International Journal of Medical Research and Review <p><em><strong>ISSN: <a href="" target="_blank" rel="noopener">2320-8686 (Online)</a>, <a href="" target="_blank" rel="noopener">2321-127X (Print)</a></strong></em></p> en-US (Mr Daulat Ram) (Mr Daulat Ram) Thu, 29 Feb 2024 00:00:00 +0000 OJS 60 Expert opinion on the clinical approach of using sodium glucose cotransporter-2 inhibitors for managing diabetic patients with cardiovascular and renal complications in Indian settings <p><strong>Objective: </strong>To evaluate the prescription practice of sodium-glucose co-transporter-2 (SGLT2) inhibitors with a special focus on dapagliflozin to treat cardiac and renal disorders in obese Indian diabetic patients.</p> <p><strong>Methods: </strong>A cross-sectional, questionnaire based study was conducted to collect the perspectives among physicians with expertise in treating diabetic obese patients with cardiac and renal disorders in endocrinology across India between June 2022 and December 2022. Descriptive statistics were used to summarize the characteristics of the study by employing frequencies and percentages.</p> <p><strong>Results:</strong> Among the 1,446 survey participants, 80% of them indicated that young diabetic patients with obesity, and obese patients with cardio-renal complications may require SGLT2 inhibitors. Furthermore, patients aged between 41-50 and 51-60 years also required SGLT2 inhibitors for diabetes management according to 57% and 27% of the respondents. The majority of the respondents (91.29% and 90.53%) recommended dapagliflozin as the best SGLT2 inhibitor for treating patients with chronic kidney disease and heart failure. Additionally, about 59% and 66% of the experts indicated that patients would experience an average weight loss of 2-3 kilograms and an average blood pressure reduction of 3-6 mm Hg after 12 weeks of treatment with dapagliflozin, respectively.</p> <p><strong>Conclusion: </strong>Experts recommend the use of SGLT2 inhibitors for the treatment of young diabetic patients with obesity and obese subjects with cardiorenal complications. Dapagliflozin monotherapy was preferred for patients with chronic kidney disease and heart failure. Furthermore, experts highly recommend the combinations of dapagliflozin + metformin and DPP4 inhibitors + metformin + dapagliflozin for effective diabetes management</p> Manjula S Copyright (c) 2024 Author (s). Published by Siddharth Health Research and Social Welfare Society Tue, 20 Feb 2024 00:00:00 +0000 4Dimensional XStrain Echocardiography assessment of Left Bundle Branch Cardiomyopathy in an elderly male : A case report <p>Left bundle branch block (LBBB) is generally associated with a poorer prognosis in comparison to normal intraventricular conduction. LBBB may be the first manifestation of a more diffuse myocardial disease. The typical surface ECG feature of LBBB is a prolongation of QRS above 0.11s in combination with a delay of the intrinsic deflection in leads V5 and V6 of more than 60 ms and no septal q waves in leads I, V5, and V6 due to the abnormal septal activation from right to left. LBBB may induce abnormalities in left ventricular performance due to abnormal asynchronous contraction patterns. Asynchronous electrical activation of the ventricles causes regional differences in workload which may lead to asymmetric hypertrophy and left ventricular dilatation, especially due to increased wall mass in late-activated regions, which may aggravate preexisting left ventricular pumping performance or even induce it.</p> Akhil Mehrotra, Mohammad Shaban, Ujala Shakya Copyright (c) 2024 Author (s). Published by Siddharth Health Research and Social Welfare Society Mon, 19 Feb 2024 00:00:00 +0000 Pharmacological therapy approaches for the treatment of knee osteoarthritis <p>To date, no effective treatment has been able to modify the pathological progression of osteoarthritis (OA). Current therapy can be broadly categorized into pharmacological and non-pharmacological approaches before considering surgical interventions. Non-pharmacological methods address lifestyle modifications, weight reduction and physical therapy, all aiming at alleviating mechanical stress on the affected joint. In this article, we focused on pharmacological treatment options, that primarily target pain reduction by reducing joint inflammation or restoring the altered synovial environment to a normal state. In this literature review, the main focus is on approved conservative therapies and examined emerging conservative strategies. Evaluating their advantages and limitations.</p> Maren Hofmann, Pēteris Studers, Dārta Jakovicka Copyright (c) 2024 Author (s). Published by Siddharth Health Research and Social Welfare Society Mon, 19 Feb 2024 00:00:00 +0000