Cementless Total Knee Arthroplasty Safe for Osteoporotic Patients Under 75, unravels study

Researchers found that patients with osteoporosis younger than 75 years of age who underwent cementless total knee arthroplasty (TKA) had comparable results of implant-related complications, medical complications, readmissions, and implant survival as those undergoing cemented TKA. A recent study was published in The Journal of Arthroplasty. The study was conducted by Jacquelyn and colleagues

Historical contraindications for TKA have included poor bone stock, a characteristic common to osteoporotic individuals. This study seeks to establish whether patients with osteoporosis who are below 75 years old and undergo cementless TKA have comparable implant-related and medical complications, hospital readmission rates, and 3-year implant survivability to those who undergo the cemented technique.

Using a national administrative claims database from 2010 to 2022, this study conducted a retrospective analysis of data. The inclusion criteria were patients 75 or younger with osteoporosis at diagnosis who received primary TKA. The cohort was split into two treatment groups according to the presence of cementless versus cemented TKA. To allow for a balanced comparison, propensity score matching was applied controlling for age, sex, obesity, and the Charleston Comorbidity Index (CCI), creating two well-matched groups: 1,321 patients in the cementless group and 6,602 in the cemented group. Primary endpoints consisted of the 90-day and 2-year implant-related complications, and the postoperative medical complications at 90 days and readmissions at 90 days. Additionally, Kaplan-Meier survival analysis was performed to assess the all-cause revision implant survivability rate at 3 years. The level of significance for type 1 error was set at P < 0.01 to minimize the error of the first type.

Key Findings

No statistically significant complications were detected between the cementless group and the cemented TKA regarding implant-related complications, medical complications, and admission rates within 90 days after the research.

The main results included the following.

  • Implant-related complications: No significant difference between cemented and cementless groups.

  • Medical complications within 90 days: Similar rates between both cohorts.

  • 90-day readmissions: No statistically significant differences.

  • Lengths of hospital stay were also comparable between the two groups.

The Kaplan-Meier analysis demonstrated that the 3-year implant survivability was nearly identical between the cemented and cementless TKA groups:

  • Cemented TKA survivability: 97.6% (95% confidence interval [CI], 96.6 to 98.5),

  • Cementless TKA survivability: 97.2% (95% CI, 96.7 to 97.7),

This study had strong evidence that when it comes to cementless TKA in osteoporotic patients under 75 years old, complications rates and implant survivability weren’t significantly different compared with patients treated with cemented TKA. Surgeons might extend the indications of cementless TKA to a broader spectrum than standard and report the results in osteoporotic patients, accounting for variability in individual bone strength.

Reference:

Xu, J. J., Magruder, M. L., Lama, G., Vakharia, R., Tabbaa, A., & Wong, J. (2024). Osteoporosis may not be an absolute contraindication for cementless total knee arthroplasty. The Journal of Arthroplasty. https://doi.org/10.1016/j.arth.2024.10.011

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Will NEET UG 2025 feature a new exam pattern? Here’s what NTA confirms

The National Testing Agency (NTA) is waiting for the report of a High-Powered Expert Committee, formed on the directions of the Supreme Court, on the potential changes in the exam pattern of the National Eligibility-Entrance Test (NEET) 2025 exam.
Activist Dr. Vivek Pandey had filed a Right to Information (RTI) application seeking the minutes of the meetings regarding any potential changes in the NEET 2025 exam pattern. “Please provide the details of minutes of meeting held in month on July & August 2024 regarding the NEET 2024 & NEET 2025 Exam,” Dr. Pandey mentioned in the RTI filed before the NMC.

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Supreme Court Extends NEET Expert Panel Report Deadline to November 4

The Supreme Court bench has granted two more weeks to the High-Level Committee of Experts to submit its recommendations to enhance the security measures for the National Eligibility-Entrance Test (NEET) exam.
Extending the time till November 4, 2024, the Apex Court bench comprising Chief Justice of India DY Chandrachud, and Justices J B Pardiwala, and Manoj Misra mentioned in the order, “Time is extended for that purpose till 4 November 2024.”

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NBE temporarily suspends DNB courses in Himachal Pradesh

Shimla: In a major setback for the postgraduate medical education in Himachal Pradesh, the National Board of Examinations in Medical Sciences (NBEMS) has suspended the Diplomate of National Board (DNB) courses in the State. 

Due to this, no DNB seats will be allocated in the state for this academic year i.e. 2024-2025, Tribune has reported. 

MBBS graduates are eligible to pursue the DNB courses, which are run by the NBEMS. These three-year postgraduate medical courses are considered to be equivalent to the postgraduate courses of Doctor in Medicine (MD) and Master of Surgery (MS). 

In the case of Himachal Pradesh, there are 30 DNB postgraduate medical seats in medical colleges across the state. Apart from these, the State also has 15 DNB Diploma courses, which are two-year PG courses.

Also Read: Threats of withholding stipend: DNB Residents in Chitradurga Allege Harassment by consultants, Doctors’ body Files RTI

However, as per the latest media report by The Tribune, NBEMS has suspended seats courses temporarily in the State due to a pending court case filed by some students challenging NBE’s decision of transferring some students from one college to another due to the issue of non-payment of stipend.

Commenting on the matter, Dr. Praveen Sharma, the Controller of Examination at Atal Medical and Research University, Himachal Pradesh told the daily, “The seats have been suspended temporarily by the NBEMS due to a pending case in the Himachal Pradesh High Court. The NBEMS has instructed us to stop the allocation of seats until the court gives its verdict. Once the case is decided, the suspension is likely to be revoked.”

NBE issued orders to transfer the DNB students from Hamirpur Medical College in the previous academic session. Reportedly, NBE issued the orders in this regard, after some of the students complained that the college was not providing them with stipend as per the NBEMS recommendation. However, challenging the decision of transfer, some of the students approached the High Court and filed a case.

Referring to this, Dr. Sharma added, “As the case is pending in the High Court, the NBEMS has suspended the courses for the time being in the state.”

Sources informed The Tribune, “As per our postgraduate policy, students pursuing post graduate courses are required to fill up the bond to serve in the state for a certain period. If the students fill up the bond, they get the stipend. In case the students do not fill up the bond, they do not get stipend.”

“The students pursuing DNB course in Hamirpur medical college did not fill up the bond, so they were not given the stipend. But they still complained to the NBEMS that they were not getting the stipend, which eventually led to the court case and suspension of DNB courses,” added the sources.

However, at this outset, a senior healthcare professional has feared that NBEMS may not resume the DNB courses as it is a matter of conflict of policies. The official added, “As per the NBEMS policy, paying stipend to students pursuing DNB courses is compulsory. In the state’s PG policy, paying stipend is not compulsory if the student does not sign a bond.”

Medical Dialogues had earlier reported that through a recent notice, NBE released the revised stipend guidelines applicable to all the NBE accredited Hospitals/Medical Institutions. In the notice, NBE specified the basic stipend prescribed by NBEMS for post-MBBS DNB (Broad Speciality), Post-Diploma DNB (Broad Speciality), 2 Years Diploma (Post MBBS—Broad Speciality), DrNB (Super Speciality), and FNB courses.

Further, NBE had clarified in the notice dated 09.09.2024 that “Paying stipend to the NBEMS trainees by the accredited hospitals/medical institutions is compulsory.”

Also Read: Around 5 percent Stipend Hike for Post Diploma DNB Broad Speciality trainees: Here are NBE’s Revised Stipend Guidelines

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Mumbai doctor duped of Rs 34.97 lakh in medical camp fraud

In a recent fraud case, a Mumbai-based doctor was swindled out of Rs 34.97 lakh by an elderly medical professional who claimed to be organizing free medical camps for police officers and the public.
The victim has been identified as a resident of Andheri who runs a clinic. The accused is a 52-year-old doctor who introduced himself as a paediatrician from Santacruz with a clinic in Juhu. The doctor allegedly orchestrated an elaborate plan and posed as a trustee of Sai Sansthan Shirdi and Baba Hospital Trust.

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Only D.Pharm, B.Pharm, M.Pharm, Pharm.D Holders Can Be Drug Wholesalers: DTAB

New Delhi: The Drugs Technical Advisory Board (DTAB) has reaffirmed its recommendation to finalize amendment to Rule 64 of the Drugs Rules, 1945, which governs the qualifications required for a ‘competent person’ to hold a wholesale drug license (Form 20B, 21B, and 20G).

The proposed amendment would restrict the qualification for this role to those with a pharmacy background, such as individuals holding a D.Pharm, B.Pharm, M.Pharm, Pharm.D, or registered pharmacists.

The Rule 64 specifies the conditions to be satisfied before a licence in Form 20, 20B, 20F, 20G, 21 or 21B is granted or renewed. The second proviso to sub-rule (2) of this Rule specifies the requirements of the area and the qualification of the competent person for grant of license in Form 20B and 21B.

Under the present rules, the qualifications for a competent person also include a matriculation exam with four years of experience in drug sales, or a degree from a recognized university with one year of experience in dealing with drugs. The amendment seeks to remove these qualifications, limiting eligibility to those with formal pharmacy education.

Also Read: Pharmacy Council of India approves new D Pharm, B Pharm, M Pharm courses at IP University with 220 seats

The DTAB initially discussed this proposal in its 70th meeting on August 18, 2015, where it recommended deleting the broader qualifications under clauses (b) and (c) of the second proviso of sub-rule 64(2). Additionally, it was recommended that a protection clause be added to exempt individuals registered as competent persons before the final notification date from the new educational requirements.

In December 2016, a draft notification (G.S.R. 1179(E)) was published to amend Rule 64. However, the proposal was met with widespread opposition, with concerns raised about its impact on accessibility and the practical implementation of the new requirements. Following stakeholder feedback, the Ministry has sought further comments and inputs to reassess the proposal’s feasibility.

In its latest review, DTAB has reiterated the need for this amendment to be finalized, citing the importance of strengthening the pharmaceutical supply chain and ensuring the quality, safety, and efficacy of drugs. The Central Government has also sought further comments and inputs on the matter before proceeding with the final notification.

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Even Healthcare raises Rs 252 crore in Series A funding to launch hospital operations, enhance patient care

Bengaluru: Even Healthcare, a Bengaluru-based managed care provider, recently secured USD 30 million (approximately Rs 252 crore) in a Series A funding round. The round was led by Khosla Ventures, with participation from prominent investors like Founders Fund, 8VC, and Lachy Groom.

The newly raised capital will be used to establish hospital operations in Bengaluru and improve patient care and support processes. This funding brings Even Healthcare’s total capital raised to $50 million to date. The company previously raised $5 million in 2021, followed by a $15 million round in November 2022.

Founded in 2020 by Mayank Banerjee, Matilde Giglio, and Alessandro Ialongo, Even Healthcare operates as a managed care provider, offering its members benefits such as unlimited free consultations, diagnostic tests, and cashless hospitalization. These services are delivered through its in-house clinical team, along with owned and partner clinics, and supported by insurance partners.

“In the market, most insurance products focus solely on hospitalization. We cover everything—prevention, diagnostics, and all tests, including OPD (outpatient department) services. Outpatient care is part of our offerings, not just hospitalization, and we manage most of it in-house,” Giglio told ET.

The company currently serves around 200 business-to-business clients, including Grant Thornton, Pixxel, Mensa, Ultrahuman, Slice, and Urban Ladder. “We have five clinics in Bengaluru, and for clients outside the city, we connect them to thousands of partner clinics,” she added.

In the 2023-24 fiscal year, Even Healthcare recorded $9 million in revenue. According to Express Healthcare, since its commercial launch just 1.5 years ago, the company has attracted hundreds of thousands of members and generated $28 million in revenue. For an annual fee of ₹4,800, members enjoy unlimited consultations across episodic care, lifestyle management, and chronic condition treatment, with the option to add health insurance for hospital coverage.

“This year, our run rate has reached $28 million, and we expect to close at $35 million in FY25,” Giglio stated.

Presently, the company employs around 300 people and serves clients across India, with a focus on metro and tier-2 cities. “Our key centers include Delhi, Mumbai, Hyderabad, Pune, and Bengaluru,” Giglio added.

According to a recent ET report, Even Healthcare plans to establish three secondary care hospitals in Bengaluru. “We’ve demonstrated that by managing healthcare in-house, we can enhance the customer experience and improve margins. As a result, we plan to open three hospitals in Bengaluru to deliver IPD (inpatient department) services directly,” Giglio explained. “Our goal is to become a fully integrated healthcare provider, and given our rapid growth and increased access to capital, we can accelerate this hospital expansion.”

Vinod Khosla, founder of Khosla Ventures, remarked, “Modernized healthcare is vital for any nation. Even Healthcare is delivering high-quality, affordable care to one of the world’s largest populations, and we’re thrilled to partner with them as they boldly reimagine healthcare for India.”

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Rajasthan: 7000 resident doctors strike for stipend increase, bond policy changes, workplace safety

Rajasthan healthcare services were impacted as around 7,000 resident doctors in the State suspended all services over their pending demands for a stipend hike and enhanced security measures at the workplace. Apart from these demands, the protesting doctors, who resumed their strike on Saturday, are also demanding revision of the mandatory bond policy, better hostel facilities and direct job recruitment based on merit for postgraduate and super-speciality doctors.
Commenting on the matter, a representative of the Jaipur Association of Resident Doctors (JARD) said that during the talks with them in August, the administration had assured that their demands would be fulfilled. However, they are now compelled to shut down all services due to inaction, the representative told PTI.

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Cancer prevalence across vertebrate species decreases with gestation time, may increase with adult mass

Cancer prevalence rates varied widely across vertebrate species and generally increased with higher adult mass and decreased with longer gestation time, according to results published in Cancer Discovery.

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Mouse study sheds light on the secret to maintaining a youthful immune system

What keeps some immune systems youthful and effective in warding off age-related diseases? In a new paper published in Cellular & Molecular Immunology, USC Stem Cell scientist Rong Lu and her collaborators point the finger at a small subset of blood stem cells, which make an outsized contribution to maintaining either a youthful balance or an age-related imbalance of the two main types of immune cells: innate and adaptive.

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