Cloudnine Hospital runs mock drill on child abduction, slapped Rs 2 lakh compensation

Holding Cloud Nine Hospital accountable for causing distress to a family due to an unannounced mock drill for child abduction soon after the birth of a baby, the Gurgaon District Consumer Disputes Redressal Commission has directed the facility to pay Rs 2 lakhs as compensation to the newborn’s family for the mental harassment caused during the incident.

The order was pronounced by a bench comprising Sanjeev Jindal, President, and members Jyoti Siwach and Khushwinder Kaur.

For more news & updates, check out the link given below:

Code Pink Gone Wrong: Cloudnine Hospital Runs Mock Drill On Child Abduction, Slapped Rs 2 Lakh Compensation

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Forcing Patient to buy Medicine from in-house pharmacy, Charging more than MRP: TN Hospital, Doctor slapped compensation

Madurai: Holding a Tirunelveli-based hospital and its attending doctor guilty of unfair trade practices and services deficiencies, the Circuit Bench of the Tamil Nadu State Consumer Disputes Redressal Commission in Madurai directed them to pay Rs 1 lakh compensation to the Tamil Nadu State Consumer Welfare Fund.

The consumer court gave such an order after noting that the hospital and its doctor forced patients to exclusively buy costly medicines from the pharmacy of the hospital. Further, the complainant was forced to purchase blood even though her sister had the same blood group and they were also charged more than the MRP of the medicines.

“…this Commission deeply saddened by the facts that once the hospitals are felt Equivalent to Temples . But now-a-days it has become a commercial business market. Absolutely, there is no necessity for the hospital and the doctor to direct the patient to purchase the medicines only from them. They may even directly use medicines and charged for the same. But, forcing the patient to buy medicines than required and charging more amount than MRP certainly amounted to unfair trade practice,” noted the Consumer Court.

Apart from paying the compensation to the Consumer Court fund, they have also been directed to pay the complainant Rs 1 lakh towards the extra amount charged from the complainant and compensation for mental agony suffered by the complainant.

Also Read: Consumer Court relief to Max hospital, cardiologist accused of recommending unnecessary tests including angiography, coercion into cardiac procedures

The matter goes back to 2012 when the complainant approached the hospital and got admitted for undergoing hysterectomy procedures. The operation went on uneventful and she was treated at the hospital as an inpatient for the next couple of days.

As per the complainant, the complainant’s sister had also the same blood group. However, even tough this was informed to the hospital and the doctor, they allegedly forced the attender to purchase blood bottle for Rs 1100 from the blood bank.

Allegedly, during the transmission of blood and after it was over, the complainant developed some complications and she was immediately brought to the Intensive Care Unit and treated with medicines, CTC scan was also done. The complainant and her attender were allegedly forced to purchase medicines only from the hospital’s pharmacy. In fact, the attender of the complainant was allegedly ill-treated when she purchased and brought some medicines from outside.  

Apart from this, the attender and the complainant were asked to purchase the medicines in large quantity than necessary. They also alleged that they were charged for the medicines more than the Maximum Retail Price (MRP). Alleging it to be unfair trade practice on the part of the hospital, the complainant approached the consumer court asking direction upon the hospital and the doctor to refund the value of the medicines and also to furnish medical records such as history of treatment, discharge summary etc.

They also demanded Rs 3 lakh as compensation of Rs 3 lakhs for mental agony and pain suffered by the Complainant and another sum of Rs 18 lakh as compensation payable to the Tamil Nadu State Consumer Welfare Fund for financial loss or injury suffered by the large number of patients.

On the other hand, the hospital and the doctor denied the allegations labeled against them. They submitted that the medicines were purchased and kept by the hospital only for the welfare of the patient and for keeping those medicines it costs more. They denied committing any deficiency in service or getting indulged in any unfair trade practice. 

After considering the entire version of the hospital and the doctor, the Commission noted that the denial on their part is not specific with regard to each allegations rather it is very general in nature.

“For example, the complainant alleged that her sister is having same blood group of the complainant but they were forced to buy blood from other blood bank for that only an evasive reply was given as if the complainant failed to disclose what her blood group was. The point for consideration is whether any representation was made to the hospital with regard to the attender is also having same blood group of the patient. If it is so, then why they were forced to buy blood from other blood bank. The opposite parties did not reply to the above allegation in the written version. Even, the opposite parties did not mention the necessity for purchasing such blood from outside, in particular, no medical history and treatment particulars were not produced by the opposite parties. Operation theatre notes were also not produced by them. When the complainant alleged that she was forced to buy a large quantity of medicines than required, is it not the duty of the opposite parties to produce the treatment particulars to prove the fact that the medicines are very much necessary for treatment and all the purchased medicines were administered only to the patients?” questioned the consumer court.

The State Commission further observed how medicines and equipment were purchased in bulk and noted, “Though the complainant has given elaborate tabular column with regard to the quantity of medicines purchased by her, there is no whisper about those particulars. For example, Venflon injection has been purchased for each day. Similarly, disposable syringes were purchased more than 50 in numbers. The purpose of Venflon is to fix for administering liquid medicines. When a Venflon once fixed and utilized, it can be used for days together. There is no necessity to fix Venflon for every day. As rightly argued if Venflon is fixed for every day, the very purpose of using the same became ridiculous. By marking the purchase receipt, the complainant is able to prove that she was forced to purchase more quantity of medicines than required and as there is contra proof in not producing the medical records, the above allegation is accepted by this Commission as proved.”

In respect of the complainant’s allegation that they were charged more than Maximum Retail Price, the Commission noted that the hospital and the doctor did not deny the same. It also noted that the complainant gave very elaborate particulars what was the price bought by her and what was the MRP for the above medicines and they were not at all disputed by the other side.

“But, in the written version they impleadly admitted the sale of medicines for higher rate than MRP by stating that the medicines were kept for the use of inpatients and hence it costs more. Therefore, all these complaint’s allegations are proved,” the Commission observed.

Apart from this, the Commission further observed that on the basis of a complaint sent to the Drug Inspector and Revenue Inspector, the hospital was inspected and they found irregularities in keeping and selling the medicines which is against the provisions of Drugs and Cosmetics Act, 1940.

“So, the complainant has proved his case and this Commission found that the Doctors and the hospital have committed deficiency in service as well as indulged in unfair trade practice,” opined the Commission.

While fixing the amount of compensation, the Commission noted that there was no proof of ill-treatment and the patient was cured by the hospital and its doctor. The only offense was that they were charged an extra amount than the actual expenses. 

Therefore, to disallow such practices, the Commission directed the hospital and the doctor to pay Rs 1 lakh to the complainant and another Rs 1 lakh to the Tamil Nadu State Consumer Welfare Fund.

“So, to disallow the above such practice, this Commission directed the opposite parties jointly and severally to pay Rs.1,00,000/- to the Tamil Nadu State Consumer Welfare Fund and also to pay another sum of Rs.1,00,000/- to the complainant as compensation for extra amount charged and for mental agony suffered by her within one month from the date of receipt of copy of this order failing which the above amounts shall carry interest at the rate of 9% per annum from the date filing the complaint till its realization. The opposite parties 1 & 2 are also directed jointly and severally to pay the complainant a sum of Rs.10,000/- as costs,” ordered the consumer court.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/unfair-trade-practice-227621.pdf

Also Read: 18 ICU Patient deaths Due to Lack of Oxygen: Hospital held guilty of administrative negligence, slapped Rs 20 lakh compensation

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Tragic: Safdarjung Hospital Resident Doctor Kills Self, was Suffering from Depression

New Delhi: In a tragic incident, a third-year postgraduate student in the medicine department and resident doctor at Delhi’s Safdarjung Hospital has committed suicide by hanging from a ceiling fan in his rented accommodation in south Delhi.

Police informed that the deceased PG medico had been suffering from depression for the past two years, which was mentioned in a suicide note that was recovered from the spot.

The 25-year-old medico hailed from Kandivali West in Mumbai. He was found hanging from the ceiling fan by the Police.

Deputy Commissioner of Police (South), Chandan Chowdhary, said a PCR call was received at the Hauz Khas police station at 3.55 p.m. on Friday informing about a person found hanging, adds IANS.

The caller, Payal , stays on the first floor of the house located in Gautam Nagar, while the doctor lived on the second floor. The landlady told the police that her tenant, Dr Savla, committed suicide by hanging himself.

Also Read: Kerala doctor involved in girlfriend suicide case over dowry demands suspended by IMA

“We were informed by his landlady that Savla had committed suicide by hanging himself. On checking, the aforesaid boy was found hanging by ceiling fan through bed sheet,” a police officer said.

“The investigating officer (IO) found Savla hanging from the ceiling fan with a bedsheet. One suicide note was found from the room in which the deceased wrote that he was suffering from depression and was under medication,” the DCP said.

“On Saturday, the statements of the deceased’s father, Dipesh Ratilal Saval, and other relatives were recorded. They don’t suspect any foul play. Savla’s body has been handed over to his family members after conducting an autopsy at AIIMS,” the officer said.

Savla’s father was told about the death through a phone call, police informed PTI. “His family members have confirmed that he was suffering from depression for the past two years,” said another officer.

Savla’s body was handed over to the family and an inquest proceeding was begun, he said. The police have initiated an inquest proceeding in the matter.

Mourning Savla’s demise, the Federation of Resident Doctors’ Association (FORDA) tweeted a video posted by Savla earlier with the comment: “@JaySavla15 was a sincere Medicine PG. He made a video in Dec’22, and look at how intricate and sorted his thought process was. He was happy with his course in Medicine. Had wonderful goals for ‘23 and we hoped he achieved them. Sadly, we lost him to depression. It can strike and take even the strongest ones, even the most insightful ones.”

“A 3rd year Medicine PG resident doctor in a top medical institution, Safdarjung Hospital, has committed suicide. What’s shocking me is he was not any ordinary doctor! He was a Black Belt in martial arts and an international-rated chess player and had active presence on all the social issues. Mentioning it for those who think that only weak people commit suicide,” posted Dhruv Chauhan, a medical influencer and Assistant Medical Superintendent at Sanjeevan Hospital, New Delhi.

“Depression in this country and specially among doctors is not just an illness anymore, rather it’s an ‘pandemic’ now! The govt and authorities should realise it before more losses happen. Just to remind, this is the fourth suicide by doctors in the past 1-2 weeks,” he added.

Also Read: Allegedly harassed by three other medical students, 1st year MBBS student commits suicide

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Intas Pharma gets USFDA warning letter due to manufacturing lapses at Ahmedabad plant

New Delhi: The US health regulator has pulled up Intas Pharmaceuticals for manufacturing lapses, including violation of current good manufacturing practice (CGMP) regulation, at its Ahmedabad-based plant. In a warning letter to the company’s CEO and MD Nimish Chudgar, the US Food and Drug Administration (USFDA) has pointed out various manufacturing lapses at the Matoda-Sanand, Ahmedabad-based facility.

A warning letter is issued when the US health regulator finds that a manufacturer has significantly violated its regulations.
The USFDA inspected the facility from May 1-12, 2023.
“This warning letter summarises significant violations of CGMP regulations for finished pharmaceuticals… Because your methods, facilities, or controls for manufacturing, processing, packing, or holding do not conform to CGMP, your drug products are adulterated,” it noted.
In the warning letter, the health regulator pointed out the company “failed to exercise its responsibility to ensure drug products manufactured are in compliance with CGMP, and meet established specifications for identity, strength, quality, and purity”.
It also noted that the company’s Quality Assurance (QA) and production departments failed to provide adequate oversight and ensure the reliability of data related to the quality of finished drug products manufactured at the facility.
“Since 2021, visual inspectors manipulated particle and other defect counts on manual visual inspection records in many instances, in order to keep the finished product batches within rejection limits,” USFDA said.
More specifically, the investigation found that operators manipulated the defect quantities “to keep the category wise rejections within limits to avoid a deviation and investigation,” it added.
The US health regulator also pointed out that the company failed to thoroughly investigate any unexplained discrepancy or failure of a batch or any of its components to meet any of its specifications, whether or not the batch has already been distributed.
Besides, the company “failed to establish adequate written procedures for production and process controls designed to assure that the drug products have the identity, strength, purity, and quality that they are purported or represented to possess,” USFDA stated.
The US health regulator further pointed out that the company failed to establish and follow appropriate written procedures that are designed to prevent microbiological contamination of drug products.
The USFDA noted that in a previous inspection, including the inspection of July 22 to August 2, 2019, FDA had cited similar CGMP observations.
“Repeated failures demonstrate that executive management oversight and control over the manufacture of drugs is inadequate,” it added.
Significant findings in the letter demonstrate that the company does not operate an effective quality system in accord with CGMP, the USFDA stated.
It further said, “Correct any violations promptly. FDA may withhold approval of new applications or supplements listing your firm as a drug manufacturer until any violations are completely addressed and we confirm your compliance with CGMP.”
Failure to address any violations may also result in the FDA continuing to refuse admission of articles manufactured at the plant, it added.

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NAFLD tied to brain damage in patients with type 2 diabetes without cognitive impairment: Study

China: A recent study has suggested that controlling lipid levels, blood glucose levels, and abdominal obesity may reduce brain damage in patients with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD).

The findings, published in Diabetes, Obesity and Metabolism, provide novel insights into neuroimaging correlates for underlying pathophysiological processes inducing brain damage in patients with type 2 diabetes (T2D) with NAFLD.

T2D and NAFLD are the two most prevalent metabolic dysfunction types and have overlapping pathophysiological aspects. There is an increasing incidence of both conditions, posing severe health threats. About 55.5% of type 2 diabetes patients have NAFLD.

Cognitive impairment is a recognizable and clinically significant complication of T2D; however, recently, the neurocognitive implications of NAFLD have garnered significant attention. T2D patients are at 1.5 to 2.5 times higher risk of developing dementia than those without diabetes. NAFLD has been associated with cerebral perfusion, cognitive dysfunction, and brain ageing. However, there is no clarity on whether NAFLD worsens brain damage in T2D patients.

Bing Zhang, Nanjing University, Nanjing, China, and colleagues aimed to investigate the neural static and dynamic intrinsic activity of intra-/inter-network topology among patients with type 2 diabetes with NAFLD and those without NAFLD (T2NAFLD group and T2noNAFLD group, respectively) and to evaluate the relationship with metabolism.

The study included fifty-six patients with T2NAFLD, 78 with T2noNAFLD, and 55 healthy controls (HCs). Participants had normal cognition and underwent clinical measurements, functional magnetic resonance imaging (MRI) scans, and local cognition evaluation. Static functional network connectivity, frequency spectrum parameters, and temporal properties of dynamic functional network connectivity were identified using independent component analysis.

The study led to the following findings:

  • T2NAFLD patients had more disordered glucose and lipid metabolism, had more severe insulin resistance, and were more obese than T2noNAFLD patients
  • Type 2 diabetes patients exhibited disrupted brain function, as evidenced by alterations in intra-/inter-network topology, even without clinically measurable cognitive impairment.
  • T2NAFLD patients had more significant reductions in the frequency spectrum parameters of cognitive executive and visual networks than those with T2noNAFLD.
  • Altered brain function in T2D patients was correlated with postprandial glucose, high-density lipoprotein cholesterol, and waist-hip ratio.

“Our study indicates the presence of brain function disruption before the clinically measurable cognitive in T2D patients, and T2NAFLD worsens intra-network rather than inter-network disruption,” the researchers wrote. “Therefore, the impact of T2NAFLD is less extensive for cognitively normal T2D patients.

“Brain alterations were related to dysregulated lipid metabolism, hyperglycaemia, and waist-hip ratio (WHR); therefore, controlling lipid and blood glucose levels and abdominal obesity may potentially reduce the brain damage in these patients,” they concluded.

Reference:

Li, Xin, et al. “Non-alcoholic Fatty Liver Disease Is Associated With Brain Function Disruption in Type 2 Diabetes Patients Without Cognitive Impairment.” Diabetes, Obesity & Metabolism, 2023.

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FDA approves Fabhalta as oral treatment for paroxysmal nocturnal hemoglobinuria

The US Food and Drug Administration has approved Fabhalta (iptacopan) as first oral monotherapy for adults suffering from paroxysmal nocturnal hemoglobinuria (PNH). PNH is a rare and chronic blood disorder where red blood cells are prone to premature destruction by the complement system. Despite prior anti-C5 treatments, a good number of patients with PNH still suffer with anemia, requiring blood transfusions.

The approval was based on the APPLY-PNH trial that revealed patients switching to Fabhalta experienced remarkable increases in hemoglobin levels, surpassing those continuing on anti-C5 treatment. Fabhalta demonstrated superior increases of hemoglobin levels ≥ 2 g/dL (82.3% vs. 0%) and hemoglobin level ≥ 12 g/dL (67.7% vs. 0%), both achieved without the need for red blood cell transfusions. This underscores the efficacy of Fabhalta in addressing the persistent unmet need for improved hemoglobin levels in PNH patients.

Fabhalta is a Factor B inhibitor targeting the complement pathway of immune system, crucial in complement-mediated hemolysis in PNH. The importance of this approval not only lies in its efficacy but also in being the first oral monotherapy for PNH, potentially offering a paradigm shift in the management of this rare blood disorder.

The approval comes after rigorous evaluation in the Phase III APPLY-PNH trial, where Fabhalta showcased its superiority in hemoglobin improvement in the absence of transfusions compared to anti-C5 treatments. Notably, patients avoiding transfusion reached an impressive rate of 95.2% with Fabhalta compared to 45.7% with anti-C5.

The most commonly reported adverse reactions with Fabhalta were headache, nasopharyngitis, diarrhea, abdominal pain, bacterial infection, nausea, and viral infection. Serious adverse reactions were reported in a small percentage of patients, including instances of pyelonephritis, urinary tract infection, COVID-19, and bacterial pneumonia.

Fabhalta is expected to be available in the US market soon, offering hope to those living with PNH and setting the stage for further exploration of its potential in other complement-mediated diseases. 

Source:

Novartis receives FDA approval for Fabhalta® (iptacopan), offering superior hemoglobin improvement in the absence of transfusions as the first oral monotherapy for adults with PNH. (2023, December 6). Novartis. 

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Low PUFA intake may magnify risk of developing CVD among people with family history of heart disease

A recent study delving into the interplay between dietary intake of polyunsaturated fatty acids (PUFA) and family history in relation to cardiovascular disease (CVD) risk has uncovered a significant association. Researchers have found in a new study that Low PUFA intake may magnify risk of developing CVD among people with family history of heart disease. 

This study was published in the Circulation journal by Laguzzi A. and colleagues.

Researchers examined data from over 40,000 adults, exploring the impact of low PUFA intake, particularly eicosapentaenoic/docosahexaenoic acids (EPA/DHA), in individuals with and without a family history of CVD. The study, conducted across a large consortium, assessed blood and tissue PUFA levels, categorizing PUFA levels ≤25th percentile as indicative of low intake of specific fatty acids. A family history of CVD was defined as having at least one first-degree relative who had experienced a CVD event.

The most striking finding revealed a significant interaction between low EPA/DHA intake and a family history of CVD. After meticulous adjustments for various influencing factors, the combined exposure to low EPA/DHA and a family history of CVD was associated with a substantial increase in relative risk for CVD (pooled relative risk 1.41; 95% CI, 1.30–1.54). In comparison, the relative risk was lower for those with a family history alone (pooled relative risk 1.25; 95% CI, 1.16–1.33) and even lower for individuals with low EPA/DHA intake alone (pooled relative risk 1.06; 95% CI, 0.98–1.14).

The study highlighted that low intake of EPA/DHA in conjunction with a family history of CVD significantly amplified the risk of developing CVD, emphasizing the potential impact of this dietary factor on cardiovascular health.

Although the relative excess risk due to interaction did not show statistical significance, the findings underscore the need for individuals with a family history of CVD to pay particular attention to their dietary intake of EPA/DHA, primarily found in oily fish. This novel insight could inform healthcare strategies, advocating for the consumption of oily fish as a preventive measure against CVD for those with a family history.

These findings pave the way for further investigation into personalized dietary interventions targeting high-risk populations. Emphasizing the inclusion of EPA/DHA-rich foods in the diet, especially for individuals with a genetic predisposition to CVD, may prove pivotal in reducing cardiovascular risk and promoting long-term heart health.

Reference:

Laguzzi, F., Åkesson, A., Marklund, M., Qian, F., Gigante, B., Bartz, T. M., Bassett, J. K., Birukov, A., Campos, H., Hirakawa, Y., Imamura, F., Jäger, S., Lankinen, M., Murphy, R. A., Senn, M., Tanaka, T., Tintle, N., Virtanen, J. K., Yamagishi, K., … Fatty Acids and Outcomes Research Consortium (FORCE). Role of polyunsaturated fat in modifying cardiovascular risk associated with family history of cardiovascular disease: Pooled DE Novo results from 15 observational studies. Circulation,2023. https://doi.org/10.1161/circulationaha.123.065530 

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Placement of 6-mm implants as good as 11-mm implants for combined maxillary sinus floor augmentation

Placement of 6-mm implants as good as 11-mm implants for combined maxillary sinus floor augmentation suggests a new study published in the Clinical Oral Implants Research.

A study was done to compare the clinical performance of single crowns in the posterior maxilla supported by either 11-mm long implants combined with maxillary sinus floor augmentation (MSFA) surgery or by 6-mm long implants during a 10-year follow-up period.

Subjects were randomly allocated to receive one 11-mm long implant in combination MFSA or to receive one 6-mm long implant without any grafting. Twenty-one implants in 20 patients were placed in the 6-mm group and 20 implants in 18 patients were placed in the 11-mm group. Both groups were followed by clinical and radiographic examinations up to 10 years. Patients’ satisfaction was also scored before treatment.

Results

Two patients died and eight patients moved during the follow-up. Two patients lost an implant in the 6-mm group and one implant was lost in the 11-mm group (implant survival 89.5% and 90.9%, respectively). From loading to 10 years’ follow-up, mean ± SE marginal bone loss in the 6-mm group and 11-mm group was 0.18 ± 0.10 mm and 0.26 ± 0.12 mm, respectively, without a significant difference between the groups at 10 years (p = .650). In both groups, indices scores for plaque, calculus, gingiva and bleeding were low as well as mean pocket probing depth. Patients’ satisfaction at 10 years was high in both groups; mean overall satisfaction in the 6-mm group and 11-mm group was 9.6 ± 0.6 and 9.2 ± 0.8, respectively (p = .168).

Placement of 6-mm implants or 11-mm implants combined MFSA are equally successful during a 10-year follow-up period when applied for supporting a single restoration.

Reference:

Guljé, F. L., Raghoebar, G. M., Gareb, B., Vissink, A., & Meijer, H. J. A. (2023). Single crowns in the posterior maxilla supported by either 11-mm long implants with sinus floor augmentation or by 6-mm long implants: A 10-year randomized controlled trial. Clinical Oral Implants Research, 00, 1–12. https://doi.org/10.1111/clr.14200

Keywords:

Placement, 6-mm, implants, as, good, 11-mm, implants, combined, maxillary, sinus, floor, augmentation, Guljé, F. L., Raghoebar, G. M., Gareb, B., Vissink, A., & Meijer, H. J. A.

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Prenatal maternal inflammation tied to ADHD diagnosis by age 10

The available preclinical and registered data indicate that maternal inflammation during pregnancy may impact early neurodevelopment in offspring. However, there is limited clinical evidence of the risk of abnormal neurodevelopment in children later in life. In the population-based COPSAC2010 mother-child cohort, a team of researchers examined the relationship between maternal inflammation levels during pregnancy and the likelihood of a child being diagnosed with ADHD, as well as the severity of ADHD symptoms in children at age 10.

A recent study published in Brain, Behavior, and Immunity has concluded that Prenatal maternal inflammation, assessed by hs-CRP, is linked to ADHD by age 10. Maternal inflammation associated with ADHD symptom load in the full cohort. This study identified inflammation as a marker crucial for future prevention during pregnancy to improve neurodevelopmental outcomes in children.

This study followed 700 mothers and their children since pregnancy week 24. The mother’s hs-CRP level at week 24 was investigated about the child’s neurodevelopment at age 10. The children underwent a neurodevelopment exam using K-SADS-PL and ADHD-RS. Logistic and linear regression models were used with confounder adjustment, including socioeconomic status and maternal polygenic risk of ADHD.

Key findings from the study are:

  • Total 604/ 700 children in the COPSAC2010 cohort participated in the COPSYCH visit at age 10.
  • Sixty-five (16 girls and 49 boys), constituting 10.8 %, fulfilled a research diagnosis of ADHD.
  • Higher maternal hs-CRP level in pregnancy at week 24 was associated with increased risk for ADHD diagnosis with adjusted OR 1.40.
  • Higher maternal hs-CRP was associated with increased ADHD symptom load in the entire cohort, reflected by ADHD-RS raw scores.

Discussing further, they said the clinical data demonstrates a robust association of prenatal maternal inflammation assessed by hs-CRP with ADHD diagnosis by age 10.

Attention-Deficit/Hyperactivity Disorder is the most frequent neurodevelopmental disorder in childhood and adolescence, with an estimated worldwide prevalence of around 5–7 %. To our knowledge, this is the first study combining deep phenotyping with lege artis clinical evaluations to confirm associations between exposure to prenatal inflammation and subsequent risk of ADHD in the offspring in mid-childhood. Furthermore, we report positive associations between maternal inflammation and a load of ADHD symptoms in the entire cohort, they said.

Reference:

Rosenberg, J. B. et al. Maternal inflammation during pregnancy is associated with the risk of ADHD in children at age 10. Brain Behavior and Immunity, 115, 450–457. https://doi.org/10.1016/j.bbi.2023.10.023

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Body fat and nutrition strongly associated with diabetic kidney disease in type 2 diabetes patients: Study

China: A recent study published in Diabetes Therapy showed increased odds of diabetic kidney disease (DKD) in subjects with diabetes having poor nutritional parameters and high body fat.

“Nutritional parameters and body fat were strongly associated with and considerably contributed to DKD presence, indicating that nutrition and body fat might be promising markers representing a metabolic state in the DKD pathogenesis and clinical utility of bioelectrical impedance analysis (BIA) might provide valuable recommendations to patients with type 2 diabetes mellitus (T2DM),” the researchers wrote.

Diabetic kidney disease develops in about 40% of patients with diabetes and has become a leading cause of chronic kidney disease and end-stage renal failure in most developed and developing countries. Therefore, there arises an urgent need for strategies aimed at identifying potentially modifiable risk factors for DKD.

To address the same, Junwei Yang, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China, and colleagues investigated the association between clusters of body fat and nutritional parameters with DKD in adults with type 2 diabetes in a cross-sectional study.

The study included 184 participants with T2DM. Biochemical parameters including haemoglobin A1c, fasting blood glucose, haemoglobin, creatinine, albumin, and urinary albumin-to-creatinine ratio (UACR) were measured. BIA was used to obtain data for visceral fat area (VFA), percentage of body fat mass (PBF), body cell mass (BCM), and phase angle at 50 kHz (PA50).

DKD diagnosis was made by UACR and estimated glomerular filtration rate (eGFR). Factor analysis was used for dimensionality reduction clustering among variables. Binary logistic regression analysis was used to assess the association of clusters with the presence of DKD.

Based on the study, the researchers reported the following findings:

· Factor analysis identified two clusters which were interpreted as a body fat cluster with positive loadings of VFA, waist circumstance, body mass index, and PBF and a nutritional parameters cluster with positive loadings of PA50, haemoglobin, albumin, and BCM.

· Participants were divided into four groups based on the sex-specific cutoff value (median) of each cluster score calculated using the cluster weights and the original variable values.

· Only participants with high body fat and poor nutritional parameters (OR 3.43) were associated with increased odds of having DKD.

“Although the BIA method and consequent findings require further studies for confirmation, our findings indicate that nutritional parameters and body fat could be strong risk markers of DKD and are promising for clinical diagnosis and interventions,” the researchers concluded.

Reference:

He, A., Shi, C., Wu, X. et al. Clusters of Body Fat and Nutritional Parameters are Strongly Associated with Diabetic Kidney Disease in Adults with Type 2 Diabetes. Diabetes Ther (2023). https://doi.org/10.1007/s13300-023-01502-5

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