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New Delhi: The fire department rushed to the All India Institute of Medical Sciences (AIIMS), New Delhi after receiving a call reporting a fire in the surgery block of the institute but initial reports have turned out to be false.
Responding swiftly to the call, DFS dispatched seven fire tenders to the location mentioned. However, upon arrival, firefighters found no evidence of a fire. An official from DFS revealed that the reported smoke was emanating from an LED light, which the caller mistook for flames.
According to a PTI report, The call was made by a nearby resident at fire control room number 101 at 9.28 pm. The caller said that a fire broke out on top floor of the surgery block in AIIMS, officials said.
“Soon after the call, we sent seven fire tenders to the spot but they found no fire had occurred. There were some fumes from the LED light, which the caller believed that it is a fire,” said an official of DFS.
Also Read:Fire breaks out at teaching block of Delhi AIIMS, Office records gutted
The local police also reached the spot and later declared the call as bogus, he said.
The officer said that the caller has accepted that he mistakenly made the call.
As investigations continue, authorities urge the public to remain vigilant and refrain from making false reports to emergency services, ensuring that resources are available to respond effectively to genuine emergencies.
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Ernakulam: Granting interim relief to the doctor accused of abetting his former fiance’s suicide, the Kerala High Court has allowed him to rejoin his post-graduate studies.
This order was passed by a single-judge bench consisting of Justice Ziyad Rahman AA after considering the ‘irreversible damage’ caused by preventing the accused doctor from attending classes, Live Law has reported.
Medical Dialogues had earlier reported about the death of the 26-year-old young doctor, who was pursuing her postgraduate medical studies at the surgery department of the Thiruvananthapuram Medical College. The PG medico committed suicide by injecting a heavy dose of anaesthesia into her body.
The relatives of the deceased doctor claimed that the medico possibly committed suicide because her marriage was on hold. It was alleged that the former fiance of the PG medico had demanded a huge dowry for the marriage.
The relatives alleged that the groom’s family demanded Rs 50 lakhs, 50 sovereigns of gold and a car as dowry. Despite having financial difficulties since their father passed away a few months ago, the doctor’s family accepted the request. However, as per the statements of the relatives, the matter became twisted when the groom’s family started demanding more money and an expensive car and later backed out from the marriage after the doctor’s family cited their inability to provide the dowry.
Based on their statements, the accused, also a postgraduate doctor in the College, was taken into custody from Karunagappally. He was booked under Section 306 of the Indian Penal Code for Abetment of Suicide and Section 4 of the Dowry Prohibition Act 1961. Earlier the State Health Department had suspended the accused doctor.
Later, while considering his plea, a Single Judge bench of the Kerala High Court granted him interim relief by allowing him to re-join his postgraduate medical course in MS Orthopaedics at the Government Medical College, Thiruvananthapuram.
The Court observed that even though the charges against him were serious, those charges had not been proven yet. “Taking into account the fact that the petitioner is only an accused in a crime, of course, the charges are serious, and that he had obtained admission on merit for the Post Graduate course, keeping him away from studies pending the enquiry or trial would place him in such a situation where the damage would become irreversible in case, the charges are not proved,” the Court mentioned in the order.
However, the Interim order dated 13.03.2024 was challenged by the principal of the medical college and the Government authorities, who filed an appeal under Section 5 of the Kerala High Court Act, 1958.
The counsel for the State, appearing for the appellants, submitted that if sufficient time had been granted to the State authorities to file a counter affidavit with relevant documents and permitted to argue the matter, the grievance raised in this appeal might not have arisen.
Further, it was also brought to the notice of the Court that an Enquiry Committee had been constituted and the Committee had completed its inquiry.
Taking note of this, a Division bench of the HC had set aside the interim relief and directed the authorities to complete the disciplinary proceedings initiated against the doctor within a week.
It mentioned in its order dated March 20, 2024, “The disciplinary proceedings initiated against the original petitioner shall be completed within a period of one week. On completion of the proceedings, the appellants may file an additional counter affidavit before the learned Single Judge, within a period of four days of the decision. The learned Single Judge is requested to decide the writ petition at the earliest.”
Now, as per the latest media report by Live Law, a single-judge bench comprising Justice Ziyad Rahman AA has allowed the accused doctor to re-join his postgraduate medical education and observed, “The damages, if any caused, if the petitioner is prevented from attending the classes would be irreversible once it is found that the proceedings initiated against the petitioner, were not legally sustainable. Therefore, I am of the view that the balance of convenience is also in favour of the petitioner. In such circumstances, I am inclined to grant an interim order to the petitioner, permitting to join classes and at the same time, to ensure that, the punishment imposed against him is implemented in case the same is upheld by the court.”
The HC bench has listed the matter for further hearing on 21st May, 2024.
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Mumbai: Global pharma major Lupin Limited has announced the
launch of first generic version of Oracea (Doxycycline Capsules, 40 mg), in the United States, after
having received an approval from the United States Food and Drug Administration (U.S. FDA).
Read also: Lupin gets USFDA nod for generic equivalent of Oracea Capsules
Doxycycline Capsules, 40 mg is indicated for the treatment of only inflammatory lesions (papules and
pustules) of rosacea in adult patients.
Rosacea is a chronic skin condition characterized by facial redness, visible blood vessels, and sometimes small, red, pus-filled bumps. It typically affects the central part of the face and can also involve eye irritation. While the exact cause is unknown, factors like genetics, blood vessel abnormalities, and certain bacteria may contribute.
Doxycycline Capsules had estimated annual sales of USD 128 million in the U.S. (IQVIA MAT February
2024).
Read also: Lupin bags USFDA nod for Eslicarbazepine Acetate Tablets for partial-onset seizures
Lupin is an innovation-led transnational pharmaceutical company headquartered in Mumbai, India. The
Company develops and commercializes a wide range of branded and generic formulations, biotechnology
products, and APIs in over 100 markets in the U.S., India, South Africa, and across the Asia Pacific (APAC), Latin
America (LATAM), Europe, and Middle East regions.
The Company specializes in the cardiovascular, anti-diabetic, and respiratory segments and has
a significant presence in the anti-infective, gastro-intestinal (GI), central nervous system (CNS), and women’s
health areas. The company
invested 7.9% of its revenue in research and development in FY23.
Lupin has 15 manufacturing sites, 7 research centers.
Read also: Lupin names Dr Ranjana Pathak as Chief Quality Officer
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South Korea: Adjunctive pioglitazone therapy in type 2 diabetes mellitus (T2DM) inadequately controlled with dapagliflozin and metformin yielded considerable metabolic benefits, glycemic improvement, and a low hypoglycemia risk, a phase 3 trial showed. The findings were published online in Diabetes, Obesity and Metabolism on February 29, 2024.
The researchers, however, suggest weighing its advantages against the potential for weight gain and increased waist circumference.
“In the randomized, placebo-controlled study, pioglitazone add-on therapy was tied to a significantly reduced fasting plasma glucose (FPG), HbA1c, and postload glucose at 120 min versus placebo in patients with uncontrolled T2DM on metformin and dapagliflozin therapy,” the researchers reported. “This led to greater achievement of the glycaemic target goal of HbA1c < 7.0%: 39.5% vs. 20.5%.”
Additionally, the researchers noted a significant decrease in insulin levels and HOMA-IR and an increase in adiponectin levels in the pioglitazone group, which were not found in the placebo group.
Type 2 diabetes is a complex disease with multiple pathophysiologies. Evidence indicates that only one-third to one-half of diabetes patients achieve their glycemic targets, underscoring the persisting difficulties in ensuring optimal glycemic control. A third agent is commonly needed if the glycemic target is not reached even with two-drug combination therapy.
It has yet to be determined which antidiabetic agent would be best for patients already treated with metformin and a sodium-glucose cotransporter-2 (SGLT2) inhibitor. Sungrae Kim, The Catholic University of Korea, Bucheon, South Korea, and colleagues investigate the safety and efficacy of pioglitazone compared to a placebo when added to metformin plus dapagliflozin, an SGLT2 inhibitor, for patients with type 2 diabetes.
For this purpose, the researchers conducted a multicentre study, with a randomized, double-blind, placebo-controlled design comprising 249 Korean patients with T2DM suboptimally managed on dapagliflozin and metformin. They were assigned to receive either pioglitazone (15 mg daily) or placebo for 24 weeks, followed by an extension of a 24-week pioglitazone.
The study’s primary outcomes were changes in glycated hemoglobin (HbA1c). Secondary outcomes assessed adiponectin levels, insulin resistance, lipid profiles, body weight, liver enzymes, and waist circumference.
The study revealed the following findings:
“Our study findings suggest that pioglitazone could be a safe and effective option for better glycaemic control in patients with type 2 diabetes treated with metformin and SGLT2 inhibitors,” the researchers concluded.
Reference:
Lim S, Lee SH, Min KW, Lee CB, Kim SY, Yoo HJ, Kim NH, Kim JH, Oh S, Won JC, Kwon HS, Kim MK, Park JH, Jeong IK, Kim S. A multicentre, double-blind, placebo-controlled, randomized, parallel comparison, phase 3 trial to evaluate the efficacy and safety of pioglitazone add-on therapy in type 2 diabetic patients treated with metformin and dapagliflozin. Diabetes Obes Metab. 2024 Feb 29. doi: 10.1111/dom.15526. Epub ahead of print. PMID: 38425186.
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China: A two-sample Mendelian randomization (MR) study provides genetic evidence supporting the anti-inflammatory effects of sodium-glucose cotransporter 2 (SGLT-2) inhibitors and their beneficial impact in reducing heart failure (HF) risk.
CXCL10 emerged as a potential mediator, offering a novel intervention pathway for the treatment of heart failure. The findings were published online in Cardiovascular Diabetology on April 2, 2024.
“Our findings suggest that SGLT-2 inhibitors may reduce HF risk by modulating inflammatory biomarkers, with CXCL10 potentially playing a mediating role—accounting for approximately 18% of the association between SGLT-2 inhibition and HF risk,” the researchers wrote.
SGLT-2 inhibitors represent a novel class of antihyperglycemic drugs that act by SGLT-2 inhibition in the renal tubules, thereby reducing the reabsorption of filtered glucose and enhancing glycosuria effects. Further research has clarified SGLT-2 inhibitors’ role beyond blood glucose reduction, especially highlighting their potential in HF management. However, the precise mechanisms involved remain to be fully delineated. Evidence points to their potential anti-inflammatory pathway in reducing the risk of HF.
To fill this knowledge gap, Hongbing Yan, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China, and colleagues employed a two-sample, two-step MR approach to assess the correlation between SGLT-2 inhibition and HF, along with the mediating effects of inflammatory biomarkers in this relationship.
MR is an analytical methodology that leverages single nucleotide polymorphisms as instrumental variables to infer potential causal inferences between exposures and outcomes within observational data frameworks. Using datasets from the Genotype-Tissue Expression project and the eQTLGen consortium, genetic variants correlated with the expression of the SLC5A2 gene and glycated hemoglobin levels (HbA1c) were selected.
Using datasets, the researchers obtained the Genome-wide association study (GWAS) data for 92 inflammatory biomarkers from two datasets comprising 14,824 and 575,531 individuals of European ancestry, respectively.
GWAS data for heart failure was derived from a meta-analysis that combined 26 cohorts, including 47,309 HF cases and 930,014 controls. Odds ratios (ORs) for HF were calculated per 1 unit change of HbA1c.
The study led to the following findings:
· Genetically predicted SGLT-2 inhibition was associated with a reduced risk of heart failure (OR 0.42).
· Of the 92 inflammatory biomarkers studied, two inflammatory biomarkers (C-X-C motif chemokine ligand 10 [CXCL10] and leukemia inhibitory factor) were associated with SGLT-2 inhibition and HF.
· Multivariable MR analysis revealed that CXCL10 was the primary inflammatory cytokine related to HF (MIP = 0.861, MACE = 0.224).
·CXCL10 by 17.85% of the total effect mediated the effect of SGLT-2 inhibition on HF.
In conclusion, the study provides genetic support for the relationship between SGLT-2 inhibition, inflammatory biomarkers, and heart failure. Specifically, CXCL10 appears to mediate the effect of SGLT-2 inhibitors on HF.
Reference:
Guo, W., Zhao, L., Huang, W. et al. Sodium-glucose cotransporter 2 inhibitors, inflammation, and heart failure: a two-sample Mendelian randomization study. Cardiovasc Diabetol 23, 118 (2024). https://doi.org/10.1186/s12933-024-02210-5
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Withdrawing aspirin one month after percutaneous coronary intervention (PCI) in high-risk heart patients and keeping them on ticagrelor alone safely improves outcomes and reduces major bleeding by more than half when compared to patients taking aspirin and ticagrelor combined (also known as dual antiplatelet therapy or DAPT), which is the current standard of care.
These are the results from the ULTIMATE-DAPT study announced during a late-breaking trial presentation at the American College of Cardiology Scientific Sessions on Sunday, April 7, and published in The Lancet.
This is the first and only trial to test high-risk patients with recent or threatened heart attack (acute coronary artery syndromes, or ACS) taking ticagrelor with a placebo starting one month after PCI, and compare them with ACS patients taking ticagrelor with aspirin over the same period. The significant findings could change the current guidelines for standard of care worldwide.
“Our study has demonstrated that withdrawing aspirin in patients with recent ACS one month after PCI is beneficial by reducing major and minor bleeding through one year by more than 50 percent. Moreover, there was no increase in adverse ischemic events, meaning continuing aspirin was causing harm without providing any benefit,” says Gregg W. Stone, MD, the study co-chair of ULTIMATE-DAPT, who presented the trial results.
“It is my belief that it’s time to change the guidelines and standard clinical practice such that we no longer treat most ACS patients with dual antiplatelet therapy beyond one month after a successful PCI procedure. Treating these high-risk patients with a single potent platelet inhibitor such as ticagrelor will improve prognosis,” adds Dr. Stone, who is Director of Academic Affairs for the Mount Sinai Health System and Professor of Medicine (Cardiology), and Population Health Science and Policy, at the Icahn School of Medicine at Mount Sinai.
The study analyzed 3,400 patients with ACS at 58 centers in four countries between August 2019 and October 2022. All of the patients had undergone PCI, a non-surgical procedure in which interventional cardiologists use a catheter to place stents in the blocked coronary arteries to restore blood flow. The patients were stable one month after PCI and were on ticagrelor and aspirin. Researchers randomized the patients after one month, withdrawing aspirin in 1,700 patients and putting them on ticagrelor and a placebo, while leaving the other 1,700 patients on ticagrelor and aspirin. All patients were evaluated between 1 and 12 months after the procedure.
During the study period, 35 patients in the ticagrelor-placebo group had a major or minor bleeding event, compared to 78 patients in the ticagrelor-aspirin group, meaning that the incidence of overall bleeding incidents was reduced by 55 percent by withdrawing aspirin. The study also analyzed major adverse cardiac and cerebrovascular events including death, heart attack, stroke, bypass graft surgery, or repeat PCI. These events occurred in 61 patients in the ticagrelor-placebo group compared to 63 patients in the ticagrelor-aspirin group, and were not statistically significant – further demonstrating that removing aspirin did no harm and improved outcomes.
“It was previously believed that discontinuing dual antiplatelet therapy within one year after PCI in patients with ACS would increase the risk of heart attack and other ischemic complications, but the present study shows that is not the case, with contemporary drug-eluting stents now used in all PCI procedures. Discontinuing aspirin in patients with a recent or threatened heart attack who are stable one month after PCI is safe and, by decreasing serious bleeding, improves outcomes,” Dr. Stone adds. “This study extends the results of prior work that showed similar results but without the quality of using a placebo, which eliminates bias from the study.”
Reference:
Zhen Ge, Jing Kan, Xiaofei Gao, Afsar Raza, Jun-Jie Zhang, Bilal S Mohydin, Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT): a randomised, placebo-controlled, double-blind clinical trial, The Lancet, https://doi.org/10.1016/S0140-6736(24)00473-2.
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Brazil: A recent study has revealed that adjuvant hyperbaric oxygen therapy (HBOT) may provide some benefits in treating pyoderma gangrenosum patients, particularly those with multiple comorbidities precluding them from receiving more traditional treatments.
The study findings were published online in the Journal of the European Academy of Dermatology and Venereology on March 20, 2024
“After HBOT sessions initiation, 58.4% of the patients achieved complete lesion healing, and 20.8% showed an “improved lesion status,” the researchers reported. However, 20.8% of the patients did not experience improvement with HBOT.
Pyoderma gangrenosum is a painful, rare, and difficult-to-treat neutrophilic dermatosis often linked with underlying medical conditions such as hematologic malignancies or inflammatory bowel disease. It is often a challenging condition for diagnosis and treatment. First, the diagnosis can be delayed. Pyoderma gangrenosum patients do not always present to dermatologists and can go through rounds of broad-spectrum systemic antibiotics, local wound care, and even surgical debridement before making a correct diagnosis. Second, even with the correct diagnosis, treatment is challenging.
Treatment of Pyoderma gangrenosum mainly has two main goals — first, cessation of the neutrophilic inflammation, and, second, healing the chronic wound.
Against the above background, Gisele Viana de Oliveira, Medical Sciences School of Minas Gerais, Belo Horizonte, Brazil, and colleagues conducted a literature review of case reports and series to evaluate the outcomes of using HBOT as an adjuvant treatment in pyoderma gangrenosum patients.
The study is a review of 32 case reports and two case series comprising 48 patients with pyoderma gangrenosum treated with HBOT. In the review, about 60% of the patients experienced complete healing of lesions.
The key findings of the study were as follows:
The researchers suggest it to be an excellent idea and fit within the already established indications for HBOT, as these are chronic wounds. Additionally, based on the small retrospective data set, indicates that the intervention is helpful in many cases.
The article’s authors were careful to note that most patients had received adjuvant therapy. “This is expected as the proposed mechanism of action of HBOT in chronic is angiogenesis and increased tissue oxygenation. These effects are likely more relevant to chronic wound healing versus the underlying neutrophilic inflammation seen in pyoderma gangrenosum,” Jonathan Jeter, a dermatologist in the US Army and is currently practicing at the McDonald Army Health Center in Fort Eustis, Virginia, suggested.
He added, “If HBOT is available to you, this would be an excellent treatment option to have in your back pocket for a patient with pyoderma gangrenosum who has stabilized with medical therapy but needs a little help with the healing process.”
Reference:
Xavier, F., Guimarães, N. S., Diniz, R. C., & Canabrava, P. P. Hyperbaric oxygen therapy as an adjuvant treatment in pyoderma gangrenosum: A scoping review. Journal of the European Academy of Dermatology and Venereology. https://doi.org/10.1111/jdv.19943
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