Effective reduction of blood pressure to accepted goals is the key to reduce the risk of CV events and stroke. Dual inhibition of neprilysin and the angiotensin receptor with sacubitril/valsartan may represent an attractive and serendipitous therapeutic approach for a range of CV diseases, including hypertension and HF, in which vasoconstriction, volume overload and neuro-hormonal activation play a part in pathophysiology. Sacubitril/Valsartan appears to be more efficacious in reducing blood pressure than currently available ACEi and ARBs with a similar safety and tolerability profile. Besides, pleiotropic benefits like HbA reduction, better eGFR progression and a greater decrease in blood pressure and serum creatinine levels make this drug a novel addition to the current hypertension armamentarium.

Group A beta-hemolytic streptococcal (GABHS) infection is the most common bacterial cause of acute pharyngitis. GABHS is more commonly seen in the pediatric age group than in adults. The disease responds to antibiotics. Untreated GABHS leads to non-suppurative and suppurative complications. Penicillin is the drug of choice recommended by most guidelines. Most GABHS isolates are sensitive to penicillin including penicillin G. Penicillins play a very important role in preventing transmission rates of GABHS, resolution of symptoms, and prevention of GABHS complications. Intramuscular penicillin G benzathine is one of the treatment options for GABHS. Penicillin G potassium is a natural penicillin, with a narrow spectrum of activity, as is required for GABHS. This review aims to understand the role of penicillins in the treatment of GABHS and its complications.

Background: We conducted a physician-based survey to understand the management and clinical practicing patterns of venous thromboembolism (VTE) by physicians in India. Methods: This was an observational, physician-based clinical survey. A set of 22 questions on diagnosis, prophylaxis, duration of treatment, and risk factors of VTE was formulated along with nine patient case-studies. Seventy-six consulting physicians across India responded to the survey questionnaire. An expert panel comprising vascular surgeon, cardiac surgeon, and senior physicians provided recommendations on the recorded survey responses. Results: About 63.16% of physicians considered clinical examination of VTE based on signs and symptoms, whereas 23.68% used deep-vein thrombosis (DVT) scores (Wells score) to assess patients' risk. Recent surgery was considered a risk factor for developing DVT or pulmonary embolism by 86.84% of physicians; 82.89% preferred performing duplex ultrasonography test, and on positive results, treated patients for DVT. Dabigatran was the preferred choice of treatment by the participants. VTE prophylaxis with oral anticoagulants was considered by 80.3% of physicians during major orthopedic surgery. Direct oral anticoagulant (DOAC) with bridging therapy was preferred by 44.74% of physicians and 77.63% felt that DOACs will lead to a better quality of life for VTE patients. For patients with permanent risk factors of DVT, 76.32% of physicians preferred the indefinite duration of anticoagulation therapy. Conclusions: VTE remains a growing area of concern that needs to be managed in line with the clinical guidelines. These insights may aid in developing strategies for diagnostic accuracy and treatment of DVT.

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