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

{"title":"A Clinical Study to Evaluate the Anti-inflammatory Effect of Lactoferrin + Disodium Guanosine Monophosphate Therapy in the Patients with Chronic Kidney Disease.","authors":"Rajkanwar Yadav, Sukhwinder Singh Sangha, Sushma Yadav, Preeti Sharma, Harsh Shah, Dipankar Bhowmik","doi":"10.59556/japi.73.0757","DOIUrl":"https://doi.org/10.59556/japi.73.0757","url":null,"abstract":"<p><strong>Introduction: </strong>India is impacted by the increasing burden of chronic kidney disease (CKD) and end-stage renal disease (ESRD), necessitating efficient management and therapy. CKD is characterized by elevated levels of inflammatory biomarkers, specifically IL-1β, IL-1RA, IL-6, TNF-α, TGF-β, and fibrinogen. The aim of this research is to determine the antiinflammatory effects of lactoferrin + disodium guanosine monophosphate therapy in CKD patients. The objective of this study is to examine the efficacy of this therapy versus conservative CKD management alone in reducing inflammation. This study intends to examine the possible benefits of study drug in treating inflammation associated with CKD by analyzing its effect on inflammatory markers including IL-6 and TNF-α.</p><p><strong>Methods: </strong>This randomized, open-label, parallel group, two-arm clinical study, comprising of 40 patients with CKD, with 20 patients in each group. The groups were well-matched in terms of demographic characteristics. Conception, screening, randomization, and follow-up visits including physical examinations, laboratory investigations, and medication dispensation were all carried out over a 29-week period. Creatinine clearance, estimated glomerular filtration rate (eGFR), estimated urine urea nitrogen, and inflammatory markers (IL-6, IL-10, TNF-α, CRP) were analyzed at time of screening and at 3 and 6-month postrandomization.</p><p><strong>Results: </strong>The study found a significant decrease in inflammatory markers, including TNF-α, IL-6, and IL-10, in the group receiving study drug, indicating its potential as an antiinflammatory intervention for managing CKD. Secondary endpoints, including hemoglobin (Hb) and e-GFR levels, showed nonsignificant improvements in the study group compared to the control group. No significant adverse events were reported during the study.</p><p><strong>Conclusion: </strong>The study highlights the potential antiinflammatory effects of the lactoferrin + disodium guanosine monophosphate therapy in individuals with CKD. The findings suggest that study drug may be a viable intervention for managing inflammation in CKD patients. Further research is needed to validate these results and explore its long-term effects in CKD management.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075469","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":"Advancing Diabetes Equity through Health Policy Advocacy.","authors":"Neelesh Kapoor, Amit Gupta","doi":"10.59556/japi.73.0794","DOIUrl":"https://doi.org/10.59556/japi.73.0794","url":null,"abstract":"<p><p>As per International Diabetes Federation estimates, the world diabetic population is expected to reach 643 million by 2030 and 783 million by 2045.¹ The global rise in diabetes cases has underscored the urgent need to address the inequities that persist in diabetes care. As per the World Health Organization, \"health equity\" has been defined as \"the absence of unfair, avoidable, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, geographically, or by other dimensions of inequality (e.g., sex, gender, ethnicity, disability, or sexual orientation).\"².</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"11-12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075481","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":"Erdosteine: Reigniting a Thiol Mucolytic for Management of Chronic Obstructive Pulmonary Disease.","authors":"Agam Vora, Mangesh Tiwaskar, Charmy Prajapati, Anooja Jose, Amit Qamra, Parthasarathy Muralidharan","doi":"10.59556/japi.73.0810","DOIUrl":"https://doi.org/10.59556/japi.73.0810","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a major health burden globally and in India. Oxidative stress plays a pivotal role in the pathogenesis of COPD, causing mucus hypersecretion, bronchoconstriction, and accelerated lung function decline. An important class of pharmacological agents that are often less discussed are the thiol mucolytic agents, which have a two-pronged effect of serving as both a mucolytic and an antioxidant. One of these agents which has reignited interest lately is erdosteine, with recent evidence demonstrating advantages over traditionally used N-acetylcysteine. In this review, we have summarized the key available evidence for the role of erdosteine in COPD, with takeaways on its place in therapy.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075428","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":"Lest We Miss Hansen Arthritis: Case Series of Combo Articular Manifestations; One of Acute Lepra Reaction with Chronic Arthritis, and Another of Swollen Feet and Hand Syndrome besides Acute Lepra with Chronic Arthritis.","authors":"Poonam Gupta, Ajeet Kumar Chaurasia, Ashish Kumar Gautam","doi":"10.59556/japi.73.0753","DOIUrl":"https://doi.org/10.59556/japi.73.0753","url":null,"abstract":"<p><p>Hansen's disease is an infectious granulomatous disease with classical cutaneous and neurological profile and varied musculoskeletal manifestations. Poor awareness and low specificity of symptoms lead to a delay in the diagnosis of a treatable disease, culminating in worsening morbidity. A rare case series of Hansen's arthritis, showing complex, diverse, and rare combinations of musculoskeletal manifestations of acute lepra reaction over chronic arthritis, besides cutaneous and neurological manifestations, must be understood for early diagnosis and treatment to avoid debilitating complications.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"90-92"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075431","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>Cyclospora cayetanensis</i> or <i>Clostridium difficile:</i> Who Caused the Diarrhea?","authors":"Shashwat Mallik, Aayushi J Rajani, Shahin Khan, Juhi Amin, Vaishnavi Rathod, Darshankumar M Raval","doi":"10.59556/japi.73.0802","DOIUrl":"https://doi.org/10.59556/japi.73.0802","url":null,"abstract":"<p><p>Cyclospora cayetanensis, a parasite causing human enteritis, has been rarely reported from healthcare laboratories despite its universal presence. While it is usually responsible for self-limiting diarrhea in immunocompetent individuals, we present a case where the patient suffered from severe, unrelenting diarrhea despite having no obvious immune defects. Additionally, there was no history of international travel or consumption of outside food or water. A week after testing positive only for Cyclospora, the patient tested positive for Clostridium difficile as well, and her diarrhea showed no signs of improvement. This posed a dilemma for the clinicians, as the patient was suffering from diarrhea even when she had tested negative for C. difficile, but she recovered only when fidaxomicin was prescribed. To add to the perplexion, Cyclospora remained positive in her stool even after the completion of the prescribed treatment. Several hypotheses have been derived from this unusual case, and the most probable one seems to be a case of coinfection; however, such a coinfection has never been reported in the literature. This case report serves as a unique opportunity to explore the possible mechanisms that may have led to this condition.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"e24-e26"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075464","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":"An Uncommon Etiology of Photographic Negative of Pulmonary Edema in an Undifferentiated Connective Tissue Disorder Patient.","authors":"Priyanka Singh, Amit S Vasan, Kunal Kumar, Robin Chaudhary, Sandeep Rana, Arun Hegde","doi":"10.59556/japi.73.0801","DOIUrl":"https://doi.org/10.59556/japi.73.0801","url":null,"abstract":"<p><p>The gamut of connective tissue disorders (CTDs) is vast. In addition to involvement of the rheumatological system, other organs like the renal and pulmonary systems are frequently affected in CTDs over the course of illness. The involvement of the pulmonary system commonly includes interstitial lung disease (ILD) and infections, mainly due to immunosuppression. A chest radiograph is the basic investigation done in these patients. Some radiographic patterns have typically been attributed to specific diagnoses and etiologies. Here, we discuss a 40-year-old woman's case with undifferentiated connective tissue disease (UCTD) having a classic imaging picture of a photographic negative of pulmonary edema. However, despite a classic textbook radiographic picture suggesting an inflammatory condition of the lung, a final diagnosis of malignancy was reached on biopsy.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"93-95"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075486","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>Cladophialophora bantiana</i> Brain Abscess in an Immunocompetent Host: A Diagnostic Challenge.","authors":"Rahul Kumar, Pooja Khosla, Vinus Taneja, Rishikesh Dessai, Sunila Jain, Manuj Sondhi","doi":"10.59556/japi.73.0812","DOIUrl":"https://doi.org/10.59556/japi.73.0812","url":null,"abstract":"<p><p>Cladophialophora bantiana has been identified as one of the most common causes of cerebral pheohyphomycosis. While intrafungal cerebral abscesses are historically known to be associated with immunocompromised patients, C. bantiana has a specific predilection for immunocompetent hosts. Successful treatment is based on accurate microbiological and histopathological diagnosis as well as the initiation of targeted antifungal treatment. We hereby report a case of a 64-year-old male who presented with atypical chest pain for 1 day, pain in both lower limbs, and blackish discoloration of the left foot. He also had left foot drop for 1 month. During his hospital stay, he developed a lower respiratory tract infection, was diagnosed with polycythemia vera, and later developed severe headache and dizziness. He was found to have a space-occupying lesion in the cerebellum and a pulmonary nodule. He was started on antitubercular therapy based on a lung biopsy suggestive of necrotizing granulomatous inflammation. However, the patient's sensorium kept worsening, and he was intubated. The fever persisted, and he had episodes of upper and lower gastrointestinal (GI) bleed. His sensorium continued to worsen. Autoimmune and immunodeficiency workups were inconclusive. Repeat imaging suggested an increase in the size of the lesions. Suboccipital craniectomy was performed and showed the growth of C. bantiana.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"73-76"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075461","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":"Spontaneous Cervical Epidural Hematoma: A Case Report.","authors":"Arun Bahulikar, Siddharth Damle, Sushil Patkar, Deepak Phalgune","doi":"10.59556/japi.73.0800","DOIUrl":"https://doi.org/10.59556/japi.73.0800","url":null,"abstract":"<p><p>An acute spinal cord compression can very rarely cause a spinal epidural hematoma. The functional recovery will be the highest if early detection and prompt surgical management are undertaken. The conservative management was successful in the present case of the cervical epidural hematoma with lesser neurodeficits and smaller hematoma size with minimal cord compression. The patient had no neurodeficit at the end of 7 days.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"63-65"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075490","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":"Integrated Phenotypic and Endotypic Assessment: A Need for Precision Medicine in Asthma Management.","authors":"Ajay Kumar Verma, Shreya Tripathi, Arpita Singh, Jyoti Bajpai, Surya Kant","doi":"10.59556/japi.73.0808","DOIUrl":"https://doi.org/10.59556/japi.73.0808","url":null,"abstract":"<p><p>Asthma is a long-term, persistent disease characterized by inflammation in the lower airways. Patients with asthma can be of any age, from young children to elderly people, and present with various clinical manifestations such as chest tightness, wheezing, coughing, and difficulty in breathing. Distinguishing these variations is essential for the personalized and adequate management of the disease. Based on the factors that trigger asthma attacks, the duration of the illness, or the prognosis, clinicians have worked to categorize asthma into various phenotypes. Different pathobiological mechanisms can lead to similar symptoms but might be applicable to different phenotypes. These apparent pathways are referred to as endotypes, which are introduced to understand the complex pathophysiological mechanisms of asthma. Endotypes can be Th2 high or Th2 low, depending on the level of Th2 cells involved in the pathogenesis of the disease. There is a need to discuss various clinical presentations of asthma in the form of \"phenotypes\" and its complex pathomechanisms represented as \"endotypes.\" Here, in this article, we have reviewed some research articles and literature based on various observable and intrinsic characteristics related to asthma. The present status of asthma classification has been outlined to better understand the disease and its precision treatment.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"41-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075430","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":"Two Concerns and A Single Solution in Managing Type 2 Diabetes: A Narrative Review on Imeglimin.","authors":"Shambo Samrat Samajdar, Kaushik Biswas, Mohan Shenoy, Shatavisa Mukherjee, Bharat Saboo, Rutul A Gokalani, Shashank R Joshi, Jyotirmoy Pal","doi":"10.59556/japi.73.0795","DOIUrl":"https://doi.org/10.59556/japi.73.0795","url":null,"abstract":"<p><p>Type 2 diabetes (T2D) presents a formidable challenge to healthcare, with rising prevalence and complex pathogenesis involving beta-cell dysfunction and insulin resistance. Imeglimin, the progenitor of the \"glimins\" class, emerges as a multifaceted agent capable of attenuating beta-cell apoptosis, reducing hepatic gluconeogenesis, and augmenting muscular glucose uptake. This positions it as a promising solution for T2D management, especially for patients inadequately controlled by current therapies. This narrative review delves into the potential of imeglimin to address the mitochondrial dysfunctions central to T2D pathology, offering insights into its distinct mechanism that leverages the modulation of mitochondrial bioenergetics to enhance insulin sensitivity and reduce oxidative stress. The Trials of Imeglimin for Efficacy and Safety (TIMES) program, consisting of multiple clinical trials, has substantiated the efficacy and safety of imeglimin, illustrating significant glycated hemoglobin (HbA1c) reductions and favorable safety profiles. This review synthesizes evidence from these trials, providing a comprehensive overview of imeglimin as a novel monotherapy and its compatibility in combination therapies, heralding a novel approach to T2D treatment that targets the disease's mitochondrial roots.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 1","pages":"e14-e20"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075453","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}