Maulana Azad Medical College (MAMC) is a medical college in New Delhi, India affiliated to University of Delhi and run by the Delhi government. It is named after Indian freedom fighter and first education minister of independent India Maulana Abul Kalam Azad. It was established in 1959 at Bahadur Shah Zafar Marg near Delhi Gate.Four hospitals attached to MAMC have a combined bed strength of 2800 beds and cater to millions in Delhi alone and many more from the surrounding states in north India. The college is a tertiary care referral centre and has teaching programs for graduate and postgraduate degrees and residency and subspecialities/fellowships (referred to as superspecialities in India)..
Dipeptidyl peptidase-4 (DPP-4) inhibitors are widely prescribed second-line agents for type 2 diabetes mellitus (T2DM). Secondary treatment failure with DPP-4 inhibitors is conventionally attributed to progressive β-cell dysfunction. Acquired resistance to DPP-4 inhibitor therapy, characterised by progressive glycemic deterioration despite preserved endogenous insulin secretion, remains an under-recognised and poorly documented clinical phenomenon. We report a case of secondary DPP-4 inhibitor failure with preserved β-cell function, raising the hypothesis of acquired incretin resistance as an alternative mechanism of treatment failure. A 52-year-old non-obese man (body mass index 24.9 kg/m²) with a 4-year history of T2DM developed progressive glycemic deterioration after 22 months of stable glycemic control with metformin and sitagliptin combination therapy. His glycated haemoglobin (HbA1c) increased from 6.7
Solid organ transplantation (SOT) has moved from a rescue option to a planned, disease-modifying therapy for selected inborn errors of metabolism (IEMs). In liver-dominant enzymopathies, transplantation can provide clinically meaningful metabolic capacity and reduce exposure to recurrent catabolic crises; in kidney- or dual-organ phenotypes, it may offer definitive organ replacement while attenuating the downstream consequences of toxic metabolite burden. It is imperative to understand that transplantation does not “cure” many IEMs: extrahepatic enzyme deficiency, established neurologic injury, and chronic systemic complications can persist, and outcomes depend as much on meticulous perioperative metabolic care and long-term multidisciplinary follow-up as on the surgical act itself. This review synthesizes an organ-based, practice-oriented approach to SOT in IEMs, focusing on (i) the therapeutic intent of transplantation (metabolic replacement, end-organ replacement, or risk-reduction), (ii) indications and timing for liver, kidney, combined liver–kidney, heart, lung, and multivisceral transplantation, (iii) sequencing decisions in dual-organ disease, and (iv) peri-transplant metabolic and immunosuppression considerations that are distinctive to IEM. The decision frameworks and succinct conditions where shared decision-making, and context-sensitive practice in resource-variable settings are also of paramount importance.
Accurate tissue acquisition (TA) of solid pancreatic lesions is essential for guiding treatment with endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) being the preferred method. Among FNB designs, the three-pronged Franseen-tip needle demonstrates strong diagnostic performance, though direct head-to-head comparisons with other FNB designs remain limited. This meta-analysis was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420251123856). Eligible studies enrolled patients with solid pancreatic lesions who underwent EUS-guided FNB, directly compared the Franseen-tip with other FNB needles. Six databases were systematically searched through July 2025, and study selection, data extraction, and risk of bias assessment (QUADAS-2 tool) were performed independently by two reviewers. Pooled estimates were generated using random-effects and bivariate hierarchical models. Sixteen studies (2,010 Franseen vs. 2,811 comparator) were included. Bivariate analysis showed that sensitivity and specificity of the Franseen needle were comparable to newer-generation comparator needles (sensitivity 91.3
Hypertension is a known complication and modifiable risk factor for chronic kidney disease (CKD). Diurnal variability is better assessed using continuous ambulatory blood pressure monitoring (CABPM). We enrolled 74 adolescents (78.4
