Kidney transplant facility to be launched at GBP Hospital: Tripura CM Manik Saha

Agartala: Taking a notable step towards improving healthcare provisions, the Government Medical College and Agartala GBP Hospital in the state are preparing to commence kidney transplant surgeries.

Tripura Chief Minister Manik Saha on Thursday conducted inspection of various hospital facilities, including the super speciality block and nephrology department of GBP Hospital in Agartala. During his visit, Saha reviewed the neurosurgery and nephrology departments, engaging in discussions with medical staff regarding medication, equipment maintenance, and quality control.

Also Read:Tripura CM inaugurates advanced imaging facility at Niramay Health Centre

As per the officials, the state-of-the-art infrastructure required for the program, constructed within the speciality block at a cost of Rs 180 crores, is nearing completion, heralding a new era in medical care for residents, reports news agency ANI.

Manik Saha who also holds the portfolio of the health ministry in the state undertook an inspection tour of various hospital facilities, including the super speciality block, nephrology and generic medicine counter, and cardiology department.

“This proactive engagement underscores the government’s commitment to ensuring robust healthcare services and expanding treatment options for patients,” an official statement said.

The upcoming kidney transplant program signifies a monumental advancement in medical capabilities within the region.

It promises to offer hope and relief to patients grappling with kidney-related ailments, enabling them to access life-saving treatments closer to home.

According to an ANI report, “With the infrastructure nearing readiness, authorities are poised to inaugurate the kidney transplant program, marking a milestone achievement in the state’s healthcare landscape. The initiative reflects a concerted effort towards fostering comprehensive healthcare solutions and prioritizing the well-being of citizens,” the statement added.

The community and future patients of GB Pant Hospital are optimistic about the forthcoming enhancements, which are expected to significantly elevate the quality of healthcare services offered. 

Also Read:CM Saha urges Tripura Medical College to establish Trauma Care Centre, Embrace CM-JAY Scheme

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Delhi HC slaps Rs 3 lakh fine on drugmaker for violating Pfizer trademark of Viagra

Delhi: The Delhi High Court has made a definitive ruling to permanently prohibit the use of the ‘Vigoura’ mark by a homeopathic drug manufacturer for marketing products related to sexual disorders. This decision stemmed from a trademark infringement lawsuit filed by Pfizer Products Inc., renowned for its erectile dysfunction medication sold under the ‘Viagra’ trademark.

In a detailed judgment, the high court emphasized the significant potential for confusion between ‘Vigoura’ and ‘Viagra’, citing phonetic similarity that could mislead consumers into believing that ‘Vigoura’ was either a variant of or endorsed by the makers of ‘Viagra’. Consequently, the court granted Pfizer nominal damages of Rs 3 lakh, reinforcing Pfizer’s exclusive ownership of the ‘Viagra’ trademark.

Justice Sanjeev Narula noted the unique creation of the term ‘Viagra’ and its subsequent association with the medication. Pfizer’s consistent and lawful use of the mark, along with international registrations, regulatory approvals, and inclusion in reputable dictionaries, further affirmed its rightful ownership of the ‘Viagra’ trademark in Indian jurisdiction.

The legal dispute arose when Pfizer challenged Renovision Exports Private Limited for marketing products labelled as “Nervine Tonic for Men” and “Homeopathic Medicine Invented in Germany” under the ‘Vigoura’ mark. Despite Renovision’s claims of distinction based on composition and intended use, the court determined that the ‘Vigoura’ mark’s deceptive similarity to ‘Viagra’ constituted trademark infringement and passing off.

Deliberating the case, the court observed;

“The trademarks “VIGOURA” and “VIAGRA” exhibit a high degree of phonetic similarity. Both marks are comprised of three syllables, with ‘Vi’ as a common prefix and ‘Ra’ as a similar suffix, producing a strikingly similar auditory impression. This phonetic resemblance is particularly concerning in the pharmaceutical industry, where the precise identification of products is crucial for consumer safety and confidence. The similarity in sound could mislead consumers into believing that “VIGOURA” is either a variant of, associated with, or endorsed by the makers of “VIAGRA,” potentially resulting in mistaken purchases or the belief in equivalent efficacy.”

“To conclude, the Defendants’ trademark “VIGOURA” is held to be deceptively similar to the Plaintiff’s trademark “VIAGRA”. In view of the resemblances between the two trademarks and the overlap in field of use and commercial operations, as elucidated above, there is a strong potential of confusion amongst the general public. Thus, the Court answers this issue in favour of the Plaintiff and against the Defendants, holding that Defendants’ “VIGOURA” mark infringes the Plaintiff’s registered “VIAGRA” mark under Sections 29(1) and 29(2)(b) of the Act.”

“Defendants’ trademark “VIGOURA” and its formative marks have a high likelihood of causing confusion, particularly in view of the fact that the impugned mark is being issued for similar pharmaceutical products. There is thus apparent danger of the public getting confused, or at least wondering, whether the products marketed under the impugned “VIGOURA” mark are associated with the products of Plaintiff (Pfizer). These factors lead the Court to conclude that the Defendants’ use of the “VIGOURA” mark constitutes a clear case of passing off, undermining the distinctive character and reputation of the Plaintiff’s “VIAGRA” trademark.”

Subsequently, the court granted a permanent injunction against Renovision, restraining the company from promoting its homoeopathic medicine under the ‘Vigoura’ mark. Additionally, the court ordered Renovision to compensate Pfizer with Rs 3 lakh as nominal damages, marking a significant legal victory for Pfizer in safeguarding its trademark rights against unauthorized usage. It noted;

“The Defendants (Renovision) or anyone acting on their behalf are permanently restrained from manufacturing, selling, or offering for sale, marketing, advertising, or in any other manner using the mark “VIGOURA” or any mark deceptively similar to the Plaintiff’s trademark “VIAGRA” in relation to any of their goods as would amount to infringement or passing off of the Plaintiff’s registered mark “VIAGRA”. The Plaintiff shall be entitled to nominal damages to the tune of Rs. 3,00,000/-, recoverable jointly and severally from the Defendants.”

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Dr Reddy’s Labs unveils Doxycycline Capsules, 40 mg in US to treat inflammatory lesions of rosacea

Hyderabad: Dr Reddy’s Laboratories Ltd. has announced its launch of Doxycycline Capsules, 40 mg in the U.S. market, a therapeutic generic
equivalent of ORACEA (doxycycline, USP) Capsules, 40 mg approved by the U.S. Food and Drug
Administration (USFDA).

Doxycycline is a tetracycline-class drug indicated for the treatment of only inflammatory lesions (papules and pustules) of rosacea in adult patients. Inflammatory lesions, including papules and pustules, are common symptoms of rosacea. These lesions manifest as raised, red bumps (papules) and pus-filled bumps (pustules) on the skin, typically on the face. They are often accompanied by redness, swelling, and sensitivity in the affected areas.

Dr. Reddy’s Doxycycline Capsules, 40 mg, are supplied in bottle counts of 30. Each capsule contains: 26 mg immediate-release pellets and 14 mg delayed-release pellets equivalent to 40 mg of
anhydrous doxycycline, USP.

ORACEA is a trademark of Galderma Holdings, S.A.

Read also: Nestle India, Dr Reddy’s to form JV to bring nutraceutical brands to consumers in India, other agreed territories

Established in 1984, Dr Reddy’s Laboratories Ltd. is a global pharmaceutical company headquartered in Hyderabad, India. Dr Reddys offers a portfolio of products and services including APIs, generics, branded generics, biosimilars and OTC. Its major therapeutic areas of focus are gastrointestinal, cardiovascular, diabetology, oncology, pain management and dermatology. Dr Reddys major markets include – USA, India, Russia & CIS countries, China, Brazil and Europe.

Read also: Dr Reddy’s Laboratories gets CDSCO Panel Nod To Import and Market Toripalimab 240mg solution for infusion

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Assam Allocates 3 Additional MBBS Seats for Bhutanese Students

Assam- The Assam government has decided to allocate three more MBBS seats in medical colleges of Assam for Bhutanese students, taking the total number of reserved seats to 5.

In November 2023 the King of Bhutan visited India. It was during his visit to India that the Government of India announced the allocation of additional MBBS seats for Bhutanese students in medical colleges in the state of Assam.

Also Read: Assam to set up New Medical College in Karimganj With 100 MBBS Seats

This announcement has now also been made public through a press release by the Indian Embassy in Thimphu.

According to the press release, “In addition to the existing two MBBS seats reserved in the Gauhati Medical College (GMC) for the Bhutanese students, three additional MBBS seats in the medical colleges in Assam for Bhutanese students are being reserved, as per National Medical Council and NEET guidelines. Accordingly, there will now be a total of five MBBS seats reserved for Bhutanese students in the medical colleges in Assam”.

The Royal Civil Service Commission, Royal Government of Bhutan, in coordination with the Embassy of India, Thimphu will oversee the selection process for eligible candidates based on National Medical Commission and NEET guidelines, the press release further informed.

Also Read: PWD Kickstarts development of New Medical College and Hospital in Assam, to be completed by 2026

However, the last two MBBS seats have already been allotted to Nalbari Medical College and Fakhruddin Ali Ahmed Medical College and Hospital (FAAMCH), Barpeta. This announcement was made by Assam Chief Minister Himanta Biswa Sarma in the cabinet meeting on November 1 2023.

Now, with these three new reserved seats, a total of five MBBS seats will be available in medical colleges in Assam for Bhutanese students.

This initiative by the Government of India has not only opened up avenues for Bhutanese students to study medical in India but also reflects the strong India-Bhutan cooperation in the field of STEM education and skill development.

“Another step towards furthering the age old relation between the two countries,” the Assam chief minister’s office (CMO) said.

“Following up on His Majesty the King of Bhutan’s visit to India, three additional MBBS seats have been reserved for Bhutanese students in Assam’s medical colleges taking the total seats to five,” stated the Assam CMO, as quoted by Northeast Now.

To check the press release, click the link below

https://medicaldialogues.in/pdf_upload/press-release-final-mbbs-seats-30-apr-2024-237368.pdf

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C-Peptide Index may Predict endogenous insulin secretory capacity under non-fasting conditions: Study

Researchers have found that the C-peptide index (CPI) at 2 hours post-meal is a significant indicator of endogenous insulin secretory capacity in patients with type 2 diabetes, according to a study published in Diabetes Obesity & Metabolism. This measure can help predict the likelihood of patients being able to withdraw from insulin therapy, providing valuable insights for personalized diabetes management. The study was conducted by Yuichiro Iwamoto and colleagues.

Type 2 diabetes is a chronic metabolic disorder characterized by insulin resistance and pancreatic beta-cell dysfunction. Managing the condition often involves insulin therapy; however, the ability to withdraw from insulin therapy can improve the quality of life for patients. Identifying reliable indicators for withdrawal can guide treatment plans and optimize patient outcomes.

The study was a single-center retrospective analysis involving 147 patients with type 2 diabetes admitted to a hospital. Participants were divided into a withdrawal group (n = 72) and a non-withdrawal group (n = 75) based on whether they were able to withdraw from insulin therapy at discharge. Researchers evaluated the correlation between CPI at 2 hours post-meal and diabetes-related parameters. Machine learning was employed to create clinical models to predict the possibility of withdrawal from insulin therapy.

The key findings of the study were:

  • The CPI at 2 hours post-meal was significantly higher in the withdrawal group (2.97 ± 2.07) compared to the non-withdrawal group (1.93 ± 1.28) with a p-value of <0.001.

  • This suggests that a higher post-meal CPI is associated with a greater likelihood of withdrawing from insulin therapy.

  • CPI at 2 hours post-meal was an independent predictor of withdrawal from insulin therapy.

  • It was also found to be a better predictor than fasting CPI.

  • Six factors associated with insulin therapy withdrawal (age, duration of diabetes, creatinine, alanine aminotransferase, insulin therapy until hospitalization, and CPI at 2 hours post-meal) were used to create two clinical models using machine learning.

  • The accuracy of the generated clinical models ranged from 78.3% to 82.6%.

The study concludes that the CPI at 2 hours post-meal is a clinically useful measure of endogenous insulin secretory capacity under non-fasting conditions. This measure can serve as a valuable tool for predicting the possibility of withdrawal from insulin therapy in patients with type 2 diabetes. This finding can help tailor treatment plans to individual patients’ needs, potentially improving their overall quality of life.

Reference:

Iwamoto, Y., Kimura, T., Shimoda, M., Morimoto, Y., Watanabe, Y., Itoh, T., Sasaki, T., Mori, S., Kubo, M., Takenouchi, H., Dan, K., Iwamoto, H., Sanada, J., Fushimi, Y., Katakura, Y., Nakanishi, S., Mune, T., Kaku, K., & Kaneto, H. (2024). C‐peptide index at 2 h post‐meal is a useful predictor of endogenous insulin secretory capacity and withdrawal from insulin therapy in subjects with type 2 diabetes. Diabetes, Obesity & Metabolism. https://doi.org/10.1111/dom.15595

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Licences of 14 products suspended: Patanjali Ayurved calls for legal action against Uttarakhand SLA

Dehradun: In a recent update amid the misleading ads controversy, Patanjali Ayurved has called for legal action against the decision of the Uttarakhand State Licensing Authority (SLA) to suspend manufacturing licenses of 14 products of Patanjali Ayurved Ltd and Divya Pharmacy.

On Tuesday, the Uttarakhand SLA informed the Supreme Court that the order was issued to Baba Ramdev’s company after repeated violations of the drug advertisements law.  

The authority told the apex court that on April 16, the drug inspector/district ayurvedic and unani officer, Haridwar, had filed a criminal complaint before the chief judicial magistrate against Yoga Guru Ramdev, his aide Balkrishna, Divya Pharmacy and Patanjali Ayurved Ltd under sections 3, 4 and 7 of the Drugs and Magic Remedies (Objectionable Advertisements) Act.

Also read- Tamil Nadu Doctors’ Association Demands Strict Action Against Misleading Ads By Patanjali

The 14 products which has been suspended with immediate effect include Swasari Gold, Swasari Vati, Bronchom, Swasari Pravahi, Swasari Avaleh, Mukta Vati Extra Power, Lipidom, Bp Grit, Madhugrit, Madhunashini Vati Extra Power, Livamrit Advance, Livogrit, Eyegrit Gold, Patanjali Drishti Eye Drop.

As per TOI news report, the state government has not only banned the manufacturing of the drugs, but has also asked Patanjali for the formula. Ramdev has been given three months by the state government to appeal the order.

Speaking to the Daily, Patanjali Ayurved media in-charge S K Tijarawala responded by saying, “We will reply to the notice served by the state govt and take recourse to law regarding the action taken against us.”

In an affidavit filed in the top court, the SLA has given details of the steps taken by it against Patanjali and Divya Pharmacy.

During the hearing on Tuesday, a bench of Justices Hima Kohli and Ahsanuddin Amanullah came down heavily on the SLA for its “inaction” for six years in the matter, saying it has to be honest with the court if it wanted “sympathy and compassion”.

The affidavit was filed through Dr Mithilesh Kumar, the joint director of SLA, Ayurvedic and Unani Services, Dehradun.

“The SLA issued an order dated April 15, 2024, to Divya Pharmacy and … Patanjali Ayurved Ltd, stating therein that the manufacturing licenses for 14 of their products namely are suspended with immediate effect under Rule 159(1) of The Drugs and Cosmetics Rules, 1945 for repeated violations under the said Acts and Rules,” the affidavit said.

It said the order was also marked to the drug inspector/district ayurvedic and unani officer, Haridwar, to ensure strict compliance.

“On April 16, 2024, the drug inspector/district ayurvedic and unani officer, Haridwar, filed criminal complaint … before the chief judicial magistrate, Haridwar against Swami Ramdev, Acharya Balkrishna, Divya Pharmacy and Patanjali Ayurved Limited under sections 3, 4 and 7 of the DMR Act,” it said.

As per PTI report, the affidavit said the SLA tenders an “unconditional and unqualified apology” for any “inadvertent and unintentional non-compliance” with the orders of the apex court.

It said the SLA had addressed a letter dated April 23 to all ayurvedic/unani medicine factories in Uttarakhand directing that they shall strictly comply the Drug and Magic Remedies Act, 1954 and no pharmaceutical factory will use claims like approved/certified by the Ministry of Ayush on the label of its product.

“The SLA herein is completely aware of the gravity of the situation and seriousness of the matter at hand and has always endeavored to discharge its duties to the best of his capacity and in accordance with law,” the affidavit said.

“The SLA will continue to take all due/further steps against Divya Pharmacy and/or Patanjali Ayurved Limited, as per procedure prescribed in law and/or as per directions of this court,” it said.

During the hearing, the apex court expressed dissatisfaction over the explanation offered in the affidavits, including the one filed by the SLA, and questioned why the authority has “woken up” only after the court’s April 10 order. The counsel appearing for SLA urged the court that they be permitted to file better affidavit in the matter.

The bench granted 10 days time to file the affidavit and posted the matter for hearing on May 14.

The court is hearing a plea filed in 2022 by the IMA alleging a smear campaign against the Covid vaccination drive and modern systems of medicine.

Also read- SC Slams IMA, Allows Patanjali To File Contempt Plea Against Doctors’ Body Chief

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TAVR associated with lower in-hospital complications in AS patients with cardiogenic shock compared to SAVR: Study

A nationwide observational analysis of patients with aortic stenosis (AS) and cardiogenic shock (CS) who underwent transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) determined that patients who underwent TAVR had lower in-hospital complications and resource utilization compared with SAVR. The results were presented today at the Society for Cardiovascular Angiography & Interventions (SCAI) 2024 Scientific Sessions.

As many as 300,000 people in the United States are diagnosed with AS every year. It predominantly affects those aged 65 and older. In its most severe form, life expectancy is only one to two years if not properly treated, a prognosis worse than most cancers. CS occurs often due to severe heart attacks and also comes with a poor prognosis: a 50% mortality rate. AS and CS are difficult to treat and often have few successful procedure outcomes. There is little data on the use of TAVR vs SAVR for this high-risk patient population.

The retrospective cohort study used the National Inpatient Sample database to identify patients hospitalized for AS-CS from 2016 to 2020 who underwent isolated TAVR or SAVR. In-hospital outcomes of TAVR vs. SAVR were compared using multivariable regression analysis. The data helps show the feasibility of TAVR, especially in patients who are already high-risk.

Of 13,215 patients hospitalized for AS-CS, 5,095 (38.6%) underwent isolated TAVR and 8,120 (61.4%) underwent isolated SAVR. The factors independently associated with TAVR selection in AS-CS included age ≥65 years, female sex, renal failure, chronic pulmonary disease, prior coronary artery bypass grafting, and Impella support. For SAVR, the factors independently associated with selection included Black race, Hispanic ethnicity, and peripheral vascular disease. Compared with SAVR, TAVR was associated with lower odds of stroke (adjusted odds ratio [aOR] of 0.48), acute kidney injury, and major bleeding. In-hospital mortality, pacemaker placement, and vascular complications were similar between the two, while length of stay was shorter and total costs were lower with TAVR (both P<0.01). The study also found that from 2016 through 2020, the use of TAVR increased, while the use of SAVR decreased in AS-CS (both P<0.01).

“Results show that TAVR is a more feasible and safe option when compared to SAVR for some of the most high-risk patients who have AS and CS. We were initially able to see this in our clinical practice, so it is rewarding to share it with the cardiology community at this prestigious meeting,” said Mahmoud Ismayl, MD, cardiology fellow and Assistant Professor at the Mayo Clinic, and lead author of the study. “It is important that patients and cardiovascular professionals are aware of the benefits of the use of TAVR such as lower in-hospital complications and resource utilization because they are then able to advocate for the best treatment option.”

Further studies exploring the long-term comparative safety and effectiveness of TAVR compared to SAVR among patients with AS-CS are warranted.

Reference:

TAVR is associated with lower in-hospital complications in patients with aortic stenosis and cardiogenic shock compared to SAVR, Society for Cardiovascular Angiography and Interventions, Meeting: SCAI 2024 Scientific Sessions.

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CPDHE, UGC MMTTC Invites Applications for Faculty Development Programme- Registration Open Till 6th May: BFUHS issues notice

New Delhi- Through a recent notice released on its official website, the Baba Farid University of Health Sciences (BFUHS) has informed that Centre for Professional Development in Higher Education (CPDHE) and Malaviya Mission Teacher Training Centre (UGC-MMTTC), University of Delhi is organising an online faculty Development Programme on NEP Orientation & Sensitisation Programme. On this, an advertisement has been released detailing the programme.

This event is scheduled to take place in May from 7 to 16 May 2024 from 2:00 to 3:30 pm and 3:45 to 5:15 pm. It will be 8 days over a two-week period, with two live online sessions (90 minutes each) per day.

Interested candidates can register and apply through the link given in the advertisement on the BFUHS website before 6th May 2024. After registration, registered candidates will receive a confirmation email with guidelines and a course link. There is no registration fee for the program.

Also Read: JIPMER Announces Schedule For PG Orientation Program

ELIGIBILITY

Faculty members of the state and central universities/deemed universities/affiliated colleges/ constituent colleges/private universities/ colleges, etc (including professors, associate professors, assistant professors, research scholars and research associates at the PhD or post-doctoral level). The NOSP shall be considered equivalent to a one-week FDP/STP.

THEME OF THE PROGRAMME

1 Indian knowledge system.

2 Research and Development.

3 Holistic and Multidisciplinary Education.

4 Higher Education and Society.

5 Academic Leadership, Governance and Management.

6 Information and Communication Technology.

7 Student Diversity and Inclusive Education.

8 Skill Development.

9 Autonomy to the institution and choice to the students.

10 Curriculum, development, pedagogy and assessment.

Also Read: DCI directs Dental Colleges To Conduct Anti-Ragging Orientation Program, details

ASSESSMENT AND EVALUATION PARAMETERS

The total marks are to be fixed at 100 and it will be decided upon 2 MCQ tests of (40+40 Marks) and overall response (20 Marks). However, those participants who will score less than 50 marks will not be given a certificate and will have to repeat the course at their own expense. Apart from this, attendance of every participant is mandatory in all the sessions.

After the completion of the orientation programme, an e-certificate will be issued to those participants who have attended the two-week program and have met the assessment criteria.

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Sri Ramachandra Hospital doctors remove LED bulb from 5-year-old’s lung

Chennai: A five year old poor boy had a miraculous save when an LED bulb swallowed a month ago was removed from his lungs through bronchoscopy at Sri Ramachandra Hospital. 

The boy was brought to the medical college hospital OP with refractory cough and breathing difficulty last Friday. The child which had swallowed a foreign object was admitted to another hospital and after two attempts of boronchoscopic removal failed was advised an open chest surgery after two weeks.

Also Read:Newborn makes miraculous recovery after 15 days in Sarvodaya Hospital

Fearing a major surgery the boy was brought to Sri Ramachandra Hospital where HoD paediatric surgery Dr R Madhu and his team took a CT scan and found an LED bulb deposited in the distal breathing tube branch (segmental bronchus). Parents were explained of the plan of removal through bronchoscopy failing which an open chest surgery and postoperative ICU and ventilation.

With excellent anaesthesia support headed by Dr Aruna Parameswari, HoD, Anaesthesia paediatric surgeons removed the LED bulb safely. The child did not require ICU or ventilation and has since been discharged.

Also Read:Tamil Nadu Chapter of Telemedicine Society of India launches learning centre

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People with diabetes at significantly higher risk of developing carpal tunnel syndrome, finds study

People with diabetes are at significantly higher risk of developing carpal tunnel syndrome, according to a study published in PlosOne.

In recent years, several studies have reported on the relationship between diabetes and carpal tunnel syndrome (CTS). However, due to their contradictory results, a systematic review and meta-analysis were conducted to investigate this subject. This study is a systematic review and meta-analysis of studies published in ISI Web of Science, Scopus, PubMed, Cochrane, Google Scholar, and Embase databases. Heterogeneity in the studies included in the meta-analysis was evaluated using statistical tests such as the Chi-square test, I2, and forest plots. Publication bias was assessed using Begg’s and Egger’s tests.

Results: This investigation analyzed data from 42 studies conducted between 1985 and 2022, with a total of 3,377,816 participants. The meta-analysis demonstrated that the odds ratio (OR) of CTS in participants with a history of diabetes compared to those without was 1.90 (95% CI: 1.64–2.21; P-value < 0.001). Given that publication bias was observed in this study (Begg’s test P-value = 0.01), the modified OR was calculated with consideration of missed studies, which was 1.68 (95% CI: 1.45–1.94; P-value < 0.001). The results of this study suggest that diabetic patients have 90% higher odds of developing CTS compared to non-diabetic individuals, which is statistically significant.

Reference:

Sanjari E, Raeisi Shahraki H, G Khachatryan L, Mohammadian-Hafshejani A. Investigating the association between diabetes and carpal tunnel syndrome: A systematic review and meta-analysis approach. PLoS One. 2024 Apr 16;19(4):e0299442. doi: 10.1371/journal.pone.0299442. PMID: 38626071; PMCID: PMC11020394.

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