Only UDID certificate mandatory for exam concessions
While students will no longer need to submit separate medical certificates signed by the district civil surgeon to avail concessions for Class 10 and 12 board exams, the UDID certificate does not clearly mention the specific academic concessions required by autistic students, raising concerns about how they will receive appropriate support during the board exams.
Under the current system, students with special needs falling under 21 categories of disabilities including visual impairment, hearing loss, speech and language disorders, locomotor disabilities, mental illness, cerebral palsy, autism, multiple disabilities, intellectual disability, thalassaemia, haemophilia, sickle cell disease, and Parkinson's are entitled to various academic concessions such as writer assistance, extra time during exams, and relaxation in subject choices. To avail these benefits, students up until now had to submit a medical certificate from the district civil surgeon in addition to the standard disability certificate. With the recent directive however, the board has categorically stated that only the UDID certificate will be sufficient, going forward, eliminating the need for an additional medical document. Although the parents of autistic students have expressed concern over this change, pointing out that the UDID certificate does not specify the learning challenges unique to autism, nor does it outline the academic concessions needed.
Autistic students often struggle with subjects like mathematics, science, and languages. In such cases, schools typically allow substitution of subjects for example, home science instead of science, or alternative basic math from lower grades instead of geometry or algebra. These substitutions and other concessions like writer assistance and extra time during exams are usually based on detailed assessments conducted by specialists at public hospitals. These assessments take up to four months and result in detailed concession certificates tailored to the student's needs.
The UDID certificate, however, does not mention such detailed academic concessions, leading parents to worry that these essential concessions might no longer be available. As the board has not issued any clear guidelines on how such needs will be addressed under the new system, the lack of clarity has caused confusion.
Without the necessary academic concessions, autistic students may find it difficult to pass Class 10 and 12 examinations, potentially missing out on future opportunities. Many students on the autism spectrum have demonstrated high potential in fields such as computer applications, coding, and software testing. Losing exam-related support at the school level could hinder access to such opportunities.
Schools typically ask parents to submit concession certificates between August and September for students appearing in the Class 10 exams. As the assessment and certification process for autistic students is time-consuming, hospitals often advise parents to begin the process well in advance.
In response to various concerns, Sharad Gosavi, president of the Maharashtra State Board, said that the new system will prioritise the UDID certificate, and students without UDID cards will still be eligible for concessions based on recommendations from doctors and specialists. He also assured that the old process for autistic students will continue to remain in place to ensure that they are not disadvantaged. However, he emphasised that safeguards will be put in place to prevent misuse of the UDID system.
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The Print
a day ago
- The Print
Indian doctors more confident about oestrogen therapy for menopause as USFDA may scrap black box warning
The move came after the findings of a Women's Health Initiative (WHI) study—the largest-ever randomised controlled trial of hormone therapy in 2002—went public. The study found a combined oestrogen-progestin therapy linked to a rise in heart attacks and strokes, and a slightly elevated risk of breast and endometrial cancers. The USFDA, in 2003, mandated a black box warning—the highest level of warning associated with approved drugs when proven to be associated with serious or life-threatening adverse events—on all menopause treatments containing oestrogen, regardless of form or absorption rates. New Delhi: The United States Food and Drug Administration (USFDA) has declared its plan to remove the currently mandated, strictest health warning on oestrogen replacement therapies. The development has triggered a debate around the treatment, once widely used to manage menopausal symptoms but later linked to harmful side effects, such as cancer. However, the FDA panel, which held a discussion telecast publicly last month, was of the view that at least local oestrogen therapy, such as vaginal cream, is safe and should not carry the same warnings as systemically delivered oestrogen via patches or pills taken orally. The panel suggested that the risks associated with hormone replacement therapy (HRT) likely were overstated. The FDA has now invited submission of broad, public comments on the risks and benefits related to menopause hormone therapy, including 'data that could support updates to the labelling of such products'. Typically occurring between the ages of 45 and 55, menopause is the cessation of menstruation and the decline in ovarian function. This biological process comes with hormonal fluctuations, mainly the lowering of oestrogen and progesterone levels, which can lead to a variety of physical and psychological symptoms. A hallmark symptom of menopause is hot flashes, characterised by sudden waves of heat, flushing, and sweating, often accompanied by palpitations and feelings of anxiety. Additionally, many women experience night sweats while the drop in oestrogen levels has links to a marked rise in mood swings and behavioural changes, vaginal dryness, adverse bone health, cardiovascular events, and the risk of breast cancer. HRT had been a common approach since the 1970s to manage menopausal symptoms by supplementing the body with oestrogen, progesterone, or both. However, since 2000, following the WHI findings, most doctors and patients worldwide have been cautious in recommending or using it, and its popularity has dramatically dropped. In India, where HRT is available in the form of pills, vaginal creams, and topical cream applied on the arms, but no implants or patches, like in the US, there is no country-specific box warning, which is mandatory for the products in India. India never updated the official regulatory stance to reflect the advanced risk-benefit understanding associated with the treatment. However, experts maintained that clinicians had been hesitant in prescribing it. Now, many, including those in India, believe the situation will change. 'I am glad at the development concerning the warning status related to HRT for menopause,' Dr Archana Dwiwedi, the chair of the mid-life committee in the Federation of Obstetric and Gynaecological Societies of India (FOGSI), told ThePrint. A large number of women undergoing menopause or post-menopause can benefit majorly from HRT but remain deprived of it, mainly on account of evidence that may now be outdated, she said, adding that current scientific understanding is that HRT's benefits for most women far outweigh the risks. Also Read: What is the 'women's health gap' and how to close it 'Evolving' evidence In 1991, the National Institutes of Health in the US launched the WHI, a $625 million, long-term, randomised controlled study to investigate ways to prevent the leading causes of death and disability in postmenopausal women. The WHI recruited 1,61,808 postmenopausal women aged 50 to 79 for its study, and over 68,000 participated in one of three clinical trial arms—hormone therapy, diet modification, or calcium and vitamin D supplementation. The hormone therapy trial, intended to last nine years, would evaluate the long-term health impacts of the two most common HRT regimens at the time—conjugated equine estrogen (CEE-oestrogen derived from the urine of pregnant mares) plus progestin, or synthetic progesterone for women with a uterus and CEE alone for others who underwent a hysterectomy and no longer had a uterus. Eleven years later, the NIH announced that it was stopping the oestrogen-plus-progestin arm of the trial early, citing increased rates of blood clots, stroke, heart attacks, and breast cancer in women taking the combined hormone therapy. These findings led to a dramatic shift in the usage pattern of HRT globally, with a large number of patients and doctors abandoning it overnight. However, experts now say the WHI findings have since come under intense scrutiny, and an understanding has evolved that the results, which profoundly impacted the use of HRT, could have been skewed. For instance, the trial participants were old—63-year-olds on average—who in any case have a high baseline risk for cardiovascular conditions. Also, a follow-up study, which came out in 2024, concluded that HRT is safe and beneficial for most healthy women with bothersome menopause symptoms if they start it in the years shortly after menopause begins. 'The latest versions of HRT are also far safer and can make life easier for a high percentage of women, who face bothersome health challenges in the menopause stage, which severely affects their quality of life,' Dwiwedi said. There, however, are some sceptics too. 'I suspect the pharmaceutical industry pushed the latest FDA development. While the FDA panel batting for warning labels in the HRT shared a lot of anecdotal evidence to suggest they are safe, why was there not any scientific presentations to back those claims?' asked a gynaecologist with AlIMS Delhi, who did not wish to be named. However, while there is no clarity on whether the FDA will remove the requirement of black box warnings on all HRT for menopause, several of the panel members made a strong case for at least local oestrogen therapies, with comparatively low level of oestrogen, for symptoms such as vaginal dryness and urinary issues, as opposed to systemic therapies in the form of pills and implants. Some Indian clinicians agree with this argument. Vaginal oestrogen cream, mainly prescribed based on requirement, is not for a systemic replacement of oestrogen, but for local reasons, such as dryness or burning sensation, or poor urinary control or poor comfort level in terms of intercourse, said gynaecologist Dr Hemanandini Jayaraman from Manipal Hospital in Bengaluru. She said that the absorption of vaginal creams into the body is negligible, so no enhanced risk or risk factors are associated with the creams, which women generally use for local reasons. 'As far as continuing the vaginal application is concerned, if a patient gets symptomatic relief, which is extremely good, it can be safely pursued for a longer duration of time,' the clinician added. However, she also maintained that HRT, even in the form of oral prescription, could be safe provided there is regular monitoring of the users. Also Read: Over 50% of Indian women are anaemic. We need health literacy, support groups: Shabana Azmi Attitudes towards HRT in India India has nearly 15 crore women estimated to be postmenopausal, and roughly 30-40 percent of them could be considered potential candidates for HRT. 'These are women who are symptomatic and have no contraindications, such as prior hormone-sensitive cancers or high clotting risk, typically considered suitable candidates for HRT,' the Federation of Obstetrics & Gynaecological Societies of India (FOGSI) member said. However, according to estimates, less than five percent of women receive HRT. Currently, India follows a global prescription for norms for hormone therapy, including the USFDA as well as European guidelines. And while there is no equivalent to the FDA's black box warning on systemic risks like breast cancer, stroke, or clots here, the Indian drug monographs and medical literature still describe side effects for estrogen therapy, such as deep vein thrombosis, hypertension, breast and endometrial cancer, and dementia. Moreover, the guidelines from Indian expert groups mirror international concerns about systemic oestrogen use in women with certain risk factors, usually after age 60 or more than 10 postmenopause years, pointed out Dr Sweta Kumar, a gynaecologist and obstetrician with Surya Mother and Child Super Speciality Hospital in Pune. While many gynaecologists in India are aware of HRT and do prescribe it to some patients, a significant number are hesitant or prefer alternative options. Younger or less experienced clinicians tend to be more cautious, and alternative therapies are still quite common in practice, Kumar said. According to the 2025 national cross-sectional survey of 514 young Indian obstetricians-gynaecologists, the combined oestrogen-progestin therapy for vasomotor symptoms was recommended by 83 percent of the practitioners with three years' or below-three years' experience. When their experience range was seven to 10 years, fewer practitioners, 77 percent, recommended it. Moreover, younger doctors (0–3 years) were found less likely to support early initiation of therapy—30 percent of them—compared to more experienced ones—49 percent of them. A large number of patients also find HRT risky and are hesitant to use it, Dr N.S. Saradha, a senior gynaecologist with SIMS Hospital in Chennai, underlined. 'Women experiencing early or surgical menopause, accelerated bone loss, and high risk of osteoporosis benefit the most from HRT. I hope with the evolving understanding around HRT, both doctors and patients can make informed decisions on its usage,' Saradha said. (Edited by Madhurita Goswami) Also Read: AI can aid in early, precise detection of breast cancer, show results of 1st randomised trial
Time of India
3 days ago
- Time of India
Struggling US healthcare stocks endure rough 2025 but draw some bargain hunters
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Year-to-date, shares of both Merck and Bristol Myers are down roughly 20%. The group is drawing bets from some value investors such as Patrick Kaser, portfolio manager at Brandywine Global, whose portfolio is overweight the sector including owning shares of CVS Health and European drugmakers GSK and Sanofi. "Our perspective is a lot of this bad news is priced in and then some," Kaser said. "To bet against the sector from here, you're essentially continuing to bet on the valuation gap, which is already large, continuing to widen." The group's decline means the total market value of the S&P 500 healthcare sector is about $4.8 trillion, not much higher than the $4.3 trillion value of Nvidia, the semiconductor company that has symbolized the artificial intelligence boom. Indeed, some investors said a shift in capital away from Nvidia and other massive tech companies could spark healthcare shares. Such a move appeared to occur in the first quarter, investors said, when the healthcare sector rose 6% while declines in tech and megacap stocks dragged indexes lower. Fears of an economic downturn also could help healthcare shares, at least on a relative basis. The group is often viewed as a defensive area in rockier economic times. Economic fears flared following last Friday's weaker-than-expected employment report, while some strategists say the market could be due for a pullback after surging over 20% since its April lows. "During the first quarter, healthcare did great even as tech rolled over, as the fears of an economic slowdown got to more economically sensitive stocks," said Chris Grisanti, chief market strategist at MAI Capital Management, adding he expects healthcare "will perform better in a more difficult market." More clarity on regulatory issues, including tariffs, also could support healthcare, investors said. But some value investors are hesitant to dive into the group. Michael Mullaney, director of global markets research at Boston Partners, said he is wary some healthcare shares could be "value traps," preferring to overweight areas including industrials or financials. "There's been just so much of an overhang in the sector," Mullaney said. "There are better places to go with cleaner stories."
India Today
3 days ago
- India Today
Trump's war on Indian drugs risks a global supply shock
India, a top-five supplier of medicines to the US, is now in the crosshairs of Donald Trump's latest trade offensive. In a move that could ripple through hospitals and households across America, the US president is planning tariffs as high as 250 per cent on imported drugs. In this sector, India plays a crucial US president has already proposed 200 per cent tariffs on pharmaceutical imports and reportedly conveyed this to Ireland's prime minister. Ireland is the largest exporter of drugs to America. India's USD 12.5 billion shipments of low-cost generics make it a critical link in the US healthcare chain — and a vulnerable Why it matters: The US relies on India for affordable generics. Steep tariffs could spike drug prices, strain supply chains, and hit both Indian exporters and American patients. Markets are already flashing numbers:$12 billion: Value of Indian drug exports to the US in 2024$10.5 billion: US trade deficit in pharma as of May 202525–250%: Range of proposed tariffs on Indian medicines+9 percentage points: Rise in average US pharma tariffs if 25% levy holds$50 billion: Total size of India's pharma market$26.5 billion: Value of India's total drug exports5th: India's ranks among US pharma suppliers after Ireland, Germany, Italy, and the NetherlandsIn-depth: India is a pharmaceutical powerhouse. It manufactures one in every five generic drugs used in the US, earning its nickname, 'pharmacy of the world'. These low-cost treatments keep healthcare affordable for millions of Trump's new tariffs risk unravelling that system. Industry experts say even a 25 per cent tariff could lift average pharma duties by nine points, a shock for hospitals, insurers, and patients. The threat of further hikes has already rattled April, the S&P 1500 Pharma Index has fallen more than India's Nifty Pharma. Investors expect pain, not protection, for US while the goal is to shift manufacturing home, pharma executives say the tariffs will only raise costs and delay investments. Many drug ingredients still come from abroad. The result could be supply gaps, higher prices, and worse picture: When Trump took office, the average US tariff rate was just 2.5 per cent. It has since surged to between 17 and 19 per cent, depending on the estimate. The Atlantic Council warns it could reach 20 per cent, the highest in a century, as another round of duties kicks in on before Thursday midnight, Trump claimed that billions of dollars would start pouring into the US thanks to the tariffs targeting nearly 70 US trade partners with duties from 10 to 41 per cent. Trump launched a tariff campaign in April, accusing other countries of unfair imposed a 25 per cent tariff on Indian imports, adding to the 25 per cent levy announced last week. This higher duty takes effect in 21 days, as stated in the order, leaving room for negotiations. However, pharmaceutical products are on the exemption list at the used to protect factory jobs. Today, they're tools of foreign policy. Trump's evolving doctrine is part punishment, part politics — and the drug industry could be the latest they said: 'In one year, one and a half years maximum, it's going to go to 150 per cent, and then it's going to go to 250 per cent because we want pharmaceuticals made in our country,' Donald Trump told CNBC in an interview.- EndsTune InMust Watch
