Axial spondyloarthropathy (SpA) is seronegative arthritis which mainly affects young adults and causes much morbidity. Tumor necrosis factor-alpha (TNF-α) is one of the main mediators of inflammation in joints and enthuses in SpA. Nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologics like TNF-α inhibitors are the mainstay of therapy in SpA. However, in India, the cost is one limiting factor in the use of biologics for the treatment of SpA in eligible patients. Thalidomide is an oral TNF-α inhibitor which has reported benefit in axial SpA, and it is a cheap option in the Indian setting. However, there is almost no Indian data on its efficacy.

This is a retrospective analysis of patients receiving thalidomide for axial SpA in the rheumatology clinic of a tertiary care hospital of Kolkata. In this clinic, thalidomide was used at 100 mg/day. Patients receiving thalidomide, who had completed at least one year follow up were included in the analysis. Assessment of SpondyloArthritis International Society (ASAS)-20, ASAS-40, and ankylosing spondylitis disease activity score with C-reactive protein (ASDAS-CRP) were measured three monthly during the follow-up. Side effect profile of thalidomide was also recorded.

The completed data of 66 patients were analyzed. All patients were human leukocyte antigen (HLA) B27 positive. Ninety-five point percent fulfilled ASAS-20 criteria at 12 months and 71.2% fulfilled the ASAS-40 criteria at 12 months. Three patients were nonresponders. The average ASDAS-CRP score also decreased from 2.9 to 1.5 over one year.

In our study, oral thalidomide resulted in significant improvements in axial SpA. Further randomized controlled trials are needed to find the relative efficacy of thalidomide with respect to other forms of treatment.

Cardiac magnetic resonance imaging (cMRI) scan is rapidly becoming an indispensable tool for the management of various disorders. This technique has the advantages of good temporal and spatial resolution and no exposure to radiation. Various ischemic and non-ischemic conditions of the heart may be diagnosed with high sensitivity and specificity. This review article aims to introduce the clinicians to the various uses of cardiac MRI and its future potential.

Molecular diagnostic tests are the molecular techniques used to detect a nucleic acid of organisms. They have revolutionized the diagnosis of tuberculosis (TB) and drug resistance. Cartridge-based nucleic acid amplification tests (CBNAAT) and line probe assay (LPA) have been accepted in our national tuberculosis control program. CBNAAT has the advantage that it can be done from crude samples and smear negative samples and results can be obtained by 2 hours. But CBNAAT can detect rifampicin resistance only.

On the contrary, LPA can detect rifampicin and isoniazid resistance, but the test can only be done at regional or national levels. LPA cannot be done from smear negative or crude specimens. The recent version of LPA (version 2.0) can overcome that problem. Second line LPA can detect the drug resistance against fluoroquinolones, second line injectable drugs and ethambutol (in version 1.0 only). GeneXpert Omni is a portable technique having 4-hour lasting battery using the same cartridge. GeneXpert Ultra has more sensitivity due to larger chamber size and due to two additional probes. Ultra may replace Xpert soon as it will be more effective against smear-negative TB, TB in HIV positive persons, childhood TB, and extrapulmonary TB. With the introduction of molecular diagnostic tests for TB, we will be able to reduce the time of diagnosis of TB and drug resistance. Thereby, we will be able to start first line or second line anti-tubercular chemotherapy earlier, and that will help us to achieve our goal in controlling TB.

Qualitative research is a simple, inexpensive and effective tool in medical research. The data analysis in qualitative researches, though based on certain ground rules, do not follow a rigid process like the data analysis of quantitative researches. It is ongoing through and through method. One interesting feature of data collection and analysis in qualitative research is “constant comparison”. This is a highly unique method in this type of research as compared to the quantitative research. Qualitative researches usually involve inductive reasoning, but there is deductive reasoning also. The first step of analyzing qualitative data is to transcribe all data into English from vernacular language. This transcript is then subjected to selection of “codes” which are nothing but descriptive names applied to certain thoughts coming up repeatedly in a transcript. Several codes together make a broader “category”. Themes are emerged from categories which are broad categories of information. The process of transcript analysis is called “content analysis” and this is at the end converted into “thematic analysis” which gives the meaning of the whole research and the answers to the original research question(s). There is ‘consolidated criteria’ for reporting qualitative research (COREQ) which is a 32 item check list for interviews and focus group discussions.

Cardiac transplant is a life-saving procedure and with the advancement in technology, it is rapidly becoming available for patients in all corners of the world. As the heart transplant program is extended to Eastern India, this is an opportune moment to look back on the history of this medical miracle and how we reached the current level of excellence. this article is a brief recount of that illustrious history.

In this new millennium, the clinical trial is inseparably linked with an upgrade of health care by generating invaluable data in preventive, promotive and curative health. Globally research experts have concerns regarding ensuring financial and other compensations along with optimum health benefits for research participants in clinical trials in the emerging market economy. A significant number of human healthy volunteers (participants) take part in researches in both developed and developing countries. Participants are frequently unaware that the informed consent process is mandatory for investigators, funders and participants and their free will must be documented. There are sparse published medical works of literature that attempted to assess the extent to which all the norms of the informed consent process are followed in Indian settings in this area to the best of our knowledge. We need to conduct researches on the preparedness of the clinical trials participants towards their awareness of the criticality of the informed consent process and their motives for participation. This narrative review enlightened the facts that very patient, extensive and careful transparent narration and dissemination of the information can only ensure truly informed and autonomous decision improving the validity of the study.

Therapeutic diet is needed so that nutritional factors may not affect individuals in diseases during convalescence and rehabilitation. Different research groups have observed a correlation between diseases and diets with diagnosis, prognosis, clinical outcomes and complications. In spite of considerable progress in healthcare, there is scarce evidence-based research excellence on community-level compliance on dietary advice. We need to change our mindset to find user-friendly dietary guidelines for the improvement in clinical approach and treatment in patients with diverse diseases in daily medical practice.