All India Institute of Medical Sciences, New Delhi (AIIMS, New Delhi) is a public hospital and medical research university based in New Delhi, India. The institute is governed by the AIIMS Act, 1956 and operates autonomously under the Ministry of Health and Family Welfare.
The South-East Asia Region (SEAR) faces a growing burden of non-communicable diseases (NCDs), shaped in part by complex commercial determinants of health (CDoH). This analysis considers how aggressive marketing, policy interference and addictive product design by the tobacco, alcohol and ultra-processed food (UPF) industries contribute to this burden. SEAR’s distinctive demographic, cultural and economic conditions create both vulnerabilities and opportunities. Rapid urbanisation, high population density, rising disposable incomes and uneven policy enforcement create environments in which commercial actors can expand market reach and influence consumption patterns. These industries frequently target youth and lower socioeconomic groups through tailored marketing, sponsorships, digital engagement and strategic product placement. Cultural norms further shape consumption in SEAR, including the longstanding use of smokeless tobacco, socially embedded alcohol consumption in several countries and the growing incorporation of UPFs into daily diets. These patterns are strengthened by expanding digital and e-commerce ecosystems that increase exposure, accessibility and the normalisation of health-harming products across diverse populations. Despite challenges, the region can address CDoH by adapting evidence-based strategies like marketing restrictions, excise taxes on sugar-sweetened beverages and safeguards against industry interference to local policies. Strengthening regulatory frameworks, enforcing comprehensive marketing restrictions and adopting WHO ‘best buy’ interventions are critical steps. In parallel, international cooperation and capacity building in low- and middle-income countries are essential, as is the engagement of civil society and academia to enhance accountability and support effective policy implementation. Collectively, these strategies can help SEAR accelerate progress in reducing NCD risks and improving population health.
India's rising twin birth rate, driven by assisted reproductive technologies and delayed childbearing, generates approximately 30,000-40,000 twin pairs annually, yet this invaluable research resource remains systematically underutilized. While established twin registries in the United Kingdom, Australia, and Nordic countries have transformed understanding of disease heritability and gene-environment interactions, India, despite its 1.4 billion population and exceptional genetic diversity, lacks a coordinated infrastructure to capitalize on this scientific opportunity. Twin studies provide nature's ideal control experiment, enabling researchers to disentangle genetic predisposition from environmental influences through comparison of monozygotic and dizygotic pairs, with discordant twins offering particularly powerful insights into modifiable risk factors. India's extraordinary genetic heterogeneity, encompassing over 4600 distinct population groups, coupled with rapid environmental transitions including urbanization, dietary shifts, and pollution exposure, creates unparalleled natural experiments for investigating conditions demonstrating marked interpopulation variation such as type 2 diabetes, cardiovascular disease, and neuropsychiatric disorders. Establishing a National Twin Registry through a federated model linking existing birth registries with opt-in research participation, leveraging digital health infrastructure like Ayushman Bharat Digital Mission, would require modest investment while generating insights applicable across the disease spectrum. Initiating pilot registries in states with robust health systems such as Kerala, Tamil Nadu or Karnataka would enable iterative refinement before national expansion. International collaborations with established registries could accelerate development while preserving data sovereignty through robust governance frameworks. A National Twin Registry represents a strategic imperative for transitioning India from a research subject pool to a research leader in precision medicine, enabling Indian investigators to drive discovery addressing India-specific health priorities.
We report a woman in her early 80s who presented with rapidly progressive proximal muscle weakness and functional decline and was diagnosed with anti-signal recognition particle (SRP) immune-mediated necrotising myopathy. Given the recognised aggressive phenotype of anti-SRP-associated disease, she received standard induction and early combination immunosuppressive therapy. Despite appropriate treatment, recovery was limited, with persistent severe weakness and progressive dysphagia, and she died at home 3 months after discharge. This case highlights that in very frail older adults with severe inflammatory myopathy, correct and timely therapy may not translate into meaningful functional recovery, underscoring the prognostic impact of frailty and comorbidity rather than limitations in access to treatment.
OBJECTIVE:Evidence on cancer outcomes in patients with rheumatoid arthritis (RA) is limited and conflicting. We conducted a systematic review to evaluate the association between RA and overall survival among patients with cancer. METHODS:A comprehensive literature search from inception through November 2024 identified observational studies evaluating mortality after cancer diagnosis in patients with RA. Study quality was assessed using the Newcastle-Ottawa Scale, and mortality estimates (RA with cancer vs cancer alone) were pooled using inverse variance weighting and random effects models in RevMan. RESULTS:Twenty studies met our eligibility criteria. A total of 59,299 patients with both RA and any type of cancer were included, whereas 1,761,008 patients with cancer only were included. Compared with patients with cancer alone, those with RA and cancer did not have a significant difference in mortality (pooled hazard ratio [HR] 1.13; 95% confidence interval [CI] 0.90-1.42). There was significantly worse survival in patients with RA and lung cancer (HR 1.22; 95% CI 1.01-1.46), RA and hematologic malignancies (HR 1.20; 95% CI 1.04-1.37), and RA and breast cancer (pooled HR 1.41; 95% CI 1.22-1.63). Results for other cancer types were inconclusive across studies. All studies were of generally good quality, and no major publication bias was identified. CONCLUSION:Patients with both RA and cancer overall do not experience poorer survival compared to patients with cancer alone. However, survival significantly worsens for patients with RA with lung, hematologic, or breast malignancies. Future prospective studies are warranted to elucidate underlying mechanisms and optimize cancer management strategies in RA.
