Individualizing Time-in-Range Goals in Management of Diabetes Mellitus and Role of Insulin: Clinical Insights From a Multinational Panel.

Diabetes mellitus is a global health concern associated with significant morbidity and mortality. Inadequate control of diabetes leads to chronic complications and higher mortality rates, which emphasizes the importance of achieving glycemic targets. Although glycated hemoglobin (HbA) is the gold standard for measuring glycemic control, it has several limitations.

The effect of Bertholletia excelsa on body weight, cholestrol, and c-reactive protein: A systematic review and meta-analysis of randomized controlled trials.

Background & Objective(s): Bertholletia excelsa is a rich herbal source of anti-oxidants and phenols. The goal of this study is to evaluation the effect of bertholletia excelsa nut on body weight, C-reactive protein (CRP) and lipid profile.

Methods: A literature search was conducted in PubMed, Scopus and Web of sciences databases by two reviewers up to October 2019.

Lumbosacral extradural extramedullary hematopoiesis in thalassemia major causing spinal canal stenosis.

Background: Extramedullary hematopoiesis (EH) is common in patients with ineffective erythropoiesis like thalassemia major (TM). EH commonly involves intra-abdominal organs (e.g.

A prospective, multi-center, open-label, single-arm phase 2b study of autologous adult live cultured buccal epithelial cells (AALBEC) in the treatment of bulbar urethral stricture.

Purpose: To evaluate the safety and efficacy of autologous adult live cultured buccal epithelial cells (AALBEC) in treatment and management of bulbar urethral stricture in men.

Methods: This was a prospective, multi-center, open-label, single-arm phase 2b study. A total of 18 male patients with bulbar urethral stricture of at least 1 - 4 cm in length were enrolled in the study.

High frequency of exon 20 S768I EGFR mutation detected in malignant pleural effusions: A poor prognosticator of NSCLC.

Background: Lung cancer is the cause of a fourth of all cancer-related deaths. About a third of all lung adenocarcinoma tumours harbour mutations on exons 18 to 21 of the epidermal growth factor receptor (EGFR) gene. Detection of these mutations allows for targeted therapies in the form of EGFR Tyrosine kinase inhibitors.

Toxicity syndrome and early competing deaths in head-and-neck cancer undergoing radiation therapy: Observation and hypothesis.

Radiotherapy (RT) and/or concurrent chemoradiation (CRT) is the mainstay for the treatment of locally advanced head-and-neck cancer (LAHNC). Sepsis remains a poorly understood and unrecognized event in head-and-neck cancer. The study aims to hypothesize a 'toxicity syndrome' leading to sepsis and subsequent sepsis-related deaths.

Effect of Dipeptidyl Peptidase 4 Inhibitors on Cardiovascular Events in Type-2 Diabetes Patients with Renal Impairment: A Systematic Review and Meta-analysis.

Background: Recent studies suggested that the increased risk of heart failure by DPP-4 inhibitors may have an interconnection with patients' baseline eGFR. We decided to investigate the effect of DPP-4 inhibitors and the degree of renal function on cardiovascular (CV) safety in type 2 diabetes (T2D) patients.

Materials And Methods: Systemic search of literature that examined the DPP-4 inhibitors and reported cardiovascular outcomes in diabetes patients with renal impairment were performed.

Posterior latissimus dorsi transfer for massive irreparable posterosuperior rotator cuff tears: does it work in the elderly population? A comparative study between 2 age groups (≤55 vs. ≥75 years old).

Hypothesis And/or Background: Management of irreparable posterosuperior rotator cuff tears (RCTs) presents a significant challenge to shoulder surgeons. Previous studies on latissimus dorsi transfer (LDT) have demonstrated good to excellent outcomes in younger patients, but this indication is debatable in the elderly. The main objective of this study was to compare the results of LDT in a group of patients aged ≤55 years vs.

Effect of point mutation on structure-function correlation of hemoglobin variants, HbE and HbD Punjab.

Hemoglobinopathies are examples of autosomal recessive disorders of human hemoglobin. Hemoglobin E (HbE) and Hemoglobin D Punjab (HbD Punjab) are two of the most common hemoglobin variants geographically spread across Asian continent. These two variants differ from normal human hemoglobin (HbA) at a single amino acid residue caused by the point mutation of β globin gene.

Villitis of unknown etiology (VUE): effect on placental size and association with clinical parameters.

Objectives: Villitis of unknown etiology (VUE) is an inflammatory placental lesion with immune-mediated pathogenesis, diagnosed by histopathological examination. It is one of the three placental lesions which tend to recur in subsequent pregnancies, the other two being chronic histiocytic intervillositis and massive fibrin deposition. The frequency of VUE and its association with maternal, obstetric and neonatal complications are variability reported in the literature.

Perioperative risk factors for pulmonary complications after non-cardiac surgery.

Background And Aims: Postoperative pulmonary complications (PPCs) lead to increased morbidity, mortality, length of hospital stay, and cost to the patient. This study was conducted to determine the risk factors and assess the incidence of PPC after non-cardiac surgery.

Material And Methods: This prospective, observational study was conducted on 1,170 patients undergoing non-cardiac surgery.

Antiepileptic Overdose.

Unlabelled: Antiepileptics include various groups of drugs that have different mechanisms of actions and adverse effects. They are often also used to treat other disorders such as psychosis, chronic pain, and migraine. The most common drugs implicated in overdose include phenytoin, sodium valproate, carbamazepine, and phenobarbital.

Initial Management of Poisoned Patient.

Chandran J, Krishna B. Initial Management of Poisoned Patient. Indian J Crit Care Med 2019;23(Suppl 4):S234-S240.

Poisoning-The Road Less Travelled.

Chacko B, Krishna B, Kulkarni AP. Poisoning-The Road Less Travelled. Indian J Crit Care Med 2019;23(Suppl 4):S233.

A Behavioral Adherence Intervention Improves Rates of Viral Suppression Among Adherence-Challenged People Living with HIV in South India.

The success of antiretroviral therapy (ART) has led to both extended life expectancy and improved quality of life among people living with HIV (PLWH). To maximize the efficacy of first line ART regimens in low- and middle-income countries (LMIC), we need culturally-relevant interventions that empower participants to reduce barriers to long-term uninterrupted adherence. The Chetana adherence intervention trial was designed in collaboration with local community groups as a comprehensive wellness program for adherence-challenged PLWH and included peer-led adherence support, yoga, nutrition, information about local resources, and individual counseling using motivational interviewing techniques.

Does Quality of Life Among Modified Radical Mastectomy and Breast Conservation Surgery Patients Differ? A 5-Year Comparative Study.

Breast cancer is the most common cancer among females worldwide, of whom more than 80% survive for more than 5 years. Hence, ensuring a good quality of life (QOL) is essential to achieve holistic approach in treating patients. A cross-sectional study was conducted to compare the QOL in women who underwent modified radical mastectomy (MRM) and breast conservation surgery (BCS) for breast cancer in the last 5 years.

Acyl ethanolamides in Diabetes and Diabetic Nephropathy: Novel targets from untargeted plasma metabolomic profiles of South Asian Indian men.

The pathophysiology of diabetic nephropathy (DN) in type 2 diabetes (T2D) patients is minimally understood. We compared untargeted high-resolution accurate mass (HRAM) orbitrap-based plasma metabolomic profiles of 31 T2D-DN (with estimated glomerular filtration rate ≤80 mL/min/1.73 m), 29 T2D and 30 normal glucose tolerance (NGT) Indian men.

Medical student's perception to different types of set induction in anatomy lectures.

Set induction refers to the process of using a thought-provoking statement, interesting fact, or an audio-visual stimulus at the beginning of lecture to gain student's attention and give an overview about the lecture topic. In the present study, students were introduced to three types of set induction namely narratives, food-based analogies and humor-based images or activities at the beginning of anatomy lecture and their response to it is collected and analyzed. The objective of the study is to estimate the difference in a questionnaire-based perception score between the three different types of set induction; estimate sex differences in the questionnaire-based perception score.

Between Many Rocks and Hard Places.

Varma MMK, Krishna B, Sampath S. Between Many Rocks and Hard Places. Indian J Crit Care Med 2019;23(8):388.

Effect of a multicomponent intervention on achievement and improvements in quality-of-care indices among people with Type 2 diabetes in South Asia: the CARRS trial.

Aims: To evaluate whether and what combinations of diabetes quality metrics were achieved in a multicentre trial in South Asia evaluating a multicomponent quality improvement intervention that included non-physician care coordinators to promote adherence and clinical decision-support software to enhance physician practices, in comparision with usual care.

Methods: Using data from the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) trial, we evaluated the proportions of trial participants achieving specific and combinations of five diabetes care targets (HbA <53 mmol/mol [7%], blood pressure <130/80 mmHg, LDL cholesterol <2.6 mmol/L, non-smoking status, and aspirin use).

Risk of latissimus dorsi tendon rupture after arthroscopic transfer for posterior superior rotator cuff tear: a comparative analysis of 3 humeral head fixation techniques.

Background: To compare latissimus dorsi tendon rupture rates after arthroscopic transfer for posterior superior rotator cuff tear using 3 different humeral head fixation techniques.

Methods: One-hundred fifty consecutive latissimus dorsi transfers were included. Inclusion criteria were massive irreparable posterosuperior rotator cuff tear with advanced fatty infiltration associated with persistent pain and limited range of motion after failed conservative treatments or surgery.

Secular Trends in an Indian Intensive Care Unit-database Derived Epidemiology: The Stride Study.

Context: The Indian Society of Critical Care Medicine (ISCCM), had taken an initiative to enable all Indian ICUs (Intensive Care Unit) to capture and store relevant data in a systematic manner in an electronic database: "CHITRA" (Customized Health in Intensive Care Trainable Research and Analysis tool).

Aims: This study was aimed at capturing, and summarising longitudinal epidemiological data from a single tertiary care hospital ICU (Intensive Care Unit), based on a pre-existing database and the CHITRA system.

Settings And Design: Prospective Observational.

Surgical Notes: To Play or Not to Play.

Introduction: Music is any sound that is perceived as pleasingly harmonious. The link between music and healthcare can be traced long back in the history of mankind. Thus, our study aimed at assessing the impact of different genre of music on the cognition functioning, memory and attention levels of the surgeons.

2019 WACEM - Academic College of Emergency Experts Consensus Recommendations on Admission Criteria to Pediatric Intensive Care Unit from the Emergency Departments in India.

Unlabelled: There is a global variation in policies that define clear indications for pediatric intensive care unit (PICU) admissions. In resource-limited countries where PICU service availability is limited, the admission criteria to PICU are urgently needed to optimize the utilization of available intensive care services and to maximize patient benefit. The objective of these consensus recommendations on PICU admission criteria is to provide a framework and reference for future policy development by professional societies and governments.

Effect of Cricoid Pressure on the Glottic View and Intubation with King Vision Video Laryngoscope.

Context: To establish the usefulness of King Vision video laryngoscope (KVL) in patients with rapid sequence anesthesia.

Aims: This study aims to compare the role of KVL on glottic visualization, intubation time and associated sympathetic response in routine intubations to those intubations done with cricoid pressure (CP).

Settings And Design: Randomized controlled study in a tertiary care hospital.