PM Modi to inaugurate 6-storey AIIMS Bhopal extension building on October 29

Bhopal: Prime Minister Narendra Modi is set to virtually inaugurate the six-storey new extension building of the All India Institute of Medical Sciences (AIIMS) Bhopal and launch its drone service facility on Tuesday, an official said on Monday. 

The AIIMS extension “Kautilya Bhavan” is a modern six-storey building covering an area of 11,900 square metres, with a project cost of Rs 64.44 crore.

According to the PTI report, the new facility will facilitate further advancements in medical education, research and clinical services, AIIMS Executive Director and CEO Prof Ajai Singh said.
“The construction of Kautilya Bhavan is the result of our continuous efforts aimed at not only improving the quality of healthcare services but also enhancing access to regional health services. This building reflects our commitment to providing quality and affordable healthcare to all,” he said.
During the inauguration, an advanced drone service will also be launched, enabling safe and efficient transport of essential medical supplies.
The service will initially connect AIIMS Bhopal with the Community Health Centre (CHC) in Goharganj, Raisen district, covering a distance of 30 km in just 20 minutes, compared to the two-hour travel time by road, the official said.
“We could not have achieved this ambitious project without the cooperation of the Ministry of Health. Their assistance has enabled us to develop new facilities in AIIMS Bhopal,” Singh said, news agency PTI reported.

The inauguration of these two key facilities is part of several initiatives by the Union Ministry of Health and Family Welfare, all to be inaugurated by the Prime Minister on Tuesday. 

The event will also be attended by Madhya Pradesh Chief Minister Mohan Yadav, state minister (independent charge) Krishna Gour, Bhopal MP Alok Sharma, AIIMS Bhopal president Dr Sunil Malik and other dignitaries, the official added.
Read also: PM Modi inaugurates R J Sankara Eye Hospital in Varanasi

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DME Tripura Invites Applications for NEET 2024 Stray Vacancy Round, check Schedule, seat matrix here

Tripura: The Director of Medical Education (DME Tripura) has invited applications for Online Stray Vacancy Round of Tripura State NEET UG 2024 counselling for Tripura state quota/Domicile seats and All India other than Tripura candidates.

All the eligible candidates who have not registered in earlier Rounds of Tripura State NEET UG 2024 Counselling can register themselves in Stray Vacancy Round of Tripura State NEET UG 2024 Counselling.

All the registered candidates (Round-I, Round-2, Round-3 & freshly registered candidates of Stray Vacancy Round) who intend to apply for Stray Vacancy Round of Tripura State NEET UG 2024 Counselling MUST APPLY ONLINE by submitting the online application form of Stray Vacancy Round through the counselling website.

If any candidate (registered in Round-1/Round-2/Round-3/ Stray Vacancy Round) fails to submit the online application form for Stray Vacancy Round of Tripura State NEET UG 2024 Counselling, then his/her candidature for the Stray Vacancy Round counselling will not be considered.

Schedule for Stray Vacancy Round of Tripura State NEET UG 2024 Online Counselling

Event

Date & Time
  • Online Registration
  • Online Payment of registration fee.
  • Offline
    payment of security deposit and submission of security deposit details ONLINE and
    physical submission to the
    DME office.

28-10-2024 (12 Noon) to 30-10-2024
(up to 12 Noon)

Publication of Merit list

31-10-2024

Choice Filling by the candidates

31-10-2024 (4 PM onwards) to
02-11-2024 (up to 10 AM

Allotment Result

02-11-2024

Submission
of Allotment letter to the office of DME

03-11-2024

Nomination to be collected from DME office by a
candidate allotted a seat

03-11-2024 (3 PM onwards) 05-11-2024 (12 noon)

Physical
verification of original documents
and other admission formalities and admission in the allotted admitting Institutions

03-11-2024 (3 PM onwards) 05-11-2024 (5 PM)

Counselling Link 

Counselling Related Information

Candidates are instructed not to wait for the last hours regarding any event of the schedule of Registration/choice filling/submission of relevant documents at DME/admission.

; seat matrix is furnished as per information of vacant seats received from respective Institute up to 25-10-2024. A) Seat Matrix for MBBS

Seat Matrix for MBBS

Name of
Medical College		 Total UR EWS ST OBC SC
Agartala Government Medical College, Agartala, Tripura 2 — 2 — _
Tripura Medical College & Dr. BRAM Teaching Hospital, 1 …….. — 1 —- —
Tripura Santiniketan Medical College,Agartala,
Tripura,Madhuban, Ranir Khamar, Amtali, 		36 seats at Prescribed tuition fee rate of Tripura Santiniketan
Medical College		 8 —– 18 09+01(WESM
All India other than Tripura State Domicile candidates
All India other than Tripura StateTripura State Domicile
candidates in Tripura Medical College & Dr. BRAM Teaching Hospital,		 1 — — — …… 1
All India other than Tripura State Domicile
candidates in Tripura Santiniketan Medical College, Agartala, Tripura,
Madhuban, RanirKhamar, Amtali,Agartala, Tripura		 67 32 —– 5 20 10

Seat Matrix for BDS

Name of
Dental College

Total

UR

ST

SC

Agartala Government Dental
College, Agartala, Tripura

02

02

—

—

Regional Institute of Medical
Sciences, Imphal, Manipur

01

—

01-

—

Seat Matrix for BHMS

Name of
the College		 Total UR ST SC
Midnapore Homoeo Medical College, Midnaporc, West Bengal 1 — 1 —

Seat Matrix for BASLP

Name of
the College		 Total UR ST SC
Regional Institute of Medical Sciences, Imphal, Manipur 1 0
1

A) NON-REFUNDABLE REGISTRATION FEES FOR ONLINE NEET UG 2024 COUNSELLING

The Registration fees for fresh candidates (not registered in earlier Rounds), who wants to register in the NEET UG 2024 counselling, will be as follows according to their category.

Online Submission of Application Form with Registration Fee by
the Candidate		 Registration
Fees for Counselling
Category General/OBC-NCL-(State
Domicile)		 Rs.
2500/-
General-EWS (State Domicile)/OBC-NCL-(Non
Domicile)		 Rs.
2000/-
SC/ST/PwD/Other Rs.
1800/-

*Registration fees for the candidates under OBC-NCL (Non creamy Layer) category registering for State quota/Domicile seats will be as per registration fees for General candidate.

*Registration fees for the candidates under OBC-NCL (Non creamy Layer) category registering for All India other than Tripura seats will be as per registration fees for General-EWS candidate.

B) MANDATORY SECURITY DEPOSIT

The Mandatory Security deposit has to be paid by the candidates-

i) Freshly registered candidates of Stray Vacancy Round (who have not registered in earlier Rounds).

ii) The candidates who have not paid their mandatory security deposit in Round-1 3.

iii) The candidates who have already paid rnandatory security deposit for Government College seats only (Rs.10.000 or Rs. 5.000) and now want to apply for Tripura Medical College (TMC) or Tripura Santiniketan Medical college(TSMC) Seats by paying Rs.1 lakh as Security deposit

Details of Mandatory Security Deposit
For Government College Seats For
SC/ST category candidate Rs. 5000/- (Rupees five thousand) only. For other category candidate Rs.
10,000/- (Rupees ten thousand) only.
For 1) Non-Government College Seats 2) Both Non-Government &
Government College Seats. 3) Non- Government College seats (Tuition fee rate
of Government Medical college at Tripura Santiniketan Medical College)		 For
all category candidates Rs. 100000/-(Rupees One Lakh) Only.

The mandatory security deposit shall have to be submitted through Bank Demand Draft/Bank Deposit/Online transaction. The demand draft shall have to be payable in favour of “Directorate of Medical Education, Government of Tripura- from any nationalized bank Preferably SBI.

Account
details of DME
ACCOUNT NO OF DME 34706666148
BANK NAME STATE
BANK OF INDIA
IFSC code SBLN0000002
ADDRESS OF THE BANK H.G
BASAK ROAD, AGARTALA

All  the candidates who are submitting the security deposit for first time during the Stray Vacancy Round or chan2edimodified the already submitted amount of security deposit of earlier rounds (Round-2/Round-3). are requested to mandatorily submit the original demand draft/counterfoil of original bank deposit/scanned copy of online transaction receipt mentioning the transaction number/ID to the office of the Director of Medical Education, Bidurkarta Chowmohani, Agartata PHYSICALLY on or before 30-10-2024 (up to 12 Noon). The format for submission of security deposit details is given in ANNEXURE-1.

Eligibility and qualification: The eligibility and qualification to get a seat shall be in accordance with information bulletin of Tripura State NEET UG 2024 Counselling published by DME and information bulletin published by NTA/Guidelines of MCC/NMC/MCl/MoHFW/Ministry of AYUSH/ guidelines of Institutions.

Following categories of Candidates are not eligible for Stray Vacancy Round:-

a) Candidates who have not registered for Stray Vacancy Round.

b) Candidate joined/holding any seat from either State or MCC Counselling at the time of Stray Vacancy Round.

c) Candidates allotted a seat in Round 3 of Tripura State NEET UG 2024 Counselling.

The candidates are reminded that-

The scanned copy of original demand draft/counterfoil of original bank deposit/online transaction ,receipt mentioning the transaction number/ID in respect of mandatory security deposit shall have to be provided wherever applicable during uploading of the security deposit details.

2) The fresh candidates are also reminded to go through the information bulletin and earlier notifications issued by the Director of Medical education, Govt. of Tripura in respect to the earlier Rounds of Tripura NEET UG 2024 Counselling to keep abreast of the counselling.

3) All the aspirant eligible candidates are instructed to follow the DME website regularly for further Notices/Updates/Notification which may be issued from time to time.

  • Candidates are instructed to participate in the “Choice filling” as per their choices in the Counselling for allotment of seats as per seat matrix and category according to Merit (Result score and Rank of NEET UG 2024). Candidates are instructed to follow the website of Allotted Institutions for details regarding admission and other details.
  • Freshly Registered Candidates shall have to submit Registration fees and mandatory Security deposit as notified earlier which is mandatory for all to participate in Stray Vacancy Round. Documents of Eligibility, NEET UG 2024 score Card, Admit Card, Age Proof Certificate and all others relevant certificates shall have to be uploaded during Online Registration.

The details of appropriate supporting document to be uploaded by the freshly registered candidates of Stray Vacancy Round are as follows:

Serial No. Certificates Documents to be
uploaded
1.
 		Age
Proof		 Birth
Certificate/Class X Admit Card/Class X pass certificate
2.
 		Clause
Supporting Documents		 1) Clause-1: PRTC of
the candidate/PRTC of the parents.
2) Clause 2: Parents service certificate clearly
mentioning about service in the state of Tripura. 3) Clause 3: Parents
service/deputation certificate issued by the appointing authority.
4) Clause 4: Valid Certificate of WESM issued from Rajya
Sainik Board 5) Clause 5: Service Certificate of the
parents along with candidate’s class 12th admit card /marksheet However, if
any other clause supporting documents is submitted confirming the eligibility
of the candidate is subject to be verified by the Tripura NEET UG 2024
counselling committeee
3 Economically
Weaker Section (EWS)		 EWS
certificate issued form the appropriate authority for the Financial year
2023-2024.
4 Ward
of Ex-serviceman (WESM)		 Valid
WESM certificate for NEET UG 2024 issued from the Rajya Sainik Baord
5 SC/ST/OBC-NCL SC/ST/OBC-NCL
Certificate issued by the competent authority.
6 Disability
Certificate		 Issued
from a duly constituted and authorized Medical Board in an ONLINE format by
the designated centeres as per NMC norms (Gazette Notification no.
MCI-34(41)/2018Med./170045 dated 04/02/2019) No other PWD certificate, issued
by any other Authority/Hospital will be entertained.
7 H.S(+2)
Marksheet		 H.S
(+2) Marksheet (In case of Grades are awarded instead of secured marks
/percentage, then the details of Grade to the corresponding marks/percentage
must be produced by any supporting official document)
8 NEET
Score card 2024		 Latest
NEET Score card 2024
9 NEET
2024 Admit Card		 NEET
2024 Admit Card

All the candidates who are going to participate in the Stray Vacancy Round are instructed to go through all the earlier notifications/information bulletin/guidelines/steps of counselling/flow chart in connection with Tripura State NEET UG 2024 Counselling throughly.

To view the official Notice, Click here :  https://medicaldialogues.in/pdf_upload/educational-notification-regarding-online-stray-vacancy-round-of-tripura-state-neet-ug-2024-counselling-258553.pdf

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Interrelation between Heart Failure and Cancer may need Multidisciplinary Approach, suggests study

A recent scientific statement from the Heart Failure Society
of America discussed the various risk factors, mechanisms, diagnosis, and
management strategies and also the relationship between heart failure and
cancer. The article was published in the Journal of Cardiac Failure. 

Heart failure and cancer have a complex link with shared biological
processes of inflammation, cell death, mutations, and hormonal alterations. One
condition can lead to the risk of developing into another. Specific genetic markers
like clonal hematopoiesis increase the risk of cardiac disease and cancer. Mutations
of these markers have similar poor outcomes in both cancers and cardiac
diseases.

Also Read: Extreme morning sickness during pregnancy tied to increased risk of CVD decades later: JAHA

Hypertension, Diabetes, obesity, and habits like smoking
increase the risk of heart failure and cancer when under-addressed leading to
complicated course. Literature in the past has shown that hypertension can
increase the risk of cancer and diabetes that is linked to inflammation and
oxidative stress can lead to cardiac pathologies and cancers.

Heart failure can also occur as a treatment side effect in
cancers. Chemotherapeutic drugs like anthracyclines, HER-2 targeted therapies
and radiotherapies can cause heart failure in cancer patients. Alkylating
agents like cyclophosphamide can cause acute heart damage, antimetabolites like
5-fluorouracil can cause temporary heart conditions, and tyrosine kinase inhibitors
also can cause cardiac complications. However,
early detection and intervention can help in managing certain cardiac conditions.

Individuals at high risk of cardiac morbidities from cancer
therapies have to be evaluated by regular echocardiograms, blood markers, and
troponins to track their cardiac health. Individuals who show early signs of
cardiac malfunction can continue the cancer therapies with cardio-protective
medications. In the case of advanced cardiac diseases while receiving cancer
therapies a multidisciplinary approach is needed to balance both cardiac and
cancer diseases.

They have also mentioned that in individuals who are
undergoing advanced therapies like stem cell transplants and immunotherapies myocarditis
can occur. In such cases, heart imaging and genetic profiling should be done to
reduce the risk.

Also Read: Long-Term Study Reveals Comparable Outcomes for iFR and FFR in Coronary Revascularization: DEFINE FLAIR Trial

Researchers also emphasized a multidisciplinary approach
with cardiologists, oncologists, palliative care, pharmacy, and nursing teams
in monitoring, identifying, and preventing cardiac complications. Preventive
strategies using a multidisciplinary approach can improve the quality of life
and reduce the burden of heart failure in long-term outcomes for cancer
patients.

Further reading: Cardio-Oncology and Heart Failure: A Scientific Statement from the Heart Failure Society of America. Doi:  10.1016/j.cardfail.2024.08.04

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Oral Semaglutide Improves liver steatosis and injury in Diabetes Patients with MASLD, suggests study

A recent study highlights the potential benefits of oral semaglutide in managing type 2 diabetes mellitus (T2DM) for patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This single-arm, multicenter, prospective trial showed oral semaglutide to improve glycemic control, reduce body weight, and enhance liver health in patients with both T2DM and MASLD. The findings published in the Diabetes, Obesity and Metabolism journal are expected to contribute to treatment strategies for managing complex cases of diabetes where liver health is also compromised.

The study spanned for 48 weeks and included 80 patients initially, with 70 completing the trial. These patients had newly initiated oral semaglutide therapy and were monitored across several parameters, including body weight, liver enzymes, lipid profile, glycemic control, and liver fibrosis markers. Dose adjustments were tailored to response of every patient and the presence of any adverse reactions, managed under close supervision by their physicians.

The results demonstrated significant improvements across multiple health markers. The patients showed notable reductions in body weight, liver enzyme levels, and controlled attenuation parameter (CAP) values, all reflecting a positive shift in liver health when compared to baseline readings. CAP values were significantly lower which indicated reduced liver steatosis. Alanine aminotransferase (ALT) levels which is associated with liver damage, also saw significant reductions which highlighted the potential of the medication in managing liver-related issues among diabetic patients.

In addition to these findings, improvements in the lipid profile were evident. The patients displayed better levels of cholesterol and triglycerides, essential for reducing the risk of cardiovascular complications in diabetes. The study also tracked markers for liver fibrosis like type IV collagen 7S, Wisteria floribunda agglutinin-positive Mac-2-binding protein, the fibrosis-4 index, and liver stiffness measurement. All showed a decrease from baseline by indicating that oral semaglutide might aid in slowing down or potentially reversing the fibrotic process in the liver.

The positive effects on liver enzymes and CAP values were significantly correlated with weight loss which meant that as patients lost weight, their liver health markers also improved. This connection highlighted the importance of weight management in patients with T2DM and MASLD. About 28.8% of patients experienced nausea, 15% had dyspepsia, and 5% reported a loss of appetite. These symptoms were transient and categorized as mild to moderate, with no serious side effects reported. Overall, the study highlighted the potential of oral semaglutide as a therapeutic option not only for managing blood sugar levels but also for addressing liver health in diabetic patients with MASLD. 

Source:

Arai, T., Atsukawa, M., Tsubota, A., Oikawa, T., Tada, T., Matsuura, K., Ishikawa, T., Abe, H., Kato, K., Morishita, A., Tani, J., Okubo, T., Nagao, M., Iwabu, M., & Iwakiri, K. (2024). Beneficial effect of oral semaglutide for type 2 diabetes mellitus in patients with metabolic dysfunction‐associated steatotic liver disease: A prospective, multicentre, observational study. In Diabetes, Obesity and Metabolism (Vol. 26, Issue 11, pp. 4958–4965). Wiley. https://doi.org/10.1111/dom.15898

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Findings Call for Caution: Broad-Spectrum Antibiotics Raise ADE Risks in Outpatient Pneumonia Patients

USA: Recent research published in Clinical Infectious Diseases has illuminated the safety of various antibiotic regimens for treating community-acquired pneumonia (CAP) in otherwise healthy adults receiving outpatient care.

Findings indicate that broad-spectrum antibiotics, while effective against a wide range of pathogens, were linked to a higher incidence of adverse drug events (ADEs) in patients treated for CAP. Based on the findings, the researchers emphasize the importance of antimicrobial stewardship to encourage the careful use of broad-spectrum antibiotics, aiming to reduce antibiotic-related ADEs.

Community-acquired pneumonia is a common infection often managed in outpatient settings and typically affects otherwise healthy individuals. Current evidence on the comparative safety of antibiotic regimens for treating CAP remains limited, especially amid growing concerns about antibiotic resistance and the varying safety profiles of different treatments. To fill this knowledge gap, Anne M Butler, Washington University School of Medicine, St. Louis, MO, USA, and colleagues assessed the risk of adverse drug events linked to antibiotic regimens used for treating community-acquired pneumonia in otherwise healthy, non-elderly adults.

For this purpose, the researchers conducted an active comparator new-user cohort study from 2007 to 2019, focusing on commercially insured adults aged 18 to 64 diagnosed with outpatient CAP confirmed by chest X-ray and prescribed a same-day CAP-related oral antibiotic regimen. The follow-up duration for ADEs varied from 2 to 90 days, with specific conditions such as renal failure monitored over 14 days. They estimated risk differences per 100 treatment episodes and risk ratios using propensity score-weighted Kaplan-Meier functions and also included ankle/knee sprains and influenza vaccination as negative control outcomes.

Key Findings of the Study

  • Among 145,137 otherwise healthy patients with community-acquired pneumonia and no comorbidities:
    • 52% received narrow-spectrum regimens:
      • 44% were prescribed macrolides
      • 8% received doxycycline
    • 48% received broad-spectrum regimens:
      • 39% were prescribed fluoroquinolones
      • 7% received β-lactams
      • 3% received a combination of β-lactam and macrolide
  • Compared to macrolide monotherapy, broad-spectrum antibiotic regimens were associated with an increased risk of several adverse drug events:
    • β-lactam regimen:
      • Nausea/vomiting/abdominal pain: Risk difference (RD) per 100 = 0.32
      • Non-Clostridioides difficile diarrhea: RD per 100 = 0.46
      • Vulvovaginal candidiasis/vaginitis: RD per 100 = 0.36
  • Narrow-spectrum antibiotic regimens largely exhibited similar risk profiles for ADEs.
  • The negative control outcome analysis showed similar risks, indicating minimal confounding.

The authors state that the study’s results contribute to growing evidence indicating that transitioning prescribing practices from broad-spectrum to narrower-spectrum antibiotics could help prevent adverse drug events (ADEs).

They noted, “Ultimately, understanding antibiotic-related harms can empower patients, prescribers, and stewardship programs to make informed decisions regarding antibiotic use.”

Reference:

Butler, A. M., Nickel, K. B., Olsen, M. A., Sahrmann, J. M., Colvin, R., Neuner, E., A, C., Fraser, V. J., Durkin, M. J., & Epicenters Program, C. P. Comparative safety of different antibiotic regimens for the treatment of outpatient community-acquired pneumonia among otherwise healthy adults. Clinical Infectious Diseases. https://doi.org/10.1093/cid/ciae519

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Once-Weekly Semaglutide Cuts Heart Failure Risk in Diabetes and Kidney Disease: FLOW Trial Analysis

USA: In a significant advancement for cardiovascular care, the FLOW trial has demonstrated that semaglutide, a glucagon-like peptide-1 receptor agonist, substantially reduces the risk of heart failure (HF) events and cardiovascular (CV) death in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD).

The trial, which involved a high-risk population, has provided crucial insights into how semaglutide can positively impact heart health among individuals already managing these chronic conditions. The findings were published online in the Journal of the American College of Cardiology.

“Semaglutide significantly decreased the time to the first occurrence of composite outcomes related to HF events or CV death, as well as reducing HF events and CV death on their own, in a high-risk population with T2D and CKD. These benefits were observed consistently, regardless of whether patients had a prior history of heart failure,” the researchers wrote.

Individuals with type 2 diabetes and CKD face a heightened risk of heart failure (HF) and early mortality due to CV issues. The FLOW study, designed to evaluate the effects of semaglutide—a glucagon-like peptide-1 receptor agonist—on participants with T2D and CKD, found that semaglutide reduced the occurrence of the primary composite outcome (which includes a persistent decline in estimated glomerular filtration rate, advanced kidney failure, kidney replacement therapy, and CV death) by 24%. In light of these findings, Richard E. Pratley, AdventHealth Translational Research Institute, Orlando, Florida, USA, and colleagues conducted a prespecified analysis to assess the impact of semaglutide on heart failure outcomes within this high-risk group.

For this purpose, participants were randomly assigned (1:1) to receive either once-weekly subcutaneous semaglutide at a dose of 1 mg or a placebo. The primary outcome, as outlined in the study, was a composite of heart failure (HF) events, which included new onset or worsening HF resulting in unscheduled hospital admissions or urgent visits, alongside the initiation or intensification of diuretic or vasoactive therapy. The research team collected data on heart failure incidents, while an independent adjudication committee assessed cases of cardiovascular death.

The following were the key findings of the study:

  • A total of 3,533 participants were randomized and followed for a median period of 3.4 years.
  • At baseline, heart failure was present in 19.4% of participants in the semaglutide group and 19.0% in the placebo group.
  • Across the entire trial population, semaglutide was associated with an increased time to the first occurrence of HF events or CV death, showing a hazard ratio (HR) of 0.73.
  • It also significantly reduced the incidence of HF events alone (HR: 0.73) and CV death alone (HR: 0.71).
  • The risk reduction for the composite HF outcome was consistent in participants with (HR: 0.73) and without (HR: 0.72) a history of HF at baseline.
  • Participants classified as NYHA functional class III and those with heart failure with reduced ejection fraction exhibited generally higher risks of HF outcomes (HF events or CV death), regardless of the treatment administered.

This analysis from the FLOW trial showed that once-weekly subcutaneous semaglutide 1.0 mg significantly lowered the risk of heart failure events or cardiovascular death by 27% in a high-risk group with type 2 diabetes and CKD. It also reduced the risk of CV death alone by 29%.

“The benefits of semaglutide were consistent among participants, regardless of whether they had HF at baseline, across various clinical subgroups during a mean follow-up of 3.4 years,” the researchers wrote.

Reference:

Pratley RE, Tuttle KR, Rossing P, Rasmussen S, Perkovic V, Nielsen OW, Mann JFE, MacIsaac RJ, Kosiborod MN, Kamenov Z, Idorn T, Hansen MB, Hadjadj S, Bakris G, Baeres FMM, Mahaffey KW; FLOW Trial Committees and Investigators. Effects of Semaglutide on Heart Failure Outcomes in Diabetes and Chronic Kidney Disease in the FLOW Trial. J Am Coll Cardiol. 2024 Oct 22;84(17):1615-1628. doi: 10.1016/j.jacc.2024.08.004. Epub 2024 Aug 30. PMID: 39217553.

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Groundbreaking surgical technique makes combined face and whole-eye transplantation a reality

An explanation of how an NYU Langone Health surgical team performed the world’s first combined face and whole-eye transplantation will be presented at the American College of Surgeons (ACS) Clinical Congress 2024 in San Francisco, California. Their achievement demonstrates the feasibility of transplanting an entire eye alongside a face transplant.

This operation, performed in 2023, showcases the potential for future eye transplant procedures and marks a significant advancement in vascularized composite allotransplantation (VCA). This type of transplantation is particularly challenging since, unlike organ transplants that involve just one type of tissue, like a kidney or heart, VCA involves transplanting a complex combination of different tissues — skin, muscle, blood vessels, nerves, and sometimes bone — all in one piece.

Led by Eduardo D. Rodriguez, MD, FACS, director of the face transplant program at NYU Langone Health, the surgery involved a multidisciplinary team of more than 140 medical professionals. The transplant was performed on Aaron James, a 46-year-old military veteran from Arkansas, who suffered extensive facial and eye injuries from a high-voltage electrical accident.

According to the researchers, the primary goal was to ensure the transplanted eye remained viable, and the innovative techniques used were critical to achieving that outcome. The team focused on optimizing blood flow, a key factor for the long-term success of such a complex transplant.

The team developed a microvascular bypass technique to maintain blood flow to the transplanted eye. This bypass used nearby blood vessels, specifically the superficial temporal artery and vein, which were rotated to connect to the transplanted eye’s ophthalmic artery and vein. This innovative approach minimized retinal ischemia (loss of blood flow) and simultaneously restored blood flow to the face and eye, addressing a major challenge in eye transplantation.

Key Surgical Achievements

• Reduced Ischemia: The bypass technique shortened the time without blood flow, protecting the transplanted eye.

• Enhanced Blood Flow: Post-surgery tests confirmed strong blood flow to the retina and other critical areas.

• Surgical Precision: Customized cutting guides ensured precise alignment and preserved the intricate structures of the eye and surrounding tissue.

“The successful transplantation of a face and whole eye demonstrated that with the right surgical techniques, a whole-eye transplant is feasible and can maintain long-term viability,” said Bruce E. Gelb, MD, FACS, associate professor, department of surgery, at NYU Grossman School of Medicine. “Aaron James, the patient, was made aware that while sight restoration was not the goal, maintaining a healthy, vascularized eye represented a critical breakthrough that could significantly impact the feasibility of similar procedures in the future.”

Reference:

Chinta S, et al. Revolutionizing Vascularized Composite Allotransplantation: Surgical Underpinnings of the World’s First Combined Face and Whole-Eye Transplantation, Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2024.

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Developmental disability patients not at higher infection risk after third molar extractions, suggests study

Patients with developmental disability do not at higher rates of infections after third molar extractions, suggests study published in the Journal of Oral Maxillofacial Surgery.

Patients with developmental disabilities may exhibit behavioural problems or be unable to maintain proper hygiene, potentially placing them at greater risk for infection following the extraction of third molars. The purpose of this study was to estimate and compare the risk for surgical site infection after third molar removal between patients with and without developmental disabilities. This was a retrospective cohort study of patients who underwent extraction of all four-third molars at Boston Children’s Hospital from August 1, 2021, to July 31, 2023. Patients were excluded if all four-third molars were not present or if all four-third molars were not extracted during one visit. The primary predictor variable was developmental disability status. Subjects were grouped by developmental disability, coded as present or absent. The primary outcome variable was diagnosis of a postoperative surgical site infection. Secondary outcomes included time to follow-up and infection treatment. RESULTS: A total of 1,896 subjects were evaluated. There were 236 subjects in the developmental disability group (72.5% male [n = 171] mean age of 19.3 ± 2.7 years) and 1,660 in the nondevelopmental disability group (53.4% female [n = 887] mean age of 19.0 ± 2.3 years). Subjects in the developmental disability group more frequently underwent their extractions in the operating room under general anesthesia (57.6% [n = 136] P < .001). The overall postoperative infection rate was 2.7% (n = 52). There was no statistically significant difference in the rate of infection between the developmental disability group (0.8% [n = 2]) and the nondevelopmental disability group (3.0% [n = 50]) (P = .057). There was no significant difference in time to follow-up between subjects who were and were not diagnosed with an infection (6.26 ± 9.39 weeks vs 4.69 ± 10.95 weeks, P = .434) or for subjects in the developmental disability and nondevelopmental disability group who had an infection (2.64 ± 0.30 weeks vs 6.43 ± 9.76 weeks, P = .588). Patients with a developmental disability do not exhibit higher rates of postoperative infections following third molar extractions when compared to patients without developmental disabilities.

Reference:

Britt MC, Sepe EA, Green MA. Third Molar Extractions in Patients With Developmental Disabilities. J Oral Maxillofac Surg. 2024 Aug 22:S0278-2391(24)00742-0. doi: 10.1016/j.joms.2024.08.012. Epub ahead of print. PMID: 39245262.

Keywords:

Patients, developmental, disability, higher rates, infections, after, third molar, extractions, suggests, study, Britt MC, Sepe EA, Green MA, Journal of Oral Maxillofacial Surgery

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Can Aerosolized nut particles circulation in aircraft ventilation system pose risk of allergy?

A new study published in the Archives of Diseases in Childhood showed that passengers at risk of anaphylaxis should always carry two adrenaline auto-injectors during the flight. In the UK, 1% to 2% of adults and 2% to 3% children suffer from a food allergy where the frequency is comparable in other medium-to-high income nations. The kids with food allergies take extra care when travelling, which is likely why allergic responses during commercial air travel are 10 to 100 times less prevalent than the ones on the ground, despite popular perception.

Studies have indicated that peanuts are easily spread by contact and saliva. During a commercial trip when deshelled roasted peanuts were consumed and another flight where no peanuts were given, Jin and team assessed the amount of peanuts found in surface swabs from aeroplane tray tables, seats, and air samples. The evidence for methods to help avoid unintentional allergic responses when flying on commercial aircraft was examined by Paul Turner and his team in this research.

The findings of a systematic review of the literature, which was commissioned by the Civil Aviation Authority of U.K, were compiled for this evidence review. The review covered studies between 1980 and 2022 that examined the risks to food-allergic passengers on commercial flights and potential mitigation strategies.

  • According to research investigations (including simulations of airplanes), there is no proof that nut allergens are likely to spread via the air. Therefore, announcements calling for “nut bans” are not encouraged and might provide a false sense of security.
  • Passengers cleaning their seat area which included the tray table and seat-back entertainment system was considered to be the most efficient solution. Food proteins are frequently “sticky” and attach to these surfaces, making it simple for them to move from there to a person’s hands and onto potentially edible food.
  • Through pre-boarding, airline businesses may assist in making this possible. 2 adrenaline [epinephrine] autoinjector devices should be recommended for passengers who are at risk of anaphylaxis and should always be carried on board, especially during flights.

Overall, in the event of an emergency, airlines should think about including a separate supply of “general use” adrenaline autoinjectors in the onboard medical kit. Every airline should have transparent food allergy rules that are readily accessible on their websites or upon request. To reassure passengers with food allergies and their caretakers, ground crew and cabin crew should implement these regulations uniformly.

Reference:

Turner, P., & Dowdall, N. (2024). Flying with nut and other food allergies: unravelling fact from fiction. In Archives of Disease in Childhood (p. archdischild-2024-327848). BMJ. https://doi.org/10.1136/archdischild-2024-327848

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Patients with ICU acquired Rapid Muscle Loss at increased risk of mortality, suggests study

A new study published in the Journal of Critical Care showed that individuals with ICU-acquired weakness (ICU-AW) exhibited comparable skeletal muscle mass upon ICU admission but a worse cellular nutritional status when compared to non-ICU-AW patients. Extensive muscular weakness that appears after admission to the intensive care unit is known as intensive care unit-acquired weakness. A poor prognosis is linked to the development of ICU-AW, which results in longer hospital stays, longer mechanical ventilation, and longer ICU stays.

The most recent developments in bioelectrical impedance analysis (BIA) offer a novel method for determining body composition and nutritional status. Since BIA is non-invasive, portable, affordable, and reproducible, it may be used with critically ill patients more readily than other nutritional evaluations. Prior research has documented correlations between BIA-derived indicators and outcomes in a number of illnesses, including malignant tumors, chronic obstructive pulmonary disease, and liver cirrhosis.

In order to assess the variations in body composition between patients with and without ICU-acquired weakness at the time of admission, Yoshito Yabe and his team carried out this study. It was anticipated that knowing the function of body composition prior to the emergence of ICU-AW would aid in the identification of possible treatment targets and enhance patient outcomes.

The mixed ICU at Tsukuba Memorial Hospital in Japan served as the site of this single-center, retrospective cohort research. The patients who were able to walk without assistance before admission, who underwent therapy after admission, and who lived for at least 48 hours were included in this study. During ICU admission, bioelectrical impedance analysis (BIA) was used to determine body composition. The characteristics, results, and body compositions of patients who were divided into ICU-AW and non-ICU-AW groups were compared.

28 (9.9%) of the 282 patients under analysis experienced ICU-AW. The SOFA ratings of ICU-AW patients were higher and they were older. In the ICU-AW group, BIA revealed a lower phase angle and a greater extracellular water to total body water ratio. The skeletal muscle mass was comparable between the groups. Overall, when compared to non-ICU-AW patients, the ICU-AW patients had relatively poor cellular nutritional status but comparable skeletal muscle mass at admission.

Source:

Yabe, Y., Komori, A., Iriyama, H., Ikezawa, K., & Abe, T. (2025). Association between the development of intensive care unit-acquired weakness and body composition at intensive care unit admission: A descriptive study. In Journal of Critical Care (Vol. 85, p. 154933). Elsevier BV. https://doi.org/10.1016/j.jcrc.2024.154933

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