Study finds increased survival with nivolumab plus ipilimumab vs. chemo for metastatic colorectal cancer
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Ahmedabad: In the wake of the ongoing investigation into Ahmedabad’s Khyati Multispecialty Hospital for performing unnecessary angioplasty procedures on several PMJAY beneficiaries, the Gujarat Health Department has debarred five private hospitals and two doctors from participating in the Pradhan Mantri Jan Arogya Yojana (PMJAY) due to alleged irregularities.
The Gujarat health ministry on Monday said it has debarred five private hospitals from providing services under the Pradhan Mantri Jan Arogya Yojana (PMJAY) due to irregularities in the last one week, taking the count of medical facilities de-panelled so far in 2024 to 12.
Following the inspection of these facilities, several fraudulent activities were uncovered, including altered laboratory reports, insufficient infrastructure, and violations of guidelines.
According to the PTI report, two doctors working in these hospitals were also suspended from providing services under PMJAY – a flagship health insurance scheme of the Centre – and one of the de-panelled medical facilities was fined Rs 50 lakh.
The action comes in the backdrop of Ahmedabad-based Khyati Multispecialty Hospital caught performing unnecessary angioplasty procedure on several PMJAY cardholders just to siphon off government money.
Also Read:Botched Angioplasties Case: 112 deaths at Khyati Hospital in 3 Years, claims police probe
The scam, in which the private hospital’s management and doctors were involved, came to light after two healthy people died following angioplasty, a procedure used to open blocked coronary arteries in heart patients.
“Five empanelled hospitals — two in Patan district, one each in Dahod, Ahmedabad and Aravalli districts — and two doctors under PMJAY were suspended in the last one week for irregularities,” a release of the health department said, news agency PTI reported.
Heer Children Hospital, and Niskha Children Hospital and Neonatal Care of Patan district, Sonal Hospital of Dahod, Sentora Hospital of Ahmedabad and Shree Jalaram Hospital of Aravalli district were suspended between December 2 and December 8 after an inspection, it said.
During the inspection at Heer Hospital in Patan, it was revealed authorities had changed 91 lab reports to get benefit under PMJAY. It was also found the hospital had applied for higher package under the insurance scheme when it was not required, said the release.
So, Heer Hospital and a doctor working there, Hiren Patel, were suspended from PMJAY empanelment. Health Spring Pathology Laboratory was also suspended from the scheme. A fine of Rs 50 lakh has been imposed on the hospital, it said.
The inspection at Niskha Children Hospital and Neonatal Care has revealed 60 medical reports were changed to get undue benefits under the central scheme. The hospital and its doctor Divyesh Shah were suspended from PMJAY, according to the release.
A recovery notice of Rs 15 lakh has been issued to the hospital, it said.
Sonal Hospital of Dahod did not have required manpower and infrastructure under the scheme and their work regarding infection control was also not up to the mark. Hence, the medical centre was de-empanelled under PMJAY, the health department said.
Sentora Hospital of Ahmedabad did not have Building Use (BU) permission for its fourth and fifth floors and lacked proper staff as well as a modular operation theatre. Medicines past their expiry dates were also recovered from the hospital premises, said the release.
In case of Shree Jalaram Hospital of Aravalli district, a lack of fire certificate and not having intensive care unit (ICU) as per prescribed norms led to its suspension, according to the department.
The release further said since January 2024 the state health department has suspended 12 hospitals from PMJAY for irregularities.
The health department will not allow irregularities in the scheme meant to give free medical treatment to the poor and people from middle class, it emphasised.
In the Khyati Hospital scam, the Ahmedabad crime branch has so far arrested seven persons, including its CEO and director (marketing), after the death of two PMJAY beneficiaries following botched angioplasty procedures last month.
Police investigations were triggered by complaints from the families of the deceased “patients”, who were among seven individuals who underwent angioplasty at the hospital on November 11.
The investigations showed the hospital organised free check-up camps in villages to convince PMJAY cardholders to undergo angioplasty, which is covered under the scheme without any payment by patients, despite no medical necessity for the procedure.
Patients were falsely registered under the “emergency” category to expedite government approval. In return, the hospital claimed payments from the government, police have stated.
On November 12, the city’s Vastrapur police registered three FIRs over the death of PMJAY beneficiaries due to botched angioplasty and arrested a cardiologist, Dr Prashant Vazirani. The accused were charged with culpable homicide not amounting to murder, forgery, and criminal conspiracy, among others.
The FIRs accused the Khyati hospital management and doctors of conspiring to obtain financial benefits under PMJAY, a scheme implemented by the Centre in partnership with states and Union Territories.
Also Read:Gujarat Medical Council suspends Cardiologist Arrested for Performing Unnecessary Angioplasties
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An Instagram post claims that applying a mixture of castor oil, coconut oil, and baking soda will make moles and warts disappear in three nights. The claim is False.
An Instagram post titled “chehre ke til masse asani see hataye (Remove moles and warts from the face easily)”. In the post user jabeen_ki_jahaan explained “By applying this for just three nights, even the oldest moles and warts will disappear. Take two teaspoons of castor oil, one teaspoon of coconut oil, and half a teaspoon of baking soda, mix them well, and apply the mixture on the area with the mole or wart before sleeping at night. Leave it overnight and wash it off in the morning.”
The post has 9,508 likes and can be accessed here.
The claim is False. Coconut oil, castor oil, and baking soda may benefit skincare, but no evidence supports their use in removing moles, warts, or skin tags in three nights. Always consult a professional for safe treatment.
Castor oil is a natural vegetable oil made from the Ricinus communis plant, often favoured for its safe, plant-based origins. While not commonly used in modern medicine, it’s FDA-approved as a laxative to relieve occasional constipation and is useful for colon cleansing before medical procedures like colonoscopies. Recent studies suggest castor oil, combined with other solutions, can improve bowel preparation with fewer side effects compared to traditional methods. It’s a key material in the chemical industry, creating eco-friendly products that are often better than petroleum-based ones. Its unique properties also help in drug delivery, such as in cancer treatments like paclitaxel, where it forms stable mixtures for non-water-soluble medicines. Additionally, castor oil is used in research to induce diarrhoea in animals for testing new natural medicines, making it an important tool in both science and industry.
Coconut, scientifically known as Cocos nucifera, is a tree celebrated for its rich nutritional and medicinal benefits, which have recently garnered renewed interest in Western medicine. Coconut oil, a staple tropical edible oil in many Asian cultures, consists of approximately 90-95% saturated fatty acids. It is extracted from the dried kernel or meat of the coconut, commonly referred to as copra. The oil is primarily composed of lauric acid (47.5%), a low molecular weight saturated fatty acid recognized as a healthier alternative to other saturated fats. Coconut oil is known for its antibacterial, antifungal, antiviral, and anti-dermatophytic properties. Traditionally used in Ayurvedic medicine and various cultural practices worldwide, it also exhibits antiviral, anti-inflammatory, cardio-protective, and hepatoprotective effects.
Baking soda, also called sodium bicarbonate, breaks down into carbon dioxide, water, and a type of salt when used. The carbon dioxide gas helps dough rise quickly, making it ideal for baking cakes and bread. It also boosts athletic performance by helping the body manage acidity and reducing muscle fatigue. It helps lower bad cholesterol, and blood sugar and increases good cholesterol. For people with kidney issues, it helps slow disease progression and improves nutrition. It also helps reduce nausea and diarrhoea in cancer patients undergoing chemotherapy.
A mole, a nevus (plural: nevi), is a small skin growth formed when pigment cells called melanocytes cluster together. Commonly found on sun-exposed areas like the arms, legs, and back, moles are usually round or oval, smooth, and less than 5 millimetres wide (pencil eraser size). They can be pink, tan, or brown and often appear in childhood, gradually fading with age.
Skin tags are harmless, soft growths that often appear on the neck, eyelids, or underarms. They can match your skin colour or appear darker and can turn pink or red if irritated. They usually form where skin rubs against skin, clothing, or jewellery, such as under the breasts, on the neck, eyelids, groin, or underarms. People with diabetes, metabolic syndrome, or a family history of skin tags are more likely to develop them.
Warts are non-cancerous skin growths caused by the human papillomavirus (HPV). They are very common, contagious, and can appear at any age, though they are most frequent in children and teenagers. Warts occur when the virus enters the skin through small cuts, causing extra cell growth that thickens the outer skin layer. Most warts are harmless and often disappear on their own within weeks or months. While they usually cause no symptoms, some may itch, feel tight, or be painful, especially those on the soles of the feet. Some warts may have tiny black or brown dots, which are clotted blood from broken capillaries in the skin.
Dr Dharani Ravi, MD DVL, Consultant Dermatologist, Prashanth Hospitals, Chennai explained the causes of moles and warts to Medical Dialogues. She stated, “Moles and warts, though seemingly similar, are fundamentally different. Moles, also known as birthmarks, are harmless overgrowths of pigment-producing cells that can vary in type depending on their origin and may be present at birth or develop later in life. It is important to note that moles cannot be removed using creams. Warts, on the other hand, are caused by a viral infection from the Human papillomavirus (HPV). They are contagious and can spread through both direct and indirect contact.”
Studies highlight the health benefits and nutritional properties of coconut oil, castor oil, and baking soda, including their use as laxatives to relieve occasional constipation, antibacterial, antifungal, antiviral, and anti-dermatophytic properties, help lower bad cholesterol, and blood sugar and increase good cholesterol. However, there is no scientific evidence or medical consensus to support the claim that applying a mix of castor oil, coconut oil, and baking soda makes moles and warts disappear in three nights.
There is no research article found that castor oil, coconut oil and baking soda have any potential to remove moles and warts in three nights, although there is evidence that demonstrates their role in dermatology and skin-related issues. One such study published in the Journal of Physics Conference Series concludes that both virgin coconut oil (VCO) cream and castor oil cream are effective in treating dry skin.
A narrative review published in the Journal of Indian System of Medicine mentioned that Virgin Coconut Oil (VCO) offers numerous benefits for dermatological conditions. It possesses antifungal and antibacterial properties, acts as an immunomodulator, and demonstrates anti-inflammatory, angiogenic, wound-healing, and skin-protective effects. Yet this review did not mention anything about the ability of coconut oil to remove moles, warts or skin tags.
Yet another study published in the Journal of Integrative Dermatology where sodium bicarbonate (SB) demonstrates its potential as an effective and safe dermatologic agent, also may provide supportive benefits in managing conditions like psoriasis and aquagenic pruritus, but its use should be approached with caution and under medical guidance.
All these studies have featured the role of coconut oil, castor oil and baking soda for skin conditions but none of the studies has mentioned its role in making warts, moles and skin tags disappear in 3 nights and there is no medical consensus in the medical fraternity that recommend their use for removal of moles, warts and skin tag.
Dr Dharani Ravi, MD DVL, Consultant Dermatologist, Prashanth Hospitals, Chennai told Medical Dialogues, “The application of castor oil, coconut oil, baking soda, or similar substances is never recommended, as these can irritate the mole or wart and the surrounding skin. This irritation may lead to pigmentation and scarring, especially on the face and neck, which can cause cosmetic concerns.”
To this Dr Amit Vij, MBBS, MD (Dermatology & Venereology), Senior Consultant Dermatologist, PSRI Hospital, New Delhi added, “Using such methods risks burning your skin, causing first-degree burns, and leaving scars. Traditional practices of removing growths with irritants like thuja, incense sticks (agarbati), lime, garlic, onions, or baking soda have been followed for ages but are highly inappropriate. These methods can result in irritation, redness, burns, pigmentation changes, and scarring.”
Coconut oil, castor oil, and baking soda are recognized for their beneficial properties in skin care, but no scientific evidence or medical consensus supports their effectiveness in removing moles, warts, or skin tags within three nights. It is important to seek medically approved treatments and consult a healthcare professional for safe and reliable options instead of relying on unproven remedies.
Hence the claim that applying a mix of castor oil, coconut oil, and baking soda makes moles and warts disappear in three nights is False.
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Yamunanagar: The Sub-Divisional Hospital in Jagadhri, Yamunanagar, is facing a staff shortage, which is severely impacting its ability to provide adequate patient care. With 88 out of 164 sanctioned positions remaining vacant, the hospital is currently operating at only 46% of its required staffing capacity.
According to information revealed through an RTI request by advocate Kamal Anand last month, the hospital has two posts of Deputy Medical Superintendent, but one is vacant. Out of the sanctioned 42 posts of Medical Officer, only 11 posts are filled and 31 are lying vacant. There are 38 posts of nursing officers. Out of these, 33 posts are filled and five posts are lying vacant. Additionally, four out of eight posts for Pharmacy Officers are unfilled, and there is a noticeable lack of specialized staff in certain areas.
Also Read: Haryana Govt Hospitals grapples with shortage of staff, Patient services hit
The RTI information further reveals that all positions for Senior Dental Surgeon (one authorized post), Senior Medical Officers (three authorized posts), Dental Surgeon (two authorized posts), Assistant (one authorized post), and Medical Lab Technologist (ten authorized posts) have been filled, with no vacancies currently existing.
The staffing shortage directly affects patient care, with the hospital handling an average daily outpatient department (OPD) footfall of 800. A social worker has highlighted that this staffing crisis could lead to a further decline in the quality of care, as an increasing number of patients are being referred to other hospitals due to the lack of sufficient treatment options at Jagadhri’s Sub-Divisional Hospital.
Dr Anuj Mangla, the Medical Superintendent of Sub-Divisional Civil Hospital, Jagadhri, acknowledged the staff shortage but assured that the hospital was doing its best to manage the situation.
Also Read: 22 per cent shortfall of specialist doctors in AP: CAG Report
As per the recent media report, commenting on this Dr Anuj Mangla, Medical Superintendent of Sub-Divisional Hospital, Jagadhri told Tribune India, “In the labour room, we have only two doctors, but we are taking the services of two more doctors on deputation so that the delivery work is not affected in the hospital. Similarly, we are managing work in other departments too.”
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Karnal: In a move to enhance cardiac care for heart patients of Karnal and nearby districts, Kalpana Chawla Government Medical College (KCGMC) is set to establish a cardiac catheterization laboratory (cath lab). The medical college has already initiated the tender process for the installation of the facility, which is expected to be operational soon.
This new cath lab will offer life-saving procedures like angiography and angioplasty, significantly improving cardiac care for residents.
KCGMC currently lacks a dedicated cardiology department, with cardiac patients being treated under the Department of Medicine. As a result, those requiring advanced cardiac interventions are forced to seek care at larger medical centres or private hospitals. This situation not only leads to delays in treatment but also imposes an added financial burden on patients.
The sources at the medical college revealed that KCGMC typically receives three to four patients per week requiring urgent cardiac interventions. In the absence of specialized services, these patients have to travel long distances which can be critical in cardiac emergencies. The establishment of a dedicated cath lab is expected to address this issue by providing diagnostic and treatment services within the college premises.
Also Read:Kerala: Ernakulam Hospital gets cath lab and advanced invasive cardiac unit
Dr Amandeep Singh, Head of the Department of Medicine, emphasized that the addition of a cath lab would greatly enhance patient care. He mentioned that the establishment of a cath lab would enhance patient care, enabling cardiac patients to receive timely and comprehensive treatment. He expressed hope that the lab would be functional by the end of January.
Also Read: Delhi AIIMS to boost CATH Lab capacity amid growing demand
The news has been enthusiastically welcomed by the residents of Karnal, who have expressed that there has been a long-standing demand for a dedicated cardiac care facility in the city. Rajiv Kumar, a resident of Karnal, highlighted the long-standing struggle faced by families due to the lack of local treatment options for heart-related issues.
According to Tribune India, he stated, “A state-of-the-art cardiac center for patient care is a long-standing demand. Many families have struggled with the lack of local treatment options for heart-related issues.” He mentioned that this new facility will improve the healthcare infrastructure of the medical college and it will allow patients to receive cardiac care at their doorstep.
Amneet Singh, another resident of the city said that a cath lab is much needed for any health institution. He added that the setting up of a cath lab in Karnal is a welcome step.
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Germany: A recent cohort study published in JAMA Network Open has shed light on the comparative outcomes of ticagrelor and prasugrel in treating individuals with acute coronary syndrome (ACS) undergoing invasive procedures.
The research, conducted in routine care settings, revealed that prasugrel was linked to reduced rates of all-cause mortality, myocardial infarction (MI), or stroke compared to ticagrelor among individuals with acute coronary syndrome undergoing invasive treatment in routine care, especially in those with ST-segment elevation myocardial infarction.
In patients with ACS undergoing invasive treatment, ticagrelor, and prasugrel are guideline-recommended P2Y12 receptor inhibitors, with the ISAR-REACT5 randomized clinical trial demonstrating prasugrel’s superiority. However, concerns about the generalizability of certain underpowered subgroup analyses have persisted. To address these concerns, Nils Krüger, Department of Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany, and colleagues aimed to emulate a randomized clinical trial by evaluating the safety and effectiveness of ticagrelor versus prasugrel under routine care conditions in individuals with ACS who were planned for an invasive treatment strategy.
For this purpose, the researchers conducted a new-user cohort study using German statutory health insurance claims data from 2012 to 2021. They applied 1:1 propensity score matching to emulate the ISAR-REACT5 trial. The study included individuals aged 18 years or older with acute coronary syndrome treated with ticagrelor or prasugrel after hospital discharge, followed for one year.
The primary outcome was a composite of all-cause mortality, myocardial infarction, or stroke, with secondary outcomes including stent thrombosis and major bleeding—data analysis from May 2023 to May 2024, employing Cox regression for the overall cohort.
The study led to the following findings:
The authors of this cohort study analyzed 17,642 individuals discharged after invasive treatment for acute coronary syndrome (ACS). They found that prasugrel was associated with significantly lower rates of all-cause mortality, myocardial infarction, or stroke compared to ticagrelor, without an increased risk of bleeding. These results align with the superior effectiveness of prasugrel observed in prior randomized clinical trials like ISAR-REACT5.
The study also provided insights into ACS subtypes, showing that prasugrel yielded better outcomes in patients with ST-segment elevation myocardial infarction (STEMI). At the same time, there were no significant differences in patients with non-STEMI or unstable angina.
“These findings further support guideline recommendations favoring prasugrel over ticagrelor for patients with acute myocardial infarction undergoing invasive treatment,” the researchers concluded.
Reference:
Krüger N, Krefting J, Kessler T, et al. Ticagrelor vs Prasugrel for Acute Coronary Syndrome in Routine Care. JAMA Netw Open. 2024;7(12):e2448389. doi:10.1001/jamanetworkopen.2024.48389
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