Fire breaks out at LNJP Hospital, no casualties reported

New Delhi: A fire broke out in the emergency block of Delhi’s Lok Nayak Jai Prakash Hospital (LNJP) late Monday night. The fire tenders reached the spot and the fire was doused off.

Medical Director Suresh Kumar said that the reason for the blaze was a short circuit.

Speaking to ANI, Medical Director, LNJP Hospital, Suresh Kumar said, “There was an electric short circuit in the emergency block. All the patients are safe. There was no need to shift any of the patients from their wards.”

Also Read:Fire breaks out at teaching block of Delhi AIIMS, Office records gutted

Kumar further said, “Fire tenders reached the spot on time and the fire was doused off. All services had been restarted after the fire clearance.”

Further details into the matter are awaited.

Also Read:Fire at SGPGI operation theatre claims life of two patient, one woman, one child

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Health bulletin 26/ February/ 2024

Here are the top health stories for the day:

Renowned rheumatologist Dr Debashish Danda dies in a car accident

In an unfortunate incident, Dr Debashish Danda, a 60-year-old renowned rheumatologist and retired professor in the Rheumatology Department of Christian Medical College (CMC) Vellore died in a tragic car accident on Saturday.

Dr Debashish, a distinguished figure in the medical community succumbed to his injuries sustained in the accident after his car collided with a container lorry near Vellore. He was recognised worldwide due to his passionate contribution to the field.

For more details check out the link below:

Unfortunate: Prominent Rheumatologist Dr Debashish Danda Dies In Car Accident


Gynecologist in Assam arrested after nurse reports sexual harassment disguised as job offers

A gynaecologist has been arrested in Assam’s Lakhimpur
district for allegedly attempting to rape a woman, who sought the job of a
nurse at his hospital, a police officer said. The accused was taken into
custody late on Friday.

The doctor has been identified as a gynaecologist and the
proprietor of the Avaneesh Hospital & Research Center, located in North
Lakhimpur town.

The arrest was made on the basis of the woman’s police
complaint about molestation and attempted rape, the officer said.

New surrogacy rules allow couples with medical conditions to use donor gametes

In a significant modification to the Surrogacy (Regulation) Rules, 2022, the Central government has notified that couples suffering from a medical condition need not source both gametes from an intending couple.

The Union Health Ministry has revised the previous rules, which mandated that both gametes should be from the intending couple undergoing surrogacy. This amendment follows a directive from the Supreme Court questioning the delay in the government’s decision.

For more details check out the link below:

Donor Gametes Allowed For Couples With Medical Conditions: New Rule On Surrogacy


PM Modi inaugurates 300-bed PGI satellite
center in Sangrur, boosting healthcare infrastructure

Prime Minister Narendra Modi Sunday virtually inaugurated a 300-bed satellite centre of the Postgraduate Institute of Medical Education and Research in Punjab’s Sangrur and laid the foundation stone of a 100-bed facility in Ferozepur.

According to a statement issued by the PGIMER (Postgraduate Institute of Medical Education and Research) here, the move marks a significant milestone and fruition of the continued endeavour of the Union Health Ministry to provide top-notch, affordable and accessible healthcare services to people in Punjab.

For more details check out the link below:

PM Modi Dedicates 300-Bed PGI Satellite Centre In Sangrur


Pulmonologist Dr Kailash Rathi critically injured, attacked
18 times with sickle, in ICU

In a gruesome incident, a Nashik-based Pulmonologist Dr Kailash Rathi, is fighting for his life in the Intensive Care Unit (ICU) after being brutally attacked inside a hospital in Maharashtra over a monetary dispute.

The horror was captured on a CCTV camera and the viral video shows that the attacker striked the 49-year-old doctor around 18 times with a sickle on Friday night. Thereafter, the doctor, a chest physician and critical care specialist, was admitted in a local hospital in a critical condition.

For more details check out the link below:

Nashik Shocker: Pulmonologist Dr Kailash Rathi Brutally Attacked 18 Times With Sickle, Critical In ICU

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Retired CMC professor Dr Debashish Danda passes away in car accident

In an unfortunate incident, Dr Debashish Danda, a 60-year-old renowned rheumatologist and retired professor in the Rheumatology Department of Christian Medical College (CMC) Vellore died in a tragic car accident on Saturday.

Dr Debashish, a distinguished figure in the medical community succumbed to his injuries sustained in the accident after his car collided with a container lorry near Vellore. He was recognised worldwide due to his passionate contribution to the field.

For more details check out the link below:

Unfortunate: Prominent Rheumatologist Dr Debashish Danda Dies In Car Accident



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Liquid synthetic detergents good option for Atopic Dermatitis patients

Liquid synthetic detergents are often acidic, making them suitable for individuals with atopic dermatitis. According to new research presented at the 2024 American Academy of Allergy, Asthma & Immunology Annual Meeting, these detergents may provide better results for atopic dermatitis patients.

Due to the many options available and conflicting claims on labels, it may be confusing when looking for skin cleanser products for Atopic dermatitis. However, if manufacturers disclose the pH of their products, it can help narrow down the choices. Liquid synthetic cleansers are particularly effective because they closely resemble the pH of normal skin.
AD skin changes pH from acidic to alkaline, contributing to skin-barrier dysfunction. Researchers investigated the pH of 250 cleansing products used for atopic dermatitis (AD) skincare using an Accumet pH meter. Solutions were made by dissolving 1 mL of liquid product or 1g of bar scrapings in 9 mL of distilled water, and pH values 6.65 to 7.35 were considered neutral.
Findings from this research are:
· Of the 250 cleansing products, 37 were soaps, 32 bar soaps and five liquid soaps, and 213 were synthetic detergents (syndets), 14 bar syndets and 199 liquid syndets.
· All soaps were alkaline
· Soap labels did not disclose pH levels.
· In 14 syndet bars, 6 had neutral pH, and eight were alkaline.
· Among the 199 syndet liquids, 84.9% were acidic, 11.1% were neutral, and 4% were alkaline.
· Only 32 syndets, 16.1%, disclosed pH levels.
· Nine bars were labelled ‘balanced’, with 6 having a neutral pH and 3 having an alkaline pH. Of the remaining 23 syndets, 20 were also referred to as ‘balanced’, with 2 having a neutral pH, 18 with acidic and 3 with a pH range of 4.25 to 6.0″ (pH was 4.40 to 6.11).
· Only 12.8% of cleansers disclosed pH, and the pH varied widely among brands. 84.5% of liquid syndets were acidic, and 11% were neutral.
According to recent findings, liquid syndets may be a better option for patients with atopic dermatitis. Including pH levels on product labels can help health providers advise patients with atopic dermatitis more appropriately.
Reference:
PH Labelling of Skin Cleansers Can Lead to Better Options for People with Atopic Dermatitis. The American Academy of Allergy, Asthma & Immunology (AAAAI). February 20, 2024. https://www.prweb.com/releases/ph-labelling-of-skin-cleansers-can-lead-to-better-options-for-people-with-atopic-dermatitis-302066157.html#:~:text=%22Manufacturers%20that%20choose%20to%20disclose,closely%20mimic%20normal%20skin%20pH.%22&text=Skin%20with%20atopic%20dermatitis%20(AD,contributes%20to%20skin%2Dbarrier%20dysfunction. Date accessed: February 20, 2024.

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AstraZeneca blood disorder drug recommended for EU nod

Cambridge: AstraZeneca has announced that Voydeya (danicopan) has been recommended for marketing authorisation in the European Union (EU) as an add-on to ravulizumab or eculizumab for the treatment of adult patients with paroxysmal nocturnal haemoglobinuria (PNH) who have residual haemolytic anaemia.

Voydeya is a first-in-class, oral, Factor D inhibitor developed as an add-on to standard-of-care Ultomiris (ravulizumab) or Soliris (eculizumab) to address the needs of the approximately 10-20% of patients with PNH who experience clinically significant extravascular haemolysis (EVH) while treated with a C5 inhibitor.

The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) based its positive opinion on results from the pivotal ALPHA Phase III trial. Results from the 12-week primary evaluation period of the trial were published in The Lancet Haematology.

PNH is a rare and severe blood disorder characterised by the destruction of red blood cells within blood vessels, known as intravascular haemolysis (IVH), and white blood cell and platelet activation that can cause thrombosis (blood clots) and result in organ damage and potentially premature death. Immediate, complete and sustained terminal complement inhibition by blocking the C5 protein helps reduce symptoms and complications, resulting in improved survival for patients with PNH. Approximately 10-20% of people living with PNH who are treated with a C5 inhibitor experience clinically significant EVH, which can result in continued symptoms of anaemia and require blood transfusions.

Professor Hubert Schrezenmeier, MD, Medical Director, Institute of Transfusion Medicine at The University of Ulm, said, “C5 inhibition with Ultomiris or Soliris is the standard-of-care in PNH, proven to control IVH and reduce life-threatening thrombotic events, yet a small portion of patients may experience clinically significant EVH. In the ALPHA trial, Voydeya as an add-on to Soliris or Ultomiris increased haemoglobin levels and reduced fatigue, anaemia and transfusion dependence. If approved, Voydeya may optimise care for people impacted by this burdensome condition while allowing patients to maintain disease control with an established C5 inhibitor.”

Marc Dunoyer, Chief Executive Officer, Alexion, said, “The positive CHMP recommendation recognises the promise of Voydeya as an add-on to standard-of-care to address signs and symptoms of clinically significant EVH for this small subset of patients. As we saw in the pivotal ALPHA Phase III trial, dual complement pathway inhibition at Factor D and C5 may be an optimal treatment approach for these patients.”

The ALPHA Phase III trial evaluated the efficacy and safety of Voydeya as an add-on to Ultomiris or Soliris in patients with PNH who experienced clinically significant EVH. Results showed that Voydeya met the primary endpoint of change in haemoglobin from baseline to week 12 and all key secondary endpoints, including transfusion avoidance and change in Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-Fatigue) score.

Results from the ALPHA Phase III trial showed Voydeya was generally well tolerated, and no new safety concerns were identified. 

Voydeya has been granted Breakthrough Therapy designation by the US Food and Drug Administration and PRIority MEdicines (PRIME) status by the EMA. Voydeya has also been granted Orphan Drug Designation in the US, EU and Japan for the treatment of PNH. Voydeya was recently approved in Japan, and regulatory submissions for Voydeya are currently under review in additional countries.

Read also: AstraZeneca Gets CDSCO Panel nod to study Anti-cancer Drug Datopotamab Deruxtecan and Durvalumab

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Simple measurement can predict risk of worsening of widespread kidney disease

A team of researchers from Aarhus University has found a simple method to predict which individuals are at high risk of rapid progression of chronic kidney disease. This could be a significant step towards more effective prevention and treatment.

About ten percent of the Danish population suffers from chronic kidney disease, and some individuals experience rapid deterioration after the diagnosis is made.

Now, a team of researchers from Aarhus University in a comprehensive study has investigated the precise risk of rapid progression, and the result could be a significant step towards more effective treatment of the disease.

The study, which is based on data from Danish health registers, provides healthcare professionals with new insights into how to better identify patients at high risk of rapid worsening of kidney disease.

“We chose to investigate chronic kidney disease because some of the patients experience rapid deterioration of their condition without us knowing exactly who. Our goal was to understand which patients are most at risk and whether we can intervene early to delay or even prevent this progression,” says Professor at the Department of Clinical Medicine at Aarhus University, Christian Fynbo Christiansen, one of the authors of the study.

A simple measurement

The study showed that patients with newly diagnosed mild to moderate chronic kidney disease within three years have a 15 percent risk of rapid progression, which could lead to severe cardiovascular disease or even death.

Surprisingly, the study also showed that the risk of rapid progression varied significantly among patients.

A simple measurement of protein in the urine proved to be a strong indicator of the course of kidney disease.

For women without diabetes or elevated blood pressure/cardiovascular disease and without the protein albumin in their urine, the risk of rapid progression was seven percent, while the risk peaked at 47 percent for men with both diabetes, elevated blood pressure/cardiovascular disease, and albumin in their urine.

“This is an important finding since albumin can be used as an indicator of kidney disease progression, thereby making it possible to identify patients at high risk of rapid deterioration of the disease, and it can improve the prevention of complications and hopefully increase patients’ quality of life,” explains Christian Fynbo Christiansen, adding:

“It underscores the need to use this simple test to a far greater extent.”

Benefit for patients and society

The measurement can help healthcare professionals to target treatment and follow-up to patients at high risk. This could potentially be a significant gain for patients both in Denmark and the rest of the world.

“We hope that this result can contribute to increased awareness of the importance of using readily available markers – including albumin in the urine – to identify patients at high risk of rapid progression,” says Christian Fynbo Christiansen.

And it’s not only the patients who can benefit from the results. Faster and more effective prevention could also potentially help to reduce healthcare costs.

“I think we will focus much more in the future on patients with milder stages of the disease, like those we included in this study. If we get better at preventing and treating chronic kidney disease and its associated complications, it could potentially benefit both patients and society,” explains Christian Fynbo Christiansen.

He emphasizes that further research and development of precise treatment methods are still needed. Although the study provides important insight into risk groups, a precise model for predicting individual patient outcomes is still lacking.

Reference:

Anne H S Vestergaard, Simon K Jensen, Uffe Heide-Jørgensen, Line E Frederiksen, Henrik Birn, Dorte E Jarbøl, Jens Søndergaard, Frederik Persson, Reimar W Thomsen, Christian F Christiansen, Risk factor analysis for a rapid progression of chronic kidney disease, Nephrology Dialysis Transplantation, 2024;, gfad271, https://doi.org/10.1093/ndt/gfad271.

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Repeat CT-guided biopsy Ok, trial does not support PET-CT in diagnostic pathway of non-diagnostic pleural biopsy

Repeat CT-guided biopsy Ok, trial does not support PET-CT in diagnostic pathway of non-diagnostic pleural biopsy suggests a new study published in the European Respiratory Journal.

Pleural biopsy is the gold standard for diagnosis of pleural malignancy but a significant proportion will have an inconclusive biopsy despite ongoing clinical suspicion of malignancy. They investigated whether positron emission tomography-computed tomography (PET-CT) targeted pleural biopsy is superior to standard CT-guided pleural biopsy following an initial non-diagnostic biopsy. The TARGET trial was a multicentre, parallel group randomised trial. Patients with a previous inconclusive pleural biopsy but an ongoing suspicion of pleural malignancy were randomised (1:1) to receive either CT-guided biopsy (standard care) or PET-CT followed by a targeted CT biopsy (intervention).

The primary outcome was pleural malignancy correctly identified from the trial biopsy. Results: Between September 2015 and September 2018, 59 participants were randomised from eight UK hospital sites: 29 to CT-only followed by targeted biopsy and 30 to PET-CT followed by targeted biopsy. The proportion of pleural malignancy correctly identified was similar between the groups (risk ratio 1.03 (95% CI 0.83–1.29); p=0.77). The sensitivity of the trial biopsy to identify pleural malignancy was 79% (95% CI 54–94%) in the CT-only group versus 81% (95% CI 54–96%) in the PET-CT group. The results do not support the practice of PET-CT to guide pleural biopsies in patients with a previous non-diagnostic biopsy. The diagnostic sensitivity in the CT-only group was higher than anticipated and supports the practice of repeating a CT-guided biopsy following an inconclusive result if clinical suspicion of malignancy persists.

Reference:

Duneesha de Fonseka, David T. Arnold, Helena J.M. Smartt, Lucy Culliford, Louise Stadon, Emma Tucker, Anna Morley, Natalie Zahan-Evans, Anna C. Bibby, Geraldine Lynch, Eleanor Mishra, Shahul Khan, Mohammed Haris, Henry Steer, Leon Lewis, Alina Ionescu, John Harvey, Kevin Blyth, Najib M. Rahman, Anthony E. Edey, Chris A. Rogers, Nick A. Maskell European Respiratory Journal 2024 63: 2301295; DOI: 10.1183/13993003.01295-2023

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Triple combo of alpha-lipoic acid, epalrestat, and mecobalamin better for treating diabetic peripheral neuropathy than monotherapy : study

A triple combo of alpha-lipoic acid, epalrestat, and mecobalamin is better for treating diabetic peripheral neuropathy than monotherapy finds a new study published in the Journal of Diabetes and its Complications.

Alpha-lipoic acid, epalrestat, and mecobalamin are widely used as monotherapies for diabetic peripheral neuropathy. However, whether a triple-combination therapy with these three drugs is superior to monotherapy or dual therapy remains debatable. Nine randomized controlled trials were identified through a search on electronic databases such as PubMed, Web of Science, and Cochrane Library. The trial participants (N = 1153) were divided into the experimental group which received the triple-combination therapy and the control group who received conventional or dual therapy with the aforementioned drugs. Results: Therapeutic outcomes were better in the experimental group than in the control group (odds ratio: 3.74; 95 % confidence interval: 2.57–5.45; I2 = 0 %; p < 0.00001).

No statistical difference was noted in adverse effects. Compared with the control group, the experimental group exhibited significant improvements in median motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV), peroneal MNCV, peroneal SNCV, and vibration perception thresholds (VPT) in the left and right lower limbs. In the control group, a subgroup analysis by treatment strategy revealed similar improvements in total efficacy, MNCV, and SNCV. For diabetic peripheral neuropathy, triple-combination therapy may be more effective than monotherapy or dual therapy.

Reference:

Gui-Lin Ran, Yan-Ping Li, Li-Chin Lu, Shao-Huan Lan. Disease-modifying therapies for diabetic peripheral neuropathy: A systematic review and meta-analysis of randomized controlled trials. Journal of Diabetes and its Complications, Volume 38, Issue 2, 2024, 108691, ISSN 1056-8727. https://doi.org/10.1016/j.jdiacomp.2024.108691. (https://www.sciencedirect.com/science/article/pii/S1056872724000175)

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Patch test and biopsies may help detect gingival hypersensitivity reactions to oral hygiene products

Patch test and biopsies may aid in the detection of gingival hypersensitivity reactions to oral hygiene products suggests a new study published in the Journal of American Dental Association.

Hypersensitivity reactions to toothpaste are rare. The objective of this study was to present the authors’ clinical cases in the past 10 years and perform a scoping review of gingival hypersensitivity responses to toothpaste. The authors reviewed records of documented gingival hypersensitivity reactions to dentifrices at the Postgraduate Clinic of Oral Medicine, Complutense University, Madrid, Spain, from January 2013 through December 2022. Furthermore, the authors conducted a search in PubMed with no date limit for articles reporting these hypersensitivity responses up through October 18, 2023. Results: Eleven cases were collected from the clinic. Eight gingival hypersensitivity reactions occurred in women, and 6 were associated with cinnamon. The most frequent lesions diagnosed were red gingiva. The discontinuation of the toothpaste led to the disappearance of the lesions. The search yielded 643 references. Thirteen articles were included in the scoping review, all of them case series and case reports, reporting 32 cases. Lesions affected middle-aged women most frequently, the most common hypersensitivity reaction was gingival redness, and the cases implicated toothpastes containing cinnamon and herbal composition. This study provides clues for diagnosing and treating hypersensitivity reactions to toothpaste, which may improve the identification, management, and reporting of these cases.

Reference:

López-Pintor RM, González-Serrano J, Ivaylova Serkedzhieva K, Serrano Valle J, de Arriba L, Hernández G, Sanz M. Gingival hypersensitivity reactions to toothpaste: A case series and scoping review. J Am Dent Assoc. 2024 Jan 11:S0002-8177(23)00680-3. doi: 10.1016/j.adaj.2023.11.003. Epub ahead of print. PMID: 38206258.

Keywords:

Patch test, biopsy, detection, gingival, hypersensitivity reactions, oral hygiene products, López-Pintor RM, González-Serrano J, Ivaylova Serkedzhieva K, Serrano Valle J, de Arriba L, Hernández G, Sanz M, Journal of American Dental Association, Hypersensitivity reactions; allergic reactions; dentifrice; gingiva; hypersensitivity response; toothpaste.

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Feeding donor human milk versus preterm formula during birth hospitalization, which is better for preterm infants? Study sheds light

USA: A recent study published in the Journal of the American Medical Association (JAMA) showed comparable 2-year neurodevelopmental outcomes among extremely preterm infants fed donor human milk versus infants fed preterm formula.

“In the randomized clinical trial, the Bayley Scales of Infant and Toddler Development (BSID) adjusted mean cognitive score for infants fed donor human milk was 80.7 (measured at 22-26 months corrected age) versus 81.1 for infants fed preterm formula (adjusted between-group mean difference, −0.77), which was not a significant difference,” the researchers reported. Also, there was no difference in the adjusted mean language and motor scores.

Maternal milk feeding of extremely preterm infants during birth hospitalization has been linked with better neurodevelopmental outcomes compared to the preterm formula. For infants receiving no or minimal maternal milk, there is no information on whether donor human milk conveys similar neurodevelopmental advantages versus preterm formula.

To fill this knowledge gap, Tarah T. Colaizy, University of Iowa, Iowa City, and colleagues aimed to determine if among extremely preterm infants who received minimal maternal milk, nutrient-fortified, pasteurized donor human milk improves neurodevelopmental outcomes at 22 to 26 months corrected age compared with preterm infant formula.

For this purpose, the research team conducted a double-blind, randomized clinical trial at 15 US academic medical centres within the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. The study enrolled infants younger than 29 weeks 0 days gestation or with a birth weight of less than 1000 g between 2012 and 2019.

Exposures were preterm formula or donor human milk feeding from randomization to 120 days of age, death, or hospital discharge. • Of 1965 eligible infants, 483 were randomized (239 in the donor milk group and 244 in the preterm formula group); the median gestational age was 26 weeks, the median birth weight was 840 g, and 52% were female.

The study’s primary outcome was the BSID cognitive score measured at 22 to 26 months corrected age; a score of 54 (score range, 54-155; a score of ≥85 indicates no neurodevelopmental delay) was assigned to infants who died between randomization and 22 to 26 months corrected age. The 24 secondary outcomes included BSID language and motor scores, necrotizing enterocolitis, in-hospital growth, and death.

Key findings of the study include:

  • Fifty-four infants died before follow-up; 88% of survivors were assessed at 22 to 26 months of corrected age.
  • The adjusted mean BSID cognitive score was 80.7 for the donor milk group vs 81.1 for the preterm formula group (adjusted mean difference, −0.77, which was not significant); the adjusted mean BSID language and motor scores also did not differ.
  • Mortality (death before follow-up) was 13% in the donor milk group vs 11% in the preterm formula group (adjusted risk difference, −1%).
  • Necrotizing enterocolitis occurred in 4.2% of infants in the donor milk group vs 9.0% of infants in the preterm formula group (adjusted risk difference, −5%).
  • Weight gain was slower in the donor milk group (22.3 g/kg/d) compared with the preterm formula group (24.6 g/kg/d).

“Neurodevelopmental outcomes at 22 to 26 months’ corrected age did not differ between infants fed donor milk or preterm formula, among extremely preterm neonates fed minimal maternal milk,” the researchers concluded.

Reference:

Colaizy TT, Poindexter BB, McDonald SA, et al. Neurodevelopmental Outcomes of Extremely Preterm Infants Fed Donor Milk or Preterm Infant Formula: A Randomized Clinical Trial. JAMA. Published online January 30, 2024. doi:10.1001/jama.2023.27693

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