Background: Type 2 diabetes mellitus (T2DM) in India disproportionately presents with multiple concurrent non-communicable diseases (NCDs). Urban populations in Central India, particularly in the Vidarbha region, represent an understudied yet rapidly growing cohort with unique cardiometabolic risk profiles. This study aimed to assess the burden of multimorbidity and associated cardiometabolic parameters among T2DM patients enrolled in a structured chronic care programme in Nagpur, Maharashtra. Methods: A cross-sectional analysis was conducted using clinical records of 76 unique T2DM patients attending the GTT Diabetes & Lifestyle Care Centre, Nagpur (Vidharbha RIC) between April 2025 and April 2026. Sociodemographic, clinical, anthropometric, biochemical, and pharmacological data were extracted. Multimorbidity was defined as the co-occurrence of two or more chronic conditions in addition to T2DM. Descriptive statistics and frequency analysis were performed. Results: The mean age of participants was 51.4 ± 9.5 years (range: 33–75 years); 57.9% were male. Multimorbidity was present in 61.8% (n=47) of patients. The most prevalent comorbidities were hypertension (40.8%), obesity (31.6%), dyslipidaemia (10.5%), ischaemic heart disease (IHD) (9.2%), coronary artery disease (CAD) (6.6%), and hypothyroidism (6.6%). Mean baseline HbA1c was 8.39 ± 2.03%, mean BMI was 26.6 ± 4.3 kg/m², and mean systolic blood pressure was 124.8 ± 13.7 mmHg. Patients with ≥4 comorbidities exhibited markedly elevated cardiometabolic risk parameters including higher polypharmacy burden (up to 42 medications dosage units). Conclusion: Multimorbidity is highly prevalent among urban Indian T2DM patients in Central India. The compounding burden of hypertension, obesity, and cardiovascular diseases significantly elevates cardiometabolic risk. Structured multidisciplinary care models are urgently needed to address this complex disease burden. These findings provide essential real-world data to inform clinical practice guidelines and public health policy in the Central Indian urban context.

Background: Insulin resistance is the foundational metabolic lesion of type 2 diabetes mellitus (T2DM), driving both progressive beta-cell failure and the accumulation of cardiovascular risk factors. Pharmacotherapy addresses symptoms of insulin resistance but does not reverse its root cause — excess adiposity, sedentary muscle metabolism, and chronic low-grade inflammation. Intensive lifestyle interventions combining caloric restriction, exercise, and metabolic therapies have demonstrated T2DM remission, but real-world implementation of multimodal insulin resistance reversal programs remains limited. This study reports outcomes from the Comprehensive Diabetic Care (CDC) program, a structured multimodal intervention combining very-low-calorie dietary modification, structured botanical therapy targeting insulin-signaling pathways, physical conditioning, and antidiabetic medication tapering. Objectives: To evaluate the clinical efficacy of the Comprehensive Diabetic Care (CDC) program — comprising caloric restriction, structured herbal per-rectal therapy (Panchakarma) (structured botanical per-rectal therapy with Gymnema sylvestre, Berberis aristata, and Glycyrrhiza glabra), exercise and yoga — on glycemic control, anthropometric parameters, insulin resistance surrogates, and antidiabetic drug reduction; to quantify the dose-dependent relationship between treatment intensity and outcomes; and to report Oral Glucose Tolerance Test (GTT) outcomes as a remission criterion. Methods: Retrospective observational study of 79 consecutive T2DM patients enrolled in the CDC (Comprehensive Diabetic Care) program at an integrative metabolic clinic in Mumbai, India. The multimodal intervention included: (1) an 800 kcal/day low-carbohydrate, high-protein dietary program (Prameha diet); (2) Panchakarma comprising herbal oleation, medicated sudation, and per-rectal botanical therapy delivering berberine, gymnemic acids, and glycyrrhizin via direct colonic-portal absorption; and (3) individualized yoga and exercise prescription targeting muscle glucose uptake and insulin sensitization. Antidiabetic medications were systematically tapered based on glycemic response. Outcomes included HbA1c, fasting/random blood glucose, weight, BMI, abdominal girth, blood pressure, and heart rate. Treatment intensity was quantified by Panchakarma sessions completed (range 1–20). Pearson correlations and paired t-tests were used. GTT results were documented for 5 patients as a remission criterion.

The present study was carried out to evaluate the extraction yield, phytochemical constituents, and anti-arthritic potential of the hydroalcoholic extract of Antidesma diandrum. The plant material was subjected to hydroalcoholic extraction, and the percentage yield was determined. Preliminary phytochemical screening of the extract revealed the presence of flavonoids, phenols, proteins, carbohydrates, and saponins. Quantitative analysis showed a total phenolic content of 0.263 mg gallic acid equivalent (GAE)/100 mg and a total flavonoid content of 0.742 mg quercetin equivalent (QE)/100 mg of extract. The anti-arthritic activity was evaluated using Freund’s adjuvant-induced arthritis model in rats. The hydroalcoholic extract was administered orally at doses of 100 mg/kg and 200 mg/kg and compared with aspirin (200 mg/kg) as a standard drug. The extract produced a significant, dose-dependent reduction in paw edema, particularly at the higher dose, which showed activity comparable to the standard drug. The observed anti-arthritic effect may be attributed to the presence of flavonoids and phenolic compounds with known anti-inflammatory properties. The results of the study scientifically support the traditional use of Antidesma diandrum in the management of inflammatory and arthritic conditions.

Arteriovenous malformations (AVMs) of the urinary bladder are rare vascular anomalies and represent an uncommon cause of gross hematuria. Their occurrence within a bladder diverticulum is extremely rare and can pose a diagnostic challenge during routine evaluation. A 60-year-old male presented with acute painless gross hematuria with passage of clots. Initial cystoscopy was inconclusive due to poor visualization caused by clot retention. Following clot evacuation, repeat cystoscopy revealed a wide-mouthed diverticulum on the left posterolateral bladder wall. Inspection of the diverticulum revealed tortuous pulsatile vessels with active bleeding, consistent with an AVM. The lesion was successfully treated using Holmium:YAG laser fulguration. Bladder AVMs should be considered in cases of unexplained hematuria. Careful cystoscopic evaluation, including inspection of diverticula, is essential. Endoscopic laser fulguration is an effective and minimally invasive treatment option.

Background: Heart failure (HF) remains one of the leading causes of morbidity and mortality worldwide, with an estimated 64 million individuals affected globally. Despite established pharmacotherapy, residual cardiovascular risk and hospitalizations remain unacceptably high. Sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as transformative therapies with robust evidence from major cardiovascular outcomes trials. Objective: To critically appraise and synthesize published evidence regarding the shared and distinct mechanistic pathways through which SGLT2 inhibitors and GLP-1 receptor agonists exert cardiovascular benefit in heart failure, spanning both heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Methods: A systematic literature search was conducted across PubMed/MEDLINE, Embase, and the Cochrane Library (2015–2025). Landmark randomized controlled trials (RCTs), mechanistic studies, and major international cardiology guidelines were reviewed and synthesized using the SANRA framework for narrative reviews. Key Findings: SGLT2 inhibitors consistently reduce cardiovascular death and HF hospitalization across HFrEF and HFpEF phenotypes. GLP-1 RAs demonstrate significant benefit predominantly in obese HFpEF patients with metabolic comorbidities. While both drug classes share anti-inflammatory, antifibrotic, and metabolic modulatory properties, they differ fundamentally in direct cardiac receptor activity, neurohormonal effects, and influence on myocardial energetics. SGLT2 inhibitors exert unique benefits through osmotic diuresis, NHE1 inhibition, and mitochondrial protection, whereas GLP-1 RAs act via direct GLP-1 receptor agonism with cardioprotective, anorexigenic, and systemic metabolic effects. Conclusion: SGLT2 inhibitors and GLP-1 RAs represent complementary rather than competing therapeutic strategies in heart failure. Their distinct mechanistic profiles, coupled with emerging evidence supporting combination therapy, offer an unprecedented opportunity to target multiple HF pathophysiological pathways simultaneously.