A PROSPECTIVE NON-RANDOMIZED STUDY OBSTRUCTION OF GASTRIC OUTLET: OUTCOMES OF ANTRODUODENAL STENTING.

Background: The advanced stage of gastric cancer is commonly characterized by gastric outlet obstruction (GOO), extrinsic lymph node compression, and pancreaticobiliary malignancy. The patient presents with symptoms of gastric discomfort, postprandial epigastric fullness, and recurrent abdominal pain. The act of emesis can lead to significant consequences such as severe dehydration, malnutrition, and a diminished quality of life (QoL). Endoscopic enteral stent implantation has gained recognition as a viable alternative treatment modality for malignant gastric outlet obstruction (GOO) due to its favorable safety profile, minimal invasiveness, and cost-effectiveness. Method: For five years, a prospective, non-randomized study was conducted on Patients who had a gastric outlet obstruction (GOO) and weren’t candidates for surgery because of the procedure’s high morbidity, refusal, or low nutritional status were suitable if they were over 18. The stent that was utilized was a Wallflex by Boston Scientific Corporation, MA, United States, exposed SEMS with a diameter of 27 mm (22 mm at the mid-body) and lengths of 60, 90, or 120 mm preloaded in a 10 Fr delivery system Result: The presence of Gastric Outlet Obstruction Score (GOOS) 1 was observed in three instances 8 instances (53.33%) of those with laboratory evidence of biliary blockage had biliary drainage (50.00% endoscopic and 50.00% surgical). A favorable response to the intervention of oral diet tolerance was observed, with an average duration of approximately 1 day (19 hours) until the patient could tolerate a liquid diet Conclusion: The utilization of self-expandable metal stents (SEMS) in the management of gastroduodenal malig- nancies is a viable, safe, and effective strategy, especially in individuals with a limited life expectancy or in advanced disease states. This intervention facilitates improvements in both nutritional status and overall quality of life

A RETROSPECTIVE OBSERVATIONAL STUDY ON THE EFFECTS OF TYPE 2 DIABETES AND ITS MANAGEMENT ON INDIVIDUALS WITH SEVERE COVID-19 PATIENTS’ PROGNOSIS.

Background: Type 2 diabetes (T2D) as a worldwide chronic disease combined with the COVID-19 pandemic necessitates improving the management of hospitalized COVID-19 patients with preexisting T2D to reduce complications and the risk of death. Methods: In this retrospective study, the clinical characteristics of 193 patients with severe covid-19 were gathered. 48 patients with severe covid-19 had diabetes, while 145 patients (the control group) did not. Results: 48 (24.9%) of 193 patients with severe covid-19 had diabetes. In comparison to patients with severe covid-19 who did not have diabetes, those with diabetes were elderly, more likely to require mechanical ventilation and ICU admission, and had a higher mortality rate. Moreover, patients with severe covid-19 and diabetes had elevated levels of leukocyte count, neutrophil count, high-sensitivity C reaction protein, procalcitonin, ferritin, interleukin (IL) 2 receptor, IL-6, IL-8, tumour necrosis factor, D-dimer, fibrinogen, lactic dehydrogenase, and N-terminal pro-brain natriuretic peptide. Among patients with severe covid-19 and diabetes, men were more likely to not survive [30 (76.9%) vs. 9 (23.1%)]. Conclusion: The mortality rate among patients with severe covid-19 and diabetes is substantial. Diabetes may increase the likelihood of mortality

Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the East India cohort of the A 1 chieve study

Background: The A1chieve, a multicentric (28 countries), 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from East India. Results: A total of 2177 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n=1605), insulin detemir (n=230), insulin aspart (n=233), basal insulin plus insulin aspart (n=49) and other insulin combinations (n=54). At baseline glycaemic control was poor for both insulin naïve (mean HbA1c: 8.9%) and insulin user (mean HbA1c: 9.1%) groups. After 24 weeks of treatment, both the groups showed improvement in HbA1c (insulin naïve: -1.6%, insulin users: -1.6%). SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia