Medtronic gets USFDA approval for Inceptiv closed-loop spinal cord stimulator for chronic pain

Dublin: Medtronic plc, a global leader in healthcare technology, has announced that the U.S. Food and Drug Administration (FDA) has approved the Inceptiv closed-loop rechargeable spinal cord stimulator (SCS) for the treatment of chronic pain. Inceptiv is the Medtronic SCS device to offer a closed-loop feature that senses biological signals along the spinal cord and automatically adjusts stimulation in real time, keeping therapy in harmony with the motions of daily life.

“Pain is intensely personal, and stimulation therapy should meet the needs of every patient, moment to moment,” said Dr. Krishnan Chakravarthy, M.D., Ph.D., Director of Innovative Pain Treatment Solutions and Surgery Center, VA San Diego Healthcare, and Chairman of the Empower You Chronic Pain Foundation. “Inceptiv listens to what the body is saying and, more quickly than you can blink, it seamlessly adjusts. This represents an important leap forward for the treatment of chronic pain.”

Traditional fixed-output SCS devices deliver constant, mild electrical impulses that disrupt pain signals before they reach the brain. As patients go about their daily lives, certain movements such as laughing, bending, or sneezing may result in brief moments of uncomfortable overstimulation. This in turn may lead some patients to turn down their device’s stimulation output, resulting in a suboptimal therapy experience.

By contrast, Inceptiv SCS senses biological signals and consistently maintains the physician’s prescribed stimulation that is tailored to a patient’s needs. Specialized circuitry and a proprietary algorithm detect ECAPs (Evoked Compound Action Potentials), signals generated by the spinal cord in response to electrical stimuli. ECAPs are a direct measure of how much nerve tissue is activated in the spinal cord and can be used to inform real-time adjustments to stimulation. Inceptiv SCS senses the body’s response to stimulation† 50 times per second and instantly increases or decreases stimulation to maintain prescribed settings as determined by the physician.

The Inceptiv system delivers additional advantages beyond its closed-loop capability. Inceptiv offers unparalleled access to diagnostic imaging, with 1.5T and 3T full-body MRI access with no power or impedance restrictions.‡ It is the only FDA-approved closed-loop spinal cord stimulator that offers full-body 3T MRI access. Up to 84% of SCS-implanted patients are expected to need at least one MRI within five years of implant. It is the world’s smallest and thinnest fully implantable SCS device, designed for patient comfort. In addition, Inceptiv SCS allows the option of multiple types of waveforms, including Medtronic’s proprietary DTM SCS therapy, which demonstrated an 84% responder rate at 12 months in a large, multicenter randomized controlled trial (RCT). Patients with Inceptiv SCS can also access CareGuidePro, a mobile application and web portal that serves as a virtual guide throughout their Medtronic spinal cord stimulation therapy journey.

“A new era for spinal cord stimulation technology is beginning, and with Inceptiv SCS, Medtronic is at the forefront,” said David Carr, vice president and general manager, Pain Interventions within the Neuromodulation business, which is part of the Neuroscience Portfolio at Medtronic. “For patients dealing with chronic pain, every day is a struggle. They deserve personalized and effective relief, without compromising future access to MRI. They deserve the comfort that the smallest and thinnest device on the market can provide. We are proud to offer the most cutting-edge solution available today with Inceptiv SCS.”

Medtronic will initiate the U.S. market launch of Inceptiv in the coming weeks. The system previously earned approvals for sale in Europe and in Japan.

Read also: Medtronic inaugurates RnD center outside US in Hyderabad

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No approvals if failed to submit Self-Assessment forms, Compliance reports by April 30th: NMC issues warning to medical colleges

Noting that some of the medical colleges have not submitted the requisite documents within the prescribed timeline, the Medical Assessment and Rating Board (MARB) of the National Medical Commission (NMC) has warned that the Compliance report and the Self Assessment Forms (SAF) for both MBBS and PG courses shall not be processed for the Academic Year 2024-2025 if they are received after 30th April 2024.

The Apex Medical Commission has warned all the medical colleges across the country that applications for UG and PG medical courses shall be liable to be disapproved without any further communication if the documents are received after 30.04.2024.
For more information click on the link below:
No Approvals If Failed To Submit Self-Assessment Forms, Compliance Reports By April 30th: NMC Warns Medical Colleges

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Health Bulletin 27/ April/ 2024

Here are the top heath stories for the day:

NMC initiates online survey on mental health, medical colleges told to submit response by 3rd May, 2024
The National Task Force, constituted by the National Medical Commission (NMC) is conducting an online survey on the mental health and well-being of medical students.
Through a recent notice, the Apex Medical Commission has shared a link to the Google form in this regard and asked all medical students and faculties of medical colleges to submit their responses by 3rd May 2024.
For more information, click on the link below:
NMC Initiates Online Survey On Mental Health, Seeks Response From MBBS, PG Medicos, Faculties

Bengaluru Radiologist assaulted, robbed of Rs 50 lakh gold, cash at gunpoint
A radiologist’s house in the city became the scene of a major money heist after three miscreants entered his house, assaulted him, threatened him at gunpoint and robbed 500 grams of gold ornaments worth Rs 30 lakh, Rs 20 lakh in cash, and six wristwatches.
In response to the robbery, the police registered a case against the three individuals under relevant sections of the Indian Penal Code (IPC). They suspect the miscreants to be gangsters from Uttar Pradesh who planned the robbery meticulously after observing the doctor’s family members’ routines. Consequently, they formed a special investigation team to catch the culprits.
For more information, click on the link below:

Rise in diabetics forced to go for amputations due to foot ulcers: CMC Vellore Study
A recent study conducted by the Christian Medical College, Vellore, has uncovered a concerning trend among diabetes patients in India: a rising number of toe and foot amputations due to diabetes-related sores. Published in the peer-reviewed journal Science Direct, the study reveals that the risk of subsequent amputations triples after the first procedure, underscoring the severity of the issue.
In India, diabetic foot ulcers (DFU) tend to present as larger wounds compared to global standards, leading to higher rates of amputation. The study, led by the Department of Endocrinology, Diabetes, and Metabolism at Christian Medical College, Vellore, found that over a 10-year period, mortality rates among patients with DFU range between 25% and 30%, with heart-related issues and sepsis infections being the primary causes of death.
NCDRC slaps Rs 25 lakh compensation on Safdarjung hospital, 2 cardiologists
The National Consumer Disputes Redressal Commission (NCDRC) recently upheld the Delhi State Consumer Court’s order to hold Safdarjung Hospital and its two Cardiologists liable for medical negligence and directed them to pay Rs 25 lakh compensation to the wife of the patient, who died during the treatment.
In its order, the NCDRC held, “the standard of care and medical protocol required the administering of Inj. Nirmin which was not available in the Hospital. The State Commission’s finding that this amounted to negligence is based on its view that an essential injection such as this was to have been available in a hospital such as the appellant hospital. There is no evidence led to prove that the alternative of Inj. Albumin was the alternative prescribed under the protocol for treatment. No medical records as mandated under the Medical Council of India Regulations (MCI) 2002 were also made available.”
For more information, click on the link below:

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NEET 2024 applications: NTA provides one-time opportunity to upload correct photograph

Observing that the photos uploaded by some candidates during the registration for the NEET-UG 2024 examination are not as per the prescribed standards format or required specifications, the National Testing Agency (NTA) has given one-time opportunity to candidates to upload the correct photograph.

Through the notice, the National Testing Agency (NTA) has given strict instructions to the candidates to update their correct photograph during the photo update window in the next few days to avoid withholding of the issuance of admit card.
For more information, click on the link below:

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NBE unveils Credential Verification Online Portal

To submit the requests for verification of credentials issued by the National Board of Examinations in Medical Sciences (NBEMS), the NBEMS has introduced a Credential Verification Online Portal (CVOP). The portal can be accessed through the official website of NBEMS under the “Digital Services” tab.

This portal allows the organisations (Employer/ Public Authority/ Credential Verification Agency) to submit the credential verification requests to NBEMS online as well as the agency to track their submitted requests.
For more information click on the link below:

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NHRC highlights rights of patients and doctors, raises concern on violence against medical professionals

New Delhi: The National Human Rights Commission (NHRC), India organized a meeting of the Core Group on Health and Mental Health issues.

The aim of the meeting was to deliberate upon the rights of patients and doctors. The meeting was held in hybrid mode, chaired by Justice Shri Arun Mishra, Hon’ble Chairperson, NHRC, in the presence of Shri Rajiv Jain, Member, NHRC, Shri Bharat Lal, Secretary General, Shri Ajay Bhatnagar, Director General (Investigation), Shri Devendra Kumar Nim, Joint Secretary and other officers of the NHRC. 

The meeting was attended by the members of the Core Group, representatives from the Government, including the Ministry of Health and Family Welfare, and DGHS; National Medical Commission; Indian Medical Association; eminent doctors and domain experts from the field; academicians; and Resident Doctors’ Associations.

The meeting was held in four technical sessions, including the issuance of bonds in medical colleges, the issues related to disbursal of stipend to doctors, the rights of the patients and the rights of the doctors.

Also Read:NHRC notices to Delhi Chief Secretary, DCGI and Police Commissioner after epilepsy drug Sodium Valproate fails quality test

In his inaugural address, NHRC Chairperson, Justice Arun Mishra highlighted that the rights of doctors and the rights of patients are like the two pillars that hold our healthcare system. He emphasised on various challenges faced by both patients and the doctors in our country, focusing on the enormous work pressure on the doctors, lack of basic facilities for the doctors in hospitals, and issues related to cases of alleged medical negligence against doctors.

While talking about the rights of the patients, Justice Mishra shared from his visits to mental health institutes last year, the undignified conditions in which the patients were living, lack of sanitation and hygiene, and practice of keeping the patients in hospitals even after their recovery. With regard to the cases of medical negligence, Justice Mishra stated that while we want to make the doctors feel guilty for any negligence, we fail to understand the pressure and burden placed upon them.

Justice Mishra underscored that all of these issues are not issues of individuals, but signifies a systemic issue. He acknowledged that the healthcare system is overburdened, but also said that there is a strong need to implement the existing laws and schemes for the welfare of all, especially the Ayushman Bharat scheme, which has the potential to be a great success if implemented properly and fully.

He mentioned about the unfortunate phenomenon, where top Indian doctors were willing to practice in foreign countries, serving at the rural level, but in India they don’t want to serve in remote areas for even 2-3 years. Therefore, there was a necessity of bonds, upheld by the Hon’ble SC; however, according to Justice Mishra, the bond system shouldn’t be exploitative and should be reformed reasonably to enforce the purpose behind it. He did acknowledge that while health is a state subject, there could be some standard guidelines that may be prescribed for the bond system with the help of all stakeholders.

There are multiple social welfare schemes and provisions facilitated by the government, but are we able to transfer the benefits of these schemes directly to the needy, questioned Justice Mishra. He concluded his address reflecting hope that all the stakeholders must work untiringly and must implement all the schemes in the right direction for the welfare for people, especially, the marginalised.

Shri Rajiv Jain, Member, NHRC in his address briefed about the rights of patients and the doctors. He emphasised on the issue of bonds in medical colleges and disbursal of stipend to doctors. While quoting the landmark judgment of Jacob Mathew v. State of Punjab, he emphasised that there is a need for the NMC and the government to form guidelines with regard to cases of medical negligence. Furthermore, a large number of states still lack Medical Boards that are tasked with reviewing complaints of alleged medical negligence, which must be addressed on priority.

Highlighting a few challenges, Shri Jain gave the example of categorisation of medical establishments to highlight that most of the provisions of the CEA have not been legally implemented. Similarly there are other significant provisions that impact the rights of health of patients in the CEA, which need to be formally notified by the Ministry of Health & Family Welfare to enable its implementation. In cases of non payment of stipend, there are hundreds of cases received by the Commission. Shri Jain pointed out that the NMC in this issue says that the implementation of its regulations is for the “appropriate authority” in the state, while not defining who the appropriate authority is.

The Member also stressed on the working conditions of the doctors, calling attention to their long working hours and continuous shifts, lack of proper restrooms, hygiene, lack of rest etc. He reiterated that doctors have fundamental rights that are necessary for them to carry out their tasks in an efficient manner, just as patients have rights within the healthcare system.

He underlined that violence against doctors has an adverse impact on medical professionals. It can result in poor patient care in addition to stress, worry, or psychological damage. It is, therefore, crucial to address this issue by strengthening the legal framework, enhancing security measures, promoting communication and proper support system for doctors and all medical health professionals.

Shri Bharat Lal, Secretary General focused on the virtues of compassion and empathy towards all human beings, especially to the most vulnerable sections of the society. He mentioned that the cases of deaths by suicide amongst medical students is quite disturbing and require immediate attention. He said that we can’t afford half-measures and dithering as all inaction has consequences and end of the day someone is paying the price. Similarly, suffering of patients due to negligence is unacceptable.

Appreciating the government for having various schemes and making provisions for the welfare of the people, he highlighted that it is the duty of officers to implement them in full spirit. If not implemented fully, it contributes to many challenges that we are discussing today.

Talking about the Mental Healthcare Act, 2017, the Secretary General said that despite the best intentions of the government and the Parliament, the Act has not been fully implemented throughout the country which accentuates the existing challenges. He expressed his expectations from the meeting that the deliberations would result in specific and actionable recommendations, and also pave the way towards implementation in letter and true spirit, leading to the real change on ground.

Shri Ajay Bhatnagar mentioned that as a laudable practice, senior doctors are looking after their juniors, being their mentors and guiding their work, so that the young doctors have a sense of confidence, and have someone to approach. “A happy doctor is a good and efficient doctor”, Shri Bhatnagar said. If a doctor gets adequate rest, facilities and time to look after himself, his performance will definitely improve. He emphasized that the strength of any organisation comes from the organisational culture.

Shri Devendra Kumar Nim, Joint Secretary, gave an overview of the four sessions of the meeting, highlighting the significance of each topic and requested all the participants to share concrete and actionable recommendations that can be taken up by the Commission for further appropriate action.

Dr. B. N. Gangadhar, Chairman (Officiating), National Medical Commission provided his inputs throughout the technical sessions, on behalf of the NMC. One of the crucial points shared by him was that the NMC has constituted a committee under the chairmanship of Director, NIMHANS, Bangalore, to look into the matter of deaths by suicide and drop-outs of medical students. He also shared that they are now promoting yoga to deal with stress in doctors and medical students. He also focused on the issue of bond system, mental health of medical students, and mental health human resource in the country.

Other issues, such as female PG students not receiving benefits during their maternity leave; poor living and working circumstances; physical and biological risks in the workplace; psycho-social pressures; heavy workload; erratic work schedules, lone women doctor postings in distant buildings/ departments; unreliable pay schedules; lack of necessary facilities like proper washrooms, especially for women; and other professional stressors were also discussed during the meeting.

Other prominent speakers in the meeting included Shri Elangbam Robert Singh, Joint Secretary, Dept. of Health & Family Welfare, M/o HFW, GoI; Dr. Jitendra Prasad, Addl. DGHS, Directorate General of Health Services; Dr M C Misra, former Director, AIIMS; Prof. R K Dhamija, Director, IHBAS, Delhi; Dr Nimesh Desai, Senior Consultant Psychiatrist, Core Group Member; Dr Abhay Shukla, Public Health Specialist, Core Group Member; Dr Sunil Khatri, Advocate; Dr Shivkumar Utture, National Vice President, IMA; Dr Rajesh Sagar, Prof. of Psychiatry, AIIMS; Dr Aviral Mathur, President, Federation of Resident Doctors Association (FORDA); Dr Rohan Krishnan, National President, Federation of All India Medical Association (FAIMA); Dr Shankul Dwivedi, IMA Junior Doctors Network; Dr Rajeev Ranjan, co-founder, Aid for Mankind; and Dr Vivek Pandey, RTI activist.

Also Read:NHRC seeks report on medical negligence in MKCG Medical College Hospital

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Missing MBBS student found dead near railway track, batchmate arrested, Probe On

Muzaffarnagar: In a shocking incident, the body of a first-year MBBS student of Muzaffarnagar Medical College who went missing from the hostel was discovered dead lying near a railway track by police in Muzaffarnagar district of Uttar Pradesh on Thursday night.

Following the recovery of her dead body, the family members accused her male batchmate of abducting their daughter, killing her and then dumping her body near the railway track which is situated some distance away from her college premises.

Subsequently, the deceased medico’s father filed a complaint at the police station against the batchmate. Based on the complaint, the police arrested him under sections 302 (murder), 366 (kidnapping, abducting or inducing woman to compel her marriage, etc), 201 (causing disappearance of evidence of the offence, or giving false information, to screen offender) of the Indian Penal Code.

Also read- First-Year Nursing Student Of Saifai Medical College Murdered, 3 Arrested

According to the Chief Administrative Officer of Medical College Prasanjeet, the victim was found missing during the head counting of the students in the hostel which is done every day at 9:30 pm. After several failed attempts to find her, the hostel authorities informed the police who immediately reached the spot and began a search operation.

While searching for the student, the police found her body near a railway track at Begarazpur village under the Mansurpur police station, towards the back side of the hostel of Muzaffarnagar Medical College, reports PTI.

During the investigation, the police examined the CCTV footage and found that the student left the hostel with her batchmate on Friday evening. Upon questioning the accused, the student told the police that they went for a walk on the railway track when she suddenly fell and got hit by a goods train leading to her death, as reported by Aajtak. 

Meanwhile, the family members have alleged that the student had killed their daughter. Speaking to TOI, The deceased student’s father said, “My daughter was a diligent student residing in the girls’ hostel. We suspect her classmate lured her outside the college gate on Thursday evening, abducted her and then killed her, dumping her body near the railway track.”

According to media reports, the cause of her death remains unclear and the police have launched an in-depth investigation into the matter. 

Also read- Horror At Rama Medical College: Blood-Soaked Body Of 2nd Year MBBS Student Found In Basement After His Birthday Celebration

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Medical Bulletin 27/ April/ 2024

Here are the top medical news for the day:

Can cancer vaccine with immunotherapy shrink liver tumor?
According to a study published in the journal Nature Medicine, people with Hepatocellular Carcinoma treated with immunotherapy and a personalized anti-tumor vaccine were twice as likely to experience tumor shrinkage compared to those receiving immunotherapy only.
Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer and is a leading cause of cancer-related death worldwide. Despite recent advancements in systemic therapy for advanced HCC, the 5-year survival rate remains <10%. One of the newest treatment options for HCC is immunotherapy — a treatment using a person’s own immune system to fight the cancer. However, past studies show that only 15–20% of HCC diagnoses respond to immunotherapy and about 30% may be resistant.
In the study, researchers recruited 36 participants for the clinical trial. All participants received the combination of a personalized DNA vaccine, GNOS-PV02, and pembrolizumab.
At the end of the study, researchers found that almost one-third of participants experienced tumor shrinkage, which is about twice as many people seen in studies of immunotherapy alone for HCC. Additionally, about 8% of the study participants had no evidence of a tumor after receiving the combination treatment.
“The response rate on this study is high enough that I think it’s unlikely that the pembrolizumab alone did this and it supports the idea that the vaccine contributed to the efficacy observed. I think it’s also notable that the response rate was higher than pembrolizumab alone without a major increase in toxicity”
said Mark Yarchoan, lead study author.
Reference: Yarchoan, M., Gane, E.J., Marron, T.U. et al. Personalized neoantigen vaccine and pembrolizumab in advanced hepatocellular carcinoma: a phase 1/2 trial. Nat Med (2024). https://doi.org/10.1038/s41591-024-02894-y
Does healthy diet lower heart disease risk in breast cancer survivors?
A new study published in the journal JNCI Cancer Spectrum, published by Oxford University Press, discovered that following a healthy diet lowers the risk of cardiovascular disease in breast cancer survivors.
Cardiovascular disease is the leading cause of non-breast cancer-related mortality in women with breast cancer, who face a higher risk of cardiovascular issues compared to those without breast cancer. This increased risk is attributed to the cardiotoxic effects of breast cancer treatments and shared risk factors like aging, sedentary lifestyle, and smoking. Dietary recommendations for breast cancer survivors have been scarce, mainly relying on cancer prevention research until recent times.
In the study, researchers used data from the Pathways Study to investigate the link between diet quality and cardiovascular events in women diagnosed with invasive breast cancer. The study, comprising 3,415 participants, assessed diet quality based on the Dietary Approaches to Stop Hypertension (DASH) diet, which prioritizes fruits, vegetables, whole grains, lean protein, and low-fat dairy while limiting sodium, red meats, processed meats, and sugary beverages. Other diets, including a plant-based diet, the 2020 Healthy Eating Index, and the alternate Mediterranean diet, were also evaluated for their impact on heart health.
The results revealed that women with diets resembling the DASH diet at breast cancer diagnosis had significantly lower risks of heart failure, arrhythmia, cardiac arrest, valvular heart disease, and venous thromboembolic disease compared to those with diets less aligned with DASH. Higher intake of low-fat dairy was associated with reduced risk of cardiovascular disease-related death. Additionally, the impact of DASH on cardiovascular disease risk seemed to vary depending on the type of chemotherapy received.
“Our findings suggest that we need to begin talking to breast cancer survivors about the potential heart benefits of the DASH diet. We know that breast cancer survivors have an elevated risk for cardiovascular disease, and the diet might be able to help improve the overall health of this population”
said the paper’s lead author, Isaac J. Ergas.
Reference: Isaac J Ergas, PhD, MPH, MFA, et al,; Diet quality and cardiovascular disease risk among breast cancer survivors in the Pathways Study; JNCI Cancer Spectrum; https://doi.org/10.1093/jncics/pkae013
Study finds higher risk of immune issues in children of HIV-positive mothers
In a study published in the journal Nature Communications, researchers from Queen Mary University of London have found that children of women with HIV infection have an increased risk of immune abnormalities following exposure to maternal HIV viremia, immune dysfunction, and co-infections during pregnancy.
The study compared clinical outcomes between infants who were HIV-exposed and HIV-unexposed in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial. Despite high coverage of maternal antiretroviral therapy (ART) and uptake of exclusive breastfeeding, mortality in infants exposed to HIV was 41% higher than in infants not exposed to HIV. Infants who survived and remained HIV-free had impaired growth and development.
Analysis of blood samples from mothers and children in the trial revealed pathways contributing to higher infant mortality. Maternal systemic inflammation, measured by hiv,inflammation,infants,infant mortality,infections,crp,immune,pregnancyC-reactive protein (CRP), was linked to increased infant mortality, suggesting interventions targeting maternal inflammation could reduce it. HIV-exposed babies, especially boys, showed altered immune development, potentially affecting their ability to fight infections.
“Collectively, these findings show how the disrupted immune system of women with HIV in pregnancy – characterized by inflammation, immune dysfunction, and co-infections – shapes immune development in their offspring. Inflammation, as indicated by CRP, is inexpensive and simple to measure, offering the immediate opportunity for point-of-care testing to be used to identify those most at risk of infant mortality, with more support provided for high-risk pregnancies”
said Dr. Ceri Evans, NIHR Clinical Lecturer in Paediatric Infectious Diseases.
Reference: Evans, C., et al. (2024). Inflammation and cytomegalovirus viremia during pregnancy drive sex-differentiated differences in mortality and immune development in HIV-exposed infants. Nature Communications. doi.org/10.1038/s41467-023-44166-2.

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Bengaluru Nephrologist saves woman with CPR who suffers cardiac arrest at polling booth

Bengaluru: A heroic move and prompt action of a Bengaluru-based nephrologist and transplant physician Dr Ganesh Srinivasa Prasad saved the life of a woman who collapsed while standing in a queue at a polling booth on Friday.  

Dr Ganesh like many other citizens, was waiting in line to cast his vote for the second phase of the Lok Sabha elections in Karnataka when he noticed the woman standing in front of him fell ill and fainted while taking water from a can at the booth.

Immediately addressing the situation, the doctor wasted no time and performed cardiopulmonary resuscitation (CPR) on the woman who had suffered a cardiac arrest following which she regained a pulse and spontaneous circulation began within minutes.

Also read- NHS doctor saves woman’s life mid-air using Apple Watch

Dr Ganesh works as a nephrologist at Narayana Health Centre in Bommasandra after completing his MBBS in Andhra Pradesh and Doctorate in National Board (DrNB) Nephrology from Narayana Health Centre.

The incident gained widespread attention after Dr Ganesh posted it on the social media platform ‘X’. Sharing a video and photos of the incident, he said “As I was waiting in queue….one lady had syncope and cardiac arrest in front of me. There was no pulse and I started immediate CPR … luckily she got ROSC within minutes”

In the video, the woman could be seen regaining consciousness and others assisting her onto a stretcher. The post received praise from the netizens who expressed their gratitude to the doctor for his prompt action in saving the woman’s life.

Speaking to TNIE, Dr Ganesh said, “I checked her pulse but did not feel it. She was gasping for breath and I immediately resorted to CPR till her condition improved. She would have lost her life had there been a delay in attending to her.”

Further, he said, “Vasovagal Syncope could have triggered the cardiac arrest. Her heart had stopped beating when I checked. Many factors, including anxiety, heat stroke or even fear when injections are given can cause the condition.”

Also read- Doctor saves breathless man’s life on Akasa flight

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NMC Initiates Online Survey on Mental Health, seeks response from MBBS, PG medicos, Faculties

New Delhi: The National Task Force, constituted by the National Medical Commission (NMC) is conducting an online survey on the mental health and well-being of medical students.

Through a recent notice, the Apex Medical Commission has shared a link to the Google form in this regard and asked all medical students and faculties of medical colleges to submit their responses by 3rd May 2024.

“Anti Ragging cell in NMC has constituted a National Task Force on Mental Health and Wellbeing of Medical Students. Task Force has decided to conduct an online survey of medical students as well as the faculty in medical colleges. A google form for this purpose has been prepared which may be accessed from the link (mentioned in the notice),” NMC stated in the public notice.

“All the medical students and faculties of the medical college are requested to kindly submit their responses by 3 rd May 2024,” the Commission added.

NMC has assured the participants that their identities will be kept confidential and will only be used by the Task Force for the purpose of analysis and recommendations.

“Identity of the participants will be kept confidential and will not be shared with anyone. It will be used by the Task Force only for the purpose of analysis and recommendations in its report,” the NMC notice said.

Similarly, the Google form also clarified that the data collected from this survey will be used for research and analysis and individual responses will not be shared publicly. Regarding Data Security, the form mentioned that even though appropriate measures have been taken to ensure the security of the data, no method of transmission over the internet or electronic storage is 100% secure.

The participants will have to submit personal data including their name, age, gender, email ID, medical college name, etc. As per the survey details, the participants can be either UG/PG students or medical college faculty or administrator. They will also have to choose whether they would like to talk on call after submitting the responses for the purpose of giving suggestions or any other discussion. If yes, the participants will also have to provide their mobile number.

Details to be Filled by MBBS Students: 

MBBS Students will have to submit details such as their year of study, they will have to submit if their medical college is located in their home State, their type of residence (parent’s place/relatives/hostel/own apartment or shared accommodation etc). Details about their total family income per annum, their family structure, number of siblings, the place where they completed majority of their school education (rural/urban/semi-urban), medium of language in school are also required.

MBBS students have also been asked to rate the overall supportiveness of their family environment, academic pressure from family, financial strain in the family, rate the conflict or lack of harmony, overall academic workload, etc. They will also have to submit details regarding the total hours spent on study and attending classes (outside personal study), details about how often they feel overwhelmed/burdened by academic demands.

They will have to give their opinions on subjects like exams adequately assessing their knowledge and skill, fear of failure negatively impacting their academic performance, the pressure on students to achieve top grades, balancing academic workload with personal life and well-being. Further, they will have to inform if factors like- volumes of coursework, difficulty of study material, frequency of exams contribute to their stress. They will also have to submit if fear of failure leads to procrastination/excessive perfectionism/skipping classes/using unhealthy study aids such as caffeine or stimulants/cheating or academic dishonesty/thoughts of self-harm/substance use/considering leaving the medical course etc.

Apart from this, the UG medical students have also been asked to rate the overall condition of hostel facilities, provide details if the hostel rooms have adequate privacy and personal space, rate the quality/variety of food served in mess/cafeteria, rate their experience with the availability of resources in the college library. They have also been asked to submit details regarding ragging in the medical college, inform if adequate measures have been taken to prevent and address ragging, etc.

The students will also have to provide details about the stress level experienced by them due to tuition/living costs etc, details of educational loan and the pressure of repayment, details of number of family members financially dependent on them, their opinion on seat leaving bond, their thoughts about leaving the MBBS course etc.

Details regarding relationship and social support have also been sought and the students have been asked to provide details if they have any difficulties in romantic/family/friends/roommates/classmates relationships, rate the emotional support received from family and friends. The students have been also asked if they feel lonely or isolated, if they find it difficult to make friends or or maintain social connections at medical college, if they have anyone to discuss personal difficulties, they have been told to submit details of when they feel most socially isolated, and they have also been asked to give their suggestions to reduce feelings of social isolation among medical students.

NMC has also sought details of the mental health history and stigma of UG medical students. The students have been asked to inform if they were ever diagnosed with mental health conditions such as depression, anxiety, bipolar disorder etc., if they ever experienced thoughts of self-harm or suicide, their opinion regarding seeking help from mental health professionals, etc. They are asked the support they receive from friends, family and faculty/mentors, and how comfortable seeking support from parents/family/friends/peers/factulty/mentors, the students have been asked if their medical college has a formal mentor-mentee programme, effectiveness of the mentor-mentee relationship, etc.

The students have also been asked to describe an instance when they felt particularly stressed or overwhelmed as a medical college student, and their opinion how their college could support them best.

Details Sought from PG Medical Students: 

PG medical students have been told to submit details of their department, year of study, marital status, total family income etc. They have been told to rate their experience with the overall facilities provided by the college, cleanliness and variety of food items available in the cafeteria, opinion with the overall facilities available in the hostels, arrangements for students’ families to stay on the campus at the time of their visit, mechanism of interaction between student and hostel management, kind of interaction existing between student body and hostel management, etc.

They have been asked to submit their opinion on if the hostel environment affects their academic performance, if they want to suggest any change in the hostel management policy, if they feel stressed over PG seat leaving bond, if they feel stressed about rural service bond, if faculty/ college come to the college regularly and engage in teaching, with whom the students in the hostel encounter most problems frequently, if students in their institute face frequent problems over clinical or academic workload/thesis etc. 

The PG students have been asked to describe the current academic workload, if they get offs as per regulations, if they experience stress due to academic demands, support received from guide/teacher, they have been asked to give opinion on additional support from colleagues or faculty to improve academic experience. They have been also questioned if they were ever asked unreasonable favours in exchange for passing exams, how they cope with academic stress, if they share academic or departmental challenges with their family, if they are concerned over the reaction by their family members with the problems faced by them.

Questions regarding peer relationships include, if relationship with peers contribute to their stress levels, if they need support from the authorities to resolve interpersonal relationship issues. The PG students have been asked to rate how the experiences of ragging or bullying by senior students affected them, their awareness of the anti-ragging measures, they have also been asked to give their opinions on support systems to address bullying, they have been told to inform if they face harassment from seniors in clinical settings, harassment from faculty or residents regarding clinical work.

NMC also asked the PG students if their family issues ever affected their ability to focus on studies and clinical work, if they need held managing stress related to family, they have been asked if family counselling on campus would be beneficial for them, how their marital or relationship status impacted their stress levels, if they faced challenges balancing their academic responsibilities with marital or relationship commitments and how they manage these demands, they were asked what kind of support they expect from the administration to help manage marital or relationship-related stress, if they ever felt pressured to use drugs or alcohol etc., how they perceive the relationship between stress and substance among peers.

The students also have to submit details regarding their workload, inform if it affects their mental well-being, submit what aspects of the workload they find most challenging, how they manage heavy workload, how they feel about the support received from seniors in clinical work, give their opinion if some PG students get more affect by clinical works than the others. Further, the PG students have to submit their suggestions to decrease the workload, inform about the challenges faced by them by thesis-related work, inform if the thesis guide ever tried to exploit them, if the thesis guide intentionally delayed the submission of thesis, how much stress they feel because of this, what kind of assistance they expect from administration regarding thesis work, if they easily get resources from the college library etc.

The Commission also asked PG students if they ever experienced thoughts of suicide in the past, if they ever attempted suicide in the past year, what reasons for suicide attempts, plans, and thoughts, if they suffered from any mental illness, if they felt comfortable seeking help within the hospital regarding mental health issues, they have also asked to submit their opinion on effective strategies for prevention of suicide.

Further, the students have to rate their overall stress level, inform about the self-care practices they found effective to cope with stress, instances when they felt overwhelmed with the workload, if financial concerns affect their stress and well-being, strategies used by them to cope with financial stress. The students have to inform NMC if they receive sufficient stipend and on regular basis, if their families are dependent on them, if they are aware of the PG regulations and anti-ragging regulations. They have to give their opinions on possible effective steps taken by medical college within first 6 months of PG medical admission to alleviate stress, they have to inform if they ever felt discrimination based on gender, ethnicity, caste, geography, language, etc.

Details Sought From Faculty/Administrator:
Faculties and Medical College Administrators have to submit information regarding their years of teaching/administrative experience, their highest qualification, speciality, number of MBBS students enrolled at their college in a year, total number of enrolled in MD/MS/MHA. They have to rate how approachable or accessible they consider their students, they have to submit their opinion if they think students should be given protected leisure time or leave periods to relax, their opinion on how stressful is their academic schedule/curriculum for the students, if they feel that sometimes faculties themselves are responsible for avoidable mental stress to students.
They have to give their opinion on whether they feel the faculties were responsible for avoidable mental stress to students, if they are aware of the counselling services/psychiatry/psychology services for students at their college, if they suggested any of these services to any of the students, how many students did they refer to the counselling service in the last 5 years.
NMC asked the faculties and administrators to submit their opinion on the possible measures to reduce mental stress of medical students, if they ever managed challenges in managing cases of depression among medical students, if they ever shared some examples of overcoming challenges with the students, if there is a clear system to address or tackle cases of depression among students in their colleges, how many extracurricular events, wellness workshops, or recreational activities did they help organise in the past two years, how many such events or workshops did they attend in the past 2 years.
They have been asked to give their opinion if they think that extracurricular events, wellness workshops, or recreational activities should be organized regularly at their college, if they ever had conversation with the students about mental wellness and stress, if they could express good ideas to improve wellness and learning experience of the students to the superiors, if there is any system at place to address discrimination/bias faced by students to their financial, social, cultural or academic background. They have been asked the measures adopted by them in the past 30 days to support mental health and well-being.
The faculties and administrators also have to rate the stress levels at their workplace, inform if they can impact mental well-being of their students, if they have support from superiors to initiate activities to promote mental wellness in the students, if they would ever volunteer to be a mentor under the mentor-mentee programme, how many students they could mentor. They have to give their opinion on the importance of hectic schedule and mental stress as a part of proper training of medical professionals, their opinions on the possible measures to help improve mental wellness in MBBS students and PG medical students, they also have to give their opinion on the possible danger signs for mental wellness that may predate attempts to self-harm.

National Task Force: 

Medical Dialogues had earlier reported that recently taking cognizance of cases of depression and suicide by medical students, the Anti-Ragging Committee of NMC has set up a National Task Force to address the mental health of medicos.

Comprising of 15 members of the Apex Medical Commission, will study the existing literature and data on mental health and suicide of medical students, analyze factors contributing to these challenges, and propose evidence-based strategies for improving mental health and preparatory of suicides. The committee may also pay a visit to the colleges where incidents of suicides have been reported.

Issuing an order dated 21.02.2024, NMC announced that the National Task Force on Mental Health and Well-being of Medical Students will submit its final report by 31st May, 2024. During this period, the task force will submit its progress report to Anti Ragging Cell of NMC once in a month, NMC said.

To view the NMC notice, click on the link below:

https://medicaldialogues.in/pdf_upload/nmc-notice-on-mental-health-survey-237055.pdf

To access the Google form, click on the link below:

https://docs.google.com/forms/d/e/1FAIpQLSfEmhp3oEfRGUa6vQI7nw3ieSITguU1w4Qykylo-x8OBh_yMw/viewform

Also Read: 122 Suicides, 1270 Drop-Outs in Last 5 Years: NMC Constitutes National Task Force to address mental health concerns of medicos

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