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Byline: Surjeet. Kumar, Azhar. Navid, Raman. Sharma, Renu. Suthar, Sameer. Vyas, Suresh. Angurana Dear Editor Dengue is a common arboviral infection in India and it classically presents with fever, arthralgia, [...]

Renewed interest in psychedelic substances in the 21st century has seen the exploration of psychedelic treatments for various psychiatric disorders including substance use disorder (SUD). This review aimed to assess the effectiveness of psychedelic treatments for people with SUD and those falling below diagnostic thresholds (i.e. substance misuse). We systematically searched 11 databases, trial registries, and psychedelic organization websites for empirical studies examining adults undergoing psychedelic treatment for SUD or substance misuse, published in the English language, between 2000 and 2021. Seven studies investigating treatment using psilocybin, ibogaine, and ayahuasca, alone or adjunct with psychotherapy reported across 10 papers were included. Measures of abstinence, substance use, psychological and psychosocial outcomes, craving, and withdrawal reported positive results, however, this data was scarce among studies examining a wide range of addictions including opioid, nicotine, alcohol, cocaine and unspecified substance. The qualitative synthesis from three studies described subjective experience of psychedelic-assisted treatments enhanced self-awareness, insight, and confidence. At present, there is no sufficient research evidence to suggest effectiveness of any of the psychedelics on any specific substance use disorder or substance misuse. Further research using rigorous effectiveness evaluation methods with larger sample sizes and longer-term follow-up is required. [ABSTRACT FROM AUTHOR]

Aims: Brepocitinib is a tyrosine kinase 2/Janus kinase 1 inhibitor being investigated for the treatment of several autoimmune diseases. This study assessed the absorption, distribution, metabolism and excretion of oral brepocitinib, and the absolute oral bioavailability (F) and fraction absorbed (Fa) using a 14C microtracer approach. Methods: This was a phase 1 open‐label, nonrandomized, fixed sequence, two‐period, single‐dose study of brepocitinib in healthy male participants. Participants received a single oral 60 mg dose of 14C brepocitinib (~300 nCi) in Period A, then an unlabelled oral 60 mg dose followed by an intravenous (IV) 30 μg dose of 14C labelled brepocitinib (~300 nCi) in Period B. Mass balance, pharmacokinetic parameters and safety were assessed. Results: Six participants were enrolled. Brepocitinib was absorbed rapidly following oral administration. In Period A, total recovery of the oral dose was 96.7% ± 6.3% (88.0% ± 8.0% in urine, 8.7% ± 2.1% in faeces). In Period B, a small fraction (6.0% of the oral dose) was recovered unchanged in urine. F and Fa were 74.6% (90% confidence interval 67.3%, 82.8%) and 106.9%, respectively. Brepocitinib demonstrated an acceptable safety profile and was well tolerated following oral or oral then IV administrations. No deaths, serious adverse events or discontinuations were reported. Conclusion: Intestinal absorption of brepocitinib was essentially complete after oral administration, with F ~75%. Drug‐related material recovery was high, with the majority excreted in urine. The major route of elimination of brepocitinib was renal excretion as metabolites, whereas urinary elimination of unchanged brepocitinib was minor. NCT: NCT03770039. [ABSTRACT FROM AUTHOR]

Introduction The role of endoscopes in the ear, nose, and throat (ENT) field has been described since the 1980s; It started with endoscopic nasal surgeries, followed by otological and laryngological procedures, and, since then, it has experienced a rapid evolution. Endoscopes help otologists understand how to approach difficult areas of middle ear, as well as the physiology of middle ear cleft. Objectives Despite the introduction of endoscopes in the field of otology, microscopes are still widely used in clinics and in operation theaters either alone or with endoscopes. The present study, which was conducted amongst otologists in India, is on their experience with and knowledge of the use of the endoscope compared to microscopes. Methods A Google form-based questionnaire comprising 18 questions was developed and sent online to otologist all over the country. The final dataset included responses from 354 active otologists. Results Out of 354 participants, only 3% had more than 5 years of experience in endoscopic ear surgery (EES), and 16.1% had never worked with an endoscope. Endoscopes were used in clinics and in operation theaters by 74.9% of the participants. Conclusion There has been a rise in the acceptance and use of endoscopes among Indian otologists and otology surgeons in last few decades. [ABSTRACT FROM AUTHOR]

Introduction: Pulmonary complications develop in patients suffering from liver disease either with or without Decompensation. Hypoxemia can develop in patients with liver cirrhosis due to massive ascites, active aggressive U.G.I. bleed, primary pulmonary or cardiovascular cause, or due to pulmonary complications of liver cirrhosis. Hypoxemia in liver cirrhosis patient should be evaluated for pulmonary complications of liver cirrhosis along-with other primary pulmonary or cardiac causes. Development of these complications worsen the prognosis of disease and modifies the line of management. This study was undertaken to find out the prevalence of arterial hypoxemia and hepatopulmonary syndrome in patients of liver cirrhosis. Objectives: To determine the arterial hypoxemia using arterial blood gas analysis in liver cirrhosis. To further determine the intrapulmonary vascular dilatation and hepatopulmonary syndrome using 2d-Contrast enhanced echocardiography. Material and Methods: The cross-sectional study was conducted on 80 patients, aged 18 years and above, fulfilling the inclusion and exclusion criteria, diagnosed with chronic liver disease. The detailed history was taken followed by clinical examination which was done after due consent. All these patients underwent routine blood investigations, chest x-ray, ultrasonography, UGI endoscopy, 2samples of arterial blood gas analysis(one supine and other upright), and agitated saline enhanced 2D-Echocardiography to detect intra-pulmonary vasodilation. The patients who had arterial hypoxemia, orthodeoxia, and had intrapulmonary vasodilation were diagnosed to have Hepatopulmonary syndrome. Results: Six(6)out of those 80 patients had hypoxemia in the population which were included in the study. Among those 6 patients who had hypoxemia, 4 patients had Intra-pulmonary vessel dilation on saline agitated 2dechocardiography and were labelled as Hepatopulmonary syndrome. Conclusion: The patients of liver cirrhosis presenting with hypoxia and other pulmonary manifestations, with or without Decompensation, should be evaluated for hepatopulmonary syndrome. The early detection of intra-pulmonary vessel dilatation leads to early modification of line of management and poor prognosis of liver disease can be explained at early stages. [ABSTRACT FROM AUTHOR]

Background: Prediabetes is a condition of intermediate hyperglycaemia in which blood glucose levels are high, but not more than the required diagnostic criteria to be labelled as Diabetes Mellitus. Now, there is a growing evidence regarding occurrence of peripheral neuropathy as well as cardiovascular autonomic neuropathy even in prediabetics. Aim: To determine nerve conduction abnormalities and cardiovascular autonomic dysfunction in pre-diabetics. Material and Methods: Total 100 subjects were divided into two groups of 50 each i.e. cases and controls, according to the ADA Criteria. Nerve conduction studies and Ewing's cardiovascular autonomic reflex tests (CARTs) were performed on all the subjects. Results: On comparing the changes in the nerve conduction studies of the pre-diabetic subjects with the controls, statistically significant difference was found in the conduction velocity of the B/L peroneal nerve. Similarly, difference in the amplitude of the B/L tibial nerve was also found to be statistically significant. Cardiovascular autonomic neuropathy was found in 18 % of the pre-diabetic subjects. Conclusion: Neuropathy is often associated with long standing diabetes mellitus but neuropathy can occur even in pre-diabetics. Although full blown neuropathy is not present but the nerve damage has already started at the prediabetic stage, which is reflected upon by the nerve conduction abnormalities and cardiovascular autonomic dysfunction. [ABSTRACT FROM AUTHOR]

Byline: Sudhir. Bhandari, Ajit. Shaktawat, Raman. Sharma, Amitabh. Dube, Shivankan. Kakkar, S. Banerjee, Prakash. Keshwani, Shrikant. Sharma, Sunil. Mahavar, C. Nawal, Sudhir. Mehta, Abhishek. Agarwal, Vishal. Gupta, Ashwin. Mathur, Amita. [...]