Background/Objectives Medical nutrition therapy along with pharmacological interventions as a multidisciplinary approach is required to treat type 2 diabetes mellitus (T2DM). This study evaluated the efficacy of Jackfruit365™ green jackfruit flour as an integral part of daily meal in patients with T2DM. Subjects/Methods This was a randomized, double-blind, placebo-controlled study conducted between May 2019 and February 2020. Patients of either sex aged ≥18 to ≤60 years with a diagnosis of T2DM for >1 year receiving oral antihyperglycemic agents were randomized (1:1) to receive either jackfruit flour 30 g/day (Group A) or placebo flour (Group B) (breakfast and dinner) daily for 12 weeks replacing an equal volume of rice or wheat flour. The primary endpoint was a mean change in glycosylated hemoglobin (HbA1c). Other endpoints were mean changes in fasting plasma glucose (FPG), postprandial plasma glucose (PPG), lipid profile, and body weight. The independent t-test was used to compare changes between the groups. Results A total of 40 patients were enrolled (n = 20 each). A significantly higher reduction in HbA1c was observed in Group A compared to Group B from baseline to week 12 [−2.73 mmol/mol (−0.25%) vs. 0.22 mmol/mol (0.02%), p = 0.006]. The mean change in FPG and PPG was significantly higher in Group A than that of Group B (p = 0.043 and p = 0.001). The continuous glucose monitoring showed decreasing mean blood glucose in 7 days of administration of jackfruit flour meal. Conclusion Patients from Group A had a significantly higher reduction in HbA1c, FPG, and PPG than Group B demonstrating the efficacy of jackfruit flour in glycemic control as medical nutrition therapy replacing an equal volume of rice or wheat flour in daily meal. Clinical trial registry CTRI/2019/05/019417.

<strong>Background:</strong>Knowledge of demographic profiles and baseline characteristics of HIV infected patients is essential for devising prevention strategies. Analysis of factors influencing improvement in CD4 cell count will help to determine prognosis and better implementation of ART.<p><strong>Objectives:</strong> This retrospective study was conducted on HIV patients in Manipur, to assess clinical profile and factors influencing baseline immunological status and response to ART.</p><p><strong>Methodology:</strong> 1231 patients were enrolled. Baseline demographic and laboratory parameters were recorded. CD4 cell counts were recorded at baseline and 6 months after ART initiation.</p><p><strong>Results:</strong> 66.3% patients were male, 74.6% aged 21-40 years, 65.6% were Hindus and 52.9% of urban residence. 17.5% patients had Haemoglobin ≤9 grams/dl. Prevalence of HIV-HBV and HIV-HCV coinfection was 3.4% and 20.5% respectively. Male sex (141.51±96.21 vs. 169.92±111.2 cells/mm³; p=0.001), age &gt;20 years and Haemoglobin ≤9 g/dl (127.5±99.5 vs. 153.8±99.1cells/mm³; p=0.001) were associated with lower baseline CD4 count. Females (219.01±187.2 vs. 161.79±153.35cells/mm³; p=0.001), age group 1-20 years and those without HIV-HCV coinfections (188.72±170.81 vs. 154.20±155.88 cells/mm³; p=0.004) had significant improvement in CD4 count at 6 months-post ART initiation. CD4 response in HIV-HBV coinfected patients was lower (188.59±170.65 vs. 162.39±139.8 cells/mm³; p=0.324) but not statistically significant.</p><p><strong>Conclusion:</strong> Majority of HIV patients in Manipur were - Males, Hindus, aged 21-40 years and of urban residence. Males, age &gt;20 years and haemoglobin ≤9 g/dl were associated with lower baseline CD4 count. HIVHBV/ HIV-HCV coinfection wasn't associated with lower baseline CD4 count. Females, age &lt;20 years and absence of HIV-HBV/HIV-HCV coinfections were associated with superior immunological response to ART.</p>

Background Hydroxychloroquine had attracted significant attention in the initial phases of the COVID-19 pandemic but current recommendations do not support its use. However, the evidence against its use as pre-exposure prophylaxis have been of low to moderate quality and have been limited by high risk of bias. Methods Following institutional ethics committee approval, healthcare workers (n = 1294) completing their first week-long COVID in-patient duty, subsequent institutional quarantine and RT-PCR testing for COVID-19 infection were included for this prospective cohort study. Demographic data, hydroxychloroquine usage and related adverse effects were captured through a ‘Caring for the Caregivers’ surveillance system. A chi-Square test of independence was used to determine the effect of hydroxychloroquine prophylaxis. Results Among the 1294 participants (age: 31 ± 7 years, 61% women), 273 (21.1%) healthcare workers used hydroxychloroquine prophylaxis as per Indian Council of Medical Research recommendations and 83/1294 (6.4%) tested positive after their duty. There was no significant difference in COVID-19 incidence between those on hydroxychloroquine prophylaxis and those not on it (5.9% vs 6.6%, χ 2 = 0.177, p = 0.675; RR = 0.89, 95% CI – 0.53 to 1.52). There were no significant adverse effects to hydroxychloroquine usage. Conclusion This study demonstrated no benefit of hydroxychloroquine prophylaxis and provides quality evidence against its use in COVID-19 prevention.

Introduction The Coronavirus disease 2019 (COVID-19) pandemic has provided a push in the search for alternative screening methods to replace annual fundoscopic examination of patients with type 2 diabetes mellitus (T2DM) to detect diabetic retinopathy (DR). Materials and methods This retrospective study was conducted using the data of T2DM patients from their routine follow-up hospital visits. The details from their history and physical examination were extracted. As part of their routine follow-up visit, they had undergone a panel of investigations that included blood glucose measurements and urinary albumin excretion measurements. Univariate and logistic multivariate regression analyses were applied to identify the potential clinical and laboratory parameters associated with the presence of DR in them. Results Analysis of the medical records of 272 T2DM patients revealed that 147 patients had DR while 125 did not. Furthermore, 135 had non-proliferative DR (64 mild, 53 moderate, and 18 severe grades), whereas the remaining 12 had proliferative DR. On sequential univariate and multiple regression analysis, urinary albumin creatinine ratio (UACR), known duration of T2DM, and history of ischemic heart disease were seen to be independently associated with the presence of DR. Median UACR for those without DR was 42.6 mg/g (range 18.21-183.3 mg/g) while for those with retinopathy it was 214 mg/g (range 45.4-1260 mg/g) (p<0.001). The receiver operating characteristics curve analysis provided an area under the curve of 70% for UACR. UACR value of 140 mg/g could predict the presence of DR with a sensitivity of 60.5% & specificity of 72%, as well as had positive and negative likelihood ratios of 2.16 and 0.54, respectively. Conclusion UACR has the potential to be used as a screening tool for DR until the easing of social restrictions due to the COVID-19 pandemic.