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Context: Gallbladder carcinoma (GBCA) is the fifth most common types of gastrointestinal malignancy and is the most common malignancy of the biliary tract. Cholelithiasis, gallbladder polyps, porcelain gall, and choledochal cysts are common known associations with GBCA. Because of the better understanding of the etiopathogenesis, the traditional nihilistic attitude toward the prognosis has, over the years, given way to greater interest and hope for treating the disease. Long-term survival has been reported in patients with resectable lesions in the hands of expert hepatobiliary surgeons. Objective: This prospective observational study was conducted at a tertiary referral hospital of Eastern India on patients with the diagnosis of GBCA. The main objective was to assess the incidence of gallstones in patients with GBCA, and the relationship, if any, between the size and number of stones and GBCA in our patient cohort. Materials and Methods: This prospective observational study was conducted, over a period of 2 years, at a tertiary referral hospital of Eastern India which caters to patients from all the neighboring districts. A total of 54 patients with the diagnosis of GBCA were included in the study. Data on their demographic and clinical profile, the incidence of associated gallstones, their size (<3 or ≥3cm), and number (solitary or multiple) were collected. Known predisposing factors of GBCA, if any, in those presenting without stones were noted. Results: GBCA was found to afflict females 2.4 times as frequently as males. Patients, irrespective of their sex, were mostly in their sixth decade. Approximately three-fourth of the cases had associated cholelithiasis. The number of stones had no correlation with the disease. However, contrary to available published data, stones <3 cm were significantly more common in our study cohort. Conclusion: The results of this study reaffirm that cholelithiasis is a strong predisposing factor for GBCA and females with gallstones in their sixth decade, are more at risk. Although number of stones was not found to be an independent risk factor, patients with stones <3 cm (mostly multiple) were found to be more at risk in our study
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Diabetes Mellitus is a disorder of global proportion. Despite various treatment modalities presently being available, yet the desired glycaemic control and patient outcomes have not been achieved completely. Sodium glucose co-transporter type 2 inhibitors (SGLT2 inhibitors) are one such promising group of emerging drugs in diabetes treatment. Ertugliflozin prevents the reabsorption of glucose by inhibiting sodium-glucose cotransporter-2 (SGLT2) at proximal convoluted tubules. Ertugliflozin is available as 5mg and 15mg tablets. Ertugliflozin has been related to genital mycotic infections and urinary tract infections. Benefits of Ertugliflozin include better control on blood glucose, body weight and blood pressure.
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Background The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. Methods and results A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012–2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3–2.3) versus 2.3 (IQR 1.8–2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32–9.35) vs 4.34 (4.16–4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. Conclusion Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF.
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Background:Breast cancer is the most common cancer among women accounting for 41 per 1,00,000 population in Delhi, followed by Chennai (37.9), Bangalore (34.4) and Thiruvanantapuram (33.7) district. The aim of the present study is to find the severity of distress in cancer patients and the factors influencing it. Methods: All eligible patients (N = 58) were screened for distress on NCCN (National Comprehensive Cancer Network) distress thermometer scale. Once the cancer care team identifies those patients having problems in certain areas, they work with them to address those concerns and can refer to other health care professionals, like a social worker, nutritionist, or chaplain, if needed. Most people can use this scale to rate their distress in a way that helps the cancer care team. If the response is 4 or above, he would likely have a moderate-to-high degree of distress. The doctor and/or cancer care team would find out more and offer some help with the distress. Results: Emotional problems were encountered in 98.27% of patients. Practical problems were encountered in 82.75% of patients. Family problems were encountered in 43.1% of patients. Most of the patients included in this study group were in the age group of 31 to 60 years. Conclusion: Patients with Breast cancer need support from cancer care treatment in every aspect. Screening plays an important tool to reduce the incidence of Breast cancer.
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Every orthodontists often appear to have conflicting treatment plans for the same patient. The reason is not that they see very different problems or have radically different philosophies of treatment, but rather that each doctor has a different line in the gray area between extractions and nonextraction. Two treatment plans that appear very different can both be based on a similar analysis of the patient’s problem, but end up with very different treatments due to the black and white nature of the decision making process.It is important to understand that in borderline cases there are no correct or right answers. Both treatments performed by competent orthodontists would produce a good result, but neither is perfect. Each option would have pros and cons, and orthodontists and dentists could (and do) spend endless amounts of time debating which option is “right”.
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BACKGROUND & OBJECTIVES: Oxidative stress occurs in association with painful exacerbations of chronic pancreatitis and antioxidant supplementation appears to benefit this condition. Curcumin, the active constituent of turmeric, is known to exhibit antioxidant activity. This pilot study was therefore undertaken to evaluate the effect of oral curcumin with piperine on the pain, and the markers of oxidative stress in patients with tropical pancreatitis (TP). METHODS: Twenty consecutive patients with tropical pancreatitis were randomised to receive 500 mg of curcumin with 5 mg of piperine, or placebo for 6 wk, and the effects on the pattern of pain, and on red blood cell levels of malonyldialdehyde (MDA) and glutathione (GSH) were assessed. RESULTS: There was a significant reduction in the erythrocyte MDA levels following curcumin therapy compared with placebo; with a significant increase in GSH levels. There was no corresponding improvement in pain. INTERPRETATION & CONCLUSION: Oral curcumin with piperine reversed lipid peroxidation in patients with tropical pancreatitis. Further studies with large sample are needed to define its effect on the pain and other manifestations of tropical pancreatitis.