Long COVID: SARS-CoV-2 spike protein accumulation linked to long-lasting brain effects
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Kolkata: The special CBI court at Alipore rejected the chargesheet filed by the Central Bureau of Investigation (CBI) in the RG Kar Medical College and Hospital financial irregularities case, which names former principal Sandip Ghosh as the prime accused.
According to a PTI report, the Special CBI court at Alipore here, however, did not accept the chargesheet as the official approval required to file a chargesheet against any state government employee was not available, he said.
In the 100-odd page chargesheet, the central probe agency has also named four others who were arrested for alleged involvement in the irregularities, he said.
“Apart from Ghosh (who has been suspended), the chargesheet includes the names of the other four arrested accused – Biplab Singh, Afsar Ali, Suman Hazra and Ashish Pandey. The CBI has also attached at least 1,000 pages of documents in support of their investigation of the case,” the officer told PTI.
Also Read:Financial Irregularities at RG Kar Hospital: CBI links Sandip Ghosh to Alleged Illegal Contracts with Private Firm
Another official said, “The West Bengal government needs to approve a chargesheet that has the name of its employee before it is submitted in the court. In this case, the approval has not yet come. Both Ghosh and Pandey are doctors of the state-run hospital.”
The chargesheet was filed almost three months after Ghosh was arrested on September 2 in connection with the financial irregularities at RG Kar Medical College and Hospital, which grabbed national headlines after the body of an on-duty medic was found in the seminar room in August, news agency PTI reported.
It has been alleged that financial fraud was underway at the hospital for over three years. During this period, tenders were rigged while purchasing medical equipment for the hospital, and Ghosh allegedly helped his close associates to bag the tenders. Ghosh was suspended 26 days after the doctor’s body medic was found.
On August 23, the Calcutta High Court ordered transfer of the probe into the alleged financial irregularities at RG Kar Hospital from the state-constituted Special Investigation Team (SIT) to the Central Bureau of Investigation (CBI).
The direction came in response to a petition by former deputy superintendent of the medical facility, Dr Akhtar Ali, who prayed for a probe by the Enforcement Directorate (ED) into multiple counts of alleged financial misconduct at the state-run hospital during Ghosh’s tenure as principal.
In his plea before the high court, Ali accused Ghosh of illegal sale of unclaimed corpses, trafficking of biomedical waste and passing tenders in lieu of commission paid by medicine and medical equipment suppliers.
Also Read:RG Kar Victim’s parents meet opposition leaders to demand justice
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Kollam: A surgeon at Paripally Medical College Hospital has been booked for allegedly attempting to sexually assault a junior doctor after allegedly offering her liquor. Following the complaint filed by the female doctor, the surgeon has been suspended from his duties.
According to the junior doctor’s complaint, the incident occurred in a hospital room, where the doctor allegedly lured her by offering her liquor before attempting to assault her sexually. The victim, a junior colleague of the doctor, reported the incident to the Paripally police.
Following her complaint, the Paripally police have registered a case against the surgeon, who is reportedly hiding since the allegations came to light. The police have initiated an investigation into the matter to gather evidence and locate the suspect.
Also Read: FIR lodged against doctor for molesting female patient
However, the police have reported that the surgeon is currently on the run.
This disturbing incident has raised serious concerns about the safety and security of medical professionals, particularly the female staff members within the hospital.
Also Read: Nurse drugged, raped by director in UP Hospital
Medical dialogues had earlier reported that a 22-year-old nurse was allegedly intoxicated and raped by the director after being held hostage inside a private hospital, police said. An FIR has been registered, and the accused has been arrested. It is suspected that the nurse was given a soft drink laced with intoxicants before the assault took place.
On Sunday evening, she attended a party thrown by the director in the hospital. The accused asked her to stay at the hospital during night hours on the pretext of official work, he said. Around midnight he called her to his room and forcefully pulled her inside and locked the door, the ACP said.
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Netherlands: A recent study, published in Diabetes, Obesity and Metabolism has revealed that atrasentan, an endothelin receptor antagonist, significantly improves insulin sensitivity in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). The findings, which focus on how this drug affects various phenotypic clusters of patients, highlight its potential as a valuable treatment option for those struggling with both conditions.
Patients with type 2 diabetes who exhibit a clinical phenotype marked by high insulin resistance are at a greater risk of developing chronic kidney disease. Previous research has shown that the endothelin receptor antagonist (ERA) atrasentan can reduce insulin resistance in T2D patients. In the study, Hiddo J. L. Heerspink, Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, and colleagues evaluated how atrasentan affects insulin resistance in different phenotypic clusters of T2D patients, providing insight into its potential benefits for various patient profiles.
For this purpose, the researchers conducted a post hoc analysis of the SONAR trial, a randomized, placebo-controlled study evaluating the effects of the endothelin receptor antagonist atrasentan in patients with type 2 diabetes and chronic kidney disease.
Patients in the trial were categorized into four previously identified phenotypic clusters: severe insulin-deficient diabetes (SIDD), severe insulin-resistant diabetes (SIRD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD). The researchers then compared changes in insulin resistance, as measured by the HOMA-IR index, across these phenotypic clusters using a mixed-effects model.
The key findings of the study were as follows:
The study found that atrasentan, an endothelin receptor antagonist (ERA), significantly improved insulin sensitivity in T2D patients with CKD, particularly in those with a high degree of insulin resistance (SIRD cluster).
An important limitation of the study, as noted by the authors, is that only a subset of SONAR trial participants were eligible for this analysis. The findings are primarily based on insulin-naive T2D patients at high risk of CKD progression, meaning the results may not be applied to the broader population of T2D patients.
“Therefore, a more extensive analysis involving a larger cohort of patients is needed to determine whether the improvement in insulin sensitivity associated with atrasentan is predictive of its kidney-protective effects,” they concluded.
Reference:
Smeijer JD, Gomez MF, Rossing P, Heerspink HJL. The effect of the endothelin receptor antagonist atrasentan on insulin resistance in phenotypic clusters of patients with type 2 diabetes and chronic kidney disease. Diabetes Obes Metab. 2024 Nov 6. doi: 10.1111/dom.16041. Epub ahead of print. PMID: 39503150.
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USA: A recent study published in Open Forum Infectious Diseases found that treating patients with bone and joint infections using oral antibiotics resulted in more patients being discharged on oral therapy alone and shorter hospital stays, without increasing treatment failure rates. This suggests oral antibiotics can effectively manage infections while offering benefits like reduced hospitalization.
The management of bone and joint infections has long relied on intravenous (IV) antibiotics. Still, emerging evidence suggests that oral antibiotics could be just as effective for certain patients, offering opportunities for earlier discharge and reduced hospital stays. A recent study evaluating institutional guidelines for switching from IV to oral antibiotics has provided valuable insights into how these guidelines can improve patient care while streamlining hospital operations.
Although intravenous antibiotics have traditionally been the preferred treatment for bone and joint infections, clinical trial evidence has demonstrated the safety and effectiveness of oral antibiotics. Despite this, intravenous therapy remains common, and research evaluating the impact of institutional guidelines promoting oral antibiotics is still limited. To fill this knowledge gap, Marten R Hawkins, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, and colleagues evaluated institutional guidelines for switching from IV to oral antibiotics. They provided valuable insights into how these guidelines can improve patient care while streamlining hospital operations.
For this purpose, the researchers implemented a new institutional guideline in April 2023 to prioritize oral antibiotics for treating bone and joint infections. Using a retrospective chart review, they compared a cohort of patients treated under the new guideline with a historical cohort.
The primary outcome was the proportion of patients discharged on oral antibiotics alone, while secondary outcomes included 90-day treatment failure rates, length of hospital stay, and adverse effects. This approach assessed the effectiveness and safety of transitioning from intravenous to oral antibiotics in managing bone and joint infections.
The following were the key findings of the study:
“The findings showed that implementing an institutional guideline improved the proportion of patients with bone and joint infections discharged on oral antibiotics. The study showed that, after the guideline was introduced, clinical outcomes remained similar to those observed with intravenous antibiotics, leading to reduced hospital stays,” the researchers concluded.
Reference:
Hawkins, M. R., Thottacherry, E., Juthani, P., Aronson, J., Chang, A., Amanatullah, D. F., Markovits, J., Shen, S., Holubar, M., Andrews, J. R., Parsonnet, J., & Furukawa, D. Implementing oral antibiotics for bone and joint infections: Lessons learned and opportunities for improvement. Open Forum Infectious Diseases. https://doi.org/10.1093/ofid/ofae683
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According to phase 2 study, MariTide achieved significant weight loss in individuals with obesity or overweight, with up to ~20% loss in non-diabetics and ~17% in those with type 2 diabetes.In both study populations, a weight loss plateau was not observed, again indicating the potential for further weight loss beyond 52 weeks.
MariTide also demonstrated robust and clinically meaningful improvements in cardiometabolic parameters, including blood pressure, triglycerides and high-sensitivity C-reactive protein (hs-CRP) across doses. There were no significant increases in free fatty acids.
There was no association between the administration of MariTide and bone mineral density changes.
The most common adverse events (AEs) in the Phase 2 study were gastrointestinal (GI) related, including nausea, vomiting and constipation. Nausea and vomiting were predominately mild, transient and primarily associated with the first dose. The incidence of nausea and vomiting was substantially reduced with dose escalation. In the dose escalation arms, for those with symptoms, nausea and vomiting were episodic; generally resolving within a median window of six days for nausea and one to two days for vomiting. The discontinuation rate in the dose escalation arms due to any AE was ~11% and less than 8% for GI-related events. No additional safety signals were identified. In a separate ongoing Phase 1 pharmacokinetic study, additional dosing regimens have been evaluated in a planned preliminary analysis.
“We are very excited by MariTide’s differentiated profile, with clinically meaningful attributes of substantial and progressive weight loss, monthly or less frequent dosing, significant improvements in cardiometabolic parameters and strong reduction of HbA1C,” said Jay Bradner, M.D., executive vice president of Research and Development and chief scientific officer at Amgen. “These results provide us confidence to initiate MARITIME, a Phase 3 program across obesity and a number of related conditions, providing a unique potential new treatment option for patients.”
Data from this Phase 2 study will be presented at a future medical congress and submitted for publication.
The ongoing Part 2 of the Phase 2 study is investigating MariTide beyond 52 weeks to evaluate further weight loss with continued treatment, weight maintenance through less frequent or lower dosing and durability of weight loss after discontinuation of MariTide. More than 90% of eligible patients chose to continue to participate in Part 2 of the study.
MariTide is expected to be delivered as a single dose in a convenient, handheld, patient-friendly, autoinjector device with a monthly or less frequent single-injection administration. MariTide is produced in Amgen’s industry-leading manufacturing network.
Amgen is also advancing its obesity pipeline, which includes both oral and injectable approaches, composed of both incretin and non-incretin mechanisms.
MariTide is a bispecific glucagon-like peptide 1 (GLP-1) receptor agonist and glucose-dependent insulinotropic polypeptide receptor (GIPR) antagonist being investigated for the treatment of obesity and Type 2 diabetes mellitus. As a pioneering antibody-peptide conjugate molecule with a long half-life and dual mechanism of action, MariTide may allow for greater durability or reduce the likelihood of weight rebound after treatment stops. Pre-clinical studies have demonstrated that simultaneously activating GLP-1 and inhibiting GIP pathways had a stronger effect on weight loss than targeting either GLP-1 or GIP receptors alone. Amgen utilized its strong capabilities of human genetics to confirm the benefits of GIPR inhibition.
The clinical goal for people living with obesity or overweight is to achieve weight loss, and to maintain weight thereby improving health. Given the heterogeneity of obesity and the number of people impacted, a variety of approaches will be needed. In addition to MariTide, Amgen is also advancing an obesity pipeline, which includes both oral and injectable approaches, composed of both incretin and non-incretin mechanisms.
The trial enrolled 592 adults included two Cohorts of people living with obesity or overweight. Cohort A enrolled participants without a diagnosis of Type 2 diabetes, Cohort B participants had Type 2 diabetes. In Part 1, participants in Cohort A (n=465), without Type 2 diabetes, were assigned to one of four monthly fixed dose arms (placebo, 140 mg, 280 mg, 420 mg) or an 8-week 420 mg dose arm. There were also two dose escalation arms with either 4-week or 12-week dose escalation periods to a target dose of 420 mg. Adults in Cohort B (n=127), with type 2 diabetes, were assigned to one of four monthly fixed dose arms (placebo, 140 mg, 280 mg and 420 mg). At the end of Part 1, participants who met eligibility criteria (at least 15% weight loss at week 52 and still taking investigational product) had the option to enter Part 2 of the study.
Part 2 of this Phase 2 study is investigating MariTide beyond 52 weeks. In Part 2, Cohorts from Part 1 were pooled, then re-randomized based on their Part 1 doses to receive either placebo or a fixed monthly dose of 70 mg, 140 mg, 420 mg or a 12-week 420 mg dose. The purpose of Part 2 is to evaluate further weight loss with continued treatment, durable weight loss after discontinuation of MariTide and weight maintenance through less frequent or lower dosing.
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