Evaluating LDL-C control in Indian acute coronary syndrome (ACS) patients- A retrospective real-world study LDL-C control in ACS.

Background: Low-density lipoprotein-cholesterol (LDL-C) is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) progression. Although lipid lowering therapies remain the cornerstone of secondary ACSVD prevention, there exists residual dyslipidemia. The current study aimed to evaluate the real-world experience related to the treatment patterns and LDL-C control in Indian Acute Coronary Syndrome (ACS) patients. Methods: This was a real-world, descriptive, retrospective, observational, and multicentric study conducted across India. The data was collected for 1 year following the ACS event. The change in the levels of LDL-C from the baseline to the follow-up visits and the control of LDL-C, the change in lipid profile, lipoprotein levels, treatment patterns for lipid-lowering, and tolerability of existing treatments were evaluated. Results: Overall, 575 patients were included from 11 centers across India. The mean age of the patients was 52.92 years, with male predominance (76.35%). Although there was a significant reduction in the mean levels of LDL-C from the baseline [(122.64 ± 42.01 mg/dl to 74.41 ± 26.45 mg/dl (p < 0.001)], it was observed that despite high-intensity statin therapy, only 20.87% patients managed to achieve target LDL-C of <55 mg/dL and 55.65% were unable to reach LDL-C levels of <70 mg/dl one year after the event. Six patients reported adverse events without treatment discontinuation. Conclusion: The majority of the patients received high-intensity statins and did not attain target LDL-C levels, suggesting LDL-C control after an ACS event requires management with novel therapies having better efficacy as recommended by international and national guidelines.

SGLT2-inhibition and Vascular Euphoria a Reconciliation of Vascular Health and Disease Homeostasis.

The concept of SGLT2-inhibition, once regarded as a non-physiological approach to glycemia control, now finds a foundational relevance in risk-modification for cardiovascular, kidney, and metabolic outcomes, spanning beyond type-2 diabetes. Major studies have proven meaningful improvements in various clinical outcomes, with different SGLT2-i agents. Apart from glycosuria, SGLT2-inhibition is associated with several patho-physiological effects, which may contribute to the clinical benefits seen with these agents. This narrative review is an attempt to appraise the different patho-physiological effects mediated by SGLT2-inhibition, based on contemporary evidence. The review classifies these effects in the acronym of EUPHORIA, and grades the possible relevance of each effect, in improving clinical outcomes.

Basic and Clinical Pharmaco-Therapeutics of SGLT2 Inhibitors: A Contemporary Update.

Clinical relevance of sodium/glucose cotransporter 2 (SGLT2) inhibitors has been rapidly evolving across several therapy areas, apart from type 2 diabetes mellitus. While some of these developments are based on recognized scientific explanations, unexpected study findings have also shaped much of our present understanding. As the role of these agents evolves in various facets of cardiology, nephrology, hepatology and endocrinology, their optimum clinical value propositions should be realized in line with the principles of personalized medicine. An updated pharmaco-ergonomic qualification tool, based on the present evidence with these agents, would be a step in this direction. This review describes the present evidence on diverse pharmacological and therapeutic aspects for various SGLT2 inhibitors, as an attempt to provide useful guidance for optimum application in clinical practice.

Effectiveness of flipped classroom as a teaching-learning method among undergraduate medical students - An interventional study.

BACKGROUND: Attempts to put the available teaching-learning time to better use and address the needs of students by increasing active involvement led to the evolution of the flipped classroom (FC). It involves providing study resources for students to use outside the class so that class time is freed up for instructional activities. This study was done to assess the effectiveness of flipped classroom activity as a teaching-learning method. MATERIALS AND METHODS: In this interventional study, 98 students were divided into two batches of flipped class and conventional small group teaching (SGT). An online Google group was created for the batch of FC. Brief introduction and prerecorded videos related to the assigned topic were posted in the Google group. Discussion was carried out in the form of solving cases and problem-solving exercises. Pretest and posttest were conducted at each session, and an end of module test was conducted for both the groups. RESULTS: There was a significant difference between the pre- and posttest scores and also the mean scores of summative test between two groups (P < 0.001). The perception of the students regarding FC was also evaluated. Eighty-two percent strongly agreed that FC was more engaging and interesting in comparison to traditional class. Seventy-six percent strongly agreed that more such classes should be conducted in the future. CONCLUSION: Flipped classroom improved the student performance and learning experience effectively as compared to conventional SGT, and students' response was also largely positive.