Archive for category: News

New Delhi: Days after 13 female MBBS students of Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi have accused an Assistant Professor of Pharmacology of sexual harassment, the Vigilance department has asked the Health department to send a proposal for initiating disciplinary action against the accused.

According to PTI, the 22-year-old medical student alleged that her professor “sexually harassed” her during a viva examination, police said on Monday.

A case has been registered under sections 354A (assault or criminal force to woman with intent to outrage her modesty) and 509 (word, gesture or act intended to insult the modesty of a woman) of the Indian Penal Code (IPC) against the accused, police said.

Medical Dialogues team recently reported that based on the complaint by the students, a case has been registered by the police. Meanwhile, soon after the matter came to light, a demonstration was organized by a women’s group and the protest soon manifested as a massive Public Outrage outside the college premises. Protesters were seen holding placards denouncing the accused professor and demanding justice.

Writing to the Principal of the medical college, a student belonging to the 2021 MBBS batch stated that the alleged incident took place during a practical exam in the pharmacology department.

In a formal letter addressed to the Secretary of the Health and Family Welfare Department, the Vigilance Directorate highlighted the significance of media reports regarding the incident.

“From the media, it is also observed that at least two students have recorded their statement under Section 164 of Cr. P.C. It is also reported in the media that the accused was arrested and was booked under sections 354(A) and 509 of the IPC,” said the directorate letter, news agency PTI reported.

“It is requested to send the proposal for initiating necessary disciplinary action against the accused professor to the Directorate of Vigilance, Delhi government, for placing before the Competent Authority as per extant rules,” it said.

The Health Department has so far not sent any file for taking disciplinary action against the accused, it added.

Immune-mediated diseases encompass a diverse range of conditions, all characterized by abnormal immune system activity. While some, like type 1 diabetes, typically manifest before reproductive age, others emerge later in life. Scientists have investigated systemic lupus erythematosus for its effects on reproductive health as the condition increases the risk for some adverse pregnancy outcomes, including pre-eclampsia, preterm delivery, C-sections, and low birth weight. However, the impact of other autoimmune diseases—such as psoriasis—on fertility and pregnancy is unclear.

In the study, researchers used data from Finnish nationwide health registers to study the impact of immune-mediated diseases on reproductive health measures such as reproductive success, and for women, ever having experienced adverse maternal and perinatal outcomes. Out of all people born in Finland between 1964 and 1984, 7.9% of the women and 7.8% of the men had an autoimmune disease diagnosed before or during reproductive years.

The findings highlighted that many immune-mediated diseases had little impact on the number of children. However, women with selected immune-mediated diseases experience a higher prevalence of childlessness, with the top three diseases being Addison’s disease (23.9% more childlessness), juvenile idiopathic arthritis (9.3%), and vitamin B12 deficiency anaemia (8.6%). Several of the rheumatic diseases—particularly systemic lupus erythematosus and juvenile idiopathic arthritis—lead to higher rates of childlessness and fewer children.

The risks for pre-eclampsia, low birth weight, preterm delivery, non-elective C-sections and need of neonatal intensive care were increased for many conditions. Systemic lupus erythematosus and type 1 diabetes showed over two-fold risks for some of these outcomes. However, the risk of gestational diabetes was not higher for patients with any of the rheumatic diseases compared to the population.

“Despite seeing an elevated risk for diverse childbearing problems in rheumatic and other immune-mediated diseases, many of the complications are still fairly rare,” said Anne Kerola, the lead author of the study. “Family planning should actively be discussed between patients, both men and women, with rheumatic diseases and their healthcare providers. Pregnancies in women with rheumatic diseases are carefully followed up to tailor medications appropriately, which helps reduce risks.”

Reference: Anne M Kerola, Antti Palomäki, Hannele Laivuori, Tarja Laitinen, Martti Färkkilä, Kari K Eklund, Samuli Ripatti, Markus Perola, Andrea Ganna, Joni V Lindbohm, Nina Mars; Patterns of reproductive health in inflammatory rheumatic diseases and other immune-mediated diseases: a nationwide registry study; Journal: Rheumatology; DOI: 10.1093/rheumatology/keae122

According to the study, primary infections can also lead to severe disease, including dengue shock syndrome or dengue hemorrhagic fever challenging the belief that only secondary dengue infections are severe. The study findings, published in Nature Medicine, call for a reevaluation of dengue understanding and strategies in vaccine intervention research.

It is a common belief that dengue gets severe when one gets affected for the second time. The new study from the International Centre for Genetic Engineering and Biotechnology (ICGEB, New Delhi) showed that a substantial number of primary dengue infections also carry severe disease conditions.

Dengue is a global epidemic that has led to over 100 million cases annually. The clinical symptoms vary from mild fever to severe haemorrhage and shock, including some fatalities. The current paradigm is that these severe dengue cases mostly occur during secondary infections due to antibody-dependent enhancement after infection with a different dengue virus serotype.

India has the highest dengue burden worldwide, but not much is known about the disease severity and its link with primary and secondary dengue infections. To address this issue, Charu Aggarwal, International Centre for Genetic Engineering and Biotechnology, New Delhi, India, and her colleagues examined 619 children with febrile dengue-confirmed infection from three hospitals in different regions of India.

They classified primary and secondary infections based on IgM: IgG ratios using a dengue-specific enzyme-linked immunosorbent assay according to the World Health Organization (WHO) guidelines.

The main findings of the study were as follows:

• Primary dengue infections accounted for more than half of total clinical cases (344 of 619), severe dengue cases (112 of 202) and fatalities (5 of 7).
• Consistent with the classification based on binding antibody data, dengue-neutralizing antibody titers were also significantly lower in primary infections compared to secondary infections.

To conclude, dengue virus infection is a huge public health problem in India. Many patients develop severe diseases that can also be sometimes fatal. However, much of the ongoing vaccine intervention research is focused on the currently widely held global belief that primary dengue infections are not usually dangerous and that severe dengue diseases are mainly due to secondary dengue infections.

The study questions this widely held belief and shows that primary infections constitute a substantial fraction of severe disease cases and fatalities.

Reference:

Aggarwal, C., Ahmed, H., Sharma, P., Reddy, E. S., Nayak, K., Singla, M., Maheshwari, D., Chawla, Y. M., Panda, H., Rai, R. C., Gunisetty, S., Priyamvada, L., Bhaumik, S. K., Ahamed, S. F., Vivek, R., Bhatnagar, P., Singh, P., Kaur, M., Dixit, K., . . . Chandele, A. (2024). Severe disease during both primary and secondary dengue virus infections in pediatric populations. Nature Medicine, 1-5. https://doi.org/10.1038/s41591-024-02798-x

A study was done to examine whether patient-level disease diagnoses, drug treatments, and dental clinical factors are correlates of early implant failure. This historical, nested case-control study used electronic medical records to retrieve patient-level data on individuals with implant failure occurring up to 6 months after implantation, including demographics, clinical information (number, location, and complicated status of implants), underlying diseases (osteoporosis, diabetes, hypertension, inflammatory bowel disease [IBD], myocardial infarction [MI]), and drug purchases (chemotherapy, bisphosphonates, selective serotonin inhibitors, antihypertensive medications, proton pump inhibitors [PPIs], disease-modifying antirheumatic drugs, corticosteroids, and nonsteroidal anti-inflammatory drugs) among adult members of a large, state-mandated health provider in Israel between 2015 and 2020. Individuals with implant extraction occurring up to 6 months after implantation were matched 1:1 to controls. Univariate and adjusted multivariate conditional logistic regression models were used to examine the odds ratios (ORs) of all dental implant risk factors among the patients. Results: A total of 585 individuals with implant failure (mean age, 53 years [42,62], 51.3% females and 49.7% males) were identified among 29,378 eligible patients. Compared to controls, patients who experienced implant failure (ie, cases) were more likely to have smoked in their lifetime (18% vs 11.5%, P = .009), experienced IBD (1.5% vs 0.02%, P = .059), and consumed PPIs within 6 months of the implant surgery (40.0% vs 32.5%, P = .028). Clinical factors, including the number of implants per person (individuals with two implants, OR = 1.53; individuals with at least four implants, OR = 3.33; P < .01), location of implant (maxilla; OR = 1.59; 95% CI: 1.2–2.04), and smoking (OR = 1.57; 95% CI: 1.09–2.26) were significant correlates of early implant failure among the included cases. Crohn’s disease, MI, and osteoporosis were found to be borderline significant correlates of early dental implant failure. Conclusions: Among the factors examined, the number of implants, the location of implants, and smoking history were significant correlates of early implant failure, while Crohn’s disease, MI, and osteoporosis were found to not be significant. Larger patient-level studies are needed to examine the individual and combined effects of diseases, medications, and clinical factors on early implant failure.

Reference:

Basson, A. A., Mann, J., Findler, M., & Chodick, G. (Year). Correlates of Early Dental Implant Failure: A Retrospective Study. Journal of Oral Implantology, Volume(Issue), 897-906. DOI: 10.11607/jomi.10199

Keywords:

Smoking, number of implants, implant location, early implant failure, new study, The International Journal of Oral & Maxillofacial Implants, dental implant failure, smoking, Crohn’s disease, myocardial infarction, osteoporosis, maxillary implants, Basson, A. A., Mann, J., Findler, M., & Chodick, G

“While there was no difference in the risk of death in the hospital or at 30 days with transcatheter edge-to-edge repair for primary mitral regurgitation when done at low-, intermediate-, and high-volume surgical centers, that equivalence didn’t hold up at one year,” the researchers reported.

The findings were published online in Circulation: Cardiovascular Interventions on March 4, 2024.

Transcatheter edge-to-edge mitral valve repair is an effective treatment for patients with primary mitral regurgitation at prohibitive risk for surgical MV repair. High-volume TEER centers and high-volume MVr centers have better outcomes than low-volume centers. However, it is unknown whether MVr volume predicts TEER outcomes.

Against the above background, Paul A. Grayburn, Baylor Scott, and White Heart Hospital Plano, TX, and colleagues hypothesized that high-volume MV surgical centers would have superior risk-adjusted outcomes for TEER than low-volume centers.

To test the hypothesis, the researchers combined data from the Society of Thoracic Surgeons adult cardiac surgery database and the American College of Cardiology/Society of Thoracic Surgeons Transcatheter Valve Therapy registry.

Surgical MV repair was defined as leaflet resection or artificial chords with or without annuloplasty and was evaluated as a continuous variable and as predefined categories (<25, 25-49, and ≥50 MV repairs/year). A generalized linear mixed model assessed risk-adjusted in-hospital/30-day mortality, TEER success (mitral regurgitation ≤2+ and gradient <5 mm Hg), and 30-day heart failure readmission.

The study revealed the following findings:

• The study included 41,834 patients from 500 sites of which 66.4% were low, 20.4% intermediate, and 13.2% high-volume surgical centers.
• TEER success was 54.6% and was not statistically significantly different across MV surgical site volumes.
• TEER mortality at 30 days was 3.5%, with no significant difference across MVr volume on unadjusted or adjusted analysis of volume as a continuous variable.
• One-year mortality was 15.0% and was lower for higher MVr volume centers when adjusted for clinical and demographic variables.
• Heart failure readmission at one year was 9.4% and statistically significantly lower in high-volume centers on both unadjusted and adjusted analysis.

In conclusion, TEER can be performed safely in centers with low volumes of MV repair. However, hospitals with more surgical experience see better M-TEER outcomes in 1 year.

Reference:

Grayburn PA, Mack MJ, Manandhar P, Kosinski AS, Sannino A, Smith RL 2nd, Szerlip M, Vemulapalli S. Comparison of Transcatheter Edge-to-Edge Mitral Valve Repair for Primary Mitral Regurgitation Outcomes to Hospital Volumes of Surgical Mitral Valve Repair. Circ Cardiovasc Interv. 2024 Mar 4:e013581. doi: 10.1161/CIRCINTERVENTIONS.123.013581. Epub ahead of print. PMID: 38436084.