Obesity is a global health crisis affecting developing nations, including India. The management of obesity continues to evolve with newer drugs, metabolic and bariatric surgery and endoscopic interventions, requiring family physicians and specialists to adapt their clinical practice accordingly. There is an urgent need for a standardized algorithm to diagnose, stage, and treat obesity. The Endocrine Society of India (ESI) and the Obesity Surgeons Society of India (OSSI) appointed a steering committee to develop an evidence-based algorithm for managing patients with obesity in India. This was put to vote by 80 specialists (38 from OSSI and 42 from ESI) in a physical meeting. A proposed stage-wise algorithm based on Edmonton Obesity Staging System, Asian definition of obesity, and resources in India, received 100
Obesity is a global health concern, with weight regain (WR) common after bariatric surgery. Clear guidelines on post-surgical medication use are essential. This expert consensus evaluates the role of obesity management medications (OMMs) in optimizing weight loss (WL) and preventing WR in individuals undergoing metabolic and bariatric surgery (MBS). Using a modified Delphi approach, a panel of 12 experts reviewed evidence and formulated consensus recommendations. Two voting rounds led to consensus on 11 of 15 statements, covering preoperative WL strategies and postoperative weight management. The recommendations guide OMM selection, timing, and effectiveness in enhancing WL outcomes. Integrating OMMs into bariatric care protocols can help clinicians improve long-term success rates in obesity management.
Lipoleiomyoma is a rare, benign uterine leiomyoma variant primarily found in postmenopausal women. These tumors are composed of smooth muscle and mature adipose tissue and are often misdiagnosed due to their resemblance to malignant tumors on imaging. We report the case of a 60-year-old postmenopausal woman with a history of diabetes and hypertension, presenting with complaints of prolapse and intermittent spotting. Clinical evaluation revealed a hypertrophied cervix with a third-degree uterovaginal prolapse and a retroperitoneal mass. Imaging suggested a lipoleiomyoma, and histopathology confirmed this diagnosis following surgical excision. The patient also had a concurrent early stage cervical carcinoma, which was managed surgically. Lipoleiomyomas, though benign, can mimic more serious conditions and lead to unnecessary invasive procedures. Improved recognition of their imaging characteristics can enhance diagnostic accuracy, allowing for more conservative management approaches. Our case underscores the importance of a thorough evaluation and multidisciplinary approach in the management of pelvic masses, particularly when malignant conditions coexist.
Background: Preeclampsia remains a major cause of maternal and perinatal morbidity, presenting with hypertension and proteinuria after 20 weeks of gestation. Although multifactorial in origin, maternal inflammatory and endothelial dysfunction play crucial roles in its pathogenesis. Urinary tract infection (UTI), a common condition in pregnancy, has been proposed as a potential trigger for systemic inflammation contributing to preeclampsia. This study aimed to evaluate the association between UTI and the subsequent development of preeclampsia among pregnant women attending a tertiary care hospital in Chennai. Methods: A prospective cohort study was conducted from October 2023 to October 2024 at Madras Medical College, Chennai. A total of 116 pregnant women were enrolled and categorized into UTI (n=58) and non-UTI (n=58) groups based on urine routine and culture findings. Participants were followed throughout pregnancy with serial assessments of blood pressure, urine albumin, and clinical parameters each trimester. Statistical analysis was performed using Chi-square and Fisher’s exact tests, and relative risk was calculated to estimate the strength of association. Results: UTI occurred most frequently in the first trimester, whereas preeclampsia was mainly observed in the third trimester. Among women with UTI, 60% developed preeclampsia compared to 18.7% without UTI, yielding a relative risk of 3.2, signifying a significant association. Conclusions: UTI in pregnancy was associated with a 3.2-fold increased risk of preeclampsia. Early identification and prompt treatment of UTI may reduce preeclampsia-related complications. Further large-scale studies are needed to confirm this relationship.
The therapeutic efficacy of various phytoconstituents is improved by the use of phytosome, innovative drug delivery methods based on phytochemicals, by enhancing their absorption, bioavailability, and therapeutic availability. This exceedingly complex type of herbal formulation contains the active phytoconstituent of the herbal extract and is joined by a phospholipid molecule. They also operate as vesicular systems for a wide range of fascinating and important phytoactives. The phytosome method produces startlingly tiny spheres or cells, which is advantageous in keeping active phytochemical contents from being destroyed by the stomach environment. Phytosome also produce pharmacokinetic and pharmacodynamic effects that are more potent than those of conventional herbal extracts. Phytosome demonstrated increased pharmacokinetics and pharmacodynamic response when compared to conventional botanical extracts. Through the use of phytosome technology, the bioavailability of several of the most widely used herbal extracts, such as milk thistle, Ginkgo biloba, grape seed, green tea, hawthorn, ginseng, etc., has been improved. These drug-phospholipid complexes can be produced as a liquid solution, suspension, emulsion, syrup, lotion, gel, cream, tablet, capsule, powder, or granule. The purpose of this review is to emphasize the application of how the phytosome technology has helped to improve the bioavailability and absorbance of the cosmeceuticals.
