Poor quality clinical data informing NICE decisions on treatments in over half of cases

The quality of evidence submitted to the National Institute for Health and Care Excellence (NICE) for informing its decisions to recommend technologies for use in the NHS was poor in more than half of cases, reveals a 20-year analysis published in the open access journal BMJ Open.

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Acupuncture may curb heightened risk of stroke associated with rheumatoid arthritis

A course of acupuncture may curb the heightened risk of stroke associated with rheumatoid arthritis, finds a comparative study published in the open access journal BMJ Open.

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New digital therapy reduces anxiety and depression in people living with long-term physical health conditions

A therapist-guided digital cognitive behavioral therapy reduced distress in 89% of participants living with long-term physical health conditions, a new King’s College London study finds. The findings appear in Psychological Medicine.

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Menopause and migraines: New findings point to power of prevention

For middle-aged women plagued by migraines, or hot flashes and night sweats, another worry may linger in the backs of their minds: whether these experiences have set them up for a heart attack, a stroke or another cardiovascular crisis.

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Committe to address grievances, demands of doctors: Himachal CM Sukhu

Shimla: Himachal Pradesh Chief Minister Sukhvinder Singh Sukhu has given directions for constituting a committee under the chairmanship of Special Secretary (Health) to look into the grievances and demands of the medical officers of the state. 

The Committee will comprise of Director Health and Family Welfare, Director, Medical Education and representatives of the Medical Officers Association. He said that this committee would also study the various aspects of promotions of the doctors and recommend guidelines for the betterment of medical officers.

The Chief Minister said that the State Government was considering all their genuine demands sympathetically, but the financial condition of the State is precarious, a release said.

Also Read:North Bengal Medical College and hospital gets Duarey Council for healthcare grievances

Due to the efforts of the state government, the economy of the state is coming back on the track gradually, he said.

“My Government will surely provide the financial benefits of the government employees in due course,” he assured. The Chief Minister urged the doctors to cooperate with the State Government and assist in improving the economy of the State.

Chief Minister said that they are focusing to strengthen the health infrastructure in the State to provide specialized health services to the people at their doorsteps.

The Government is setting up Adarsh Swasthya Sansthans in all 68 assembly constituencies of the state, with six specialist doctors in each.

To meet shortage of doctors and para-medical staff in health institutions, the State Government is recruiting new medical officers and supporting staff.

Plans are underway to improve working conditions in health institutions and introduce fixed eight-hour shift for medical personnel, the release said.

The Chief Minister said that overseas exposure visits would also be conducted for the doctors on the latest techniques and skills in health care sector. He directed the Health Department to digitize the data of medical officers to streamline their functioning.

Also Read:56 hospitals to be soon digitized under Health Information Management System: Himachal Pradesh CM

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Lupin unveils Bromfenac Ophthalmic Solution, 0.075% in US

Mumbai: Global pharma major Lupin Limited has announced
the launch of Bromfenac Ophthalmic Solution, 0.075%, after having received an approval from the
United States Food and Drug Administration (U.S. FDA).

Bromfenac Ophthalmic Solution, 0.075% is a generic equivalent of BromSite Ophthalmic Solution,
0.075%, of Sun Pharmaceutical Industries Limited.
It is indicated for the treatment of postoperative
inflammation and prevention of ocular pain in patients undergoing cataract surgery.
Bromfenac Ophthalmic Solution 0.075% (RLD BromSite) had estimated annual sales of USD 15 million
in the U.S. (IQVIA MAT December 2023).
Read also: Lupin bags USFDA nod for Bromfenac Ophthalmic Solution, 0.075%
Lupin is an innovation-led transnational pharmaceutical company headquartered in Mumbai, India. The
Company develops and commercializes a wide range of branded and generic formulations, biotechnology
products, and APIs in over 100 markets in the U.S., India, South Africa, and across the Asia Pacific (APAC), Latin
America (LATAM), Europe, and Middle East regions.
The Company specializes in the cardiovascular, anti-diabetic, and respiratory segments and has
a significant presence in the anti-infective, gastro-intestinal (GI), central nervous system (CNS), and women’s
health areas. The company
invested 7.9% of its revenue in research and development in FY23.
Lupin has 15 manufacturing sites, 7 research centers.
Read also: Lupin posts bigger-than-expected rise in Q3 profit

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Glutamate Infusion Reduces Kidney Injury After Cardiac Surgery: JAMA

A recent study published in the Journal of American Medical Association unveiled promising results regarding the prevention of acute kidney injury (AKI) following cardiac surgery. This study explored the potential benefits of utilizing glutamate infusion during coronary artery bypass graft (CABG) procedures. 

Acute kidney injury (AKI) is a serious complication associated with cardiac surgery that contributes to increased morbidity and mortality rates among patients. Despite numerous attempts to reduce this risk, success rate has been limited. Thereby, GLUTAMICS (Glutamate for Metabolic Intervention in Coronary Surgery) study pooled data from two prospective, randomized, double-blind multicenter trials and was conducted across five cardiac surgery centers in Sweden. The trials spanned from 2005 to 2020 and included a total of 791 patients without diabetes who were undergoing CABG surgery.

During the procedure, patients received either intravenous infusion of l-glutamic acid or saline. The results found that patients who received glutamate infusion expressed a significantly lower risk of AKI with a relative risk reduction of 51% when compared to the control group. Also, the need for dialysis post-surgery was significantly lower in the glutamate group.

The study emphasized the importance of these findings by highlighting that glutamate infusion represents a potentially transformative approach to AKI prevention in cardiac surgery patients. While further research is mandated to validate these results, the positive implications for patient care are profound from this research.

Globally, cardiac surgeons and medical professionals are optimistic about the implications of this study. If confirmed in future trials, glutamate infusion could become a standard intervention for patients against AKI during CABG procedures which ultimately improve the patient outcomes and reduce healthcare burdens.

Source:

Holm, J., Vanky, F., & Svedjeholm, R. (2024). Association of Glutamate Infusion With Risk of Acute Kidney Injury After Coronary Artery Bypass Surgery. In JAMA Network Open (Vol. 7, Issue 1, p. e2351743). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.51743

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Overweight adolescents with high fasting blood sugar at higher risk of subclinical atherosclerosis

Previous studies have suggested the association of incident diabetes with higher carotid intima-media thickness, coronary artery calcium scores ⩾of 400, and incident cardiovascular events.

According to a study published in Jornal de Pediatria, researchers have concluded that Adolescents who are overweight and exhibit elevated fasting blood sugar levels face an increased risk of subclinical atherosclerotic disease or SAD.
This Cross-sectional study included 161 adolescents aged 10-19 years with a BMI of ≥ +1 z-Score. To assess subclinical atherosclerotic disease, ultrasound was used to evaluate IMT (Carotid intima-media complex thickness).
The cardiometabolic indicators were age, sex, nutritional status, central adiposity, blood pressure, lipid profile, and glycemic profile. The data was presented using central tendency, dispersion measures, and absolute and relative frequency.
Pearson or Spearman correlation and multiple regression modelling determined the relationship between IMT measurement and other variables and predictors of IMT.
Key findings from the study are:
23.7 % had Carotid thickening.
The prevalence of abnormal fasting glucose was the lowest.
Age and fasting glucose were predictors of IMT increase.
IMT decreased by 1 % with age yearly and increased by 0.24 % per mg/dL with glucose.
They said the main objective of our study was to build a model based on cardiometabolic indicators, allowing the identification of overweight adolescents at higher risk of SAD. We found adolescents at higher risk are younger with higher fasting glycemia levels.
Reference:
Medeiros, Camila M., et al. “Fasting Glucose: a Cardiometabolic Indicator for Subclinical Atherosclerosis On Excess Weight Adolescents.” Jornal De Pediatria, 2024.

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ADB approves Rs 4k crores loan to boost health infrastructure in Maharashtra

Thane: Maharashtra Chief Minister Eknath Shinde on Monday said the Asian Development Bank will provide loan of Rs 4,000 crore to improve medical facilities in the state.

The in principle approval for the first tranche of Rs 1,200 crore has been given, he added.

“The Asian Development Bank has sanctioned the pending proposal of Rs 4000 crore loan to Maharashtra for creating advanced healthcare infrastructure and medical education. It has also given in-principle approval for Rs 1,200 crore in the first phase,” the CMO said in a statement.

Also Read:Over Rs 112 crore financial aid to over 13000 patients in just 14 months in Maha: Official

It said the CM had instructed officials to start work on a 500-bed hospital in Dharashiv (formerly Osmanabad).

“The ADB has suggested seven different types of improvements at administrative level as well as in medical education. It includes centre of excellence, digital medical education and health policy, e-hospital, encouragement to medical officers and staff, property management, sustainability policy, recruitment centres, decentralisation of medicine procurement,” it said.

“The ADB would be giving Rs 1,200 crore for construction of the hospital. The tender procedure for construction of similar infrastructure at Alibaug in Raigad district is completed while process for Kolhapur and Sindhudurg is going on,” the release quoted him as saying.

Speaking after inaugurating a super speciality hospital in Ulhasnagar in Thane, Shinde his government aimed to start a medical college and super speciality hospital in every district.

Shinde hailed the cashless hospitalisation system prevalent in Thane and said he would take efforts to replicate it across the state.

Shinde also said he had carried out the “biggest surgery in the state” as everything was in a bad state, a reference to his rebellion in June 2022 which brought down the Uddhav Thackeray-led Maha Vikas Aghadi government.

Also Read:Maharashtra to Set up Super-Specialty Hospitals in 34 districts

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Many Adults and kids may report shortness of breath after recovery from COVID-19 infection: Study

Research evidence describes new and persistent symptoms and conditions as potential post-acute sequelae of SARS-CoV-2 infection (PASC).

In their recent investigation, Yongkang Zhang et al. and colleagues concluded that hospitalized SARS-CoV-2 patients are at higher risk of developing specific symptoms and conditions following acute infection. This study is published in BMC Infectious Diseases.
In this retrospective investigation, scientists analyzed the prevalence of particular symptoms and conditions linked to COVID-19 as potential post-acute sequelae of SARS-CoV-2 infection occurring between 31 to 150 days after a SARS-CoV-2 test in both adults and children with positive and negative test outcomes.
The study used data from electronic health records (EHR) from 43 PCORnet sites participating in a national COVID-19 surveillance program. It involved over 3 million adults and over 675,000 children who underwent a SARS-CoV-2 laboratory test between March 1, 2020, and May 31, 2021, as recorded in their HER. Logistic regression and Cox models were used to calculate the risk and estimate the odds of having symptoms.
Key findings of the study are:
  • Out of 3,091,580 adults, 316,249 were SARS-CoV-2 positive, and 2,775,331 were negative.
  • Among 675,643 children, 62,131 were positive and 613,512 negative.
  • Hospitalized adults and children who had positive tests had increased odds of being diagnosed with more than 1 symptom, with aOR of 1.17 and 1.18 for adults and children, respectively.
  • The aOR for shortness of breath in adults and children were 1.50 and 1.40, respectively, 31–150 days following a SARS-CoV-2 test when compared to those who were hospitalized individuals with a negative test.
  • Hospitalized adults with a positive test had a higher risk of being diagnosed with ≥ 3 symptoms or fatigue.
  • Among hospitalized adults with a positive test, there were higher risks of being newly diagnosed with type 1 or type 2 diabetes, haematological disorder or respiratory disease with aHR of 1.25, 1.19 and 1.44, respectively.
  • Non-hospitalized adults with a positive test also had a greater risk of being diagnosed with specific symptoms or conditions.

We observed that variations in symptoms and conditions after SARS-CoV-2 infection were more pronounced among hospitalized patients than non-hospitalized individuals. This aligns with previous literature indicating that individuals with severe acute SARS-CoV-2 infection, such as those requiring hospitalization, are at increased risk of experiencing post-acute sequelae of SARS-CoV-2 infection (PASC) symptoms and conditions.

The results of this study have both clinical and public health implications, they added.
Study limitations include underestimating and underestimating prevalence and symptoms using EHR data, different lengths of baseline periods, lower specificity, and non-inclusion of covariates, such as vaccination status.
Reference:
Zhang, Y et al. Association between SARS-CoV-2 infection and select symptoms and conditions 31 to 150 days after testing among children and adults. BMC Infect Dis 24, 181 (2024). https://doi.org/10.1186/s12879-024-09076-8

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