cotransporter-2 (SGLT2) inhibitors.
According to the study, bexagliflozin, when used in Chinese patients on metformin, showed nearly identical effects and a similar safety profile to dapagliflozin. The findings were published online in the Journal of Diabetes on April 7, 2024.
Metformin, due to its effective glucose-lowering effects, widespread availability, favorable cost-benefit ratio, and extensive clinical history, is typically the first-line therapy for T2D management. With the progression of diabetes, controlling the disease requires the addition of one or more drugs as adjunctive therapy.
SGLT2 inhibitors are a promising class of oral hypoglycemic agents for T2D patients with inadequate glycemic control. Large-scale cardiovascular outcomes studies have shown that SGLT2 inhibitors can reduce cardiovascular (CV) events, particularly hospitalization for heart failure in patients with type 2 diabetes and heart failure with reduced ejection fraction, with or without diabetes. Recently, SGLT2 inhibitors have also demonstrated beneficial effects in delaying the progression of kidney disease.
No direct comparison of SGLT2 inhibitors has been reported in a randomized controlled trial. Considering this, Bo Zhang, China-Japan Friendship Hospital, Beijing, China, and colleagues aimed to determine whether the efficacy of bexagliflozin would be noninferior to that of the maximum approved dapagliflozin (10 mg) dosage when used in combination with metformin hydrochloride.
For this purpose, the research team conducted a multicenter, randomized, double-blind, active-controlled trial comparing bexagliflozin to dapagliflozin for treating type 2 diabetes in adults with disease inadequately controlled by metformin. Four hundred and six participants were randomized to receive 20mg bexagliflozin, or 10 mg dapagliflozin plus metformin.
The study’s primary endpoint was the noninferiority of bexagliflozin to dapagliflozin for the change in HbA1c from baseline to week 24. Secondary endpoints were intergroup differences in 2-h-postprandial glucose (PPG), fasting plasma glucose (FPG), systolic blood pressure (SBP), and body weight from baseline to week 24. The trial also evaluated the safety profiles.
The following were the key findings of the study:
In the trial, both bexagliflozin and dapagliflozin produced significant and clinically significant reductions in HbA1c. For the primary endpoint of change in HbA1c (from baseline to week 24), the main objective to demonstrate that bexagliflozin was noninferior to dapagliflozin was achieved.
The researchers observed similar reductions in HbA1c with dapagliflozin and bexagliflozin, suggesting that both SGLT2 inhibitors are effective in glycemic control. Moreover, the consistent outcomes between the ITT and PP sets reinforce the results’ reliability, indicating that the findings are likely applicable in broader clinical practice.
Reference:
Xie, L., Han, J., Cheng, Z., Liu, D., Liu, J., Xu, C., Sun, W., Li, Q., Bian, F., Zhang, W., Chen, J., Zhu, Q., Thurber, T. K., Lock, J. P., & Zhang, B. (2024). Efficacy and safety of bexagliflozin compared with dapagliflozin as an adjunct to metformin in Chinese patients with type 2 diabetes mellitus: A 24-week, randomized, double-blind, active-controlled, phase 3 trial. Journal of Diabetes, 16(4), e13526. https://doi.org/10.1111/1753-0407.13526
Powered by WPeMatico
A recent phase 2 clinical trial found positive outcomes in patients with pemphigus a rare and potentially life-threatening autoimmune disease. The study focused on the use of rilzabrutinib which is an oral, reversible, covalent Bruton tyrosine kinase (BTK) inhibitor to manage pemphigus. The results of this clinical trial were published in the recent issue of Journal of Investigative Dermatology.
Pemphigus is a serious condition to treat and often require long-term therapy to control the symptoms and minimize the exposure to corticosteroids that can have significant side effects. However, this phase 2 trial demonstrated that rilzabrutinib could offer both rapid and sustained effectiveness with well-tolerated safety profiles in patients.
During the study period, adults who were of 18 to 80 years with moderate-to-severe pemphigus vulgaris/foliaceus (PV/PF) were randomized into two groups. One group received rilzabrutinib and the other group received a placebo. The participants in the rilzabrutinib group were administered 400 mg of the drug twice daily along with the corticosteroids at a dose of 0.5 mg/kg/d, over a period of 37 weeks.
The primary endpoint was to achieve a complete remission (CR), from week 29 to 37 with a reduced corticosteroid dose was not statistically significant. The secondary endpoints hinted at the potential benefits of rilzabrutinib therapy which included reduced corticosteroid usage, prolonged CR duration and a faster time to first CR.
The results of this study emphasized the well-tolerated nature of rilzabrutinib and the need to consider alternative analyses. A prespecified sensitivity analysis evaluated a minimal corticosteroid dose of ≤5 mg/d and included all observations and patients that provided encouraging results which supports BTK inhibition as a potential therapeutic strategy for pemphigus. While the primary endpoint did not reach the statistical significance using the traditional criteria but the sensitivity analysis highlighted the potential of rilzabrutinib in pemphigus management with reduced corticosteroid exposure.
The results of the phase 2 trial represent a significant step forward in pemphigus research and offer hope to patients grappling with this challenging autoimmune condition. Further research including the larger-scale trials and long-term follow-up are imperative that will help enhance crucial understanding of the efficacy and safety of rilzabrutinib in pemphigus management.
Reference:
Murrell, D. F., Caux, F., Patsatsi, A., Hagino, O., Rudnicka, L., Vassileva, S., Uzun, S., Ye, J., Yen, K., Arora, P., Gourlay, S. G., Joly, P., & Werth, V. P. (2024). Efficacy and Safety of Rilzabrutinib in Pemphigus: PEGASUS Phase 3 Randomized Study. In Journal of Investigative Dermatology. Elsevier BV. https://doi.org/10.1016/j.jid.2024.02.023
Powered by WPeMatico
Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract, affecting millions worldwide. Bowel resection is a common surgical intervention in IBD patients, with significant implications for quality of life. While vitamin D has been studied for its anti-inflammatory and immune-modulating properties, its association with bowel resection risk in IBD remains unclear. A recent study was published in the International Journal Of Surgery by Dan Lintao and colleagues.
This longitudinal cohort study analyzed data from 5474 individuals with IBD in the UK Biobank. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured, and bowel resection events were recorded via national inpatient data. Cox proportional hazard regression and restricted cubic spline analysis were used to assess the association between serum 25(OH)D levels and bowel resection risk.
The key findings of the study were:
Over a mean follow-up of 13.1 years, 513 incident bowel resection cases were documented.
Participants with non-deficient vitamin D levels had a significantly reduced risk of bowel resection in IBD (HR 0.72, 95% CI 0.59-0.87, P=0.001), Crohn’s disease (CD, HR 0.74, 95% CI 0.56-0.98, P=0.038), and ulcerative colitis (UC, HR 0.73, 95% CI 0.57-0.95, P=0.020) compared to those with vitamin D deficiency.
Comparison of extreme quintiles of 25(OH)D level revealed a 34% reduced risk of bowel resection in IBD (95% CI 11%-51%, P=0.007) and a 46% reduced risk in UC (95% CI 19%-64%, P=0.003), with no significant association in CD.
Linear dose-response associations were observed, indicating a consistent reduction in bowel resection risk with increasing serum 25(OH)D levels (all P-nonlinearity>0.05).
This study highlights the importance of adequate vitamin D levels in reducing bowel resection risk in IBD patients. While the association was significant in UC, further research is needed to elucidate the relationship in CD. Vitamin D deficiency emerges as a risk factor for bowel resection, suggesting its potential as a predictive metric for surgical events in IBD.
The study concluded that elevated serum levels of 25(OH)D are independently associated with a reduced risk of bowel resection in IBD, particularly in UC. Addressing vitamin D deficiency may offer a preventive strategy against surgical interventions in IBD patients.
Reference:
Powered by WPeMatico
Researchers at Tel Aviv University (TAU) and the Leviev Cardiothoracic and Vascular Center at the Sheba Medical Center have found a mechanism which is responsible for increasing the risk of developing cancer among patients with heart disease: those small extracellular bubbles, or vesicles (sEVs), that are secreted from the sick heart to heal itself are released into the bloodstream-and promote the growth of cancer cells throughout the body. The researchers estimate that the important discovery may improve the protocols for treating heart disease so that clinicians also consider the increased risk of cancer. The study was funded by the Israel Cancer Association and the Israel Science Foundation.
The research was conducted under the leadership of Prof. Jonathan Leor from the Neufeld Cardiac Research Institute, Faculty of Medical & Health Sciences at Tel Aviv University and the Taman Institute at Sheba’s Leviev Center and his student Tal Caller, a medical and research student at Tel Aviv University’s School of Medicine. The research was published in the important medical journal Circulation.
Caller explains: “In 2013, the Israeli cardiologist Tal Hasin showed for the first time that there is a connection between heart failure and cancer. Patients with heart disease are at a higher risk of developing cancer, and since heart disease is already a leading cause of death–first place in the US and second place in Israel – that means that many people are at risk. Our research revealed that the diseased heart secrete a cancer-promoting factors, which we identified as small extracellular vesicles (sEVs). These are tiny particles wrapped in a simple membrane, which all cells secrete, but because of heart damage, these vesicles are released in greater quantities and contain factors related to inflammation, healing, growth, creation of new blood vessels, and changes in the immune system. These vesicles move through the circulatory system and eventually reach the tumor or the pre-cancerous tissue.”
Caller adds, “Following an injury in the heart muscle and deterioration to heart failure, sEVs containing growth factors and small nucleic acid molecules that promote cell division are released. These sEVs contribute to the healing of the injured cardiac tissue. However, released from the injured heart, those vesicles move within the body’s circulatory system, eventually targeting cancerous growths.”
Prof. Jonathan Leor: “Many theories have been proposed to explain the increased risk of cancer in heart patients. They started with shared risk factors such as smoking, diabetes, and obesity and ended with a single protein or molecule. We showed for the first time that the diseased heart secretes sEVs that contain thousands of different growth factors. These bubbles directly promote the growth of certain tumors and also modulate the immune system, making the body more vulnerable to tumor growth.”
To test their hypothesis, the researchers at TAU inhibited the formation of sEVs in animal models with heart disease and found that the risk of cancer decreases along with the inhibition of vesicle production. However, this is not a viable therapeutic option since inhibiting the production of the vesicles causes severe undesired side effects.
Prof. Leor: “When you systemically inhibit the formation of sEVs, you get less cancer – but you cause collateral damage along the way. That is why we tried a different strategy: treat the patient’s heart to reduce the damage to the cardiac tissue so that it secretes fewer sEVs. We used spironolactone, which is a well-known, old, and effective drug used to treat heart failure. We treated the animals with spironolactone at a very early stage of the disease and found that the heart secreted 30% fewer sEVs– and the cancerous tumors grew more slowly. Our experiment shows that it is possible to intervene in heart disease in a way that reduces the risk of cancer among heart patients.”
As for the clinical implications of the study, Caller is careful in his words: “It may be necessary to adjust the existing treatments for the heart so that they also consider the risk of cancer. In addition, it is possible to find biomarkers among heart patients that will indicate an increased risk of cancer since not all patients are at an increased risk. This is basic research, and much work is still required to unravel the connection between the two.”
Moshe Bar-Haim, CEO of the Israel Cancer Association, adds: “Thanks to public donations and designated funds, the research committee of the Israel Cancer Association examines and selects dozens of studies every year and funds researchers and doctors from research and treatment centers across Israel. From these studies, new methods were developed for the diagnosis, treatment, and rehabilitation of cancer patients. Research has no territorial boundaries, so every achievement in research here in Israel is an achievement for the entire world. We hope that the new research – that reveals that because of heart diseases, extracellular bubbles are secreted and increase the risk of cancer – will allow for immediate application in Israel and around the world for the benefit of accurate treatment for patients.”
Reference:
Tal Caller, Itai Rotem, Olga Shaihov-Teper, Daria Lendengolts, Yeshai Schary, Ruty Shai, Efrat Glick-Saar, Dan Dominissini, Menachem Motiei, Idan Katzir, Rachela Popovtzer, Small Extracellular Vesicles From Infarcted and Failing Heart Accelerate Tumor Growth,Circulation, https://doi.org/10.1161/CIRCULATIONAHA.123.066911
Powered by WPeMatico
South Korea: Findings from two Korean cohort studies revealed that simply lowering cholesterol intake may not be sufficient to prevent chronic kidney disease (CKD). The study was published online in Nutrition, Metabolism and Cardiovascular Diseases.
The researchers showed that although cholesterol intake was associated with increased serum cholesterol levels, it was not associated with CKD incidence and prevalence. The daily intake of eggs was not associated with incident CKD.
Although dyslipidemia is a major risk factor for chronic kidney disease, there is no knowledge of the relationship between dietary cholesterol and chronic kidney disease. Haekyung Lee, Soonchunhyang University Seoul Hospital, Daesagwan-ro, Yongsan-gu, Seoul, Republic of Korea, and colleagues investigated the association between cholesterol intake and CKD risk.
The researchers used the Korea National Health and Nutrition Examination Survey (KNHANES) 2019–2021 (n = 13,769) and the Korean Genome and Epidemiology Study (KoGES) (n = 9225) data for the study. Cholesterol intake was evaluated using a 24-hour recall food frequency questionnaire. Participants were categorized into three groups based on cholesterol intake: T1, T2, and T3. The primary outcomes were the prevalence and incidence of CKD.
The researchers reported the following findings:
In conclusion, although cholesterol intake was associated with increased serum cholesterol levels, it was not associated with CKD prevalence and incidence.
“Our findings suggest that reducing cholesterol intake alone may not be sufficient to prevent chronic kidney disease,” the researchers wrote.
Reference:
Lee H, Park J, Kwon SH, Jeon JS, Noh H, Kim H. Dietary cholesterol intake is not associated with the development of chronic kidney disease: Results from two Korean cohort studies. Nutr Metab Cardiovasc Dis. 2024 May;34(5):1198-1206. doi: 10.1016/j.numecd.2023.12.011. Epub 2023 Dec 16. PMID: 38218709.
Powered by WPeMatico
A recent study that could revolutionize the treatment approach for severe gastroesophageal reflux disease (GERD) unveiled compelling evidence that support the efficacy of Potassium-competitive acid blockers (P-CAB) over the traditional Proton Pump Inhibitors (PPI) in treating grade C/D esophagitis. This severe manifestation of GERD requires active treatment and diligent follow-up due to its significant impact on the quality of life of patients and the potential for progression to more serious conditions. The crucial findings of this study were published in the recent issue of American Journal of Gastroenterology.
The comprehensive study involved a systematic review of randomized controlled trials to compare the healing capabilities and safety profiles of P-CAB and PPI in patients with this advanced stage of esophagitis. After rigorous analysis of data from 5,876 articles, 24 studies were deemed eligible which highlight the effectiveness of three P-CABs (vonoprazan, tegoprazan and keverprazan) against six PPIs (lansoprazole, esomeprazole, omeprazole, rabeprazole extended-release (ER), pantoprazole and dexlansoprazole).
These findings from this exhaustive analysis underlined the superior performance of vonoprazan in achieving both initial and sustained mucosal healing in grade C/D esophagitis patients. With a surface under the cumulative probability ranking score of 0.89 for initial healing and 0.87 for maintained healing, vonoprazan 20 mg once daily (q.d.) was immediately effective than its PPI counterparts which makes it as a potential first-line therapy for this patient demographic.
The study looked into the safety and tolerability of these treatments with a critical consideration for the chronic nature of GERD management. Vonoprazan demonstrated a comparable risk profile to PPIs in terms of adverse events, severe adverse events and drug withdrawal rates making it suitability for long-term use. 10 mg of vonoprazan once daily emerged as a viable and effective option by balancing efficacy with safety for the patients who consider low maintenance doses.
This research highlights the promising role of vonoprazan in the therapeutic landscape of severe esophagitis and emphasizes the need for clinicians to reevaluate the current treatment strategies. Further research and practical implications are required that could ultimately enhance the clinical decision-making which helps in ensuring that patients canreceive the most advanced care possible for their condition.
Reference:
Zhuang, Q., Chen, S., Zhou, X., Jia, X., Zhang, M., Tan, N., Chen, F., Zhang, Z., Hu, J., & Xiao, Y. (2024). Comparative Efficacy of P-CAB vs Proton Pump Inhibitors for Grade C/D Esophagitis: A Systematic Review and Network Meta-analysis. In American Journal of Gastroenterology. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.14309/ajg.0000000000002714
Powered by WPeMatico