BACKGROUND: Carnitine insufficiency is responsible for various co-morbid conditions in maintenance hemodialysis (MHD) patients. L-carnitine supplementation is expected to improve the quality of life (QoL) of patients on MHD. AIMS: To study the effect of L-carnitine supplementation on QoL of Indian patients on MHD. SETTING AND DESIGN: This was a single (patient) blind, randomized, placebo-controlled clinical trial conducted on patients on MHD attending hemodialysis unit of the study center. MATERIALS AND METHODS: Twenty patients on MHD suffering from hemodialysis related symptoms were randomly assigned to receive intravenous L-carnitine 20 mg/ kg or placebo after every dialysis session for 8 weeks. SF36 (Short Form with 36 questions) score for QoL, laboratory investigations and dialysis related symptoms were recorded at baseline and after 8 weeks. Improvement in QoL, laboratory parameters and dialysis related symptoms in the two groups after 8 weeks was compared. STATISTICAL ANALYSIS USED: Depending on normality of data, unpaired T test or Mann Whitney U test was used for comparison of change (8 weeks-baseline) in SF36 scores and laboratory parameters observed in the two groups. RESULTS: L-carnitine supplementation increased total SF36 score by 18.29 ± 12.71 (95% CI: 10.41 to 26) while placebo resulted in reduction in total SF36 score by . L-carnitine also resulted in significant increase in hemoglobin and serum albumin and decrease in serum creatinine as compared to placebo. More patients were relieved of dialysis related symptoms in L-carnitine group. CONCLUSION: Intravenous L-carnitine supplementation improves QoL in patients on MHD.

To assess the effect of miglitol versus repaglinide on postprandial hyperglycemia and glycosylated hemoglobin in Type-2 diabetes mellitus. METHODOLOGY: This open-labeled randomized glycaemic control. parallel group prospective clinical trial of 16-week duration included 60 patients of Type-2 diabetes randomly assigned to receive miglitol 25 mg thrice a day for four weeks followed by 50 mg thrice a day for 12 weeks or repaglinide 0.5 mg thrice a day for four weeks followed by 1 mg thrice a day for 12 weeks. Glycosylated hemoglobin, fasting and postprandial plasma glucose levels were assessed at the start and end of the study. RESULTS: The mean glycosylated hemoglobin, postprandial plasma glucose levels as well as fasting plasma glucose decreased significantly in miglitol as well as repaglinide group (P<0.001). There was no significant difference in the reduction of glycosylated hemoglobin between miglitol (1.14%) versus repaglinide group (1.45%, P=0.32). The postprandial glucose reduction in miglitol group (88.5 mg%) was not different from repaglinide (101.2 mg%, P=0.23). Similarly reduction in fasting glucose between miglitol (45.6 mg%) and repaglinide (40.86 mg%) was not significantly different (P=0.73). Conclusion: Miglitol and repaglinide are equally efficacious in reducing postprandial glucose levels, fasting glucose levels as well as glycosylated hemoglobin.