Publications by authors named "Ashok Kumar Das"

Background & objectives While obesity usually produces cardio-metabolic dysfunction, some obese individuals are metabolically healthy, and conversely, some nonobese individuals have significant metabolic dysfunction. This study aims to assess the national prevalence of various obesity subtypes and their association with type 2 diabetes (T2D), coronary artery disease (CAD), and chronic kidney disease (CKD) in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. Methods The ICMR-INDIAB study is a nationally representative cross-sectional survey of 1,13,043 individuals aged ≥20 yr from urban and rural areas across 31 Indian States and Union Territories.

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Primary prevention of diabetes still remains as an unmet challenge in a real world setting. While, translational programmes have been successful in the developed nations, the prevailing social and economic inequities in the low and middle income countries, fail to integrate diabetes prevention into their public health systems. The resulting exponential increase in the prevalence of diabetes and the cost of treatment has put primary prevention in the back seat.

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Introduction: A slower adoption rate of fixed dose combinations (FDC) in diabetes management is partly due to insufficient data. This study evaluates the safety and efficacy of an FDC of dapagliflozin + sitagliptin + metformin hydrochloride extended release (XR), compared to a dual FDC of sitagliptin + metformin hydrochloride XR among patients with type 2 diabetes mellitus (T2DM) with poor glycemic control when treated with metformin monotherapy.

Methods: A total of 274 patients with T2DM were randomized (1:1) to either arm X, receiving FDC of dapagliflozin (10 mg) + sitagliptin (100 mg) + metformin hydrochloride XR (1000 mg) (Dapa + Sita + Met) tablets, or arm Y, receiving sitagliptin phosphate (100 mg) + metformin hydrochloride XR (1000 mg) (Sita + Met) tablets, and treated for 16 weeks.

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The prevalence of hypertension is on the rise, with approximately 200 million individuals affected by this condition in India. Epidemiological studies suggest that one in every three adults in India has hypertension. Fixed-dose combinations (FDCs) present a potential strategy to address the challenge of effective blood pressure control.

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Squamous cell carcinoma of the oral cavity is the most common malignancy of head and neck cancer in India. With nodal dissemination, there is a significant decrease in survival. This study is aimed at studying the impact of occult metastasis on an estimated overall survival in clinically N0 patients post neck dissection.

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Article Synopsis
  • * The research introduces a new model called NATURE, which uses a multi-level clustered structure to improve attack resistance, reduce communication load, and enhance efficiency in industrial settings.
  • * NATURE incorporates a multifactor trust estimation framework that evaluates node performance based on behavior, energy use, and communication reliability, enabling adaptive trust assessments and prioritizing recent node actions for better network dependability.
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Background: with the requirement of aggressive follow-up in patients with biochemically incomplete response in patients of papillary ca. thyroid with neck node, a predictor for clinical response would be of great help for better treatment and follow-up planning.

Aim: To determine the utility of lymph-node ratio (central and lateral) as predictors for clinical response post total thyroidectomy and neck dissection.

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Skull base chordomas are a rare entity that requires multidisciplinary decision-making for management. We report a case wherein the patient was initially mismanaged at a peripheral centre, and was then redeemed by a multidisciplinary tumor board decision-making and specialized surgical procedures. We also present a brief review of the therapeutic options.

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Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been used for almost a decade and have proven to be effective not only in managing Type 2 diabetes (T2D), but their cardio and renal protective features make them very useful in managing patients with risk of multiple comorbidities. This systematic review was undertaken by the authors because there is no evidence currently available in India that has studied the suitability of SGLT2i as a first-line agent in patients newly diagnosed with T2D in India.

Materials And Methods: First, literature was searched to identify features that are considered important when deciding on a first-line agent for managing T2D.

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Article Synopsis
  • - The study aimed to analyze the usage patterns of proton-pump inhibitors (PPIs) in prescriptions and to promote evidence-based recommendations for incorporating probiotics alongside PPIs for various gastrointestinal conditions.
  • - A survey of 1,007 healthcare professionals revealed that over 43% believed 10-30% of patients were on long-term PPI therapy, with most often prescribing PPIs for GERD-related gastritis and peptic ulcers; 91% noted that long-term PPI use disrupts gut flora.
  • - The findings highlighted a strong consensus among healthcare professionals (85%) on the benefits of prescribing probiotics to prevent gastrointestinal issues linked to PPI use, emphasizing a trend towards co-prescription to enhance patient health.
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Vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor is effective in reducing HbA1c levels in patients with type 2 diabetes (T2DM) when administered as monotherapy, dual or triple combination therapy. In India, Vildagliptin is commonly prescribed in T2DM patients because it reduces mean amplitude of glycemic excursion (MAGE), has lower risk of hypoglycemia and is weight neutral. Early combination therapy with vildagliptin and metformin is effective and well-tolerated in patients with T2DM, regardless of age or ethnicity.

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Orbital exenteration is a mutilating surgery which involves the removal of the entire contents of the bony orbit, including the globe, extraocular muscles and periorbital fat, and many times includes the eyelids. Since it leads to severe disfigurement, it is an infrequent procedure largely indicated in malignant conditions. The current study aims to report the clinicodemographic profile and treatment outcome of orbital exenteration patients done in a cancer care center in Northeast India.

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Introduction: The Industrial Internet of Things (IIoT) is a technology that connects devices to collect data and conduct in-depth analysis to provide value-added services to industries. The integration of the physical and digital domains is crucial for unlocking the full potential of the IIoT, and digital twins can facilitate this integration by providing a virtual representation of real-world entities.

Objectives: By combining digital twins with the IIoT, industries can simulate, predict, and control physical behaviors, enabling them to achieve broader value and support industry 4.

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The Bariatric Pyramid is a model which serves to explain the goals of obesity management, act as a milestone for monitoring of therapy, and to benchmark the utility of various anti-obesity medications and interventions. Built upon a base of sustainability, it lists three more desired aspects of care: sufficiency (sufficient strength) safety and security. Each of the four aspects of the pyramid: sustainability, sufficiency safety and security have three angles, which allows the reader to understand them easily.

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Article Synopsis
  • * The lack of a national guideline, alongside various international guidelines, complicates decision-making for some physicians in selecting the best treatment approach.
  • * The current consensus seeks to clarify the advantages of SU, provide expert recommendations, and enhance physicians' knowledge to improve management and outcomes for T2DM patients in India.
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The prevalence of prediabetes, a forerunner of diabetes is very high, and its conversion to diabetes is also more rapid among Asian Indians. Prediabetes also predisposes to the development of macrovascular and to a lesser extent of microvascular complications of diabetes. In a large community-based epidemiological study, the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB), data reported an overall prevalence of prediabetes of 10.

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People with type 2 diabetes mellitus (T2DM) have a higher risk of developing chronic liver disease (CLD) and its complications. T2DM, obesity, and insulin resistance are all strongly associated with nonalcoholic fatty liver disease (NAFLD). Conversely, people suffering from cirrhosis have reduced glucose tolerance in approximately 60% of cases, diabetes in 20% of cases, and insulin-mediated glucose clearance is lowered by 50% as compared with those who do not have cirrhosis.

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Background: Non-communicable disease (NCD) rates are rapidly increasing in India with wide regional variations. We aimed to quantify the prevalence of metabolic NCDs in India and analyse interstate and inter-regional variations.

Methods: The Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study, a cross-sectional population-based survey, assessed a representative sample of individuals aged 20 years and older drawn from urban and rural areas of 31 states, union territories, and the National Capital Territory of India.

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Recently, with the increasing application of the Internet of Things (IoT), various IoT environments such as smart factories, smart homes, and smart grids are being generated. In the IoT environment, a lot of data are generated in real time, and the generated IoT data can be used as source data for various services such as artificial intelligence, remote medical care, and finance, and can also be used for purposes such as electricity bill generation. Therefore, data access control is required to grant access rights to various data users in the IoT environment who need such IoT data.

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Excision of submandibular gland is currently victim in all neck dissections. In this study we intend to estimate the prevalence of submandibular gland involvement in squamous cell oral carcinomas and identify the factors associated with it. This is a single institutional, retrospective observational study conducted from 22 to 2018 to 28 February 2020.

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Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic neoplasm with high risk of recurrence and aggressive behaviour. Presence of clear cells in head and neck is hallmark, but not pathognomic for the entity. Deceptive behaviour admist wide range of differentials, poses an immense diagnostic challenge.

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Introduction: Nutrition plays a significant role in the life of every individual and helps in recovering from any injury including surgery. Pre-treatment malnutrition is found in 15%-40% of cases and can influence treatment outcome. The study aims to determine the impact of nutritional status on the post-operative outcome after head and neck cancer surgery.

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Background And Aim: Basal insulin combined oral therapy consisting of insulin and oral anti-diabetic drugs (OADs) is recommended for type 2 diabetes uncontrolled on OADs. There is a lack of clear evidence and recommendations on the combined use of basal insulin analogues to more than one OADs (glimepiride plus metformin) in effective control of glycemic parameters and its safety in terms of reduced hypoglycemic events, weight gain and cardiovascular risk. In this context, a group of clinical experts discussed the utility of basal insulin combined oral therapy with metformin and glimepiride in the current era.

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Article Synopsis
  • About 1-2% of scalp tumors are malignant, but they make up to 13% of all malignant skin cancers; the study focuses on reconstructing scalp and forehead areas after treatment for these tumors at a cancer center in North East India.
  • The study measured post-operative quality of life using FACE-Q scales, revealing mean satisfaction scores of 54.9 and distress scores of 34.8 three months after surgery, with significant improvements over time.
  • Although reconstructing scalp and forehead defects after cancer surgery is complex, careful planning and understanding various reconstruction options can lead to satisfactory long-term outcomes.
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This study was conducted to see the pattern of neck node metastasis in relation to the size of primary tumour in Well-differentiated thyroid cancer. A prospective study on 50 patients was carried out in the Department of Head and Neck Surgery, Dr B. Borooah Cancer Institute from 1st August, 2018 to 31st July, 2019.

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