Journal of the Association of Physicians of India

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Coronavirus disease 2019 (COVID-19) is a highly hypercoagulable viral infection complicated as COVID-inflicted coagulopathy (CIC), that is associated with increased risk of morbidity and mortality. International guidelines recommend low molecular weight heparin (LMWH) to treat CIC in both in-hospital and in-home settings. However, in India, using subcutaneous LMWH may not be a feasible option for a vast majority of patients under home management. Additionally, while some evidence advocates the use of novel oral anticoagulants (NOACs), in hospitalized settings, most guidelines find no role of NOACs in hospital settings...

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Non syndromic Anonychia congenita or congenital absence of finger and toe nails is a rare disorder known to occur due to autosomal recessive inheritance of mutation in the R-spondin-4 gene. We present a case of a 32 year old female born of a non-consanguineous marriage presenting with complete absence of finger and toe nails since birth and similar presentation in family members over four generations, suggesting an autosomal dominant inheritance.

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Several systemic anti-inflammatory and immunomodulatory agents were tried in the management of hyper inflammatory manifestations of COVID 19. JAK inhibitors have been widely deployed in rheumatology due to their benefits in managing uncontrolled inflammation. Tofacitinib is one of the most widely studied immunomodulators in rheumatology. We assessed the safety and efficacy of Tofacitinib in an open-labeled randomized control study, in addition to the standard of care (SOC) in hospitalized adults with mild to moderate COVID-19 pneumonia...

Apart from the individual diseases, some patients also show overlapping manifestations of asthma and COPD. Nevertheless, the diagnosis of COPD is often delayed due to inaccessibility to spirometry; the prevalence of the asthma COPD overlap phenotype is rather high given the exposure to biomass smoke. Furthermore, the rates of exacerbations are twice as high compared to the patients with either of the diseases. A treatment strategy that would reduce the risk of exacerbations would contribute immensely to the management of such patients...

INTRODUCTION: Targeted HIV 1 viral load testing has been recommended in 2010 only for suspected cases of antiretroviral therapy failure. India is committed to achieve UNAIDS '90-90-90' target by 2020. The third 90 target was to ensure all people receiving antiretroviral therapy (ART) are virologically suppressed. Implementation of routine viral load testing in national programme helps us in assessing early treatment failure and the need to switch to second line therapy; thus eventually reducing drug resistance and improving patient outcomes...

OBJECTIVES: The present study aimed to calculate the risk of osteoporotic fracture in patients of Rheumatoid arthritis (RA) by Fracture Risk Assessment Tool (FRAX) and its relationship with osteoporotic-specific risk factors. METHODS: This was a observational cross-sectional analytical study conducted from January 2019 to September 2020 where 185 patients, aged 40-90 years, who presented to the Rheumatology Clinic meeting the ACR/EULAR (2010) Classification Criteria for Rheumatoid Arthritis were included in the study and matched with 185 healthy individuals...

INTRODUCTION: Scrub typhus is a re-emerging infectious disease. Though considered as disease of rural areas, this disease has been urbanized and the prevalence has broadened further. Disease has been reported with increasing frequency from various parts of India and has resurgence in north east. It is a disease with multi organ involvement, with or without characteristic eschar and early detection and initial specific treatment is important. MATERIAL: An observational hospital-based study in patients >18years admitted to a tertiary care center in eastern India...

OBJECTIVES: Diabetes mellitus (DM) refers to a group of metabolic disorders characterized by hyperglycemia resulting from insulin resistance, insulin action or both. Despite availability of various treatment modalities it is difficult to achieve the desired glycemic control in many patients. In such patients new class of anti-diabetic agent sodium-glucose co-transporter II (SGLT2) inhibitors has been approved by FDA. SGLT-2 inhibitor Empagliflozin has been associated with HbA1c reduction and weight loss in a broad range of patients with type 2 Diabetes Mellitus (T2DM)...

BACKGROUND: Hyperuricemia has been associated with chronic kidney disease, evidence suggests that hyperuricemiamight plays a role in progression of renal damage. Whether hyperuricemia can lead to renal tubular injury remains unclear. In this study we aimed to determine serum NGAL and urinary NGAL/creatinine ratio as markers of reanal tubular injury in metabolic syndrome patientshave hyper or normouricemia. MATERIAL AND METHODS: In this hospital based cross- sectional study,180 par ticipants with metabolic syndrome were included,90 patients had hyperuricemia and 90 were with normouricemia...

AIMS: To study association of hyperuricemia with severity of scrub typhus. METHODS: We studied clinical features, laboratory profile, in hospital course and outcome of 92 patients of scrub typhus and association of hyperuricemia with severity of disease. RESULTS: Of total 92 patients in study group, 66 (71.7%) were females and 26(28.3%) were males. Fever (100%), cough (37%), headache (33%), vomiting (31%), altered sensorium (23%), diarrhea (18%), abdominal pain (16%), myalgia (14%), and seizures (3%) were common clinical features...

BACKGROUND: Cilnidipine, an upcoming anti-hypertensive drug, is a combined L- and N-type calcium channel blocker. It is proposed to be more efficacious and safer due to its two-pronged approach in treating hypertension. METHODS: The study was a randomized open-label parallel-group study, conducted in the Department of General Medicine, Sri Ramachandra Medical College Hospital, Chennai, during the period September 2014 to May 2015. 50 patients were randomized to the amlodipine group and 50 to the cilnidipine group...

BACKGROUND: As majority of cases of dengue are associated with thrombocytopenia, it is indispensable to study clinical presentation, biochemical parameters and outcome of dengue fever in a population known with low platelet count. METHODOLOGY: A prospective observational study was conducted from September 2016 to August 2017that included forty NS-1 antigen (IgM) Dengue positive patients. Clinical features, laboratory parameters and outcome of dengue patients were noted...

OBJECTIVES: Primary objective was to determine an association between Atherosclerotic Cardiovascular Disease (ASCVD) and Framingham (FRS) risk scores with Syntax score(SS). Secondary objective was to determine sensitivity, specificity and discriminative ability of FRS and ASCVD risk scores in detecting Coronary Artery Disease (CAD) and predicting its severity. MATERIALS AND METHODS: This is a cross-sectional study carried out in the Comprehensive Health Clinic of Amrita Institute of Medical Sciences, Kochi, Kerala...