Indian Journal Of Clinical Practice
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Iron Deficiency in Heart Failure: Unveiling the Hidden Culprit
Get PDFIron deficiency (ID) is a frequent comorbidity in patients with heart failure (HF). Coexistent HF and ID make the issuesmore challenging to diagnose and treat. Iron deficiency exacerbates clinical symptoms, impairs quality of life and increasesthe risk of recurrent hospitalization for HF. Conversely, a proinflammatory state and altered gut kinetic in HF may resultin absolute or functional ID, which conventional laboratory makers may not diagnose and differentiate accurately. Noveldiagnostic markers like soluble transferrin receptor (sTfR), reticulocyte hemoglobin concentration, red blood cell distributionwidth, sTfR: log (ferritin) ratio and serum hepcidin levels may help to diagnose ID more accurately in the setting of HF. Theintravenous (IV) iron formulation has shown promising results in improving the functional class and reducing recurrenthospitalization in patients with HF and ID. Futuristic therapies like nanosized iron preparations, hepcidin inhibitors andhepcidin antagonists may help manage ID more efficiently and conveniently in HF. This manuscript explores the relationshipbetween ID and HF. It also provides the latest information related to the diagnosis and treatment of ID in HF patient
Effect of Background Diuretic Therapy on the Clinical Efficacy of SGLT2 Inhibitors in Patients of Heart Failure with Reduced Ejection Fraction: Current Evidence
Get PDFSodium-glucose cotransporter-2 (SGLT2) inhibitors are a fundamental therapy for heart failure with reduced ejection fraction(HFrEF). The clinical efficacy of SGLT2 inhibitors in the presence of background diuretic therapy has been questioned, mainlybecause of the overlapping diuretic mechanism of action. However, recently, data analysis from two landmark trials, DELIVERand EMPEROR-Reduced, has attempted to settle this question. Both analyses demonstrate a consistent benefit of SGLT2inhibitors across a wide range of background diuretic therapy. This brief communication sheds light on the key findings fromthese scientific studie
Milk-Alkali Syndrome: A Century Old Cause of Resurgence of Severe Hypercalcemia Due to Excessive Use of Calcium Supplements
Get PDFThe milk-alkali syndrome (MAS) is characterized by a triad of elevated calcium levels, metabolic alkalosis and acute kidney injury that commonly occurs due to the combined intake of large amounts of calcium and absorbable alkali. The syndrome can have an acute onset with the rapid development of hypercalcemia and, if left untreated, may result in acute renal failure and metastatic calcification. An increased number of cases of MAS have recently been reported. This is likely due to the common use of over the counter (OTC) preparations of calcium for preventing and treating osteoporosis in postmenopausal women. Herein, we report a case of severe hypercalcemia due to prolonged intake of calcium carbonate supplements in the absence of any alkali
Prevalence of Health Problems, Professional and Financial Satisfaction among Doctors Working Across Vadodara City: A Cross-sectional Study
Get PDFBackground: The present study was conducted to know the distribution of various health problems among doctors and to assess professional and financial satisfaction levels among doctors. Methods: A Google Form questionnaire-based cross-sectional study was conducted among 122 doctors in Vadodara selected purposively after taking consent. Google form was circulated by email and WhatsApp groups. The form consisted of questions related to demographic details, health problems, financial and job satisfaction. All the responses were recorded and analyzed in MS Excel 2019. Results: Among the 122 doctors, 89 (72.95%) were male and 33 (27.04%) were female and 101 (82.78%) doctors were taking treatment for some ailment. Around 86.9% of doctors regularly opt for a health check-up. Among the health problems reported by doctors, the most common were musculoskeletal ailments (72.13%) followed by hypertension (28.9%), diabetes (17.2), cardiac (12.3%), endocrinal (10.65%), eye (9.01), mental (6.55) problems. Approximately 37.70% of doctors answered that health problems temporarily affect their work; 5.73% of doctors felt the need to modify their work pattern. About 91.80% of doctors were satisfied by their profession, while 108 (88.52%) doctors were financially satisfied with their work. Conclusion: More than half of the professionals complained of musculoskeletal problems. The majority of health care professionals were professionally and financially satisfied
