Gallstones may Significantly Raise Risk of Fatty Liver Disease, unravels study

Researchers have determined that gallstones greatly increase the incidence of non-alcoholic fatty liver disease (NAFLD). To evaluate whether there is a chance of association between gallstones and NAFLD, a recent case control study was conducted among the patients of Imam Khomeini and Golestan hospitals affiliated to Ahvaz University of Medical Sciences. The study was conducted by Sheibani A. and colleagues and was published in the journal Health Science Reports.

Both NAFLD and gallstones are frequently associated with common risk factors, including obesity, insulin resistance, diabetes, and other metabolic disorders. The association has been suspected by previous studies, but little has been done to quantify this risk. This study aimed to assess the incidence of gallstones in patients with NAFLD to determine the strength of this relationship, and to find which factors most significantly contribute to the development of NAFLD in patients with gallstones.

The research inducted 300 patients referred to Imam Khomeini and Golestan hospitals in 2023. The patients were divided into two groups according to ultrasound findings; the case group included 150 patients diagnosed with NAFLD, while the control group included patients without any findings for NAFLD (n =150). The research records all clinical data, including age, gender, BMI, the presence of diabetes, and status of gallstone, using checklists. SPSS version 26 was utilized in doing statistical analysis, and the examinations of how gallstones, diabetes, and obese conditions might impact the risk of NAFLD were conducted using binary logistic regressions.

The results of the study established the following associations for gallstones, diabetes, and obesity with NAFLD:

  • The patients who had gallstones showed a likelihood of 2.33 times more to have NAFLD (p = 0.035).

  • The presence of DM increased the risk of NAFLD about 16 times above the baseline rate (p <0.001).

  • For every one unit increase in BMI, added 30% to the odds of having NAFLD (p <0.001).

Gallstones have emerged as an important risk factor for NAFLD and most likely to double the patients’ odds of suffering from fatty liver. Clinically, these findings highlight the necessity to monitor and manage NAFLD risk in patients with gallstones, especially in obese or diabetic subjects, where preventive measures may delay or reduce NAFLD progression.

Reference:

Sheibani, A., Reihani, H., Shoja, A., Gharibvand, M. M., & Hanafi, M. G. (2024). Gallstones increase the risk of nonalcoholic fatty liver: A case‐control study. Health Science Reports, 7(11). https://doi.org/10.1002/hsr2.70068

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Bilateral single orbital triamcinolone injections provided relief from Thyroid Eye Disease symptoms, reveals research

Thyroid eye disease (TED) represents a prevalent type of
orbital tissue inflammation associated with autoimmune disorders linked to
thyroid dysfunction, which is characterized by a spectrum of metabolic and
immunologic disturbances. Because of their potent anti-inflammatory and
immunosuppressive properties, systemic glucocorticoids have traditionally
served as the first-line treatment for TED to mitigate inflammation. However,
their use is fraught with a plethora of adverse effects, encompassing hyperglycemia,
hypertension, metabolic disorders leading to the characteristic “moon face”,
gastric ulcers, osteoporosis, and an increased susceptibility to infectious
diseases.

To circumvent these adverse effects, local administration of
glucocorticoids has been explored. Localized delivery is accomplished through
subconjunctival, and sub-Tenon injections. In contrast, retro-orbital-septal
injection offers an alternative method. This procedure, performed
transcutaneously using a half-inch, 27-G needle, facilitates the precise
delivery of medication into the lateral lower deep orbital fat, yielding
promising results in the anti-inflammatory treatment of orbital tissue.7
Furthermore, Bagheri et al reported retroorbital-septal injection of
triamcinolone and dexamethasone into both the upper and lower quadrants of the
orbital soft tissue.

In this report, this approach was applied for patients with
active TED who were resistant to or dependent on systemic steroids or faced
complications related to systemic steroid use. The results demonstrated a
significant reduction in orbital inflammation, including upper and lower eyelid
retraction, ocular motility issues, and inflammatory markers such as the
Clinical Activity Score (CAS) and NOSPECS classification. An intriguing aspect
of the retro-orbital-septal delivery method is its capacity to produce a
dramatic effect after only one or two injections.

Thus, this novel procedure may have advantages not only in
local control of orbital inflammation but also in mitigating systemic adverse
effects. However, no study to date has comprehensively evaluated the systemic
effects of orbital corticosteroid injections, primarily because of the systemic
absorption of the medication. The current report aimed to address this gap by
focusing on the efficacy and systemic effects of deep orbital injection of
triamcinolone, with the intent of promoting and advancing this procedure. To
achieve this goal, authors conducted a prospective clinical investigation
involving TED patients who underwent a single deep orbital injection of
triamcinolone, followed by comprehensive ophthalmic and pharmacological
assessments, including blood and urinary panels.

In a prospective investigation conducted from January 2021
to March 2023, patients diagnosed with TED were enrolled. Inclusion criteria
encompassed a Clinical Activity Score (CAS) of ≥3, extraocular muscle
inflammation, and upper eyelid retraction. A total of 1 mL of triamcinolone
acetonide (40 mg/mL) was administered posterior to the orbital septum at both
the medial and lateral aspects of both the upper and lower eyelids. Parameters,
including CAS, margin-reflex distances (MRD1 and MRD2), intraocular pressure
(IOP), ocular motility (Hess area ratio [HAR%]), exophthalmometry, extraocular
muscle size, and blood and urinary indices, were evaluated before and at 2 and
4 weeks after a single injection.

Analysis included 28 patients (23 women, 5 men; mean age
(SD): 38.7 (11.1) years), representing 56 eyes. Following the injection at 4
weeks, the mean CAS and MRD1 significantly decreased by 2 points and 0.8 mm,
respectively. There was a 4.5% increase in HAR%, and extraocular muscle size
decreased by 4 to 15.3 mm². Neutrophil count, C-reactive protein, and thyroid
antibodies significantly decreased. No severe adverse ophthalmic or systemic
effects, including IOP increases or liver damage, were observed.

In summary, this study robustly demonstrates the favorable
effects of a single deep orbital corticosteroid administration for TED
treatment without inducing substantial local or systemic adverse effects.
Improvements in local and systemic assessments, TED-related antibody levels,
and orbital muscle dimensions underscore the effectiveness of this intervention
in modulating TED activity. While the study has limitations, including a
limited patient cohort and a lack of iterative treatments, comprehensive
validation will necessitate an expanded and iteratively treated patient series
in the future.

Source: Yamana et al; Clinical Ophthalmology 2024:18

https://doi.org/10.2147/OPTH.S476562

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Innovative risk score predicts which kidney transplant candidates have risk of MI or stroke, new study finds

Using an innovative risk score assessment score, heart researchers at Intermountain Health in Salt Lake City say they can accurately predict whether patients being assessed for kidney transplant will likely have a future major cardiac event, like a heart attack or stroke, according to a new study.

Intermountain Health clinicians regularly review patient data through their electronic health system to determine who may have heart disease without knowing it. Now, in a major new study, Intermountain heart researchers found that using their Intermountain Risk Score (IMRS) they could also accurately predict whether patients being assessed for kidney transplant would have a major cardiac event, like a heart attack or stroke.

“This study demonstrates that we could adapt our already existing risk score guide to help identify which of these patients might also be at risk for having a heart event, which could lead to better and more personalized treatment,” said Benjamin Horne, PhD, director of cardiovascular and genetic epidemiology at the Intermountain Health.

Findings from the new study will be presented at the American Heart Association Scientific Sessions in Chicago on Sunday, November 17, 2024.

The Intermountain Risk Score is a well-validated, sex-specific risk prediction tool that includes factors like age and results from complete blood count and basic metabolic profile testing to predict the risk of major cardiovascular events and death.

These scores are assessed automatically based on information input into electronic health records. If a patient has a high score, their care team is alerted.

In the Intermountain study, researchers looked specifically at the accuracy of the IMRS for patients being considered for kidney transplant.

They identified patients who were assessed for transplant surgery at Intermountain Health between June 2015 and April 2024 and found 891 patients. 200 patients did not have all of the laboratory tests needed to calculate an IMRS, so they were excluded from the next step in the study.

That left 691 patients with enough information to retroactively calculate IMRS.

Intermountain researchers found that these patients were on average 55.9 years old, and 34.3% were women.

Of those 691 patients, 171 experienced a major cardiac event over a five-year follow-up period. Researchers found that IMRS was effective in predicting these outcomes, showing the potential use of calculating such a score in people being evaluated for kidney transplant.

The score can be “a really valuable piece of information, but some of these patients were missing lab tests that would have enabled us to calculate it,” said Dr. Horne, referring to the 200 people in this retrospective study who did not have enough laboratory tests to be included.

“This is the first step in assessing if we can make a risk score specifically keyed to the risk of people who are going to have a rental transplant, and make sure we collected all the appropriate data so we can do so,” he said.

Next steps include validating the risk score in another patient population, determining whether modifying the risk score by adding data routinely collected in kidney patients improves its ability to assess risk for kidney transplant patients, and then conducting a prospective clinical trial of using the risk score in modifying clinical care processes to determine whether personalized care improves patient outcomes.

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Levonorgestrel-releasing IUD Use associated with Site-Specific Gynecologic and Breast Cancers: Study

The levonorgestrel-releasing intrauterine device (LNG-IUD) is commonly utilized to manage conditions such as endometriosis and menorrhagia. However, it is becoming a popular choice for contraception among young women due to its capacity to suppress menstruation and alleviate discomfort. LNG-IUD is known for its high effectiveness and satisfaction, surpassing that of oral contraceptives. Recent nationwide cohort study in Sweden provides novel evidence on the association between the use of levonorgestrel-releasing intrauterine device (LNG-IUD) and the risk of site-specific gynecologic and breast cancers, considering the influence and potential interaction of family history of cancer. The key findings are: 1. LNG-IUD use was associated with a 13% higher risk of breast cancer compared to non-users. Importantly, a significant additive interaction was observed between LNG-IUD use and family history of breast cancer, indicating a relative 19% excess risk for interaction and 1.63 additional cases per 10,000 person-years. 2. LNG-IUD use was associated with a 33% lower risk of endometrial cancer, a 14% lower risk of ovarian cancer, and a 9% lower risk of cervical cancer compared to non-users. 3. The site-specific effects of LNG-IUD on gynecologic and breast cancers were consistent across different age and menopausal status subgroups, though the results were not statistically significant likely due to small sample sizes. 4. While LNG-IUD use alone slightly increased the risk of breast cancer, the risk was significantly higher among women with a family history of breast cancer. This suggests the need for close monitoring for breast cancer development, especially in women with a family history.

Conclusions

The study highlights the importance of considering the influence of family history of cancer when evaluating the association between LNG-IUD use and site-specific gynecologic and breast cancers. The observed effect size for breast cancer is small, and the results are limited by the observational study design. Further research, including randomized trials, is needed to confirm these findings and establish causal relationships.

Key Points –

1. The study found that use of a levonorgestrel-releasing intrauterine device (LNG-IUD) was associated with a 13% higher risk of breast cancer compared to non-users. However, this risk was significantly higher, with a 19% excess risk, among women with a family history of breast cancer.

2. LNG-IUD use was associated with a 33% lower risk of endometrial cancer, a 14% lower risk of ovarian cancer, and a 9% lower risk of cervical cancer compared to non-users.

3. The site-specific effects of LNG-IUD on gynecologic and breast cancers were consistent across different age and menopausal status subgroups, though the results were not statistically significant likely due to small sample sizes.

4. The study highlights the importance of considering the influence of family history of cancer when evaluating the association between LNG-IUD use and site-specific gynecologic and breast cancers.

5. The observed effect size for breast cancer is small, and the results are limited by the observational study design.

6. Further research, including randomized trials, is needed to confirm these findings and establish causal relationships.

Reference –

Yi H, Zhang N, Huang J, et al. Association of levonorgestrel-releasing intrauterine device with

gynecologic and breast cancers: a national cohort study in Sweden. Am J Obstet Gynecol 2024;231:450.e1-12

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Swimming tied to greater risk of developing dental staining and poor oral QoL than non-swimmers: Study

Swimming tied to greater risk of developing dental staining and poor oral QoL than non-swimmers suggests a study published in the Australian Dental Journal

Swimming has classically been associated with a distinctive type of extrinsic dental staining. However, its prevalence and characteristics have not been explored in Australia. This case controlled cross-sectional cohort study aimed to determine the prevalence and severity of dental staining among children who swim competitively compared to non-swimmers and its impact on oral health-related quality of life (OHRQL). Parents and children from Western Australian swimming clubs completed a survey assessing swimming routine, risk factors for staining and OHRQL. Intra-oral photographs were taken and staining of anterior teeth was assessed using a modified Lobene Stain Index. A Global Stain Score (GSS) was calculated and compared against age-matched non-swimmer controls. Results: Maxillary anterior teeth from swimmers (n = 400) and non-swimmers (n = 400) were analysed. Staining prevalence was greater in swimmers (83%) than non-swimmers (44%). GSS scores were positively correlated with both the total lifetime swimming hours and practice time (P < 0.05), with a significant difference in GSS between swimmers and non-swimmers (P = <0.001, OR: 6.21). Dietary factors for staining were not significantly correlated with GSS. Swimmers had a greater risk of developing staining than non-swimmers, and this negatively impacted their OHRQL. The extent and intensity of staining were associated with the amount of swimming.

Reference:

Patel, J., Cai, S., Huong, B., Macdonald, M. and Anthonappa, R. (2024), Competitive swimming and dental staining among Australian children. Aust Dent J. https://doi.org/10.1111/adj.13033

Keywords:

Australian Dental Journal, Patel, J., Cai, S., Huong, B., Macdonald, M. and Anthonappa, R, Swimming , dental staining, poor oral QoL

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Mortality and CVD risk due to Use of Glucocorticosteroids among RA patients persists even after their cessation: Study

Mortality and CVD risk due to Use of Glucocorticosteroids among Rheumatoid arthritis patients persists even after their cessation suggests a study published in the ACR Meeting Abstracts.

Glucocorticosteroid (GC) use is associated with increased mortality risk, especially from cardiovascular diseases (CVD) and infections, with dose and duration of use influencing risk. How long the impact lasts after stopping Glucocorticosteroid, and how this is influenced by duration of previous use, are not known. This study aims to estimate how the risk of mortality from CVD and infections is associated with i) cumulative duration of past Glucocorticosteroid use and ii) time since cessation of Glucocorticosteroid. They conducted a longitudinal study of a population-based incident Rheumatoid arthritis cohort, using administrative health data in a universal health care system. All incident RA cases in British Columbia, Canada, who met Rheumatoid arthritis definition between 01/01/1996 and 12/31/2013, using a 5 yr look back period, were identified using physician billing data and followed until 12/31/2018. Oral Glucocorticosteroid exposure was measured as time-varying variables representing: current use, total cumulative duration of use, and time since discontinuation. Deaths with CVD or infections as the primary cause were identified from death certificates. Each incident user of Glucocorticosteroid was followed from time of starting Glucocorticosteroid(if started after Rheumatoid arthritis index date) or of meeting Rheumatoid arthritis criteria (if Glucocorticosteroid started before Rheumatoid arthritis index date), using delayed entry to avoid immortal time bias, until death or censoring due to moving out of province or end of F/U. Multivariable conventional Cox PH model and its flexible extensions with non-linear effects were used to estimate the risk of death associated with cumulative duration of Glucocorticosteroid use, time since Glucocorticosteroid cessation and time varying interactions between the 2, adjusting for potential confounders (sociodemographic and comorbidities measured at index date and other Rheumatoid arthritis meds as time-varying covariates). Results: They identified 28,078 incident Glucocorticosteroid users (55.9% of cohort), with mean (SD) and median (25;75Q) Glucocorticosteroid use duration of 603 (1116) and 131(18;598) days. See Table 1 for sample characteristics. They observed 2,489 CVD deaths and 387 from infections. In conventional Cox PHM risk of CVD / infection mortality increased by 7.5% / 6.8% for every year of Glucocorticosteroid use; and decreased by 1.3% / 4.9% for every year after stopping Glucocorticosteroid. Flexible extensions revealed non-linear relationships for both variables (Figure 1). Duration of previous use influenced risk after cessation (Figure 2). Risk decreased to that of someone prior to starting GC at 1.5, 3.5 and 10 years after cessation if Glucocorticosteroid had been used for 6,12, and 24 months for CVD deaths and at 2.5, 3.5, and 5.5 years, resp. for deaths from infections. Risk of death from CVD and infections never returned to pre-Glucocorticosteroid use risk in patients who used Glucocorticosteroid for > 2 years and > 3 years, respectively. Despite advances in Rheumatoid arthritis therapy Glucocorticosteroid are still commonly used and for long periods in some. The increased mortality risk from CVD and infections lasts for a substantial time after cessation, and never returns to that pre-GGlucocorticosteroid with prolonged use. These findings are of high clinical relevance to people with rheumatoid arthritis and physicians, inform shared decision-making for starting and stopping Glucocorticosteroid, and provide evidence supporting Rheumatoid arthritis guidelines recommending Glucocorticosteroid use at the lowest dose for shortest periods possible.

Reference:

Abstract Number: 2673 Changes in Mortality Risk After Stopping Glucocorticosteroids – a Population-based Study in Rheumatoid Arthritis Diane Lacaille1, Coraline Danieli 2, Kasra Moolooghy1 and Michal Abrahamowicz 3, 1 Arthritis Research Canada, University of British Columbia, Vancouver, BC, Canada, 2Research Institute of McGill University Health Center (RI-MUHC), Montreal, QC, Canada, 3McGill University, Verdun, Canada

Keywords:

Mortality, CVD, risk, Use, Glucocorticosteroids, among, RA, patients, persists, cessation, Study , ACR Convergence 2024

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Flagellin aerosol therapy safe against antibiotic-resistant pneumonia: Study

In the fight against antibiotic-resistant pneumonia, new research published in the Antimicrobial Agents and Chemotherapy highlighted the use of aerosolized flagellin which is delivered directly to the lungs and could enhance the immune response and help antibiotic treatments. With increasing rates of resistance in Streptococcus pneumoniae there is a dire need for therapies that can bolster treatment outcomes when standard antibiotics are less effective.

Flagellin, a Toll-like receptor 5 (TLR5) agonist, has shown promise in previous studies as an enhancer of lung immunity. When delivered intranasally, flagellin helped activate lung defenses by leading to reduced bacterial loads and improved outcomes when used along with antibiotics. However, translating this therapeutic strategy to clinical applications requires a delivery method that is not only effective but also non-invasive and easy to implement in a healthcare setting. Thus, this recent study tested a novel delivery approach using a vibrating mesh nebulizer to aerosolize flagellin directly into the airways of mice.

The findings of this study outlined in an in-depth table when compared to two delivery methods which is the traditional intranasal administration and aerosolized delivery via nebulization. The table detailed lung deposition rates, with intranasal delivery achieving approximately 40% of the administered flagellin dose in the lungs. Also, nebulization was significantly lower, with less than 1% lung deposition. Despite the low lung uptake through nebulization, the approach still triggered a robust immune response, including the production of cytokines and chemokines, as well as the recruitment of neutrophils into the airways.

This immune activation was transient, suggesting that nebulized flagellin induces a controlled and time-bound inflammatory response in the lung which is a characteristic crucial for avoiding excessive lung inflammation. The study also showed that aerosolized flagellin not only activated local lung defenses but also accelerated the reduction of systemic pro-inflammatory responses, an important factor in the overall health outcomes of pneumonia patients.

In a therapeutic trial, combining nebulized flagellin with the antibiotic amoxicillin was found to be effective against antibiotic-resistant strains of S. pneumoniae in mice. This combination therapy could represent a breakthrough for patients where conventional antibiotics alone may fail due to resistance. The study suggest that this inhaled approach could be an important addition to the arsenal against bacterial pneumonia, particularly in the context of rising antimicrobial resistance. Overall, the findings suggest that nebulized flagellin may serve as an adjunct therapy by improving the effectiveness of antibiotics while leveraging the the own immune defenses to combat severe pneumonia.

Source:

Baldry, M., Costa, C., Zeroual, Y., Cayet, D., Pardessus, J., Soulard, D., Wallet, F., Beury, D., Hot, D., MacLoughlin, R., Heuzé-Vourc’h, N., Sirard, J.-C., & Carnoy, C. (2024). Targeted delivery of flagellin by nebulization offers optimized respiratory immunity and defense against pneumococcal pneumonia. In B. P. Howden (Ed.), Antimicrobial Agents and Chemotherapy. American Society for Microbiology. https://doi.org/10.1128/aac.00866-24

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KEA releases seat matrix for PG medical admissions 2024, details

Karnataka- The Karnataka Examinations Authority (KEA) has released the seat matrix for admission to the Medical Post Graduate Degree Courses in Government Medical Colleges & Self Financing Medical Educational Institutions in the State for the academic session 2024-25.

As per the seat matrix, a total of 998 seats are vacant, of these, 818 seats are vacant in Category-wise Seat distribution (excluding In-Service/Minority/NRI quota seats) and 180 seats are vacant in Minority and NRI Quota Seats in Self Financing Medical Colleges.

Also Read: 354 PG medical seats available in 25 specialities: KEA releases NEET PG counselling seat matrix

CATEGORY-WISE SEAT DISTRIBUTION

S.NO

COLLEGES

VACANCY

1

ALP: Govt. Medical College.

36

2

CMC: Govt. Medical College.

3

3

KKM: Govt. Medical College.

100

4

KLM: Govt. Medical College.

3

5

KNM: Govt. Medical College.

16

6

KTM: Govt. Medical College.

54

7

MLP: Government Medical College.

2

8

PKM: Govt. Medical College.

4

9

RCC: Regional Cancer Centre.

8

10

TCM: Govt. Medical College.

65

11

TVM: Govt. Medical College.

117

12

AAM: Al Azhar Medical College & Super speciality Hospital.

10

13

AMC: Amala Institute of Medical Sciences.

33

14

AZC: Azeezia Institute of Medical Sciences & Research.

10

15

BCM: Believers Church Medical College Hospital.

6

16

DMM: Dr Moopen’s Medical College & Hospital.

14

17

EMC: MES Medical College.

46

18

GMC: Sree Gokulam Medical College & Research Foundation.

48

19

JMC: Jubilee Mission Medical College & Research Institute.

30

20

KCM: KMCT Medical College.

29

21

KDM: P K Das Institute of Medical Sciences.

10

22

MMC: Malankara Orthodox Syrian Church Medical College.

14

23

MMH: Malabar Medical College Hospital & Research Centre.

46

24

MZM: Mount Zion Medical College.

5

25

PMC: Pushpagiri Institute of Medical Science & Research Centre.

37

26

SIM: Sree Narayana Institute of Medical Sciences.

12

27

SMC: Dr. Somervell Memorial CSI Medical College.

12

28

SUC: SUT Academy of Medical Sciences.

29

29

TRM: Travancore Medical College.

19

TOTAL

818

MINORITY AND NRI QUOTA SEATS

S.NO

COLLEGES

VACANCY

1

Al Azhar Medical college.

2

2

Amala Institute of Medical Sciences.

29

3

Azeezia Institute of Medi. Science.

9

4

Believers Church Medical College.

6

5

Dr. Moopen’s Medical College.

2

6

MES Medical College.

8

7

Sree Gokulam Medical College.

9

8

Jubilee Mission Medical College.

22

9

KMCT Medical College.

6

10

P K Das Institute of Medical.

2

11

Malankara Orthodox Syrian Church Medi.College.

12

12

Malabar Medical College Hospital.

8

13

Pushpagiri Institute of Medical Science.

28

14

Sree Narayana Institute of Medical Sciences.

2

15

Dr. Somervell Memorial CSI Medical College.

16

16

SUT Academy of Medical Sciences.

5

17

Travancore Medical College, Umayanalloor.

14

TOTAL

180

To view both the seat matrixes, click the link below

https://medicaldialogues.in/pdf_upload/kea-1-261717.pdf

https://medicaldialogues.in/pdf_upload/kea-1-261718.pdf

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BFUHS Invites Applications For MD, MS, PG Diploma, DNB, Ultrasonography courses, Know all admission Details

Faridkot: Through a recent notice, the Baba Farid University of Health Sciences (BFUHS) has invited applications for MD, MS, PG Diploma, MDS, Six Months Training in Ultrasonography, Post MBBS DNB (Degree) and Post MBBS Diploma Courses for this academic year.

Online Application/Registration for admission to MD/MS/Diploma/MDS/DNB/PGDSM and six months training in Ultrasonography courses is to be undertaken online at the University website

Candidates are advised to fill the online admission application form well in advance to avoid the last minute rush and other technical issues. BFUHS will not be responsible for any delays in filling the online application. No application will be accepted after the last date of receipt of applications as released from time to time.

Application form for admission to PG courses can’t be submitted offline/printed copy by post. Incomplete application not in accordance with instructions shall not be considered and are liable to be rejected. The application fee shall not be refunded under any circumstances.

Admissions including eligibility to various PG Courses shall be governed and regulated as per the rules and regulations etc. as per Punjab Govt. notifications as well as detailed instructions mentioned on Govt. of India, Ministry of Health and Family Welfare/Directorate of Health and Family Welfare at its website etc.

Those who are not eligible as per guidelines of Punjab Govt. notification, terms & conditions of Govt. of India on its website mcc.nic.in will not be considered for admission. The candidates will participate in counselling process at their own risk & responsibility. Eligibility is also subject to medical fitness and such criteria as may be prescribed by the Punjab Government/ University/MCC/NMC/DCI.

Candidates’ eligibility is purely provisional & subject to the fulfillment of eligibility criteria as per Punjab Government Notification incorporated in this prospectus.

Application of candidates producing false or fabricated information shall not be considered and candidates shall be further debarred from participating in any Counseling’s conducted by BFUHS, Faridkot.

Any attempt by a candidate to influence directly or indirectly any person concerned with the admission will disqualify him/her.

Final seat matrix shall be displayed at the time of choice filling during respective round of online counseling.

The admission for PG courses shall be made only to those institutions and specialties which have permission from all of the concerned authorities.

The fee structure for the Government/Privately managed colleges/hospitals is as per Punjab Government notification(s) for Post Graduate Degree/Diploma courses. If Punjab Government issues any subsequent amendment/corrigendum for change in fee structure, the same will be applicable in letter and spirit.

In case of any discrepancy or contradiction between the Government notification/s and the University instructions contained in this Prospectus, the letter and spirit of the notification/s shall be prevailing.

Only deposition of fee does not confirm the admission of the candidate. The candidate must fulfill the eligibility criteria for admission to PG Courses as per terms & conditions of Punjab Govt. notification and GOI instructions on its website

Changes, if any, in the schedule of counselling etc. shall be notified only through website of the University so keep in touch with website regularly.

Candidates must retain the copy of prospectus with them till admissions. They should read carefully the instructions and the rules & regulations of the Punjab Govt. Notification/s and comply with all instructions therein strictly.

The allotment of specialty and college/hospital to the applicants for admission shall be made as per merit determined on the basis of NEET-PG-2023 and the availability of specialty and college/hospital preferred by the candidate at the time of online counselling.

Candidates applying under any of the reserve category are directed to fill the right category code mentioned in this prospectus for claiming reservation under a category and also bring/attach/upload all relevant documents/proof of respective category with admission application form and also directed to bring along photocopies and originals at the time of reporting to the college/hospital. Any request for change in category/quota will not be considered after the last date of receipt of applications as released from time to time. This is explicitly made clear that one claimed in online application form for any round, any request for change in cateogory/quota will not be considered in the subsequent round under any circumstances.

Candidates should ensure before applying for the admission that their MBBS/BDS degree is recognized as per provisions of Indian Medical/Denal Council Act. If it is found at any time that MBBS/BDS degree is not recognized, the candidature shall be cancelled/ deemed to be cancelled.

APPLICATION FEE

(i) Admission Application Fee of Rs. 5000 +18% GST (Rs. 5900/-) will be deposited through online payment gateway only. SC candidates will deposit fee of Rs. 2500+18% GST (Rs. 2950).

(ii) Only those Admission Application Forms will be considered for counseling, fee for which has been deposited by due date/time.

(iii) No request for accepting the deposition of application fee shall be considered after due date/time.

(iv) Fee once deposited in University Account will not be refunded/adjusted in any case.

(v) Fee shall not be accepted in any other mode i.e. Cash, Cheque, Demand Draft etc. 

ELIGIBILITY / INSTRUCTIONS FOR NRI CANDIDATES

1. The NEET PG qualified candidates who seeks to apply under NRI quota seats, have to obtain provisional Eligibility/equivalency certificate from the BFUHS, Faridkot and will have to apply on prescribed format available on university website along with prescribed fee for NRI seats.

2. For ascertaining the eligibility relevant documents including foreign Country Passport or Green Card or Permanent Resident Card or Proof of Residency of Foreign Country issued by competent authority or OCI/PIO Card issued by the Government of India shall be taken into consideration.

3. The admission under NRI category shall be strictly according to preference category wise merit as per Punjab Govt. notification/instructions. After selection, the candidate will be required to deposit the prescribed fee as per instructions.

4. The following is the procedure of admission under NRI Category :

(i) Application form for issuing of Eligibility/ Equivalency certificate is available in the Admission Branch BFUHS, Faridkot and can be downloaded from University website

(ii). Eligibility * NRI who passed MBBS

* Must have completed internship as per NMC

* Must be qualified- NEET-PG-2024

(iii). Candidate must be registered with MCI /State Medical Council and must have recognition Certificate of MBBS/Equivalent Degree from MCI.

(iv). After getting Eligibility/ Equivalency certificate, candidate has to apply on prescribed application form upto stipulated period to the University for Counselling for admission to PG Medical Courses under NRI quota in Private colleges.

(v) Fee Structure in Private Colleges:

Fee
Structure for NRI candidates:
Lump sum MD/MS
(Clinical) US $		 MD/MS
(Basic Sciences)US $		 PG
Diploma US $
125,000/- 20,000/- 30,000/-
Installments MD/MS
(Clinical) US $		 MD/MS
(Basic Sciences)US $		 PG
Diploma US $
First (at the time of Admission) 65000/ 10,000/- 15,000/
Second (after the one year of 1st Payment) 30,000/ 5,000/- 8,000/-
Third (after the 2 year of 1st payment) 30,000/ 5,000/- 7,000/-

(a) The student will have to give a bank guarantee/surety bond for the residual fee, if he/she opts to pay the fee in installment as provided.

(b) Selected Candidates will have to deposit full/1st installment of the fee through university website from the foreign NRI account after seat allotment and before joining the allotted college.

(c) If payment made through Demand Draft, Demand Draft should be in favour of Registrar, Baba Farid University of Health Sciences, payable at Faridkot.

(d) The payment should either be in US $ or is drawn from their own or parents NRE account along with bank certificate/statement showing that payment is drawn from candidate or parents account.

ELIGIBILITY CONDITIONS

1. The admission to MD/MS/PG Diploma/DNB/PGDSM and six months training in Ultrasonography shall be opened to candidates who have qualified NEET-PG-2024 and eligible as per Punjab Govt. notifications and subsequent amendment(s)/ corrigendum(s) and possessing basic qualifications i.e. MBBS for various PG Medical Courses.

2. Candidates cannot claim a seat/admission on the basis of the NEET-PG-2024 rank alone. Eligibility and Merit of a candidate for admission against any PG seat will be determined by the Admission Committee at the time of reporting in the college/hospital, strictly as per rules and regulations laid down in the Punjab Govt. Notification(s) as published in this prospectus and instructions of Govt. of India available on website

3. Counseling / Admissions shall be conducted by the Admission Committee constituted by the Punjab Government for this purpose.

4. Minority Quota seats: The final eligibility for getting seat under Minority Quota will be determined by the respective Minority institution in accordance with Punjab Govt. notifications and as per rules and regulations followed by respective institutions.

 

Steps to be followed for submission of online application form, submission of online preferences/choices for online counselling, etc.

SUBMISSION OF ONLINE APPLICATION FORM

Step-1 SUBMISSION OF ONLINE ADMISSION APPLICATION FORM

1. Candidates will have to log on University website i.e. www.bfuhs.ac.in and read the Punjab Govt. notification and instructions as contained in the Prospectus carefully.

2. Candidates who qualifies NEET-PG-2024 are eligible to apply ONLINE for admission to Post Graduate Courses including Post Graduate Diploma Courses and six month training in Ultrasonography.

3. Following documents are required to upload on the online registration form :

I. Soft copy of Photograph of the candidate. (Maximum size 30 KB)

II. Soft copy of the signatures of the candidate. (Maximum Size 30 KB)

4. Specifications for Photograph:–

I. A colour photograph of minimum 35×45 mm with at least 75% coverage of face & head of the candidate

II. A caption indicating name of candidate and date of taking photograph should be there at the bottom of photo.

III. Photograph should be taken in a white /very light colored background.

IV. Photograph should not have cap or goggles. Spectacles are allowed if being used regularly. POLAROID and COMPUTER generated photos are not acceptable.

V. The photograph needs to display full front view of the face. Please look directly into the camera with a neutral expression.

VI. Please avoid photograph with reflection or shadow on the face with red eyes.

VII. The photograph needs to be printed on a high quality paper with at least 600 dpi resolutions.

VIII. The colours must possess the natural appearance and skin tone.

IX. The photograph must not have kinks, scratches and stains.

Note: Applications not complying with these instructions or with unclear photographs are liable to be rejected.

5. After completion of filling online admission application form, University will issue a unique Registration ID (i.e Login ID) and password will be provided to the candidate at his/her registered Mobile number in admission application form through SMS/ email. Registration Number and password are mandatory for further process, so keep it secret and don’t disclose to any unknown person.

6. Merely submission of online application form & fee does not confer any automatic rights to secure a Postgraduate MD/MS/Diploma/DNB/PGDSM seat/six months training in Ultrasonography courses.

7. Candidates should ensure before applying for the admission that their MBBS degree is recognized as per provisions of Indian Medical Council Act. If it is found at any time that MBBS degree is not recognized, the candidature/result shall be cancelled/ deemed to be cancelled. 

8. Candidate shall submit online ADMISSION APPLICATION FORM only once. Applications submitted more than once are liable to be rejected.

9. Candidates are required to fill online Admission Application Form very carefully and should not leave any column blank.

10. Candidate has to deposit the application fee through online University payment gateway.

11. Application form for admission to PG COURSES submitted offline/printed copy shall not be accepted.

12. Candidate shall retain the Admission Application Form till the completion of admission process.

13. Incomplete application forms shall not be considered and are liable to be rejected. The fee shall not be refunded under any circumstances. 

Step-II CATEGORY IN APPLICATION FORM

Fill category carefully in the online Admission Application Form. Category once claimed will not be changed in any case after submitting the form. Those candidates, who will not fill/claim any category code as per prospectus or wrongly filled category code other than mentioned in prospectus, will be treated as Open/General Category candidate. The candidate has to select a category code from the codes given below and fill the category accordingly. More than one category may be filled by a candidate if it is considered applicable in the candidate’s particular case.

Category codes are exclusively for the purpose of facilitating the candidates to know and understand his/her respective merit placement at the time of counselling in particular reserved category as filled by him/her. No benefit of reservation whatsoever shall be given if the claim is not made in online Admission Application Form. Reserve category selection on the part of the candidate shall not in any case be construed to give him/her any legitimacy or right or claim on the benefits for reserved seats during admission unless he/she fulfills the eligibility criteria for being considered in particular reserve category as per Punjab Govt. instructions and submit the relevant documents as per Punjab Government Notifications published in the prospectus. 

Categories

 11

Open/General Category

 12

Schedule Castes

 13

Backward Classes

 14

Persons With Disability *

 15

Economically Weaker Section (EWS) ** 

 16

* Instructions for Persons with Disability category :

(i) Disability certificate – The candidates must obtain their online disability certificate from designated disability board in an online mode generated by the disability Centre as per the NMC norms before the choice filling commences. Only candidates who have made their disability certificate through online mode from the designated centres will be eligible to fill in the PwD choices. BFUHS/MCC does not issue/ authenticate/ verify and has no role in generation of online Disability certificate

(ii) Candidates shall bring the valid certificate in the prescribed format from any of the designated centre on the day of counselling.

(iii) No separate medical board will be constituted for the admission under this category and no other disability certificate in this regard shall be entertained

** Instructions for Economically Weaker Section (EWS) category :

(i) It is explicitly made clear that candidate applying under EWS category shall have to produce the EWS certificate as prescribed in the Prospectus by the competent authority of Govt. of Punjab only.

(ii) EWS certificate produced from States other than Punjab will not be considered at any cost.

(iii) The instructions for EWS certificate are as per the guidelines and terms and conditions of State of Punjab.

Step-III THE PROVISIONAL MERIT LIST

1. The University shall display the State Merit List (of registered candidates) on the University website. After displaying the state merit list of registered candidates, the University shall open the online portal for choice filling. Online counselling will be held as per schedule posted on website.

B. INSTRUCTIONS FOR 1ST ROUND OF ONLINE COUNSELING. 

Step-IV FILLING OF CHOICES/PREFERENCES OF COURSE DURING ONLINE COUNSELING

1. Only registered candidates are eligible for the counselling(s), no candidate shall be allowed to participate in the counselling (online/physical) without registration and deposition of fee before last date as prescribed.

2. The candidates should read the eligibility conditions carefully and just exercising online option of college/hospital / appearing in counselling does not entitle him/her for admission. Eligibility conditions for admissions are as per Punjab Govt. Notification(s).

The eligibility of the candidate shall be determined by the Principal / Nodal Officer of allotted college/hospital at the time of document verification and checking of eligibility at the provisional allotted College/Hospital. Those who are not eligible as per Punjab Govt. notification and not found fit medically as per MCI Gazette notification No. MCI34(41)/2019-Med./112862 dated 13.05.2019, will not be considered for admission.

3. Counselling for admission to PG courses, session 2024 will be conducted online followed by Physical reporting of the candidates to allotted college/hospital. During online counseling, candidates will fill online counselling form. They shall give their preferences of course, specialty and college/hospital. The Provisional Seat will be allocated as per merit list and in order of preferences given by the candidate

Therefore, candidates are advised to take proper caution while filling up the order of preferences of course, specialty and college/hospital.

4. Candidates of reserved categories (who scored marks equivalent or more than the minimum cut-off of open merit NEET PG marks) will be considered first in open merit and if seat is not available in open merit as per choice/merit of candidate then the seat will be allotted in reserve category provided that seat is available in that category.

5. Candidates of reserved categories with score less than the cut-off of open merit will be considered only for reserve category seats as per qualifying criteria of NEET PG.

6. After provisional allocation of seat, candidates can download provisional allocation letter from the University website after logging into their account and report to the allocated college/hospital along with all original documents for verification of eligibility.

Issuing of Provisional Selection Slip alone does not confer any right to claim the allocated seat in respective college/hospital as provisional selection is subject to verification of documents and checking of eligibility as per guidelines of Punjab Govt. Notification enshrined in the Prospectus.

7. After allocation of seat, mere deposition of tuition fee does not confer any automatic rights to secure a seat/admission. If any candidate failed to report to the college/hospital within stipulated time his/her seat shall automatically stand cancelled.

8. If any candidate does not follow the said process, his/her allocated seat will be cancelled automatically without any intimation and his/her seat shall be declared as vacant for the subsequent round of counseling.

9. In case any candidate wants to quit the course/seat after allotment/joining in first round of counselling, he/she will have to submit written application to the respective college/hospital regarding his/her surrender of seat within the stipulated period.

10. There will be an option for up-gradation and free exit, only in Round 1 of the counselling

STEP-V PROVISIONAL ALLOTMENT OF SEAT:-

1. The online allotment made will be deemed provisional to be confirmed subject to verification of documents at the time of physical joining in the allotted college/hospital.

2. The Provisional seat will be allotted to the candidate as per merit list and speciality/college/hospital for preferences/choices filled by the candidate.

3. After provisional allocation of seat, candidate shall have to report to the allocated college/hospital within stipulated time for verification of documents and checking of eligibility by the Principal/Nodal Officer of concerned College/Hospital. It is sole responsibility of the Principal/Nodal Officer to authenticate the eligibility of the provisionally allocated candidate before joining.

4. The distribution of seats during online allotment will be strictly as per Punjab Govt. notification. During the process of the allotment if person is eligible for that particular quota, then the 1st preference will be given to the availability of seat in Mgt. Quota in a Private institute. However if the seat is not available in Mgt. quota but is available in IP quota then that IP seat will be allotted as per eligibility. This process is followed by the University to give preference to Graduates of Punjab state over other state candidates as other state candidates have their IP/Preference in their parent state. While filling  online choices the candidates can go through the seat matrix where all the details of availability of seats as per specialty/Quota/Category wise are shown.

5. The distribution of seats during online allotment will be as per Punjab Govt. notification. During the process of the allotment if candidate is eligible for that particular quota, then the 1st preference will be given to the availability of seat in General/ IP Quota in a respective institute. However if the seat is not available in General/ IP quota but is available in respective category that is SC/BC/EWS candidates of Punjab state quota then that will be allotted. This process is followed by the University as per para no. 12 in Punjab Govt. notification.

For example If a person from SC/BC/EWS category wants to take a seat of M.D. Radiology in Government college through IP, then if there is availability of seat in IP Quota of Govt. Medical College for MD Radiology the candidate will get the same.

However if the seat is not available in the IP Quota of the Govt. Medical College of Radiology then if it is available under the respective reserved category and the candidates is of reserve category of Punjab state, he/she will be allotted the same.

STEP-VI VERIFICATION OF DOCUMENTS:-

1. The candidates are required to deposit the tuition fee through online University payment gateway only and then report to the respective allotted college/hospital for verification of original documents/credentials. The candidate must submit proof of fee remittance to the Principal/Nodal Officer of concerned College/Hospital/Institution. If the provisionally selected candidate is found eligible as per instructions mentioned in Punjab Govt. Notification no. 5/26/2016-5HB-III/423 dated 06.03.2023 or Notification No.5/8/2021-5HB3/1323 dated 07.06.2023, candidate will be allowed to submithis/her joining report after medical checkup and completing other formalities.

2. The respective Colleges will send the Registration Return of candidates to the university within stipulated date alongwith proforma, original documents, registration fee of the candidate for registering the candidate in particular course/speciality/quota. If at the time of registration, any candidate is found not eligible as per Punjab Govt. notification by the University, then his/her selection will be cancelled by the University immediately.

3. The selected candidates shall report to the provisional allocated college / hospital for checking of eligibility and document verification along with the following documents:

i) Candidates allotted seat must carry one of the identification proofs (ID Proof) to the allotted college/hospital at the time of admission (as mentioned in the information Bulletin published by the National Board of Examinations (NBE) for AIPGMEE/AIPGDEE i.e. PAN Card, Driving License, Voter ID, Passport or Aadhar Card.)

ii) Receipt of deposition of six month fee as per clause 18(i) of notification.

iii) Admit card issued by NBE

iv) Result/Rank Latter issued by NBE.

v) High School/Higher Secondary Certificate/Birth Certificate as proof of date of Birth.

vi) Mark Sheets of all MBBS Professional Examinations.

vii) MBBS Degree Certificate/Provisional Certificate.

viii) Internship Completion Certificate/Certificate from the Head of Institution.

ix) Permanent / provisional Registration Certificate issued by NMC /State Medical Council.

x) In service candidates will produce provisional NOC from the competent authority.

xi) The Candidate should also bring the following certificate if applicable.

a) SC Certificate issued by the competent authority of Punjab or BC certificate issued by the competent authority of Punjab. The BC certificate must be in the format as mentioned in the prospectus or

Disability Certificate issued from duly constituted and authorized Medical Board for 21 Benchmark Disabilities as per the Rights of Persons with Disability Act,2016 as mentioned in the Information Bulletin for National Eligibility-cum-Entrance Test (Post Graduate) NEET-PG-2024. No other PWD certificate, issued by any other Authorities/ Hospital will be entertained. or EWS certificate issued by the competent authority of Punjab.

b) The undertaking mentioned in the Prospectus as Annexure B (if applicable).

4. Verification of Documents of candidates applied under Christian and Sikh Minority Quota.

The candidate who have applied under minority quota will report to the respective minority institutions before conducting online counselling as per schedule. Verification of eligibility under Sikh Minority Quota and Christian Minority Quota is made compulsory to participate in the online process of counselling. The list of candidates who have applied for respective minority quota will be forwarded to the respective institute. The minority status of the candidate will be verified by the institute as per rules and regulations followed by their institute. The list of eligible candidates under Minority Quota will be provided by the institutes only.

Those candidates who will be found eligible will be considered for the respective quota as per the notification.

STEP-VII INSTRUCTIONS REGARDING DEPOSITION OF FEE BY PROVISIONALLY SELECTED CANDIDATES IN ONLINE COUNSELLING – FEE AND SPECIALITIES (BASIC/CLINICAL)

1. The provisionally selected candidates are required to deposit the requisite six months fee through university payment gateway in university account after logging into their login ID account and carry the payment receipt to the respective allotted institute.

2. The Provisional Selection Slip will be generated only after the confirmation of deposition of fee

Details of six month fee/minimum fee for 1st year to be collected from the provisionally selected candidates.

Sr. No.

Speciality

Stream

Govt. College/Hospital six month fee

Private Colleges Six month fee

Govt. Quota

Mgt. Quota

NRI Quota 1st Installment

1.

Anatomy

Basic

50000

130000

130000

US$ 10000

2.

Biochemistry

Basic

50000

130000

130000

US$ 10000

3.

Immuno Haematology and Blood Transfusion

Basic

50000

130000

130000

US$ 10000

4.

Microbiology

Basic

50000

130000

130000

US$ 10000

5.

Pharmacology

Basic

50000

130000

130000

US$ 10000

6.

Physiology

Basic

50000

130000

130000

US$ 10000

7.

Community Medicine

Basic

50000

130000

130000

US$ 10000

8.

Forensic Medicine & Toxicology

Basic

50000

130000

130000

US$ 10000

9.

Anaesthesiology

Clinical

62500

325000

325000

US$ 65000

10.

Skin & STD

Clinical

62500

325000

325000

US$ 65000

11.

General Medicine

Clinical

62500

325000

325000

US$ 65000

12.

Obstetrics & Gynaecology

Clinical

62500

325000

325000

US$ 65000

13.

Ophthalmology

Clinical

62500

325000

325000

US$ 65000

14.

Orthopedics

Clinical

62500

325000

325000

US$ 65000

15.

ENT

Clinical

62500

325000

325000

US$ 65000

16.

Pathology

Clinical

62500

325000

325000

US$ 65000

17.

Paediatrics

Clinical

62500

325000

325000

US$ 65000

18.

Psychiatry

Clinical

62500

325000

325000

US$ 65000

19.

Radio-diagnosis

Clinical

62500

325000

325000

US$ 65000

20.

General Surgery

Clinical

62500

325000

325000

US$ 65000

21.

Radiotherapy

Clinical

62500

325000

325000

US$ 65000

22.

TB & Chest

Clinical

62500

325000

325000

US$ 65000

23.

Diploma in Anaesthesia (DA)

Clinical

62500

195000

195000

US$ 15000

24.

Diploma in Child Health (DCH)

Clinical

62500

195000

195000

US$ 15000

25.

MDS Courses

Clinical

62500

292500

292500

US$50000

26.

PGDMS

20000

27.

Ultrasonography Training

Training

10000

50000

50000

28.

DNB Courses

37500

INSTRUCTIONS FOR 2ND AND SUBSEQUENT ROUND OF ONLINE COUNSELING.

STEP VIII : SUBMISSION OF WILLINGNESS FOR 2ND AND SUBSEQUENT ROUNDS OF ONLINE COUNSELLING.

1. The process for inviting willingness to participate in the 2nd /subsequent rounds of online PG counselling shall be commenced before submission of online preferences/choices for 2nd / subsequent round of counseling. If candidate want to participate for 2nd / subsequent round, he/she will have to submit willingness as per the rules & regulations of Government of India posted on www.mcc.nic.in. Only those candidates will be considered for 2nd /subsequent round who will submit willingness by depositing requisite security amount for participation.

2. Security Deposit :The amount of Security to be deposited for submitting willingness will be as under :

(i) For Government colleges/institutions – Rs. 25,000/- (Rs. 10000/- for SC/BC/PwD)

(ii) For Private Colleges – Rs. 2,00,000/- for all categories

Instruction for 2nd round of online counselling only : If candidate is satisfied with seat allocated to him/her during 1st round of online counselling, he/she is not required to participate in the 2nd round of counselling. In case, candidate wishes/intends to upgrade/shift/change his/her seat, he/she will have to participate in the 2nd round of counselling and will have to give willingness to participate in 2nd round counseling and will have to submit preferences afresh for the course, specialty and college. It is pertinent to mention here that the candidates can fill the choices of colleges which are not reflecting in the vacancy position of seats as few seats may arise due to shifting of candidates from one stream/category to another stream / category during 2nd round of counseling. In this regard, it is made clear that during 2nd online counseling one can upgrade/shift seat. Therefore, any seat may arise in 2nd round due to shifting of seats.

Hence, it is not mandatory to fill only those choices/preference which are reflected in the vacancy position of seats. So candidates are advised to fill the preference/choices of colleges as per their choice. The seats in 2nd round will be allocated as per availability of seats as per merit cum choice/preference submitted by the candidate.

The candidates to whom seats are allotted in the 1st round of counseling will also submit the willingness to participate in the 2nd round of online counselling, however, the fee deposited by them will be adjusted and they will have to pay the remaining amount of security deposit. Those who have already paid more than Rs. 200,000/- need not to pay security deposit again. The consent/willingness is mandatory to participate in 2nd round. In case seat is upgraded/changed in the 2nd round of counselling, the tuition fee deposited at the time of first counselling will be adjusted and only difference in fee, if any, has to be deposited.

Instruction for 3rd round of online counselling only : If candidate is satisfied with seat allocated to him/her during 1st /2nd round of online counseling and joined the seat, he/she is not required to participate in the 3rd round of counselling. In case, candidate wishes/intends to upgrade/change his/her seat he/she will have to participate in the 3rd round of counselling and will give his/her preferences afresh for the course, specialty and college/hospital. It is pertinent to mention here that the candidates can fill the choices of colleges/hospital which are not reflecting in the vacancy position of seats as few seats may arise due to shifting of candidates from one stream/category to another stream / category during 3rd round of counseling. In this regard, it is made clear that during 3rd online counseling one can upgrade/shift seat as per his/her choice.

This is also made clear that some seats of reserve category, NRI Quota seats, etc. may remain vacant after exhausting all candidates of respective category/quota as per notification. Therefore, any seat may become vacant in 3rd round due to shifting/conversion of seats. Hence, it is not mandatory to fill only those choices/preference which are reflected in the vacancy position of seats. So candidates are advised to fill the preference/choices of colleges/hospitals as per their choice. The seats in 3rd round will be allocated as per availability of seats as per merit cum choice/preference submitted by the candidate. The candidates who have joined the seat of 1st/2nd round of counseling and want to shift/upgrade the seat, will also submit the willingness to participate in the 3rd round of online counseling as per schedule,

however, the fee deposited by them will be adjusted and they will have to pay the remaining amount of security deposit. Those who have already paid more than Rs. 200,000/- need not to pay security deposit again. The consent/willingness is mandatory to participate in 3rd round. In case seat is upgraded/changed in the 3rd round of counselling, the tuition fee deposited at the time of first/second counselling will be adjusted and only difference in fee, if any, has to be deposited.

5. Shifting/upgradation of seat is not allowed after the 3rd round of counseling

To view the official Notice, Click here :  https://medicaldialogues.in/pdf_upload/prospectusmdmsdnb-261712.pdf

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Setback to Cipla: DoP rejects plea challenging NPPA order for Acivir Tablets pricing

New Delhi: The Department of Pharmaceuticals (DoP) has rejected Cipla Ltd’s review application challenging the ceiling price fixed for Acivir 800 mg Tablet DT 5’s by the National Pharmaceutical Pricing Authority (NPPA).

Cipla argued that NPPA incorrectly relied on outdated pricing data for its January 2023 order, ignoring a revised price submitted in August 2022 with supporting evidence.

Cipla filed the review application under Para 31 of the Drugs (Prices Control) Order, 2013 against the order issued by NPPA on 11 January, 2023, that fixed the ceiling price of Acivir 800 mg Tablet DT 5’s containing Acyclovir 800 mg per Tablet.

Cipla alleged that NPPA erred in determining the ceiling price of the said drug and therefore should be directed to revise the same.

Cipla submitted that the formulation “Acivir 800 mg Tablet DT 5’s” was included in the revised Schedule-I of the DPCO, 2013 notified on November 11, 2022. Hence, the formulation “Acivir 800 mg Tablet DT 5’s” was also included in the draft calculation of ceiling price under the provisions of Para 4, 6, 10, I l, 14, 16, 17 and 18 of DPCO 2013.

In spite of representation filed against the draft ceiling price with all relevant documents proving that Cipla has duly implemented the 10% revision in MRP as per Para 20(1), NPPA considered the old PTR for ceiling price fixation, Cipla argued, adding that the ceiling price calculation of “Acyclovir 800 mg per tablet” should have included the revised PTR for “Acivir 800 mg Tablet DT 5’s” at Rs. 175.88 and not IQs. 159.89.

The drug maker further contended that non-reflection of PTR in the market based data should not be construed as non-implementation of revised MRP, especially when invoices of sales and pack shots at revised MRP are provided as documentary evidence.

Cipla maintained that the manufacturers, as per Para 20(1) of DPCO 2013, reserve the right to increase the MRP of non-scheduled formulations by 10% once in a year. Thus, an increase in PTR post July, 2022 should also be considered in the calculation of ceiling prices of the scheduled formulation.

It further submitted that the NPPA in its 105th Authority Meeting had also clarified that in case of any revision in the draft calculation of ceiling prices, the corrected working sheet shall be uploaded on NPPA website for 10 working days for comments, if any. In case of non-receipt of any comments or after addressing any issues received on the revised working sheets, the same shall be placed before the Authority for decision. In those cases, where the data has been verified and confirmed by Pharmarack, prices will be re-computed based on revised data. Accordingly, corrigendum / addendum / new price notifications will be issued. However, NPPA in violation of the decision of the Authority Committee, did not upload the revised working sheet, despite presenting the revised Ceiling price to the Authority for approval. Ceiling price calculation was later shared on 23 rd December 2022 and 16th January 2023, however correction was not made.

NPPA on the other side argued that the review was not tenable as according to per para 9(5) of the DPCO 2013, the market based data for fixing the ceiling price of a scheduled formulation due to a revision in the first schedule shall be the data available for the month ending immediately before six months of notification of revision in the first schedule. Accordingly, the Authority in its 104th meeting held on 23.11.2022 noted that the data to be considered for fixation of ceiling prices would be the prices in the month of April, 2022 which is the month that is six months prior to date of issue of Notification SO No. 5249(E) dated 11.11.2022. However, taking cognizance of the time lag with which price changes carried out due to revision in WPI is reflected/captured by the data; the Authority, under Para 9(7) of the DPCO 2013, decided that data for the month of July, 2022 may be considered for calculation of ceiling prices.

NPPA further explained that the said strength of the subject formulation has been added in the Schedule-I under NLEM, 2022 for the first time.

“This formulation was non-scheduled before NLEM, 2022. Hence, submission of Form-Il is not applicable in this case. Cipla has submitted Form-V with NPPA in respect of revised PTR of “Acivir 800 mg Tablet DT 5’s” at Rs.175.88 on 03.08.2022. The PTR of the said formulation prevailing in July, 2022 was Rs. 159.89 (Form-V filed on 03.03.2021), which was already reflected in the Pharmarack database. Therefore, the revised PTR of Rs. 175.88, as claimed by the Applicant, was not considered,” the Authority said.

It further asserted that the clarification provided by NPPA in its 105th Authority Meeting dated December 15, 2022 referred to by Cipla is applicable only in case of Suo Moto corrections in the notified prices. In other cases, where based on the representations, the data has been verified and confirmed from/by Pharmatrack, prices will be re-computed based on revised data. Accordingly, corrigendum / addendum / new price notifications are issued.

Examining the issue, the DoP upheld NPPA’s actions, noting that the use of July 2022 data was consistent with Paragraph 9(7) of the DPCO. It observed;

“The Authority in its 104th meeting held on 23.11.2022 had decided, under Para 9(7) of the DPCO 2013, that data for the month of July, 2022 may be considered for calculation of ceiling prices instead of April, 2022 so as to accommodate for the time lag with which the price changes carried out due to revision in WPI is reflected/captured in the database. Accordingly, prices as captured by the Pharmarack database for the month of July, 2022 were used for fixing the ceiling price of the subject formulation.”

It further observed;

“The subject formulation was earlier non-scheduled and hence, submission of Form-Il is not applicable in this case. The Authority has decided to fix the ceiling price based on July, 2022 data. NPPA has taken the relevant price as available in the Pharmarack data for the month of July, 2022 which is the same as the available PTR under Form-V of the Applicant for the month.”

Consequently, DoP rejected Cipla’s review application and upheld NPPA’s ceiling price for Acivir 800 mg Tablet DT 5’s. It noted;

“The decision taken vide para 6.8 of Minutes of 105 th Authority Meeting held on 15.12.2022 was only in the context of Suo Moto corrections in the notified prices by NPPA and not in other cases. The practice adopted by NPPA in this regard suffers no infirmity. Therefore, in view of the facts as at paras of 5.1 and 5.3 above, arguments and logics given by NPPA are accepted. ”

“The action of NPPA fixing the ceiling prices of subject formulation is upheld and the Review Application under consideration is accordingly rejected.”

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