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New Delhi: Two senior cardiologists at Dr. Ram Manohar Lohia (RML) Hospital, along with seven other persons were arrested on Wednesday by the Central Bureau of Investigation (CBI) for allegedly demanding and accepting bribes from medical equipment suppliers to use their products and stents.
One of the arrested cardiologists has been identified as Professor Dr Ajay Raj, Professor of Cardiology, ABVIMS and RML hospital while the other is Assistant Professor, Dr Parvatagouda Channappagouda. They allegedly formed a nexus with the medical equipment supplier firms and promoted their products for monetary gains.
Busting the bribery racket, CBI also nabbed the medical equipment supplier Naresh Nagpal of Nagpal Technologies who paid Rs 2.48 lakh to Parvatagouda for promoting the sale of medical equipment, mainly, Bharat Singh Dalal of Bharti Medical Technologies who bribed Raj using UPI twice, and Abrar Ahmed who paid bribes to Cath Lab in charge in the hospital Rajnish Kumar, PTI has reported.
Officials informed that Rajnish Kumar as well as clerks Bhuval Jaiswal, Sanjay Kumar, and Vikas Kumar have also been arrested. The probe agency alleged that Bhuval Jaiswal took bribes for fixing appointments with doctors while Sanjay Kumar took bribes for fake medical certificates.
All arrested accused were produced before a special court which sent them to CBI custody till May 14. At least four private firms based in Delhi and Gurgaon are under CBI scanner, TOI has reported.
More than 13 locations in Delhi and other places were subsequently raised and searched by CBI, which seized around Rs 2.5 lakh cash, gold bars, and lockers of the accused. The Bureau has alleged that the scan was being carried out at multiple levels. Until now, the probe is still at an early stage and more arrests are likely to occur soon.
As per the latest media report by the Times of India, the CBI laid the trap for Dr. Parvathgouda and arrested him red-handed on Tuesday. During its technical surveillance, CBI found that on May 2, the doctor had demanded a bribe from the owner of Nagpal Technologies, one Naresh Nagpal for being allowed to use medical equipment supplied by him.
Commenting on the matter, an official told the Daily, “Dr Parvathgouda asked Nagpal to clear previous month’s dues of bribes because he was leaving for Europe. Nagpal assured him that the amount would be delivered on May 7 at the hospital.”
Based on this communication, the CBI registered an FIR under sections of the Prevention of Corruption Act besides those related to criminal conspiracy on Tuesday. The FIR by CBI stated, “There is a likelihood that Nagpal may deliver the bribe money of Rs 2.48 lakh to Dr Parvathgouda at RML anytime on May 7.”
Accordingly, CBI laid a trap at the RML Hospital, and its sleuths were stationed there in disguise. Already, the movements of Nagpal were being tracked. After he entered the doctor’s cabin, CBI conducted a raid during the alleged exchange of bribes. Another doctor, Professor Ajay Raj was detained on Wednesday based on the investigation. Similarly, based on the probe that followed, the CBI summoned other accused as well and arrested them. One of the accused, Abrar Ahmed fled to Jaipur. However, he was tracked down.
“Information has been received through reliable sources that several doctors and employees of Ram Manohar Lohia Hospital in Delhi have been indulging in corrupt practices and collecting bribes from patients either directly or indirectly through representatives of the companies supplying different equipment required for diagnosis and treatment of patients. Sources have informed that Dr Parvathgouda and Dr. Ajay Raj were blatantly demanding and accepting bribes in pursuance of the conspiracy with Naresh Nagpal in lieu of allowing the use of medical devices to be implanted in patients,” stated the FIR by CBI.
Dr. Parvathgouda completed his MD from RML in 2016 and later joined the hospital in 2021. On the other hand, Dr. Raj has been working at the hospital since 2011 after he completed his MD from another hospital in 2006, TOI has reported.
Meanwhile, the CBI is in the process of summoning the accused from different firms who were in touch with the doctors. Account transactions are being analyzed to ascertain the number of patients who were given stents in exchange for bribes.
Commenting on this, an officer informed the Daily, “We are also probing if the stents were substandard. The patients are being contacted after checking hospital records. Other doctors are being spoken to. We are also probing the price difference of the stents.”
Dr. Ajay Shukla, the director and medical superintendent of the hospital has referred to the arrest of the hospital employees as shocking. He said, “No complaint was filed by any of the patients. We will cooperate with the agency to ensure a fair probe.”
This is the second major operation against a nexus between doctors and medical suppliers in recent times. Medical Dialogues had earlier reported that CBI last year had arrested an associate professor with the Neurosurgery department at the prominent Safdarjung Hospital in New Delhi for allegedly being involved in illegal activities and accepting money in exchange for medical advice.
Back then, CBI had accused the associate professor Dr. Rawat of colluding with his accomplices to extract payment from patients for medical consultations and surgical procedures while flouting the hospital’s established protocols.
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Mangalore: A 17-year-old boy has been arrested by the police after he allegedly entered the premises of Mangaluru’s Kastruba Medical College disguised as a patient and placed a mobile phone inside the women’s restroom.
The incident came to light on Wednesday when the security personnel discovered the phone after it rang, police said.
According to a PTI report, The college authorities handed over the phone to the police following which the minor was apprehended based on the details available on the phone.
A case has been booked in the North Police Station of the city under the appropriate section of the Indian Penal Code.
The individual in question purportedly disguised himself as a patient to gain access to the college premises.
Subsequently, he was presented before the Juvenile Justice Board in accordance with established procedures.
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Mumbai: Pharma giant Cipla has informed through a recent BSE filing that the Company has received 1 inspectional observation in Form 483 from the United States Food and Drug Administration (USFDA) at the conclusion of the inspection at Kurkumbh manufacturing facility.
The inspection was held from 29th April, 2024 to 8th May, 2024.
“A routine current Good Manufacturing Practices (cGMP) inspection was conducted by
the United States Food and Drug Administration (USFDA) at manufacturing facility of the Company located
in Kurkumbh, Maharashtra, India from 29th April, 2024 to 8th May, 2024,” Cipla stated.
An FDA Form 483 is issued to firm management at the conclusion of an inspection when an investigator(s) has observed any conditions that in their judgment may constitute violations of the Food Drug and Cosmetic (FD&C) Act and related Acts.
“The
Company will work closely with the USFDA and is committed to address this observation comprehensively
within stipulated time,” Drug major added.
In April, the Medical Dialogues team reported that Cipla received six inspectional observations in Form 483 from the USFDA at the conclusion of a routine current Good Manufacturing Practices (cGMP) inspection at the company’s manufacturing facility located in Patalganga, Maharashtra, India.
Read also: Cipla gets 6 USFDA observations for Maha facility
Cipla Limited is an Indian multinational pharmaceutical and biotechnology company headquartered in Mumbai, India. Khwaja Abdul Hamied founded the Company in 1935 in Mumbai. Cipla has extended its presence to 80+ countries providing over 1,500 products across various therapeutic categories in 50+ dosage forms. The Company is also deepening its presence in the key markets of India, South Africa, and the U.S. among other economies of the emerging world.
Read also: Cipla Gets CDSCO Panel Nod To import, market Human Insulin inhalation powder with inhaler
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Researchers have found that ertugliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, significantly improves left ventricular global longitudinal strain and left atrial remodeling, and reduces functional mitral regurgitation (MR) in patients with heart failure (HF). The EFFORT trial assessed the efficacy of ertugliflozin for the reduction of functional MR associated with HF and mild to moderately reduced ejection fraction, offering a potential new treatment option for patients. This study was published in the journal Circulation by Kang and colleagues.
Functional mitral regurgitation (MR) is a common complication in patients with heart failure (HF), contributing to significant morbidity and mortality despite standard medical therapy. The EFFORT trial was a multicenter, double-blind, randomized study examining whether ertugliflozin could improve MR in patients with HF, New York Heart Association functional class II or III, and an ejection fraction between 35% and 50%.
A total of 128 patients were randomly assigned to receive either ertugliflozin or placebo, in addition to guideline-directed medical therapy for HF. The primary endpoint was a change in the effective regurgitant orifice area of functional MR from baseline to the 12-month follow-up. Secondary endpoints included changes in regurgitant volume, left ventricular (LV) volume indices, left atrial volume index, LV global longitudinal strain, and NT-proBNP (N-terminal pro-B-type natriuretic peptide).
The key findings of the study were as follows:
The treatment groups were well-matched in baseline characteristics, with mean age 66±11 years and 61% male participants.
The decrease in the effective regurgitant orifice area was significantly greater in the ertugliflozin group compared to the placebo group (−0.05±0.06 versus 0.03±0.12 cm2; P<0.001).
Ertugliflozin was associated with a reduction in regurgitant volume by 11.2 mL (95% CI, −16.1 to −6.3; P=0.009), a decrease in the left atrial volume index by 6.0 mL/m2 (95% CI, −12.16 to 0.15; P=0.005), and improved LV global longitudinal strain by 1.44% (95% CI, −2.42% to −0.46%; P=0.004).
There were no significant between-group differences in LV volume indices, ejection fraction, or NT-proBNP levels.
Serious adverse events occurred in 1.6% of ertugliflozin group participants versus 9.2% of the placebo group (P=0.12).
Ertugliflozin demonstrated significant improvement in left ventricular global longitudinal strain and left atrial remodeling, as well as a reduction in functional MR in patients with HF. Sodium-glucose cotransporter 2 inhibitors like ertugliflozin may offer a novel therapeutic approach for patients with functional MR.
Reference:
Duk-Hyun Kang, MD, PhD, Sung-Ji Park, MD, PhD, Sung-Hee Shin, MD, PhD, In-Chang Hwang, MD, Yeonyee Elizabeth Yoon, MD, PhD, Hyung-Kwan Kim, MD, PhD, Mijin Kim, MD, PhD, Min-Seok Kim, MD, PhD, Sung-Cheol Yun, PhD, Jong-Min Song, MD, PhD, Seok-Min Kang, MD, PhD Ertugliflozin for Functional Mitral Regurgitation Associated With Heart Failure: EFFORT TrialCirculation. 2024;149:00–00. DOI: 10.1161/CIRCULATIONAHA.124.069144
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A recent study unveiled the potential benefits of omega-3 polyunsaturated fatty acids (PUFAs) for individuals with diabetes. This study illuminates a previously underexplored aspect of dietary interventions for diabetic patients and their long-term prognosis. The key highlights of this study were published in the recent edition of The Journal of Clinical Endocrinology and Metabolism.
This research was conducted by the team led by Jinhang Che and extensively analyzed data from the National Health and Nutrition Examination Survey (NHANES) which spanned from 2003 to 2018. The cohort included a big group of 16,539 individuals who either were prediabetic or diabetic. These participants were categorized into three groups based on their levels of omega-3 PUFAs. Over a median follow-up period of 8.42 years, this study observed a remarkable correlation, where those with higher levels of omega-3 PUFAs underwent significantly reduced risks of both all-cause and cardiovascular mortality. The reduction in risk was particularly pronounced in the second and third tertiles when compared to the reference group.
The study employed sophisticated statistical analyses to analyze in depth regarding the relationship between omega-3 PUFAs and mortality. Restricted cubic spline (RCS) curves unveiled a negative nonlinear association by suggesting that the benefits of omega-3 PUFAs were dose-dependent. Subgroup analyses revealed intriguing insights with body mass index (BMI) emerging as a crucial factor that influences the interaction.
The outcomes of this study identified specific types of omega-3 PUFAs that appeared to drive these benefits associated with mortality. Alpha-linolenic acid (ALA) and docosapentaenoic acid (DPA) were found to be the primary contributors which underlined the importance of dietary choices in reaping the full rewards of omega-3 supplementation.
This comprehensive study emphasized the significance of these findings that effectively highlights the potential for targeted dietary interventions to reduce the elevated mortality risks underwent by the individuals with diabetes. The patients at risk may be able to safeguard their long-term health outcomes by incorporating omega-3-rich foods into their diets.
Overall, the major findings of this study offers hope for the millions worldwide with diabetes, with the future initiatives that could potentially optimize dietary habits which prove instrumental in stemming the tide of morbidity and mortality associated with this pervasive condition.
Reference:
Che, J., He, N., Kuang, X., Zheng, C., Zhou, R., Zhan, X., & Liu, Z. (2024). Dietary n-3 Fatty Acids Intake and All-Cause and Cardiovascular Mortality in Patients With Prediabetes and Diabetes. In The Journal of Clinical Endocrinology & Metabolism. The Endocrine Society. https://doi.org/10.1210/clinem/dgae265
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Bhubaneswar: In a remarkable feat of medical innovation and collaborative healthcare, a team of doctors at AIIMS Bhubaneswar has successfully treated a middle-aged man by removing a rare scalp tumour, marking a significant milestone.
According to an official release from AIIMS Bhubaneswar, “The 51-year-old man identified as Rabindra Bishui from West Bengal was saved through a collaborative endeavour led by a dedicated team of medical professionals.”
Also Read:1.1 kg newborn with duodenal atresia gets new lease of life at AIIMS Bhubaneswar
The patient, Rabindra Bishui underwent the complex procedure to address a longstanding scalp swelling that had plagued him for over two decades.
The growth, later diagnosed as a 7 kg Synovial Sarcoma tumor, posed a formidable challenge to conventional treatment methods.
The exceptionally rare tumour, synovial sarcoma, especially in the scalp, with only scant documented cases in the medical literature was removed following a surgery that was only the second of its kind in India.
According to an ANI report, AIIMS Bhubaneswar Executive Director Doctor Ashutosh Biswas congratulated the group of doctors for such a rare operation and reiterated the commitment of the national institute to provide modern and quality health care service to the people of Odisha as well as the neighbouring states.
As per the official release, the patient had gone to different medical colleges and hospitals for treatment but was denied, later he ultimately reached the Department of Plastic Surgery at AIIMS Bhubaneswar.
“A multidisciplinary team from AIIMS Bhubaneswar, comprising experts in Interventional Radiology, Surgical oncology, Neurosurgery, Plastic surgery, Anesthesiology, and Pathology meticulously crafted a treatment strategy under the guidance of Dr Sanjay Kumar Giri, Head of the department of Burns and Plastic Surgery,” added Dr Biswas.
Medical Superintendent Dr Dillip Kumar Parida also conveyed best wishes to the team of doctors for such work.
The procedure was intricate, necessitating the ligation of the left external carotid artery and posterolateral neck dissection, culminating in the successful removal of the tumor.
Despite the challenges posed by the surgery, including significant intraoperative blood loss requiring approximately 6 units of blood and other blood products, the dedicated anesthesia team led by Dr Aparajita Panda, along with the vigilant nursing team consisting of Surya, Ashoka, Sibanjali, Pramod, and Sangeeta, ensured the patient’s safety and well-being throughout the procedure, which lasted about 7 hours, reports news agency ANI.
Following the successful surgery, the patient received intensive care for 24 hours before being transitioned to the ward for further observation and recovery.
The intricate procedure involved precise embolization of blood vessels, targeting the bilateral superficial temporal arteries and the left occipital artery, by Dr Manoj Kumar Nayak from the Radiodiagnosis department, followed by surgical excision by Dr Rabi Narayan Sahu (Neurosurgery), Dr Kanav Gupta, Dr Anil Kumar, Dr Phanindra Kumar Swain(Surgical Oncology), Dr Dinesh, Dr Sanjay K Giri, Dr Santanu Subba, Dr R K Sahu, Dr Aparna Kanungo(Plastic Surgery), Dr Gopika Jith, Dr Akanksha Rajpoot, and Dr Ahana.
Dr Pritinanda Mishra’s timely pathological evaluation of the specimen played a crucial role in the treatment process.
The collaborative efforts of the surgical teams not only resulted in the successful treatment of a rare scalp tumor but also highlighted the significance of interdisciplinary cooperation in addressing complex medical cases.
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Schizophrenia patients are more prone to long hospitalisations due to non-psychiatric illnesses suggests a study published in the American Psychiatric Association (APA) 2024 Annual Meeting in New York, NY.
Patients with schizophrenia are more likely to be admitted for hospital stays—and experience lengthier durations of stay and therefore, costlier care—for conditions including sepsis, COPD exacerbation, and pneumonia. According to a data analysis presented at the American Psychiatric Association (APA) 2024 Annual Meeting in New York, NY, this week, investigators reported findings highlighting a significantly disparate hospitalization experience for patients with schizophrenia when presenting with non-psychiatric conditions for emergent care. The data may allude to potential pursuits in qualitative research that can better identify the drivers of elongated and exacerbated hospital stays experienced by patients with schizophrenia. The research team conducted a retrospective analysis to identify the most common reasons for hospital admissions among patients with schizophrenia. As they noted, such patients have a well-evidenced shorter life span than the general population—up to 20 years on average, according to research. But their shorter life spans are often due to illnesses beyond their psychiatric condition. Investigators compiled state-level inpatient hospitalization data for adults aged ≥18 years old between 2016 – 2019 from the National Inpatient Sample (NIS) database.
They identified the 10 most common primary diagnoses for hospital admission of patients with and without schizophrenia based on the data, before conducting a multivariate logistic regression to assess the impact of schizophrenia on the odds of being admitted with each of the top 10 primary diagnoses. They then analyzed proportions for each diagnosis, as well as odds ratios (ORs) for admission while excluding for schizophrenia-based admissions to fully interpret the drivers of non-psychiatric hospital admissions among patients with schizophrenia. Lastly, they compared the characteristics, lengths of stay, and in-hospital mortality of patients with each diagnosis across the schizophrenia and control cohorts. Their final analysis showed schizophrenia-related diagnoses accounted for only one-third (35%) of hospital admissions among such patients, compared to 65% of admissions being due to other causes. Among the primary diagnoses to be 1 of the 10 most prevalent in both hospitalized patients with and without schizophrenia included:
• Sepsis
• COPD exacerbation
• Acute renal failure
• Pneumonia
• Urinary tract infection (UTI)
• Hypertensive heart failure
The other most prevalent primary diagnoses in patients with schizophrenia included hyponatremia, aspiration pneumonia, and acute hypoxic respiratory failure. Patients without schizophrenia were more likely to be admitted to the hospital due to non-ST-elevation myocardial infarction or knee osteoarthritis than patients with schizophrenia. Investigators found that patients with schizophrenia were significantly more likely to be admitted for most of the observed medical illnesses, except for heart failure and acute renal failure. Though patients with schizophrenia were more likely to die from sepsis, acute hypoxic respiratory failure and aspiration pneumonia than the control cohort, they were also shown to have significantly longer lengths of hospital stay for all diagnoses, as well as greater costs of care for most diagnoses. The data elucidated a tendency for patients with schizophrenia to experience a more difficult hospitalisation—despite their non-psychiatric diagnoses trending similarly to hospitalized patients without schizophrenia.
Reference:
Venkataramanan A, et al. Most common causes of nonpsychiatric hospitalizations in patients with schizophrenia in the United States. Paper presented at: American Psychiatric Association (APA) 2024 Annual Meeting. New York, NY. May 4-8, 2024.
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Germany: In a groundbreaking study, researchers have delved into the intricate relationship between clindamycin concentrations and osteonecrosis of the jaw (ONJ). This prospective trial sheds light on a crucial aspect of medication efficacy in combating this debilitating condition.
The study, published in the Journal of Cranio-Maxillofacial Surgery, revealed clindamycin (CLI) as an appropriate antibiotic option for patients requiring treatment/prophylaxis for ONJ. It could also be used as an alternative to sulbactam/ampicillin in patients allergic to penicillin.
According to the authors, the study is the first to present data on CLI concentrations in both necrotic and vital jawbone tissue.
Osteonecrosis of the jaw is a rare but serious condition characterized by the death of bone tissue in the jaw, often associated with the use of certain medications, particularly those used in cancer treatment. Clindamycin, an antibiotic commonly prescribed to treat bacterial infections, has been implicated in some cases of ONJ. However, the precise relationship between clindamycin concentrations and the development or exacerbation of ONJ has remained unclear until now.
Against the above background, Anton Straub, University Hospital Würzburg, Würzburg, Germany, and colleagues aimed to investigate the jawbone concentration of clindamycin in patients with osteonecrosis of the jaw.
The study included patients with medication-related ONJ (MRONJ) and osteoradionecrosis (ORN) with an antibiotic treatment with CLI. Vital, plasma and necrotic bone samples were collected. Liquid chromatography-tandem mass spectrometry was used to analyze plasma and jawbone samples.
The study led to the following findings:
The findings showed that CLI concentrations are considerably lower than in plasma, but sufficient for most bacteria present in ONJ.
“Within the study limitations, it seems that CLI is a relevant alternative to other antibiotics in treating ONJ because it reaches adequate concentrations in the jawbone,” the researchers wrote.
“By using modern bioanalytical methods, some of the limitations identified in previous studies could be circumvented, and thus could provide a more solid statement on the bone penetration properties of CLI,” they concluded.
The study findings can revolutionize the management and treatment of ONJ. By elucidating the relationship between clindamycin concentrations and ONJ development or progression, clinicians can better tailor treatment regimens to individual patients, optimizing efficacy while minimizing the risk of adverse effects.
Reference:
Straub, A., Stapf, M., Brands, R. C., Kübler, A. C., Lâm, T., Vollmer, A., Gubik, S., Scherf-Clavel, O., & Hartmann, S. (2024). Investigation of clindamycin concentrations in human plasma and jawbone tissue in patients with osteonecrosis of the jaw: A prospective trial. Journal of Cranio-Maxillofacial Surgery, 52(3), 355-362. https://doi.org/10.1016/j.jcms.2024.01.014
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