Subthalamic DBS as an Effective Therapy for Parkinson’s Disease: JAMA

A recent trial published in the Journal of American Medical Association found that subthalamic deep brain stimulation (DBS) is an effective therapy for people living with moderate to advanced Parkinson’s disease (PD)

The Implantable Neurostimulator for the Treatment of Parkinson’s Disease (INTREPID) trial tracked outcomes in 313 patients implanted with Boston Scientific’s Vercise DBS system between 2013 and 2022. This study followed participants for 5 years, making it one of the most comprehensive long-term DBS trials to date.

Of the 191 patients who received DBS, 137 completed the 5-year follow-up. At baseline, the participants had significant motor impairment, with average Unified Parkinson’s Disease Rating Scale (UPDRS-III) scores of 42.8 in the “off medication” state. By year one, DBS cut this score nearly in half, down to 21.1, which represented a 51% improvement. While some decline occurred by year 5 the benefit remained strong, with a 36% overall improvement when compared to pre-surgery levels.

The patients began with an average score of 20.6 and saw a 41% improvement in year one, which leveled to a still-significant 22% gain by year five. Also, dyskinesia is a disabling side effect of long-term medication use, dropped from 4.0 at baseline to 1.0 at year one and stabilized at 1.2 after 5 years, which reflected a 70–75% reduction.

The patients reduced their levodopa equivalent doses by 28% in the first year, with this reduction maintained through the 5-year mark. This highlights the potential of DBS to not only improve symptoms but also lower dependence on medications that carry side effects. The most frequent serious adverse event was infection, reported in 9 participants. 10 deaths occurred during the study, though none were related to DBS or the trial itself.

While Parkinson’s disease is progressive, meaning symptoms inevitably worsen over time, the INTREPID results demonstrate that DBS offers sustained and clinically meaningful relief well beyond the initial years of therapy. Overall, these findings reinforce DBS as a standard treatment option for patients with moderate to advanced PD, particularly those struggling with medication fluctuations and uncontrolled motor symptoms.

Source:

Starr, P. A., Shivacharan, R. S., Goldberg, E., Tröster, A. I., House, P. A., Giroux, M. L., Hebb, A. O., Whiting, D. M., Leichliter, T. A., Ostrem, J. L., Metman, L. V., Sani, S., Karl, J. A., Siddiqui, M. S., Tatter, S. B., Haq, I. ul, Machado, A. G., Gostkowski, M., Tagliati, M., … Nazzarro, J. M. (2025). Five-Year Outcomes from Deep Brain Stimulation of the Subthalamic Nucleus for Parkinson Disease. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2025.3373

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Choline Intake Boosts Bone Density in Postmenopausal Women, reveals research

A new study published in Scientific Reports has found that higher dietary choline consumption is linked to greater bone mineral density (BMD) in postmenopausal women, a group highly vulnerable to osteoporosis. Since the accelerated bone loss caused by estrogen deficiency during menopause, identification of modifiable dietary factors such as choline is important for establishing osteoporosis prevention strategies. The study was conducted by Jincheng and colleagues.

The study involved 4,160 postmenopausal women aged 50 years and above with no exclusion based on income or ethnicity. The information was captured in six cycles of the NHANES from 2007 through 2018. Researchers used weighted linear regression models to test how cumulative dietary choline consumption was associated with lumbar spine bone mineral density. The models were completely adjusted for suspected confounders, such as age, race, income level, body mass index (BMI), and comorbidities. Stratified analyses were performed to determine whether socioeconomic and demographic characteristics altered the detected effects.

Key Findings

  • With every 1 g/day higher choline intake, there was a 0.082 g/cm² rise in lumbar spine BMD (β: 0.082, 95% CI: 0.025–0.139).

  • Participants in the highest quartile of choline consumption (Q4) also had a 0.025 g/cm² greater BMD than those in the lowest quartile (Q1) (β: 0.025, 95% CI: 0.007–0.042).

The association was significantly larger in some subgroups:

  • Obese women had a greater effect size of 0.146 g/cm² (95% CI: 0.067–0.220, P interaction = 0.015).

  • High-income women (PIR > 4) experienced a rise in BMD of 0.121 g/cm² (95% CI: 0.013–0.228, P interaction = 0.003).

  • Non-Hispanic White women had a BMD increase of 0.110 g/cm² (95% CI: 0.034–0.185, P interaction = 0.039).

This research yields the first holistic evidence that increased dietary choline is positively associated with higher lumbar spine BMD in postmenopausal women, especially in obese women, high-income populations, and non-Hispanic Whites. These results indicate the promise of choline-focused nutritional interventions for the prevention of osteoporosis in this at-risk population. The role of income and race also highlights the importance of equitable diet interventions able to reach the bone health disparity among aging women.

Reference:

Bai, J., Lv, P., Li, L. et al. Association between total dietary choline intake and lumbar spine bone mineral density in postmenopausal women based on NHANES 2007–2018. Sci Rep 15, 23483 (2025). https://doi.org/10.1038/s41598-025-08891-6

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Opportunistic chest X-rays effective in identifying bone loss risk: Study

A new study published in the Journal of Primary Care & Community Health revealed that it may be possible to detect people at risk of bone loss outside of the conventional screening age range by using chest x-rays opportunistically.

The primary method of osteoporosis screening is dual-energy X-ray absorptiometry (DXA) scans, which measure bone mineral density. Typically, screening doesn’t begin until age 65. In primary care settings, where DXA may not be easily accessible, individuals with osteoporosis risk and symptoms of bone demineralization may be identified by the opportunistic use of chest X-rays taken for other purposes.

Between May 1, 2021, and May 31, 2021, this research performed a cross-sectional assessment of the electronic medical records of patients aged 50 to 65 who underwent a chest X-ray at the emergency room of a sizable Level 1 trauma center in an urban teaching hospital. Based on the X-ray data, they calculated the prevalence of “bone demineralization” and contrasted it with the results of a review by an impartial radiologist.

This research also looked into the clinical and demographic correlates of LBM and estimated the number of persons aged 50 to 65 who may be at risk for the disease using data from the 2020 US population census. This study analyzed 390 patient data, including 201 (51.5%) males and 189 (48.5%) females. A radiologist analysis showed 49 (12.6%) reports with a bone demineralization remark, when compared to 4 (1.0%) reports.

This study predicted that roughly 8.4 million persons in the US population aged 50 to 64 will have bone demineralization, based on a sex-adjusted prevalence of 13.1% (using the direct method, using the 2020 US population as benchmark). In women, LBM was linked to hypertension (OR = 2.41, 95% CI = 1.03-5.64).

Overall, using plain chest radiographs obtained for other causes might offer a way to identify people at risk at little or no additional expense to the patient, even if mass screening for osteoporosis or bone demineralization in all persons aged 50 to 65 is not currently advised. 

Source:

Chinapuvvula, N. R., Hatley, M., Khan, R., Awiwi, M., des Bordes, J., & Rianon, N. (2025). Opportunistic use of chest X-ray for identifying older adults at risk of osteoporosis and not meeting criteria for screening. Journal of Primary Care & Community Health, 16(21501319251353372), 21501319251353372. https://doi.org/10.1177/21501319251353372

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Robot-assisted surgery tied to Higher postoperative Pulmonary Complications versus conventional laparoscopic surgery: Study

Researchers have found in a new cohort study published in JAMA Surgery that patients undergoing robot-assisted surgery were more likely to experience postoperative pulmonary complications compared with those who had conventional laparoscopic procedures, raising important questions about perioperative management in minimally invasive surgery.

The study evaluated outcomes in a large group of patients undergoing abdominal and pelvic operations and specifically examined differences in pulmonary function following robot-assisted versus conventional laparoscopic approaches. Findings revealed that individuals in the robot-assisted surgery group required longer and more intensive mechanical ventilation after surgery, and this increased need for respiratory support appeared to contribute to the higher incidence of pulmonary complications observed.

However, when researchers adjusted for potential confounders, only ventilation duration—not intensity or surgical approach itself—was independently associated with pulmonary complications, suggesting that prolonged ventilation times during robot-assisted procedures may explain the elevated risks rather than the robotic technique alone. This distinction is clinically meaningful, as it emphasizes the role of anesthetic management and ventilatory strategies in reducing pulmonary risks, rather than placing the burden solely on surgical modality choice. The findings also underscore the importance of enhanced intraoperative monitoring, lung-protective ventilation strategies, and careful postoperative respiratory care for patients undergoing robot-assisted operations, particularly given the increasing adoption of robotic platforms in general and subspecialty surgery.

Pulmonary complications remain a leading cause of morbidity after abdominal surgery, and understanding modifiable contributors such as ventilation time provides an avenue for targeted interventions to improve outcomes. While the data indicate that robot-assisted procedures may expose patients to longer anesthetic and ventilation times, they also suggest that optimizing perioperative respiratory management could mitigate risks without negating the potential benefits of robotic technology, such as improved dexterity, visualization, and precision. The authors conclude that further research should evaluate strategies to shorten ventilation duration and assess whether tailored respiratory care protocols can reduce pulmonary complication rates in robot-assisted surgery, ultimately supporting safer integration of robotic systems into surgical practice.

Keywords: robot-assisted surgery, conventional laparoscopic surgery, postoperative pulmonary complications, ventilation, minimally invasive surgery, JAMA Surgery

Reference: JAMA Surgery. Association of Robot-Assisted Surgery With Postoperative Pulmonary Complications Compared With Conventional Laparoscopic Surgery. Published September 17, 2025. DOI: 10.1001/jamasurg.2025.3445.

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Low- and alcohol-free drinks gaining popularity among ‘risky’ UK drinkers

There’s been a significant rise in the use of low- and alcohol-free drinks to curb alcohol intake among “risky drinkers” over the past five years in England, Wales, and Scotland, finds research published in BMJ Public Health.

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SII, Vidal Health join hands on HPV vaccine access

Mumbai:  Serum Institute of India Pvt. Ltd., part of Cyrus Poonawalla Group, and Vidal Health, a 100 percent subsidiary of Bajaj Finserv Health, India’s TPA service provider, have announced a strategic collaboration to enhance cervical cancer prevention and awareness across the country.

Starting October 1, 2025, Vidal Health’s platform will offer an end- to-end, convenient and cashless experience for HPV vaccine – from digitally booking a doctor’s appointment at a preferred location, to providing consent and receiving certification – all with zero paperwork. The fully managed health programme will provide complete support with timely dosage reminders, adherence monitoring, and efficient network management to ensure continuity of care.

Vidal Health is a 100% subsidiary of Bajaj Finserv Health, a digital platform that integrates the fragmented healthcare delivery ecosystem and offers products and services ranging from preventive to prepaid healthcare, including OPD care and telemedicine.

Sanjiv Bajaj, Chairman & Managing Director, Bajaj Finserv, said, “Healthcare in India is experiencing a fundamental shift from reactive, post-illness care to preventive care, driven by awareness and transformative initiatives like Ayushman Bharat. At Bajaj Finserv Health, we are shaping this change by building a digital platform that empowers people to stay healthy, with preventive healthcare at its core. Our collaboration with Serum Institute marks a strong start to our vaccination programme. By equipping individuals and corporates with digital convenience to manage health proactively, we not only help them cut long-term healthcare costs but also contribute to the nation’s sustained well-being.”

Adar Poonawalla, Chief Executive Officer, Serum Institute of India, said, “The HPV vaccine is an important step in preventing cervical cancer, but wider access and awareness are key to its impact. Our collarboration with Vidal Health helps bridge that gap by using technology to deliver the vaccine more efficiently and at scale. This initiative supports our ongoing efforts to make essential vaccines more accessible and improve public health outcomes.”

Neetha Uthaiah, Whole Time Director, Vidal Healthcare Services Ltd, said, “The collaboration with Serum Institute is significant in our journey towards making healthcare inclusive and accessible to all. It enables us to deliver transparent and preventive healthcare, in addition to our existing offering of efficient claims processing and a range of wellness programmes. Through this fully managed programme, we aim to reduce hospitalisations and out-of-pocket medical spends, which are high in India, thus optimising the care ecosystem.”

The initiative brings together healthcare providers, vaccine manufacturers and national digital platforms such as Aarogya Setu. It also broadens the gamut of Vidal Health’s preventive healthcare offering for individuals — allowing it to expand its health-focused solutions to a broader range of preventive care. Vidal Health’s digital platform currently offers doctor consultations, diagnostic tests, health check-ups, wellness programs, and health financing options.

As per the release, The HPV vaccine will be directly available on Vidal Health’s digital platform. The platform will enable digital registration, cashless payment and automated tracking of the multi-dose vaccination schedule. Employees at corporates will have the flexibility to get vaccinated at the work premises or at any Vidal Health partner clinic. The entire health programme has been designed to maximise transparency and adoption across user groups with a pricing that is affordable and inclusive.

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Journal retracts paper on apple cider vinegar and weight loss

BMJ Group has retracted research suggesting that small daily quantities of apple cider vinegar might help people who are overweight or obese to lose weight.

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Drinking any amount of alcohol likely increases dementia risk

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

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Retired Gynaecologist sentenced to 5 years in jail for bribery

Bengaluru: A retired gynaecologist from a government hospital in Tumakuru has been sentenced to five years of rigorous imprisonment and fined Rs 20,000 for allegedly accepting a bribe of Rs 2,000 from a pregnant daily wage worker in February 2021 to perform her delivery.  

The judgment was delivered by a special court for Lokayukta cases, comprising Judge Yasmin Parveen Ladkhan. The judge noted that, despite being a government employee, the doctor demanded money from a financially weak pregnant woman to carry out the delivery. 

The incident dates back to February 2, 2021, when the complainant, a daily wage worker, was brought to the government hospital in labour pain, accompanied by her brother-in-law. 

Also read- Doctor sentenced to 20 years jail for sexually assaulting minor

At that time, the doctor allegedly refused to attend to the complainant unless her brother-in-law paid Rs 3,000 in advance for the delivery. Since the husband of the complainant was away for work, the brother-in-law managed to arrange Rs 2,000 and handed it over to the doctor through a Group D staff member. 

Later, when he questioned the doctor whether it was right to act so ruthlessly during an emergency, which could have affected the pregnant woman and the child. In response, the doctor said that almost every pregnant patient who visits the hospital for delivery pays Rs 3,000. Therefore, he was not an exception. 

To keep the information as evidence, the complainant’s brother-in-law recorded his conversation with the doctor. Later, he filed a complaint with the Lokayukta police on February 4, 2021. 

Following the complaint, the police launched an investigation. The audio recording was sent to the forensic science laboratory, which confirmed that the voices belonged to the doctor and the brother-in-law. Along with other circumstantial evidence, the police filed a chargesheet against the doctor, accusing her of demanding and accepting the bribe. 

After the matter was taken up by the court, Special Public Prosecutor N Basavaraju informed the judge that the case was not a trap and the voice recording was played during the trial. 

Speaking to TOI, Basavaraju said, “The woman was writhing in pain, but that did not affect the doctor. The woman’s husband, also a daily wage worker, was away in the field. Summoned by his brother, he rushed to the hospital. With great difficulty, they arranged a Rs 2,000 bribe, and the brother-in-law handed it over to the doctor through a Group D staffer of the hospital.”

Considering his side, the court sentenced the doctor to five years of rigorous imprisonment and imposed a Rs 20,000 fine. The judge also imposed an additional six months of simple imprisonment in case of payment default.

Also read- 66-year-old doctor sentenced to 3 years jail for molesting minor

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Intermittent energy restriction may improve outcomes in people with obesity and diabetes, suggests study

Intermittent energy restriction, time-restricted eating and continuous energy restriction can all improve blood sugar levels and body weight in people with obesity and type 2 diabetes, according to a study being presented Sunday at ENDO 2025, the Endocrine Society’s annual meeting in San Francisco, Calif.

“This study is the first to compare the effects of three different dietary interventions intermittent energy restriction (IER), time-restricted eating (TRE) and continuous energy restriction (CER) in managing type 2 diabetes with obesity,” said Haohao Zhang, Ph.D., chief physician at The First Affiliated Hospital of Zhengzhou University in Zhengzhou, China.

Although researchers identified improved HbA1c levels, and adverse events were similar across the three groups, the IER group showed greater advantages in reducing fasting blood glucose, improving insulin sensitivity, lowering triglycerides, and strengthening adherence to the dietary interventions.

“The research fills a gap in directly comparing 5:2 intermittent energy restriction with a 10-hour time-restricted eating in patients with obesity and type 2 diabetes. The findings provide scientific evidence for clinicians to choose appropriate dietary strategies when treating such patients,” Zhang said.

Zhang and colleagues performed a single-center, randomized, parallel-controlled trial at the First Affiliated Hospital of Zhengzhou University from November 19, 2021 to November 7, 2024.

Ninety patients were randomly assigned in a 1:1:1 ratio to the IER, TRE or CER group, with consistent weekly caloric intake across all groups. A team of nutritionists supervised the 16-week intervention.

Of those enrolled, 63 completed the study. There were 18 females and 45 males, with an average age of 36.8 years, a mean diabetes duration of 1.5 years, a baseline BMI of 31.7 kg/m², and an HbA1c of 7.42%.

At the end of the study, there were no significant differences in HbA1c reduction and weight loss between the IER, TRE and CER groups. However, the absolute decrease in HbA1c and body weight was greatest in the IER group.

Compared to TRE and CER, IER significantly reduced fasting blood glucose and triglycerides and increased the Matsuda index, a measure of whole-body insulin sensitivity. Uric acid and liver enzyme levels exhibited no statistically significant changes from baseline in any study group.

Two patients in the IER group and the TRE group, and three patients in the CER group, experienced mild hypoglycemia.

The IER group had the highest adherence rate (85%), followed by the CER group at 84% and the TRE group at 78%. Both the IER and CER groups showed statistically significant differences compared with the TRE group.

Zhang said these findings highlight the feasibility and effectiveness of dietary interventions for people who have obesity and type 2 diabetes.

Reference:

Intermittent energy restriction may improve outcomes in people with obesity and type 2 diabetes, The Endocrine Society, Meeting: ENDO 2025.

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