Introduction: Among all the risk factors for atherosclerosis, diabetes is one that has a direct causal association with it, so it has been a focus in major primary prevention studies. The prediabetic population is considered at the same risk as non-diabetics as per the latest guidelines. By using the Coronary artery calcium score (CACS) which is a predictor of cardiovascular events, in this subset of people authors tried to analyse whether prediabetics can be treated the same as non-diabetics. Methods: Patients undergoing CT coronary angiography with no major epicardial coronary artery obstruction were in-cluded and divided into three subgroups of non-diabetic, pre-diabetic and diabetic. Their CACS were measured and compared for any significance. Results: A total of 300 patients were part of the study with 100 patients in each subgroup. The mean age of the population was 48 years. Lipid profile was significantly deranged in the non-diabetic and pre-diabetic subgroup as they were not on any therapy. CACS was 5.4 ± 37.37, 98.02 ± 300.89, 209.47 ± 277.61 in non-diabetic, pre-diabetic and diabetic subgroups respectively. The CACS was much higher in the pre-diabetic subgroup of people missing statistical significance by only a small margin. Conclusion: From this observational study authors conclude that prediabetics are at much higher risk of adverse cardio-vascular events than non-diabetics and so when it comes to primary prevention therapy, they should not be considered in the same risk category as non-diabetics.
The current drug discovery paradigm has a high attrition rate, postmarketing withdrawals, and costly development. Drugs have been emerging serendipitously “from the bedside,” without an organized approach. Drug discovery, at the bedside, is followed in reverse pharmacology (RP) by the relevant science of drug development for safety, efficacy, and mechanistic understanding. Such a transdisciplinary structured path can explore the large potential for novel drugs. The phytoactives can be novel scaffolds for new drugs. Ayurveda and other living traditional systems of medicine have a rich reservoir of pharmacotherapeutics. The documented therapeutic experience defines the nature of the drug targets to be studied in vitro and in vivo models. The phytomolecules may lead to newer dimensions of drug actions. Reserpine and Atremisinin exemplify such a potential. The delay in drug discovery can be eliminated by reverse pharmacology (RP). A well-structured multisystem and functionally multidisciplinary organization is needed for RP; it also needs an appropriate locus for academic growth, development, and intellectual appeal. A close and continuous collaboration between academia and industry is needed. In the future, RP can differentiate into unique specialities: Ayurvedic pharmacoepidemiology, observational therapeutics, pharmacodynamic methods, advanced pharmacokinetics, and biosynthesis. Early attention to RP is a prerequisite for achieving this. The medical pluralism in India offers observational opportunities for the bedside hits and leads for several unmet medical needs. Such leads can be facilitated by RP as drug discoveries for integrative medicine.
Lynch syndrome, is one of the most common hereditary colorectal cancer predisposition conditions, is characterised by an increased risk to a spectrum of cancers, primarily colorectal and endometrial cancers. We highlight the urgent need to diagnose, explain diagnostic methodologies and several cancer risks reducing interventions in these patients and their rela-tives. We highlight the role of aspirin as a potent chemo preventive agent in Lynch syndrome patients and discuss patient groups where the dose and duration of the intervention may require personalisation. With new genetic technologies on the horizon, early detection of these patients coupled with targeted chemo preventive intervention could potentially lead to the reduction of the cancer burden in India.
Aim: To evaluate the performance of chest computed tomography (CT) scan in the preliminary diagnosis of suspected coronavirus disease 2019 (COVID-19).Material and methods: Suspected 1149 COVID-19 patients who underwent both chest CT and RT-PCR tests were included. Considering RT-PCR as a reference standard, the performance of chest CT in diagnosing COVID-19 was evaluated. Obtained data was statistically analysed for sensitivity, specificity and accuracy for the diagnosis of COVID-19 cases.Results: Out of 1149 patients RTPCR was positive in 188 (16.36%) of patients and CT findings were positive in 368 (32.03%) of patients. The majority (21.15%) of the patients’ CT scan revealed sub-pleural ground-glass opacities (GGO), consolidation was seen in 76 (6.61%), pleural effusion in 73 (6.35%) and interstitial oedema in 41 (6.35%) respectively. Considering RT-PCR results as the reference standard, the chest CT revealed a sensitivity of 73.40%, specificity of 76.07% and accuracy of 75.63% in identifying COVID 19.Conclusion: Chest CT revealed diagnostic accuracy (75.63%) in diagnosing COVID-19 and it could be considered as a basic modality for detecting COVID-19 cases early. This can be valuable to initiate early triage and infection control practices and appropriate isolation strategies in Emergency Department.
