The Indian Practitioner

N. K. Soni ¹, H. H. Trivedi ², Sanjay Kumar ³, Anukalp Prakash ⁴, Soumen Roy ⁵, Amit Qamra ⁵, Supriyo Mukherjee ⁶

Affiliations
1 Yatharth Super Speciality Hospital, Greater Noida, IN
2 Senior Consultant, Internal Medicine, Bhopal, IN
3 Sunflower Medical Centre, Lucknow, IN
4 Paras Hospitals, Gurugram, IN
5 Medical Affairs, Macleods Pharmaceuticals Ltd., Mumbai, IN
6 Centre for Clinical Research and Practice & Research Centre for Diabetes, Hypertension and Obesity, Samastipur, IN

Abstract

Functional gastrointestinal disorders (FGIDs) also known as disorders of gut-brain interaction are chronic, recurrent disorders with no identifiable underlying pathology. The FGID with upper abdominal pain and discomfort is the hallmark feature of functional dyspepsia. Around 11-30 % prevalence of functional dyspepsia is reported worldwide. One of the unique features of functional dyspepsia is transient deficiency of digestive enzymes in the system. Digestive enzymes are produced and secreted by the gastrointestinal system to break down fats, proteins, and carbohydrates, to accomplish digestion and, afterwards, the absorption of nutrients. Supplementation with digestive enzymes could provide management of disorders caused by impaired digestive function. Various formulations of enzyme supplementation are available commercially in the market, and are currently used in clinical practice for the management of several digestive diseases. Probiotics have multi-faceted role, helping to restore the gut microbiota.

This review elaborates the potential of multi digestive enzymes along with probiotics in the management of digestive diseases and dyspepsia.

Keywords

Digestive enzyme, Probiotics, Functional Dyspepsia, Indigestion.

Full Text

     

Sandeep Nayar ¹, Puneet Khanna ², Pankaj Anand ³, N. K. Soni ⁴, Niraj Tyagi ⁵, Yashwant Dubey ⁶, Siddharth Patanwar ⁷, Aaditi Phadke ⁸, Parthasarathy Muralidharan ⁸, Amit Qamra ⁸

Affiliations
1 Senior Director and Head, BLK Centre for Chest & Respiratory diseases, BLK Super Speciality Hospital, New Delhi, IN
2 Senior Consultant and Head, Department of Interventional Pulmonology, Respiratory & Sleep Medicine, Manipal Hospitals, New Delhi, IN
3 Senior Consultant, Critical Care & Internal Medicine, Fortis Escorts Hospital, Jaipur, IN
4 Senior Consultant & Head- Internal Medicine & Diabetology. Yatharth Super Speciality Hospital, Greater Noida, IN
5 Consultant, Institute of Critical Care Medicine, Sir Ganga Ram Hospital, New Delhi, IN
6 Senior Consulting Physician, Arpan Sugar Clinic, Bilaspur, IN
7 Department of Pulmonary Medicine, AIIMS, Raipur, IN
8 Department of Medical Affairs, Macleods Pharmaceuticals Ltd., Mumbai, IN

Abstract

The COVID‑19 pandemic has gripped the world in fear with more than 109 million cases and more than 2.4 million deaths as of 16th February 2021. After US, India has the second highest number of cases in the world. A pandemic of this scale has clearly become an unmet medical need warranting research on effective pharmaco-therapeutic agents. Given the time constraints, existing drugs have been repurposed to fill in the gap. Ivermectin is an FDA-approved broad spectrum antiparasitic agent. It is enlisted in the core list of WHO Model List of Essential Medicine 2019. Ivermectin is economical, easily available and safe without any major side effects. Recent research has shown that Ivermectin possesses strong anti-viral properties. It can also be safely combined with other repurposed drugs for Covid-19. Here, we review mechanism of action and current scientific evidence of Ivermectin in treatment and prophylaxis of Covid-19. A number of ongoing clinical trials are evaluating the drug further in the treatment and prophylaxis of Covid-19. Based on the current clinical evidence in treatment and prophylaxis, Indian Experts’ consensus and recommendations by multiple Indian state governments, Ivermectin may effectively and safely add to the current armamentarium of Indian clinicians involved in the care and management of Covid-19 patients.

Keywords

Ivermectin, Covid-19. SARS-CoV-2.

Full Text

     

K. R. Meghanadh ¹, Mandeep Kaur ², Deepak Haldipur ³, Charuhas Jagtap ⁴, N. K. Soni ⁵, Ashwin Kotamkar ⁶, Aaditi Phadke ⁶, Parthasarathy Muralidharan ⁶, Amit Qamra ⁶

Affiliations
1 Department Otorhinolaryngology and Head and Neck Surgery, MAA ENT Hospital, Hyderabad, IN
2 Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, IN
3 Department of ENT, Trustwell Hospitals, Bangalore, IN
4 Department of ENT, Jagtap Hospital, Dhule, IN
5 Department of Internal Medicine & Diabetology, Yatharth Super Speciality Hospital, Greater Noida, IN
6 Department of Medical Affairs, Macleods Pharmaceuticals Ltd., Mumbai, IN

Abstract

Recurrent aphthous stomatitis (RAS) is one of the commonly observed disease of the oral cavity and the prevalence ranges from 5 to 60%. Despite its high prevalence, the exact pathophysiology of the disease remains unknown. Multiple etiologic factors, followed by three stages of the disease, and types based on severity, with addition of pain and inflammation makes the management challenging for the clinician. A number of drugs are available for the treatment having their own advantages and limitations. In this narrative review, we review the available Indian evidence with Rebamipide in RAS. Indian clinical evidence clearly establishes the safety and efficacy of rebamipide in the management of RAS. Thus, considering the benefits of reduced duration of pain, accelerated healing and decreased recurrence, we conclude that the current Indian evidence supported by our clinical experience establishes the role of Rebamipide in RAS. Hence, we recommend Rebamipide may be considered as a first line treatment option in RAS.

Keywords

Recurrent Aphthous Stomatitis, Rebamipide.

Full Text