Archive for category: News

Drinking any amount of alcohol likely increases the risk of dementia, suggests the largest combined observational and genetic study to date, published online in BMJ Evidence Based Medicine.

Even light drinking-generally thought to be protective, based on observational studies-is unlikely to lower the risk, which rises in tandem with the quantity of alcohol consumed, the research indicates.

Current thinking suggests that there might be an ‘optimal dose’ of alcohol for brain health, but most of these studies have focused on older people and/or didn’t differentiate between former and lifelong non-drinkers, complicating efforts to infer causality, note the researchers.

To try and circumnavigate these issues and strengthen the evidence base, the researchers drew on observational data and genetic methods (Mendelian randomisation) from two large biological databanks for the entire ‘dose’ range of alcohol consumption.

These were the US Million Veteran Program (MVP), which includes people of European, African, and Latin American ancestry, and the UK Biobank (UKB), which includes people of predominantly European ancestry.

Participants who were aged 56–72 at baseline, were monitored from recruitment until their first dementia diagnosis, death, or the date of last follow-up (December 2019 for MVP and January 2022 for UKB), whichever came first. The average monitoring period was 4 years for the US group, and 12 for the UK group.

Alcohol consumption was derived from questionnaire responses—over 90% of participants said they drank alcohol—and the Alcohol Use Disorders Identification Test (AUDIT-C) clinical screening tool. This screens for hazardous drinking patterns, including the frequency of binge drinking (6 or more drinks at a time).

In all, 559,559 participants from both groups were included in observational analyses, 14,540 of whom developed dementia of any type during the monitoring period:10,564 in the US group; and 3976 in the UK group. And 48,034 died: 28,738 in the US group and 19,296 in the UK group.

Observational analyses revealed U-shaped associations between alcohol and dementia risk: compared with light drinkers (fewer than 7 drinks a week) a 41% higher risk was observed among non-drinkers and heavy drinkers consuming 40 or more drinks a week, rising to a 51% higher risk among those who were alcohol dependent.

Mendelian randomisation genetic analyses drew on key data from multiple large individual genome-wide association studies (GWAS) of dementia, involving a total of 2.4 million participants to ascertain lifetime (rather than current) genetically predicted risks.

Mendelian randomisation leverages genetic data, minimising the impact of other potentially influential factors, to estimate causal effects: genomic risk for a trait (in this case, alcohol consumption) essentially stands in for the trait itself.

Three genetic measures related to alcohol use were used as different exposures, to study the impact on dementia risk of alcohol quantity, as well as problematic and dependent drinking.

These exposures were: self-reported weekly drinks (641 independent genetic variants); problematic ‘risky’ drinking (80 genetic variants); and alcohol dependency (66 genetic variants).

Higher genetic risk for all 3 exposure levels was associated with an increased risk of dementia, with a linear increase in dementia risk the higher the alcohol consumption.

For example, an extra 1-3 drinks a week was associated with a 15% higher risk. And a doubling in the genetic risk of alcohol dependency was associated with a 16% increase in dementia risk.

But no U-shaped association was found between alcohol intake and dementia, and no protective effects of low levels of alcohol intake were observed. Instead, dementia risk steadily increased with more genetically predicted drinking.

What’s more, those who went on to develop dementia typically drank less over time in the years preceding their diagnosis, suggesting that reverse causation-whereby early cognitive decline leads to reduced alcohol consumption-underlies the supposed protective effects of alcohol found in previous observational studies, say the researchers.

They acknowledge that a principal limitation of their findings is that the strongest statistical associations were found in people of European ancestry, because of the numbers of participants of this ethnic heritage studied. Mendelian randomisation also relies on assumptions that can’t be verified, they add.

Nevertheless, they suggest that their findings “challenge the notion that low levels of alcohol are neuroprotective.”

And they conclude: “Our study findings support a detrimental effect of all types of alcohol consumption on dementia risk, with no evidence supporting the previously suggested protective effect of moderate drinking.

“The pattern of reduced alcohol use before dementia diagnosis observed in our study underscores the complexity of inferring causality from observational data, especially in ageing populations.

“Our findings highlight the importance of considering reverse causation and residual confounding in studies of alcohol and dementia, and they suggest that reducing alcohol consumption may be an important strategy for dementia prevention.”

Reference:

Topiwala, A., et al. (2025) Alcohol use and risk of dementia in diverse populations: evidence from cohort, case-control and Mendelian randomisation approaches. BMJ Evidence Based Medicine. DOI: 10.1136/bmjebm2025-113913

Researchers have found in a new nationwide population-based study published in the Journal of Affective Disorders that patients with Graves’ disease face a significantly higher risk of developing psychiatric disorders compared with the general population, highlighting the complex interplay between thyroid autoimmunity, neuropsychiatric health, and long-term disease management. The study analyzed a large cohort of individuals diagnosed with Graves’ disease against matched controls and found that the risk was particularly elevated for depression, bipolar disorder, anxiety disorders, and sleep disturbances, with these associations persisting even two years after the initial diagnosis. Interestingly, no significant association was observed between Graves’ disease and the risk of schizophrenia, suggesting that the thyroid-psychiatric link may be specific to certain mental health conditions rather than encompassing all psychiatric disorders. These findings underscore the importance of integrating psychological assessment and monitoring into routine clinical care for patients with Graves’ disease, as mental health complications may extend beyond the acute phase of endocrine dysfunction and persist well into long-term follow-up. The mechanisms underlying these associations may involve immune-mediated pathways, alterations in thyroid hormone regulation affecting neurotransmitter systems, chronic disease burden, or psychosocial stressors related to living with a long-term autoimmune condition. For clinicians, the results reinforce the need for interdisciplinary collaboration between endocrinologists, psychiatrists, and primary care physicians to ensure early detection and appropriate management of psychiatric symptoms in patients with Graves’ disease. For patients, the findings highlight the importance of awareness regarding mood changes, anxiety, or sleep disturbances as possible complications linked to their thyroid condition, emphasizing the role of proactive mental health care in improving quality of life and treatment outcomes. While the study provides robust evidence from a large dataset, further research is warranted to explore causal mechanisms, evaluate the impact of antithyroid treatments on psychiatric risk, and determine whether early psychological interventions can mitigate long-term complications. Overall, the study strengthens the argument for holistic management approaches that address both the endocrine and psychological dimensions of Graves’ disease.

Recent study investigated the relationship between second-trimester anthropometric obesity indicators and cesarean section (CS) in Chinese pregnant women, aiming to identify effective predictors to reduce unnecessary CS rates. The research highlighted the increasing global CS rates and the associated short- and long-term risks for both mothers and infants. Maternal obesity during the second trimester has been linked to an elevated CS risk, emphasizing the need for reliable obesity indicators for prenatal risk assessment. Different indicators like Body Mass Index (BMI), Subcutaneous Fat Thickness (SCFT), Waist Circumference (WC), Body Fat Percentage (BFP), and Body Roundness Index (BRI) were evaluated for their associations with CS risk.

Key Findings and Associations

The findings showed that BMI, BFP, WC, and BRI were significant predictors of CS risk, with BRI demonstrating the strongest association. Maternal age and fetal sex were identified as modifiers influencing these associations, with advanced maternal age and male infants showing heightened CS risks. The study included a large sample of Chinese pregnant women, and statistical analyses revealed significant correlations between anthropometric indicators and CS risk after adjusting for covariates.

Recommendations for CS Risk Assessment

Integrated approaches combining BMI and WC were recommended for effective CS risk assessment, with BRI being a superior indicator despite its complexity. The study emphasized the importance of early identification of high-risk subgroups and integrating obesity-related indicators into routine prenatal care to optimize delivery planning and develop targeted interventions. The research findings suggested that an individualized perinatal care approach using multiple anthropometric indicators could enhance risk stratification and improve maternal and neonatal outcomes.

Limitations and Future Research Directions

While the study provided valuable insights into the associations between anthropometric obesity indicators and CS risk, certain limitations such as the observational design, single-center setting, limited participant characteristics, and the need for further longitudinal studies to confirm the findings were acknowledged. Future research directions were proposed to explore the longitudinal impact of maternal adiposity changes on delivery outcomes and develop accessible tools for integrating anthropometric indicators into routine obstetric care for enhanced risk assessment and improved maternal health outcomes.

Key Points

– Investigated the relationship between second-trimester anthropometric obesity indicators and cesarean section (CS) in Chinese pregnant women to identify predictors for reducing unnecessary CS rates in response to the increasing global CS rates and associated risks for mothers and infants.

– Found that Body Mass Index (BMI), Body Fat Percentage (BFP), Waist Circumference (WC), and Body Roundness Index (BRI) were significant predictors of CS risk, with BRI showing the strongest association, while maternal age and fetal sex modulated these associations.

– Recommended integrated BMI and WC approaches for effective CS risk assessment, suggesting the superiority of BRI as an indicator and highlighting the importance of early identification of high-risk subgroups and integrating obesity-related indicators into routine prenatal care.

– Acknowledged study limitations such as observational design, single-center setting, and the need for further longitudinal research to confirm findings, proposing future directions to explore the impact of maternal adiposity changes on delivery outcomes and develop accessible tools for enhanced risk assessment in obstetric care.

– Emphasized the need for reliable obesity indicators for prenatal risk assessment due to the linkage between maternal obesity during the second trimester and elevated CS risk, aiming to optimize delivery planning, develop targeted interventions, and improve maternal and neonatal outcomes through individualized perinatal care approaches using multiple anthropometric indicators.

Reference –

Anqi Xiong et al. (2025). Second-Trimester Anthropometric Estimators Of Cesarean Section: The Agreement Between Body Roundness Index, Body Mass Index, Body Fat Percentage, And Waist Circumference. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07643-8.

New Delhi: The National Consumer Disputes Redressal Commission (NCDRC) recently upheld the charges of medical negligence against a Karnataka-based hospital, which was told to pay Rs 5 lakh compensation to a patient.

Previously, while considering the matter, the District Commission had held the neurosurgeon negligent and directed him to pay Rs 15 lakh compensation to the patient, whereas the hospital had been slapped with Rs 5 lakh compensation.

While considering the hospital’s appeal against the district and state consumer court verdicts, the Apex Consumer Court opined that the District Commission order was fully justified in holding the hospital negligent. NCDRC observed that the discharge summary was incomplete, and operation notes were not provided despite an RTI appeal. 

The history of the case goes back to 2007, when a spinal surgery on the patient was performed at the treating hospital by a neurosurgeon. While performing the surgery, a metallic screw was utilised, and a minute fragment of the said screw seemed to have scraped during the performance of the surgery, which got lodged somewhere around the area of surgery.

Later, the patient discovered that such a metallic object was left behind when he faced some complications. After inquiring into the matter and obtaining some details, he filed a consumer complaint before the Dakshina Kannada District Consumer Disputes Redressal Commission, Mangalore, Karnataka.

The District Commission, through an elaborate order dated 29.10.2010, held the surgeon liable for negligence on a clear finding that the piece of metal that was left behind during the process of surgery was an act of gross negligence. Accordingly, the District Consumer Court allowed the complaint and directed the surgeon to pay Rs 15 lakh with interest @ 9% from the date of the complaint till the date of payment.

Further, the District Commission also held the petitioner hospital liable for not informing the patient/complainant about the said lapse in the procedure. Apart from this, the Commission held that the hospital had issued a discharge summary cryptically without mentioning the aforesaid lapse, which stood admitted in view of the evidence on record and the admissions made by the doctors themselves.

It was also held that the operation notes had not been provided and the complainant had to file applications under the Right to Information Act and it was much later when the complainant went to his work in Dubai, he experienced pain, whereafter he got himself examined and the radiological reports confirmed the lodging of the splinter metal in his body that was deliberately not informed by the hospital. Accordingly, the hospital was also held liable and was directed to pay a sum of Rs 5.00 Lakhs together with interest.

The hospital and the neurosurgeon challenged the District Commission’s order before the Karnataka State Consumer Court, which upheld the District Commission’s order and dismissed the appeals.

Consequently, the treating hospital filed a revision petition before the NCDRC bench. The counsel for the hospital argued that the hospital was a charitable institution and, therefore, was not liable for any deficiency. It was also submitted that the District Commission had already recorded a finding that even the surgical instruments that were utilised by the doctor during the surgery were not supplied by the hospital and belonged to the doctor alone. Therefore, any negligence by the doctor while performing the surgery could not be saddled as a deficiency against the hospital, argued the top consumer court.

Further, the counsel submitted that all documents had been provided to the complainant, and in fact, there was no evidence to draw any inference of deficiency against the hospital. 

However, the counsel for the complainant urged that the deficiency regarding non-supply of the documents, providing a deficit discharge summary without mentioning the negligence of the doctors, was a deficiency in service.

After going through the District Commission’s orders, as well as the findings recorded by it, the Commission observed that the information regarding the presence of a metallic object that was left behind during surgery was not mentioned in the discharge summary that was admittedly issued by the petitioner hospital.

At this outset, the Commission observed,

“The discharge summary is cryptic and without any indication of the fact of the presence of the metallic object which stood admitted and was left inside the body of the patient. The hospital had the custody of the operation notes and there can be no two opinion that the said notes did indicate the presence of a cut-piece surgical instrument inside the body. Not only this, the patient had been taken inside the operation theatre for the second time and it was the evidence of the doctor before the District Commission that he had informed the complainant/respondent no.1 (patient) about the presence of the metal inside the body immediately after the operation with an assurance that it will not have any side effect. It is therefore evident that the fact of the presence of the metallic object stood admitted by the surgeon being present in the body of the complainant/respondent no.1 and its mention in the operation notes which were in the custody of the petitioner/hospital. The petitioner hospital has been unable to give any explanation as to why the said fact was omitted from being mentioned in the discharge summary of the hospital.”

Opining that the District Commission’s order was justified, the Apex Consumer Court held,

“In our opinion, the District Commission was fully justified in drawing an adverse inference against the petitioner hospital on that count. The negligence of the petitioner hospital in providing a discharge summary which was clearly incomplete and which withheld a material fact affecting the health of the complainant/respondent no.1 was therefore a gross negligence. Not only this, the operation notes were also provided after an attempt was made under the Right to Information Act. This also, in our opinion, was a deficiency on which the District Commission has rightly arrived at a correct conclusion. The findings of the District Commission have been therefore appropriately confirmed in appeals and these findings of fact do not suffer from any perversity or non-consideration of relevant material.”

With this observation, the NCDRC dismissed the review petition.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/ncdrc-upholds-compensation-301953.pdf

Also Read: Nerve injury due to negligence in spinal anaesthesia: Consumer court slaps Rs 3.2 lakh compensation on hospital, doctors