Penile strangulation by a metal ring

Penile strangulation due to the metallic ring is an uncommon clinical entity that requires urgent attention to prevent irreversible nerve damage, and if neglected gangrene of the penis. Various methods have been described in the literature for removing constricting foreign bodies, but there is no consensus regarding an acceptable technique. We report the case of a 51-year-old man with a history of a metal ring used for sexual pleasure lodged over the shaft of his penis with an inability to remove the same.

​Efficacy Of Teneligliptin As Add-On Therapy In Patients With Type 2 Diabetes Mellitus And Chronic Kidney Disease: A Real-World Experience

Introduction: Type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD) is dreadful combination necessitatingadequate glycemic control to prevent further complications. Teneligliptin is found to be renal friendly antidiabetic agent whichcan provide effective glycemic control.Objective: The objective of this study was to determine the efficacy of teneligliptin as add-on to existing therapy in patients ofT2DM with CKD.Materials and Methods: This was a retrospective study where patients with T2DM and CKD who received teneligliptin wereincluded in the study. Changes in glycemic parameters such as hemoglobin A1c (HbA1c) (%), fasting plasma glucose (FPG),and postprandial plasma glucose (PPG) and change in estimated glomerular filtration rate (eGFR) were analyzed.Results: In total, 66 patients were included in analysis. Mean age was 57.7 ± 14.0 years and 60.6% were males. BaselineHbA1c, FPG, and PPG levels were 7.8 ± 0.7%, 128.0 ± 25.5 mg/dl, and 214.0 ± 55.9 mg/dl, respectively. There was a significantreduction in HbA1c at 3 and 6 months (mean difference from baseline: −0.9 ± 0.5 and −1.2 ± 0.5 respectively, P < 0.001 forboth). Similarly, mean change in FPG (−28.4 ± 20.9 and −29.9 ± 24.3 mg/dl, respectively) and PPG (−70.5 ± 49.2 and −97.0 ±60.7 mg/dl, respectively) was also significant (P < 0.001 for all comparisons). The change in eGFR was significant at 3 months(P = 0.049) and 6 months (P = 0.014).Conclusion: Teneligliptin is effective in reducing glycemic burden in patients with T2DM and CKD and can be considered asbe considered among first choices for glycemic control in patients with renal impairment.

Prevalence Study of Vitamin D Deficiency and to Evaluate the Efficacy of Vitamin D3 Granules 60,000 IU Supplementation in Vitamin D Deficient Apparently Healthy Adults.

Objective: The objective of this study was to assess the prevalence of vitamin D deficiency in apparently healthy urban adults and to evaluate the efficacy of vitamin D3 granules 60,000 IU supplementation in increasing serum 25 hydroxyvitamin D [25(OH)D] levels. Material and methods: Healthy adults in an urban hospital were screened for 25(OH)D (radioimmunoassay method). Those found to be deficient or insufficient in vitamin D (defined as 25(OH)D <30 ng/ml) were supplemented with oral cholecalciferol granules 60,000 IU/week for eight weeks. Serum 25(OH)D level was estimated at the end of 60 days. Results: A total of 510 subjects (age 19-66 years) were enrolled for the study. Baseline data was available for 474 subjects and 178 subjects consumed a total of eight sachets as per the study protocol. Of these 178 subjects, 94.94% subjects were found to be vitamin D deficient (<20 ng/ml) and the mean plasma vitamin D3 25(OH)D level was 9.36 ng/ml (±5.19) at baseline. At the end of the study, the mean 25(OH)D plasma level was noted to be 29.28 ng/ml (±13.57). The mean change from baseline was 19.92 ng/ml (±13.25). Among these 178 participants only 5.06% had 25(OH)D >20 ng/ml at baseline, which increased to 78.09% at the end of the study following vitamin D3 supplementation for eight weeks. Conclusion: This study showed that vitamin D deficiency is highly prevalent in the urban healthy adult population. Eight weeks of vitamin D3 60,000 IU/week oral granules supplementation increased serum 25(OH)D to optimal levels.