Indian Journal Of Clinical Practice
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HCFI Round Table Environment Expert Zoom Meeting on “Innovative Scheme for Sustainable Plantation – Hari Bhari Vasundhara”
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Clinical Experience with Triple Drug Combination Efficacy and Patient Treatment Survey – The TRICEPT Study: Expert Perspectives on Triple Drug Therapy in Type 2 Diabetes Management in India
Get PDFType 2 diabetes (T2D) is a progressive metabolic disorder that often requires multiple medications to achieveoptimal glycemic control. The increasing pill burden and dosing frequency can significantly impact patient adherence,influencing overall treatment efficacy. This study investigates the perspectives of health care professionals (HCPs) on the useof triple-drug combination therapy—glimepiride, metformin, and sitagliptin—in managing T2D in Indian clinical settings.Method: A nationwide observational survey was conducted between September and December 2024, gathering responsesfrom 214 HCPs across 109 Indian cities. Results: The findings reveal that 86% of HCPs preferred adding an oral agent overinitiating insulin for patients failing dual therapy, with 61.2% supporting triple-drug therapy as a first-line option. Keyfactors influencing the adoption of triple therapy included inadequate glycemic control with dual therapy (79%), presenceof comorbidities (53.3%), and patient affordability (28%). Efficacy was ranked as the highest prescribing priority, followedby safety and ease of administration. Most HCPs (96.3%) endorsed triple therapy for working professionals due to itssimplified dosing and improved adherence. Clinical outcomes showed glycemic improvement in more than 50% of patients,with reported adverse effects including gastrointestinal discomfort (43.5%) and mild to moderate hypoglycemia (40.7%).Conclusion: These findings highlight the growing acceptance of triple therapy as an effective, patient-friendly approachto diabetes management in real-world practice. The study underscores the importance of balancing efficacy, safety, andaffordability to enhance adherence and prevent complications
Role of Beta-Blockers in Prevention of Hepatopulmonary Syndrome in Chronic Liver Disease: An Observation
Get PDFAim: Study was initiated to study the presence of hepatopulmonary syndrome (HPS) in chronic liver disease patients, and roleof beta-blockers in its occurrence. Methods: Patients admitted in Dept. of Medicine and patients attending the Medicine OPDwere examined and investigated for presence of HPS irrespective of its typical clinical features as explained in the literature.Patients having ascites or pleural effusion were managed by means of paracentesis and pleural tap first and then includedin the study. Patients having any other primary pulmonary disease like bronchial asthma or chronic obstructive pulmonarydisease were excluded from the study. Arterial blood gas analysis and contrast-enhanced echocardiography was done to confirmpresence of arterial hypoxemia and pulmonary shunt, the diagnostic criteria. Results: During 1 year study, total 125 patientswere enrolled in the study after appropriate selection criteria. Twenty-eight out of 125 patients were not taking propranolol.Propranolol is contraindicated in these patients for one or two reasons. Four out of these 28 patients developed HPS. One outof 97 patients who were on propranolol developed HPS. Total 5 patients were confirmed having HPS. The Fisher’s exact teststatistic value is 0.008887. The result is significant at p < 0.01. Conclusion: Patients of cirrhosis with portal hypertension ontreatment with propranolol were having significantly lower chances of development of HPS then those without propranolol.Propranolol may have preventive role for development of HPS
Vitamin D3 Deficiency: Prevalence, Prevention, and Prevailing Management Strategies
Get PDFVitamin D is a fat-soluble vitamin and plays a vital role in human physiology. Vitamin D3 deficiency is a significantpublic health issue globally, with varying prevalence depending on geographic, socioeconomic, and demographic factors.Vitamin D3 deficiency can be influenced by a variety of risk factors that affect its synthesis, absorption, and metabolism. Thisdeficiency has an impact on both musculoskeletal and nonmusculoskeletal health. This article summarizes the prevention andtreatment strategies for combating vitamin D3 deficiency, current guidelines for vitamin D supplementation across differentage groups, comparative efficacy of oral versus intramuscular vitamin D supplements, and factors influencing response tovitamin D supplementation. The Indian diet frequently lacks adequate levels of vitamin D, owing to its scarcity in commonlyconsumed foods. This emphasizes the need for fortification of staple foods with vitamin D through national programs. Thiswould ensure that vitamin D reaches even the most underserved populations, including those in rural or low-income settings
Insights into Physician\u27s Perceptions of Levocloperastine\u27s Safety and Efficacy in Children: An Online Survey in Clinical Practice
No full textCough is a common symptom in pediatric patients, often requiring effective and well-tolerated antitussive treatments.Although traditional agents like dextromethorphan and codeine are effective, they are associated with side effects likedrowsiness, nausea, and dependency risks. Levocloperastine (LCP), a nonopioid antitussive, has emerged as a safer alternativewith a dual mechanism of action targeting both central and peripheral pathways. This manuscript highlights the findings froman online survey that gathered insights from Indian physicians regarding their perceptions of LCP\u27s safety and efficacy inchildren aged 2 to 15 years. The survey data came from 161 physicians through a structured electronic questionnaire. Resultsindicated high physician confidence in LCP\u27s rapid onset of action, tolerability, and minimal side effects. Notably, 86.6%of participants prescribed LCP in their clinical practice to the children, with 69.6% finding it faster-acting than traditionalagents. Additionally, 80.7% reported reduced night-time sleep disruptions, and 96.9% found it well-tolerated in pediatricpatients. These findings align with existing literature and reinforce LCP\u27s role as a preferred antitussive in pediatric coughmanagement
Effectiveness and Safety of Fixed-Dose Combination of Dapagliflozin and Linagliptin in Patients not Controlled on Glimepiride and Metformin in Real-World Settings in India: LEAD INDIA Study
Get PDFGlimepiride/metformin is commonly used in India for its cost-effectiveness and efficacy, but one-third of patientsmay not achieve adequate glycemic control. Dapagliflozin/linagliptin fixed-dose combination (FDC) could be an effectivealternative. Methods: A retrospective study of type 2 diabetes patients aged >18 years, not meeting glycated hemoglobin(HbA1c) goal <7% on glimepiride and metformin. Patients received dapagliflozin (10 mg)/linagliptin (5 mg) FDC. Changesin HbA1c, fasting plasma glucose (FPG)/postprandial plasma glucose (PPG), blood pressure, and body weight were analyzedover 3 months. Results: The study included patient (n = 114) with a mean age of 55.15 years and mean duration of 8.5 years.Adjunct to dietary/lifestyle modifications, up-titration of metformin-glimepiride along with FDC of dapagliflozin/linagliptindemonstrated significant reduction in HbA1c (from mean 8.8 ± 1.12 to 6.92 ± 0.23; p < 0.001), FPG (157.8 ± 28.86 mg/dLto 113.6 ± 9.24 mg/dL; p < 0.001), and PPG (237.21 ± 40.58 mg/dL to 161.39 ± 12.76 mg/dL; p < 0.001) indicating improvedglycemic control. Additionally, there was a marginal decrease in body weight (73.19 to 72.12 kg), systolic blood pressure(137.6 to 129.11 mmHg), and diastolic blood pressure (84.26 to 78.68 mmHg) largely attributed to dapagliflozin. Treatmentwas well-tolerated. Conclusion: FDC of dapagliflozin/linagliptin is an attractive therapeutic option for patients with type 2diabetes mellitus not controlled with ongoing glimepiride and metformin