Lokmanya Tilak Municipal Medical College and General Hospital is a full-fledged Government medical college located in Mumbai, Maharashtra. The college imparts the degree Bachelor of Medicine and Bachelor of Surgery (MBBS). It is recognised by the Medical Council of India. This is one of the oldest medical colleges in Mumbai. Lokmanya Tilak municipal medical college hospital is also locally known as Sion Hospital.
The Mediterranean diet is a nutritional approach reported to be beneficial in various diseases. We performed a systematic review about its role in the treatment of inflammatory bowel disease (IBD). Electronic databases (PubMed, Embase and Scopus) were searched on 10th February 2025 to identify reports on the use of the Mediterranean diet in the treatment of IBD. We extracted data with respect to clinical response, remission and endoscopic and histological responses with the use of the Mediterranean diet in the treatment of IBD. Pooled clinical response rates and remission rates were calculated. Eight studies were eventually included. Seven studies involving 223 participants provided information about the induction of remission. The pooled clinical remission rate with Mediterranean diet was 0.62 (95
[This retracts the article on p. e49461 in vol. 15, PMID: 38152804.].
Resistant hypertension (RH) is characterized by persistently elevated blood pressure despite treatment with three or more antihypertensive agents, including a diuretic. Excess production of aldosterone is a key contributor to this condition. Baxdrostat is a novel, highly selective aldosterone synthase inhibitor that reduces aldosterone synthesis without affecting cortisol production. This systematic review and meta-analysis evaluated the efficacy and safety of baxdrostat in patients with RH. Following a preregistered PROSPERO protocol (CRD420251038564) and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, we searched PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus through December 2025 for randomized controlled trials (RCTs) comparing baxdrostat with placebo in adults with RH. Primary efficacy outcomes were changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP). Primary safety outcomes included adverse events and hyperkalemia. Data were pooled using random-effects models. Risk of bias was assessed using Cochrane RoB 2, and evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Three RCTs (the BrigHTN trial, the BaxHTN trial, and the HALO trial) involving 1,318 patients were included. Pooled analysis demonstrated that baxdrostat significantly reduced SBP compared with placebo (mean difference (MD): -7.93 mmHg; 95% CI: -12.64 to -3.21; I² = 84%; high-certainty evidence). DBP was also significantly reduced (MD: -3.49 mmHg; 95% CI: -5.18 to -1.81; I² = 68%; high certainty). Dose-dependent effects were observed, with greater reductions at 2 mg. There was no significant difference in overall adverse events (risk ratio (RR): 1.05; 95% CI: 0.95-1.16) or serious adverse events (RR: 1.10; 95% CI: 0.70-1.73). However, baxdrostat increased hyperkalemia risk (serum potassium ≥5.5 mmol/L) (RR: 2.87; 95% CI: 1.61-5.11; moderate certainty), although most cases were mild and manageable. Baxdrostat provides clinically meaningful blood pressure reductions in RH with a favorable safety profile. Its highly selective, cortisol-sparing mechanism offers a promising therapeutic option that directly targets aldosterone dysregulation in RH.
BACKGROUND:Alopecia areata (AA) affects all ages, genders, and ethnicities. AA severely impacts patients' quality of life. Treatments indicated for AA have only been approved since 2022/2023. While some Asia Pacific (APAC) countries/regions have national or regional guidelines, many lack AA-specific guidance or have not updated existing guidelines to incorporate recently approved treatments. METHODS:To better inform treatment decisions, 18 dermatologists from Australia, China, India, Korea, Malaysia, Singapore, Taiwan, and Thailand completed a three-round Delphi-based consensus process involving survey completion, open discussion, and statement voting. A consensus for Likert-type and multiple-choice statements was defined as ≥ 70% agreement or disagreement. RESULTS:Consensus was achieved on 140 statements. The panel recognizes that AA is clinically heterogeneous and imposes a considerable burden on patients and their families. Trichoscopy is deemed essential for diagnosing and monitoring AA, while skin biopsy is reserved for when the cause of hair loss is unclear. In terms of disease severity, moderate AA is defined as 21%-49% hair loss and severe AA as ≥ 50% hair loss. Regarding treatment, topical corticosteroids are recommended in children < 12 years. For patients aged ≥ 12 years, topical and intralesional corticosteroids could be used for mild-to-moderate AA, while Janus kinase inhibitors and systemic corticosteroids have a role in moderate-to-severe AA. Adjuvant minoxidil could also be used in chronic AA. CONCLUSIONS:This modified Delphi-based consensus provides a practical, region-focused framework to standardize the diagnosis and management of AA across diverse APAC healthcare settings in hope of improving patient outcomes.
INTRODUCTION:Obesity is highly prevalent in India, creating an urgent need for effective management interventions. The study hypothesizes that synthetic semaglutide has comparable safety and efficacy to the innovator drug when used in obese adults for weight management. METHODS:A phase III multicenter randomized active-controlled non-inferiority trial enrolled adults with obesity across 19 centers in India. Subjects were randomized to the test arm receiving synthetic semaglutide (Alkem Laboratories Limited) or the reference arm administered with innovator semaglutide (Wegovy®, Novo Nordisk) over 24 weeks in a 2:1 ratio. The primary efficacy endpoint was the percentage change in body weight,24 weeks post-intervention. Synthetic semaglutide was established to be non-inferior if the lower bound of the one-sided 97.5% confidence interval for the between-group difference did not exceed 4.5%. RESULTS:Of the 249 randomized participants, 246 (98.8%) completed the study. Mean percentage weight loss after 24 weeks was -14.39 ± 4.17% in the test arm and -14.61 ± 4.36% in the reference arm. The least square-mean difference was 0.15% (-0.93 to 1.24), meeting the predefined non-inferiority criterion. Weight loss >10% was achieved by 86.67% (n=143) in the test arm and 83.95% (n=68) in the reference arm (p = 0.5666), while >15% weight loss occurred in 38.79% (n=64) and 40.74% (n=33), respectively (p = 0.7683). Mean body mass index decreased by -4.93 ± 1.43 kg/m² in the test arm and -5.00 ± 1.50 kg/m² in the reference arm (p = 0.7128). Treatment-emergent adverse events were reported in 55.42% (n=92) of test-arm participants and 54.22% (n=45) of reference-arm participants. CONCLUSIONS:Test semaglutide demonstrated non-inferior efficacy, comparable safety, and similar tolerability to the innovator product.
