Postgraduate medical journal
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The incidence of type 2 diabetes is rapidly rising worldwide leading to an increasing burden of cardiovascular and microvascular complications. The aim of treatment of the condition is to improve quality of life and reduce such complications. To this end, improvement in glucose control remains an important consideration. ⋯ These include the use of dipeptidylpeptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium glucose transporter-2 inhibitors. The latter two classes appear to have some specific beneficial effects on cardiovascular and renal outcomes, independent of their antihyperglycaemic effects. This review aims to outline the current state of diagnosis and management of diabetes for the general physician, with a particular focus on new therapeutic agents for management of glucose in patients with type 2 diabetes.
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Randomized Controlled Trial
Drain in laparoscopic cholecystectomy in acute calculous cholecystitis: a randomised controlled study.
There is paucity of evidence regarding the role of drain in laparoscopic cholecystectomy (LC) in acute calculous cholecystitis (ACC), and surgeons have placed the drains based on their experiences, not on evidence-based guidelines. This study aims to assess the value of drain in LC for ACC in a randomised controlled prospective study. ⋯ Drains should not be placed routinely after LC in ACC as it increases pain and does not help in detecting or decreasing complications.
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Comparative Study
Comparative evaluation of quality of diabetes care within a population using discrete HbA1c thresholds versus longitudinal trends within a defined time period.
HbA1c is a quality measurement for a population's diabetes care. Currently, discrete values are used to judge the care quality. However, an improved trend may have been achieved without reaching a discrete threshold. We aimed to compare the quality of glycaemic care using discrete thresholds versus longitudinal trends of a patient's HbA1c. ⋯ Our study highlights the need to consider longitudinal trends when measuring quality of diabetes care.
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In this study, we aimed to investigate the usefulness of P wave peak time (PWPT), a novel ECG parameter, in patients who were diagnosed with acute ischaemic stroke (IS) and had paroxysmal atrial fibrillation (PAF) on Holter monitoring. ⋯ To the best of our knowledge, this is the first study to demonstrate a significant relationship between PWPT in lead DII and PAF among patients with acute IS.