All commonly prescribed oral antibiotics tied to increased risk of serious cutaneous adverse drug reactions leading to an ED visit: JAMA

All commonly prescribed oral antibiotics tied to increased risk of serious cutaneous adverse drug reactions leading to an ED visit suggests a study published in the JAMA.

Serious cutaneous adverse drug reactions (cADRs) are potentially life-threatening drug hypersensitivity reactions involving the skin and internal organs. Antibiotics are a recognized cause of these reactions, but no studies have compared relative risks across antibiotic classes. A study was done to explore the risk of serious cADRs associated with commonly prescribed oral antibiotics, and to characterize outcomes of patients hospitalized for them. Nested case-control study using population-based linked administrative datasets among adults aged 66 years or older who received at least 1 oral antibiotic between 2002 and 2022 in Ontario, Canada. Cases were those who had an emergency department (ED) visit or hospitalization for serious cADRs within 60 days of the prescription, and each case was matched with up to 4 controls who did not. Conditional logistic regression estimate of the association between different classes of oral antibiotics and serious cADRs, using macrolides as the reference group.Results During the 20-year study period, we identified 21 758 older adults (median age, 75 years; 64.1% female) who had an ED visit or hospitalization for serious cADRs following antibiotic therapy and 87 025 matched controls who did not. In the primary analysis, sulfonamide antibiotics (adjusted odds ratio [aOR], 2.9; 95% CI, 2.7-3.1) and cephalosporins (aOR, 2.6; 95% CI, 2.5-2.8) were most strongly associated with serious cADRs relative to macrolides. Additional associations were evident with nitrofurantoin (aOR, 2.2; 95% CI, 2.1-2.4), penicillins (aOR, 1.4; 95% CI, 1.3-1.5), and fluoroquinolones (aOR, 1.3; 95% CI, 1.2-1.4). The crude rate of ED visits or hospitalization for cADRs was highest for cephalosporins (4.92 per 1000 prescriptions; 95% CI, 4.86-4.99) and sulfonamide antibiotics (3.22 per 1000 prescriptions; 95% CI, 3.15-3.28). Among the 2852 case patients hospitalized for cADRs, the median length of stay was 6 days (IQR, 3-13 days), 9.6% required transfer to a critical care unit, and 5.3% died in the hospital. Commonly prescribed oral antibiotics are associated with an increased risk of serious cADRs compared with macrolides, with sulfonamides and cephalosporins carrying the highest risk. Prescribers should preferentially use lower-risk antibiotics when clinically appropriate.

Reference:

Lee EY, Gomes T, Drucker AM, et al. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions. JAMA. Published online August 08, 2024. doi:10.1001/jama.2024.11437

Keywords:

All, commonly, prescribed, oral, antibiotics, increased risk, serious, cutaneous, adverse, drug, reactions, ED visit, JAMA, Lee EY, Gomes T, Drucker AM

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Excessive Coffee Consumption Linked to Faster Cognitive Decline, Study Finds

USA: A recent study presented at the Alzheimer’s Association International Conference (AAIC) 2024 revealed that drinking over three cups of coffee daily may accelerate cognitive decline, according to a large study.

Researchers explored how varying amounts of coffee and tea affect fluid intelligence, which encompasses cognitive abilities like abstract reasoning, pattern recognition, and logical thinking. They revealed that moderate coffee consumption served as a protective factor against cognitive decline.

Cognitive development refers to the progression of mental processes and abilities that allow individuals to acquire, process, and use knowledge and information. Tea and coffee, both rich in caffeine and antioxidants, can influence cognitive development and function in various ways. Both of these are beneficial in the short term and reduce the risk of cognitive decline and neurodegenerative diseases over time. Observational and epidemiologic studies indicate that the consumption of coffee and tea has a beneficial effect on stroke, heart failure, cancer, Parkinson’s disease and diabetes. Considering this, Pauline Anderson, et al conducted a study to evaluate the cognitive function at baseline with an additional two patient visits.

For this purpose, the research team investigated the relationship between coffee and tea intake and cognitive decline over time in a larger sample of older adults. They divided the coffee and tea consumption into tertiles: high, moderate, and no consumption.

To conduct the research, the researchers included 8451 individuals, from UK Biobank which includes 60% females and 97% white cognitively impaired adults and are older than 60 years. All the subjects had a body mass index of 26, and 26% were apolipoprotein epsilon 4 gene carriers.

They found the following results: –

• 18% reported daily consumption of coffee drinking as high consumption ( four or more cups), 58% reported drinking one to three cups in a day and considered as moderate consumption and 25% reported that they never drink coffee.

• 47% reported drinking four or more cups of tea in a day and considered as high consumption, 38% reported drinking one to three cups in a day considered as moderate consumption and 15 % reported that they never drink tea.

• After 8.83 years of monitoring, individuals who drank four or more cups of coffee a day experienced a slower decrease in fluid intelligence compared to those who never drank coffee and those with moderate coffee consumption.

• During the follow-up period, individuals with high coffee consumption experienced the most rapid decline in fluid intelligence compared to those with moderate coffee consumption and those who never drank coffee.

• Moderate coffee consumption appears to offer a degree of protection against cognitive decline.

• Individuals who never drank tea experienced a greater decline in fluid intelligence compared to those who consumed it moderately or heavily.

“Consumption of coffee and tea may offer a safe and affordable approach to delaying the onset and lowering the risk of Alzheimer’s disease”, the researchers concluded.

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Illicit fentanyl use linked to increased risk of hepatitis C among people who use drugs: Study

An international team of researchers from University of California San Diego and el Colegio de la Frontera Norte in Mexico have revealed a significant association between the use of illicit fentanyl and the transmission of hepatitis C virus (HCV) among people who inject drugs in San Diego, California and Tijuana, Mexico. The findings, published in Clinical Infectious Diseases, suggest that illicit fentanyl use could be driving recent increases in HCV incidence.

“Our study provides the first evidence that illicit fentanyl use is linked to an increased risk of acquiring hepatitis C infection, which disproportionately affects people who inject drugs,” said Steffanie Strathdee, Ph.D., senior author and professor of medicine at UC San Diego School of Medicine. “This underscores the importance of making point-of-care HCV viral load testing more widely available in the U.S., so those needing treatment can access it immediately.”

HCV is one of several types of hepatitis, inflammation of the liver most often caused by a viral infection. HCV is most often transmitted through blood, which means that people who inject drugs are at particularly high risk of acquiring the disease.

Once acquired, the virus is easy to transmit unknowingly, because symptoms of HCV often don’t emerge until months or years after the initial infection. According to the U.S. Department of Health and Human Services (HHS), about half of people with HCV do not know they have it.

HCV prevalence is also on the rise in recent years; according to the Centers for Disease Control and Prevention (CDC), the number of reported cases of acute hepatitis C has doubled since 2014 and, during 2021, increased by 5 percent from 2020.

The new study, which followed a cohort of 398 people who inject drugs over two years, found that illicit fentanyl use was associated with a 64 percent increased risk of acquiring HCV.

“The broad shift from heroin to illicit fentanyl may be playing an important role in sharply rising HCV incidence among young people in recent years,” said Joseph Friedman, M.D., Ph.D., a resident physician in the Department of Psychiatry at UC San Diego School of Medicine and the study’s first author. “HCV elimination has been prioritized as a goal of the White House, and these findings suggest that accomplishing that goal may require taking a closer look at the role of fentanyl and other synthetic drugs in driving infectious disease risks.”

The researchers suggest that fentanyl’s short half-life – the time it takes for half the dosage of a drug to metabolize – may lead to more frequent dosing and sharing of syringes and smoking materials, which may increase the risk of HCV transmission. Notably, the relationship between illicit fentanyl use and HCV was not confined to those who inject the drug, but was noted among those who smoke as well.

“There are a variety of complex lifestyle factors that could be contributing to the increase in HCV infections among those who don’t inject, especially given how long HCV can go undetected,” said Strathdee. “We don’t have all the answers just yet, but what we are seeing is that this is a major unmet public health need.”

The study’s findings have significant implications for public health policy and practice across both the United States and Mexico. According to the researchers, immediate steps that could be taken include making fentanyl testing kits more accessible to people who use drugs, many of whom don’t even realize they’re using fentanyl due to widespread contamination of the illicit drug supply.

Also critical to reducing the burden of HCV is increasing access to accurate point-of-care HCV tests, which are used in other countries but are only just now starting to be approved for use in the United States.

“Since hepatitis C can be cured with a short course of antiviral treatment, efforts are needed in both the U.S. and Mexico to make these treatments more widely available,” said study co-author Gudelia Rangel, Ph.D., a professor at el Colegio de la Frontera Norte. “Both countries have dedicated government programs focused on eliminating hepatitis C, but our results show that there is so much more that needs to be done to meet the goals of these programs.”

Reference:

Joseph R Friedman, Daniela Abramovitz, Britt Skaathun, Gudelia Rangel, Alicia Harvey-Vera, Carlos F Vera, Irina Artamonova, Sheryl Muñoz, Natasha K Martin, William H Eger, Katie Bailey, Bo-Shan Go, Philippe Bourgois, Steffanie A Strathdee, Illicit Fentanyl Use and Hepatitis C Virus Seroconversion Among People Who Inject Drugs in Tijuana and San Diego: Results From a Binational Cohort Study, Clinical Infectious Diseases, 2024;, ciae372, https://doi.org/10.1093/cid/ciae372.

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Ultrasound thalamotomy effective in treating bilateral essential tremor: JAMA

A new study conducted by Michael Kaplitt and team found that both the functional impairment ratings and the intensity of the tremor were dramatically decreased by staged, bilateral focused ultrasound thalamotomy. The findings of this study were published in the Journal of American Medical Association.

While untreated contralateral or midline symptoms may still be limiting for certain individuals, unilateral magnetic resonance-guided targeted ultrasound ablation of the ventralis intermedius nucleus of the thalamus for vital tremor lowers tremor on one side. In the past, deep brain stimulation replaced bilateral lesioning due to its unacceptably high hazards and now, as unilateral targeted ultrasound lesioning becomes more widely accepted, interest in a bilateral alternative is growing. Thus, this study was to assess the safety and effectiveness of bilateral focused ultrasound thalamotomy that is performed in stages.

The patients with essential tremor were treated in this study at 7 US academic medical institutions from July 2020 to October 2021, with a 12-month follow-up. 11 individuals were eliminated, and 51 received treatment out of the 62 recruited patients who had undergone unilateral focused ultrasound thalamotomy at least nine months before inclusion. The patient age, drug resistance, the severity of the tremor, and functional handicap were all requirements for eligibility. Real-time alignment of thermography maps with anatomy was made possible by a focused ultrasound device that interfaced with magnetic resonance imaging. Prior to inducing an ablation, subthreshold sonications enabled target inquiry for effectiveness and off-target consequences.

There were 44 participants (86.3%) who were male, and the population’s mean (SD) age was 73 (13.9) years. After 3 months, the mean (SD) tremor/motor score decreased from 17.4 to 6.4. Also, the mean (SD) disability score and mean (SD) postural tremor were significantly improved. 12 individuals experienced moderate ataxia (as determined by the research), which remained in 6 at the 12-month mark.

Numbness/tingling (n = 17 total; n = 8 at 12 months), dysarthria (n = 15 total; n = 7 at 12 months), ataxia (n = 12 total; n = 6 at 12 months), unsteadiness/imbalance (n = 10 total; n = 0 at 12 months), and taste disturbance (n = 7 total; n = 3 at 12 months) were the most frequently reported adverse events. Articulation, phonation, and dysphagia were among the speech difficulties that were often minor and temporary. Overall, staged bilateral MRgFUS thalamotomy considerably lowered tremor severity and functional impairment ratings where speech, swallowing, and ataxia-related adverse effects were mainly moderate and temporary.

Source:

Kaplitt, M. G., Krishna, V., Eisenberg, H. M., Elias, W. J., Ghanouni, P., Baltuch, G. H., Rezai, A., Halpern, C. H., Dalm, B., Fishman, P. S., Buch, V. P., Moosa, S., Sarva, H., & Murray, A. M. (2024). Safety and Efficacy of Staged, Bilateral Focused Ultrasound Thalamotomy in Essential Tremor. In JAMA Neurology. American Medical Association (AMA). https://doi.org/10.1001/jamaneurol.2024.2295

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HACOR Score may predict NIV Failure among Post-TB Obstructive Airway Disease Patients: Study

INDIA:
A recent study published in the Journal of the Association of Physicians
of India concluded that The HACOR score is useful for predicting the likelihood of non-invasive ventilation (NIV) failure in patients experiencing an acute exacerbation of post-tuberculosis obstructive airway disease (TB-OAD).

Post- Post-Tuberculosis
obstructive airway disease is associated with pulmonary TB. In
India, smoking is a common cause of chronic AOD. Cough,
breathlessness, obstructive abnormality, and spirometry are the symptoms which
are associated with it. Inhaled steroids and inhaled bronchodilators are the
mainstay treatment of post-TB-OAD. Hypoxia and respiratory fatigue are the
indicators for hospitalization. Considering this, Siddharth R Waghmare, from
the Department of Respiratory Medicine, Lokmanya Tilak Municipal Medical
College and General Hospital (LTMGH), Mumbai, Maharashtra, India, et.al
conducted a study to assess the utility of HACOR score in acute exacerbation of
post- tuberculosis obstructive airway disease ( post – TB-OAD).

For this purpose, the
research team conducted an observational study with 100 patients with acute
exacerbation of post-TB-OAD. HACOR score was calculated for patients in acute
exacerbation of post-TB-OAD who needed non-invasive ventilation (NIV) support in
1,12,24,48 hours. A cutoff score of >5 was used, and the specificity,
sensitivity, positive predictive value, and negative predicted value were
calculated.

After 1 hour of the NIV
trial, the receiver operating characteristic (ROC) curve was plotted based on the
HACOR score. Paired t-test was used to analyze the trend in HACOR scores in
subjects requiring NIV for up to 2 days. To calculate sensitivity and specificity
truth table was used for evaluation.

They found the following results:
–

  • Out of 100 patients, 38 were classified in
    the NIV failure group. The average HACOR score at 1 hour for this group was
    9.47.
  • For a score greater than 5, the
    sensitivity was 89.47% and the specificity was 87.09%. The positive predictive
    value was 80.95%, while the negative predictive value was 93.10%.
  • The area under the ROC curve (AUC) was
    0.853. In the NIV failure group, the mean score increased over time, whereas in
    the NIV success group, it decreased.
  • The change in the score in the NIV success
    group was statistically significant
  • In the NIV failure group, 34 patients had
    HACOR scores above 5, whereas only 8 patients in the NIV success group had
    scores above this threshold. The sensitivity of the score was 89.47%, and the
    specificity was 87.09%.
  • The positive predictive value of the score
    was 80.95%, and the negative predictive value was 93.10%. ROC analysis of the
    HACOR score at 1 hour revealed an area under the curve of 0.853.

“HACOR score can be used
to predict failure in post-TB-OAD patients. HACOR score demonstrates higher
specificity and negative predictive value in predicting NIV failure. Patients whose
scores >5 require more frequent monitoring whereas an increasing score is considered
as a harbinger of impending NIV failure.”, the researchers concluded.

Reference:

Waghmare,
S. R. (2024, August 1). Utility of the HACOR score in patients with acute
exacerbation of post-tuberculosis obstructive airway disease: A retrospective
observational study. The Journal of the Association of Physicians
of India, Volume 72, Issue 8, P26-29, August 2024. https://www.japi.org/article/japi-72-8-26

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Intermittent IV Paracetamol reduces cumulative morphine consumption in Pediatric Cardiac Surgery: Study

Recently published research paper is a multi-center randomized controlled trial that investigated the use of intermittent intravenous (IV) paracetamol as the primary analgesic to reduce morphine consumption in children aged 0–3 years after cardiac surgery with cardiopulmonary bypass. The study aimed to test whether intermittent IV paracetamol administration would result in a reduction of at least 30% of the median weight-adjusted cumulative morphine dose during the first 48 hours after cardiac surgery.

The study found that intermittent IV paracetamol significantly reduced the median weight-adjusted cumulative morphine consumption in the first 48 hours postoperative by 79% compared to continuous morphine. The study, conducted between March 2016 and July 2020, included 208 children aged 0–3 years undergoing cardiac surgery with cardiopulmonary bypass. It found that 102 patients received intermittent IV paracetamol, while 106 received continuous morphine. Additionally, the study showed that the rescue morphine consumption was similar between the two groups. The analysis also demonstrated non-inferiority of IV paracetamol administration in terms of Numeric Rating Scale (NRS) pain scores.

The authors concluded that in children aged 0–3 years undergoing cardiac surgery, the use of intermittent IV paracetamol reduces the median weight-adjusted cumulative morphine consumption in the first 48 hours after surgery by 79%. The study implications suggest that intermittent IV paracetamol as the primary analgesic could be an effective approach for postoperative pain management in this patient population, potentially leading to reduced morphine consumption and equal pain relief.

Overall, the research paper provides evidence for the potential benefits of using intermittent IV paracetamol as a primary analgesic to reduce morphine consumption in young children after cardiac surgery with cardiopulmonary bypass. The findings have implications for clinical practice in managing postoperative pain in this specific patient population.

The study was approved by the relevant medical ethics committees and registered in clinical trial registries. The data used in the study are available, and the study was funded by relevant health research and development organizations. The authors declared no competing interests in the study.

The paper provides detailed insights into the methodology, patient characteristics, outcomes, statistical analysis, and implications of the study. The findings have significant implications for postoperative pain management in young children undergoing cardiac surgery with cardiopulmonary bypass.

Key Points

1. The study included 208 children and found that intermittent IV paracetamol significantly reduced the median weight-adjusted cumulative morphine consumption in the first 48 hours postoperative by 79% compared to continuous morphine. Additionally, the rescue morphine consumption was similar between the two groups, and the analysis demonstrated non-inferiority of IV paracetamol administration in terms of Numeric Rating Scale (NRS) pain scores.

2. The authors concluded that the use of intermittent IV paracetamol reduces the median weight-adjusted cumulative morphine consumption in the first 48 hours after surgery by 79% in young children undergoing cardiac surgery. They suggest that intermittent IV paracetamol as the primary analgesic could be an effective approach for postoperative pain management in this patient population, potentially leading to reduced morphine consumption and equal pain relief. This study has potential implications for clinical practice in managing postoperative pain in young children undergoing cardiac surgery with cardiopulmonary bypass.

Reference –

Zeilmaker-Roest, G., de Vries-Rink, C., van Rosmalen, J. et al. Intermittent intravenous paracetamol versus continuous morphine in infants undergoing cardiothoracic surgery: a multi-center randomized controlled trial. Crit Care 28, 143 (2024). https://doi.org/10.1186/s13054-024-04905-3

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Hyaluronic Acid Promising Alternative in Pediatric Pulpotomy for Primary Molars

Hyaluronic Acid Promising Alternative in Pediatric Pulpotomy for Primary Molars, claims study published in the BMC Oral Health.

This retrospective study aimed to determine the long-term clinical and radiographic success of our previous randomized clinical trial and to compare the success of hyaluronic acid, with the widely used formocresol and ferric sulphate agents. This retrospective study is the extension of the 1-year survey of our randomized clinical trial that had compared the effectiveness of a hyaluronic acid pulpotomy over formocresol and ferric sulphate pulpotomies and included clinical and radiographic evaluations with a follow-up period of over 24 months for 44 children who applied to our clinic between May 2019 and September 2019. Long-term clinical and radiographic data were obtained from the periodic files of our department, wherein each tooth’s file was examined to identify any clinical and radiographic findings. Descriptive statistics and Pearson’s chi-square tests were used to evaluate the data. Statistical significance was considered as p < 0.05. Results: The clinical and radiographic success rates of the hyaluronic acid, formocresol, and ferric sulphate groups were not statistically different at > 24 months. None of the teeth in the hyaluronic acid group showed any clinical findings at > 24 months. Hyaluronic acid pulpotomies exhibited comparable success rates to formocresol and ferric sulphate materials spanning over 24 months examinations. Because of convenient accessibility and applicability of hyaluronic acid, it may be recommended as a promising alternative medicament for pulpotomy treatments of primary molars. However, further long-term follow-up human studies are needed to better understand the effect of hyaluronic acid on the dental pulp of human primary molars.

Reference:

Sezgin BI, Ildes Sezgin GC, Koyuncu Ö, Mentes A. Hyaluronic acid as a pulpotomy material in primary molars: an up to 30 months retrospective study. BMC Oral Health. 2024 Jun 12;24(1):683. doi: 10.1186/s12903-024-04405-4. PMID: 38867194; PMCID: PMC11167839.

Keywords:

Hyaluronic Acid, promising, alternative, Pediatric Pulpotomy, primary, molars, study, Sezgin BI, Ildes Sezgin GC, Koyuncu Ö, Mentes A, BMC Oral Health, Ferric sulphate; Formocresol; Hyaluronic acid; Primary molars; Pulpotomy; Retrospective study.

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Advanced sperm selection system signals breakthrough in assisted reproduction, reveals research

 An advanced sperm selection system for men experiencing sperm with low motility has been announced by scientists at City University of Hong Kong (CityUHK).

The research, published in Med under the publisher Cell Press, indicates that

in samples with only 1% live sperm, the average live-sperm percentage can be elevated to 76% after selection. The success rates of fertilisation, cleavage, early embryos and blastocysts were also significantly elevated.

The research outlines the benefits of high-throughput, non-invasive sperm selection via their energy metabolites, selecting live sperm from immotile sperm samples with over 90% accuracy, and drastically improved fertilization outcomes for patients with total asthenozoospermia.

The single-cell screening/selection system, called BLASTO-chip, is based on microfluidic droplet technology and transformable hydrogel material. The system can achieve automatic high-throughput, label-free selection of sperm, bringing hope to patients with asthenozoospermia, an infertility condition in which a man produces sperm with low motility.

Cell selection usually relies on using proteins or other molecules either on the cell surface or inside the cell as labels. However, the application of cell labels is limited in certain scenarios, making it impossible to identify specific cell types (e.g. circulating tumour cells and stromal stem cells), and the added markers for the labels may interfere with cell activity.

Led by Michael Yang, Yeung Kin Man Chair Professor of Biomedical Sciences at CityUHK, in collaboration with cross-disciplinary teams in China, the team utilised microfluidic droplet technology and transformable hydrogel material to analyse the metabolic activity of individual cells, effectively isolating and enriching specific cell populations. Sperm selection for assisted reproduction is the first application of the BLASTO-Chip system.

Sperm selection, a critical step in assisted reproductive technology, is usually based on simple physical parameters, such as morphology or motility. Owing to extremely poor or completely absent sperm motility in patients with asthenozoospermia, the current technology can only “blindly select” potentially live sperm based on their morphology for subsequent fertilisation. The fertilisation rate for such blind selection is only 10–20%, compared to over 80% for standard sperm samples.

Therefore, there is a clinical need for improved sperm selection technology. As the selected sperm will be used for subsequent fertilisation, the improved technology must be label-free and intact. It is a significant technical challenge to detect biochemical activity without invasive procedures or causing damage to the sperm.

“We utilise microfluidic droplet technology to encapsulate individual sperm in droplets. The more vigorous sperm produce acidic metabolic substances through respiration, which promotes the transformation of the droplet into the hydrogel, achieving the goal of screening high-quality sperm,” said Yang.

Xianjin Xiao from Huazhong University of Science and Technology, and co-corresponding author of the paper, published in Med, says the project combines novel bioanalytical techniques and innovative biomaterials with cell physiological activity to achieve an automated, high-throughput, label-free sperm selection process. It fills an unmet medical need and has significant clinical potential.

Yang adds that the platform has been successfully applied to deterministic single-cell encapsulation, including high-throughput single-clone selection, and adipose stem cell isolation and enrichment.

Taking advantage of the development opportunities presented by the Guangdong-Hong Kong-Macao Greater Bay Area International Science and Technology Innovation Center, the team aims to complete clinical validation as soon as possible to bring the product to market and contribute to human health.

References: aoqin Mu 7, Xiaoyu Zhou 7, Longjie Li 7, Xiaowen Liu, Xu Wen, Lei Zhang, Bei Yan, Wei Zhang, Kejun Dong, Hao Hu, Yangwei Liao, Zhengxin Ye, Aimin Deng, Yuan Wang, Zenghui Mao, Mengsu Yang, Xianjin Xiao 8 Open Access Published: April 11, 2024 DOI:https://doi.org/10.1016/j.medj.2024.03.008

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NMC speaks up after Kolkata incident, directs medical colleges to ensure safety of doctors

New Delhi: Amidst the widespread outrage within the medical fraternity in the country prompting doctors and medical students to strike in protest against the unfortunate event in Kolkata where an on-duty PG medico was reportedly brutally raped and murdered, the National Medical Commission (NMC) has issued a statement and an advisory.

In its advisory issued under the authority of Dr B Srinivas, NMC Secretary, the apex medical commission noted that incidents of violence against doctors in medical colleges have been reported in the recent past. Hence, the NMC has directed medical colleges to ensure the safety of doctors by developing a policy towards a safe work environment on the campus for all staff members including doctors and medical students.

Incidents of violence against Doctors in Medical Colleges have been reported in the recent past. All Medical Colleges are requested to develop a policy for a safe work environment within the College and Hospital campus for all the staff members including Faculty, Medical Students and resident Doctors. The policy should ensure adequate safety measures at OPD, wards, casualty, hostels and other open areas on campus and in residential quarters. Corridors and campus be well-lit in the evening for staff to walk safely from one place to other and all sensitive areas be covered by CCTV for monitoring.

Further, the NMC has ordered the said policy to ensure the implementation of adequate safety measures including well-lit campus areas, CCTV monitoring, and posting of security personnel.

Adequate security measures including posting of adequate security staff (male and female) should be made available at the OPD, wards, casualty, labor rooms, hostels and residential quarters and other open areas in the Medical College and Hospital campus.

Moreover, strictly calling for a prompt investigation of cases of violence against doctors and medical students, the NMC mentioned that these cases should be immediately investigated by the institute management and an FIR should be lodged with the police.

Assuring more support to the medicos and doctors across the country who have been asking for authorities to pay heed to their long-standing demand to address such violence against them, the NMC has ordered that a detailed action report should be sent to it within 48 hours of the incident.

Any incident of violence against the medical students should be promptly investigated by the college management and FIR should be lodged with the Police. A detailed action taken report on any incident of violence should invariably be sent to the National Medical Commission (NMC) within 48 hours of the incident.

Medical Dialogues had earlier reported that the half-naked body of the deceased RG Kar PG Respiratory Medicine medico was recovered from the seminar hall of the hospital on Friday morning. A preliminary autopsy report has indicated sexual abuse before she was killed. As per the inquest report, there was bleeding from the doctor’s eyes and mouth, injury on the face and nails, bleeding from her genitals, and several other injury marks on different parts of her body. Soon after the news of this horrific incident came to light, doctors in Bengal and across the country started a massive protest demanding justice.
More than 3 lakh resident doctors across the country and doctors across all AIIMS institutions are currently on strike, causing major disruptions to medical services nationwide. The doctors are demanding not only justice but also for the authorities to address safety concerns at the workplace.
During the hearing today, the Calcutta High Court observed that there was no significant development in the police investigation of the rape and murder case of the medicoand transferred the case for further investigation to the Central Bureau of Investigation (CBI).
While considering the pleas in this regard, the Division bench of Chief Justice TS Sivagnanam and Justice Hiranmay Bhattacharya noted that the deceased’s parents expressed an apprehension that if the investigation were allowed to continue in this manner, it would derail.

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Fortified Dairy with Vitamin D3 Reduces Restless Legs Syndrome in Women with Severe PMS, Study Finds

Iran: Fortifying dairy products with vitamin D3 can boost serum vitamin D levels and alleviate the severity of restless legs syndrome (RLS) in women with severe premenstrual syndrome (PMS), but does not have the same effect in other populations, a recent pilot study has stated. The findings were published online in BMC Women’s Health on July 30, 2024.

Restless legs syndrome is characterized by an uncontrollable urge to move the legs, often accompanied by uncomfortable sensations. It is commonly observed in individuals with PMS, especially those who also suffer from vitamin D deficiency and abdominal obesity. Given the growing concern over the role of vitamin D in various health conditions, the researchers focused on whether fortifying dairy products with vitamin D3 could offer a beneficial intervention.

Vitamin D plays an important role in female reproduction through its impact on calcium homeostasis and neurotransmitters. Considering this, Majid Ghayour-Mobarhan, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, and colleagues aimed to evaluate the effect of dairy products fortified with Vitamin D3 on RLS in women with PMS.

For this purpose, the research team conducted a 2.5-month, randomized, total-blinded clinical trial to assess the effectiveness of low-fat milk and yogurt fortified with vitamin D on RLS in women with PMS.

Among 141 middle-aged women with abdominal obesity, 71 were assigned to receive fortified low-fat dairy products, while 70 received non-fortified low-fat dairy products. All participants completed both the Symptoms Screening Tool (PSST) and questionnaires assessing RLS.

The study led to the following findings:

  • In women with severe PMS (PSST > 28), serum levels of vitamin D increased significantly following vitamin D fortification.
  • The mean restless legs score in the severe PMS subgroup (PSST > 28) was significantly lower after the intervention.
  • Serum Vitamin D levels significantly differed between intervention and control groups in all individuals (PSST < 19, PSST 19–28, and PSST > 28), but there were no significant differences between the RLS scores of the intervention and control groups in the three PMS subgroups.

“We found that consuming low-fat dairy products fortified with 1500 IU of nano-encapsulated vitamin D3 can alleviate restless legs syndrome (RLS) in women with severe symptoms who have low vitamin D levels,” the researchers wrote.

“These results suggest a promising avenue for future research and the potential development of effective treatments for individuals with similar conditions. However, additional studies are required to validate these findings,” they concluded.

Reference:

Sharifan, P., Sahranavard, T., Rashidmayvan, M. et al. Effect of dairy products fortified with vitamin d3 on restless legs syndrome in women with premenstrual syndrome, abdominal obesity and vitamin d deficiency: a pilot study. BMC Women’s Health 24, 434 (2024). https://doi.org/10.1186/s12905-024-03159-z

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