March Medicaid Madness
The Host
Julie Rovner
KHN
Julie Rovner is chief Washington correspondent and host of KHN’s weekly health policy news podcast, “What the Health?” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A to Z,” now in its third edition.
With Medicare and Social Security apparently off the table for federal budget cuts, the focus has turned to Medicaid, the federal-state health program for those with low incomes. President Joe Biden has made it clear he wants to protect the program, along with the Affordable Care Act, but Republicans will likely propose cuts to both when they present a proposed budget in the next several weeks.
Meanwhile, confusion over abortion restrictions continues, particularly at the FDA. One lawsuit in Texas calls for a federal judge to temporarily halt distribution of the abortion pill mifepristone. A separate suit, though, asks a different federal judge to temporarily make the drug easier to get, by removing some of the FDA’s safety restrictions.
This week’s panelists are Julie Rovner of Kaiser Health News, Alice Miranda Ollstein of Politico, Rachel Cohrs of STAT News, and Lauren Weber of The Washington Post.
Panelists
Rachel Cohrs
Stat News
Alice Miranda Ollstein
Politico
Lauren Weber
The Washington Post
Among the takeaways from this week’s episode:
- States are working to review Medicaid eligibility for millions of people as pandemic-era coverage rules lapse at the end of March, amid fears that many Americans kicked off Medicaid who are eligible for free or near-free coverage under the ACA won’t know their options and will go uninsured.
- Biden promised this week to stop Republicans from “gutting” Medicaid and the ACA. But not all Republicans are on board with cuts to Medicaid. Between the party’s narrow majority in the House and the fact that Medicaid pays for nursing homes for many seniors, cutting the program is a politically dicey move.
- A national group that pushed the use of ivermectin to treat covid-19 is now hyping the drug as a treatment for flu and RSV — despite a lack of clinical evidence to support their claims that it is effective against any of those illnesses. Nonetheless, there is a movement of people, many of them doctors, who believe ivermectin works.
- In reproductive health news, a federal judge recently ruled that a Texas law cannot be used to prosecute groups that help women travel out of state to obtain abortions. And the abortion issue has highlighted the role of attorneys general around the country — politicizing a formerly nonpartisan state post. –And Eli Lilly announced plans to cut the price of some insulin products and cap out-of-pocket costs, though their reasons may not be completely altruistic: An expert pointed out that a change to Medicaid rebates next year means drugmakers soon will have to pay the government every time a patient fills a prescription for insulin, meaning Eli Lilly’s plan could save the company money.
Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:
Julie Rovner: The New York Times’ “A Drug Company Exploited a Safety Requirement to Make Money,” by Rebecca Robbins.
Alice Miranda Ollstein: The New York Times’ “Alone and Exploited, Migrant Children Work Brutal Jobs Across the U.S.,” by Hannah Dreier.
Rachel Cohrs: STAT News’ “Nonprofit Hospitals Are Failing Americans. Their Boards May Be a Reason Why,” by Sanjay Kishore and Suhas Gondi.
Lauren Weber: KHN and CBS News’ “This Dental Device Was Sold to Fix Patients’ Jaws. Lawsuits Claim It Wrecked Their Teeth,” by Brett Kelman and Anna Werner.
Also mentioned in this week’s podcast:
- Politico’s “Why One State’s Plan to Unwind a Covid-Era Medicaid Rule Is Raising Red Flags,” by Megan Messerly.
- The Washington Post’s “Doctors Who Touted Ivermectin as Covid Fix Now Pushing It for Flu, RSV,” by Lauren Weber.
- NPR’s “To Safeguard Healthy Twins in Utero, She Had to ‘Escape’ Texas for Abortion Procedure,” by Selena Simmons-Duffin.
- The Daily Beast’s “Tennessee Abortion Ban a ‘Nightmare’ for Woman With Doomed Pregnancy,” by Michael Daly.
click to open the transcript
Transcript: March Medicaid Madness
KHN’s ‘What the Health?’Episode Title: Medicaid March MadnessEpisode Number: 287Published: March 2, 2023
Julie Rovner: Hello and welcome back to KHN’s “What the Health?” I’m Julie Rovner, chief Washington correspondent at Kaiser Health News. And I’m joined by some of the best and smartest health reporters in Washington. We are taping this week on Thursday, March 2, at 10 a.m. As always, news happens fast, and things might have changed by the time you hear this. So, here we go. We are joined today via video conference by Alice Miranda Ollstein of Politico.
Alice Miranda Ollstein: Good morning.
Rovner: Rachel Cohrs of Stat News.
Rachel Cohrs: Hi, everybody.
Rovner: And we officially welcome to the podcast panel this week Lauren Weber, ex of KHN and now at The Washington Post covering a cool new beat on health and science disinformation. Lauren, welcome back to the podcast.
Lauren Weber: Thanks for having me.
Rovner: So we’re going to get right to this week’s news. We’ve talked a lot about the political fight swirling around Medicare the past couple of weeks. So this week, I want to talk more about Medicaid. Our regular listeners will know, or should know, that states are beginning to re-determine eligibility for people who got on Medicaid during the covid pandemic and were allowed to stay on until now. In fact, Arkansas is vowing to re-determine eligibility for half a million people over the next six months. Alice, the last time Arkansas tried to do something bureaucratically complicated with Medicaid, it didn’t turn out so well, did it?
Ollstein: No. It was so much of a cautionary tale that no other state until now has gone down that path, although now at least a couple are attempting to. So Arkansas was the only state to actually move forward under the Trump administration with implementing Medicaid work requirements. And we covered it at the time, and just thousands and thousands of people lost coverage who should have qualified. They were working. They just couldn’t navigate the reporting system. Part of the problem was that you had to report your working hours online and a lot of people who are poor don’t have access to the internet. And, you know, the system was buggy and clunky and it was just a huge mess. But that is not stopping the state from trying again on several fronts. One, they want to do Medicaid work requirements again. The governor, Sarah Huckabee Sanders, has said that they plan to do that and also they plan to do their redeterminations for the end of the public health emergency in half the time the federal government would like states to take to do it. The federal government has incentives for states to go slow and take a full year to make sure people know how to prove whether or not they qualify for Medicaid and to learn what other insurance coverage options might be available to them. For instance, you know, Obamacare plans that are free or almost free.
Rovner: Yeah. Presumably most of the people who are no longer eligible for Medicaid but are still low-income will be eligible for Obamacare with hefty subsidies.
Ollstein: That’s right. So the fear is that history will repeat itself. A lot of people who should be covered will be dropped from coverage and won’t even know it because the state didn’t take the time to contact people and seek them out.
Rovner: This is something that we will certainly follow as it plays out over the next year. More broadly, though, there have been whispers — well, more than whispers, whines — over the past couple of weeks that President [Joe] Biden’s challenge to Republicans not to cut Social Security and Medicare, and Republicans’ apparent acceptance of that challenge, specifically leaves out Medicaid. Now, I never thought that was true, at least for the Democrats. But earlier this week, President Biden extended his promises to Medicaid and the Affordable Care Act. How much of a threat is there really to Medicaid in the coming budget battles? Rachel, you wrote about that today.
Cohrs: There is a lot of anxiety swirling around this on the Hill. I know there’s a former Trump White House official who’s circulated some documents that are making people a little bit nervous about Republicans’ position. But it is useful to look at existing documents out there. It is not reflective necessarily of the consensus Republican position. And it’s a very diverse party right now in the House. They have an incredibly narrow majority and Kevin McCarthy is really going to have to walk a tightrope here. And I think it is important to remember that when Medicaid has come up on steep ballot initiatives in red states, so many times it has passed overwhelmingly. So I think there is an argument to be made that Medicaid enjoys more political support among the GOP voting populace than maybe it does among members of Congress. So I think I am viewing it with caution. You know, obviously, it’s something that we’re going to have to be tracking and watching as these negotiations develop. But Democrats still hold the Senate and they still hold the presidency. So Republicans have more leverage than they did last Congress, but they’re still … Democrats still have a lot of sway here.
Rovner: Although I’ll just point out, as I think I pointed out before, that in 2017, when the Republicans tried to repeal the Affordable Care Act, one of the things they discovered is that Medicaid is actually kind of popular. I think … much to their surprise, they discovered that Medicaid is also kind of popular, maybe not as much as Medicare, but more than I think they thought. So I guess the budget wars really get started next week: We get President Biden’s budget, right?
Ollstein: And House Republicans are allegedly working on something. We don’t know when it will come or how much detail it will have, but it will be some sort of counter to Biden’s budget. But, you know, the real work will come later, in hashing it out in negotiations. And, really, a small number of people will be involved in that. And so just like Rachel said, you know, you’re going to see a lot of proposals thrown out over the next several months. Not all of them should necessarily be taken seriously or taken as determinative. Just one last interesting thing: This has been a really interesting education time, both for lawmakers and the public on just who is covered under these programs. I mean, the idea is that Medicare is so untouchable, is this third rail, because it is primarily seniors, and seniors vote. And seniors are more politically important to conservatives and Republicans. But people forget a lot of seniors are also on Medicaid. They get their nursing home coverage through there. And so I’ve heard a lot of Democratic lawmakers really hammering that argument lately and saying, look, you know, the stereotype for Medicaid is that it’s just poor adults, but …
Rovner: Yeah, moms and kids. That was how it started out.
Ollstein: Exactly.
Rovner: It was poor moms and kids.
Ollstein: Exactly. But it’s a lot more than that now. And it is more politically dicey to go after it than maybe people think.
Rovner: Yeah, I think Nancy Pelosi … in 2017 when, you know, if the threat with Medicare is throwing Granny off the cliff in her wheelchair, the threat of Medicaid is throwing Granny out of her nursing home, both of which have their political perils. All right. Well, we’ll definitely see this one play out for a while. I want to move to the public health beat. Lauren, you had a really cool story on the front page of The Washington Post this week about how the promise of ivermectin to treat infectious diseases in humans. And for those who forget, ivermectin is an anti-wormer drug that I give to my horse and both of my dogs. But the idea of using it for various infectious diseases just won’t die. What is the latest ivermectin craze?
Weber: Yes, and to be clear, there is an ivermectin that is a pill that can be given to humans, which is what these folks are talking about. But there’s this group called the Front Line COVID-19 Critical Care Alliance that really pushed ivermectin in the height of covid. As we all know on this podcast, scientific study after scientific study after clinical trial has disproved that there is any efficacy for that. But this group has continued to push it. And I discovered, looking at their website back this winter, that they’re now pushing it for the flu and RSV. And as I asked the CDC [Centers for Disease Control and Prevention] and medical experts, there’s no clinical data to support pushing that for the flu or RSV. And, you know, as one scientist said to me, they had data that … had antiviral properties in a test tube. But as one scientist said to me, well, if you put Coca-Cola in a test tube, it would show it had antiviral properties as well. So there’s a lot of pushback to these folks. But, that said, they told me that they have had their protocols downloaded over a million times. You know, they’re … absolutely have some prominence and have, you know, converted a share of the American population to the belief that this is a useful medical treatment for them. And one of the doctors that has left their group over their support of ivermectin said to me, “Look, I’m not surprised that they’re continuing to push this for something else. This is what they do now. They push this for other things.” And so it’s quite interesting to see this continue to play out as we continue into covid, to see them kind of expand, as these folks said to me, into other diseases.
Rovner: I know I mean, usually when we see these kinds of things, it’s because the people who are pushing them are also selling them and making money off of them. And I know that’s the case in some of this, but a lot of these are just doctors who are writing prescriptions for ivermectin. Right? I mean, this is an actual belief that they have.
Weber: Yeah, some of them do make money off of telehealth appointments. They can charge up to a couple hundred dollars for telehealth appointments. And one of the couple of co-founders had a lucrative Substack and book deal that talks about ivermectin and do get paid by this alliance. One of them made almost a quarter of a million dollars in salary from the alliance. But yeah, I mean, the average doctor that’s prescribing ivermectin, I mean — there were over 400,000 ivermectin prescriptions in, I think, it was August of 2021. So that’s a lot of prescriptions.
Rovner: They’re not all making money off of it.
Weber: They’re not all making money. And I mean, what’s wild to me is Merck has come out and said, which, in a very rare statement for a pharmaceutical company, you know, don’t prescribe our drug for this. And when I asked them about RSV and the flu, they said, yeah, our statement would still stand on that. So it’s a movement, to some extent. And the folks I talked to about it, they really believe …
Rovner: And I will say, for a while in 2021, you couldn’t get horse wormer, which is a very nasty-tasting paste, even the horses don’t really like it. Because it was hard to get ivermectin at all. So we’ll see where this goes next. Here’s one of those “in case you missed It” stories. The Tulsa World this week has an interview with former Republican Sen. James Inhofe, who said, in his blunt Inhofe way, that he retired last year not only because he’s 88, but because he’s still suffering the effects of long covid. And he’s not the only one — quote, “five or six others have [long covid], but I’m the only one who admits it,” he told the paper, referring to other members of the Senate, presumably other Republican members of the Senate. Now, mind you, the very conservative Inhofe voted against just about every covid funding bill. And my impression from not going to the Hill regularly in 2021 and 2022 is that while covid seemed to be floating around in the air, lots of people were getting it, very few people seemed to be getting very sick. But now we’re thinking that’s not really the case, right?
Ollstein: When I saw this, I immediately went back to a story I wrote about a year ago on Tim Kaine’s long covid diagnosis and his attempts to convince his colleagues to put more research funding or treatment funding, more basic covid prevention funding … you know, fewer people will get long covid if fewer people get covid in the first place. And there was just zero appetite on the Republican side for that. And that’s why a lot of it didn’t end up passing. Inhofe was one of the Republicans I talked to, and I said, you know, do you think you should do more about long covid? What do you think about this? And this is what he told me: “I have other priorities. We’re handling all we can right now.” And then he added that long covid is not that well defined. And he argued there’s no way to determine how many people are affected. Well.
Rovner: OK.
Ollstein: So that … in “Quotes That Aged Poorly Hall of Fame.”
Rovner: You know, obviously Tim Kaine came forward and talked about it. But now I’m wondering if there are people who are slowing down or looking like they’re not well, maybe they have long covid and don’t want to say.
Ollstein: Well, I mean, something that Tim Kaine’s case shows is that there’s no one thing it can look like and somebody can look completely healthy and normal on the outside and be suffering symptoms. And Tim Kaine has also said that members of Congress have quietly disclosed to him and thanked him for speaking up, but said they weren’t willing to do it themselves. And he, Tim Kaine, told me that he felt more comfortable speaking up because the kind of symptoms he had were less stigmatized. They weren’t anything in terms of impeding his mental capacity and function. And there’s just a lot of stigma and fear of people coming forward and admitting they’re having a problem.
Rovner: I find it kind of ironic that last week we talked about how, you know, members of Congress and politicians with mental health, you know, normally stigmatizing problems are more willing to talk about it. And yet here are people with long covid not willing to talk about it. So maybe we’ll see a little bit more after this or maybe not. I want to talk a little bit about artificial intelligence and health care. I’ve been wanting to talk about this for a while, but this week seems to be everyone is talking about AI. There have been a spate of stories about how different types of artificial intelligence are aiding in medical care, but also some cautionary tales, particularly about chat engines. They get all their information from the internet, good or bad. Now, we already have robots that do intricate surgeries and lots and lots of treatment algorithms. On the other hand, the little bit of AI that I already have that’s medical-oriented, my Fitbit, that sometimes accurately tracks my exercise and sometimes doesn’t, and the chat bot from my favorite chain drugstore that honestly cannot keep my medication straight. None of that makes me terribly optimistic about launching into health AI. Is this, like most tech, going to roll out a little before it’s ready and then we’ll work the bugs out? Or maybe are we going to be a little bit more careful with some of this stuff?
Cohrs: I think we’ve already seen some examples of things rolling out before they’re exactly ready. And I just thought of my colleague Casey Ross’ reporting on Epic’s algorithm that was supposed to help …
Rovner: Epic, the electronic medical records company.
Cohrs: Yes, yes. They had this algorithm that was supposed to help doctors treat sepsis patients, and it didn’t work. The problem with using AI in health care is that there are life-and-death consequences for some of these things. If you’re misdiagnosing someone, if you’re giving them medicine they don’t need, there are, like, those big consequences. But there are also the smaller ones too. And my colleague Brittany Trang wrote about how with doctor’s notes or transcripts of conversations between a physician and a patient sometimes AI has difficulty differentiating between an “mm-hm” or an “uh-huh” and telling whether that’s a yes or a no. And so I think that there’s just all of these really fascinating issues that we’re going to have to work through. And I think there is enormous potential, certainly, and I think there’s getting more experimentation. But like you said, I think in health care it’s just a very different beast when you’re rolling things out and making sure that they work.
Weber: Yeah, I wanted to add, I mean, one of the things that I found really interesting is that doctors’ offices are using some of it to reduce some of the administrative burden. As we all know, prior authorizations suck up a lot of time for doctors’ offices. And it seems like this has actually been really helpful for them. That said, I mean, that comes with the caveat of — my colleagues and I and much reporting has shown that — sometimes these things just make up references for studies. They just make it up. That level of “Is this just a made-up study that supports what I’m saying?” I think is really jarring. This isn’t quite like using Google. It cannot be trusted to the level … and I think people do have caution with it and they will have to continue to have caution with it. But I think we’re really only at the forefront of figuring out how this all plays out.
Rovner: I was talking before we started taping about how I got a text from my favorite chain drugstore saying that I was out of refills and that they would call my doctor, which is fine. And then they said, “Text ‘Yes’ if you would like us to call” … some other doctor. I’m like, “Who the heck is this other doctor?” And then I realize he’s the doctor I saw at urgent care last September when I burned myself. I’m like, “Why on earth would you even have him in your system?” So, you know, that’s the sort of thing … it’s like, we’re going to be really helpful and do something really stupid. I worry that Congress, in trying to regulate tech, and failing so far — I mean, we’ve seen how much they do and don’t know about, you know, Facebook and Instagram and the hand-wringing over TikTok because it’s owned by the Chinese — I can’t imagine any kind of serious, thoughtful regulation on this. We’re going to have to basically rely on the medical industry to decide how to roll this out, right? Or might somebody step in?
Ollstein: I mean, there could be agency, you know, rulemaking, potentially. But, yes, it’s the classic conundrum of technology evolving way faster than government can act to regulate it. I mean, we see that on so many fronts. I mean, look how long has gone without any kind of update. And, you know, the kinds of ways health information is shared are completely different from when that law was written, so …
Rovner: Indeed.
Weber: And as Rachel said, I mean, this is life-or-death consequences in some places. So the slowness with which the government regulates things could really have a problem here, because this is not something that is just little …
Rovner: Of the things that keep me awake at night, this is one of the things that keeps me awake at night. All right. Well, one of these weeks, we will not have a ton of reproductive health news. But this week isn’t it. As of this taping, we still have not gotten a decision in that Texas case challenging the FDA approval of the abortion pill, mifepristone, back in the year 2000. But there’s plenty of other abortion news happening in the Lone Star State. First, a federal judge in Texas who was not handpicked by the anti-abortion groups ruled that Texas officials cannot enforce the state’s abortion ban against groups who help women get abortion out of state, including abortion funds that help women get the money to go out of state to get an abortion. The judge also questioned whether the state’s pre-Roe ban is even in effect or has actually been repealed, although there are overlapping bans in the state that … so that wouldn’t make abortion legal. But still, this is a win for the abortion rights side, right, Alice?
Ollstein: Yeah, I think the right knows that there are two main ways that people are still getting abortions who live in ban states. They’re traveling out of state or they are ordering pills in the mail. And so they are moving to try to cut off both of those avenues. And, you know, running into some difficulty in doing so, both in the courts and just practically in terms of enforcing. This is part of that bigger battle to try to cut off, you know, people’s remaining avenues to access the procedure.
Rovner: Well, speaking exactly of that, Texas being Texas, this week, we saw a bill introduced in the state legislature that would ban the websites that include information about how to get abortion pills and would punish internet providers that fail to block those sites. It would also overturn the court ruling we just talked about by allowing criminal prosecution of anyone who helps someone get an abortion. Even a year ago, I would have said this is an obvious legislative overreach, but this is Texas. So now maybe not so much.
Ollstein: I mean, I think lots of states are just throwing things at the wall to see what sticks and to see what gets through the courts. You had states test the waters on banning certain kinds of out-of-state travel, and that hasn’t gone anywhere yet. But even things that don’t end up passing and being implemented can have a chilling effect. You have a lot of confusion right now. You have a lot of people not sure what’s legal, what’s not. And if you create this atmosphere of fear where people might be afraid to go out of state, might be afraid to ask for funding to go out of state, afraid to Google around and see what their options are that serves the intended impacts of these proposals, in terms of preventing people from exploring their options and seeing what they can do to terminate a pregnancy.
Rovner: Yeah. Well, meanwhile, a dozen states that are not named Texas are suing the FDA, trying to get it to roll back some of the prescribing requirements around the abortion pill. The states are arguing that not only are the risk-mitigation rules unnecessary, given the proven safety of mifepristone, but that some of the certification requirements could invade the privacy of patients and prescribers and subject them to harassment or worse. They’re asking the judge to halt enforcement of the restrictions while the case is being litigated. That could run right into [U.S. District] Judge [Matthew] Kacsmaryk’s possible injunction in Texas banning mifepristone nationwide. Then what happens? If you’ve got one judge saying, “OK, you can’t sell this nationwide,” and another judge saying … “Of course you can sell it, and you can’t use these safety restrictions that the FDA has put around it.” Then the FDA has two conflicting decisions in front of it.
Weber: Yeah, and I find the battles of the AGs and the abortion wars are really fascinating because, I mean, this is a lawsuit brought by states, which is attorneys general, Democratic attorneys general. And you’re seeing that play out. I mean, you see that in Texas, too, with [Ken] Paxton. You see it in Michigan with [Dana] Nessel. I mean, I would argue one of the things that attorney generals have been the most prominent on in the last several decades of American history and have actually had immediate effects on due to the fall of Roe v. Wade. So we’ll see what happens. But it is fascinating to see in real time this proxy battle, so to speak, between the two sides play out across the states and across the country.
Rovner: No, it’s funny. State AGs did do the tobacco settlement.
Weber: Yes.
Rovner: I mean, that would not have happened. But what was interesting about that is that it was very bipartisan.
Weber: Well, they were on the same side.
Rovner: And this is not.
Weber: Yeah, I mean, yeah, they were on the same side. This is a different deal. And I think to some extent, and I did some reporting on this last year, it speaks to the politicization of that office and what that office has become and how it’s become, frankly, a huge launching pad for people’s political careers. And the rhetoric there often is really notched up to the highest levels on both sides. So, you know, as we continue to see that play out, I think a lot of these folks will end up being folks you see on the national stage for quite some time.
Ollstein: I’ve been really interested in the states where the attorney general has clashed with other parts of their own state government. And so in North Carolina, for example, right now you have the current Democratic attorney general who is planning to run for governor. And he said, I’m not going to defend our state restrictions on abortion pills in court because I agree with the people challenging them. And then you have the Republican state legislatures saying, well, if he’s not going to defend these laws, we will. So that kind of clash has happened in Kentucky and other states where the attorney general is not always on the same side with other state officials.
Rovner: If that’s not confusing enough, we have a story out of Mississippi this week, one of the few states where voters technically have the ability to put a question on the ballot, except that process has been blocked for the moment by a technicality. Now, Republican legislators are proposing to restart the ballot initiative process. They would fix the technicality, but not for abortion questions. Reading from the AP story here, quote, “If the proposed new initiative process is adopted, state legislators would be the only people in Mississippi with the power to change abortion laws.” Really? I mean, it’s hard to conceive that they could say you can have a ballot question, but not on this.
Ollstein: This is, again, part of a national trend. There are several Republican-controlled states that are moving right now to attempt to limit the ability of people to put a measure on the ballot. And this, you know, comes as a direct result of last year. Six states had abortion-related referendums on their ballot. And in all six, the pro-abortion rights side won. Each one was a little different. We don’t need to get into it, but that’s the important thing. And so people voted pretty overwhelmingly, even in really red states like Kentucky and Montana. And so other states that fear that could happen there are now moving to make that process harder in different ways. You have Mississippi trying to do, like, a carve-out where nothing on abortion can make it through. Other states are just trying to raise, like, the signature threshold or the vote threshold people need to get these passed. There are a lot of different ways they’re going about it.
Rovner: I covered the Mississippi “personhood” amendment back in 2011. It was the first statewide vote on, you know, granting personhood to fetuses. And everybody assumed it was going to win, and it didn’t, even in Mississippi. So I think there’s reason for the legislators who are trying to re-stand up this ballot initiative process to worry about what might come up and how the voters might vote on it. Well, because I continue to hear people say that women trying to have babies are not being affected by state abortion bans and restrictions, this week we have not one but two stories of pregnant women who were very much impacted by abortion bans. One from NPR is the story of a Texas woman pregnant with twins — except one twin had genetic defects not only incompatible with life, but that threatened the life of both the other twin and the pregnant woman. She not only had to leave the state for a procedure to preserve her own life and that of the surviving twin, but doctors in Texas couldn’t even tell her explicitly what was going on for fear of being brought up on charges of violating the state’s ban. I think, Alice, you were the one talking about how, you know, women are afraid to Google. Doctors are afraid to say anything.
Ollstein: Yeah, absolutely. I mean, it’s a really chilling and litigious environment right now. And I think, as more and more of these stories start to come forward, I think that is spurring the debates you’re seeing in a lot of states right now about adding or clarifying or expanding the kind of exceptions that exist on these bans. So you have very heated debates going on right now in Utah and Tennessee and in several states around, you know, should we add more exceptions because there are some Republican lawmakers who are looking at these really tragic stories that are trickling out and saying, “This isn’t what we intended when we voted for this ban. Let’s go back and revisit.” Whether exceptions even work when they are on the books is another question that we can discuss. I mean, we have seen them not be effective in other states and people not able to navigate them.
Rovner: We’ve seen a lot of these stories about women whose water broke early and at what point is it threatening her life? How close to death does she have to be before doctors can step in? I mean, we’ve seen four or five of these. It’s not like they’re one-offs. The other story this week is from the Daily Beast. It’s about a 28-year-old Tennessee woman whose fetus had anomalies with its heart, brain, and kidneys. That woman also had to leave the state at her own expense to protect her own health. Is there a point where anti-abortion forces might realize they are actually deterring women who want babies from getting pregnant for fear of complications that they won’t be able to get treated?
Ollstein: Most of the pushback I’ve seen from anti-abortion groups, they claim that the state laws are fine and that doctors are misinterpreting them. And there is a semantic tug of war going on right now where anti-abortion groups are trying to argue that intervening in a medical emergency shouldn’t even count as an abortion. Doctors argue, no, it is an abortion. It’s the same procedure medically, and thus we are afraid to do it under the current law. And the anti-abortion groups are saying, “Oh, no, you’re saying that in bad faith; that doesn’t count as an abortion. An abortion is when it’s intended to kill the fetus.” So you’re having this challenging tug of war, and it’s not really clear what states are going to do. There’s a lot of state bills on this making their way through legislatures right now.
Rovner: And doctors and patients are caught in the middle. Well, finally this week, Eli Lilly announced it would lower, in some cases dramatically, the list prices for some of its insulin products. You may remember that, last year, Democrats in Congress passed a $35-per-month cap for Medicare beneficiaries but couldn’t get those last few votes to apply the cap to the rest of the population. Lilly is getting very good press. Its stock price went up, even though it’s not really capping all the out-of-pocket costs for insulin for everybody. But I’m guessing they’re not doing this out of the goodness of their drugmaking heart, right, Rachel?
Cohrs: Probably not. Even though there’s a quote from their CEO that implied that that was the case. I think there was one drug pricing expert at West Health Policy Center, Sean Dickson, who is very sharp on these issues, knows the programs well. And he pointed out that there’s a new policy going into effect in Medicaid next year, and it’s really, really wonky and complicated. But I’ll do my best to try to explain that, generally, in the Medicare program, rebates are capped, or they have been historically, at the price of the drug. So you can’t charge a drugmaker a rebate that’s higher than the cost. But …
Rovner: That would make sense.
Cohrs: Right. But that math can get kind of wonky when there are really high drug price increases and then that math gets really messed up. But Congress, I want to say it was in 2021, tweaked this policy to discourage those big price increases. And they said, you know what? We’re going to raise the rebate cap in Medicaid, which means that, drugmakers, if you are taking really big price increases, you may have to pay us every time someone on Medicaid fills those prescriptions. And I think people thought about insulin right away as a drug that has these really high rebates already and could be a candidate disproportionately impacted by this policy. So I thought that was an interesting point that Sean made about the timing of this. That change is supposed to go into effect early next year. So this could, in theory, save Lilly a lot of money in the Medicaid program because we don’t know exactly what their net prices were before.
Rovner: But this is very convenient.
Cohrs: It’s convenient. And there’s a chance that they’re not really losing any money right now, depending on how their contracts work with insurers. So I think, yeah, there is definitely a possibility for some ulterior motives here.
Rovner: And plus, the thing that I learned this week that I hadn’t known before is that there are starting to be some generic competition. The three big insulin makers, which are Lilly, Sanofi, and Novo Nordisk, may actually not become the, almost, the only insulin maker. So it’s probably in Lilly’s interest to step forward now. And, you know, they’re reducing the prices on their most popular insulins, but not necessarily their most expensive insulin. So I think there’s still money to be made in this segment. But they sure did get, you know, I watched all the stories come across. It’s, like, it’s all, oh, look at this great thing that Lilly has done and that everything’s going to be cheap. And it’s, like, not quite. But …
Cohrs: But it is different. It’s a big step. And I think …
Rovner: It is. It is.
Cohrs: Somebody has to go first in breaking this cycle. And I think it will be interesting to see how that plays out for them and whether the other two companies do follow suit. Sen. Bernie Sanders asked them to and said, you know, why don’t you just all do the same thing and lower prices on more products? So, yeah, we’ll see how it plays out.
Weber: Day to day, I mean, that’s a huge difference for people. I mean, that is a lot of money. That is a big deal. So, I mean, you know, no matter what the motivation, at the end of the day, I think the American public will be much happier with having to pay a lot less for insulin.
Rovner: Yeah, I’m just saying that not everybody who takes insulin is going to pay a lot less for insulin.
Weber: Right. Which is very fair, very fair.
Rovner: But many more people than before, which is, I think, why it got lauded by everybody. Although I will … I wrote in my notes, please, someone mention Josh Hawley taking credit and calling for legislation. Sen. Hawley from Missouri, who voted against extending the $35 cap, as all Republicans did, to the rest of the population, put out a tweet yesterday that was, like, this is a great thing and now we should have, you know, legislation to follow up. And I’m like: OK.
Cohrs: You’ll have to check on that. I actually think Hawley may have voted for it.
Rovner: Oh, a-ha. All right.
Cohrs: There were a few Republicans.
Rovner: Thank you.
Cohrs: It’s not enough, though.
Rovner: Yeah, I remember that they couldn’t get those last few votes. Yes, I think [Sen. Joe] Manchin voted against. He was the one, the last Democrat they couldn’t get right. That’s why they ended up dropping …
Cohrs: Uh, it had to be a 60-vote threshold, so …
Rovner: Oh, that’s right.
Cohrs: Yeah.
Rovner: All right. Good. Thank you. Good point, Rachel. All right. Well, that is the news for this week. Now it is time for our extra-credit segment. That’s when we each recommend a story we read this week we think you should read, too. As always, don’t worry if you miss it. We will post the links on the podcast page at khn.org and in our show notes on your phone or other mobile device. Alice, why don’t you go first this week?
Ollstein: Yeah. So I did the incredible New York Times investigation by Hannah Dreier on child labor. This is about undocumented, unaccompanied migrant children who are coming to the U.S. And the reason I’m bringing it up on our podcast is there is a health angle. So HHS [the Department of Health and Human Services], their Office of Refugee Resettlement has jurisdiction over these kids’ welfare and making sure they are safe. And that is not happening right now. The system is so overwhelmed that they have been cutting corners in how they vet the sponsors that they release the kids to. Of course, we remember that there were tons of problems with these kids being detained and kept for way too long and that being a huge threat to their physical and mental health. But this is sort of the pendulum has swung too far in the opposite direction, and they’re being released to people who in some cases straight up trafficking them and in other cases just forcing them to work and drop out of school, even if it’s not a trafficking situation. And so this reporting has already had an impact. The HHS has announced all these new initiatives to try to stop this. So we’ll see if they are effective. But really moving, incredible reporting.
Rovner: Yeah, it was an incredible story. Lauren.
Weber: I’m going to shout out my former KHN colleague Brett Kelman. I loved his piece on, I guess you can’t call it a medical device because it wasn’t approved by the FDA, which is the point of the story. But this device that was supposed to fix your jaw so you didn’t have to have expensive jaw surgery. Well, what it ended up doing is it messed up all these people’s teeth and totally destroyed their mouths and left them with a bunch more medical and dental bills. And, you know, what I find interesting about the story, what I find interesting about the trend in general is the problem is, they never applied for anything with the FDA. So people were using this device, but they didn’t check, they didn’t know. And I think that speaks to the American public’s perception that devices and medical devices and things like this are safe to use. But a lot of times the FDA regulations are outdated or are not on top of this or the agency is so understaffed and not investigating that things like this slipped through the cracks. And then you have people — and it’s 10,000 patients, I believe, that have used this tool — that did not do what it is supposed to do and, in fact, injured them along the way. And I think that the FDA piece of that is really interesting. It’s something I’ve run into before looking at air cleaners and how they fit the gaps of that. And I think it’s something we’re going to continue to see as we examine how these agencies are really stacking up to the evolution of technology today.
Rovner: Yeah, capitalism is going to push everything. Rachel.
Cohrs: So my extra credit this week is actually an opinion piece, in Stat, and the headline is “Nonprofit Hospitals Are Failing Americans. Their Boards May Be a Reason Why.” It was written by Sanjay Kishore and Suhas Gondi. I think the part that really stood out to me is they analyzed the backgrounds and makeups of hospital boards, especially nonprofit hospitals. I think they analyzed like 20 large facilities. And the statistic that really surprised me was that, I think, 44% of those board members came from the financial sector representing investment funds, real estate, and other entities. Less than 15% were health care workers, 13% were physicians, and less than 1% were nurses. And, you know, I’ve spent a lot of time and we’ve spent a lot of time thinking about just how nonprofit hospitals are operating as businesses. And I think a lot of other publications have done great work as well making that point. But I think this is just a stark statistic that shows these boards that are supposed to be holding these organizations accountable are thinking about the bottom line, because that’s what the financial services sector is all about, and that there’s so much disproportionately less clinical representation. So obviously hospitals need admin sides to run, and they are businesses, and a lot of them don’t have very large margins. But the statistics just really surprised me as to the balance there.
Rovner: Yeah, I felt like this is one, you know, we’ve all been sort of enmeshed in this, you know, what are we going to do about the nonprofit hospitals that are not actually acting as charitable institutions? But I think the boards had been something that I had not seen anybody else look at until now. So it’s a really interesting piece. All right. Well, my story this week is the other big investigation from The New York Times. It’s called “A Drug Company Exploited a Safety Requirement to Make Money,” by Rebecca Robbins. And it’s about those same risk-mitigation rules from the FDA that are at the heart of those abortion drug lawsuits we talked about a few minutes ago. Except in this case, the drug company in question, Jazz Pharmaceuticals, somehow patented its risk-mitigation strategy as the distribution center — it’s actually called the REMS [Risk Evaluation and Mitigation Strategies] — which is managed to fend off generic competition for the company’s narcolepsy drug. It had also had a response already. It has produced a bipartisan bill in the Senate to close the loophole — but [I’ll] never underestimate the creativity of drugmakers when it comes to protecting their profit. It’s quite a story. OK. That’s our show for this week. As always, if you enjoy the podcast, you can subscribe wherever you get your podcasts. We’d appreciate it if you left us a review; that helps other people find us, too. Special thanks, as always, to our ever-patient producer, Francis Ying. Also, as always, you can email us your comments or questions. We’re at whatthehealth — all one word — at kff.org. Or you can tweet me. I’m @jrovner. Alice?
Ollstein: @AliceOllstein
Rovner: Rachel.
Cohrs: @rachelcohrs
Rovner: Lauren.
Weber: @LaurenWeberHP
Rovner: We will be back in your feed next week. In the meantime, be healthy.
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2 years 3 months ago
COVID-19, Health Care Costs, Health Industry, Insurance, Medicaid, Medicare, Multimedia, Abortion, Biden Administration, Drug Costs, FDA, KHN's 'What The Health?', Obamacare Plans, Podcasts, Prescription Drugs, texas, Women's Health
Health – Demerara Waves Online News- Guyana
PNCR’s Lethem office building needed for health facility but Forde deems demolition “declaration of war”
Even as Shadow Attorney General and Minister of Legal Affairs Roysdale Forde said political parties’ headquarters were untouchable, Local Government and Regional Development Minister Nigel Dharamlall said the building that housed the People’s National Congress Reform’s (PNCR) office in Lethem has been earmarked for a health care facility. “The location of this site is slated ...
Even as Shadow Attorney General and Minister of Legal Affairs Roysdale Forde said political parties’ headquarters were untouchable, Local Government and Regional Development Minister Nigel Dharamlall said the building that housed the People’s National Congress Reform’s (PNCR) office in Lethem has been earmarked for a health care facility. “The location of this site is slated ...
2 years 3 months ago
Health, News, Politics
Health Archives - Barbados Today
Centenarian ‘real happy’ to celebrate milestone with family
Barbados’ newest centenarian, Maria St. Auburn-Cave, is very happy to reach her 100th birthday.
St. Auburn-Cave, who celebrated her special day on Tuesday, February 28, with family at her Valley Development home, St. George said her only regret on reaching the milestone was that her husband was not alive to share it with her.
“I feel good; I feel real happy. The only thing [is], I feel sad that my husband is not here… God take him and I have to live without him, but he was a good husband and a good father. He worked day and night to provide for us; we never suffered a day… I love[d] him very much,” she said.
President of Barbados, Her Excellency, The Most Honourable Dame Sandra Mason, paid a visit via Zoom, as part of the celebrations, and wished the centenarian a very special birthday. Her Excellency noted that. St. Auburn-Cave’s day “is special in a number of ways, especially because she is the widow of Prince Cave, who has given Barbados so much pleasure over the years.”
The centenarian’s second daughter, Antoinette Sealy, paid a tribute on behalf of the family, stating: “Mummy’s pride and joy has always been her seven children… her 12 grandchildren and her 12 great-grandchildren. Her family always came first.”
Lloyd Cave, one of the centenarian’s eldest grandchildren, noted that she is “the rock of the family”.
Prince Cave Jr., one of the centenarian’s sons and a member of the Troubadours band in Barbados, shared that one of his fondest memories was “the strength she had” when his father, Inspector Prince Cave, former Director of the Royal Barbados Police Force Band (now Barbados Police Service Band) traveled for three years to complete a Band Master’s course at the Royal Military School of Music, Kneller Hall, England.
Perhaps one of the most poignant tributes was that from Ronald Cave, who shared that when he took ill with tetanus as a boy, “every day, sometimes twice a day” his mum would walk from work or from home to the hospital. “There were some days I was so bad that she could not see me directly, but I remember that sometimes she would come by the window to catch a glimpse,” he noted.
Auburn-Cave worked in the Accounts Department at Perkins and Sons and then at French Trading Co. Ltd. until retirement. Both businesses were on Roebuck Street, Bridgetown.
She was known for sticking to a schedule and the family knew that growing up, when it was noon it was time to eat and at 7 p.m. she would watch the Evening News on CBC TV, which to this day, she still does with the lights turned off.
One of the centenarian’s favourite songs is Wind Beneath My Wings,, which Prince Cave Jr. played on the saxophone, as part of his tribute to his mother.
An avid cook, Auburn-Cave still prepares some of her own meals, mainly breakfast (tea and a boiled egg) and her evening tea, which she takes with a fried egg. She has a special fondness for eggs, and she eats two every day. The centenarian appreciates all types of food and is known to like dessert – ice cream and jam puffs.
(BGIS)
The post Centenarian ‘real happy’ to celebrate milestone with family appeared first on Barbados Today.
2 years 3 months ago
A Slider, Arts & Culture, Health, Living Well
Health Archives - Barbados Today
QEH staff rewarded for going beyond
By Anesta Henry
The Queen Elizabeth Hospital (QEH) has launched a monthly Employee Recognition Programme to honour staff for their hard work, dedication and going the extra mile to deliver patient care.
By Anesta Henry
The Queen Elizabeth Hospital (QEH) has launched a monthly Employee Recognition Programme to honour staff for their hard work, dedication and going the extra mile to deliver patient care.
Delivering remarks at the inaugural awards held at the QEH Auditorium on Tuesday, Executive Chairman Juliette Bynoe-Sutherland said such an initiative is pivotal simply because only those within the organisation understand what it truly takes to deliver patient care to the public.
She stressed that employees understand the times of plenty, scarcity, as well as the creativity, professional skills, ingenuity, collyfoxing, and sacrificing that it takes to make QEH work.
Bynoe-Sutherland said reward and recognition programmes are important to increase motivation for workers to maintain a positive attitude, encourage friendly competition, improve productivity, and also boost employee retention as satisfied workers are less likely to leave or complain and are most likely to deliver the best service or patient care.
“But forgive me if I dwell on a lesson that I have learnt over the past three years and why I pushed so hard on this event. The QEH organisational culture is a work in progress, we are trying to create a culture of open and effective communication between ourselves and with our patients.
“We are seeking to maintain a unified purpose and build and sustain a culture of excellence. Our culture will not be changed by mandates from the board or directives from management. What QEH has taught me, what all of you in this room teach us, is that a positive organisational culture is built by inculcating in each and every employee the sense that their words and actions make a difference,” she said.
Suggesting that employees are motivated when commended for a job well done, the Executive Chairman said the 64-plus employees honoured at the inaugural event were chosen because of their deliberate choice to give of themselves, rise against their own personal circumstances and to give to the people of Barbados.
Noting that there are not yet many hospitals on the island where healthcare professionals can trade their skills, Bynoe-Sutherland said for many, working at QEH is the goal.
“Therefore, we are compelled to do all that we can to build recognition into the fabric and sinews of the organisation. This event is just one corporate measure for executive directors to celebrate their teams. Peer recognition is equally important.
“We are going to continue with our annual Peer Recognition event, the RESPECT Awards where team members vote and recognise other team members, as recognition from co-workers can be equally as important, and it’s really important to get staff engaged in celebrating and recognising others.
“In building this culture of recognition – a radio shout out, a thank-you card, handwritten notes, or an anonymous gift can have tremendous power in showing authentic appreciation. It is also important to recognise that some of your employees love the spotlight and others are much more private so recognition can be tailored to the individuals,” she said.
Employees were honoured for various contributions to patient care and for keeping the facility functioning even during challenging times.
Groups from several departments were recognised for the significant role they played, going beyond the call of duty and working long hours, to ensure QEH systems kept running during the cyber-attack on the hospital’s information technology systems. anestahenry@barbadostoday.bb
The post QEH staff rewarded for going beyond appeared first on Barbados Today.
2 years 3 months ago
A Slider, Health, Local News
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
A Nearly Obstructive Intratracheal Mass in a Pediatric Patient: Clinical Challenge
A 12-year-old girl presented to the clinic with a 3-month
history of intermittent stridor. Her symptoms were initially most prominent
while playing sports and were suspected to be due to asthma or seasonal
allergies. However, medical management with albuterol, intranasal fluticasone,
and cetirizine failed to provide relief. More recently, the patient’s parents
A 12-year-old girl presented to the clinic with a 3-month
history of intermittent stridor. Her symptoms were initially most prominent
while playing sports and were suspected to be due to asthma or seasonal
allergies. However, medical management with albuterol, intranasal fluticasone,
and cetirizine failed to provide relief. More recently, the patient’s parents
noted that she developed stridor while sleeping and while at rest, prompting
the family to present for medical attention. Previous workup, including
pulmonary function testing, was concerning for an upper airway obstructive
process, for which she was referred to otolaryngology. In-office flexible
videostroboscopy revealed a mass in the distal cervical trachea that appeared
nearly obstructive. Chest radiography confirmed the presence of an
approximately 1.5-cm, well circumscribed soft tissue mass within the cervical
trachea.
Direct laryngoscopy and bronchoscopy were performed in the
operating room under general anesthesia. This demonstrated an exophytic,
pedunculated mass that emanated from the anterior wall of the cervical trachea.
The patient was intubated via Seldinger technique to bypass the mass, with a
4.0-mm cuffed endotracheal tube loaded over a 0-degree Hopkins endoscope. With
the airway secured, attention was turned to excision of the mass. Lidocaine,
1%, with epinephrine 1:100 000 was injected in a submucosal plane, and
laryngeal scissors were used to excise the attachment of the mass from the
tracheal wall. The mass was then resected en bloc and removed with laryngeal
cupped forceps. The attachment site was then ablated with the Coblator. The patient was diagnosed having Schwannoma.
Intratracheal schwannomas are very rare neurogenic tumors
that are generally benign and have a predilection for adult females. Diagnosis
is often delayed or misdiagnosed as asthma due to the insidious presentation of
tracheal schwannomas. More obvious signs such as stridor, coughing, and
wheezing typically only become more apparent when the tumor enlarges and
obstructs more than half of the tracheal lumen.
Pulmonary function testing is useful for early diagnosis of
such intratracheal masses and may demonstrate an obstructive ventilatory defect
with no considerable bronchodilator response. Radiography and computed tomography
scans can help define tumor size, location, and potential extratracheal
extension. Ultimately, bronchoscopy with biopsy is the most effective way to
diagnose intratracheal schwannomas.
Reported bronchoscopic manifestations of intratracheal
schwannomas include (1) a broad base with a round or oval protrusion into the
tracheal lumen; (2) a pedicled tumor with polyplike growth into the lumen; and
(3) a dumbbell-shaped mass growing into the lumen. Definitive diagnosis depends
on histopathologic analysis. Key findings on histopathology include an intact
envelope and Antoni A and B architectural patterns. Positive S-100 and negative
beta-catenin and SMA immunohistochemical staining also help confirm the
diagnosis. In the present patient, histologic section analysis showed a benign
spindle cell lesion with focal nuclear palisading. Immunohistochemical stains
of the specimen were positive for S-100 and negative for beta-catenin and SMA.
Reported treatments for pedunculated and completely intraluminal
tumors include endoscopic excision with or without a carbon dioxide laser,
electronic snaring, and cryotherapy. Continued postoperative monitoring is advised
because local recurrence has been previously reported, albeit rarely. Patients
with recurrent disease, cancer, or extratracheal tumor extension may benefit
from limited tracheal resection with primary anastomosis. Fortunately, this
patient had no evidence of recurrence on follow-up direct laryngoscopy and
bronchoscopy 3 months later.
Careful consideration of airway management is essential
prior to surgical intervention on obstructive tracheal masses. Obtaining a secure
airway, distal to the mass, is paramount.
Obtaining a secure airway can be difficult in the case of obstructive
tracheal masses. Maintaining spontaneous ventilation is useful to preserve patients’
preoperative ability to ventilate. The use of bag-mask ventilation should be
confirmed early in the management of a difficult airway, as this, if nothing
else, provides reassurance of the ability to maintain oxygenation and
ventilation over a period of time. Certainly, intubation with a cuffed
endotracheal tube distal to the lesion is ideal. Ultimately, a carefully
coordinated, algorithmic, team-based approach to the management of such
difficult airways allows for the highest chance of successfully securing the
airway
Source:Hakimi AA, Orobello NC, Mudd PA. A Nearly
Obstructive Intratracheal Mass in a Pediatric Patient. JAMA
Otolaryngol Head Neck Surg. Published online February 02, 2023.
doi:10.1001/jamaoto.2022.4908
2 years 3 months ago
ENT,ENT News,Case of the Day
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
Transcanal endoscopic ear surgery feasible and effective for the removal of Congenital cholesteatoma:JAMA
Congenital cholesteatoma (CC) is an uncommon condition. The
reported incidence of CC, however, has been increasing, which might be due to
early identification and increased awareness of cholesteatomas. The improvement
in and widespread use of diagnostic tools, such as endoscopes and microscopes,
in local clinics have likely played an important role in the early
Congenital cholesteatoma (CC) is an uncommon condition. The
reported incidence of CC, however, has been increasing, which might be due to
early identification and increased awareness of cholesteatomas. The improvement
in and widespread use of diagnostic tools, such as endoscopes and microscopes,
in local clinics have likely played an important role in the early
identification of CCs by primary care physicians, pediatricians, and
otolaryngologists. The treatment of choice for CC is complete surgical removal,
avoiding damage to the normal structures, and prevention of recurrence. The
traditional method of middle ear cholesteatoma surgery is performed under a
microscope
With advances in endoscopic technology, the role of
transcanal endoscopic ear surgery (TEES) has gained more attention in managing
cholesteatoma, particularly in pediatric populations. The angled endoscope
provides wide dynamic visualization, which aids in looking for hidden areas in
the middle ear cavity during CC removal. The improved visualization offered by
the endoscope may also obviate a large incision (postauricular or endaural
incision), which provides minimally invasive transcanal access to the middle
ear.
This study by Choi JE et
al assessed the outcomes of TEES for CC to determine the clinical efficacy of
TEES in pediatric patients with CC.
This cohort study evaluated retrospective, multicenter data
for 271 children with CC who underwent TEES at 9 tertiary referral hospitals in
South Korea between January 1, 2013, and December 31, 2021, and had a follow-up
of at least 6 months after surgery. Outcomes included the incidence of residual
cholesteatoma and audiometric data after TEES.
- Of the 271 patients, 190 had Potsic stage I CC (70.1%), 21
(7.7%) had stage II, 57 (21.0%) had stage III, and 3 (1.1%) had stage IV.
- Thirty-six patients (13.3%) with residual cholesteatoma were
found, including 15 (7.9%) with Potsic stage I, 3 (14.3%) with stage II, and 18
(31.6%) with stage III.
- In the multivariable analysis, invasion of the malleus (HR,
2.257; 95% CI, 1.074-4.743) and posterosuperior quadrant location (HR, 3.078;
95% CI, 1.540-6.151) were associated with the incidence of recidivism.
- Overall, hearing loss (>25 dB on auditory behavioral test
or >30 dB of auditory evoked responses) decreased from 24.4% to 17.7% after
TEES.
- This cohort study represents the largest series to date of
CC removed by TEES and reveals a favorable surgical outcome, with a recidivism
rate of 13.3% among 271 children with CC limited to the middle ear and/or
mastoid antrum. The observed recidivism rate was lower than published estimates
with microscopic techniques, which range from 20% to 52%.
Risk of residual cholesteatoma was associated with a higher
Potsic stage. These rates compare favorably with those of residual
cholesteatoma removed by the microscopic technique, ranging from a 13% risk in
stage I to 67% in stage IV. The TEES technique improves visualization and can
reduce the risk of residual cholesteatoma. The use of both hands to dissect
cholesteatoma, which is difficult while using an endoscope, does not provide an
advantage for resection completeness of middle ear and attic cholesteatomas.
The findings suggest that TEES may be effective in treating
CC limited to the middle ear and/or mastoid antrum in children. Recidivism was
low even for advanced stages. Based on findings, cholesteatoma invasion of the
malleus and presence in the PSQ of the tympanic cavity may be associated with
significantly higher residual rates. These results may help to guide surgeons
to achieve optimal results for patients with CC.
Source: Choi JE, Kang WS, Lee JD, et al. Outcomes of Endoscopic
Congenital Cholesteatoma Removal in South Korea. JAMA
Otolaryngol Head Neck Surg. Published online January 19, 2023.
doi:10.1001/jamaoto.2022.4660
2 years 3 months ago
ENT,ENT News,Top Medical News
Grenada under high alert against Avian Influenza
Avian Influenza is transmitted by wild migratory birds moving from cold climates into warmer regions
View the full post Grenada under high alert against Avian Influenza on NOW Grenada.
Avian Influenza is transmitted by wild migratory birds moving from cold climates into warmer regions
View the full post Grenada under high alert against Avian Influenza on NOW Grenada.
2 years 3 months ago
Agriculture/Fisheries, Health, PRESS RELEASE, gis, highly pathogenic avian influenza, kimond cummings, ministry of agriculture, thaddeus peters
The ‘next Ozempic’ became a social media sensation. Then everything changed - The Independent
- The ‘next Ozempic’ became a social media sensation. Then everything changed The Independent
- Do Wegovy and Ozempic work for weight loss? Deseret News
- Why the Ozempic Conversation Has Become Unavoidable: Breaking Down the Controversy E! NEWS
- Some ‘can’t get it to live;’ weight-loss trend blamed for nationwide storage of diabetic medication WHIO
- Weight loss drug trend on TikTok worries doctors Jamaica Observer
- View Full Coverage on Google News
2 years 3 months ago
Health & Wellness | Toronto Caribbean Newspaper
Cardiovascular disease, cancer and diabetes; the three Caribbean killers
BY TRISHA SMITH Just when you thought gun violence was our biggest enemy, there is and always was, a greater force that takes the lives of hundreds of our Caribbean people every day. Although islands like Jamaica and Trinidad and Tobago have been proudly independent since 1962, we have never really been free of western […]
The post Cardiovascular disease, cancer and diabetes; the three Caribbean killers first appeared on Toronto Caribbean Newspaper.
2 years 3 months ago
Your Health, #LatestPost
Public Health issues epidemiological alert against chikungunya
The Ministry of Public Health issued an epidemiological alert on Wednesday against chikungunya, a viral disease transmitted through the bite of the Aedes Aegypti mosquito, the same one that transmits dengue. The information was offered by the Vice Minister of Collective Health, Eladio Pérez, who assured that so far there are no cases in the country.
Pérez explained that the alert is issued in a preventive mode, since, in countries of the Southern Cone, such as Brazil and Paraguay, there has been an exponential increase in affected patients.
In this context, the director of Epidemiology, Ronald Skewes, indicated that by the year 2021, in the region of the Americas, 137,000 cases of chikungunya were recorded; 271 thousand cases in 2022, and 30,707 cases during the first four weeks of 2023, marking a pattern of accelerated growth. “That it arrives in the country is a matter of time,” highlighted the doctor.
Swekes indicated that the term “chikungunya” means “The bent man”, alluding to the severe pain that this disease produces throughout the body, making it difficult to walk upright and whose conditions can persist for long months. Other symptoms are fever, rash, and general malaise.
2 years 3 months ago
Health, Local
UWI medical researchers advocate for improved cancer care | Loop Caribbean News - Loop News Caribbean
- UWI medical researchers advocate for improved cancer care | Loop Caribbean News Loop News Caribbean
- UWI medical researchers advocate for improved cancer care in developing states Jamaica Observer
- View Full Coverage on Google News
2 years 3 months ago
Obesity, the other epidemic in the Dominican Republic
The balance suffers year after year. The weight of a sedentary life and an inadequate diet, due to lack of food or high consumption by the least fit, make the Dominican population increasingly fat.
In less than 15 years, the country has gone from less than 25% of its people being overweight to more than 70%, according to the latest survey carried out by the Health authorities in 2021, and that, without the rigor of a scientific study, serves as an indicator of the need to act against a problem that is worsening and causes diabetes and hypertension.
“31% of schoolchildren are overweight. In less than 15 years, the country has gone from less than 25% of people overweight to more than 70%.” With the causes documented in more than one report and much more consequences, even the economic cost of being overweight has been analyzed, the country has to apply measures so that the balance begins to decline.
But the recommended actions have not yet materialized and the Dominican Republic experiencing the failure of the goals set, despite the millionaire burden that being overweight implies for the State. Controlling overweight will require national policies that go beyond training and information. One first step could be to tax sugary drinks in the country.
2 years 3 months ago
Health, Local
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
MCh Neurosurgery: Admissions, Medical colleges, fees, eligibility criteria details
MCh Neurosurgery or
Master of Chirurgiae in Neurosurgery also known as MCh in Neurosurgery is a
super specialty level course for doctors in India that they do after
completion of their postgraduate medical degree course. The duration of this
super specialty course is 3 years, and it deals with the
MCh Neurosurgery or
Master of Chirurgiae in Neurosurgery also known as MCh in Neurosurgery is a
super specialty level course for doctors in India that they do after
completion of their postgraduate medical degree course. The duration of this
super specialty course is 3 years, and it deals with the
diagnosis and surgical treatment of patients with injury or diseases/disorders of
the brain, spinal cord and spinal column, and peripheral nerves within all
parts of the body.
The course is a
full-time course pursued at various recognized medical colleges across the
country. Some of the top medical colleges offering this course include All India Institute of Medical Sciences, Delhi,
Sree Chitra Thirunal Institute for Medical Science and Technology,
Thiruvananthapuram, Postgraduate Institute of Medical Education & Research,
Chandigarh
and more.
Admission to this course
is done through the NEET-SS Entrance exam conducted by the National Board of
Examinations, followed by counseling based on the scores of the exam that is
conducted by DGHS/MCC/State Authorities.
The fee for pursuing MCh
(Neurosurgery) varies from college to college and may range from Rs.7 thousand
to Rs. 30 lakhs per year.
After completion of
their respective course, doctors can either join the job market or can pursue
certificate courses and Fellowship programmes recognized by NMC and NBE.
Candidates can take decent jobs as Senior residents, Consultants,
etc. with an approximate salary range of Rs 32 lakhs to Rs. 95 lakhs per annum.
What is MCh in Neurosurgery?
Master of Chirurgiae in Neurosurgery,
also known as MCh (Neurosurgery) or MCh in (Neurosurgery) is a three-year super
specialty programme that candidates can pursue after completing a postgraduate
degree.
MCh Neurosurgery provides
training to diagnose and surgically treat patients with injury or
diseases/disorders of the brain, spinal cord and spinal column, and peripheral
nerves within all parts of the body. The speciality of neurosurgical care includes
both adult and pediatric patients. Dependent upon the nature of the injury or
disease a neurological surgeon may provide surgical and/or non-surgical care to the
body.
The postgraduate
students must gain ample knowledge and experience in the diagnosis, and
treatment of patients with acute, serious, and life-threatening medical and
surgical diseases.
PG education intends to
create specialists who can contribute to high-quality health care and advances
in science through research and training.
The required training
done by a postgraduate specialist in the field of Neurosurgery would help the
specialist to recognize the health needs of the community. The student should
be competent to handle medical problems effectively and should be aware of the
recent advances in their specialty.
The candidate is also
expected to know the principles of research methodology and modes of the
consulting library. The candidate should regularly attend conferences,
workshops and CMEs to upgrade her/ his knowledge.
Course
Highlights
Here are some of the
course highlights of MCh in Neurosurgery
Name of Course
MCh in Neurosurgery
Level
Doctorate
Duration of Course
Three years
Course Mode
Full Time
Minimum Academic Requirement
Candidates must have a postgraduate medical
Degree in MS/DNB (General Surgery) obtained from any college/university
recognized by the Medical Council of India (Now NMC)/NBE, this feeder
qualification mentioned here is as of 2022. For any further changes to the
prerequisite requirement please refer to the NBE website.
Admission Process / Entrance Process /
Entrance Modalities
Entrance Exam (NEET-SS)
INI CET for various AIIMS, PGIMER Chandigarh,
JIPMER Puducherry, NIMHANS Bengaluru
Counseling by DGHS/MCC/State Authorities
Course Fees
Rs.7 thousand to Rs. 30 lakhs per year
Average Salary
Rs 32 lakhs to Rs.95 lakhs per annum
Eligibility
Criteria
The eligibility criteria
for MCh in Neurosurgery are defined as the set of rules or minimum
prerequisites that aspirants must meet to be eligible for admission, which
include:
Name of Super Specialty course
Course Type
Prior Eligibility Requirement
Neurosurgery
MCh
MS/DNB (General Surgery)
Note:
· The feeder
qualification for MCh Neurosurgery is defined by the NBE and is subject to
changes by the NBE.
· The feeder
qualification mentioned here is as of 2022.
·For any changes,
please refer to the NBE website.
- The prior entry qualifications
shall be strictly by Post Graduate Medical Education Regulations, 2000,
and its amendments notified by the NMC and any clarification issued from
NMC in this regard. - The candidate must have
obtained permanent registration with any State Medical Council to be
eligible for admission. - The medical college's
recognition cut-off dates for the Postgraduate Degree courses shall be as
prescribed by the Medical Council of India (now NMC).
Admission
Process
The admission process
contains a few steps to be followed in order by the candidates for admission to
MCh in Neurosurgery. Candidates can view the complete admission process for MCh
in Neurosurgery mentioned below:
- The NEET-SS or National
Eligibility Entrance Test for Super specialty courses is a national-level
master’s level examination conducted by the NBE for admission to
DM/MCh/DrNB Courses. - Qualifying Criteria-Candidates
placed at the 50th percentile or above shall be declared as qualified in
the NEET-SS in their respective speciality. - The following Medical
institutions are not covered under centralized admissions for DM/MCh
courses through NEET-SS:
1. AIIMS, New Delhi and
other AIIMS
2. PGIMER, Chandigarh
3. JIPMER, Puducherry
4. NIMHANS, Bengaluru
- Candidates from all eligible
feeder speciality subjects shall be required to appear in the question
paper of the respective group if they are willing to opt for a
super-speciality course in any of the super-speciality courses covered in
that group. - A candidate can opt for
appearing in the question papers of as many groups for which his/her
Postgraduate speciality qualification is an eligible feeder qualification. - By appearing in the question
paper of a group and on qualifying for the examination, a candidate shall
be eligible to exercise his/her choices in the counselling only for those
super-speciality subjects covered in the said group for which his/ her
broad speciality is an eligible feeder qualification.
Fees Structure
The fee structure for
MCh in Neurosurgery varies from college to college. The fee is generally less
for Government Institutes and more for private institutes. The average fee
structure for MCh in Neurosurgery is from Rs.7 thousand to Rs. 30 lakhs per
year.
Colleges
offering MCh in Neurosurgery
Various medical colleges
across India offer courses for pursuing MCh in (Neurosurgery).
As per National Medical Commission (NMC) website, the following medical
colleges are offering MCh in (Neurosurgery) courses for the academic year
2022-23.
Sl.No.
Course Name
State
Name and Address of
Medical College / Medical Institution
Management of College
Annual Intake (Seats)
1
M.Ch - Neuro Surgery
Andhra Pradesh
Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati
Govt.
3
2
M.Ch - Neuro Surgery
Andhra Pradesh
Andhra Medical College, Visakhapatnam
Govt.
3
3
M.Ch - Neuro Surgery
Andhra Pradesh
Rangaraya Medical College, Kakinada
Govt.
2
4
M.Ch - Neuro Surgery
Andhra Pradesh
Guntur Medical College, Guntur
Govt.
4
5
M.Ch - Neuro Surgery
Andhra Pradesh
NRI Medical College, Guntur
Trust
1
6
M.Ch - Neuro Surgery
Assam
Gauhati Medical College, Guwahati
Govt.
3
7
M.Ch - Neuro Surgery
Bihar
All India Institute of Medical Sciences, Patna
Govt.
2
8
M.Ch - Neuro Surgery
Chandigarh
Postgraduate Institute of Medical Education & Research, Chandigarh
Govt.
12
9
M.Ch - Neuro Surgery
Chattisgarh
All India Institute of Medical Sciences, Raipur
Govt.
3
10
M.Ch - Neuro Surgery
Delhi
All India Institute of Medical Sciences, New Delhi
Govt.
20
11
M.Ch - Neuro Surgery
Delhi
G.B. Pant Institute of Postgraduate Medical Education and Research,
New Delhi
Govt.
6
12
M.Ch - Neuro Surgery
Delhi
Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML
Hospital, New Delhi
Govt.
6
13
M.Ch - Neuro Surgery
Goa
Goa Medical College, Panaji
Govt.
2
14
M.Ch - Neuro Surgery
Gujarat
SBKS Medical Instt. & Research Centre, Vadodra
Trust
1
15
M.Ch - Neuro Surgery
Gujarat
B J Medical College, Ahmedabad
Govt.
4
16
M.Ch - Neuro Surgery
Gujarat
Smt. N.H.L.Municipal Medical College, Ahmedabad
Govt.
4
17
M.Ch - Neuro Surgery
Haryana
Pt. B D Sharma Postgraduate Institute of Medical Sciences, Rohtak
(Haryana)
Govt.
2
18
M.Ch - Neuro Surgery
Jammu & Kashmir
Sher-I-Kashmir Instt. Of Medical Sciences, Srinagar
Govt.
4
19
M.Ch - Neuro Surgery
Jharkhand
Rajendra Institute of Medical Sciences, Ranchi
Govt.
4
20
M.Ch - Neuro Surgery
Karnataka
Vydehi Institute Of Medical Sciences & Research Centre, Bangalore
Trust
2
21
M.Ch - Neuro Surgery
Karnataka
Kasturba Medical College, Manipal
Trust
4
22
M.Ch - Neuro Surgery
Karnataka
National Institute of Mental Health & Neuro Sciences, Bangalore
Govt.
10
23
M.Ch - Neuro Surgery
Karnataka
Bangalore Medical College and Research Institute, Bangalore
Govt.
2
24
M.Ch - Neuro Surgery
Karnataka
M S Ramaiah Medical College, Bangalore
Trust
4
25
M.Ch - Neuro Surgery
Karnataka
St. Johns Medical College, Bangalore
Trust
1
26
M.Ch - Neuro Surgery
Karnataka
Jawaharlal Nehru Medical College, Belgaum
Trust
3
27
M.Ch - Neuro Surgery
Kerala
Sree Chitra Thirunal Institute for Medical Science and Technology,
Thiruvananthapuram
Govt.
3
28
M.Ch - Neuro Surgery
Kerala
Pushpagiri Institute Of Medical Sciences and Research Centre,
Tiruvalla
Trust
1
29
M.Ch - Neuro Surgery
Kerala
Amala Institute of Medical Sciences, Thrissur
Trust
1
30
M.Ch - Neuro Surgery
Kerala
Government Medical College, Kottayam
Govt.
4
31
M.Ch - Neuro Surgery
Kerala
Government Medical College, Kozhikode, Calicut
Govt.
2
32
M.Ch - Neuro Surgery
Kerala
Medical College, Thiruvananthapuram
Govt.
6
33
M.Ch - Neuro Surgery
Kerala
Government Medical College, Thrissur
Govt.
3
34
M.Ch - Neuro Surgery
Kerala
T D Medical College, Alleppey (Allappuzha)
Govt.
2
35
M.Ch - Neuro Surgery
Kerala
Amrita School of Medicine, Elamkara, Kochi
Trust
4
36
M.Ch - Neuro Surgery
Madhya Pradesh
Gajra Raja Medical College, Gwalior
Govt.
8
37
M.Ch - Neuro Surgery
Madhya Pradesh
All India Institute of Medical Sciences, Bhopal
Govt.
4
38
M.Ch - Neuro Surgery
Madhya Pradesh
Sri Aurobindo Medical College and Post Graduate Institute, Indore
Trust
2
39
M.Ch - Neuro Surgery
Maharashtra
Dr D Y Patil Medical College, Hospital and Research Centre, Pimpri,
Pune
Trust
3
40
M.Ch - Neuro Surgery
Maharashtra
Armed Forces Medical College, Pune
Govt.
3
41
M.Ch - Neuro Surgery
Maharashtra
Lokmanya Tilak Municipal Medical College, Sion, Mumbai
Govt.
4
42
M.Ch - Neuro Surgery
Maharashtra
Bombay Hospital Institute of Medical Sciences, Mumbai
Govt.
3
43
M.Ch - Neuro Surgery
Maharashtra
Grant Medical College, Mumbai
Govt.
3
44
M.Ch - Neuro Surgery
Maharashtra
Seth GS Medical College, and KEM Hospital, Mumbai
Govt.
4
45
M.Ch - Neuro Surgery
Maharashtra
Topiwala National Medical College, Mumbai
Govt.
4
46
M.Ch - Neuro Surgery
Maharashtra
B. J. Govt. Medical College, Pune
Govt.
2
47
M.Ch - Neuro Surgery
Maharashtra
Krishna Vishwa Vidyapeeth, Karad (Formerly known as Krishna Institute
of Medical Sciences University)
Trust
1
48
M.Ch - Neuro Surgery
Orissa
All India Institute of Medical Sciences, Bhubaneswar
Govt.
4
49
M.Ch - Neuro Surgery
Orissa
SCB Medical College, Cuttack
Govt.
4
50
M.Ch - Neuro Surgery
Pondicherry
Jawaharlal Institute of Postgraduate Medical Education & Research,
Puducherry
Govt.
4
51
M.Ch - Neuro Surgery
Pondicherry
Mahatma Gandhi Medical College & Research Institute, Pondicherry
Trust
1
52
M.Ch - Neuro Surgery
Punjab
Dayanand Medical College & Hospital, Ludhiana
Trust
2
53
M.Ch - Neuro Surgery
Punjab
Christian Medical College, Ludhiana
Trust
1
54
M.Ch - Neuro Surgery
Rajasthan
All India Institute of Medical Sciences, Jodhpur
Govt.
6
55
M.Ch - Neuro Surgery
Rajasthan
SMS Medical College, Jaipur
Govt.
14
56
M.Ch - Neuro Surgery
Rajasthan
R N T Medical College, Udaipur
Govt.
4
57
M.Ch - Neuro Surgery
Rajasthan
Mahatma Gandhi Medical College and Hospital, Sitapur, Jaipur
Trust
6
58
M.Ch - Neuro Surgery
Rajasthan
National Institute of Medical Science & Research, Jaipur
Trust
3
59
M.Ch - Neuro Surgery
Rajasthan
Dr SN Medical College, Jodhpur
Govt.
4
60
M.Ch - Neuro Surgery
Tamil Nadu
Sri Ramachandra Medical College & Research Institute, Chennai
Trust
3
61
M.Ch - Neuro Surgery
Tamil Nadu
Madras Medical College, Chennai
Govt.
9
62
M.Ch - Neuro Surgery
Tamil Nadu
SRM Medical College Hospital & Research Centre, Chengalpattu
Trust
1
63
M.Ch - Neuro Surgery
Tamil Nadu
Stanley Medical College, Chennai
Govt.
3
64
M.Ch - Neuro Surgery
Tamil Nadu
Madurai Medical College, Madurai
Govt.
4
65
M.Ch - Neuro Surgery
Tamil Nadu
Christian Medical College, Vellore
Trust
6
66
M.Ch - Neuro Surgery
Tamil Nadu
Chettinad Hospital & Research Institute, Kanchipuram
Trust
1
67
M.Ch - Neuro Surgery
Tamil Nadu
Coimbatore Medical College, Coimbatore
Govt.
4
68
M.Ch - Neuro Surgery
Tamil Nadu
Thanjavur Medical College,Thanjavur
Govt.
4
69
M.Ch - Neuro Surgery
Telangana
Gandhi Medical College, Secunderabad
Govt.
4
70
M.Ch - Neuro Surgery
Telangana
Nizams Institute of Medical Sciences, Hyderabad
Govt.
6
71
M.Ch - Neuro Surgery
Telangana
Osmania Medical College, Hyderabad
Govt.
6
72
M.Ch - Neuro Surgery
Telangana
Mamata Medical College, Khammam
Trust
2
73
M.Ch - Neuro Surgery
Uttarakhand
All India Institute of Medical Sciences, Rishikesh
Govt.
20
74
M.Ch - Neuro Surgery
Uttar Pradesh
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow
Govt.
6
75
M.Ch - Neuro Surgery
Uttar Pradesh
King George Medical University, Lucknow
Govt.
8
76
M.Ch - Neuro Surgery
Uttar Pradesh
Institute of Medical Sciences, BHU, Varanasi
Govt.
4
77
M.Ch - Neuro Surgery
Uttar Pradesh
Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow
Govt.
3
78
M.Ch - Neuro Surgery
West Bengal
Institute of Postgraduate Medical Education & Research, Kolkata
Govt.
10
79
M.Ch - Neuro Surgery
West Bengal
Calcutta National Medical College, Kolkata
Govt.
1
80
M.Ch - Neuro Surgery
West Bengal
Nilratan Sircar Medical College, Kolkata
Govt.
2
Syllabus
MCh in Neurosurgery is a
three years specialization course that provides training in the stream of Neurosurgery.
As
of 27/02/2022 the Competency-Based Curriculum for MCh in Neurosurgery course is
not available on the National Medical Commission's official Website. However, the
course content of AIIMS represented here can be used for reference and an idea of
what a typical Syllabus of an MCh in Neurosurgery course will contain:
SYLLABUS
1.
Clinical Neurosurgery
including history taking, physical examination, diagnosis, selection and
planning of relevant investigations, appropriate treatment and rehabilitation
of patients with neurosurgical disorders including those presenting as
emergencies.
2.
Essentials of Clinical
Neurology especially concerning disorders common in India and those likely
to present to Neurosurgeons.
3.
Basic medical sciences
relevant to the practice of Neurosurgery
4.
Surgical Neuropathology
and the essentials of the Pathology of Neurological disorders likely to present
to the Neurosurgeon.
5.
Performance and
interpretation of Neuroradiological procedures, such as carotid arteriography
and myelography. Familiarity with the technique of selective arteriography and
its interpretation.
6. Principles and interpretation of common Neurophysiological,
Neuro-ophthalmological, Neurootological and Neuroendocrinological tests
especially concerning Neurosurgical disorders.
7. Principles and interpretation of computerized axial tomography,
MRI and other modern investigations.
8. Performance of common neurosurgical operations in the supra and
infra-tentorial compartments in
the spinal canal and the peripheral nerves – initially under the supervision and later independently.
The ability to use the operating microscope is mandatory.
9. Familiarity with various types of anaesthesia used in
neurosurgery their indications and
contraindications, the use of ventilators and techniques of
monitoring and resuscitation.
10. Pharmacology of various drugs used in Neurosurgery.
11. Knowledge of the history of neurological surgery and its
allied disciplines with special reference to India.
12. Knowledge of recent advances in the field of neurological
surgery.
13. Preparation of papers for presentation at scientific
conferences and for publication.
14. Introduction to the techniques involved in the organisation
and development of a department, its
subsections and newer facilities.
15. It is desirable to have microsurgical laboratory training
where candidates learn dissection/suturing
of fine arteries/nerves under a microscope and skull base
dissections.
16. Development of proper attitudes towards patients,
subordinates, colleagues and seniors.
17. Should have basic knowledge about the application of computers
Career Options
After completing an MCh
in Neurosurgery, candidates will get employment opportunities in Government as
well as in the Private sector.
In the Government
sector, candidates have various options to choose from which include Registrar,
Senior Resident, Demonstrator, Tutor etc.
While in the Private
sector, the options include Resident Doctor, Consultant (Neuro Surgery), Visiting Consultant (Neuro Surgery),
Junior Consultant (Neuro Surgery), Senior Consultant (Neuro Surgery), Assistant Professor (Neuro Surgery), Associate Professor
(Neurosurgery).
Courses After
MCh in Neurosurgery Course
MCh in Neurosurgery is a
specialization course that can be pursued after finishing a Postgraduate
medical course. After pursuing a specialization in MCh in Neurosurgery, a
candidate could also pursue certificate courses and Fellowship programmes
recognized by NMC and NBE, where MCh in Neurosurgery is a feeder qualification.
These include
fellowships in:
·
Clinical Fellowships in
Neurosurgery
·
Neurosurgery Spine
Fellowships
·
Paediatric Neurosurgery
Fellowships
Frequently
Asked Questions (FAQs) –MCh in Neurosurgery Course
- Question: What is the complete full form of an MCh?
Answer: The full form of
an MCh is Master of Chirurgiae.
- Question: What is an MCh in Neurosurgery?
Answer: MCh Neurosurgery
or Master of Chirurgiae in Neurosurgery also known as MCh in Neurosurgery is a
super specialty level course for doctors in India that they do after
completion of their postgraduate medical degree course.
- Question: What is the duration of an MCh in Neurosurgery?
Answer: MCh in Neurosurgery
is a super specialty programme of three years.
- Question: What is the eligibility of an MCh in Neurosurgery?
Answer: The candidate must have a postgraduate medical Degree in MS/DNB (General Surgery) obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE, this feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.
- Question: What is the scope of an MCh
in Neurosurgery?
Answer: MCh in Neurosurgery
offers candidates various employment opportunities and career prospects
- Question: What is the average salary
for an MCh in Neurosurgery candidate?
Answer: The MCh in Neurosurgery
candidate’s average salary is between Rs. 32 lakhs to Rs. 95 lakhs per annum
depending on the experience.
- Question: Can you teach after completing an MCh Course?
Answer: Yes, the
candidate can teach in a medical college/hospital after completing an MCh
course.
2 years 3 months ago
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Medical News, Health News Latest, Medical News Today - Medical Dialogues |
MCh Urology: Admissions, Medical Colleges, Fees, Eligibility Criteria details
MCh Urology or Master of
Chirurgiae in Urology also known as MCh in Urology is a super specialty level
course for doctors in India that they do after completion of their
postgraduate medical degree course. The duration of this super specialty
course is 3 years, and it focuses on the diagnosis and treatment of diseases
MCh Urology or Master of
Chirurgiae in Urology also known as MCh in Urology is a super specialty level
course for doctors in India that they do after completion of their
postgraduate medical degree course. The duration of this super specialty
course is 3 years, and it focuses on the diagnosis and treatment of diseases
of the urinary-tract system and the reproductive organs. Organs under the
domain of urology include the kidneys, adrenal glands, ureters, urinary
bladder, urethra, and the male reproductive organs.
The course is a
full-time course pursued at various recognized medical colleges across the
country. Some of the top medical colleges offering this course include All India Institute of Medical Sciences, New Delhi, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, and more.
Admission to this course
is done through the NEET-SS Entrance exam conducted by the National Board of
Examinations, followed by counselling based on the scores of the exam that is
conducted by DGHS/MCC/State Authorities.
The fee for pursuing MCh
(Urology) varies from college to college and may range from Rs.7 thousand to
Rs. 28 lakhs.
After completion of
their respective course, doctors can either join the job market or can pursue
certificate courses and Fellowship programmes recognized by NMC and NBE.
Candidates can take reputed jobs as Senior residents, Consultants,
etc. with an approximate salary range of Rs 4.5 lakhs to Rs. 30 lakhs per
annum.
What is MCh in Urology?
Master of Chirurgiae in Urology,
also known as MCh (Urology) or MCh in (Urology) is a three-year super
specialty programme that candidates can pursue after completing a postgraduate
degree.
MCh Urology provides
training to evaluate, understand, and manage medical and
surgical aspects of genitourinary disorders. The curriculum includes basic and
clinical research in renovascular hypertension, adult and pediatric urinary
tract infection, treatment of urinary incontinence, neuro-urology, urinary tract
physiology, anatomy and cellular biology of the prostate gland, and
genitourinary oncology.
The postgraduate
students must gain ample knowledge and experience in the diagnosis, and
treatment of patients with acute, serious, and life-threatening diseases.
PG education intends to
create specialists who can contribute to high-quality health care and advances
in science through research and training.
The required training
done by a postgraduate specialist in the field of Urology would help the
specialist to recognize the health needs of the community. The student should
be competent to handle medical problems effectively and should be aware of the
recent advances in their speciality.
The candidate is also
expected to know the principles of research methodology and modes of the
consulting library. The candidate should regularly attend conferences,
workshops and CMEs to upgrade her/ his knowledge.
Course
Highlights
Here are some of the
course highlights of MCh in Urology
Name of Course
MCh in Urology
Level
Doctorate
Duration of Course
Three years
Course Mode
Full Time
Minimum Academic Requirement
Candidates must have a postgraduate medical
Degree in MS/DNB (General Surgery) obtained from any college/university
recognized by the Medical Council of India (Now NMC)/NBE, this feeder
qualification mentioned here is as of 2022. For any further changes to the
prerequisite requirement please refer to the NBE website.
Admission Process / Entrance Process /
Entrance Modalities
Entrance Exam (NEET-SS)
INI CET for various AIIMS, PGIMER Chandigarh,
JIPMER Puducherry, NIMHANS Bengaluru
Counselling by DGHS/MCC/State Authorities
Course Fees
Rs.7 thousand to Rs. 28 lakhs per year
Average Salary
Rs 4.5 lakhs to Rs.30 lakhs per annum
Eligibility
Criteria
The eligibility criteria
for MCh in Urology are defined as the set of rules or minimum prerequisites
that aspirants must meet to be eligible for admission, which include:
Name of Super Specialty course
Course Type
Prior Eligibility Requirement
Urology
MCh
MS/DNB (General Surgery)
Note:
· The feeder
qualification for MCh Urology is defined by the NBE and is subject to changes
by the NBE.
· The feeder
qualification mentioned here is as of 2022.
· For any changes,
please refer to the NBE website.
- The prior entry qualifications
shall be strictly by Post Graduate Medical Education Regulations, 2000,
and its amendments notified by the NMC and any clarification issued from
NMC in this regard. - The candidate must have
obtained permanent registration with any State Medical Council to be
eligible for admission. - The medical college's
recognition cut-off dates for the Postgraduate Degree courses shall be as
prescribed by the Medical Council of India (now NMC).
Admission
Process
The admission process
contains a few steps to be followed in order by the candidates for admission to
MCh in Urology. Candidates can view the complete admission process for MCh in Urology
mentioned below:
- The NEET-SS or National
Eligibility Entrance Test for Super speciality courses is a national-level
master’s level examination conducted by the NBE for admission to
DM/MCh/DrNB Courses. - Qualifying Criteria-Candidates
placed at the 50th percentile or above shall be declared as qualified in
the NEET-SS in their respective speciality. - The following Medical
institutions are not covered under centralized admissions for DM/MCh
courses through NEET-SS:
1. AIIMS, New Delhi and
other AIIMS
2. PGIMER, Chandigarh
3. JIPMER, Puducherry
4. NIMHANS, Bengaluru
- Candidates from all eligible
feeder speciality subjects shall be required to appear in the question
paper of the respective group if they are willing to opt for a
super-speciality course in any of the super-speciality courses covered in
that group. - A candidate can opt for
appearing in the question papers of as many groups for which his/her
Postgraduate speciality qualification is an eligible feeder qualification. - By appearing in the question
paper of a group and on qualifying for the examination, a candidate shall
be eligible to exercise his/her choices in the counselling only for those
super-speciality subjects covered in the said group for which his/ her
broad speciality is an eligible feeder qualification.
Fees Structure
The fee structure for
MCh in Urology varies from college to college. The fee is generally less for
Government Institutes and more for private institutes. The average fee
structure for MCh in Urology is from Rs.7 thousand to Rs. 28 lakhs per year.
Colleges
offering MCh in Urology
Various medical colleges
across India offer courses for pursuing MCh in (Urology).
As per National Medical
Commission (NMC) website, the following medical colleges are offering MCh in (Urology)
courses for the academic year 2022-23.
Sl.No.
Course Name
State
Name and Address of
Medical College / Medical Institution
Management of College
Annual Intake (Seats)
1
M.Ch - Urology/Genito-Urinary Surgery
Andhra Pradesh
Andhra Medical College, Visakhapatnam
Govt.
3
2
M.Ch - Urology/Genito-Urinary Surgery
Andhra Pradesh
Sri Venkateswara Institute of Medical Sciences
(SVIMS), Tirupati
Govt.
4
3
M.Ch - Urology/Genito-Urinary Surgery
Andhra Pradesh
Dr P.S.I. Medical College, Chinoutpalli
Trust
2
4
M.Ch - Urology/Genito-Urinary Surgery
Andhra Pradesh
Guntur Medical College, Guntur
Govt.
2
5
M.Ch - Urology/Genito-Urinary Surgery
Andhra Pradesh
Narayana Medical College, Nellore
Trust
4
6
M.Ch - Urology/Genito-Urinary Surgery
Assam
Gauhati Medical College, Guwahati
Govt.
4
7
M.Ch - Urology/Genito-Urinary Surgery
Bihar
Indira Gandhi Institute of Medical
Sciences, Sheikhpura, Patna
Govt.
4
8
M.Ch - Urology/Genito-Urinary Surgery
Chandigarh
Postgraduate Institute of Medical Education &
Research, Chandigarh
Govt.
10
9
M.Ch - Urology/Genito-Urinary Surgery
Chattisgarh
All India Institute of Medical Sciences, Raipur
Govt.
2
10
M.Ch - Urology/Genito-Urinary Surgery
Delhi
All India Institute of Medical Sciences, New
Delhi
Govt.
11
11
M.Ch - Urology/Genito-Urinary Surgery
Delhi
Atal Bihari Vajpayee Institute of Medical
Sciences and Dr RML Hospital, New Delhi
Govt.
4
12
M.Ch - Urology/Genito-Urinary Surgery
Delhi
Vardhman Mahavir Medical College & Safdarjung
Hospital, Delhi
Govt.
5
13
M.Ch - Urology/Genito-Urinary Surgery
Gujarat
B J Medical College, Ahmedabad
Govt.
4
14
M.Ch - Urology/Genito-Urinary Surgery
Haryana
Maharishi Markandeshwar Institute Of Medical
Sciences & Research, Mullana, Ambala
Trust
2
15
M.Ch - Urology/Genito-Urinary Surgery
Jammu & Kashmir
Sher-I-Kashmir Instt. Of Medical Sciences,
Srinagar
Govt.
4
16
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Bangalore Medical College and Research Institute,
Bangalore
Govt.
2
17
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
S S Institute of Medical Sciences& Research
Centre, Davangere
Trust
2
18
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Vijaynagar Institute of Medical Sciences, Bellary
Govt.
4
19
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Jawaharlal Nehru Medical College, Belgaum
Trust
5
20
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Kasturba Medical College, Manipal
Trust
6
21
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Rajarajeswari Medical College & Hospital,
Bangalore
Trust
4
22
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Yenepoya Medical College, Mangalore
Trust
3
23
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Father Mullers Medical College, Mangalore
Trust
2
24
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
K S Hegde Medical Academy, Mangalore
Trust
3
25
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
A J Institute of Medical Sciences & Research
Centre, Mangalore
Trust
4
26
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Vydehi Institute Of Medical Sciences &
Research Centre, Bangalore
Trust
1
27
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
St. Johns Medical College, Bangalore
Trust
1
28
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Shri B M Patil Medical College, Hospital &
Research Centre, Vijayapura(Bijapur
Trust
3
29
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
Institute of Nephro-Urology, Bangalore
Govt.
6
30
M.Ch - Urology/Genito-Urinary Surgery
Karnataka
M S Ramaiah Medical College, Bangalore
Trust
6
31
M.Ch - Urology/Genito-Urinary Surgery
Kerala
Medical College, Thiruvananthapuram
Govt.
6
32
M.Ch - Urology/Genito-Urinary Surgery
Kerala
Government Medical College, Kottayam
Govt.
3
33
M.Ch - Urology/Genito-Urinary Surgery
Kerala
Government Medical College, Kozhikode, Calicut
Govt.
4
34
M.Ch - Urology/Genito-Urinary Surgery
Kerala
T D Medical College, Alleppey (Allappuzha)
Govt.
2
35
M.Ch - Urology/Genito-Urinary Surgery
Kerala
Amrita School of Medicine, Elamkara, Kochi
Trust
3
36
M.Ch - Urology/Genito-Urinary Surgery
Madhya Pradesh
All India Institute of Medical Sciences, Bhopal
Govt.
2
37
M.Ch - Urology/Genito-Urinary Surgery
Maharashtra
Bombay Hospital Institute of Medical Sciences,
Mumbai
Govt.
2
38
M.Ch - Urology/Genito-Urinary Surgery
Maharashtra
Mahatma Gandhi Missions Medical College,
Aurangabad
Trust
1
39
M.Ch - Urology/Genito-Urinary Surgery
Maharashtra
Lokmanya Tilak Municipal Medical College, Sion,
Mumbai
Govt.
4
40
M.Ch - Urology/Genito-Urinary Surgery
Maharashtra
Topiwala National Medical College, Mumbai
Govt.
3
41
M.Ch - Urology/Genito-Urinary Surgery
Maharashtra
Seth GS Medical College, and KEM Hospital, Mumbai
Govt.
4
42
M.Ch - Urology/Genito-Urinary Surgery
Maharashtra
Mahatma Gandhi Missions Medical College, Navi
Mumbai
Trust
3
43
M.Ch - Urology/Genito-Urinary Surgery
Maharashtra
Bharati Vidyapeeth University Medical College,
Pune
Trust
3
44
M.Ch - Urology/Genito-Urinary Surgery
Maharashtra
Dr D Y Patil Medical College, Hospital and
Research Centre, Pimpri, Pune
Trust
4
45
M.Ch - Urology/Genito-Urinary Surgery
Manipur
Regional Institute of Medical Sciences, Imphal
Govt.
2
46
M.Ch - Urology/Genito-Urinary Surgery
Orissa
SCB Medical College, Cuttack
Govt.
5
47
M.Ch - Urology/Genito-Urinary Surgery
Pondicherry
Jawaharlal Institute of Postgraduate Medical
Education & Research, Puducherry
Govt.
3
48
M.Ch - Urology/Genito-Urinary Surgery
Pondicherry
Mahatma Gandhi Medical College & Research
Institute, Pondicherry
Trust
2
49
M.Ch - Urology/Genito-Urinary Surgery
Punjab
Dayanand Medical College & Hospital, Ludhiana
Trust
2
50
M.Ch - Urology/Genito-Urinary Surgery
Rajasthan
Sardar Patel Medical College, Bikaner
Govt.
4
51
M.Ch - Urology/Genito-Urinary Surgery
Rajasthan
SMS Medical College, Jaipur
Govt.
10
52
M.Ch - Urology/Genito-Urinary Surgery
Rajasthan
Mahatma Gandhi Medical College and Hospital,
Sitapur, Jaipur
Trust
6
53
M.Ch - Urology/Genito-Urinary Surgery
Rajasthan
National Institute of Medical Science &
Research, Jaipur
Trust
3
54
M.Ch - Urology/Genito-Urinary Surgery
Rajasthan
Dr SN Medical College, Jodhpur
Govt.
4
55
M.Ch - Urology/Genito-Urinary Surgery
Tamil Nadu
SRM Medical College Hospital & Research
Centre, Chengalpattu
Trust
3
56
M.Ch - Urology/Genito-Urinary Surgery
Tamil Nadu
Sri Ramachandra Medical College & Research
Institute, Chennai
Trust
6
57
M.Ch - Urology/Genito-Urinary Surgery
Tamil Nadu
Madras Medical College, Chennai
Govt.
8
58
M.Ch - Urology/Genito-Urinary Surgery
Tamil Nadu
Kilpauk Medical College, Chennai
Govt.
6
59
M.Ch - Urology/Genito-Urinary Surgery
Tamil Nadu
Christian Medical College, Vellore
Trust
5
60
M.Ch - Urology/Genito-Urinary Surgery
Tamil Nadu
Stanley Medical College, Chennai
Govt.
5
61
M.Ch - Urology/Genito-Urinary Surgery
Tamil Nadu
Chettinad Hospital & Research Institute,
Kanchipuram
Trust
3
62
M.Ch - Urology/Genito-Urinary Surgery
Tamil Nadu
Meenakshi Medical College and Research Institute,
Enathur
Trust
2
63
M.Ch - Urology/Genito-Urinary Surgery
Telangana
Osmania Medical College, Hyderabad
Govt.
4
64
M.Ch - Urology/Genito-Urinary Surgery
Telangana
Gandhi Medical College, Secunderabad
Govt.
2
65
M.Ch - Urology/Genito-Urinary Surgery
Telangana
Nizams Institute of Medical Sciences, Hyderabad
Govt.
4
66
M.Ch - Urology/Genito-Urinary Surgery
Telangana
Mamata Medical College, Khammam
Trust
2
67
M.Ch - Urology/Genito-Urinary Surgery
Telangana
Kamineni Institute of Medical Sciences, Narketpally
Trust
1
68
M.Ch - Urology/Genito-Urinary Surgery
Telangana
Chalmeda Anand Rao Institute Of Medical
Sciences, Karimnagar
Trust
1
69
M.Ch - Urology/Genito-Urinary Surgery
Telangana
Deccan College of Medical Sciences, Hyderabad
Trust
1
70
M.Ch - Urology/Genito-Urinary Surgery
Uttarakhand
All India Institute of Medical Sciences,
Rishikesh
Govt.
22
71
M.Ch - Urology/Genito-Urinary Surgery
Uttar Pradesh
Institute of Medical Sciences, BHU, Varansi
Govt.
4
72
M.Ch - Urology/Genito-Urinary Surgery
Uttar Pradesh
Sanjay Gandhi Postgraduate Institute of Medical
Sciences, Lucknow
Govt.
4
73
M.Ch - Urology/Genito-Urinary Surgery
Uttar Pradesh
King George Medical University, Lucknow
Govt.
6
74
M.Ch - Urology/Genito-Urinary Surgery
West Bengal
Institute of Postgraduate Medical Education &
Research, Kolkata
Govt.
10
75
M.Ch - Urology/Genito-Urinary Surgery
West Bengal
Nilratan Sircar Medical College, Kolkata
Govt.
2
76
M.Ch - Urology/Genito-Urinary Surgery
West Bengal
RG Kar Medical College, Kolkata
Govt.
3
77
M.Ch - Urology/Genito-Urinary Surgery
West Bengal
Calcutta National Medical College, Kolkata
Govt.
2
Syllabus
MCh in Urology is a
three years specialization course that provides training in the stream of Urology.
As
of 27/02/2022 the Competency-Based Curriculum for MCh in Urology course is not
available on the National Medical Commission's official Website. However, the
course content of AIIMS represented here can be used for reference and an idea of
what a typical Syllabus of an MCh in Urology course will contain:
SYLLABUS
It will cover a wide
spectrum of diseases of the urogenital system & retroperitoneum. Apart from
the clinical aspect of these subjects, the candidate has to acquire in-depth
knowledge of the related basic subjects like applied; anatomy; embryology,
physiology; biochemistry, pharmacology; pathology, microbiology epidemiology,
immunology etc.
1. Anatomy and
Embryology of GU tracts, adrenal & retroperitoneum.
2. Applied physiology
and biochemistry about Urology, Nephrology, renal transplantation and renovascular
hypertension.
3. Investigative urology
& Genito-urinary radiology and imaging including nuclear medicine.
4. Male Infertility,
Andrology and Urological endocrinology
5. Sexual dysfunction-
investigations and management.
6. Perioperative care,
management of urological complications and care of critically ill patients.
7. Urodynamics and
Neurology.
8. Genito-urinary
trauma.
9. Urolithiasis-Medical,
Biochemical & Surgical aspects.
10. Uro-oncology-Adult
& Paediatric
11. Reconstructive
Urology.
12. Paediatric
Urology-congenital malformations and acquired diseases.
13. Urinary tract
infections and sexually transmitted diseases.
14. Obstructive
Uropathy.
15. Renal transplantation
(including transplant immunology medical & surgical aspects).
16. Renovascular
Hypertension.
17. Gynaecological
urology.
18. Newer developments
in urology.
19. Operative
Urology-open & endoscopic
20. Endourology
21. Behavioural and
social aspects of urology.
22. Neonatal problems in
Urology.
23. Electrocoagulation,
lasers, fibre optics, instruments,
catheters, endoscopes
etc.
24. Retroperitoneal
Diseases & Management.
25. Medical aspects of kidney diseases.
26. Laparoscopic
Urologic Surgery.
Apart from the above-mentioned subjects, each candidate should have basic knowledge of the
following:
1. Biostatistics &
Epidemiology.
2. Computer Sciences.
3. Experimental &
Research methodology and Evidence-Based Medicine.
4. Scientific
presentation.
5. Cardio-pulmonary
resuscitation.
6. Ethics in medicine.
Career Options
After completing an MCh
in Urology, candidates will get employment opportunities in Government as well
as in the Private sector.
In the Government
sector, candidates have various options to choose from which include Registrar,
Senior Resident, Demonstrator, Tutor, etc.
While in the Private
sector, the options include Resident Doctor, Consultant (Urology), Visiting Consultant (Urology),
Junior Consultant (Urology), Senior Consultant (Urology), Assistant Professor (Urology), Associate Professor
(Urology).
Courses After
MCh in Urology Course
MCh in Urology is a
specialization course that can be pursued after finishing a Postgraduate
medical course. After pursuing a specialization in MCh in Urology, a candidate
could also pursue certificate courses and Fellowship programmes recognized by
NMC and NBE, where MCh in Urology is a feeder qualification.
These include
fellowships in:
·
FNB
Paediatric Urology
·
FNB
Minimal Access Urology
Frequently
Asked Questions (FAQs) –MCh in Urology Course
- Question: What is the complete full form of an MCh?
Answer: The full form of
an MCh is a Master of Chirurgiae.
- Question: What is an MCh in Urology?
Answer: MCh Urology or
Master of Chirurgiae in Urology also known as MCh in Urology is a super
specialty level course for doctors in India that they do after
completion of their postgraduate medical degree course.
- Question: What is the duration of an MCh in Urology?
Answer: MCh in Urology
is a super specialty programme of three years.
- Question: What is the eligibility of an MCh in Urology?
Answer: Candidates must
have a postgraduate medical Degree in MS/DNB (General Surgery) obtained from any college/university recognized by the
Medical Council of India (now NMC)/NBE.
- Question: What is the scope of an MCh
in Urology?
Answer: MCh in Urology
offers candidates various employment opportunities and career prospects
- Question: What is the average salary
for an MCh in Urology candidate?
Answer: The MCh in Urology
candidate’s average salary is between Rs. 4.5 lakhs to Rs. 30 lakhs per annum
depending on the experience.
- Question: Can you teach after completing an MCh Course?
Answer: Yes, the
candidate can teach in a medical college/hospital after completing an MCh
course.
2 years 3 months ago
News,Health news,NMC News,Medical Education,Medical Colleges News,Medical Courses News,Medical Universities News,Medical Admission News,Latest Medical Education News,Medical Courses
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
AbbVie gets positive EMA committee opinion for Upadacitinib to treat adults with moderate to severe Crohn's disease
North Chicago: AbbVie has announced the European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP) has recommended the approval of upadacitinib (RINVOQ, 45 mg [induction dose] and 15 mg and 30 mg [maintenance doses]) for the treatment of adult patients with moderately to severely active Crohn's disease who have had an inadequate response, lost response or were intol
erant to either conventional therapy or a biologic agent.
"The recent CHMP recommendation to approve upadacitinib for use in Crohn's disease is a momentous step, bringing us closer to offering a first-of-its-kind, once-daily oral treatment that can make a difference for people living with this disease," said Roopal Thakkar, M.D., senior vice president, development, regulatory affairs and chief medical officer, AbbVie. "We remain steadfast in our commitment to researching and developing treatment options as part of a diverse portfolio of therapies for those living with inflammatory bowel diseases."
AbbVie's application for the approval of upadacitinib in Crohn's disease is supported by data from two induction studies, U-EXCEED and U-EXCEL, and one maintenance study, U-ENDURE. Patients receiving upadacitinib were treated with 45 mg once daily for the induction studies, and were randomized to receive either 15 mg or 30 mg once-daily doses for the maintenance study. Across all three Phase 3 studies, a significantly greater proportion of patients treated with upadacitinib achieved the co-primary endpoints of clinical remission per SF/AP (defined as average daily stool frequency [SF] ≤2.8 and abdominal pain [AP] score ≤1.0 and neither greater than baseline) and endoscopic response (defined as decrease in simple endoscopic score for Crohn's disease [SES-CD] >50% from baseline of the induction) compared to placebo.
In all three studies, a statistically significant greater proportion of patients treated with upadacitinib achieved the key secondary endpoint of endoscopic remission (defined as SES-CD ≤4 and at least a 2-point reduction vs. baseline and no subscore >1). Additionally, more upadacitinib-treated patients achieved SES-CD ulcerated surface subscore of 0 at weeks 12 and 52 (nominal p-value<0.001) in patients with SES-CD ulcerated surface subscore ≥1 at baseline. Absence or disappearance of ulceration coupled with improvements seen by endoscopy are associated with mucosal healing.
The safety profile of upadacitinib in Crohn's disease was generally consistent with the known safety profile of upadacitinib.
"The impact of Crohn's disease extends beyond the gut to include systemic symptoms such as fatigue, bowel symptoms and social and emotional functioning. Treatment options that achieve critical endpoints such as clinical remission and endoscopic response can make a difference in managing the challenging symptoms of this condition and health-related outcomes related to quality of life," said Jean-Frédéric Colombel, M.D., professor of medicine and director of Inflammatory Bowel Disease Center, Icahn School of Medicine, Mount Sinai and study investigator. "Upadacitinib could be a promising treatment option for patients who live with uncontrolled moderate to severe Crohn's disease. I look forward to the European Commission's final decision."
RINVOQ is approved in the EU for the treatment of adults with radiographic axial spondylarthritis, non-radiographic axial spondylarthritis, psoriatic arthritis, rheumatoid arthritis, moderately to severely active ulcerative colitis and adults and adolescents with atopic dermatitis.
Use of upadacitinib in Crohn's disease is approved in Great Britain as of January 2023. Its safety and efficacy remain under evaluation in the European Union.
Crohn's disease is a chronic, systemic disease that manifests as inflammation within the gastrointestinal tract, causing persistent diarrhea and abdominal pain. It is a progressive disease, meaning it gets worse over time in a substantial proportion of patients or may develop complications that require urgent medical care, including surgery. Because the signs and symptoms of Crohn's disease are unpredictable, it causes a significant burden on people living with the disease—not only physically, but also emotionally and economically.
Read also: AbbVie raises sales outlook of Skyrizi, Rinvoq to USD 17.5 billion in 2025
2 years 3 months ago
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The History of vegan activist; the veganism movement started a long time ago
BY RACHEL MARY RILEY Have you ever heard the term that history truly repeats itself? The veganism movement started a long time ago. There are many perspectives on being a vegan, either way there are its benefits and cons. Some activists back in the day had a revelation about vegan life. I have a few […]
The post The History of vegan activist; the veganism movement started a long time ago first appeared on Toronto Caribbean Newspaper.
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Fitness, #LatestPost
HIV Vaccine Candidate Stops Virus As it Enters Body
Researchers at the Texas Biomedical Research Institute are developing a vaccine candidate against HIV. The vaccine is intended to block HIV entry into the body and is administered to the mucosal lining of the rectum and vagina to achieve this. The formulation then stimulates antibodies against HIV in precisely the areas where the virus first enters the body’s cells. Cleverly, the researchers designed the vaccine to target the basal cells of the epithelium, which then give rise to a constant supply of epithelial cells to replace cells that are routinely sloughed off. This may lead to long-term protection against HIV with this vaccine. In tests with primates, the vaccine has shown significant efficacy in reducing viral transmission, and when vaccinated animals did become infected, they were able to control the infection much better and showed no disease symptoms.
HIV has evaded our best attempts to create an effective vaccine for decades. Although anti-retroviral therapy can allow people with HIV infection to live normal lives and avoid progression to AIDS, it still requires that someone takes these treatments for the rest of their lives. Moreover, these treatments may not be widely available for everyone, and lack of access can be an issue in low-resource areas. A vaccine that prevents people from getting infected with HIV in the first place, and allows them to control the infection if it does occur, would be very useful.
Part of the issue is that HIV spreads through the body relatively quickly. In response, these researchers had the idea of developing a vaccine that acts specifically on the areas of the body where the virus typically enters – the mucosal lining of the vagina or rectum. The concept is to give the virus a hard time before it even gets a chance to get a foothold in the body. “I had this idea as a postdoc,” said Marie-Claire Gauduin, a researcher involved in the study. “I thought it had to be naïve because nobody was talking about it. It was so obvious and simple to me; I thought someone would have already done it.”
The vaccine is a live attenuated vaccine, meaning that the viral particles within contain the full genetic code, albeit with some alterations to prevent the virus from replicating. The researchers describe the resulting particles as “single-cycle” vaccine virus. These modified viral particles can enter cells in the mucosa, but cannot proliferate and leave the cells again. The immune system can recognize that these cells are ‘infected’ and so generates antibodies against the virus, which will give any real virus attempting to enter the mucosa a hard time.
Cleverly, the vaccine targets cells in the mucosa that give rise to new cells, helping to keep the vaccine effective for as long as possible. “The idea is that as long as the vaccine is in the mother cells, it will be passed on and be present in all new epithelial cells in these regions,” said Gauduin. “I did not think it would work so well, but it did!”
In tests in non-human primates, the vaccine candidate helped animals to avoid infection in the first place, and once infected they showed a better ability to control the virus and showed no disease symptoms. It’s too early to know if the vaccine will work in humans, but the researchers have recently received some funding to develop it further.
2 years 3 months ago
Medicine, Public Health, aids, hiv, txbiomed