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A new large-scale study published in the Journal of American Medical Association highlighted the increased risk of depressive disorder among patients diagnosed with retinitis pigmentosa (RP) that causes progressive vision loss. This population-based cohort study revealed that individuals with RP face a significantly higher likelihood of developing depressive symptoms when compared to the general population. 

The research analyzed data from the Health Insurance Review and Assessment Service in Korea between 2008 and 2022 and involved 10,879 individuals newly diagnosed with RP from 2011 to 2021. The objective of this research was to examine the link between RP and depressive disorder, particularly in the context of different age groups and sexes.

The study found that the 10-year cumulative incidence rate of depressive disorder in RP patients, which stood at 17.67%. The study also reported that older patients and women with RP were at even higher risk of developing depression. Also, women had a 46% greater risk of depression when compared to men. Additionally, the individuals aged 40 and older were nearly twice as likely to develop depression than the younger RP patients.

The patients were categorized into 3 groups based on their age at diagnosis as under 20 years old, between 20 and 39 years old and 40 years or older. The study then calculated age- and sex-adjusted standardized incidence ratios (SIRs) of depressive disorder by revealing that RP patients had an overall SIR of 1.19 which indicated a 19% higher risk of depression than the general population. This increased risk was present in both men and women, though it was slightly higher in female patients. Age-based analysis showed a trend where the risk of depression was 50% higher than in the general population. The patients aged 60 and older also showed an elevated SIR of 1.25.

The results of this study indicated that individuals with RP who were older adults and women are particularly vulnerable to depression, likely due to the emotional and psychological toll of living with progressive vision loss. These findings highlight the critical need for emotional and mental health support for RP patients, alongside the management of their physical symptoms. Overall, the study emphasized the importance of early detection and treatment of depressive symptoms in RP patients to improve their overall quality of life.

Reference:

Kim, H. R., Lee, N. K., Suh, Y., Lee, C. S., Byeon, S. H., Kim, S. S., Lee, S. W., & Kim, Y. J. (2024). Incidence and Risk of Depressive Disorder in Patients With Retinitis Pigmentosa. In JAMA Ophthalmology. American Medical Association (AMA). https://doi.org/10.1001/jamaophthalmol.2024.3641

Researchers from West China Hospital, Sichuan University, have conducted a study revealing a significant association between COVID-19 and acute kidney disorders (AKD), including acute kidney injury (AKI), that varies over time. The study, led by Dr. Li Chunyang and Dr. Zeng Xiaoxi from the West China Biomedical Big Data Center, was recently published in the journal Health Data Science.

COVID-19, known for its impact on the respiratory system, also affects other organs, including the kidneys. The study aimed to investigate the time-dependent effects of COVID-19 on acute kidney disorders. Using data from the UK Biobank, the researchers conducted a matched cohort study and a Mendelian randomization analysis to explore both the association and potential causality between COVID-19 and AKD.

“Our research highlights the time-varying risk of acute kidney disorders in COVID-19 patients, particularly in the first three weeks following infection,” said Dr. Li Chunyang, a research associate at the West China Biomedical Big Data Center, West China Hospital, Sichuan University. “We observed that the hazard effects peak in the second week post-infection and decline by the fourth week.”

The study involved 10,121 COVID-19 patients matched with 29,004 unexposed historical controls based on age, sex, deprivation index, and hospitalization status. A conditional and time-varying Cox proportional hazard regression model was used to assess the association between COVID-19 and AKD within four weeks of infection. The results indicated that the risk of AKD peaked during the second week after infection (hazard ratio, 12.77; 95% confidence interval, 5.93–27.70) and decreased by the fourth week (hazard ratio, 2.28; 95% confidence interval, 0.75–6.93).

The study also found that only patients with moderate to severe COVID-19 showed a significant risk of acute worsening of renal function. This risk was not observed in patients with mild COVID-19. A one-sample Mendelian randomization analysis further demonstrated a potential “short-term” causal effect of COVID-19 on AKD risk, primarily confined to the first week after infection.

The findings suggest that healthcare providers should closely monitor kidney function in COVID-19 patients, particularly those with moderate to severe cases, during the critical first few weeks after infection. The study provides important insights into the temporal nature of COVID-19’s impact on kidney health, which may guide clinical management and follow-up strategies.

Looking ahead, the research team plans to further explore the time-varying impact of COVID-19 on the risk of incident acute kidney disorders in East Asian populations. Additionally, they aim to investigate the underlying molecular mechanisms that may link COVID-19 to subsequent acute kidney disorders to establish more definitive causal pathways.

“The molecular mechanisms behind the association between COVID-19 and kidney damage remain unclear,” added Dr. Zeng Xiaoxi, an associate professor in the Nephrology Department at West China Hospital. “Our future research will focus on elucidating these mechanisms and verifying causality, which could pave the way for targeted interventions.”

Reference:

Chunyang Li, Chao Zhang, Jie Chen, Yilong Chen, Zhiye Ying, Yao Hu, Huan Song, Ping Fu, Xiaoxi Zeng. The Time-Varying Impact of COVID-19 on the Acute Kidney Disorders: A Historical Matched Cohort Study and Mendelian Randomization Analysis. Health Data Sci. 2024;4:0159.DOI:10.34133/hds.0159.

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

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