Vitamin D increases likelihood that breast cancer will disappear with chemotherapy: Study

A study conducted at the Botucatu School of Medicine at São Paulo State University (FMB-UNESP) in Brazil has shown that low-dose vitamin D supplementation can increase the effectiveness of chemotherapy treatment in women with breast cancer. The results suggest that the substance could be an alternative to hard-to-access drugs that also aim to increase the response to chemotherapy.

The research, supported by FAPESP, involved 80 women over the age of 45 who were about to start treatment at the oncology outpatient clinic of the general and teaching hospital (“Hospital das Clínicas”) at FMB-UNESP. They were separated into two groups: 40 of them took 2,000 IU (international units) of vitamin D a day, while the other 40 received placebo tablets.

After six months of cancer treatment and supplementation, 43% of participants using vitamin D saw their disease disappear with the use of chemotherapy, compared to 24% of the placebo group. All the participants in the study underwent so-called neoadjuvant chemotherapy, which is used to facilitate surgery to remove the tumor.

“Even with a small sample of participants, it was possible to observe a significant difference in the response to chemotherapy. In addition, the dosage used in the research [2,000 IU per day] is far below the target dose for correcting vitamin D deficiency, which is usually 50,000 IU per week,” says Eduardo Carvalho-Pessoa, president of the São Paulo Regional Brazilian Society of Mastology and one of the authors of the article published in the journal Nutrition and Cancer.

Immunity

Vitamin D is a hormone that aids in the absorption of calcium and phosphorus, which is essential for bone health. Recent studies have shown that it also plays an important role in the immune system by helping to fight infections and diseases, including cancer. However, most studies linking cancer and vitamin D supplementation have used high doses of the substance.

This hormone is obtained primarily through exposure to sunlight and food. The recommended daily intake is 600 IU for those who are not deficient in the vitamin, and 800 IU a day for older people. The American Academy of Pediatrics recommends 400 IU of vitamin D per day for babies. It is important to note that too much can be toxic and cause vomiting, weakness, bone pain, and kidney stones.

Most of the participants in the study had low levels of vitamin D, defined as less than 20 nanograms per milliliter (ng/mL) of blood. The Brazilian Society of Rheumatology recommends levels between 40 and 70 ng/mL. “With supplementation, levels increased throughout chemotherapy treatment, which reinforces a possible contribution to the patients’ recovery,” Carvalho-Pessoa told Agência FAPESP. “Vitamin D is an accessible and inexpensive option compared to other drugs used to improve the response to chemotherapy, some of which are not even included in the list of the Unified Health System [the Brazilian national public health network, known as the SUS, its acronym in Portuguese],” he adds.

For the researcher, the findings pave the way for further investigation into the auxiliary role of the substance in the response to cancer treatment. “These are encouraging results that justify a new round of studies with a larger number of participants. This will allow a greater understanding of the role of vitamin D in increasing the response to chemotherapy treatment and, consequently, in the greater likelihood of breast cancer remission,” he concludes.

Reference:

Omodei, M. S., Chimicoviaki, J., Buttros, D. A. B., Almeida-Filho, B. S., Carvalho-Pessoa, C. P., Carvalho-Pessoa, E., … Nahas, E. A. P. (2025). Vitamin D Supplementation Improves Pathological Complete Response in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Randomized Clinical Trial. Nutrition and Cancer, 77(6), 648–657. https://doi.org/10.1080/01635581.2025.2480854

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FDA Approves Clesrovimab to Prevent RSV in Infants

The FDA has approved clesrovimab, marketed as Enflonsia, for the prevention of RSV lower respiratory tract disease in neonates and infants during their first RSV season.

ENFLONSIA is a preventive, long-acting monoclonal antibody (mAb) designed to provide direct, rapid and durable protection through 5 months, a typical RSV season, with the same 105 mg dose regardless of weight. A typical RSV season usually spans autumn to spring of the next year.

“RSV disease is the leading cause of infant hospitalization in the U.S. and can lead to serious respiratory conditions like bronchiolitis and pneumonia,” said Dr. Octavio Ramilo, chair of the Department of Infectious Diseases at St. Jude Children’s Research Hospital and investigator for the CLEVER (MK-1654-004) and SMART (MK-1654-007) trials. “ENFLONSIA combines dosing convenience with strong clinical data showing significant reductions in RSV disease incidence and hospitalizations, making it a promising new intervention to help protect infants from RSV.”

ENFLONSIA should not be administered to infants with a history of serious hypersensitivity reactions, including anaphylaxis, to any component of ENFLONSIA. See additional Selected Safety Information below.

The approval is based on results from the pivotal Phase 2b/3 CLEVER trial (MK-1654-004) evaluating a single dose of ENFLONSIA administered to preterm and full-term infants (birth to 1 year of age). The trial met its primary and key secondary endpoints, as outlined below.

• ENFLONSIA demonstrated a reduction in incidence of RSV-associated medically attended lower respiratory infections (MALRI) requiring ≥1 indicator of lower respiratory infection (LRI) or severity compared to placebo through 5 months (primary endpoint) by 60.5% (95% CI: 44.2, 72.0, p<0.001) (incidence rates: ENFLONSIA, 0.026; placebo, 0.065).

• ENFLONSIA demonstrated a reduction in RSV-associated hospitalizations through 5 months (key secondary endpoint) by 84.3% (95% CI: 66.7, 92.6, p<0.001) (incidence rates: ENFLONSIA, 0.004; placebo, 0.024), showing increasing efficacy with increasing disease severity.

The approval is also supported by results from the Phase 3 SMART trial (MK-1654-007) evaluating the safety and efficacy of ENFLONSIA versus palivizumab in infants at increased risk for severe RSV disease.

“ENFLONSIA provides an important new preventive option to help protect healthy and at-risk infants born during or entering their first RSV season with the same dose regardless of weight,” said Dr. Dean Y. Li, president, Merck Research Laboratories. “We are committed to ensuring availability of ENFLONSIA in the U.S. before the start of the upcoming RSV season to help reduce the significant burden of this widespread seasonal infection on families and health care systems.”

The U.S. Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices is expected to meet later this month to discuss and make recommendations for the use of ENFLONSIA in infants. Ordering is anticipated to begin in July, with shipments delivered before the start of the 2025-2026 RSV season.

About ENFLONSIA™ (clesrovimab-cfor)

ENFLONSIA (clesrovimab-cfor) is Merck’s extended half-life monoclonal antibody (mAb) indicated for passive immunization for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in newborns and infants who are born during or entering their first RSV season. ENFLONSIA is administered using non-weight-based dosing and is designed to provide direct, rapid and durable protection through 5 months, a typical RSV season. For infants born during the RSV season, ENFLONSIA is to be administered starting from birth. For infants born outside of the RSV season, ENFLONSIA should be administered prior to the start of their first RSV season. For infants undergoing cardiac surgery with cardiopulmonary bypass during or entering their first RSV season, an additional 105 mg dose is recommended as soon as the infant is stable after surgery.

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Cast immobilization effective in treating pediatric medial epicondyle fractures: JAMA

A new study published in the Journal of American Medical Association showed that casting by itself was just as successful as surgery in treating youngsters with medial epicondyle fractures.

A fall on an outstretched hand usually causes medial humeral epicondyle fractures, which account for 12% to 20% of all pediatric elbow fractures and have an incidence of three or more per 100,000 children. With the exception of situations in which the fragment becomes lodged in the elbow joint, when surgery is usually advised, there is presently little agreement on how to treat displaced medial epicondyle fractures in children.

Traditional nonoperative treatment for displaced children’s medial humeral epicondyle fractures involves casting. Nevertheless, even though there is little high-level data to support the benefits of surgery, its usage has expanded. Thus, to ascertain if open surgical reduction and internal fixation, as opposed to extended arm casting, enhance functional outcomes in children with displaced medial humeral epicondyle fractures at 12 months post-injury, Petra Grahn and team carried out this study.

Between August 30, 2019, and August 22, 2023, four university hospitals in Finland participated in this noninferiority randomized clinical study. A 12-month follow-up was finished on August 20, 2024. Children (ages 7–16) with medial humeral epicondyle fractures that were not imprisoned and that had more than 2 mm of displacement were among the participants. Intention to treat served as the foundation for data analysis. The Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) score at 12 months was the main result.

A total of 37 patients (19 [51.4%] female) were randomly assigned to the surgery group, while 35 patients (24 [68.6%] female) were assigned to the cast group. The surgery group’s mean QDASH score at 12 months was 1.73, whereas the cast group’s was 2.71, indicating noninferiority.

There was a statistically significant difference of −8.9 points between the cast group and the other group on the cosmetic visual analog scale. Nearly, 24 out of 35 patients who had cast treatment (68.6%) and 1 out of 37 patients who received surgery (2.7%) experienced nonunion. There were no crossovers from casting to surgery.

Overall, for pediatric patients with displaced humeral medial epicondyle fractures, internal fixation and open reduction were not inferior to casting without reduction. Future research should evaluate long-term results throughout adolescence, especially elbow function under load and late instability, even if this experiment offers compelling evidence for one year.

Source:

Grahn, P., Helenius, I., Hämäläinen, T., Kivisaari, R., Nietosvaara, Y., Sinikumpu, J.-J., Jalkanen, J., Löyttyniemi, E., Ahonen, M., & Finnish Pediatric Orthopedic Study Group Investigators. (2025). Casting vs surgical treatment of children with medial epicondyle fractures: A randomized clinical trial. JAMA Network Open, 8(5), e258479. https://doi.org/10.1001/jamanetworkopen.2025.8479

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Chronic Hepatitis B May Raise Risk of Pre-eclampsia and Eclampsia, Genetic Study Finds

China: A recent study published in the Journal of Obstetrics and Gynaecology has found compelling genetic evidence suggesting that chronic hepatitis B (CHB) infection significantly raises the risk of developing pre-eclampsia and eclampsia during pregnancy. The findings, stemming from a Mendelian randomization (MR) analysis, emphasize the importance of early hepatitis B virus (HBV) screening and personalized maternal care in affected women.

The study was led by Rui Pu and colleagues from Zhejiang University School of Medicine, China. Using genetic data from large-scale population cohorts, the researchers aimed to explore whether a causal relationship exists between CHB infection and hypertensive complications during pregnancy, namely pre-eclampsia, a condition marked by high blood pressure and organ dysfunction, and eclampsia, a severe progression involving seizures.

To investigate this potential link, the team employed a two-sample MR approach, utilizing genome-wide association study (GWAS) summary statistics. CHB-related genetic data were obtained from the UK Biobank involving over 350,000 individuals. The outcome data for pre-eclampsia and eclampsia were drawn from two large Finnish datasets (FinnGen), comprising over 118,000 and 126,000 participants, respectively.

The key findings of the study were as follows:

  • Women with a genetic predisposition to chronic hepatitis B (CHB) infection had a 15% higher risk of developing pre-eclampsia (OR = 1.15).
  • These women also had a 56% higher risk of developing eclampsia (OR = 1.56).
  • The associations were statistically significant.
  • The findings remained consistent across multiple sensitivity analyses, supporting the reliability of the results.

“The study provides genetic support for a causal link between chronic hepatitis B infection and increased susceptibility to pregnancy-related hypertensive disorders,” the authors noted. They further stressed that these findings could have important clinical implications for maternal healthcare, especially in regions with high HBV prevalence.

The research suggests that including hepatitis B status in maternal risk assessments could help identify women at greater risk of developing pre-eclampsia or eclampsia. Early screening for HBV in women of childbearing age and enhanced antenatal surveillance, such as regular monitoring of blood pressure and protein levels in urine, may play a key role in reducing complications.

The authors also advocate for integrating CHB status into future obstetric risk-prediction models. By doing so, healthcare providers can deliver more individualized care plans for pregnant women living with CHB, thereby potentially improving both maternal and fetal outcomes.

As plant-based diets, lifestyle diseases, and viral infections increasingly intersect in global health, this study emphasizes the importance of a multidisciplinary approach to maternal care, one that considers both infectious and genetic risk factors for optimal pregnancy management.

Reference:

Pu, R., Wang, Z., Shang, X., Lu, J., Xu, J., & Xing, Y. (2025). Chronic hepatitis B infection and pre-eclampsia/eclampsia: a Mendelian randomisation study. Journal of Obstetrics and Gynaecology, 45(1). https://doi.org/10.1080/01443615.2025.2500972

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Phentolamine Eye Drops Improve Night Driving Post-Refractive Surgery in Phase 3 trial

Researchers have found in a phase 3 trial that phentolamine ophthalmic solution 0.75% led to significant improvements in mesopic low contrast distance visual acuity and patient-reported night driving ability within 15 days.

The treatment will be available by prescription only.

Opus Genetics, Inc. (Nasdaq: IRD), a clinical-stage biopharmaceutical company developing gene therapies for the treatment of inherited retinal diseases (IRDs) and small molecule therapies for other ophthalmic disorders, announced positive topline results from LYNX-2, a pivotal Phase 3 clinical trial evaluating Phentolamine Ophthalmic Solution 0.75% for the treatment of significant, chronic night driving impairment in keratorefractive patients with reduced mesopic vision.

Patients who undergo keratorefractive procedures such as Laser-Assisted In Situ Keratomileusis (LASIK), Photorefractive Keratectomy (PRK), Small-Incision Lenticule Extraction (SMILE) and Radial Keratotomy (RK), often experience vision disturbances including glare, halos and starbursts, due to increased optical aberrations and light scatter under low-light (mesopic), low-contrast conditions.

These disturbances can significantly impair night driving and daily functioning in dim environments. Phentolamine Ophthalmic Solution 0.75% is designed to reduce pupil diameter through a sympatholytic mechanism of action that avoids engaging the ciliary muscle, potentially reducing risks such as retinal tears or detachment associated with older parasympathomimetic agents.

The LYNX-2 study met its primary endpoint of a gain of three lines (or 15 letters) or more of distance vision improvement on a low contrast chart in low light conditions after 15 days of dosing. In the study, 17.3% of patients treated with Phentolamine Ophthalmic Solution 0.75% achieved a ≥15-letter Early Treatment Diabetic Retinopathy Study (ETDRS) (≥ 3-line) improvement in Mesopic Low Contrast Distance Visual Acuity (mLCVA) at Day 15, compared to 9.2% in the placebo group (p<0.05).

“In LYNX-2, Phentolamine Ophthalmic Solution 0.75% delivered a statistically significant primary endpoint. In addition, patient-reported outcome results demonstrated improvements in night-driving vision, enabling patients to function more effectively in low-light, low-contrast conditions,” said George Magrath, MD, CEO, Opus Genetics. “This data builds on earlier results from the LYNX-1 trial and provides evidence of efficacy for this condition, which currently has no FDA-approved therapies. We believe this therapy could address a true unmet need and could offer meaningful benefits to keratorefractive patients experiencing glare, halos, and reduced functional vision in low-light, low-contrast environments.”

“The positive results from the LYNX-2 trial reinforce the potential of Phentolamine Ophthalmic Solution 0.75% as a first-in-class treatment for keratorefractive patients with vison disturbances under low-light conditions,” said Jay Pepose, MD, PhD, Chief Medical Advisor, Opus Genetics. “After just 15 days of treatment, 17% of patients with dysphotopsia following keratorefractive surgery achieved at least 15-letter gain in mesopic low contrast distance vision. Importantly, we also saw functional improvements in difficulty of seeing the road because of oncoming headlights; and difficulty seeing due to glare when driving at dawn or dusk, as reported by patients in the trial.”

LYNX-2 Phase 3 Study

LYNX-2 was a randomized, double-masked, placebo-controlled Phase 3 trial evaluating the safety and efficacy of Phentolamine Ophthalmic Solution 0.75% in 199 patients who had previously undergone keratorefractive surgery and reported decreased visual acuity under mesopic low contrast conditions, and who were randomized to receive either Phentolamine or placebo, self-administered in both eyes, nightly, treated and observed over 6 weeks. The mITT Population includes all randomized patients who received at least one dose of study medication and was used for the primary endpoint analysis and to analyze efficacy endpoints. The trial was conducted under a Special Protocol Assessment (SPA) agreement with the U.S. FDA.

Top-Line Results:

The primary endpoint was defined as the percentage of patients achieving a ≥15-letter ETDRS (≥3-line) improvement in mesopic low contrast distance visual acuity (mLCVA).

17.3% of patients in the Phentolamine arm achieved ≥15-letter ETDRS (≥3-line) gain in mLCVA at Day 15, compared to 9.2% of those receiving placebo (p<0.05).

Patient-reported benefit was observed at Day 15 in difficulty of seeing the road because of oncoming headlights and difficulty seeing due to glare when driving at dawn or dusk, in patients taking Phentolamine Ophthalmic Solution 0.75% compared to placebo (p<0.05) when assessed by the validated Vision and Night Driving Questionnaire (VND-Q).

As per the pre-specified testing, no evidence of tachyphylaxis out to Week 6 of dosing.1

Phentolamine Ophthalmic Solution 0.75% demonstrated a safety profile consistent with previous trials, with no new safety signal identified.

LYNX-2 patients will continue to be monitored for long-term safety over 48 weeks. Additional details on the study design can be found at ClinicalTrials.gov (NCT06349759).

Opus Genetics and Viatris (through its affiliate) are parties to a global licensing agreement which provides for the development of Phentolamine Ophthalmic Solution 0.75% and grants exclusive rights to Viatris to commercialize Phentolamine Ophthalmic Solution 0.75% in the U.S.

1 The study is also designed to examine tachyphylaxis of the therapeutic response to Phentolamine Ophthalmic Solution 0.75% for mLCVA. This was to be achieved by comparing change from Baseline at Week 6 in the Phentolamine Ophthalmic Solution 0.75% group to the best change from baseline achieved during the first month of treatment for mLCVA.

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Study Finds Significant Link Between Serum Magnesium Levels and Carotid Atherosclerosis in hemodialysis patients

Researchers in a new study have found significant association between serum magnesium (Mg) levels and carotid intima-media thickness (CIMT), suggesting a connection between magnesium levels and carotid atherosclerosis.

They aimed to examine whether serum magnesium level is related to cardiovascular events in hemodialysis patients by investigating the relationship between serum magnesium (Mg) level and carotid intima media thickness (CIMT). In this cross-sectional study, we evaluated 88 hemodialysis patients. The mean CIMT of these patients was measured and recorded by doppler ultrasonography. Patients were divided into two groups according to their serum magnesium level. Correlation analysis and linear regression analysis were used to define the relationship between study parameters. We divided our patients into 2 groups according to Mg value as group 1 (Mg ≥ 2.3 mg/dl) and group 2 (Mg < 2.3 mg/dl). Results: The mean CIMT of patients with group 1 and group 2 were respectively 0.93 ± 0.22 mm and 1.03 ± 0.22 mm. There was statistically significant difference between two groups in terms of the mean CIMT value (p = 0.045). We found negative, low-level, statistically significant correlations between Mg and mean CIMT ​​(r=-0.272; p = 0.010), calcium and mean CIMT (r: -0.221, p: 0.039) and hemoglobin and mean CIMT (r: -0.215, p: 0.044). According to regression analysis, serum magnesium level and age were found independent risk factors for mean CIMT value (p: 0.004 and p: 0.045). They found a significant relationship between serum Mg level and CIMT, which indicates carotid atherosclerosis.

Reference:

Kara, A.V., Ozdemir, R., Inan, H. et al. Effect of serum magnesium level on carotid intima media thickness in hemodialysis patients. BMC Nephrol 26, 270 (2025). https://doi.org/10.1186/s12882-025-04168-2

Keywords:

Study, Finds, Significant, Link, Between, Serum, Magnesium, Levels, Carotid Atherosclerosis, Kara, A.V., Ozdemir, R., Inan, H, Hemodialysis, Magnesium, Carotid intima-media thickness, Cardiovascular disease

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Continuous exercise may immediately lower glucose levels regardless of Menstrual Cycle Phase, finds study

Researchers have found in a new study Continuous exercise (CONT) immediately lowers glucose levels regardless of the menstrual phase. However, time in range (TIR) remains stable during the follicular phase but declines during the luteal phase, leading to increased hyperglycemia. This suggests that exercise-induced glucose control varies with menstrual phases and may require insulin dose adjustments accordingly. This study was published in Diabetes Research and Clinical Practice by Rodrigo M. and colleagues.

The study aimed to evaluate the effects of continuous moderate-intensity aerobic exercise (CONT) on glycemic control in women with T1D during different phases of the menstrual cycle. A total of 25 women with T1D were enrolled and completed two separate 30-minute CONT sessions, one during the follicular phase and another during the luteal phase of their menstrual cycles.

Glycemic control was also measured both in the session during exercise with plasma glucose levels and at 24 hours after exercise by continuous glucose monitoring (CGM). The research aimed at determining how the levels of blood glucose varied during exercise and tracked episodes of hypoglycemia and hyperglycemia in the post-exercise hours, based on the menstrual cycle stage.

Key Findings

The research offered obvious numerical findings concerning the relationship of exercise and menstrual phases in females with T1D:

  • At both phases, blood glucose concentration decreased from the baseline value around 155 mg/dL to 110 mg/dL post-30 min CONT, displaying a reliable transient glucose-lowering effect of exercise.

  • The frequency of hypoglycemia within the 24 hours after exercise was extremely low, <2%, in both phases of menstruation, and this suggests adequate short-term safety of CONT in this group.

  • In contrast, the luteal phase demonstrated an increase in hyperglycemia from 38.2% to 44.2% within the 24 hours after exercise, and this indicates a deteriorating glucose control in this phase.

  • In comparison to the follicular phase, increased mean blood glucose levels were noted in the luteal phase after exercise, indicating the effect of hormonal changes on post-exercise glucose control.

  • Time-in-range (TIR) was maintained after exercise during the follicular phase but decreased during the luteal phase, supporting the necessity for individualized insulin approaches according to menstrual cycle phases.

This research confirmed that regular moderate-intensity aerobic exercise reduces blood glucose levels right away in women with type 1 diabetes across all menstrual cycle phases. Although glucose stability following exercise is ensured in the follicular phase, hyperglycemia increases and TIR decreases during the luteal phase. These observations indicate that menstrual cycle phases impact exercise-induced glucose control and note the possibility that insulin therapy must be tailored by menstrual phase in order to maximize safety and efficacy in physically active women with T1D.

Reference:

Agustín, R. M.-S., del Pino, A. C., Laguna Sanz, A. J., Rossetti, P., Bondia, J., & Ampudia-Blasco, F. J. (2025). Impact of continuous moderate-intensity aerobic exercise on glycemic control according to different phases of the menstrual cycle in females with type 1 diabetes. Diabetes Research and Clinical Practice, 112192, 112192. https://doi.org/10.1016/j.diabres.2025.112192

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Machine learning model helps identify patients at risk of postpartum depression

Postpartum depression (PPD) affects up to 15 percent of individuals after childbirth. Early identification of patients at risk of PPD could improve proactive mental health support. Mass General Brigham researchers developed a machine learning model that can evaluate patients’ PPD risk using readily accessible clinical and demographic factors. Findings demonstrating the model’s promising predictive capabilities are published in the American Journal of Psychiatry.

“Postpartum depression is one of the biggest challenges that some parents may experience in the period after childbirth – a time when many cope with sleep deprivation, new stresses, and significant life changes,” said lead author Mark Clapp, MD, MPH, of the Department of Obstetrics and Gynecology at Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system. “Persistent feelings of sadness, depression, or anxiety can be more common than many people realize. Our team, under the leadership of Dr. Roy Perlis, undertook this work to better understand which patients may be at higher risk of PPD to help us facilitate strategies and solutions to either prevent PPD or reduce its severity.”

Typically, PPD symptoms are evaluated at postpartum visits, which occur 6-to-8 weeks post-delivery. As a result, many parents may struggle for several weeks before receiving mental health support. To help deliver earlier PPD care, the researchers designed a model that requires only information readily available in the electronic health record (EHR) at the time of delivery, including data on demographics, medical conditions, and visit history. This model weighs and integrates these complex variables to more accurately evaluate PPD risk.

To develop and validate the model, the authors used information from 29,168 pregnant patients who delivered at two academic medical centers and six community-based hospitals in the Mass General Brigham system between 2017 and 2022. In this cohort, 9 percent of patients met the study’s criteria for PPD in the six months following delivery.

The researchers used health record data from approximately one-half of the patients to train the model to identify PPD. They then tested the model by asking it to predict PPD in the other half of the patients. The researchers found that the model was effective in ruling out PPD in 90 percent of cases. The model showed promise in predicting PPD: nearly 30 percent of those predicted to be high risk developed PPD within the six months after delivery. The model was about two to three times better at predicting PPD than estimating based on the general population risk.

In further analyses, the researchers showed that the model performed similarly regardless of race, ethnicity, and age at delivery. The study included only those without a previous psychiatric diagnosis to determine if the model can predict PPD even among low-risk patients and to better understand the risk factors that influence PPD outside of prior psychiatric diagnoses. Notably, scores on the Edinburgh Postnatal Depression Scale acquired in the prenatal period improved the predictive capabilities of the model, highlighting that this existing tool may be useful both pre- and post-delivery.

The researchers are prospectively testing the model’s accuracy, an essential step toward real-world use, and working with patients, clinicians and stakeholders to determine how information derived from the model might best be incorporated into clinical practice.

“This is exciting progress toward developing a predictive tool that, paired with clinicians’ expertise, could help improve maternal mental health,” Clapp said. “With further validation, and in collaboration with clinicians and patients, we hope to achieve earlier identification and ultimately improved mental health outcomes for postpartum patients.”

Reference:

Mark A. Clapp, Stratifying Risk for Postpartum Depression at Time of Hospital Discharge, American Journal of Psychiatry, https://doi.org/10.1176/appi.ajp.20240381.

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Medical Students Evacuated from Iran

Karnataka- 126 students from Karnataka stranded in Iran have been evacuated and brought to Turkmenistan. The 126 people were divided into two batches, the first batch has already landed in Bengaluru on Thursday, and the second will arriveon  Friday.

The move comes after a forum was written to the Ministry of External Affairs and the Indian Embassy in Tehran, urging them to take immediate steps to evacuate the stranded people to safe places and bring them back to Karnataka.

Also Read: Physiotherapist dies after speeding car skids in Mangaluru

On this, the Indian government launched an Operation called “Sindhu” to evacuate Indians from Iran and Israel, therefore, Indians started arriving in India from Thursday morning.

Meanwhile, in this regard, Dr Arathi Krishna, Vice President of the Non-Resident Indian Forum of the Government of Karnataka, said, “The 126 people evacuated include medical students, tourists and people who went on pilgrimage in Iran. They contacted the NRI Forum and sought help. We coordinated, made arrangements and they were evacuated from Iran”, quoted EdexLive.

Dr Aarti further informed that on Thursday, June 19, these people were in Turkmenistan, from where they will be brought to Karnataka. The first batch was scheduled to land in the state on Thursday, while the second batch is expected to arrive by Friday. Meanwhile, she also said that the Forum has not received any call from Israel yet.

Along with this, Aarti’s Officer on Special Duty HS Satish said, “The students who were in Qom (city of Iran) have now been shifted to Mashad. The embassy is making all preparations to evacuate them. However, those who had gone for religious studies have not yet reached Mashad and efforts are being made by the embassy.”

Also Read: Beware of Fraudsters: Karnataka Minister Warns MBBS Aspirants Against Fake Medical Seat Promises

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‘Doctors are not slaves’, State cannot force service if bond is paid: HC

Shimla: Observing that ‘doctors are not slaves’, the Himachal Pradesh High Court recently directed the State Government to give a No Objection Certificate (NOC) to a doctor for pursuing a super-speciality course.

The doctor was posted as a Senior Resident at the Radiotherapy department of Pt. Jawahar Lal Nehru Government Medical College (PJLNGMC), Chamba. After clearing the National Eligibility-Entrance Test (NEET) super speciality 2025 exam, the doctor applied for a NOC from the institute, and his request was rejected.

While the State argued that the denial of granting NOC to the doctor was in the interest of Public Interest, the HC bench comprising Justice Sandeep Sharma observed that if the petitioner doctor submitted an undertaking that after completing the Super Speciality Course, he would not only join State service as a Super Specialist but would also complete his remaining bond tenure, “no prejudice shall be caused to the respondents rather public at large would be benefited at later stage.”

Accordingly, the Court ordered, “Respondents are directed to issue No Objection Certificate as well as Original MBBS Degree…, enabling him to join Super Specialty Course in the institution concerned subject to his furnishing amount of Rs. 40,00,000/- within a period of one week in the bank account of the Director Health Services, details wherein shall be furnished by the respondents to the petitioner and furnishing copy of undertaking given to this Court.”

After completing his MBBS degree, the petitioner doctor was appointed as a Medical Officer on a contractual basis in the Radiotherapy department. Consequently, the petitioner was selected for the PG course in Radiation Oncology/Radiotherapy at IGMC, Shimla, against the in-service quota. At the time of admission, the petitioner submitted a Rs 40 lakh bond undertaking to serve for four years after completing the PG Course. Results of the PG Course were declared, and the State gave posting to the petitioner as a Medical Officer in PJLNGMC&H, Chamba, and he worked there from 12.09.2023 till 04.12.2023. Thereafter, the petitioner was appointed as Senior Resident at USPGMC&H Nahan. But, after some time, he was again posted at PJLNGMC&H, Chamba as Senior Resident.

The petitioner had been working as a Senior Resident there for more than one year and nine months. Meanwhile, completing the PG medical course, the petitioner appeared in the NEET SS 2024 exam and cleared it; he was allotted an All India Quota seat for DNB SS Medical Oncology in the first round of counselling. 

On 24.05.2025, the petitioner submitted a representation to the authorities seeking an NOC to pursue a three-year DNB SS Medical Oncology Course. However, the authorities rejected the grant of NOC/Sponsorship for the DNB SS Course on the ground that he had not completed the mandatory field posting of one year after completion of the Post-Graduation Course. 

Even though the petitioner promised to serve the State after completing the course and completing the remaining bond period, his request for the NOC was rejected. Therefore, the petitioner was forced to submit an unconditional resignation.

Approaching the High Court, the petitioner doctor claimed that with the allotment of the DNB seat, he got a once in a life time opportunity, which he could not miss. He also argued that securing the seat would help the State in times to come.

While considering the case, the Court on 03.06.2025 ordered the authorities to take note of the fact that the petitioner had already completed Senior Residency and was willing to serve the State by completing his bond period, after doing a Super Speciality Course, and to deposit the bond money.

However, the State submitted that after completing his PG course, the doctor only completed 94 days (three months and four days) period out of one year mandatory field posting, and a period of eight months and 26 days of mandatory field posting was still pending to be completed by the petitioner including the other requisite bonded service of four years. On this ground, they had not granted the NOC to the petitioner.

The counsel for the State, Advocate General, also pointed out that there was an acute shortage of doctors in the State of Himachal Pradesh and therefore the prayed of the petitioner could not be accepted. He also submitted that it might not be in the interest of public at large to permit the petitioner to join Super Speciality Course that too without him completing the bond period.

The HC bench observed at this outset,

“No doubt, in terms of bond furnished by the petitioner, he is bound to serve the State of Himachal Pradesh for four years after his completing PG Course but bond condition also provides that in case petitioner or person responsible for executing the bound fails to serve the State of Himachal Pradesh for prescribed period, bond money shall be forfeited, which otherwise stands deposited by way of undated cheques. Meaning thereby, bond though makes it mandatory for bond executant to serve the State of Himachal Pradesh for four years, but in case he/she fails to do so, bond money deposited in the shape of undated cheques can be forfeited. In the case at hand, petitioner has given two options. He, while making offer to deposit Rs.40,00,000/- has agreed to come back to the State of Himachal Pradesh after completion of Super Specialty Course for joining services or in alternative, he has prayed that his resignation may be accepted and sum of Rs.40,00,000/- agreed to be deposited by him may be forfeited.”

Noting that doctors cannot be forced to work after submitting the bond money, the HC bench further observed,

“No doubt, this Court cannot lose sight of the fact that there is a shortage of doctors in State of Himachal Pradesh but that cannot be sole ground to stop progression of individual who after his having PG course wants to do Super Specialty that too at his own expense. Petitioner herein has already served State of Himachal Pradesh for one year and nine months after his having completed PG Course, meaning thereby, he has still left to serve the State of Himachal Pradesh for two years under bond, which he is ready and willing to do after completion of Super Specialty but as has been observed hereinabove, aforesaid proposal is not acceptable to the State of Himachal Pradesh. In that eventuality, second proposal given by the petitioner with regard to acceptance of his unconditional resignation otherwise cannot be turned down by the State of Himachal Pradesh on the ground that there is shortage of doctors. Needless to say, once bond money is deposited, person concerned cannot be compelled to work against his wishes.”

The bench noted that the High Court in the case of Ajay Kumar Chauhan v. State of Himachal Pradesh had noted that “in case an employee is not willing to serve the department, he cannot be forced to do so.” In the case of Dr. Trilok Chand v. Union of India and Anr., the Court had ruled that shortfall of vacancy cannot be a valid ground for the State to deny NOC.

The bench further noted that in another case titled State of Himachal Pradesh and others Vs. Lovdeep Singh and others, the Court had ordered release of documents and NOC for those doctors who had deposited Rs 40 lakh bond amount each in terms of the policy. In this case, the HC bench had held that

“…respondents (doctors) are not slaves, they are only required to serve the State in case they are willing to abide by the bond. Once the respondents have opted for depositing the bond amount then, the State essentially has no authority whatsoever to withhold the No Objection Certificate as well as the original documents/certificates of those of the respondents.”

In this case, the Court observed that the authorities, despite sufficient opportunities, failed to accept the first offer given by the petitioner. “…but in large public interest, this Court is of the view that in case his first offer i.e. deposit of Rs.40,00,000/- with further undertaking that after completion of Super Specialty Course, petitioner shall not only join State of Himachal Pradesh as Super Specialist but would also complete his remaining bond period of PG Course, no prejudice shall be caused to the respondents rather public at large would be benefited at later stage,” opined the bench.

The petitioner gave an undertaking before the Court that in case, an NOC was granted to him, he shall not only deposit Rs 40 lakh within a period of one week, but would also serve the State of Himachal Pradesh as Super Specialist after his having completed Super Specialty Course from the institution concerned for five years in lieu of the remaining bond period and he further will avail extra ordinary leave without pay for the duration of course, failing which, the afore bond amount shall stand forfeited by the State.

He further stated that he would not claim any interest upon the bond amount, which would become refundable to him after serving the remaining bond period. His statement in this regard was taken on record and the doctor was apprised of the fact that if he failed to honour the undertaking given before the Court, he would not only render himself liable for penal consequences but would also invite contempt proceeding and in addition to afore bond money deposited by him shall also be forfeited, which otherwise in the event of his joining back shall be returned to him after completion of bond period but without interest.

Accordingly, the Court ordered, “Consequently, in view of detailed discussion as well as law taken note hereinabove, this Court finds merit in the present petition and accordingly, the same is allowed. Impugned Order dated 26.05.2025 (Annexure P-6) is quashed and set aside.” It further directed the State to issue NOC as well as an educational degree to the enable him to join the Super Speciality Course.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/in-the-high-court-of-himachal-pradesh-shimla-291518.pdf

Also Read: No relief on Bond service for Doctors: Himachal HC stays single bench order

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