Evaluation of antidiabetic activity of fruit of Coriandrum sativum. Linn methanolic extract in Streptozocin induced diabetic wistar Albino rats

Background: Diabetes prevalence is estimated to increase annually. Numerous people use traditional medicine, such as India also considered as the diabetic capital in the world. Diabetes is a metabolic disorder characterized by disturbances in lipid, carbohydrate and protein metabolism. The present study to evaluate the antidiabetic potential of coriandrum sativum. linn fruits methanolic extract in streptozocin induced diabetic wistar albino rats model.Methods: Diabetes induction in wistar albino rats by administration of streptozocin (50mg/kg, i.p.) in citrate buffer. 30 wistar albino rats were divided into 5 groups (A, B, C, D, E). Group A: served as normal control, whereas Group B: diabetic control, Group C, D methanolic coriandrum sativum Linn. fruits extract (CSFME) at a dose of 100, 200mg/kg orally, Group E was given standard drug Glibenclamide (0.5mg/kg) orally. All groups are administered for the period of 14 consecutive days and blood sugar levels was measured at regular intervals up to end of the study.Results: This present research study confirms that the test drug compound CSFME has sustained oral hypoglycaemic activity and statistically significant (p ≤0.05) and which is comparable with standard drug Glibenclamide.Conclusions: This research study confirms that the CSFME has antidiabetic activity against streptozocin induced wistar diabetic albino rats. It could be a novel antidiabetic agent and also a dietary adjunct in the type 2 diabetes management and its complication. Further studies are necessary required to confirm the antidiabetic activity of individual phytochemical compounds of Coriandrum sativum

Evaluation of antidiabetic potential of hydroalcoholic extract of Annona squamosa (HAEAS) leaf in alloxan monohydrate induced diabetic Albino rats

Background: Diabetes is almost growing health concern worldwide and now emerging as an epidemic world over. Recently, full attention is being paid to the study of natural products as potential antidiabetics. Objective of the study was to evaluate the antidiabetic effect of hydroalcoholic leaf extract of Annona squamosa (HAEAS) plant in alloxan monohydrate induced diabetic albino rats.Methods: Almost a 30 Albino rats with 150- 200 grams weight were weighed and grouped into 5 equal groups taking 6 rats in every group. Group A served as normal control, Group B as diabetic control, received alloxan monnohydrate. Group C and D was received alloxan + HAEAS suspension at 350 and 700 mg/kg doses orally respectively, Group E was given alloxan + standard drug (Glibenclamide 5mg/kg) suspension for 28 successive days and the effect of HAEAS on blood sugar(BS) levels was measured at regular intervals. At the end portion of this investigational research study samples of blood were collected from all rats on 0day (initial), after 72 hrs and after 28th day (29thday) of given test drug HAEAS treatment for biochemical estimation of BS and the BS values were observed.Results: The present research study revealed that HAEAS leaves has antidiabetic effect against alloxan monohydrate induced diabetic rats on i.p. alloxan injection at 150mg/kg.b.w. and confirms that on i.p. alloxan injection causes a significant rise off BS in untreated albino rats when compared to control group. Diabetic rats treatment with HAEAS leaves for 28 days caused dose a dependent fall in BS values. Glibenclamide treated diabetic rats also showed a significant (P <0.00) fall in BS content after 28 days of treatment.Conclusions: This research study confirms that HAEAS leaves has shown significant antidiabetic effect at 350 and 700 mg/kg. b.w. doses in alloxan monohydrate induced diabetic rats

Diabetic Muscle Infarction - A Case Report

Diabetic muscle infarction is a rare complication in patients of longstanding diabetes mellitus with multiple end organ microvascular sequelae. A case of a 69 year old lady with a 10 year history of diabetes mellitus, with sudden onset of right thigh pain is described here. This case illustrates the need for increasing awareness among clinicians for early recognition of diabetic muscle infarction.Key words: Diabetic complications; Muscle infarctio

COMPARISON OF ETEST AND AGAR DILUTION FOR DETERMINING MINIMUM INHIBITORY CONCENTRATION OF VANCOMYCIN TO HEALTHCARE-ASSOCIATED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS

ABSTRACTObjectives: To compare agar dilution method and Etest in the determination of minimum inhibitory concentration (MIC) of vancomycin to healthcareassociatedmethicillin-resistantStaphylococcusaureus(HA-MRSA).Methods: A total of 98 non-duplicate strains of HA-MRSA isolated from different clinical specimens were tested for their antibiotic susceptibilitypattern by Kirby-Bauer disk diffusion method and vancomycin MIC by agar dilution method and Etest (BioMerieux, France).Results: Out of 98 strains of HA-MRSA, 94 (95.9%) were vancomycin susceptible (MIC ≤2 µg/ml and 4 (4.1%) were vancomycin intermediate (MIC4 µg/ml) by agar dilution method. By Etest, 53 (54.1%) were vancomycin susceptible, 4 (4.1%) were vancomycin intermediate, and the remaining 41isolates had vancomycin MIC between 2 µg/ml and 4 µg/ml.Conclusion: Etest allows the detection of HA-MRSA strains with intermediate MIC values in addition to traditional dilutions. These properties willhelp in detection of MIC creep and also decision-making in using vancomycin for the treatment of serious infections caused by HA-MRSA.Keyword: Vancomycin, Minimum inhibitory concentration, Etest, Agar dilution

IN VITRO ACTIVITY OF VANCOMYCIN AND DAPTOMYCIN AGAINST HEALTHCARE-ASSOCIATED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS ISOLATED FROM CLINICAL SPECIMENS

ABSTRACTObjective: The present cross-sectional study was conducted to determine minimum inhibitory concentration (MIC) of daptomycin and vancomycinto clinical isolates of healthcare-associated-methicillin-resistant Staphylococcus aureus (HA-MRSA).Methods: Centers for Disease Control and Prevention Criteria were used to define HR infections due to MRSA. Antibiotic susceptibility testing wasdone by Kirby–Bauer disk diffusion method. MIC of vancomycin and daptomycin was determined by Agar dilution method and E-test, respectively.Results of antibiotic susceptibility testing and MIC were interpreted as per Clinical Laboratory Standard Institute guidelines.Results: A total of 110 strains of MRSA were isolated from healthcare-associated infections. All were susceptible to daptomycin, linezolid, andteicoplanin. A total of 106 isolates were vancomycin susceptible and four were vancomycin-intermediate S. aureus (VISA). MIC ofvancomycin were 2 µg/ml. All MRSA isolates were susceptible to daptomycin. Four VISA strains had daptomycin MIC 1 µg/ml.Conclusion: The present study showed the emergence of VISA among HA-MRSA isolates with high MIC for vancomycin. Although all HA-MRSAisolates were susceptible to daptomycin, VISA isolates had high daptomycin MIC. This indicates that daptomycin may not be used as an alternativechoice for VISA infections.Keywords: Healthcare-associated methicillin-resistant Staphylococcus aureus, Vancomycin, Daptomycin.9090and MIC5

Healthcare-Associated Methicillin-Resistant Staphylococcus aureus : Clinical characteristics and antibiotic resistance profile with emphasis on macrolide-lincosamide...

Objectives: Healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen worldwide and its multidrug resistance is a major concern. This study aimed to determine the clinical characteristics and antibiotic susceptibility profile of healthcare-associated MRSA with emphasis on resistance to macrolide-lincosamide-streptogramin B (MLSB) phenotypes and vancomycin. Methods: This cross-sectional study was carried out between February 2014 and February 2015 across four tertiary care hospitals in Mangalore, South India. Healthcare-associated infections among 291 inpatients at these hospitals were identified according to the Centers for Disease Control and Prevention guidelines. Clinical specimens were collected based on infection type. S. aureus and MRSA isolates were identified and antibiotic susceptibility tests performed using the Kirby-Bauer disk diffusion method. The minimum inhibitory concentration of vancomycin was determined using the Agar dilution method and inducible clindamycin resistance was detected with a double-disk diffusion test (D-test). Results: Out of 291 healthcare-associated S. aureus cases, 88 were MRSA (30.2%). Of these, 54.6% were skin and soft tissue infections. All of the isolates were susceptible to teicoplanin and linezolid. Four MRSA isolates exhibited intermediate resistance to vancomycin (4.6%). Of the MRSA strains, 10 (11.4%) were constitutive MLSB phenotypes, 31 (35.2%) were inducible MLSBphenotypes and 14 (15.9%) were macrolide-streptogramin B phenotypes. Conclusion: Healthcare-associated MRSA multidrug resistance was alarmingly high. In routine antibiotic susceptibility testing, a D-test should always be performed if an isolate is resistant to erythromycin but susceptible to clindamycin. Determination of the minimum inhibitory concentration of vancomycin is necessary when treating patients with MRSA infections

Inhibitor binding mode and allosteric regulation of Na+-glucose symporters.

Sodium-dependent glucose transporters (SGLTs) exploit sodium gradients to transport sugars across the plasma membrane. Due to their role in renal sugar reabsorption, SGLTs are targets for the treatment of type 2 diabetes. Current therapeutics are phlorizin derivatives that contain a sugar moiety bound to an aromatic aglycon tail. Here, we develop structural models of human SGLT1/2 in complex with inhibitors by combining computational and functional studies. Inhibitors bind with the sugar moiety in the sugar pocket and the aglycon tail in the extracellular vestibule. The binding poses corroborate mutagenesis studies and suggest a partial closure of the outer gate upon binding. The models also reveal a putative Na+ binding site in hSGLT1 whose disruption reduces the transport stoichiometry to the value observed in hSGLT2 and increases inhibition by aglycon tails. Our work demonstrates that subtype selectivity arises from Na+-regulated outer gate closure and a variable region in extracellular loop EL5

Acute Kidney Injury in Severe Trauma Patients; a Record-Based Retrospective Study

Introduction: Acute kidney injury (AKI) is a common and devastating clinical issue in the community associated with high rates of morbidity and mortality.&nbsp;Objective: We aimed at estimating the frequency and levels of severity of AKI in trauma patients requiring hospital admission using the RIFLE criteria and assess their outcome.&nbsp;Method: Our retrospective record based study enrolled data of 80 participants aged 18-59 years who presented to the emergency department of KIMS hospital following an acute traumatic event. Participants with pre-existing renal dysfunction, chronic heart failure and chronic liver disease were excluded. Tests of significance were Chi square and independent sample t test, a p&lt;0.05 was considered statistically significant.&nbsp;Results: Participants with AKI had significantly lower age (p=0.02) and lower revised trauma score (RTS) (p=0.01). Significant association of AKI with hypotension (p=0.01) and Glasgow coma scale (GCS) (p=0.008) was observed. No association of AKI with gender was observed (p=0.6). None of the AKI patients required renal replacement therapy and all participants attained normal renal function at discharge. Significantly longer mean duration of hospital stay (14.4 days) was observed among AKI patients (p=0.02). Totally, 6.3 % mortality was observed among both participants with and without AKI.&nbsp;Conclusion: Forty percent of acute trauma patients had AKI (in risk and injury category); but none were in failure, loss or end stage renal disease. No association of AKI and mortality was observed. AKI was associated with age, RTS, hypotension and GCS

Molecular and Clinical Features of Heterogeneous Vancomycin Intermediate Staphylococcus aureus in Tertiary Care Hospitals of South India

Objectives: This study aimed to detect heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) among methicillin resistant S. aureus (MRSA) isolated from healthcare-associated infections and identify staphylococcal cassette chromosome mec (SCCmec) types. Methods: Isolation and identification of MRSA were done using standard bacteriological methods. Antimicrobial susceptibility testing was done using Kirby-Bauer disc diffusion and macrolide-lincosamide-streptogramin B (MLSB) phenotypes identified using D test. The minimum inhibitory concentration (MIC) of vancomycin was determined using agar dilution. hVISA were confirmed by modified population analysis profile-area under the curve (PAP-AUC) test. SCCmec types and Panton-Valentine leukocidin (pvl) were detected using multiplex PCR. Results: Out of 220 MRSA stains, 14 (6.4%) were hVISA. None of the MRSA isolate was vancomycin intermediate or resistant. All hVISA were susceptible to linezolid and teicoplanin. Macrolide-streptogramin B (MSB) phenotype was present in 42.9% hVISA. 92.9% hVISA strains had vancomycin MIC in the range 1-2 µg/mL. Majority of hVISA and vancomycin susceptible MRSA were isolated from skin and soft tissue infections. SCCmec III and IV were present in 50% and 35.7% hVISA respectively. 14.3% hVISA harboured SCCmec V. Conclusion: The rate of hVISA among MRSA was 6.4%. MRSA strains should be tested for hVISA before starting vancomycin treatment. None of the isolates was vancomycin intermediate or resistant. All the hVISA strains were susceptible to linezolid and teicoplanin. The majority of hVISA were isolated from skin and soft tissue infections. The majority hVISA harboured SCCmec III and IV. Keywords: MRSA; Hospital infection; Molecular typing; Vancomyci

LIPIDS AND ISCHEMIA MODIFIED ALBUMIN IN MILD SUBCLINICAL HYPOTHYROIDISM: RESPONSE TO LEVOTHYROXINE REPLACEMENT

Objective: Subclinical hypothyroidism (SCH) with thyroid-stimulating hormone (TSH) less than 10 µIU/ml is a common finding discovered duringroutine thyroid function testing. Thyroxine substitution and its benefits to alleviate dyslipidemia and oxidative stress (OXs) markers at this stage area matter of debate.Methods: This study aimed to investigate the influence of thyroxine substitution on lipid profile and OXs markers in newly diagnosed SCH subjects.The study included a total number of 50 newly diagnosed (20 treated and 30 untreated), SCH subjects aged 20-50 years with (TSH&lt;10 µIU/ml), andfree thyroxine (FT4) levels in the normal range. Patients on medications that could cause thyroid hormone dysfunction, diabetes mellitus, and currentor pregnancy during the last 2 years were excluded from the study. Serum TSH, T3, T4, FT4, anti-thyroid peroxidase antibodies, total cholesterol (TC),high-density lipoprotein cholesterol (HDL), triglycerides (TG), low-density lipoprotein cholesterol (LDL), and ischemia modified albumin (IMA) weredetermined in all subjects at baseline and after 9 months.Results: After thyroxine replacement, a significant decrease in TSH, LDL, IMA and an increase in FT4 were observed. The decrease in TC was notstatistically evident. There was no significant change in T3, T4, TG, HDL, after treatment. The untreated group showed an insignificant increase onlyin TSH.Conclusion: Thyroid substitution therapy has a favorable influence on lipid profile and OXs, where it particularly reduced LDL and IMA