Hydroxychloroquine - An Antimalarial and Anti-inflammatory Drug

Hydroxychloroquine – a quinoline antimalarial, has hypoglycemic effects that manifest due to its action on the intracellular insulin metabolism in peripheral tissues. Recent studies confirm that the use of Hydroxychloroquine can aid in preventing new onset diabetes and complications of diabetes, systemic lupus erythematosus and rheumatoid arthritis, as well as in improving the mortality rate of these patients

The Dampening Effect of Iceberg Orders on Small Traders' Welfare

Iceberg orders, which allow traders to hide a portion of their order size, have become prevalent in many electronic limit order markets. This paper investigates, via a real options analysis, whether small traders, who have no use for submitting iceberg orders, are better off submitting their orders to fully transparent markets which have low depth, or to more liquid markets which do permit the placement of iceberg orders by large traders. Surprisingly, we find that in the context of our model, small traders are better off submitting to fully transparent markets in spite of them being less liquid

Usage of Glimepiride/Metformin Fixed-dose Combination in Young Individuals with Type 2 Diabetes: The Indian Experience

Background: The prevalence of diabetes has been rising among the younger population and is a cause for concern. The present case-based questionnaire survey evaluated the treatment pattern and clinical experience of healthcare professionals (HCPs) in prescribing glimepiride/metformin fixed-dose combination (FDC) to young diabetes patients (up to 40 years of age) in the Indian setting. Material and methods: A retrospective, multicenter, observational, questionnaire-based survey was conducted in Indian healthcare centers using medical records of patients having type 2 diabetes mellitus (T2DM), who were prescribed different strengths of glimepiride/metformin FDCs. Data was collected from the patients’ medical records and were analyzed using statistical tests. Results: A total of 2,715 patients aged between 18 and 40 years were included in the study. Mean diabetes duration among the young patients was 2.76 ± 1.97 years. Among the young T2DM patients, 83.2% patients received glimepiride/metformin FDC as first-line therapy, and 16.8% received it as second-line therapy. Hypoglycemia at 6 months was noted in only 2.47% of the young patients. Mean glycated hemoglobin (HbA1c) before and after treatment was 8.7% ± 3.4% and 7.3% ± 3.9%, respectively. Mean fasting plasma glucose (FPG) was 171.8 ± 80.1 mg/dL in patients prior to treatment initiation and came down to 122.8 ± 41.8 mg/dL after treatment with glimepiride/metformin FDC. Mean postprandial plasma glucose (PPG) prior to combination therapy use was 248.7 ± 64.0 mg/dL and dropped to 177.2 ± 39.9 mg/dL after treatment. Good to excellent efficacy and tolerability were reported for 86% and 86.6% patients, respectively. Conclusion: This case-based questionnaire survey demonstrates the usage pattern of various strengths of glimepiride/metformin FDCs and the HCPs’ practice approach regarding the use of this combination in young T2DM patients in the Indian setting. The combination is commonly prescribed to young diabetes patients in India and is associated with beneficial effects on glycemic parameters

Spontaneous Splenic Rupture: A Rare Complication of Acute Pancreatitis in a Patient with Crohn's Disease

Crohn's disease (CD) is an idiopathic inflammatory bowel disease which can involve any part of the gastrointestinal tract. It frequently involves the ileum, colon and the anorectum. Although rare, acute pancreatitis as a complication of CD involving the duodenum has been described in the literature. We describe a 37-year-old male with CD presenting with acute pancreatitis and spontaneous splenic rupture. The potential mechanisms associated with acute pancreatitis along with spontaneous rupture of the spleen in this patient population and its treatment will be discussed. Common complaints such as upper abdominal pain in a patient with CD should undergo workup to exclude less commonly involved sites such as the pancreas and spleen. Close monitoring in the critical care setting is recommended in carefully selected and hemodynamically stable patients with splenic rupture. Surgical treatment is considered as the standard of care in hemodynamically unstable patients

Ancient and recent collisions revealed by phosphate minerals in the Chelyabinsk meteorite

AbstractThe collision history of asteroids is an important archive of inner Solar System evolution. Evidence for these collisions is brought to Earth by meteorites. However, as meteorites often preserve numerous impact-reset mineral ages, interpretation of their collision histories is controversial. Here, we combine analysis of phosphate U-Pb ages and microtextures to interpret the collision history of Chelyabinsk—a highly shocked meteorite. We show that phosphate U-Pb ages correlate with phosphate microtextural state. Pristine phosphate domain U-Pb compositions are generally concordant, whereas fracture-damaged domains universally display discordance. Combining both populations best constrains upper (4473 ± 11 Ma) and lower intercept (−9 ± 55 Ma, i.e., within error of present) U-Pb ages. All phosphate U-Pb ages were completely reset during an ancient high energy collision, whilst fracture-damaged domains experienced further Pb-loss during mild and recent collisional re-heating. Targeting textural sub-populations of phosphate grains permits more robust reconstruction of asteroidal collision histories.</jats:p

Critical Roles for LIGHT and Its Receptors in Generating T Cell-Mediated Immunity during Leishmania donovani Infection

LIGHT (TNFSF14) is a member of the TNF superfamily involved in inflammation and defence against infection. LIGHT signals via two cell-bound receptors; herpes virus entry mediator (HVEM) and lymphotoxin-beta receptor (LTβR). We found that LIGHT is critical for control of hepatic parasite growth in mice with visceral leishmaniasis (VL) caused by infection with the protozoan parasite Leishmania donovani. LIGHT-HVEM signalling is essential for early dendritic cell IL-12/IL-23p40 production, and the generation of IFNγ- and TNF-producing T cells that control hepatic infection. However, we also discovered that LIGHT-LTβR interactions suppress anti-parasitic immunity in the liver in the first 7 days of infection by mechanisms that restrict both CD4+ T cell function and TNF-dependent microbicidal mechanisms. Thus, we have identified distinct roles for LIGHT in infection, and show that manipulation of interactions between LIGHT and its receptors may be used for therapeutic advantage

Host Plant Induced Variation in Gut Bacteria of Helicoverpa armigera

Helicoverpa are important polyphagous agricultural insect pests and they have a worldwide distribution. In this study, we report the bacterial community structure in the midgut of fifth instar larvae of Helicoverpa armigera, a species prevalent in the India, China, South Asia, South East Asia, Southern & Eastern Africa and Australia. Using culturable techniques, we isolated and identified members of Bacillus firmus, Bacillus niabense, Paenibacillus jamilae, Cellulomonas variformis, Acinetobacter schindleri, Micrococcus yunnanesis, Enterobacter sp., and Enterococcus cassiliflavus in insect samples collected from host plants grown in different parts of India. Besides these the presence of Sphingomonas, Ralstonia, Delftia, Paracoccus and Bacteriodetes was determined by culture independent molecular analysis. We found that Enterobacter and Enterococcus were universally present in all our Helicoverpa samples collected from different crops and in different parts of India. The bacterial diversity varied greatly among insects that were from different host plants than those from the same host plant of different locations. This result suggested that the type of host plant greatly influences the midgut bacterial diversity of H. armigera, more than the location of the host plant. On further analyzing the leaf from which the larva was collected, it was found that the H. armigera midgut bacterial community was similar to that of the leaf phyllosphere. This finding indicates that the bacterial flora of the larval midgut is influenced by the leaf surface bacterial community of the crop on which it feeds. Additionally, we found that laboratory made media or the artificial diet is a poor bacterial source for these insects compared to a natural diet of crop plant

The functioning of the Cuban home hospitalization programme: a descriptive analysis

BACKGROUND: Over the last decades hospital at home (HaH) programmes have been set up in many, mainly European, countries. The Cuban HaH programme is not hospital driven, but the responsibility of the first line health services, and family doctors play a pivotal role. METHODS: We analyse the structure and functioning of the Cuban programme. In this descriptive study, information was prospectively collected on HaH patients admitted between July 1st 2001 and June 30th 2002. RESULTS: Admission rates varied between areas from 0.014 to 0.035 per person per year (ppy). The < 1 y and 1-4 y age groups had the highest admission rates. In one area the follow-up of pregnancy problems led to high 15-24 y and 25-49 y female admission rates (0,070 and 0,058 respectively). Respiratory affections were the most frequent reason for admission (32,6%), followed by early hospital discharge (16,0%) and gynaeco-obstetrical problems (10.8%). The median length of stay varied from 5 to 7 days between regions and from 5 days (early discharge) to 7 days (gynaeco-obstetrical problems) in function of the reason for admission. On average an HaH episode entailed 1.4 and 1.6 contacts per patient-day with the family doctor and nurse respectively. CONCLUSION: Difference in admission criteria in function of geography, distance to the hospital, transport facilities, and staff factors, as well as differences in hospital policy on early discharge explain the observed variability. The programme plays an important role in the integrated approach to quality care in the Cuban health system, but could benefit from more uniform admission criteria