NEET PG 2024: Health Ministry, NBE officials review exam process 2 days after postponement

New Delhi: 2 days after the postponement of PG medical entrance test, the top officials from the Union health ministry and the National Board of Examinations in Medical Sciences reviewed the process of the NEET PG exam.

The National Eligibility Entrance Test (Postgraduate) entrance examination is conducted by the National Board of Examinations in Medical Sciences (NBEMS), along with its technical partner Tata Consultancy Services (TCS), for medical students.

According to sources, senior officers from the TCS were present in the meeting, reports PTI.

Also Read:NBE issues caution advisory for NEET PG 2024 applicants

Medical Dialogues had earlier reported that the government on Saturday postponed the NEET-PG entrance examination, scheduled to be held on June 23, as a “precautionary measure” in the wake of recent allegations on the integrity of certain competitive exams.

The Monday meeting was held to check the “robustness” of the system for the conduct of the exam in the coming days, sources informed PTI.

It was learnt that the TCS top brass briefed about the various aspects of the exam procedure that is followed in the meeting.

“The process of uploading the NEET-PG exam paper starts an hour before the exam is to be held. This time it was postponed as a preventive measure to ensure the exam is held in a transparent and secure manner. New dates will be announced soon depending upon the availability of centres,” the source said.

Also Read:Supreme Court notice to NBE, MCC over plea seeking release of NEET PG Question Paper, Answer Key

Releasing a Statement on June 22, 2024, the Ministry postponed the exam around 12 hours before its scheduled date i.e. on June 23, 2024. The exam will now be rescheduled and a new date will be announced soon. Ministry had informed that the exam was being postponed after considering the incidents of allegations regarding the integrity of certain competitive examinations.

“Taking into consideration, the recent incidents of allegations regarding the integrity of certain competitive examinations, Ministry of Health has decided to undertake a thorough assessment of the robustness of processes of NEET-PG Entrance Examination, conducted by National Board of Examinations for medical students. It has accordingly been decided, as precautionary measure to postpone the NEET-PG Entrance Examination, scheduled to be held tomorrow i.e. 23rd June, 2024,” the Union Health Ministry stated in a release.

However, since the exam was deferred only hours before the actual exam date, several candidates and parents arrived at the exam centres unaware that it had been postponed. They rued allegations of irregularities plaguing exams conducted by the exam bodies and asserted that it was adding to their already heightened stress and tension.

Also Read:Losing faith in Indian Medical Education system! Doctors upset Over NEET PG 2024 Postponement

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Dadasiba Civil Hospital to be upgraded in phases, says Himachal CM Sukhu

Kangra: Himachal Pradesh Chief Minister Sukhvinder Singh Sukhu on Sunday inspected the under-construction Dadasiba Civil Hospital in the Jaswan Pragpur Assembly constituency of Kangra district. 

During the visit, he directed the Public Works Department to ensure the quality of the construction. The Chief Minister stated that the hospital would initially be upgraded to a 50-bed facility in the first phase and subsequently to a 100-bed hospital in the second phase.

Highlighting the hospital’s crucial role as a primary healthcare provider in the Jaswan region, Sukhu assured that all deficiencies would be promptly addressed. 

Also Read:Rs 160 crore released to expedite construction of Chamba Medical College: Himachal CM

According to an ANI report, “Approximately 50 per cent of the construction is complete, with an additional Rs 3.61 crore required to finish the remaining work, which the state government will provide. To enhance healthcare services, the hospital will be staffed with specialist doctors in gynaecology, orthopaedics, surgery, and anaesthesia, as well as lab technicians,” Sukhu said.

The Chief Minister said that the state government would transform Dadasiba Hospital into an ‘Aadarsh Swaysthya Sansthan’, deploying specialist doctors in sub-division-level hospitals to improve local healthcare accessibility.

Sukhu expressed concern over the slow pace of the hospital’s construction over the past five years and called for an acceleration of the work. He reiterated the state government’s commitment to enhancing health facilities across Himachal Pradesh.

“In a recent cabinet meeting, it was decided to create and fill 200 medical officer positions in the Health and Family Welfare Department. Additionally, 22 posts for Professor, Associate Professor, and Assistant Professor will be filled in various medical colleges statewide,” Sukhu said, news agency ANI reported.

“Efforts to improve emergency health services include creating eight emergency medical officer positions at Tanda Medical College in Kangra and five assistant professor positions at Chamba Medical College, which will facilitate the establishment of functional trauma centres in these institutions,” he added.

Agriculture Minister Chander Kumar, Congress spokesperson Surender Mankotia, and other dignitaries were present at the inspection.

Also Read:56 hospitals to be soon digitized under Health Information Management System: Himachal Pradesh CM

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Understanding Pre-Existing Conditions in Health Insurance

You are looking to the future, focusing on
your health, and deciding to invest in a good, comprehensive health insurance
plan. But then you start wondering about the asthma that you struggled with as
a child or that surgery you had a couple of years ago. How will these
pre-existing conditions affect your health insurance?

Health insurance is a cornerstone in every
financial plan that acts as a safety net in case of a medical emergency. Yet,
making sense of the ins and outs of pre-existing medical conditions is easier
said than done. This article will teach you more about pre-existing conditions
and how they affect your health insurance.

An Overview
of Pre-Existing Conditions

Simply said, a pre-existing condition is any
health issue already present before the effective date of your new health
insurance plan. This could be chronic diseases like diabetes, asthma, or heart
disease, or even things like old injuries or surgeries. These are factors that
insurers closely monitor because of the heightened likelihood of a claim
shortly after the policy goes on risk.

How Do
These Conditions Impact Health Insurance?

If you have pre-existing conditions, they will
impact your health insurance policies in the following ways:

  • Waiting Period: Health insurance policies generally have a waiting
    period for any pre-existing condition to prevent fraud. This is a set
    period, which can be as short as three months or as long as three years or
    more, depending on the insurance company. For this time period, the
    policyholder is not eligible to be reimbursed for treatment regarding
    pre-existing diseases. Accidental injuries will be covered during this
    period.
  • Higher Premiums: Insurance companies may demand higher premiums due
    to the policyholder’s pre-existing condition. This is a way of offsetting
    the claims the policyholder will likely make.
  • Coverage Exclusions: Some insurance policies may have provisions
    which exclude all expenses the policyholder makes over a particular
    disease. Anything they might spend on their pre-existing condition will
    not be eligible for reimbursement.
  • Medical Examination: Health insurance companies subject any
    potential policyholder to detailed questioning about their health before
    determining the policy terms. If the answers they receive indicate a
    too-large risk, they demand a higher premium or simply refuse to provide a
    policy.

How to Buy
Health Insurance When You Have Pre-Existing Conditions

If you have a pre-existing condition and are
wondering how to approach the matter of health insurance, the best advice is to
be as informed as possible. Here are some tips to guide you along the way:

  • Disclose all conditions: Never lie about any aspect of your medical
    history. It might lead to a denial of your claim and potentially an
    investigation culminating in the cancellation of your policy.
  • Compare policies: Not all health insurance policies are identical,
    and some insurers might be more or less accepting of pre-existing
    conditions than others. Do your research before making a decision.
  • Read the fine print: Find out the specific terms and conditions.
    Different waiting periods, exceptions, and rules are to be expected.
  • Consider riders: Some policies might look poorly equipped to deal
    with your pre-existing condition on the surface but will also feature
    optional add-on covers. Acquiring them as part of the base policy might be
    a good idea.

Trust ACKO
for All Your Health Insurance Needs

Acko is a digital-first insurance company
taking an innovative approach to health insurance in India. Their idea is to
simplify insurance for people. The company can offer price-effective health
insurance plans through an online distribution model.

Are you sceptical about buying health
insurance from ACKO to cover pre-existing conditions? Here are some reasons to
convince you:

  • Transparent policies: ACKO Insurance is known for its
    transparency. When buying a policy, the terms and conditions about
    pre-existing conditions are spelt out clearly. So you do not see any
    surprises when you make a claim.
  • Reduced waiting periods: ACKO has been working on reducing the
    waiting periods for pre-existing conditions. Traditional insurance
    companies may make you wait for up to four years for some pre-existing
    conditions. However, ACKO’s waiting period is typically shorter, so you
    can get the health care you need when needed. In fact, you have zero
    waiting period under the ACKO Platinum Health Insurance plans.
  • Customised plans: ACKO recognises that people are all different,
    and each person’s health needs vary enormously. ACKO allows you to build a
    customised plan depending on your particular requirements and the current
    state of your health.

Conclusion

Pre-existing conditions are a significant
factor affecting health insurance. But they should not stop you from getting
the coverage you want. With the correct information and determination, you can
get the best medical insurance policy to keep you healthy without too much
financial pressure. You can quickly browse through ACKO’s website to check out
the best health insurance policies for pre-existing conditions.

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Handed over NEET case to CBI: Bihar govt issues official notification

Patna: After the central government entrusted the CBI with the matter of alleged irregularities in the NEET 2024 for a comprehensive investigation, the Bihar government has issued an official notification regarding handing over the NEET UG paper leak case to the Central Bureau of Investigation (CBI).

According to the ANI report, in the notification, the government said, “In exercise of the powers conferred under Section 6 of the Delhi Police Establishment Act, 1946 (Act 25 of 1946), the Governor of Bihar is pleased to give his assent to the Delhi Special Police Establishment, who have been entrusted with the exercise of powers and jurisdiction in the state and other places related to the case to investigate/supervise and investigate the FIR No. 5117081240358, dated 05.05.2024, registered at the Shashtri Nagar Police Station in Patna under sections 407, 408, 409, 120 of the IPC, which relate to irregularities in the NEET (UG) 2024 examination held on May 5, 2024.”

Notably, the Bihar government had handed over the investigation of alleged irregularities in the 2024 NEET-UG exam to the CBI for a thorough probe.

Also Read:NEET paper leak case: 6 arrested accused undergo medical examination in Patna

“Bihar government is to hand over the case related to the irregularities in the NEET UG examination held on May 5 to the CBI. The CBI team is expected soon in Patna to take over the investigation of the case. Economic Offences Unit shall hand over all the updated case records to CBI,” Economic Offences Unit (EOU) DIG, Nayyar Hasnain Khan had said on Sunday.

After taking over the probe into the alleged irregularities in the National Eligibility-cum-Entrance Test (NEET)-UG exams in 2024, the CBI formed special teams to investigate the case, the central agency said in a statement on Sunday.

This comes after the central government entrusted the CBI with the matter of alleged irregularities in the NEET-UG exam in 2024 for a comprehensive investigation.

“National Testing Agency (NTA) conducted the NEET (UG) Examination on May 5, 2024, in OMR (pen and paper) mode. Certain cases of alleged irregularities, cheating, impersonation, and malpractices have been reported. For transparency on the conduct of the examination process, the Ministry of Education, Government of India, after a review, has decided to entrust the matter to the CBI for a comprehensive investigation,” the government said.

The Central Government has also enacted the Public Examination (Prevention of Unfair Means) Act, 2024, to prevent unfair means in public examinations and to provide for matters connected therewith or incidental thereto,” it said.

“The government is committed to ensuring the sanctity of examinations and protecting the interests of students. It is reiterated that any individual or organisation found to be involved will face strictest action,” it added.

The NTA, which conducted the NEET-UG exams, is facing criticism over alleged irregularities in the exams.

This resulted in several protests across the country, with protestors and political parties demanding to disband the NTA.

An unprecedented 67 candidates achieved a perfect score of 720 out of 720, which added to the concerns.

Also Read:NEET 2024 paper leak case: More than 10 MBBS students from Bihar, Jharkhand GMCs under scanner

Medical Dialogues team had earlier reported that four arrested men confessed that the question paper for the MBBS entrance test had leaked the previous night. These four accused include NEET aspirant Yadav, his uncle Sikandar, who is a Junior Engineer at Danapur Municipal Council, and two others- Nitish Kumar and Amit Anand. They confessed that they received the question paper for the NEET examination on the day before the exam date i.e. May 5, 2024.

As per these accused, they were made to memorize the paper. In their statement to the Bihar police officials, these four accused stated that the exact questions were asked in the exam the next day.

Meanwhile, responding to the demands of various medical aspirants who called out the alleged irregularities in the conduct of the NEET exam and demanded a CBI inquiry into the matter, the Ministry of Education entrusted the matter of alleged irregularities in NEET (UG) Examination 2024 to CBI for the comprehensive investigation.

This year’s National Eligibility-and-Entrance Test Undergraduate (NEET-UG) 2024 Examination was mired in controversies after the allegations of paper leak came into light. Around 13 people, including four examinees and their family members, were arrested in Bihar for their alleged involvement in the paper leak of the NEET-UG exam. Patna police sources had previously claimed that the NEET-UG question papers along with their answers were provided to around 20 aspirants a day before the date of the exam i.e. May 5, 2024.

Then, the Economic Offences Unit (EOU) of Bihar Police, which took over the investigation, revealed that the brokers involved in the NEET paper leak scam took between Rs 30 lakh to Rs 50 lakh from each of the medical aspirants in exchange for giving them the question paper of the NEET UG 2024 question paper ahead of the examination.

Multiple pleas have been filed before the High Courts and the Supreme Court seeking an investigation into the alleged paper leak scam. Some of the pleas demanded the scrapping of the NEET UG 2024 exam and holding a retest.

Meanwhile, NEET aspirants across the country have been protesting against the alleged paper leak issue in NEET UG 2024 and the National Testing Agency’s policy of awarding grace marks to 1563 candidates. While finally the NTA decided to scrap the grace marks, the issue of alleged paper leak is still unsolved.

Although earlier, the Union Education Minister Dharmendra Pradhan had denied such allegations of paper leak, recently he assured action against NTA officials if they were found guilty of the “irregularities” in the conduct of the MBBS entrance exam.

The NEET 2024 issue has now taken a political turn as opposition parties are accusing the government over the allegations of rigging, paper leaks, and corruption. Recently Congress leader Rahul Gandhi argued that the BJP-ruled states were the “epicentre of paper leak”.

While hearing pleas concerning the NEET examination, the apex court had on June 18 said that even if there was “0.001 per cent negligence” on the part of anyone in the conduct of the examination, it should be thoroughly dealt with.

The Apex Court had also sought responses from the Centre and the NTA on a plea for a Central Bureau of Investigation (CBI) probe into allegations of question paper leak and other irregularities in the exam.

Also read- NEET 2024 Paper Was Leaked! 4 Accused Confess To Bihar Police

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Unlocking Heart Health: Bariatric Surgery Reverses Obesity-Related Cardiac Changes, study reveals

UK: In a significant breakthrough for patients struggling with obesity-related heart conditions, recent research has highlighted the beneficial effects of bariatric surgery in partially reversing proarrhythmic structural, electrophysiological, and autonomic changes associated with obesity. This study sheds light on the profound impact of weight loss surgery beyond just metabolic benefits.

The study revealed that obesity leads to detrimental changes in electrophysiological, structural, and autonomic function, which show partial reversal following bariatric surgery.

The findings, published in the journal Heart Rhythm, carry significant implications for determining weight thresholds and refining weight loss approaches in the context of bariatric surgery.

Obesity is known to increase the risk of cardiovascular diseases, including arrhythmias, due to structural changes in the heart and alterations in its electrical activity and autonomic function. These changes can predispose individuals to abnormal heart rhythms, which can be life-threatening if left untreated.

The extent to which weight loss reverses subclinical proarrhythmic adaptations in arrhythmia-free obese individuals is unknown. Considering this, Kiran Haresh Kumar Patel, National Heart and Lung Institute (NHLI), Imperial College London, London, UK, and colleagues study structural, electrophysiological, and autonomic remodeling in arrhythmia-free obese patients, and their reversibility with bariatric surgery using electrocardiographic imaging (ECGi).

The study included sixteen arrhythmia-free obese patients (43+12years, 13 female, BMI 46.7+5.5kg/m2) who had ECGi pre-bariatric surgery (PreSurg), of which twelve had ECGi post-surgery (PostSurg, 36.8+6.5kg/m2). Sixteen age- and sex-matched lean healthy individuals (42+11 years, BMI 22.8+2.6kg/m2) were controls and had ECGi once.

The study led to the following findings:

· Obesity was associated with autonomic (blunted heart rate variability), structural (increased epicardial fat volumes and left ventricular mass), and electrophysiological (slower atrial conduction and steeper ventricular repolarisation gradients) remodelling.

· Following bariatric surgery, there was partial structural reverse remodelling, with a reduction in epicardial fat volumes (68.7cm3 versus 64.5cm3) and left ventricular mass (33g/m2.7 versus 25g/m2.7).

· There was also partial electrophysiological reverse remodelling with a reduction in mean spatial ventricular repolarisation gradients (26mm/ms versus 19mm/ms), although atrial activation remained prolonged.

· Heart rate variability, quantified by the standard deviation of successive differences of RR intervals, was also partially improved following bariatric surgery (18.7ms versus 25.9ms).

· Computational modelling showed that PreSurg obese hearts had a greater window of vulnerability to unidirectional block and had earlier spiral-wave break-up with more complex re-entry patterns than PostSurg counterparts.

The study showed that bariatric surgery decreased arrhythmia vulnerability.

“These findings offer valuable mechanistic insights into the arrhythmic risks associated with obesity, both before and after weight loss interventions such as bariatric surgery. They underscore the importance of early management strategies to mitigate and potentially reverse adverse cardiac remodeling in obese patients,” the researchers concluded.

Reference:

Patel KHK, Bajaj N, Statton BK, Bishop MJ, Herath NS, Stoks J, Li X, Sau A, Nyamakope K, Davidson R, Savvidou S, Agha-Jaffar D, Coghlin JA, Brezitski M, Bergman H, Berry A, Ardissino M, de Marvao ASM, Cousins J, Ware JS, Purkayastha S, Volders P, Peters NS, O’Regan DP, Coronel R, Cluitmans M, Lambiase PD, Ng FS. Bariatric surgery partially reverses subclinical proarrhythmic structural, electrophysiological and autonomic changes in obesity. Heart Rhythm. 2024 May 31:S1547-5271(24)02665-1. doi: 10.1016/j.hrthm.2024.05.052. Epub ahead of print. PMID: 38825299.

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Phentermine Shows Promise in Enhancing Weight Loss for Patients Discontinuing GLP-1s: Study

USA: In the realm of weight management, the quest for effective strategies continues to evolve, with recent findings shedding light on promising approaches for patients who may not achieve the desired results with their initial treatments. A groundbreaking study has unveiled that individuals who struggle to lose significant weight with GLP-1 treatment may experience substantial weight reduction upon transitioning to phentermine, offering renewed hope in the battle against obesity.

Recent findings showed that patients prescribed phentermine after losing fewer than 20 pounds while on a GLP-1 receptor agonist were more likely to lose weight one year after GLP-1 discontinuation versus those not prescribed phentermine. The data are from a non-peer-reviewed report by Epic Research.
“Patients prescribed phentermine after GLP-1 medication discontinuation were 29% less likely to regain all the weight they lost on the GLP-1 medication one year after the end of their GLP-1 treatment than those who were not prescribed phentermine (19.3% versus 27.3%),” the researchers reported.
Phentermine is one of the earliest FDA-approved weight loss medications that function by appetite suppression. Kersten Bartelt, RN, a clinician at Epic Research, and colleagues aimed to determine whether patients who transitioned to phentermine after discontinuing a glucagon-like peptide-1 receptor agonist (GLP-1) medication maintained or experienced additional weight loss.
For this purpose, they studied 7,773 patients who were prescribed phentermine following GLP-1 medication discontinuation. They categorized patients based on the amount of weight they lost while on GLP-1 treatment.
They found that patients who maintained their weight or gained weight while on a GLP-1 medication were most likely to experience weight loss after switching to phentermine, with a median weight loss of around 3% in the year after GLP-1 medication discontinuation. Those who switched to phentermine after losing at least 20 pounds while on the GLP-1 medication were most likely to regain weight one year after GLP-1 medication discontinuation, with more than half regaining some or all their weight.
The researchers then evaluated whether patients prescribed phentermine after GLP-1 medication discontinuation were more likely to keep their weight off one year later than those who did not start phentermine after discontinuing their GLP-1.
The research team found that 27.3% of patients who did not use phentermine after their GLP-1 medication regained all the weight they lost while on the GLP-1 compared to 19.3% of patients who started phentermine after discontinuing their GLP-1.
“There is a need for more research on the long-term impacts of switching from GLP-1s to phentermine,” they concluded.

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Tanda Medical College conducts first kidney transplant surgery

Kangra: The Dr Rajendra Prasad Medical College Tanda achieves a landmark with a successful first kidney transplant, heralding a new era in its healthcare achievements.

Dr Rajendra Prasad Medical College Tanda is setting new dimensions in health facilities. 

This sentiment was expressed by Himachal Pradesh Tourism Development Corporation Chairman and Tourism Corporation Chairman (Cabinet Rank) R.S. Bali at Tanda Medical College while addressing a press conference in the medical library on Saturday.

According to a UNI report, He said that a new dimension has been established in the field of health by successful kidney transplant operations by the doctors at Medical College Tanda. R.S. Bali congratulated the principal, Dr Milap Sharma, and his entire team for this achievement.

Also Read:Kidney transplant facility to be launched at GBP Hospital: Tripura CM Manik Saha

RS Bali said that two such successful kidney transplant surgeries were conducted, and thirty other patients were in waiting. He said that patients with this ailment will not have to visit PGI and AIIMS, and this will not only save them money but also their time and energy.

He said that patients will get the benefit of this facility free of charge under Himcare and Ayushman.

He said that this mission was successfully achieved with the support and blessings of the Chief Minister, Sukhvinder Singh Sukhu.

He disclosed that patients are getting the facility of heart valve transplantation besides other open heart surgeries at Medical College Tanda now.

He said that a trauma centre in this college will start functioning soon with nine assistant professors and 91 other technical staff, as 100 posts for this trauma centre have been sanctioned.

He said that the present government has made every possible effort to provide state-of-the-art facilities in the medical college so that the people of the state can get high-level health facilities at Dr. Rajendra Prasad Medical College. He said that the nursing school at Dr Rajendra Prasad Medical College has been upgraded and given the status of a nursing college. He said that along with this, a lactation management centre will be opened for infants and mothers at Tanda Medical College to encourage breastfeeding of newborns, news agency UNI reported.  

On this occasion, Principal Dr. Milap Sharma said that the credit for this success of kidney transplantation at Medical College Tanda goes to the Himachal Government and the Chairman of the Himachal Pradesh Tourism Development Corporation, R.S. Bali, because he made continuous efforts to bring this facility here.  

He said that Dr. Amit, a kidney transplant surgeon today, had been a student at this college. Additional Director Dr Major Avnindra Kumar, Dr Abhinav Rana, Dr Amit, Dr Sanjeev, and Dr Dheeraj were present on this occasion.  

Also Read:Open heart surgery facility now at Tanda Medical College Hospital

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Financial incentives may improve outcomes of dietary intervention among adolescents with severe obesity: JAMA

Researchers have found that combining financial incentives (FIs) with meal replacement therapy (MRT) significantly improves weight loss outcomes in adolescents with severe obesity. A recent study was published in the journal JAMA Pediatrics by Amy C. Gross and colleagues. This randomized clinical trial, conducted at a large academic health center in the Midwest from 2018 to 2022, aimed to evaluate the impact of FIs on BMI reduction, body fat, and cardiometabolic risk factors.

Adolescent severe obesity is notoriously difficult to treat with traditional lifestyle modification therapies. MRT has shown short-term efficacy for BMI reduction, but sustaining these outcomes over the long term remains challenging. Introducing FIs as an adjunct intervention could potentially enhance adherence to healthy behaviors and improve long-term efficacy.

The study involved 126 adolescents aged 13 to 17 years with severe obesity, defined as ≥120% of the 95th BMI percentile or a BMI ≥35. Participants were randomized to receive either MRT alone or MRT plus FIs. The MRT included preportioned, calorie-controlled meals (~1200 kcals/day). The FI group received incentives based on their weight reduction from baseline. The primary endpoint was the mean percentage change in BMI from randomization to 52 weeks. Secondary endpoints included changes in total body fat, blood pressure, triglyceride to high-density lipoprotein ratio, heart rate variability, and arterial stiffness. Cost-effectiveness and safety, particularly concerning unhealthy weight-control behaviors, were also assessed.

  • Among the participants (73 females [57.9%]; mean [SD] age, 15.3 [1.2] years), 63 received MRT plus FIs, and 63 received only MRT.

  • After 52 weeks, the MRT plus FI group experienced a significantly greater mean BMI reduction of −5.9 percentage points (95% CI, −9.9 to −1.9 percentage points; P = .004) compared to the MRT group.

  • The MRT plus FI group saw a mean total body fat mass reduction of −4.8 kg (95% CI, −9.1 to −0.6 kg; P = .03).

  • There were no significant differences between the groups in cardiometabolic risk factors or unhealthy weight-control behaviors.

  • The intervention was also found to be cost-effective, with an incremental cost-effectiveness ratio of $39,178 per quality-adjusted life year.

The study indicates that adding FIs to MRT enhances weight loss outcomes in adolescents with severe obesity. The greater reductions in BMI and total body fat in the FI group suggest that financial incentives may improve adherence to dietary interventions and promote sustained healthy behaviors. Importantly, the study did not observe any increase in unhealthy weight-control behaviors, addressing a common concern regarding incentive-based interventions.

This study demonstrates that integrating financial incentives with meal replacement therapy significantly enhances BMI and body fat reduction in adolescents with severe obesity, without promoting unhealthy weight-control behaviors. These findings suggest that FIs could be a valuable tool in obesity management, promoting better adherence to treatment and improving health outcomes.

Reference:

Gross, A. C., Freese, R. L., Bensignor, M. O., Bomberg, E. M., Dengel, D. R., Fox, C. K., Rudser, K. D., Ryder, J. R., Bramante, C. T., Raatz, S., Lim, F., Hur, C., & Kelly, A. S. (2024). Financial incentives and treatment Outcomes in adolescents with severe obesity: A randomized clinical trial. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2024.1701

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Pandemic stress in pregnant mothers may affect anxiety regions of babies’ brains: JAMA

A critical part of the brain linked to risks for anxiety later in life-the left amygdala-was significantly smaller by volume in babies of mothers who reported stress during the COVID-19 pandemic, according to a new manuscript published in JAMA Network Open.

The right hippocampus, which governs spatial, visual and verbal memories, and the white matter were also reduced in children whose mothers reported stress.

The research from Children’s National Hospital provides mounting evidence that children of the pandemic, even those far too young to understand it, need ongoing assessments of developmental or mental health support later in life.

“Looking ahead, we want to use this information-and studies with similar findings-to empower pregnant mothers to request support to mitigate their stress, especially in the event of another global health crisis,” said Nickie Andescavage, M.D., a neonatologist and principal investigator at the Center for Prenatal, Neonatal & Maternal Health Research. “We also want to make sure babies born during COVID-19 get the services that they need in life if they develop anxiety or other mental health disorders.”

Researchers at the center used magnetic resonance imaging (MRI) to compare the brains of 103 babies born between 2014 and 2019 prior to the pandemic to 59 born between 2020 and 2022. Mothers who had COVID-19 or other complications in their pregnancies were excluded. The babies underwent MRI imaging while in utero and again soon after delivery.

The mothers were evaluated for stress and anxiety, using the Spielberger State-Train Anxiety Inventory and other evidence-based scoring measures. Pre-pandemic, 21% of mothers reported elevated symptoms of anxiety; in the pandemic cohort, that number jumped to nearly 62%.

Their babies’ brains were also changed, as regions widely understood to control emotion and anxiety displayed smaller volumes on MRI imaging. Given the global impact of the pandemic and universal reports of mental distress worldwide, the potential impact of these findings may impact an entire generation of children born during the pandemic. The team is just beginning to unravel the medical significance.

Catherine Limperopoulos, Ph.D., director of the Center for Prenatal, Neonatal & Maternal Health Research, said understanding the impact of stress is vital in supporting the healthy development of young children. Current studies are underway at her center to tease apart the role of stress in prenatal development and examine its long-term impact on development, including cognition, behavior and mental health.

“We all know that being pregnant can be quite stressful, and there are certain times of collective stress that can provide us windows to understand how the body and mind manage it,” Dr. Limperopoulos said. “At our center, we care deeply about the health of mothers and babies, and our researchers plan to continue investigating the role of stress in development to continue building data to show that mental health must be a greater priority.”

Reference:

Weiner S, Wu Y, Kapse K, et al. Prenatal Maternal Psychological Distress During the COVID-19 Pandemic and Newborn Brain Development. JAMA Netw Open. 2024;7(6):e2417924. doi:10.1001/jamanetworkopen.2024.17924.

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Azithromycin administration does not significantly reduce maternal or neonatal mortality: Study

In recent years, the use of azithromycin as a prophylactic treatment during pregnancy has garnered attention due to its potential benefits for both maternal and neonatal health. Initial randomized controlled trials (RCTs) suggested that azithromycin could improve outcomes which could lead to hopeful anticipation within the medical community. However, this new study published in the eClinicalMedicine journal on azithromycin highlighted the findings which indicated no significant benefit to neonatal survival.

A comprehensive systematic review and meta-analysis meticulously searched seven major databases like PubMed, Scopus, Embase, Cochrane Library, EBSCOHost, ProQuest, and Web of Science, along with clinical trial registries up to April 23, 2024. The focus was on RCTs which compared azithromycin prophylaxis administered either antenatally or intrapartum against placebo or routine care in pregnant women. The primary outcome of interest was neonatal mortality.

The review included data from 20 RCTs that encompassed a total of 56,381 participants. The findings revealed that for intrapartum administration, azithromycin appeared to have little or no effect on neonatal mortality, with a Risk Ratio (RR) of 1.02 (95% CI 0.86–1.20), based on data from five RCTs involving 44,436 participants. Also, the impact on maternal mortality was negligible, with an RR of 1.26 (95% CI 0.65–2.42) from three RCTs including 44,131 participants. The certainty of these findings was rated as very low for neonatal mortality and low for maternal mortality.

The antenatal administration of azithromycin showed comparable results. Three RCTs involving 5,304 participants revealed an RR of 0.74 (95% CI 0.35–1.56) for neonatal mortality which indicated no substantial benefit. For maternal mortality, the RR was 1.62 (95% CI 0.67–3.91) from three RCTs including 8,167 participants. Also, the certainty of this evidence was considered very low for neonatal mortality and low for maternal mortality.

The study also highlighted a significant gap in data regarding long-term adverse outcomes and antimicrobial resistance, areas that require further investigation. These findings challenge the previously held optimism about azithromycin prophylaxis in pregnancy. The low to very low certainty evidence from this meta-analysis suggests that administering azithromycin, whether antenatally or intrapartum, does not significantly reduce maternal or neonatal mortality.

Source:

Shamim, M. A., Kumar, J., Patil, A. N., Tiwari, K., Sharma, S., Anil, A., Saravanan, A., Sandeep, M., Varthya, S. B., Singh, S., Ahmed, M. I., Najmi, A., Shamim, M. A., Gandhi, A., Satapathy, P., Sah, R., Rustagi, S., Gaidhane, A. M., Zahiruddin, Q. S., … Dwivedi, P. (2024). PeRinatal, neOnatal, and Maternal OuTcomEs with azithromycin prophylaxis in pregnancy and labour (PROMOTE-PROPHYLAXIS): systematic review and meta-analysis. In eClinicalMedicine (Vol. 73, p. 102691). Elsevier BV. https://doi.org/10.1016/j.eclinm.2024.102691

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