Postmenopausal Women with T1D Face Glucose Regulation Changes and severe menopausal symptoms: Study

A new study published in the journal of Diabetologia showed that the intensity of menopausal symptoms is associated with moderate to severe abnormalities in glucose control, which are reported by almost two-thirds of postmenopausal women with type 1 diabetes.

The amount of insulin needed by women with type 1 diabetes varies throughout pregnancy and the menstrual cycle. Whether women with type 1 diabetes notice changes in glucose control during and after the menopausal transition has not yet been investigated. Thus, this study evaluated the relationships between glucose regulation and type 1 diabetes.

To find out if women with type 1 diabetes think that their glucose management has changed since their last menstrual cycle, this study performed a cross-sectional survey. In the Netherlands, adverts for the online surveys were placed in hospitals and on websites for individuals with type 1 diabetes. Type 1 diabetic postmenopausal women (≥1 year of amenorrhea) between the ages of 45 and 65 were included.

The study excluded participants who had been diagnosed with postmenopausal diabetes, premenopausal hysterectomy, or primary amenorrhea. Using a 5-point Likert scale, the main result measured how much individuals thought their glucose control had changed after their last menstrual cycle. The Greene climacteric scale (GCS) was used to measure the severity of menopausal symptoms.

A total of 159 ladies in all filled out the relevant questions. The average age of the participants was 54.9 years, their average duration of diabetes was 30.3 years, and their average age at menopause was 50.1 years.

In all, moderate to severe postmenopausal alterations in glucose control were reported by 67.4% of respondents. 41.9% reported higher glucose levels, 19.6% reported lower levels, and 38.5% reported no change. 55.0% of respondents said glucose fluctuations were more common, while 18.1% said they were less often.

While 38.5% of women reported more hypoglycemic incidents and 28.0% fewer, 61.6% of women reported an increase in hyperglycemic events. The severity of menopausal symptoms was higher after menopause than before (mean GCS 18.8 vs. 11.7; p<0.001).

The likelihood of experiencing glycemic alterations was positively correlated with the intensity of symptoms (adjusted OR 1.04; p=0.014). Furthermore, 57.2% reported having poor sleep quality (PSQI >5), although this did not correlate with perceived increases in blood sugar levels (adjusted OR 1.10; p=0.731).

Overall, because women going through the menopausal transition may encounter changes in glucose metabolism that may effect their treatment goals, the results illuminate the need of medical providers being aware of these changes while treating women with type 1 diabetes.

Source:

Speksnijder, E. M., Simsek, S., Bisschop, P. H., Stenvers, D. J., Siegelaar, S. E., & MenoPause Consortium. (2025). Perceived blood glucose regulation after menopause: a cross-sectional survey in women with type 1 diabetes in the Netherlands. Diabetologia. https://doi.org/10.1007/s00125-025-06518-z

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New monthly pill shows potential as pre-exposure prophylaxis HIV drug candidate, reveals research

A new HIV antiretroviral shows promise as a long-acting, oral prophylactic agent, according to a new study by Izzat Raheem, Tracy Diamond and colleagues from Merck & Co., Inc., Rahway, NJ, USA, published August 26th in the open-access journal PLOS Biology.

HIV pre-exposure prophylaxis (PrEP) is a key part of reducing the number of new HIV infections. The most common oral PrEP therapies, consisting of once-daily pills, are highly effective at protecting people from acquiring HIV, but they only work if taken properly. Currently, the only long-acting PrEP therapies require injection by a healthcare provider, which isn’t always feasible for people. Long-acting, oral PrEP therapies could facilitate adherence, provide greater privacy and discretion, reduce concerns about stigma, and improve accessibility for more people to initiate and continue on PrEP, ultimately helping to stem the tide of the nearly 1.3 million new HIV infections globally per year.

Researchers from Merck engaged in a lead optimization campaign to develop a novel nucleoside reverse transcriptase translocation inhibitor (NRTTI). NRTTIs are a new class of anti-HIV drugs that have shown potential for long-acting prophylaxis. They inhibit viral replication by more than one mechanism, including blocking translocation of reverse transcriptase on the growing viral DNA chain.

Using a known NRTTI, islatravir, as a starting point, researchers used several medicinal chemistry strategies to modify the structure and optimize it using both in vitro and in vivo assays. The lead compound, dubbed MK-8527, showed robust antiviral activity in vitro, and pharmacokinetics in animal studies demonstrated that it may be suitable as a long-acting oral therapy. Studies in humans are underway to assess the safety and tolerability of MK-8527 as a once-monthly oral pill in volunteers at low likelihood of HIV exposure, and at least one completed clinical study shows promising results.

Reference:

Izzat T. Raheem ,Vinay Girijavallabhan,Kerry L. Fillgrove,Shih Lin Goh,Carolyn Bahnck-Teets,Qian Huang,Fangbiao Li,Bang-Lin Wan,Gregory T. O’Donnell,Jonathan B. Patteson,Maria E. Cilento,Amrith Bennet, MK-8527 is a novel inhibitor of HIV-1 reverse transcriptase translocation with potential for extended-duration dosing, PLOS Biology, https://doi.org/10.1371/journal.pbio.3003308. 

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Dad’s childhood passive smoking may confer lifelong poor lung health onto his kids

A father’s exposure to passive smoking as a child may impair the lifelong lung function of his children, putting them at risk of COPD-a risk that is heightened further if they are childhood passive smokers themselves-finds research published online in the respiratory journal Thorax.

The findings highlight the intergenerational harms of smoking, say the researchers, who urge fathers to intercept this harmful legacy by avoiding smoking around their children.

Chronic obstructive pulmonary disease, more usually known by its acronym of COPD, includes chronic bronchitis and emphysema. Now the third leading cause of death around the world, COPD kills around 3 million people every year, say the researchers.

Several factors throughout the lifespan may increase the risk of poor lung function and subsequent COPD, and attention is now beginning to focus on the potential role of intergenerational factors, they explain.

While previously published research showed that passive smoking during a father’s childhood may be linked to a heightened risk of asthma in his children by the time they are 7, it’s not clear if compromised lung function may extend into middle age and beyond, they add.

To explore this further, the researchers drew on 8022 child participants in the Tasmanian Longitudinal Health Study (TAHS), all of whom had tests to assess their lung function (spirometry).

Their parents completed an initial comprehensive survey on their and their children’s respiratory health. Further check-ups ensued when those children were 13, 18, 43, 50 and 53. These included spirometry to assess 2 measures of lung function (FEV1 and FVC) as well as questionnaires on demographics and respiratory symptoms/disease.

Of the 7243 parents who were alive and could be traced in 2010, 5111 were re-surveyed about whether either of their own parents had smoked when they were under the age of 5 and/or up to when they were 15.

Among the 5097 respondents with complete data, 2096 were fathers. The final analysis included 890 father-child pairs with data on the father’s passive smoke exposure before puberty and lung function data for their children up to the age of 53.

More than two thirds of the fathers (nearly 69%) and more than half of their children (56.5%) had been exposed to passive smoking during their childhoods.

Around half of the children (49%) had a history of active smoking by middle age, and just over 5% of them had developed COPD by this time point, as assessed by spirometry.

After adjusting for potentially influential factors, including the father’s lifetime history of asthma/wheeze and his age, his passive smoke exposure as a child was associated with 56% higher odds of below average FEV1, but not FVC, across the lifespan of his children.

Similarly, fathers’ childhood passive smoke exposure was also associated with a doubling in the odds of an early low-rapid decline in FEV1/FVC in their children. This was statistically significant even after adjusting for potentially influential factors.

And paternal exposure to passive smoking as a child was also associated with a doubling in the risk of COPD by the age of 53 in his children, although this was no longer statistically significant after adjusting for potentially influential factors.

But children whose fathers had been exposed to passive smoking as a child were twice as likely to have below average FEV1 if they, too, had been exposed to passive smoking during their childhood.

The observed associations were only partly mediated through smoking and respiratory illnesses in fathers and their children (each contributing less than 15%).

This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. And the researchers acknowledge that TAHS lacks data on paternal lung function and genetics, preventing assessment of familial aggregation as a potential mechanism.

And their children’s childhood passive smoke exposure was defined as at least one parent smoking 6 days a week, which might have misclassified moderate/light smokers as non-smokers, they add.

But the period before puberty is especially critical for boys, when exposure to harmful substances may change gene expression and modify repair mechanisms, which may then become heritable, say the researchers by way of an explanation for their findings.

“Our findings are novel as this is the first study to investigate and provide evidence for an adverse association of paternal prepubertal passive smoke exposure, rather than just active smoking, on impaired lung function of offspring by middle age,” they write.

“This is of importance from a public health perspective, as passive smoke exposure affects about 63% of adolescents, which is significantly higher than the approximately 7% affected by active smoking.”

They conclude: “These findings suggest that smoking may adversely affect lung function not only in smokers but also in their children and grandchildren…Fathers exposed to tobacco smoke during prepuberty may still reduce risk for future generations by avoiding smoking around their children.” 

Reference:

https://thorax.bmj.com/lookup/doi/10.1136/thorax-2024-222482

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Health Ministry Drafts Rule Change to Halve Drug Trial Approval Time from 90 to 45 Days

New Delhi: With an aim to ease the processes for preclinical and analytical drug testing, the Ministry of Health and Family Welfare has released draft rules to amend the New Drugs and Clinical Trials Rules, 2019, proposing the approval timelines for the Central Licensing Authority to grant permissions under Rules 53 and 60 will be reduced from ninety working days to forty-five working days.

Under the proposed amended Rule 52(1) of the New Drugs and Clinical Trials Rules, 2019, no person will be allowed to manufacture a new drug or an investigational new drug for the purpose of conducting a clinical trial, a bioavailability or bioequivalence study, or for examination, testing, and analysis, without first obtaining permission from the Central Licensing Authority, or through a notification as provided under the proviso to sub-rule (2) of Rule 52, as applicable.

A new provision has been added after sub-rule (2) of Rule 52 of the New Drugs and Clinical Trials Rules, 2019, which allows the manufacture of a new drug or investigational new drug for analytical and preclinical testing on the basis of an online notification, rather than waiting for prior approval. However, this relaxation will not apply to certain sensitive categories, namely sex hormones, cytotoxic drugs, beta-lactam antibiotics, biologics containing live microorganisms, and narcotic or psychotropic substances.

This came as a draft of certain rules further to amend the New Drugs and Clinical Trials Rules, 2019, which the Central Government proposes to make, in exercise of the powers conferred by sub-section (1) of section 12 and sub-section (1) of section 33 of the Drugs and Cosmetics Act, 1940 (23 of 1940), after consultation with the Drugs Technical Advisory Board is hereby published for information of all persons likely to be affected thereby, and notice is hereby given that the said draft rules shall be taken into consideration on or after the expiry of a period of thirty days from the date on which the copies of the Gazette of India containing these draft rules are made available to the public.

The draft amendment to Rule 53 of the New Drugs and Clinical Trials Rules, 2019, proposes to expedite approvals by reducing the time limit for the Central Licensing Authority to process applications. The existing period of ninety working days under sub-rule (1) and clause (ii) of sub-rule (3) will be cut down to forty-five working days, effectively halving the approval timeline for new drug and clinical trial applications.

The draft amendment to Rule 59 of the New Drugs and Clinical Trials Rules, 2019 introduces a proviso allowing manufacturers to produce a new drug or investigational new drug for analytical and preclinical testing on the basis of an online notification instead of prior approval. However, this relaxation will not apply to specific high-risk categories such as sex hormones, cytotoxic medicines, beta-lactam antibiotics, biologics containing live microorganisms, and narcotic or psychotropic substances.

The draft amendment to Rule 60 of the New Drugs and Clinical Trials Rules, 2019 proposes to cut down the approval timelines for permissions granted by the Central Licensing Authority.

Rule 60 of the New Drugs and Clinical Trials Rules, 2019 deals with the grant of permission to manufacture unapproved active pharmaceutical ingredients for the development of pharmaceutical formulations for tests or analysis or clinical trials or bioavailability and bioequivalence studies.

At present, the authority has up to ninety working days to approve or reject applications for manufacturing or importing new drugs and investigational new drugs. The draft amendment reduces this timeframe to forty-five working days, thereby halving the approval period and allowing faster initiation of clinical trials, bioavailability and bioequivalence studies, and related drug development activities in the country.

As per the proposed amendment,

“1. (i) These rules may be called the New Drugs and Clinical Trials (… Amendment) Rules, 2025.
(ii) These rules shall come into force from the date as specified by the Government at the time of final publication of the rules in the Official Gazette.
2. In the New Drugs and Clinical Trials Rules, 2019, the sub-rule (1) of rule 52 shall be substituted, namely:―
“(1) No person shall manufacture a new drug or an investigational new drug to conduct a clinical trial or bioavailability or bioequivalence study or for examination, test and analysis without obtaining permission or the notification as referred to in the provision to sub-rule (2) of rule 52 to the Central Licensing Authority, as the case may be, to manufacture such new drug or investigational new drug.”
3. In the New Drugs and Clinical Trials Rules, 2019, after the sub-rule (2) of rule 52, the following proviso shall be inserted, namely: ―
“Provided that in case of manufacture of new drug or Investigational new drug for Analytical and preclinical testing (excluding the new drug and Investigational new drug of category of sex hormones, cytotoxic, beta lactum, Biologics with live microorganism and narcotics & psychotropic drugs) an online application shall be submitted as notification and applicant can manufacture such drugs based on the notification.”
4. In the New Drugs and Clinical Trials Rules, 2019, in rule 53: ―
(a) under the sub-rule (1), the words “ninety working days” shall be substituted with the words “forty-five working days” wherever occurs.
(b) under the clause (ii) of sub-rule (3), the words “ninety working days” shall be substituted with the words “forty-five working days”.
5. In the New Drugs and Clinical Trials Rules, 2019, after the sub-rule (1) of rule 59, the following proviso shall be inserted, namely: ―
“Provided that in case of manufacture of new drug or Investigational new drug for Analytical and preclinical testing (excluding the new drug and Investigational new drug of category of sex hormones, cytotoxic, beta lactum, Biologics with live microorganism and narcotics & psychotropic drugs) an online application shall be submitted as notification and applicant can manufacture such drugs based on the notification.”
6. In the New Drugs and Clinical Trials Rules, 2019, in rule 60: ―
(a) under the clause (i) of sub-rule (1), the words “ninety working days” shall be substituted with the words “forty-five working days”.
(b) under the clause (ii) of sub-rule (1), the words “ninety working days” shall be substituted with the words“forty-five working days”.
(c) under the clause (ii) of sub-rule (2), the words “ninety working days” shall be substituted with the words“forty-five working days”.”

Further, the gazette notification stated that objections and suggestions that may be received from any person within the period specified above will be considered by the Central Government.

“Objections and suggestions, if any, may be addressed to the Under Secretary (Drugs), Ministry of Health and Family Welfare, Government of India, Room No. 545, A Wing, Nirman Bhavan, New Delhi – 110011 or emailed at drugsdiv-mohfw@gov.in.”the notification added.

To view the official notice, click the link below:

https://medicaldialogues.in/pdf_upload/20250827gsr-588e-299522.pdf

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High Surgical Rate in Orbital Cellulitis Demands Targeted Management: Study

China: A new study has found that over 80% of orbital cellulitis (OC) cases require surgical intervention, regardless of patient age, primarily due to abscess formation or failure of medical therapy. Staphylococcal species, including MRSA, are common causative agents, highlighting the need for customized empiric antibiotic regimens. Implementing cost-effective management strategies that consider Chandler staging and vaccination history is advised.

The retrospective study, published in The Journal of Craniofacial Surgery, analyzed 40 cases of orbital cellulitis that occurred over 12 years at Xi’an Fourth Hospital. The research team, led by Mingyang Wang from the Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, assessed both pediatric and adult cohorts to identify clinical features, treatment outcomes, and factors predicting surgical intervention.

Among the patients studied, 13 were children and 27 were adults, with an overall mean age of 34.8 years. Surgical management emerged as a cornerstone of treatment, being necessary in 84.6% of pediatric and 88.9% of adult cases. The main reasons for operative intervention were the development of orbital abscesses and inadequate response to intravenous antibiotics alone.

The key findings of the study were as follows:

  • Staphylococcus aureus (17.1%) and Staphylococcus epidermidis (11.4%) were identified as the predominant organisms.
  • MRSA accounted for 8.6% of isolates.
  • Nearly one-third of patient cultures showed no bacterial growth, highlighting the need for empiric therapy.
  • Ceftriaxone was the most commonly used antibiotic (45%), followed by cefotaxime (7.5%).
  • Surgical intervention significantly increased treatment costs (¥13,317 ± ¥5,351 versus ¥1,843 ± ¥509 for non-surgical cases).
  • In adults, surgery was linked to improved visual outcomes, with mean visual acuity increasing from 0.5 ± 0.3 at presentation to 0.6 ± 0.4 at final follow-up.
  • All patients achieved complete resolution of symptoms.

The study highlights that OC remains a vision-threatening condition requiring prompt recognition and aggressive management. The high prevalence of staphylococcal infections, including MRSA, points to the need for carefully selected empiric antibiotic regimens tailored to local resistance patterns. The authors also emphasize the importance of incorporating Chandler staging and vaccination history into treatment algorithms to ensure a structured and cost-effective approach.

By providing comparative insights into pediatric and adult OC cases, the findings underline that the requirement for surgical intervention transcends age groups. According to the authors, adopting a multidisciplinary approach that combines timely imaging, targeted antibiotics, and early surgical consideration is essential to prevent vision loss and systemic complications.

“The large-scale analysis reinforces the critical role of individualized management in orbital cellulitis and offers valuable guidance for clinicians dealing with this potentially severe infection in both children and adults,” the authors concluded.

Reference:

Wang, Mingyang MD*,†; Qin, Bixuan MD‡; Fu, Junxia MD§; Zhang, Ju MD*; Liu, Honglei MD‖; Li, Dongmei MD*,‡. Orbital Cellulitis Management in Pediatric and Adult Cohorts: A 12-Year Retrospective Analysis From a Tertiary Center. The Journal of Craniofacial Surgery ():10.1097/SCS.0000000000011711, July 30, 2025. | DOI: 10.1097/SCS.0000000000011711

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Can botox be used to alleviate pain in a jaw disorder?

Temporomandibular disorder (TMD) limits jaw function and is so painful that it lessens the quality of life. Botulinum toxin-also known as botox-is emerging as an effective treatment option, but there are concerns about side effects, like muscle dysfunction. Eungyung Kim and Yu Shin Kim, from the University of Texas Health Science Center at San Antonio, led a study using a mouse model of TMD to explore the possibility of using botox as a treatment.

In their JNeurosci paper, the researchers discovered that injecting botox directly into the male mouse temporomandibular joint (TMJ) instead of surrounding muscle tissue reduced TMD-related pain without causing side effects.

More specifically, hypersensitivity and pain from TMD were mitigated without impairing general movement abilities and feeding behavior. The researchers also found that the botox injections they delivered reduced TMD-related neural activity. On a molecular level, mice that received botox injections into the TMJ had less expression of proteins that promote pain.

While sex differences remain unexplored, according to the authors, this work suggests it may be possible to overcome botox side effects by avoiding muscle tissue and injecting the toxin directly into the TMJ. 

Reference:

Eungyung Kim, Hyeonwi Son, Yan Zhang, John Shannonhouse, Ruben Gomez, BoNT injection into temporomandibular joint alleviates TMJ pain in forced mouth opening mouse model, JNeurosci, https://doi.org/10.1523/JNEUROSCI.2035-24.2025 

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Early Drug Resistance in Focal Epilepsy Linked to Seizure Frequency and Psychiatric History: JAMA

Australia: A new study published in JAMA Neurology highlights that most people with newly diagnosed focal epilepsy take more than a year and often require multiple antiseizure medications (ASMs) to achieve seizure freedom. The research, led by Sarah N. Barnard and colleagues from the School of Translational Medicine at Monash University, further indicates that patients with frequent pretreatment seizures and psychiatric comorbidities are at greater risk of developing drug resistance.

“Patients with newly diagnosed focal epilepsy needed extended treatment—often exceeding a year and involving more than one ASM—to attain seizure freedom, while baseline seizure frequency and mental health issues were strong indicators of treatment resistance,” the authors wrote.
The findings are from the Human Epilepsy Project, an international, prospective cohort study that followed participants across 34 epilepsy centers in the US, Australia, and Europe for up to six years. The study aimed to quantify treatment response and identify predictors of resistance among individuals with newly diagnosed focal epilepsy. Participants aged 12 to 60 years were enrolled within four months of initiating ASM therapy and closely monitored to assess outcomes using standardized definitions from the International League Against Epilepsy.
The analysis of 448 participants yielded several significant findings:
  • 59.6% of participants eventually became seizure-free, with 83.5% of these maintaining remission without relapse.
  • Early control was uncommon; during the first year of therapy, 63% of patients continued to experience seizures or worsening symptoms.
  • Most patients required more than one ASM trial to achieve stability, and the median time to seizure freedom was 12.1 months.
  • For those who never relapsed, this milestone was reached much sooner—around 2.2 months—compared to 7.4 months for those who experienced recurrence.
  • More than half of the cohort (54.7%) were classified as treatment-sensitive, achieving seizure control with two or fewer adequate ASM trials, and nearly 90% of these responded to monotherapy.
  • About half of the treatment-sensitive group, representing 27% of the total study population, became seizure-free on their first ASM.
  • Treatment resistance was seen in 22.8% of participants, while 22.5% had outcomes that did not fit either category.
  • The study identified important predictors of resistance. Patients who experienced frequent seizures before treatment were significantly more likely to fail therapy compared to those with infrequent episodes.
  • Individuals with a history of psychiatric disorders had an approximately 1.8-fold higher risk of developing treatment resistance than those without such conditions.
According to the authors, recognizing these risk factors early can help clinicians tailor treatment strategies and reduce the time to seizure control. The findings highlight the importance of individualized care, taking into account seizure frequency and mental health history when managing newly diagnosed focal epilepsy.
Reference:
Barnard SN, Chen Z, Holmes M, et al. Treatment Response to Antiseizure Medications in People With Newly Diagnosed Focal Epilepsy. JAMA Neurol. Published online August 25, 2025. doi:10.1001/jamaneurol.2025.2949

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Combination therapy improves outcomes for advanced triple-negative breast cancer: Study

 A new study led by researchers at the Icahn School of Medicine at Mount Sinai has found that adding the targeted therapy everolimus to standard carboplatin chemotherapy extends the time before disease progression in patients with advanced triple-negative breast cancer (TNBC), one of the most aggressive and hard-to-treat forms of breast cancer.

The randomized phase 2 clinical trial, published in Breast Cancer Research and Treatment, showed that patients receiving the combination treatment experienced a 52 percent reduction in the risk of disease progression or death compared to those treated with carboplatin alone. The regimen was well tolerated, with no unexpected safety concerns.

“Triple-negative breast cancer has limited treatment options and is often resistant to standard therapies,” said senior author Amy Tiersten, MD, Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine. “Our findings suggest that the combination of carboplatin and everolimus could offer a new option for patients, and should be further tested in larger clinical trials to confirm its effectiveness and safety.”

According to the American Cancer Society, triple-negative breast cancer is a type of breast cancer that makes up about 10 to 15 out of every 100 cases. It’s tougher to treat and can be more dangerous than other kinds of breast cancer.

Many TNBC tumors are missing something called the PTEN gene, which usually helps keep cell growth under control. Without PTEN, a “growth switch” called the mTOR pathway gets turned on, making the cancer grow faster. Everolimus can block this switch, which may slow down or even stop the cancer from spreading.

In this study, Mount Sinai doctors worked with patients whose TNBC had already been treated up to three times before. They randomly chose some patients to receive carboplatin (a common chemotherapy) alone, while others got carboplatin plus everolimus. The patients who got both medicines lived without their cancer getting worse for longer than those who got only chemotherapy. “This combination could represent a promising new treatment option for advanced triple-negative breast cancer if validated in phase 3 trials,” said Rima Patel, MD, Assistant Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine and first author of the study.

Future phase 3 studies will be needed to confirm the efficacy of carboplatin and everolimus in metastatic TNBC. If the efficacy of the combination is confirmed in larger studies, carboplatin and everolimus could be considered another treatment option for patients with TNBC in lieu of offering carboplatin or another single-agent chemotherapy alone.

Reference:

Patel, R., Fukui, J., Klein, P. et al. Randomized phase II comparison of single-agent carboplatin versus combination of carboplatin and everolimus for advanced triple negative breast cancer. Breast Cancer Res Treat (2025). https://doi.org/10.1007/s10549-025-07802-7

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Osteoarthritis Linked to Increased Risk of Sleep Apnea, Study Finds

Researchers have discovered in a new study that patients with osteoarthritis (OA) are at higher risk of developing sleep apnea (SA), a disease with high morbidity and mortality. Osteoarthritis is the most prevalent joint disease, leading to chronic pain and inflammation, two established risk factors for sleep apnea. The study was published in the journal of Clinical Rheumatology by Yanqiu Zhu and colleagues.

The purpose of the current study was to examine whether OA, such as knee, hip, and hand OA, is linked with a higher risk of sleep apnea. Employing data from the IQVIA Medical Research Database, three individual cohort studies were performed to evaluate the rate of SA among persons with OA versus those without OA.

The research utilized a cohort design of participants who were 50 years and older, stratified into three cohorts according to the type of OA (knee, hip, and hand OA). Each OA patient was matched with a maximum of five non-OA patients according to age, sex, entry-time, and body mass index (BMI) to control for confounding factors.

OA Cohorts:

  • Knee OA: 58,674 patients

  • Hip OA: Not explicitly given in the summary

  • Hand OA: Not specifically provided within the summary

Non-OA Cohorts:

  • Knee OA Comparison Group: 235,850 non-OA participants

The risk incidence of SA was estimated separately within OA and non-OA groups. Cox proportional hazard regression was employed to estimate the association of OA with developing SA, controlled for suspected confounders .

Key Findings

Knee Osteoarthritis

  • SA Incidence: 2.29 per 1,000 person-years for the OA group versus 1.41 per 1,000 person-years for the non-OA group.

  • Risk Increase: Knee OA patients had a 45% increased risk of developing SA (adjusted hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 1.34–1.56).

Hip Osteoarthritis:

  • Risk Increase: Hip OA patients also had a 45% increased risk of SA (adjusted HR: 1.45, 95% CI: 1.28–1.66).

Hand Osteoarthritis:

  • Risk Increase: Hand OA patients had a 50% increased risk of SA (adjusted HR: 1.50, 95% CI: 1.26–1.78).

This study has concluded that patients with knee, hip, and hand osteoarthritis are at significantly increased risk of developing sleep apnea relative to those without OA. These results underscore the need to consider sleep apnea as a possible comorbidity in OA patients and indicate that targeted screening, prevention, and treatment strategies for sleep apnea in OA patients may be an effective way to decrease the overall disease burden.

Reference:

Zhu, Y., Jiang, Q., Zhang, Y. et al. Osteoarthritis and the risk of sleep apnea: a general population-based cohort study. Clin Rheumatol (2025). https://doi.org/10.1007/s10067-025-07457-1

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Bihar Govt approves stipend hike: MBBS, BDS, AYUSH, FMG interns to get Rs 27k per month

Patna: Offering respite to the MBBS, BDS, and AYUSH interns in Bihar, the State Government has announced a stipend hike. Now, the MBBS, BDS, Ayurvedic, Unani, and Homoeopathy Interns in the government medical colleges, Patna Dental College and other institutes across the State will get Rs 27,000 per month. Previously, they used to get Rs 20,000 per month as their stipend.

Apart from this, the State has also announced to give a Rs 27,000 monthly stipend to the Foreign Medical Graduates undergoing mandatory internship in the State’s Government medical colleges.

Meanwhile, the Physiotherapy and Occupational Therapy interns will get Rs 20,000 per month as their stipend, announced the Bihar Government.

Medical Dialogues had earlier reported that the MBBS interns of the State-run Patna Medical College and Hospital (PMCH) were on a protest demanding a hike in their monthly stipend. They had also threatened to intensify their protest by disrupting the out-patient department (OPD) services if their monthly stipend was not increased.

The MBBS interns at PMCH, who were receiving approximately Rs 20,000 as a monthly stipend, were demanding a hike in the stipend amount from Rs 20,000 per month to Rs 40,000 per month.

According to the intern doctors, the State Government had last revised the monthly internship allowance back in 2022, with an assurance to revise it again after three years.

While the MBBS interns across 10 other medical colleges under the Bihar government used to get a monthly stipend of around Rs 19,600, the MBBS interns at IGIMS get Rs 30,000 as a monthly stipend, while those at AIIMS get Rs 32,000.

Meanwhile, the intern doctors in West Bengal and Odisha get Rs 43,000 and Rs 40,000 per month, respectively. Therefore, the interns were urging the State to take immediate action to revise the stipend structure and bring Bihar at par with other States. 

Also Read: Bihar MBBS Interns on Strike Demanding Stipend Hike to Rs 40k

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