Copper and iron levels may influence development of fibromyalgia, reports research

A recent study which employed Mendelian randomization (MR) analysis identified copper (Cu) and iron (Fe) as potential contributors to fibromyalgia (FM) risk, shedding new light on the role of trace elements in the chronic pain condition. While FM’s exact cause remains elusive, the findings published in the recent issue of Nature Scientific Reports suspect that abnormalities in trace element metabolism may influence its development.

Using data from genome-wide association studies (GWAS), the study investigated 15 major trace elements to determine their causal relationships with FM. Single nucleotide polymorphisms (SNPs), or genetic variations linked to these elements, were analyzed through multiple MR methods, including inverse-variance weighting (IVW), MR Egger, weighted median, weighted mode, and simple mode approaches.

The two-sample MR analysis revealed a significant link between Cu and an increased risk of FM. According to the IVW method, higher Cu levels were associated with a 9.5% greater risk of developing FM (OR = 1.095, 95% CI: 1.015 to 1.181, P = 0.018). Also, Fe was found to have a protective effect, reducing the FM risk by 56% (OR = 0.440, 95% CI: 0.233 to 0.834, P = 0.011).

To ensure these relationships were not influenced by other factors, this study conducted a multivariable analysis controlling for selenium, a potential confounder. The findings remained consistent which confirmed the independent effects of Cu and Fe on FM risk. No significant associations were observed for other trace elements such as zinc and selenium.

These results highlight the potential importance of Cu and Fe in FM pathophysiology and suggest that monitoring and regulating these elements could be valuable in managing the condition. While Cu appears to elevate FM risk, Fe may offer protective benefits, opening new avenues for dietary and therapeutic strategies.

However, the study calls for further research to validate these findings and to explore the precise biological mechanisms through which Cu and Fe influence FM risk. Future investigations may provide deeper insights into whether dietary modifications or supplementation strategies could reduce FM symptoms or prevent its onset. With FM affecting millions globally and often leading to chronic pain, fatigue, and cognitive issues, identifying modifiable risk factors such as trace elements could be a major step in improving patient outcomes.

Reference:

Zeng, W., Hu, M., Ma, L., Huang, F., & Jiang, Z. (2025). Copper and iron as unique trace elements linked to fibromyalgia risk. Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-86447-4

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Hysteroscopic diagnostic criteria precise in detecting chronic endometritis: Study

A new study published in the American Journal of Obstetrics and Gynecology found the hysteroscopic diagnostic criteria to be highly sensitive and reliable for identifying chronic endometritis.

Chronic endometritis (CE) is characterized by ongoing inflammation of the uterine mucosa. The microscopic detection of plasma cells in the endometrial stroma is a characteristic of this disease. Although few cases of abacterial CE have been reported, several bacteria, mostly gram-negative and intracellular (including Enterococcus faecalis, Escherichia coli, urea-plasma, Mycoplasma, Chlamydia, and Streptococcus spp.), have been linked to the development of CE.

The gold standard method for diagnosing and treating endocervical and intracavitary lesions is hysteroscopy. Thus, to evaluate the diagnostic accuracy of current hysteroscopic criteria in comparison to histological examination (with or without supplementary immunohistochemistry) for the diagnosis of chronic endometritis, Gaetano Riemma and colleagues carried out this study.

The diagnostic accuracy of hysteroscopy for chronic endometritis was assessed by comparing hysteroscopic criteria with histological (with or without immunohistochemistry) diagnosis. Studies were chosen based on whether they were prospective, retrospective, or randomized. The diagnostic odds ratio, sensitivity, specificity, and area under the summary receiver operating characteristic curve were the main results. Secondary outcomes included both positive and negative probability ratios.

In accordance with the Synthesizing Evidence from Diagnostic Accuracy Tests methodological standards and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, a diagnostic accuracy meta-analysis was carried out. The Quality Evaluation Tool for Diagnostic Accuracy Studies−2 (QUADAS-2) was used to perform the quality evaluation. Using the Deeks funnel plot asymmetry test, publication bias was assessed.

A total of 13 investigations compared the histological examination of endometrial samples with the existing hysteroscopic criteria. The diagnostic odds ratio, after combining all the investigations, was 40. With a very good diagnostic accuracy, the assessed area under the summary receiver operating characteristic curve was 0.93. The corresponding sensitivity and specificity were 84% and 89%. Also, the probability ratios for good and negative outcomes were 7.4 and 0.19, respectively.

Overall, hysteroscopic diagnostic criteria are very sensitive and accurate for the detection of chronic endometritis. If there is no hysteroscopic suspicion, the illness may be ruled out. However, because hysteroscopy alone carries a risk of false positives, endometrial biopsy is advised to confirm the diagnosis in situations where hysteroscopic diagnostic signs of chronic endometritis are present.

Reference:

Riemma, G., Parry, J. P., De Franciscis, P., Carugno, J., Lettieri, D., Cobellis, L., Vitagliano, A., Etrusco, A., Lin, L.-T., Angioni, S., & Vitale, S. G. (2025). Hysteroscopic criteria for the diagnosis of chronic endometritis: A systematic review and diagnostic test accuracy meta-analysis. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2025.03.005

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Air pollution exposure may increase cardiovascular disease risk among diabetes patients: Study

A new study published in the journal of BMC Diabetology and Metabolic Syndrome revealed that air pollution exposure is linked to a higher risk of cardiovascular disease (CVD) in middle-aged and older persons with diabetes, and the inflammatory lipid ratio (ILR) exacerbates this risk.

In addition to affecting glucose metabolism, diabetes causes a number of metabolic dysfunctions that raise the risk of cardiovascular disease. According to studies, people with diabetes are far more likely than people without the disease to get myocardial infarction and stroke. The patients with diabetes who are middle-aged or older are more vulnerable to the negative effects of air pollution.

Globally, air pollution is widely acknowledged as a serious danger to public health, particularly in regions experiencing rapid urbanization, where its detrimental effects on human health are most noticeable. Studies that systematically examine the precise impact of air pollution on the risk of CVD in middle-aged and older diabetes patients are scarce, nevertheless. 

Thus, to understand the interplay and to offer a scientific foundation for targeted health interventions for diabetic patients, the current study sought to examine the relationship between air pollution exposure and CVD risk in this population as well as the function of ILR as a modifier.

This study tracked 5,430 persons over 4 years using data from the China Health and Retirement Longitudinal Study (CHARLS). Air pollution exposure to PM1, PM2.5, PM10, and O3 was evaluated using high-resolution data, and baseline CVD and diabetes status were established. To account for inflammatory and lipid metabolic states, the inflammatory lipid ratio (ILR) was computed. The impact of air pollution and ILR on the risk of CVD associated with diabetes was examined using a generalized linear model (GLM).

In the healthy population, the prevalence of CVD was 8.5%, but in the diabetic group, it was 13.8%. Exposure to air pollution was substantially linked to a higher risk of CVD in those with diabetes.

In the diabetic group, the risk of CVD increased by 21%, 19%, 28%, and 19% for every interquartile range (IQR) rise in the concentrations of pollutants O3, PM1, PM10, and PM2.5. A nonlinear link between ILR levels and CVD risk was found, and higher ILR values were positively correlated with CVD incidence. This suggests that higher ILR values worsen the effects of air pollution on people with diabetes.

Overall, the results highlight the need for improved clinical and environmental treatments in the diabetic community to lower exposure to air pollutants and manage systemic inflammation in order to lower the risk of CVD in this susceptible population.

Source:

Yan, C., Chen, G., Jing, Y., Ruan, Q., & Liu, P. (2025). Association between air pollution and cardiovascular disease risk in middle-aged and elderly individuals with diabetes: inflammatory lipid ratio accelerate this progression. Diabetology & Metabolic Syndrome, 17(1). https://doi.org/10.1186/s13098-025-01638-3

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Gut microbes release cancer-fighting bile acids that block hormone signals, suggests research

Bacteria naturally present in the human intestine (known as the gut microbiota) can transform cholesterol-derived bile acids into powerful metabolites that strengthen anti-cancer immunity by blocking androgen signaling, according to a preclinical study led by Weill Cornell Medicine investigators. The study was published on April 15 in Cell.

“I was very surprised by our findings. As far as I know, no one has previously discovered molecules like these bile acids that can interact with the androgen receptor in this way,” said co-senior author Dr. Chun-Jun Guo, an associate professor of immunology in medicine in the Division of Gastroenterology and Hepatology and a scientist at the Jill Roberts Institute for Research in Inflammatory Bowel Disease at Weill Cornell Medicine.

Dr. David Artis, director of the Jill Roberts Institute and the Friedman Center for Nutrition and Inflammation and the Michael Kors Professor in Immunology, and Dr. Nicholas Collins, assistant professor of immunology in medicine, both at Weill Cornell Medicine, are co-senior authors of the study. Drs. Wen-Bing Jin, formerly a postdoctoral associate, and Leyi Xiao, a current postdoctoral associate in Dr. Guo’s lab, are the co-first authors of the study.

Primary bile acids are produced by the liver and released into the gut, where diverse groups of bacteria work together to modify their chemical structures. Researchers suspected these gut microbial modifications could affect how bile acids function and interact with human signaling pathways. To test this idea, the investigators set out to explore the full extent of bacterial modifications to bile acids and understand how these changes affect their biological roles.

It turns out that gut bacteria have remarkable potential to transform bile acids. “We discovered more than fifty different bile acid molecules modified by the microbiota-many of which had never been identified before,” said Dr. Guo, who is also the Halvorsen Family Research Scholar in Metabolic Health at Weill Cornell Medicine.

These newly uncovered structures could open the door to new biological insights-particularly in how they interact with human receptors that sense bile acids. Given that bile acids share the same steroid backbone as sex hormones like testosterone and estrogen, the structural resemblance raised an intriguing question for the researchers: could these microbially modified bile acids also interact with sex hormone receptors in the body? “It seemed like a wild idea at the time,” Dr. Guo said.

Surprisingly, the answer appears to be yes. When the investigators tested the 56 altered bile acids that they discovered, they found one that antagonizes the androgen receptor — a molecule that interacts with sex hormones to regulate many aspects of human development. When they tested an additional 44 microbiota-modified bile acids that had previously been characterized, the team found three more that act similarly. This

unexpected finding raised exciting new questions for the team: which specific cells were affected by the altered bile acids-and what biological functions these modified molecules might influence.

In addition to its role in development, the androgen receptor is also found in certain immune cells, including CD8 T cells. Previous studies have shown that blocking this receptor can enhance the ability of these immune cells to fight tumors. The investigators wondered whether the bile acids could replicate this effect by binding to and inactivating the androgen receptor. To test the idea, they treated mice with bladder cancer using these compounds—and observed a potent anti-tumor response. Further analysis revealed that the modified bile acids specifically boosted the activity of T cells-the immune cells best equipped to kill cancer.

“Our results suggest that these altered bile acids help shrink tumors by enhancing T cells’ ability to survive within the tumor and destroy cancer cells,” Dr. Collins said.

“This study highlights the profound and evolving partnership between the human host and its gut microbiota, emphasizing the importance of integrating microbial activity into the design of future cancer therapies.” Dr. Artis said. “It also exemplifies the power of multidisciplinary collaboration in driving microbiome science toward deeper molecular understanding of host–microbe interactions.”

This discovery opens up exciting new possibilities for boosting tumor-killing immune response. Potential approaches include introducing targeted gut microbes to cancer patients before therapy, or directly administering the anti-cancer bile acids as part of treatment, the researchers suggested. Although these compounds still need to be tested in humans, the team is optimistic that bile acids could eventually become a key component of effective cancer therapies-especially when combined with existing treatments for a more powerful impact.

However, important questions remain. For example, how might diet-which is known to influence microbiota composition-affect the production of these bile acids? And beyond their anti-cancer properties, what physiological effects might these androgen receptor–blocking bile acids have in healthy individuals? The team is now focused on precisely controlling the synthesis and release of these beneficial molecules using advanced techniques to genetically engineer gut commensal bacteria, aiming to understand the broader physiological impact in the host initiated by these androgen blocking, microbiota-derived bile acids.

Reference:

Jin, Wen-Bing et al., Microbiota-derived bile acids antagonize the host androgen receptor and drive anti-tumor immunity, Cell.

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Exclusive E-Cigarette Use Linked to COPD and Hypertension in Adults, finds study

Researchers have identified in a new study that sole e-cigarette use is strongly linked with the risk of chronic obstructive pulmonary disease (COPD) and hypertension in adults between 30 and 70 years. The current study, based on longitudinal data from the All of Us research program, sheds light on the potential health hazards of e-cigarettes. The results call for regulation policy covering the health threats of emerging tobacco products. This study was conducted by John E. and colleagues published in the journal Nicotine & Tobacco Research.

Data from 249,190 participants, including 67.2% female and 52.0% classified as non-Hispanic White, were followed up during a duration of 3.7-3.9 years. The investigators used Cox regression models to evaluate the correlation between exclusive e-cigarette smoking (EE), exclusive combustible cigarette smoking (ECC), and dual use (DU) with the risk of hypertension, type 2 diabetes mellitus (T2DM), COPD, heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD). The models were controlled for important variables including age, sex, race and ethnicity, and body mass index (BMI). ECC was utilized as a positive control to confirm the results.

Key Findings

Exclusive E-Cigarette Use (EE) Outcomes:

  • EE was strongly related to COPD (adjusted hazard ratio [aHR] 2.29, 95% confidence interval [CI] 1.42-3.71).

  • In subjects between the ages of 30-70 years, EE was strongly correlated with hypertension (aHR 1.39, 95% CI 1.09-1.77).

  • No substantial correlations were noted between EE and hypertension in the overall population (aHR 1.01, 95% CI 0.83-1.23), T2DM (aHR 0.88, 95% CI 0.66-1.16), ASCVD (aHR 1.05, 95% CI 0.59-1.86), or HF (aHR 0.82, 95% CI 0.47-1.41).

Exclusive Combustible Cigarette Use (ECC) and Dual Use (DU) Outcomes:

  • ECC and DU were strongly correlated with all examined cardiometabolic disorders.

  • DU had increased point estimates for the majority of outcomes, with a very high association with ASCVD (aHR 2.18, 95% CI 1.82-2.62), suggesting possibly increased risk in dual users.

The research offers strong evidence of a relationship between exclusive e-cigarette use and heightened risk of COPD and hypertension in adults aged 30-70 years. Dual use of combustible cigarettes and e-cigarettes was also highly correlated with all cardiometabolic conditions examined, with a particularly high risk for ASCVD. These results underscore the need for well-informed public health warnings and strict regulation to counteract the possible harms of e-cigarette use.

Reference:

John Erhabor, Zhiqi Yao, Erfan Tasdighi, Emelia J Benjamin, Aruni Bhatnagar, Michael J Blaha, E-cigarette Use and Incident Cardiometabolic Conditions in the All of Us Research Program, Nicotine & Tobacco Research, 2025;, ntaf067, https://doi.org/10.1093/ntr/ntaf067

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UPSC Combined Medical Services Exam date released, check out details

New Delhi- The Union Public Service Commission (UPSC) has released the schedule of Combined Medical Services (CMS) examinations for the year 2025.

Candidates who are registered to appear for the CMS 2025 exam can now check the detailed timetable from the official website of UPSC. The schedule contains information such as date, day, time slot, paper and subjects. 

As per the schedule, the CMS 2025 exam is scheduled on July 20, 2025 and will be conducted in two sessions. Of these, the first slot will have the exam for General Medicine and Paediatrics from 9:30 am to 11:30 am and the second slot will have the exam for Surgery, Gynaecology and Obstetrics, Preventive and Social Medicine.

Below is the complete schedule-

SCHEDULE

DATE

DAYE

TIME SLOT

PAPER

SUBJECT

July 20, 2025

Sunday

9:30 AM – 11:30 AM

Paper I

General Medicine and Paediatrics

2:00 PM – 4:00 PM

Paper II

Surgery, Gynaecology & Obstetrics, Preventive & Social Medicine

Meanwhile, candidates appearing for the exam should note that the admit cards will be available for download around a week before the exam date.

UPSC is known for conducting the Civil Services Examination (CSE). It conducts exams for various specialised services such as administrative, revenue, police or foreign service. Similarly, the commission also conducts recruitment to other government services, such as IES, ISS and CMS.

The Combined Medical Services (CMS) exam selects medical professionals to serve in government healthcare departments, including railways and municipal corporations.

To view the schedule, click the link below

https://medicaldialogues.in/pdf_upload/upsc-exam-calendar-2025-combined-medical-services-exams-schedule-out-285293.pdf

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Over 1100 medical students dropped out, 119 committed suicides in 5 years, reveals RTI data

Altogether 1166 medical students dropped out of their undergraduate and postgraduate medical courses, and 119 medical students committed suicide in the last five years, revealed the data obtained through a Right to Information (RTI) application.

The data in this regard was shared by the National Medical Commission (NMC) while responding to an RTI application filed by a member of the United Doctors’ Front (UDF).

For more information, click on the link below:

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MSN Laboratories Gets CDSCO Panel Nod To study Brexpiprazole Tablets

New Delhi: Considering the bioequivalence study of Brexpiprazole Tablets 0.25mg /0.5 mg/1mg/2mg/3mg/4mg, the Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) has given its nod to drug maker MSN Laboratories to conduct a Phase III clinical trial study of the Brexpiprazole Tablets.

However, this approval is subject to the condition that the clinical trial sites should be geographically distributed with 50% government sites and include a qualified psychiatrist by training and experience as the principal investigator, as the drug (brexpiprazole) will be evaluated in psychiatric patients.

This came after the firm presented a proposal for a grant of permission to manufacture and market Brexpiprazole Tablets 0.25mg/0.5 mg / 1mg /2mg /3mg /4mg, along with a bioequivalence study report and phase III clinical trial protocol, before the committee.

Brexpiprazole is an atypical antipsychotic and a novel D2 dopamine and serotonin 1A partial agonist called a serotonin-dopamine activity modulator (SDAM). It has a high affinity for serotonin, dopamine, and alpha (α)-adrenergic receptors.

Although the exact mechanism of action of brexpiprazole in psychiatric disorders has not been fully elucidated, the efficacy of brexpiprazole may be attributed to combined partial agonist activity at 5-HT1A and dopamine D2 receptors and antagonist activity at 5-HT2A receptors. Brexpiprazole binds to these receptors with subnanomolar affinities. These therapeutic targets have been implicated in psychiatric conditions such as schizophrenia and depression.

At the recent SEC meeting for Neurology and Psychiatry held on 19th March 2025, the expert panel reviewed the proposal for grant of permission to manufacture and market Brexpiprazole Tablets 0.25mg/0.5 mg/1mg/2mg/3mg/4mg, along with Bioequivalence study report and Phase III Clinical trial protocol.

After detailed deliberation, the committee considered bioequivalence study results and recommended granting permission to conduct a Phase III clinical trial study as per the protocol presented, subject to the following conditions.

1. Clinical trial sites should be geographically distributed with 50% government sites.
2. The firm should include a qualified psychiatrist by training and experience as the principal investigator, as the drug (brexpiprazole) will be evaluated in psychiatric patients.

Also Read: Torrent Pharmaceutical Gets CDSCO Panel Nod To study Semaglutide Tablets

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Mumbai court grants bail to doctor accused of using fake degree

A magistrate court in Mumbai on Wednesday granted bail to a 44-year-old orthopaedic surgeon arrested last week over allegations of forging his MS Orthopaedics degree and misrepresenting his medical credentials. Judicial Magistrate SP Bhosale ordered the doctor’s release upon furnishing a cash bail of Rs. 50,000.

Medical Dialogues had earlier reported that a fake orthopaedic surgeon has been arrested for allegedly duping patients by pretending to be a qualified and certified medical practitioner at several top private hospitals in the western suburbs without a valid medical degree. He is currently in judicial custody.

For more information, click on the link below:

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Demanding NEET PG 2025 in Single Shift, Doctors Move Supreme Court

New Delhi: Doctors’ demand for holding the upcoming National Eligibility-Entrance Test Postgraduate (NEET-PG) examination in a single shift has now reached the Supreme Court.

The United Doctors’ Front (UDF) has filed a petition with the Supreme Court. In the plea, UDF, a registered medical association representing thousands of doctors and medical aspirants, has urged the Apex Court to issue directions to conduct the upcoming NEET PG 2025 exam in a single shift across the country.

The petition, filed under Article 32 of the Constitution, challenges the arbitrary and non-transparent decision of the National Board of Examinations (NBE) to conduct NEET PG in two shifts with different question papers, using a disputed normalisation process for result calculation. UDF contends that this violates the aspirants’ fundamental rights under Articles 14 and 21 of the Constitution, specifically the right to equality and the right to a fair, merit-based opportunity, the association mentioned in a release.

Commenting on the matter, Dr. Lakshya Mittal, the National President of UDF, said, “Our petition is in response to overwhelming concerns raised by NEET PG aspirants across India. Conducting exams in two shifts with different levels of difficulty and applying a normalisation formula without transparency directly impacts the fairness and credibility of the entire process.”

Stressing that NEET PG 2025 should be conducted in a single shift, recently Dr. Mittal had highlighted the demand for “One Nation, One Shift” to ensure fairness, transparency and trust in the examination process.

Medical Dialogues had earlier reported that a recent public survey conducted on the social media platform by UDF revealed that more than 2,513 NEET-PG aspirants anticipated, and a remarkable 96% of respondents demanded that the examination be conducted in a single shift to ensure fairness, transparency, and uniform evaluation. Raising this demand, UDF recently urged the Union Health Minister, Shri J.P. Nadda to reconsider the decision to conduct the PG medical entrance test in two shifts.

Previously, raising concerns about the multiple-shift exam format for NEET PG, UDF had highlighted the issues if normalisation discrepancies, legal complexities, and loss of candidate confidence.

Doctors across the country have been upset over the conduct of the upcoming NEET PG 2025 exam after the NBEMS announced that it would be held in two shifts on June 15, 2025. While the first shift is scheduled from 9:00 AM to 12:30 PM, the second shift is scheduled from 3:30 PM to 7:00 PM.

The doctors expressed their concerns primarily over the normalisation process. Even though the normalisation formula was introduced for NEET PG 2024 to adjust the scores across different exam shifts to ensure fairness, critics have argued that the process is flawed.

A few candidates who appeared in the second shift of the NEET PG 2024 exam had questioned the normalisation formula adopted by NBEMS and further claimed that the board had scammed them in the name of a competitive exam. They pointed out that the Shift 2 paper was tougher compared to Shift 1 and further termed the process of calculating scores as debatable. These concerns were also raised before the Supreme Court, where the aspirants prayed for transparency in the NEET PG 2024 exam.

Recently, a poll conducted by Shiksha.com revealed that when asked about their opinions on the two-shift NEET PG 2025 examination, 89% of the respondents in the poll opposed the idea. While 89% of respondents said “No” to the NEET PG exam in two shifts, 9% of respondents supported the idea, and the remaining 2% were undecided.

Despite the protests and demands from the aspirants to hold the upcoming PG entrance test in a single shift, NBEMS has not yet announced any changes in its plans of holding the exam in double shifts. Meanwhile, the plea alleging a lack of transparency in the NEET PG 2024 exam is still pending before the Supreme Court.

Amid this, UDF has now challenged NBE’s decision to hold NEET PG 2025 in two shifts before the Supreme Court by filing a plea yesterday. Making an official announcement in this regard, Dr. Mittal mentioned in an X (formerly Twitter) post, “𝗨𝗻𝗶𝘁𝗲𝗱 𝗗𝗼𝗰𝘁𝗼𝗿𝘀 𝗙𝗿𝗼𝗻𝘁 (UDF) @UDF_BHARAT through its National President @drlakshyamittal, has officially filed a petition in the 𝗛𝗼𝗻’𝗯𝗹𝗲 𝗦𝘂𝗽𝗿𝗲𝗺𝗲 𝗖𝗼𝘂𝗿𝘁 𝗼𝗳 𝗜𝗻𝗱𝗶𝗮 demanding a 𝗦𝗜𝗡𝗚𝗟𝗘 𝗦𝗛𝗜𝗙𝗧 𝗡𝗘𝗘𝗧-𝗣𝗚 𝟮𝟬𝟮𝟱. This fight is not just about an exam— It’s about equality, transparency, and every deserving doctor’s future.”

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