The Journal of the Association of Physicians of India最新文献

{"title":"Imeglimin in Type 2 Diabetes Mellitus: Expert Opinions and Consensus in Indian Context.","authors":"Krishna G Seshadri, Viswanathan Mohan, Subhash K Wangnoo, Aravind Sosale, Banshi Saboo, Rakesh Kumar Sahay, Subhadra Polisetti, Vamsi Krishna Kolukula","doi":"10.59556/japi.73.0938","DOIUrl":"https://doi.org/10.59556/japi.73.0938","url":null,"abstract":"<p><strong>Introduction: </strong>The morbidity of type 2 diabetes mellitus (T2DM) is rising dramatically both at the national and international levels. In recent years, many novel medications are developed or in development for better management of hyperglycemia in people with T2DM. Focusing on the new promising molecules, here we aim to present the opinion of experts and their consensus on the use of imeglimin for the treatment of T2DM in India.</p><p><strong>Methods: </strong>Multiple advisory board meetings were conducted with six leading key opinion leaders (KOLs) in endocrinology and diabetes specialty across India to share their experiences, understand and discuss the real-world imeglimin treatment strategies, its effectiveness and safety in patients with T2DM.</p><p><strong>Discussion: </strong>A novel oral antidiabetic drug (ADD), imeglimin, a tetrahydrotriazine compound of the \"glimin\" family, is currently being used in the treatment of T2DM. Its mode of action is unique when compared to other types of ADDs as it has a dual mode of action, which includes (1) improving the action of insulin and (2) reversing pancreatic β-cell dysfunction. Additionally, imeglimin has been associated with reduced hepatic steatosis, protection from β-cell apoptosis and stimulation of skeletal muscle glucose absorption. Efficacy and safety of imeglimin as a monotherapy is well demonstrated in treatment-naive patients when metformin is contraindicated or in patients who are intolerant to metformin, metformin failure, or as an add-on/combination with other oral antidiabetic drugs (OADs), mainly DPP4i, SGLT2i or insulin. The clinical efficacy of imeglimin is dose dependent, and it is observed that the efficacy of imeglimin 1,000 mg BID is >500 mg BID.</p><p><strong>Conclusion: </strong>This consensus paper presents the experts' opinion of their real-world clinical experiences on imeglimin treatment, its clinical efficacy, safety and their recommendations for better management of T2DM.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6","pages":"e15-e22"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485831","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}

{"title":"Letter to Editor in Response to Article \"Peak Inspiratory Flow Rate as a Prerequisite for Prescription of Inhaler Devices: A Cross-sectional Study.\" J Assoc Physicians India 2024;72(12):27-29.","authors":"Brahmansh Singh, K P Shaily, Madhu S Barthwal","doi":"10.59556/japi.73.0997","DOIUrl":"https://doi.org/10.59556/japi.73.0997","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6","pages":"99"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485833","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}

{"title":"Restriction Enzymes-Molecular Scissors.","authors":"Jayant Pai-Dhungat","doi":"10.59556/japi.73.1011","DOIUrl":"https://doi.org/10.59556/japi.73.1011","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6","pages":"98"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485837","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}

{"title":"Multisystemic Manifestations of Systemic Lupus Erythematosus: A Diagnostic Challenge.","authors":"Vishnu Sharma, Abhishek Jhajharia, Naman Modi, Sidharth Mahajan, Vansh Bagrodia","doi":"10.59556/japi.73.0908","DOIUrl":"https://doi.org/10.59556/japi.73.0908","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) stands as a complex autoimmune disorder renowned for its diverse clinical manifestations that intricately involve various organ systems. Within this context, we present a compelling case study featuring a 24-year-old female patient, unraveling a sequence of captivating events culminating in her diagnosis of SLE. Her medical journey commenced with a diagnosis of hypothyroidism, which later paved the way for a succession of intriguing incidents, including central retinal artery occlusion (CRAO), bilateral avascular necrosis (AVN)-all transpiring without the use of steroids-and subsequently, secondary immune thrombocytopenic purpura (ITP). These events spanned a period of 7 years, finally prompting extensive investigations to uncover a potential rheumatological link. Ultimately, the patient was diagnosed with SLE, revealing the classic multisystemic involvement characteristic of the disorder, even encompassing the occurrence of bilateral AVN without steroid usage.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6","pages":"e33-e34"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485836","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}

{"title":"<i>Salmonella</i> Typhi Septic Arthritis: A Case Report in an Immunocompetent Adult.","authors":"Jay Mukesh Vashisth, Sanjay Wagle, Ritik Wadhwani, Snehal Chouhan","doi":"10.59556/japi.73.0919","DOIUrl":"10.59556/japi.73.0919","url":null,"abstract":"<p><p><i>Salmonella</i> Typhi species is known to cause acute gastroenteritis, ileitis, bacteremia, and fever. This is a case of an immunocompetent adult in her early twenties who presented with complaints of high-grade fever, pain in the epigastrium, and left-sided hip pain with difficulty in walking. Since this patient was immunocompetent, the unique feature in her history was fasting (religious) for approximately 3 weeks. She consumed mainly liquids (water), which may have made her susceptible to infections. Septic arthritis being an emergency, an orthopedic opinion was taken. The routine investigations revealed leukocytosis with deranged liver profile. Blood culture revealed growth of <i>Salmonella</i> Typhi. The patient was started on ceftriaxone 2 gm intravenous (IV) every 12 hours, to which she responded and made remarkable recovery, thus avoiding surgical intervention.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6","pages":"e25-e26"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485790","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}

{"title":"Prevalence and Clinical Characteristics of Acute Cough in Indian Adults and Elderly Population: A Retrospective Real-world Study.","authors":"Surinder Kumar Jindal, Agam Vora, Priti Thakor, Harshad Malve, Roshni Panchal","doi":"10.59556/japi.73.1025","DOIUrl":"https://doi.org/10.59556/japi.73.1025","url":null,"abstract":"<p><strong>Introduction: </strong>Acute cough is a common symptom reflecting the body's protective reflex and is associated with many ailments beyond respiratory conditions. This study aims to assess the prevalence of acute cough, including its categorization, associated complaints, and conditions in adult and elderly patients in real-world settings in India.</p><p><strong>Methodology: </strong>A retrospective analysis of electronic medical records (EMRs) was conducted to evaluate the prevalence and clinical features of acute cough in adult and elderly patients.</p><p><strong>Results: </strong>Of 22,51,735 patients with cough complaints in the EMR, 64.06% were adults (18-65 years) and 10.39% were elderly patients (>65 years). Among the adult patients with cough complaints, nonproductive cough was prevalent in a higher proportion (16.34%) than productive cough (12.62%). Additionally, in 71.04% of adults, cough was not categorized and marked as unspecified cough. While in the geriatric population, productive cough (18.78%) was more common than nonproductive cough (14.80%). In 66.42% of geriatric patients, cough remained unspecified. A higher proportion of adult and geriatric patients visited consulting physicians (CPs) and general physicians (GPs). Respiratory tract infection (RTI) was the most frequently associated condition, followed by asthma, bronchitis, and other ailments. Fever and cold were common complaints among patients with both productive and nonproductive cough. This study underscores the substantial prevalence of acute cough in adults and the elderly population and the need for targeted strategies to manage it effectively.</p><p><strong>Conclusion: </strong>While cough categorization will help in symptom-targeted management approach for productive or nonproductive cough, the majority of cough patients are not yet categorized and are referred to as unspecified cough. This challenge persists irrespective of specialty of the doctors with a direct impact on patient outcomes.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6S","pages":"14-21"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485843","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}

{"title":"A Rare Case of HLA-B51 Positive MAGIC Syndrome: A Clinical Conundrum.","authors":"M N Arvind, Avinash Hannabe Rajanna, Ramesh Teli, Nagaraja Kamath","doi":"10.59556/japi.73.0917","DOIUrl":"10.59556/japi.73.0917","url":null,"abstract":"<p><p>The term mouth and genital ulcers with inflamed cartilage (MAGIC) syndrome was initially dubbed by Firestein et al. in 1985. He described five patients with clinical manifestations of Behcet's disease (BD) as well as relapsing polychondritis (RP), putting forward the terminology MAGIC syndrome to describe the overlap of the two diseases. Thereafter, not many cases have been documented in the literature. In our case, a 20-year-old male fulfilled the criteria for BD as well as RP and was diagnosed with MAGIC syndrome. Human leukocyte antigen (HLA) typing showed HLA-B51 positivity. He was effectively treated with oral colchicine and oral prednisolone. The patient's symptoms recovered gradually, and prednisolone was tapered and stopped. The exact pathophysiology behind MAGIC syndrome is still unestablished, and the number of cases reported is not sufficient enough to indicate an apparent explanation. Hence, accretion of additional cases and supplementary research is required to enhance the comprehension of MAGIC syndrome.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6","pages":"e27-e29"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485793","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}

{"title":"Brown Tumor of Hyperparathyroidism Presenting as Mandibular Mass.","authors":"Shrikant Solav, Shailendra Savale, Rajlaxmi Jagtap, Aman S Solav","doi":"10.59556/japi.73.0920","DOIUrl":"10.59556/japi.73.0920","url":null,"abstract":"<p><p>Mandibular tumors could be benign or malignant. Benign lesions could be cystic or solid. Examples of benign solid lesions are ameloblastoma, odontoma, and ossifying fibroma. Periapical cysts, follicular cysts, and odontogenic keratocysts are a few benign cystic lesions. Hemangioma, neurofibroma, giant cell granuloma, and metabolic bone disease are additional lesions to be considered in the differential diagnosis. An important uncommon cause of a mandibular mass is a Brown tumor secondary to primary hyperparathyroidism. Presented here is a case of a mandibular mass secondary to primary hyperparathyroidism.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6","pages":"e23-e24"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485820","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}

{"title":"Preface.","authors":"Mangesh Tiwaskar, Agam Vora","doi":"10.59556/japi.73.1032","DOIUrl":"https://doi.org/10.59556/japi.73.1032","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6S","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485842","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}

{"title":"<i>Rothia mucilaginosa:</i> A Surprising Culprit of Pneumonia in an Absolute Immunocompetent Patient.","authors":"Sujal R Agarwal, Abhinandan Jangid, Shashikala T Surkunda, Arjun N Ballal, Weena Stanley","doi":"10.59556/japi.73.1017","DOIUrl":"https://doi.org/10.59556/japi.73.1017","url":null,"abstract":"<p><strong>Introduction: </strong><i>Rothia mucilaginosa,</i> a gram-positive coccus and typical resident of the oropharyngeal and upper respiratory system, has increasingly been recognized as a human pathogen since its first identification in 1978. While it commonly affects immunocompromised individuals, causing serious infections like endocarditis, septicemia, and pneumonia, infection in immunocompetent hosts is rare. This article presents a case of pneumonia caused by <i>R. mucilaginosa</i> in an immunocompetent individual.</p><p><strong>Case description: </strong>A 42-year-old male with no significant medical history presented with a persistent cough and high-grade fever. Investigations revealed elevated neutrophils, C-reactive protein (CRP), and high-resolution computed tomography (HRCT) thorax indicating multifocal consolidation. Empirical management with piperacillin-tazobactam and clindamycin was ineffective, leading to a switch to meropenem-sulbactam. Bronchoalveolar lavage (BAL) identified <i>R. mucilaginosa,</i> prompting cotrimoxazole therapy. The patient's fever subsided, and inflammatory markers decreased. After a 2-week course and follow-up, the patient exhibited no symptoms or recurrence of infection and remained stable.</p><p><strong>Discussion: </strong><i>R. mucilaginosa</i> primarily affects immunocompromised individuals or those with underlying comorbidities. Diagnosis requires careful specimen collection and identification techniques. Treatment is challenging due to variable antibiotic susceptibility, with vancomycin, third-generation cephalosporins, and rifampicin often used. The pathogen's ability to cause pneumonia in healthy individuals without comorbidities remains unreported. Underreporting due to misidentification and the need for awareness among clinicians are significant concerns in managing <i>R. mucilaginosa</i> infections.</p><p><strong>Conclusion: </strong>R. mucilaginosa is a significant pathogen causing pneumonia in diverse patient groups. Without formal treatment guidelines, diagnosis relies on clinical experience. Early detection and appropriate antibiotic therapy are crucial for effective management.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 6","pages":"82-84"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485789","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}