Bharti Hospital and BRIDE

Karnāl, India

Bharti Hospital and BRIDE

Karnāl, India
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Kalra S.,Bharti Hospital And Bride
Journal of Diabetes and Metabolic Disorders | Year: 2012

Developing countries shoulder most of the burden of diabetes and tuberculosis. These diseases often coexist. Suboptimal control of diabetes predisposes the patient to tuberculosis, and is one of the common causes of poor response to anti-tubercular treatment. Tuberculosis also affects diabetes by causing hyperglycemia and causing impaired glucose tolerance. Impaired glucose tolerance is one of the major risk factors for developing diabetes. The drugs used to treat tuberculosis (especially rifampicin and isoniazid) interact with oral anti-diabetic drugs and may lead to suboptimal glycemic control. Similarly some of the newer oral anti-diabetic drugs may interact with anti-tuberculosis drugs and lower their efficacy. Therefore diabetes and tuberculosis interact with each other at multiple levels - each exacerbating the other. Management of patients with concomitant tuberculosis and diabetes differs from that of either disease alone. This article reviews the association between diabetes and tuberculosis and suggests appropriate management for these conditions. © 2012 Niazi and Kalra; licensee BioMed Central Ltd.


Kalra S.,Bharti Hospital And Bride | Gupta Y.,Government Medical College and Hospital
Diabetes Therapy | Year: 2015

Coformulations are a novel pharmaceutical development in diabetology. They are composed of two medicinal products, both of which maintain their distinct pharmacokinetic and pharmacodynamic properties. Currently available coformulations include combinations of basal and rapid-acting insulin, and basal and glucagon-like peptide 1 receptor agonists (GLP1RA). This review describes three coformulations which are in advanced stages of development, or are approved in certain markets. We discuss the basic and clinical pharmacology of these drugs, while describing clinical usage of the commercially available insulin degludec aspart (IDegAsp). © 2015, The Author(s).


Kalra S.,Bharti Hospital and BRIDE | Gupta Y.,Government Medical College
Recent Patents on Endocrine, Metabolic and Immune Drug Discovery | Year: 2014

Insulin analogues are a major improvement in diabetes pharmacotherapy. Rapid acting insulins have certain advantages over regular insulin, but there is a need to develop even faster acting insulin preparations, which mimic physiological insulin release in a better manner. This review discusses recent developments and patents in the field of Ultra-fast acting insulins. It classifies various approaches towards creation of an Ultra-fast acting insulin profile based upon the method used to achieve a faster onset of action. These include change in formulation of insulin, addition of excipients to insulin, and utilization of novel insulin sites or delivery methods. It examines the current state of evidence, and the developments in the field of newer insulin analogues & delivery methods. © 2014 Bentham Science Publishers.


Kalra S.,Bharti Hospital and BRIDE
Journal of the Pakistan Medical Association | Year: 2013

The grand dame of diabetes pharmacotherapy, nearly a century old, insulin continues to be the subject of discovery and innovation. Fresh research, combined with extensive clinical experience, has brought newer facets of insulin use to the fore. Thus, insulin still exudes maiden charm. This review covers recent advances in the clinical pharmacology of insulin.


Kalra S.,Bharti Hospital and BRIDE
Journal of the Pakistan Medical Association | Year: 2014

Premixed biphasic insulin is the most commonly prescribed insulin in Pakistan, as well as in neighbouring countries. This article describes the rationale of using premixed insulin both for initiation and intensification, the evidence in its favour, and the guidelines supporting its use. The review discusses recent advances in the field of premixed insulin, especially insulin degludec aspart combination.


Kalra S.,Bharti Hospital and BRIDE | Balhara Y.P.S.,All India Institute of Medical Sciences
Recent Patents on Endocrine, Metabolic and Immune Drug Discovery | Year: 2014

Thyroid dysfunction and psychiatric disorders share a bidirectional relation. Thyroid hormones have been found to affect the central nervous system both structurally and functionally. Conventional antidepressant drug therapy is characterized by a delayed and at times suboptimal response. Various strategies have been devised in order to circumvent this limitation. L- Thyroxine has been used as both acceleration therapy and augmentation therapy as adjuvant therapy with antidepressants. The hormone has also been used as monotherapy, both in prevention and management of depression. The potential use of thyroid hormone as an adjunct therapy in management of euthyroid depression and relevant patents has been discussed. © 2014 Bentham Science Publishers.


Kalra S.,Bharti Hospital and BRIDE
Journal of the Pakistan Medical Association | Year: 2014

Alpha glucosidase inhibitors (AGIs) are a unique class of anti-diabetic drugs. Derived from bacteria, these oral drugs are enzyme inhibitors which do not have a pancreato -centred mechanism of action. Working to delay carbohydrate absorption in the gastrointestinal tract, they control postprandial hyperglycaemia and provide unquestioned cardiovascular benefit. Specially suited for a traditional Pakistani carbohydrate-rich diet, AGIs have been termed the 'untapped diamonds' of diabetology. The use of these oral antidiabetic drugs (OADs) that target pathophysiology in the early stages of type 2 diabetes, notably to reduce postprandial hyperglycaemia and hyperinsulinaemia will inevitably increase with time. This review describes the history of their development, mechanism of action, basic and clinical pharmacology, and suggests practical, evidence-based guidance for their optimal use.


Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a newly developed class of oral anti-diabetic drugs (OADs) with a unique mechanism of action. This review describes the biochemistry and physiology underlying the use of SGLT2 inhibitors, and their clinical pharmacology, including mechanism of action and posology. The pragmatic placement of these molecules in the existing OAD arena is also discussed. © 2014, The Author(s).


Kalra S.,Bharti Hospital and BRIDE
Diabetes Therapy | Year: 2014

Insulin degludec/insulin aspart (IDegAsp) is the first soluble co-formulation which combines two insulin analogues, and provides effective basal and prandial glycemic coverage. It has been assessed as basal insulin in type 2 diabetes mellitus (T2DM), and as part of basal-bolus regime in both type 1 diabetes mellitus and T2DM. Insulin degludec has also been assessed as flexibly administered basal insulin in terms of time of administration. This review discusses data pertaining to the efficacy, safety, tolerability, and clinical potential of IDegAsp. The discussion includes comparisons of IDegAsp with basal as well as premixed insulin. © 2014, The Author(s).


Kalra S.,Bharti Hospital and BRIDE
Journal of the Pakistan Medical Association | Year: 2014

Hypoglycaemia is perhaps the most common complication of diabetes management. Often fatal, this condition can easily be prevented and managed. This paper reviews recent advances in understanding the causes of iatrogenic hypoglycaemia in diabetes, and the clinical risk factors associated with it. It provides a simple framework to help classify and asses these causative and risk factors. Also discussed are relevant nonpharmacological and pharmacological strategies to help prevent and manage hypoglycaemia.

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