INI CET July 2024 At NIMHANS, SCTIMST: Check seat matrix, fee details here

New Delhi- On its website, the AIIMS has released prospectus for INI CET July 2024 admissions at National Institute of Mental Health and Neuro Sciences (NIMHANS) and Shree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST).

In the 2  prospectus, the institutes have provided details on the fees, eligibility criteria, seat matrix and much more. The candidates can check out the same as mentioned below.

NIMHANS

ELIGIBILITY CRITERIA OF (NIMHANS) FOR MD, DM (3 & 6 YEARS), MCh (3 & 6 YEARS) COURSES

1 MBBS degree from a recognised University or from any other University recognised as equivalent thereto by NIMHANS and by the Medical Council of India/ National Medical Commission (NMC).

2 The candidate should have completed a compulsory rotation internship of one year after MBBS or its equivalent as recognized by NMC on or before 31st July 2024. A certificate to that effect has to be produced. The candidate should have permanent/provisional registration with the State Medical Council. Candidates who do not submit the Internship certificate on the day of admission to the course will not be admitted under any circumstance.

FEES STRUCTURE

S.NO

DETAILS

AMOUNT PER YEAR

COURSE WITH DURATION IN YEARS

MD Course

DM/M.Ch Courses

3 Years

6 Years

1

Eligibility fee

5,000

500

500

500

100

2

Registration fee

1,000

1,000

1,000

3

Tuition Fee

50,000

50,000

50,000

4

Laboratory fee

500

1,500

3,000

5

Gymkhana & Recreation Fee

250

750

1,500

6

Library fee

1,000

3,000

6,000

7

Caution Money & Hostel Deposit

5,000

5,000

5,000

8

Identification card fee

100

100

100

9

NHS card fee

100

100

100

10

Examination fee: Part I

4,500

4,500

4,500

11

Part II

6,500

6,500

6,500

12

Part III

12,500

12,500

13

Exit Examination Application fee

50

100

150

14

Marks Card fee

100

200

100

15

Total

73,250

90,950

FOREIGN NATIONALS (EXCEPT FROM SAARC COUNTRIES)

S.NO

NAME OF THE COURSE

TUITION FEE

REGISTRATION FEE

1

DM/M.Ch. ( 6 years duration) Courses

60,000

1,000

2

MD ( 3 years duration) Courses

50,000

1,000

SEAT MATRIX

The following seats are reserved for various ‘Domicile Categories’ in various courses:

Domicile reservation category

Karnataka Domicile

North Eastern States Domicile

MD in Psychiatry Course:

Session 1

04 seats under ‘Institute Stipendiary’ and 01 seat under ‘Sponsored Category’

03 Seats under ‘Institute Stipendiary Category’

SCTIMST

IMPORTANT DATES FOR ADMISSION IN (SCTIMST)

Admission Notification

As per schedule/important dates available in the Prospectus Part-A of the INIs for July 2024 session

Availability of online Application

Hall ticket download

Commencement of courses

1st July 2024

Director’s welcome address

06th July 2024

ELIGIBILITY CRITERIA OF (SCTIMST) FOR MD, MS, DM (6 YEARS), MCh (6 YEARS) & MDS COURSES

MBBS or equivalent degree from a recognised university. They should complete one year of compulsory internship from a medical college/institute on or before 31st July 2024. The candidate should have applied for and obtained registration with the State Medical Council before admission.

FEES STRUCTURE

S.NO

PARTICULARS

AMOUNT (INR)

1

Admission fee

2,000

2

Tuition Fee

63,000 (per year)

3

Caution Deposit (Refundable)

10,000

4

Examination Fee

10,000

5

Thesis Evaluation Fee

1500

6

Identity Card

220

7

Library

1,000

8

Student Welfare Fund

1,000

9

Certificates

1,000

10

Miscellaneous Fee

10,000

SEAT MATRIX

Program

Number of Seats

Duration (Years)

Qualifications required

General quota

Sponsored seats

MD in Transfusion Medicine

NIL

1

3

MBBS or equivalent degree from a recognised University

To view the (SCTIMST) prospectus, click the link below

To view the (NIMHANS) prospectus, click the link below

https://medicaldialogues.in/pdf_upload/nimhans-prospectus-236014.pdf

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Choosing sugary drinks over fruit juice for toddlers may increase risk of adult obesity: Study

Consuming sugar-sweetened drinks in the first few years of childhood can be linked to poor diet patterns that increase the risk of obesity in later life, according to a new study by the School of Psychology at Swansea University.

Published in the European Journal of Clinical Nutrition, the study tracked the influence of diet on 14,000 British children from birth to adulthood and is believed to be the longest of its kind ever reported.

Using the Avon Longitudinal Study of Parents and Children, the research team found:

Children who drank fizzy drinks such as cola or sugar-sweetened fruit cordials before the age of two gained more weight when they were 24 years old. Girls who had pure fruit juice gained less weight, while the weight of boys remained the same.

At three years of age, toddlers who drank cola consumed more calories, fat, protein, and sugar but less fibre. In contrast, those given pure apple juice consumed less fat and sugar but higher amounts of fibre.

The study also highlighted corresponding differences in food choices. Children who consumed pure apple juice often followed a diet with more fish, fruit, green vegetables, and salad, whereas those drinking cola ate more burgers, sausages, pizza, french fries, meat, chocolate, and sweets.

Additionally, the team discovered a link between sugar-sweetened drinks and social deprivation, with children from affluent backgrounds more likely to have access to pure fruit juice.

Lead researcher Professor David Benton said: “The early diet establishes a food pattern that influences, throughout life, whether weight increases. The important challenge is to ensure that a child develops a good dietary habit: one that offers less fat and sugar, although pure fruit juice, one of your five a day, adds vitamin C, potassium, folate, and plant polyphenols.”

Dr Hayley Young added: “Obesity is a serious health concern, one that increases the risk of many other conditions. Our study shows that the dietary causes of adult obesity begin in early childhood and that if we are to control it, more attention needs to be given to our diet in the first years of life.”

References: Benton, D., Young, H.A. Early exposure to sugar sweetened beverages or fruit juice differentially influences adult adiposity. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01430-y

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Submit analysis of clinical data of Asian, Indian Population: CDSCO Panel Tells AstraZeneca on Durvalumab

New Delhi: In response to the drug major AstraZeneca’s proposal for the approval of additional indication of Durvalumab 120 mg/2.4 mL and 500 mg/10 mL solution, the Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) has opined the firm to submit the subset analysis of the clinical data of Asian population and Indian population of Global clinical study(AEGEAN) conducted in the proposed indication.

In addition to the above, the expert panel stated to submit the results of the ongoing Phase IV clinical study and the status of regulatory approval of the proposed indication of Durvalumab 120 mg/2.4 mL and 500 mg/10 mL solution.

This came after the drug major AstraZeneca presented the proposal for approval of additional indication i.e.,“Durvalumab (IMFINZI) in combination with chemotherapy as neoadjuvant treatment, followed by IMFINZI as monotherapy after surgery, is indicated for the treatment of patients with resectable (tumours ≥ 4 cm and/or node positive) NSCLC and no known epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangements” based on the global clinical trial conducted including subjects from India.

Durvalumab injection is in a class of medications called monoclonal antibodies. It works by helping the immune system to slow or stop the growth of cancer cells. Durvalumab is an anticancer antibody that works to promote the antitumor responses mediated by immune cells. By blocking the action of PD-L1, durvalumab exerts its anticancer effects by increasing T-cell activation and enhancing the detection and ablation of tumor cells.

Durvalumab is used alone or with other drugs to treat adults with certain types of biliary tract cancer (including bile duct cancer and gallbladder cancer), hepatocellular carcinoma (a type of liver cancer), non-small cell lung cancer, and small cell lung cancer.

At the recent SEC meeting for Oncology held on 19th and 20th March 2024, the expert panel reviewed the proposal presented by the drug major AstraZeneca for the approval of the additional indication of Durvalumab (IMFINZI) based on the global clinical trial conducted including subjects from India.

The committee noted that the proposed indication is not yet approved by any regulatory authorities. Furthermore, the expert panel found that phase IV study of the drug is ongoing in India for the approved indication i.e., locally advanced, unresectable non-small cell lung cancer (NSCLC) and urothelial cancer.

After detailed deliberation, the committee recommended the firm to submit

1)subset analysis of clinical data of the Asian population and Indian population of Global clinical study(AEGEAN) conducted in the proposed indication.

2) Results of ongoing Phase IV clinical study

3) Status of regulatory approval of the proposed indication for further evaluation.

Also Read:Eli Lilly Gets CDSCO Panel Nod To Market Mirikizumab for ulcerative colitis in adults

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Lupin Gets CDSCO Panel Nod to Study Glycopyrronium Bromide, Vilanterol Trifenatate powder for inhalation in capsule

New Delhi: Reviewing the Phase IV clinical trial protocol of Lupin’s pulmonary FDC (Fixed Dose Combination) Glycopyrronium Bromide plus Vilanterol Trifenatate powder for inhalation in capsule, the Subject Expert Committee (SEC) functioning under the Central Drugs Standard Control Organization (CDSCO) has approved the firm conduct the Phase IV clinical trial of the said combination.

This decision came after the firm presented the Phase IV clinical trial protocol before the committee.

Glycopyrronium is an anticholinergic agent used to treat hyperhidrosis, severe drooling, and COPD, as well as in combination with other medications for ulcer treatment and anesthesia.

Vilanterol trifenatate, a novel inhaled long-acting beta2 adrenoceptor agonist, is well tolerated in healthy subjects and demonstrates prolonged bronchodilation in subjects with asthma and COPD.

During the recent SEC meeting for Pulmonary held on March 5th, 2024, the expert panel reviewed the Phase IV clinical trial protocol of the pulmonary FDC Glycopyrronium Bromide eq. to 50mcg Glycopyrronium 63mcg + Vilanterol Trifenatate eq. to 25mcg Vilanterol 40mcg powder for inhalation in capsule.

After detailed deliberation, the committee recommended the conduct of the Phase IV clinical trial. Furthermore, the expert panel suggested that the firm is required to submit the Phase IV clinical trial report to CDSCO for further review by the committee.”

Also Read: CT waiver not considered, Conduct BA study: CDSCO Panel Tells Sun Pharma on Pulmonary FDC

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NMC specifies how many leaves medico can take while pursuing PG medical courses

The National Medical Commission (NMC) has recently specified how many leaves a medico can take while pursuing PG medical courses.

According to a recent NMC notification, PG medical students are allowed “weekly one-day off (subject to exigencies of work). In addition, they are eligible for twenty days of Paid Casual Leave. Five days of Academic Leave per year, if availed by a student will be counted as duty. Thus, a student is entitled to 52 weekly offs and 20 Paid Casual Leave per year.”
For more information, click on the link below:

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Health Bulletin 13/ April/ 2024

Here are the top medical news for the day:

Delhi government’s outdated essential medicines list has more drugs than national, WHO lists
The Essential Medicine List (EML) managed by the Delhi government comprises 806 drugs and 1,520 formulations, a figure comparable to the World Health Organisation’s list. However, it hasn’t been updated since 2016, leading to concerns over medicine shortages in government facilities. 

Delhi boy swallows ₹5-coin, doctor’s timely intervention saves his life

Amidst the hustle and bustle of Delhi’s Moolchand Hospital, a young boy’s life hung in the balance after he accidentally swallowed a five-rupee coin. Shubham Mishra, son of Umashankar Mishra, found himself in a precarious situation when the coin lodged itself in his throat, posing a potentially fatal risk. Despite the absence of symptoms, an X-ray revealed the alarming truth: a currency coin lay nestled within his stomach.

Swift action was imperative, and Dr. Rishi Raman, leading a dedicated team at Moolchand Hospital, stepped up to the challenge. With precision and expertise, they administered anesthesia and performed the delicate Roth net procedure to extract the coin, averting a tragedy that loomed dangerously close.
How to appoint HoDs in Central Govt hospitals, associated medical colleges?
The Union Ministry of Health and Family Welfare has recently notified the latest guidelines for appointing the Head of the Departments (HoDs) in three Central Government Hospitals and associated medical colleges.

Releasing an Office Memorandum (OM) on 28.03.2024, the Ministry notified about the rules regarding the composition of the Standing Selection Committee, and the tenure of the said Committee. Apart from this, the latest guidelines also include details about the process of selecting HoDs, eligibility criteria for applying to the posts of HoDs, qualifications and experience required to be eligible to apply, details of how to apply, selection of a panel of candidates by the committee, details of the panel, eligibility for consideration by the selection committee etc.

For more information, click on the link below:

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Kenya drug regulator recalls a batch of JnJ children cough syrup

Nairobi: Kenya’s drug regulator said on thursday it is recalling a batch of Johnson & Johnson children’s cough syrup, following Nigeria’s recall of the same batch of medication under the Benylin Paediatric brand.

Nigeria’s health regulator revealed that laboratory tests conducted on the syrup indicated a concerning level of diethylene glycol. This chemical has been associated with the deaths of numerous children in countries including Gambia, Uzbekistan, and Cameroon since 2022, marking one of the most severe episodes of poisoning linked to oral medication worldwide.

According to a Reuters report, the Pharmacy and Poisons Board (PPB) of Kenya stated in a statement that it had initiated investigations into the matter and recommended the suspension of sales for certain batches of the product, urging their return to suppliers.

Kenvue, the entity now in possession of the Benylin brand following its separation from J&J last year, responded by stating its engagement with Nigeria’s health regulator and undertaking its own evaluation to authenticate the sampled product, assess testing procedures, and review results.

“We take this matter very seriously and are acting with urgency to conduct a thorough safety and quality assessment,” Kenvue said in a statement.

The batch under recall, manufactured by J&J in South Africa in May 2021 and bearing an expiration date of April 2024, was identified by the PPB as the subject of concern.

Read also: USFDA approves Carvykti for patients with Relapsed or Refractory Multiple Myeloma who have received at least one prior line of therapy

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Pune Cardiologist Dr Manuel Durairaj passes away

Pune: Dr Manuel Durairaj, an illustrious figure in the realm of cardiology, breathed his last, leaving behind an indelible legacy of excellence in clinical practice, research and academia. Throughout his illustrious career, Dr Durairaj earned global acclaim for his profound expertise and unwavering dedication to advancing the field of cardiology.

A distinguished alumnus of Armed Forces Medical College, Dr Durairaj a Gold Medalist, completed his DM Cardiology in 1974 at CMC Vellore. Following his academic pursuits, he embarked on a remarkable journey in the Army Medical Corp, retiring with the esteemed rank of Lieutenant Colonel. His tenure in the armed forces was marked by exemplary service and a commitment to upholding the highest standards of medical care.  

According to Pune Mirror, Dr Durairaj’s professional journey took him to prestigious institutions, including CMC Vellore and Poona University, where he played a pivotal role in establishing the DM Cardiology programme. His visionary leadership as Head of Cardiology at MH (CTC), Lullanagar, laid the foundation for groundbreaking advancements in cardiac care. In 1988, Dr Durairaj embarked on a new chapter in his career by founding the Marian Cardiac Centre and Research Foundation, a beacon of hope for countless individuals grappling with cardiac ailments.

His tenure as Professor and inaugural Chairman of the Academic Department of Cardiology at the Grant Medical Foundation in Pune exemplified his unwavering commitment to nurturing the next generation of medical professionals.

A luminary in his field, Dr Durairaj’s influence extended far beyond the realms of academia and clinical practice. His transformative work in cardiology revolutionized treatment modalities, saving countless lives and setting new benchmarks for excellence in healthcare delivery. His compassionate approach endeared him to patients from diverse corners of the globe, with many seeking his expertise from the Middle East, United States, West Indies, West Africa, and beyond.

Beyond his professional achievements, Dr Durairaj’s altruistic spirit and unwavering commitment to serving humanity were evident in his tireless efforts to provide care and support to the less fortunate. Dr Durairaj’s passing leaves a void in the medical fraternity, but his legacy of compassion, dedication, and excellence will continue to inspire generations to come. He is survived by his beloved wife, Mrs Valsamma, children Mrs Manju Durairaj Schwister and Dr Manoj Durairaj, along with grandchildren Joseph-Durai, James, and Maria.

A solemn church service will be held on April 12 at 4:30 pm at St. Patrick’s Cathedral, Pune, Prince of Wales Drive, followed by interment at Sepulchre Cemetery, Hadapsar. As the medical community mourns the loss of a stalwart, Dr Manuel Durairaj’s enduring impact on healthcare and humanity will be cherished and commemorated by all whose lives he touched, reports the Daily. 

Also Read: Renowned plastic surgeon Dr Sam Chandra Bose passes away at 95

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Medical Bulletin 13/ April/ 2024

Here are the top medical news for the day:

Does replacing beef with fish like sardines prevent early death?

According to a study published in the journal BMJ Global Health, replacing red meat with forage fish could prevent up to 750,000 deaths and lower disability linked to diet-related diseases.
Considerable evidence has shown that red meat, especially processed red meat, is associated with increased risks of non-communicable diseases (NCDs) in humans. NCDs accounted for approximately 70% of all deaths globally in 2019. Previous studies have shown that seafood not only provides higher concentrations of essential nutrients than terrestrial animal-source foods but also prevents diet-related NCDs, as it is rich in omega-3 long-chain polyunsaturated fatty acids.
In the study, researchers based their study on datasets of red meat projections in 2050 for 137 countries and forage fish catches. They replaced the red meat consumption in each country with forage fish (from marine habitats), without exceeding the potential supply of forage fish and further used a comparative risk assessment framework to investigate how such substitutions could reduce the global burden of diet-related NCDs in adults.
The results showed that forage fish may replace only a fraction (approximately 8%) of the world’s red meat due to its limited supply. Such a substitution could avoid 0.5–0.75 million deaths and 8–15 million disability-adjusted life years. Forage fish as an alternative to red meat could double (or more) the number of deaths that could be avoided by simply reducing red meat consumption.
“Forage fish provides essential nutrients such as omega-3 fatty acids which are known to reduce inflammation, blood pressure, low-density lipoprotein (LDL) cholesterol, and triglyceride levels,” said Thomas M. Holland, MD, physician-scientist at the RUSH Institute for Healthy Aging, Rush University System for Health.
“Beyond their fatty acid profile, these small fish are rich in other health-promoting essential nutrients, too, including vitamins D and B12, and minerals such as calcium, iron, and zinc,” concluded Eliza Whitaker, MS, RDN, a registered dietitian and medical nutrition advisor at Dietitian Insights.
Reference: Xia S, Takakura J, Tsuchiya K, et al; Unlocking the potential of forage fish to reduce the global burden of disease; BMJ Global Health; 2024;9:e013511.
Is there a difference in gut microbiome of prediabetic patients?
A recent study published in the journal Nutrients compares the composition of the gut microbiome in prediabetic patients and healthy individuals.
Prediabetes is defined as glycated hemoglobin levels between 5.7-6.5% and fasting blood glucose levels between 100-126 mg/dL which significantly increases the mortality risks and burden on the healthcare system.
The gut microbiome regulates lipid and glucose metabolism, but its dysbiosis leads to diseases. It’s linked to increased gut permeability and systemic inflammation, contributing to metabolic syndrome and diseases like type 2 diabetes. Diet, drugs, and age alter gut microbiota. Few studies have examined gut bacteria in prediabetic patients and its impact on their health mechanisms.
The study compared gut microbial composition between prediabetic patients and healthy individuals. The impact of diet on the gut microbiome of prediabetic patients was also assessed to identify nutrition-based interventions that could potentially prevent the progression of prediabetes to diabetes. A total of 57 study participants were recruited from a Hospital in Taiwan. Gut microbiota data of 60 healthy individuals between 18 and 65 years were obtained from biobanks and used as the reference group. Participants were advised to keep a three-day food record and collect fecal samples on the third day. The nutrient composition of the participants’ diet was measured.
The results showed that the composition, diversity, and abundance of the gut microbiota were significantly reduced in prediabetic patients compared to healthy individuals. Differential gut microbial composition and abundance were observed in prediabetic patients compared to healthy controls. This difference is also associated with altered metabolic and physiological responses.
These findings suggest that improving the gut microbiome could prevent the onset of diabetes by maintaining normal physiological metabolism.
Reference: Chang, W., Chen, Y., Tseng, H., et al. (2024). Gut Microbiota in Patients with Prediabetes. Nutrients 16(8); 1105. doi:10.3390/nu16081105
Is hypertensive disorder linked to cardiovascular death risk in pregnant women?
In a study published in the journal Paediatric and Perinatal Epidemiology, researchers from Rutgers Health found that hypertensive disorders in pregnancy are strongly associated with fatal cardiovascular disease for up to a year after birth.
Among the hypertensive disorders that cause dangerously high blood pressure during pregnancy — chronic hypertension, gestational hypertension, preeclampsia without severe features, preeclampsia with severe features, superimposed preeclampsia and eclampsia — all but gestational diabetes were associated with a doubling in the risk of fatal cardiovascular disease compared to women with normal blood pressure. Eclampsia, a condition whereby hypertensive disorders cause seizures, is associated with a nearly 58-fold increase in fatal cardiovascular disease.
“Maternal and postpartum mortality rates in the U.S. are higher than in other high-income countries and rising, but more than half of cardiovascular disease-related deaths are preventable. This study provides new information about how each hypertensive disorder is related to fatal cardiovascular disease, so healthcare providers can monitor patients with such complications more closely and develop strategies for keeping them healthy postpartum,” said lead author Rachel Lee, a data analyst at Rutgers Robert Wood Johnson Medical School.
In the study, researchers used the Nationwide Readmissions Database to examine pregnancy-related mortality rates for females 15 to 54 years old from 2010 to 2018. Data from more than 33 million delivery hospitalizations identified hypertensive disorders in 11 percent of patients, although the number increased with time. In 2010, 9.4 percent of patients in the study had hypertensive disorders of pregnancy. By 2018, that figure had risen by more than half to 14.4 percent.
“Cases of chronic hypertension are rising sharply among people of childbearing age, but optimal treatment strategies remain uncertain. While we’re treating more pregnant people with mild hypertension with antihypertensive medications, there remain many questions about the right definitions of hypertension in pregnant compared to non-pregnant individuals,” said Lee.
“Pregnant people with hypertensive disorders, especially those with pre-existing hypertension, need high-quality care as heart disease and related cardiac symptoms can be confused with common symptoms of normal pregnancy. Delays in diagnosis are associated with an increased incidence of preventable complications. Early identification and optimal treatment of hypertensive disorders, especially preeclampsia-eclampsia, are crucial for the primary prevention of maternal stroke,” concluded the study authors.
Reference: Rachel Lee, Justin S. Brandt, K. S. Joseph, Cande V. Ananth Pregnancy-associated mortality due to cardiovascular disease: Impact of hypertensive disorders of pregnancy; Journal: Paediatric and Perinatal Epidemiology; https://doi.org/10.1111/ppe.13055

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Mumbai: Depressed over low marks, 2nd-year MBBS student commits suicide

Mumbai: Depressed over scoring low marks in exams, a second-year MBBS student allegedly ended his life after hanging himself from the ceiling fan at his residence on Friday in the northern Mumbai suburb of Kandivali. 

According to the police. the 22-year-old student from Vilasrao Deshmukh College in Latur reportedly lost all hope in life after receiving his exam results on Friday. This further intensified his feelings of frustration and depression, as he once again scored low marks.

It was alleged that the deceased was taking medication for depression in the past few days leading up to his tragic decision. His family members are said to have known about his worries regarding his poor exam results.

Also read- Depressed Over Low Marks In Prep Test, NEET Aspirant Commits Suicide In UP’s Etah

The student was found hanging in the hall of his house when his mother was in another room and his father was out for work. Staying at home for the last two months, he allegedly committed suicide on Friday at around 11:30 am. 

As per a Free Press Journal news report, the incident occurred when his mother was busy in the kitchen unaware of what had happened with his son. However, she was shocked soon after he came into the hall and discovered her son’s body hanging from the ceiling fan with a scarf.

Following this, he was immediately rushed to Shatabdi Hospital where the doctors declared him dead. 

“His mother spotted him hanging and alerted her husband and neighbours. He was rushed to hospital where doctors declared him dead on arrival. The family has told us they do not have complaints against anybody in connection with the incident,” the official informed PTI.

Anand Bhoite, Deputy Commissioner of Police (Zone-11), told the daily, “No suicide note was found at the home. The body has been sent for postmortem and the report is awaited.” 

The police have registered an accidental death case in this regard and an investigation is underway. Moreover, they have recorded statements from his relatives, who said that the deceased interacted with them normally when they visited his house.

Also read- Depressed Over Obesity, MBBS Student Commits Suicide In Mangaluru

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