Buprenorphine 'microdosing' method for switching patients with opioid dependence from methadone to buprenorphine.

Various factors limit the acceptability of methadone as an opioid agonist treatment (OAT), in which case, buprenorphine becomes the preferred alternative. The classical approach is to gradually taper methadone to a low dose and buprenorphine is initiated after some opioid-free period, which generally takes weeks. A novel approach known as 'microdosing' or the 'Bernese method' might serve as a valuable alternative.

Naltrexone and its Effects on Craving and Alcohol Use among Patients with Alcohol Dependence Syndroms: A Report.

Background: Naltrexone is a Food and Drug Administration (FDA)-approved anti-craving agent for the long-term treatment of alcohol dependence syndrome (ADS). However, it may not be equally effective in all patients. This study aims to assess naltrexone treatment response over four weeks in a national-level tertiary care setting.

Prevalence of substance use and substance use disorder in medically ill patients: A cross-sectional, hospital-based study from India.

Background Untreated co-occurring substance use and substance use disorders (SUDs) in patients with medical conditions may be associated with unfavourable medical outcomes. Understanding the prevalence of substance use and SUDs among patients admitted to hospital for medical illness may help in developing appropriate strategies to manage SUDs in this population and improve the outcomes of medical illness. We assessed the prevalence of substance use and SUDs among patients admitted for medical illnesses and the association between substance use and medical illness.

Assessment of treatment retention rates and predictors of retention on opioid agonist treatment among adolescents.

Introduction: Opioid agonist treatment (OAT) is an effective treatment for opioid dependence syndrome in adults. However, studies on effectiveness of OAT in adolescents are limited; existing studies show varying retention rates. The present study aimed to assess OAT retention rates in adolescent patients with opioid dependence syndrome registered in a community drug treatment clinic in Delhi, India, and to analyse factors associated with retention at 1 year.

Experience of patients on methadone maintenance treatment receiving take-home methadone doses during COVID-19 pandemic: A multi-site study from India.

Background: Methadone take-home doses for opioid dependence treatment are strictly regulated due to diversion and overdose concerns, so patients must visit the clinic daily for dispensing. This was also done in India until the COVID-19 pandemic, when lockdown restriction compelled take- home dispensing of methadone. This study examined experience of patients who received take- home methadone during COVID-19 pandemic in India.

Exploring the pharmacological and chemical aspects of pyrrolo-quinazoline derivatives in .

is one of the biggest and complex genera of the Acanthaceae family. is commonly known as 'Adosa'. It is an ayurvedic medicine with a medicinal history of more than a thousand years in India.

Trazodone for sleep disturbance in opioid dependent patients maintained on buprenorphine: A double blind, placebo-controlled trial.

Background: Sleep disturbances are seen even in individuals on opioid agonist treatment (OAT). Established pharmacotherapy for sleep disturbances such as benzodiazepines have misuse potential and increased mortality risk in patients with OAT. No study has explored the role of trazodone on sleep disturbance in individuals maintained on buprenorphine.

Angiographic quantification of aortic regurgitation following myval octacor implantation; independent core lab adjudication.

Background: The balloon expandable Myval transcatheter heart valve (THV) showed encouraging results regarding residual aortic regurgitation (AR) from multiple observational studies. The newly designed Myval Octacor has been introduced recently, aiming for a reduction in AR and improved performance.

Objectives: The focus of this study is to report the incidence of AR using the validated quantitative Videodensitometry angiography technology (qLVOT-AR%) in the first in human use of the Myval Octacor THV system.

Does ethyl glucuronide in hair correlate with alcohol consumption? A comparative study with other traditional biomarkers among individuals with alcohol dependence syndrome.

Aim: Ethyl glucuronide (EtG) in hair is a direct biomarker proven to be useful for the detection of chronic excessive alcohol use. This study investigated the association of self-reported alcohol consumption with traditional biomarkers: GGT, AST, ALT, CDT, and MCV in blood and a direct biomarker, hair EtG, in a total of 122 patients with alcohol dependence syndrome. The diagnostic accuracy of the biomarkers to differentiate heavy from non-heavy drinkers was also evaluated.

Digital Capacity and Interest in mHealth Interventions Among Individuals on Opioid Agonist Maintenance Treatment: A Cross-Sectional Community-Based Study.

Background: Integrating mobile technologies in healthcare (mHealth) is helpful to manage various medical conditions. mHealth applications can bridge the gap in the management of patients with opioid use disorder (OUD). Research evaluating the feasibility of mHealth to address OUD is limited in developing countries.

Evaluation of alcohol use pattern among OST patients using alcohol biomarkers: Report from community clinics in India.

Background: Opioid-dependent patients undergoing opioid substitution therapy (OST) consume alcohol in a hazardous pattern which adversely affects their treatment outcome. This study aims to measure alcohol biomarkers to screen for secondary alcohol use in OST patients.

Methods: A pilot study was planned to measure alcohol biomarkers (AST, ALT, GGT, and CDT) to assess alcohol use in OST patients from three community clinics.

Effect of chronic opioid use on the hematological and inflammatory markers: A retrospective study from North India.

Background: Chronic opioid use affects biological functioning implicating the hematopoietic and immune system. It may alter various hematological parameters and inflammatory markers. This study aimed to assess the association of opioid dependence with the hematological parameters and inflammatory markers in the Indian population.

Physical and mental health status of women whose spouses inject drugs - A cross-sectional, multisite study.

Substance use disorder impacts the lives of significant others, more especially the wives of individuals using substances. However, the physical and mental health issues among wives of people who inject drugs (PWID) are less studied. The current cross-sectional, multisite study assessed the physical and mental health of wives of 433 PWID across six sites in Delhi.

Safety and procedural outcomes of intravascular lithotripsy in calcified coronaries in Indian patients.

Objective: Calcified coronaries still remain a major challenge for interventional cardiologist. This study aims to evaluate safety and efficacy of intravascular lithotripsy (IVL) in management of coronary artery calcification.

Methods: This was a retrospective single centre study regarding the utility of IVL in management of calcified coronaries.

Validity of Categories Related to Gender Identity in ICD-11 and DSM-5 Among Transgender Individuals who Seek Gender-Affirming Medical Procedures.

Background/objective: The most recent versions of the two main mental disorders classifications-the World Health Organization's ICD-11 and the American Psychiatric Association's DSM-5-differ substantially in their diagnostic categories related to transgender identity. ICD-11 gender incongruence (GI), in contrast to DSM-5 gender dysphoria (GD), is explicitly not a mental disorder; neither distress nor dysfunction is a required feature. The objective was compared ICD-11 and DSM-5 diagnostic requirements in terms of their sensitivity, specificity, discriminability and ability to predict the use of gender-affirming medical procedures.

Improving Treatment of Substance Use Disorders through Community Drug Treatment Clinics: An Experiential Account.

India has a huge burden of substance use disorder (SUD). The national response to the problem of SUD has been to support addiction treatment centers either in government hospitals or in nongovernmental settings. The existing number of addiction treatment facilities is less compared to the burden of substance use in India.

Mobile methadone dispensing in Delhi, India: implementation research.

Objective: To assess the implementation of a mobile dispensing service to improve opioid users' access to methadone maintenance therapy.

Methods: In March 2019, we started mobile methadone dispensing in an urban underprivileged locality in Delhi, India. The doctor was available only at the main community drug treatment clinic for clinical services, while the nurse dispensed methadone from a converted ambulance.

Cognitive functioning in patients maintained on buprenorphine at peak and trough buprenorphine levels: An experimental study.

Objectives: To assess the cognitive functions in participants maintained on buprenorphine for opioid dependence at peak and trough buprenorphine levels.

Methods: This was a double-blind, randomized, experimental study. Sixty participants maintained on buprenorphine were matched for age and education and randomly allocated to "peak" group or "trough" group.

Chronic Noncancer Pain and Opioid Addiction: Diagnostic and Management Challenges.

Chronic pain is associated with higher rates of psychiatric comorbidity, including substance use disorders. Patients with chronic pain often require opioids for their pain relief. Often, clinicians are reluctant to prescribe opioids to patients with chronic pain due to fear of patients becoming dependent on opioids.