Dayanand Medical College & Hospital

Sarcopenia is linked to adverse outcomes in patients undergoing liver transplantation (LT), including higher post-transplant complication rates and mortality rates. The current study aims to assess the impact of sarcopenia on outcomes in LT recipients. The National Inpatient Sample Database 2016-2020 was used to identify LT recipients. Patients were categorized into two groups based on the presence or absence of sarcopenia. Data were collected on patient demographics, etiology of liver disease, and decompensation of liver disease. The outcomes studied include in-hospital mortality, shock, acute kidney injury (AKI), ICU stay, and LT-related complications. The impact of sarcopenia was assessed using multivariate logistic/linear regression analysis. Of the 170 650 LT recipients included in the analysis, 24 525 (14.4%) had sarcopenia. After adjusting for confounding factors, sarcopenia was associated with a higher odds of in-hospital mortality [adjusted odds ratio (aOR), 2.16; 95% confidence interval (CI), 1.83-2.56; P < 0.001], shock (aOR, 2.18; 95% CI, 1.92-2.48; P < 0.001), AKI (aOR, 1.4; 95% CI, 1.32-1.49; P < 0.001), ICU stay (aOR, 2.23; 95% CI, 1.98-2.52; P < 0.001), LT-related complications (aOR, 1.47; 95% CI, 1.23-1.75; P < 0.001), longer length of stay (adj. coefficient, 4.71 days; 95% CI, 4.31-5.10; P < 0.001), and total hospitalization charges (adj. coefficient-$56 359.88; 95% CI, $49 737.17-$62 982.58; P < 0.001). We noted that sarcopenia is associated with worse outcomes and higher resource utilization in LT recipients, highlighting the need for early detection and targeted interventions.

The qualitative analysis of pharmaceuticals is a crucial part of the pharmaceutical industry's strategy for human safety. Developing a precise, consistent, and focused RP-HPLC stability test method for measuring Dapagliflozin in pharmaceutical dosage forms and API is the main objective of the ongoing efforts. The PDA detector was used for the inquiry, and the Agilent C18 column was used to obtain the separation required for this specific experiment. The mobile phase was a 30:10:60% v/v mixtures of sodium acetate buffer, THF, and methanol, and the effluent was measured at 223nm using a diode array detector. There was a 1 ml/min flow rate. The retention duration for Dapagliflozin was 6.5 minutes. After reviewing the literature, we found that , There was linearity in the range of for Dapagliflon, the correlation coefficient between 60 and 140 µg/ml (microgram/milliliter) was shown to be R2 = 0.99. The present method's accuracy was evaluated at 80%, 100%, and 120%. It was concluded that the Dapagliflozin test was accurate because the HPLC method produced 101.32% of the recoveries. Precision experiments revealed relative standard deviation values of less than two. The results from the previous data show that the RP-HPLC technique may be used successfully for the simultaneous assessment of Dapagliflozin in their formulation.

Second branchial sinus anomalies are rare congenital paediatric maladies that arise during intrauterine embryogenesis. A unique case of second branchial arch sinus in a 5-month-old infant, where a minimally invasive transcervical endoscopic intervention was undertaken, is being reported. The presentation was with recurrent discharge from a punctum at the lower lateral aspect of the neck. Global literature on second branchial arch anomalies is reviewed with clinical presentation, imaging, diagnosis, and therapeutic modalities of this rare entity.

Functional dyspepsia (FD) is a common disorder with multi-factorial pathophysiology. It has two sub-types, post-prandial distress syndrome (PDS) and epigastric pain syndrome (EPS), which frequently overlap. Emerging evidence suggests that low-grade inflammation, particularly duodenal eosinophilia (DE), may play a pathogenic role in FD. However, Indian data on this subject remains scarce. This study aimed at evaluating the prevalence and clinical correlates of DE in patients with refractory FD. In this prospective, cross-sectional study, Rome- IV defined FD patients with refractory symptoms and normal esophagogastroduodenoscopy (EGD) were enrolled. Age and sex-matched non-dyspeptic controls with normal EGD were also recruited. Standardized duodenal biopsies from cases and controls were independently assessed by two blinded histopathologists for eosinophil counts and degranulation. Symptom profiles and health-related quality of life (HRQoL) were evaluated using validated questionnaires. Of 274 patients with refractory dyspepsia screened, 189 patients with normal EGD (mean age 41.4 ± 15.2years; 54.5% males) were enrolled, along with 96 controls. The mean duodenal eosinophil count in controls was 8.2 ± 1.5 per high-power field (HPF). Applying the mean + 3 standard deviation criteria, DE was defined as ≥ 13 eosinophils/HPF. DE was identified in 65.3% (123/189) of refractory FD patients (65.7% in EPS, 52.5% in PDS and 69.1% in the overlap group, p > 0.05). Duodenal eosinophil counts correlated positively with PDS symptom severity (r = 0.376; p < 0.0001), overlap symptom severity (r = 0.3; p = 0.031) and worse HRQoL (r = 0.21; p = 0.010). Furthermore, patients with eosinophilic degranulation (24.3%) had significantly higher PDS scores and worse HRQoL scores, compared to those without degranulation. Up to two-thirds of the refractory FD patients exhibited duodenal eosinophilia, which was associated with increased symptom severity in PDS and overlap sub-types and poorer HRQoL. These findings support the incorporation of duodenal mucosal assessment in the diagnostic algorithm for refractory FD.

HFpEF accounts for 12-25% of heart failure cases in South Asia, primarily driven by hypertension, diabetes, and obesity. Late diagnosis and healthcare disparities worsen outcomes. This expert consensus aims to provide region-specific guidelines for the diagnosis, management, and prevention of HFpEF. A modified Delphi process with experts from five South Asian countries was conducted, informed by a literature review (2018-2024) and adapted international guidelines. Recommendations include the use of an adjusted H2FPEF score (BMI > 25 kg/m²), essential echocardiographic criteria (E/e' > 9, LAVi > 34 mL/m²) for diagnosis, and SGLT2 inhibitors as first-line pharmacotherapy, with finerenone for cardio-renal protection. Emphasis on lifestyle modification, patient education, and aggressive management of comorbidities is highlighted to reduce hospitalizations. HFpEF presents earlier and is associated with higher comorbidity in South Asia. Adaptations such as lower BMI thresholds and region-specific screening are critical. Cost and accessibility challenges persist in the use of SGLT2 inhibitors and finerenone. Public health measures and infrastructure strengthening are necessary to improve outcomes. Early diagnosis, multidisciplinary management, and tailored treatment strategies can enhance outcomes in HFpEF in South Asia. This consensus serves as a call for regionally focused implementation to reduce the burden of HFpEF.

Abstract Background Sexual dysfunction is an underrecognized but important concern among women with inflammatory bowel disease (IBD). We aimed to determine the prevalence and predictors of sexual dysfunction among women with IBD compared with age-matched controls in a low middle income country (LMIC). Methods This was a cross-sectional, case-control study conducted in north India between January and June 2025. Sexually active women with IBD and age-matched controls were enrolled. Sexual function was assessed using the Arizona Sexual Experiences Scale (ASEX). Clinical, demographic, reproductive, and psychosocial variables were recorded. Disease activity was assessed using the partial Mayo score (ulcerative colitis) or Harvey-Bradshaw Index (Crohn’s disease). Logistic regression identified independent predictors of sexual dysfunction in the IBD cohort. Results Ninety-eight women with IBD (median age 43 years) and 60 controls (median age 43 years) were included. The prevalence of sexual dysfunction was significantly higher in the IBD cohort than in controls (83.7% vs. 41.7%; p &amp;lt; 0.001). Domain-specific impairments in the IBD group were most pronounced in desire, arousal, and lubrication (all p &amp;lt; 0.001), with no significant differences in orgasmic domains. On multivariate analysis, diagnosis of IBD prior to marriage was independently associated with lower odds of sexual dysfunction (OR 0.055, 95%CI 0.004-0.73; p = 0.03). No significant associations were observed with disease subtype, activity, extent, medications, surgical history, or psychological co-morbidities. Conclusion Sexual dysfunction is highly prevalent among women with IBD, particularly affecting early stages of the sexual response cycle. Determinants extend beyond inflammatory activity, highlighting the need for routine sexual health assessment in IBD care. Conflict of interest: Dr. Singh, Arshdeep: No conflict of interest Bhardwaj, Arshia: No conflict of interest Bhardwaj, Gopal: No conflict of interest Sharma, Riya: No conflict of interest Thakur, Aman: No conflict of interest Bawa, Ashutosh: No conflict of interest Kaur, Harmeet: No conflict of interest Midha, Vandana: No conflict of interest Sood, Ajit: Ajit Sood received honorarium for speaker events from Pfizer India and Takeda India.

Dyslipidemia is a major, yet under-recognized, driver of atherosclerotic cardiovascular disease (ASCVD) in Indian women. This expert consensus provides India-specific guidance on early detection, risk stratification, and management of lipid disorders across the female life course. Seventy-five specialists from cardiology, endocrinology, lipidology, obstetrics–gynecology, and primary care participated in a modified Delphi process with three structured rounds. An agreement threshold of ≥80% was maintained to develop statements based on 20 key clinical questions and a comprehensive review of international and Indian evidence. The consensus emphasizes early and repeated lipid screening. All women should have at least one lipid profile between ages 20 and 39 years, with earlier and more frequent testing in those with a family history of premature ASCVD, suspected familial hypercholesterolemia, polycystic ovary syndrome, gestational diabetes, pre-eclampsia, premature menopause, or autoimmune disorders. Life-stage checkpoints such as pre-conception, 6–12 weeks postpartum, and at menopause are highlighted as critical opportunities for evaluation and intervention. The panel developed India-specific, life-stage-oriented risk assessment and management statements for women, emphasizing early lipid screening, recognition of female-specific risk enhancers, and practical treatment pathways. Management begins with lifestyle optimization and, when indicated, stepwise pharmacotherapy: Statins as first line (avoiding routine use in pregnancy and lactation), ezetimibe or fibrates as add-on therapy, and PCSK9 inhibitors or Inclisiran for very-high-risk cases not at target. Bile-acid sequestrants are identified as the safest drug option during pregnancy or breastfeeding. This statement integrates global best practice with India-specific risk profiles and care pathways. By embedding life-stage-oriented screening, female-specific risk enhancers, and risk stratification into routine care, it provides a practical roadmap for clinicians and public health programs to reduce the burden of ASCVD in Indian women.

Non-steroidal anti-inflammatory drugs (NSAIDs) are essential for their analgesic, anti-inflammatory and anti-pyretic properties. However, their extended use can lead to NSAID enteropathy, a frequently underdiagnosed condition of the small intestine. This pathology manifests as mucosal damage, ulcerations, strictures and increased intestinal permeability, potentially resulting in complications such as bleeding, protein loss and nutrient malabsorption. Modern diagnostic technologies, particularly capsule endoscopy, have revealed that small-bowel injury affects up to 70% of chronic NSAID users, although many patients remain asymptomatic. This comprehensive review explores the epidemiology, underlying mechanisms, clinical manifestations, diagnostic approaches and treatment strategies for NSAID enteropathy, while emphasizing the growing importance of increased clinical awareness and continued research into preventive and therapeutic interventions, especially as long-term NSAID use becomes more prevalent in our aging global population.