Frequency of Autonomic Neuropathy in Type-1 Diabetes Mellitus Patients

Abstract Objectives: To determine the frequency of diabetic autonomic neuropathy in type 1 diabetes mellitus.Methodology: This cross-sectional study was conducted at Medical Unit-IV, Services Institute ofMedical Sciences, Lahore. A total of 236 cases fulfilling the inclusion/exclusion criteria were enrolledfrom Medical OPD Services Institute of Medical Science, Lahore. Informed consent of the patientswas taken to include their data in the study. Detailed history for Diabetes Mellitus was taken. All thepatients were undergoing for evaluation of diabetic autonomic neuropathy. Presence/absence ofDAN was recorded. All this information was recorded.Results: In our study, frequency of diabetic autonomic neuropathy in type 1 diabetes mellitus wasrecorded in 17.80%(n=42) whereas 82.20%(n=194) had no findings of the morbidity.Conclusion: We conclude that the frequency of diabetic autonomic neuropathy in type 1 diabetesmellitus is not very high, but it varies according to diagnostic criteria and population, however,some-other studies in different health centers of our country is required

Helicobacter Pylori in Patients with Hepatitis C Virus

Abstract Objective: To determine the frequency and association of Helicobacter Pylori (H. Pylori) infection among patients infected with hepatitis C virus (HCV). Methodology: The study was conducted in Services Institute of Medical Sciences, Lahore. A total of 200 cases fulfilling the inclusion/exclusion criteria were enrolled from Medical OPD Services Institute of Medical Science, Lahore. An informed consent of the patients was taken to include their data in the study. Detailed history for hepatitis C virus was taken. Blood samples were collected and sent to the hospital laboratory for evaluation of presence/absence of H. Pylori in the subjects of HCV. Results: In this study, out of 200 subjects, 32%(n=64) aged 30-50 years while 68%(n=136) aged 51-80 years, and the mean S.D was calculated as 53.99+8.67 years. 54%(n=108) males and 46%(n=92) females were included. The frequency of H. Pylori in subjects with HCV was recorded in 37.5%(n=75) whereas 62.5%(n=125) had no findings of the morbidity. Conclusion: The frequency of H. Pylori is higher in patients of Hepatitis C. &nbsp

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Kinetic characterization of glucose aerodehydrogenase from Aspergillus niger EMS-150-F after optimizing the dose of mutagen for enhanced production of enzyme

In the present study enhanced production of glucose aerodehydrogenase from Aspergillus niger has been achieved after optimizing the dose of chemical mutagen ethyl methane sulfonate (EMS) that has not been reported earlier. Different doses of mutagen were applied and a strain was developed basing upon the best production. The selected strain Aspergillus niger EMS-150-F was optimized for nutrient requirements in order to produce enzyme through fermentation and the results showed the best yield at 2% corn steep liquor (CSL), 36 hours fermentation time, pH 5, 30°C temperature, 0.3% KH2PO4, 0.3% urea and 0.06% CaCO3. The enzyme was then purified and resulted in 57.88 fold purification with 52.12% recovery. On kinetic characterization, the enzyme showed optimum activity at pH 6 and temperature 30°C. The Michaelis-Menton constants (Km, Vmax, Kcat and Kcat/Km) were 20 mM, 45.87 U mL-1, 1118.81 s-1 and 55.94 s-1 mM-1, respectively. The enzyme was found to be thermaly stable and the enthalpy and free energy showed an increase with increase in temperature and ΔS* was highly negative proving the enzyme from A. niger EMS-150-F resistant to temperature and showing a very little disorderliness

Ameliorative effect of apple pomace and mango peels against hyperlipidemia and lipid peroxidation induced by hyperlipidemic diet

Diet induced hyperlipidemia is a major cause for atherosclerosis, lipid peroxidation, and fatty liver diseases. Fruit processing waste rich in dietary fiber and antioxidant capacity can be an economical way to manage such risk factors. The major objective of the present study was to manage hyperlipidemia by including apple pomace and mango peels in daily diet. Dry powder obtained from apple pomace, mango peels and their mixture was added to the normal chow on replacement basis by 12%. These were fed to the rats along with hyperlipidemic diet to the experimental groups (N=30, 10/group), while control group (N=10) was fed hyperlipidemic diet alone. The rats were analyzed for water and feed intake, body weight, organs to body weight ratio, glucose concentration, lipid profile, lipid peroxidation test, liver cholesterol, and liver and renal function tests. The results showed that high cholesterol in diet was well managed by rat groups on apple pomace and mango peels supplement. The mango peels powder was found to be more effective as compared to apple pomace powder against hyperlipidemia. Mango peels and apple pomace powders not only improved the lipid profile but also resulted in lower liver cholesterol concentration and better lipid peroxidation status of the experimental rats as compared to control group. It can be concluded that fruit processing waste specially mango peels can be cost effective tool to manage diet induced hyperlipidemia, lipid peroxidation and fatty liver diseases

Facile and Green Synthesis of Saturated Cyclic Amines

Single-nitrogen containing saturated cyclic amines are an important part of both natural and synthetic bioactive compounds. A number of methodologies have been developed for the synthesis of aziridines, azetidines, pyrrolidines, piperidines, azepanes and azocanes. This review highlights some facile and green synthetic routes for the synthesis of unsubstituted, multisubstituted and highly functionalized saturated cyclic amines including one-pot, microwave assisted, metal-free, solvent-free and in aqueous media