1.Progress in the management of type 2 diabetes mellitus: a narrative review of telerehabilitation and wearable devices
Huma KHAN ; Kamran ALI ; Arshiya ASLAM ; Deepika SINGLA ; Ifra AMAN
Annals of Pediatric Endocrinology & Metabolism 2025;30(2):69-76
		                        		
		                        			
		                        			 Type 2 diabetes mellitus (T2DM) management demands innovative strategies that address its complex nature. Telerehabilitation and conventional rehabilitation, which utilize wearable devices, represent promising avenues in this regard. This narrative review synthesizes the current literature to comprehensively compare these modalities in terms of accessibility, monitoring mechanisms, patient adherence, cost-effectiveness, and social support. Telerehabilitation offers unparalleled convenience, real-time monitoring, and personalized feedback through wearables, thereby fostering greater patient engagement and adherence compared to conventional rehabilitation. However, conventional rehabilitation provides face-to-face interactions, immediate feedback, and a more personalized touch, albeit with logistical challenges and higher costs. This review emphasizes the significance of patient preferences, technological access, and healthcare infrastructure in selecting the appropriate approach. It also calls for further research into long-term outcomes, cost-effectiveness, and the optimal integration of wearable technology in diabetes management programs. Ultimately, both telerehabilitation and conventional rehabilitation demonstrate considerable potential in empowering individuals with T2DM, underlining the imperative for tailored and patient-centric interventions in diabetes care. The review also stresses the significance of integrating patient preferences and their level of comfort with technology when deciding on treatment approaches. It also takes into account the diverse socioeconomic contexts and healthcare infrastructures globally, which can affect the viability and efficacy of both telerehabilitation and conventional rehabilitation. Moreover, the integration of wearable technology in diabetes management programs holds promise for enhancing self-management capabilities and promoting healthier lifestyles. However, it is essential to tackle prospective discrepancies in access to these technologies and ensure fair distribution. Looking forward, ongoing research efforts should focus on justifying long-term outcomes, optimizing cost-effectiveness, and refining implementation strategies to maximize the benefits of both modalities. 
		                        		
		                        		
		                        		
		                        	
2.Progress in the management of type 2 diabetes mellitus: a narrative review of telerehabilitation and wearable devices
Huma KHAN ; Kamran ALI ; Arshiya ASLAM ; Deepika SINGLA ; Ifra AMAN
Annals of Pediatric Endocrinology & Metabolism 2025;30(2):69-76
		                        		
		                        			
		                        			 Type 2 diabetes mellitus (T2DM) management demands innovative strategies that address its complex nature. Telerehabilitation and conventional rehabilitation, which utilize wearable devices, represent promising avenues in this regard. This narrative review synthesizes the current literature to comprehensively compare these modalities in terms of accessibility, monitoring mechanisms, patient adherence, cost-effectiveness, and social support. Telerehabilitation offers unparalleled convenience, real-time monitoring, and personalized feedback through wearables, thereby fostering greater patient engagement and adherence compared to conventional rehabilitation. However, conventional rehabilitation provides face-to-face interactions, immediate feedback, and a more personalized touch, albeit with logistical challenges and higher costs. This review emphasizes the significance of patient preferences, technological access, and healthcare infrastructure in selecting the appropriate approach. It also calls for further research into long-term outcomes, cost-effectiveness, and the optimal integration of wearable technology in diabetes management programs. Ultimately, both telerehabilitation and conventional rehabilitation demonstrate considerable potential in empowering individuals with T2DM, underlining the imperative for tailored and patient-centric interventions in diabetes care. The review also stresses the significance of integrating patient preferences and their level of comfort with technology when deciding on treatment approaches. It also takes into account the diverse socioeconomic contexts and healthcare infrastructures globally, which can affect the viability and efficacy of both telerehabilitation and conventional rehabilitation. Moreover, the integration of wearable technology in diabetes management programs holds promise for enhancing self-management capabilities and promoting healthier lifestyles. However, it is essential to tackle prospective discrepancies in access to these technologies and ensure fair distribution. Looking forward, ongoing research efforts should focus on justifying long-term outcomes, optimizing cost-effectiveness, and refining implementation strategies to maximize the benefits of both modalities. 
		                        		
		                        		
		                        		
		                        	
3.Progress in the management of type 2 diabetes mellitus: a narrative review of telerehabilitation and wearable devices
Huma KHAN ; Kamran ALI ; Arshiya ASLAM ; Deepika SINGLA ; Ifra AMAN
Annals of Pediatric Endocrinology & Metabolism 2025;30(2):69-76
		                        		
		                        			
		                        			 Type 2 diabetes mellitus (T2DM) management demands innovative strategies that address its complex nature. Telerehabilitation and conventional rehabilitation, which utilize wearable devices, represent promising avenues in this regard. This narrative review synthesizes the current literature to comprehensively compare these modalities in terms of accessibility, monitoring mechanisms, patient adherence, cost-effectiveness, and social support. Telerehabilitation offers unparalleled convenience, real-time monitoring, and personalized feedback through wearables, thereby fostering greater patient engagement and adherence compared to conventional rehabilitation. However, conventional rehabilitation provides face-to-face interactions, immediate feedback, and a more personalized touch, albeit with logistical challenges and higher costs. This review emphasizes the significance of patient preferences, technological access, and healthcare infrastructure in selecting the appropriate approach. It also calls for further research into long-term outcomes, cost-effectiveness, and the optimal integration of wearable technology in diabetes management programs. Ultimately, both telerehabilitation and conventional rehabilitation demonstrate considerable potential in empowering individuals with T2DM, underlining the imperative for tailored and patient-centric interventions in diabetes care. The review also stresses the significance of integrating patient preferences and their level of comfort with technology when deciding on treatment approaches. It also takes into account the diverse socioeconomic contexts and healthcare infrastructures globally, which can affect the viability and efficacy of both telerehabilitation and conventional rehabilitation. Moreover, the integration of wearable technology in diabetes management programs holds promise for enhancing self-management capabilities and promoting healthier lifestyles. However, it is essential to tackle prospective discrepancies in access to these technologies and ensure fair distribution. Looking forward, ongoing research efforts should focus on justifying long-term outcomes, optimizing cost-effectiveness, and refining implementation strategies to maximize the benefits of both modalities. 
		                        		
		                        		
		                        		
		                        	
4.Assessment of the phenotypic severity of hemophilia A: using rotational thromboelastometry (ROTEM) and APTT‑clot waveform analysis
Deepika GUPTA ; Vandana ARYA ; Jasmita DASS ; Nitin GUPTA ; Manas KALRA ; Anupam SACHDEVA ; Jyoti KOTWAL
Blood Research 2024;59():19-
		                        		
		                        			 Background:
		                        			Hemophilia A (HA) is an X-linked inherited bleeding disorder caused by reduced factor VIII (FVIII) levels.Approximately 10–15% of patients with severe HA (SHA) do not present with the anticipated bleeding pattern. Here, we assessed the phenotypic severity of hemophilia A using rotational thromboelastometry (ROTEM) and activated partial thromboplastin time-clot waveform analysis (APTT-CWA). 
		                        		
		                        			Methods:
		                        			Patients diagnosed with hemophilia A were enrolled. Clinical phenotype assignment was performed according to the published literature, and patients were classified into four phenotypic subgroups. The whole blood sample was first run on ROTEM in INTEM mode using platelet-poor plasma, APTT was run, and the APTT-CWA graph was simultaneously recorded. 
		                        		
		                        			Results:
		                        			A total of 66 patients were recruited for this study. Statistically significant differences were observed between the four phenotypically categorized groups using ROTEM and APTT-CWA. On comparing patients with mild/ moderate-to-severe phenotypes (Group II) with SHA without inhibitors (Group IV), no significant difference was found for all parameters of ROTEM or APTT-CWA. The MCF, MA30, MAXV, and Alpha angle values using ROTEM were found to be the lowest in patients with SHA with inhibitors, which helped differentiate them from those with SHA without inhibitors. However, these two groups could not be differentiated using the APTT-CWA parameters. 
		                        		
		                        			Conclusion
		                        			ROTEM can be used to distinguish patients with SHA with inhibitors from those with SHA without inhibitors using a combination of parameters with high sensitivity and specificity. However, APTT-CWA cannot be used to differentiate these patient groups. 
		                        		
		                        		
		                        		
		                        	
5.Assessment of the phenotypic severity of hemophilia A: using rotational thromboelastometry (ROTEM) and APTT‑clot waveform analysis
Deepika GUPTA ; Vandana ARYA ; Jasmita DASS ; Nitin GUPTA ; Manas KALRA ; Anupam SACHDEVA ; Jyoti KOTWAL
Blood Research 2024;59():19-
		                        		
		                        			 Background:
		                        			Hemophilia A (HA) is an X-linked inherited bleeding disorder caused by reduced factor VIII (FVIII) levels.Approximately 10–15% of patients with severe HA (SHA) do not present with the anticipated bleeding pattern. Here, we assessed the phenotypic severity of hemophilia A using rotational thromboelastometry (ROTEM) and activated partial thromboplastin time-clot waveform analysis (APTT-CWA). 
		                        		
		                        			Methods:
		                        			Patients diagnosed with hemophilia A were enrolled. Clinical phenotype assignment was performed according to the published literature, and patients were classified into four phenotypic subgroups. The whole blood sample was first run on ROTEM in INTEM mode using platelet-poor plasma, APTT was run, and the APTT-CWA graph was simultaneously recorded. 
		                        		
		                        			Results:
		                        			A total of 66 patients were recruited for this study. Statistically significant differences were observed between the four phenotypically categorized groups using ROTEM and APTT-CWA. On comparing patients with mild/ moderate-to-severe phenotypes (Group II) with SHA without inhibitors (Group IV), no significant difference was found for all parameters of ROTEM or APTT-CWA. The MCF, MA30, MAXV, and Alpha angle values using ROTEM were found to be the lowest in patients with SHA with inhibitors, which helped differentiate them from those with SHA without inhibitors. However, these two groups could not be differentiated using the APTT-CWA parameters. 
		                        		
		                        			Conclusion
		                        			ROTEM can be used to distinguish patients with SHA with inhibitors from those with SHA without inhibitors using a combination of parameters with high sensitivity and specificity. However, APTT-CWA cannot be used to differentiate these patient groups. 
		                        		
		                        		
		                        		
		                        	
6.Assessment of the phenotypic severity of hemophilia A: using rotational thromboelastometry (ROTEM) and APTT‑clot waveform analysis
Deepika GUPTA ; Vandana ARYA ; Jasmita DASS ; Nitin GUPTA ; Manas KALRA ; Anupam SACHDEVA ; Jyoti KOTWAL
Blood Research 2024;59():19-
		                        		
		                        			 Background:
		                        			Hemophilia A (HA) is an X-linked inherited bleeding disorder caused by reduced factor VIII (FVIII) levels.Approximately 10–15% of patients with severe HA (SHA) do not present with the anticipated bleeding pattern. Here, we assessed the phenotypic severity of hemophilia A using rotational thromboelastometry (ROTEM) and activated partial thromboplastin time-clot waveform analysis (APTT-CWA). 
		                        		
		                        			Methods:
		                        			Patients diagnosed with hemophilia A were enrolled. Clinical phenotype assignment was performed according to the published literature, and patients were classified into four phenotypic subgroups. The whole blood sample was first run on ROTEM in INTEM mode using platelet-poor plasma, APTT was run, and the APTT-CWA graph was simultaneously recorded. 
		                        		
		                        			Results:
		                        			A total of 66 patients were recruited for this study. Statistically significant differences were observed between the four phenotypically categorized groups using ROTEM and APTT-CWA. On comparing patients with mild/ moderate-to-severe phenotypes (Group II) with SHA without inhibitors (Group IV), no significant difference was found for all parameters of ROTEM or APTT-CWA. The MCF, MA30, MAXV, and Alpha angle values using ROTEM were found to be the lowest in patients with SHA with inhibitors, which helped differentiate them from those with SHA without inhibitors. However, these two groups could not be differentiated using the APTT-CWA parameters. 
		                        		
		                        			Conclusion
		                        			ROTEM can be used to distinguish patients with SHA with inhibitors from those with SHA without inhibitors using a combination of parameters with high sensitivity and specificity. However, APTT-CWA cannot be used to differentiate these patient groups. 
		                        		
		                        		
		                        		
		                        	
9.Quality of life in patients treated for COVID-19–associated mucormycosis at a tertiary care hospital
Pragya KUMAR ; Rajath Rao UR ; Nilanjan ROY ; Deepika AGRAWAL ; Shamshad AHMAD ; Kranti BHAVANA
Osong Public Health and Research Perspectives 2023;14(2):119-128
		                        		
		                        			 Objectives:
		                        			Coronavirus disease 2019 (COVID-19)–associated mucormycosis (CAM) has emerged as a formidable infection in patients with COVID-19. The aggressive management ofCAM affects quality of life (QOL); thus, this study was designed to assess the QOL in patients with CAM at a tertiary healthcare institution. 
		                        		
		                        			Methods:
		                        			This cross-sectional study of 57 patients with CAM was conducted over 6 monthsusing a semi-structured standard questionnaire (the abbreviated World Health Organization Quality of Life questionnaire [WHO-BREF]) and a self-rated improvement (SRI) scale ranging from 0 to 9. Cut-off values of ≤52 and < 7 were considered to indicate poor QOL and poor improvement, respectively. The correlations of QOL and SRI scores were evaluated using Spearman rho values. 
		                        		
		                        			Results:
		                        			In total, 27 patients (47.4%; 95% confidence interval [CI], 34.9%–60.1%) and 26 patients (45.6%; 95% CI, 33.4%–58.4%) had poor QOL and poor SRI scores, respectively. The overall median (interquartile range) QOL score was 52 (41–63). Headache (adjusted B, −12.3), localized facial puffiness (adjusted B , −16.4), facial discoloration (adjusted B, −23.4), loosening of teeth (adjusted B, −18.7), and facial palsy (adjusted B, −38.5) wer e significantly associated with the QOL score in patients with CAM. 
		                        		
		                        			Conclusion
		                        			Approximately 1 in 2 patients with CAM had poor QOL and poor improvement.Various CAM symptoms were associated with QOL in these patients. Early recognition is the key to optimal treatment, improved outcomes, and improved QOL in patients with CAM. 
		                        		
		                        		
		                        		
		                        	
10.Comparative evaluation of the effectiveness of two innovative methods in the management of anxiety in a dental office: a randomized controlled trial
Jay PANCHAL ; Anup PANDA ; Krishna TRIVEDI ; Deepika CHARI ; Rushita SHAH ; Binny PARMAR
Journal of Dental Anesthesia and Pain Medicine 2022;22(4):295-304
		                        		
		                        			 Background:
		                        			The first dental experience is vital in molding a child's attitude towards dentistry and dental outcomes. The cooperation of a child during dental treatment is essential to render successful and high-quality treatment. Dental anxiety is common in children undergoing dental treatment. The success of pediatric dental treatments and patient comfort depends on controlling the levels of patient anxiety in clinical settings. This study aimed to compare the effectiveness of the recorded maternal voice and virtual cognitive tool (Roogies application) in the management of pediatric dental patients. 
		                        		
		                        			Methods:
		                        			The study was carried out with children aged of 4-7 years [n = 80, (40 male and 40 female)], without any past dental history, and were randomly allocated into two groups. After informed consent was obtained, the entire procedure was explained to the parents. Anxiety was assessed pre-, during, and post-treatment by measuring pulse rate, and recording Venham Picture Test (VPT) scores. Group A [n = 40; 20 boys and 20 girls)] was provided with a headphone that played a recorded maternal voice. Group B [n = 40; 20 boys and 20 girls)] was administered the virtual cognitive tool. After conditioning the children, oral prophylaxis was performed for both groups. A comparative evaluation was conducted for each treatment session. 
		                        		
		                        			Results:
		                        			The intra-group comparison of VPT scores and heart rate for patients assigned to the recorded maternal voice showed a statistically significant difference in dental anxiety (P-value ≤ 0.001). 
		                        		
		                        			Conclusion
		                        			This study demonstrated that a reduction in dental anxiety with the help of recorded maternal voice forms an important component of non-pharmacological behavior management. Alternatively, the use of a virtual cognitive tool as an anxiety-reducing technique can also be advocated. 
		                        		
		                        		
		                        		
		                        	
            
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