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Hypothyroidism is one of the common endocrine disorders encountered in clinical practice. Though thyroxine (T4) remains the treatment of choice in most clinical situations, with the recent introduction of oral triiodothyronine (T3) in South Asian countries, it is important to know about its utility in clinical practice. In this brief communication, we delineate potential clinical indications for T3 therapy, while highlighting possible concerns and caveats.

Glucocorticoids are potent immunosuppressive and anti-inflammatory drugs used for various systemic and localized conditions. The use of glucocorticoids needs to be weighed against their adverse effect of aggravating hyperglycemia in persons with diabetes mellitus, unmask undiagnosed diabetes mellitus, or precipitate glucocorticoid-induced diabetes mellitus appearance. Hyperglycemia is associated with poor clinical outcomes, including infection, disability after hospital discharge, prolonged hospital stay, and death. Furthermore, clear guidelines for managing glucocorticoid-induced hyperglycemia are lacking. Therefore, this consensus document aims to develop guidance on the management of glucocorticoid-induced hyperglycemia. Twenty expert endocrinologists, in a virtual meeting, discussed the evidence and practical experience of real-life management of glucocorticoid-induced hyperglycemia. The expert group concluded that we should be proactive in terms of diagnosis, management, and post-steroid care. Since every patient has different severity of underlying disease, clinical stratification would help understand patient profiles and determine the treatment course. Patients at home with pre-existing diabetes who are already on oral or injectable therapy can continue the same as long as they are clinically stable and eating adequately. However, depending on the degree of hyperglycemia, modification of doses may be required. Initiating basal bolus with correction regimen is recommended for patients in non-intensive care unit settings. For patients in intensive care unit, variable rate intravenous insulin infusion could be temporarily used, but under supervision of diabetes inpatient team, and patients can be transitioned to subcutaneous insulin once stable baseline assessment and continual evaluation are crucial for day-to-day decisions concerning insulin doses. Glycemic variability should be carefully monitored, and interventions to treat patients should also aim at achieving and maintaining euglycemia. Rational use of glucose-lowering drugs is recommended and treatment regimen should ensure maximum safety for both patient and provider. Glucovigilance is required as the steroids taper during transition, and insulin dosage should be reduced subsequently. Increased clinical and economic burden resulting from corticosteroid-related adverse events highlights the need for effective management. Therefore, these recommendations would help successfully manage GC-induced hyperglycemia and judiciously allocate resources.

Polycystic ovary syndrome (PCOS), a frequently occurring health issue, has a significant effect on the cosmetic, metabolic, psychosocial and fertility aspects of women. A multidisciplinary team approach based on the core pillars of screening, assessment and counselling to detect, prevent and treat physiological and psychological issues in PCOS is very essential. Women are treated medically, but the psychosocial part is often forsaken. Hence, counselling forms an integral part of PCOS management that enables enhanced clinical outcomes and patient satisfaction. Digital tools and PCOS support groups have built an opportunity for physicians to create awareness, help timely diagnosis and overcome PCOS symptoms. The absence of clear guidelines to tackle the often less discussed aspects of PCOS warrants the need for consensus on PCOS counselling. This review summarizes the biopsychosocial health, clinical assessment and treatment strategies of PCOS and associated co-morbidities. The review article will discuss the clinician's role in patient education with the special focus on counselling of females with PCOS regardless of age group.

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. In view of already existing data on vildagliptin and the latest emerging clinical evidence, a group of endocrinologists, diabetologists and cardiologists convened for an expert group meeting to discuss the role and various combinations of vildagliptin in T2DM management. This practical document aims to guide Physicians and Specialists regarding the different available strengths and formulations of vildagliptin for the initiation and intensification of T2DM therapy.

A plant nursery is a specialized facility where various plants are grown, nurtured, and often sold for gardening, landscaping, or agricultural purposes. These nurseries can range from small-scale operations run by individuals or families to large commercial enterprises. Plant nurseries typically provide a controlled environment conducive to plant growth, with factors like temperature, humidity, and lighting carefully managed to optimize plant health. Nurseries may specialize in certain types of plants, such as ornamental flowers, fruit trees, shrubs, or native species, depending on the market demand and the expertise of the nursery owners. Customers may visit plant nurseries to purchase plants for their gardens, landscapes, or agricultural projects. The plants available at nurseries are often at various stages of growth, from seeds or seedlings to mature specimens ready for transplanting. Additionally, nurseries may offer advice and guidance on plant care and cultivation to help customers achieve successful growth and landscaping outcomes. This research paper is an effort to throw light on customers' perspectives on the problems and suggestions on improving and improving nursery business in Haryana. An effort has been made to determine customers' opinions regarding the problems of nurseries and seek their suggestions for improvement in nursery business. The research paper is based on the primary data collected through a well-structured questionnaire from 250 customers of nurseries in Haryana.

The main objective of the present study is to identify the factors and activities considered by first generation agripreneuers in managing agribusiness which plays a vital role in the success and sustainable development of any agribusiness. To accomplish this objective, a factor analysis method was adopted to gather and understand the findings. The data has been gathered from four geographical zones (East zone, West zone, North zone, South zone) of Haryana state comprising 22 districts through a purposive sampling strategy. The major findings of the study highlight that out of seven factors, effective leadership was considered the most important factor with the highest Cronbach value 0.812. It plays significant role in the success of any enterprise by ensuring supportive environment for the workers in agro-industries. Strategic planning was also important because becoming a successful agripreneur requires planning before converting all business activities into action.In addition, all the other factors such as scanning business opportunities, organizing and business activities, prior analysis, and credit facilities all play a vital role in the success of agro-industries.

Purpose of Review This review aims to highlight the evolution and multifaceted benefits of modern sulfonylureas (SUs) in managing Type 2 Diabetes Mellitus (T2DM). It discusses their enhanced glycemic control, pleiotropic advantages, usage with other antidiabetic agents, safety, and tolerability, supporting their persistent relevance and effectiveness in diabetes care. Recent Findings Recent findings indicate that modern SUs, like glimepiride, offer significant cardioprotective and renoprotective benefits along with their primary role in glycemic control. Additionally, they have also shown their anti-inflammatory effects, lipid-lowering properties, testosterone-enhancing effects, and neuroprotective effects in recent years. These findings support the broader therapeutic advantages of modern SUs beyond glucose lowering. Hence, many guidelines now recommend modern SUs as an add-on therapy to metformin. Summary Modern sulfonylureas remain a vital component in T2DM management strategy due to their efficacy, safety profile, and cost-effectiveness. Their pleiotropic benefits, like cardiovascular, renal, anti-inflammatory, neuroprotective effects, etc., make them a comprehensive therapeutic option. Considering their efficacy and safety profile, SUs are expected to remain vital components of antidiabetic therapy, providing valuable benefits in managing T2DM in the long run.

Purpose: The purpose of this study is to investigate the significance of improved marketing of agricultural produce in the context of enhancing farmers' livelihoods and rural development. Specifically, it aims to identify market-related challenges faced by agribusinesses at their inception. The study seeks to understand how marketing practices can impact the success of various agribusiness ventures, such as mushroom farming, dairy farming, aquaculture, beekeeping, and others.   Design/Methodology/Approach: This section outlines the research methodology employed in the study. It mentions the use of purposive sampling to select 180 agripreneurs engaged in different agribusinesses. The research approach involves assessing the impact of market knowledge, product quality, market research, pricing strategies, packaging, sales promotion, internet marketing, and test marketing on the launch of agricultural products. It also explores the influence of first-generation agripreneurs on factors like the number of employees and experience.   Findings: Here, the study presents its key findings. It reveals that enhancing market knowledge and product quality, conducting prior market research, adopting appropriate pricing strategies, implementing effective packaging, engaging in sales promotion, utilizing internet marketing, and conducting test marketing are essential for the successful launch of agri-products. Furthermore, the study suggests that the perspectives of first-generation agripreneurs have a significant and positive impact on factors such as employee numbers and experience.   Research, Practical & Social Implications: This section discusses the broader implications of the research. It highlights how the findings can benefit agribusiness management, particularly for first-generation agripreneurs in Haryana. It addresses the practical implications for improving marketing practices in agribusinesses and how this, in turn, can contribute to rural development and farmers' livelihoods. The study aims to offer practical suggestions and solutions to the challenges faced by agripreneurs.   Originality/Value: In this part, the paper underscores its originality and value within the field of agribusiness. It emphasizes that the research not only identifies management challenges but also provides valuable recommendations. The study contributes to the understanding of marketing dynamics in the context of diverse agricultural ventures, ultimately offering insights that can enhance the success and impact of agribusinesses in Haryana and potentially other similar regions.

In spite of the presence of definitive diagnostic criteria to diagnose Cushing syndrome diagnosis may become challenging. We report a young female with mild clinical features of Cushing syndrome, who had nonsuppressible oral dexamethasone suppression tests; also she had a suspicious pituitary lesion. She underwent pituitary surgery and a pituitary microadenoma (non-ACTH staining) was removed. Now she had come to us with similar complaints to those before. Again she had nonsuppressible oral dexamethasone suppression tests. As the diurnal variation of serum and salivary cortisol was maintained and urinary free cortisol was normal, further evaluation with IV dexamethasone suppression test was performed which clearly ruled out Cushing syndrome. The patient was not on any medicines known to alter dexamethasone metabolism. Fat malabsorption was also ruled out using appropriate tests. The reason for this discrepancy is thought to be altered (increased) metabolism of dexamethasone in this patient as it is widely variable in the general population.

Purpose: The purpose of this study is to investigate the significance of improved marketing of agricultural produce in the context of enhancing farmers' livelihoods and rural development. Specifically, it aims to identify market-related challenges faced by agribusinesses at their inception. The study seeks to understand how marketing practices can impact the success of various agribusiness ventures, such as mushroom farming, dairy farming, aquaculture, beekeeping, and others. Design/Methodology/Approach: This section outlines the research methodology employed in the study. It mentions the use of purposive sampling to select 180 agripreneurs engaged in different agribusinesses. The research approach involves assessing the impact of market knowledge, product quality, market research, pricing strategies, packaging, sales promotion, internet marketing, and test marketing on the launch of agricultural products. It also explores the influence of first-generation agripreneurs on factors like the number of employees and experience. Findings: Here, the study presents its key findings. It reveals that enhancing market knowledge and product quality, conducting prior market research, adopting appropriate pricing strategies, implementing effective packaging, engaging in sales promotion, utilizing internet marketing, and conducting test marketing are essential for the successful launch of agri-products. Furthermore, the study suggests that the perspectives of first-generation agripreneurs have a significant and positive impact on factors such as employee numbers and experience. Research, Practical & Social Implications: This section discusses the broader implications of the research. It highlights how the findings can benefit agribusiness management, particularly for first-generation agripreneurs in Haryana. It addresses the practical implications for improving marketing practices in agribusinesses and how this, in turn, can contribute to rural development and farmers' livelihoods. The study aims to offer practical suggestions and solutions to the challenges faced by agripreneurs. Originality/Value: In this part, the paper underscores its originality and value within the field of agribusiness. It emphasizes that the research not only identifies management challenges but also provides valuable recommendations. The study contributes to the understanding of marketing dynamics in the context of diverse agricultural ventures, ultimately offering insights that can enhance the success and impact of agribusinesses in Haryana and potentially other similar regions.