Diabetes Mellitus Type 2: Evaluation of Microvascular and Macrovascular Complications

INTRODUCTION: Diabetes Mellitus comprises a group of common metabolic disorder that shares the phenotype of hyperglycemia. Several distinct type of DM exists and is caused by complex interaction of genetic, environmental factors and lifestyle choices. The two broad categories of DM are designated as Type 1 and Type 2 Diabetes. Type 1 Diabetes occurs due to auto-immune Beta cell destruction. Type 2 DM is a heterogeneous group of disorders characterized by variable degrees of insulin resistance, impaired insulin secretion and increased glucose production. The chronic complication of DM affects many organ systems and is responsible for the majority of morbidity and mortality associated with the disease. The vascular complication of DM are further subdivided into Micro-vascular (Retinopathy, neuropathy, nephropathy) and Macro-vascular (coronary artery disease, peripheral arterial disease and cerebro-vascular disease). The micro-vascular complications of both Type 1 and Type 2 DM result from chronic hyperglycemia. Since type 2 DM often has a long asymptomatic period of hyperglycemia, many individuals with Type 2 DM have complications at the time of diagnosis. The evidence implicating a causative role of chronic hyperglycemia in macrovascular complications is less conclusive. Moreover coronary heart disease events and mortality are two to four times greater in patients with Type 2 DM. Other factors like dyslipidaemia and Hypertension play an important role in macro vascular complications. AIM OF THE STUDY: 1. To evaluate the microvascular and macrovascular complications of Type 2 Diabetes Mellitus, attending the Diabetology Out-Patient Department at Government Stanley Hospital, Chennai. The Patients were categorised according to the duration of diabetes for the purpose of study into (a) Newly diagnosed DM. (b) DM of < 5 years. (c) DM for 5 – 10 years. (d) DM > 10 years. 2. To evaluate the Risk factors such as hypertension, obesity, hypercholesterolemia and smoking. METHODOLOGY: Selection of Cases: Patients with type 2 DM aged more than 35 years attending the Diabetology Out-Patient Department, Government Stanley Hospital were evaluated for (A) Risk factors - Hypertension, Obesity, Smoking & Hypercholesterolemia. (B) Microvascular Complications – Retinopathy, Nephropathy & Neuropathy. (C) Macrovascular Complications – CAD, Cerebrovascular Disease, Peripheral Vascular Disease. (D) For evaluation of complications they were categorised according to the duration of diabetes: 1. Newly Diagnosed, 2. DM < 5 Years, 3. DM 5 – 10 Years, 4. DM > 10 Years. A detailed history was recorded in respect of all the subject patients, particularly the duration of DM, Smoking, Complications, Family History of DM, etc. The following criteria was taken (1) Diagnosis of Diabetes, Fasting Plasma Glucose > 126mg%, 2 Hrs Plasma glucose > 200mg%. CONCLUSION: 1. In this study 53% of patients were males and 47% were females, all of them being above 35 years of age. The mean age of the Patients was 54 years. 2. The highest number of patients with diabetes was in the age group of 41 – 60 years. 3. 85% of Patients had duration of diabetes < 5 years. 4. Hypertension was found in 62% of patients. 5. Obesity was found in 57% of patients. 6. Smoking was found in 20% of patients. 7. Hypercholestrolemia was found in 74% of patients. 8. The highest risk factor was Hypercholestrolemia followed by Hypertension. 9. Retinopathy was found in 34% of the Patients. 10. Neuropathy was found in 20% of the Patients. 11. Nephropathy was found in 32% of the DM patients. 12. The most common Microvascular Complication was Retinopathy. 13. Newly diagnosed DM patients presented with Retinopathy in 34%, Neuropathy in 24% and Nephropathy in 24%. 14. Coronary artery disease was found in 36% of Patients. 15. Peripheral Vascular Disease was found in 6% of patients. 16. Cerebrovascular Disease was found in 10% of patients. 17. The most common Macrovascular Complication is coronary artery disease. 18. Significant number of patients with coronary artery disease presented by patients with < 5 Years duration of DM

Qualitative and quantitative approach towards the molecular understanding of structural, vibrational and optical features of urea ninhydrin monohydrate

In this study, single crystals of urea ninhydrin monohydrate (UNMH) have been grown by slow evaporation method. The grown crystals were characterized by FT-IR, FT-Raman and UV-Vis-NIR spectroscopies. The Kurtz and Perry powder method was employed to confirm the near-zero SHG efficiency of the as-grown centrosymmetric UNMH crystal. The third order nonlinearity of the crystal has been studied by the open aperture Z-scan method. The nonlinear absorption coefficient is calculated and the potentiality of UNMH in optical limiting applications is identified. The molecular geometry and the origin of optical non-linearity at the molecular level have been investigated by the density functional theory. The normal coordinate analysis was carried out to assign the molecular vibrational modes. Vibrational spectral studies confirms the presence of weak O-H ... O and moderate O-H ... O type hydrogen bonds in the molecule as well as O-H ... O, N-H ... O and blue-shifted C-H ... O type H-bonds in the crystal. The intramolecular charge transfer interactions and the electronic absorption mechanisms have been discussed. The static and the dynamic values of hyperpolarizabilities for UNMH were estimated theoretically by DFT methods. (C) 2017 Elsevier B.V. All rights reserved.Peer reviewe

4-[(E)-(Hy­droxy­imino)­meth­yl]-N,N-di­methyl­anilinium chloride

In the title compound, C9H13N2O+·Cl−, the cation, apart from the methyl groups, is almost planar, with a maximum deviation of 0.040 (1) Å; the methyl C atoms deviate by 0.389 (2) and −1.247 (1) Å, from the mean plane. In the crystal, cations and anions associate through C—H⋯Cl hydrogen bonds, forming a helical arrangement. In addition, inter­molecular O—H⋯Cl, N—H⋯Cl and C—H⋯N inter­actions are observed

Unraveling Genetic Diversity Through Molecular Insights: RAPD Profiling of Hybanthus enneaspermus (L.) F. Muell.

Hybanthus enneaspermus (L.) F. Muell, commonly known as the Indian Violets or Purple Balsam, is a flowering plant belonging to the family Violaceae. It is widely distributed in tropical and subtropical regions. It holds cultural and medicinal importance in various traditional systems of medicine. Extracts from different parts of the plant have been traditionally employed to address ailments ranging from respiratory conditions to skin disorders. RAPD (Random Amplified Polymorphic DNA) analysis is a molecular biology technique used to generate fingerprint-like patterns of genomic DNA. In this study, we employ RAPD analysis to investigate the genetic diversity and relationships within species/Population/group of interest. Through the amplification of random genomic regions, we aim to generate informative banding patterns that will serve as molecular fingerprints for the individuals under investigation. This study clearly demonstrates the efficacy of this technique as a robust tool for molecular characterization, underscoring its relevance in contemporary genetic research

Development of Beneficiation Process for High Alumina Iron Ores of Bellary-Hospet Region

JSW Steel is operating a 4.2 Mtpa capacity Pellet Plant to produce iron oxide pellets from the iron ore fines avail-able in the surrounding Bellary-Hospet region of southern India. Iron ore fines which get generated during mining are soft and rich in alumina with high amount of ultra fines. These characteristics of iron ore fines make it difficult to produce good grade pellets for use in COREX iron making units. Apart from this, high alumina in the pellets increases the slag volume in Corex, which demands additional heat energy, resulting in increased fuel rate. Hence, it was decided to set up a beneficiation plant to reduce the alumina content of the ore fines. Iron ore fines from several sources available in the Bellary- Hospet region were evaluated for their suitability for beneficiation as each source differs in chemistry, particle size distribution and washability characteris-tics. A technique called "Sizewise Washability Technique" was developed to study the washability characteristics of the ore fines to determine the extent of alumina reduction on washing and corresponding yield of concentrate. Iron ore fines from 13 sources were tested and were classified as Preferable, Tolerable and Not- Washable depending on their suitability for beneficiation. Mineralogical studies were also undertaken to understand the liberation characterist-ics of gangue minerals to achieve proper alumina reduction during beneficiation

Improvement and Optimization of Performance of Iron Ore Beneficiation Plant

JSW steel in an integrated steel plant of 2.5 Mtpa crude steel capacity and is being expanded to 10 Mtpa in phases. The plant facilities include 3 Mt Iron Ore Beneficiation Plant, 4.2 Mt Pellet Plant, 1.6 Mt Corex iron making, 0.9 Mt Blast Furnace, 2.5 Mt BOF — CCP and 2 Mt Hot Strip Mill. In order to control alumina in iron ore fines, the iron ore beneficiation plant was installed based on in-house developed process. During its operation of last two years, number of improvements and innovations have been introdu-ced to improve the reduction in alumina, improve yield and reduce moisture of concentrate

MEROPENEM INDUCED REDUCTION IN SERUM VALPROATE LEVEL- A CASE REPORT

Objective: To report a case of meropenem induced reduction in serum valproate level. Methods: The clinical data of an epileptic patient who experienced a decrease in seizure control due to a drug interaction between valproate and meropenem is described.Results: The patient was a 26 years old male who was a known case of refractory focal epilepsy and underwent surgery for the same. This patient was on five antiepileptic drugs including valproate. On treatment with meropenem for the management of post surgical site infection due to multidrug resistant Klebsiella pneumoniae, the patient experienced seizures due to decline in valproate level. Increasing the dose of valproate could not control the seizures. However, changing the antibiotics to a non carbapenem controlled the seizures.Conclusion: The present report highlights the potential drug interaction between valproate and meropenem. Physicians should thus avoid co-administration of both these agents. If concomitant administration is essential, close monitoring of valproate concentration and clinical monitoring for breakthrough seizures are necessitated.Â

Resorcinol ninhydrin complex: 1,5,9-trihy­droxy-8-oxatetra­cyclo­[7.7.0.02,7.010,15]hexa­deca-2,4,6,10(15),11,13-hexaen-16-one

In the title compound, C15H10O5, the cyclo­penta­none (r.m.s. deviation = 0.049 Å) and oxolane (r.m.s. deviation = 0.048 Å) rings make a dihedral angle of 67.91 (4)°. An intra­molecular O—H⋯O hydrogen bond is observed. In the crystal, mol­ecules associate via O—H⋯O hydrogen bonds, forming a three-dimensional network

Performance of the tsunami forecast system for the Indian Ocean

The Indian Tsunami Early Warning System (ITEWS) at the Indian National Centre for Ocean Information Services, Hyderabad, is responsible for issuing tsunami bulletins in India. The tsunami centre oper- ates on a 24×7 basis and monitors seismological sta- tions, bottom pressure recorders and tidal stations throughout the Indian Ocean to evaluate potentially tsunamigenic earthquakes and disseminating tsunami bulletins. The end-to-end capabilities of this warning system have been well proven during all the tsunami- genic earthquakes that occurred since September 2007. Comparison of the earthquake parameters estimated by ITEWS with other international seismological agencies suggests that the system is performing well and has achieved the target set up by the Inter- governmental Oceanographic Commission

Plasma chemokines CXCL10 and CXCL9 as potential diagnostic markers of drug-sensitive and drug-resistant tuberculosis

Tuberculosis (TB) diagnosis still remains to be a challenge with the currently used immune based diagnostic methods particularly Interferon Gamma Release Assay due to the sensitivity issues and their inability in differentiating stages of TB infection. Immune markers are valuable sources for understanding disease biology and are easily accessible. Chemokines, the stimulant, and the shaper of host immune responses are the vital hub for disease mediated dysregulation and their varied levels in TB disease are considered as an important marker to define the disease status. Hence, we wanted to examine the levels of chemokines among the individuals with drug-resistant, drug-sensitive, and latent TB compared to healthy individuals. Our results demonstrated that the differential levels of chemokines between the study groups and revealed that CXCL10 and CXCL9 as potential markers of drug-resistant and drug-sensitive TB with better stage discriminating abilities