Saifee Hospital is a healthcare facility at Charni Road, Mumbai, India, overlooking the Arabian Sea. The head of the Dawoodi Bohra faith, Syedna Mohammad Burhanuddin, dedicated the hospital to the memory of his revered father, Syedna Taher Saifuddin.
Obesity and type 2 diabetes mellitus (T2DM) are global challenges, with obesity increasing risk of T2DM. Body mass index (BMI), the conventional measure of obesity, may not accurately predict metabolic risk, especially in Asian individuals. Evaluation of alternative anthropometric indices may offer additional approaches for risk assessment. The multicenter, cross-sectional study examined whether anthropometric indices—such as waist, hip, neck, calf, and wrist circumferences, as well as waist–hip, neck–height, and waist–calf ratios—are associated with T2DM in adults with obesity. The study included 750 adults (BMI ≥ 25 kg/m2) recruited from four endocrinology centers across India. Anthropometric and clinical data were recorded using a standardized electronic form. T2DM was present in 73
This meta-thinking communication explores the concept of metacrinology through various prisms. The Greek prefix 'meta' has place of pride in metabolism, metamorphosis, metastasis, and meta-analysis. We now suggest its use as part of metacrinology, to convey the ever-expanding vastness of hormonal anatomy and function, as well as homeostasis and ill-health. Metacrinology can be defined in various ways. The most comprehensive definitions, however, are the study of endocrinology, beyond currently accepted pathways, paradigms, and processes, in an openminded, evidence-based manner, so as to explore and elucidate newer physical and functional facets of hormonal health and disease.
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
This chapter examines the integration of spirituality into healthcare, emphasizing its role as foundational component of holistic patient care and staff well being. Utilizing five dimensional framework Self, Society, State, Systems and Spirituality, discussion highlights how spiritual awareness aids healthcare providers in managing emotional burdens, moral distress and burnout. The chapter presents real world applications including leadership practices, institutional rituals and chaplaincy models from global healthcare organizations. Challenges such as secular resistance and cultural pluralism are addressed with strategies proposed for developing inclusive policies and support systems. Evaluation tools for assessing the impact of spiritual care on patient outcomes and organizational sustainability are also discussed. Ultimately the chapter advocates for recognizing spirituality as central to creating healing environments that honor the whole person urging healthcare leaders and policymakers to embed spiritual considerations into their systems as a public good and clinical necessity.
BACKGROUND:The optimal surgical approach for patients with primary glenohumeral osteoarthritis (GHOA) and an intact rotator cuff remains debated. While anatomic total shoulder arthroplasty (TSA) has traditionally been favoured, reverse TSA (RTSA) is increasingly utilized. AIM:To systematically compare the outcomes of RTSA and TSA in this specific patient population. METHODS:A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Retrospective comparative studies evaluating RTSA and TSA in patients with GHOA and intact rotator cuff were included. Key outcomes assessed included complication and reoperation rates, patient-reported outcome measures (PROMs), and range of motion. Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool. RESULTS:Twelve studies encompassing 1608 patients (580 RTSA, 1028 TSA) met inclusion criteria. RTSA was associated with a lower reoperation rate compared to TSA [odds ratio = 0.37; 95% confidence interval (CI): 0.14-0.94; P value = 0.04], while no significant difference in overall complication rates was observed (odds ratio = 0.47; 95%CI: 0.19-1.16; P value = 0.10). RTSA patients showed superior outcomes in University of California Los Angeles, Simple Shoulder Test, and Shoulder Pain and Disability Index scores; however, the differences did not exceed the minimal clinically important difference. TSA patients had significantly better external rotation (mean difference= -9.0°; 95%CI: -13.21 to -5.02; P value < 0.0001). No significant differences were found in other range of motion measures or satisfaction scores. The overall methodological quality of included studies was moderate to serious. CONCLUSION:In patients with GHOA and an intact rotator cuff, RTSA may offer comparable or improved outcomes to TSA with lower reoperation rates and similar complication profiles. Functional outcomes favour RTSA in certain patient-reported outcome measures, while TSA retains an advantage in external rotation. Surgical decision-making should remain individualized based on patient characteristics and functional demands.
