Archive for month: November, 2024

 Valid Consent of Affiliation (CoA) in the prescribed Proforma, and

 Justification for the number of requested seats

The Commission had also clarified that the applications would only be accepted after online payment of the requisite fee through the link generated during the filling of the application.

New Delhi: Global Health Limited (NSE: Medanta, BSE: 543654), one of the largest private multi-specialty tertiary care providers operating in the North and East regions of India, announced that the Company has signed an Operations and Management Agreement with Dr Narayan Dutt Shirmali Foundation International Charitable Trust Society (”Society”) to operate and manage a 750 bed super specialty hospital in Pitampura, New Delhi. 

The hospital is expected to commence operations in 4 years, subject to necessary statutory and customary approvals.

As per the agreement, the hospital building and associated civil infrastructure will be developed by the Society and Medanta will make the necessary investments in internal fitouts, MEP, furniture and medical equipment. Medanta is expected to incur a project capex of ~Rs. 600 crores in next 3-4 years, to be funded by a combination of internal accruals and debt financing.

Also Read:Four Medanta Doctors on Stanford’s Global Top 2% Scientists List

Medanta will have full control over the day to day running of the hospital. The agreement is for an initial term of 30 years, further extendable on mutually agreeable terms.

The hospital will be located on a 7-acre site in Pitampura, New Delhi, with a total built-up area of 7.6 Lakh sq.ft excluding the basement. The site offers good connectivity to the Outer Ring road and is in close proximity to high-density residential areas, which will enable Medanta to serve the region’s growing healthcare needs.

The state-of-the-art ~750 bedded super-specialty hospital will cater to over 30 super specialties including cardiac, neurosciences, cancer, orthopaedics, digestive, hepatobiliary sciences, multispecialty robotic surgeries, regenerative medicine, as well as full range of transplants.

Commenting on the development, Dr Naresh Trehan, Chairman & Managing Director, Medanta, said, “We are thrilled to expand our footprint in New Delhi by entering into an O&M agreement to operate and manage a ~750 bed super-speciality hospital in Pitampura. This large scale format hospital aligns with our commitment to providing high-quality quaternary care and will allow us to serve communities in Delhi for decades to come.”

“This strategic expansion reinforces our vision to build a sustainable and high-standard healthcare delivery platform. By securing this O&M agreement, we are strengthening our presence in Delhi/NCR and reaffirming our dedication to elevating patient care in the region through world-class services and facilities.” added Pankaj Sahni, Group CEO and Director.

Also Read:Medanta achieves National Recognition as Active Emerging Lung Transplant Centre in North India

Glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy offers significant glycemic benefits for individuals with type 2 diabetes. However, the impact of combining GLP-1 RA therapy with FreeStyle Libre systems (FSL) has not been previously explored. To address this gap, Eugene E. Wright, Abbott, Sylmar, California, USA, and colleagues aimed to compare changes in hemoglobin A1c (HbA1c) levels between individuals receiving GLP-1 therapy alongside FSL (GLP-1+FSL) and those receiving GLP-1 therapy alone (GLP-1).

For this purpose, the researchers utilized Optum’s de-identified Market Clarity Data, a linked electronic health records (EHR)-claims database. The study included adults with T2D and HbA1c levels of 8% or higher who started their first GLP-1 RA medication between 2018 and 2022. Participants in the GLP-1+FSL group initiated their first FreeStyle Libre system within ±30 days of starting their first GLP-1 medication.

The cohorts were matched in a 1:5 ratio based on baseline insulin therapy, age, sex, baseline HbA1c, and the type of GLP-1 RA. Changes in HbA1c were then compared between unmatched and matched groups at the six-month mark.

The study led to the following findings:

• The study comprised 24,724 adults in the unmatched cohort, with 478 participants in the GLP-1+FSL group and 24,246 in the GLP-1 group. In the matched cohort, there were 478 GLP-1+FSL users and 2,390 GLP-1 users, with a mean age of 53.5 ± 11.8 years and 53.5 ± 11.3 years, respectively.
• The HbA1c levels were 10.25 ± 1.68% in the GLP-1+FSL group and 10.22 ± 1.69% in the GLP-1 group.
• The reduction in HbA1c was significantly greater in the GLP-1+FSL group compared to the GLP-1 group, with changes of −2.43% versus −1.73% in the unmatched cohort and −2.43% versus −2.06% in the matched cohort.
• Further analysis showed that the combination of GLP-1+FSL was associated with greater HbA1c reductions across various subgroups: in patients on intensive insulin therapy (−2.32% versus −1.50%), non-intensive insulin therapy (−2.50% versus −1.74%), and those not using insulin (−2.46% versus −1.78%).
• Among users of specific GLP-1 RAs, HbA1c reductions were also greater for semaglutide (−2.73% versus −1.92%) and dulaglutide (−2.45% versus −1.71%).

In the real-world, retrospective observational study, adults with suboptimally controlled type 2 diabetes who initiated GLP-1 RA therapy alongside FreeStyle Libre demonstrated greater improvements in HbA1c compared to those receiving GLP-1 RA therapy alone. This enhancement in glycemic control was observed across patients on intensive insulin therapy, non-intensive insulin therapy, and non-insulin medications. Additionally, there were significant HbA1c reductions in patients using either semaglutide or dulaglutide formulations of GLP-1 RA.

“These findings suggest that the combined use of continuous glucose monitoring (CGM) with GLP-1 therapy may provide an additive benefit, aiding patients in reaching their glycemic targets. To further validate these results and explore the relationship between CGM usage and improved outcomes with GLP-1 RA therapy, additional studies are warranted,” the researchers concluded.

Reference:

Wright EE, Roberts GJ, Chuang JS, Nabutovsky Y, Virdi N, Miller E. Initiating GLP-1 Therapy in Combination with FreeStyle Libre Provides Greater Benefit Compared with GLP-1 Therapy Alone. Diabetes Technol Ther. 2024 Oct;26(10):754-762. doi: 10.1089/dia.2024.0015. Epub 2024 May 31. PMID: 38669474.

The most commonly documented cause of vaginitis is bacterial
vaginosis (BV). BV is characterized by a dramatic switch of vaginal bacterial
flora from normal predominant Lactobacilli to a polymicrobial flora. Vulvovaginal
candidiasis (VVC) is the second most common vaginal infection, while trichomoniasis,
caused by Trichomonas vaginalis, is the most common non-viral sexually
transmitted infection. True mixed infection rarely occurs in women with
vaginitis, but coinfection occurs much more frequently. Coinfection with
Candida species is observed in about 20%-30% of women with BV. The coinfection
rates of BV pathogens and trichomoniasis are even more prevalent. Other
etiologies of vaginitis include vulvar skin diseases, desquamative inflammatory
vaginitis, and genitourinary syndrome of menopause.

Despite the availability of numerous oral, topical, and
intravaginal medications for the treatment of vaginal infections, their
management remains challenging. Associated side effects, development of
resistance, lack of prevention and destruction of biofilms, and higher
recurrences are the limitations of currently available conventional therapies.
Ineffectiveness due to poor penetration and rapid removal from the vaginal
canal are the major hurdles in achieving infection cure with local
antimicrobial therapies. There is a need to develop newer therapeutic options
for treating vaginal infections that overcomes the limitations of current
therapies.

During the last decades, nanotechnologies-based
formulations, such as nanoparticles, have been explored to overcome the
limitations of current therapies for vaginal infections. These novel
formulations can improve local drug delivery, biodistribution, retention, and
uptake in vulvovaginal tissues. Other important benefits nanotechnology-based
formulations offer are reduced toxicity, enhanced patient compliance, and
improved treatment outcomes.

The study by Dani, Godbole and Mehta evaluated the efficacy
and safety of colloidal nano silver gel (SilverSol® Vagigel) (A patented
technology from American Biotech Labs, USA) in combination with 0.2% lactic
acid in the female subjects for the treatment of vaginal infections.

This study was a multicenter, randomized, double-blind,
placebo-controlled pilot study in which post-menarchal female subjects between
18 and 65 years of age clinically diagnosed with bacterial vaginosis and
vulvovaginal candidiasis were enrolled. The participants were randomized to
receive treatment with SilverSol® Vagigel or placebo (vehicle) gel (both
treatments as one 4 gm application inserted into the vagina with an applicator
device, once daily at bedtime for internal use and 2 gm gel for local
application to the vulva and vagina for external use twice daily for a period
of 14 days). The primary endpoint evaluated was the proportion of subjects
achieving clinical cure. The secondary endpoint was the proportion of subjects
achieving microbiological cure at the end of the study visit.

A total of 57 subjects were randomized in the study out of
which 38 subjects were randomized in SilverSol® Vagigel arm and 19 subjects
were randomized in placebo arm. SilverSol® Vagigel significantly improved cure
rates of vaginal infections compared to placebo.

The proportion of subjects achieving clinical cure of
vaginal infections was higher i.e., 33 (86.84%) subjects in SilverSol® Vagigel
arm compared to 07 (41.18%) subjects in Placebo gel arm (p-value: 0.0009).

The clinical cure rate with SilverSol® Vagigel was 81.82%
(P=0.1758) for bacterial vaginosis and 92.59% (P=0.0010) for vulvovaginal
candidiasis patients at the end of the study.

Overall SilverSol® Vagigel treatment resulted in a
significantly higher microbial cure of vaginal infections (P=0.0028) compared
to placebo, with a microbial cure rate of 100% for bacterial vaginosis
(P=0.0330) and 85.19% for vulvovaginal candidiasis (P=0.0097).

No adverse events were reported in subjects treated with
SilverSol® Vagigel.

In this study, SilverSol® Vagigel was effective and safe in
treating the most common vaginal infections i.e. bacterial vaginosis and
vulvovaginal candidiasis. Overall, the findings of this study, combined with
the existing body of evidence, indicate that SilverSol® Vagigel may represent a
valuable addition to the armamentarium of available therapies for vaginal
infections, offering potential benefits for patients in terms of improved
outcomes and reduced side effects. Overall, SilverSol Vagigel represents an
excellent advancement in women’s health, offering a highly effective and safe
solution for treating vaginal infections. Leveraging the exceptional antibacterial,
antiviral, antifungal, andimmune-enhancing properties of SilverSol®, SilverSol®
Vagigel formulation can emerge as a promising therapeutic option for treating a
wide range of vaginal infections and delivering unparalleled safety and
efficacy in addressing diverse feminine health concerns.

Source: Dani, Godbole and Mehta / Indian Journal of
Obstetrics and Gynecology Research 2024;11(1):83–89;
https://doi.org/10.18231/j.ijogr.2024.015