Managing gestational diabetes earlier in pregnancy can prevent complications and improve outcomes: Lancet

A shift in testing for and managing Gestational Diabetes Mellitus (GDM) to much earlier in pregnancy (before 14 weeks) can prevent health complications for both the mother and baby, according to a new Series published in The Lancet. Series authors challenge the current approach to GDM management – which focuses on late GDM (24 weeks+) – and call for better detection and prevention efforts alongside a personalised, integrated life-course approach for those who experience or are at risk for GDM.

GDM, also known as gestational diabetes – a type of diabetes that is found during pregnancy where blood glucose levels are higher than average but not as high as diabetes – is the most common medical pregnancy complication worldwide, affecting one in seven (14%) of pregnancies. As obesity and other metabolic conditions continue to increase around the world, more women of reproductive age will experience some degree of abnormal glucose/insulin regulation, which leads to higher risks of pregnancy complications as well as health conditions later in life, such as type 2 diabetes (T2D) and cardiovascular disease.

“Our new Series emphasises the urgent need for a major shift in how GDM is first diagnosed and managed, not only during pregnancy but throughout the lifetime of mothers and their babies,” said Series lead Prof. David Simmons of Western Sydney University, Australia. “GDM is an increasingly complex condition, and there isn’t a one-size-fits-all approach to managing it. Instead, a patient’s unique risk factors and metabolic profile should be considered to help guide them through pregnancy and support them afterward to achieve the best health outcomes for women and babies everywhere.”

GDM and its complications are on the rise

As obesity continues to increase worldwide, along with impaired glucose tolerance and T2D rates in women of reproductive age, GDM prevalence has also increased two to threefold across multiple countries over the last 20 years. The current GDM prevalence rates range from over 7% in North America and the Caribbean region to almost 28% in the Middle East and North Africa region.

Between 30% and 70% of women with GDM experience high blood glucose (hyperglycemia) from early pregnancy (20 weeks gestation or sooner, also known as early GDM). These women have worse pregnancy outcomes compared to women whose GDM is not present until later in pregnancy (24-28 weeks). Even later in pregnancy, in studies where GDM was not managed adequately (e.g., where insulin was needed but not used), GDM was associated with increased risks of cesarean delivery (16%), preterm delivery (51%), and large for gestational age babies (57%). Other studies that looked at GDM pregnancies requiring insulin therapy found it was associated with a more than two-fold increased risk of neonatal intensive care unit admission.Women diagnosed with GDM have a 10-fold higher risk of developing T2D later in life compared to women who did not experience GDM.

They are also more likely to have co-existing hypertension, dyslipidemia (high blood lipid levels), obesity, and fatty liver, with a two-fold higher risk for developing cardiovascular disease during their lifetime. Women with GDM also experience more significant risks of mental health conditions, including stress, depression, and anxiety, along with stigma and feelings of guilt and shame related to GDM during pregnancy. Beyond their own impacts, these feelings of guilt and shame can lead to additional adverse outcomes if patients avoid testing glucose levels or taking insulin because of them.

Recent studies have suggested that GDM diagnosis may be associated with an increased risk of subsequent postpartum depression. Conversely, treatment of late GDM is associated with lower rates of depression at three months postpartum, while treatment of early GDM is associated with improvement of quality of life at 24 to 28 weeks gestation.

“GDM is a tremendous public health challenge. Women who experience it need support from the medical community, policymakers, and society as a whole to ensure they can effectively access proper treatment, reduce the stigma associated with GDM, and improve their overall pregnancy experience,” said Series author Dr Yashdeep Gupta of the All India Institute of Medical Science.

Early diagnosis for a lifetime of better health outcomes

GDM has historically been considered a pregnancy complication involving the treatment of high blood glucose levels late in the second trimester. The World Health Organization’s current diagnostic criteria for GDM recommends testing at 24-28 weeks gestation without prior screening. 

However, recent evidence suggests that GDM has foundations before pregnancy and can be present in early pregnancy. Overall, 30-70% of GDM can be found early using oral glucose tolerance testing and includes those at most significant risk of requiring insulin therapy and experiencing pregnancy complications.

Recent studies, such as the TOBOGM RCT , showed that among women with early GDM, identification, and treatment before 20 weeks gestation (compared to 24-28 weeks) not only reduced pregnancy complications and postpartum complications, including neonatal respiratory distress and length of stay in neonatal intensive care units, but also improved quality of life mid-pregnancy and increased breastfeeding initiation, which can reduce the likelihood of developing obesity, T2D, and other long-term conditions. “The benefits of early GDM detection are clear – we can keep mothers and babies healthier during pregnancy and hopefully continue that path for a lifetime. What is needed now is earlier testing and an approach to managing GDM that takes the available resources, circumstances, and personal wishes of the patient into consideration,” said Series author Dr Helena Backman of Örebro University, Sweden.

New strategies are urgently needed to improve GDM management

A better understanding of GDM and its effects can help researchers, clinicians, and policymakers develop new management approaches that focus on improved prevention and treatment of GDM complications from pre-conception through pregnancy and beyond.

The recommended strategies developed by the Series authors include:

• Early GDM testing of those with risk factors, ideally before 14 weeks gestation.

• Promoting health at the population level that prepares women, especially those with risk factors for a healthy pregnancy and, after that, for healthy aging. – Improve antenatal care that includes postpartum screening for glycemic status.

• Tailored annual assessments in women with prior GDM to prevent or better manage complications such as T2D (particularly in subsequent pregnancies) and cardiovascular disease.

• More research into GDM and how to improve outcomes of women with GDM and their children across the life course.

“It is past time to move from ‘late pregnancy’ focused services to an integrated, personalized life-course strategy across both high- and low-resource settings. This includes new, systematic approaches to prevention, early GDM treatment, identifying and overcoming barriers to uptake, better health system integration, and more research to better understand how GDM affects women and their children during pregnancy and throughout their lives,” said Prof. Simmons.

Reference:

Marie-France Hivert, Helena Backman, Katrien Benhalima, Prof Patrick Catalano, Prof Gernot Desoye, Jincy Immanuel, Christopher J D McKinlay, Prof Claire L Meek, Prof Christopher J Nolan, Pathophysiology from preconception, during pregnancy, and beyond, The Lancet, https://doi.org/10.1016/S0140-6736(24)00827-4.

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New studies suggest benefit of total robotic metabolic and bariatric surgery over conventional laparoscopy

Two new studies presented today at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2024 Annual Scientific Meeting suggest total robotic metabolic and bariatric surgery may result in shorter operative times, reduced lengths of stay and lower complications compared to laparoscopic approaches.

In one study, researchers from AdventHealth in Celebration, FL examined the outcomes of a single surgeon who performed 809 metabolic and bariatric operations – 498 totally robotic and 311 laparoscopic — between 2020 and 2023. They found total robotic Roux-en-Y gastric bypass (RYGB) resulted in significantly shorter operative times (97.6 min. vs. 115.4 min), reduced hospitalization (1.19 days vs. 1.39 days), and lower complication rates (1.7% vs. 5.1%) compared to conventional laparoscopy.

Total robotic sleeve gastrectomy procedures produced similar benefits — less operative time (47.4 min. vs. 53.1 min.), shorter length of stay (1.14 days vs. 1.30 days), and fewer complications (0.8% vs. 3.2%). The surgical approach to a duodenal switch did not influence operative times and complication rates but the total robotic approach did result in shorter lengths of stay.

This study comes after recent meta-analyses and registry reports found metabolic and bariatric surgery performed robotically had similar outcomes to conventional laparoscopy but with longer operative times and higher costs. The researchers note, however, that most of the robotic surgeries in these reports were robot-assisted rather than totally robotic.

In a second study, these same researchers report improved outcomes and efficiencies for robotic procedures involving patients, this time with severe obesity and type 2 diabetes. A total of 744 patients received either totally robotic (n= 469) or laparoscopic RYGB or sleeve gastrectomy (n=275). Major complication rates for patients with diabetes (2.4% vs. 8.3%), length of stay (1.19 days vs. 1.48 days) and operative times (71.7 min. vs. 90.5 min.) were all lower compared to laparoscopy and were comparable to rates seen with patients with no diabetes. The average preoperative BMI was 46.1.

“The robotic platform has advantages for patients with diabetes and high surgical risk,” said study co-author on both studies, Cynthia Buffington, PhD, researcher at AdventHealth. “Surgeons may achieve a higher level of precision, flexibility and control than is possible with conventional laparoscopy. This results in less tissue trauma, shorter recovery times, less opportunity for scarring, milder postoperative pain, and lower risk for infections and bleeds.”

The ASMBS reports that in 2022 nearly 280,000 metabolic and bariatric procedures were performed in the U.S., which represents only about 1% of those who meet eligibility requirements based on BMI. While the ASMBS does not track the number of robotic surgeries performed each year, these types of procedures are on the rise.

“Total robotic surgery is playing an increasing role in metabolic and bariatric surgery bringing new efficiencies and fewer complications for certain procedures and patients,” said Ann Rogers, MD, ASMBS President-elect and Director, Penn State Surgical Weight Loss Program, Penn State Health, Hershey, PA, who was not involved in the study.

According to the U.S. Centers for Disease Control and Prevention (CDC), obesity effects 42.4% of Americans. Studies show the disease can weaken or impair the body’s immune system and cause chronic inflammation and increase the risk of many other diseases and conditions including cardiovascular disease, stroke, type 2 diabetes, and certain cancers. 

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Synovial Sealant Variant cost effective solution for Minced Cartilage Repair: Study

Cartilage defects are a common pathology in active people and affect quality of life. A common treatment option is treatment with minced cartilage (MC). As conservative therapy has a limited effect, surgical treatments vary in terms of procedure and results. A modified technique for autologous cartilage repair is presented by Philipp Ahrens et al.

The study has been published in ‘Indian Journal of Orthopaedics.’

MC was modified by adding a synovial sealant. This improves the stability of the graft, allowing the cartilage to proliferate. The synovial tissue has the potential to stimulate the implanted cartilage, which promotes healing and regeneration. The clinical and functional results of the modified technique were examined in a retrospective case series.

The key findings of the study were:

• The technique has proven to be reproducible for retropatellar cartilage defects and is both efficient and cost effective.

• MC with synovial sealing was performed in ten patients with retropatellar cartilage damage.

• In the conducted cases series, 10 patients were available for follow-up after 18±3 months.

• The group consisted of four women and six men with a mean age of 35±15 years (range 17–56 years) and BMI of 24±4 kg/m2.

• Eight of the 10 patients had no pain at rest at the follow up time point. The mean pain level in motion was 1.9±1.6 according to VAS.

• Patients showed good clinical results in terms of pain (VAS=1.9, KOOS Pain=89.7), symptoms (KOOS Symptoms=83.6), and daily activity (KOOS Activity=96.6).

• No major complication was observed and revision surgery was not needed in this case series. Two patients experienced joint effusion postoperatively, while two others complained of an initial extension deficit. Treatment was successful with conservative treatment in these cases.

The authors concluded that – “The procedure combines the advantages of autologous cartilage repair with a one-stage surgical approach. It utilizes the regenerative potential of synovial tissue while providing improved mechanical stability. This technique offers a cost-effective, autologous solution for full-thickness cartilage defects, and shows promising clinical results in the medium term.”

Further reading:

The Synovial Sealant Variant for Minced Cartilage Repair: A Technical Note and Retrospective Study

Philipp Ahrens et al

Indian Journal of Orthopaedics

https://doi.org/10.1007/s43465-024-01174-8

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NPPA authority rejects Sun Pharmaceuticals application for separate ceiling price for Antibiotic Suspension Dual Chamber Pack with novel technology

New Delhi: Observing that there is no data or evidence in the survey report that shows reduction in reconstitution time and spillage as claimed, the National Pharmaceutical Pricing Authority (NPPA) in its authority meeting has rejected the application presented by the drug major Sun Pharmaceuticals Industries for a separate ceiling price for scheduled formulation of Amoxicillin 200 mg Clavulanic acid 28.5 mg suspension in a Dual Chamber Pack with Novel Technology.

This came after the authorities deliberated on application to fix a separate ceiling price under paragraph 11(3) of DPCO-2013, of a scheduled formulation of Amoxicillin 200 mg + Clavulanic acid 28.5 mg suspension in a dual chamber pack with novel technology, being introduced in India for the first time, at the 256th authority meeting, which is the 124th meeting under the DPCO, 2013, held on June 7, 2024, under the Chairmanship of Shri Kamlesh Kumar Pant, Chairman, NPPA.

Sun Pharmaceuticals Industries has sought additional price for dual chamber pack over and above existing ceiling price.

The Authority noted the application filed by Sun Pharmaceuticals Industries Limited on 29.09.2023 for fixation of separate ceiling price for scheduled formulation of Amoxicillin 200 mg Clavulanic acid 28.5 mg suspension in a Dual Chamber Pack with Novel Technology under para 11(3) of DPCO, 2013.

Para 11(3) of DPCO, 2013, states,

“Notwithstanding anything contained in sub-paragraph (1) and (2), in the case of injections or inhalation or any other medicine for which dosage form or strength or both are not specified in the Schedule-I of the Drugs (Prices Control) Order, 2013, the Government may fix and notify separate ceiling price or retail price for such formulations with specified therapeutic rationale, considering the type of packaging or pack size or dosage compliance or content in the pack namely liquid, gaseous or any other form, in the unit dosage as the case may be, conforming to Indian Pharmacopeia or other standards as specified in the Drugs and Cosmetics Act, 1940 (23 of 1940) and the rules made thereunder for the same formulation.”

In connection with the above, it was noted that the current applicable ceiling price of this formulation is Rs 2.02 per ml and that additional price of Rs.0.34 per ml over the ceiling price has been sought by the applicant on account of novel pack, dose accuracy, hygiene, better efficacy, lesser reconstitution time and no spillage while administering the drug.

The Authority noted that the matter was deliberated in 56th, 57th& 59th meeting of the Multidisciplinary Committee (MDC) held on 20.12.2023, 27.02.20248 08.05.2024 respectively. The representatives of the company gave detailed presentation before the MDC in the 57th meeting held on 27.02.2024 and also attended the 59th MDC meeting through video conferencing.

The Authority also noted that the applicant was asked by MDC in the 57th meeting to submit the Published literature / clinical study / evidence that the dual chamber pack helps in reducing the clinical error or improved compliance as claimed by the applicant.

However, the applicant stated that this kind of novel pack is not available anywhere in the world, therefore no published literature on this novel pack is available nationally or internationally and submitted a self-commissioned survey report dated 28.06.2023.

The MDC in the 59th meeting examined the submissions made by the applicant and observed that there is no data / evidence in the survey report that shows reduction in reconstitution time and spillage as claimed and applicant has not provided any evidence/supporting documents towards improved efficacy of the product due to innovative packaging. Accordingly, the MDC recommended rejecting the application.

In line with the above, the Authority deliberated upon the matter in detail and accepted the recommendation of MDC and accordingly rejected the application of company to fix a separate ceiling price for their scheduled formulation of Amoxicillin 200 mg and Clavulanic acid 28.5 mg suspension in a Dual Chamber Pack with novel technology.

Also Read:NPPA Revises Ceiling Price of FDC Budesonide Plus Formoterol Inhalation

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Non-adherence to Guidelines: NMC imposes Rs 12 lakh fine on GMC Udhampur, conditional renewal for MBBS seats

Jammu: The National Medical Commission (NMC) has imposed a fine of Rs 12 lakh on the Government Medical College (GMC) Udhampur for persistent deficiencies and non-adherence to NMC guidelines and regulations.

NMC imposed the fine while evaluating the annual declaration form submitted by the institute while applying for renewal of their 100 MBBS seats. Even though the Commission imposed a fine on the institute, it has granted a conditional renewal for the academic year 2024-2025.

The Apex Medical Commission, NMC, grants renewal of MBBS seats to the Medical Colleges with valid Letters of Permission (LoP) for MBBS admission after assessing the Annual Declaration Form, which the medical colleges need to upload on the NMC portal.

Also Read: First time: NMC slaps fine on 3 TN medical colleges for Faculty, Clinical Material Deficiencies

As per the latest media report by Daily Excelsior, GMC Udhampur, which has a valid LoP for MBBS admission, had applied this year for renewal of their 100 MBBS seats. For this, the college uploaded the requisite details/data on the NMC portal.

However, while evaluating the annual declaration form, video of examination and SAF-C provided by the College with AEBAS (Aadhaar Enabled Biometric Attendance System) report, the Commission found several deficiencies.

Taking note of the deficiencies, the Commission issued a show-cause notice to the medical college and directed the management of the institution to furnish a point-wise reply within 3 days, explaining as to why the seats allocated to the institute should not be reduced in the Academic Year 2024-2025 or why a monetary penalty should not be imposed.

Apart from this, the College was also given an additional opportunity to submit an explanation on the NMC observation through a virtual meeting before the Undergraduate Medical Education Board (UGMEB) on 23.05.2024.

During the virtual hearing, the Principal of the college represented the institute but the authorities while reviewing the observations found breaches to be substantial and opined that the clarification given by the college was unsatisfactory.

Even though the Commission imposed a fine of Rs 12 lakh, it granted the renewal of 100 MBBS seats for the academic year 2024-2025 to GMC Udhampur. However, the NMC permission has been granted subject to the deposit of a fine of Rs 12 lakh. 

The Commission has also decided to do a reassessment after 2 months with a warning of initiating stringent action if deficiencies pointed by it exist.

Issuing a Communication to the medical college, the Director of UGMEB, informed, “The competent authority is of the view that in all respects, your college becomes the fit case for reduction of seats due to non-adherence guidelines, regulations notified and issued by NMC from time to time. Since the portal for submission of the Annual Declaration Form has been introduced for first time, taking a lenient view, the Board decided to grant renewal of 100 MBBS seats for the year 2024-25, subject to the deposit of a fine of Rs 12lakh as a first measure. However, a reassessment will be done after 2 months. If deficiencies exist with your college, this organization will initiate the stringent action as mandated under MSMER-2023 Chapter-III clause-8 and any other relevant act and rules.”

Medical Dialogues had earlier reported that the NMC had been in talks with the medical colleges across the country on a daily basis to ensure that the medical colleges have been complying with the requirements regarding faculty numbers, biometric attendance, clinical materials and other rules. The process is ongoing and NMC has already reached out to the administrators of around half of the medical colleges.

Earlier, medical colleges were facing physical inspections, where a team of assessors would go and visit medical colleges and assess those facilities. This process was widely criticized and accused of being full of bribery and corruption. It was alleged that the assessor would take bribes and approve medical colleges. However, under the new system, the Apex Medical Regulator is slowly moving online in terms of inspection of medical colleges as well as overseeing the fulfilment of requirements. Although online, with features, like AEBAS and biometric attendance system, it is being difficult for medical colleges to engage ghost faculties.

Also Read: Medical Colleges Under Tight Scrutiny of National Medical Commission

NMC introduced the provisions of monetary penalty in the Maintenance of Standards of Medical Education Regulations, 2023 or MSMER 2023. The Commission had mentioned that it may impose several forms of penalty such as issue warning to the medical college to rectify or comply, impose monetary penalty up to Rs 1 crore, impose penalty up to Rs 5 lakhs to the faculties of the medical college for misconduct. It may also withhold the accreditation process, recommend to the Medical Assessment and Rating Board (MARB) of NMC to withhold the application process for any new course including increase of seats in the existing course, reduce the number of students in the next or subsequent academic years, stop admission to one or more courses, recommend for withdrawal of permission, withhold or withdraw accreditation for up to five academic years.

Recently, for the first time, taking note of deficiencies in faculty and clinical material, NMC imposed fines on medical colleges for violating the Maintenance of Standards of Medical Education Regulations, 2023 (MSMER) rules. The Commission slapped a fine of up to Rs 3 lakh on government medical colleges in Tamil Nadu, including the colleges in Dharmapuri, Ramanathapuram, and Nagapattinam. Apart from these colleges, the Commission also issued show-cause notices to many other colleges for deficiencies in Aadhaar-based biometric attendance.

Later, noticing a critical faculty shortage and lack of essential resources, the Commission took strict action against the government medical colleges in Chhattiagarh. NMC slapped a penalty of Rs 1 crore on Kanker Medical College, Rs 4 lakh fine on Durg Medical College, and Rs 3 lakh fine each in the medical colleges located at Bilaspur, Ambikapur, Mahasamund, and Jagdalpur. Along with this, Mahasamund, Kanker, and Raigarh medical colleges have also been served with show-cause notices over the shortage of faculty.

Also Read: Renew Blood Bank License or pay Rs 6 lakh Penalty for Non-Compliance: NMC warns Medinirai Medical College Hospital

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MUHS notifies on Rules, Procedures to issue University Migration Certificates to Students

Maharashtra- Maharashtra University of Health Sciences (MUHS) has released the rules and procedure for issuing university migration certificates to students through a notice.

The rules and procedure for issuing University Migration Certificates to students are applicable to all affiliated colleges and recognised institutions of MUHS. The rules and procedures will come into effect from the date of its issue.

As per the notice, students are required to follow the rules and procedures mentioned to obtain the Migration Certificate-

1 Students studying in any Department, Affiliated College, Maintained or Autonomous College or Recognised Institution of the University who wish to take admission to any other Institution or College affiliated to any other Statutory University in India or abroad, may apply to the University in the prescribed format for obtaining Migration Certificate after or in between the completion of the course.

2 The student must submit the application form along with all the required documents, certified by the Dean or Principal or Director of the affiliated college or recognized institution where the applicant has last studied. The college will forward the application to the university as per the format under a cover letter along with supporting documents.

Also Read: MUHS To Hold Additional Mini Convocation, instructions issued for students, all details here

DOCUMENTS

A Migration Certificate will be issued on the basis of the following documents-

1 First College Leaving or Transfer Certificate in original.

2 In any unavoidable circumstances, if the student is unable to produce the first College Leaving or Transfer Certificate in original, then the College Leaving or Transfer Certificate specifically marked ‘Issued for Management Certificate Purpose only’ will be accepted in original. However, it will be mandatory for the student concerned to submit the undertaking as per the format along with the letter from the college or institute which is affiliated with the other university in which he/she proposes to take admission or has been admitted.

3 In case the original, first transfer or renunciation certificate is lost, stolen, accidentally burnt or damaged or damaged due to natural calamities, the student may submit a copy of the transfer or renunciation certificate, a copy of the complaint/FLR filed by the student with the concerned police station or a certificate from the concerned fire department, as the case may be, and an affidavit to that effect on non-judicial stamp paper.

4 Self-attested photocopy of original degree certificate or self-attested statement of marks of final year or self-attested provisional degree certificate (for the particular year) if issued by the University.

5 Self-attested photocopy of University Internship Completion Certificate.

6 In case of a student who has completed an Undergraduate (UG)/ Postgraduate (PG) course from a Government College or a College run by the Local Self Government and has signed the requisite bond for compulsory service with such College, the UG student is required to submit an undertaking as per the specimen and the PG student is required to submit an undertaking as per the specimen regarding completion of bond service.

7 Applicant students seeking Migration Certificates are required to submit a self-declaration certificate regarding furnishing correct information as per the sample.

8 If the Transfer or Leaving Certificate issued by the College or Institute is of the previous academic year and not of the current academic year, the student will have to submit a self-declared gap certificate for such a gap period.

Also Read: MUHS Releases Final Allotment List for Summer Internship Programme 2024

FEES STRUCTURE

1 The student is required to pay the Migration Certificate fee as notified by the University from time to time through RTGS/NEFT/Online payment gateway on the official website of the University.

2 For issuance of Migration Certificate on an urgent basis or in hand on the same day, the student will have to pay additional fees as notified by the University from time to time.

3 Migration Certificate fee once paid will not be transferable or refundable under any circumstances.

ISSUE OF MIGRATION

1 After receiving the application from the student for issuance of a Migration Certificate, the University will issue the Migration Certificate to the student as per his/her name, admission eligibility and enrolment registration.

2 If admission is cancelled in the first year of the course, a Migration Certificate will not be issued before granting enrolment registration. The applicant will be informed accordingly by the University.

3 Migration Certificate will, as far as possible, be issued within seven working days on an urgent basis and within 15 working days on a regular basis after receipt of the complete application from the student along with the prescribed fee as notified by the University from time to time.

4 If a Migration Certificate is required by post then it will be sent to the correspondence address of the applicant student or to the concerned college by speed or registered post.

5 If the Migration Certificate is asked for in hand, the student concerned or the person authorised on his/her behalf will have to produce his/her identity proof or authority letter, as the case may be.

Also Read: Summer Internship Programme 2024: MUHS Releases Revised Provisional List of candidates

ISSUE OF DUPLICATE MIGRATION CERTIFICATE

1 If the original Migration Certificate is lost, stolen, burnt or damaged accidentally or due to natural calamities, a duplicate Migration Certificate may be issued on submission of a copy of the complaint or FIR lodged by the student with the concerned police station or a certificate from the concerned Fire Brigade and an affidavit to that effect on non-judicial stamp paper, a written application and fee as notified by the University from time to time.

2 The student has to pay a fee for a duplicate copy of the Licence Certificate as notified by the University from time to time through RTGS/NEFT/Online payment on the University’s official website.

VALIDITY OF MIGRATION CERTIFICATE

1 There is no specific period for the use of the Migration Certificate from the date of its issue. It can also be submitted when a student is taking further admission to another educational institution.

2 Migration Certificates once issued can be used for getting admission in only one University or Institute.

CANCELLATION OF MIGRATION CERTIFICATE

1 If the Migration Certificate is returned by the student to the University within a period of six months from the date of issue of the Migration Certificate, the Migration Certificate will be cancelled by the University and the original documents will be returned to the student. However, no fee will be refunded.

2 Migration Certificate once issued can be used only for seeking admission in one University or Institute, as the case may be, failing which the Migration Certificate will be cancelled by the University.

To view the notice, click the link below

https://medicaldialogues.in/pdf_upload/muhs-announces-new-procedures-for-issuing-migration-certificates-to-students-241903.pdf

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Assistant Professor denied NOC for Employment At Medical Colleges Outside State, SC issues notice on plea challenging Uttarakhand Govt Decision

New Delhi: The Apex Court has issued a notice in a plea challenging the Uttarakhand Government’s decision to not grant a No-Objection Certificate (NOC) to the medical teachers seeking employment outside the State of Uttarakhand. 

As per the Government Order by the Uttarakhand Government, the NOC would be provided to the faculty only when employment was sought at other medical colleges within the State.

Challenging the order and the decision of the Uttarakhand High Court, which had upheld the Government Order of denying NOC to the petitioner, an Assistant Professor of Community Medicine at Government Medical College, Haldwani approached the Apex Court bench.

Filing the plea, the petitioner urged the Apex Court to issue directions so that the NOC is applied for a faculty position at the Institute of Medical Sciences, Banaras Hindu University at Varanasi.

While considering the matter, the Apex Court Vacation Bench comprising Justices Rajesh Bindal and Prasanna B Varale issued notice noting, “Issue notice to the respondents, returnable within six weeks, only for consideration of the validity of the communication dated 27.08.2020 in terms of which no objection certificate is not issued to the Members of Faculty working in the Government Medical Colleges, for employment else where. No case is made out for grant of interim order.”

Also Read: Faculty shortage in India is twofold- Genuine shortage and lack of inclination to teach at college level: Parliamentary Panel

The matter has been listed for further hearing on 7th August 2024. 

As per the latest media report by Live Law, the petitioner argued that the condition put by the Government Order specifying that the NOC would be given only when a teacher applies for appointment in a Government College within the State was arbitrary and illegal. He further contended that all Medical Colleges formed a homogeneous class and therefore, the artificial classification made by the impugned Government Order between Government Medical Colleges within and outside Uttarakhand was unsustainable. Therefore, the petitioner prayed to the Court to set aside the impugned Government Order.

On the other hand, the State Counsel argued that the grant of NOC was the sole prerogative of the State and if it found an individual to be indispensable for the institute he could turn down the request for NOC without violating any law.

Earlier, while considering the matter, the HC bench had upheld the Government Order after noting that since Uttarakhand was a Hill State and the Government Medical Colleges within the State were facing a scarcity of faculty members, “if the number of faculty members falls short of the prescribed standard, then the Medical College may lose recognition, which shall have devastating effect, not only on the medical students, but also for the masses, who depend on Government Medical Colleges for quality medical services.”

“Thus, if the employer has some reservation against his employee seeking employment elsewhere, then the employer can refuse to grant NOC. This is a right, which inheres in every employer,” held the High Court.

Further, the HC bench rejected the argument of the petitioner that an artificial classification was made by the Government Order between the medical colleges which was in reality a homogenous class.

“Government Medical Colleges fall in a different class and equality clause contained in Article 14 of the Constitution cannot be pressed into service for questioning the classification made between Government Medical Colleges vis-a-vis other colleges,” observed the HC bench.

To view the Supreme Court order, click on the link below:

https://medicaldialogues.in/pdf_upload/supreme-court-uttarakhand-241910.pdf

Also Read: SGRR Resident Doctor Suicide Aftermath: Uttarakhand Medical Council summons Principal, doctors call for nationwide protest

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100 Vacancies For SR Post At JIPMER Puducherry: Apply Now

Puducherry: The Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER Puducherry) has invited online applications for the post of Senior Resident (Non Academic) on a regular basis in different departments in this institute. 

JIPMER became an institution of national importance under the Ministry of Health and Family Welfare, Government of India in the year 2008. JIPMER offers various undergraduate and postgraduate medical courses. Located in Pondicherry, JIPMER is also a fully functional hospital that provides medical treatments to patients from all over the world. It has about 200 faculty members 3,000 staff and 360 resident physicians.

JIPMER Puducherry Vacancy Details:

Total no of vacancies: 100

The vacancies are in the Departments of Anaesthesiology, Anatomy, Biochemistry, Dermatology, Emergency Medicine, ENT, Forensic Medicine & Toxicology, General Medicine, General Surgery, Geriatric Medicine, Microbiology, Nuclear Medicine, Obstetrics & Gynaecology, Ophthalmology, Orthopaedics, Paediatrics, Pathology, Pharmacology, Physiology, Physical Medicine & Rehabilitation, Preventive and Social Medicine, Psychiatry, Pulmonary Medicine, Radiation Oncology, Radilogy, and Transfusion Medicine.

The last date of submission of online application is 24th June 2024.

For more details about Qualifications, Age, Pay Allowance, and much more, click on the given link:

https://medicaljob.in/jobs.php?post_type=&job_tags=JIPMER&location=&job_sector=all

Eligible Candidates (How to Apply):-

APPLICATION – REGISTRATION & SUBMISSION

SUBMISSION OF APPLICATION: THROUGH ON-LINE MODE ONLY.

Log on to link in the Home page https://www.jipmer.edu.in and navigate to the link “RECRUITMENT TO THE POST OF SENIOR RESIDENT ON REGULAR BASIS AT PUDUCHERRY–JUNE 2024”.

Read the Advertisement in detail and instructions carefully.

The flow chart for filling application on-line given as Appendix (ANNEXURE-I) in the Advertisement.

Candidate should acquaint themselves with all requirements with regard to filling up the application on-line.

Filling up of application

1. Online Registration

2. Entry of candidate details & uploading required documents

3. Online payment

4. Confirmation page

1. Online Registration

a. Click the link in the Home page www.jipmer.edu.in in and navigate to the link “RECRUITMENT TO THE POST OF SENIOR RESIDENT ON REGULAR BASIS AT PUDUCHERRY – JUNE 2024” and start the registration process.

b. FULL NAME entered by the candidate in the application must match with both his/her Govt. Photo ID Card (Aadhaar Card / Pan Card / Identity Card / Driver’s License etc.) and undergraduate Degree Certificate. (Spelling and order must be same – if it is not same, the candidate is advised to get it changed in the above-mentioned document/documents before applying)

c. A candidate can apply in any one of the discipline subject to fulfilling the essential eligibility criteria

2. Entry of candidate details &uploading required documents

Candidate details

The candidates should fill the details carefully. No request for change in the details provided by the candidate in the application will be considered or entertained after submission of the online application, Photograph, Signature etc.

Also Read:SR Post In Various Departments: Walk In Interview At AIIMS Patna, Apply Now

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Roche gets USFDA nod for chronic blood disorder treatment Crovalimab

Roche has received approval from the U.S. Food and Drug Administration (USFDA) for Crovalimab for the treatment of chronic blood disorder.

Crovalimab, branded as PiaSky, is a monthly under-the-skin or intravenous treatment for paroxysmal nocturnal hemoglobinuria (PNH).

PNH is a disorder in which red blood cells break apart prematurely. It can cause anemia, fatigue and blood clots, and can lead to kidney disease.
Roche said the disease affects around 20,000 people worldwide.
The approval is based on a late-stage study in which PiaSky showed a 79.3% control in the destruction of red blood cells versus 79% for the standard-of-care eculizumab from week 5 to week 25, according to a Reuters report.
“Crovalimab could provide an option to self-administer as infrequently as every four weeks, thereby reducing clinic visits for people with this lifelong condition,” said Levi Garraway, chief medical officer of Roche.
Other treatments for PNH such as Astrazeneca’s Ultomiris and eculizumab, sold as Soliris, and Amgen’s Bkemv require infusion by healthcare professionals.
Read also: CDSCO Panel approves Roche’s Protocol Amendment proposal to study Entrectinib
PiaSky was approved in China in February and Japan in March.
The drug is also being tested in two other blood disorders, atypical hemolytic uremic syndrome and sickle cell disease, and a kidney disease called lupus nephritis.
Read also: CDSCO Panel Rejects Roche Products India local Phase III CT waiver proposal for Atezolizumab injection SC route
Medical Dialogues had earlier reported that Roche has launched the clinically approved, highly-sensitive in-situ hybridisation (ISH) test, the VENTANA Kappa and Lambda Dual ISH mRNA Probe Cocktail assay, in countries accepting the CE Mark. The test is designed to help pathologists differentiate a B-cell malignancy from a normal, reactive response to an infection.

Read also: Roche unveils new highly-sensitive B-cell lymphoma test

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Lawsuit could challenge trust in Ozempic and other popular weight loss drugs

The manufacturers of the most popular weight loss drugs are being challenged in court.

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