Single-pill Combination of Empagliflozin and Linagliptin in Real World Indian Type 2 Diabetes Patient (GRID).

INTRODUCTION: For the recently introduced single-pill combination of empagliflozin and linagliptin, real-world evidence has not been available. This observational study aims to assess real-world effectiveness of this combination, in the Indian outpatient setting of type-2 diabetes. METHODS: This was a prospective cohort study design, involving patients from 4 centres across western India. Patients with type-2 diabetes and uncontrolled HbA1c, were categorized into 4 groups, including: (1) Naïve to DPP-4i or SGLT-2i; (2) Receiving DPP-4i; (3) Receiving SGLT-2i; (4) Receiving SGLT-2i and DPP-4i as individual pills. Patients were initiated on the fixed-dose combination of empagliflozin + linagliptin, and followed-up over 12-week duration. Clinical parameters of changes in glycaemia, body-weight, and blood-pressure were observed. RESULTS: 251 patients were included in the analysis, with just over half of them being males (57%), or having pre-existing cardiovascular disease (54%). The group-wise patient distribution was approximately 47%, 18%,15%, and 20% respectively. The study represented patients across broad range of duration of type-2 diabetes, use of background antidiabetic therapies, and comorbid cardiovascular risk. The use of combination demonstrated significant and clinically meaningful reductions in HbA1c, fasting and postprandial glycaemia levels across all the study groups. Reductions in body-weight and blood-pressure levels were also demonstrated. Interestingly, patients in group 4, who were switched from free drug combination to the fixed-dose combination, also demonstrated significant and meaningful improvements in HbA1c, fasting as well as postprandial glycaemia levels, suggestive of possible improvement in medication-adherence. CONCLUSION: This real-world evidence complements the results observed in randomized controlled trials, for meaningful effectiveness with the use of empagliflozin-linagliptin fixed dose combination in the Indian outpatient setting. More evidence may facilitate further characterization of clinical value of this promising combination.

Evidence-based orthodontics. Current statistical trends in published articles in one journal.

OBJECTIVE: To ascertain the number, type, and overall usage of statistics in American Journal of Orthodontics and Dentofacial (AJODO) articles for 2008. These data were then compared to data from three previous years: 1975, 1985, and 2003. MATERIALS AND METHODS: The frequency and distribution of statistics used in the AJODO original articles for 2008 were dichotomized into those using statistics and those not using statistics. Statistical procedures were then broadly divided into descriptive statistics (mean, standard deviation, range, percentage) and inferential statistics (t-test, analysis of variance). Descriptive statistics were used to make comparisons. RESULTS: In 1975, 1985, 2003, and 2008, AJODO published 72, 87, 134, and 141 original articles, respectively. The percentage of original articles using statistics was 43.1% in 1975, 75.9% in 1985, 94.0% in 2003, and 92.9% in 2008; original articles using statistics stayed relatively the same from 2003 to 2008, with only a small 1.1% decrease. The percentage of articles using inferential statistical analyses was 23.7% in 1975, 74.2% in 1985, 92.9% in 2003, and 84.4% in 2008. CONCLUSIONS: Comparing AJODO publications in 2003 and 2008, there was an 8.5% increase in the use of descriptive articles (from 7.1% to 15.6%), and there was an 8.5% decrease in articles using inferential statistics (from 92.9% to 84.4%).

A clinical trial to evaluate the effects of prophylactic fluoride agents on the superelastic properties of nickel-titanium wires.

AIM: To study the effects of a prophylactic fluoride regimen on the mechanical properties of nickel-titanium (Ni-Ti) archwires under clinical conditions. METHOD: The unloading properties of 100 Ni-Ti wires were tested using a three-point bending test at five deflections (0.5 mm, 1.0 mm, 2.0 mm. 3.0 mm, and 3.1 mm). Sixty-six 0.016 3 0.022-inch Ni-Ti wires were tested after being used intraorally for 6 weeks using two protocols. Thirty-three wires were evaluated after the use of fluoride-containing Crest toothpaste (sodium fluoride 0.243%, 0.15% w/v fluoride ion) and Equate fluoride rinse (sodium fluoride 0.05%, fluoride ion 0.0226%). Another 33 wires were examined after a nonfluoridated natural toothpaste (Tom's of Maine; calcium carbonate, xylitol, myrrh, propolis, sodium lauryl sulfate, carrageenan, spearmint and peppermint oils, glycerin, and water) was used. Another 34 Ni-Ti wires served as a control; they were tested as received. Statistical analyses were carried out with a linear-mixed model (analysis of variance [ANOVA]). RESULTS: Force degradation occurred within both groups of intraorally used wires but not in the unused archwires. When compared to unexposed wires, those with fluoride exposure exhibited slightly higher force degradation at 3.1 and 3.0 mm deflection, but they displayed less force degradation at 0.5 and 1.0 mm deflection. CONCLUSIONS: Topical fluoride regimens decreased the unloading property of Ni-Ti wires at higher deflections but increased it at lower deflections.