The effect of amlodipine on blood glucose level and its interaction with oral hypoglycemic drugs in albino rabbits

Background:  Amlodipine used as many cardiac conditions esp in hypertension. Diabetes affects cardiovascular system adversely. So this study was done to see effect of amlodipine on blood glucose level and its interaction with commonly used oral hypoglycemic agents in diabetic & non diabetic albino rabbits. Methods: Rabbits were divided into nine groups of 6 rabbits in each group. I and II group were non-diabetic given normal saline and amlodipine respectively. Group III to IX were made diabetic by using alloxan monohydrate (150mg/kg i.p.) & given normal saline, glimepiride, metformin, pioglitazone, amlodipine + glimepiride, amlodipine + metformin and amlodipine + pioglitazone respectively. All drugs were given orally once daily for 7 day except group VII, VIII and IX in which glimepiride, metformin and pioglitazone were added on 7th day. After GTT blood glucose level were measured at 0, 1, 2 and 6 hours on 7th day in all groups by using spectrophotometer. Results: After 7 days of treatment the amlodipine produced significant hyperglycemia in normal rabbits. Amlodipine on combination, causes significant decreased in hypoglycemic effect of glimepiride, significant increased the hypoglycemic effect of metformin, while no significant changes in hypoglycemic effects of pioglitazone in diabetic rabbits. Conclusion: The present study shows that amlodipine causes hyperglycemia in normal rabbits. Amlodipine significantly altered hypoglycemic effect of glimepiride and metformin as compared to control group. If these finding are true to human beings then amlodipine should be use cautiously in diabetic patient on oral hypoglycemic drugs

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Voltage Profile Improvement, Transmission Line Loss Reduction in Rajasthan Power System: A Case Study

The complexity is increasing day by day with the advancement of buses in interconnected power system. The complexity of the power system can easily handle by analyzing the performance of the transmission system by using load flow study. The real and reactive power losses are largely affected at the transmission level. This paper presents case study of real time system operation to reduce losses and improve the voltage profile with optimum utilization of existing transmission system elements. West-North part of Rajasthan power system having one 400 kV GSS, five 220 kV GSS and nineteen 132 kV GSS have been selected to carry out case study and simulated in PSSE software. Simulation model consists of 55 buses, 34 transmission lines, 66 transformers and 34 capacitor banks. Eight cases have been simulated considering the effect of transformer tap position, closing of opened transmission lines and shunt capacitors. From simulation studies it is found out that transmission losses are reduced by 50.36 % in addition to improve network voltage profile