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

{"title":"Nimesulide: Critical Appraisal of Safety and Efficacy in Acute Pain.","authors":"Mangesh Tiwaskar, Sushant Charde, Nikhil Balankhe, Ashok Hegde, Manish Deodhar, Ajitkumar Gondane, Dattatray Pawar, Akhilesh Sharma","doi":"10.59556/japi.73.0870","DOIUrl":"10.59556/japi.73.0870","url":null,"abstract":"<p><p>Nimesulide, a potent nonsteroidal anti-inflammatory drug (NSAID), has garnered attention for its distinct mechanism of action, characterized by its selective inhibition of cyclooxygenase-2 (COX-2) and multifaceted pharmacological properties. Extensive clinical evidence supports its safety and efficacy in addressing acute pain syndromes. In this comprehensive review, we undertake a thorough examination of various dimensions surrounding nimesulide, encompassing its historical evolution, intricate mode of action, pharmacokinetic attributes, clinical efficacy in managing acute pain, and notably its safety profile. The historical backdrop of nimesulide's development and evolution is explored, shedding light on the contextual framework of its emergence as a therapeutic agent. A detailed elucidation of its molecular mechanisms elucidates its preferential COX-2 inhibition and its impact on inflammatory pathways, providing insights into its efficacy in pain modulation. Furthermore, a comprehensive analysis of nimesulide's pharmacokinetic properties is provided, highlighting its absorption, distribution, metabolism, and excretion dynamics, which contribute to its clinical efficacy and safety profile. This review meticulously evaluates the clinical evidence supporting nimesulide's effectiveness in alleviating acute pain across various etiologies. Moreover, particular emphasis is placed on scrutinizing its safety profile, drawing comparisons with other NSAIDs. Through a critical synthesis of available data, nimesulide emerges as possessing a favorable safety profile, distinguishing itself from its counterparts in terms of gastrointestinal and cardiovascular tolerability. In conclusion, this review underscores the promising safety and efficacy profile of nimesulide in the management of acute pain, positioning it as a valuable therapeutic option. The positive benefit-to-risk evaluation further reinforces its utility in clinical practice, offering clinicians a well-founded choice for addressing acute pain syndromes effectively.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"e22-e28"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634751","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":"Clinical Phenotypes and Disease-specific Health-related Quality of Life in Patients of Chronic Obstructive Pulmonary Disease.","authors":"Rahul Verma, Devendra Kumar Singh, Sharad Bagri, Rahul Saxena, Syed Haider Mehdi Rizvi, Ajay Kumar Verma","doi":"10.59556/japi.73.0820","DOIUrl":"10.59556/japi.73.0820","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) is a common health issue globally and is expected to increase in the future. The latest Global Initiative for COPD (GOLD) guidelines describe the various phenotypes of COPD. This study assessed the different clinical phenotypes and disease-specific health-related quality of life (HRQoL) in patients with COPD.</p><p><strong>Materials and methods: </strong>A hospital-based cohort study was conducted among COPD patients of various phenotypes. All patients were evaluated through detailed history, clinical examination, complete blood count, and electrocardiogram (ECG) to fulfill the inclusion and exclusion criteria and categorized into different phenotypes: nonsmoker, nonexacerbator phenotype (NEP), exacerbator phenotype (EP), and asthma-COPD overlap (ACO). Following this, the participants were evaluated based on the modified Medical Research Council (mMRC) dyspnea scale and COPD assessment test (CAT) score to assess HRQoL at the beginning and after 3 months of standard treatment.</p><p><strong>Results: </strong>Among the 100 participants, the average age of the participants was 57.85 ± 6.78 years, with male predominance (62%). There was a significant difference in the CAT score and mMRC among the study groups. The CAT score was worst in the ACO group (22.68), with partial improvement (14.26) after 3 months of treatment, still being relatively lower than in other groups.</p><p><strong>Conclusion: </strong>Patients with ACO had significantly poorer HRQoL compared to those with NEP, EP, and nonsmokers. Hence, patients with ACO, NEP, and EP should be offered a different treatment approach, focusing on the components that exacerbated the symptoms.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"36-39"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634699","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":"Role of Meditation as Adjuvant Therapy on Gastrointestinal Quality of Life among Individuals with Functional Dyspepsia in an Outpatient Setting: A Randomized Pilot Trial.","authors":"Monika Pathania, Madhav Banjade, Meenakshi Khapre, Itish Patnaik, Divya Kanchibhotla, Minakshi Dhar","doi":"10.59556/japi.73.0859","DOIUrl":"10.59556/japi.73.0859","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Functional dyspepsia (FD) is one of the most common reasons for medical visits. Patients with FD incur large direct and indirect expenditures and may have significant financial burdens that affect quality of life. Our study aimed to assess the effectiveness of meditation as an adjuvant to the standard treatment in individuals diagnosed with FD. This will explore more cost-effective therapeutic management in diseases like FD, which is believed to be related to the gut-brain axis. Meditation is a nonpharmacological therapy, safer and economical, and its adjuvant use can minimize or avoid the adverse effects of long-term use of proton pump inhibitors (PPI) and tricyclic antidepressants (TCA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We wanted to comprehensively assess the role of meditation as an adjuvant therapy in patients with FD and compare it with the control arm receiving standard treatment alone. The primary objective was the change in gastrointestinal quality of life index (GIQLI) score, and the secondary objective was to assess the changes in the hospital anxiety and depression scale (HADS) score and Pittsburgh sleep quality index (PSQI) score before and after the intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients fulfilling the inclusion criteria were divided equally into two arms (experimental and control groups). The experimental group received standard treatment for dyspepsia (PPI, domperidone, TCAs) and Vaishvanara Agni meditation (VAM), while the control group received standard treatment alone. Both groups were compared at weeks 0, 4, and 8 in terms of change in GIQLI score, HADS (HADS-A and HADS-D score), and PSQI score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our study showed that both groups experienced significant changes in GIQLI, HADS-A, HADS-D, and PSQI scores at 4 and 8 weeks when compared with the baseline time point. However, when both groups were directly compared, it was observed that the experimental group exhibited notable variations in the GIQLI score after 8 weeks, the HADS-D score after 8 weeks, and the PSQI score after 4 weeks when contrasted with the control group. These differences were found to be statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;FD does not have an identified structural or biochemical cause, making it a functional gastrointestinal (GI) disorder that requires a tailored treatment approach. Our pilot randomized controlled trial (RCT) investigated the impact of meditation as adjuvant therapy for FD, revealing improvements in GI health, mental well-being, and sleep quality compared to standard treatment alone. The study recommends incorporating meditation into the management of FD and similar conditions, highlighting its holistic nature that addresses not only specific symptoms but also overall well-being. This study pioneers the examination of meditation as a complementary approach for FD, offering promising results in improving GIQLI, HADS, and PSQI scores and thus","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"30-35"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633636","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 Clinicoradiological and Bacteriological Profile of Community-acquired Pneumonia in a Tertiary Care Center in Eastern India.","authors":"Biswajit Hati, Debabani Biswas, Soumya Bhattacharjee, Atin Dey","doi":"10.59556/japi.73.0793","DOIUrl":"10.59556/japi.73.0793","url":null,"abstract":"<p><strong>Introduction: </strong>The world of microbes as a causative agent of community-acquired pneumonia (CAP) has been ever-changing with the emergence of new species, introduction of newer diagnostic techniques, availability of newer antibiotics and vaccines, and changing demographic profiles of patients as reported from different parts of the globe over time.</p><p><strong>Objective: </strong>The aim of the present study is to evaluate the clinicoradiological and bacteriological profile of CAP among patients admitted to a tertiary care hospital with special reference to the CURB-65 score and acute inflammatory markers.</p><p><strong>Materials and methods: </strong>It was a descriptive, observational, cross-sectional study conducted over a period of 18 months in the Department of Respiratory Medicine in a tertiary care hospital in the Indian subcontinent. Patients with features of lower respiratory tract infection of all age-groups and sexes were included in the study; immunocompromised patients, pregnant patients, patients with malignancy, active tuberculosis, and those who received antibiotics in the previous 90 days or were admitted to any other healthcare facility were excluded from the study. The study was conducted after obtaining Institutional Ethics Committee clearance and informed consent from study participants. The data obtained were analyzed by Statistical Package for the Social Sciences (SPSS) software and appropriate statistical tests.</p><p><strong>Results: </strong>A total of 100 patients with male predominance (63%), an average age of 47.61 ± 1.78 years, 33% current smokers, and with diabetes (27%) and hypertension (19%) as comorbid conditions were included in the study. <i>Klebsiella</i> and <i>Pseudomonas</i> sp. were among the most common isolates, closely followed by <i>Streptococcus pneumoniae</i> among the elderly population; whereas <i>S. pneumoniae</i> was the most common organism overall, and 48% showed no culture isolate.</p><p><strong>Conclusion: </strong>It is an absolute necessity to conduct several similar studies in the future among different patient demographics, localities, and practice settings, keeping in consideration the constantly changing microbiological profile over time and the introduction of new diagnostic and management modalities.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634622","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":"Biatrial Myxoma Twins with Acute Myocardial Infarction-A Malady of Rarities!","authors":"Gagan Jain, Harpreet Singh Minhas, Shyamveer Singh Khangrot, Bhagya Narayan Pandit","doi":"10.59556/japi.73.0862","DOIUrl":"10.59556/japi.73.0862","url":null,"abstract":"<p><p>We describe a young male patient who suffered myocardial infarction and was discovered to have a biatrial myxoma where stalks originated from opposite sides at the same point of the atrial septum, also described as \"myxoma twins\". The rarity of having a biatrial mirror image myxoma among cardiac myxomas, complicated by an even rarer event of coronary embolism in such milieu, prompted us to present the following case report.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"96-98"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634678","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":"Enzymes and Virus Protein Pioneers.","authors":"J V Pai-Dhungat","doi":"10.59556/japi.73.0867","DOIUrl":"10.59556/japi.73.0867","url":null,"abstract":"<p><p>Eduard Buchner (1860-1917) proved that biochemical processes do not necessarily require living cells but are driven by special catalyst substances. He called the catalyst substance enzyme zymase (Nobel Prize 1907).</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"106"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634716","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":"Nonconvulsive Status Epilepticus in a Patient with Dengue Fever.","authors":"Pradipkumar Patel, Abhishek Thakkar, Vipul Khandelwal, Vipin Ola, Dev Kumar Jain","doi":"10.59556/japi.73.0883","DOIUrl":"10.59556/japi.73.0883","url":null,"abstract":"<p><p>Dengue fever is an infectious disease transmitted by mosquitoes and caused by the flavivirus. Dengue fever is endemic in tropical and subtropical areas of the world. The clinical presentation of dengue varies from being asymptomatic to developing severe complications such as dengue hemorrhagic fever, dengue shock syndrome, and dengue-expanded syndrome. Unlike most arboviral infections, neurological symptoms are not typically associated with the dengue virus, rarely causing neurological dysfunction with encephalitis and seizures. Here, we report a case of a 26-year-old patient who presented with altered mental status and pyrexia, eventually diagnosed with dengue encephalitis with nonconvulsive status epilepticus, which is very uncommon for dengue-expanded syndrome. Our case proves that in some cases, the early signs of infection may be mild, even when there is direct involvement of the central nervous system, leading to diagnostic challenges.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"e37-e38"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634769","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":"Clinical Spectrum and Therapeutic Outcome of Myasthenia Gravis in a Tertiary Care Hospital: A Retrospective Study.","authors":"Sujaya Raghavendra, Jawahar Marimuthu, Daisy Precilla Senthilathiban, Balasubramanian Samivel","doi":"10.59556/japi.73.0843","DOIUrl":"10.59556/japi.73.0843","url":null,"abstract":"<p><strong>Introduction: </strong>Myasthenia gravis (MG) is characterized by defective transmission of electric impulses across the neuromuscular junction. To date, there is a lack of real-world data to understand its management, specifically in the Indian context. To bridge this gap in clinical knowledge, the current study was designed to understand the clinical management of MG in the Indian population.</p><p><strong>Materials and methods: </strong>This retrospective study included clinical data of MG patients at Madras Medical College, Chennai (2021-2023). Patients were assessed for demographics, clinical characteristics, therapeutic interventions, and clinical outcome. Statistical analysis was performed using GraphPad Prism v.8.0.1.</p><p><strong>Results: </strong>A total of 49 MG cases were observed, and 14 patients presented with myasthenic crisis (MC). Young onset was observed in 26 cases. Clinical features included ptosis (90%), diplopia (90%), bulbar symptoms (60%), and respiratory illness (19.2%). Bedside tests depicted a decremental response to repetitive nerve stimulation (RNS) (93.8%), acetylcholine receptor (AChR) antibody positivity (45%), and MUSK Ab positivity (3.8%). Treatment comprised intravenous immunoglobulin (IVIG) (10.79%), plasmapheresis (PLEX) for impending crisis or thymoma (3.5%), and combination therapy using acetylcholine esterase inhibitors with immunomodulators (63.26%). Mortality was observed in 4 cases (8.1%), while the remaining 45 MG patients (91.84%) exhibited stable vitals with a median hospital stay of 14 days. Thymectomy had potentially reduced the risk of crisis.</p><p><strong>Discussion and conclusion: </strong>Early detection of MG can prevent the onset of crisis. Electrophysiological studies were crucial in the diagnosis of atypical cases. Rituximab successfully normalized bulbar and respiratory functions in PLEX/IVIG-resistant patients, enhancing crisis response. Combining AChE inhibitors with immunomodulators ensured good drug compliance and, thereby, reduced the risk of crisis and enabled effective management of MG. Centric studies like this may serve as reference points for designing more extensive studies on MG involving multiple centers nationwide.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"40-49"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634704","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":"Pulse Corticosteroid Therapy and Bradycardia.","authors":"Bishakha Swain, Sandeep Yadav, Girija Sachdev, Aditi Sanjiv Patankar, Rohini Satish Samant, Canchi Balakrishnan","doi":"10.59556/japi.73.0868","DOIUrl":"https://doi.org/10.59556/japi.73.0868","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"109-110"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633621","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":"Why Medical Doctors Hesitate to Write for Scientific Journals?","authors":"Abhijit A Trailokya","doi":"10.59556/japi.73.0857","DOIUrl":"https://doi.org/10.59556/japi.73.0857","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"108-109"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634493","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}