Last Month in Medicine – What’s happening in the Medical World??

Reported by- Dr. Sai Lavanya Patnala & Madhav Bansal

1. Students admitted to the MBBS course in 2019 will be the first batch to take the National Exit Test (NExT)

The National Exit Test (NExT) will form the basis of certifying the eligibility of the medical graduate to register to practice the modern system of medicine in India and therefore serve as a Licentiate Examination and will replace both the Foreign Medical Graduates Exam (FMGE) and the National Eligibility cum Entrance Test – Postgraduate (NEET-PG) and will be a two-step exam. Step 1 of NExT will be a computer-based examination based on multiple choice questions (MCQs) and Step 2 will be a practical or clinical examination. Both Step 1 and 2 will be held twice a year. The All India Institute of Medical Sciences (AIIMS), Delhi, will conduct NExT Step-1 in May and November. Students will be allowed to sit for Step 2 after the completion of their internship and the exam will be conducted in June and December.

2. New Tennessee Law allows International Medical Graduates to obtain licensure bypassing US Residency

Experienced IMGs who have received medical training abroad can skip US residency requirements and obtain a temporary license to practice medicine in Tennessee if they meet certain qualifications. They must demonstrate competency, as determined by the state medical board. In addition, they must have completed a 3-year postgraduate training program in the graduate’s licensing country or otherwise have practiced as a medical professional in which they performed the duties of a physician for at least 3 of the past 5 years outside the US, according to the new law. If physicians remain in good standing for 2 years, the board will grant them a full and unrestricted license to practice in Tennessee.

3. Regular naps associated with increased brain volume

Published this month in the Sleep Health, the Investigators at University College London and the University of the Republic of Uruguay found that individuals genetically predisposed to regular napping had larger total brain volume, specifically a 15.8 cubic cm increase. The investigators note that the study’s findings augment the knowledge of the “impact of habitual daytime napping on brain health which is essential to understanding cognitive impairment in the aging population. The lack of evidence for an association between napping and hippocampal volume and cognitive outcomes (eg, alertness) may be affected by habitual daytime napping and should be studied in the future.”

4. New FDA Approved anti-inflammatory drug to reduce cardiovascular risk

US Food and Drug Administration has approved the anti-inflammatory drug colchicine 0.5 mg tablets (Lodoco) as the first specific anti-inflammatory drug demonstrated to reduce the risk for myocardial infarction (MI), stroke, coronary revascularization, and cardiovascular death in adult patients with established atherosclerotic disease or with multiple risk factors for cardiovascular disease. In the LoDoCo-2 trial, the drug cut the risk of cardiovascular events by one-third when added to standard prevention therapies in patients with chronic coronary disease. And in the COLCOT study, the use of colchicine reduced cardiovascular events by 23% compared with placebo in patients with a recent MI.

5. New FDA Approved drug for Myasthenia Gravis

US Food and Drug Administration (FDA) has approved rozanolixizumab (Rystiggo) to treat adults with generalized myasthenia gravis (gMG) who are positive for anti-acetylcholine receptor (AChR) or anti-muscle-specific tyrosine kinase (MuSK) antibody. Rozanolixizumab is a subcutaneous-infused humanized IgG4 monoclonal antibody that binds to the neonatal Fc receptor (FcRn), reducing the concentration of pathogenic IgG autoantibodies. US approval is based on results of the phase 3 MycarinG study involving 200 patients with AChR or MuSK autoantibody-positive gMG, reported last month in Lancet Neurology.

6. PUFAs shown to have neuroprotective effects in ALS patients

Kjetil Bjornevik and his colleagues at Harvard University studied 449 adults with ALS who were enrolled in the EMPOWER study found higher levels of the omega-3 fatty acid alpha-linolenic acid (ALA) were associated with longer survival and slower functional decline and higher levels of the n-3 fatty acid eicosapentaenoic acid (EPA) and the n-6 fatty acid linoleic acid (LA) were also associated with a lower risk of dying during follow-up. The results suggest that specific PUFAs may have a beneficial effect for ALS patients, but more study is needed, said Bjornevik.

7. WHO prepares for rise in spread of viruses associated with El-Nino

WHO’s Director General Tedros Adhanom Ghebreyesus stated,”WHO is preparing for the very high probability that 2023 and 2024 will be marked by an El Niño event, which could increase transmission of dengue and other so called arboviruses, such as Zika and chikungunya”

An El Niño condition occurs when surface water in the equatorial Pacific becomes warmer than average and east winds blow weaker than normal; this event happens every 3-5 years and leads to wetter conditions than usual in the Southern U.S. and warmer and drier conditions in the North during the winter. El Niño also has a strong effect on marine life off the Pacific coast.

8. Combination therapy for Nausea and Vomiting in Pregnancy

A multicenter randomized controlled trial has provided more evidence that acupuncture and doxylamine-pyridoxine (Diclegis/Diclectin) are modestly effective for the nausea and vomiting of pregnancy (NVP), according to results published in Annals of Internal Medicine by a team of obstetrician-gynecologists led by Dr. Xiao-Ke Wu in Harbin, China.

9. New embryonic cell type that self-destructs to protect the developing fetus discovered

Scientists studying gene activity data of the early human embryo have discovered an overlooked type of cell which self-destructs within days of forming, as part of a quality control process to protect the developing fetus. The findings give insights on what happens at the very first stages of life after fertilisation which could in the future help improve IVF or regenerative medicine treatments.

10. Synthetic compound used in perfumes shows potential to stop coagulopathy during a massive haemorrhage

Tulane University researchers have uncovered the cause of coagulopathy in trauma victims receiving a blood infusion. They also found that a synthetic compound called dimethyl malonate – often used in perfume manufacturing – has the potential to stop coagulopathy during a massive haemorrhage. The researchers’ findings are part of a new study published in Science Advances.

11. AI system in eye scans enables better diagnosis of inherited retinal diseases

Inherited retinal diseases (IRDs), single-gene disorders affecting the retina, are very difficult to diagnose since they are uncommon and involve changes in one of many candidate genes. Eye2Gene an AI system developed by the UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, UK is capable of identifying the genetic cause of IRDs from retinal scans and is able to achieve this to a higher level of accuracy than most human experts.

12. India-born mental health researcher Vikram Patel is new chair of Harvard Medical School’s Global Health and Social Medicine

Renowned researcher and mental health expert, India-born Vikram Patel, will assume his new role as Chair of the Department of Global Health and Social Medicine at Harvard Medical School on September 1. George Q. Daley, dean of HMS, in a letter to the community announcing Patel’s appointment said “Vikram is both a worthy successor and uniquely prepared to carry the torch”.

An alumnus of University of Mumbai, Dr. Vikram Patel has a PhD from University of London for research on mental disorders in Harare. He is well known for his work on child development and mental disability in low resource settings.