ABSTRACT
Background: This study aimed to gather the clinicians� perspective regarding the use and prescription practice of dual combination oral anti-diabetic drugs (OADs) in type 2 diabetes mellitus (T2DM) management in Indian settings. Methods: A cross-sectional study was conducted by using a 29-item structured questionnaire covering factors considered, challenges, preferred indicators of glycemic control, continuous glucose monitoring (CGM) use, and strategies. Additionally, it explored clinicians' feedback and experiences with dual combination oral anti-diabetic drugs in T2DM management. Results: Seventy percent of clinicians observed improved adherence to dual combination therapy of OAD. The combination of dipeptidyl-peptidase 4 (DPP4) inhibitors and metformin was favored for early initiation and showed better tolerability within the first year according to 42% of clinicians. Approximately 63% of clinicians prefer vildagliptin + metformin for 40� year-old diabetics. The combination yields favorable outcomes: 21% in young, 14% in elderly, and 7% in long-standing diabetes cases. After 5 years, 37% of clinicians observed 40-50% of diabetics reaching an HbA1c goal of <7.0% with this combination. Clinicians choose glimepiride + metformin for treatment intensification based on its efficacy, cardiovascular (CV) safety, and fewer adverse events. These factors were collectively recognized by 66.54% of respondents. Conclusions: This study provided valuable insights into real-world clinical practices and preferences regarding dual combination therapy for diabetes management. Clinicians identified the fixed-dose combination of DPP4 inhibitors and metformin as the preferred choice and highlighted the effectiveness of glimepiride + metformin in overcoming treatment intensification challenges.
ABSTRACT
Introduction: First case of COVID-19 in the district was reported on 19th March 2020, thereby increas-ing exponentially, presenting with various symptoms to having few or no symptoms, posing challenge to prevent disease transmission by being a significant source of infection. This study conducted to assess relationship between COVID-19 infection within blood groups and burden of reported cases in the dis-trict to seropositivity among donors. Methodology: This is a prospective observational study from second largest blood bank of south Guja-rat, catering to a population of seven million, 4916 donors from the month of August 2020 to May 2021 participated in the study. Observations: Seropositivity was found to be 54.6%, with higher prevalence (68.63%) among female compared to male (54.45%), there was no statistical difference among age groups & RH groups, blood group AB was found to have highest seropositivity followed by A, B and O group. First time donors sero-positivity was higher compared to frequent donors among the study participants. Seropositivity among donors was positively corelated with RTPCR Positivity rate reported in the district. Conclusions: Looking at similar trend of active surveillance and its correlation to blood bank positivity, we urge policy makers to strengthen hospital-based surveillance for real time insights.
ABSTRACT
Bruton’s X-Linked Agammaglobulinemia (XLA) is an X linked recessive primary immune deficiency disorder characterized by recurrent bacterial infections and failure to generate immunoglobulins of all isotypes due to the absence or profoundly decreased mature B cells and plasma cells, secondary to mutations in the Bruton’s tyrosine kinase (Btk) gene. The coexistence of chronic monoarticular arthritis in a patient with Bruton’s XLA has been described an uncommon presentation. We describe a 5 year-old boy with XLA and chronic monoarticular arthritis
ABSTRACT
Wasps and bees descend from order Hymenoptera. All social wasps belong to family Vespidae. Their stings are not usually life threatening, causing mainly local reactions and rarely anaphylaxis and serious systemic manifestations. Though a few stings cause no major problems, multiple stings can cause serious effects like massive hemolysis, acute renal failure, encephalopathy, multiorgan dysfunction. We report a six years boy with acute renal failure and seizure following multiple wasp stings.
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Wiskott-Aldrich syndrome is an X-linked recessive disorder characterized by thrombocytopenia, eczema and recurrent infections. We report a 15 month old boy who had presented with lower gastrointestinal bleed, recurrent infections and eczema. Blood picture revealed microthrombocytopenia, high IgA and IgE, and low IgM and Normal IgG levels. A diagnosis of Wiskott-Aldrich Syndrome was made, which was missed by many paediatrician even after prolonged hospital stay before admission in our Institute. The recent progress in understanding of the pathophysiology and treatment are discussed.
ABSTRACT
Macrophage Activation Syndrome is a rare and potentially fatal disease, to be considered in patients with a SIRS like clinical presentation. Falling ESR and hyperferritinemia in the appropriate clinical setting can be the greatest clues. We report a case in which a female admitted with fever and rash, initially had systemic inflammatory response syndrome (SIRS) like clinical presentation, but eventually proved to be a rare case of fatal Macrophage Activation Syndrome.