American Academy of Pediatrics releases clinical practice guideline for opioid prescriptions

The American Academy of Pediatrics has published its first clinical guideline for pediatricians on prescribing opioids, including explicit instructions on how and when to prescribe these medications for pain while reducing the long-term risk of addiction.

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People who experience side effects from cranial radiation therapy may recover full neurocognitive function within months

A substantial number of patients with brain metastases who experience cognitive side effects following radiation therapy may fully regain cognitive function, according to a pooled analysis of three large, Phase III clinical trials.

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Radiopharmaceutical therapy offers promise for people with tough-to-treat meningioma brain tumors

A radiopharmaceutical therapy that has successfully extended progression-free survival for patients with neuroendocrine tumors shows early promise for delivering similar benefits to patients with difficult-to-treat meningioma, a type of brain tumor. Findings of the nonrandomized Phase II study were presented at the American Society for Radiation Oncology (ASTRO) Annual Meeting.

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Ketamine: What to know about the UK’s growing drug problem

There is growing awareness of the problems caused by the use of a fast-acting drug called ketamine. Often referred to as K or ket, it was made a class B drug in the UK in 2014 and is illegal to buy or sell. Possessing the drug can lead to a maximum five-year prison sentence and supplying the drug up to 14 years in prison.

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How alcohol-associated liver disease differs among races

Researchers have long known that outcomes for alcohol-associated liver disease (ALD) aren’t equal among all races and ethnicities in the U.S., but differences among these groups have been less clear.

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PG Medico Rape-Murder Case: Police Commissioner reviews security measures at RG Kar Hospital

Kolkata: Kolkata Police Commissioner Manoj Verma visited R G Kar Medical College and Hospital on Sunday, just a day before the Supreme Court is set to hear the rape-murder case of a female post-graduate trainee doctor. 

According to the PTI report, sources said that Verma took stock of the security system at the hospital, spoke to the police personnel present there, and went to the emergency department.  

The police commissioner’s visit comes a day before the rape-murder case comes up for hearing again before the Supreme Court on Monday.  

A mob attack at the hospital took place in the early hours of August 15, vandalising the emergency department of the government-run hospital, just a day after the Calcutta High Court had ordered the transfer of investigation into the rape-murder case to the CBI.       

Also Read:Kolkata PG Medico Death Case: Doctors’ forum submits fresh note of unmet demands

The city police are investigating the vandalism at the hospital.  

Junior doctors, who resumed work after more than a month-long agitation seeking justice for their murdered colleague, said on Saturday night that they would decide on resuming total ‘cease work’ in West Bengal’s medical colleges after observing the state government’s submission on their safety and security at workplaces during the hearing of the RG Kar case before the apex court, news agency PTI reported.  

Their announcement came after three doctors and three nurses were assaulted at the College of Medicine and Sagore Dutta Hospital on the northern outskirts of Kolkata following the death of a patient on Friday night.   

The medics alleged that the attacks at the state-run hospital have shown that the government has “totally failed” to deliver promises to provide them security.     

Also Read:Threat Culture Allegations: Only 8 out of 51 doctors, students appear before RG Kar Hospital inquiry committee

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Rs 3 lakh penalty for discontinuing PG medical courses in Andhra Pradesh this year

Vijayawada: All the PG medical candidates getting admitted to Dr NTR University of Health Sciences will have to pay Rs 3 lakh as a discontinuation penalty if they do not complete their courses.

In this regard, the selected candidates will have to execute a bond at the time of admission. This rule applies to all the candidates getting admitted to either the competent authority quota or management quota seat for the academic year 2024-2025.

The Rules specified by the University in its prospectus are as follows: 

 All the candidates joining the Post Graduate degree/diploma courses should execute bond on a stamped paper of Rs. 100/- value as prescribed in Annexure-IV to the effect that he/she will complete the prescribed period of training or in default to pay Rs.3,00,000/- + 18% GST to the University and shall refund the amount received as stipend upto that date to the Government as notified by the University from time to time.

 As per G.O.Ms.No.67, HM&FW (C1) Department dated 21-04-2017 candidates have to pay the discontinuation penalty of Rs. 3,00,000/- + 18% GST and they will be debarred for three years for admission into Post Graduate Medical Degree/Diploma courses at the colleges in the State of Andhra Pradesh for admission into PG Medical courses subject to receipt of orders from the Government if any and as notified by the University from time to time.

The Prospectus also includes a prescribed format for executing the bond regarding the course discontinuation fee. It is applicable for all the candidates and has to be executed in a Non-Judicial Stamped paper for Rs 100. 

“I, Dr…. selected for Post Graduate Degree/Diploma for the year 2024-25 do hereby undertake to complete the said course as per the requirements of the University. In the event of my leaving the studies after joining the course, I undertake to pay to Dr. NTR University of Health Sciences a sum of ₹.3,00,000/- + 18% GST and refund the amount received as stipend up to that date to Government,” states the bond document.

It will have to be signed by the candidate, and two witnesses (along with their names and addresses).

To view the prospectus click on the links below:

https://medicaldialogues.in/pdf_upload/prospectus-competent-authority-quota-254624.pdf

https://medicaldialogues.in/pdf_upload/prospectus-management-quota-254625.pdf

Also Read: UP scraps Seat Leaving Penalty, now Candidates to be Debarred from next academic year’s Counselling for Discontinuing medical courses

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Osmania General Hospital perform Life-Saving Cadaver Liver Transplants

Hyderabad : Osmania General Hospital (OGH) in Telangana, a tertiary care center, has been transforming lives through successful organ transplantations provided completely free of charge to underprivileged patients.

According to an ANI report, a patient, Ravi Sundar, 45, a native of Nalgonda, was admitted to OGH with full-blown liver failure due to viral infection. He was very sick, having very high bilimbin (25 mg/d) with coagulopathy (blood not clotting) and drowsiness (hepatic encephalopathy).

Another patient from Bathina, Narender, 46, a resident of Vallampatla, Maddur, Siddipet, and farmer by occupation. He was suffering with decompensated chronic liver disease due to viral hepatitis.

Also Read:Govt to relocate Osmania General Hospital to Goshamahal police stadium: CM Revanth Reddy

The doctors did cadaver liver transplantation as a lifesaving measure, and one is recovered and discharged, while the latter is in a recovering state. They also retrieved skin from both donors and preserved it in their skin bank for burn patients.

Recently, patients’ attendees and family members have also come forward for organ donation. Receiving the positive response from the people, has also motivated the Osmania team.

Dr. Rakesh Sahay, Superintendent, Osmania Hospital, said, “In last month, two in-house organ donations transpired at OGH, and one more organ donation was also in the process. With this organ donation, we did two cadaver liver transplants, four cadaver kidney transplants, four corneal donations, and skin donations for burn patients”, news agency ANI reported.

“In general, organ transplant surgeries are very expensive in PVT hospitals, which cost around 25 to 35 lakhs per case. Many of poor patients cannot offered that much money so they are coming to OGH. The Government of Telangana is providing all consumables and drugs free of cost under aarogyasri scheme,” he added.

“We are also providing life-long free immunosuppression drugs for them. One good sign is that not only poor people are coming to government hospitals, but doctors are also undergoing treatment at OGH. We did one emergency liver transplantation for doctor as life-saving procedure at OGH on 29-08-2024,” he further said.

Kidney transplants are performed by Prof. Manisha Sahai, Dr. Mallikarjun, Dr. Kiran Mayi, and Dr. Anand. Skin harvesting is carried out by Prof. Naga Prasad and Prof. Lakshmi, adds ANI.

The team of doctors involved in this surgeries are Prof Dr CH Madhusudhan (SGE/HOD). Dr Wasif Ali, Sudarshan Reddy, Dr Abhimanyu Singh (HOD Anaesthesia), Prof Chandra Shakar (Anaesthesia), Dr. Madhavi (Professor of Anaesthesia), Dr. Raghu (Professor of Anaesthesia), Dr. Lakshmi Narayana, Dr. N Sunil, Dr. Uma Devi, Dr. Ramesh Kumar, Dr. Nadeem, and Dr. Pavan (radiology). Dr. Rupa (biochemist), Dr. Sai Sai Sudha (blood bank), Dr. Nala Kishore, Dr. Shankar, and Mrs. Manjula, Mrs. Subba Laxmi, Mrs. Madhavi, Mr. Krishna, Mr. Babu, and other team members involved in this surgery.

Also Read:Telangana Doctors Association demand new Osmania General Hospital Building

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Carotenoid Supplementation Shows Potential for Improving Blood Sugar Control in Type 2 Diabetes, Study Reveals

Germany: A recent systematic review and meta-analysis of randomized clinical trials has explored the potential effects of carotenoid supplementation on blood sugar control, particularly in individuals with type 2 diabetes (T2D). It found that carotenoid supplementation enhanced glycemic parameters, particularly in individuals with type 2 diabetes.

The researchers noted, “However, the certainty of the evidence was quite low, primarily due to small sample sizes and indirect findings. As a result, no specific recommendations can be made at this time, and well-designed randomized controlled trials are necessary.” 

The findings were published online in the European Journal of Clinical Nutrition. 

Carotenoids are naturally occurring pigments in fruits and vegetables associated with various health benefits. Considering this, Nafiseh Shokri-Mashhadi, German Center for Diabetes Research (DZD), Partner Düsseldorf, Muenchen-Neuherberg, Düsseldorf, Germany, and colleagues conducted a systematic review and meta-analysis to evaluate the impact of carotenoid supplementation on glycemic indices and the reliability of the evidence.

For this purpose, a systematic literature search was performed across PubMed, SCOPUS, ISI–Web of Science, and the Cochrane Library, covering studies from inception until June 17, 2024. Randomized controlled trials (RCTs) that examined the effects of carotenoid supplementation on circulating glycemic parameters were included. Records were excluded if they involved co-interventions with other nutrients, did not report mean differences (MDs) and standard deviations (SDs) for outcomes, or used whole foods instead of carotenoid supplements.

Summary mean differences (MDs) between the intervention and control groups were calculated using a random-effects model. The risk of bias in the included studies was evaluated using the Risk of Bias 2.0 (RoB 2.0) tool.

Based on the review, the researchers reported the following findings:

  • A total of 36 publications, encompassing 45 estimated effect sizes, were included in the meta-analyses.
  • The results indicated a significant improvement in fasting blood glucose (FBG) levels, with a mean difference (MD) of −4.54 mg/dl, and hemoglobin A1C (HbA1C), which showed an MD of −0.25% in the intervention group compared to the control group.
  • Among individuals with T2D, supplementation with astaxanthin and fucoxanthin resulted in a reduction in FBG by 4.36 mg/dl.
  • The intervention with crocin was particularly noteworthy, leading to a decrease in FBG levels by 13.5 mg/dl (n = 5) and a reduction in HbA1C by 0.55% (n = 5) among T2D patients.
  • The researchers emphasized that the certainty of the evidence was very low.

“While carotenoid supplementation may offer some benefits for glycemic control, particularly in individuals with type 2 diabetes, the current evidence lacks the robustness to guide clinical practice. Healthcare providers and patients should approach carotenoid supplementation cautiously until more conclusive research is available,” the researchers concluded.

Reference:

Baechle, C., Schiemann, T., Schaefer, E., Barbaresko, J., & Schlesinger, S. (2024). Effects of carotenoid supplementation on glycemic control: A systematic review and meta-analysis of randomized clinical trials. European Journal of Clinical Nutrition, 1-13. https://doi.org/10.1038/s41430-024-01511-y

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Radial Access Superior for Coronary Angiography, With Distal Radial and Ulnar Access as Preferred Secondary Options, affirms study

USA: A network meta-analysis has provided new insights into the procedural outcomes associated with different access points for coronary angiography. The study that compared femoral, radial, distal radial, and ulnar access offers valuable guidance for clinicians in selecting the optimal approach for this critical diagnostic procedure.

The findings, published in Circulation: Cardiovascular Interventions, endorse radial access as the primary choice for coronary angiography, with distal radial or ulnar access recommended over femoral access as a secondary option.

Coronary angiography, a key diagnostic tool for assessing coronary artery disease, traditionally uses femoral access. However, radial access has become increasingly popular due to its lower risk of complications and quicker recovery times. Previous studies have shown that radial artery access for coronary angiography or PCI lowers the risk of death, bleeding, and vascular complications compared to femoral artery access, earning it a class 1 recommendation in clinical practice guidelines. Despite this, alternative upper extremity access options, such as distal radial and ulnar access, are not yet addressed in the guidelines, even though randomized trials support their use.

Against the above background, M Haisum Maqsood, Department of Cardiology, DeBakey Heart and Vascular Center, Methodist Hospital, TX, and colleagues aimed to evaluate procedural outcomes with femoral, radial, distal radial, and ulnar access sites in patients undergoing coronary angiography or PCI.

For this purpose, the researchers searched PubMed, EMBASE, and clinicaltrials.gov databases for randomized clinical trials comparing at least two of the four access sites in patients undergoing PCI or angiography. The primary outcomes analyzed were major bleeding and access site hematoma. An intention-to-treat mixed-treatment comparison meta-analysis was then conducted.

The researchers reported the following findings:

  • From 47 randomized clinical trials that randomized 38 924 patients undergoing coronary angiography or PCI, when compared with femoral access, there was a lower risk of major bleeding with radial access (odds ratio [OR], 0.46) and lower risk of access site hematoma with radial (OR, 0.34), distal radial (OR, 0.33), and ulnar (OR, 0.50) access.
  • Compared with radial access, there was a higher risk of hematoma with ulnar access (OR, 1.48).

“Evidence from randomized trials supports a Class 1 guideline recommendation favoring radial access over femoral access for coronary angiography or PCI. Additionally, when radial access is not feasible, distal radial or ulnar access should be considered as preferred alternatives before resorting to femoral access,” the researchers concluded.

Reference:

Maqsood MH, Yong CM, Rao SV, Cohen MG, Pancholy S, Bangalore S. Procedural Outcomes With Femoral, Radial, Distal Radial, and Ulnar Access for Coronary Angiography: A Network Meta-Analysis. Circ Cardiovasc Interv. 2024 Jul 19:e014186. doi: 10.1161/CIRCINTERVENTIONS.124.014186. Epub ahead of print. PMID: 39027936.

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