Calcipotriol Boosts Effectiveness of Daylight Photodynamic Therapy for Actinic Keratoses: Study Finds

Italy: A recent case-control study published in Dermatology Reports has demonstrated that pre-treating actinic keratoses (AKs) with calcipotriol (CAL) ointment before daylight photodynamic therapy (DL-PDT) significantly improves treatment outcomes. Actinic keratoses commonly appearing on sun-exposed skin are precursors to squamous cell carcinomas (SCCs), making effective management crucial for skin cancer prevention.

The study involved 20 immunocompetent male patients with grade I-II AKs on the face and/or scalp. Participants were randomly divided into two groups: the case group received 0.005% calcipotriol ointment for 14 days before undergoing DL-PDT, while the control group applied a standard moisturizing cream. Both groups then underwent three sessions of DL-PDT to assess treatment efficacy.

To measure the effectiveness of this approach, Benedetta Sonego, Dermatology Clinic, Maggiore Hospital, University of Trieste, Italy, and colleagues used the Actinic Keratosis Area Severity Index (AKASI) scoring system, evaluating actinic damage at baseline, three months, and six months post-treatment. Results revealed a notable reduction in AKASI scores among patients who received calcipotriol pre-treatment, suggesting that CAL enhances the therapeutic impact of DL-PDT.

The combination therapy was well tolerated, with minimal discomfort reported among participants. This underscores the potential of calcipotriol as a safe and effective adjunct to DL-PDT for managing AKs.

The study led to the following findings:

  • Significant AKASI Score Reduction: Patients pre-treated with calcipotriol (CAL) showed a greater reduction in AKASI scores compared to the control group, indicating enhanced treatment efficacy.
  • Improved DL-PDT Effectiveness: CAL pre-treatment boosted the therapeutic impact of daylight photodynamic therapy (DL-PDT) for actinic keratoses.
  • Well-Tolerated Treatment: The combination therapy was safe and effective, with minimal patient discomfort.

These findings highlight the clinical benefits of incorporating calcipotriol into AK treatment regimens, potentially improving lesion clearance and reducing the risk of progression to SCCs. Further research could help establish this approach as a standard practice, offering a more effective solution for individuals at risk of actinic damage and non-melanoma skin cancers.

“The findings indicate that integrating calcipotriol into the treatment regimen enhances AK clearance and may reduce the risk of progression to squamous cell carcinoma, offering a promising approach for improved skin cancer prevention,” the authors concluded.

Reference:

Sonego, B., Zelin, E., Bonin, S., Pozzebon, T., Bazzacco, G., Corio, A., Agozzino, M., Caro Caposiena, D. R., Zalaudek, I., & di Meo, N. (2024). Calcipotriol as a daylight photodynamic therapy enhancer: a case-control study. Dermatology Reports, 17(1). https://doi.org/10.4081/dr.2024.10077

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BioUnion™ Glass Ionomer promising for Dentin Remineralization and treating root surface and secondary caries: Study

Researchers have found in a new study that glass ionomer containing BioUnion™ fillers demonstrated effective dentin remineralization and enhanced dentin surface strength through sustained ion release during pH cycling. These properties suggest that this material could be a promising option for clinical use in treating root surface caries and secondary caries.

A novel glass ionomer cement (GIC) containing BioUnion™ fillers, was developed to enhance anti-demineralization and remineralization by releasing Zn²⁺, F⁻, and Ca²⁺ ions. This study evaluated its effectiveness in preventing root dentin demineralization during pH cycling. Bovine root dentin specimens were divided into three groups: Control (without GIC), Conventional GIC (GIC; Fuji IX, GC Corporation, Tokyo), and GIC with BioUnion™ fillers (GIC-Bio; Caredyne Restore, GC Corporation). A 4-week pH-cycling protocol was applied, involving daily exposure to a demineralizing solution (pH 4.5) for 4 hours and a simulated body fluid (pH 7.4) for 20 hours. Demineralization was assessed using swept-source optical coherence tomography (SS-OCT) and transverse microradiography (TMR). The characteristics of the dentin surface after the pH cycling were evaluated using the Vickers micro-hardness test and Fourier-transform infrared spectroscopy (FTIR). Data were analyzed using one-way ANOVA for FTIR and two-way ANOVA for TMR and micro-hardness. Results: TMR analysis revealed significantly lower mineral loss and lesion depth in the GIC-Bio group throughout the experimental period (p < 0.001), while SS-OCT images indicated intact surfaces near the margins for both GIC-Bio and conventional GIC, while the control group displayed a pronounced demineralized zone. Progressive increase on surface hardness and mineral content was observed in the GIC-Bio group as confirmed by micro-hardness testing and FTIR analysis, respectively. GIC containing BioUnion™ fillers achieved maximal reduction in lesion depth and promoted remineralization of root dentin among the tested groups. GIC containing BioUnion™ fillers represent a potentially viable material for the caries management due to its ability to enhance dentin remineralization and surface mechanical properties through sustained ion release during pH cycling.

Reference:

Kyaw Htet, Noriko Hiraishi, Kittisak Sanon, Panchanit Ubolsaard, Khin Pyae Sone, Yasushi Shimada. Effect of Zinc-Releasing Glass Ionomer Cement on Preventing Dentin Demineralization, Journal of Dentistry, 2025, 105718, ISSN 0300-5712,

https://doi.org/10.1016/j.jdent.2025.105718. (https://www.sciencedirect.com/science/article/pii/S0300571225001630)

Keywords:

BioUnion™ , Glass, Ionomer, promising, Dentin, Remineralization, treating, root, surface, secondary, caries, Study, Journal of Dentistry

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Study finds, biannual azithromycin administration reduces mortality in children

A new study published in recent issue of The Journal of Antimicrobial Chemotherapy revealed a large biennial distribution of azithromycin dramatically lowers mortality of children aged 1 to 5 in high-mortality regions.

In high-mortality areas, especially sub-Saharan Africa, biannual mass drug administration of azithromycin (MDA-azithromycin) has been suggested as a means of lowering infant mortality. Since MDA programs seem to be one of the most equitable intervention platforms in low-resource contexts, delivery through MDA presents the chance to influence the most underprivileged and marginalized groups. Thus, Meenalotchini Prakash Gurunthalingam and colleagues carried out this investigation to assess the effectiveness of MDA-azithromycin across a range of protocols and conditions.

Through September 2024, following a thorough search of PubMed, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov for randomized controlled studies (RCTs) that compared biennial MDA-azithromycin to placebo in children ages 1 to 59 months. Mortality in children under one year and those aged 12 to 59 months were the main results. Antibiotic resistance and adverse effects were secondary results.

Review Manager 5.4’s random-effects model was used to analyze the data, and I2 was used to measure heterogeneity. The Cochrane RoB2 tool evaluated risk of bias, while trial sequential analysis (TSA) evaluated cumulative evidence reliability.

There were nearly 691 to 235 children from 5 RCTs. TSA indicated inconclusive data on azithromycin’s non-significant mortality decrease in children under one year of age. MDA-azithromycin dramatically decreased mortality in children aged 12 to 59 months, with TSA confirming adequate evidence.

Although adverse effects were uncommon, there was little information on antibiotic resistance, which called for more observation. One trial had a significant risk of bias, and the quality of the evidence varied from moderate to extremely low.

Overall, as per WHO guidelines, biannual MDA-azithromycin considerably lowers mortality in children aged 12 to 59 months, hence promoting its usage in high-mortality settings.

Reference:

Gurunthalingam, M. P., Singh, M. P., & Gaikwad, N. R. (2025). Biannual azithromycin mass drug administration for reduction of childhood mortality: a systematic review and meta-analysis. The Journal of Antimicrobial Chemotherapy. https://doi.org/10.1093/jac/dkaf092

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Breast-conserving therapy linked to breast shrinkage, reports Plastic and Reconstructive Surgery

For women with early-stage breast cancer, breast-conserving therapy (BCT) including radiation therapy (RT) leads to progressive reduction in breast size over time, reports a study in the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). The journal is published in the Lippincott portfolio by Wolters Kluwer.

“Our findings suggest that women undergoing BCT/RT may lose approximately 20% of breast volume within a year, with continued reductions through five years,” comments Chris Reid, MD, of University of California San Diego. “Anticipating these changes may help guide patient expectations and assist surgical planning to restore women after breast cancer treatment.”

New data on changes in breast size after BCT for early breast cancer

Breast-conserving therapy – consisting of limited surgery (lumpectomy) and RT – is the preferred treatment for many women with early-stage breast cancer. It offers survival rates similar to those of mastectomy, with more favorable physical, psychological, and quality of life outcomes.

However, RT has adverse effects on breast tissue, including breast shrinkage due to radiation-induced tissue atrophy and fibrosis. While this long-term side effect is well-recognized, there are few data on the extent or time course of breast volume loss after BCT.

Dr. Reid and colleagues measured changes in breast volume in 113 patients who underwent BCT/RT for early-stage (T1) breast cancer between 2005 and 2023. Measurements were made using mammograms obtained before and after BCT and up to five years later. The researchers also examined the impact of initial breast size and other factors on volume loss.

Reflecting the size of the tumor, breast volume decreased by an average of 9.2% after lumpectomy. Breast volume continued to decrease over time, even after the immediate side effects of radiation resolved. After one year, the average decline in breast volume was 19.3%, in addition to the tissue removed at surgery.

Implications for patient expectations and treatment planning

“Additional volume change was observed yearly for five years,” the researchers write. By that time, the average decrease in breast size was 26.6%. Consistent with previous studies of breast shrinkage following BCT, “progressive volume loss was seen in all patients.”

Women with larger breasts and relatively smaller tumor volumes (measuring less than 10% of breast volume) had greater total breast shrinkage: 29.5%, compared to 21.7% for those with smaller breasts. Other factors associated with greater volume loss included smoking, diabetes, and receiving cytotoxic chemotherapy in addition to RT.

The study provides new evidence on breast shrinkage after BCT. Expected breast shrinkage is approximately 20% within the first year, progressing to about 26% by five years. Especially with the growing emphasis on patient satisfaction in evaluating the outcomes of breast cancer treatment, the findings highlight the need to discuss long-term changes in breast volume in patients receiving undergoing BCT/RT.

The greater volume loss in patients with larger breasts raises concerns about breast asymmetry – which is a common concern after BCT. “Anticipating these changes may help guide patient expectations and assist surgeons in planning reconstructive procedures to attain symmetry posttreatment,” Dr. Reid comments. The authors discuss key areas for further research, including the effects of different treatment techniques on breast volume changes and the need for more objective approaches to measuring breast volume.

Reference:

Becker, Miriam MS1; Reese, McKay BS1; Yessaillian, Andrea BS, MS1; Lopes, Kelli BA1; Harfouche, Cyril MD2; Leach, Garrison MD2; Blair, Sarah MD3; Yashar, Catheryn MD4; Ojeda-Fournier, Haydee MD5; Reid, Chris M. MD2. A Quantitative Evaluation of the Effects of Radiation Therapy on the Postsurgical Breast. Plastic and Reconstructive Surgery 155(4):p 595-605, April 2025. | DOI: 10.1097/PRS.0000000000011732

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Nicotine Use Increases Risk of Complications After Cervical Disc Arthroplasty, confirms study

Researchers have established in a new study that the use of nicotine products has been associated with complications in patients who have undergone cervical disc arthroplasty (CDA). This study, based on the US Nationwide Inpatient Sample from 2005 to 2020, evaluated the correlation of nicotine product usage with in-hospital outcomes of adults receiving a primary or a revision CDA. The findings emphasize the potential value of a consideration of preoperative nicotine product use in case selection and for postoperative planning. The study was published in the Journal of Orthopedic Surgery and Research by Yu-Jun Lin and colleagues.

Retrospective analysis was carried out from hospital records of adults (≥18 years) who received CDA. The patients were classified into nicotine product users and non-users. Propensity score matching (PSM) was used to balance baseline features between groups, ensuring proper comparisons. Logistic regression analyses were carried out to determine in-hospital mortality, unfavorable discharge, LOS, and complications, including infections.

Key Findings

Following 1:1 PSM, a total of 5,562 patients were included in the study. The adjusted analyses showed significant results:

  • Nicotine users developed overall complications 37% more (adjusted odds ratio [aOR] = 1.37, 95% confidence interval [CI]: 1.13-1.66, p = 0.002).

  • The risk of developing postoperative infections was 74% greater in nicotine users (aOR = 1.74, 95% CI: 1.17-2.58, p = 0.006).

  • There was no notable difference in the risk of adverse discharge or length of stay longer than desired among non-users and nicotine users (p > 0.05).

  • Male nicotine users had a 112% increased risk of infection (aOR = 2.12, 95% CI: 1.22-3.70, p = 0.008), while there was no such relationship among female patients.

  • The risk of infection was especially higher in nicotine users with no diabetes, obesity, or chronic pulmonary disease (p < 0.05).

The study highlights the harmful effect of nicotine consumption on CDA surgical outcomes. The results indicate that nicotine exposure can weaken immune response and tissue repair, resulting in increased complications such as infections. Men seemed to be more susceptible to this risk than women, which might reflect underlying sex-specific physiological variations.

This study concludes that nicotine product use significantly increases the risk of complications, especially infections, in CDA patients. More research is required to investigate the underlying mechanisms and possible interventions to reduce these risks.

Reference:

Lin YJ, Shih FY, Huang JF, Ting CW, Tsai YC, Chang L, Wang HC, Chen WF. Impact of nicotine product use on outcomes of patients receiving cervical disc arthroplasty: a propensity score analysis of the united States nationwide inpatient sample 2005-2020. J Orthop Surg Res. 2025 Mar 19;20(1):298. doi: 10.1186/s13018-025-05700-8. PMID: 40108610; PMCID: PMC11924824.

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Patients who underwent TIA have increased risk of subsequent stroke in the long-term, unravels study

A new study published in the Journal of American Medical Association showed that patients who have experienced a transient ischemic attack (TIA) or a mild stroke are at an increased risk of having another stroke.

The risk of ischemic stroke during the first 3 months after a TIA is not trivial, with reported rates ranging from 3% to 20%. However, the long-term incidence of ischemic stroke following TIA is unknown and warrants more investigation since it informs risk categorization, preventative interventions, and future studies. Thus, this study was done to evaluate the yearly and cumulative incidence rates of stroke up to 10 years following a TIA or mild stroke.

Embase, MEDLINE, and Web of Science were searched from inception to June 26, 2024. This study looked at prospective or retrospective cohort studies that reported stroke risk in individuals with TIA or mild stroke over a minimum of one year. The included studies provided unpublished aggregate-level data on the number of incidents and person-years at discrete follow-up periods, which were used to compute incidence rates in individual research. Data from many research projects were merged using random-effects meta-analysis. The main consequence was a stroke. Study-level factors were studied as possible reasons for variation in stroke rates among studies.

Of the 38 included studies, the analysis comprised 1,71,068 patients with a median age of 69 years [IQR, 65-71] and a median percentage of male patients of 57%. In the first year, there were 5.94 stroke events per 100 person-years, while in the second through fifth years, there were 1.80 occurrences per year and in the sixth through tenth years, there were 1.72 events per year. Stroke cumulative incidence was 12.5% at 5 years and 19.8% at 10 years.

Studies that employed active vs passive outcome ascertainment approaches, cohorts recruited in or after 2007, and studies done in North America and Asia as opposed to Europe had a greater incidence of stroke. Stroke rates were lower in research with an unselected patient sample than in studies that only included patients with TIA or first-ever index events. Overall, the risk of having another stroke is consistently elevated in patients who have experienced a TIA or small stroke. 

Source:

Writing Committee for the PERSIST Collaborators, Khan, F., Yogendrakumar, V., Lun, R., Ganesh, A., Barber, P. A., Lioutas, V.-A., Vinding, N. E., Algra, A., Weimar, C., Ögren, J., Edwards, J. D., Swartz, R. H., Ois, A., Giralt-Steinhauer, E., Khanevski, A. N., Leng, X., Tian, X., Leung, T. W., … Hill, M. D. (2025). Long-term risk of stroke after transient ischemic attack or minor stroke: A systematic review and meta-analysis. JAMA: The Journal of the American Medical Association. https://doi.org/10.1001/jama.2025.2033

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New IVF method mimics fallopian tube environment, increasing sperm viability ,reveals research

The success of in vitro fertilization depends on many factors, one of which is sperm viability. A recent study from the University of Illinois Urbana-Champaign documents a new way to select viable sperm and prolong their viability in the laboratory, reducing one source of variability during the process.

“The fallopian tube in women, or the oviduct, has an ability to lengthen sperm lifespan that, until now, we couldn’t recreate in IVF. In 2020, we discovered that complex sugars called glycans are the components of the oviduct that can bind and store sperm and keep them alive,” said senior study author David Miller, professor in the Department of Animal Sciences, part of the College of Agricultural, Consumer and Environmental Sciences at Illinois.

Miller’s group collaborated with chemists to test hundreds of oviduct glycans for their ability to bind pig sperm, settling on one called sulfated Lewis X trisaccharide, or suLeX, for further testing. They focused on pig sperm not only as a proof of concept for future human studies, but also because animal agriculture relies on IVF, too. In pig IVF, multiple sperm often fertilize single eggs, resulting in inviable embryos. The hope with using glycans was that fewer free-swimming sperm would approach and fertilize eggs simultaneously.

The researchers attached suLeX to the bottom of culture dishes, then added sperm. The sperm were given 30 minutes to adhere to the compounds before the researchers began adding eggs, introducing them 0, 6, 12, or 24 hours later.

“By adding eggs at later time points, we could test the system to see whether suLeX increased the longevity of the sperm. Essentially, we found we can maintain or extend fertilization rates over time, increasing the window of successful IVF,” Miller said.

At 0 hours, IVF efficiency (fertilized zygotes vs. total number of eggs) was significantly greater with sperm that were initially attached to suLeX (at 53%) than a control with no oviduct compounds (36%) and two alternative “control” compounds (about 40% each).

The time delays decreased fertilization rates for all groups, but less so for suLeX. In the control group with no oviduct glycans, fertilization was down to 1% at the 24-hour time point. But with suLeX, 12% of the eggs were fertilized after 24 hours.

The IVF setup with suLeX droplets also allowed the researchers to wash away free-swimming sperm before introducing eggs.

“Because the sperm were bound securely to the glycan compound, we could reduce the overall number of sperm, which meant fewer cases where more than one sperm fertilized the eggs,” Miller said.

The foundational study could one day improve IVF success for both animals and humans.

“There are companies, especially related to dairy cattle, that use IVF to produce and sell high-genetic-merit embryos that, after they are delivered, will produce milk more efficiently,” Miller said. “This technology could potentially help produce meat and milk more efficiently.”

He added that the specific glycans that bind human sperm have not yet been identified, but once that happens, glycan-IVF could help with timing mismatches between egg maturity at harvest and sperm viability in humans.

“Both eggs and sperm have to undergo a maturation phase before they’re ready for fertilization, so the timing is critical. There’s variability in the time it takes sperm to complete their final major maturation step,” Miller said. “We think glycan-IVF could lengthen the fertile window of sperm and possibly increase IVF rates, though we need further testing to verify that.” 

Reference:

Soto-Heras, S., Volz, L.J., Bovin, N. et al. Porcine sperm bind to an oviduct glycan coupled to glass surfaces as a model of sperm interaction with the oviduct. Sci Rep 15, 4680 (2025). https://doi.org/10.1038/s41598-025-88986-2

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GMC Nagarkurnool 3 MBBS students suspended for ragging

Hyderabad: Taking cognizance of a ragging complaint, the Government Medical College (GMC), Nagarkurnool has suspended three senior MBBS students for allegedly physically harassing, beating and slapping a first-year junior student in a hostel room. An FIR has also been registered against the accused in connection with the case.

Among the three, one student (Third year) has been suspended for three months, who is reported to be the main culprit, while the other two (Second year) have received suspensions of one month. 

The junior student in his complaint stated that he was subjected to severe harassment, including being forced into a wall chair pose, made to hold a 5kg cylinder, beaten multiple times, leading to bleeding, and blackmailed with obscene photos. 

Also read- Ragging, Extortion, No surgical cases- DY Patil Medical College Pune Resident Doctor alleges harassment

The incident occurred on March 25 in a hostel room, where the first-year MBBS student was “humiliated” by his seniors. One of them allegedly beat him with a belt and slapped him. The seniors also demanded his UPI PIN, and when he refused, they beat him again.

In his complaint, he alleged that on the evening of March 25, one student asked him to come to their hostel room, where three seniors—one third-year and two second-year students—forced him to perform the “air chair” punishment. The air chair punishment is a physical exercise where a person must squat as if sitting in an invisible chair, holding the position for an extended period. After 30 minutes, he was forced to hold a 5 kg LPG cylinder.

The trio then took his phone, accessed his private chats on an instant messaging app, and opened his phone gallery. Despite his resistance, they viewed his photos and videos, the complaint stated.

He was “ordered” to kneel with his hands up, and when he slightly lowered his hands due to pain, one senior repeatedly beat him with a belt. The seniors then called his batchmates and “humiliated” him in front of them using his photos and videos, as per the FIR. One senior also forcibly transferred 34 videos and photos from his phone to his device, it said.

The complainant was allegedly blackmailed, with the seniors threatening to send the photos and videos to his father. One senior slapped him multiple times, causing bleeding, the complainant stated.

Later, the junior student filed a complaint with the police, and a case was registered against the three seniors under relevant sections of the BNS and the Telangana Prohibition of Ragging Act, 1997, on March 26.

Following the police complaint, the accused were counselled and summoned in a meeting held on April 2 by the anti-ragging committee. After an investigation, the committee found the three students guilty of ragging the junior and accordingly recommended the actions. Later, the college suspended them. 

Telangana Today reported that the college authorities had a meeting with the parents of students after the incident of ragging was reported. The college authorities assured parents that robust measures would be initiated to prevent such incidents in the future.

“Two of the accused students are in the second year and have been suspended for a month, each. The third student, who is a third-year student, is the main perpetrator. He has been suspended for three months,” GMC Nagarkurnool principal, Dr Ramadevi, told TOI.

Also read- KMCRI ragging: 5 MBBS students suspended for forcing juniors to attend classes as proxies

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Counselling on Hold for Senior Dental Residents in Telangana

Hyderabad: The counselling for the posts of senior dental residents at the Government Dental College and Hospital, Afzalgunj has recently been deferred. Currently, the issue of counselling is being discussed with the Hyderabad Collector.

According to a circular issued by the principal of the Dental College, the counselling was postponed due to the transfer issues raised by the students. Reportedly, the students had pointed out the absence of any government dental college to opt for the zone 1 residents.

While Zone 1 includes the dental colleges across the districts in Telangana, Zone 2 is in Hyderabad.

Also Read: HC Resolves Principal Dispute at Govt Dental College Indore, Dr Alka Gupta Assumes Charge

As per the latest media report by the Times of India, recently, the senior dental residents wrote to the Director of Medical Education (Academic) and urged for the reconsideration of the eligibility of the senior residents. In the letter, they stated that the Zone one residents did not have a government dental college to opt as there is only one government dental college in the State and that is located in the city. 

Confirming that the counselling has been deferred, the National President of All India Dental Students and Surgeons Association, Dr. MD Manzur shared on social media, “The counseling for the selected Senior Resident posts has been canceled as of now. I just had a telephonic conversation with the Dean of Government Dental College, who informed me that the counseling has been stopped and the matter is currently under discussion with the Hyderabad Collector.”

Dr. Manzur told TOI, “The matter is under discussion with the principal of Govt Dental College. He has assured us that he will look into it thoroughly. The date for counselling will be announced soon.”

Also Read: Alleged Appointment Irregularities! Medical Education Dept seeks guidance from Dental College Principal in probe against herself

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Punjab Retired Doctors protest delay in pension arrears payment until 2028

Doctors who are pension holders, came under the banner of the Pensioner Doctors Association, Punjab, protested against the Punjab government‘s decision to pay the pending pension arrears from January 2016 to June 2021 in installments, extending until September 2028.

The association announced plans to extend these demonstrations to other districts in collaboration with various pensioners’ and employees’ organizations facing similar issues. Addressing the gathering, association president Dr. D.C. Sharma, along with vice-president Dr. D.S. Bhullar and other senior members, criticized the government for prioritizing excessive advertising expenses instead of addressing the financial struggles of retired doctors. They urged the administration to release the pending pension arrears in a single installment without further delay.

For more information, click on the link below:

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