A study of prevalence of metabolic syndrome in patients with type 2 diabetes mellitus in a tertiary care referral hospital in West Bengal

Background: The terms "metabolic syndrome", "insulin resistance syndrome" and "syndrome X" are now used specifically to define a constellation of abnormalities that is associated with increased risk for the development of type 2 diabetes and atherosclerotic vascular disease. It is a state of chronic low grade inflammation with the profound systemic effects. Several organisations gave several criteria to diagnose it. Effective preventive approaches include lifestyle changes, primarily weight loss, diet, and exercise, the appropriate use of pharmacological agents to reduce the specific risk factors.Methods: A cross-sectional study was done to evaluate the co-morbidity profile of patients, with metabolic syndrome and correlate clinical manifestations with specific components or metabolic syndrome, at the OPD of Bankura Sammilani Medical College and Hospitals, West Bengal. American Association of Clinical Endocrinologists criteria were chosen for diagnosis.Results: 100 patients were recruited having type II diabetes mellitus. Most of the patients were male between 20-70 years and maximum was on oral hypoglycemic agent with app 40% patient was without any glycemic control. In comorbidities hypertension was highest, followed by coronary artery disease, hypothyroidism and cerebrovascular accident. Waist-hip ratio was highest in female. All of the patients were having some cardiac risk factor assessed by ECG, echocardiography and thread mill test.Conclusions: The data demonstrates that metabolic syndrome is extremely common among diabetic patients. Frequency was much higher in women than men. Obesity is a key element in causing the metabolic syndrome and this factor was also more common in women

An observational comparative study of different doses of azilsartan and with chlorthalidone combination in moderate hypertension

Background: High blood pressure (BP) is one of the significant non-communicable diseases that are of high prevalence in our country. Hypertension (HTN) is responsible cause of 57% of stroke and 24% of coronary heart disease deaths in India. Eight classes of medications are currently used in the treatment of hypertension. Azilsartan medoxomil is a newly added FDA approved drug to the ARB class of antihypertensive agents. azilsartan and chlorthalidone combination is also got the FDA approval. There is limited study in between these two groups regarding efficacy especially in rural Bengal.Methods: A prospective observational study was done in medicine OPD of Bankura Sammilani Medical College for twelve weeks with two groups that are azilsartan (80mg) and fixed dose combination of azilsartan (40mg) plus chlorthalidone (12.5mg) in the age group of 18 to 55years of moderate hypertensive patients. Change of heart rate was assessed as safety parameter.Results: It was found that both the group of drugs are very much effective in lowering blood pressure constantly in respect of both systolic and diastolic BP but azilsartan monotherapy in high dose reduce systolic blood pressure slightly high. Significant change of heart rate was not seen with both the groups.Conclusions: Both the group was effective as well as safe in hypertensive patients

Comparative efficacy of inhaled ciclesonide, budesonide, and fluticasone in mild to moderately persistent bronchial asthma

Background: Bronchodilators and glucocorticoids have been proven to be very effective and safe in asthma treatment, which recommend the use of steroids and β2-agonist (long or short acting) as the first line of treatment in of asthma. This study was aimed to compare the efficacy of three different inhaled corticosteroids ciclesonide, budesonide, and fluticasone in bronchial asthma.Methods: A total of 30 patients with mild to moderately persistent bronchial asthma was selected as per the NAEPP classification in the expert panel report (EPR) update 2002, NHLBL USA 2003. They were randomly divided into 3 groups of 10 patients each, and they were given 3 different steroid inhalers (ciclesonide or budesonide or fluticasone). Baseline and post-therapy spirometry were performed on day 1 and after 2 months and 6 months of treatment. Data were analyzed using SPSS software.Results: It was observed that most of the cases (43.3%) were between 26 and 35 years of age with female preponderance (56.6%). Significant symptomatic improvement was observed in all 3 groups. The percentage of improvement in mean peak expiratory flow rate was 17%, 18%, and 18% in ciclesonide, budesonide, and fluticasone group, respectively. The percentage improvement of forced expiratory volume in 1 second (FEV1)/forced vital capacity after bronchodilatation was 18%, 18%, and 19% in ciclesonide, budesonide, and fluticasone group, respectively. The improvement in mean FEV1% predicted was 20%, 19%, and 21% in three groups, respectively.Conclusion: Steroid therapy along with β2-agonists showed a significant improvement in symptoms. There was no difference among the three different types of steroids

Structure-based assortment of herbal analogues against spike protein to restrict COVID-19 entry through hACE2 receptor : an in-silico approach

On-going global pandemic COVID-19 has spread all over the world and has led to more than 1.97 million deaths till date. Natural compounds may be useful to protecting health in this perilous condition. Mechanism of shuttle entry of SARS-COV-2 virus is by interaction with viral spike protein with human angiotensin-converting enzyme-2 (ACE-2) receptor. To explore potential natural therapeutics, 213 important phytochemi-cals of nine medicinal plants Aconitum heterophyllum, Cassia angustifolia, Cymbopogon flexuosus, Cymbopogon martinii, Nux vomica, Phyllanthus urinaria, Swertia chirayita, Justicia adhatoda, Vetiveria zizanioides were selected for in-silico molecular docking against the spike protein of SARS-COV-2 and compared with recently prescribed drug chloroquine, ramdesivir, lopinavir and hydroxychloroquine. Results revealed that rhamnocitrin of P. urinaria, 1,5-dihydroxy-3,8-dimethoxyxanthone of S. chirayita and laevojunenol of V. zizanioides potentially binds with the receptor binding site of SARS-COV-2 spike glycoprotein and more robustly destabilized the RBD-ACE-2 binding over chloroquine, ramdesivir, lopinavir and hydroxychloroquine. It was also found that laevojunenol, rhamnocitrin, and 1,5-dihydroxy-3,8-dimethoxyxanthone qualified the criteria for drug-likeness as per Lipinski rule. After attachment of the selected phytochemical with the spike protein the affinity of the later towards ACE-2 was minimized and the effect of 1,5-dihydroxy-3,8-dimethoxyxanthone and laevojunenol was superior. Hence, rhamnocitrin of P. urinaria, 1,5-dihydroxy-3,8-dimethoxyxanthone of S. chirayita and laevojunenol of V. zizanioides, are potential therapeutic molecules for SARS-COV-2, which upon binding with spike protein changes the affinity of the spike towards ACE-2 and therefore restrict the entry of the virus into a human cell. Subsequent clinical validation is needed to confirm these phytochemicals as drugs to combat COVID-19

A study on evaluation of antidepressant effect of Imipramine adjunct with Ashwagandha and Bramhi

Introduction: Depressive disorders increases the risks of self-harm or even suicide in patients. Indigenous drugs are being tried to treat such patient along with conventional antidepressant drugs. Objective: To investigate the antidepressant action of Ashwagandha and Bramhi  and also to confirm its efficacy in the behavioural despair animal model of depression. Material and methods: Normal saline as control (5ml/kg), imipramine as standard (16,32,64 mg/kg) and ashwagandha (50,100,150 mg/kg), bramhi (20,40,80 mg/kg) as test drugs were introduced to the albino rats weighing between 200-250gm for 2 weeks, 1 hr before electric shock in Learned helplessness test (LHT) and swimming in Forced swimming test (FST). Effects of individual drugs as well as their combination were evaluated. Result: Avoidance response, escape failure and immobility period in case of imipramine and ashwagandha showed highly significant (p<0.01) result on individual use.  There was no significant result in case of Bramhi used alone except in escape failure and immobility period (FST), where at higher doses it showed significant (p<0.01) result . But combination of Bramhi and ashwagandha in low doses with low dose of imipramine gave a highly significant result (p<0.01) in all the parameters. Conclusion: Ashwagandha had significant antidepressant action, but bramhi had not when used alone. Combination of these two indigenous drugs with imipramine showed high efficacy in animal model

Clinical and pathological status of haemoglobinopathies among pregnant women in southern Orissa

456-457Sixty-two pregnant women were categorized into four age groups and investigated to know the prevalence of haemoglobinopathies among them in and around Berhampur using sickling test, naked eye single tube red cell osmotic fragility test (NESTROFT), and haemoglobin electrophoresis. Out of the 62 pregnant women four cases of sickle cell trait and one of -thalassaemia trait was found. There was no significant difference recorded in the blood cell indices between normal and sickle cell trait in pregnant women. Sickle cell haemoglobinopathy is prevalent among the general, scheduled caste followed by other backward class groups of southern Orissa and less HbS% was observed among the pregnant women which indicate the probable interaction of sickle hemoglobin with - thalassemi

Epidural Naloxone to Prevent Buprenorphine Induced PONV

Epidural infusion of local analgesic and opioid are commonly used for postoperative pain relief. This combina-tion gives excellent anlgesia but nausea and vomiting remains a major concern. Low dose epidural naloxone prevents PONV induced by spinal opioids like morphine, fentanyl and sufentanil. However, it is not known that epidural naloxone administration prevents PONV induced by epidural buprenorphine. We have reported three cases of major abdominal operation in which lowdose epidural infusion of naloxone releived the symptom of buprenorphine induced severe PONV and improved the quality of analgesia

Media optimization, extraction, purification and characterization of exopolysaccharide from Fusarium proliferatum: A novel source bioactive polysaccharide

Polysaccharides from fungal source have been proved to be effective in different plethora of biomedical fields. The present study was carried out on exopolysaccharide (EPS) production by Fusarium proliferatum, considered novel fungus as no reports on its EPS production capability has been reported yet. The main objective of this study was to optimize media for better EPS production extracellularly under submerged culture conditions. Among all malt extract broth was selected as favorable medium for EPS yielding 81.4 ± 0.48 mg/l. Optimization revealed 9 days of incubation period, pH 6.0 and temperature 25 °C best for the growth and EPS yield. The medium 12 out of sixteen media was selected as best for the EPS yield which was ensured by various permutation and combinations of chemical factors. The optimized medium includes: malt extract medium (basal medium), xylose 4%, glucose 4%, tryptophan 0.1%, olive oil 3%, Tween 80 0.2%, vitamin C 0.2%, K2HPO4 0.2%, CaCl2 0.5%, pH 6.0, incubation period of 9 days at temperature 25 °C yielding 4067 ± 153.08 mg/l of EPS. HPTLC, FTIR and LCMS analysis exhibited the monomeric composition of maltose, fructose, xylose, galactose, glucose, raffinose and sorbose with functional group of –OH, C=O, C–O–C, C–O, –C–H, COO– with glycosidic likanges and suggested the production of glycan by these fungi. Owing to the existing reports of anti-cancerous property of β-Glycan an in-silico investigation was carried out to which indicatedits higher reactivity and lower binding affinityin comparison to imatinib, an oral chemotherapy drug to treat cancer

Investigations on microbial diversity of Jakrem hot spring, Meghalaya, India using cultivation-independent approach

Jakrem hot water spring is located in the West Khasi Hill District of the state of Meghalaya, and is one of the most popular hot springs of the state. There is a populist belief among the inhabitants and people that the hot spring water has got curative properties against various skin ailments. This is the first report on V3 hyper-variable region of 16S rDNA metagenome sequence employing Illumina platform to profile the microbial community of this less known hot spring from Meghalaya, India. Metagenome comprised of 10, 74,120 raw sequences with a sequence length of 151 bp and 56.35% G + C content. Metagenome sequence information is now available at NCBI, SRA database accession no. SRP056897. A total of 8, 77, 364 pre-processed reads were clustered into 694 OTUs (operational taxonomical units) comprising of 14 bacterial phyla including unknown phylum demonstrating 49 families. Hot spring bacterial community is dominated by Firmicutes (61.60%), Chloroflexi (21.37%), Cyanobacteria (12.96%) and unclassified bacteria (1.2%) respectively