Fortis Healthcare Limited (FHL) is an Indian multinational chain of private hospitals headquartered in India. Fortis started its health care operations from Mohali where first Fortis hospital was started. Later on, the hospital chain purchased the healthcare branch of Escorts group and increased its strength in various parts of the country. The Escorts Heart and research Center, Okhla, Delhi became a major operating unit of the chain. Dr. Tehran, the current MD of Medanta and several others have started their career from this institute.The Fortis Memorial research Institute (FMRI) hospital at Gurgaon is the headquarter and flagship hospital of Fortis healthcare with all the major facilities at the hospital. It was named as 23rd smart hospital in the world for the year 2021. FMRI was also named as 22nd best hospital in the country for the year 2022 by Newsweek. Apart from Fortis Escorts Okhla, & FMRI, Fortis healthcare has other units in Delhi NCR as well which includes Fortis Hospital Faridabad, Noida, Vasant Kunj, Shalimar Bagh (Delhi) and at several other places in the country. Currently, the company operates its healthcare delivery services in India, Dubai and Sri Lanka with 36 healthcare facilities.Malaysia's IHH Healthcare became the controlling shareholder of Fortis Healthcare Ltd by acquiring a 31.1% stake in the company. Fortis Healthcare also appointed four persons from IHH Healthcare to its board in a meeting held at Mohali. The board approved the allotment of over 230 million shares through preferential issue to Northern TK Venture Pte Ltd, a wholly owned indirect subsidiary of IHH Healthcare, at ₹170 per share of ₹10 face value.
Importance:The optimal dual antiplatelet therapy after percutaneous coronary intervention (PCI) in patients with diabetes is not clearly defined. Although both ticagrelor and prasugrel are potent inhibitors of P2Y purinergic receptor 12 (P2Y12), evidence directly comparing their efficacy and safety in this high-risk group remains limited. Objective:To compare the clinical outcomes of ticagrelor vs prasugrel, each in combination with aspirin, in patients with diabetes and multivessel coronary artery disease who underwent percutaneous coronary intervention. Design, Setting, and Participants:The Ultrathin Strut vs Xience in a Diabetic Population With Multivessel Disease 2-India Study (TUXEDO-2) is an investigator-initiated, prospective, open-label, multicenter, 2 × 2 factorial design, 1:1 randomized clinical trial. Participants with diabetes and multivessel disease undergoing percutaneous coronary intervention were enrolled at 66 clinical sites from February 2020 to August 2024. Interventions:Patients undergoing percutaneous coronary intervention were randomized to receive either ticagrelor or prasugrel, each in combination with low-dose aspirin. Main Outcomes and Measures:The primary outcome was a composite of death, nonfatal myocardial infarction, stroke, or major bleeding as defined by the Bleeding Academic Research Consortium at 1 year. The trial was designed to test the noninferiority of ticagrelor compared with prasugrel with a noninferiority margin of 5%. Results:Among the 1800 participants randomized, mean (SD) age was 60 (10) years with 1296 (72.0%) male participants, 436 (24.2%) receiving insulin therapy, and 1530 (85.0%) with triple-vessel disease. At 1 year, the primary end point occurred in 129 participants (16.6%) taking ticagrelor and 107 participants (14.2%) taking prasugrel (P = .12). The risk difference of 2.33 percentage points (95% CI, -2.07 to 6.74 percentage points) failed to meet the prespecified threshold for noninferiority (P = .84). There was numerically higher (but not statistically significant) composite of death, myocardial infarction, stroke (10.43% vs 8.63%; P = .30), and major bleeding (8.41% vs 7.14%; P = .19) with ticagrelor when compared with prasugrel. Conclusions and Relevance:In patients with diabetes and multivessel disease undergoing PCI, ticagrelor was not noninferior to prasugrel for the reduction of primary outcome at 1 year of follow-up. Trial Registration:CTRI/2019/11/022088.
Atopic dermatitis (AD) is a chronic inflammatory skin disease with significant morbidity. Recognising the need for region-specific guidance, the Skin Allergy Research Society and Society for Eczema Studies have collaborated to develop updated, evidence-based guidelines tailored to the Indian context. These guidelines address AD management across all age groups, special populations while considering local epidemiology, healthcare infrastructure, and treatment accessibility. A structured Delphi consensus process was conducted among 23 dermatology experts over 3 months through virtual and in-person meetings. Literature from MEDLINE, Cochrane, and Google Scholar was systematically reviewed, and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach was used to assess evidence quality. Clinical recommendations were refined through multiple voting rounds, leading to consensus statements. Recommendations are based on an extensive literature review up to December 2024. This document updates the 2019 Skin Allergy Society guidelines, reinforcing global recommendations while allowing local adaptability. These guidelines provide updated recommendations for topical, systemic, phototherapy, and biologic therapies in AD. Key advancements include the introduction of topical crisaborole and JAK inhibitors for mild to moderate AD, along with a focus on emerging systemic therapies, such as biologics and systemic JAK inhibitors. In the Indian context, the guidelines define the roles of dupilumab and abrocitinib while also addressing the off-label use of tofacitinib and baricitinib in resource-limited settings. Specific recommendations are provided for children, elderly patients, and pregnant women, emphasising safety considerations for systemic and biologic therapies. These guidelines align with global AD management while incorporating India-specific adaptations based on epidemiology, accessibility, and affordability. They serve as a key reference for dermatologists, pediatricians, and general practitioners in India and other resource-limited settings. Though tailored for India, they are also relevant to dermatologists in developing countries, guiding treatment selection based on disease patterns, environmental factors, and medication availability.
This randomized clinical trial investigates if ticagrelor is noninferior to prasugrel after percutaneous coronary intervention in patients with diabetes and multivessel coronary artery disease (CAD). QuestionIs ticagrelor noninferior to prasugrel after percutaneous coronary intervention in patients with diabetes and multivessel disease?FindingsIn this randomized clinical trial, among 1800 participants with diabetes and multivessel disease randomized to ticagrelor or prasugrel plus aspirin, the 1-year primary composite end point (death, myocardial infarction, stroke, or major bleeding) did not differ between the treatments. The risk difference failed to meet the prespecified 5% noninferiority margin.MeaningTicagrelor did not demonstrate noninferiority to prasugrel in this high-risk population with diabetes and multivessel disease. ImportanceThe optimal dual antiplatelet therapy after percutaneous coronary intervention (PCI) in patients with diabetes is not clearly defined. Although both ticagrelor and prasugrel are potent inhibitors of P2Y purinergic receptor 12 (P2Y12), evidence directly comparing their efficacy and safety in this high-risk group remains limited.ObjectiveTo compare the clinical outcomes of ticagrelor vs prasugrel, each in combination with aspirin, in patients with diabetes and multivessel coronary artery disease who underwent percutaneous coronary intervention.Design, Setting, and ParticipantsThe Ultrathin Strut vs Xience in a Diabetic Population With Multivessel Disease 2-India Study (TUXEDO-2) is an investigator-initiated, prospective, open-label, multicenter, 2 x 2 factorial design, 1:1 randomized clinical trial. Participants with diabetes and multivessel disease undergoing percutaneous coronary intervention were enrolled at 66 clinical sites from February 2020 to August 2024.InterventionsPatients undergoing percutaneous coronary intervention were randomized to receive either ticagrelor or prasugrel, each in combination with low-dose aspirin.Main Outcomes and MeasuresThe primary outcome was a composite of death, nonfatal myocardial infarction, stroke, or major bleeding as defined by the Bleeding Academic Research Consortium at 1 year. The trial was designed to test the noninferiority of ticagrelor compared with prasugrel with a noninferiority margin of 5%.ResultsAmong the 1800 participants randomized, mean (SD) age was 60 (10) years with 1296 (72.0%) male participants, 436 (24.2%) receiving insulin therapy, and 1530 (85.0%) with triple-vessel disease. At 1 year, the primary end point occurred in 129 participants (16.6%) taking ticagrelor and 107 participants (14.2%) taking prasugrel (P = .12). The risk difference of 2.33 percentage points (95% CI, -2.07 to 6.74 percentage points) failed to meet the prespecified threshold for noninferiority (P = .84). There was numerically higher (but not statistically significant) composite of death, myocardial infarction, stroke (10.43% vs 8.63%; P = .30), and major bleeding (8.41% vs 7.14%; P = .19) with ticagrelor when compared with prasugrel.Conclusions and RelevanceIn patients with diabetes and multivessel disease undergoing PCI, ticagrelor was not noninferior to prasugrel for the reduction of primary outcome at 1 year of follow-up.Trial RegistrationCTRI/2019/11/022088
Background and Aims: To enhance recovery, we can use short acting agents and monitor depth of anaesthesia. Desflurane is less soluble in blood and has good emergence characteristics. Traditionally, MAC was used to assess the depth of anaesthesia and to aid in recovery from anaesthesia. Recently, Bispectral index (BIS) monitor has gained popularity for monitoring the depth of anaesthesia. Aims and Objectives: The present study aims to compare the efficacy of BIS and corrected MAC as monitors for the depth of anaesthesia and the recovery profile of patients undergoing surgery under general anaesthesia Patients and Methods A prospective randomised comparative double blinded study was conducted. Sixty patients in the age group of 18–65 years were scheduled for mastectomy surgery under general anaesthesia with ASA grade 1 and 2 were included in the study and were randomly divided into two groups. Group B: Desflurane concentration was adjusted to maintain a BIS value of 45–55. Group M: Desflurane concentration was adjusted to maintain a target age-corrected MAC of 0.8–1.3 Observations and Results: Patients monitored with BIS had faster awakening and less consumption of desflurane. Conclusion: With the use of BIS monitor, there is less anaesthetic gas consumption and early recovery from anaesthesia, which makes it a superior choice for monitoring the depth of anaesthesia.
Coronary artery disease (CAD) is a significant global health burden, warranting pragmatic, low-cost biomarkers for effective risk stratification. The atherogenic index of plasma (AIP), calculated as log(TG/HDL-C), is a lipid-derived indicator of cardiometabolic risk. We evaluated AIP as an associative marker for CAD and compared its diagnostic performance with commonly used biomarkers. In a hospital-based, angiography-confirmed case–control cohort (n = 340; 211 cases, 129 controls), we assessed AIP alongside uric acid, creatinine, neutrophil-to-lymphocyte ratio (NLR), TG/HDL‑C, HbA1c, and ejection fraction. Group characteristics were summarized using descriptive statistics, chi-square tests, and ANOVA. Associations with CAD were examined using multivariable logistic regression adjusted for age, sex, body mass index, diabetes, hypertension, smoking status, and statin use. Discriminative performance was evaluated via receiver operating characteristic (ROC) analysis, with pairwise comparisons conducted using DeLong’s test. Values of AIP (OR 1.42, 95
