A Prospective study on the assessment of risk factors for type 2 diabetes mellitus in outpatients department of a south Indian tertiary care hospital: A case-control study

Background: Type 2 diabetes mellitus (T2DM) is the most general type of diabetes. In India, the risk factors (modifiable and nonmodifiable) for diabetes are seen more frequently and there is lack of perception about this problem.Objective: The objective of the study was to assess the incidence and risk factors for T2DM in a south Indian tertiary care hospital.Materials and Methods: A prospective study was conducted on 1161 subjects (with or without T2DM) from November 2014 to April 2015 in general medicine department of Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Andhra Pradesh, south India. Chi-square test was used to evaluate the incidence of T2DM and odds ratios were calculated in univariate logistic regression analysis for risk factors.Results: T2DM was significantly higher in the subjects of age above 41 years (86.3%, P<0.0001), married (95.4%, P=0.002), educators (degree and above, 13.2%, P<0.0001), known family history (50.8%, P<0.0001), BMI (>25 kg/m2,58.7%; P<0.0001), Govt. job holders (5.5%, P<0.0001), business people (12%, P<0.0001), house wives (38.3%, P<0.0001), high economic status (34.9%, P<0.0004), preexisting hypertension (40.2%, P<0.0001), urban residence (50.4%, P<0.0001), physical inactivity (45.3%, P<0.001), stress (61.0%, P=0.01), consumption of tea and coffee (daily thrice or more, 6.3%, P=0.0003), soft drinks (weekly thrice or more, 4%, P=0.0008) and junk foods (weekly thrice or more 2.6%, P=0.025) than non-diabetic subjects. Univariate logistic regression analysis showed that the age (above 41 years), marital status, education, family history, BMI (>25 kg/m2), high economic status, co-morbidities (hypertension and thyroid disorders) urban residence, physical inactivity, stress, consumption of tea and coffee (daily thrice or more), soft drinks (weekly thrice or more) and junk foods are the significantly risk factors for T2DM.Conclusion: The present study results suggested that beware of hypertension, thyroids disorders, physical inactivity, stress, soft drinks and junk foods, which are major risk factors of T2DM.Â

Tuberculosis: an overview of current literature on types, diagnosis and drug therapy

Tuberculosis (TB) is an airborne infectious disease caused by organisms of the Mycobacterium tuberculosis complex. It is a global problem and increases in case rates are occurring not only in the developing countries of the world but also in several industrialized nations. There has also been an alarming increase in the number and proportion of cases caused by strains of Mycobacterium tuberculosis that are resistant to multiple first-line drugs. The increase in multiple-drug resistant tuberculosis has re-taught physicians about the importance of pursuing and ensuring treatment until cure. In many low-income and middle-income countries, TB continues to be a major cause of morbidity and mortality, and drug-resistant TB is a major concern in many settings. This article offers an overview of types, diagnosis and management of TB

Immune checkpoint blockade reprograms systemic immune landscape and tumor microenvironment in obesity-associated breast cancer

Immune checkpoint blockade (ICB) has improved outcomes in some cancers. A major limitation of ICB is that most patients fail to respond, which is partly attributable to immunosuppression. Obesity appears to improve immune checkpoint therapies in some cancers, but impacts on breast cancer (BC) remain unknown. In lean and obese mice, tumor progression and immune reprogramming were quantified in BC tumors treated with anti-programmed death-1 (PD-1) or control. Obesity augments tumor incidence and progression. Anti-PD-1 induces regression in lean mice and potently abrogates progression in obese mice. BC primes systemic immunity to be highly responsive to obesity, leading to greater immunosuppression, which may explain greater anti-PD-1 efficacy. Anti-PD-1 significantly reinvigorates antitumor immunity despite persistent obesity. Laminin subunit beta-2 (Lamb2), downregulated by anti-PD-1, significantly predicts patient survival. Lastly, a microbial signature associated with anti-PD-1 efficacy is identified. Thus, anti-PD-1 is highly efficacious in obese mice by reinvigorating durable antitumor immunity

Effect of hesperetin on the pharmacokinetics of metoprolol succinate in rats

Abstract Background Metoprolol is a substrate of CYP3A4, 2B6, CYP2D6, CYP2C9, and p-glycoprotein (p-gp). Hesperetin was reported as an inhibitor of cytochrome P-450 (CYP) enzymes and p-gp. The objective of this study was to investigate the effect of hesperetin on the pharmacokinetics of metoprolol in rats and in vitro models. In in vivo studies, male Wistar rats were treated with metoprolol (30 mg/kg) once a day for 15 consecutive days alone and in combination with hesperetin (25, 50, and 100 mg/kg). Blood samples were withdrawn from the tail vein on the 1st day in the single-dose pharmacokinetic study and on the 15th day in the repeated-dose pharmacokinetic study. In in vitro studies, metoprolol was incubated in the presence or absence of hesperetin and traditional p-gp inhibitors using rat-everted gut sacs. Reverse phase-high-performance liquid chromatography (RP-HPLC) was used to determine the amounts of metoprolol in the plasma and incubated samples (RP-HPLC). Results The C max, AUC, and half-life (t 1/2) of metoprolol significantly increased by twofold compared to the metoprolol group in rats pre-treated with hesperetin. The clearance and volume of distribution both decreased significantly. Metoprolol transport was dramatically increased in the presence of hesperetin and quinidine (standard p-gp inhibitor) in in vitro study. Conclusion The present study results revealed that hesperetin significantly increased the absorption of metoprolol in rats and everted gut sacs in vitro might be due to the inhibition of CYP and p-gp