Pelvic Inflammatory Disease linked to Increased Risk of Serous Borderline Ovarian Tumors, study

Sweden: A recent nationwide case-control study conducted in Sweden has uncovered a significant association between pelvic inflammatory disease (PID) and an elevated risk of developing borderline ovarian tumors (BOTs).

The research, published in the International Journal of Cancer, indicates that individuals with a history of PID face a 48% increased likelihood of being diagnosed with these tumors, specifically highlighting a stronger correlation with serous tumors compared to mucinous types. Moreover, a dose-response relationship was identified, indicating that a greater number of PID episodes is associated with an elevated risk of serous tumors.

While pelvic inflammatory disease has been associated with tubo-ovarian carcinoma, its relationship with borderline ovarian tumors (BOT) remains less clear. This population-based case-control study utilizing Swedish national registers revealed that PID diagnosed before BOT development was linked to serous BOT but not to mucinous BOT. Additionally, a significant trend showed an increased BOT risk corresponding to the number of PID episodes. These findings suggest that infections of the fallopian tubes and adjacent tissues may elevate the risk of serous BOT.

The similarity between fallopian tube cells and serous borderline ovarian tumors points to a potential origin link, with salpingitis suggested as a contributing factor in the development of BOTs. Considering this, Sarah Jonsson, Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden, and colleagues aimed to investigate the potential relationship between pelvic inflammatory disease (PID) and the risk of developing BOT.

For this purpose, the researchers conducted a national population-based case-control study in Sweden, including women diagnosed with borderline ovarian tumors from 1999 to 2020, along with ten matched controls. They analyzed data from nationwide registers using conditional logistic regression, adjusting for factors such as age, residential district, educational level, and parity.

The following were the key findings of the study:

  • Among 4782 cases and 45,167 controls, 2.0% of cases and 1.3% of controls had a history of PID.
  • Previous PID was associated with an increased risk of BOT overall (aOR, 1.48).
  • A significant association was observed with serous tumors (aOR, 1.76), while not with mucinous tumors (aOR, 0.95).
  • A dose-response relationship was noted between the number of PID episodes and serous BOT risk.

“This study shows that pelvic inflammatory disease is linked to a heightened risk of serous borderline ovarian tumors, with evidence of a dose-response relationship. The findings emphasize the significant implications of upper reproductive tract infections and inflammation. This highlights the necessity for further exploration of the biological mechanisms involved and the potential effects of PID on the development of serous BOT,” the researchers concluded.

Reference:

Jonsson, S., Jonsson, H., Lundin, E., Häggström, C., & Idahl, A. Pelvic inflammatory disease and risk of borderline ovarian tumors: A national population-based case–control study in Sweden. International Journal of Cancer. https://doi.org/10.1002/ijc.35180

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What Will Happen if Respiratory Medicine Dept Goes Away from 706 Medical Colleges? HC to decide on NMC Decision

Nagpur: While considering the plea by the Indian Chest Society (ICS) challenging the National Medical Commission’s (NMC) decision of eliminating the Respiratory Medicine Department from the MBBS curriculum, the Nagpur bench of Bombay High Court recently sought to know from the NMC the rationale behind such decision.

During the proceedings, the HC bench comprising Justice Bharti Dangre and Justice Abhay Mantri noted the argument that if the subject is eliminated, it means that the teaching staff for these courses or the department of respiratory medicine setup for this purpose would also be unavailable at 706 medical colleges across the country, which in turn would affect the healthcare facilities and the treatment of ordinary citizens.

Medical Dialogues reported that last year, the Undergraduate Medical Education Board (UGMEB) of the National Medical Commission (NMC) had removed three departments- Physical Medicine and Rehabilitation (PMR), Respiratory Medicine, and Emergency Medicine from the list of departments that every medical college/institution must have to be approved for undergraduate medical admissions on an annual basis. The provision for a separate department for respiratory medicine is also absent in the newly released Competency-Based Medical Education 2024 guidelines.

Even though the respiratory medicine specialists had approached different authorities urging to change this decision, they did not get any respite and decided to pursue the legal remedy. Accordingly, the Indian Chest Society (ICS) filed a Public Interest Litigation in this regard before the Bombay High Court. Apart from ICS, the Indian Association of Physical Medicine and Rehabilitation is also a petitioner in this case.

Also Read: MBBS Curriculum: Why are Respiratory Medicine Specialists at Loggerheads with NMC

During the previous hearing of the matter, the doctors’ counsel argued that UGMEB is required to function under the Act of 2019 and it is subject to the Regulations made by NMC as per Section 16 (2) of the Act of 2019. Further, the counsel pointed out that as per Section 57 of the 2019 Act, NMC is empowered to frame Regulations, and accordingly, on 28th October 2020, NMC framed Regulations as per which 24 Departments (including Departments of Respiratory Medicine, Physical Medicine, and Rehabilitation and Emergency Medicine) were identified to be established by every Medical College and Medical Institution approved for MBBS admissions annually.

As per the latest media report by The Hitavada, during the hearing of the case on Friday, the Apex Medical Commission informed the bench that these subjects will now be included as part of General Medicine. However, the Court underlined the importance of Respiratory Medicine during the COVID-19 pandemic and questioned the NMC’s decision to eliminate the course. Further, the HC bench also questioned the justification of including such an important topic in General Medicine.

The High Court bench has directed the Commission to provide a reasoned explanation for this decision within three weeks. Meanwhile, the petitioner association was asked to submit a reply.

Responding to the NMC’s argument that the subject would be part of General Medicine, the petitioner’s counsel argued that this would adversely affect the availability of doctors in hospitals for these critical subjects. Further, the counsel contended that the Commission’s decision would deprive medical students of crucial courses and also adversely impact the treatment of ordinary citizens. 

“Mr. Rahul Bhangde, learned counsel appear for the respondent nos.2 and 3 and seek time of three weeks to file reply. We expect the affidavit to be filed within a period of three weeks as undertaken,” ordered the HC bench.

“The petitioners are at liberty to file their rejoinder within a period of two weeks thereafter. Re-notify to 19th November, 2024,” it further mentioned in the order.

Speaking to Medical Dialogues regarding the NMC’s decision, Dr. Neel Thakkar, Vadodara-based pulmonologist and a member of the Indian Chest Society said, “The matter is not just about medical education, whether they teach respiratory medicine to MBBS students. But because of the department only and the absence of training , how many lives will be lost, how much Drug-resistant Tuberculosis and COPD will spread, how will this affect the mortality and morbidity should another pandemic strike our nation? All these questions need answers.”

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/bombay-hc-respiratory-medicine-255599.pdf

Also Read: Respiratory Medicine, Emergency Medicine, PMR Depts no longer mandatory to start new medical colleges, Doctors question move

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MBBS candidate Denied Sports Quota admission: Karnataka HC Directs State to Pay Rs 10 Lakh compensation

Bengaluru: While considering the plea by an MBBS aspirant, who was denied a seat under the sports quota despite representing India in several national and international chess tournaments, the Karnataka High Court recently directed the State Government to pay Rs 10 lakh to the student within six weeks from the date of order i.e. 01.10.2024.

The petitioner student is a chess player and she participated in various State/National and International Chess events. She had participated in the 32nd National U-13 Open and Girls Chess Championship 2018, the 7th National School Chess Championship 2018, the Asian Youth Chess Championship 2018, and the Common Wealth Championship 2018.

Aspiring to become a Doctor, the petitioner cleared the National Eligibility-and-Entrance Test UG Examination of 2022-2023 and scored a good rank. Consequently, she filed an application seeking admission to the Government seats in the Medical Colleges against the sports quota.

As per the petitioner, she is to be considered as a Preference P-I or P-III candidate. However, she was given P-V and was placed at Serial Number 9 in the provisional eligibility list and representations to various authorities remained unsuccessful. Ultimately, during the pendency of the case proceedings, the petitioner was admitted to the MBBS course on a Private Seat incurring fees exceeding Rs 11 lakh.

While considering her plea, the HC Division bench of Chief Justice NV Anjaria and Justice KV Aravind observed that the State’s actions in denying the petitioner a seat under the sports quota and forcing her to get admitted to a private medical college was arbitrary.

The bench observed that the petitioner is to be considered as P-I by considering the Winning Certificate issued by the Asian Youth Chess Championship, 2018. “It is not in doubt that All India Chess Federation is recognized by the Ministry of Youth Affairs and Sports. The certificate issued by AICF on the participation of the petitioner in Asian Youth Chess Championship 2018 would evident representing the Country. In the light of the aforesaid reasons, the Certificate of Winning issued by Asian Youth Chess Championship, 2018 at Thailand is while representing the country,” noted the Court.

“As per Rule 9 read with Second Schedule, the Asian Championship is in the list of Super-A Games. The candidate who has won a medal while representing the country in the Super-A Games is to be categorized as P-I,” it further observed.

Accordingly, the bench held that the categorization of the petitioner as P-V is “on the face of it illegal”. “The respondent authorities have committed serious errors either due to non-application of mind or the arbitrary exercise of the power. This action of the respondent authorities has deprived the petitioner’s aspiration to pursue MBBS Course under Government seat reserved as sports quota,” it noted.

At this outset, the Court also noted that due to the arbitrary decision by the authorities, the ambition of the parents and the student in pursuing sports activity to claim incentive of preference for admission was totally shattered. “The Court is bound to recognize the volume of time and money spent on pursuing the sport, apart from sacrificing academic training. Another aspect to be noticed and recognized is the moment of pride for the nation that was brought about by winning the certificate,” it further observed. 

However, the Court observed that if at this stage, the authorities are directed to consider the petitioner under the sports quota as P-I category, the admissions already concluded would be disturbed and the seat that the petitioner was pursuing would be vacant if she were to shift her admission to the sports quota. Similarly, one of the candidates admitted under sports quota would be displaced. Therefore, the Court opined that “In that view, disturbing the admissions already finalized is neither permissible nor prudent.”

“Once the Court holds that the action of the respondent-State has resulted in suffering to the petitioner, applying the test of time constraints, the petitioner cannot be denied of redressal of sufferings. Once the remedy of admission under the sports quota is not viable, the other method to remedy the grievance is with adequate compensation,” it concluded.

The Court noted that the amount of fee fixed for admission to Government Medical College is Rs 50,000. The fee for government seats in private medical colleges in Rs 1,40,000 whereas for private seats it is Rs 11,88,000. “In the event, the petitioner was considered under P-I category, she would be eligible to secure admission either in Government college or a government seat in a private college which would not have exceeded Rs.1,44,000/- per year. As per the pleadings, the petitioner is admitted in a private college on a private seat,” noted the Court.

Accordingly the Court ordered that being denied the opportunity to be admitted as a P-I candidate, the petitioner was entitled to compensation of Rs 10 lakh. “For the aforesaid reasons, the writ petition is allowed to the extent that the respondent-State is directed to pay compensation of Rs.10,00,000/- within six weeks from the date of service of this order,” the High Court bench ordered.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/karnataka-hc-rs-10-l-255577.pdf

Also Read: Karnataka HC Upholds NMC Rule of Doing Away with Grant of Grace Marks in MBBS Exams, junks students’ plea

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Sun Pharmaceutical Industry gets CDSCO Panel nod to study Aflibercept Injection

New Delhi: The Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organization (CDSCO) has granted approval to the drug major Sun Pharmaceutical Industries to conduct the Phase III clinical study of Aflibercept injection 40 mg/mL, 0.278 mL/vial in patients with neovascular age-related macular degeneration.

This came after the firm presented the protocol to conduct a Phase III clinical study of Aflibercept injection at 40 mg/mL and 0.278 mL/vial in patients with neovascular age-related macular degeneration titled “A Prospective, Multicenter, Double-Blind, Active-Controlled, Parallel-Group, Phase III Study to Compare the Efficacy, Safety and Immunogenicity of Sun’s Aflibercept with Reference Biologic in Patients with Neovascular Age-Related Macular degeneration (wet AMD)” vide Protocol No. ICR/24/006, Version No. 1.0; dated 18.6.2024.

However, the nod is subject to the condition that the follow-up duration of the study should be increased to 6 months and a subsequent dose of the study drug should be provided to the study subjects if required based on the observation during the follow-up study duration.

Furthermore, the condition added that all the proposed primary and secondary efficacy endpoints should be evaluated at 6 months (24 weeks) in addition to the safety.

In addition to the above, the condition stated that for the standard care treatment, Ranibizumab should be used if required along with other medications.

Aflibercept is a vascular endothelial growth factor (VEGF) inhibitor used to treat Neovascular (Wet) Age-Related Macular Degeneration (AMD), various types of macular edema and diabetic retinopathy, and metastatic colorectal cancer.

Aflibercept is a recombinant protein composed of the binding domains of two human vascular endothelial growth factor (VEGF) receptors, VEGFR1 and VEGFR2, fused with the Fc region of human immunoglobulin gamma 1 (IgG1).

At the recent SEC meeting for ophthalmology held on September 19, 2024, the expert panel reviewed the protocol for conducting a Phase III clinical study of aflibercept injection, which was submitted by the drug major Sun Pharmaceutical Industries.

After detailed deliberation, the committee recommended the conduct of the proposed Phase III study with the following changes in the protocol:

1. Follow-up duration of the study should be increased to 6 months and subsequent dose of study drug should be provided to the study subjects if required based on the observation during the follow up study duration. All the proposed primary and secondary efficacy endpoints should be evaluated at 6 months (24 weeks) in addition to the safety.

2. For the standard care treatment, Ranibizumab should be used if required along with other medications.

Accordingly, the expert panel stated the firm should submit the revised protocol to CDSCO for evaluation.

Also Read: CDSCO becomes Affiliate Member of International Medical Device Regulators Forum

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Applying For PG Medical Admissions Under Management Quota At NTRUHS? Know The Fee Structure

Andhra Pradesh- Dr NTR University of Health Sciences (DR NTRUHS) is inviting online applications for admission into the Post Graduate Medical Degree and Diploma Courses in private un-aided non-minority and minority medical colleges under management quota in the state of Andhra Pradesh for the academic year 2024-25. On this, NTRUHS has released a prospectus detailing the complete fee structure and registration & processing fee regarding the course.

As per the prospectus, all the selected candidates shall pay the Non – Non-refundable university Fee of Rs.49,600/- for Medical courses.

Following is the Tuition fee structure for the academic year 2024-25 to be payable for the Competent Authority Quota seats in Private Un-aided Medical Colleges.

Below are the complete fee structure details-

S.NO

NAME OF THE COURSE

Fee for Category-B (MQ) seats

Fee for Category-C NRI/Institutional

Quota seats

1

Clinical Degree/Diploma.

₹. 9,93,600/-

₹.57,50,000/-

2

Para Clinical Degree/Diploma.

₹.3,10,500/-

₹.17,25,000/-

3

Pre-Clinical Degree/Diploma.

₹.1,40,760/-

₹.9,20,000/-

Meanwhile, the application and processing fees including the late fee once paid will not be refunded or adjusted to a future date under any circumstances. The fee can be paid through a Debit card, Credit card or Net Banking.

THE REGISTRATION & PROCESSING FEE (WITHOUT LATE FEE)

S.NO

CATEGORY

REGISTRATION & PROCESSING FEE INCLUDING 18% GST

IN ADDITION TO REGISTRATION & PROCESSING FEE, VERIFICATION FEE INCLUDING 18% GST

TOTAL AMOUNT

MBBS COMPETED WITHIN AP

1

OC/BC

₹.7080/- (6,000/- + 1,080/- GST 18%)

—

₹.7,080/-

MBBS COMPETED OUTSIDE AP

2

OC/BC

₹.7080/- (6,000/- + 1,080/- GST 18%)

₹.3,540/- (3,000/-+540/- (GST 18%)

₹.10,620/-

MBBS COMPETED OUTSIDE COUNTRY

3

OC/BC

₹.7080/- (6,000/- + 1,080/- GST 18%)

8,260/- (7,000/-+1,260/- (GST 18%)

₹.15,340/-

THE REGISTRATION & PROCESSING FEE (WITHOUT LATE FEE)

S.NO

CATEGORY

FEE IN RS

LATE FEE RS

TOTAL AMOUNT

1

OC/BC

₹.7080/- (6,000/- + 1,080/- GST 18%)

₹.20,000/- (FEE RS.16,950 + GST @ 18% = 3,050/-)

₹.27,080/-

MBBS COMPETED OUTSIDE AP

2

OC/BC

₹.7080/-+3540/-=10,620/-

₹.20,000/- (FEE RS.16,950 + GST @ 18% = 3,050/-)

₹.30,620/-

MBBS COMPETED OUTSIDE COUNTRY

3

OC/BC

₹.7080/-+8260/- =15,340/-

₹.20,000/- (FEE RS.16,950 + GST @ 18% = 3,050/-)

₹.35,340/-

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Fake Doctor Reg Aftermath: Rajasthan Health dept faces herculean task of now verifying 70,000 doctors

Jaipur: In the wake of the scam involving the alleged fake registration of doctors, the Rajasthan Health Department is currently engaged in the process of verifying the documents provided by more than 70,000 to the Rajasthan Medical Council (RMC) over the years.

This initiative has been taken to identify fake documents submitted to RMC by doctors after a Registrar of the Rajasthan Medical Council (RMC) along with two other personnel were recently suspended in connection a few days ago. 

Medical Dialogues had reported that the decision to suspend the RMC Registrar and officials was taken based on an interim report by a five-member committee set up by the State Health Minister Gajendra Singh Khinvsar. Based on the interim report, the Registrar of the Council, Dr Rajesh Sharma, assistant administrative officer Akhilesh Mathur, and Junior Assistant Farhan were suspended with immediate effect.

Also read- Fake Registration of Doctors: Doctors’ Associations demand Elections for Rajasthan Medical Council Members

In response, a five-member committee headed by the Commissioner of Medical Education Iqbal Khan has been assigned to verify the documents of the doctors. However, the task is hectic and burdensome due to the department’s transition from offline to online medical registrations in 2022, leading to a backlog of documents of over 70,000 doctors which are stored in rooms at RMC.

For a smooth process of verification, the health department has decided to implement a two-strategic approach to address the issue. One of the approaches is to assign a five-member committee to verify the online registrations submitted after 2022 while the other is to ask the new registrar to asses the offline documents submitted before the digital transition.

The health department also plans to collaborate with medical councils across different states. Its goal is to identify and revoke the registrations of fraudulent doctors and preventing them from practicing medicine.

Speaking to TOI, Principal Secretary (health) Gayatri Rathore said “We have divided the task of verification of the documents in two parts. While the five-member committee is verifying documents submitted by candidates after 2022, those submitted before 2022 are being looked at by RMC’s new registrar, who replaced the one placed under suspension in the case.”

“Identifying fake documents submitted to RMC by candidates remains a daunting task, and officials are seeking help from the public, doctors’ associations and informers to collect information on practitioners having fraudulent credentials. We will identify the suspected cases first and then check their documents,” said Iqbal Khan.

Also read- Rajasthan Medical Council Registrar suspended over Fake Registrations of Doctors

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Long-term efficacy for lebrikizumab seen in moderate, severe eczema

For patients with moderate-to-severe atopic dermatitis (AD), lebrikizumab has long-term efficacy, according to a study presented at the annual meeting of the European Academy of Dermatology and Venereology, held from Sept. 25 to 28 in Amsterdam.

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Low pay, high staff turnover and employee burnout took a toll on social service nonprofits during the COVID-19 pandemic

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DR Congo launches mpox vaccination drive, hoping to curb outbreak

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Fear of cancer recurrence common decades after surviving childhood cancer

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