Santo Domingo.- The Ministry of Public Health in the Dominican Republic has stated that there is no proven evidence of fentanyl circulation in the country. The director of the Department of Mental Health, Alejandro Uribe, explained that institutions such as the National Institute of Forensic Sciences (Inacif), the National Drug Control Directorate (DNCD), and the Comprehensive Care Center for Dependencies (Caidep) have not recorded any cases of fentanyl use or circulation.

Uribe emphasized that if these institutions have not detected any fentanyl cases through laboratory tests or typical symptoms, it indicates that the drug is not present. However, he acknowledged that fentanyl is a concern and emphasized the need for vigilance and a strategy to prevent its infiltration.

Mental Health is actively monitoring suspicious cases in emergency rooms, and efforts are being made to develop specific tests to detect fentanyl. Currently, tests are being sent to a laboratory in the United States to rule out false positive results for heroin. The cost of each test is $78, and negotiations are underway to facilitate the process and receive timely results.

It is critical to raise awareness about these hidden threats to ensure early detection and treatment.

Understanding Silent/Asymptomatic Kidney Stones

The absence of visible symptoms distinguishes silent or asymptomatic kidney stones from symptomatic counterparts. This category is thought to account for approximately 80% of kidney stones. Stones can live in the kidneys or urinary tract silently for months or even years without causing pain or discomfort. Unfortunately, their lack of symptoms frequently results in delayed diagnosis and potentially serious complications.

Causes of Silent/Asymptomatic Kidney Stones

Gender, age, and lifestyle choices all have an impact on the prevalence of silent/asymptomatic kidney stones. Men are more likely than women to develop kidney stones, and the risk increases with age. A sedentary lifestyle, a high salt and protein diet, obesity, and a family history of kidney stones all contribute to their emergence.

Dehydration and dietary factors both play a role in the development of silent/asymptomatic kidney stones. Excessive consumption of oxalate-rich foods like spinach, beets, and nuts, as well as high-sodium diets, can raise the risk. Dehydration, frequently caused by insufficient fluid intake, concentrates urine, resulting in stone formation.

Silent/asymptomatic kidney stones are also influenced by genetic and hereditary factors. If you have a family history of kidney stones, you are much more susceptible to getting them. Hyperparathyroidism, cystic kidney disease, and urinary tract infections are all medical conditions that can contribute to stone formation.

Identifying Silent/Asymptomatic Kidney Stones

The lack of obvious symptoms makes diagnosing silent/asymptomatic kidney stones difficult. These stones are frequently discovered by chance during routine medical exams, such as imaging scans or blood tests. As a result, it is critical to have regular check-ups and screenings to detect any silent stones early on.

Prevention of Silent/Asymptomatic Kidney Stones

The key to effectively managing silent/asymptomatic kidney stones is prevention. Adequate hydration is the foundation of prevention. Drinking plenty of water throughout the day dilutes urine and flushes out minerals that may contribute to stone formation. Aim for eight glasses of water per day, or more if you engage in strenuous physical activity or live in a hot climate.

Aside from hydration, dietary changes can significantly lower the risk of silent/asymptomatic kidney stones. Limit your consumption of oxalate-rich foods and sodium, both of which can contribute to stone formation. Instead, concentrate on incorporating calcium-rich foods into your diet, such as low-fat dairy products. In the intestines, calcium can bind to oxalate, preventing its absorption and lowering the risk of stone formation.

Maintaining a healthy weight and getting regular exercise are also crucial in avoiding kidney stones. Obesity and sedentary lifestyles raise the likelihood of stone formation. You can help keep silent stones at bay by eating a well-balanced diet and leading an active lifestyle.

Treatment Options for Silent/Asymptomatic Kidney Stones

The treatment of silent/asymptomatic kidney stones is determined by their size, location, and the individual's overall health. Small stones may require only observation and monitoring, with regular check-ups to assess any changes in size or symptoms. To aid in stone dissolution or to prevent stone growth, medications such as alpha-blockers may be prescribed.

Various methods and interventions are available for larger stones that cause symptoms or pose a risk to kidney health. Extracorporeal Shock Wave Lithotripsy (ESWL) breaks the stones into smaller pieces, allowing them to pass more easily.

Ureteroscopy entails inserting a thin tube into the ureter to remove or break up stones. Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgery that removes large stones through a small back incision.

Complications and Risks Associated with Silent/Asymptomatic Kidney Stones

Neglecting silent/asymptomatic kidney stones can have serious consequences for your kidney health in the long run. These stones can grow in size and obstruct the urinary tract, impairing kidney function. They can cause kidney damage, infections, and even kidney failure if left untreated. As a result, seeking medical advice and taking proactive steps to manage and prevent these hidden threats is critical.

Silent/asymptomatic kidney stones are a significant health risk, and it is critical to raise awareness about their causes, prevention, and treatment. We can reduce the occurrence of these silent stones by understanding the risk factors and incorporating preventive measures into our daily lives. Remember that early detection and preventative measures can significantly impact your kidney health.

Disclaimer: The views expressed in this article are of the author and not of Medical Dialogues. The Editorial/Content team of Medical Dialogues has not contributed to the writing/editing/packaging of this article.

Takeda's tetravalent dengue vaccine candidate (TAK-003) is based on a live-attenuated dengue serotype 2 virus, which provides the genetic “backbone” for all four vaccine viruses

Osaka: Takeda has announced that the Company has voluntarily withdrawn the U.S. Biologics License Application (BLA) for its dengue vaccine candidate, TAK-003, following discussions with the U.S. Food and Drug Administration (FDA) on aspects of data collection, which cannot be addressed within the current BLA review cycle.

The future plan for TAK-003 in the U.S. will be further evaluated given the need for travelers and those living in dengue-endemic areas of the U.S., such as Puerto Rico. The vaccine is approved in multiple endemic and non-endemic countries, with more approvals expected over the coming years.

“Our clinical program was designed to account for the complex global nature of dengue, and data from our 4.5-year trial has built confidence in TAK-003’s ability to help provide long-term protection against dengue, with a positive benefit and risk profile regardless of baseline serostatus,” said Gary Dubin, M.D., president of Takeda’s Vaccines Business Unit. “The urgent global need to combat the growing burden of dengue remains, and we will continue to progress regulatory reviews and provide access for people living in and traveling to dengue-endemic areas while we work to determine next steps in the U.S.”

The efficacy and safety profiles of TAK-003 have been demonstrated through a robust clinical trial program, including a 4.5-year Phase 3 study of over 20,000 children and adolescents living in eight dengue endemic areas. The study was designed per World Health Organization (WHO) guidance for a second-generation dengue vaccine, and it considered the need to achieve high levels of subject retention and protocol compliance in endemic regions.

Last year, TAK-003 received a positive opinion from the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) after going through the EU-M4all process, a parallel review of the vaccine for use in the EU and participating dengue endemic countries around the world. The vaccine has since been approved in the EU, United Kingdom, Brazil, Argentina, Indonesia, and Thailand.

Dengue is a global public health crisis and further prevention measures are needed to support the millions of individuals around the world exposed to dengue.

Takeda's tetravalent dengue vaccine candidate (TAK-003) is based on a live-attenuated dengue serotype 2 virus, which provides the genetic “backbone” for all four vaccine viruses.

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All such candidates who fulfill the eligibility criteria and are desirous of opting for the sponsored DNB (Post MBBS and Post Diploma) seats 2023 are required to submit their application to the Director of Medical Education, Dept of Health and Family Welfare, Swasthya Bhawan, GN-29, Sector —V, Kolkata -700091. (If they belong to the WIIMES cadre) or Director of Health Services, Dept of Health and Family Welfare, Swasthya Bhawan, GN-29, Sector —V, Kolkata -700091(11 they belong to WBHS or WI3PIIAS cadre).

The submission of the application will be via email at tr.noc.mert@gmail.com for the candidates of WBHS and WBPHAS and via email at wbcounselingcell@gmail.com for the candidates of WBMES in the required format. The circular is already published on the websites www.wbhealth.gov.in and www.wbmcc.nic.in dated 22.3.2023. The applications will have to be submitted by 5:00 pm on 17.7.2023.

Eligibility criteria for Sponsored DNB (Post MBBS) seats –

1. Candidates who are working under the Dept of Health and Family Welfare Govt. of West Bengal on a regular basis are eligible for Sponsored DNB (Post MBBS) seats.

2. Candidates must be in possession of the M1313S degree Certificate recognized by the Indian Medical Council Act 1956 and possess a permanent registration certificate of MBBS qualification issued by the Medical Council of India/ State Medical Council.

3. Must have "Qualified" MEET PG 2023.

Also Read:TN Health Issues Clarification on eligibility for NEET PG, MDS candidates, check out details

Eligibility criteria for Sponsored DNB (Post Diploma) Seats -

1. Candidates who are working under Dept of Health and [Tamil) Welfare Govt. of West Bengal on a regular basis are eligible for Sponsored DNB (Post Diploma) seats.

2. Candidates who have passed the final examination leading to the award of Post Graduate Diploma from Indian Universities, which are duly recognized as per provisions of the Indian Medical Council Act 1956, Govt, of India i.e. have passed final examinations for Postgraduate diploma on or before 31-03-2021 as per provisions of the Trainee Reserve Rules 2015 and its amendments.

3. Candidate must have "Appeared" in DNB-PDCLT 2023.

The physical verification of the candidates shall be conducted from 12 noon till 3 pm on the days as follows: 17-07-2023 till 20-07-2023 (4 days). During such physical verification, the candidate has to attend with the original documents along with the filled-up and duly forwarded proforma as stated above and one set self-attested photocopies of the original documents before the Assistant Director of Medical Education at the Counseling Cell in the ground floor of Swasthya Sathi Building within premises of Swasthya Bhawan (for WBMES cadre) or Assistant Director of Health Services, MERT, in rd floor of B wing at Swasthya Bhawan (if they belong to WBVIS/WBPHAS cadre).

The following documents are required to be placed for verification (original and one set self-attested photocopy) -

1. MEET PG 2023/DNB PDCET 2023 --rank card and admit card

2. Any two of the following valid photo ID (Aadhar card/Voter card/Passport)

3. Age proof (birth certificate/class X admit card/class X certificate)

4. MBBS certificate and final rvIBBS mark sheet

5. Permanent Registration certificate issued by MCIINMC/WBMC

6. Caste certificate (as applicable and issued by the appropriate authority in West Bengal)

7. Non-creamy layer certificate for OBC candidates issued on or after 01.04.2023

8. PwD certificate (as applicable and issued by Medical Board of IPGMER Kolkata)

9. Proof of previous Diploma if acquired (on or before 31.03.2021)

10. Proof of any bond formalities (if applicable, to be completed on or before 31.03.2023)

11. Posting orders and joining reports as proof of regular service

The candidates who fail to submit email on time or fail during verification, or do not attend verification with required documents within the scheduled time, shall not be included in the list for provisional NOC (No Objection Certificate) for Centralized merit-based online counseling for admission to Sponsored DNB seats (Post MBBS and Post Diploma) 2023.

The provisionally eligible candidates shall be handed Provisional NOC on authenticated letterhead, and the scanned copy shall be uploaded to the websites www.wbhealth.gov.in and www.wbmcc.nic.in for public viewing on or after 29.07.2023. It shall also be communicated to NBEMS as per their instructions via email req.cc@natboard.edu.in latest by 31.07.2023. The format of NOC shall be provided by NBEMS in their notice 04.07.2023 on the website www.natboard.edu.in.

The candidates shall bear in mind that this NOC is purely provisional and does not ensure a seal for a particular candidate. The in-service candidates of the Dept. of Health and Family Welfare, Government of West Bengal, must contact respective branch officials to find out whether they are eligible for trainee reserve as per extant rules so that seats are not wasted after allotment, if any.

To view the notice, click on the link below –

https://medicaldialogues.in/pdf_upload/dnb-214034.pdf

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