Archive for month: August, 2024

New Delhi: Nationwide protests have erupted in response to the rape and murder of a postgraduate trainee at R G Kar Medical College Hospital in Kolkata, leading medical professionals across India to demand a Central Protection Act for healthcare workers.

The tragic incident has spurred demonstrations at various institutions, including prominent medical colleges across the country.

AIIMS Delhi doctor Kumar Kartikay said that they will not step back till they get an assurance that action will be taken in the matter.

As per an ANI report, “We want to peacefully put forward our demands. We demand a Central Protection Act for healthcare workers. Until we get a written assurance, we will continue our strike… We are expecting around 3000-5000 people at Nirman Bhawan today from all the medical colleges in Delhi… We will not step back or sit quietly till we get an assurance that action will be taken,” he said.

“On the eve of Independence Day, protesting doctors at RG Kar faced mob attacks and also police attacks. The hospital was vandalised and evidence was erased. In condemnation of this, we are protesting here… It’s not just a crime against doctors. It’s a crime against women and humanity… We request the CBI to conduct a transparent investigation… The victim’s family should receive adequate compensation… We also demand a Central Protection Act for all healthcare workers,” she said, news agency ANI reported.

Medical professionals at Chandigarh PGIMER have been continuing the protest on Friday. The doctors have stated that the protest will continue till justice is delivered.

Patients who have been coming to the Chandigarh PGIMER stated that they have been facing a lot of trouble because of the ongoing protest for five days and urged the government to fulfil the demands of the doctors.

“We are facing a lot of problems due to the absence of OPD. We have come from a long distance,” said Nitin, a patient, adds ANI.

“If the OPD is closed, then, we should have informed first. Now we have come. Our checkup was done on the old card but the card for meeting the new doctor is not being made, so we will have to come again,” said another patient Pushpa.

“We have been roaming around here since last night but no one is listening to us nor the doctors are attending to us. The government must listen to the doctors so that the strike gets over,” said Gurpreet, a patient.

Meanwhile, the Resident Doctors Association, Government Medical College in Amritsar, Punjab has announced the suspension of all non-essential and elective hospital services, including Out Patient Departments, Operating theatres and wards, beginning on August 16 and continuing until further notice.

New Delhi: 27-year-old Dr RG, presented to ENT OPD in an emergent condition with complaints of acute onset vision loss in right eye for 3 days.

He also has history of right-sided nasal obstruction off and on since the last 3 months.

He underwent a CT scan of his sinuses, and he was diagnosed to have nasal polyposis and fungal sinusitis which was compressing the nerve of vision inside the sphenoid sinus. This is a rare condition and if not acted upon soon can lead to complete blindness in the affected eye.

During the surgery, fungus was seen to be spreading in all sinuses and between the nerve and the brain layer in the sphenoid sinus. Complete removal of the disease was achieved, and the nerve was decompressed and freed from the surrounding swollen nasal lining.

Dr Varun Rai stated that these types of surgeries are extremely specialised due to the fact that the optic nerve is very delicate and a slightest misstep can lead to permanent blindness. He used special instruments around the nerve so as not to cause pressure over the affected part of nerve while still achieving complete clearance of fungal tissue around it. The nerve was then decompressed 270 degrees leaving the blood supply to the nerve intact.

In the immediate post operative period his vision improved and gradually returned to normal within 2 days. He was discharged in a stable condition in two days with vision which was completely restored.

Dr Varun Rai, ENT Consultant, SGRH said, “This case serves to highlight the rarity of the condition and the fact that untreated sinusitis can lead to consequences which can have devastating complications. “

He also mentioned that this case was unique in the sense that the anatomy of the sphenoid sinus was such that it allowed the fungus to creep in between the optic nerve and the brain dura layer leading to compression and eventually blindness. He also stated that prompt treatment is necessary in such cases and surgeons typically have only a few hours to save the eye in cases of complete blindness.

Dr Manish Munjal, ENT Senior Consultant, SGRH opined that these cases are rare nowadays due to increased awareness and good diagnostic facilities which are readily available. He also mentioned the increased incidence of such cases due to rising pollution levels which leads to nasal allergic responses.

The typical symptoms which patients present with are nasal stuffiness and discharge from the nose. The ENT doctor establishes a diagnosis based on an OPD based endoscopic examination and a CT scan.

Sir Ganga Ram Hospital has been at the forefront of innovation and technology and has recently acquired the Image Guided Navigation system where we routinely use real time surgical mapping based on preoperative CT scans to perform nasal surgery in a safe and effective manner. This ensures complete disease clearance in all patients with minimal chances of complications during surgery. SGRH was the first private Hospital in Delhi to start the Navigation Guided Sinus surgery program and has been leading the way in training and teaching programmes around the country.

The impact of dietary fat intake on long-term human health has attracted substantial research interest, and the health effects of diverse dietary fats depend on available food sources. Yet there is a paucity of data elucidating the links between dietary fats from specific food sources and health. A study was done to find associations of dietary plant and animal fat intake with overall mortality and cardiovascular disease (CVD) mortality. This large prospective cohort study took place in the US from 1995 to 2019. The analysis of men and women was conducted in the National Institutes of Health–AARP Diet and Health Study. Data were analyzed from February 2021 to May 2024. Results The analysis included 407 531 men and women (231 881 [56.9%] male; the mean [SD] age of the cohort was 61.2 [5.4] years). During 8 107 711 person-years of follow-up, 185 111 deaths were ascertained, including 58 526 CVD deaths. After multivariable adjustment (including adjustment for the relevant food sources), a greater intake of plant fat (HRs, 0.91 and 0.86; adjusted ARDs, −1.10% and −0.73%; P for trend < .001), particularly fat from grains (HRs, 0.92 and 0.86; adjusted ARDs, −0.98% and −0.71%; P for trend < .001) and vegetable oils (HRs, 0.88 and 0.85; adjusted ARDs, −1.40% and −0.71%; P for trend < .001), was associated with a lower risk for overall and CVD mortality, respectively, comparing the highest to the lowest quintile.

In contrast, a higher intake of total animal fat (HRs, 1.16 and 1.14; adjusted ARDs, 0.78% and 0.32%; P for trend < .001), dairy fat (HRs, 1.09 and 1.07; adjusted ARDs, 0.86% and 0.24%; P for trend < .001), or egg fat (HRs, 1.13 and 1.16; adjusted ARDs, 1.40% and 0.82%; P for trend < .001) was associated with an increased risk for mortality for overall and CVD mortality, respectively, comparing the highest to the lowest quintile. Replacement of 5% energy from animal fat with 5% energy from plant fat, particularly fat from grains or vegetable oils, was associated with a lower risk for mortality: 4% to 24% reduction in overall mortality, and 5% to 30% reduction in CVD mortality. The findings from this prospective cohort study demonstrated consistent but small inverse associations between a higher intake of plant fat, particularly fat from grains and vegetable oils, and a lower risk for both overall and CVD mortality. A diet with a high intake of animal-based fat, including fat from dairy foods and eggs, was also shown to be associated with an elevated risk for both overall and CVD mortality.

Reference:

Zhao B, Gan L, Graubard BI, et al. Plant and Animal Fat Intake and Overall and Cardiovascular Disease Mortality. JAMA Intern Med. Published online August 12, 2024. doi:10.1001/jamainternmed.2024.3799

“The real-world data affirm the effectiveness of dupilumab for safely treating pediatric patients with alopecia areata (AA), supporting the involvement of Th2 skewing in children with AA and associated atopy. This underscores the need for larger clinical trials to further explore these findings,” the researchers wrote in Archives of Dermatological Research.

Alopecia areata is a nonscarring form of hair loss marked by Th1 and concurrent Th2 skewing, especially in atopic individuals. While there have been advances in treating adult AA, safe and effective options for pediatric patients are still lacking. Dupilumab, known for its well-established safety profile, could offer promising therapeutic potential for pediatric patients with atopic alopecia areata.

Against the above background, Emma Guttman-Yassky, Department of Dermatology, and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA, and colleagues aimed to evaluate the ability of dupilumab to regrow hair in pediatric AA patients.

For this purpose, the researchers conducted a single-center, retrospective observational study to assess hair regrowth using the Severity of Alopecia Tool (SALT) in 20 children aged 5 to 16 years (mean age 10.8 years) with both atopic dermatitis (AD) and alopecia areata (AA). The baseline SALT scores ranged from 3 to 100, with a mean of 54.4.

The study collected data on patient demographics, atopic history, IgE levels, and SALT scores during follow-up visits at 12 weeks and up to more than 72 weeks to evaluate hair regrowth. Spearman correlations were used to analyze the relationship between clinical data and hair regrowth outcomes.

The study led to the following findings:

• Patients showed clinical improvement over the follow-up period (range 24 to > 72 weeks, mean 67.6 weeks) with a significant mean reduction in SALT at 48 weeks versus baseline [20.4 versus 54.4, respectively] and continued improvement up to > 72 weeks.
• Baseline SALT positively correlated with disease duration (r = 0.54), and negatively correlated with improvement in SALT at weeks 24, 36, and 48 (|r|≥ 0.65 for all comparisons).
• Baseline IgE positively correlated with improvement in SALT at week 36 (r > 0.60).

The study has several limitations, including its retrospective design, relatively small sample size, and absence of a comparator group. Despite these constraints, it represents the largest cohort of pediatric alopecia areata patients treated with dupilumab over an extended follow-up period.

“Future research, including larger randomized placebo-controlled trials, is needed to further assess the benefits of dupilumab for the long-term management of AA in children and adolescents with concurrent atopy and familial atopic conditions,” the researchers concluded.

Reference:

David, E., Shokrian, N., Del Duca, E. et al. Dupilumab induces hair regrowth in pediatric alopecia areata: a real-world, single-center observational study. Arch Dermatol Res 316, 487 (2024). https://doi.org/10.1007/s00403-024-03225-4