Pub Date : 2024-02-14DOI: 10.36346/sarjm.2024.v05i01.006
Manjula S, Krishna Kumar M
Background: In India, the prevalence of diabetes is constantly rising in both urban and rural settings. The innovation of newer drugs and the combination of available drugs to treat diabetes has also been increasing. So, this study aimed to understand the practice of clinicians and their perspective towards prescribing appropriate oral hypoglycemic agents for individuals diagnosed with type 2 diabetes mellitus (T2DM) in India. Methods: This cross-sectional survey was conducted among diabetologists who provided consent to participate in the survey on their prescription pattern of oral hypoglycemic agents for management of T2DM individuals. Results: Majority of physicians preferred sitagliptin and dapagliflozin fixed dose combination (FDC) (84.42%) for T2DM individuals with high-risk. The experts also mentioned the FDC reduces time in range (40.04%) when sodium glucose cotransporter-2 inhibitors (SGLT2i) and Dipeptidyl peptidase-4 inhibitors (DPP4i) FDC was given. Sitagliptin and dapagliflozin combination therapy was given majorly to newly diagnosed T2DM individuals with cardiovascular risk (CV risk) (67.07%). Sitagliptin and dapagliflozin FDC for 16 weeks reduces 1.5 to 2% of glycated hemoglobin (HbA1c) (40.63%). Conclusion: Sitagliptin and dapagliflozin FDC was effective for T2DM individuals with high-risk and for newly diagnosed T2DM (and with CV risk). The combination also showed benefit in reducing blood pressure and weight loss when compared to SGLT2 inhibitors monotherapy. Hospitalization rate and CV risk was reduced in individuals who take sitagliptin and dapagliflozin FDC.
{"title":"Expert Opinion on the Prescription Practice of Oral Hypoglycemic Agents for the Management of Type 2 Diabetes Mellitus in India","authors":"Manjula S, Krishna Kumar M","doi":"10.36346/sarjm.2024.v05i01.006","DOIUrl":"https://doi.org/10.36346/sarjm.2024.v05i01.006","url":null,"abstract":"Background: In India, the prevalence of diabetes is constantly rising in both urban and rural settings. The innovation of newer drugs and the combination of available drugs to treat diabetes has also been increasing. So, this study aimed to understand the practice of clinicians and their perspective towards prescribing appropriate oral hypoglycemic agents for individuals diagnosed with type 2 diabetes mellitus (T2DM) in India. Methods: This cross-sectional survey was conducted among diabetologists who provided consent to participate in the survey on their prescription pattern of oral hypoglycemic agents for management of T2DM individuals. Results: Majority of physicians preferred sitagliptin and dapagliflozin fixed dose combination (FDC) (84.42%) for T2DM individuals with high-risk. The experts also mentioned the FDC reduces time in range (40.04%) when sodium glucose cotransporter-2 inhibitors (SGLT2i) and Dipeptidyl peptidase-4 inhibitors (DPP4i) FDC was given. Sitagliptin and dapagliflozin combination therapy was given majorly to newly diagnosed T2DM individuals with cardiovascular risk (CV risk) (67.07%). Sitagliptin and dapagliflozin FDC for 16 weeks reduces 1.5 to 2% of glycated hemoglobin (HbA1c) (40.63%). Conclusion: Sitagliptin and dapagliflozin FDC was effective for T2DM individuals with high-risk and for newly diagnosed T2DM (and with CV risk). The combination also showed benefit in reducing blood pressure and weight loss when compared to SGLT2 inhibitors monotherapy. Hospitalization rate and CV risk was reduced in individuals who take sitagliptin and dapagliflozin FDC.","PeriodicalId":487007,"journal":{"name":"SAR journal of medicine","volume":"119 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139963488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-29DOI: 10.36346/sarjm.2023.v04i05.003
Ali Fadhil Hashim, Ali Abd Al-Hur Al-Ibrahemy, Asaad Hashim
Background: Gluten-enteropathy or Celiac disease (CD) is a well-known autoimmune gastroenteropathy. The disease incidence is globally like an iceberg with many cases are believed to be undiscovered in the community. Many researches are continuously done to detect the pathogenesis of the disease. Soluble Interleukin-2 receptor (sIL-2R) is well a mediator involved in the inflammatory process including celiac disease. ELISA technique was used to evaluate the serum level of sIL-2R, anti- tissue tTG IgA and anti-deamidated gliadin peptide (DGP) IgG. The duodenal histological changes were evaluated dependent on the MARSH grading system. Forty five patients were included in this cross-sectional study with other 45 healthy persons as control group. Statistical analysis using the SPSS system revealed the followings facts. Aim: This study aimed to assess the level of sIL-2R in association with duodenal histopathological changes in CD together with other serological and clinical parameters in comparison with healthy individuals (control group). Materials and Methods: A forty five patients were included in this cross-sectional study with other forty five healthy persons as control group. Statistical analysis using the SPSS system to reveal the followings facts. Results: Anemia was present in most of patients. The patients with celiac disease had high levels of serum anti-tTG, DGP & s.IL-2 receptors with significant difference in comparison with the control group (P< 0.05). MARSH grades were highly significant with the immunological markers. Conclusion: CD can be a hidden disease with variable severity modes that can be monitored by immunological and pathological methods. Soluble IL-2R antibody is a good tool to assess CD activity and patient compliance.
{"title":"Gluten Enteropathy in Adult Iraqi Patients: Immunological and Histopathological Assessment (A Cross-Sectional Study)","authors":"Ali Fadhil Hashim, Ali Abd Al-Hur Al-Ibrahemy, Asaad Hashim","doi":"10.36346/sarjm.2023.v04i05.003","DOIUrl":"https://doi.org/10.36346/sarjm.2023.v04i05.003","url":null,"abstract":"Background: Gluten-enteropathy or Celiac disease (CD) is a well-known autoimmune gastroenteropathy. The disease incidence is globally like an iceberg with many cases are believed to be undiscovered in the community. Many researches are continuously done to detect the pathogenesis of the disease. Soluble Interleukin-2 receptor (sIL-2R) is well a mediator involved in the inflammatory process including celiac disease. ELISA technique was used to evaluate the serum level of sIL-2R, anti- tissue tTG IgA and anti-deamidated gliadin peptide (DGP) IgG. The duodenal histological changes were evaluated dependent on the MARSH grading system. Forty five patients were included in this cross-sectional study with other 45 healthy persons as control group. Statistical analysis using the SPSS system revealed the followings facts. Aim: This study aimed to assess the level of sIL-2R in association with duodenal histopathological changes in CD together with other serological and clinical parameters in comparison with healthy individuals (control group). Materials and Methods: A forty five patients were included in this cross-sectional study with other forty five healthy persons as control group. Statistical analysis using the SPSS system to reveal the followings facts. Results: Anemia was present in most of patients. The patients with celiac disease had high levels of serum anti-tTG, DGP & s.IL-2 receptors with significant difference in comparison with the control group (P< 0.05). MARSH grades were highly significant with the immunological markers. Conclusion: CD can be a hidden disease with variable severity modes that can be monitored by immunological and pathological methods. Soluble IL-2R antibody is a good tool to assess CD activity and patient compliance.","PeriodicalId":487007,"journal":{"name":"SAR journal of medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135295478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The current article discusses clotting through Pulmonary Embolism (PE), thereafter, it delves in to the epidemiology of PE, its clinical features, management & finally the application of homoeopathy to deal with this issue. It concludes with the cost effectiveness & therapeutic effectiveness of the homoeopathic system of medicine & suggests its involvement on a large scale in the nation. It only reinforces the age old concept of managing these chronic conditions through diet, regimen, exercise & homoeopathy. The suggestion of large scale use of homoeopathy is based on the premise of the modalities of essential medicines. The National List of Essential Medicines (NLEM) envisages that a medicine can be called essential only if it is cost effective, clinically effective & has no side effects. Homoeopathy fits into this triad fully. The article also suggests a treatment protocol based on the typical clinical features of PE & aspires that the public benefits from the protocol at large.
{"title":"Homoeopathy in Clotting","authors":"Tridibesh Tripathy, Shankar Das, Dharmendra Pratap Singh, Umakant Prusty, Madan Mohan Mishra, Jeevan Krushna Pattanaik, Pramod Bihary Pradhan, Anil Dubey, Anjani Kumar, Sanskriti Tripathy, Anjali Tripathy, Rakesh Dwivedi, Mohini Gautam","doi":"10.36346/sarjm.2023.v04i05.002","DOIUrl":"https://doi.org/10.36346/sarjm.2023.v04i05.002","url":null,"abstract":"The current article discusses clotting through Pulmonary Embolism (PE), thereafter, it delves in to the epidemiology of PE, its clinical features, management & finally the application of homoeopathy to deal with this issue. It concludes with the cost effectiveness & therapeutic effectiveness of the homoeopathic system of medicine & suggests its involvement on a large scale in the nation. It only reinforces the age old concept of managing these chronic conditions through diet, regimen, exercise & homoeopathy. The suggestion of large scale use of homoeopathy is based on the premise of the modalities of essential medicines. The National List of Essential Medicines (NLEM) envisages that a medicine can be called essential only if it is cost effective, clinically effective & has no side effects. Homoeopathy fits into this triad fully. The article also suggests a treatment protocol based on the typical clinical features of PE & aspires that the public benefits from the protocol at large.","PeriodicalId":487007,"journal":{"name":"SAR journal of medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136238995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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