Ludhiana Doctor booked over false Medico-Legal Report

Ludhiana: The Sarabha Nagar police have registered a case against a city-based doctor for allegedly issuing a fraudulent medico-legal report (MLR) and falsely categorising an injury as grievous. 

The incident dates back to April 11, 2024, when an FIR for attempted murder was lodged against four residents of Sarabha Nagar. Following the registration of the case, Palwinder Kaur, wife of one of the accused, approached the Police Commissioner, alleging that the injury sustained by the complainant, Daljit Singh, had been misrepresented in the MLR prepared by the doctor, who is associated with a nursing home in Samrala Chowk.

According to news reports, in response to the complaint, a five-member medical board was constituted on April 16, 2024, by the then Civil Surgeon, Dr. Jasbir Singh Aulakh. The board consisted of Dr Varun Saggar, senior medical officer (SMO), Hathur; Dr Davinder, senior medical officer (SMO), CHC Sudhar; Dr Ravi Datt, senior medical officer, Manupur; Dr Gurbinder Singh Kakkar (forensic expert), civil hospital, Khanna; and Dr Aditya Prakash (orthopaedician).

Also Read: Punjab Govt doctor under scanner for fake medical report case

According to the TOI, the FIR says that the inquiry report of the medical board was sent to the police commissioner on May 2 last year. The board observed, “From the available record, the board of doctors is of the unanimous opinion that there is nothing to suggest that any injury to the person of Daljit Singh was either grievous or dangerous in nature. Rather, it was done fraudulently.” The inquiry report by the then civil surgeon mentioned that the accused doctor did not follow the guidelines of the government of Punjab and the Punjab and Haryana High Court.

Emphasising the absence of any life-threatening injuries, the report also raised serious questions about the conduct of ASI, the investigating officer from Sarabha Nagar police station. As per the report, the board stated that Kumar failed to provide any credible medical documentation during the inquiry to establish that Daljit Singh’s injuries were life-threatening.

Ironically, the same officer has reportedly been assigned to investigate the current FIR, raising questions of procedural fairness and conflict of interest.

Also Read: Neurosurgeon arrested for allegedly providing fake medical report in hit-and-run case gets bail

In the inquiry report, the then civil surgeon also recommended to the registrar, Punjab Medical Council, Mohali, to delete the name of Dr Jasvir Singh Kathuria permanently from the register of Punjab Medical Council, Mohali, as per section 7.7 of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002. Police said that legal opinion was sought from the deputy district attorney (legal), who said that a doctor issuing a fraudulent MLC can face both criminal and civil legal action, reports TOI.  

On Friday, the Sarabha Nagar police registered a case against the doctor under the following sections of the Indian Penal Code (IPC)- sections 420 (cheating), 195 (giving or fabricating false evidence), and 197 (issuing or signing of false certificates) of the IPC against the accused.

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Finding motivation to exercise can be the greatest challenge in working out. This might be part of the reason why less than a quarter of people achieve the activity goals recommended by the World Health Organization.

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Review compares efficacy, safety of treatments for hidradenitis suppurativa

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Breast cancer: Treatment decisions on basis of biomarker-based test can be harmful

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The myth of 200 daily food decisions: Study challenges widely-cited claim

Researchers at the Max Planck Institute for Human Development have critically examined the basis for a frequently cited figure: that people make more than 200 unconscious decisions about food every day. This figure has circulated in scientific publications, the media, and health promotion campaigns for nearly 20 years without ever being empirically validated. An article published in the journal Appetite shows why a more nuanced view of eating behavior is needed.

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BMI and Waist Circumference Show Mixed Links to Diabetic Complications in Type 2 Diabetes, Study Finds

Japan: A large-scale Japanese study has uncovered complex relationships between body mass index (BMI), waist circumference (WC), and the risk of serious complications in individuals with type 2 diabetes mellitus (T2DM). Published in Diabetes, Obesity and Metabolism, the study was led by Dr. Megumi Nokihara and her team from the Department of Hematology, Endocrinology, and Metabolism at Niigata University Faculty of Medicine in Niigata, Japan.

The research drew on data from over 114,000 patients with T2DM, making it one of the most comprehensive investigations of its kind. Participants were followed for a median of 4.6 years to assess how BMI and WC might influence the likelihood of developing major diabetes-related complications.

The study revealed the following findings:

  • Higher BMI and greater waist circumference were not consistently linked to worse outcomes in individuals with type 2 diabetes.
  • Elevated BMI in women and a waist circumference of 95 cm or more in men were associated with a lower risk of developing diabetic eye disease requiring treatment.
  • Men with larger waist circumference had a hazard ratio (HR) of 0.79 for diabetic eye disease, indicating reduced risk.
  • A BMI of 25 kg/m² or higher or a waist circumference of at least 90 cm was linked to a significantly lower risk of progressing to dialysis (HR 0.42).
  • The protective association of higher body metrics was not observed for all diabetic complications.
  • Both BMI and waist circumference showed a U-shaped relationship with heart failure risk, where both low and high values increased risk.
  • A BMI ≥25 kg/m² and WC ≥90 cm were associated with a higher risk of heart failure (HR 1.33).
  • Abdominal obesity was linked to an increased risk of cerebrovascular disease, with a hazard ratio of 1.36.
  • Men with very low BMI (<20 kg/m²) showed a higher prevalence of coronary artery disease, indicating that being underweight also carries cardiovascular risks.

The authors conclude that BMI and waist circumference have nuanced and varied associations with diabetic complications. These results highlight the need for individualized risk assessments when setting weight-related health goals for people with T2DM. Instead of adopting a one-size-fits-all approach, clinicians are encouraged to consider the type of complication when advising patients on weight and abdominal fat targets.

“Body mass index and waist circumference showed both protective and harmful associations with various diabetic complications,” the researchers wrote. “Hence, it is important to individualize BMI and waist circumference targets based on the specific complication being addressed, while also taking into account the potential risk of other related health conditions.”

Reference:

Nokihara M, Fujihara K, Yaguchi Y, Takizawa H, Khin L, Ferreira EA, Sato T, Horikawa C, Kitazawa M, Matsubayashi Y, Kodama S, Sone H. The associations of body mass index and waist circumference with the risk of diabetic complications in people with type 2 diabetes mellitus. Diabetes Obes Metab. 2025 May 16. doi: 10.1111/dom.16461. Epub ahead of print. PMID: 40375805.

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Time-Restricted Eating Matches Calorie Restriction in Reducing Liver Fat in MASLD, Study Finds

Korea: A recent clinical trial published in the Journal of Hepatology has highlighted the potential of time-restricted eating (TRE) as a practical dietary intervention for individuals with metabolic dysfunction-associated steatotic liver disease (MASLD), a condition formerly referred to as non-alcoholic fatty liver disease.

The study was led by Dr. Joo Hyun Oh from the Department of Internal Medicine, Eulji University College of Medicine, Seoul. They aimed to assess whether TRE could deliver similar benefits to calorie restriction (CR) in reducing liver fat and improving metabolic health.

TRE is a dietary pattern where food intake is limited to a specific time window each day, typically without calorie counting. Although it has gained popularity for its metabolic benefits, its role in managing MASLD remains unclear. This 16-week randomized controlled trial provided clinical evidence for its efficacy and safety.

The study enrolled 337 overweight or obese adults diagnosed with MASLD. Participants were randomly assigned to one of three groups: standard of care (SOC), calorie restriction (CR), or time-restricted eating (TRE), in equal proportions. Ultimately, 333 participants were included in the final analysis: 113 in the SOC group and 110 each in the CR and TRE groups.

The primary focus was to evaluate changes in liver fat using magnetic resonance imaging-proton density fat fraction (MRI-PDFF), a non-invasive and accurate imaging tool. Secondary outcomes included alterations in liver stiffness, body composition, lipid and glucose metabolism, and sleep quality.

The following were the key findings of the study:

  • After 16 weeks, participants in the TRE group experienced a 25.8% reduction in liver fat.
  • The reduction in liver fat in the TRE group was significantly greater than the 0.7% reduction seen in the standard care group.
  • The liver fat reduction in the TRE group was nearly identical to the 24.7% reduction observed in the calorie restriction group.
  • TRE also resulted in significant reductions in body weight, waist circumference, and body fat mass.
  • These changes in body composition were comparable to those seen with calorie restriction.
  • No serious adverse events were reported during the study.
  • Liver stiffness, glucose regulation, and sleep quality showed similar outcomes in both the TRE and calorie restriction groups.

The study authors concluded that TRE can be an effective and safe strategy to manage MASLD, offering similar benefits to calorie restriction without requiring strict calorie counting. These findings suggest TRE may be a feasible long-term dietary approach for individuals with fatty liver disease, though further studies are needed to confirm its sustained benefits over time.

Reference:

Oh JH, Yoon EL, Park H, Lee S, Jo AJ, Cho S, Kwon E, Nah EH, Lee JH, Park JH, Ahn SB, Jun DW. Efficacy and safety of time-restricted eating in metabolic dysfunction-associated steatotic liver disease. J Hepatol. 2025 Jun 19:S0168-8278(25)02272-X. doi: 10.1016/j.jhep.2025.06.005. Epub ahead of print. PMID: 40543603.

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Vaccination as a new form of cardiovascular prevention: an ESC Clinical Consensus Statement

A new ESC Clinical Consensus Statement published in the European Heart Journal discusses the key role of vaccination in preventing cardiovascular events following various viral and bacterial infections.

“We have known for many years that influenza can increase the risk of major adverse cardiovascular events such as heart attacks and can exacerbate heart failure,” said Professor Thomas F. Lüscher, ESC President and senior author of the ESC Clinical Consensus Statement. “More recently, evidence suggests that other respiratory infections are also associated with increased cardiovascular morbidity and mortality. The new publication describes how vaccinations not only prevent infections but also reduce the risk of cardiovascular events, particularly in susceptible individuals.”

The ESC Clinical Consensus Statement describes data on the risk of cardiovascular complications following infections such as pneumococcal pneumonia, influenza, SARS-CoV-2 and respiratory syncytial virus, among others, and describes the inflammatory mechanisms that may be responsible. Evidence is then summarised for the beneficial effects of vaccines in reducing cardiovascular events following various viral and bacterial infections, particularly in at-risk patient groups. Clinical practice guidelines from the ESC and from the American College of Cardiology (ACC)/American Heart Association (AHA) are presented, which advocate for vaccination against influenza and other widespread infections in patients with chronic coronary syndromes (including coronary artery disease) and in those with heart failure.

Serious adverse reactions to vaccinations are very rare. The consensus statement also discusses the risks of cardiovascular adverse events after vaccination, such as myocarditis, and describes appropriate management strategies. Then follows advice on which vaccines should be given to patients with cardiovascular diseases and how often. Vaccination of pregnant women and other vulnerable patient groups, such as those with congenital heart disease and heart transplantation, is considered.

Professor Lüscher concluded: “Prevention is crucial for reducing the considerable burden of cardiovascular disease. The totality of the evidence indicates that vaccinations should become a foundational pillar of preventive strategies alongside other established measures.”

Reference:

Heidecker B, Libby P, Vassiliou VS, et al. Vaccination as a new form of cardiovascular prevention: an ESC Clinical Consensus Statement. Eur Heart J. 2025. doi: 10.1093/eurheartj/ehaf384.  

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Decoding the Brain: Study evaluates Patterns of Neuronal Death in Hypoxic-Ischemic Encephalopathy Post-Cardiac Arrest

Recent study investigates the pathophysiology of hypoxic-ischemic encephalopathy (HIE) in patients following cardiac arrest (CA), focusing on selective eosinophilic neuronal death (SEND) across various brain regions. A total of 319 patients who experienced successful resuscitation and underwent brain autopsies were analyzed. Eosinophilic neuronal death was quantified in the cerebral neocortex, hippocampus, basal ganglia, cerebellum, and brainstem, categorized according to previously established HIE severity classifications.

Histopathological Findings

Findings revealed that the mean SEND scores varied significantly by brain region, with the hippocampus exhibiting the highest average SEND of 1.8, followed by the neocortex at 1.4, and the brainstem at 0.9. The results identified four distinctive histopathological patterns of HIE: (I) no/mild SEND across all regions, (II) severe SEND localized predominantly to the hippocampus, (III) severe SEND in the neocortex with preserved brainstem function, and (IV) severe SEND impacting the brainstem accompanied by neocortical injury. Notably, 9.7% of patients exhibited substantial heterogeneity in SEND between different neocortical regions, indicating potential clinical implications for neuroprognosis.

Prevalence of Severe SEND

In the cohort studied, 48.3% of patients displayed severe SEND in at least one brain region, with significant proportions demonstrating severe damage to the neocortex while the brainstem remained relatively unaffected. This spatial distribution underscores the hippocampus’s vulnerability, which aligns with previous literature highlighting selective neuronal death patterns following CA.

Variability in SEND Distribution

The inter-regional correlation analysis revealed a predominantly homogeneous SEND distribution across the neocortex. However, a subset of patients indicated substantial regional variation in SEND, challenging the assumption of a uniform HIE pattern following CA. These atypical distributions suggest the necessity for refined neuroprognostic assessments that consider potential nuances in HIE presentations.

Demographic Insights

Demographic data indicated a median patient age of 68, with a higher prevalence of male subjects. Notably, a significant number of patients regained consciousness prior to death, suggesting varying trajectories of neurological recovery linked to the extent of SEND.

Conclusions and Future Directions

The conclusions emphasize the critical need for further investigation into less common HIE patterns and their role in neuroprognostic evaluations. Future research should enable deeper insights into the complex interplay between SEND patterns and clinical outcomes, enhancing predictive accuracy and patient management following CA.

Key Points

– The study analyzes pathophysiological mechanisms of hypoxic-ischemic encephalopathy (HIE) post-cardiac arrest (CA) by examining selective eosinophilic neuronal death (SEND) across brain regions in a cohort of 319 resuscitated patients who underwent brain autopsies, categorizing findings based on established HIE severity classifications.

– Histopathological assessments revealed significant regional variance in mean SEND scores, with the hippocampus showing the highest SEND (1.8), followed by the neocortex (1.4) and brainstem (0.9). Four distinct HIE patterns were identified: (I) no/mild SEND, (II) severe SEND predominantly in the hippocampus, (III) severe neocortical SEND with preserved brainstem, and (IV) severe SEND impacting brainstem and neocortex.

– In this cohort, 48.3% of patients exhibited severe SEND in at least one brain region, with notable neocortical damage often accompanied by relatively intact brainstem function. This finding underscores the susceptibility of the hippocampus to injury in the context of HIE after CA.

– Variability in SEND distribution was observed; while send scores were typically homogeneous across neocortical regions, some patients displayed significant inter-regional differences, suggesting that previous assumptions about uniform HIE patterns need reconsideration. This highlights the complexity of SEND presentations post-CA.

– Demographic analysis revealed a median age of 68 years among subjects, with a notable predominance of males. Additionally, a considerable fraction of patients regained consciousness before death, indicating diverse recovery trajectories linked to the severity and patterns of SEND.

– Conclusions drawn from the study underscore the urgency for further investigations into atypical HIE patterns that could refine neuroprognostic assessments. Future research is recommended to elucidate the relationship between SEND patterns and clinical outcomes, potentially improving predictive models for managing patients after cardiac arrest.

Reference –

C. Endisch et al. (2025). Histopathological Patterns Of Hypoxic-Ischemic Encephalopathy After Cardiac Arrest: A Retrospective Brain Autopsy Study Of 319 Patients.. *Resuscitation*, 110608 . https://doi.org/10.1016/j.resuscitation.2025.110608.

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