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The petitioner had contested the legality of Rule 7 of the Senior
Resident/Tutor & Bihar Medical Education Service (Recruitment, Appointment,
and Promotion) Rules, 2008, which sets the maximum age limit for unreserved
candidates at 45 years, for other backward castes at 48 years, and for
scheduled castes and tribes at 50 years, for the appointment to assistant
professor positions in government medical colleges in Bihar, reports the Times of India.

Dr Nishant’s counsel, Kumar Kaushik, argued that the state’s age limit
should match that set by the National Medical Commission (NMC), India’s
regulatory body for the medical profession and education. The NMC has
established the maximum age limit for appointing assistant professors in
medical colleges at 70 years. However, the court upheld the existing
rules and dismissed the petition.

The age limit has been a persistent problem for many doctors. In a move that will bring relief to thousands of doctors wanting to start their careers in the field of medical education, the National Medical Commission (NMC) might soon do away with the age limit of 45 years prescribed for the initial appointment of the Senior Residents. The Postgraduate Medical Education Board (PGMEB) of NMC examined the cases of the non-medical postgraduate students with MSC (Medical) degrees and decided to recommend to NMC abolishing the age limit of 45 years prescribed for the Senior Residents in the Teachers Eligibility Qualifications in Medical Institutions Regulations, 2022.

The researchers reported that CT imaging reveals the influence of blood glucose levels on the severity of COVID-19.

The study revealed a significant correlation between blood glucose control and CT severity score (CTSS); the higher the blood glucose is, the more severe the lung manifestation. Also, the CTSS can be used to predict and evaluate COVID-19’s clinical severity.

Previous studies have shown that patients with diabetes exhibit more severe conditions concerning the clinical course and chest imaging and are more likely to develop critical COVID-19 compared with normal-infected individuals. Furthermore, those with poor blood glucose control have a worse prognosis.

Against the above background, Jin Wang from the Yan’an Hospital Affiliated with Kunming Medical University in Kunming, Yunnan, China, and colleagues aimed to analyze the correlation between blood glucose control and the severity of COVID-19 infection in diabetes patients.

For this purpose, the researchers retrospectively collected imaging and clinical data of 146 patients with diabetes combined with COVID-19 who visited the hospital between 2022 and 2023.

The patients were categorized into two groups based on an assessment of their blood glucose control: the good blood glucose control group and the poor blood glucose control group. The two groups were compared for the clinical data, computed tomography (CT) appearance and score, and the severity of COVID-19 infection, with the COVID-19 severity being the dependent variable to analyze other influencing factors.

The study led to the following findings:

· The group with poor blood glucose control showed a higher lobar involvement degree and total CT severity score than the group with good blood glucose control (13.30 ± 5.25 versus 10.38 ± 4.84).

· The two groups exhibited no statistically significant differences in blood lymphocyte, leukocyte, pleural effusion, C-reaction protein, consolidation, ground glass opacity, or crazy-paving signs.

· Logistic regression analysis showed that the total CTSS significantly influences the clinical severity of patients (odds ratio 1.585). In contrast, fasting plasma glucose and blood glucose control are not independent factors influencing clinical severity.

· The area under the curve (AUC) of CTSS prediction of critical COVID-19 was 0.895 with sensitivity of 79.3% and specificity of 88.1% when the threshold value is 12.

In conclusion, chest CT imaging is a reliable testing method for evaluating COVID-19; the higher the blood glucose level is, the more severe the clinical manifestation and the more evident the lung inflammation. This indicates that clinical patients should receive a CT scan upon admission to evaluate their initial condition, and there should be a thorough analysis of imaging appearances.

“Targeted treatment should be administered, and education and publicity activities should be implemented aiming to popularise the necessity of controlling their blood glucose among patients with diabetes and encouraging them to make an active effort to keep healthy and follow appropriate diets, thus improving their quality of life,” the researchers wrote.

Reference:

Lu, D., Liu, Y., Ma, P. et al. Severity of COVID-19 infection in patients with COVID-19 combined with diabetes. J Health Popul Nutr 43, 55 (2024). https://doi.org/10.1186/s41043-024-00548-w

The study found a significantly lower atherosclerotic cardiovascular disease (ASCVD) mortality in adults without clinical ASCVD with elevated Lp(a). Given the high prevalence of predominantly genetically determined elevated Lp(a), the findings may have public and clinical health implications for aspirin utilization in primary prevention.

Analyzing more than 2900 people with a median follow-up of 26 years, the researchers found that regular aspirin use in those aged 40 to 70 years cut the risk of ASCVD mortality in half among those with Lp(a) levels of 50 mg/dL or more but had no benefit among those with reduced Lp(a).

Lipoprotein(a) is an atherogenic and prothrombotic lipoprotein associated with ASCVD. Alexander C. Razavi, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, and colleagues aimed to assess the association between regular aspirin use and ASCVD mortality among individuals with versus without elevated Lp(a) in a nationally representative US cohort.

Eligible participants were aged 40–70 years without clinical ASCVD, reported on aspirin use, and had Lp(a) measurements from the Third National Health and Nutrition Examination Survey (NHANES III, 1988–1994), the only cycle of this nationally representative US cohort to measure Lp(a).

Regular aspirin use was defined as aspirin intake ≥30 times in the previous month. Over a median 26-year follow-up, using NHANES III linked mortality records and weighted Cox proportional hazards regression, the association between regular use of aspirin and ASCVD mortality was observed in those with and without elevated Lp(a) (≥50 versus <50 mg/dL).

The study revealed the following findings:

• Among 2,990 persons meeting inclusion criteria (∼73 million US adults), the mean age was 50 years; 53% were female, and 7% reported regular aspirin use.
• The median Lp(a) was 14 mg/dL, and the proportion with elevated Lp(a) was similar among those with versus without regular aspirin use (15.1% versus 21.9%).
• Among individuals with elevated Lp(a), the incidence of ASCVD mortality per 1,000 person-years was lower for those with versus without regular aspirin use (1.2 versus 3.9).
• In multivariable modeling, regular aspirin use was associated with a 52% lower risk of ASCVD mortality among individuals with elevated Lp(a) (HR=0.48) but not for those without elevated Lp(a) (HR=1.01).

“Regular aspirin use was associated with a 52% lower risk of ASCVD mortality among adults without clinical ASCVD who had elevated Lp(a),” the researchers wrote. “These findings suggest that Lp(a) measurement may help identify individuals who benefit from aspirin therapy for primary prevention.”

Reference:

Razavi, A. C., Richardson, L. C., Coronado, F., Dzaye, O., Bhatia, H. S., Mehta, A., Quyyumi, A. A., Vaccarino, V., Budoff, M. J., Nasir, K., Tsimikas, S., Whelton, S. P., Blaha, M. J., Blumenthal, R. S., & Sperling, L. S. (2024). Aspirin Use for Primary Prevention Among US Adults With and Without Elevated Lipoprotein(a). American Journal of Preventive Cardiology, 100674. https://doi.org/10.1016/j.ajpc.2024.100674