525 research outputs found
A revision of Indian species of Parurios Girault with a new record of Papuopsia Boucek (Hymenoptera: Pteromalidae) from India
Two new species of Parurios Girault viz. P. bouceki Narendran sp. nov. and P. sringericus Narendran sp. nov. are described from India. The female of P. keralensis Narendran is also described. A key to Indian species of Parurios is provided. The genus Papuopsia is recorded for the first time from India
Does exercise improve glycaemic control in type 1 diabetes? A systematic review and meta-analysis.
This is the final published version. Available from PLoS via the DOI in this record.OBJECTIVE: Whilst regular exercise is advocated for people with type 1 diabetes, the benefits of this therapy are poorly delineated. Our objective was to review the evidence for a glycaemic benefit of exercise in type 1 diabetes. RESEARCH DESIGN AND METHODS: Electronic database searches were carried out in MEDLINE, Embase, Cochrane's Controlled Trials Register and SPORTDiscus. In addition, we searched for as yet unpublished but completed trials. Glycaemic benefit was defined as an improvement in glycosylated haemoglobin (HbA1c). Both randomised and non-randomised controlled trials were included. RESULTS: Thirteen studies were identified in the systematic review. Meta-analysis of twelve of these (including 452 patients) demonstrated an HbA1c reduction but this was not statistically significant (standardised mean difference (SMD) -0.25; 95% CI, -0.59 to 0.09). CONCLUSIONS: This meta-analysis does not reveal evidence for a glycaemic benefit of exercise as measured by HbA1c. Reasons for this finding could include increased calorie intake, insulin dose reductions around the time of exercise or lack of power. We also suggest that HbA1c may not be a sensitive indicator of glycaemic control, and that improvement in glycaemic variability may not be reflected in this measure. Exercise does however have other proven benefits in type 1 diabetes, and remains an important part of its management
Urine nevirapine as a predictor of antiretroviral adherence
Background & objectives: Incomplete adherence is a major contributor to failure of antiretroviral
therapy. Although the available methods to monitor adherence to therapy have proved to be
predictive of outcomes, the results are variable. We assessed the feasibility of detecting nevirapine
(NVP) in spot urine samples to monitor patient adherence to antiretroviral treatment and to study
the urinary excretion of NVP in healthy volunteers after oral administration of a single dose of
NVP (200 mg).
Methods: Spot urine samples were collected from 50 HIV-infected patients (36 on treatment regimen
containing NVP and 14 on drugs other than NVP) and tested for NVP by HPLC in a blinded
manner. Sixteen healthy volunteers (9 males and 7 females) were administered a single oral dose of
200 mg NVP and spot urine samples were collected on day ‘0’ before drug administration, and
thereafter every 24 h up to 9 days and tested for NVP.
Results: All the urine samples collected from patients undergoing treatment with NVP-containing
regimens at different time points after drug administration tested positive for NVP. Thirteen out
of 14 samples from patients not on NVP yielded a negative result. The drug was detected in the
urine of healthy volunteers up to 9 days. The urinary excretion of NVP was prolonged in females
than in males.
Interpretation & conclusion: In view of its long half-life, NVP gets excreted in urine for a long
period of time. Hence, testing spot urine samples for NVP may not be a useful measure to monitor
patient adherence to treatment
CCR2, MCP-1, SDF-1α & DC-SIGN gene polymorphisms in HIV-1 infected patients with & without tuberculosis
Background & Objectives: Variability in the clinical outcome of persons exposed to and infected with HIV-1 and tuberculosis (TB) is determined by multiple factors including host genetic variations. The aim of the present study was to find out whether chemokine, chemokine receptor and DC-SIGN gene polymorphisms were associated with susceptibility or resistance to HIV and HIV-TB in south India. Methods: CCR2 V64I (G/A), monocyte chemoattractant protein-1 (MCP-1) -2518 A/G, stromal cell derived factor-1α; (SDF-1α) 3'UTR G/A and DC-SIGN gene polymorphisms were studied by polymerase chain reaction based methods in HIV-1 infected patients without TB (n=151), with pulmonary TB (PTB) (n=81) and extrapulmonary TB (n=31), 155 PTB patients without HIV and 206 healthy controls. Results: The genotype frequencies of CCR2 V64I, MCP-1 -2518 and DC-SIGN polymorphisms did not differ significantly between the study groups. A significantly increased frequency of GG genotype of SDF-1alpha polymorphism was observed among HIV+PTB+ patients compared to healthy controls (P=0.009, Pc=0.027). Interpretation & Conclusions: Our data suggest that GG genotype of SDF-1alpha 3'UTR polymorphism may be associated with susceptibility to PTB in HIV-1 infected patients. A better understanding of genetic factors that are associated with TB could help target preventive strategies to those HIV patients likely to develop tuberculosis
Carbohydrate restriction for glycemic control in Type 2 diabetes : a systematic review and meta-analysis
Aim
To conduct a systematic review and meta‐analysis to evaluate the effect of carbohydrate restriction on glycaemic control in Type 2 diabetes.
Methods
We searched Medline, EMBASE and CINAHL for the period between 1976 and April 2018. We included randomized controlled trials comparing carbohydrate restriction with a control diet which aimed to maintain or increase carbohydrate intake, and that reported HbA1c as an outcome and reported the amount of carbohydrate consumed during or at the end of the study, with outcomes reported at ≥3 months.
Results
We identified 1402 randomized controlled trials, 25 of which met the inclusion criteria, incorporating 2132 participants for the main outcome. Definitions of low carbohydrate varied among the studies. The pooled effect estimate from meta‐analysis was a weighted mean difference of –0.09% [95% CI –0.27, 0.08 (P = 0.30); I2 72% (P <0.001)], suggesting no effect on HbA1c of restricting the quantity of carbohydrate. A subgroup analysis of diets containing 50–130 g carbohydrate resulted in a pooled effect estimate of –0.49% [95% CI –0.75, –0.23 (P <0.001); I2 0% (P = 0.56)], suggesting a clinically and statistically significant effect on HbA1c in favour of low‐carbohydrate diets in studies of ≤6 months’ duration.
Conclusions
There was no overall pooled effect on HbA1c in favour of restricting carbohydrate; however, restriction of carbohydrate to 50–130 g per day had beneficial effects on HbA1c in trials up to 6 months. Future randomized controlled trials should be of >12 months’ duration, assess pre‐study carbohydrate intake, use recognized definitions of low‐carbohydrate diets and examine reasons for non‐concordance in greater detail
Carbohydrate restriction for glycaemic control in Type 2 diabetes:a systematic review and meta-analysis
Study of ABCB1 polymorphism (C3435T) in HIV-1-infected individuals from South India
Studies on P-glycoprotein expression and function have
revealed that a single nucleotide polymorphism (SNP) in
the human ABCB1 gene at 3435 (C > T) results in altered
expression and function of P-glycoprotein [1, 2].There have
been reports of lower nelfinavir and efavirenz (EFV) concentrations
associated with TT genotypes (mutant) of
ABCB1 C3435T polymorphism [3, 4].Frequency distribution
of this polymorphism is known to vary across populations
[3, 5, 6]. We report the genotype distribution of ABCB1
C3435T in 179 individuals (126 HIV-infected and 53
healthy) from South India. The polymorphism was correlated
with plasma 12 h EFV and 2 h nevirapine (NVP) concentrations
in 55 and 71 patients, respectively. Plasma EFV
and NVP were estimated by HPLC [7, 8]. Genotyping was
carried out by PCR-RFLP [9]
Sensitivity & specificity of combination testing algorithms for HIV in a tuberculosis clinic
Introduction: Co-management of tuberculosis (TB) and HIV is complicated by pharmacologic drug
interactions between rifampicin (RMP) and certain classes of antiretroviral agents. The NNRTIs
Nevirapine (NVP) or Efavirenz (EFV), used to HIV infection, are known to induce the CYP 450
enzyme system. Thus when RMP is co-administered along with NVP or EFV, the bioavailability of
RMP could be lowered leading to drug resistance and treatment failure.
Objectives: To study the steady state pharmacokinetics of RMP in HIV and HIV-TB patients
receiving antiretroviral regimens containing NVP or EFV respectively.
Methods: The study population comprised of HIV and HIV-TB patients undergoing antiretroviral
treatment with NVP and EFV containing regimens respectively. These patients were also receiving
concomitant RMP. Rifampicin was estimated by HPLC in blood collected at different time points
after drug administration. The pharmacokinetic variables of RMP were calculated using WinNonlin
software.
Results & Conclusions: Co-administration of NVP or EFV did not alter the pharmacokinetics of
RMP in HIV and HIV-TB patients, suggesting that the dose of RMP need not be altered during
antiretroviral treatment with NVP or EFV
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