A Case Report on Metformin-Associated Lactic Acidosis.

Metformin is the first-line therapy for patients with type 2 diabetes, and its most common adverse effects are gastrointestinal. Lactic acidosis associated with metformin use is rare. Here, we report the case of a 77-year-old man with a medical history of diabetes (treated with metformin), hypertension, chronic alcohol abuse, and prostate and bladder cancer, who presented with abdominal pain, nausea, vomiting, and diarrhea for five days. He was admitted with severe metabolic acidosis due to metformin toxicity (metformin-associated lactic acidosis) with metformin level 23 mcg/mL (therapeutic range approximately 1-2 mcg/mL) in the setting of acute kidney failure due to acute pancreatitis and sepsis secondary to aspiration pneumonia. He was intubated, required pressor support, and received daily hemodialysis. Despite aggressive management, his hospital course became complicated with acute respiratory distress syndrome, myocardial infarction, acute hepatic failure, and ischemic and metabolic encephalopathy. In the end, the family decided to withdraw care and the patient was terminally extubated

Association of Breakfast Intake with Obesity, Dietary and Physical Activity Behavior Among Urban School-Aged Adolescents in Delhi, India: Results of a Cross-Sectional Study

In developed countries, regular breakfast consumption is inversely associated with excess weight and directly associated with better dietary and improved physical activity behaviors. Our objective was to describe the frequency of breakfast consumption among school-going adolescents in Delhi and evaluate its association with overweight and obesity as well as other dietary, physical activity, and sedentary behaviors. Methods: Design: Cross-sectional study. Setting: Eight schools (Private and Government) of Delhi in the year 2006. Participants: 1814 students from 8th and 10th grades; response rate was 87.2%; 55% were 8th graders, 60% were boys and 52% attended Private schools. Main outcome measures: Body mass index, self-reported breakfast consumption, diet and physical activity related behaviors, and psychosocial factors. Data analysis: Mixed effects regression models were employed, adjusting for age, gender, grade level and school type (SES). Results: Significantly more Government school (lower SES) students consumed breakfast daily as compared to Private school (higher SES) students (73.8% vs. 66.3%; p<0.01). More 8th graders consumed breakfast daily vs. 10th graders (72.3% vs. 67.0%; p<0.05). A dose-response relationship was observed such that overall prevalence of overweight and obesity among adolescents who consumed breakfast daily (14.6%) was significantly lower vs. those who only sometimes (15.2%) or never (22.9%) consumed breakfast (p<0.05 for trend). This relationship was statistically significant for boys (15.4 % vs. 16.5% vs. 26.0; p<0.05 for trend) but not for girls. Intake of dairy products, fruits and vegetables was 5.5 (95% CI 2.4-12.5), 1.7 (95% CI 1.1-2.5) and 2.2 (95% CI 1.3-3.5) times higher among those who consumed breakfast daily vs. those who never consumed breakfast. Breakfast consumption was associated with greater physical activity vs. those who never consumed breakfast. Positive values and beliefs about healthy eating; body image satisfaction; and positive peer and parental influence were positively associated with daily breakfast consumption, while depression was negatively associated. Conclusion: Daily breakfast consumption is associated with less overweight and obesity and with healthier dietary-and physical activity-related behaviors among urban Indian students. Although prospective studies should confirm the present results, intervention programs to prevent or treat childhood obesity in India should consider emphasizing regular breakfast consumption.Obesity Prevention Center, University of MinnesotaPRIME program of the University of Texas, School of Public Health (Stigler, PI)Center for Health Promotion and Disease Prevention Research in Underserved Population

Superfluid Phase Stability of 3^3He in Axially Anisotropic Aerogel

Measurements of superfluid $^3$He in 98% aerogel demonstrate the existence of a metastable \emph{A}-like phase and a stable \emph{B}-like phase. It has been suggested that the relative stability of these two phases is controlled by anisotropic quasiparticle scattering in the aerogel. Anisotropic scattering produced by axial compression of the aerogel has been predicted to stabilize the axial state of superfluid $^3$He. To explore this possiblity, we used transverse acoustic impedance to map out the phase diagram of superfluid $^3$He in a $\sim 98$% porous silica aerogel subjected to 17% axial compression. We have previously shown that axial anisotropy in aerogel leads to optical birefringence and that optical cross-polarization studies can be used to characterize such anisotropy. Consequently, we have performed optical cross-polarization experiments to verify the presence and uniformity of the axial anisotropy in our aerogel sample. We find that uniform axial anisotropy introduced by 17% compression does not stabilize the \emph{A}-like phase. We also find an increase in the supercooling of the \emph{A}-like phase at lower pressure, indicating a modification to \emph{B}-like phase nucleation in \emph{globally} anisotropic aerogels.Comment: 4 pages, 4 figures, submitted to LT25 (25th International Conference on Low Temperature Physics

SPECTRO-ANALYTICAL, COMPUTATIONAL AND BIOLOGICAL STUDIES ON 4-PYRIDINE CARBOXALDEHYDE-3-HYDROXY-5-(HYDROXY METHYL)-2-METHYL HYDRAZONE HYDROCHLORIDE AND ITS CU (II) COMPLEXCA

Objective: The title compound 4-pyridine carboxaldehyde 3-hydroxy-5-(hydroxy methyl)-2-methyl hydrazone (PCHHMMH) hydrochloride an analogue of Pyridoxal isonicotinoyl hydrazone PIH, is an iron chelator. The PCHHMMH has potential donor sites suitable for metal ion binding, the study on structural aspects of the compound and its copper complex are explored. With a view to understand biological importance of title compounds, antimicrobial and cytotoxic studies were planned. Methods: In the present study the spectroanalytical techniques employed were pH-metry, spectrophotometry, IR, 1H &amp; 13C-NMR, UV-Vis, ESR, Magnetic measurements, TGA and SEM. The computational method employed is HyperChem 7.5 software. The antimicrobial studies were carried out by agar disc diffusion method for antibacterial studies against Gram positive and Gram negative bacteria. The cytotoxic potential was measured by Sulforhodamine B (SRB) method against selected tumor cells. Results: The equilibrium studies by employing pH-metric method inferred the dissociation of two protons in it. Further titration in presence of Cu (II) ion, it is confirmed the release of two protons from title compound and formation of corresponding complex. The orientations of frontier orbitals for molecular and ionized forms of compound were computed to understand the electronic properties. The Cu (II) PCHHMMH complex was characterized by spectroanalytical methods and screened for, antimicrobial and cytotoxic activities. Conclusion: As the structural features are important to understand the chemical behavior of metal complexes, in the present study copper complex was synthesized and characterized by employing various spectro-analytical tools viz; IR, 1H &amp; 13C-NMR, UV-Vis, ESR, Magnetic measurements, TGA and SEM. Further the antimicrobial and cytotoxic activities were evaluated and correlated with computed QSAR data

study of gene effects for stalk sugar yield and its component traits in sweet sorghum [sorghum bicolor (l.) moench] using generation mean analysis

Generation mean analysis was carried out to estimate the nature and magnitude of gene effects for sugar yield and its component traits in sweet sorghum [Sorghum bicolor (L.) Moench. Six basic generations, namely P1, P2, F1, F2, BC1P1, BC1P2 of four crosses involving seven diverse parents were evaluated in rainy 2009. The mean performance of the F1 in all the crosses indicated dominant gene effect for all the characters. Simple additive-dominance model indicated presence of epistatic interaction. High positive additive × additive interaction effects were found in all the crosses. Higher magnitude of dominance and dominance × dominance gene interactions which were found minimizes the expression of heterosis leading to non-exploitation of crosses with duplicate epistasis. Reciprocal recurrent selection and/or biparental mating in early segregating generations has been suggested for development of high sugar yielding genotypes in view of the genotypes studied

Reversal of hepatorenal syndrome type 1 with terlipressin plus albumin vs. placebo plus albumin in a pooled analysis of the OT-0401 and REVERSE randomised clinical studies

Background The goal of hepatorenal syndrome type 1 (HRS-1) treatment is to improve renal function. Terlipressin, a synthetic vasopressin analogue, is a systemic vasoconstrictor used for the treatment of HRS-1, where it is available. Aim To compare the efficacy of terlipressin plus albumin vs. placebo plus albumin in patients with HRS-1. Methods Pooled patient-level data from two large phase 3, randomised, placebo-controlled studies were analysed for HRS reversal [serum creatinine (SCr) value ≤133 μmol/L], 90-day survival, need for renal replacement therapy and predictors of HRS reversal. Patients received intravenous terlipressin 1–2 mg every 6 hours plus albumin or placebo plus albumin up to 14 days. Results The pooled analysis comprised 308 patients (terlipressin: n = 153; placebo: n = 155). HRS reversal was significantly more frequent with terlipressin vs. placebo (27% vs. 14%; P = 0.004). Terlipressin was associated with a more significant improvement in renal function from baseline until end of treatment, with a mean between-group difference in SCr concentration of −53.0 μmol/L (P \u3c 0.0001). Lower SCr, lower mean arterial pressure and lower total bilirubin and absence of known precipitating factors for HRS were independent predictors of HRS reversal and longer survival in terlipressin-treated patients. Conclusions Terlipressin plus albumin resulted in a significantly higher rate of HRS reversal vs. albumin alone in patients with HRS-1. Terlipressin treatment is associated with improved renal function