Pulmonary Function Test in Type 2 Diabetics and Non-Diabetics: A Comparative study

BACKGROUND : The complications which are associated with type 2 Diabetes mellitus are mostly caused by macro vascular and micro vascular damages. The pulmonary complications of diabetes mellitus have been poorly characterised. The present study has focused on the mechanical aspects of lung dysfunction which are attributable to type 2 Diabetes Mellitus; maximal forced Spiro metric Pulmonary Function Tests (PFTs) like Forced vital capacity (FVC), Forced Expiratory Volume in 1sec (FEV1) and FEV1/FVC % to be specific. AIMS AND OBJECTIVES : 1. To do a comparative study of the PFTs in type 2 diabetics and non-diabetics by using computerised spirometry. 2. To assess the effects of chronic hyperglycaemia on lung functions and pulmonary complications in patients with type 2 diabetes. MATERIAL AND METHODS: Spirometry was performed by using a computerised electronic spirometer, on 50 type 2 diabetics who were between 30-50 years of age and on 50 controls (who were matched for age, sex and BMI). Any person with a H/O smoking or any condition which affected the lung functions, was excluded from the study. The study was a cross sectional and a retrospective study. Data was analyzed and processed with the help of EPI INFO statistical software by using unpaired Student’s ‘t’–test (two-tailed). RESULTS : This study clearly showed a statistically significant reduction in FVC, FEV1, in type 2 diabetics as compared to those in the controls. FEV1/FVC% was increased in type 2 diabetics as compared to that in controls and the increase was statistically significant. CONCLUSION: This study concluded that type 2 diabetes adversely affects the mechanical functions of the lung, the pattern of disease being primarily restrictive in nature

Development of technology for modified starch incorporated grains and pulse blended bakery and pasta products

The study aimed to investigate the appropriate technology for the development of modified starch and standardize the millet-based bakery and pasta products incorporated with modified starch and measure the glycemic index of the standardized therapeutic baked and pasta products. The physical modification and chemical modification techniques were performed to optimize the technology for modified starch. Refined wheat flour was substituted with millet flour, modified starch and pulse flour at various percentages to optimize the flour blend for pasta and bakery products. The products were subjected to in vitro study to measure the glycemic index. Physical modification technique, i.e. autoclave-cooling, was found to be optimum for the development of modified starch. The optimum flour blend for pasta products was whole wheat flour(50%), millet flour (25 and 50%), cassava modified starch (15 and 25%) and green ram flour (10%) and it was found to be acceptable without affecting its sensory attributes. The optimum blend for bread was whole wheat flour (50%), kodo / barnyard millet flour (50%) with cassava modified starch (10%) and for low-fat cookies, it was millet flour (20%) and modified starch (15 %). Among the three pasta products, noodles and macaroni were found to be highly acceptable with minimum cooking loss. The in vitro study showed that the pasta products have a hypoglycemic effect suitable for lifestyle disorder patients and do not involve high production costs and earn good returns to the entrepreneurs

A Study on Diastolic Dysfunction in Asymptomatic Type 2 Diabetes Mellitus with Normal Systolic Function

INTRODUCTION: The incidence of diabetes mellitus (DM) is on the raise across the world and it is turning out to be an epidemic of non communicable disease. Diabetic heart disease and Diabetic Cardiomyopathy as a separate entity has been proposed in the last couple of decades. Diastolic heart failure, otherwise called as heart failure with preserved ejection fraction, is common finding of hypertensive heart disease, but various studies report a high incidence of diastolic heart failure in patients with type 2 diabetes mellitus inspite of the absence of coronary artery heart disease and hypertension. AIM AND OBJECTIVES: 1. To determine the incidence of LV diastolic dysfunction in asymptomatic type 2 DM patients and to compare it with normal subjects. 2. To quantify the relation of LV diastolic dysfunction with age, duration of DM, obesity indices and other diabetic complications such as microangiopathies. MATERIALS AND METHODS: Settings and Design: This will be case control prospective study conducted at the tertiary care hospital during a one year period. Period of study: One year. Sample size: 50. Inclusion Criteria: All type 2 DM with patients with duration > 5 years with normal left ventricular systolic function (LVEF: ≥ 50%). Exclusion Criteria: 1. Subjects with evidence of coronary artery disease - CAD (excluded by history of angina, chest pain, Electrocardiogram (ECG) changes and abnormal Treadmill test (TMT) results). 2. Subjects with evidence of valvular disease. 3. Hypertensive patients on antihypertensive agents and/ or angiotensin-converting enzyme (ACE) inhibitors, with evidence of left ventricular hypertrophy on echocardiography. 4. Subjects with poor transthoracic echo window. METHOD OF STUDY: Detailed medical history was collected from each eligible subject; and, they underwent physical examination and biochemical investigations. Biochemical investigations of fasting sugar, lipid profile, HbA1C, anthropometric examination of waist hip ratio, height, weight and BMI were calculated. Echocardiogram was done to find out diastolic dysfucntiom. Diagnostic criteria: 1. Dyslipidemia: defined if TC ≥ 200 mg/dL; LDL cholesterol ≥ 130 mg/dL; HDL cholesterol 40 mg/dL; and, TG ≥ 150 mg/dL. 2. Obesity indices: Cut-off for high Body Mass Index (BMI) ≥ 25 for females and ≥ 27 for males. Cutoff for high waist to hip ratio (WHR) ≥ 0.9 for males, and ≥ 0.8 for females. Cut-off for high WC > 85 cm for females and > 90 cm for males. 3. Diabetes mellitus (DM): If a subject is a known diabetic on treatment, or with any fasting blood sugar level (F-BSL) ≥ 126 mg/dL. 4. Retinopathy: Microangiopathy to be assessed by fundoscopy (direct ophthalmoscopy). The ophthalmologist doing fundoscopy will be unaware of this study. Fundoscopic examination to be done after dilating the pupil with tropicamide (1%). Retinopathy status will be labeled as follow: a) no evidence of diabetic retinopathy, b) preproliferative diabetic retinopathy, c) proliferative diabetic retinopathy. 5. Diastolic dysfunction is labelled according to the standard guidelines. Diastolic dysfunction: LV diastolic dysfunction is considered to be present if any of the following findings is seen, • E/A ratio 2 • DT 220 ms, • IVRT 100 ms, or • E/e’ ratio > 15. RESULTS: Of the total 50 patients in the cases arm 30 had diastolic dysfunction which is 60% prevalence. On the control arm a total of 7 had diastolic dysfunction which equals to 14%. A total of 13 patients were of age 45 years. A total of 23 patients in this category had diastolic dysfunction which equals 62.16%.31 patients in cases arm had HBA1c less than 7.5 gm% and 19 had HBA1c greater than7.5gm%. 14 patients with HBA1c less than 7.5gm% had diastolic dysfunction with a prevalence of 45.2%. 16 patients with HBA1c greater than 7.5 gm% had diastolic dysfunction with a prevalence of 84.2%.38 patients had diabetes mellitus for 6-10 years and 12 had duration between11-15 years. 22 patients with duration 6-10 years had diastolic dysfunction with a prevalence of 57.9%. 8 patients with duration of diabetes 11-15 years had diastolic dysfunction with a prevalence of 66.67%. A total of 12 patients had diabetic retinopathy while the remaining 38 did not show features of diabetic retinopathy. Of the 12 patients 9 had diastolic dysfunction with a prevalence of 75%. A total of 12 patients had autonomic dysfunction and remaining 38 patients did not have autonomic dysfunction. Of the 12 patients with autonomic dysfunction 9 had diastolic dysfunction with an incidence of 75%. The incidence of diastolic dysfunction is more in age > 45 years with the Statistical ‘p’ value of 7.5 gm% with a statistical ‘p’ value of < 0.02. The incidence of diastolic dysfunction occurs more often after a 5 years duration with an incidence in 6-10 years of 73.33% of total and a stastical ‘p’ value of < 0.02. The incidence of diastolic dysfunction 75 % when the patient develops diabetic retinopathy. The incidence of diastolic dysfunction 75% when the patient develops diabetic autonomic neuropathy. CONCLUSION: Diabetes Mellitus causes serious morbidities one of which is cardiovascular. The occurrence of coronary artery disease and systolic dysfunction are well known. However the prevalence of a diastolic dysfunction even in asymptomatic patients independent of a CAD is a relatively new observation. It is also obvious that, diastolic dysfunction correlates well with diabetes duration, micro vascular abnormalities obesity index, lipid profile and HbA1c. Diastolic dysfunction, being a marker of Diabetic Cardiomyopathy, may be useful as the predictor of heart failure with preserved ejection fraction and mortality in the medium to long ter

Development of interlocking lightweight cement blocks

Self-weight of building units, construction time and sound workmanship are key factors affecting the quality and cost effectiveness of masonry construction. Amongst the loads a structure should resist, self-weight is a major component thus the reduction of self-weight by introducing lightweight material would effectively reduce the load as well as the cost of construction. Furthermore, large individual units would help speedy construction and results in cost reduction. Yet, it is difficult to achieve sound workmanship in construction of masonry works without skilled workers. By having interlocking blocks, requirement of skilled workers can be reduced. Hence an experimental investigation was carried out to develop interlocking lightweight cement blocks, contrary to those existing, to address the above mentioned requirements. The interlocking hollow blocks developed are 600mm x200mm x200mm in size with a weight of 20 kg. The expanded polystyrene beads have been used to reduce the self-weight. Experimental investigation has shown that average compressive strength of block was 4.91N/mm2 and wall panel strength was 2.13 N/mm2, therefore it can be used for load bearing masonry walls. It was also observed ductile load deformation behaviour at the failure of the masonry wall panel, which is an added advantage

Next Generation Designed Protein as a Photosensitizer for Biophotovoltaics Prepared by Expanding the Genetic Code

We explored the possibility of generating nonpoisonous, renewable, low cost and a completely biodegradable photosensitizer for dye-sensitized solar cells (DSSC) as an alternative to synthetic molecules that involve expensive, time-consuming tedious synthesis and purification procedures. Several natural dyes from plants and microbes had successfully been demonstrated as photosensitizers to develop biosensitized solar cells (BSSCs). The objective of this work is to develop a next generation cleaner sensitizer for BSSC using a green fluorescent protein (GFP) and its designer variant (GFPdopa) through an expanding genetic code approach. The designer protein showed higher adsorption with TiO₂ surface through oriented immobilization. The nanostructured layer formed by GFPdopa with TiO₂ resulted in 0.94% level of photon conversion efficiency with open circuit voltage of 0.60 V, short circuit current of 1.75 mA/cm² and fill factor of 0.88. It is one of the better energy conversion efficiencies obtained for BSSC when compared to with earlier reported sensitizers generated through protein and chemical complex synergism. From the results obtained, it is suggested that designer fluorescent itself can generate similar photoconversion efficiency and also could serve as an environmental friendly photosensitizer. The research and efficiency level of BSSC is in the early stages, and our proof of principle opens a new avenue to synthesize biologically designer sensitizers for BSSC. It also could be widely applied to other proteins to develop efficient sensitizers for BSSC with a green approach

Conservatively treated Congenital Hyperinsulinism (CHI) due to K-ATP channel gene mutations: reducing severity over time.

Patients with Congenital Hyperinsulinism (CHI) due to mutations in K-ATP channel genes (K-ATP CHI) are increasingly treated by conservative medical therapy without pancreatic surgery. However, the natural history of medically treated K-ATP CHI has not been described; it is unclear if the severity of recessively and dominantly inherited K-ATP CHI reduces over time. We aimed to review variation in severity and outcomes in patients with K-ATP CHI treated by medical therapy.This article is freely available via Open Access. Click on Additional Link above to access the full-text via the publisher's website