NBE Invites Applications for Diploma Final Exams June 2025, details

New Delhi- Through a notice, the National Board of Examinations in Medical Sciences (NBEMS) has invited online applications for the NBEMS Diploma Final Examination June 2025.

As per the notice, NBEMS is going to conduct the NBEMS Diploma Final Theory Examination – June 2025 on 09th, 10th and 11th June 2025 on a computer-based platform at various examination centres across the country.

On this, the online submission of the application form for the theory and practical exam and practical exam only will be available from today, i.e., April 30, 2025, 03:00 PM to May 20, 2025, 11:55 PM on the official website of NBEMS.

The information bulletin will also be available from today, i.e., April 30, 2025, 03:00 PM, on the official website of NBEMS for the candidates willing to appear for the NBEMS Diploma Final Examination June 2025. The information bulletin will contain important details such as eligibility, exam scheme, schedule, application process, fees, etc.

STEPS TO FILL OUT THE NBEMS DIPLOMA FINAL EXAM JUNE APPLICATION FORM 2025

STEP 1- Visit the official NBE website.

STEP 2- Register with a valid email ID and mobile number.

STEP 3- Fill out the application form with personal, academic, and contact details.

STEP 4- Upload required documents such as a passport-size photograph, signature, and degree certificates.

STEP 5- Pay the application fee online.

STEP 6- Submit the application form and take a printout for future reference.

The National Board of Examinations (NBE) was established in 1975 in New Delhi. It is an autonomous entity within the Ministry of Health and Family Welfare, Government of India. NBE conducts a few examinations, such as DNB final (exit) examinations, Fellowship Entrance and Exit examinations, NEET-SS for admission to DM/Mch/DrNB superspecialty medical courses across India, etc.

To view the notice, click the link below

https://medicaldialogues.in/pdf_upload/nbe-invites-applications-for-diploma-final-exam-june-2025jpg-284994.pdf

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Cabinet to decide on Free MRIs at all Delhi Govt Hospitals

New Delhi: In a bid to strengthen health infrastructure, the Delhi government is expected to decide on key proposals in a meeting scheduled on Tuesday, including outsourcing of staff through PSUs and installing MRI machines in hospitals under a PPP model, official sources said.

The proposals will be discussed in the Cabinet meeting chaired by Chief Minister Rekha Gupta, scheduled for 12 noon, they said, news agency PTI reported.

The Health Department seeks to centralise the outsourcing of staff required for documentation and other formalities at government hospitals and other health facilities of the government by roping in public sector undertakings (PSUs), they said.

Also Read:Ayushman Vay Vandana: Delhi launches Rs 10 lakh health cover for Senior Citizens

Presently, the hospitals and other facilities like clinics hire these personnel through private placement entities, said an official.

The other proposal is regarding the installation of magnetic resonance imaging (MRI) machines through a public-private partnership to meet the growing demand for such crucial scans, he said.

There is a shortage of MRI machines in government hospitals, which needs to be immediately addressed to ensure that patients are not forced to get these tests done from expensive private facilities, he added, reports PTI.

As per a media report in the TOI, “Referring patients to a doctor in OPD or admitting them to hospital for treatment requires a lot of details from the kin and documentation to ensure they get the benefits of all schemes as per their eligibility. The govt has thus decided to engage a public sector undertaking to provide manpower for the purpose,” said an official, requesting anonymity.

“We will begin the process of engaging a company to provide manpower as soon as the cabinet accords approval to the proposal,” the official added. There are 39 state-run hospitals in the capital. 

Also Read:Shortage of Senior, Junior Residents at Delhi AIIMS: MoS Health informs Parliament

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Ragging at Pune’s BJ Medical College: Orthopaedics PG medicos Suspended, expelled from hostel

Pune: Taking disciplinary action, BJ Medical College, Pune, has suspended three second-year postgraduate students from the Orthopaedics Department and evicted them from the hostel for allegedly ragging juniors.

The action followed a formal complaint received by the college on Monday, alleging that the second-year PG students had subjected four juniors to mental and physical harassment, including the use of threatening language. A committee was promptly formed to investigate the allegations

Speaking to PTI on the incident, an official from the medical college said, “Three postgraduate students of the state-run BJ Medical College in Pune have been suspended and removed from their hostel for allegedly ragging junior doctors.”

The college took action after it received a complaint against three second-year PG students from the Orthopaedic Department, said Dr Eknath Pawar, dean of the medical college, which is attached to the Sassoon General Hospital.

Also Read:KMCRI ragging: 5 MBBS students suspended for forcing juniors to attend classes as proxies

Sources in the medical college told PTI that the accused targeted four junior medical students from their department. They allegedly harassed the juniors mentally, sometimes physically, and even used intimidating language, said the sources.

“The parents of the students first approached Mantralaya (state secretariat) in Mumbai. On Monday, the college authorities received a complaint. We formed a committee to investigate the matter. Based on the findings, three PG students were suspended and removed from their hostel,” said Pawar.

A probe is underway, he added.

Also Read:GMC Nagarkurnool 3 MBBS students suspended for ragging

Medical Dialogues had earlier reported taking cognisance of a ragging complaint, the Government Medical College (GMC), Nagarkurnool suspended three senior MBBS students for allegedly physically harassing, beating and slapping a first-year junior student in a hostel room. An FIR had also been registered against the accused in connection with the case.

Among the three, one student (Third year) had been suspended for three months, who was reported to be the main culprit, while the other two (Second year) received suspensions of one month.

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50 per cent salary cut for Contractual Medical officers, Rajasthan Govt faces backlash

Jaipur: In a recent job notification that went viral on social media, the Rajasthan government has announced that contractual Allopathy Medical Officers will now receive a monthly salary of Rs 28,050. This decision has drawn widespread criticism from the medical community, as it is a major cut from the previous salary of Rs 56,000 per month. 

The official advertisement, signed by the Mission Director on April 17, 2025, under the National Health Mission (NHM), announced 162 vacancies for Allopathy Medical Officers. To be eligible, candidates must have an MBBS degree from a recognised institution, completed a mandatory rotatory internship, and be registered with the Rajasthan Medical Council. For this, the government will only pay them Rs 28,050 monthly. 

The significant salary cut has angered doctors across the state, who believe they deserve fair pay for the critical role they play in every emergency, saving countless lives. After investing years of hard work and a large amount of money into completing their medical education, they feel disrespected and frustrated by such a low amount.

Also read- Salary Hike! WB Senior Residents to now get Rs 15,000 MORE, Junior Doctors Rs 10,000

Previously, doctors who were employed on a contract basis were earning Rs 56,000 per month, but with the new salary structure, the pay has been slashed by almost 50 per cent. This has come as a major disappointment for doctors, especially at a time when healthcare workers have been demanding better pay and improved working conditions in the public health system for a long time. 

Slamming the state government for giving such a low salary, several doctors took to social media to express their frustration. They strongly criticised the significant pay cut for MBBS doctors, especially when compared to other welfare schemes where beneficiaries earn more.

The recruitment notice going viral on the internet and igniting rage among doctors states, “In accordance with the above reference and under the provisions of the Rajasthan Contractual Hiring to Civil Posts Rules, 2022, approval is hereby granted to proceed with the recruitment for vacant contractual posts under NHM through the District Health Committee, considering the urgent need for human resources and operational efficiency. Approval has been received from the Finance Department’s letter No. 152500633 dated 29.03.2025. Recruitment may be carried out either through a walk-in process or on a merit basis no later than 30.03.2026, and action must be taken at the district level accordingly.”

The notice also adds that the government is planning to recruit a total of 2,855 health workers under NHM. The posts include Allopathy Medical Officers, Female Health Workers, Nurses, Lab Technicians, Pharmacists, and Radiographers. All appointments will be made at the district level by the respective health committees.

Along with medical officers, 159 posts have also been announced for Female Health Workers, with a monthly pay of Rs 13,150. Applicants for this role must have completed the Auxiliary Nurse Midwifery (ANM) training or Health Worker Female course and must be registered with the Rajasthan Nursing Council as a B Grade Nurse.

The government has also announced the hiring of 1,941 nurses at a monthly pay of Rs 18,900. Applicants must have completed their senior secondary education and hold a GNM diploma or equivalent qualification, along with registration in the Rajasthan Nursing Council. Additionally, the government is recruiting for 414 Lab Technician posts, 151 Pharmacist posts, and 28 Radiographer posts, each offering a salary of Rs 13,150 per month. 

With the new salary structure, healthcare workers have raised concerns that such a drastic pay cut could affect the morale of doctors and their willingness to work passionately. Not only doctors but also the general public slammed the government for paying such low salaries to the healthcare workers. 

Sharing the information, one doctor wrote on X (formerly Twitter), “In a shocking move, the Rajasthan government has slashed the monthly salary of contractual doctors from ₹56,000 to ₹28,050, contrary to expectations of a hike. Can it improve the health structure?

Similarly, Dr Harshad Sharma, State executive member at Indian Medical Association (IMA), said in a tweet, “This decision is completely contrary to the previous orders. On March 30, 2022, the then Mission Director, Dr. Jitendra Kumar Soni had fixed the salary of full-time contract doctors at Rs 56,600. Even in another order issued on March 1, 2024, the same salary was fixed for contract doctors.

However, the old doctors will continue to get a salary of Rs 56,600, but the new doctors will get a reduced amount. Experts say that after deducting the contract part, this amount will be only around Rs 25,000. The government’s decision to cut doctors’ salaries by up to 50% is not just an administrative order but a blatant insult to our dedication, sacrifice and spirit of service to humanity. This decision is not only an economic injustice but also a deep blow to the dignity of an ideal profession like medicine. We are the ones who sacrificed our youth under the burden of books, the ones who sacrificed their sleep, festivals, family and personal happiness to save the lives of unknown faces, the same people who risked their lives to protect the country during the storm of the pandemic.”

Dr Lakshya Mittal, National President of United Doctors Front (UDF), tweeted, “Rajasthan- The first state in India where medical education was made a joke. Faculty from YouTube, study by yourself, job on contract, and the salary of Rs 56100 is now only Rs 25000.”

Medical Dialogues had previously reported that despite completing their postgraduate degrees, the doctors in 13 different specialities in Rajasthan are unable to contribute to the State public health sector as the Rajasthan Government has not created any posts of junior specialists, senior specialists, and principal specialists in those specialities in its hospitals. 

These specialities include biochemistry, radiation oncology, transfusion medicine, preventive and social medicine, emergency medicine, physical medicine and rehabilitation, palliative medicine, anatomy, physiology, pharmacology, nuclear medicine, family medicine, and hospital administration.

Even though the MBBS doctors have completed their post-graduation in these 13 different specialities in the State’s medical colleges and many are studying the courses, there is not a single approved position in those 13 specialities in medical colleges, district and sub-district hospitals.

Due to this, neither the people nor the State Government are able to utilise the money invested in the specialised education of the doctors studying these specialities. On the other hand, the medical students who are pursuing their PG degrees in these specialities are also worried about their future due to the limited opportunities to work in the State.

Also read- Rajasthan’s Healthcare Paradox: Trained Doctors, But No Jobs in 13 specialities

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Invasive Coronary Function Testing Safe and Effective for Diagnosing Vasomotor Dysfunction in ANOCA Patients: Study

Netherlands: A recent study published in JAMA Cardiology has demonstrated that coronary function testing (CFT) is a feasible and safe procedure across various healthcare settings. The findings highlight the high diagnostic yield of the test, reinforcing its role in assessing coronary vasomotor function. 

Notably, the study also found that invasive coronary functional testing to identify the cause of angina in patients with nonobstructive coronary artery disease (ANOCA) can be safely performed at highly experienced and less-experienced centers, further supporting its broader clinical applicability.

“The invasive testing was conducted across 15 tertiary and nontertiary hospitals in the Netherlands, yielding a high diagnostic success rate. Spasm emerged as the most common ANOCA endotype, while the procedure was associated with low rates of both major and minor complications,” the researchers reported.

The researchers note that patients with angina and no obstructive coronary artery disease often have coronary vasomotor dysfunction, including epicardial spasm, microvascular spasm, and microcirculatory dysfunction. Invasive coronary function testing effectively diagnoses these endotypes and has previously been deemed safe in expert tertiary centers. Considering this, Caïa Crooijmans, Department of Cardiology Radboudumc, Nijmegen, the Netherlands, and colleagues aimed to assess the prevalence of vasomotor dysfunction in clinically referred ANOCA patients while evaluating the safety and feasibility of coronary function testing.

For this purpose, the researchers conducted a quality improvement study using the Netherlands Registry of Invasive Coronary Vasomotor Function Testing (NL-CFT), a prospective observational registry involving 15 hospitals, including two tertiary and 13 nontertiary centers. The study included patients with angina and no obstructive coronary artery disease who were referred for a clinically indicated coronary function test (CFT) between December 2020 and January 2024. A complete CFT comprised of acetylcholine spasm provocation testing and the assessment of microcirculatory function. The study evaluated the prevalence of different endotypes based on test results while also assessing the overall safety of the procedure.

The investigation uncovered the following findings:

  • 1,207 patients were included, with 978 (81%) females. The mean age of participants was 60 years.
  • Coronary vasomotor dysfunction was highly prevalent, affecting 78% of patients.
  • Major complications were reported in 11 cases (0.9%), while minor complications occurred in 10 of the cases (0.8%).
  • Among these, three major and all minor complications were directly related to the coronary function test.
  • No cases of procedural death, myocardial infarction, or stroke were observed.
  • The occurrence of complications was similar between tertiary and nontertiary centers.

The researchers found coronary function testing is feasible and safe across tertiary and nontertiary centers, demonstrating a high diagnostic yield. Their findings suggest considering CFT for all patients with angina and no obstructive coronary artery disease, given its effectiveness in identifying vasomotor dysfunction, which was present in 78% of cases.

“Conducted within the Dutch NL-CFT network, the study reported a very low overall complication rate of 1.7%, reinforcing the procedure’s safety. With no observed cases of procedural death, myocardial infarction, or stroke, and comparable complication rates across different healthcare settings, the results support broader clinical adoption of CFT for improved diagnosis and management of coronary vasomotor dysfunction,” the researchers wrote.

Reference:

Crooijmans C, Jansen TPJ, Meeder JG, et al. Safety, Feasibility, and Diagnostic Yield of Invasive Coronary Function Testing: Netherlands Registry of Invasive Coronary Vasomotor Function Testing. JAMA Cardiol. Published online February 19, 2025. doi:10.1001/jamacardio.2024.5670

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Smoking, high BP and diabetes independently linked to peripheral vascular disease, suggests study

A new study published in the journal of Cureus showed that smoking, diabetes, and high blood pressure are independent risk factors for peripheral vascular disease (PVD) in Northeast India that are specific to a certain location.

Peripheral arterial disease (PAD) is the subject of this study because of its increased rates of morbidity and mortality associated with cardiovascular fatalities. The majority of research on PVD risk factors comes from Western nations, with little information accessible in developing nations like India. This study was set to examine the different risk factors most frequently linked to peripheral vascular disease in a northeastern Indian tertiary care hospital because there is a severe paucity of data on PVD in this area.

Finding risk variables in patients with PVD was the goal of this hospital-based case-control research, which was carried out in both retrospective and prospective modalities. From January 2015 to January 2025, a tertiary care teaching hospital in Northeast India served as the study’s site. Group A consisted of individuals with PVD, while Group B consisted of healthy volunteers who did not have PVD.

The study examined the course of the disease and the results of treatment over a ten-year period (January 2015–January 2025). It included prospective data (October 2020–January 2025) from a questionnaire survey and follow-ups, as well as retrospective data (January 2015–October 2020) from hospital records.

A total of 688 controls and 172 cases, at a 1:4 ratio, took part in the study. When compared to controls, cases had considerably higher rates of hypertension, diabetes mellitus, smoking history, and cardiac conditions. Peripheral vascular disease was substantially correlated with smokers’ daily cigarette consumption and smoking duration. The risk of peripheral vascular disease was considerably raised when smoking was coupled with diabetes mellitus and hypertension.

The most prevalent vascular pathology was atherosclerosis below the aortic bifurcation, which was detected in 104 patients (60.47%), followed by thromboangiitis obliterans in 63 individuals (36.63%). Male gender, smoking history, daily cigarette use, diabetes mellitus, and hypertension were all found to be distinct risk factors for peripheral vascular disease using multivariate logistic regression analysis.

The most popular therapy was amputation, which was followed by rehabilitation. Amputation was avoided in 17 of the 21 patients who tried bone marrow cell treatment. Overall, in Northeast India, smoking, diabetes, and alcohol use were found to be independent risk factors for PVD that were specific to a given location.

Source:

Hajong, R., Rabha, P., Medhi, B. B., Sharma, S., Pai, P. S., Baruah, A. J., & Devi, K. M. (2025). A retrospective risk-factor analysis of patients presenting with peripheral vascular disease in a tertiary care hospital in North-East India. Cureus. https://doi.org/10.7759/cureus.82661

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Statin use may improve survival in patients with some blood cancers: Study

Patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who were taking cholesterol-lowering statin medications at the start of their cancer treatment had a 61% lower risk of dying from their cancer compared to similar patients who were not taking statins, according to a study published today in the journal Blood Advances.

“This is the first systematic evaluation of the association of statin use with survival outcomes in patients with CLL or SLL who have been treated with contemporary targeted agents such as ibrutinib,” said the study’s principal investigator, Ahmad Abuhelwa, PhD, an assistant professor of pharmacy practice and pharmacotherapeutics at the University of Sharjah in the United Arab Emirates. “Our results highlight a strong link between statin use and improved survival in this patient population.”

CLL is a slow-growing cancer that starts in the blood-forming cells of the bone marrow and is the most common form of leukemia in adults in the United States. SLL, also a slow-growing cancer, affects the same type of cells as CLL but starts in lymphoid tissues such as the spleen instead of in the blood-forming cells.

Statins are among the most widely prescribed medications. It’s estimated that over 90 million adults in the United States take a statin drug to reduce their cholesterol levels and lower their risk for heart disease, which can lead to heart attacks or strokes. Previous studies have linked statin use to reduced death rates from several cancers, including CLL, said Dr. Abuhelwa. However, those studies did not evaluate the effects of statin use in patients who were treated with newer cancer therapies such as the targeted drug ibrutinib, he said.

In the current study, Dr. Abuhelwa and his colleagues analyzed data from 1,467 patients with CLL or SLL who participated in four international clinical trials conducted between 2012 and 2019. In these trials, patients were randomly assigned to treatment with ibrutinib either alone or in combination with other anti-cancer drugs, or to a drug regimen that did not include ibrutinib. A total of 424 patients (29%) were taking a statin at the time they started treatment across the four clinical trials. The median patient age was 65, and 66% were men; 92% had CLL, which was either newly diagnosed, had come back, or had not responded to prior treatment.

The study’s primary endpoints were cancer-specific survival (how long patients lived after starting treatment before dying specifically from their cancer), overall survival (how long patients lived after starting treatment, regardless of the cause of death), and progression-free survival (how long patients lived after starting treatment before their cancer worsened or they died from any cause). The secondary endpoint was the proportion of patients who experienced severe or life-threatening adverse events. The median follow-up time for all patients enrolled in the four trials was five years for overall survival and 22 months for progression-free survival.

To account for potential confounding factors, the investigators adjusted their analysis for variables including each patient’s diagnosis, age, sex, weight, physical functioning (as assessed by doctors), disease severity, length of time since their diagnosis, number of co-existing illnesses, use of other medications for heart conditions or high blood pressure, and the specific anti-cancer treatment regimen received.

Results showed that, regardless of any of these factors, patients who took a statin had, on average, a 61% reduced risk of dying from their cancer, a 38% reduced risk of death from any cause, and a 26% reduced risk of disease progression. Importantly, statin use did not increase the likelihood of severe or life-threatening adverse events.

“These findings don’t allow us to say for certain that statins directly improve cancer outcomes,” said Dr. Abuhelwa. “However, the fact that this association remained strong even after accounting for multiple factors makes it an important area for future research.” As next steps, he recommended conducting laboratory studies to better understand how statins may influence cancer biology, as well as prospective clinical trials in which patients with CLL or SLL are randomly assigned to take a statin or not.

The study has several limitations given its observational nature. For example, patients enrolled in clinical trials tend to be monitored more closely than those who receive treatment outside of a clinical trial, so the study findings may not be generalizable to patients treated in non-clinical trial settings. Additionally, because patients used various statins at different doses, the study could not determine the effects of specific statin types, doses, or duration of use on patients’ survival.

“While our results are very promising, we can’t recommend starting statins for CLL/SLL treatment based on this study alone,” Dr. Abuhelwa said. “Future clinical trials are needed to determine definitively whether statins have a direct benefit on cancer survival.” 

Reference:

Ahmad Y Abuhelwa, Sara A Almansour, Jennifer R. Brown, Humaid O Al-Shamsi, Ziad Abuhelwa, Zelal Kharaba, Yasser Bustanji, Mohammad H Semreen, Salma M. Ali, Ahmad Alhuraiji, Ross A McKinnon, Michael J Sorich, Karem H Alzoubi, Ashley M Hopkins, Statin use and survival in SLL/CLL treated with ibrutinib: Pooled analysis of four randomized controlled trials, Blood Advances, https://doi.org/10.1182/bloodadvances.2024015287

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Antenatal care Contacts beyond 4 to 7 years fails to enhance immediate or exclusive breastfeeding rates: Study

Recent study investigates breastfeeding practices in sub-Saharan Africa following the 2016 World Health Organization (WHO) antenatal care (ANC) policy update, which recommends a minimum of eight ANC contacts during pregnancy. It examines trends in immediate and exclusive breastfeeding (IEBF) and explores the relationship between ANC uptake (specifically comparing 4-7 contacts versus 8+ contacts) and breastfeeding practices.

Analysis of DHS Data in Sub-Saharan Africa

Data from Demographic and Health Surveys (DHS) conducted between 2018 and 2023 across 19 sub-Saharan African countries were analyzed. The analysis included 25,669 individuals and focused on immediate breastfeeding (IBF), defined as breastfeeding within one hour of birth, and exclusive breastfeeding (EBF) for infants aged zero to six months. Several health service, clinical, social and contextual factors available in DHS surveys for eligible countries were also considered.

Variations in Breastfeeding Rates Across Countries

The study found substantial variations in breastfeeding rates across countries. IBF ranged from 24.4% in Senegal to 86.7% in Rwanda, while EBF ranged from 17.6% in Gabon to 74.2% in Kenya. Most countries’ IBF rates were higher than EBF rates. Only a small fraction of women, 8.6% on average, reported attending eight or more ANC contacts.

Association Between ANC Contacts and Breastfeeding Practices

Pooled analysis across all countries showed that having 8+ ANC contacts, compared to 4-7 contacts, was not significantly associated with either IBF or EBF. However, results did indicate that there was a relationship between health service, clinical, demographic, and contextual factors and IBF and EBF.

Implications for Promoting Optimal Breastfeeding Practices

The findings suggest limited additional benefits of 8+ ANC contacts over 4-7 contacts in promoting IEBF, despite the WHO’s recommendation. It emphasizes the need for comprehensive strategies to promote ANC uptake and improve the quality of ANC contacts through behavior change interventions and complementary health service delivery. The results highlight the need to focus on improved quality of care, tailored interventions, and addressing misconceptions to improve both ANC attendance and breastfeeding outcomes in sub-Saharan Africa.

Key Points

* The study analyzes data from Demographic and Health Surveys (DHS) conducted between 2018 and 2023 in 19 sub-Saharan African countries, involving 25,669 individuals, to assess breastfeeding practices following the 2016 WHO antenatal care (ANC) policy update.

* Immediate breastfeeding (IBF) rates varied significantly across countries, ranging from 24.4% in Senegal to 86.7% in Rwanda, while exclusive breastfeeding (EBF) rates ranged from 17.6% in Gabon to 74.2% in Kenya.

* Across the surveyed countries, a small percentage of women (8.6% on average) reported attending eight or more ANC contacts, as recommended by the WHO.

* Pooled analysis revealed that attending 8+ ANC contacts, compared to 4-7 contacts, did not show a significant association with either immediate or exclusive breastfeeding practices.

* Health service, clinical, demographic, and contextual factors were found to have a relationship with immediate breastfeeding and exclusive breastfeeding practices.

* The findings suggest that increasing ANC contacts beyond 4-7 may not significantly improve immediate and exclusive breastfeeding rates, highlighting the importance of comprehensive strategies focusing on the quality of ANC contacts, behavior change interventions, and complementary health service delivery.

Reference –

Bolanle Olapeju et al. (2025). Antenatal Care And Breastfeeding Practices In Sub-Saharan Africa: An Analysis Of Demographic And Health Surveys. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07188-w.

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Study Finds TD/PV Ratio Boosts Prostate Cancer Detection When Combined with PI-RADS

Japan: A recent retrospective analysis has highlighted the tumor diameter-to-prostate volume ratio (TD/PV) as an effective predictive marker for prostate cancer (PCa) and clinically significant prostate cancer (csPCa) in men undergoing MRI/transrectal ultrasound (MRI/TRUS) fusion-targeted biopsies.

Published in Urologic Oncology: Seminars and Original Investigations, the study demonstrated that incorporating TD/PV into the biopsy process enhanced prediction accuracy, surpassing traditional markers. Additionally, when combined with the prostate imaging-reporting and data system (PI-RADS), TD/PV further improved prediction accuracy, achieving AUC values of 0.861 and 0.845 for PCa and csPCa, respectively.

MRI, alongside PI-RADS and MRI/TRUS fusion-targeted biopsy, has significantly improved the accuracy of prostate cancer diagnosis. However, some suspected PCa lesions in PI-RADS categories 3 and 4 remain undiagnosed, pointing to the need for further refinement of diagnostic methods. The researchers suggest that the accuracy of MRI/TRUS fusion-targeted biopsy can be improved by incorporating lesion size and prostate volume (PV) into the PI-RADS evaluation.

To explore this, Shunsuke Miyamoto and colleagues from the Department of Urology at Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan, investigated how the TD/PV ratio could enhance the prediction of PCa and csPCa in PI-RADS categories 3–5 lesions. They also aimed to develop predictive nomograms that combined TD/PV and PI-RADS.

The researchers reviewed data from patients who underwent MRI/TRUS fusion-targeted biopsy for PI-RADS 2.1 categories 3–5 lesions between 2017 and 2023. TD/PV was calculated by dividing tumor diameter by total prostate volume, with csPCa defined as a Gleason score of ≥ 3+4. The predictive nomograms for PCa and csPCa were created using univariable and multivariable logistic regression. Their accuracy was evaluated using receiver operating characteristic (ROC) curves and the area under the curve (AUC).

Key findings from the study included:

  • A total of 565 patients were analyzed.
  • The AUC of TD/PV was significantly higher than that of PSA, tumor diameter, PSA density, and PI-RADS for predicting PCa (AUC: 0.840) and csPCa (AUC: 0.819).
  • Multivariable analyses confirmed TD/PV as a significant predictive factor for both PCa and csPCa in MRI/TRUS fusion-targeted biopsy.
  • Predictive nomograms combining TD/PV and PI-RADS were developed, with AUCs for PCa and csPCa predictions being 0.861 and 0.845, respectively.

“In the retrospective analysis, the combination of TD/PV and PI-RADS category significantly improved the prediction of PCa and csPCa in MRI/TRUS fusion-targeted biopsy, particularly for PI-RADS categories 3 and 4 lesions,” the authors noted. “The predictive nomograms integrating TD/PV with PI-RADS provided a more accurate prediction of PCa and csPCa diagnoses.”

They concluded, “These findings offer valuable insights for physicians, aiding in better decision-making regarding the indications for MRI/TRUS fusion-targeted biopsy.”

Reference:

Kohada, Y., Miyamoto, S., Hayashi, T., Tasaka, R., Honda, Y., Ishikawa, A., Kobatake, K., Sekino, Y., Kitano, H., Goto, K., Ikeda, K., Goriki, A., Hieda, K., Kitamura, N., Awai, K., & Hinata, N. (2025). Utility of tumor diameter-to-prostate volume ratio for predicting the outcome of magnetic resonance imaging/transrectal ultrasound fusion-targeted biopsy. Urologic Oncology: Seminars and Original Investigations. https://doi.org/10.1016/j.urolonc.2025.03.021

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Twice-Weekly and Thrice-Weekly Hemodialysis have Comparative Survival Outcomes: Study

Researchers have found in a new study that Patients undergoing twice-weekly hemodialysis demonstrated comparable overall survival at two years when compared to those on a thrice-weekly schedule. While a twice-weekly regimen may serve as a viable option during the initial year of dialysis—particularly in resource-limited settings—it poses potential risks that require vigilant monitoring beyond the first year.

The optimal frequency of maintenance hemodialysis remains a subject of debate. In many countries, twice-weekly hemodialysis is still commonly practiced. This trial aimed to compare the outcomes of patients undergoing twice-weekly versus thrice-weekly hemodialysis.

This prospective, multicenter, nonrandomized trial included incident adult patients, with chronic kidney disease stage 5, initiating hemodialysis between January 2018 and August 2021. Patients were allocated to either a twice-weekly or thrice-weekly regimen, and monitored at 1, 3, 6, 12 and 24 months. This trial was terminated before reaching the required sample size due to the COVID-19 pandemic and economic factors. Recruitment achieved 25% of the projected number. Missing baseline factors were imputed using multiple imputation algorithms, then entered in a logistic regression model to estimate propensity scores. The primary outcome was two-year survival analyzed using a Cox regression survival model adjusted for propensity scores and baseline residual urine output. Secondary outcomes included hospitalization rates, uncontrolled hypertension and cumulative erythropoietin dose at two years, analyzed using regression models adjusted for propensity scores and baseline residual urine output. All analyses were conducted on an intention-to-treat basis. Results: A total of 132 patients on thrice-weekly hemodialysis and 71 on twice-weekly hemodialysis were included. The mean age was 67 ± 15 years and the median eGFR at dialysis initiation was 6 (4,8) mL/min/1.73 m2. At one year, patients in the twice-weekly group had greater residual urine output. At two years, there was no significant difference in survival (HR = 0.84; 95% CI: 0.37, 1.90), hospitalization rates (P = 0.515) or uncontrolled hypertension (P = 0.442). The twice-weekly group showed a trend toward higher erythropoietin requirements (P = 0.08). Serum potassium levels and the number of antihypertensive medications were greater in the twice-weekly group. Patients on twice-weekly hemodialysis showed comparable overall survival at two years to those on thrice-weekly hemodialysis. While a twice-weekly regimen may be a viable option during the first year of dialysis, especially in low-resource settings, it carries potential risks that necessitate careful monitoring after the first year.

Reference:

Aoun, M., Finianos, S., Beaini, C. et al. Twice against thrice-weekly hemodialysis (TATH): a multicenter nonrandomized trial. BMC Nephrol 26, 176 (2025). https://doi.org/10.1186/s12882-025-04105-3

Keywords:

Twice-Weekly, Thrice-Weekly, Hemodialysis, Survival, Outcomes, Study, Aoun, M., Finianos, S., Beaini, C, Hemodialysis, Mortality, Frequency, Twice-weekly Thrice-weekly, Residual diuresis, Residual urine output, Antihypertensive drugs, Erythropoietin, Serum potassium

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