January 2023
Treadmill Test – Changing Paradigm
Abstract – Exercise or stress ECG referred to as treadmill test (TMT) has been used for the last several decades for the diagnosis of obstructive coronary artery disease (CAD) but is limited by its low sensitivity and specificity. The advent of other modalities which combines imaging such as echocardiography, nuclear perfusion imaging, computed tomography (CT), and magnetic resonance imaging (MRI) is highly sensitive and specific for the diagnosis of myocardial ischemia. Anatomic imaging of coronary arterial obstruction by CT angiography has also emerged as a highly sensitive and specific test to rule out CAD. TMT now moved from diagnosis of myocardial ischemia to assessment of valvular heart disease, congenital heart disease, pulmonary hypertension, arrhythmia, diastolic dysfunction, genetic CV disease, and peripheral arterial disease. It remains an important test for assessing exercise-induced symptoms, functional capacity, exercise duration, heart rate, and blood
pressure during exercise and during recovery after exercise. Of its low sensitivity and specificity TMT should be avoided as a routine test in asymptomatic individuals and in persons with a low probability of CAD. However, due to its wide availability, low-cost and easy interpretation, when used judiciously in cases of moderate to a high probability of CAD, it remains invaluable.
Author – Dr. Biswaranjan Mishra, Dr. Chinmay Divyadarshi Kar
2. Thunderstorm Asthma
Abstract – Thunderstorm asthma is a form of allergic asthma occurring after sudden thunderstorms. This can happen suddenly to people in spring or summer when there are a lot of allergens in the air and the weather is hot, dry, windy, and stormy. This can affect a large number of inhabitants in a locality and hence local medical services may find it difficult to meet the exigency. This article reviews the important features and clinical significance of thunderstorm asthma.
Author – Jis B john, Dr. Ravindran Chetambath
3. Sleep Apnea
Abstract – Obstructive sleep apnea is one of the well recognized sleep-related breathing disorders characterized by snoring, episodic cessation (apnea) or reduction (hypopnea) of breathing during sleep and excessive sleepiness during the daytime. The prevalence of sleep apnea shows a rising trend in both developed as well as developing countries. If undiagnosed or untreated, sleep apnea can lead to adverse cardio-pulmonary, metabolic and neurocognitive outcomes including road traffic accidents. Early screening for symptoms and risk factors by the family physician, followed by referral of patients at risk to a sleep centre or specialist for timely diagnosis by polysomnography and effective treatment by positive airway pressure therapy is the standard of care.
Author – Dr. Nikhil Sarangdhar, Dr. Priya Deshpande, Dr. Shahid Patel, Dr. Prem Maurya, Dr. Girija Nair, Dr. Abhay Uppe, Dr. Nivedita Moulick
4. Acromegaly – Case Series
Abstract – Acromegaly is a clinical syndrome with isolated cases globally. Patients may remain undiagnosed for several years after the onset of initial signs and symptoms. Timely diagnosis and initiation of its treatment play a crucial role in patients with acromegaly. In this article, we present physical, biochemical, and radiological characteristics in a set of 6 cases that may aid in prompt diagnosis and appropriate management of acromegaly.
Author – Dr. Silima Subhasnigdha Tarenia, Dr. Puranjoy Chakraraborty, Dr. Niladri Das, Dr. Arjun Baidya
February 2023
- Gains from Covid Lockdown: Moving to Online Platforms for Better Service and Outcome in Autism
Abstract – In the gloom of uncertainties, the COVID era most certainly has necessitated a bevy of transitions in the healthcare domain. Moving on with these metamorphoses, the world is moving onto the virtual platform for healthcare, accepting it as one of the primary means of availing healthcare services. The effect of the pandemic on children with special needs, especially on children with Autism Spectrum Disorder (ASD) has been of utmost concern since then. The aim of this program was to help overcome the challenges faced by
families in accessing developmental pediatrician led multidisciplinary treatment for ASD (e.g., in smaller cities etc.) and delivering an intervention program in the home and community. With the virtual format quickly gaining traction, theE-nable Parent Coaching
program was thus introduced, facilitating improvement in developmental trajectories and functional outcomes in children with Autism Spectrum Disorder (ASD) with complex neurodevelopmental profiles across the globe through an outcome- based, individualized,
interdisciplinary approach based on the Theory of interaction. Five cases of children with ASD with varying severity have been reported that illustrate the functional improvement across various domains within months of the program; much in contrast to long term therapies often failing to deliver the desired clinical outcomes. Our findings revealed resolution of co-morbidities without the role of exogenous pharmacotherapy or long standing intensive behavioural interventions. The paradigm shift from conventional therapies to targeted goal- oriented interventions solely based on meticulously designed and structured parent coaching based on the Theory of Social Interaction has shown remarkable clinical outcomes.
Author – Dr. Samir Dalwai, Dr. Hilla Sookhadwala, Dr. Barkha Chawla
2. Efficacy and Safety of Liposomal Curcumin in the Management of Pain due to Osteoarthritis
Abstract – The most prevalent chronic joint disease, which remains as one of the few chronic disorders of ageing is Osteoarthritis (OA). One of the predominant symptoms of OA is pain, with very little effective treatment and contributes to limitations in daily functioning. Therapy of pain due to OA includes pharmaceutical agents that need to be used in lowest possible dose to avoid adverse effects. Lot of advances have taken place in understanding the pathogenesis of OA, however, relief of pain have always remained an unfulfilled need. The anti-inflammatory property of Curcumin is mediated through the inhibition of induction of COX-2, LOX, iNOS and production of cytokines and tumor necrosis factor and activation of transcription factors like NF-κB, and AP-1. Its oral bioavailability is extremely poor.
Author – Dr. Yogesh Dound, Dr. Akhil Chaudhari
3. Screening of Diabetic Patients for Non-Alcoholic Fatty Liver Disease Based on Liver Indices: A Retrospective Cross-Sectional Study
Abstract – Non-Alcoholic Fatty Liver Disease (NAFLD) includes a wide spectrum of liver pathophysiology, ranging between relatively benign Nonalcoholic fatty liver to a serious pathology like fibrosis and cirrhosis. NAFLD is commonly associated with Type 2 Diabetes Mellitus (T2DM) and Metabolic Syndrome and may increase the risk for mortality.
American Diabetes Association and European Association for the study of Diabetes have recommended screening of all T2DM patients for NAFLD.
Author – Dr. Anand Shindikar, Dr. Anushree Mehta, Dr. Ashwinikumar Raut, Dr. Rama Vaidya
4. Dapagliflozin and Neuro-nutrition: A Pragmatic Approach to Manage Diabetic Peripheral Neuropathy
Abstract – Diabetic peripheral neuropathy (DPN) is the most prevalent microvascular complication of diabetes mellitus. DPN results from a complex interaction of factors including hyperglycemia, glucotoxicity, increased intracellular glucose concentration induced mitochondrial dysfunction, oxidative stress, etc. A multifaceted approach is warranted for the clinical treatment of DPN. Combination therapy of an antidiabetic agent along with neuro-nutrition aimed at addressing the pathogenic features of neuropathy can be a potential treatment option for effective management of DPN.
Author – Dr. Manish Maladkar, Dr. Shrikant Patil, Dr. Ashok Yadav
March 2023
- ECG Computerized Interpretation and Reporting – A Cautious and Informed Approach
Abstract – ECG is an often-prescribed investigation for both routine screening and diagnosis of cardiac rhythm and function. Computerized interpretation of ECG through software and algorithm is being used for improving the efficiency of diagnosis.However, there may be errors and inaccuracies in such auto-reports that may lead to further unnecessary tests or altered, inappropriate clinical management, and stress for the patient. This can adversely impact the patient as well as the healthcare system. Therefore, it is important to sensitize and train physicians at various levels about ECG interpretation and ensure that the ECG is analyzed, interpreted, and reported by a qualified physician or cardiologist, before documenting the final report for any further action.
Author – Dr. Varsha Narayanan
2. Biomedical Waste Management in a COVID Care Hospital and its Challenges
Abstract – Bio-Medical Waste (BMW) management is of the utmost importance, as its improper management poses a serious threat to health care workers, waste handlers, patients, care givers, the community, and finally the environment. The waste produced in the course of healthcare activities carries a higher potential for infection and injury than any other type of waste. In addition to this, the ongoing COVID-19 pandemic has posed a huge challenge to all fields of the healthcare sector, starting right from disease screening up to biomedical waste disposal.
Author – Dr. Jyothirmai, Dr. Asima Banu, Dr. Varnitha Mohan
3. Heart-type Fatty Acid-binding Protein (H-FABP) as an Early Diagnostic and Reperfusion Biomarker in Patients with Acute Chest Pain and its Correlation with Echocardiographic Left Ventricular Ejection Fraction and Angiographic Spectrum of Coronary Vessels
Abstract – Heart-type fatty acid-binding protein (H-FABP) is a novel marker of myocardial injury, released rapidly (<1 h) after the onset of myocardial injury and plays an important role in both early diagnoses of high-risk patients presenting with chest pain as well as an early reperfusion marker in post-thrombolytic patients. We aim to assess and compare the efficacy of H-FABP as an early marker of cardiac injury with Troponin I (cTnI) and creatinine Phospholinase Kinase (CPK-MB) and to correlate it with Left ventricular Ejection Fraction (LVEF)and percentage of stenosis in Coronary arteries
Author – Dr. Monika Maheshwari, Dr. V.B. Singh, Dr. Deepa Thadani
April 2023
- Role of Comforting Manoeuvres in Reducing Perioperative Anxiety
Abstract – Fear of unexpected scenarios and anxiety is common in preoperative cohorts. It is often multifactorial. Pre-operative anxiety, if not addressed appropriately may lead to difficulty in stabilizing hemodynamics owing to aggravated stress response due to sympathetic overactivity and catecholamine release. Moreover, it might be challenging for the treating physician to manage an apprehensive patient for the optimal outcome since they may not cooperate and need additional perioperative analgesics and anaesthetics leading to delayed recovery and discharge. Different non-pharmacological and pharmacological methods are used to allay the anxiety of patients. Honest communication with the patient, pre-operative educational materials like movies and bulletins, music, aromatherapy, having a family member accompany the patient during surgery, etc. are
some non-pharmacological interventions that are frequently used. Various researchers have recommended including such calming and comforting manoeuvres to include in routine perioperative care to achieve high patient satisfaction.
Author – Dr.Imran Ahmed Khan, Dr.Geeta Karki
2. A Narrative Review on Telehealth Services Adoption in Rural Areas and Related Barriers to Telehealth in India Technological, Regional, Cultural, and Linguistics
Abstract – With the use of Telehealth, specialty services can be conceivably doable for rural healthcare facilities rather than staffing with specialty and subspecialty providers. Telehealth allows specialists and subspecialists to visit rural cases, perfecting access as well as providing a wider range of healthcare services available to rural communities via telemedicine for various specialties. The primary objective of this paper is to understand telemedicine services and the challenges in implementing the same in rural areas of India. Databases like PubMed, Scopus, Cochrane, and Google Scholar were used for document searches. Further analysis of the selected studies was done on the basis of study design sample size, methodology, and outcomes. From the document search, 987 articles were found and 18 were selected. Out of the studies selected 11 articles were conducted in rural areas and 7 articles were regarding technological advancement in telehealth. Providers and public health units can use telehealth, tele pharmacy, and RPM services to communicate with patients and citizens in their homes and provide them with the benefits. Factors hindering the growth of telemedicine are privacy concerns, reluctance towards adoption of advances in technology, unavailability of technological infrastructure, bandwidth issues, cost-effectiveness, legal concerns, etc. Study results show that to ensure high-quality healthcare across the country, healthcare professionals
should prioritize addressing the telehealth challenges.
Author – Arun S, Sidheshkumar Kesarwani2, Dr. Subodh S Satheesh
2. Bacteriological Study of Ocular Fluids in Endophthalmitis in a Tertiary Care Hospital
Abstract – Endophthalmitis is the most challenging complication seen in ophthalmic practice. Endophthalmitis is defined as an inflammation of the inner structures of the eyeball i.e. uveal tissue and retina associated with the pouring of exudates in the vitreous cavity, anterior chamber, and posterior chamber. The study’s objective is to
isolate and identify the bacteria causing endophthalmitis.
Author – Dr. Asima Banu, Dr. B.L. Sujatha Rathod, Dr. Jyothirmai
3. Training Program for Good Clinical Practices
Abstract – This is a report of the webinar on Good Clinical Practices (GCP) jointly organized by Kasturba Health Society’s Medical Research Centre and Inter System Biomedica Ethics Committee. The training was organized in six scientific sessions arranged over two half days. The delegates for this webinar were from the faculties of Nutrition, Ayurveda, Life Sciences, Pharmacy, Pharmacology, and Clinical Science. The program had prominent national authorities in the domain of ethics and clinical research, who delivered opening remarks. This was followed by scientific sessions on pharmaceuticals, phyto-pharmaceuticals, Ayurceuticals, nutraceuticals, and dietary supplements. A special session was dedicated to the informed consent form (ICF). The final session was a panel discussion on diagnostics, non-drug therapies, medical devices, quality control, clinical trials & safety monitoring. This write-up gives the gist of the presentation made by various experts
Author – Roda Dalal, Dr. Ashwinikumar Raut
May 2023
- Hypertension: Burden, Awareness, and Control
Abstract – Hypertension is a highly prevalent modifiable cause of cardiovascular disease, stroke, and death. However, awareness,treatment, and control of high BP are very low, significantly increasing the risk of CVD and premature mortality and morbidity. Accuracy in BP measurement is critical, as even an error of 5-mmHg in measurement can lead to incorrect classification of hypertension in 84 million individuals worldwide. As the consequences of inaccurate BP measurement are grave, all the leading hypertension guidelines have placed a strong emphasis on accurate BP measurement. Achieving BP
target goals is absolutely essential for significantly reducing composite cardiovascular outcomes in hypertensive patients
Author – Dr. Manish Maladkar
2. Molecular Basis for the Development of Coloboma: A Review
– Colobomas are congenital anomalies that cause pediatric blindness due to gaps between the corneas and optic nerves. They are typically characterized by inferior or ventral origins and can cause vision loss. During embryonic development, PAX6 belongs to a family of geneAbstract s that play critical roles in tissue and organ development. PAX protein apparently activates centralized genes that play a role in the development of the eyes, spinal cord, brain, and pancreas during embryonic development. PAX6 protein controls many aspects of eye development before and after birth. Many structures of the eye are likely affected by the PAX6 protein, which regulates the expression of various genes.
Author – Dr. Sanjay Kumar Pandey
3. Asthma – Current Trends and Management Perspectives
Abstract – Bronchial asthmais a chronic inflammatory disorder of the airways in which several cells and cellular elements play an important role, the hallmark of which is airway hyperresponsiveness, or an exaggerated response (bronchoconstriction) on exposure to certain triggers such as allergens and/or respiratory infections and others. The airway inflammation and obstruction are usually reversible but manifest clinically as acute episodes of wheezing, breathlessness, cough, or chest tightness, that occur particularly at night or early in the morning. Exacerbations and comorbidities affect disease severity as well as impact treatment success in many patients. Therapies are directed toward controlling airway inflammation and relieving airway obstruction.
Author – Dr. Nikhil Sarangdhar, Dr. Priya Deshpande, Dr. Shahid Patel, Dr. Girija Nair, Dr. Abhay Uppe, Dr. Nivedita Moulick
3. Stem Cell Therapy for Autism Spectrum Disorder and Other Developmental Disorders: What is the Recommendation?
Abstract – Autism spectrum disorder (ASD) is a biologically-based neurodevelopmental disorder characterized by impairments in two major domains of development: social communication and social interaction, and restricted, repetitive patterns of behavior, interests, or activities. The severity of symptoms and impairments becomes evident when social demands exceed limited capacities. Over the past decade, there has been a significant increase in media attention, industrial growth, and patient interest in stem cell-based interventions.There is a rise in direct-to-consumer businesses offering stem cell “therapies” for various indications, despite a lack of evidence regarding their safety and efficacy. According to current regulatory guidelines, stem cell treatments, except for approved blood disorders such as hematopoietic disorders, are considered investigational and require approvals from the Central Drugs Standards Control Organization. Thus, using them outside the scope of clinical trials is not permissible. Some centers claim that “stem cell therapy” can “cure” and “treat” autism and promote and recommend its use. However, apart from causing financial strain, this procedure carries a high opportunity cost as it diverts valuable time and resources that could be better invested in evidence-based therapies for autism.Currently, the scientific evidence supporting the use of stem cells for treating ASD is limited. Therefore, it is insufficient to recommend their use in clinical practice. Future efforts should focus on developing standardized methods that generate robust data before considering their application in clinical settings.
Author – Dr. Hilla Sookhadwalla, Dr. Samir Dalwai
June 2023
- Impact of Climate Changes on Allergic Diseases
Abstract – Climate change is a serious global health concern. Longer allergy seasons and worsening air quality are the results of rising temperatures brought on by climate change. Extreme weather events increased exposure to pollen and other allergens, all contributing to worsening allergy and asthma symptoms with a rising prevalence of allergic disorders. Allergic disorders are conditions induced by the immune system’s hypersensitivity to normally harmless chemicals known as allergens. Allergic diseases include Allergic Rhinitis (AR), allergic asthma, urticaria, atopic dermatitis, contact allergies, and food allergies. The prevalence of allergic illnesses is rising globally, which is quite concerning. AR is the most common of all atopic diseases, afflicting 10%–30% of adults and up to 40% of children all over the world. The increased prevalence of allergic airway disease worldwide can be partially attributed to those global environmental changes. Climate change and air pollution pose adverse impacts on respiratory allergies. The chronic and recurring nature of AR, which results in poor qualityof life and work/school loss despite the fact that it is not a life-threatening condition, poses a serious healthcare challenge.
Author – Dr. Manish Maladkar
2. Creating Better Insight into Asthma Management
Abstract – Asthma is a common disease affecting all age groups. Global Initiative for Asthma is preparing and updating asthma management guidelines regularly. This is to make medical practitioners aware of the importance of early diagnosis and optimal management of asthma. The main factor that creates suffering for asthma patients is undertreatment. This may be from the side of the practitioner in the form of delay in diagnosis and failure to use optimal medications. This article focuses on creating awareness among caregivers regarding the selection of optimal management for their asthma patients
Author – Dr. Ravindran Chetambath, Dr. Rameesa Shanavas
3. Snake Bite – Current Management Perspective and Brief Review
Abstract – A snake bite is an acute life-threatening and time-limiting medical emergency. It is a preventable health hazard often faced by rural populations in tropical and sub-tropical countries with heavy rainfall and humid climate. In India, snake bite is included in a list of neglected tropical diseases. With its triad of high mortality, high disability, and substantial psychological morbidity, snake bite warrants high-priority research.The number of snake bite deaths is greatest in the states of Uttar Pradesh, Andhra Pradesh, and Bihar, and snake bites are more common in rural communities. Currently, treatment quality is highly varied, ranging from good quality in some areas, to very poor quality in other areas.Our article aims to sensitize clinicians regarding different types of snake bite, their clinical features, and the use of anti-snakebite venom (ASV), for better patient management and improved prognosis.
Author – Dr. Felin Ann Francis, Dr. Nivedita Moulick, Dr. Harshit Thole
4. Sickle Cell Disease and Pregnancy
Abstract – Sickle cell disease is caused by a mutation in the beta-globin gene, leading to the formation of abnormal haemoglobin and various complications. Managing this condition during pregnancy requires a collaborative approach, involving close follow-up, patient education, and active patient involvement. The process begins with pre-conception genetic counselling and assessing the patient’s baseline health. If the disease is uncontrolled or if the patient has kidney disease, hypertension, or frequent vaso-occlusive crises, pregnancy may need to be delayed or alternative reproductive options considered. The use of hydroxyurea during pregnancy is a subject of debate and is determined on a case-by-case basis. High-dose folic acid supplementation is recommended before and during pregnancy. Medications should be carefully reviewed, and any potentially harmful drugs to the fetus should be discontinued. Low-dose aspirin and adequate hydration are used to prevent hypertensive and vaso-occlusive crises, respectively. Severe anaemia may require a blood transfusion, but haemoglobin levels are maintained below 10g/dl to prevent increased blood viscosity. Vaginal delivery can be safely performed with appropriate measures such as hydration, warmth, and nasal oxygen. Cesarean sections are reserved for obstetric indications
Author – Dr. Reena J. Wani, Dr. Mahin Bhatt
July 2023
- Evidence-Based Cost-Effective Interventions for Universal Health Coverage
Abstract – India has intensified efforts towards Universal Health Coverage. To achieve this goal, it is important to spend the resources on cost-effective healthcare interventions. Economic evaluations and Health Technology Assessments are important tools to ensure the efficient use of resources. India has made significant progress in this direction, especially with the establishment of Health Technology Assessment (HTA) – India. Further capacity-building and strengthening of HTA is required to ensure the implementation of evidence-based cost-effective interventions in the health sector
Author – Dr. Beena Joshi, Dr. Akshita Vikani
2. A Study of the Correlation Between Echocardiography and Lipid-based Genetic Markers Among Children with Severe Acute Malnutrition
Abstract – Children with Severe Acute Malnutrition (SAM), especially those with edema, are believed to be at high risk for cardiovascular morbidity and sodium overload, both of which could lead to early death during treatment. This study evaluated the correlation between echocardiography and lipid molecular markers in children with SAM
Author – Dr. Jitendra Singh, Dr. Sanjay Kumar Pandey
3. Addressing the Surge in Patient and Attendant Misbehavior: Effects on Healthcare Delivery and Quality of Care
Abstract – Healthcare professionals, both in India and in the rest of the world, have been coming under increasing attack – both physical and verbal – from patients, their relatives, and attendants. This has led to physical and emotional stress on healthcare
workers, which is creating difficulties in performing their duties. Not only the safety of healthcare workers is threatened but the quality of healthcare delivery to patients is also impacted. By understanding the underlying reasons and implementing proactive strategies, healthcare organizations can foster a safer environment for patients and providers alike. By addressing this issue head-on, we can preserve the integrity of healthcare systems, maintain quality care, and ensure the well-being of all involved parties.
Author – Dr. Imran Ahmed Khan, Dr. B.B. Tripathi
4. Nanotechnology: Current and Future Perspectives
Abstract – Nanomedicine has emerged as a rapidly advancing field at the intersection of nanotechnology and medicine, offering innovative approaches for disease diagnosis, treatment, and prevention. This review article explores the current trends in nanomedicine, focusing on recent developments in nanoparticle-based therapeutics, nano diagnostics, and nanotechnologyenabled drug delivery systems. Additionally, we discuss the challenges and future prospects of nanomedicine, highlighting the potential impact on healthcare and personalized medicine.
Author – Dr. Sabahat Hasan
August 2023
- Creating a Hepatitis-Free Future: Awareness and Prevention Initiatives
Abstract – Hepatitis poses a significant challenge globally, with its diverse strains and modes of transmission. The complexity lies in preventing its spread, ensuring early diagnosis, and promoting vaccination. Overcoming this challenge requires comprehensive public health efforts, awareness campaigns, and accessible healthcare services to address the burden of hepatitis effectively. This editorial focuses on raising awareness among the population, which is crucial for combating the spread of the disease. By educating individuals about the modes of transmission, preventive measures, and the importance of vaccination, we can empower them to protect themselves and others. Increasing awareness can lead to early detection, timely treatment, and the adoption of safe practices, ultimately reducing the burden of hepatitis on individuals and communities. Promoting hepatitis awareness is vital to ensuring better health outcomes and preventing the further spread of this global health concern.
Author – Dr. Manish Maladkar
2. Awareness of Non-Communicable Diseases & their Risk Factors among Young Adult Women in Delhi
Abstract – In India, rapid urbanization, easy lifestyle, and improvement in healthcare facilities have led to a shift in the disease spectrum from communicable to noncommunicable diseases (NCDs). Awareness about NCDs and their risk factors has an important role in the prevention and management strategies of these diseases. Adult female mortality and morbidity affect the family healthdrastically; therefore, women’s health is critically important to the health of future generations.
Author – Dr. Ankita Singh, Dr. Tapas Kumar Ray
3. Emerging Roles for Vitamin K2-7 in Cellular Energy Pathways
Abstract – Vitamin K exists in three distinct forms, vitamin K1 (phylloquinone), vitamin K2 (menaquinone), and vitamin K3 (menadione). Vitamin K2 is chemically present in different forms based on several isoprene units. Among them, menaquinone-7 (MK-7 or
K2-7) remains in the bloodstream for a longer period and acts as an important cofactor in numerous biological processes. Also, it is clinically proven to possess numerous health benefits in the treatment of various diseases. Energy metabolism involves a complex biochemical process that produces energy from nutrients. This energy is required to perform different physiological functions, cellular processes, thermal homeostasis, and organ function. Nutrients undergo a series of metabolic pathways like glycolysis, citric acid cycles, β-oxidation, and oxidative phosphorylation to produce energy in the
form of adenosine triphosphate. These energy pathways are regulated by hormones and enzymes. Also, recent clinical studies have shown that K2-7 has been useful in fat loss suggesting the role of K2-7 in metabolism. To understand the mechanism of K2-7 in these metabolic processes, there is a need to explore the activity of K2-7 on these pathways. Hence,we have comprehensively discussed the energy pathways and potential targets of K2-7 in the modulation of energy pathways.
Author – Praful Saha, Vivek Basudkar, Tanay Mehta, Dishant Maniar, Dr. Sujit Nair
September 2023
- Uniting Against Lymphoma: Reflections on World Lymphoma Day
Abstract – Lymphoma is a cancerous disease that needs to be diagnosed with special tests by an expert histopathologist on tissue like lymph nodes or bone marrow to give the correct subtype for appropriate treatment and the best outcome. They usually present as lymph node enlargement, hepatomegaly or splenomegaly, or fever of unknown origin. It has excellent response to treatment especially in the early-stage disease with relapse more often in advanced disease. World Lymphoma Day which is celebrated on 15th September creates awareness, gives support, and helps fight this disease so that patients are not
diagnosed late or given unnecessary treatment with anti-Koch’s for lymphadenopathy.
Author – Dr. Abhay A Bhave, Dr. Neha Handa, Dr. Juilee Charmode
2. Expert Opinion on the Use of Mouthwashes in Dental Care in India
Abstract – The use of mouthwash in India is underrated and lacks an expert consensus for optimum clinical use and benefits. Ten expert dentists and one expert otolaryngologist participated in a panel discussion where insights were sought to understand the role of mouthwash in maintaining oral hygiene and preventing/treating dental diseases and their complications. Current evidence regarding the effectiveness of octenidine-based mouthwash was also explored. Consensus was formulated on
the basis of expert insights and contemporary supportive evidence. Antimicrobial mouthwash was recommended as an adjunct to brushing as it helps control plaque and reduce gingivitis, thereby maintaining oral hygiene in routine and pre and post-dental procedures. The risk of alveolar osteitis and bacteremia following tooth extraction and the incidence or severity of oral mucositis in patients treated with chemotherapy or radiotherapy may also be reduced with the use of mouthwash. Mouthwash use also reduces the risk of fungal infections, including denture stomatitis, and helps treat halitosis. Antimicrobials such as chlorhexidine, octenidine,cetylpyridinium chloride, probiotics or essential oils, and some antifungal and anti-inflammatory agents are recommended as active agents in mouthwash. The suggested duration of mouthwash use may be 2 weeks to 6 months depending upon the clinical condition. Octenidine-based mouthwash could be an effective alternative to other currently available mouthwash formulations. Appropriate use of mouthwash in addition to mechanical means of plaque control shall provide significant adjunctive benefits in specific clinical situations and for general oral health.
Author – Dr. Vishakha Grover, Dr. Ajay Doiphode, Dr. Dipto De, Dr. N. Chandra Sekhar, Dr. Ashwini Bhalerao
3. The Crucial Role of Anatomy in Shaping Competent Medical Doctors
Abstract – A thorough study of human anatomy is mandatory to become a competent medical practitioner. Anatomy is the first subject taught in medical education. Anatomy deals with the study of the structural elements and their interrelationships in the human body. It gives future medical professionals a thorough insight into the complex interactions between the various tissues and organ systems that make up the human body. Medical professionals who have a thorough knowledge of anatomy are better able to diagnose and treat patients, improving both patient care and safety. So, it can be easily interpreted that anatomy is very important in producing skilled medical professionals.
Author – Dr. Imran Ahmed Khan, Dr. Yogendra Singh
4. Fall Prevention: Awareness to Action
Abstract – Fall and fall-related disabilities are a cause of concern in the older population as there is a high prevalence of falls in the older age group. It has an impact on a person’s mobility, independence, and quality of life. It increases the cost of health concerns and the well-being of a person. It is necessary to create public health awareness amongst the elderly population about the risk of falls, and the need to prevent them and motivate them to take action by taking guidance from a multidisciplinary team of professionals.
Author – Dr. Mona Shah, Dr. Vithika Rai
October 2023
- Shift in Managing Cardiovascular Disease
Abstract – The escalating global burden of cardiovascular diseases (CVDs) is worrisome. The editorial emphasizes the critical role of individualized cardiovascular risk management, addressing controversies in cholesterol management and recognizing ethnicity-specific risk factors particularly considering genetic variations in Asian populations. It also delves into, creating awareness of hypertension and prevalent CVD including Ischaemic heart disease (IHD) and Heart failure (HF), their prevalence, and shifts in current management to tackle them. World Heart Day 2023, themed “Use Heart, Know Heart”, emphasizes the significance of knowing our heart and heart health for a healthy life.
Author – Dr. Manish Maladkar
2. Reflections on the Current Scenario of Breast Cancer and Paradigm Shift in its Management: An Indian Context
Abstract – Breast cancer stands as a widespread malignancy impacting women on a global scale. Low-resource countries, including India, face a significant and increasing burden of breast cancer cases. Notably, a higher proportion of breast cancer diagnoses in India are now occurring among younger age groups. This trend is compounded by issues such as delayed diagnosis, presentation at advanced disease stages, and postponed initiation of treatment, all contributing to lower survival rates compared to Western nations. Late-stage diagnosis not only results in poorer treatment outcomes but also escalates the costs of treatment. Decisions regarding breast cancer treatment in India are influenced not just by medical factors but also by logistical and accessibility challenges. In the last decade, there have been remarkable advancements in breast cancer diagnosis and treatment, with the introduction of novel prognostic & diagnostic modalities as well as innovative treatment protocols and therapeutic options. These developments have led to substantial improvements in early disease detection, significantly enhancing overall survival rates, progression-free survival, and freedom from relapse. This progress marks a positive stride forward in the battle against breast cancer.
Author – Priya Mehta, Samir Desai
3. Bone Health – Understanding Calcium Supplements and Benefits of Other Vitamin Minerals
Abstract – Bone health is an important concern throughout life, but more so during certain phases of life, such as pregnancy and foetal bone development, in post-menopausal women, elderly people, ones with low bone mineral density or with osteoporosis, and ones recovering from fractures and surgery. Calcium supplements are often prescribed in these cases; however, there is a large variability in the type of calcium salt. The amount of elemental calcium, the level of vitamin D3, and other vitamins-minerals present in the products, varies according to the brands available in the market. Therefore, it is important for doctors to have an awareness of the product and a thorough understanding of the same. They prescribe a supplement to a particular patient. Calcium supplements have also been linked to cardiovascular risk. Therefore, the risk benefit ratio as well as the composition of the product should be determined before prescribing it to post-menopausal women and elderly people with comorbidities.
Author – Dr. Varsha Narayanan
4. Giant Exudative Fluid (Tubercular) Collection in Hepatogastric Ligament in an
Immunocompromised Host Masquerading as Subacute Intestinal Obstruction
Abstract – Hepatogastric ligament is a component of hepatogastric compartment. It is found to be usually involved in patients with complicated pancreatitis. In such cases, pancreatic pseudocyst is a common presentation. Malignant lesions present as follicular dendritic cell sarcoma. This involves hepatogastric ligament. Such cases have also been reported in the literature to date. However, tubercular lesions are rarely observed in these cases. The authors have reported a tubercular lesion in hepatogastric ligament. It appears as a giant cystic collection.
Author – Dr. Sarthak Mahapatra, Dr. Sanjay Fotedar, Dr. Kunj Supragya
5. Revolution in Cancer Care: Artificial Intelligence and Adaptive Radiotherapy
Abstract – In recent years, significant strides have been made in the field of cancer treatment, largely attributed to the emergence of personalized medicine and precision cancer care. This paradigm shift represents a ground breaking approach that tailors
medical interventions to the unique genetic makeup of individual patients. This abstract delves into the concept of precision cancer care within the framework of personalized medicine and its profound impact on advancing cancer treatment. Recent advancements in radiation oncology technology have led to improved dose distributions and reduced toxicity in specific tumor locations. As a result of these advancements, there is a greater potential for improving local tumor control and increasing cure rates. Strict immobilization, good quality imaging, efficient motion management techniques precise and accurate treatment delivery systems, skill and expertise of the clinicians and staff – all contribute to an efficient radiotherapy department. Moreover, precision cancer care transcends the realm of treatment initiation. It facilitates the monitoring of a patient’s cancer over time, allowing for real-time adjustments to the treatment strategy as the cancer’s genetic profile evolves. This adaptability ensures that patients receive therapies that remain effective even in the face of cancer’s attempts to evade treatment. Additional clinical trials are necessary to demonstrate the benefits of advanced technologies before they are adopted for widespread use.
Author – Dr. Vinitha Reddy
November 2023
- Insights on the 3P’s of Stroke: Prevalence, Pathophysiology, and Prevention
Abstract – Stroke ranks as the fourth leading cause of death and the fifth leading cause of disability in India. Globally, stroke accounts for a significant mortality rate. This editorial is dedicated to comprehensively understanding the pathophysiology of stroke, encompassing its various types, associated risk factors, and the primary means of preventing it. It also underscores the importance of mitigating risk factors such as hypertension, diabetes, hyperlipidemia, smoking, dietary choices, and regular exercise, as these interventions can potentially prevent up to 90% of strokes. Furthermore, the World Stroke Organization
(WSO) has announced the theme “Together we are #GreaterThan Stroke” for the year 2023 to emphasize the importance of collaborative efforts in stroke prevention. This initiative aims to promote a proactive approach to comprehending, identifying, and addressing stroke risks through accessible management perspectives.
Author – Dr. Manish Maladkar
2. The Antivenom Activity of Phytochemicals: An Emerging Role in Modern Medicine
Abstract – Many plants were used as antivenoms by aboriginal people, so villagers have also used them. However, ignorance and superstition can cause people to lose their lives. Accordingly, the antivenom properties of plants should be identified and proved in the system of modern medicine. Various secondary metabolites are present in medicinal plants, and they contribute to their diverse pharmacological properties. We are still deciphering how ethnobotanical research can help us more in discovering medicinal plants for the treatment of various health conditions. This is because pharmacology deals with how drugs interact with biological systems. Drugs are classified in terms of their history, sources, chemical properties, biological effects, and therapeutic uses. A preliminary pharmacological study is the first step in developing herbal medicines. Then, the standardization of extracts or fractions is undertaken by using approved scientific methods. Finally, the herbal medicines are subjected to systematic clinical and pharmacological testing. To ensure the safety and efficacy of drugs, we must consider modern technologies. Medicinal plants can be used to produce a wide variety of drugs. Such plants should be studied to learn more about their properties, safety, and efficacy. Several medicinal plants have accepted therapeutic values, and these were investigated as potential treatment drugs for snake bites. A major public health concern in tropical countries, especially in India, is snakebite. As a result of unplanned development programs, modern healthcare facilities, and the impact of modern civilization, natural resources, and traditional knowledge are disappearing at an alarming rate all across the world. Therefore, we should explore and document the unique, ancestral, and traditional knowledge of tribal communities.
Author – Sweta Pandey, Dr. Manoj Indurkar, Dr. Rahul Mishra, Dr. Shankhpani Mahapatra, Dr. Adesh Patidar, Dr. Sanjay Kumar Pandey
3. Gallbladder Perforation Presenting as Liver Abscess: A Case Report
Abstract – Gallbladder perforation is a rare but life-threatening complication of acute cholecystitis. A rapid diagnostic work-up helps in identifying the type of gallbladder perforation. All these measures help in deciding the most effective means of management. We reported a case of an elderly man, who had co-morbidities. He presented an intrahepatic perforation of the gall bladder (GB) and a liver abscess. The patient was managed initially by performing a percutaneous image-guided drainage of the abscess. Then, we performed an endoscopic retrograde cholangiopancreatography and an extraction of the common bile duct stone. The patient underwent a successful open cholecystectomy
after stabilization.The GB perforation and a liver abscess were detected in an elderly patient with co-morbidities. Initially, this condition can be managed conservatively by performing a percutaneous drainage of the abscess. Thus, this technique acts as a bridge to surgery.
Author – Dr. Rajesh Sharma1, Dr. Brij Sharma2, Dr. Vishal Bodh3, Dr. Sushma Makhaik
4. Steroid Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) or Hashimoto’s Encephalopathy: A Masquerader of Acute Psychosis
Abstract – Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) or Hashimoto’s encephalopathy is a relatively rare condition; it is a poorly understood entity and is often misdiagnosed and mistreated. It is seen in a very small
percentage of patients, who have an autoimmune thyroid disease and a high level of anti-thyroid antibodies. This condition causes various neurological and psychiatric disorders. Although the exact association between SREAT and thyroid disorder is not yet established, it is important to diagnose SREAT. This condition is treatable and often reversible. Here, we report a case of a 24-year-old female, who was being treated for Vitamin B12 deficiency, anaemia, and hypothyroidism. She suddenly developed encephalopathy. After ruling out other causes, we detected elevated levels of thyroid peroxidase (TPO). Therefore,a diagnosis of Hashimoto’s encephalopathy was made, and the patient responded dramatically to steroids.
Author – Dr. Kunj Supragya, Dr. Shaveta Dahiya, Dr. Mohini, Dr. Sandeep Kaur, Dr. H.K. Aggarwal, Dr. Deepak Jain
December 2023
- Onwards and Upwards: Navigating the Future of Diabetes Care
Abstract – The escalating global prevalence of type 2 diabetes mellitus prompts a critical need for innovative approaches to its management. Managing T2DM presents challenges, and the call for treatments targeting different pathways is paramount. Current antidiabetic drugs predominantly focus on glucose control, but the surge in T2DM cases necessitates newer agents that not only regulate glucose levels but also address the multifaceted aspects of the disease. As the diabetes epidemic persists, exploring innovative therapeutic avenues becomes crucial for improved outcomes and a better quality of life for those grappling with this prevalent metabolic disorder. This editorial emphasizes newer targets, spotlighting novel agents regulating glucose levels and delaying disease progression.
Author – Dr. Manish Maladkar
2. Sero Prevalence of Hepatitis B Surface Antigen in Symptomatic Patients in A Tertiary Care Hospital- An Overview
Abstract – Viral hepatitis is a major public health problem in India that needs special attention. Hepatitis B virus is one of the important causative agents for viral hepatitis. Hepatitis B surface Antigen (HBsAg) positivity in the general population ranges from
1.1% to 12.2%, with an average prevalence of 3-4%. This study aimed to know the seroprevalence rate of hepatitis B surface antigen from symptomatic patients in our area.
Author – Dr. M. Bharathi, Dr. A. Usharani
3. Reaven Syndrome Revisited
Abstract – Reaven or Metabolic syndrome has many well-recognized cardiovascular disease risk (CVD) factors. Choosing which one of these is primarily responsible for the accelerated atherogenesis that characterizes this syndrome is a complex task. The problem is further compounded by a need for more understanding of the cellular and molecular changes resulting from insulin resistance. We aim to revisit the current understanding of Reaven syndrome or Metabolic syndrome in light of the lifestyle transition. The growing burden of metabolic syndrome is associated with rising exposure to behavioural, dietary and metabolic risk factors. These risks are, in turn, linked to a calorie dense diet, physical inactivity, sedentary time, tobacco use and alcohol consumption. Moreover, the altered lifestyle has increased the risk of metabolic syndrome associated with CVD in the younger as well as non-obese population. This growing risk could be attributed to the increased insulin resistance due to lifestyle changes probably associated with technological advances reducing the physically active time. Periodic screening even in young adults may aid in timely recognition and resolution of CVD risk factors
Author – Dr. C B Sridhar, Dr. Mahesh DM
4. Unveiling the Vital Contributions of Professional Medical Writers in the Evolving Healthcare Landscape
Abstract – In the rapidly evolving landscape of medical research and education, the role of professional medical writers is increasingly being recognized. These professionals convey complicated medical knowledge obtained from medical research, clinical trials, and scientific publications to their peers. Maintaining scientific rigor and making sure that their work is understandable by the target audience are two competing priorities for medical writers. By following ethical norms, they may contribute to the improvement of medical practices and knowledge while upholding the scientific community’s confidence in their abilities for the betterment of healthcare and reliable evidence. The present paper discusses the role of professional medical writers and its related factors in healthcare.
Author – Dr. Imran Ahmed Khan
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