Flapless Immediate Implants with Bone Graft May Aid Bone Preservation, reveals research

A recent study published in Clinical and Experimental Dental Research suggests that flapless immediate implant placement combined with bone grafting may help preserve alveolar bone more effectively than traditional approaches. Authored by Xiang et al., the research highlights that this minimally invasive technique—where implants are placed directly into the extraction socket without raising a flap—could reduce postoperative bone loss, improve esthetic outcomes, and potentially shorten recovery time. The study analyzed clinical outcomes from patients undergoing flapless immediate implant placement with graft material added to fill the peri-implant gap, observing promising early results in bone volume retention. However, the authors emphasize that while these findings are encouraging, long-term randomized trials are needed to validate the technique’s consistency and compare it against conventional implant protocols. Preservation of the alveolar ridge following tooth extraction is critical for both function and esthetics, especially in anterior zones, and bone grafting at the time of implant placement may offer structural support and enhance soft tissue contour. The study contributes to the growing interest in flapless surgical techniques in implant dentistry, which aim to reduce trauma, maintain blood supply, and promote faster healing. As implantology continues to evolve toward patient-centered, minimally invasive care, this approach offers a potential pathway for balancing surgical efficiency with biological preservation. Clinical decision-making, however, should consider individual bone quality, implant site morphology, and operator experience.

Keywords: flapless implant, immediate implant placement, bone grafting, alveolar bone preservation, Xiang et al., Clinical and Experimental Dental Research, dental implant surgery, ridge preservation, peri-implant bone, minimally invasive dentistry

Reference:
Xiang, Y., et al. (2024). Flapless immediate implant placement combined with bone grafting for alveolar ridge preservation: A clinical evaluation. Clinical and Experimental Dental Research. https://doi.org/10.1002/cre2.70182

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Polygenic Risk Score Outperforms PSA and MRI in Detecting Clinically Significant Prostate Cancer: NEJM

Researchers have found in a new BARCODE1 study that a polygenic risk score identified a higher proportion of clinically significant prostate cancer compared to PSA or MRI screening, which would have missed 71.8% of cases. Further Overdiagnosis rates were comparable to those seen in previous PSA-based studies. The study was published in The New England Journal of Medicine by Jana K. and fellow researchers. This method might provide a more accurate and focused way of detecting high-risk individuals who would be indicated for more extensive diagnostic assessment.

The UK trial sought to investigate whether germline genetic information could enhance prostate cancer detection earlier, by targeting those with the greatest genetic risk with screening. Through the use of genome-wide association data to determine a polygenic risk score based on 130 established variants, researchers were able to target those in the top 10% of genetic risk and invite them for screening with multiparametric MRI and transperineal biopsy, irrespective of PSA.

Men aged 55 to 69 years were recruited from primary care centers in the UK. Saliva was sampled to yield germline DNA that was then used to compute a polygenic risk score for each participant based on 130 known prostate cancer-associated genetic variants. Of 40,292 men invited to join, 8953 (22.2%) were interested, and 6393 received polygenic risk score testing. The 745 men with a score at or above the 90th percentile (11.7%) were offered intensive screening. This included multiparametric MRI followed by transperineal biopsy, regardless of the participants’ PSA levels.

Key Findings

  • Of 40,292 invited men, 6393 had polygenic risk scoring.

  • 745 men (11.7%) were classified in the top 10% of genetic risk.

  • 468 of these men (62.8%) underwent MRI and biopsy.

  • 187 (40.0%) were found to have prostate cancer.

  • 103 (55.1%) had cancer of intermediate or higher risk that needed treatment.

  • 74 (71.8%) of these high cases would not be detected with existing PSA-based methods.

  • 40 men (21.4%) had high-risk or very high-risk prostate cancer.

This British study offers strong evidence that prostate cancer screening using polygenic risk scores can identify more clinically relevant cancers than conventional PSA-based methods. The approach has the potential to be a revolutionary step towards more personalized and efficient cancer screening. Applying genetic information to select men most likely to gain from more sophisticated diagnostic equipment can contribute to alleviating the population burden of undetected, high-risk prostate cancer.

Reference:

McHugh, J. K., Bancroft, E. K., Saunders, E., Brook, M. N., McGrowder, E., Wakerell, S., James, D., Rageevakumar, R., Benton, B., Taylor, N., Myhill, K., Hogben, M., Kinsella, N., Sohaib, A. A., Cahill, D., Hazell, S., Withey, S. J., Mcaddy, N., Page, E. C., … Eeles, R. A. (2025). Assessment of a polygenic risk score in screening for prostate cancer. The New England Journal of Medicine, 392(14), 1406–1417. https://doi.org/10.1056/nejmoa2407934

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Rising FIB-4 Scores Signal Higher Risk of Liver Stiffness and Mortality in MASLD Patients: Study Shows

China: A new study published in Clinical Gastroenterology and Hepatology suggests that tracking dynamic changes in the Fibrosis-4 Index (FIB-4) can provide valuable insights into liver stiffness progression, fibrosis advancement, and future clinical outcomes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). The research, led by Ming-Hua Zheng and colleagues from the Institute of Hepatology, Wenzhou Medical University, emphasizes the prognostic value of monitoring FIB-4 over time rather than relying solely on baseline measurements.

The study assessed three large cohorts to evaluate the relationship between longitudinal FIB-4 changes and disease outcomes. The VCTE-Prognosis cohort (n=10,203) was analyzed for liver stiffness progression, the Paired Liver Biopsy cohort (n=1,145) for histological fibrosis progression, and the Wenzhou Real-World (WRW) cohort (n=41,105) for clinical outcomes of mortality, cardiovascular events, and liver-related complications.

Patients were divided into low (<1.3) and high (≥1.3) FIB-4 groups. An increase in FIB-4 was defined as a ≥20% rise, with additional thresholds for patients moving from low to high categories.

The study led to the following findings:

  • In the VCTE-Prognosis cohort, patients with low baseline FIB-4 who showed rising scores had over twice the risk of liver stiffness progression compared to those with stable levels (adjusted OR=2.36).
  • In the high FIB-4 group, rising scores were linked to more than a threefold increase in liver stiffness progression risk (adjusted OR=3.42).
  • Data from the Paired Liver Biopsy cohort indicated that increasing FIB-4 scores significantly raised the likelihood of a one-stage fibrosis progression (adjusted OR=2.20 in low FIB-4; adjusted OR=3.68 in high FIB-4).
  • In the WRW real-world cohort, dynamic increases in FIB-4 were strongly associated with higher risks of all-cause mortality, cardiovascular events, and liver-related complications.

“These findings indicate that longitudinal changes in FIB-4 serve as a predictive marker not only for structural liver deterioration but also for overall prognosis in MASLD patients,” the researchers wrote.

According to the researchers, this approach addresses a critical gap in current clinical practice, where single-time FIB-4 values are often used for risk stratification. By incorporating serial monitoring, clinicians can identify patients at higher risk earlier and intervene proactively to prevent disease progression and adverse outcomes.

However, the authors note that despite the robust sample size across cohorts, further validation in diverse populations is warranted. They suggest integrating dynamic FIB-4 tracking into routine MASLD management protocols alongside other non-invasive assessments to improve patient monitoring and treatment strategies.

“The study highlights the clinical significance of monitoring FIB-4 trends over time. A ≥20% rise in FIB-4 levels was consistently linked with increased risks of worsening liver stiffness, fibrosis progression, and adverse events, highlighting its potential as a practical tool for early risk detection and personalized care in MASLD management,” the authors concluded.

Reference:

Zhou, X., Li, Y., Kim, S. U., Cheuk-Fung Yip, T., Petta, S., Nakajima, A., Tsochatzis, E., Shi, J., Chan, W., Boursier, J., Bugianesi, E., Yilmaz, Y., Hagström, H., Romero-Gomez, M., Alswat, K., Calleja, J. L., Takahashi, H., De Lédinghen, V., Castéra, L.,… Zheng, M. (2025). Longitudinal Changes in Fibrosis Markers: Monitoring Stiffness/Fibrosis Progression and Prognostic Outcomes in MASLD. Clinical Gastroenterology and Hepatology. https://doi.org/10.1016/j.cgh.2025.07.011

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Older paternal age linked to higher miscarriage risk and lower live birth rates in donor egg IVF cycles, new study finds

A new international study presented today at the 41st Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) reveals that IVF cycles involving male partners over the age of 45 carry significantly increased miscarriage risks and lower live birth rates – even when young donor eggs are used.

By isolating paternal age from female reproductive factors through the exclusive use of donor eggs from young women, the study provides robust evidence that male age plays a critical role in reproductive success, challenging the common assumption that sperm age has little impact once fertilisation occurs.

The retrospective study analysed 1,712 first oocyte donation cycles conducted between 2019 and 2023 across six IVF centres in Italy and Spain. All cycles used fresh donor oocytes (mean donor age 26.1 years) and frozen sperm from male partners, with only the first single blastocyst transfer included. Female recipients had a mean age of 43.3 years.

Participants were divided into two groups: men aged 45 or younger (n=1,066) and those over 45 (n=646). While fertilisation rates and embryo development were comparable between groups, significant differences emerged in clinical outcomes.

Miscarriage rates were notably higher among couples where the male partner was over 45, reaching 23.8% compared to 16.3% in the younger paternal age group. Similarly, live birth rates were significantly lower in the older paternal age group, at 35.1% versus 41% for men aged 45 or younger.

Discussing the findings, Dr. Maria Cristina Guglielmo, Embryologist at Eugin Italy, said, “Traditionally, maternal age has been the central focus in reproductive medicine, but our results show that the age of the male partner also plays a crucial and independent role. Even when using eggs from young, healthy donors and transferring only a single, high-quality embryo, we observed poorer outcomes in men over 45.”

Explaining the potential underlying mechanisms, Dr. Guglielmo elaborated, “As men age, the continuous division of spermatogonial stem cells increases the chance of DNA replication errors. This results in a greater number of new genetic mutations and a higher rate of sperm aneuploidy, where sperm carry abnormal chromosomes. Older paternal age is also linked to increased sperm DNA fragmentation and changes in the epigenetic profile of sperms, such as DNA methylation.”

She continued, “Together, these factors affect both the genetic integrity and the functional quality of sperm, which can impair embryo development and contribute to a higher risk of miscarriage.”

Highlighting the clinical implications, Dr. Guglielmo stated, “Our findings underscore the need for fertility clinics to adopt a more balanced approach that recognises the role of paternal age, even in donor egg cycles where maternal factors are controlled”, she said. “Clinics should ensure that male patients are fully informed about how advancing paternal age can impact fertility potential, pregnancy success, and miscarriage risk.”

Looking ahead, Dr. Guglielmo outlined the research priorities: “Our future studies will aim to deepen understanding of the biological mechanisms behind the impact of paternal age, focusing on sperm DNA damage, oxidative stress, and epigenetic changes.”

She also emphasised the importance of examining how paternal age affects the health of offspring. “There is growing evidence linking advanced paternal age to an increased risk of neurodevelopment disorders in children. Our future work will investigate the long-term health and developmental outcomes of children conceived through donor egg cycles with older fathers, where maternal factors are minimised, to isolate paternal effects more clearly.”

Professor Dr. Carlos Calhaz-Jorge, Immediate Past Chair of ESHRE, said, “This is an important paper that draws attention to an often-overlooked factor in the IVF field. Although it might be interesting to further subdivide the ‘older paternal age’ group (for instance, would men over 55 show even poorer outcomes?), the results presented should be seriously considered during the counselling process for couples in which the male partner is over 45.”

Reference:

Older paternal age linked to higher miscarriage risk and lower live birth rates in donor egg IVF cycles, new study finds, European Society of Human Reproduction and Embryology, Meeting: ESHRE 41st Annual Meeting.

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Sulfhydryl-Containing Foods and Drugs Linked to Pemphigus Vulgaris Risk: Study

Turkey: New research has revealed that foods and medications containing sulfhydryl groups may trigger the onset of pemphigus vulgaris or worsen existing disease symptoms.

The study, published in Postepy Dermatologii i Alergologii (Advances in Dermatology and Allergology), was conducted by Dr. Goknur Ozaydın Yavuz and colleagues from the Department of Dermatology, Health Sciences University, Istanbul, Turkey. It explored the potential link between serum total sulfhydryl (TSH) levels and the autoimmune skin condition pemphigus vulgaris (PV). 

Pemphigus vulgaris is a rare and potentially life-threatening autoimmune blistering disease characterized by the production of autoantibodies against desmoglein-1 and desmoglein-3, which are essential components in maintaining skin cell adhesion. The disruption of these proteins leads to acantholysis—the loss of cell-to-cell adhesion in the skin—and the formation of painful blisters and erosions.

Sulfhydryl groups, also known as thiol groups, play a crucial role in maintaining cellular function. They are involved in antioxidant defense, detoxification, cellular proliferation, and programmed cell death. Previous research has suggested that chemical exposure, including that containing sulfhydryl compounds, may contribute to acantholysis and subsequent skin damage.

To investigate this further, the research team conducted a case-control study involving 177 participants, including 86 patients diagnosed with pemphigus vulgaris and 91 healthy individuals as controls. Detailed demographic and lifestyle data—including age, gender, smoking and alcohol habits, and dietary intake of foods known to trigger pemphigus—were recorded for each participant.

The diagnosis of PV was established through clinical evaluation, histopathological findings, and confirmation via direct and indirect immunofluorescence tests. Blood samples were collected, and serum total sulfhydryl levels were measured using a spectrophotometric method.

The findings revealed the following:

  • The average age of patients in the pemphigus vulgaris (PV) group was 41.94 years.
  • The average age in the control group was 39.86 years.
  • Smoking was in 62.8% of the PV patients.
  • Alcohol consumption was observed in 32.6% of the PV patients.
  • There was a statistically significant difference in serum total sulfhydryl levels between the PV and the control group.

Based on these results, the authors concluded that compounds containing sulfhydryl groups—commonly found in certain medications and foods—may play a role in triggering or exacerbating pemphigus vulgaris. The exact mechanisms remain to be fully understood, but the study emphasizes the potential importance of monitoring sulfhydryl exposure in individuals diagnosed with PV or at risk for the disease.

The research adds to growing evidence that environmental and dietary factors may influence the course of autoimmune skin diseases. Further studies are needed to clarify the causal relationships and to establish dietary guidelines that may help in managing or preventing PV flare-ups.

Reference:

Ozaydın Yavuz, Goknur, et al. “Evaluation of Total Sulfhydryl Levels and Dietary Habits in Pemphigus Vulgaris.” Postepy Dermatologii I Alergologii, vol. 42, no. 3, 2025, pp. 255-258.

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Diabetic Retinopathy Severity Linked to Increased Heart Failure Risk in Patients with Diabetes and CKD: Study

Taiwan: A new study published in Scientific Reports has shed light on the relationship between diabetic retinopathy (DR) severity and heart failure (HF) risk in individuals with both diabetes and chronic kidney disease (CKD). Conducted by Dr. Ping-Hsun Wu and colleagues from Kaohsiung Medical University Hospital in Taiwan, the research highlights how worsening retinal microvascular damage may signal increased vulnerability to cardiovascular complications, including HF.

The observational cohort study involved 1,503 adults diagnosed with both diabetes and CKD. Participants underwent detailed retinal imaging (fundus photography), and DR severity was categorized into three groups, ranging from mild or no apparent retinopathy to proliferative diabetic retinopathy (PDR). The researchers then assessed whether the extent of DR correlated with concurrent HF and predicted future hospitalizations due to HF over five years.

The study revealed the following findings:

  • Statistical analysis showed a strong association between advanced diabetic retinopathy and an increased likelihood of heart failure.
  • Patients with severe DR had more than twice the odds of having concurrent heart failure compared to those with mild or no DR (adjusted odds ratio: 2.09).
  • Among individuals without heart failure at baseline, those with moderate-to-severe DR had a notably higher risk of being hospitalized for heart failure during follow-up.
  • The hazard ratio for heart failure hospitalization was 1.37 in patients with severe non-proliferative DR.
  • The hazard ratio increased to 1.86 in those with proliferative DR compared to individuals with less severe forms of DR.

These findings suggest that the severity of diabetic retinopathy could serve as a valuable clinical indicator of cardiovascular risk, particularly in a population already burdened with diabetes and CKD. The results reinforce the interconnected nature of microvascular and macrovascular complications in diabetes and highlight the importance of holistic monitoring.

However, the authors caution that the observational nature of the study does not allow for conclusions about causality. Certain confounding factors, such as duration of diabetes, statin adherence, and the type of heart failure—preserved versus reduced ejection fraction—were not captured in detail. These limitations highlight the need for future prospective studies incorporating broader datasets and more refined cardiovascular assessments.

According to the authors, the study also raises the possibility that DR may act as a visual marker of underlying cardiovascular strain. Retinal imaging, a relatively non-invasive and accessible diagnostic tool, could be integrated into routine risk assessments to help identify patients at heightened risk of HF progression.

The authors concluded, “Among adults with diabetes and CKD, DR severity appears to be independently associated with both existing heart failure and future risk of HF-related hospitalization. Incorporating DR assessments into cardiovascular screening protocols may enhance risk stratification and aid in the timely implementation of preventive strategies for this high-risk population.”

Reference:

Huang, Y., Shen, F., Liu, P., Su, W., Huang, T., Lin, M., Kuo, M., Chiu, Y., Hwang, S., Lin, Y., & Wu, P. (2025). Dissecting the relationship between heart failure and diabetic retinopathy severity in patients with diabetes and chronic kidney disease: An observational cohort study. Scientific Reports, 15(1), 1-11. https://doi.org/10.1038/s41598-025-04523-1

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SC takes cognisance of NEET suicide case, issues mental health guidelines to safeguard students

New Delhi: While considering the case of a 17-year-old NEET aspirant‘s death by suicide in Visakhapatnam, the Supreme Court on July 25 addressed the increasing instances of student suicides in India and issued interim guidelines to safeguard the mental health of students across all educational institutes.

The top court bench comprising justices Vikram Nath and Sandeep Mehta took note of “a legislative and regulatory vacuum in the country with respect to a unified, enforceable framework for suicide prevention of students in educational institutions, coaching centres, and student-centric environments”, and issued the interim guidelines “aimed at laying down a preventive, remedial, and supportive framework for mental health protection and prevention of suicides by students across all educational institutions.”

“Keeping in view of the above, and in exercise of the powers conferred upon this Court under Article 32 of the Constitution of India for the enforcement of fundamental rights, and treating this pronouncement as law declared by this Court under Article 141, we hereby issue the following guidelines, which shall remain in force and be binding until such time as appropriate legislation or regulatory frameworks are enacted by the competent authority,” observed the top court bench.

The guidelines issued by the Apex Court are as follows: 

I. All educational institutions shall adopt and implement a uniform mental health policy, drawing cues from the UMMEED Draft Guidelines, the MANODARPAN initiative, and the National Suicide Prevention Strategy. This policy shall be reviewed and updated annually and made publicly accessible on institutional websites and notice boards of the institutes.

II. All educational institutions with 100 or more enrolled students shall appoint/engage at least one qualified counsellor, psychologist, or social worker with demonstrable training in child and adolescent mental health. Institutions with fewer students shall establish formal referral linkages with external mental health professionals.

III. All educational institutions shall ensure optimal student-to-counsellor ratios. Dedicated mentors or counsellors shall be assigned to smaller batches of students, especially during examination periods and academic transitions, to provide consistent, informal, and confidential support.

IV. All educational institutions, more particularly the coaching institutes/centres, shall, as far as possible, refrain from engaging in batch segregation based on academic performance, public shaming, or assignment of academic targets disproportionate to students’ capacities.

V. All educational institutions shall establish written protocols for immediate referral to mental health services, local hospitals, and suicide prevention helplines. Suicide helpline numbers, including Tele-MANAS and other national services, shall be prominently displayed in hostels, classrooms, common areas, and on websites in large and legible print.

Also Read: NEET Aspirant Suicide in Rajasthan- SC seeks Action Report from State

VI. All teaching and non-teaching staff shall undergo mandatory training at least twice a year, conducted by certified mental health professionals, on psychological first-aid, identification of warning signs, response to self-harm, and referral mechanisms.

VII. All educational institutions shall ensure that all teaching, non-teaching, and administrative staff are adequately trained to engage with students from vulnerable and marginalised backgrounds in a sensitive, inclusive, and nondiscriminatory manner. This shall include, but not be limited to, students belonging to Scheduled Castes (SC), Scheduled Tribes (ST), Other Backward Classes (OBC), Economically Weaker Sections (EWS), LGBTQ+ communities, students with disabilities, those in out-of-home care, and students affected by bereavement, trauma, or prior suicide attempts, or intersecting form of marginalisation.

VIII. All educational institutions shall establish robust, confidential, and accessible mechanisms for the reporting, redressal, and prevention of incidents involving sexual assault, harassment, ragging, and bullying on the basis of caste, class, gender, sexual orientation, disability, religion, or ethnicity. Every such institution shall constitute an internal committee or designated authority empowered to take immediate action on complaints and provide psycho-social support to victims. Institutions shall also maintain zero tolerance for retaliatory actions against complainants or whistle-blowers. In all such cases, immediate referral to trained mental health professionals must be ensured, and the student’s safety, physical and psychological, shall be prioritised. Failure to take timely or adequate action in such cases, especially where such neglect contributes to a student’s self-harm or suicide, shall be treated as institutional culpability, making the administration liable to regulatory and legal consequences.

IX. All educational Institutions shall regularly organise sensitisation programmes (physical and/or online) for parents and guardians on student mental health. It shall be the duty of the institution to sensitise the parents and guardians to avoid placing undue academic pressure, to recognise signs of psychological distress, and to respond empathetically and supportively. Further, mental health literacy, emotional regulation, life skills education, and awareness of institutional support services shall be integrated into student orientation programmes and co-curricular activities.

X. All educational institutions shall maintain anonymised records and prepare an annual report indicating the number of wellness interventions, student referrals, training sessions, and mental health-related activities. This report shall be submitted to the relevant regulatory authority, which may be the State Education Department, University Grants Commission (UGC), All India Council for Technical Education (AICTE), Central Board of Secondary Education (CBSE), or as otherwise indicated.

XI. All educational institutions shall prioritise extracurricular activities, including sports, arts, and personality development initiatives. Examination patterns shall be periodically reviewed to reduce academic burden and to cultivate a broader sense of identity among students beyond test scores and ranks.

XII. All educational institutions, including coaching centres and training institutes, shall provide regular, structured career counselling services for students and their parents or guardians. These sessions shall be conducted by qualified counsellors and shall aim to reduce unrealistic academic pressure, promote awareness of diverse academic and professional pathways, and assist students in making informed and interest-based career decisions. Institutions shall ensure that such counselling is inclusive, sensitive to socioeconomic and psychological contexts, and does not reinforce narrow definitions of merit or success.

XIII. All residential-based educational institutions, including hostel owners, wardens and caretakers, shall take proactive steps to ensure that campuses remain free from harassment, bullying, drugs, and other harmful substances, thereby ensuring a safe and healthy living and learning environment for all students.

XIV. All residential-based institutions shall install tamper-proof ceiling fans or equivalent safety devices, and shall restrict access to rooftops, balconies, and other high-risk areas, in order to deter impulsive acts of self-harm.

XV. All coaching hubs, including but not limited to Jaipur, Kota, Sikar, Chennai, Hyderabad, Delhi, Mumbai, and other cities where students migrate in large numbers for competitive examination preparation, shall implement heightened mental health protections and preventive measures. These regions, having witnessed disproportionately high incidents of student suicides, require special attention. The concerned authorities, namely, the Department of Education, District Administration, and management of educational institutions, shall ensure the provision of regular career counselling for students and parents, regulation of academic pressure through structured academic planning, availability of continuous psychological support, and the establishment of institutional mechanisms for monitoring and accountability to safeguard student mental well-being.

“The above guidelines shall apply to all educational institutions across India, including public and private schools, colleges, universities, training centres, coaching institutes, residential academies, and hostels, irrespective of their affiliation. We may clarify that these guidelines are not in supersession but in parallel to the ongoing work of the National Task Force on Mental Health Concerns of Students and are being issued to provide an interim protective architecture in the interregnum. We believe that these guidelines shall be read as complementary to the ongoing work of the National Task Force and would inform and assist the National Task Force in the development of a more comprehensive and inclusive framework,” observed the top court bench.

Accordingly, the Apex Court has asked all States and Union Territories to notify these rules within two months mandating registration, student protection norms, and grievance redressal mechanisms for all private coaching centres. “These rules shall require compliance with the mental health safeguards prescribed herein,” mentioned the top court bench.

The court has instructed a district-level monitoring committee, constituted in each district under the Chairpersonship of the District Magistrate or Collector, to oversee the implementation, conduct inspections and receive complaints. Such committees may include representatives from the departments of education, health, and Child protection, civil society.

“Having regard to the serious and continuing nature of the concerns addressed herein, we direct the Union of India to file a compliance affidavit before this Court within a period of 90 days from the date of this judgment. The affidavit shall detail the steps taken to implement these guidelines, the coordination mechanisms established with State Governments, the status of regulatory rulemaking with respect to coaching centres, and the monitoring systems put in place. The affidavit shall also indicate the expected timeline for the completion of the report and recommendations of the National Task Force on Mental Health Concerns of Students,” ordered the top court bench.

The Plea before Supreme Court: 

These directions were issued by the Supreme Court while considering the plea filed by the father of a NEET aspirant, who committed suicide while undergoing preparation for the medical entrance examination in Andhra Pradesh.

Back in 2022, the appellant’s 17-year-old daughter got admitted to a coaching institute in Visakhapatnam to prepare for NEET. On 14th July, 2023, the appellant got to know that his daughter had fallen from the 3rd floor of the residential hostel building and sustained injuries. Upon reaching the spot, the appellant found his daughter unconscious and on ventilator support. On 16th July, 2023, approximately 12:00 (noon), the appellant’s daughter, while undergoing medical treatment, passed away.

After the appellant’s plea for transferring the case to the CBI for investigation was dismissed by the Andhra Pradesh High Court, the appellant filed the plea before the Supreme Court bench.

The deceased’s father had argued that tha authorities’ failure to evaluate forensic samples from the deceased’s body and their classification of the suspicious death as suicide was illegal, arbitrary and unjustified.

While considering the matter, the HC bench in February 2024 had disposed of the plea stating that since there were two FIR registered in two different States- Andhra Pradesh and West Bengal (the prayer seeking transfer of the case to CBI was beyond the jurisdiction of the Court.

However, the Apex Court bench observed that these lapses justified the transferring of the probe to CBI in order to ensure impartiality and restore public confidence. The Court also observed that there were evidence of investigative failures, hasty probe conducted by police, discrepancies in the CCTV footage of the hostel building, medical negligence, forensic lapses and a conflict of interest. It noted that the same medical officer served as an autopsy surgeon, chemical analyst, and inquiry committee member, compromising objectivity.

“The foregoing facts and circumstances, including the glaring inconsistencies in the medical records, the autopsy report indicating suspicious contents of stomach despite the deceased allegedly being on ventilatory support, the unexplained lapses in seizure and preservation of critical forensic evidence, and the contradictory statements by authorities, collectively highlight a case of exceptional complexity and concern. These elements are not indicative of mere procedural irregularities but point towards a potentially deeper malaise in the investigational process. In such a situation, it becomes imperative to ensure that the sanctity of the administration of justice is preserved, and public confidence is upheld. Criminal investigation must, in all circumstances, be both fair and effective to uphold the rule of law. It is in these rare and extraordinary circumstances that the intervention of this Court is warranted, and the transfer of the investigation to the CBI becomes not only justified but essential,” ordered the top court bench. Accordingly, the Supreme Court quashed the HC order and transferred the investigation to the CBI.

Court’s observations regarding increasing instances of suicides by students: 

While considering the matter, the Apex Court also noted that mental health is an integral component of the right to life under Article 21 of the Constitution of India, which the Court has upheld time and again. 

Further, the bench referred to Mental Healthcare Act 2017, which reinforces this constitutional mandate by recognising every person’s right to access mental healthcare and protection from inhuman or degrading treatment in mental health settings.

Section 18 of the MH Act guarantees mental health services to all, and Section 115 of the MH Act explicitly decriminalises attempted suicide acknowledging the need for care and support rather than punishment. These provisions read with judicial precedents reflect a broader constitutional vision that mandates a responsive legal framework to prevent self-harm and promote well-being, particularly among vulnerable populations such as students and youth, noted the Court.

Further, the bench highlighted that the evolving international norms reinforced the view that suicide prevention was not merely a policy objective but a binding obligation.

At this outset, the Court also noted that despite these constitutional and international obligations, there is a legislative and regulatory vacuum in the country with respect to a unified, enforceable framework for suicide prevention of students in educational institutions, coaching centres, and student-centric environments.

“Given the pressing nature of the crisis, particularly in cities like Kota, Jaipur, Sikar, Vishakhapatnam, Hyderabad, and Delhi (NCR), etc., where students migrate in large numbers for competitive examinations and face intense psychological pressure, immediate interim safeguards are the call of the day,” observed the bench while issuing the interim guidelines.

Medical Dialogues had previously reported that earlier this year, the Supreme Court bench had ordered the constitution of a National Task Force (NTF) for mental health after taking cognisance of a disturbing pattern of student suicides being reported from various educational institutes. Accordingly, the Apex Court had ordered to set up the National Task Force to address the mental health concerns of the students.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/supreme-court-mental-health-guidelines-296105.pdf

Also Read: National task force for addressing mental health of medical students faces hurdles- SC orders immediate govt action

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Canada urged to back health-care developed solutions for innovation leadership

Canada can be a leader in health innovation if it supports solutions that are developed within the health care environment, argues Dr. Muhammad Mamdani in a commentary published in the Canadian Medical Association Journal.

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Canada urged to back health-care developed solutions for innovation leadership

Canada can be a leader in health innovation if it supports solutions that are developed within the health care environment, argues Dr. Muhammad Mamdani in a commentary published in the Canadian Medical Association Journal.

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Canadian health data security is critical in changing political climate

With a rapidly changing political landscape in the United States, Canada must move quickly to safeguard valuable Canadian health data, argue the authors of a commentary published in the Canadian Medical Association Journal.

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