Complaint Filed Against Hyderabad Hospital for Unqualified Doctors, Unnecessary Surgeries

Adilabad: Serious allegations have been made against Nakshatra Hospital in the Adilabad district, accusing the facility of operating without qualified medical professionals and carrying out unnecessary tests and surgeries on patients. These claims were raised by Sama Rupesh Reddy, Vice President of the Youth Congress Assembly. 

Accusing the hospital of violating government norms, Sama Rupesh Reddy alleged that Nakshatra Hospital has been falsely claiming the presence of certified doctors in its facility and conducting unnecessary tests and surgeries on patients with no such requirements.  

Also read- Private hospital staff arrested after female patient alleges sexual harassment

In response, he filed a complaint with the Public Health Director in Hyderabad on Tuesday and asked him to take strict action against the hospital. Responding positively to his request, the director said that he would investigate the matter and take action accordingly. 

“Nakshatra Hospital in Adilabad district headquarters is operating against the rules by taking permission as if there are doctors in his hospital, but the fact is there are no doctors in his hospital. tests and operations are being performed without any need for patients, causing fear”, reports The Hans India.

“Even though there are a lot of innocent tribal people in our district, they are being punished for nothing,” he added. 

Medical dialogues had earlier reported that the Ahmedabad Crime Branch, investigating alleged irregularities at Khyati Hospital, has expanded its probe by summoning six private hospitals in the city daily for interrogation and instructing 145 hospitals to submit patient medical records.

The investigation agency has been summoning these hospitals for questioning about their treatment of patients under the Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme.

Aiming to carry out a detailed and thorough investigation to expose the full extent of the scam, the crime branch has also asked officials of 145 hospitals in the city to provide medical records of patients treated under the PMJAY scheme.

Also read- PMJAY Fraud: Crime branch seeks Patient Records from 145 hospitals

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Fact Check: Can cumin and turmeric water induce periods within a day?

A viral Instagram reel claims that cumin and turmeric water can induce periods within a day. This claim is False

Claim

In an Instagram reel, it is claimed that cumin and turmeric water can induce periods within a day. The reel by user diet_fuell is captioned as “1 secret home Remedy that works Wonders.” The user shows boiling one glass of water with a spoonful of cumin seeds for 5–10 minutes, then straining the mixture. Afterward, add a spoonful of turmeric to the strained water.

The viral reel has garnered 4.4 million views, 36,161 likes, 4,339 comments, and 166k shares. The reel can be accessed here.

Fact Check

The claim in the reel is False. Cumin and turmeric may support menstrual health, but there is no scientific evidence to validate the claim that they can induce periods within a day.

What are missed periods?

When a woman misses her period, it can be a cause for concern. Medically, the condition is referred to as amenorrhea. According to the National Institute of Child Health and Human Development, “Amenorrhea is the absence of a menstrual period.”

Amenorrhea can be primary or secondary. Primary amenorrhea is diagnosed when a girl has not experienced her first menstrual period by the age of 16. Secondary amenorrhea describes women who experience an absence of more than three menstrual cycles after having regular periods.

The factors for secondary amenorrhea include engaging in excessive exercise, pregnancy, Obesity, Eating disorders such as anorexia nervosa, Family history of amenorrhea, Early menopause and Genetics.

What can be the reasons for Maximum Delay In Periods If Not Pregnant?

A delay in menstruation, when pregnancy is ruled out, can indicate underlying health issues, as menstrual irregularities often stem from disruptions in the hormonal balance of estrogen and progesterone. Irregular cycles, defined as lengths shorter than 21 days or exceeding 35 days with abnormal blood flow, are a notable health concern due to their association with various medical conditions. These include metabolic syndromes, coronary heart disease, type 2 diabetes mellitus, PCOS/PCOD and rheumatoid arthritis, as well as complications like anemia, osteoporosis, and infertility. Psychological issues, impaired quality of life, and increased risks of pregnancy-related hypertensive disorders or adverse obstetric and neonatal outcomes are also linked to menstrual irregularities. The prevalence and causes of delayed or irregular periods vary globally, influenced by factors such as genetics, stress, and lifestyle. Evaluating the underlying factors of delayed menstruation is critical to diagnosing potential health risks and developing targeted preventive and therapeutic strategies to improve overall health and reproductive outcomes.

What are the health benefits of cumin?

Cumin (Cuminum cyminum) has been traditionally utilized in households for its medicinal properties and is known to offer various health benefits. Cumin is rich in antioxidants, iron, and fiber, aiding digestion and boosting the immune system. It can help in improving blood sugar control and has anti-inflammatory properties. Studies have shown that Cumin may help in the enhancement of memory and may aid in reducing cholesterol levels, contributing to overall health and wellness. The health benefits of cumin seeds may include anti-inflammatory, nephroprotective, antioxidant, and anti-diabetic properties. Additionally, cumin extracts can improve liver function tests in patients with non-alcoholic fatty liver disease. 

What are the nutritional benefits of turmeric?

Turmeric (Curcuma longa), commonly known as haldi, is a staple spice in Indian households. A member of the ginger family, this plant is native to Southeast Asia, with India being its main cultivator. Historically, turmeric has played a significant role in Ayurveda and other traditional Indian healing systems, as well as in Eastern practices like traditional Chinese medicine. In India, it has been traditionally employed to address skin conditions, upper respiratory issues, joint pain, and digestive disorders. Turmeric is a widely used spice and a key ingredient in curry powder. Its primary active compound is curcumin, with the benefits of turmeric often linked to curcuminoids (curcumin and similar substances). It is also responsible for turmeric’s distinctive yellow color.

In Ayurvedic medicine, turmeric is thought to provide a variety of health benefits, including increasing overall energy, reducing gas, eliminating worms, improving digestion, regulating menstrual cycles, and alleviating arthritis symptoms. It is also commonly used in South Asian countries as an antiseptic for treating cuts, burns, and bruises, as well as an antibacterial agent. Modern in vitro research has shown that turmeric has antioxidant, anti-inflammatory, antimutagenic, and antimicrobial properties.

Can cumin and turmeric water induce periods within a day?

Traditionally, cumin and turmeric water have been used to support menstrual health. Cumin, being a rich source of iron, may aid in regulating menstruation. Similarly, curcumin, the active compound in turmeric, has been studied for its potential benefits in managing PMS symptoms and dysmenorrhea, suggesting it may promote menstrual regularity. However, there is no scientific evidence or medical consensus to back the user’s claim.

Cumin has been traditionally valued for its medicinal properties and role in women’s health addressing iron deficiency and menstrual regulation. In a study by Rudra Pratap Singh et. al. revealed that cumin is a rich source of iron, which is particularly beneficial for menstruating women to replenish iron lost during menstruation. Additionally, cumin is also highlighted for its traditional use as a stimulant for menstrual flow.

Cumin also has shown potential in easing common discomforts associated with menstruation. A study published in Complementary Therapies in Clinical Practice found that cumin significantly alleviated systemic symptoms such as cold sweats, backache, fatigue, period pain and cramps during menstruation.

Curcumin, a natural compound found in turmeric has been explored as a potential treatment for premenstrual syndrome (PMS) and dysmenorrhea in recent clinical studies. A randomized controlled trial by Afsane Bahrami et. al. found that curcumin supplements may significantly reduce PMS and dysmenorrhea symptoms.

Curcumin has also been investigated for its potential effects on uterine activity and menstrual regulation. A clinical trial published in Alimentary Pharmacology and Therapeutics suggested that curcumin may induce uterine stimulation which further may potentially trigger the onset of menstruation.

While cumin and turmeric offer certain health benefits and can support menstrual health and alleviate symptoms, there is no evidence to suggest they can reliably induce menstruation within a short timeframe. Furthermore, it is important to recognize that if a missed period is due to pregnancy, natural remedies like cumin or turmeric water are not capable of inducing menstruation within a day.

Dr. Divya Sweta, Consultant Obstetrician & Gynecologist, Ankura Hospital shared her insights and said, “No, we can’t get periods in one day. Either by natural remedies or hormonal treatments. Once your periods are irregular very frequently, you need to meet your gynecologist and get an evaluation. Be regular with physical activity and consume seasonal fruits and vegetables.”

Ms Anubha Taparia Saraogi, Senior Clinical Dietician, Ankura Hospital said, “As a registered dietitian, I often hear about using cumin and turmeric to start periods. However, there’s no scientific evidence to support this. Menstrual cycles are regulated by intricate hormonal interactions, not spices. While turmeric and cumin offer some health benefits, they can’t reliably induce menstruation. Irregular periods warrant a visit to a healthcare professional for proper evaluation and management, not self-treatment with unproven remedies. Ignoring potential underlying issues can be detrimental to your health.”

Medical Dialogues Final Take

Cumin and turmeric may help support menstrual health by easing symptoms, but there is no scientific evidence or medical consensus that cumin and turmeric water can induce periods within a day. Suggesting that a simple drink can alter the complex hormonal regulation of the menstrual cycle within hours oversimplifies this intricate physiological process. For delayed periods, it is crucial to address the underlying causes, such as hormonal imbalances, stress, or pregnancy, rather than depending on unproven remedies.

Hence the claim by the user is False.

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AIIMS INI CET January 2025: Check out Guidelines for 200-Point Roster Creation, Seat Allocation for Institutional Preferential Candidates

New Delhi- Through a notice, the All India Institute of Medical Sciences (AIIMS) has released guidelines/Principles for 200-point roster creation and seat allocation for all AIIMS for PG seats regarding Institutional Preferential (IP) candidates for INI CET January 2025.

Guidelines for Seat Allocation of AIIMS PG Seats

The following guidelines will be followed for allocation of PG Seats at all AIIMS for INICET January 2025 session. Counselling and Seat Allocation may be used interchangeably and mean one and the same thing. AIIMS at every instance refers to each individual AIIMS institution.

This document outlines the methodology and principles for developing the 200 Point Roster Model and its application in the allocation of PG seats across all AIIMS, specifically for Institutional Preference (IP) candidates. The roster is designed as per calculated percentages to determine the sequence of allocation for IP seat. It is emphasized that IP seats represent a preference and not a reservation, subject to the upper limit as defined by the governing rules.

Institutional Preference (IP) Candidates

To be considered for admission against Institutional Preference (IP) seats at each AIIMS, a candidate must have studied and obtained his/her MBBS Degree from the same AIIMS and must fulfil the eligibility for Unreserved (UR) candidates for Seat Allocation.

Criteria of Eligibility for Seat Allocation

a. Eligibility and Qualifying criteria published in the prospectus Part A will be applicable for all seats.

b. All eligible and qualified candidates will be considered for online Seat Allocation in order of merit.

c. Candidates will be considered for Seat Allocation only for the seats for which they fulfil the eligibility and qualifying criteria.

d. IP and PWBD candidates will also be eligible for UR seats or seats within their respective reservation category, on merit, if they qualify and fulfil the eligibility criteria for such seats.

Proposed method of calculation of IP Seats, UR Seats and Rosters for AIIMS PG Seats

a. A maximum of 50% of MBBS seats at respective AIIMS will be available as IP seats, provided that this number shall not be more than 50% of total UR seats (excluding MDS seats) for that institution.  

b. MBBS seats at the respective AIIMS shall be determined as the number of MBBS seats at entry in the batch that most recently completed their MBBS (including internship).

c. Accordingly, for the current INICET January 2025 Session, the number of seats for MBBS for the 2019 batch at the respective AIIMS shall be considered. Process of calculation of percentages for plotting on the 200 Roster Model to determine the sequence of preference to be followed for Institutional Preference (IP) seat allocation for AIIMS are given at Annexure- 1.

d. For AIIMS where the MBBS course was not started in 2019, no IP Seats shall be available for INI-CET PG January 2025 session.

e. Subject-wise availability of seats for each category (except IP), including for PWBD, has been published as per the roster maintained by each AIIMS for each subject as per applicable constitutional reservations for different categories.

f. All 6-year DM/MCh seats shall be treated as Unreserved (UR) seats. 

Allocation of Seats 

The 200 Roster Point system, as provided (ANNEXURE-2), is prepared using IP percentages calculated as per ANNEXURE-1 for plotting on the 200 Roster Model to determine the sequence of allocation to be followed for Institutional Preference (IP) seat allocation. It is clarified that IP seats are not a reservation but a preference, subject to the upper limit defined in the applicable rules.

Seat allocation will be as per merit of the candidates at each roster-point and applicable rules & procedure starting from the first Roster Point for each AIIMS in first round.

In the second and subsequent rounds of seat allocation of current session the roster will begin from the point where first seat is vacated from the previous round of allotment. Roster points on which candidates have confirmed admission will not be called for allocation in subsequent round of allocation.

At each roster-point, candidates of the reservation category of that roster-point will be considered for seat-allocation, as per merit.

Candidates will be allotted a seat available in their respective category as per their highest available choice for that institution.

When a candidate is considered for Seat Allocation against a reserved category roster point, he/she will only be considered for seats earmarked for that reserved category. However, if a candidate considered for seat allocation at a reserved roster-point is also the highest candidate in the overall UR merit at that point, he/she shall also be considered for allocation of the available seats at subsequent UR roster point for seats. If his/her highest choice is available both in the UR category and his/her reserved category, he/she shall be allotted the UR seat as a Meritorious Reserved Candidate if he/she is eligible for a UR seat.

PWBD reservation is a horizontal reservation and PWBD candidates will be considered only for the seats within their respective reservation categories i.e. for PWBD-UR seats, only PWBD candidates other than EWS/OBC/SC/ST will be considered, for PWBD-OBC seats only PWBD of OBC category, for PWBD-EWS seat only PWBD of EWS category, for PWBD-SC seat only PWBD of SC category, for PWBD-ST seat only PWBD of ST category and so on will be considered.

PwBD seats will be filled first in order of merit and constitutional reservations. Where no candidates are available in PWBD or no PWBD candidate has opted for available PWBD seats, such seats shall be added to their respective reservation category without PwBD reservation. For an IP roster-point, if no IP candidate is available or takes a seat, it will be considered as a UR roster point.

Any seat that remains unfilled will be converted as per following (only in Open round (if any)): –

EWS seats to UR

OBC seats to UR

ST seats to SC and if still unfilled, to UR

SC seats to ST and if still unfilled, to UR 

However, AIIMS, New Delhi reserve the right on the application of these rules, or their modification at the discretion of Director, AIIMS, New Delhi. Any dispute in relation to seat allocation is subject matter of courts at Delhi jurisdiction only.

To view the official Notice, Click here : https://medicaldialogues.in/pdf_upload/22025januaryini-cetrosterpoint-264466.pdf

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Taking high-dose vitamin D supplements for five years fails to impact incidence of type 2 diabetes: Study

Using significantly higher doses of vitamin D than recommended for five years did not affect the incidence of type 2 diabetes in elderly men and women, according to a new study from the University of Eastern Finland.

In population studies, low levels of vitamin D in the body have been associated with a higher risk of type 2 diabetes. However, such observational studies cannot directly conclude whether using vitamin D supplements can reduce the risk of developing the disease. Experimental studies have shown that the use of significantly higher doses of vitamin D than recommended slightly reduces the risk of developing type 2 diabetes in individuals with impaired glucose metabolism, i.e., those with prediabetes. In contrast, no effects have been observed in individuals without prediabetes. However, the studies with non-prediabetic subjects have used relatively small doses of vitamin D or have been short-term. Until now, there has been no research data on the effects of long-term use of high doses of vitamin D on the risk of type 2 diabetes in individuals without glucose metabolism disorders.

In the Finnish Vitamin D Trial (FIND) conducted at the University of Eastern Finland from 2012 to 2018, 2,495 men aged 60 and older and women aged 65 and older were randomised for five years into either a placebo group or groups receiving either 40 or 80 micrograms of vitamin D3 per day. In the statistical analyses of the now-published sub-study, 224 participants who were already using diabetes medications at the start of the study were excluded. Comprehensive information was collected from the participants on lifestyle, nutrition, diseases, and their risk factors. Data was also obtained from national health registers. About one-fifth were randomly selected for more detailed examinations, and blood samples were taken from them.

During the five years, 105 participants developed type 2 diabetes: 38 in the placebo group, 31 in the group receiving 40 micrograms of vitamin D3 per day, and 36 in the group receiving 80 micrograms of vitamin D3 per day. There was no statistically significant difference in the number of cases between the groups.

In the more closely studied group of 505 participants, the blood calcidiol level, which describes the body’s vitamin D status, was on average 75 nmol/l at the start, and only nine percent had a low level, i.e., below 50 nmol/l. After one year, the calcidiol level was on average 100 nmol/l in the group that used 40 micrograms of vitamin D per day and 120 nmol/l in the group that used 80 micrograms of vitamin D per day. There was no significant change in the placebo group. The effects of vitamin D on blood glucose and insulin levels, body mass index, and waist circumference were examined during the first two years of the study, but no differences were observed between the groups.

The findings of the FIND study reinforce the view that the use of higher doses of vitamin D than recommended does not significantly affect the risk of developing type 2 diabetes in individuals without prediabetes and who already have a good vitamin D status. So far, there is no research data on whether high doses of vitamin D can be beneficial in preventing type 2 diabetes in individuals without prediabetes but with vitamin D deficiency.

Reference:

Virtanen, J.K., Hantunen, S., Kallio, N. et al. The effect of vitamin D3 supplementation on the incidence of type 2 diabetes in healthy older adults not at high risk for diabetes (FIND): a randomised controlled trial. Diabetologia (2024). https://doi.org/10.1007/s00125-024-06336-9.

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Sugary drinks significantly raise CVD risk, but occasional sweet treats don’t, scientists find

A little of what you fancy does you good… unless it’s a fizzy drink. Scientists studying the impact of sugar on the risk of cardiovascular disease have found that eating too much added sugar increases your risk of stroke or aneurysm, but eating a few treats is associated with a lower risk of cardiovascular diseases. Meanwhile, drinking sweetened beverages raises your risk of stroke, heart failure, and atrial fibrillation.

“The most striking finding from our study is the divergent relationship between different sources of added sugar and cardiovascular disease risk,” said Suzanne Janzi, PhD candidate at Lund University and corresponding author of the article in Frontiers in Public Health. “This surprising contrast highlights the importance of considering not just the amount of sugar consumed, but its source and context.”

A spoonful of sugar

Although most public health bodies recommend limiting sugar consumption to protect your teeth and improve your diet, there has previously been limited evidence regarding the impact of sugar intake on cardiovascular diseases. These diseases are the leading cause of death and disease in Europe, and changing your diet is a comparatively easy way to reduce your risk.

To understand how sugar consumption affects cardiovascular disease risk, and whether consuming different kinds of sugar changes those risks, the scientists collected data from two major cohort studies, the Swedish Mammography Cohort and the Cohort of Swedish Men. These studies had diet questionnaires administered in 1997 and 2009, allowing the scientists to monitor participants’ diets over time.

Once exclusions had been made to ensure the two cohorts shared the same inclusion criteria and to remove independent risk factors for cardiovascular diseases, the scientists were left with a sample of 69,705 participants. They looked at three classes of sugar consumption-toppings like honey, treats like a pastry, or sweetened beverages like fizzy drinks-and seven cardiovascular diseases: two different types of stroke, heart attacks, heart failure, aortic aneurysms, atrial fibrillation, and aortic stenosis.

The participants were monitored until they died, were diagnosed with one of the cardiovascular diseases, or reached the end of the follow-up period in 2019. During this period, 25,739 participants were diagnosed with a cardiovascular disease.

The scientists then used this data to break down how the different types of sugar intake affect the risk of different cardiovascular diseases.

Affairs of the heart

They found that consuming sweet drinks was worse for your health than any other form of sugar: drinking more sweetened drinks significantly increased the risk of ischemic stroke, heart failure, atrial fibrillation and abdominal aortic aneurysm.

“Liquid sugars, found in sweetened beverages, typically provide less satiety than solid forms-they make you feel less full-potentially leading to overconsumption,” said Janzi. “Context also matters-treats are often enjoyed in social settings or special occasions, while sweetened beverages might be consumed more regularly.”

Different cardiovascular diseases were affected differently by increased sugar intake, possibly because consuming additional sugar affected participants’ individual risk profile differently. Increased sugar in general raised the risk of ischemic stroke and abdominal aortic aneurysm, as well as increasing the risk of heart failure in participants with a normal BMI.

However, the highest risks of a negative health outcome arose in the lowest intake category for treats. Consuming occasional treats was associated with better outcomes than no treats at all.

“This might reflect underlying dietary behaviors-individuals consuming very little sugar might have very restrictive diets or might be limiting sugar due to pre-existing health conditions,” suggested Janzi. “While our observational study cannot establish causation, these findings suggest that extremely low sugar intake may not be necessary or beneficial for cardiovascular health.”

However, the scientists noted that more work will be needed to understand the mechanisms involved in the differential effects of different types of sugar consumption. They also pointed out that diet is highly demographically and culturally specific.

“Our findings are based on a Swedish population, which may have dietary habits and lifestyle factors that differ from those in other populations,” said Janzi. “Particularly relevant in this context is the social custom of ‘fika’-regular coffee and pastry breaks that are deeply embedded in Swedish culture. These results may not directly translate to other populations with different dietary cultures.” 

Reference:

Suzanne Janzi, Added sugar intake and its associations with incidence of seven different cardiovascular diseases in 69,705 Swedish men and women, Frontiers in Public Health, https://doi.org/10.3389/fpubh.2024.1452085.

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Lower levels of Free Triiodothyronine tied to Peripheral Neuropathy in Diabetics, suggests study

A groundbreaking study found that
low levels of free Triiodothyronine are a risk factor for peripheral neuropathy
in type 2 diabetics, as per results that were published in the journal
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.

Diabetic peripheral neuropathy
(DPN) is a common cause of neuropathy worldwide. Literature shows that thyroid
function abnormality can affect glucose metabolism, leading to complications in
type 2 diabetics. Triiodothyronine (T3), one of the main active ingredients of thyroid
hormones, is necessary for nerve survival. Previous research has shown that
free triiodothyronine is a predictive factor for peripheral neuropathy in
diabetics. As the role of free triiodothyronine (FT3) in nerve injury is not
elucidated, researchers conducted a study to investigate the effect of FT3 on
DPN, particularly on the conduction velocity of nerve fibers in T2DM patients
without thyroid disease.

A cross-sectional study was
carried out at the Department of Endocrinology, The First Affiliated Hospital
of USTC, by recruiting 121 patients with T2DM. Among these, 64 were diagnosed
with DPN, while 57 were not diagnosed with DPN despite having T2DM (controls).
Neuropathy caused by any cause other than diabetes was excluded from the study.
The participants were divided into the control group and the DPN group. Clinical
parameters like age, gender, diabetes mellitus (DM) duration, and biochemical
parameters were collected for each patient. Additionally, nerve conduction
velocity was tested using neurophysiological methods, such as an electromyographic
evoked potential meter. Correlation and regression analyses were employed to
examine the relationship between the concentrations of FT3 and DPN. Binary
logistic regression analysis was carried out to investigate the risk factors
for DPN in T2DM patients. Multiple linear regression analyses were performed to
explore further factors influencing nerve conduction fiber velocity.

Findings:

  • The DPN patients showed increased HbA1c and
    low-density lipoprotein cholesterol (LDL-C) levels (P=0.001 and 0.042), as well
    as decreased concentrations of FT3 (P=0.042) when compared to the controls.
  • FT3 levels were positively associated with the
    motor and sensory fibers conduction velocity of the Ulnar nerve and the motor
    conduction velocity of the Tibial nerve, with or without adjustment for HbA1c
    and LDL-C.
  • As per the multiple linear regression analysis,
    decreased FT3 levels may influence the motor and sensory fibers’ conduction
    velocity of the Ulnar nerve and the motor conduction velocity of the Tibial
    nerve.
  • The binary logistic regression analysis
    demonstrated that decreased FT3 levels are one risk factor for DPN in T2DM
    patients.

Thus, this is the first study to
report the association between FT3 and DPN in terms of specific nerve fiber
injury in T2DM patients. The study concluded that lower FT3 concentration
is a risk factor for DPN in T2DM patients. The study underscores the importance
of monitoring the FT3 levels in diabetics for early identification of DPN. The
authors also suggested that further research may be necessary to identify
diagnostic criteria and treatment thresholds in diabetics with peripheral
neuropathy.

Further reading: Chen Y, Sun L,
Chen M, et al. Lower Free Triiodothyronine is a Risk Factor of Diabetic
Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus. Diabetes
Metab Syndr Obes
. 2024;17:4407-4415. Published 2024 Nov 25.
doi:10.2147/DMSO.S489204.

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Higher Dietary Vitamin C Linked to Reduced Risk of Metabolic Syndrome: Study Finds

China: A recent study analyzing data from the National Health and Nutrition Examination Survey (NHANES) 2007–2018 highlights a significant relationship between dietary vitamin C intake and the risk of metabolic syndrome (MetS) among adults in the United States.

The findings, published in Metabolic Syndrome and Related Disorders, revealed that dietary vitamin C intake, especially from fruits and vegetables, is associated with a reduced risk of metabolic syndrome. Fruits such as oranges, kiwis, strawberries, and vegetables like bell peppers and broccoli are excellent sources of this nutrient. Regularly consuming these foods may offer synergistic benefits beyond just vitamin C, as they also provide dietary fiber, minerals, and other antioxidants that contribute to overall health.

MetS, a cluster of conditions that increase the risk of heart disease, stroke, and diabetes, includes factors such as elevated blood pressure, high blood sugar levels, excess body fat around the waist, and abnormal cholesterol levels. Fruits such as oranges, kiwis, strawberries, and vegetables like bell peppers and broccoli are excellent sources of this nutrient.

The association between vitamin C intake and the risk of metabolic syndrome has been a topic of discussion. To explore this, Xinyi Yu, Department of Endocrinology, Wenzhou Central Hospital, Wenzhou, People’s Republic of China, and colleagues investigated the relationship between dietary vitamin C intake and the risk of MetS in a large population of adult Americans.

For this purpose, the researchers examined the relationship between dietary vitamin C intake and the risk of MetS in 12,943 participants from the 2007 to 2018 NHANES. They evaluated this association using logistic regression and restricted cubic spline models and conducted subgroup analyses based on sex and age.

The study revealed the following findings:

  • The multiple regression model indicated an inverse correlation between the risk of MetS and dietary vitamin C intake, particularly vitamin C derived from fruits and vegetables.
  • The adjusted odds ratios with 95% confidence intervals for the highest versus lowest tertile were as follows: 0.80, 0.86, and 0.80.
  • Subgroup analyses revealed that the negative correlation was more pronounced among females, individuals aged 20–39, and those aged ≥60.
  • The dose-response analysis showed a nonlinear relationship between dietary vitamin C and the risk of MetS for vitamin C from diet and fruits. In contrast, a linear relationship was observed for vitamin C from vegetables.

“In adult Americans, a higher dietary intake of vitamin C, especially from fruits and vegetables, was associated with a lower risk of MetS,” the researchers concluded.

Reference: https://doi.org/10.1089/met.2024.0149

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Researchers develop new coronary risk score that accurately predicts MACE among women: Study

A new risk score accurately predicts and categorizes the risk of major adverse cardiovascular events, such as heart attack, in women. The findings were published today in Radiology: Cardiothoracic Imaging, a journal of the Radiological Society of North America (RSNA).

According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death in U.S. women. The same can be said for women in Latin America, Europe, Asia and Pacific countries. However, since men are more likely to suffer from heart conditions such as coronary artery disease, women tend to be overlooked in cardiovascular studies.

“Women are often underrepresented in research studies, and in some settings may be excluded,” said study lead author Guillermo Romero-Farina, M.D., Ph.D., cardiologist and senior researcher at the Vall d’Hebron University Hospital, Vall d’Hebron Research Institute and CIBERCV in Barcelona, Spain. “Risk stratification in women is particularly important because the clinical presentation of coronary disease in women may differ from that in men and is often atypical.”

Coronary risk stratification models are an important tool physicians use to identify which patients are most likely to experience major adverse cardiovascular events, such as heart attack, stroke or even death. Establishing a Coronary Risk Score in Women (CORSWO) may aid in the prediction of major cardiovascular events.

In this retrospective study, Dr. Romero-Farina and colleagues analyzed the data of 2,226 women aged 40 to 93 years who were referred to the Nuclear Cardiology Unit at Vall d’Hebron University Hospital for risk assessment and evaluation.

All patients underwent gated SPECT myocardial perfusion imaging, which is an imaging procedure that measures left ventricular function and myocardial perfusion at the same time.

The average follow-up time occurred around was approximately four years. The maximum follow-up time was 10 years, and all follow-ups occurred in the hospital as a result of a major adverse cardiovascular event.

Using eight variables, the CORSWO calculated the risk of a cardiac event in patients and categorized them into four risk levels: low, moderate, high and very high.

“By grouping patients into different risk levels-ranging from low to very high risk-doctors can better focus resources and treatments on those who need them the most,” Dr. Romero-Farina said.

The model accurately predicted major adverse cardiovascular events in women who were categorized as high and very high risk and performed better than other risk models.

The researchers note that this novel approach of incorporating clinical, exercise and imaging-based variables is important in accurately calculating the risk of cardiac events in women.

“The study provides additional insights into identifying high risk or very high-risk women,” Dr. Romero-Farina said. “This approach helps us catch potential heart issues earlier, especially serious events like heart attacks and sudden cardiac death, which are the outcomes cardiologists are most concerned about preventing.”

Reference:

Guillermo Romero-Farina , Santiago Aguadé-Bruix, Ignacio Ferreira-González, Prediction of Major Adverse Coronary Events Using the Coronary Risk Score in Women, Radiology Cardiothoracic Imaging, https://doi.org/10.1148/ryct.230381

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Flap Reconstruction Yields Lowest Recurrence in Hidradenitis Suppurativa: Study

Researchers demonstrated that flap reconstruction after wide excision is indeed the lowest recurrence rate amongst various wound closure methods for hidradenitis suppurativa (HS). The chronic inflammatory skin disease involves recurrent painful nodules, recurrent sinus tracts, and fistulae, with skin scarring. A recent study was conducted by Corina and colleagues and was published in the International Journal of Dermatology.

A PRISMA 2020 guideline-compliant systematic review and meta-analysis reviewed the techniques of wound closure following excision of HS lesion. The original studies retrieved up to February 2024 from PubMed, Embase, Cochrane, and ClinicalTrials.gov. From an eligible total of 121 articles that survived this process, a final meta-analysis of 1181 articles was screened after eliminating duplicate records and ineligibility. Direct and network meta-analyses compared the rates of recurrence and postoperative complication rates against the reconstruction techniques considered.

The meta-analysis showed that there were differences in recurrence rates based on the method of wound closure:

  • Primary closure: Recurrence rate of 25% (95% CI, 20–30%).

  • Skin grafts: Recurrence rate of 18% (95% CI, 14–22%).

  • Flap reconstruction: The lowest recurrence rate was at 12% (95% CI, 9–15%).

  • Secondary intention healing: The highest recurrence rate was at 28% (95% CI, 23–33%).

  • Flap reconstruction represented the most effective technique in reducing recurrence, due to more prolonged results compared with other surgical techniques.

This means that selection of a proper wound closure method following the excision of HS can be crucial. The ease in application of secondary intention healing or primary closure makes these a less desirable option since it has a higher rate of recurrence. Intermediate benefits result from skin grafting but flap reconstruction is apparently best, with the lowest recurrences and even an expected improvement in functionality and quality of life.

This comprehensive analysis reports flap reconstruction as the most efficient wound closure after wide surgical excision for lesions of HS, with minimal recurrence rates and better outcomes as compared to primary closure, skin grafts, and healing by secondary intention. These results may significantly improve the long-term outcomes and quality of life for patients afflicted with HS.

Reference:

Cucu, C. I., Ciobotariu, I., Paradisi, A., Di Nardo, L., Fossati, B., Mannino, M., Malvaso, D., Chiricozzi, A., & Peris, K. (2024). Wound closure techniques after wide excision for hidradenitis suppurativa: a systematic review and meta‐analysis. International Journal of Dermatology. https://doi.org/10.1111/ijd.17553

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Use of fine cotton swabs may reduce bleeding without compromising disinfection during Nasotracheal Intubation: Study

Nasotracheal intubation (NTI) is essential for surgeries that demand unobstructed access to the surgical area and for patients with respiratory complications. Recent study by Hirohata et al. aimed to investigate the efficacy of pre-nasotracheal intubation nasal disinfection using different cotton swab sizes. The researchers hypothesized that smaller swabs could potentially reduce bleeding while maintaining disinfection effectiveness. The randomized controlled trial involved patients scheduled for general anesthesia with nasotracheal intubation (NTI) who were divided into two groups: one using large cotton swabs (LCS) and the other using fine cotton swabs (FCS). The study collected samples to assess bacterial counts before disinfection (sample A), after disinfection with LCS or FCS (sample B), and from the endotracheal tube post-surgery (sample C). Results indicated that there was no significant difference in bacterial reduction between LCS and FCS groups after disinfection with benzalkonium chloride (BZK). However, a notable finding was that nasal bleeding occurred more frequently in the LCS group compared to the FCS group.

Patient Characteristics and Outcomes

The study involved 129 patients aged 20-70, ASA-PS class 1 or 2, with random assignment to LCS or FCS groups. The analysis revealed no significant difference in disinfection efficacy between the two swab sizes but highlighted a clear disparity in nasal bleeding incidence. Subsequent comparisons of bacterial count changes between samples A and B, and samples A and C, showed similar outcomes for both LCS and FCS groups.

Conclusions and Recommendations

The conclusion of the study recommended the use of FCS for nasal disinfection before NTI in ASA 1–2 patients due to the reduced risk of bleeding without compromising disinfection. The results emphasized that cotton swab thickness did not impact disinfection efficacy, with FCS being preferred over LCS to minimize nasal bleeding risk. The study’s findings contribute to optimizing NTI procedures and enhancing patient safety during anesthesia. The research underscored the importance of selecting appropriate disinfection methods to minimize complications associated with NTI, such as nasal bleeding and potential bacteremia.

Key Points

1. The study by Hirohata et al. focused on investigating the effectiveness of pre-nasotracheal intubation nasal disinfection using different cotton swab sizes. The researchers hypothesized that using smaller swabs could potentially reduce bleeding while maintaining disinfection efficacy.

2. The randomized controlled trial included 129 patients scheduled for general anesthesia with nasotracheal intubation, divided into two groups: one using large cotton swabs (LCS) and the other using fine cotton swabs (FCS). Samples were collected to assess bacterial counts before disinfection, after disinfection with either LCS or FCS, and from the endotracheal tube post-surgery.

3. Results indicated that there was no significant difference in bacterial reduction between the LCS and FCS groups after disinfection with benzalkonium chloride (BZK). However, a noteworthy finding was that nasal bleeding occurred more frequently in the LCS group compared to the FCS group.

4. Patient characteristics included individuals aged 20-70, ASA-PS class 1 or 2, randomly assigned to either LCS or FCS groups. The analysis showed no significant difference in disinfection efficacy between the two swab sizes but highlighted a clear difference in nasal bleeding incidence

5. Comparisons of bacterial count changes between samples A and B, and samples A and C, demonstrated similar outcomes for both LCS and FCS groups, reinforcing the findings of comparable disinfection effectiveness regardless of swab size.

6. The study concluded by recommending the use of FCS for nasal disinfection before nasotracheal intubation in ASA 1–2 patients due to the reduced risk of bleeding without compromising disinfection efficacy. The research serves to optimize nasotracheal intubation procedures, enhance patient safety during anesthesia, and stress the importance of selecting appropriate disinfection methods to minimize complications like nasal bleeding and potential bacteremia.

Reference –

Makoto Hirohata et al. (2024). Microbiological Comparison Of The Disinfecting Efficacy Of Small And Large Cotton Swabs In Nasotracheal Intubation: A Randomized Trial. *BMC Anesthesiology*, 24. https://doi.org/10.1186/s12871-024-02804-2

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