Health Bulletin 05/ August/ 2024

Here are the top health stories for the day:

Death due to medical negligence during blood transfusion: Private hospital, doctors slapped Rs 20 lakh compensation
The District Consumer Disputes Redressal Commission (DCDRC), Coimbatore recently directed a hospital and three doctors to pay Rs 20 lakh as compensation to a man, whose wife died due to medical negligence during a blood transfusion.
While considering the matter, the consumer court observed that proper informed consent was not obtained and required tests were not conducted before the transfusion and even though the patient complained of body pain, the transfusion was not immediately stopped. Following the transfusion, the patient developed TRALI (Transfusion-Related Acute Lung Injury) and consequently died.
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NEET MDS 2024: AFMS announces 1 Periodontology seat for Priority-III, IV, V candidates in upcoming MCC round
Through a notice, Armed Forces Medical Services (AFMS) has informed that 01 seat in a postgraduate subject i.e. Periodontology at AFMC, Pune is available for Priority-III, IV & V candidates in the next round of MCC counselling. As per the MCC counselling schedule, the next round is to be held from August 12, 2024.
Notice has been released for Priority-IV candidates and Dental Officers sponsored by Military Organisations and other Organisations of the Government of India for admission to Post Graduate Courses (Master of Dental Surgery-MDS) through the National Eligibility and Entrance Test (NEET MDS) Exam 2024 in AFMS Institutions for the academic year 2024.
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Green Corridor achieves 18 km in 13 minutes, enables Heart Transplant for 34-year-old at Gurugram Hospital
A green corridor was created amidst the gushing rains and traffic snarls to transport a heart from the Delhi airport to a Gurugram hospital, covering a distance of 18 km in just 13 minutes.
A heart was swiftly transported from Kolkata to Gurugram to offer a dying man a chance at life. With the support of around 100 police officers the heart was transported from Kolkata to Gurugram on Wednesday in four hours to save the life of a 34-year-old man from Rohtak, hospital authorities said.
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UP eliminates seat leaving penalty; candidates who discontinue medical courses to face next year’s counseling ban
Complying with the National Medical Commission’s earlier direction, the Uttar Pradesh Director General of Medical Education and Training has removed the practice of imposing a seat-leaving penalty on candidates discontinuing the courses midway. Instead of imposing penalties on undergraduate and postgraduate medical candidates for leaving the seats midway, the State has decided to debar such candidates from the admission process for the next academic session.
Issuing an order in this regard on Friday i.e. 02.08.2024, the UP DMET mentioned, “It has been decided by Government Order No.-I/676928/2024 dated 26 June 2024 that after admission to the seats of undergraduate/postgraduate course of all the government and private sector medical/dental colleges/institutions/medical universities established in the state, the system of taking Seat Leaving Bond amount or penalty from any candidate before completing the course will be abolished and in place of this, as per the suggestion given in paragraph-5 of the letter dated 19.01.2024 of NMC, if the concerned candidate leaves the seat before completing the course, then he will be debarred from the admission process of the next academic session.”
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National mission screens over 3 crore people for sickle cell anemia, MoS Health informs Parliament
Over 3 crore population in the 17 identified states in the country have been screened for sickle cell anaemia disease till June 30, 2024, the Union Minister of State for Health Shri Prataprao Jadhav informed the Lok Sabha last week.
The Minister informed that Sickle cell disease is a genetic blood disease that affects the whole life of the patient. It is more common in the tribal population of India but occurs in non-tribals too. It not only causes anaemia but also pain crisis, reduces growth and affects many organs like the lungs, heart, kidneys, eyes, bones and the brain.
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Castor oil is all the rage among health influencers—what you need to know about this alternative remedy

Castor oil, which was once used by fascists in Italy as punishment because of its quick-acting laxative effect, is now a weight-loss trend on TikTok. Not drinking it, but rubbing it on your belly.

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Legit Ozempic sales soar while counterfeits put patients in danger

Two new studies show how eager Americans are to obtain either safe, legitimate versions of Ozempic or counterfeit and potentially dangerous forms of the diabetes/weight-loss drug.

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Olympics 2024 shows the untapped potential of female athletes

With each Olympic Games athletes are expected to break new records. Sport science experts have been speculating for years whether we are reaching the limits of human ability. But they may be overlooking the fields where there’s untapped potential: women’s sports.

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WHO chief mulls calling emergency committee on mpox

The World Health Organization’s chief said Sunday he was considering convening an expert committee to advise on whether the growing mpox outbreak in Africa should be declared an international emergency.

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Drinking during a pregnancy: an expert offers guidance

It’s a question many women may ask themselves during pregnancy: Will an occasional glass of wine harm the baby?

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Navi Mumbai doctor couple accused of duping medical shop owner of Rs 1.27 Crore

Thane: A Navi Mumbai-based doctor couple has been booked for allegedly cheating a medical shop owner of Rs 1.27 crore after they offered him a pharmacy space at their establishment back in 2013.

Police said that based on a complaint, a case under relevant provisions of the Indian Penal Code was registered at the NRI police station on Saturday against Dr Dhaval Khanayalal Derashri and his wife, Dr Lata Derashri, and one Khanayalal Derashri.

According to a PTI report, the complainant has alleged that the accused, who owned a hospital in the Seawoods area of Navi Mumbai, offered him a pharmacy at their establishment in 2013 and took Rs 49 lakh from him, he said.  

Also Read:Telangana doctor duped of Rs 33 lakh in magical money doubling scheme

The couple also purchased medicines worth Rs 48 lakh and never paid him, and they allegedly borrowed Rs 30 lakh and failed to return the sum, the official said.  

The matter is being investigated and no arrests have been made so far, he added.  

Also Read:Lucknow doctor duped of Rs 2 crore by cyber fraudsters

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NGO opposes privatization of 10 District Hospitals in Madhya Pradesh

Bhopal: In a recent development,
Jan Swasthya Abhiyan (JSA) has criticized the Madhya Pradesh government’s decision to privatize 10 district hospitals. In a letter addressed to Chief Minister
Mohan Yadav, the NGO has urged the government to withdraw the notification and deny the private entities power to manage these hospitals.

The organization has
called for a boycott of private intervention in the health sector. The government’s
move aligns with the Niti Aayog’s proposal and affects districts such as
Katni, Morena, Panna, Balaghat, Bhind, Dhar, Khargone, Sidhi, Tikamgarh, and
Betul. JSA’s letter highlights the importance of strengthening the public
health system rather than transferring control to private entities, reports the Times of India. The NGO’s opposition is rooted in the history of unsuccessful
attempts by the state government to privatize government-run hospitals. 

Also Read:MP CM Mohan Yadav inspects Hamidia Hospital, announces facilities worth Rs 199 crore

In a joint statement by NGO
representatives, Amulya Nidhi, SR Azad, Dhirendra Arya, and Sudha Tiwari said, “Today,
the need is to strengthen the public health system and ensure health services
for all without discrimination and not to hand over public health institutions
to private hands.”

In 2016, the state’s
decision to subcontract health services at the Alirajpur District Hospital and the
Community Health Centre in Jobat encountered significant challenges. Similarly,
an initiative involving Indore’s MY Hospital in 2012 faced resistance from both
doctors and the public, leading to its eventual abandonment, reports the Daily.

“That too was
unsuccessful and due to opposition from doctors and the public, the govt had to
withdraw this decision,” said Nidhi. JSA member Amulya Nidhi
has also pointed to the Karnataka government’s Arogya Bandhu scheme, which
involved private participation but was ultimately deemed unsuccessful by the
government’s own evaluation. The NGO’s stance underscores the need for a robust
public health system and cautions against relying on privatization as a
solution to healthcare challenges.

Also Read:Death Due to Medical Negligence during Blood Transfusion: Private Hospital, Doctors slapped Rs 20 Lakh Compensation

Jan Swasthya Sahayata
Abhiyan has been formed by the Healthcare Research and Development Board
(Division of Social Welfare Organization “NAC”) to provide affordable, free and better treatment with health-related assistance to poor and needy people.
The purpose of the organization is to provide better treatment by special
doctors, medicines and medical tests to the poor and needy people of the
country through Jan Swasthya Sahayata Abhiyan, also motivating people to follow
the guidelines given by the government to stay safe from COVID-19 by organizing
awareness programs and providing health-related support as well as providing
yoga and exercise training.

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PASSION Trial’s Premature End Highlights Tadalafil’s Ineffectiveness and Possible Risks for HFpEF Patients

Germany: The PASSION trial, which was halted early due to issues with the study medication supply, does not endorse tadalafil use for patients with heart failure with preserved ejection fraction (HFpEF) and combined postcapillary and precapillary pulmonary hypertension. The trial raised potential safety concerns and found no benefits in achieving the primary or secondary endpoints.

While the results did not reveal a significant difference in the risk of the primary endpoint between the tadalafil and placebo groups, there was a potential indication of a higher risk of all-cause mortality in the tadalafil group, the researchers wrote in Circulation.

Marius M. Hoeper, Hannover Medical School, Germany, and colleagues aimed to assess the safety and efficacy of tadalafil, a phosphodiesterase type 5 inhibitor, in patients with heart failure with preserved ejection fraction and combined postcapillary and precapillary pulmonary hypertension.

In the double-blind PASSION study (Phosphodiesterase-5 Inhibition in Patients With Heart Failure With Preserved Ejection Fraction and Combined Post- and Pre-Capillary Pulmonary Hypertension), patients with HFpEF and combined postcapillary and precapillary pulmonary hypertension were randomly assigned in a 1:1 ratio to receive either tadalafil at a target dose of 40 mg or a placebo.

The primary endpoint was the time to the first composite event, which included adjudicated heart failure hospitalization or all-cause mortality. Secondary endpoints assessed included all-cause mortality and improvements in the New York Heart Association functional class or a ≥10% improvement in the 6-minute walking distance from baseline.

The study revealed the following findings:

  • Initially targeting 372 patients, the study was terminated early because of a disruption in the study’s medication supply. At that point, 125 patients had been randomized (placebo: 63; tadalafil: 62).
  • Combined primary endpoint events occurred in 32% of patients assigned to placebo and 27% of patients assigned to tadalafil (hazard ratio, 1.02).
  • There was a possible signal of higher all-cause mortality in the tadalafil group (hazard ratio, 5.10).
  • There were no significant between-group differences in other secondary endpoints.
  • Serious adverse events occurred in 48% of participants in the tadalafil group and 56% in the placebo group.

“This study does not support the use of tadalafil for patients with HFpEF and combined postcapillary and precapillary pulmonary hypertension, highlighting potential safety concerns,” the researchers concluded.

Reference:

Hoeper MM, Oerke B, Wissmüller M, Leuchte H, Opitz C, Halank M, Seyfarth HJ, Baldus S, Bauersachs J, Böhm M, Ghofrani HA, Konstantinides S, Olsson KM, Wachter R, Lam CSP, Aminossadati B, Rosenkranz S. Tadalafil for Treatment of Combined Postcapillary and Precapillary Pulmonary Hypertension in Patients With Heart Failure and Preserved Ejection Fraction: A Randomized Controlled Phase 3 Study. Circulation. 2024 Jun 28. doi: 10.1161/CIRCULATIONAHA.124.069340. Epub ahead of print. PMID: 38939948.

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Cyclophosphamide exhibits Long-Term Benefits for Myalgic Encephalomyelitis, Chronic Fatigue Syndrome: Study

Norway: A comprehensive six-year follow-up of participants from two major clinical trials investigating rituximab and cyclophosphamide for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has yielded significant insights into the long-term efficacy and safety of these treatments. The follow-up aims to provide a clearer understanding of the sustained effects and potential benefits of these drugs in managing a condition often marked by debilitating fatigue and other challenging symptoms.

Six-year follow-up data indicate that patients with ME or CFS who received cyclophosphamide experienced more significant and enduring improvements than those treated with rituximab or a placebo.

After six years, 44.1% of patients in the cyclophosphamide group achieved an SF-36 Physical Function (PF) score of 70 or higher, with 17.6% reaching a score of 90 or above,” the researchers reported in PLoS ONE. The findings suggest that cyclophosphamide may positively influence the disease course for some individuals. However, due to its potential toxicity, cyclophosphamide should be used cautiously and only within the context of clinical trials for ME/CFS patients, they warned.

Rituximab, a monoclonal antibody that targets B-cells, and cyclophosphamide, a chemotherapy agent with immunosuppressive properties, were chosen in the study due to their potential to address underlying immune system dysfunction believed to contribute to ME/CFS. Ingrid G. Rekeland, University of Bergen, Bergen, Norway, and colleagues used patient-reported outcome measures (PROMs) to compare values at baseline, at 18 months, and six-year follow-up from the RituxME and CycloME trials.

The researchers performed two clinical trials between 2014 and 2017 based on the hypothesis that ME/CFS in a subgroup of patients is a variant of an autoimmune disease.

The RituxME trial was a randomized, double-blind, placebo-controlled phase III study involving 151 patients, evaluating the effects of the B-cell-depleting antibody rituximab. In contrast, the CycloME trial was an open-label phase II study with 40 participants, assessing the use of intravenous cyclophosphamide. The present report presents the six-year follow-up results from both trials, utilizing the Short Form 36 Physical Function (SF-36 PF) and the DePaul Short Form (DSQ-SF) questionnaires.

The researchers reported the following findings:

  • Of the patients available after six years, 75.7% of RituxME and 94.4% of CycloME patients participated.
  • In the RituxME rituximab group, the mean SF-36 PF scores were 32.9 at baseline, 42.4 at 18 months, and 45.5 at six years.
  • In the placebo group, the mean SF-36 PF scores were 32.3 at baseline, 45.5 at 18 months, and 43.1 at six years.
  • In the CycloME trial, mean SF-36 PF increased from 35.4 at baseline to 54.4 at 18 months and 56.7 at six years.
  • At six-year follow-up, 44.1% of cyclophosphamide-, 27.6% of rituximab- and 20.4% of placebo-treated patients had an SF-36 PF ≥ 70, and further, 17.6%, 8.6%, and 7.4% of the corresponding patient groups had an SF-36 PF ≥ 90, which is within normal range.
  • In terms of worsening at six years, 5.9% of cyclophosphamide-treated, 10.3% of rituximab-, and 14.8% of placebo-treated patients had a drop in SF-36 PF of 20 points or more from baseline.
  • There were no serious unexpected adverse reactions.

The researchers advised physicians and patients not to use cyclophosphamide for ME/CFS patients outside of clinical trials before further research is available.

“The data should drive increased efforts to deepen our understanding of disease mechanisms and to explore targeted, less toxic immune-modulatory treatments for this patient population,” they concluded.

Reference:

Rekeland, I. G., Sørland, K., Neteland, L. L., Fosså, A., Alme, K., Risa, K., Dahl, O., Tronstad, K. J., Mella, O., & Fluge, Ø. (2024). Six-year follow-up of participants in two clinical trials of rituximab or cyclophosphamide in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. PLOS ONE, 19(7), e0307484. https://doi.org/10.1371/journal.pone.0307484

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