Category: Health

Research by the US Food and Drug Administration (FDA) has discovered that sealed bottles of tattoo and permanent makeup ink, some marked as sterile, contain millions of potentially harmful bacteria.

“In light of our study results, we want to emphasize the importance of continuously monitoring these products to ensure the microbial safety of tattoo inks,” stated Seong-Jae (Peter) Kim, a microbiologist at the FDA’s National Center for Toxicological Research. Kim, the corresponding author of the report published on July 2 in the journal Applied and Environmental Microbiology, highlighted the significant findings of the study.

Tattoo ink is injected deep into the skin, creating an environment where some bacteria can thrive, potentially causing infections and serious injuries. Linda Katz, director of the FDA’s Office of Cosmetics and Colors, explained, “Pathogens or other harmful substances in these inks can travel from the injection site through the blood and lymphatic systems to other parts of the body.”

This systemic spread of bacteria can lead to severe, life-threatening complications such as endocarditis, an inflammation of the heart lining, and septic shock, the final and most severe stage of sepsis. The US Centers for Disease Control and Prevention (CDC) warn that if not treated quickly, “sepsis can rapidly lead to tissue damage, organ failure, and death.”

Common symptoms of tattoo ink infections include injection-site rashes, impetigo (a contagious bacterial skin infection), erysipelas (a bright red and tender skin rash), and cellulitis (a deep skin infection requiring antibiotic treatment). According to Katz, individuals with multiple or large tattoos are at a higher risk due to the increased likelihood of exposure to microorganisms. Permanent makeup, especially around the eye area, poses additional risks as microbes can enter the eye and cause infections.

John Swierk, an assistant professor of chemistry at Binghamton University, noted, “We know that contamination in tattoo inks is a common occurrence. Part of the problem is that there is no agreed upon, industry-standard method for sterilizing inks. Our work and the current study really highlight the need for good, standardized manufacturing processes across the tattoo ink industry.”

The tattoo industry is working with regulatory bodies to comply with safety standards. Selina Medina, director of research at the Alliance of Professional Tattooists, stated, “Manufacturers are investing in advanced sterilization technologies and formulation advancements to improve their production environments to reduce the risk of contamination. This includes using clean rooms and enhanced quality control processes to mitigate against problems like this.”

The latest study examined 75 samples of sealed tattoo and permanent makeup ink from 14 US manufacturers. Researchers found that 26 samples from 10 manufacturers, or 35% of the sample set, had some degree of bacterial contamination. While most samples had bacterial counts of less than 250 CFUs (colony-forming units) per gram, a few contained bacterial counts as high as 105, or 100,000 bacteria per gram.

Earlier FDA studies found that 35% of unopened and sealed inks from US manufacturers had bacterial counts as high as 108 CFU, or 100 million bacteria per gram. Infectious disease expert Dr. Robert Schooley emphasized that the bacterial level in materials injected into the skin should be zero. “The level of bacteria in materials that are injected into the skin or that come into contact with abraded or injured skin should be ‘none detected,’” said Schooley.

Schooley also noted that tattooing has been associated with the transmission of viral infections like hepatitis C, hepatitis B, and HIV. He added, “These (infections) were not studied in the FDA manuscript, but the fact that so many of the inks failed bacterial sterility tests suggests that other organisms like viruses and fungi also can slip through the cracks.”

Many certified tattoo artists are aware of the contamination risks and take steps to avoid them. Medina emphasized, “Transparency with clients is vital. Artists should communicate openly about the steps they take to ensure ink safety and address any concerns clients may have.”

Some artists conduct their own testing or require proof of testing from suppliers, including microbial testing for potential contamination. Tattoo artists can also resterilize inks before application using an autoclave, a machine that uses steam to apply high pressure and temperature to eliminate bacteria.

The way ink is handled during tattooing is crucial. For instance, using the same gloves to touch a client and the ink bottle can lead to contamination. Artists should ensure ink bottles are tightly sealed when not in use and stored in cool, dry places away from direct sunlight to minimize contamination risks.

Experts advocate for regulations requiring testing and certification of tattoo and permanent makeup inks before they are marketed. Swierk mentioned, “Tattoo inks are in the process of being regulated due to the Modernization of Cosmetics Regulation Act (MoCRA) of 2022, but much of that law dealing with tattoo inks has yet to be implemented.”

“We anticipate that MoCRA will be phased in over the next few years and that will represent the first serious regulation of tattoo inks in the US. Most of this will focus on good manufacturing processes and safety substantiation.”

In June 2023, the FDA released draft guidance for the tattoo industry, detailing how manufacturers should conduct quality control measures, including sterilization.

The U.S. government has committed $176 million to Moderna for the accelerated development of a pandemic influenza vaccine targeting bird flu, federal officials announced Tuesday. This funding reflects growing concerns about the spread of bird flu to dairy cows across the country.

Moderna is currently in the early stages of testing a bird flu vaccine utilizing the same mRNA technology that facilitated the swift creation and distribution of COVID-19 vaccines. The U.S. Department of Health and Human Services (HHS) is providing this new funding to support the ongoing development of the vaccine, potentially leading to a late-stage trial next year, provided that initial study results are promising.

Importantly, HHS officials have highlighted that the project is designed to be adaptable, allowing a swift pivot to address other forms of influenza should a different threat arise, rather than the current focus on the H5N1 strain of bird flu.

The funding is being provided through the Biomedical Advanced Research and Development Authority (BARDA), a program dedicated to the development of medical treatments for potential pandemics.

The H5N1 virus, which was detected earlier this year in dairy cows, has now spread to more than 135 herds across 12 states. To date, three people have been infected, all of whom experienced only mild symptoms. Federal health officials emphasize that the overall risk to the general population remains low.

The U.S. government’s investment in Moderna is a proactive measure to combat potential pandemic threats. By leveraging mRNA technology, which proved effective against COVID-19, and ensuring flexibility in targeting various forms of influenza, this initiative aims to bolster national preparedness against future influenza outbreaks.

A recent cohort study investigated the disparity in unprofessional behavior reports among physicians across various specialties, as perceived by their coworkers. Involving 35,120 physicians, the study discovered that 9.1% had at least one report from a coworker describing unprofessional behavior.

Key Findings

Surgeons were the most frequently reported group, with 13.8% having at least one report, whereasnonsurgeonnonproceduralists had the lowest rate at 5.6%. Emergency medicine physicians and nonsurgeon proceduralists exhibited unprofessional behavior at rates of 10.9% and 12%, respectively. Physicians specializing in pediatrics were notably less likely to receive reports compared to their nonpediatric counterparts, especially among nonsurgeonnonproceduralists (3.6% vs. 6.0%).

The primary types of unprofessional behavior reported were issues with clear and respectful communication, followed by lapses in professional responsibility, competent medical care, and integrity.

Study Design

This retrospective cohort study, published in JAMA Network Open, utilized data from the Coworker Concern Observation Reporting System (CORS), administered by the Vanderbilt Center for Patient and Professional Advocacy, covering January 2018 to December 2022. Reports were categorized into clear and respectful communication, professional responsibility, competent medical care, and integrity. The study employed logistic regression to calculate the odds of any CORS report, adjusting for specialty, region, academic practice status, and pediatric specialty status.

The cohort included 18,288 nonsurgeonnonproceduralists, 1,876 emergency medicine physicians, 6,743 nonsurgeon proceduralists, and 8,213 surgeons. Notably, surgeons had the smallest proportion of pediatric-focused practitioners (5.5%). The largest proportion of the cohort practiced in academic settings, reflecting the distribution of CORS sites.

Detailed Results

Out of the 35,120 physicians in the cohort, 3,179 (9.1%) had at least one CORS report. The incidence of reports varied significantly by specialty: nonsurgeonnonproceduralists (5.6%), emergency medicine physicians (10.9%), nonsurgeon proceduralists (12.0%), and surgeons (13.8%). Nonsurgeonnonproceduralists were significantly less likely to be reported compared to all other specialties combined (5.6% vs. 12.8%).

Pediatric-focused physicians were less likely to receive a CORS report than nonpediatric-focused physicians (6.8% vs. 9.4%). Specifically, pediatric-focused nonsurgeonnonproceduralists had fewer reports compared to their nonpediatric counterparts (3.6% vs. 6.0%).

In a multivariable logistic regression model, controlling for physician and practice site characteristics, all specialty types had significantly higher odds of receiving at least one coworker concern report compared to nonsurgeonnonproceduralists. The adjusted odds ratios (OR) were: emergency medicine physicians (adjusted OR, 1.91; 95% CI, 1.63-2.24), nonsurgeon proceduralists (adjusted OR, 2.34; 95% CI, 2.12-2.57), and surgeons (adjusted OR, 2.75; 95% CI, 2.51-3.01) (P < .001). Pediatric-focused physicians were significantly less likely to have a coworker concern report than those with a nonpediatric focus (adjusted OR, 0.69; 95% CI, 0.61-0.78; P < .001).

The predominant types of CORS reports across all specialties involved issues with clear and respectful communication, followed by professional responsibility. Reports concerning professional integrity were the least common.

Implications

“Because unprofessional behaviors are associated with patient complications, malpractice claims, and well-being concerns, monitoring concerning behavior and especially those physicians with repeated reports provides important opportunities for physicians and leaders to support professionalism, which increases the chance of health care organizations meeting their clinical, cultural, and other performance goals,” the study researchers concluded.

A complete list of disclosures from the researchers is available in the study.

According to new research published in the Lancet Global Health, half of the adult population in India does not meet the World Health Organisation’s (WHO) guidelines for adequate physical activity. The study highlights that more women (57%) than men (42%) are physically inactive. Alarmingly, the prevalence of insufficient physical activity among Indian adults has escalated dramatically from 22.3% in 2000 to 49.4% in 2022.

If this trend continues unchecked, by 2030, 60% of the Indian population could be unfit and at increased risk of diseases associated with insufficient physical activity.

Importance of the Study

The WHO advises that all adults should engage in at least 150 to 300 minutes of moderate aerobic activity per week, or an equivalent amount of vigorous activity. Insufficient physical activity is defined as failing to achieve 150 minutes of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or a combination of both each week. According to the WHO, physical inactivity significantly raises the risk of cardiovascular diseases like heart attacks and strokes, Type 2 diabetes, dementia, and cancers of the breast and colon.

India ranks 12th highest in terms of insufficient physical activity among 195 countries. Globally, nearly one-third (31%) of adults—approximately 1.8 billion people—did not meet the recommended levels of physical activity in 2022. Dr. Rüdiger Krech, Director of Health Promotion at WHO, explained, “This is because of many factors, including changes in work patterns (move towards more sedentary work), changes in the environment, convenient transportation modes and changes in leisure time activities (that is more screen-based/sedentary activities).”

The highest rates of physical inactivity were found in the high-income Asia-Pacific region (48%) and South Asia (45%). Other regions showed levels of inactivity ranging from 28% in high-income Western countries to 14% in Oceania.

Why Should Indians Be Concerned?

Indians are genetically predisposed to developing non-communicable diseases like heart disease and diabetes about a decade earlier than others. Dr. K Srinath Reddy, a public health expert and leading cardiologist, noted, “Lack of physical activity means that you are just aggravating your existing risk factors. The WHO goals were set to reduce risk of heart disease, diabetes, obesity and some types of cancer while improving mental health and a stronger immune system.”

He added, “Delayed urbanisation and industrialisation in some parts of the world have led to a sedentary and comfortable lifestyle, particularly South Asia (including India).”

Overcoming a Sedentary Lifestyle

Maitreyi Bokil, a Pune-based nutritionist and exercise physiologist, believes the biggest obstacle to fitness is the mental barrier that views exercise as just another chore in a busy day. She advises starting with enjoyable physical activities, such as watering plants or doing household chores. “Once you do that regularly, take the next step by finding a friend to go for a walk or join a community club. Having a pet is a great way to break a sedentary lifestyle,” she says.

For people with comorbidities, she recommends seeking medical advice on the frequency, intensity, and type of physical activity based on their endurance levels. Regarding diet, Bokil advocates for a rainbow-colored diet. “Everyone is aware of the importance of protein, carbohydrates, and fat, but we don’t realize the importance of micronutrients like vitamins and minerals. They make sure we get the energy out of carbs, protein, and fat. In addition, they help us fight inflammation caused due to erratic lifestyles. So everyone should focus on at least two vegetables (one cooked, one raw) for each meal and two whole fruits in a day,” she advises.

As for starting exercise at any age, Bokil cites research indicating that muscle gains can be made throughout life. “New neuro-muscle connections can be made at any age,” she says.

Gender Disparity in Physical Activity

Dr. Reddy noted that several studies within India have also shown low levels of physical activity among women, who often mistakenly believe that household chores constitute sufficient exercise. Cultural barriers also contribute to this inactivity, especially among middle-aged urban women. Indian women are faring worse than their counterparts in Bangladesh, Bhutan, and Nepal, according to the study.

Dr. Fiona Bull, head of the WHO unit for physical activity, and epidemiologist Dr. Tessa Strain, attributed these figures to women bearing a larger share of home duties. “These combined with their caregiver role provide women lesser opportunities to prioritize themselves; they don’t have time and feel tired,” they said.

This comprehensive study underscores the urgent need for India to address its rising levels of physical inactivity. With a significant portion of the population at risk of developing serious health conditions, promoting a more active lifestyle through awareness and accessible initiatives is crucial.

The National Board of Physicians and Surgeons (NBPAS) commends the recent announcement made by the Federal Trade Commission (FTC), the Department of Justice (DOJ), and the Department of Health and Human Services (HHS) regarding their collaborative initiative to seek public input on anti-competitive and monopolistic practices within the healthcare sector.

Back in September, NBPAS formally approached the FTC seeking relief from what it perceives as an attempt by the American Board of Medical Specialties (ABMS) and its affiliated boards to utilize their monopolistic authority to exclude or eradicate competitors from the market for continuing certification. Of significant concern is the refusal of other segments of the medical community to engage with NBPAS, particularly given their shared board memberships and close economic ties to ABMS.

According to NBPAS, the existence of a monopoly that stifles competition not only burdens physicians but also inflates healthcare costs for consumers and exacerbates the ongoing physician shortage. Despite providing physicians with a more streamlined, less cumbersome, and cost-effective path for continuous board certification over the span of eight years, NBPAS has struggled to gain substantial traction in the market due to perceived obstacles to competition and unfair trade practices.

NBPAS founder and president, Dr. Paul Teirstein, emphasizes the importance of physicians affected by ABMS Maintenance of Certification (MOC) to voice their grievances. He asserts, “We urge every physician who has been harmed by ABMS MOC to speak now, speak loudly, and spread the word to every physician you know.” Dr. Teirstein expresses gratitude that the FTC, DOJ, and HHS are providing a platform for physicians and the public to express their concerns through the FTC’s new submission portal.

Dr. Teirstein underscores that the issue transcends NBPAS, stating, “At the end of the day, this is not about NBPAS.” He asserts that no single entity should wield unchecked authority over the lives and careers of physicians, as it ultimately impacts patient care. Taking a principled stance, NBPAS is proud to lead the charge on behalf of practicing physicians and future generations.

NBPAS emerged as a response to the demand for a continuous certification pathway founded on practice-relevant and specialty-specific Continuing Medical Education (CME). It adheres to national accreditation standards for hospitals and health plans and presently certifies over 13,000 physicians across more than two hundred institutions, including hospitals, academic medical centers, telemedicine firms, major insurers, and the Veterans Health Administration (VHA) system. NBPAS’ continuous board certification program aims to alleviate physician burnout and address the physician shortage by offering an evidence-driven, clinically relevant certification pathway.

Nobel Prize-winning molecular biologist Venki Ramakrishnan sat down with ABC News Live to discuss the science and ethics of extending the human lifespan.  In his new book, “Why We Die: The New Science of Aging and the Quest for Immortality,” Ramakrishnan explains why we may not want to lengthen our lives much longer.

Ramakrishnan’s thought-provoking argument is that a society where people lived for hundreds of years could potentially become stagnant, as it would consist of the same group of people living longer, raising important questions about societal dynamics and progress.

He discussed the cycle of life and why we die.

ABC NEWS LIVE: If you think it might be wonderful to live forever, you may want to hear what a Nobel Prize-winning molecular biologist has to say that could change your mind. Venki Ramakrishnan has examined the latest science, weighed the possibilities and researched the ethical cause of lengthening our lifespans in his new book, ‘Why We Die The New Science of Aging and the Quest for Immortality.’ Doctor, thank you so much for joining us.

ABC NEWS LIVE: So humans now live twice as long as we did 150 years ago. But you raise some, some caveats to why we may not want to lengthen our lives that much longer. Why is that?

RAMAKRISHNAN: Well, I think a society where everybody lived indefinitely or very long time, say, hundreds of years would be a very different society. It would be quite stagnant. It’d be the same group of people just living longer and longer.

You wouldn’t have that turnover between generations. You know, maybe new ideas, things like that. But I think that’s still in the realm of science fiction. I think biology is looking at the causes of aging, and that’s allowing us to tackle some of these causes. But most of the focus is how to live healthily for longer, because all developed societies are living longer lives.

So we’re having more and more older people well past retirement. And we want to see how can we keep older people healthy and productive, you know, and energetic and and actually lively. So I think a lot of biology is trying to understand those causes so we don’t suffer some of the debilitating consequences of aging.

ABC NEWS LIVE: Explain why it is that sometimes our biological age doesn’t match our chronological age.

RAMAKRISHNAN: That’s because aging you can think of as an accumulation of damage as over time. And we have very sophisticated repair mechanisms, and we have ways to deal with the problems of old age, of the accumulation of damage, accumulation of garbage in the cells. We have recycling mechanisms and all those things break down. And the rate at which they break down is different for different people.

ABC NEWS LIVE: Explain the new research, though, that talks about how there are certain blood markers that indicate why people age faster than others, and we could say this is separate from drinking and smoking or lack of sleep.

RAMAKRISHNAN: Yeah. So blood — there are different markers for aging. So some markers are on our DNA. Our DNA acquires marks called epigenetic marks as we age. And that changes the pattern with which we express different genes.

So it changes how our biology works. There are also markers in our blood. And this was found because when they connected an old animal with a young animal and allowed them to exchange their blood supply, the old animal benefited from the young blood. And that suggested these things in younger blood that deteriorate or don’t exist or have changed in older blood. And people are trying to find what those markers are.

ABC NEWS LIVE: Let’s say in the next few decades, we’re able to come up with cure for, for cancer, high blood pressure, diabetes. What’s the best-case scenario, do you think, for the longevity of human life?

RAMAKRISHNAN: So someone did a calculation. And if we eliminated some of the major causes of fatality today, like the things you mentioned, you would only gain about 15 years. But what biologists think is if you tackle the underlying causes of aging, then you could really, expect to, live a longer and healthier life.

ABC NEWS LIVE: Really fascinating. Doctor, we thank you so much for joining us. Want to let our viewers know “Why We die? The New Science of Aging and the Quest for Immortality” is now available wherever books are sold.

An analysis of cost data within the South Mississippi system’s Accountable Care Organization (ACO) uncovered that care administered by nonphysician providers managing their own patient panels was pricier than care delivered by physicians. This revelation prompted leaders at Hattiesburg Clinic to revamp the clinic’s care model and publish their discoveries. Initially employing 26 physician assistants (PAs) and nurse practitioners (NPs) in 2005, the clinic now boasts 118 such providers. Alongside certified registered nurse anesthetists and optometrists, these 186 nonphysician providers constitute what is termed as advanced practice providers (APPs) at the clinic.

According to a study titled “Targeting Value-based Care with Physician-led Care Teams,” published in the Journal of the Mississippi State Medical Association, Hattiesburg Clinic made strategic decisions over the past 15 years to expand their care teams by integrating advanced practice providers, primarily due to shortages in primary care physicians. The study highlights, “Focusing specifically on primary care, because our shortage of physicians there was so dire—due to retirements, massive panel sizes and lack of medical students entering primary care residencies—we allowed APPs to function with separate primary care panels, side by side with their collaborating physicians.”

However, upon retrospect and analysis of extensive internal data, encompassing cost data from over 33,000 Medicare-enrolled patients, the findings were consistent and unequivocal: the integration of advanced practice providers with independent panels under physician supervision fell short of meeting primary care objectives in providing patients with an equivalent value-based experience.

Hattiesburg Clinic, a private multispecialty clinic with over 300 physicians, holds membership in the AMA Health System Program. Its ACO earned the top rank in quality within its cohort in 2016 and 2017 among 471 other participants and has garnered recognition from the Centers for Medicare & Medicaid Services (CMS) for delivering high-quality care at a low cost.

According to CMS cost data spanning from 2017 to 2019, for Medicare patients excluding those with end-stage renal disease or in nursing homes, per-member, per-month spending was $43 higher for patients under the care of nonphysician primary health professionals compared to physicians. This contrast could translate to an annual increase of $10.3 million in expenditure if all patients were overseen by APPs. Following risk-adjustment for patient complexity, the disparity amounted to $119 per member, per month, equating to an annual difference of $28.5 million.

Dr. Bryan N. Batson, an internist and CEO of Hattiesburg Clinic, a co-author of the study, stated, “We didn’t set out to do a scientific study per se. This was really an observational experience that used data to help us drive decision-making going forward.” He added, “This was us looking in the mirror to say: As we’re becoming more advanced in value-based care, how do we do it better?”

Initially, upon receiving the initial CMS reports on care costs, the focus was on identifying the highest-cost physicians and collaborating with them to curtail spending. Dr. Batson mentioned, “When we got the claims data for the first time, one of the first things we did was to look at who our highest-cost providers were.” He further expressed surprise at the stark disparities in costs between physicians and advanced practice providers at the high-cost end of the spectrum.

Further analysis revealed that the additional costs were attributed to a combination of factors, including increased test ordering, more specialist referrals, and heightened emergency department utilization. Dr. John M. Fitzpatrick, a nephrologist and president of Hattiesburg Clinic, noted that “four of the five top highest-cost providers were nurse practitioners,” prompting a comprehensive analysis of the entire population and leading to the findings presented in the study.

Patients whose primary care provider (PCP) was a nonphysician exhibited higher rates of emergency department visits compared to those without a PCP. Moreover, physicians outperformed nonphysicians on nine out of ten quality measures, particularly excelling in flu and pneumococcal vaccination rates, despite these being considered manageable by nonphysician staff. Physicians also attained higher average patient satisfaction scores across six domains measured by Press Ganey.

Acknowledging the invaluable contribution of nurse practitioners and physician assistants to the care team, the study emphasized that they should not operate independently based on a wealth of information and experiences in collaborative relationships with physicians.

Driven by data insights, Hattiesburg Clinic revamped its care model, ensuring that all patients consult with a physician as their primary care provider and no patient exclusively sees a nonphysician. Dr. Batson elaborated, “We had a one-year transition period leading up to that, so that the nurse practitioners could tell their patients that beginning Jan. 1, 2021, you’re going to have alternating visits with me and my supervising physician, but your PCP will officially be the physician.”

Telemedicine has played a pivotal role in facilitating the implementation of the new care-team model, enhancing healthcare delivery in rural settings. Dr. Batson highlighted, “It really changes the way that we’re able to deliver health care in a rural setting—in a positive way—such that a clinic may be able to be staffed some days with an APP, some days with a physician, but in those days that the APP is the lead there, there’s the availability of telemedicine to support more advanced health care delivery.”

The American Medical Association (AMA) asserts that patients deserve care led by physicians, advocating against scope-of-practice expansions that jeopardize patient safety. Dr. Fitzpatrick emphasized the importance of credible, Mississippi-based data in influencing legislative decisions, noting the commendable efforts of legislators in prioritizing patient well-being while devising strategies to reduce healthcare costs.

Both doctors expressed optimism that their experience would encourage other ACOs to conduct similar analyses, potentially stimulating discussions with other organizations nationwide or attracting the attention of CMS.

“We would encourage other organizations to look at their data—like we did—to help them refine their care teams in ways that can improve health care,” Dr. Batson concluded. “That’s what this was all about: trying to improve health care of our patients and for the system.”

The Supreme Court declared on Wednesday its refusal to accept the “unconditional and unqualified” apologies tendered by Yoga guru Baba Ramdev and Patanjali Ayurved Managing Director Acharya Balkrishna. This apology came in response to contempt of court notices issued by the court, following a lawsuit by the Indian Medical Association (IMA). The IMA accused them of publishing misleading advertisements, claiming cures for certain diseases, and criticizing the allopathy branch of medicine.

A bench consisting of Justices Hima Kohli and Ahsanuddin Amanullah had previously expressed dissatisfaction with the apology affidavits submitted by Ramdev and Balkrishna. They were given an opportunity to provide better responses to the show cause notices. These notices were issued due to alleged violations of an undertaking given to the court on November 21, 2023, pledging not to make “casual statements claiming medicinal efficacy or against any system of medicine”.

The court expressed displeasure over a press conference held by Ramdev on November 22, 2023, in Haridwar, and an advertisement released by the company on December 4, 2023, which were seen as violations of the undertaking made on November 21, 2023.

Subsequently, fresh affidavits were filed on April 6, offering unqualified and unconditional apologies. However, Justice Kohli stated, “We do not accept these affidavits. We decline to accept or condone it. We consider it a wilful and deliberate violation of the order.” The court criticized the respondents’ actions as a deliberate breach of the undertaking, despite repeatedly emphasizing their apologies in the affidavits.

In its order, the court remarked, “Having regard to the entire history of the matter, and the past conduct of the respondents, we have expressed our reservations about accepting the latest affidavit filed by them.” The bench scheduled another hearing for April 16.

The court also found fault with an application submitted by the duo during the previous hearing, seeking exemption from appearing in court due to international travel. It was noted that the affidavits were sworn a day before the air tickets were issued, leading the court to believe the respondents were attempting to avoid personal appearance.

The court stated, “It is now been stated in the affidavit filed by the proposed contemnors that admittedly the tickets were issued on a date after the affidavit was sworn…Fact remains that on the date, the affidavits were shown, there was no such ticket in existence (at the time the affidavits were sworn). And therefore, the assumption is the respondents were trying to wriggle out of their personal appearance before this court, which is most acceptable.”

Furthermore, the court reprimanded the state of Uttarakhand for failing to take action against Patanjali and its subsidiary Divya Pharmacy for advertisements promising cures for diseases. The court requested affidavits from officials who had held the post of Joint Director of the State Licensing Authority in Haridwar between 2018 and the present, to explain their actions to address this issue.

The unexpected announcement from Catherine, Princess of Wales, regarding her initiation of chemotherapy for cancer treatment came as a surprise to many. In the wake of this news, major newspapers in Britain expressed concern on their front pages. The Times reassured its readers with the headline, “Princess reveals her cancer and says: I’m going to be OK.” Similarly, the FT Weekend chose the headline, “Kate puts end to speculation,” while The Sun tabloid conveyed a message of solidarity to the princess with, “KATE, YOU ARE NOT ALONE.”

In an emotional video statement released a day prior, the 42-year-old princess opened up about her battle with cancer after weeks of intense scrutiny regarding her health. Despite her usual nervousness in front of cameras, the princess bravely shared her story in her own words, filmed simply on a bench against a backdrop of spring foliage.

Acknowledging the challenging weeks she has faced, the princess addressed ongoing interest in her health, particularly following reports of a potential breach of her medical privacy by hospital staff where she underwent treatment in January. This development followed a surge of unfounded conspiracy theories, fueled by speculation surrounding her surgery in January, her husband Prince William’s absence from a memorial event, and her admission of editing a family photo for Mother’s Day.

The revelation about her health sheds new light on recent events and prompts questions about the transparency of the royal family regarding her condition. This period of uncertainty adds to the challenges faced by the monarchy, with two senior members now indisposed, leaving Prince William and Queen Camilla to take on additional responsibilities.

The diagnosis of cancer for the future Queen follows King Charles III’s own health struggles, disclosed earlier in February, further straining the monarchy. Kate’s condition, especially given her youth, contrasts sharply with her image as a symbol of health and perfection since marrying into the royal family in 2011.

Kate’s vulnerability underscores her humanity, challenging perceptions of her as a flawless public figure. Despite her previous portrayal as a steadfast member of the royal family, her battle with cancer serves as a poignant reminder of her humanity.

The prime minister’s statement reflects widespread sentiments of support for the princess, condemning media scrutiny and advocating for her privacy and well-being. While Kate was expected to resume official duties after Easter, her return will be delayed pending medical clearance, with any appearances likely to be spontaneous.

The lack of detailed updates from Kensington Palace underscores the family’s desire for privacy as they navigate this challenging time. The public’s access to Kate’s video message serves as the most comprehensive update on her health, in exchange for respecting the family’s need for space.

Prince William’s continued public engagements aim to reassure the nation amidst the upheaval, while prioritizing his family’s well-being. In her video message, Kate emphasized the importance of maintaining normalcy for their children, suggesting a desire for privacy amidst media attention.

The timing of the announcement, after the Easter holidays, highlights the couple’s consideration for their children’s routines. Despite her ordeal, Kate remains resolute in her focus on recovery, while also calling for understanding and privacy from the public.

Navigating the delicate balance between media coverage and privacy presents a challenge, particularly with international attention. While some online speculation persists, Kate’s message has prompted an outpouring of support, potentially reshaping public discourse around royal figures and confronting baseless conspiracy theories.

In the face of adversity, Kate’s openness about her health journey offers a chance for reflection on the impact of media scrutiny and the importance of empathy and understanding in the public sphere.

Following her father’s passing five years ago, Nirmala Chetty, now professionally known as Dr. Sahila, a medical practitioner based in New Jersey, faced a challenging health journey, grappling with bipolar depression and thyroid issues, among other ailments. Despite seeking relief in various hospitals, she found no solace.

However, delving into her Hindu and Indian heritage, Sahila discovered what she describes as a transformative solution. Today, she proudly asserts being “pill-free, disease-free, and stress-free,” attributing her well-being to the scientific efficacy of chakra healing.

Expressing her lament over the diminished faith in this ancient practice, Sahila, who operates her own clinic named Wellness with Sahila, remarked, “It’s very sad that, you know, such a beautiful and crucial concept is lost today because people don’t have faith in it.”

Critics have often derided chakra healing as pseudoscience, noting its exploitation by self-professed healers who charge exorbitant fees. Common perceptions associate chakras with energy centers in the body, correlated with colors and shapes representing emotions and meanings.

Yet, amidst skepticism, proponents of chakra healing, buoyed by the growing acceptance of Indian-origin practices like yoga in the West, endeavor to dispel misconceptions and assert the scientific grounding of their methods.

Reflecting on this evolution, Maetreyii Ma Nolan, a spiritual instructor in California, elucidated, “As Indian thought has come to the West, it’s gone through various incarnations, first as a spiritual tradition, and then as asana, or yoga posture tradition.”

Chakra healing, an ancient Hindu doctrine, posits that chakras—Sanskrit for “wheels”—align with specific nerve endings and internal organs. The body comprises seven chakras, prominently featuring the “third eye” at the forehead, often adorned with a bindi in Hindu culture.

According to Sahila and fellow practitioners, blockages in these chakras can manifest as emotional, physical, and spiritual maladies. For instance, an imbalance in the muladhara chakra, linked with identity and situated at the base of the spine, may result in depression, anxiety, or narcissism if not rectified. Similarly, issues with the svadhisthana chakra, situated in the lower abdomen and associated with women’s health, can affect childbirth.

Addressing these blockages, Sahila advocates surrendering the ego and embracing a journey of “sadhana”—a daily regimen of yoga and meditation targeting each chakra and its corresponding natural element.

While Western medicine often dismisses chakra healing as alternative or new-age, Sahila contends, “there’s a science to it, and if you understand the science to it, then the flow just automatically happens.”

Offering a testimony to the compatibility of chakra healing and Western medical practices, Hina Mehta, a neuroscience fellow at the National Institute of Health, revealed her initial hesitance as a scientist to explore Eastern healing. However, she emphasized the non-mutually exclusive nature of Hindu philosophy and Western science.

Mehta highlighted the direct correlation between chakras and the body’s hormone-producing glands, asserting that yogis and gurus have long mastered the art of channeling energy to these glands through specific yoga postures and hand movements.

For Lata Nigam, who underwent a significant lifestyle change following a breast cancer diagnosis, chakra healing provided a deeper understanding of her internal struggles. While acknowledging Sahila’s impact on her life, Nigam stressed the importance of personal commitment to the healing process.

Critics attribute the skepticism surrounding chakra healing to Western misinterpretations of Hindu healing concepts. Maetreyii Ma Nolan, blending psychology with Tantric philosophy, leads a community in California dedicated to meditation and self-discovery.

Evan Rofheart, another advocate of chakra healing, dismisses the necessity of subscribing to Hindu doctrines, underscoring personal experiences of divine energy transfer as foundational to his practice.

Nevertheless, proponents like Sahila emphasize the scientific underpinnings of chakra healing, citing correspondences between the seven chakras and cosmic and human realities. Sahila’s personal experiences with chakra healing, particularly the opening of her throat chakra, have reinforced her belief in its efficacy.

Sahila posits that widespread recognition of the authentic science behind chakra healing could significantly benefit society, fostering profound personal growth and well-being.

Gallup’s 2023 examination of Family and Adolescent Health requested that guardians depict the nature of their relationship with their children in the household. Former studies within this demographic and other research illustrate the varying tendencies of young individuals given the contemporary life risks they face. Gallup’s survey honed in on the wholesome and relatively non-conflictual rapport between parents and children, which fluctuates according to individual traits. It appears commonplace for adolescents to experience relationships of lesser quality with their parents than younger children, though parents perceive the lack of control less frequently than adolescents do. It’s noteworthy that married parents report higher-quality relationships compared to those who have never married, as well as biological parents compared to other relatives. Parents with conservative attitudes report more harmonious relationships of greater quality with their children compared to liberal or tolerant parents.

“The data suggests that social media usage correlates with poor mental health,” states the Family Studies Institute, “and a lack of parental regulation regarding adolescents’ screen time.” Another study from the same institute found that warm and disciplined treatment enhances adolescents’ mental well-being. The parent-child relationship appears to be age-dependent, being stronger with younger children aged three to four, with 80% of parents describing their relationship as excellent, compared to 48% with adolescent children aged 13 to 19. It’s notable that parents’ and children’s genders don’t affect the assessment of relationship quality; fathers and mothers evaluate their relationships with children similarly, as do girls and boys. Socioeconomic status, education, family income, or ethnic background do not dictate the quality of relationships. The survey indicates that parents with a high-quality relationship with their spouse report excellent treatment of children (67%) compared to those with a deficient conjugal relationship (50%).

While daily treatment differences between liberals and conservatives are similar, there’s a more pronounced distinction in setting boundaries and enforcing rules, as the former are more hesitant to administer negatives or demand order. Adolescents who perceive their relationships with parents as very good tend to have parents who describe them similarly, with 86% of parents describing their relationship with them as excellent. An unexpected finding is that parents view boys as more likely than girls to have a strong and affectionate relationship: 77% compared to 61%. There are no discernible differences among black, Hispanic, or Anglo parents regarding loss of control over children, while Asian parents report lower rates. White parents are more inclined to report frequent arguments.

It goes without saying that a high-quality relationship is vital for the well-being of both parents and children. Children with such relationships are far less likely to exhibit signs of depression, anxiety, or suicidal ideation; their behavior reflects positive social development and stronger mental health for the future, according to Gallup’s study. The robust relationships conservative parents cultivate with their children outshine those of liberal parents and protect them from the risks of mental health issues. Could this be attributed to instilling more discipline and order? Could it be because they establish boundaries and rules while offering warmth and affection, fostering balanced adolescent development? It’s imperative for parents and societal leaders to advocate for these practices within families and communities.