Retrospective real-life efficacy assessment of teneligliptin in Indian T2DM patients

Background: Teneligliptin is been introduced recently in Indian market and data available are limited on Indian patients. Hence, the hospital based real life retrospective evaluation was planned out to evaluate, the efficacy of teneligliptin in type 2 diabetes mellitus in Indian population. Hence study was designed, a retrospective evaluation, of efficacy of teneligliptin in type 2 diabetes mellitus in Indian population.Methods: Data of 775 patients, who were prescribed teneligliptin was collected from hospital records. Teneligliptin 20mg was prescribed to all patients who were uncontrolled on other OHAs and for a mean duration of 8 weeks. Parameter evaluated in this study were change in FBG, PPBG and HbA1c from the baseline at 8week. With profile of outcome i.e. response and failure rates were also assessed with respect to age, gender, BMI and duration of diabetes.Results: Of 775 patients were enrolled, 427 were males and 348 females. The average age was 53.04 years among the study population. The mean duration of diabetes was 23 months. There was significant change in HbA1c, fasting and postprandial blood glucose levels at 8 week of teneligliptin therapy. Changes in HbA1c, FPG and PPG from baseline to end of study were-1.22±1.12% (p=0.001), -35.8±25.5mg/dl (p=0.001) and -60.7±28.6mg/dl (p=0.001) respectively. Out of 775 patients, 106 (13,7%) were non-responders where it was further sub analysed with different parameter such as age, gender, BMI and duration of diabetes in order to observe response of teneligliptin in diabetic patients.Conclusions: This real life retrospective evaluation showed efficacy of teneligliptin in real world scenario. It can be an effective alternative to conventional gliptins available for prescription in India

Protein folding on the ribosome studied using NMR spectroscopy

NMR spectroscopy is a powerful tool for the investigation of protein folding and misfolding, providing a characterization of molecular structure, dynamics and exchange processes, across a very wide range of timescales and with near atomic resolution. In recent years NMR methods have also been developed to study protein folding as it might occur within the cell, in a de novo manner, by observing the folding of nascent polypeptides in the process of emerging from the ribosome during synthesis. Despite the 2.3 MDa molecular weight of the bacterial 70S ribosome, many nascent polypeptides, and some ribosomal proteins, have sufficient local flexibility that sharp resonances may be observed in solution-state NMR spectra. In providing information on dynamic regions of the structure, NMR spectroscopy is therefore highly complementary to alternative methods such as X-ray crystallography and cryo-electron microscopy, which have successfully characterized the rigid core of the ribosome particle. However, the low working concentrations and limited sample stability associated with ribosome-nascent chain complexes means that such studies still present significant technical challenges to the NMR spectroscopist. This review will discuss the progress that has been made in this area, surveying all NMR studies that have been published to date, and with a particular focus on strategies for improving experimental sensitivity

Study of clinical characteristics, risk factors and outcomes for tuberculosis post allogeneic stem cell transplant: never count it out

Background: Allogeneic stem cell transplant (AlloSCT) recipients remain at a higher risk of developing tuberculosis (TB), especially in endemic populations. We conducted a retrospective study to identify the incidence, clinical presentation, and risk factors for active TB among our alloSCT recipients. Methods: Records of all patients transplanted between 1 January 2012 and 31 July 2020 were reviewed. Patients were followed up for outcome until 30 September 2020. None of the patients received prophylactic anti-tubercular drugs. Proven diagnosis of active TB was considered if Mycobacterium tuberculosis (MTB) was cultured from clinical samples or acid-fast bacilli (AFB) or MTB demonstrated on Ziehl-Neelsen (ZN) staining or histopathology or XPERT MTB, while probable diagnosis of TB was considered if histopathology findings were suggestive of caseation necrosis/epithelioid cell granulomas without any evidence of malignancy or lymphocyte rich exudative effusions (pleural/pericardial) without an alternative cause. Results: Among 381 alloSCT recipients, 15 patients (3.9%) developed TB at median of 246 (74–279) days post AlloSCT, after being symptomatic for a median of 22 (7–60) days, amounting to a cumulative incidence of 4.9%. All patients were started on four-drug anti tubercular therapy, ATT [Rifampicin, Isoniazid, Ethambutol, Pyrazinamide (RHEZ)], of which five patients developed hepatotoxicity at a median of 12 days after start of ATT, leading to drug modification. At last follow up, TB was cured in 13 (86.67%) patients, one succumbed to disease relapse, while others are still on treatment. Age ⩾ 30 years, immunosuppression for graft versus host disease (GvHD) > 6 months, prior use of tyrosine kinase inhibitors (TKI) and chronic GvHD on univariate analysis and immunosuppression for GvHD > 6 months on multivariate analysis were found to be associated with development of TB. Conclusion: A high index of suspicion with timely workup and treatment of TB is the key in AlloSCT recipients, especially in endemic TB populations