Adults in small towns face higher impact of diabetes complications: Study

A comprehensive study highlighted the significant disparities in the health outcomes of diabetes patients across the United States by focusing the impact of living in rural areas versus urban centers. The key findings of the study were published in the Diabetes Care journal.

This study utilized data from the OptumLabs Data Warehouse which included a deidentified dataset of U.S. commercial and Medicare Advantage beneficiaries to illuminate the relative dangers of diabetes complications along the rural-urban continuum. The retrospective cohort study followed a total of 2,901,563 adults who were diagnosed with diabetes from January 2012 to December 2021 to understand how geographic location affects the prevalence of both acute and chronic complications associated with the condition. This research by Kyle Steiger and team classified the areas into three categories based on population size; the cities (population over 50,000), small towns (population 2,500–50,000) and remote areas (population under 2,500).

The findings from the study indicate that residents of small towns are at a significantly higher risk of undergoing the wide range of diabetes complications when compared to their urban counterparts. The adjusted hazard ratios (HRs) for residents of small towns showed increased risks of hyperglycemia, hypoglycemia, end-stage kidney disease, myocardial infarction, heart failure, amputation, other lower-extremity complications and revascularization. Also, these individuals had a slightly reduced risk of stroke.

There was a marked higher risk of myocardial infarction and revascularization in the remote areas and the residents experienced lower risks of hyperglycemia and stroke when compared to city dwellers. Also, when comparing remote areas to small towns, the data suggested lower hazards for hyperglycemia, hypoglycemia and heart failure among the former. The study found no significant geographical variation in the risks of developing retinopathy and atrial fibrillation/flutter that suggests some complications of diabetes are uniformly distributed regardless of residential location.

The implications of these findings highlight a clear need for targeted healthcare policies and interventions that address the unique challenges underwent by diabetes patients living in small towns and remote areas. The outcomes behind the study call for further investigation into the underlying reasons for these geographic disparities, with the goal of developing more effective strategies to reduce the increased risks by these populations. Overall, this research underscores the importance of considering geographical context in the management and prevention of diabetes complications that urge healthcare providers and policymakers to adapt their approaches to the diverse needs of patients.

Source:

Steiger, K., Herrin, J., Swarna, K. S., Davis, E. M., & McCoy, R. G. (2024). Disparities in Acute and Chronic Complications of Diabetes Along the U.S. Rural-Urban Continuum. In Diabetes Care. American Diabetes Association. https://doi.org/10.2337/dc23-1552

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Higher readmission rates after PCI versus CABG for left main coronary artery disease: EXCEL trial

USA: Findings from a 5-year follow-up of the EXCEL trial revealed that surgery has the upper hand over angioplasty for revascularization for left main coronary disease concerning hospital readmission rates.

The study was published online in the Journal of the American College of Cardiology.

In the EXCEL trial, readmission during 5-year follow-up after revascularization for left main coronary artery disease (LMCAD) was common and more frequent after percutaneous coronary intervention (PCI) than coronary artery bypass grafting (CABG). Readmissions were tied to an increased risk of all-cause death, more so after PCI than with CABG.

“This thought-provoking analysis highlights the risks and implications of late readmissions after revascularization for unprotected left main coronary artery disease,” Wayne B. Batchelor and Abdulla A. Damluji from Inova Schar Heart and Vascular in Falls Church, Virginia, wrote in an accompanying editorial.

The frequency of and the relationship between hospital readmissions and outcomes following revascularization for left main coronary artery disease are unknown. Ioanna Kosmidou, from Cardiovascular Research Foundation in New York, New York, USA, and colleagues aimed to study the predictors, incidence, and clinical impact of readmissions following PCI and coronary artery bypass grafting for LMCAD.

In the EXCEL trial, 1,905 patients with LMCAD were randomized to percutaneous coronary intervention versus coronary artery bypass grafting.

The cumulative incidence of readmissions was analyzed with multivariable Anderson-Gill and joint frailty models to consider recurrent events and the competing risk of death. A time-adjusted Cox proportional hazards model determined the impact of readmission on subsequent mortality within 5-year follow-up.

The study led to the following findings:

  • Within 5 years, 1,868 readmissions occurred in 45.2% of hospital survivors (2.2 ± 1.9 per patient with readmission[s], range 1-16), approximately one-half for cardiovascular causes and one-half for noncardiovascular causes (49.6% and 50.4%, respectively).
  • One or more readmissions occurred in 48.6% of PCI patients versus 41.8% of CABG patients.
  • After multivariable adjustment, PCI remained an independent predictor of readmission (adjusted HR: 1.22), along with female sex, comorbidities, and the extent of CAD.
  • Readmission was independently associated with subsequent all-cause death, with interaction testing indicating a higher risk after PCI than CABG (adjusted HR: 5.72 vs adjusted HR: 2.72, respectively).

“PCI was an independent predictor of readmission and associated with a higher readmission rate than CABG,” the study authors concluded.

Reference:

DOI: https://www.jacc.org/doi/10.1016/j.jacc.2024.01.012

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Use of microneedles may promote diabetic wounds healing, suggests study

The global population of patients with diabetic wounds is expected to rise to between 9.1 million to 26.1 million by 2030. Diabetic wounds severely impact patients’ quality of life, both physically and mentally while also imposing a substantial economic burden on healthcare systems.

Current treatment methods for diabetic wounds include surgical debridement, negative pressure wound therapy, vascularized flaps and different types of local dressings. Among these dressings, commonly used options include gauze, metal ion dressings, hydrogel dressings and platelet-rich plasma dressings. However, traditional dressings have limited drug loading capacity and permeability, and are unable to deliver active medications to the deep wound bed.

In recent years, microneedles have become a research focus in wound management due to their advantages of high drug load/delivery capabilities, minimal invasiveness, convenience and strong adhesion. These attributes significantly reduce patient discomfort and improve compliance. Microneedles enhance the efficiency and permeability of transdermal drug delivery by penetrating the skin barrier and incorporating drugs, proteins, nanoparticles and other therapeutic agents, effectively transporting them to the wound bed.

At present, there is a lack of summary articles on the application of microneedles of different structures and materials to diabetic wounds. This also hampers the development of microneedle dressings related to diabetic wounds.

To that end, in a review published in the KeAi journal Chinese Journal of Plastic and Reconstructive Surgery, a group of researchers from China summarizes the materials of microneedles, techniques, structure, design, release mechanism, classification of delivered substances and their effects on different stages of wound healing.

“The structural composition and material selection of microneedles influence their efficacy in treating diabetic wounds,” explains corresponding author of the study, Youbai Chen, a professor in plastic and reconstructive surgery at the First Medical Center of Chinese PLA General Hospital in Beijing. “Microneedles can promote diabetic wound healing through several mechanisms, such as antibacterial, anti-inflammatory, antioxidant, hypoglycemic and angiogenic activities at different stages of the healing process.”

“In conclusion, microneedles are promising drug delivery systems for the treatment of diabetic wounds,” adds first author Chun Liang. “We hope that our summary will be enlightening and instructive for further research on microneedle dressings.”

Reference:

Chun Liang, Ren Wang, Tian He, Dongsheng Chen, Guangliang Zhang, Xiangye Yin, Hongyu Wang, Jiale Xie, Yujing Li, Youbai Chen, Revolutionizing diabetic wound healing: The power of microneedles, Chinese Journal of Plastic and Reconstructive Surgery, https://doi.org/10.1016/j.cjprs.2023.12.004.

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D-Limonene in cannabis may reduce tetrahydrocannabinol-induced anxiety, Study finds

A recent study published in the recent edition of Drug and Alcohol Dependence journal highlighted that d-limonene, a terpenoid found in cannabis, can reduce the anxiety-inducing effects of delta-9-tetrahydrocannabinol (THC), the primary psychoactive component of the plant. This finding challenges the existing understanding of the effects of cannabis and supports the entourage effect theory, which proposes that non-THC constituents of cannabis can significantly influence its overall impact.

This study was conducted with twenty healthy adult participants which assessed the interactions between vaporized THC and d-limonene through nine different sessions. The participants were exposed to varying doses of THC (15 mg and 30 mg), d-limonene (1 mg and 5 mg), combinations of THC and d-limonene or a placebo. An additional session with 30 mg THC and 15 mg d-limonene was conducted for a subset of twelve participants. The researchers meticulously evaluated the effects of these compounds on cognitive and psychomotor performance, vital signs, subjective drug experiences and plasma concentrations of THC and d-limonene.

The results found that while d-limonene alone did not produce significant pharmacodynamic outcomes when compared to the placebo, the combination with THC notably reduced the anxiety-related subjective effects. Also, the mixture of 30 mg THC and 15 mg d-limonene significantly reduced feelings of anxiety and paranoia when compared to the administration of 30 mg THC alone. This anxiolytic effect did not extend to other pharmacodynamic effects, and the presence of d-limonene did not alter the pharmacokinetics of THC, indicating a specific interaction mechanism that merits further investigation.

Overall, the findings of this research indicates that d-limonene could play a pivotal role to enhance the therapeutic applications of THC by reducing its anxiogenic side effects. The implications of these outcomes strongly suggest that the entourage effect through which the constituents of cannabis interact in complex ways, does hold a significant potential for developing more precise and effective cannabis-based treatments. Further research is imperative to explore the impact of d-limonene in oral dose formulations and to investigate how other terpenoids and cannabinoids found in the cannabis might interact with THC to influence its pharmacological effects. 

Source:

Spindle, T. R., Zamarripa, C. A., Russo, E., Pollak, L., Bigelow, G., Ward, A. M., Tompson, B., Sempio, C., Shokati, T., Klawitter, J., Christians, U., & Vandrey, R. (2024). Vaporized D-limonene selectively mitigates the acute anxiogenic effects of Δ9-tetrahydrocannabinol in healthy adults who intermittently use cannabis. In Drug and Alcohol Dependence (Vol. 257, p. 111267). Elsevier BV. https://doi.org/10.1016/j.drugalcdep.2024.111267

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CDSCO Panel grants Novo Nordisk’s Protocol Amendment Proposal For Antidiabetic Drug Semaglutide study

New Delhi: The Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) has approved the drug major Novo Nordisk’s Protocol Amendment proposal for the antidiabetic drug Semaglutide study.

This came after the drug maker Novo Nordisk presented protocol amendment version 5.0 dated 07 September 2023 protocol No: NN9924-4437.

This is a research study to compare a new medicine oral Semaglutide to a dummy medicine in children and teenagers with type 2 diabetes (PIONEER TEENS).

Semaglutide injection is in a class of medications called incretin mimetics. It works by helping the pancreas to release the right amount of insulin when blood sugar levels are high. Insulin helps move sugar from the blood into other body tissues where it is used for energy.

This study compares 2 medicines for type 2 diabetes: semaglutide (new medicine) and a dummy medicine (placebo). Semaglutide will be tested to see how well it works compared to the dummy medicine. The study will also test if semaglutide is safe for children and teenagers. Participants will either get semaglutide or the dummy medicine – which one is decided by chance. Participants will take 1 tablet of the study medicine every morning on an empty stomach. They have to wait 30 minutes before they eat, drink, or take any other medication by mouth. The study will last for about 1 year and 3 months (66 weeks). Participants will have 12 clinic visits and 8 phone calls with the study doctor. At all 12 clinic visits, participants will have blood samples taken. Participants will also be asked some questions.

Semaglutide improves the efficiency of incretin function by activating GLP-1 receptors. It acts by numerous mechanisms like augmented insulin secretion (glucose-dependent), inhibition of glucagon release, and suppressed hepatic gluconeogenesis; thereby reducing both fasting as well as postprandial glucose.

At the recent SEC meeting for Endocrinology and Metabolism held on 7th March 2024, the expert panel reviewed protocol amendment version 5.0 dated 07 September 2023 protocol No.: NN9924-4437.

After detailed deliberation, the committee recommended the approval of the protocol amendment as presented by the firm.

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

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Cipla Gets CDSCO Panel Nod To import, market Human Insulin inhalation powder with inhaler

New Delhi: Pharmaceutical major Cipla has got a go-ahead from the Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) to import and market Human insulin inhalation powder with inhaler [Technosphere insulin 4U/ 8U/ 12U] for the indication “to improve glycemic control in adult patients with diabetes mellitus”.

However, the nod is subject to the condition that the firm should conduct an active post-marketing surveillance study (PMS) in the country.

This came after the drug maker Cipla presented the results of Phase III clinical trial conducted in India for the drug product Human insulin inhalation powder with inhaler [Technosphere insulin 4U/ 8U/ 12U for seeking approval to import and market the drug product for the indication “to improve glycemic control in adult patients with diabetes mellitus”.

Insulin human inhaled is a man-made insulin that is breathed in through the lungs and is used to control high blood sugar in patients with diabetes. Insulin is one of many hormones that help the body turn food into energy. This is done by using the glucose (sugar) in the blood as quick energy.

Inhaled insulin treats diabetes by increasing your body’s insulin levels. This medication comes in an inhaler. You can breathe in this insulin before a meal as directed. A healthcare provider will give you instructions on how to take and adjust each dose based on your activities.

Technosphere Insulin (TI) is a novel inhalation powder for the treatment of diabetes mellitus. Technosphere Insulin delivers insulin with an ultra-rapid pharmacokinetic profile that is distinctly different from all other insulin products but similar to natural insulin release. Such rapid absorption is often associated with penetration enhancers that disrupt cellular integrity.

The Technosphere technology platform is based on Technosphere particles, which are formed by the self-assembly of crystals of fumaryl diketopiperazine (FDKP), a proprietary novel excipient. Technosphere Insulin powder consists of insulin that is adsorbed to Technosphere particles with a size range appropriate for the delivery of drugs to the deep lung.

Technosphere Insulin has been shown to deliver insulin to the bloodstream with a pharmacokinetic profile characterized by a rapid rise in plasma insulin concentration that is much faster than subcutaneous insulin injection.

At the recent SEC meeting for Endocrinology and Metabolism held on 7th March 2024, the expert panel reviewed the results of Phase III clinical trial conducted in India for the drug product Human insulin inhalation powder with inhaler [Technosphere insulin 4U/ 8U/ 12U for seeking approval to import and market the drug product for the indication “to improve glycemic control in adult patients with diabetes mellitus”.

After detailed deliberation, the committee recommended the grant of permission to import and market Human insulin inhalation powder with inhaler [Technosphere insulin 4U/ 8U/ 12U] subject to the condition that the firm should conduct an active PMS study in the country.

In accordance with the above, the expert panel suggested that the firm should submit the active PMS study protocol to CDSCO within three months of the grant of marketing authorization.

Also Read: CDSCO Panel grants GSK’s Updated Prescribing Information for Antibiotic FDC of Amoxicillin, Clavulanic acid

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Substandard implant used During Total Knee Replacement Surgery: Orthopedic Surgeon slapped Compensation

Bengaluru: The Urbal II Additional District Consumer Disputes Redressal Commission, Bengaluru recently directed an Orthopaedic Surgeon to pay around Rs 4 lakh compensation to a patient for medical negligence while conducting Total Knee Replacement Surgery.

After the surgery, the patient had to suffer unbearable pain and had to seek treatment at another hospital. The Consumer Court held the doctor liable after noting that the Karnataka Medical Council (KMC) opined that “good quality of implant was not used” resulting in infection in the wound. KMC had also observed that the patient was not managed by proper follow-up and medication and for this, the Council held the treating surgeon responsible. 

Relying on the medical council order and noting that it was not challenged by the doctor before the National Medical Commission (NMC), the District Consumer Court directed him to pay Rs 2,95,638 as medical expenses, Rs 1 lakh as compensation towards mental agony and Rs 20,000 as cost of litigation.

The matter goes back to 2015 when the patient was admitted to the treating hospital with pain in the right knee. She was diagnosed by the treating doctor and asked to undergo several tests. Even though she was under continuous medication, she allegedly did not get any relief. Thereafter the treating doctor, who is a Consultant Orthopaedic Surgeon at the hospital, suggested the complainant to undergo total knee replacement surgery. The doctor allegedly assured that after the operation, the patient could walk easily within a short span of time. 

After the surgery, the patient was advised to undergo physiotherapy. Allegedly, the person who was doing physiotherapy was not a professional and doing the procedure without a knee brace, which is a must for physiotherapy. When the patient stood up, due to infection in the operated portion burst and stitches came out. The doctor hurried to the spot and allegedly put stitches once again by using a stapler hurriedly without conducting any further operation.

Later, the patient was discharged and paid a bill of Rs 3 lakh as hospital expenses and for purchasing all medicines. The person who had been dressing the complainant found certain black patches on the complainant’s knee. Based on his suspicion of some infection, the patient approached a Consultant Orthopaedic Surgeon at a Specialist Hospital. The doctor after examining the patient, opined that the Knee Cap of the Complainant had been badly damaged due to infection, and it required to be removed. Accordingly, it was removed.

It was also alleged by the complainant that after being discharged from the treating hospital, she had developed severe, uncontrollable pain in the operated area. Her leg and knee diametrically became upright. So, being unable to tolerate the pain, she consulted a Specialist. The complainant claimed that due to the wrong treatment given by the doctor, she developed severe pain after surgery and permanently became disabled due to medical negligence by the treating doctor.

It was also alleged that inferior metal was used during implantation and due to this, the patient’s knee and foot became straight due to which she was unable to walk or move.

Therefore, filing the consumer complaint, the patient demanded Rs 18 lakh as compensation. On the other hand, the doctor and hospital submitted that despite clear instructions, the patient did not follow the post-operative advice, did not report any trouble or pain to the hospital, was not brought for follow-up as required and did not consult any of the hospital or doctor on any of the alleged problems.

They denied any error in diagnosis, treatment, deficiency or negligence. Regarding the metal used for the surgery, it was submitted that the metal was purchased by the patient’s son-in-law and it was an ISI-marked Inor Brand implant; the other patients on whom this same implant had been used did not report any complications.

It was also highlighted that the complainant also approached the Karnataka Medical Council (KMC) against the treating doctor and hospital in respect of her grievance.

While considering the matter, the Consumer Court noted that there were two Discharge Summary issued by the treating hospital- the first one was on 03.09.2015 and the second one was on 19.09.2015. Referring to this, the Commission observed, “So looking to Ex. P2 it appears that even after lapse of 15 days from the date of operation complainant was not good and wound was not yet healed even after taking prescribed medicines.”

The Consumer Court also perused the IP Receipt/Cash Receipt issued by the Specialist Hospital and noted that the document disclosed that the patient was admitted to the Orthopedics Department of the hospital on 09.10.2015, discharged on 29.10.2015 and spent Rs 2,00,088 for treatment at the second hospital. She also underwent treatment at Bhagwan Mahaveer Jain Hospital from 26.09.2019 to 11.10.2019 for heart disease by spending Rs 1,81,990, noted the Commission.

Apart from this, the consumer court also took note of the order dated 04.06.2022 passed by the Karnataka Medical Council, which mentioned in the findings that “It appears that the good quality of implant was not used and as a result, the wound got infected and the patient was not managed by the proper follow-up and medication. Further, the records divulge the fact that again the patient was admitted in another hospital i.e. Specialist Hospital for debridement and removal of the impant and thereafter, there was slowly leaving immovable knee joint and bed sores. The wound was infected and there was no proper follow-up for the prevention of the infection and these are the crux points of the case for which, the Ist Respondent Dr. Mohammed Irshad Ahmed is responsible.”

In its order, the medical council had noted that there was negligence by the treating doctor. However, it further observed that there was no medical negligence on the part of another doctor and the treating hospital. The Council had ordered the Registration number of the doctor to be removed from the KMC Registry for a period of six months as a punishment.

Referring to the medical council order, the Consumer Court observed,

“On perusal of this Ex. P6 order stated supra, it cannot be stated that there is negligence on the part of the complainant which is the contention taken by OP No. 2 in his written version. But on the contrary, it is clear that there is a deficiency of service on the part of OP No.2 Dr. *** who treated the deceased complainant by conducting Right Total Knee Replacement Surgery on 31.05.2015 by using substandard quality of implant for Right Total Knee Replacement Surgery. Further, it is to be noted here that the order passed by KMC in Ex. P6 appears to have become final since OP No.2 has not at all produced any evidence to show that he has preferred appeal against the order passed by KMC in Ex. P6 to the National Medical Commission and Ex. P6 order has been set aside.”

Opining that the complainant has proved that there was a deficiency in service by the treating doctor only, the Commission partly allowed the complaint. It directed the doctor to pay Rs 2,95,638 as medical expenses, Rs 1 lakh as compensation towards mental agony and Rs 20,000 as cost of litigation. 

To read the order, click on the link below:

https://medicaldialogues.in/pdf_upload/bengaluru-consumer-court-compensation-235001.pdf

Also Read: Patient death due to Post Partum Hemorrhage: Nursing Home, Doctor slapped Rs 43 lakh compensation for negligence

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JnK Board invites online applications for Bsc Nursing, Paramedical, Technology courses, details

Jammu & Kashmir- Through a recent notice, the Jammu & Kashmir (J&K) Board has announced admission to the B.Sc. Nursing, B.Sc. Paramedical and B.Sc. Technology Courses for 2024 session in Government and Private Colleges and Institutions of UT of J&K.

The period for submission of online application form is from 30 March 2024 to 13 April 2024 (midnight). While submitting online applications candidates have to pay Rs.1000/- through Credit Card/Debit Card/Net Banking.

The Common Entrance Examination is tentatively scheduled for May 12, 2024. The examination will be conducted offline simultaneously at Jammu and Srinagar centres as may be decided by the Board. Meanwhile, information regarding availability, venue and timing of online admit card for the Common Entrance Test will be released separately in due course.

Also Read: Applications to Start/Increase PG Medical Seats: NMC Lists Down 102 Courses in 17 Medical Institutes

SUBMISSION OF ONLINE APPLICATION FORMS

The interested candidates are required to upload the following scanned original and self-attested certificates in PDF format with sizes from 100-200 KB along with the Application Form-

1 Domicile of UT of J&K/UT of Ladakh as the case may be(For Candidates of UT of Ladakh, ST certificate issued by the Competent Authority of Ladakh shall be treated as Domicile Certificate).

2 Qualifying marks (12th Class) certificate.

3 Date of Birth Certificate (only Matriculation Certificate issued by the Board of School Education).

4 Valid Reserved category certificates, (if any).

5 Any other documents, as requested.

However, it is for the information of all the concerned that the afore-titled documents as required for submission of the application form shall be considered provisional and subject to change(s), if any, as may be notified by the Government subsequently.

DOCUMENTS

The following original documents are required to be submitted to the Institution at the time of Admission-

1 Marks certificate of the qualifying examinations (12th class marks certificate).

b) Date of birth (Matriculation and Secondary School Certificate) from a recognised Board.

c) Domicile Certificate for candidates belonging to UT of J&K and ST certificate as a Domicile for candidates belonging to UT of Ladakh.

d) Category Certificate, if any.

e) Any other document as may be required by the Institution.

Also Read: ICMR Invites Applications For training course on Medical Genetics in Reproductive and Child Health, MBBS, MD, MS, DM, MCh doctors can apply

ELIGIBILITY FOR B.Sc. NURSING PROGRAMME

The candidates applying for admission to B.Sc. Nursing Programme must fulfil the following eligibility criteria-

(i) be a domicile of UT of J&K/UT of Ladakh as the case may be (For Candidates belonging to UT of Ladakh, ST certificate issued by a Competent Authority of Ladakh shall be treated as a Domicile certificate).

(ii) be at least 17 years old on 31st December 2024.

(iii) have passed the qualifying 12th Standard examination (10+2) and must have obtained a minimum of 45% marks in Physics, Chemistry and Biology taken Page 3 of 6 together and passed in English individually including the candidates from State Open School recognized by State Government and National Institute of Open School (NIOS) recognized by Central Government having Science subjects and English only.

(iv) For the candidates belonging to reserved categories, the marks obtained in 3 core subjects shall be 40% instead of 45% for General category candidates.

(v) The candidate must be medically fit.

Further, the candidates appearing and appeared in the 10+2 (12th Class) examination 2024 can also apply, provided such candidates have qualified the examination at the time of declaration of the result of the Entrance Test or before the date of counselling and admission as may be notified by the Board.

ELIGIBILITY FOR B.Sc. PARAMEDICAL PROGRAMME

The candidates applying for admission to B.Sc. Para-Medical Courses must fulfil the following eligibility criteria-

(i) be a domicile of UT of J&K/UT of Ladakh as the case may be (For Candidates belonging to UT of Ladakh, ST certificate issued by a Competent Authority of Ladakh shall be treated as a Domicile certificate).

(ii) be at least 17 years old on 31st December 2024.

(iii) have passed 10+2 or equivalent examination with Science (PCB) and English through a recognised Board / University securing a minimum 50% marks and above for Open Merit Candidates and 40 % marks and above for candidates belonging to Reserved Categories in aggregate.

Further, the candidates appearing and appeared in the 10+2 (12th Class) examination 2024 can also apply, provided such candidates have qualified the examination at the time of declaration of the result of the Entrance Test or before the date of counselling and admission as may be notified by the Board. The candidates applying for Lateral Entry only must have obtained a diploma in the concerned stream and have passed 10+2 with Physics, Chemistry, Biology and a diploma registered with J&K Para-Medical Council.

ELIGIBILITY FOR B.Sc. TECHNOLOGY PROGRAMME

The candidates applying for admission to B.Sc. Technology Courses must fulfil the following eligibility criteria-

1 Be a domicile of UT of J&K/UT of Ladakh as the case may be (For Candidates belonging to UT of Ladakh, ST certificate issued by a Competent Authority of Ladakh shall be treated as a Domicile certificate).

2 Be at least 17 years old on 31st December 2024, and have passed 10+2 or equivalent examination with Science (PCB) and English through a recognised Board and University securing a minimum of 50% marks and above for Open Merit Candidates and 40% marks and above for candidates belonging to Reserved Categories in the aggregate; Further, the candidates appearing/appeared in 10+2 (12th Class) examination 2024 can also apply, provided such candidates have qualified the examination at the time of declaration of the result in the Entrance Test or before the date of counselling/admissions may be notified by the Board.

Also Read: ICMR invites applications for ACSIR PhD Medical Research programme, All Details Here

SYLLABUS

The entrance exam is based on the syllabus and curriculum of study of class 12th. It is given as follows along with the overall importance of each topic in the question paper of the entrance examination. The question paper will be based on Physics, Chemistry and Biology subjects with a total marks of 60 per subject.

The notice also states that the board will not be responsible for any omission or commission in filling out the online application form by the candidate. J&K Board further advised the candidates to remain in touch with the BOPEE website. The Board does not take any responsibility for delays in the publication of notices and notifications in the print media. If so, such publications are not under the control of the Board, notwithstanding the Board notifying it on its official website and forwarding the said notifications/notices etc. for publication in newspapers simultaneously on the date of publication.

The applicants can also contact the Help Desk of the I.T. Section of the BOPEE during office hours and on working days only and or email for any assistance and guidance, the notice stated.

To view the notice, click the link below

https://medicaldialogues.in/pdf_upload/jk-235299.pdf

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AstraZeneca Truqap plus Faslodex gets nod in Japan for advanced HR-positive breast cancer

Cambridge: AstraZeneca’s Truqap (capivasertib) in combination with Faslodex (fulvestrant) has been approved in Japan for the treatment of adult patients with unresectable or recurrent PIK3CA, AKT1, or PTEN-altered hormone receptor (HR)-positive, HER2-negative breast cancer following progression after treatment with endocrine therapy.

The approval by the Japanese Ministry of Health, Labour, and Welfare (MHLW) was based on the results from the CAPItello-291 Phase III trial published in The New England Journal of Medicine. In the trial, Truqap in combination with Faslodex reduced the risk of disease progression or death by 50% versus Faslodex alone in patients with tumours harbouring PI3K/AKT pathway biomarker alterations (based on hazard ratio of 0.50, 95% confidence interval 0.38-0.65; p=<0.001; median progression-free survival (PFS) 7.3 versus 3.1 months).

In Japan, more than 90,000 women were diagnosed with breast cancer in 2022, and more than 17,000 patients died from the disease in the same year. Globally, HR-positive breast cancer (expressing estrogen or progesterone receptors, or both), is the most common breast cancer subtype, with more than 65% of tumours considered HR-positive and HER2-low or HER2-negative. Collectively, mutations in PIK3CA, AKT1 and alterations in PTEN occur frequently, affecting approximately 50% of patients with advanced HR-positive breast cancer. Endocrine therapies are widely used in this setting, often in combination with cyclin-dependent kinase (CDK) 4/6 inhibitors, but some tumours develop resistance to these therapies, underscoring the need for additional combination approaches with endocrine therapy to extend time before the initiation of chemotherapy.

Masakazu Toi, MD, PHD, Director of Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Japan said, “The approval of capivasertib and fulvestrant signifies a new era of care in advanced hormone receptor-positive breast cancer in Japan, providing a much-needed new treatment option for approximately half of patients in this setting who have tumours harbouring mutations in PIK3CA, AKT1 or alterations in PTEN. It is important for us to detect these specific tumour biomarker alterations in each patient we see, so that they are potentially able to benefit from this important combination to extend the effectiveness of endocrine-based treatment and delay disease progression.”

Dave Fredrickson, Executive Vice President, Oncology Business Unit, AstraZeneca, said, “Breast cancer is the most common cancer among women in Japan, and innovative, new treatment options are urgently needed. The approval of Truqap, a first-in-class AKT-inhibitor, represents a significant step forward for HR-positive breast cancer treatment and an important new option for approximately fifty per cent of patients who have tumours with these specific mutations or alterations.”

In the CAPItello-291 trial, the safety profile of Truqap plus Faslodex was similar to that observed in previous trials evaluating this combination.

The MHLW have also approved a companion diagnostic test to detect the relevant alterations (PIK3CA, AKT1 and PTEN).

Regulatory applications are currently under review in China, the European Union, and several other countries, and this indication for Truqap in combination with Faslodex is already approved in the US and several other countries based on results from the CAPItello-291 trial.

Following this approval in Japan, Astex Therapeutics is eligible to receive a milestone payment from AstraZeneca on first commercial sale of the drug in Japan as well as royalties on future sales in line with the agreement between the two companies.

Breast cancer is the second most common cancer and one of the leading causes of cancer-related death worldwide. More than two million patients were diagnosed with breast cancer in 2022, with more than 665,000 deaths globally.

HR-positive breast cancer (expressing estrogen or progesterone receptors, or both), is the most common subtype of breast cancer with more than 65% of tumours considered HR-positive and HER2-low or HER2-negative.

The growth of HR-positive breast cancer cells is often driven by estrogen receptors (ER), and endocrine therapies that target ER-driven disease are widely used as 1st-line treatment in the advanced setting, and often paired with CDK4/6 inhibitors. However, resistance to CDK4/6 inhibitors and current endocrine therapies develops in many patients with advanced disease. Once this occurs, treatment options are limited – with chemotherapy being the current standard of care – and survival rates are low with approximately 30% of patients anticipated to live beyond five years after diagnosis.

The optimisation of endocrine therapy and overcoming resistance to enable patients to continue benefiting from these treatments, as well as identifying new therapies for those who are less likely to benefit, are active areas of focus for breast cancer research.

Truqap is a first-in-class, potent, adenosine triphosphate (ATP)-competitive inhibitor of all three AKT isoforms (AKT1/2/3). Truqap 400mg is administered twice daily according to an intermittent dosing schedule of four days on and three days off. This was chosen in early phase trials based on tolerability and the degree of target inhibition.

Truqap in combination with Faslodex is approved in the US, Japan and several other countries for the treatment of adult patients with HR-positive, HER2-negative locally advanced or metastatic breast cancer with one or more biomarker alterations (PIK3CA, AKT1 or PTEN) based on the results from the CAPItello-291 trial. Eligible patients will have progressed on at least one endocrine-based regimen in the metastatic setting or experienced recurrence on or within 12 months of completing adjuvant therapy.

Truqap is currently being evaluated in Phase III trials for the treatment of multiple subtypes of breast cancer and in other tumour types in combination with established treatments. The ongoing clinical research programme is focused on tumours reliant on signalling via the PI3K/AKT pathway, and in tumours harbouring biomarker alterations in this pathway.

Truqap was discovered by AstraZeneca subsequent to a collaboration with Astex Therapeutics (and its collaboration with the Institute of Cancer Research and Cancer Research Technology Limited).

Faslodex is an endocrine therapy indicated for the treatment of estrogen receptor-positive, locally advanced or metastatic breast cancer in postmenopausal women not previously treated with endocrine therapy, or with disease relapse on or after adjuvant anti-estrogen therapy, or disease progression on anti-estrogen therapy.

In the US, EU and Japan, Faslodex is also approved in combination with CDK4/6 inhibitors for the treatment of women with HR-positive, HER2-negative advanced or metastatic breast cancer, whose cancer has progressed after endocrine medicine. Faslodex represents a hormonal treatment approach that helps to slow tumour growth by blocking and degrading the estrogen receptor – a key driver of disease progression.

Faslodex is approved as monotherapy or in combination with medicines from various drug classes including CDK4/6, PI3K and AKT inhibitors for the treatment of patients with HR-positive advanced breast cancer and is being evaluated in combination with medicines from other drug classes.

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QR-Based Cleaning System now Mandatory in Rajasthan Hospitals, 8 Medical Colleges Slapped Show-Cause Notices for non-compliance

Jaipur: The principal and controller of eight medical colleges in Rajasthan have received show-cause notices from the State Government for not implementing Artificial Intelligence (AI) based (QR Code) cleanliness system in the hospitals affiliated with the medical colleges.

Notices have been issued to JLN Medical College Hospital Ajmer, Sardar Patel Medical College Bikaner, Medical College Hospital Dungarpur, Sampurnanand Medical College Jodhpur, Medical College Hospital and Jaipuria Hospital of Rajasthan University of Health Sciences Jaipur, Dental College Hospital of Rajasthan Health Sciences University Jaipur, Medical College Sikar and Sawai Man Singh Medical College Jaipur, adds TOI.

Meanwhile, the State Health Department has made the QR code-based cleaning system mandatory in all the hospitals attached to medical colleges from April 1. The State made it a mandatory requirement to improve cleanliness in government hospitals.

As per this system, the patients and their attendants can scan the QR code using their mobile phones to raise complaints regarding improper cleanliness in the hospital. In this way, the complaints will reach the hospital administration and they will be resolved within minutes.

Also Read: Rajasthan Governor calls for using AI in identification and diagnosis of ailments

As per the latest media report by the Times of India, the Additional chief secretary of Health Shubhra Singh informed that aiming to strengthen the health services and better cleanliness in the hospital, RNT Medical College, Udaipur made the innovation of starting the QR-code-based cleaning system.

Following this, instructions were given to adopt this system in other hospitals and medical institutions associated with various medical colleges of the State. Now, the State has made it mandatory for the hospitals associated with medical colleges in the State of Rajasthan from April 1, 2024.

However, despite the orders, many hospitals failed to implement this system. Commenting on this, Additional Chief Secretary of Medical Education Shubhra Singh informed TOI that instructions were given to implement QR code-based cleaning system to strengthen the health services in the hospitals affiliated to the medical colleges. With the implementation of this system, the cleanliness situation of toilets and premises in government hospitals has improved a lot.

She mentioned that despite repeated instructions and regular inspections, QR code based cleaning system has not been implemented in some hospitals affiliated with medical colleges. Taking serious note of this, the Health Department has now issued show-cause notices to the principals of the concerned medical colleges and sought clarification within three days.

Apart from the institutes that received the show-cause notices, several Jaipur-based hospitals also have not implemented this system yet. In Jaipur, the QR-based cleaning system has not been implemented in hospitals attached to SMS medical college including PDDU Government Hospital Gangori Bazaar, TB Hospital, State Cancer Institute, IDH Hospital, SR Goyal Government Hospital Sethi Colony, Satellite Hospital Bani Park and Super Specialty Block.

Meanwhile, the State Health Department has issued a list of districts with best facilities including cleanliness and implementation of health schemes. Among these, Jodhpur, Pratapgarh and Pali are leading in the list.

However, Jaipur is not among the top 10 districts in the ranking to maintain proper healthcare services. While Jaipur-I is ranked at the 30th place in the list, Jaipur-II is at the 16th place. 

The districts were judged based on their performance of implementing the health schemes and maintaining the cleanliness in the hospitals during the 9,000 inspections in three months.

Also Read: BMC Hospitals to seek tips from private hospitals to improve healthcare services

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