T2DM on Dapagliflozin 5 mg with Urine Ketones Case by Dr Vinay Dhandhania, Diabetologist, Ranchi Patient summary : Known Type 2 Diabetes Mellitus On Dapagliflozin 5 mg HbA1c: 7.8% → unsatisfactory but not severe hyperglycaemia Estimated average glucose ~177 mg/dL Urine

🧿 IDF Diabetes Atlas 11th Edition | Lancet Diabetes & Endocrinology 2025 🔍 Global Burden at a Glance (2024) 1 in 9 adults worldwide now lives with diabetes 589 million adults (11.1%) affected globally in 2024 Projected to rise to 853 million (≈13%) by 2050 🌍 Age, Sex &

Fournier’s Gangrene in a 65-year-old man with T2DM on Dapagliflozin (Suspected SGLT2i-associated event) By Dr Vinay Dhandhania, Diabetologist, Ranchi Patient Details Age/Sex: 65-year-old male Diabetes: Type 2 diabetes mellitus × 5 years Glycemic status: HbA1c 7.6%

Lipoprotein(a) & Vascular Redox Dysfunction in Advanced CAD (Arterioscler Thromb Vasc Biol, 2025) 🔍 Key Mechanistic Insight Lp(a) promotes atherosclerosis not just by lipid burden, but by inducing vascular redox and nitrosative stress. @Lipidaoi1 @IndiaESI @drmohanv

Semaglutide vs Orforglipron: Peptide vs Small-Molecule GLP-1 RA in Obesity 🔍 Figure-Based Insight Both injectable semaglutide (2.4 mg) and oral orforglipron produce clinically meaningful weight loss and cardiometabolic benefits, but differ fundamentally in molecular design,

The Cardiovascular–Liver–Metabolic (CLM) Syndemic: A Unified Disease Paradigm 🔍 Key Insight Cardiovascular disease, metabolic-dysfunction–associated steatotic liver disease (MASLD), obesity, and type 2 diabetes do not occur in isolation—they form a global syndemic, driven by

Chronic Kidney Disease in Type 1 Diabetes: An Unmet Therapeutic Frontier 🔍 Key Insight Nearly 1 in 3 individuals with T1D develop CKD, yet most landmark renoprotective trials have excluded T1D, creating a major evidence gap despite shared pathogenic mechanisms with T2D. 🌟

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Why Do Night-Time Heart Attacks Cause Less Damage Than Daytime Events? Role of Neutrophils & the Circadian Immune Clock 🔬 Key Insight Myocardial injury shows clear circadian variation. Ischemic events occurring at night are associated with smaller infarct size and reduced

🧿 Pharmacologic Pitfalls in Heart Failure European Journal of Heart Failure – Expert Consensus (Dec 2025) 🌟 Key Clinical Pearls 1️⃣ Polypharmacy is a major driver of HF decompensation Risk of adverse drug interactions rises from 13% (2 drugs) to >80% (≥7 drugs) Many

Reversal of the VT pattern : When the electrical signatures of VT disappear and reverse, the pattern strongly supports SVT with aberrancy Electrophysiological interpretation The atrial impulse travels down the His–Purkinje network, say with a bundle branch block: The initial 40

Vereckei aVR Algorithm : Its clinical application Though the underlying electrophysiology rests on 3 fundamental components , the algorithm is interpreted through 4 decisive steps. Connecting the three electrophysiological triad with four steps sequences Initial dominant

Electrophysiological concept Vi/Vt The key electrophysiological concept Vi/Vt is illustrated here through lead aVR.

Electrophysiological Triad as registered through lead aVR In ventricular tachycardia, the electrical wavefront involves the ventricles with three distinct electrophysiological phases, which are registered through lead aVR : Initial Phase : Slow “muscle-to-muscle” activation

The lead aVR views the upper (basal) interventricular septum , the point from where the impulses are directed downward towards the ventricular system. This lead also receives reciprocal information being transferred from the oppositely situated left ventricle (LV). See

Sunday ECG ACADEMICs Vereckei Criteria through Lead aVR : A two pathway (VT/SVT-A) Diagnostic approach DR. D.P. KHAITAN, MD (MEDICINE) FCGP (IND) FIAMS (MEDICINE) FICP FICCMD,FIACM Gayajee,Bharat @EkgHacks @agingdoc1 @ShakyEKG_MD @smithECGBlog @ECGWeekly @EcgOxford @OnlyEcg1

Sunday ECG ACADEMICs Vereckei Criteria through Lead aVR : A two pathway (VT/SVT-A) Diagnostic approach DR. D.P. KHAITAN, MD (MEDICINE) FCGP (IND) FIAMS (MEDICINE) FICP FICCMD,FIACM Gayajee,Bharat @EkgHacks @agingdoc1 @ShakyEKG_MD @smithECGBlog @ECGWeekly @EcgOxford @OnlyEcg1

GLP-1 Receptor Agonists & Alcohol-Related Outcomes (2025 | Systematic Review & Meta-analysis) (Binayak Sinha & Samit Ghosal, Kolkata) @SAMITGHOSAL @BinayakSinha1 🔍 Key Question Do GLP-1 receptor agonists (GLP-1RAs) reduce alcohol consumption, craving, or alcohol-related events