Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Pathogenic, cultural, morphological and molecular variability among eight isolates of Alternaria solani, causing early blight of tomato

Among the fungal diseases infecting tomato crops, early blight caused by Alternaria solani (Ellis and Martin) Jones and Grout is one of the most catastrophic disease causing accountable losses. Further, all of the tomato cultivars presently under cultivation have succumb more or less to early blight disease. Therefore, the present studies were undertaken for the pathogenic, cultural, morphological and molecular variability among the isolates of A. solani. The results reveal all of the eight isolates of A. solani as pathogenic to tomato (Cv. Pusa Ruby) and showed variability amongst them. The test isolates could grow better on the basic culture medium potato dextrose agar; however, highest mycelial growth was recorded on the isolate AsLt (88.50 mm), followed by AsBd (82.36 mm) and AsHl (78.40 mm), with excellent sporulation. All of the eight test isolates exhibited a wide range of variability in respect of their mycelial and conidial dimensions and septation. RAPD-PCR analysis of the four most virulent A. solani isolates, using 13 OPA primers revealed that the isolates AsBd (Beed) and AsLt (Latur) were closely related with 85% genetic similarity whereas, the isolates AsHl (Hingoli) and AsJl (Jalna) were closely related with 50% genetic similarity, but distinct from that of AsLt and AsBd isolates. Key words: Tomato, Alternaria solani, isolates, pathogenic, molecular variability, virulent, primers