Serum magnesium levels in newly diagnosed type 2 diabetes mellitus and its relation with microvascular complications of diabetes

Background: Prevalence of hypomagnesaemia is significantly higher in diabetic patients with microvascular complications compared to diabetics with no microvascular complications. The aim of this study is to measure levels of serum magnesium in patients with newly diagnosed type 2 diabetes mellitus and study its association with the presenting microvascular complications.Methods: This was hospital based, one year cross-sectional study carried out in Department of Medicine, IGMC Shimla in patients with newly diagnosed type 2 diabetes mellitus. Total 53 patients were enrolled in this study who presented in medicine OPD or admitted in medicine ward.Results: Serum Magnesium value of the patients ranged from 1.20-3.0 mg/dl with mean value of 1.9±0.3 mg/dl. Fourteen patients (26.4%) had hypomagnesaemia. A total of 34 (64.2%) patients presented with complications of diabetes in which proteinuria was present in 34 (64.2%), retinopathy in 4 (7.5%) and neuropathy in 1 (1.9%). Fourteen (41.2%) patients with hypomagnesaemia presented with complications of diabetes (p value=0.003). 34 (64.2%) patients presented with proteinuria out of which 14 (41.2%) patients had hypomagnesaemia while 20 (58.8%) had normomagnesaemia (p=0.03). One (1.9%) patient had neuropathy and hypomagnesaemia was also present in this patient (p=0.6). Four patients (7.5%) presented with retinopathy out of which 3 (5.7%) had hypomagnesaemia while 1 (1.9%) had normomagnesaemia.Conclusions: Hypomagnesaemia is associated with microvascular complications of diabetes. Also there is statistically significant relationship between proteinuria and hypomagnesaemia in patients with newly diagnosed type 2 diabetes mellitus

A Comprehensive Review of The Therapeutic Potential of Elaeocarpus Ganitrus

Elaeocarpus ganitrus, also known as Rudraksha, is a member of the Elaeocarpaceae family and has a long history of antidepressant and antibacterial benefits against various illnesses. Elaeocarpus ganitrus has been used in Unani and Ayurveda medicine as an antidepressant, an antibiotic, and as an external treatment for mental disease, epilepsy, liver discomfort, and stomach pain. In addition, it is used to treat a variety of other conditions, including hepatic diseases, dyspepsia, skin infections, blood purification, asthma, tumors, and wounds. Their biological effects include their antioxidant, anti-inflammatory, neuroprotective, anticancer, hepatoprotective, immunomodulatory, antifertility, antibacterial, and antidepressant properties. To further explore the trends and perspectives for future research, a thorough discussion of Elaeocarpus ganitrus' taxonomic classification, traditional uses, botanical description, phytochemical components, pharmacology, and safety aspects is required

Clinical profile of snake bite patients in tertiary care hospital in Himachal Pradesh: a prospective study

Background: To study clinical profile of snake bite patients in tertiary care hospital in Indra Gandhi Medical College at Shimla, Himachal Pradesh of North India.Methods: Hospital based prospective observational study was conducted in the Department of Medicine, for the duration of one year from 1st June2013 to 31st May 2014.Results: A total of 78 patients were admitted with mean age of 38.46 years with male to female ratio of 1:1.6. Seasonal variation with peak incidence during rainy season was seen. Most common snake identified was green coloured and peak timing of snake bite was between 07:00am-04:00pm. There was delay in admission of more than 6 hours in 66.67% of cases. Hemotoxicity was predominant manifestation seen in 62.82% of cases and persistence of coagulopathy was most common complication (51.02%) despite giving optimal ASV. There was paucity in ASV administration seen in only 59.46% of referred patients. Mean ASV vials used were 23.41 vials ±8.72 vials.Conclusions: Mass education is required at both general population and health professional levels to improve snake bite management and monovalent ASV against Green pit viper is more practical option to manage cases in this region

Gram-negative bacterial LPS induced poor uterine receptivity and implantation failure in mouse: alterations in IL-1beta expression in the preimplantation embryo and uterine horns.

Genito-urinary tract or systemic infections of the gram-negative bacteria in pregnant women, causes abortions, preterm labor, and several other perinatal complications. LPS is the most potent antigenic component of the gram-negative bacterial cell wall and is known to modulate the expression of various proinflammatory cytokines. Here we investigate the role of the soluble form of IL-1 i.e., IL-1beta in the 'minimum dose' of LPS induced pregnancy loss in mice. Uterine cross-sections on each day of the preimplantation period of pregnancy were examined histopathologically for finding out LPS induced changes in the uterine preparation for embryo implantation. The expression of IL-1beta in the various stages of the preimplantation period of pregnancy was studied by RT-PCR in the embryos and the uterine horns of the LPS treated and normal pregnant mice. We found that LPS significantly alters the proliferation of the glandular epithelium, luminal epithelium and stroma during the preimplantation period. We also found large infiltration of macrophages into the uterine horns of the LPS treated animals. The level and pattern of IL-1beta expression in the preimplantation embryos and uterine horns were also altered in LPS treated animals. These observations indicate that LPS can alter the uterine preparation for blastocyst implantation, which could be due to the change in the IL-1beta expression in the uterine horns. However, a change in the expression pattern of IL-1beta in the preimplantation embryos underlines the significance of this molecule in LPS induced pregnancy loss or implantation failure in mouse

Effect of Bacterial Endotoxins on Superovulated Mouse Embryos In Vivo: Is CSF-1 Involved in Endotoxin-Induced Pregnancy Loss?

Mammalian embryonic development is regulated by several cytokines and growth factors from embryonic or maternal origins. Since CSF-1 plays important role in embryonic development and implantation, we investigated its role in gram-negative bacterial LPS-induced implantation failure. The effect of LPS on normal (nonsuperovulated) and superovulated in vivo-produced embryos was assessed by signs of morphological degeneration. A significantly similar number of morphologically degenerated embryos recovered from both nonsuperovulated and superovulated LPS treated animals on day 2.5 of pregnancy onwards were morphologically and developmentally abnormal as compared to their respective controls (P < .001. Normal CSF-1 expression level and pattern were also altered through the preimplantation period in the mouse embryos and uterine horns after LPS treatment. This deviation from the normal pattern and level of CSF-1 expression in the preimplantation embryos and uterine tissues suggest a role for CSF-1 in LPS-induced implantation failure

Cardiovascular abnormalities in severe scrub typhus

Background: Himachal Pradesh is an endemic area for scrub typhus. If not treated early, it can lead to life threatening complications, affecting various systems of the body. Hence, this study was done with an objective to study the cardiovascular abnormalities in patients of severe scrub typhus.Methods: Authors conducted a hospital-based study in Departments of Medicine and Cardiology, of a tertiary care hospital in Sub-himalayan region in patients of severe scrub typhus from June 2016 to May 2017.Results: Thirty-two (55%) patients were aged &lt;60 years with female preponderance (72%).   Electrocardiographic changes included sinus tachycardia in 56 (97%), axis deviation in 5(9%), ST-T changes in 3(5%) and atrial fibrillation in 1(2%). Echocardiographic changes included tricuspid regurgitation in 14(24%), pericardial effusion in 4(7%), myocarditis in 1(2%) and Regional wall motion abnormality in 1(2%). Left ventricular ejection fraction &gt;45% in 47 (81%) and &lt;45% in 11(19%).  Fifty-one patients had hypotension at presentation and 49 (90%) of them improved. Interestingly, 10 of 11 patients with reduced EF (&lt;45%) survived whereas 6 of total 7 patients, who died, had preserved EF (&gt;45 %).Conclusions: Severe scrub typhus manifested with ST/T changes, myocarditis, pericardial effusion, arrhythmias, shock and patients with reduced EF on Echocardiography had better outcome

Testosterone levels in men with type 2 diabetes mellitus

Background: To study testosterone levels in men with type 2 diabetes mellitus in age group of 30-50 years.Methods: In this cross sectional study of 193 type 2 diabetes men aged between 30-50 years, total and free testosterone levels were calculated along with other relevant clinical variables like hypertension, BMI, dyslipidemia, peripheral neuropathy, retinopathy.Results: The study group had study out of 193 patients 34.7% have low total testosterone levels, 29.53% have low free testosterone levels and 23.3% have both low and free testosterone levels. Maximum number of patients with low total testosterone levels were in the age group between 46-50 years (41.0%) and with low free total testosterone levels were in the age group between 36-40 years (41.8%).Conclusions: Type 2 diabetes mellitus is associated with low levels of total and free testosterone. Obesity and dyslipidemia are also associated with low testosterone levels

Frequency of peripheral neuropathy in pre diabetics in sub Himalayan region: a cross sectional observational study

Background: Peripheral neuropathy in pre diabetics has been studied in various studies till now. Many are in support and many against. No data was available in any study using all three criteria i.e. impaired fasting glucose, impaired glucose tolerance and HbA1C. Aim was to study the frequency of peripheral neuropathy in pre diabetics in a tertiary health care centre in sub Himalayan region.Methods: A 50 patients of prediabetes were enrolled for this study; preformed proforma was used to collect the information, data on examination and investigations. Then these patients were subjected to nerve conduction studies.Results: Out of total 50 pre diabetic patients 9(18%) were diagnosed having peripheral neuropathy. Maximum number of pre diabetic patients were (26) in the age group 46-55 years with mean age of 44.49 years ±7.01 (S.D.). 28 (56%) were males with a female to male ratio of 1:1.27. 20% patients had complaint of polyuria, 12% presented with polydipsia, 14% of total pre diabetic patients had paresthesia on history. 6% patients had impaired vibration and position sense on clinical examination. Out of total 9 patients having evidence of Peripheral Neuropathy 6 (66.66%) were meeting all three criteria for Prediabetes while 8 (88.88%) had IFG, 7 patients had IGT. 42% of the patients were fulfilling the criteria of metabolic syndrome. 28 had raised TGs and out of them 5 (17.8%) had peripheral neuropathy. Out of 24 obese patients, 4 (16.6%) had peripheral neuropathy. Out of 9 patients with peripheral neuropathy 66.66% patients were considered to be suffering with peripheral neuropathy on the basis of sensory symptoms and 33.33% were considered on the basis of impaired vibration and position sense on examination, one patient diagnosed on the basis of nerve conduction studies. 38% were in high risk group of developing T2DM in future as per Indian diabetes risk score. Mean compound motor action potential (CMAP) and nerve conduction velocity (NCV) were less in patients with peripheral neuropathy in comparison to patients without peripheral neuropathy.Conclusions: Peripheral neuropathy can occur in prediabetes though it is difficult to confirm it. Most common is small fiber neuropathy which can be diagnosed on the basis of history and examination. But by diagnosing it early in the course of prediabetes, morbidity and mortality secondary to neuropathy can be prevented

Učinak ampicilina i klorokina na humoralnu imunošku reakciju na goveđi albumin kapsuliran u liposome

Immune suppression resulting from chemoprophylaxis and potential drug interaction were investigated in experimental animals pre-medicated with ampicillin and chloroquine followed by immunization with bovine serum albumin bearing liposomes prepared by the reverse phase evaporation method. The prepared liposomes were evaluated for particle size, entrapment efficiency and in vitro release. Humoral immune response was measured in terms of systemic IgG antibody titre by the ELISA method. The present study showed that 7:3 molar ratio of soya phosphatidylcholine and cholesterol produced liposomes of mean diameter of 235.4 10.3 nm and entrapment efficiency of 41.3 3.2%. Ampicillin significantly (p < 0.05) decreased the antibody titre whereas chloroquine did not reduce the antibody titre significantly. The study will help in programming a new drug management and in characterization of vaccine-drug interaction.Na eksperimentalnim životinjama koje su prvo tretirane ampicilinom i klorokinom a zatim imunizirane goveđim serumskim albuminom s liposomima praćena je supresija imunološkog sustava i potencijalna interakcija lijekova. Liposomi su pripravljeni metodom reverzno-fazne evaporacije, a određena im je veličina čestica, količina supstancije koju mogu inkorporirati i oslobađanje in vitro. Humoralna imunološka reakcija praćena je određivanjem titra IgG antitijela ELISA metodom. Rezultati rada pokazuju da liposomi s fosfatidilkolinom iz soje i kolesterolom u molnom omjeru 7:3 imaju prosječni promjer 235.4 10.3 nm i sposobnost inkorporacije 41.3 3.2%. Ampicilin je značajno (p < 0.05) smanjio titar antitijela, a klorokin nije. Ovi će rezultati biti korisni u programiranju novog režima primjene lijekova i u praćenju interakcije između cjepiva i lijeka