Puttur Negligence Case: DHO Submits Preliminary Report

Mangaluru: Following the alleged medical negligence case in Puttur, where doctors at a private hospital reportedly left a surgical mop inside a woman’s stomach during a C-section delivery, a fact-finding team headed by DHO Dr. Thimmaiah HR has submitted a preliminary report.

Medical Dialogues had previously reported that a doctor associated with a private hospital in Puttur, Karnataka, had been accused of medical negligence for allegedly leaving a surgical mop inside a woman’s stomach while conducting her Caesarean-section surgery.

Also Read: Medical Negligence? Doctor accused of leaving surgical mop inside patient during C-section

The case stems from an allegation made by the husband of a woman who underwent a Caesarean section in November 2024. He claims that during the procedure, a surgical mop was left inside his wife’s abdomen, which led to complications. The patient, still receiving medication for the complications, has faced significant health challenges since the surgery. She has been unable to breastfeed her newborn, and her recovery process remains slow. This incident has sparked concern over patient safety and the standards of care in private hospitals, particularly regarding surgical procedures.

Speaking to TOI, the DHO said on Thursday that the report submitted to the health commissioner and the Dakshina Kannada SP, suggests medical negligence; however, a probe will help bring out the complete truth.

A team of six doctors was sent to the hospital to conduct an inquiry, where they interacted with medical staff, reviewed hospital records, and examined documents related to the surgery. The health authorities have vowed to take swift and appropriate action once the final report is submitted in the next two days. The Health and Family Welfare minister has directed the officials to submit the findings immediately.

This directive is expected to speed up the investigation, ensuring that the necessary steps are taken to address the issue and prevent similar incidents in the future.

Also Read: Chaos at Amethi’s Sanjay Gandhi Hospital! Doctor accused of being drunk during surgery

According to Udayvani, confirming the progress, DHO Dr Thimmaiah stated, “The final report will be compiled Thursday and submitted to the Principal Secretary of the Health and Family Welfare Department.”

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Biological E collaborate with Bavarian Nordic to expand Chikungunya Vaccine access in low, middle income countries

Hyderabad: Biological E. Limited has announced a strategic partnership with Bavarian Nordic A/S to expand access to Bavarian Nordic’s Chikungunya Vaccine in low- and middle-income countries (LMIC).

This partnership comprises a technology transfer of the current drug product manufacturing process for the Chikungunya Vaccine, with the option to transfer the drug substance process at a later stage. To that effect, the companies have reached an agreement to expand their capacity to provide future supplies to endemic low- and middle-income countries.

The initial technology transfer would be followed by regulatory approval applications and commencement of commercial manufacturing thereafter. BE’s existing facilities in Genome Valley, Hyderabad will be augmented to make the Chikungunya Vaccine. The manufacturing of Chikungunya Vaccine at BE is expected to generate up to 300 new jobs.

This agreement has come about as Bavarian Nordic continues to explore opportunities in line with its strategy to provide global access to its Chikungunya Vaccine via partners for markets outside the US and Europe. The recent approval of the Chikungunya vaccine in the US for persons as young as 12 years and the positive opinion from the European Medicines Agency’s Committee for Medicinal Products for Human Use have demonstrated the viability to expand regulatory approvals beyond these markets.

Ms. Mahima Datla, Managing Director, Biological E. Limited, said, “We are pleased to collaborate with Bavarian Nordic to help expand the availability of their Chikungunya Vaccine in low and middle-income countries. The scale of our manufacturing and successful track record in providing global access to vaccines is synergistically aligned with Bavarian Nordic via this strategic partnership. We are committed to utilising our advanced & efficient manufacturing technologies to meet health needs in endemic regions and we are excited that our collaborative efforts will soon help improve public health in preventing Chikungunya in various parts of the world.”

“We are pleased to announce our first collaboration to expand global access to our Chikungunya Vaccine and also our first partnership with Biological E, who have solid expertise and comprehensive experience in supplying vaccines for improving public health worldwide,” said Paul Chaplin, President & CEO of Bavarian Nordic. “Expanding supply is a prerequisite for our ability to address the increasing need for solutions to prevent Chikungunya in vulnerable populations in endemic regions, and we are dedicated to pursuing strong partnerships that can help us achieve this goal.”

CHIKV VLP is an adjuvanted VLP recombinant protein vaccine for active immunization for the prevention of disease caused by chikungunya virus (CHIKV) in individuals 12 years and older. Because VLPs contain no virus genetic material, the vaccine cannot infect cells, reproduce or cause disease.

While the mechanism of action of CHIKV VLP vaccine still needs to be further characterised, it is thought that the vaccine can induce protection from CHIKV infection by inducing neutralising antibodies against certain CHIKV proteins resulting in neutralisation of live virus. An adjuvant is added to increase the magnitude of vaccine-mediated immune responses.

In February 2025, the U.S. Food and Drug Administration (FDA) approved VIMKUNYA (CHIKV VLP) for chikungunya for persons as young as 12 years. The approval was based on results from two phase 3 clinical trials which enrolled more than 3,500 healthy individuals 12 years of age and older. The studies met their primary endpoints, with results showing that 21 days after vaccination, the vaccine induced neutralizing antibodies in up to 97.8% of the vaccinated individuals and demonstrated a rapid immune response starting to develop within one week. The vaccine was well-tolerated and vaccine-related adverse events were mainly mild or moderate in nature.

An EU approval is pending decision from the European Commission following a recommendation in January 2025 by the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA).

Chikungunya is a mosquito-borne disease caused by the chikungunya virus (CHIKV). In the past 20 years, the virus has emerged across several regions in Asia, Africa, and the Americas, including many popular travel destinations, often causing large unpredictable outbreaks. Since its discovery, CHIKV has been identified in more than 110 countries, with evidence of transmission confirmed in more than 50 countries over the past five years. Chikungunya typically presents with acute symptoms, including fever, rash, fatigue, headache, and often severe and incapacitating joint pain. Most patients recover, but 30-40% of those affected may develop chronic symptoms that can last for months or even years. In 2024, 620,000 cases of chikungunya and over 200 deaths were reported worldwide. Recent data suggest that chikungunya is severely underreported and often misdiagnosed as dengue fever due to a similar symptom profile.

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Fact Check: Is magnesium deficiency the number one cause of high blood pressure?

An Instagram post claims that magnesium deficiency is the number one cause of high blood pressure. The claim by the user is Misleading

Claim

In an Instagram reel, it is claimed that magnesium deficiency is the number one cause of high blood pressure. In the reel by user swetha._.sunil, it is said, “The single most common cause of high blood pressure is a deficiency in the mineral magnesium. You have two types of blood vessels in the human body. You have arteries and you have veins. And arteries carry blood away from the heart, veins carry blood back to the heart. Well, what’s the difference? Well, there’s one significant difference between the two. Arteries have muscles, veins do not. Why does an artery have muscle? Because God is smart. When the heart pumps blood, it goes into the artery and the muscle in the artery constricts and relaxes. constricts and relaxes constriction relaxes in order to help the heart pump the blood. That’s fantastic. Well, how does the muscle constrict and relax? The same way that a bicep constrict and relax or any muscle in the body, it’s done through magnesium and calcium. If you do not have enough magnesium, the muscle will constrict, but it cannot relax. So it stays constricted. Now, if you have a garden hose and there’s water coming out of it and you squeeze the hose just a little bit, the water comes out faster, right? It’s because you’ve decreased the volume, the pressure goes up. So when the artery gets collapsed because of not enough magnesium, the blood pressure spikes. So, you don’t have high blood pressure because you have a circulatory system. You don’t have high blood pressure because you have a bad gene. You don’t have high blood pressure because you’re getting older or because you have a voodoo curse. You have high blood pressure because your body ran out of the stuff it needed to maintain proper blood pressure. Period.”

The reel can be accessed here.

Fact Check

The claim by the user is Misleading. While magnesium deficiency contributes to high blood pressure, no scientific evidence or medical consensus supports the claim that it is the number one cause of blood pressure.

What is High Blood Pressure?

According to WHO, High blood pressure or Hypertension is when the pressure in blood vessels is high (140/90 mmHg or higher). It is common but can be serious if not treated. The risk factors of hypertension are genetics, overweight or obese, physical inactivity, age and consumption of alcohol.

Modifiable risk factors include unhealthy diets such as excessive salt consumption, a diet high in saturated fat and trans fats, low intake of fruits and vegetables, physical inactivity, consumption of tobacco and alcohol, and being overweight or obese. In addition, there are environmental risk factors for hypertension and associated diseases, where air pollution is the most significant.

Non-modifiable risk factors include a family history of hypertension, age over 65 years and co-existing diseases such as diabetes or kidney disease.

What are the causes of High Blood Pressure?

High blood pressure (hypertension) is a multifactorial condition influenced by both genetic and lifestyle factors. Several risk factors contribute to its development. Primary hypertension, the most common type, is linked to aging, family history, race (with African Americans being at higher risk), and lifestyle choices such as smoking, excessive alcohol consumption, high salt intake, lack of physical activity, and obesity. Secondary hypertension, on the other hand, results from underlying conditions like chronic kidney disease, hormonal imbalances (e.g., thyroid disorders, Cushing’s syndrome), obstructive sleep apnea, and certain medications such as NSAIDs and decongestants. Managing hypertension requires early detection, lifestyle modifications, and, in some cases, medical intervention to prevent serious complications like heart disease and stroke.

What is Magnesium?

Magnesium is an essential mineral in the body that functions as a cofactor in over 300 enzyme systems regulating biochemical processes such as protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation. It is crucial for energy production, DNA/RNA synthesis, and bone structure. Magnesium also facilitates calcium and potassium transport across cell membranes, influencing nerve impulses, muscle contraction, and heart rhythm. About 50–60% of magnesium is stored in bones, with less than 1% in blood serum, where levels are tightly regulated by the kidneys.

What is the role of Magnesium in maintaining blood pressure? 

Magnesium plays a crucial role in maintaining blood pressure by acting as a natural calcium channel blocker, which helps relax blood vessels and reduce vascular resistance. It also blocks sodium attachment to vascular smooth muscle cells, preventing excessive contraction. Additionally, magnesium enhances vasodilating prostaglandin E (PGE) production, binds potassium cooperatively, and increases nitric oxide levels, all of which contribute to improved endothelial function and vasodilation. These mechanisms collectively lead to a reduction in blood pressure, highlighting magnesium’s essential role in cardiovascular health.

Does magnesium deficiency cause high blood pressure?

Yes, magnesium deficiency has been linked to high blood pressure. Several meta-analyses of prospective cohort studies and randomized controlled trials indicate an inverse relationship between magnesium intake and hypertension risk. Magnesium supplementation has also shown a blood pressure-lowering effect. The exact mechanisms remain unclear, but magnesium is thought to help regulate vascular tone, endothelial function, and electrolyte balance, all of which contribute to blood pressure control. However, there is no scientific evidence or medical consensus to support the claim that magnesium deficiency is the number one cause of high blood pressure.

Is magnesium deficiency the number one cause of high blood pressure?

Magnesium deficiency may contribute to high blood pressure, but it is not the leading cause. While research supports magnesium’s role in cardiovascular health, hypertension is a complex condition influenced by multiple factors, including diet, lifestyle, and genetics. Hence, the claim by the user is Misleading.

Research indicates that magnesium is essential for cardiovascular health, with its deficiency being associated with an increased risk of hypertension and related complications. A study by Ligia J. Dominguez et al. suggests that individuals with hypertension are particularly vulnerable to magnesium deficiency due to multiple physiological mechanisms, which may partly explain the higher prevalence of the condition and its long-term effects.

Another study published in Advances in Chronic Kidney Disease reported that inadequate dietary magnesium intake has been linked to a higher risk of developing hypertension, as observed in prospective cohort studies.

Magnesium has been extensively studied for its potential antihypertensive effects. A study conducted by Mark Houston et al. suggests that consuming 500 mg to 1000 mg of magnesium daily may contribute to lowering blood pressure and assist in managing hypertension effectively.

Magnesium does play an important role in lowering blood pressure but no scientific evidence or medical consensus backs the claim that its deficiency is the number one cause for high blood pressure. 

In a conversation with the Medical Dialogues Fact Check Team Dr. Jinendra K Jain, Consultant Diabetologist and Physician, Mira Road said, “Magnesium deficiency is not the number one cause of high blood pressure (hypertension) in many people. While it is true that magnesium deficiency plays a significant role in regulating the functions of the blood vessels, various factors can contribute to high blood pressure. The most common factors that can influence high blood pressure include increased salt intake in daily meals, being overweight, lack of physical activity, taking too much stress, genetics, hormonal imbalances, and kidney diseases. The low levels of magnesium can significantly contribute to poor blood vessel function but it can rarely be the reason for hypertension. High blood pressure can be easily managed with the combination of lifestyle modification, and medications as prescribed by the doctor. Ensure that you eat well-balanced meals that are rich in magnesium such as nuts, seeds, leafy green vegetables, and whole grains. These foods can help support your heart health and prevent or manage high blood pressure. Along with diet focus more on staying active by exercising regularly and maintaining a healthy weight. Avoid eating foods with high sodium. Limiting your salt intake can be helpful. Always take medications prescribed by the doctors only for the betterment of your health.”

Dr Swarup Pal, Cardiovascular, Thoracic and Transplant surgeon at Gleneagles Hospital, Mumbai further added, “Hypertension is commonly seen in adults and youngsters and is linked to a wide range of health problems. A large number of people suffer from heart attack, stroke, kidney disease, vision loss, heart failure, and cognitive decline due to high blood pressure. One can suffer from hypertension because of many factors not only magnesium deficiency. Low magnesium levels can contribute to blood pressure issues, several other factors are also the culprits behind high blood pressure. Too much salt can increase fluid retention, raising blood pressure. Moreover, a sedentary lifestyle weakens the heart and increases the chances of high blood pressure. Obesity can pressurize the heart causing hypertension. Likewise, being stressed for a longer period due to professional or personal issues can also cause hypertension which will make one prone to a heart attack or a stroke. Don’t forget other factors such as smoking, and alcohol that damage blood vessels and lead to hypertension. A family history of high blood pressure can also put one at risk of hypertension. Timely management of high blood pressure is key for successful outcomes. Take medication as recommended by the doctor and check your blood pressure from time to time. If the underlying cause behind hypertension is magnesium deficiency then eat foods like nuts, seeds, legumes, bananas, spinach, avocado, and whole grains. Take magnesium supplements as per the doctor’s recommendation. High uncontrolled sugars in long standing diabetes causes hardening of arteries ( peripheral Vascular disease) which again predisposes to hypertension”

Medical Dialogues Final Take

Magnesium deficiency may contribute to high blood pressure (hypertension), but it is not the number one cause. Hypertension is a multifactorial condition influenced by genetics, diet, lifestyle, and other medical conditions. Further, no scientific evidence or medical consensus supports the claim that magnesium deficiency is the number one cause of high blood pressure.

Hence, the claim by the user is Misleading.

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AIIMS notifies on PG Research Methodology Exam February 2025, Check Schedule, Exam Scheme

New Delhi- All India Institute of Medical Sciences (AIIMS) New Delhi is soon going to conduct the Postgraduate (PG) Research Methodology Examination for the February 2025 session. In this regard, AIIMS New Delhi has released the scheme and schedule of the examination through the notice.

As per the notice, the PG Research Methodology Exam February 2025 session will be conducted from 9th to 11th March 2025 in two different shifts i.e. morning and evening shifts in online CBT mode at the Examination Section, 1st Floor, Convergence Block, AIIMS New Delhi. As decided by the Competent Authority, the PG Research Methodology Examination will be conducted as per the following schedule mentioned below-

Also Read: AIIMS Declares INI SS January 2025 Open Round Results

SCHEDULE

S.NO

DATE OF EXAMINATION

SHIFTS

1

9th March, 2025 (Sunday)

Morning Shift (11:00 AM to 12:00 Noon)

Evening Shift (3:00 PM to 4:00 PM)

2

10th March, 2025 (Monday)

Morning Shift (11:00 AM to 12:00 Noon)

3

11th March, 2025 (Tuesday)

Morning Shift (11:00 AM to 12:00 Noon)

Evening Shift (3:00 PM to 4:00 PM)

Meanwhile, the duration of the exam will be 60 minutes (one hour), it will have 40 MCQs, each carrying 2.5 marks and there will be no negative marking. However, the qualifying criteria for candidates are 50% marks i.e. 50 marks.

Further, the list of eligible candidates will be uploaded today i.e. 25 February 2025 on the official website of AIIMS, New Delhi and the admit card will be issued thereafter on 28 February 2025. The admit card will contain other important details regarding the exam like reporting time, entry and closing time will be uploaded in the admit card.

All India Institute of Medical Sciences, also known as AIIMS Delhi, is a globally acclaimed public medical research university and hospital based in New Delhi, India. The AIIMS Act, of 1956 govern the institute and operates autonomously under the Ministry of Health and Family Welfare. The main campus of AIIMS, New Delhi is located in Ansari Nagar, Delhi. 

To view the notice, click the link below

https://medicaldialogues.in/pdf_upload/aiims-to-conduct-pg-research-methodology-exam-february-2025-session-check-schedule-exam-scheme-275832.pdf

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Healing Hospital Chandigarh Awarded Best Private Hospital by Punjab Governor

Chandigarh: Healing Hospital, Chandigarh, has been awarded the ‘Best Private Hospital in Chandigarh’ at the 2nd Edition of ASSOCHAM’s Health, Beauty, and Wellness Symposium 2025. As part of its commitment to social responsibility, the hospital, in collaboration with ASSOCHAM and the Chandigarh UT Administration, has launched an impactful initiative under Prime Minister Narendra Modi’s Pradhan Mantri TB Mukt Bharat Abhiyaan.

The prestigious award was presented by Hon’ble Sh. Gulab Chand Kataria, Governor of Punjab & UT Administrator, and was received by the hospital’s management and doctors’ team, acknowledging Healing Hospital’s commitment to excellence in patient care, medical innovation, and healthcare services.

On this occasion, Healing Hospital, in collaboration with ASSOCHAM and the Chandigarh UT Administration, has taken a significant step towards social responsibility by launching an initiative under Prime Minister Narendra Modi’s Pradhan Mantri TB Mukt Bharat Abhiyaan. As part of this national mission to eliminate tuberculosis from India by 2025, Healing Hospital has adopted TB patients, pledging to support them with nutritional food baskets, social assistance, and financial aid to aid their recovery and improve their quality of life, news agency ANI reported.

Also Read:Over 5.1 lakh new TB patients identified since launch of 100-day intensified campaign

Recognizing this impactful initiative, Hon’ble Governor Sh. Gulab Chand Kataria praised Healing Hospital’s efforts and acknowledged Drishmeet Singh Buttar, Partner, Healing Hospital, for his dedication to the cause.

Speaking on the occasion, Mr. Drishmeet Singh Buttar said, “At Healing Hospital, we believe that healthcare extends beyond treatment-it’s about uplifting communities. By supporting TB patients with essential resources, we are proud to contribute to Prime Minister Narendra Modi’s vision of a TB-free India by 2025.”

Sahibjit Singh Sandhu, Managing Partner also shared his thoughts on this remarkable achievement, stating, “Healing Hospital has always been a symbol of excellence in patient care and medical innovation. This recognition is a testament to our unwavering commitment to providing world-class healthcare and making a positive impact on society. Our initiative to support TB patients aligns with our vision of creating a healthier, stronger India.”

Speaking on the occasion, Mr. Drishmeet Singh Buttar said, “At Healing Hospital, we believe that healthcare extends beyond treatment-it’s about uplifting communities. By supporting TB patients with essential resources, we are proud to contribute to Prime Minister Narendra Modi’s vision of a TB-free India by 2025”, reports ANI.

Established in 2016, Healing Hospital is a NABH-accredited super-specialty hospital with 100+ beds and over 20 medical specialties, including cardiology, orthopedics & joint replacement, neurology, gastroenterology, urology, nephrology, gynecology, pediatrics, and intensive care. With a strong focus on quality healthcare, advanced treatments, and patient-centered care, the hospital has served over 300,000 patients and successfully performed more than 15,000 surgeries.

Healing Hospital has been consistently recognized for its excellence in healthcare. It previously received the Best Hospital in Chandigarh Award from Punjab CM Bhagwant Mann and was also honored at the Six Sigma Excellence Awards, New Delhi, and Times Healthcare Pioneers.

With this award and its ongoing commitment to social initiatives and medical excellence, Healing Hospital reaffirms its mission to improve lives and make high-quality healthcare accessible to all.

Also Read:100-Day TB Elimination Campaign: WHO calls for Boosting Diagnosis, Treatment to reach unreached

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KEA Revises NEET PG 2024 Stray Vacancy Seat Allotment

Karnataka- Five candidates were wrongly allotted seats in the National Eligibility and Entrance Test-Postgraduate (NEET PG) stray vacancy round counselling for the academic year 2024. Following this, the Karnataka Examination Authority (KEA) has revised the seat allotment result for NEET PG stray vacancy round counselling 2024.

After these 5 candidates were wrongly allotted seats in the NEET PG stray vacancy round counselling 2024, KEA has now cancelled the admissions of those students and also withdrawn the seat allotment result.

As per the official notice issued in this regard, candidates who have been allotted seats in MCC Round-3 allotment are not eligible for allotment of seats through KEA as per the orders of the Hon’ble High Court. However, due to technical reasons, five candidates allotted in Round 3 of MCC were also inadvertently included in the stray vacancy round final seat allotment list.

Also Read: KEA Extends NEET PG Mop-Up Round Fee Payment, Reporting Deadline

Meanwhile, the revised final seat allotment result after the re-allotment was published, hence, students who applied for the Karnataka NEET PG counselling 2024 stray vacancy round can check the seat allotment result PDF 2024 result from the official website of KEA.

Meanwhile, students required to take the following documents to the reporting institute to complete the admission process-

1 Copy of the duly filled Karnataka NEET PG 2024 application form.

2 Two passport-sized photographs.

3 Valid photo ID proof.

4 NEET PG 2024 admit card.

5 NEET PG 2024 scorecard.

6 Class X marksheet.

7 Class XII mark sheet.

8 MBBS marksheets.

9 Qualifying degree certificate.

10 Internship completion certificates.

11 Eligibility Certificate (if applicable).

12 Migration Certificate (if applicable).

13 Registration Certificates issued by MCI/SMC.

14 Any other document as notified by the authorities.

To view the notice, click the link below

https://medicaldialogues.in/pdf_upload/kea-revises-neet-pg-2024-stray-vacancy-seat-allotment-after-error-in-admissions-276276.pdf

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Elevated PAI-1 Levels May Predict Type 2 Diabetes Before Blood Sugar Rises: Study Suggests

Sweden: New research suggests that elevated levels of plasminogen activator inhibitor-1 (PAI-1) in individuals without diabetes may serve as an early warning sign for the future development of type 2 diabetes mellitus (T2DM). The study found that higher levels of PAI-1 in non-diabetic individuals were associated with an increased risk of developing diabetes.

“After accounting for multiple factors, those with elevated baseline PAI-1 had a 1.87 times higher risk. The association was even stronger in individuals with normal glucose levels (OR: 2.68), highlighting the potential of PAI-1 as an early biomarker for assessing diabetes risk,” the researchers reported in Diabetology & Metabolic Syndrome.

Plasminogen activator inhibitor-1 (PAI-1), a key regulator of the fibrinolytic system primarily secreted by adipose tissue, plays a crucial role in blood clot regulation. While it is well known for its association with cardiovascular disease, recent research has highlighted its potential involvement in metabolic disorders, including type 2 diabetes. Emerging evidence suggests that elevated PAI-1 levels may serve as an early risk marker for diabetes.

Lars Johansson, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden, and colleagues present findings from a large prospective analysis investigating the link between PAI-1 levels and the development of type 2 diabetes mellitus.

For this purpose, the researchers conducted a prospective case-referent study within the Västerbotten Intervention Programme (VIP). Between 1990 and 2005, data on cardiovascular risk factors, fasting plasma glucose (FPG), and 2-hour plasma glucose (2-hPG) were collected during baseline health examinations. Blood samples were stored for future analysis, and participants followed over time.

During the study period, 484 individuals developed type 2 diabetes. An equal number of referents without diabetes were matched based on sex, age, and year of participation. Baseline plasma samples were analyzed for PAI-1 levels, with a subgroup analysis conducted on 201 cases and 201 matched referents with normal baseline glucose levels (FPG <6.1 and 2-hPG <8.9 mmol/L).

The following were the key findings of the study:

  • Higher baseline PAI-1 levels were linked to an increased risk of developing type 2 diabetes, even after adjusting for BMI, family history of diabetes, smoking status, hypertension, FPG, and 2-hPG (OR = 1.87).
  • In a subgroup analysis of 201 participants with normal glucose levels at the time of the health examination, elevated PAI-1 levels were associated with an even higher risk of diabetes (OR = 2.68).

“The findings showed that elevated PAI-1 levels in individuals without diabetes may serve as an early indicator of type 2 diabetes, appearing before any detectable rise in fasting plasma glucose or 2-hour plasma glucose,” the researchers concluded.

Reference:

Hernestål-Boman, J., Öhman, T., Jansson, JH. et al. Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus. Diabetol Metab Syndr 17, 61 (2025). https://doi.org/10.1186/s13098-025-01629-4

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Finerenone May Help Prevent Worsening Heart Failure, suggests JAMA study

A new study published in JAMA Cardiology identified that outpatient worsening heart failure (HF) events necessitating oral diuretic escalation are frequent and associated with a poor prognosis. Finerenone shows potential in preventing outpatient worsening heart failure in patients with mildly reduced or preserved ejection fraction. This study was conducted by Jonathan W. and colleagues.

A recent secondary analysis of the FINEARTS-HF trial assessed the impact of finerenone, a nonsteroidal mineralocorticoid receptor antagonist, in patients with heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). The trial assessed whether finerenone could decrease the necessity for outpatient oral diuretic escalation and its effect on clinical outcomes.

Patients with heart failure and an ejection fraction of 40% or more were enrolled in this worldwide, multicenter, double-blind randomized controlled trial. The trial compared finerenone versus a placebo effect on outpatient worsening HF events that necessitated the use of loop or thiazide diuretics. As worsening HF episodes, such as hospitalizations and urgent visits, are related to increased mortality risk, the recognition of effective treatment to control worsening HF episodes will be vital for enhancing patient outcomes.

The secondary analysis was based on the FINEARTS-HF trial data with 6,001 participants at a mean age of 72.0 years, 46% of whom were female (2,732 patients). The participants were allocated randomly to either finerenone or placebo in a 1:1 fashion.

Worsening HF events were defined as:

• HF hospitalizations (664 events)

• Urgent HF visits with intravenous diuretic treatment (87 events)

• Outpatient oral diuretic uptitration (1,250 events)

Primary outcome events, such as cardiovascular death, HF hospitalization, and urgent HF visits, were centrally adjudicated. Investigators measured the risk of mortality after each category of worsening HF event and assessed the effect of finerenone on outpatient intensification of oral diuretics alone and as included in an extended composite outcome of cardiovascular death, HF hospitalization, and urgent HF visits.

Key Findings

• HF hospitalization: 27.7 deaths per 100 patient-years (95% CI, 24.3-31.5)

• Urgent HF visits: 13.6 deaths per 100 patient-years (95% CI, 8.8-21.1)

• Outpatient oral diuretic intensification: 11.6 deaths per 100 patient-years (95% CI, 10.2-13.1)

• Patients without worsening HF: 4.5 deaths per 100 patient-years (95% CI, 4.2-4.9)

• Outpatient oral diuretic intensification considerably augmented the rate of patients having HF-related events from 1,343 to 2,238 cases.

• Finerenone lowered the hazard of outpatient oral diuretic intensification

• Hazard ratio (HR), 0.89 (95% CI, 0.80-0.98; p=0.02)

• Finerenone also decreased the risk in a longer composite outcome (CV death, HF hospitalization, urgent HF visit, and outpatient oral diuretic intensification); HR, 0.85 (95% CI, 0.78-0.92; p<0.001)

The research proved that finerenone minimized outpatient worsening HF events necessitating oral diuretic escalation in HFmrEF and HFpEF patients with increased risk of mortality. These findings highlight the importance of having finerenone as part of the treatment strategy for preserved ejection fraction heart failure patients, especially in minimizing outpatient worsening HF events.

Reference:

Cunningham JW, Chatur S, Claggett BL, et al. Finerenone and Outpatient Worsening Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Secondary Analysis of the FINEARTS-HF Randomized Clinical Trial. JAMA Cardiol. Published online February 26, 2025. doi:10.1001/jamacardio.2025.0016

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Botulinum Toxin Type A Shows Promise as Add-On Treatment for HS, reports research

Botulinum toxin type A may help reduce inflammation in hidradenitis suppurativa (HS) by inhibiting mast cell degranulation. Recent findings suggest its potential as an off-label add-on treatment, showing positive outcomes for patients suffering from hidradenitis suppurativa.

A recent study found that the off-label use of botulinum toxin type A (BoNT-A) can be an effective add-on treatment for symptom control in patients with hidradenitis suppurativa (HS). Led by Noor F. Goandal from Zealand University Hospital, the study highlights the continued need for alternative therapies despite the availability of biologics like secukinumab, adalimumab, and bimekizumab. BoNT-A, known for treating hyperhidrosis, may also reduce inflammation by inhibiting mast cell degranulation, a key factor in HS severity.

The retrospective case series analyzed eight HS patients treated with BoNT-A between 2018 and 2023. Investigators assessed treatment efficacy using numeric rating scales (NRS) and a Likert scale to evaluate suppuration, pain relief, and effects on daily activities. Participants reported high satisfaction with a median NRS score of 8.5. A moderate reduction was noted among six patients with suppuration (median NRS 6.5).

Pain relief was also moderate (median score 2.5), while improvements in work/education were minimal (median score 0.5). Physical activity showed some enhancement (median score 1.5). All participants said they would recommend the treatment. The study’s pain reduction findings align with prior research on BoNT-A and a randomised trial of botulinum toxin type B for hidradenitis suppurativa. Compared to tetracycline, which significantly lowered pain scores from 6 to 4, and adalimumab, which reduced pain by 30%, BoNT-A showed moderate but promising results. Researchers attribute these benefits to its inhibition of neurogenic inflammation and mast cell degranulation, potentially reducing abscess formation.

The authors emphasize the need for a randomized, placebo-controlled study to further evaluate BoNT-A’s effects on pain, suppuration, quality of life, and disease severity. Their findings lay the groundwork for future research on BoNT-A as a potential hidradenitis suppurativa treatment.

Reference:

Goandal, N.F., Jemec, G.B.E. and Saunte, D.M.L. (2025), Botulinum toxin type A efficacy on pain and suppuration in hidradenitis suppurativa. J Eur Acad Dermatol Venereol. https://doi.org/10.1111/jdv.20611.

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Dexmedetomidine may reduce agitation during anesthesia recovery in Pediatric Cochlear Implantation: Study

Recent study aimed to assess the impact of dexmedetomidine (Dex) on agitation and inflammatory response in young children during the recovery phase from anesthesia after cochlear implantation surgery. Eighty children were randomly allocated into two groups: Group D received Dex after anesthesia induction, while Group C received saline infusion. Measurements of mean arterial pressure (MAP) and heart rate (HR) were taken at different time intervals. Group D showed more stable MAP and HR trends. Children in Group D exhibited lower crying, O2 needs, vital signs changes, CRIES score, pediatric anesthesia emergence delirium (PAED) score, and agitation incidence compared to Group C. Dex group also had lower rates of supplemental pain relief. At the post-anesthesia care unit (PACU) discharge, serum IL-6 and TNF-α levels were lower in Group D. However, levels of IL-6 and TNF-α increased in both groups at discharge compared to preoperative levels.

Dex Mechanism and Benefits in Anesthesia Recovery

The study found that Dex effectively reduced agitation frequency and severity during anesthesia recovery and improved postoperative inflammatory reactions. Dex’s mechanism involved inhibiting neurotransmitter release, reducing stress response, and promoting analgesia and sedation. Dex also stabilized HR and MAP and lowered agitation scores and pain relief needs compared to the control group. Children in the Dex group exhibited reduced inflammatory response indicated by lower IL-6 and TNF-α levels. Notably, respiratory depression and sinus bradycardia did not occur in Group D during recovery. The study highlighted Dex’s role in minimizing discomfort during anesthesia recovery in young children undergoing cochlear implantation.

Study Limitations and Future Research

Limitations included a restricted sample size, single-center study design, and focus on specific observational indexes. The short-term nature of the study limited the exploration of long-term Dex effects. Further research is warranted to evaluate cognitive function, long-term hearing improvement, and quality of life post-surgery. In conclusion, Dex administration post-anesthesia reduced agitation severity, improved inflammatory responses, and enhanced the recovery experience for young children undergoing cochlear implantation surgery.

Key Points

– The study assessed the impact of dexmedetomidine (Dex) on agitation and inflammatory response in children during the recovery phase from anesthesia after cochlear implantation surgery.

– Children who received Dex showed more stable mean arterial pressure (MAP) and heart rate (HR) trends compared to the control group who received saline infusion.

– Dex administration resulted in lower crying, oxygen needs, vital signs changes, CRIES score, pediatric anesthesia emergence delirium (PAED) score, agitation incidence, and rates of supplemental pain relief.

– At discharge from the post-anesthesia care unit (PACU), children who received Dex had lower serum levels of inflammatory markers IL-6 and TNF-α compared to the control group, although levels increased in both groups at discharge compared to preoperative levels.

– Dex’s mechanism involved inhibiting neurotransmitter release, reducing stress response, promoting analgesia and sedation, stabilizing HR and MAP, and lowering agitation scores and pain relief needs.

– The study highlighted the role of Dex in reducing agitation severity, improving inflammatory responses, and enhancing the recovery experience for children undergoing cochlear implantation surgery.

Reference –

Qing Cheng et al. (2025). Impact Of Dexmedetomidine On Agitation And Inflammatory Response During Recovery From Anesthesia In Young Children Following Cochlear Implantation Surgery. *BMC Anesthesiology*, 25. https://doi.org/10.1186/s12871-025-02970-x

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