Case Note: Gout Flare Triggered by Bempedoic Acid Clinical Presentation A 42-year-old man with a background of familial hypercholesterolemia, essential hypertension, and a prior anterior wall myocardial infarction (3 years ago) presented to the outpatient clinic with acute

“Exercise Intensity Influences Body Composition: A 6-month Comparison of High-Intensity Interval, Moderate- and Low-Intensity Training among Healthy Older Adults” (Maturitas. 2025; Vol 188: 105717 | DOI: 10.1016/j.maturitas.2025.105717) CME INDIA Scientific Pearl Exercise

Obesity, Inflammation, and Testosterone 🔹 1. The Obesity–Hypogonadism Vicious Cycle Obesity → Leptin resistance and insulin resistance, impairing hypothalamic–pituitary–gonadal (HPG) signaling. ↓ Kisspeptin → ↓ GnRH → ↓ LH → ↓ Leydig cell testosterone synthesis.

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🔹 Residual C-peptide and Glycaemic Control in Type 1 Diabetes Source: Diabetologia, 2025. DOI: 10.1007/s00125-025-06578-1* 🩸 Essence Even years after diagnosis, many adults with type 1 diabetes retain measurable endogenous insulin (C-peptide). This residual secretion

Case by Dr Harish Darla, Mysuru Bilateral earlobe creases (Frank’s sign) in a 20-year-old male. Frank’s sign is classically a diagonal earlobe crease extending from the tragus toward the edge of the earlobe, historically associated with coronary artery disease (CAD) in older

Dr B Sibu: Could this be due to insulin antibody syndrome (Hirata’s disease)? Answer While Insulin Autoimmune Syndrome (Hirata’s disease) can mimic insulinoma, it usually shows: Postprandial (not fasting) hypoglycemia, Extremely high insulin with disproportionately low

* Weight based TDD calculator By Parimal Swamy, Jabalpur SMART Insulin Worksheet — (for educational purpose) Quick Steps Guide for using the SMART Insulin Worksheet app for insulin initiation, titration, and correction. Step 1: Enter Patient Details • Weight (kg) – Enter

Noninvasive Assessment of Liver Fibrosis (NEJM 2025) 🔍 Key Concepts The extent and progression of liver fibrosis define the prognosis in chronic liver disease. Early detection of fibrosis before cirrhosis develops changes outcomes and enables prevention strategies. ⚙️

CME INDIA MCQ A 40-year-old overweight female presents with recurrent episodes of sweating, dizziness, and confusion relieved by eating. Her fasting plasma glucose is 41 mg/dL, postprandial glucose 92 mg/dL, insulin 98 µIU/mL, and C-peptide 10.8 ng/mL. MRI-MRCP of the pancreas

🫀 PREVENT-TAHA8 Trial (BMJ 2025;391:e083382) “Prevention of Acute Myocardial Infarction–Induced Heart Failure by Intracoronary Mesenchymal Stem Cells” 🎯 Study Objective To determine whether early intracoronary infusion of Wharton’s jelly–derived allogenic mesenchymal stem

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Key diagnostic clues for Hirata’s disease (Insulin Autoimmune Syndrome, IAS) - ▪️The condition is marked by distinct clinical and laboratory findings that help distinguish it from other causes of hypoglycemia. ▪️Main Clinical and Laboratory Clues to Hirata’s Disease

🩸 Alpha-Lipoic Acid and Insulin Autoimmune Syndrome (IAS) 💊 Alpha-lipoic acid (ALA), an antioxidant often used for diabetic neuropathy, can rarely trigger Insulin Autoimmune Syndrome (Hirata’s disease) — a cause of spontaneous hypoglycemia in non-diabetics. 🔍 Mechanism ALA

Case based Learning Diffuse Idiopathic Skeletal Hyperostosis (DISH) in a Longstanding Diabetic Clinical Summary A 62-year-old man presented with a 3-month history of gradually progressive lower back pain and stiffness. The stiffness was particularly marked in the morning,

🧠Approach to Insulinoma — Which is the Earliest and Most Reliable Diagnostic Test ? ✅ The 72-Hour Supervised Fasting Test is the gold standard and earliest diagnostic test for insulinoma. Why This Test Is Diagnostic Insulinomas secrete insulin autonomously — even during