Intraoperative neuromonitoring important tool for monitoring neurologic function during ASD surgery: Study

Study Design: Systematic review.

Intraoperative neuromonitoring (IOMN) has become a standard practice in the detection and prevention of nerve damage and postoperative deficit. While multicenter studies have addressed this inquiry, there have been no systematic reviews to date. Chloe Cottone et al published a study in ‘global spinal journal.’ This systematic review identifies the leading causes of IONM alerts during adult spinal deformity (ASD) surgeries.

Following PRISMA guidelines, a literature search was performed in PubMed and Embase. IONM alert causes were grouped by equivalent terms used across different studies and binned into larger categories, including surgical maneuver, Changes in blood pressure/temperature, Oxygenation, Anesthesia, Patient position, and Unknown. Inclusion criteria were studies on adult patients receiving ASD correction surgery using IONM with documented alert causes.

Key findings of the study were:

• 1544 references were included in abstract review, 128 in full text review, and 16 studies (8 retrospective reviews, 4 prospective cohort studies, and 4 case series) qualified for data extraction.

• There were a total of 3945 adult patients with 299 IONM alerts.

• Surgical maneuver led the alert causes (258 alerts/86.3%), with signal loss most commonly occurring at correction or osteotomy (101/33.8% and 95/31.8% respectively).

• Pedicle screw placement caused 35 alerts (11.7%).

• Changes in temperature and blood pressure were the third largest category (34/11.4%).

• Unknown cause (1%), patient positioning (.7%), oxygenation (.3%), and anesthesia (.3%).

The authors concluded that – “IONM is an important tool for monitoring neurologic function during ASD surgery and preventing long-term neurologic injury. The purpose of this systematic review was to evaluate and quantify the most common causes of IONM alerts during ASD surgery. Our data shows the majority of IONM alerts are related to surgical maneuvers. Correction, osteotomies, and pedicle screw placement were all significant sources of alerts. A minority of alerts were related to changes in body temperature or blood pressure. These aforementioned causes were responsible for nearly 98% of all alerts, with repositioning, ischemic shock, and unknown or other reasons accounting for the remainder. In conclusion, it is important that surgeons are aware of the described and predictable causes of IONM alerts, as they introduce significant risk of long-term neurologic injury if they are not reversed in a timely manner.” 

Further reading:

Causes of Intraoperative Neuromonitoring Events in Adult Spine Deformity Surgery: A Systematic Review

Chloe Cottone et al

Global Spine Journal 2024

DOI: 10.1177/21925682241242693

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NRX-101 First Antidepressant that Lowers Suicidality in Bipolar Depression

NRX-101 is  First Antidepressant that Lowers Suicidality in Bipolar Depression, confirms Double  blind  Controlled trial. 

NRx Pharmaceuticals has today announced presentation of its Phase 2b/3 trial of NRX-101, entitled “A Randomized, Double-Blind Controlled Comparison of NRX-101 (D-cycloserine/lurasidone) to Lurasidone for Adults with Bipolar Depression and Subacute Suicidal Ideation or Behavior” at the American Society of Clinical Psychopharmacology (ASCP) in Miami Beach, FL. The lead author is Prof. Andrew Nierenberg, Director, Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital and Professor of Psychiatry, Harvard Medical School.

Akathisia rating by study day: a consistent effect is seen commencing at first post-randomization visit and continued throughout the study (Mixed Model for Repeated Measures Regression effect size =0.037, P=0.03)

“Presentation of these data at this highly respected conference is another important step toward bringing a life-saving product to patients in tremendous need,” said Dr. Jonathan Javitt, Chairman and Chief Scientist of NRx. “We believe that NRX-101 may offer a paradigm changing approach to treatment of Bipolar Depression, with a product highly effective in both treating depression and reducing suicidality and associated side effects. We will continue working to bring hope to life with life-saving medications.”

The presentation will be held at 11:15 AM, Wednesday May 29, 2024.

W89 A Randomized, Double-Blind Controlled Comparison of NRX-101 (D-cycloserine/lurasidone) to Lurasidone for Adults with Bipolar Depression and Subacute Suicidal Ideation or Behavior

CONCLUSIONS of the Poster are:

• NRX-101 and lurasidone both demonstrated > 50% response for treating bipolar depression with no difference seen on primary efficacy endpoint (MADRS)

• A clinically meaningful difference was observed on both primary and secondary safety endpoints favoring NRX-101

• NRX-101 was associated with 58% relative reduction in time to sustained remission from suicidality as measured by the Columbia Suicide Severity Rating Scale (C-SSRS) when stratified by sex, mood stabilizer use, antipsychotic use, lifetime suicide event (P=0.05).

• NRX-101 was associated with a relative 76% reduction in symptoms of akathisia compared to lurasidone that was sustained over 42 days (Effect Size 0.37; P=0.03) on the Barnes Akathisia Rating Scale

• Akathisia was seen in 2% of participants treated with NRX-101 vs. 11% treated with lurasidone.

• NRX-101 showed superiority to lurasidone in akathisia starting at day 7 and continuing through day 42/ET.

• No treatment-related serious adverse event was observed in either group. No safety issues were detected except for MedDRA General disorders: NRX-101 – 18.2% vs lurasidone – 0% (p=0.002).

Based on these findings, together with the earlier STABIL-B trial, the Company believes that NRX-101 has potential to become a standard of care drug for treating bipolar depression, an addressable population of 7 million patients in the US and many times that around the world.

This study represents the second trial conducted under FDA Good Clinical Practices guidelines to demonstrate large and meaningful advantages of NRX-101 vs lurasidone on akathisia and suicidality and clears the path for a registration trial of NRX-101 vs. placebo to treat bipolar depression together with earlier accelerated approval for those with akathisia. An additional academic trial conducted by Chen and co-workers similarly demonstrated a statistically-significant reduction in suicidality associated with D-cycloserine, the active ingredient in NRX-101, compared to various standard of care antidepressants.

To the Company’s knowledge, this trial and its prior STABIL-B study represent the only clinical trials in which an oral antidepressant has been demonstrated to cause meaningful reductions in suicidality and akathisia. All currently approved antidepressant drugs carry FDA-mandated “black box” warnings on their labels indicating that they may increase the risk of suicide. Similarly, akathisia-a side effect in which patients are agitated and frequently experience involuntary movement – is a side effect that occurs in 10-15% of patients who take the lurasidone class of drugs and is closely linked to suicide. As shown in the clinical trial, those randomized to lurasidone experienced a substantial increase in akathisia from baseline, whereas those randomized to NRX-101 demonstrated a statistically-significant reduction in akathisia.

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AIIMS INI SS July 2024 Counselling schedule, process Released, 829 Seats Up For Grabs

New Delhi- The All India Institute of Medical Sciences (AIIMS) has released the schedule of online Institute Allocation for admission to DM, MCh and MD Hospital Administration courses of INIs for the July 2024 session. Additionally, AIIMS released the information brochure detailing the process of online institute allotment of INI and also released the final seat position of the INI-SS July 2024 session.

According to the seat matrix, 503 DM, 291 MCh and 35 MD Hospital Administration seats are available for candidates.

The schedule of online Institute allocation will be opened for admission to DM/M.Ch/MD(HA) courses of INIs for the July 2024 session as per the details given below-

Also Read: INI SS July 2024: AIIMS Releases Lists of Provisional Qualified Candidates

SCHEDULE FOR 1st ROUND OF ONLINE INSTITUTE ALLOCATION

S.NO

EVENTS

DATES

1

Exercising of Choices (Institute against applied subject/speciality) for the First Round.

From: 04.06.2024, 05.00 pm (Tuesday) to 11.06.2024 up to 05.00 pm (Tuesday)

2

Announcement of Institute allocation of 1st Round.

19.06.2024 (Wednesday)

3

Online Acceptance of allocated Institute.

From: 20.06.2024, 11.00 am (Thursday) to 25.06.2024 up to 05.00 pm (Tuesday)

4

Reporting & Submission of Documents/Security Deposit.

From: 20.06.2024, 11.00 am (Thursday) to 25.06.2024 up to 05.00 pm (Tuesday)

SCHEDULE FOR 2nd ROUND OF ONLINE INSTITUTE ALLOCATION

S.NO

EVENTS

DATES

1

Announcement of Institute allocation of 2nd Round.

09.07.2024 (Tuesday)

2

Online Acceptance of allocated Institute.

From: 10.07.2024, 11.00 am (Wednesday) to 16.07.2024 up to 05.00 pm (Tuesday)

3

Reporting & Submission of Documents/Security Deposit.

From: 10.07.2024, 11.00 am (Wednesday) to 16.07.2024 up to 05.00 pm (Tuesday)

SCHEDULE FOR 3rd ROUND OF ONLINE INSTITUTE ALLOCATION

S.NO

EVENTS

DATES

1

Announcement of Institute allocation of 3rd Round.

24.07.2024 (Wednesday)

2

Online Acceptance of allocated Institute.

From: 25.07.2024, 11.00 am (Thursday) to 30.07.2024 up to 05.00 pm (Tuesday)

3

Reporting & Submission of Documents/Security Deposit.

From: 25.07.2024, 11.00 am (Thursday) to 30.07.2024 up to 05.00 pm (Tuesday)

As per the official notice in this regard, the schedule for online registration participation in the On-the-Spot Admission Round, if needed, will be informed separately on the website.

The list of eligible candidates for online institute allotment, who have obtained the qualifying marks i.e. 50% of the total marks, will be published before the start of the choice making.

Meanwhile, the Institute allocation will be done in order of merit among the candidates registered within/on specified dates & times.

Along with this, AIIMS has also released an information brochure for 1st round of online institute allocation (Institute against applied subject/speciality)/ process for DM/M.Ch/MD(HA) courses for the July 2024 session.

PROCEDURE

1 The eligible candidates will have to register themselves on the INI-SS Online Institute Allocation portal. The link for the portal will be activated only for eligible candidates in the MyPage. Candidates can log in using the credentials that have been used for filling application form and completing other processes related to the INI-SS Entrance Examination for the July 2024 session.

2 The INI-SS Online Institute Allocation portal will allow candidates to make choices of Institute (a combination of Institute against applied subject/speciality) as per his/her eligibility. The candidate can arrange the choices in the desired order preference. There is no limitation on the number of choices (Institutes) that can be made by the candidates subject to eligibility. The choices can be edited and reordered within the date and time specified in the Important Dates link in the Portal.

3 The Portal will remain open on dates specified in the Important Dates link in the Portal. The choices made by the candidate will be locked either by the candidate OR will be automatically locked on the last Date and Time as specified in the Important Dates link in the Portal.

4 All the candidates who have been allocated Institutes in the 1st Round are required to log into the INI-SS Online Institute Allocation portal and actively choose one of the following options within the date and time specified in the Important Dates link-

i Option 1-  ACCEPT allotted Institute and DO NOT WISH TO PARTICIPATE in further rounds of Institute Allocation.

ii Option 2- ACCEPT allotted Institute and WANT TO PARTICIPATE in 2nd ROUND of Institute Allocation [if the candidate chooses option 2 and participates in the 2nd round then the candidate will be allocated another Institute as per your choice in 2nd round, then the candidate will have to join the Institute allocated during 2nd round. The Institute allocated in the first round shall be considered vacated and the same shall be automatically allocated to other candidates in order of merit. Failure to join the upgraded Institute shall lead to impositions of penalty of Rs. 3.00 Lakh.

However, the option to refuse the allocated Institute is NOT available. Therefore, the candidates are requested to fill the choices carefully and responsibly. The candidate himself/herself shall be responsible for their choices.

In addition, failure to login and selecting an option after Institute allocation within the date and time specified in the Important Dates link will lead to forfeiture of the allocated Institute and render the candidate ineligible for further rounds except the open/spot round of Institute Allocation (if any).

5 All the candidates who are allocated Institute are mandatorily required to choose any of the options mentioned above to report in person (for reporting and/or joining, to the allocated Institute within the date and times specified in the Important Dates link. The candidates are required to deposit original certificates or a security deposit of Rs. 3.00 Lakh on notification of the Institute allocation of the 1st Round at the time of reporting.

FOREIGN NATIONAL CANDIDATES

i The Institute allocation will be done in order of merit and according to choices made by the candidates as described in point no 2.

ii The candidates will be eligible to exercise of choices of Institute only as per applied Subject those are filled in the online registration form and eligibility as per information provided therein.

SPONSORED CANDIDATES

i The Institute allocation will be done in order of merit and according to choices made by the candidates as described in point no 2 against seats as published in respective categories as per applicable rule.

ii In case any discrepancy is found in online data with the Sponsorship certificate’s valid information as in Sponsorship certificate will be accepted as per eligibility criteria.

iii The candidates are eligible to exercise of choice of Institute only as per the applied Subject in which sponsored Institutes are available and issued by the respective competent authority received at the Examination Section AIIMS, New Delhi within specified dates.

iv In case, the NOC has been received in place of the Sponsorship certificate, the Institute allocation will be done as per the subject/Institute available in the online registration.

v If the subject is not mentioned against the candidate’s name in the Sponsorship certificate, no allocation will be done for that institute.

vi All allocation of Sponsored candidates will be done on the basis of the Institute available against the applied subject and that is mentioned in the Sponsorship Certificate/online registration for the July 2024 session.

vii Only one best Institute available at that rank will be allocated during online Institute allocation.

viii The process of admission will be done as per the procedure available for other candidates.

The Information brochure further also noted that, those who have not been allocated any Institute in the first round of Institute allocation, the allocation will be done in the second round of Institute allocation as per their choice in order of merit, the guidelines given in the Information brochure.

Also Read: INI SS July 2024: AIIMS Releases Final Ineligible Candidates List

UPPER AGE LIMIT

1 AIIMS New Delhi & other AIIMS (As on 1st July 2024)- The age validation for Courses of AIIMS New Delhi & other AIIMS under INI-SS for the July 2024 session-

General Category- 35 Years (Candidates Born on or after 01.07.1989 are eligible).

Sponsored Category’- There is no age limit for Sponsored Category.

2 NIMHANS, Bangalore (As on 1st July 2024)- The age validation for Courses of NIMHANS under INI-SS for the July 2024 session-

General Category- 37 Years (Candidates Born on or after 01.07.1987 are eligible).

Sponsored Category’- There is no age limit for Sponsored Category.

3 SCTIMST Trivandrum (As on 1st July 2024)- The age validation for Courses of SCTIMST under INI-SS for the July 2024 session-

General – 40 Years (candidates Born on or after 01.07.1984 are eligible).

Sponsored –There is no age limit for Sponsored Category.

4 PGIMER, Chandigarh (As on 1st July 2024)- The age validation for Courses of PGIMER under INI-SS for the July 2024 session-

General Category- 45 Years (Candidates Born on or after 01.07.1979 are eligible).

Sponsored Category’- There is no age limit for Sponsored Category.

5 JIPMER, Puducherry (As on 1st July 2024)- There is no age limit for any category.

Meanwhile, the 2nd round will be initiated after completion of 1st round.

Moreover, AIIMS has also released the final seat position of the INI-SS July 2024 session.

SEAT POSITION FOR DM

S.NO

COURSE NAME

TOTAL VACANT SEATS

1

Acute Care-Emergency Medicine.

5

2

Addiction Psychiatry.

11

3

Cardiac Surgical Intensive Care.

8

4

Cardiac Anesthesiology.

15

5

Cardiology.

31

6

Cardiovascular Radiology & Endovascular Interventions.

6

7

Child and Adolescent Psychiatry.

8

8

Clinical Haematology.

10

9

Clinical Immunology and Rheumatology.

4

10

Clinical Pharmacology.

17

11

Critical Care Medicine/Intensive Care.

21

12

Endocrinology.

15

13

Forensic Pathology.

2

14

Forensic Psychiatry.

2

15

Forensic Radiology & Virtual Autopsy.

1

16

Gastroenterology.

29

17

Geriatric Psychiatry.

2

18

Haematopathology.

11

19

Hepatology.

5

20

High Altitude Medicine.

3

21

Histopathology.

4

22

Hospital Medicine & Critical Care.

2

23

Infectious Diseases.

22

24

Interventional Radiology.

6

25

Medical and Forensic Toxicology.

1

26

Medical Genetics.

15

27

Medical Oncology.

14

28

Neonatology.

14

29

Nephrology.

34

30

Neuro-Anaesthesiology & Critical Care.

26

31

Neuroimaging and Interventional Neuroradiology.

13

32

Neurology.

34

33

Neuropathology.

2

34

Onco-Anesthesia.

10

35

Paediatric Anaesthesia & Intensive Care.

1

36

Pediatric Cardiology.

4

37

Paediatric Clinical Immunology and Rheumatology.

3

38

Paediatric Emergency Medicine.

1

39

Paediatric Endocrinology.

2

40

Paediatric Gastroenterology and Hepatology.

3

41

Paediatric Haematology-Oncology.

7

42

Pediatric Nephrology.

5

43

Pediatric Neurology.

8

44

Paediatric Oncology.

5

45

Pediatric Pulmonology & Intensive Care.

1

46

Paediatric Pulmonology.

4

47

Paediatrics Critical Care.

10

48

Pain Medicine.

1

49

Pulmonary, Critical Care & Sleep Medicine.

35

50

Reproductive Medicine.

2

51

Therapeutic Nuclear Medicine.

4

52

Trauma Anaesthesia & Acute Care.

1

53

Paediatric Anaesthesiology.

2

54

Virology.

1

TOTAL- 503 vacant seats

SEAT POSITION FOR MCh

S.NO

COURSE NAME

TOTAL VACANT SEATS

1

Breast, Endocrine and General Surgery.

7

2

C.T.V.S .

52

3

Cornea, Cataract and Refractive Surgery.

1

4

G.I. Surgery.

9

5

Gynaecologic Oncology.

5

6

Hand and Microvascular surgery.

1

7

Head Neck Surgery and Oncology/Head Neck Surgery.

10

8

Joint Replacement & Reconstruction.

4

9

Minimal Access Surgery & General Surgery.

3

10

Neuro Surgery.

46

11

Paediatric Orthopedics.

4

12

Pediatric Surgery.

37

13

Plastic and Reconstructive Surgery.

39

14

Renal Transplant Surgery.

4

15

Spine Surgery.

2

16

Surgical Oncology.

13

17

Trauma Surgery and Critical Care.

18

18

Urology.

34

19

Vitreoretinal Surgery.

2

TOTAL- 291 vacant seats

Meanwhile, one seat in DM infectious diseases for AIIMS Jodhpur is reserved for candidates with MD/DNB in Microbiology and One seat is reserved for candidates with MD/DNB in Medicine/Paediatrics/Tropical Medicine.

It should be noted that seats are strictly non-convertible/non-interchangeable between different groups unless expressly mentioned as per rules applicable at any of the participating INI. Any seat remaining vacant in respective groups (General Seats, Sponsored Seats & Foreign National Seats) shall be filled subsequently as per rules applicable at respective INIs.

SEAT POSITION FOR MD (HOSPITAL ADMINISTRATION)

S.NO

INSTITUTE NAME

TOTAL VACANT SEATS

1

AIIMS New Delhi.

12

2

AIIMS Bhubaneswar.

4

3

AIIMS Bhopal.

4

4

AIIMS Jodhpur.

4

5

AIIMS Mangalagiri.

2

6

AIIMS Bilaspur.

1

7

PGIMER Chandigarh.

8

TOTAL- 35 vacant seats

To view the notice, click the link below

https://medicaldialogues.in/pdf_upload/scheduling-of-counselling-july-2024-240273.pdf

To view the information brochure, click the link below

https://medicaldialogues.in/pdf_upload/information-brouchure-july-2024-session-240276.pdf

To view the seat matrix, click the link below

https://medicaldialogues.in/pdf_upload/iniss-final-seat-postion-website-240274.pdf

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Transforming Healthcare: Insights from Vibcare Pharma’s founders

Discussing Universal Healthcare Systems with Vibcare Pharma.
Vibcare Pharma is a leading pharmaceutical manufacturer committed to enhancing health outcomes through innovative, efficient, and quality-assured pharmaceutical products.
In this video, Mr. Siddharth Singhal, Co-founder & MD of Vibcare Pharma, and Mr. Sudhanshu Singhal, Co-founder & Director of Vibcare Pharma discuss about:
1. What inspired the founding of Vibcare Pharma?
2. How does Vibcare Pharma set itself apart in the pharmaceutical industry?
3. What methods does Vibcare Pharma use to ensure effective management and distribution of its products?
4. How does Vibcare Pharma utilize digital health tools to improve patient access to healthcare services?

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Food products labelled as sugar-free could be loaded with fats, refined cereals and even hidden sugars, ICMR says

Whenever you buy food products, you likely check the price, but do you pay attention to the ingredients listed on the label? The Indian Council of Medical Research (ICMR) has highlighted the importance of reading food labels thoroughly, as they can be misleading. In its recent guidelines, ICMR pointed out that products labeled as sugar-free, perceived as beneficial for diabetics and weight-watchers, can actually be loaded with fats, refined cereals, and hidden sugars, contributing to a high glycaemic index and high calories.
Similarly, labels claiming “no-cholesterol” or “heart-friendly” can be deceptive. ICMR noted that while plant-based oils do not contain cholesterol, they are 100% fat and should be consumed in moderation.

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Failed Third Attempt, NEET Aspirant commits Suicide by Jumping In Front of Train in Rajasthan

Jaipur: In a tragic incident, a NEET aspirant committed suicide by jumping in front of a train in Dausa soon after the exam results were declared yesterday evening.

Speaking to IANS, the police said that the deceased aspirant went out on Tuesday evening after informing his parents that he was going to the emitra centre and did not return home. The parents lodged a complaint at the police station.

Also Read:Stressed over failing NEET 2024, aspirant ends life in Kota, second suicide case in 48 hours

A few hours later, they were informed of a body being found on the railway tracks. Police station in-charge Sohan Lal said that a body was found on the tracks near a railway overbridge on the Agra-Jaipur highway. It was identified as that of the aspirant. The deceased had appeared for the NEET exam and the result was announced on Tuesday evening.

The candidate had appeared for the exam for the third time and flunked it again, leading to his suicide, said officials. His body was handed over to his family members on Wednesday.

Also Read:Stressed over NEET exam, Hyderabad aspirant commits suicide

NTA conducted the (NEET-UG) for more than 24 lakh candidates at 4750 different Centres located in 571 Cities throughout the country including 14 Cities outside India on 05 May 2024 (Sunday) from 02:00 P.M. to 05:20 P.M.(IST). The Examination was conducted in 13 languages (Assamese, Bengali, English, Gujarati, Hindi, Kannada, Malayalam, Marathi, Odia, Punjabi, Tamil, Telugu, and Urdu). The examination was also conducted in 14 cities outside the country Abu Dhabi, Dubai, Bangkok, Colombo, Doha, Kathmandu, Kuala Lumpur, Kuwait City, Lagos, Manama, Muscat, Riyadh, Sharjah, and Singapore.

NTA released the NEET scorecard yesterday i.e. on June 4, 2024. A record 24.06 lakh candidates had registered for NEET this year. The passing percentage is almost the same as last year at 56.2 percent.

The results of NEET-UG 2024 shocked many as altogether 67 candidates secured the All India Rank 1 in the examination. Moreover, soon after the reports of a large number of students securing full marks i.e. 720 marks in the exam came to light, the allegations of the NEET paper leak scam started circulating on the social media platforms.

Also Read:NEET-UG 2024 Score Card now LIVE, More than 80 Students Score 720 Marks!

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New survey shows worries loom large over safety net programs and health care affordability in the US

Concerns over the potential insolvency of Medicare among those under 65 have risen, with 73% now expressing worry that it won’t be available when they need it, up from 67% in 2022, according to the new West Health-Gallup 2024 Survey on Aging in America. Worry rose most among those aged 50 to 64, up 13 percentage points to 74%. Higher percentages of adults express concern about the future of Social Security, with 80% of people under 62 and 86% of people aged 40 to 49 fearing it will not be around once they are eligible.

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Commonly used alcohol-based mouthwash brand may disrupt the balance of your oral microbiome, scientists say

The oral microbiome is the community of bacteria that live in the mouth. It helps us digest our food and keep our mouth healthy. Changes to the composition of the oral microbiome have been linked to periodontal diseases and some cancers.

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Women’s mental agility is better during menstruation, shows study

Participants reacted quicker and made fewer errors during menstruation, despite believing their performance would be worse, according to new research from UCL and the Institute of Sport, Exercise & Health (ISEH).

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Housing associations can be ‘change-makers’ for UK communities, says report

Housing associations are being urged to step out of their traditional role to deliver change in deprived areas and help people into work or entrepreneurship.

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