Daily Archives: February 15, 2022

BJP releases manifesto for Punjab polls, promises 75 per cent reservation to state youth in government jobs – The New Indian Express

Posted: February 15, 2022 at 6:22 am

By PTI

CHANDIGARH: The BJP-led NDA on Saturday released its manifesto for the February 20 Punjab polls, promising a slew of sops including 75 percent reservation in government jobs and 50 percent reservation in private jobs for the state's youth.

It also promised an unemployment allowance, 35 percent reservation for women in government jobs and massive infrastructure development to revive the state's economy if it forms the government in Punjab.

As per the manifesto, a dope test will be made mandatory before the filing of nomination forms for the elections.

An unemployment allowance of Rs 4,000 per month for all graduates for two years after completion of their degrees will be provided, it said.

The manifesto promised 35 percent reservation for women in all government jobs including contractual jobs.

Fast-track courts will be established to deal with any kind of violence, harassment and oppression against women, it said.

A special act will be formed to deal with the cases of NRI abandoned brides, it further said.

The BJP is contesting the elections in alliance with former chief minister Amarinder Singh-led Punjab Lok Congress and Sukhdev Singh Dhindsa's SAD (Sanyukt).

The Sankalp' document or the manifesto was released in Jalandhar in the presence of Union ministers Hardeep Singh Puri and Som Prakash, BJP leaders Dushyant Gautam and Tarun Chugh and Amarinder Singh's son Raninder Singh, among others.

While the BJP-led alliance had earlier released an 11-point 'Sankalp' (pledge or commitment) for the assembly polls, and later another document for the rural sector, which among other things had promised a complete loan waiver for farmers with less than five acres of landholdings.

In the fresh document, key promises from the earlier ones have been incorporated.

Among the main features of the latest manifesto include 75 percent reservation for the youth of Punjab in all government jobs and 50 percent reservation in all private jobs.

Speaking on the occasion, Puri said the manifesto is not just a vision document but carries concrete commitments.

He talked of a massive infrastructure development to revive Punjab's economy, with an infrastructure development fund of Rs one lakh crore to be spent over a period of five years.

The document also promised zero tolerance to sacrilege and said fast-track courts will be set up to decide such cases in a time-bound manner.

The manifesto is an elaborate and comprehensive document that spells out the roadmap for revival and development of Punjab's economy, addressing the issue of drugs and law and order, Puri said.

This is the most progressive and pragmatic manifesto which will be implemented from day one after the formation of the government, he said.

To check the cross-border infiltration and smuggling of weapons and drugs, the alliance promised strict drone and CCTV surveillance, construction of electric fences and outposts.

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BJP releases manifesto for Punjab polls, promises 75 per cent reservation to state youth in government jobs - The New Indian Express

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Crisis Pregnancy Centers, State-Funded Harm, and State-Based Solutions – The Regulatory Review

Posted: at 6:22 am

As the Supreme Court evaluates abortion laws, states should bolster reproductive rights and better regulate CPCs.

The U.S. Supreme Courts decision to review whether Mississippis pre-viability abortion ban is still unconstitutional, and the Courts failure to enjoin Texass near-total abortion ban, have thrown a spotlight on the precarious state of abortion rights in the United States. These cases come after decades of abortion restrictionsmostly at the state levelthat have already made abortion inaccessible for many people, especially Black and brown people, individuals living in poverty, and people in rural areas.

For example, the federal Hyde Amendment prohibits the use of federal funding for abortion care, and Pennsylvania law prohibits the use of state funding. The resulting denial of abortion coverage for people in Pennsylvanias Medicaid program disproportionately harms Black and brown people who face structural inequities that make them more likely to live in poverty than white people.

Meanwhile, Pennsylvania also diverts funding from the Temporary Assistance for Needy Families (TANF) program to anti-abortion, anti-contraception, and anti-LGBTQ+ organizations known as crisis pregnancy centers (CPCs). Furthermore, it is one of a minority of states that not only diverts TANF funding to CPCs, it also directly funds them through a state contract.

There is little government oversight of CPCs. In 2017, at the conclusion of a rare audit, the Pennsylvania Auditor General found that Real Alternatives, the umbrella organization for the state-funded CPCs, inappropriately used Pennsylvanias money to promote itself in other states. Nevertheless, the Commonwealth renewed Real Alternatives contract to provide alternatives to abortion services. In addition to lingering ethical concerns about the way state-funded CPCs operate, there are also questions about the scope and quality of the services that CPCs provide, whether state-funded or not.

To shed light on these services, the Alliance, a coalition of state advocates for womens rights and gender equality, including the Womens Law Project, and the California Womens Law Center, reviewed CPC websites and analyzed the services they offer. In its recently released report, the Alliance found that the four most common services CPCs offer are: (1) pregnancy testsoften the same as the self-administered tests available at local drugstores; (2) free material goods such as diapers and other infant suppliesor opportunities for individuals to earn these goods by completing CPC programming; (3) peer-to-peer, anti-abortion counseling; and (4) non-diagnostic ultrasounds.

In Pennsylvania, CPCs outnumber abortion clinics by a ratio of nine to one. Pennsylvania CPCs offer the same services as CPCs in the other states, except that the most common service provided is free or earned goods, followed by pregnancy testing. Pennsylvania is one of two states in the study that funds CPCs directly, which has enabled researchers to uncover disturbing differences between state-funded and non-state-funded CPCs.

The researchers found that fewer state-funded CPCs refer clients for prenatal care than non-state funded CPCs. And more state-funded CPCs promote an unscientific practice known as abortion pill reversal, which involves the administration of progesterone to individuals who have taken the first, but not the second, of the two-pill medication abortion regimen.

CPCs regularly claim that abortion pill reversal is able to stop a medication abortion, but there is no evidence to support this practice. Indeed, the American College of Obstetricians and Gynecologists has deemed it unethical and unproven. Abortion pill reversal promotion is among many examples of misleading and medically inaccurate information that the Alliances study found on CPC websites.

Another finding in the Alliances report is that, although many CPCs portray themselves as medical facilities, they provide virtually no medical services. In addition to the fact that almost none of these centers provide or refer for prenatal care, almost none provide or refer for contraception or, of course, abortion. These failures raise questions about the U.S. Department of Health and Human Services decision to permit the diversion of TANF funding to CPCs and the Pennsylvania Department of Human Services inclusion of funding for programs that promote childbirth instead of abortion in the TANF state plan.

Even though diverting TANF funding to CPCs may be consistent with the paternalism and racism underlying the TANF program, which is tied to a long history of controlling Black womens bodies, it is inconsistent with the stated goal in the statute of preventing and reducing the incidence of out-of-wedlock pregnancies.

The siphoning of funding for pregnant people and children living in poverty is emblematic of the broken safety net that CPCs exploit to prey on vulnerable people. Instead of addressing the factors that lead people to CPCs, including economic insecurity and inadequate access to comprehensive reproductive health care, states such as Pennsylvania fund fake clinics that promote misleading and harmful information, delay access to genuine health care, and collect information from clients who have no privacy protections available to thembecause CPCs typically do not qualify as health care providers and therefore do not need to comply with the Health Insurance Portability and Accountability Act (HIPAA).

CPCs have been notoriously difficult to regulate, as the U.S. Supreme Courts case of National Institute of Family and Life Advocates v. Becerra shows. In this case, the Court held that a California law that required licensed clinics that primarily serve pregnant people to notify them that the state provides free or low-cost services, including abortions, and required unlicensed clinics to disclose that they are unlicensed likely violated the First Amendment.

The Alliance report, however, includes a number of state-based policy recommendations to regulate CPCs that can avoid the First Amendment questions raised in Becerra. For example, the report recommends the passage of laws that would extend HIPAA-like protections to people served by entities providing pregnancy-related services. It also recommends addressing the maternal and reproductive healthcare gaps that CPCs exploit. It is important for states to shore up reproductive rights so that CPCs are not more accessible than genuine reproductive health careespecially now that the Court is poised to overrule or gut Roe v. Wade and Planned Parenthood v. Casey.

It is also important for states to implement antiracist measures to alleviate poverty and dismantle systemic oppression so that people do not undergo biased counseling at a CPC simply because they cannot afford a pregnancy test or infant supplies. Public funding should support evidence-based programs, not CPCs that regularly promote unproven and potentially dangerous treatments to low-income pregnant people.

The Alliance report is a call to action, highlighting the need to hold CPCs accountable amid the political landscape that has fueled and funded the CPC industrys growth while decreasing access to comprehensive, evidence-based reproductive health care.

Although there is a role for the federal government to play in the fight against CPCs, the battle is primarily in the states, which have the ability to bring back and improve reproductive rights and health care access regardless of the future for Roe and Casey in the federal courts.

Amal Bass is the Director of Policy & Advocacy for the Womens Law Project.

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Anniversary of Islamic Revolution marked in Baghdad, Damascus – Tehran Times

Posted: at 6:22 am

TEHRAN Commemorative ceremonies were held in Baghdad and Damascus to mark the 43rd anniversary of the Islamic Revolution.

The Iranian embassy in Baghdad marked Friday the forty-third anniversary of the victory of the Islamic Revolution with a massive public celebration, in the presence of political and cultural figures, including the Iranian ambassador to Iraq, Iraj Masjedi, according to U News.

The ceremony began with a recitation of the Holy Quran, followed by the national anthems of the Islamic Republic of Iran and Iraq, and then a video clip of a choral group, and then an Iraqi poet recited a poem inspired by the occasion.

Masjedi delivered a speech during the ceremony, in which he said, By God's grace, the system of the Islamic Republic of Iran was established according to Islamic and religious principles in the hands of a distinguished Islamic figure, and this sacred system continued in the hands of [Ayatollah] Seyed Ali Khamenei, who represents the religious authority.

Masjedi pointed out that the system of the Islamic Republic of Iran was established according to two principles, the first is the republican based on the people and the second is the Islamic one based on religion and the people are the main pillar of the revolution, the system and religion. And Islam is the content of this system.

He added: The title of our system is to rely on the people and also adopt religious principles. The Islamic Republic extends the hand of friendship and cooperation to all countries with all sincerity and seriousness.

Masjedi noted, The Islamic Republic wants its relations to be based on the principle of mutual respect with all countries of the world.In Damascus, there were also some celebrations to mark the 43rd anniversary of the Islamic Revolution. According to U News, a mass celebration was held in the prayer hall of Sayyida Zainab (PBUH) at the invitation of the office of Ayatollah Khamenei to commemorate the victory of the Iranian Islamic Revolution.

The speeches delivered on the occasion praised the greatness of the Islamic revolution that was launched and led by Imam Khomeini and its firm approach in supporting the weak and the oppressed in the face of arrogance.

Iranian Ambassador to Syria Mehdi Sobhani also delivered a speech at the ceremony. The ambassador stated that the Islamic revolution in Iran was one of the most important events in the last years of the twentieth century and was a comprehensive revolution in all aspects of life.

Sobhani pointed out that the forces of global arrogance have been conspiring against the Islamic Republic from the moment it was launched until today due to its resistance approach, firm support for the oppressed, and its firm position in support of the Palestinian cause.

In an interview with U News, the head of the Jaafari Islamic Council in Syria, Muhammad Ali Al-Miski, congratulated Ayatollah Khamenei, the state and the Iranian people on the victory of the revolution.

He highlighted the scientific status that the Islamic Republic witnessed under the revolution.

He described Iran as a country that exports technology. He also noted that the Islamic revolution transformed the Islamic peoples from defeated peoples into dignified peoples of resistance.

The embassy of Sanaa in Damascus also held an intellectual and political symposium on the 43rd anniversary of the victory of the Islamic Revolution in Iran, at the invitation of the Yemeni ambassador in Damascus.

The symposium was attended by intellectual, academic and media personalities and representatives of the Palestinian factions, at the embassy in Damascus, U News reported.

During the symposium, the Cultural Counselor of the Islamic Republic of Iran, Hamid Reza Esmati, said that the revolution, whose foundations were laid by Imam Khomeini, had taken root and became stronger with Imam Khamenei. And the revolution of the weak remained in the face of the forces of arrogance.

Esmati stressed that the Islamic Revolution is a revolution of pride and dignity in the face of tyranny, pointing out that it stands by the oppressed peoples to achieve their just rights.

The Yemeni ambassador in Damascus, Abdullah Ali Sabri, said in an interview with U News, We celebrate with the brothers in Iran the revolution because we see that it is a global Islamic revolution, and it is a revolution for the oppressed in all the world and it has supported the Palestinian cause as it established a strong state and an Islamic republic that we cherish and this republic has supported Yemen.

He pointed out that Iran stood by the oppressed people of Yemen in the face of the Saudi-American aggression. He stressed that the victory of the Iranian revolution is a victory for the revolution in Yemen.

Iranian President Ayatollah Seyed Ebrahim Raisi congratulated the people of Iran and the free people of the world on the victory of the Islamic Revolution.

Speaking on Friday in his speech before the Friday prayer sermon, the president described "independence-seeking", "freedom-seeking", "justice-seeking" as elements of the revolution and noted, "This revolution is justice-seeking within itself. The element of justice can never be separated from the Islamic Revolution, because within the Islamic Revolution, justice-seeking, anti-oppression and anti-corruption are institutionalized."

Regarding the characteristics of the despotic regime of the Shah, Raisi said, "That oppressive regime was the full manifestation of tyranny, dictatorship, submission to the dominating powers and arrogance against the will of the people."

Ayatollah Raisi stated, "The Islamic Revolution came to overthrow this corrupt regime, which was supported by the dominant powers, and to establish a system based on religion and what the people have repeatedly shouted "independence, freedom, the Islamic Republic".

The president added, "The glorious victory of the Islamic Revolution marked a civilization that was a new civilization in the name of Islam and the Republic, as opposed to the civilizations that formed the polarization of the world."

Raisi continued, "What is clear is that the slogans of the Islamic Revolution are innate and universal slogans and are related to the nature of all human beings."

He said, "What the Islamic Revolution is shouting is independence, national dignity, brotherhood, denial of domination and oppression."

Ayatollah Raisi added, "We neither seek to dominate anywhere in the world, nor we give up our independence, and we are not willing to oppress anyone in the world; these are among the principles of the Islamic Revolution that are still stable."

Raisi added, "These values are the ones that people have always emphasized, so you see Iranians everywhere in the world are proud of this revolution. Today, not only the Muslim people of the world, but also the non-Muslim people, but the freedom-loving and justice-loving people of the world, the deprived and the oppressed in all parts of the world, love this revolution".

He said, "The slogans of the Islamic Revolution are rational slogans, and today not only the great nation of Iran, but also the nations of the world have high hopes for this revolution."

The president stated, "The revolutionary spirit, vision and action and adherence to these principles are still emphasized by people all over the world."

The president continued, "The late Imam Khomeini and the Supreme Leader of the Islamic Revolution presented a political school in contrast to the political schools of the world, which has some characteristics. The first indicator of this political school is sincerity."

Ayatollah Raisi said, "The second point in the political school is attention to the republic and the people. The late Imam and the Supreme Leader do not consider people as a political and ceremonial thing."

The president added, "Today, we are proud that in the popular administration, we have put the republic and the people and justice in the sense that the important goal of the Islamic Revolution is the main axis in the government."

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Psoriasis Drugs Market is predicted to progress at a CAGR of 6.5% to reach a valuation of US$ 21.48 Bn by 2031 – PR Newswire UK

Posted: at 6:21 am

An array of agents exist for the symptomatic treatment of psoriasis. Patients with mild-to-moderate psoriasis typically receive topical treatments that modulate gene transcription, promote keratinocyte differentiation, and inhibit cell proliferation.

A number of innovative and advanced therapies for the treatment and management of psoriasis are under development, many of which have novel targets and mechanisms of action. Psoriasis is linked with a number of medical conditions inclusive of psoriatic arthritis, depression, and cardio metabolic syndrome. The most commonly occurring form of psoriasis is chronic plaque.

Common treatment methods of psoriasis include topical administration of vitamin D analogues, glucocorticoids, and phototherapy. Moderate to severe psoriasis often calls for systemic treatment.

Prevalence of psoriasis has displayed a growing trend over the past decade. Rising awareness initiatives regarding psoriasis disease and its management & treatment options, increasing reimbursement support, and growing research & development with the adoption of biologics and biosimilars are some of the factors responsible for impacting the psoriasis drugs market and aiding sales growth.

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"Growing adoption of combination therapy and favourable reimbursement support for psoriasis to drive market growth," says an analyst of Persistence Market Research.

Market Competition

Companies such as Amgen and Sun Pharma have been strongly working toward the development of an extensive clinical pipeline and manufacturing of new product lines for the treatment of psoriasis.

Similarly, other psoriasis drug manufacturers are also trying to maintain and strengthen their portfolios through collaborations with local players or distribution partners. All such recent developments related to companies manufacturing psoriasis drugs have been tracked by the team at Persistence Market Research, which are available in the full report.

Key companies operating in the psoriasis drugs market include Janssen Biotech Inc, Novartis International Ltd., Amgen Inc, Pfizer Inc., Takeda Pharmaceutical Company Ltd. Merck & Co, Inc., Abb Vie Inc., Eli Lilly and Company, Boehringer Ingelheim GmbH, and Sun Pharmaceutical Industries Ltd.

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Persistence Market Research offers a unique perspective and actionable insights on the psoriasis drugs market in its latest study, presenting historical demand assessment of 2016 2021 and projections for 2022 2031.

The research study is based on the product (topical, oral, and injectable), drug class (interleukin inhibitors, corticosteroids, anti-inflammatory, and tumor necrosis factor inhibitor), distribution channel (hospital pharmacies, retail pharmacies, and e-Commerce), and indication (guttate psoriasis, inverse psoriasis, pustular psoriasis, erythrodermic psoriasis, and plaque psoriasis), across seven key regions of the world.

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Psoriasis Drugs Market is predicted to progress at a CAGR of 6.5% to reach a valuation of US$ 21.48 Bn by 2031 - PR Newswire UK

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Is It Psoriasis or Ringworm? – Health Essentials from Cleveland Clinic

Posted: at 6:21 am

While there are a number of skin conditions that can cause inflamed, itchy and painful patches, two, in particular, stand out thanks to their similarities: ringworm and psoriasis. With overlapping symptoms, it can be hard to tell which is which.

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But if you know what to look for, there are a few differences, including how each condition is treated. To get a better understanding of both psoriasis and ringworm, and how to tell them apart, we spoke to dermatologist Sean McGregor, DO.

The biggest difference between psoriasis and ringworm, says Dr. McGregor, is the origins of each. Psoriasis is an autoimmune condition, while ringworm is a fungal infection. While a persons autoimmune issues trigger psoriasis, you can acquire the ringworm fungus in a number of different ways, he adds, from soil, other humans or even pets.

Additionally, psoriasis is a chronic condition, meaning it never goes away. Ringworm, conversely, will go away with treatment since its simply an infection.

For treatment purposes, of course, its important to differentiate between the two conditions and know which one you have. No matter which you think you have, though, its always important to contact your healthcare provider so you can get proper treatment.

Ringworm and psoriasis have several overlapping symptoms, which is where confusion can sometimes set in, including:

But there are signs that can help you figure out which condition you may be dealing with.

Dr. McGregor says theres one symptom in particular that can help you figure it out. Ringworm gets its name from a worm-like shape around the edges of the rashes, he says.

One other thing to look for, he advises, is a bit of clearing in the middle of a rash. Ringworm tends to have a little clearing in the center of the rash with more of the inflammation or irritation around that border.

While psoriasis doesnt have symptoms that are as clear cut as those of ringworm, there are a few other ways you might be able to tell that its psoriasis and not something else.

First, if the symptoms are recurring and lack that ring-like feature, it may be psoriasis. Since psoriasis is a chronic condition, it doesnt really go away over a few days with treatment like ringworm will.

Second, about 30% of people with psoriasis develop psoriatic arthritis, a type of arthritis closely associated with psoriasis.

As mentioned, the big difference in treatment is that ringworm can be cured, while the chronic condition of psoriasis is managed. No matter which condition you may have, its best to start by talking to your healthcare provider.

For treating ringworm, Dr. McGregor says, The antifungal cream terbinafine 1% is the best over-the-counter treatment available. Lamisil is the most prominent version of this medicine. If you wind up with ringworm on your scalp, though, your doctor will prescribe you an oral version instead of the topical cream.

There are many home remedies you can try for temporary relief for psoriasis, including:

When it comes to more long-term treatment, though, Dr. McGregor says your doctor will recommend topical steroids or Vitamin D ointment.

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Is It Psoriasis or Ringworm? - Health Essentials from Cleveland Clinic

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Early Response to Biologics Linked With Stable Long-term Efficacy in Psoriasis – AJMC.com Managed Markets Network

Posted: at 6:21 am

More patients with moderate-to-severe psoriasis were found to be early responders to ixekizumab vs ustekinumab; all those who achieved early response were associated with stable skin clearance long-term.

Early response to the biologics ixekizumab and ustekinumab was associated with positive long-term efficacy outcomes in the treatment of moderate-to-severe psoriasis, according to study findings published in the Journal of Drugs in Dermatology.

In the management of patients with psoriasis presenting with more severe disease, researchers noted that defining and predicting high levels of clinical response, as well as identifying which patients are at risk of not having such levels, is key in tailoring treatment plans.

Although baseline Psoriasis Area Severity Index (PASI) and body mass index scores have served as modifiable predictors of response, use of these metrics has not consistently determined response to biologic therapies.

Preliminary data have shown early response to treatment is predictive of subsequent clinical improvement in patients with psoriasis, they said.

During ixekizumab treatment, patients who achieve at least a 40% improvement in PASI score (PASI 40) to at least a 50% improvement in PASI score (PASI 50) at weeks 4 and 6 often reach at least a 75% improvement in PASI score (PASI 75) at week 12 with a 90% predictability.

Seeking to further assess how early response rates to biologic therapy may predict long-term response, researchers conducted a post-hoc analysis of the IXORA-S study that compared the safety and efficacy of the interleukin (IL)-17A inhibitor ixekizumab with the IL-12/23 inhibitor ustekinumab in patients with moderate-to-severe psoriasis.

In the analysis, early treatment response rates to ixekizumab and ustekinumab were evaluated by the percentage of patients treated who achieved PASI 50 at week 2 or 4. Early response rates to these therapies were then examined for stable long-term response, as measured by associations with maintaining complete (PASI 100) or almost complete (PASI 90) skin clearance at 80% of monthly visits during weeks 16-52 of treatment.

Nonresponder imputation was used for missing PASI response status, added the study authors.

In their findings, a numerically greater number of patients given ixekizumab achieved early response vs those treated with ustekinumab; these patients were significantly more likely to achieve a stable PASI 90 response (P < .0001) or PASI 100 response (P < .0001) than the ustekinumab group.

Moreover, all patients treated with either ixekizumab or ustekinumab who were identified as early responders were more likely to achieve a stable response of PASI 90 or 100 (Odds Ratio > 1).

In patients with moderate-to-severe psoriasis treated with ixekizumab or ustekinumab, early response was a significant factor in maintaining stable complete or almost complete skin clearance, concluded the study authors. Therefore, rapid response is a clinically relevant factor to consider when optimizing individual therapeutic strategies.

Reference

Augustin M, Gallo G, See K, et al. Early response is associated with stable long-term response in psoriasis patients receiving ixekizumab or ustekinumab. J Drugs Dermatol. 2022;21(2):122-126. doi: 10.36849/jdd.6063

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Early Response to Biologics Linked With Stable Long-term Efficacy in Psoriasis - AJMC.com Managed Markets Network

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Vibeke Strand, MD, on the Success of Secukinumab for Psoriatic Arthritis – MD Magazine

Posted: at 6:20 am

In an interview with HCPLive, Vibeke Strand, MD, MACR, FACP, Division of Immunology and Rheumatology, Stanford University, discussed her study on the effect of secukinumab in patients with active psoriatic arthritis (PsA).

The Phase 3 data displayed clinical and radiographical efficacy. Patients reported significantly sustained improvements across all dose levels compared with placebo.

This study included patients who were naive to tumor necrosis factor (TNF) inhibitor, as well as patients who were TNF-inadequate or TNF-incomplete responders.

Strand explained that patients who have been heavily treated, who are TNF-incomplete responders, might appear less improved because their scores were lower at baseline compared to patients who were TNF-naive. However, they actually reported very similar amounts of improvement.

"If you account for the fact that they're starting with lower scores because they've had the disease for longer, and they've had more failed treatments, what you can see is that actually, they're able to respond as well as a naive population," Strand said. "It's just that the baseline scores are lower."

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Vibeke Strand, MD, on the Success of Secukinumab for Psoriatic Arthritis - MD Magazine

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Research Report and Overview on Psoriatic Arthritis Therapeutics Market, 2021-2026 – Get News Alert

Posted: at 6:20 am

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Secukinumab in the treatment of psoriatic arthritis or ankylosing spondyloarthritis with multiple sclerosis: a case series with literature review -…

Posted: at 6:20 am

This article was originally published here

Immunotherapy. 2022 Feb 14. doi: 10.2217/imt-2021-0128. Online ahead of print.

ABSTRACT

Background/aim: Multiple sclerosis (MS) is a demyelinating central nervous system disorder with few cases reported to have concomitant spondyloarthritis (SpA) spectrum disorders such as ankylosing spondylitis and psoriatic arthritis. The aim of this study is to evaluate the effectiveness of secukinumab in the treatment of MS and accompanying ankylosing spondylitis or psoriatic arthritis. Materials & methods: In addition to four cases of their own, the authors conducted a systematic literature search. Demographics, comorbidities, symptoms of MS and SpA, medical treatments and changes in clinical and laboratory findings with treatment were recorded. Results & conclusions: After secukinumab therapy, all patients were found to have treatment response regarding axial involvement, without any progression of MS observed. For both SpA spectrum diseases and MS, secukinumab may be an appropriate choice.

PMID:35152720 | DOI:10.2217/imt-2021-0128

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Secukinumab in the treatment of psoriatic arthritis or ankylosing spondyloarthritis with multiple sclerosis: a case series with literature review -...

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GP fined S$1500 for negligence after giving medication to patient without pre-prescription tests – TODAY

Posted: at 6:20 am

SINGAPORE A retired general practitioner was fined S$1,500 on Thursday (Feb 10) for his negligence in prescribing medication for a construction worker's psoriasis without running pre-prescription tests on the patient first.

Haridass Ramdass, 77, pleaded guilty to a single charge of endangering Savarimuthu Arul Xaviers personal safety by a negligent act. He was handed the maximum fine.

Savarimuthu died in 2014 aged 28. Haridass was originally charged with causing Savarimuthus death by a rash act, but the charge was later reduced by the prosecution.

The medication that Haridass prescribed, methotrexate, is often used in the treatment of cancer and severe psoriasis a skin disease that causes itchy and scaly patches. Methotrexate can also lead to serious and life-threatening toxic reactions.

Haridass ran Tekka Clinic Surgery on his own in the Little India area at the time, the court heard.

Around Oct 20 in 2014, Savarimuthu developed rashes over his body, face and upper and lower limbs. This prompted him to visit three different doctors to seek treatment.

At Healthway Medical Clinic in Chua Chu Kang, he was prescribed an antiseptic solution, some antihistamines and steroid cream. He went back about two weeks when he noticed his skin rashes had worsened.

He was diagnosed with psoriasis and was prescribed largely the same medication.

He then visited Bless Medical Centre in Boon Lay five days later with skin lesions on his body and limbs, which he said he had been having for months with no improvement.

He was again diagnosed with psoriasis and prescribed medication such as psoriasis oil.

On Nov 24 in 2014, he went to Haridass clinic. The doctor noted that he had extensive reddish and round lesions all over his body, including his scalp.

Savarimuthu said that his skin condition had persisted for 20 days, after which Haridass diagnosed him with psoriasis and administered an injection of Dexamethasone, which is an anti-inflammatory steroid.

Haridass also prescribed 10 tablets of methotrexate, 10 tablets of prednisolone similarly used to treat inflammation and 10 tablets of chlorpheniramine, an antihistamine.

The court heard that Haridass was negligent in failing to arrange for or ensure that Savarimuthu underwent the relevant pre-prescription tests for renal function, liver function and full blood count.

As a result, Haridass failed to discover the patients pre-existing renal impairment and was not conscious of the potentially increased toxic side effects of methotrexate.

Past court documents stated thatSavarimuthu later developed neutropenia and mucositis, leading to a fatal invasive fungal infection.

Neutropenia occurs when a person lacks a certain type of white blood cell, which helps to fight infections.Mucositis happens when a persons mouth or gut becomes sore and inflamed a common side effect of chemotherapy for cancer.

Deputy Public Prosecutors (DPPs) Timotheus Koh and Grace Chua said that methotrexate use in patients with impaired renal function should be undertaken with extreme caution as the impairment will decrease the bodys ability to eliminate the drug.

While the prosecutors noted that deaths have been reported following the use of methotrexate in the treatment of psoriasis, they also agreed with the defence not to make reference on whether Savarimuthu had suffered any adverse effect resulting from its consumption.

'GENUINELY REMORSEFUL'The prosecution sought the maximum fine, noting that the sentence must adequately deter negligence by medical professionals.

Doctors are vested with enormous responsibility and influence by their patients who, in entrusting their health and well-being to them, often accept their professional judgements unquestioningly.

This dynamic is even more pronounced in the case of foreign workers like the patient, who lack the knowledge and language ability to effectively interrogate their doctors recommendations, the prosecution added.

The risk to Savarimuthu was also of significant danger, the DPPs said. Methotrexate toxicity has been reported to cause fatal opportunistic infections, such as by fungi, which can be aggravated in patients with impaired renal function such as Savarimuthu.

In mitigation, Haridass lawyer, Senior Counsel Davinder Singh from Davinder Singh Chambers, said that there was no risk of the doctor committing the offence again as he has retired and not renewed his practising certificate.

Haridass is genuinely remorseful and accepts he was wrong, Mr Singh added in agreeing for a fine of S$1,500 to be imposed.

District Judge Eddy Tham noted that the doctor had been charged only with endangering Savarimuthus personal safety.

I will assume that none of the grave consequences (mentioned in court) had come to pass If any significant harm had resulted to the patient, in fact, I would have had no hesitation in imposing a custodial sentence, he told the court.

Those convicted can be jailed for up to three months or fined up to S$1,500, or punished with both.

CORRECTION: An earlier version of the headline implied that the patient had died because of the medication prescribed to him by the doctor. However, the prosecution and defence had agreed his death was not directly linked to the doctor's prescription. We are sorry for the error.

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GP fined S$1500 for negligence after giving medication to patient without pre-prescription tests - TODAY

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