Conventional Synthetic Disease-modifying Drugs Remain the Mainstay of Therapy for Rheumatoid Arthritis in India.

Background: There are limited data on the real-world utilization of disease-modifying antirheumatic drugs (DMARDs) in Indian patients with rheumatoid arthritis (RA).

Methods: This was a cross-sectional study of a multicentric observational cohort of RA patients across rheumatology clinics at six centers across India. Patients who met the American College of Rheumatology (ACR) 2010 criteria for RA were included.

Correlation of Trichoscopic Findings with Severity in Androgenetic Alopecia.

Background: Androgenetic Alopecia (AGA) refers to the appearance of common non-scarring progressive loss of terminal hair. Trichoscopy shows a magnified view of the hair shafts and hair follicle openings and helps us to diagnose, prognosticate and determine the disease severity.

Aims: The aim of the study was to identify the trichoscopic findings in patients with androgenetic alopecia and associate these findings with disease severity.

Hypertonic saline in acute decompensated heart failure (HSHF).

Hypertonic saline with high dose furosemide improves refractory heart failure. In this case series of 10 patients of refractory acute decompensated heart failure, effect of HSS with furosemide was compared with furosemide alone. Patients responded to the therapy better, with faster decongestion, without significant adverse effects or worsening renal function.

An Unusual Presentation of Costal Intraspinal Osteochondroma Causing Compressive Myelopathy in a Patient With Hereditary Multiple Exostoses: A Case Report and Literature Review.

A 22-year-old man presented to us with back pain for four months, inability to walk, and weakness in both lower limbs. Clinical examination revealed multiple swellings in the body, motor weakness, paresthesia, and upper motor neuron signs. Both magnetic resonance imaging (MRI) and computed tomography (CT) revealed an abnormal bone mass protruding into the spinal canal from the posterior aspect of the ninth rib through the D9-D10 neural foramen.

Comparison of efficacy and safety of three different concentrations of ropivacaine for labor pain management using patient-controlled epidural analgesia (PCEA): A double-blind, randomized controlled trial.

Background And Aims: Labor pain is consistently ranked high on the various pain rating scales, when compared to other painful life experiences, and the experience of labor during the process of childbirth is both complex and subjective. Though patient-controlled epidural analgesia (PCEA) using dilute concentrations of local anesthetics (LAs) has been a popular method to control labor pain, yet the optimal dose and regimen for PCEA remain ambiguous. So, the present study was undertaken to evaluate the safety and efficacy of three different concentrations of ropivacaine for labor analgesia using PCEA.

Profiling Molecular Changes of Host Response to Predict Outcome in Children with Septic Shock.

Background: Septic shock is associated with high mortality and there is significant heterogeneity in the host response. The aim of this study was to understand the genome-wide expression transcriptomic signatures in children with septic shock and correlate them with outcomes.

Methods: This was a prospective study conducted on children (aged 1 month to 18 years) admitted to the PICU (June-December 2021) with septic shock.

A Rare Case of Disseminated Peritoneal Leiomyomatosis: A Case Report.

Disseminated peritoneal leiomyomatosis is a benign condition characterized by multiple extrauterine leiomyomas in various locations such as the peritoneum, mesentery, abdominal wall, and pelvis. This is typically observed following laparoscopic myomectomy and is an extremely rare disease, with only a limited number of cases reported thus far. It primarily affects women in their reproductive age group and is believed to be associated with ovarian secretions.

Guidelines for Antibiotics Prescription in Critically Ill Patients.

Khilnani GC, Tiwari P, Mittal S, Kulkarni AP, Chaudhry D, Zirpe KG, Guidelines for Antibiotics Prescription in Critically Ill Patients. Indian J Crit Care Med 2024;28(S2):S104-S216.

ISCCM Position Statement for Improving Gender Balance in Critical Care Medicine.

Unlabelled: Gender disparity in Critical Care Medicine (CCM) persists globally, with women being underrepresented. Female Intensivists remain a minority, facing challenges in academic and leadership positions at the workplace and within academic societies. The Indian Society of Critical Care Medicine (ISCCM) recognized the need for addressing issues related to gender parity and constituted its first Diversity Equity and Inclusion (DEI) Committee in 2023.

Prognostic Significance of "High" Tumor Budding and "High" Poorly Differentiated Clusters in Endometrial Carcinomas: Independent Predictors of Lymphovascular Space Invasion and Lymph Node Metastasis.

Tumor budding (TB) and poorly differentiated clusters (PDCs) are well-established prognostic factors in various cancers. This study aimed to assess the independent prognostic role of these markers in endometrial carcinomas. Retrospective analysis of endometrial carcinoma resection specimens by examining traditional histologic prognostic parameters.

Efficacy, safety, and tolerability of lifitegrast 5% eye drops: A randomized, double-blind, active-controlled trial in Indian patients with dry eye disease.

Purpose: To compare the efficacy, safety, and tolerability of lifitegrast 5% versus carboxymethylcellulose (CMC) 0.5% in adult patients with dry eye disease (DED).

Methods: A total of 370 eligible patients with DED were randomized equally to receive twice-daily doses of a single drop in each eye of either lifitegrast 5% or CMC 0.

Associated Risk Factors and Clinical Outcomes of Bloodstream Infections among COVID-19 Intensive Care Unit Patients in a Tertiary Care Hospital.

Introduction: The COVID-19 infection is an ongoing public health crisis causing millions of deaths worldwide. COVID-19 patients admitted to the intensive care unit (ICU) are more vulnerable to acquire secondary bloodstream infections (sBSIs) which cause a significant morbidity and mortality. Thus, we aim to assess the risk factors of sBSIs and outcomes in COVID-19 ICU patients.

The correlation between the severity of paroxysmal sympathetic hyperactivity and plasma catecholamine levels in patients with severe traumatic brain injury.

Background: There is limited literature investigating the catecholamine levels in patients with paroxysmal sympathetic hyperactivity (PSH) after traumatic brain injury (TBI). The primary objective of this study was to correlate the severity of PSH (assessed using the PSH-Assessment measure [AM]) with plasma catecholamine levels at a resting state.

Methods: In this prospective case-control study, blood samples for epinephrine and norepinephrine estimation were obtained at rest on three consecutive days, only for 'cases' of PSH after severe TBI (s-TBI) and for control patients (matched for age, gender, and Glasgow coma scale [GCS].

The Role of Artificial Intelligence in Healthcare: Enhancing Coronary Computed Tomography Angiography for Coronary Artery Disease Management.

This review aims to explore the potential of artificial intelligence (AI) in coronary CT angiography (CCTA), a key tool for diagnosing coronary artery disease (CAD). Because CAD is still a major cause of death worldwide, effective and accurate diagnostic methods are required to identify and manage the condition. CCTA certainly is a noninvasive alternative for diagnosing CAD, but it requires a large amount of data as input.

Elucidating the Role of MicroRNA-18a in Propelling a Hybrid Epithelial-Mesenchymal Phenotype and Driving Malignant Progression in ER-Negative Breast Cancer.

Epigenetic alterations that lead to differential expression of microRNAs (miRNAs/miR) are known to regulate tumour cell states, epithelial-mesenchymal transition (EMT) and the progression to metastasis in breast cancer. This study explores the key contribution of miRNA-18a in mediating a hybrid E/M cell state that is pivotal to the malignant transformation and tumour progression in the aggressive ER-negative subtype of breast cancer. The expression status and associated effects of miR-18a were evaluated in patient-derived breast tumour samples in combination with gene expression data from public datasets, and further validated in in vitro and in vivo breast cancer model systems.

The pharmaceutical company-healthcare relationship: much ado about something.

The relationship between the pharmaceutical companies and the healthcare profession, especially doctors, has always been fraught with conflicts of interest (COI). The publication of the influential The Diagnostic and Statistical Manual for Mental Disorders, Fifth edition, Text Revision (DSM-5-TR), by the American Psychiatric Society (APA) raised concerns that the financial relationships between pharma and members responsible for DSM could result in bias. This resulted in calls for stricter enforcement of controls on financial conflict of interest (FCOI) [1, 2], which could influence the formulation of diagnostic criteria (resulting in more people being "diagnosable as mentally ill"), creating a larger pool of "patients" who "need" pharmaceutical drugs.

Day and Time of Admission to ICU Affects Patient Outcome: An Illogical Belief?

Krishna B. Day and Time of Admission to ICU Affects Patient Outcome: An Illogical Belief? Indian J Crit Care Med 2024;28(5):414-415.

Correction: Expert Opinions on the Management of Hemophilia A in India: The Role of Emicizumab.

[This corrects the article DOI: 10.7759/cureus.58941.

Expert Opinions on the Management of Hemophilia A in India: The Role of Emicizumab.

Hemophilia A (HA) is a genetic disorder of hemostasis associated with a deficiency or reduced activity of clotting factor VIII (FVIII). This disorder remains unacceptably underdiagnosed in India. Early diagnosis and appropriate management of HA can substantially prevent morbidity and mortality.