STUDY OF HbA1c AS A BIOMARKER IN DYSLIPIDEMIA AND ATHEROGENICITY IN TYPE 2 DIABETES MELLITUS

HbA1c is being used to assess the glycemic control for many years. This study was done to evaluate the importance of HbA1c in predicting dyslipidemia and atherogenecity in type 2 Diabetes. Methods: 200 type 2 diabetic patients were taken as subjects. Fasting and post meal blood sugar, Glycated haemoglobin (HbA1c), lipid profile, lipid ratios and atherogenic index of plasma(AIP) was analysed in these patients. The patients were divided into 2 groups depending on their HbA1c; Good Glycemic Control was defined as having HbA1c ≤ 7.0% and Poor Glycemic Control as HbA1c >7.0%. Results & Discussion: We found a significant increase in the levels of blood glucose, total serum cholesterol (TC), triglyceride, LDL cholesterol (LDL-C) and VLDL cholesterol (VLDL-C), TC/HDL-C, LDL-C/HDL-C, atherogenic index of plasma (AIP) and a significant decrease in the levels of HDL cholesterol (HDL-C) in patients with HbA1c >7% as compared to patients with HbA1c ≤ 7%. HbA1c had a direct and significant correlation with TC, TG, VLDL-C, LDL-C, TC /HDL-C, LDL-C/HDL-C, and an inverse correlation with HDL-C. AIP correlates with cardiovascular risk very well, and the association between HbA1c with various lipid parameters and atherogenic ratios suggests the importance of glycemic control in order to control dyslipidemia and future risk of cardiovascular disease in type 2 diabetics. KEYWORDS: Lipid profile; Type 2 diabetes mellitus; Glycosylated haemoglobin; Glycemic control, Atherogenic index of plasma

STUDY OF HbA1c AS A BIOMARKER IN DYSLIPIDEMIA AND ATHEROGENICITY IN TYPE 2 DIABETES MELLITUS

HbA1c is being used to assess the glycemic control for many years. This study was done to evaluate the importance of HbA1c in predicting dyslipidemia and atherogenecity in type 2 Diabetes. Methods: 200 type 2 diabetic patients were taken as subjects. Fasting and post meal blood sugar, Glycated haemoglobin (HbA1c), lipid profile, lipid ratios and atherogenic index of plasma(AIP) was analysed in these patients. The patients were divided into 2 groups depending on their HbA1c; Good Glycemic Control was defined as having HbA1c ≤ 7.0% and Poor Glycemic Control as HbA1c >7.0%. Results & Discussion: We found a significant increase in the levels of blood glucose, total serum cholesterol (TC), triglyceride, LDL cholesterol (LDL-C) and VLDL cholesterol (VLDL-C), TC/HDL-C, LDL-C/HDL-C, atherogenic index of plasma (AIP) and a significant decrease in the levels of HDL cholesterol (HDL-C) in patients with HbA1c >7% as compared to patients with HbA1c ≤ 7%. HbA1c had a direct and significant correlation with TC, TG, VLDL-C, LDL-C, TC /HDL-C, LDL-C/HDL-C, and an inverse correlation with HDL-C. AIP correlates with cardiovascular risk very well, and the association between HbA1c with various lipid parameters and atherogenic ratios suggests the importance of glycemic control in order to control dyslipidemia and future risk of cardiovascular disease in type 2 diabetics. KEYWORDS: Lipid profile; Type 2 diabetes mellitus; Glycosylated haemoglobin; Glycemic control, Atherogenic index of plasma

Anti-Hyperglycemic And Anti-Hyperlipidemic Potential Of A Polyherbal Preparation “Diabegon” In Metabolic Syndrome Subject With Type 2 Diabetes

Background: In the present study, “Diabegon” a poly-herbal preparation, with hypoglycemic activity, was evaluated for its preventive effect inmetabolic syndrome subjects with type 2 diabetes and also to reveal its side effects, on liver and kidney.Materials and Methods: Type 2 diabetic subjects with metabolic syndrome (N=58) were categorized on the basis of age and fasting blood glucose.The grouping was as follows: Group I (35-50 yrs), Group II (51-65 yrs), Group III >65 yrs, Group IV FBS<145.9, Group V FBS>145. Each group wasadministered 4 gm of diabegon daily. Blood glucose levels, lipid profile, liver and kidney function of the subjects were regularly monitored within 3months of interval to 18 months.Results: The reduction in fasting blood glucose level ranged from 12.3% (P<0.05) to 42% (P<0.001) after 18 month of therapy whereas in postprandial blood glucose, the decrease ranged from 28% (P<0.05) to 32% (P<0.05) after 18 month of therapy. Overall reductions in the individual parameters of the metabolic syndrome subjects were significantly higher in Group I. Cholesterol level decreased from 11% to 27.2% (P<0.001), triglyceride levels decreased from 24% to 55%, VLDL and LDL levels reduced by 60% & 54% respectively after 18 months of therapy. The HDL-C level increased in all groups. Moreover, diabegon administration for 1.5 years exhibited no alteration in liver and kidney function tests, which indicate its non-toxicity.Conclusion: Our study suggests that diabegon could be included as a preventive treatment in metabolic syndrome subjects with type 2 diabetesespecially for long term treatment as it efficiently shows anti-hyperglycemic and anti-lipidemic effects with no adverse impacts on the liver and kidney.Key words: Metabolic syndrome, Type 2 diabetes, Diabegon, Polyherbal preparation

Erosion of Trust in the Medical Profession in India : Time for Doctors to Act

In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs), the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developments in India, to argue that a purely control-based regulatory response to this crisis in the medical profession, as is being currently envisaged by the Parliament and the Supreme Court of India, runs the risk of undermining the trusting interpersonal relations between doctors and their patients. A more balanced approach which takes into account the differences between system and interpersonal forms of trust and distrust is warranted. Such an approach should on one hand strongly regulate the institutions mandated with the stewardship and qualities of care functions, and simultaneously on the other hand, initiate measures to nurture the trusting interpersonal relations between doctors and patients. The paper concludes by calling for doctors, and those mandated with the stewardship of the profession, to individually and collectively, critically self-reflect upon the state of their profession, its priorities and its future direction

An Exact Fluctuating 1/2-BPS Configuration

This work explores the role of thermodynamic fluctuations in the two parameter giant and superstar configurations characterized by an ensemble of arbitrary liquid droplets or irregular shaped fuzzballs. Our analysis illustrates that the chemical and state-space geometric descriptions exhibit an intriguing set of exact pair correction functions and the global correlation lengths. The first principle of statistical mechanics shows that the possible canonical fluctuations may precisely be ascertained without any approximation. Interestingly, our intrinsic geometric study exemplifies that there exist exact fluctuating 1/2-BPS statistical configurations which involve an ensemble of microstates describing the liquid droplets or fuzzballs. The Gaussian fluctuations over an equilibrium chemical and state-space configurations accomplish a well-defined, non-degenerate, curved and regular intrinsic Riemannian manifolds for all physically admissible domains of black hole parameters. An explicit computation demonstrates that the underlying chemical correlations involve ordinary summations, whilst the state-space correlations may simply be depicted by standard polygamma functions. Our construction ascribes definite stability character to the canonical energy fluctuations and to the counting entropy associated with an arbitrary choice of excited boxes from an ensemble of ample boxes constituting a variety of Young tableaux.Comment: Minor changes, added references, 30 pages, 4 figures, PACS numbers: 04.70.-s: Physics of black holes; 04.70.-Bw: Classical black holes; 04.50.Gh Higher-dimensional black holes, black strings, and related objects; 04.60.Cf Gravitational aspects of string theory, accepted for publication in JHE

High-resolution radiation hybrid mapping in wheat: an essential tool for the construction of the wheat physical maps

ArtigoO poema épico da época moderna nasce na literatura portuguesa como oceânico logo a partir da sua gestação. Este estudo enquadra a sua génese num contexto europeu.Università di Roma, La Sapienz

Improvements to water purification and sanitation infrastructure may reduce the diarrheal burden in a marginalized and flood prone population in remote Nicaragua

<p>Abstract</p> <p>Background</p> <p>The isolated northern region of Nicaragua has one of the highest rates of diarrheal disease in Central America. Political and environmental hardships faced by inhabitants of this region are contributing factors to this health inequity. The aim of this study was to assess the relationship between water and latrine infrastructure and the prevalence of diarrhea in this region.</p> <p>Methods</p> <p>A population-based, cross-sectional survey of women of reproductive age was conducted in the Sahsa region of northern Nicaragua in July, 2009. Households were selected by two stage cluster sampling methodology. A questionnaire was administered in Spanish and Miskito with assessment of household and socioeconomic conditions, sanitation practices, and health care access. Diarrhea prevalence differences at the household level over a two week reporting period were estimated with a standardized instrument which included assessment of water treatment and latrine use and maintenance.</p> <p>Results</p> <p>There were 189 women enrolled in the current study. The use of water purification methods, such as chlorine and filters, and latrine ownership were not associated with reduced prevalence of household diarrhea in the two week reporting period. Latrine overflow, however, was associated with an increased prevalence of diarrhea during the same two week period [adjusted prevalence difference and 95% CI: 0.19 (0.03, 0.36)].</p> <p>Conclusions</p> <p>Simple, low cost interventions that improve water and latrine infrastructure may reduce the prevalence of diarrheal disease in the isolated regions of Nicaragua and Central America.</p

Sampling strategies to measure the prevalence of common recurrent infections in longitudinal studies

<p>Abstract</p> <p>Background</p> <p>Measuring recurrent infections such as diarrhoea or respiratory infections in epidemiological studies is a methodological challenge. Problems in measuring the incidence of recurrent infections include the episode definition, recall error, and the logistics of close follow up. Longitudinal prevalence (LP), the proportion-of-time-ill estimated by repeated prevalence measurements, is an alternative measure to incidence of recurrent infections. In contrast to incidence which usually requires continuous sampling, LP can be measured at intervals. This study explored how many more participants are needed for infrequent sampling to achieve the same study power as frequent sampling.</p> <p>Methods</p> <p>We developed a set of four empirical simulation models representing low and high risk settings with short or long episode durations. The model was used to evaluate different sampling strategies with different assumptions on recall period and recall error.</p> <p>Results</p> <p>The model identified three major factors that influence sampling strategies: (1) the clustering of episodes in individuals; (2) the duration of episodes; (3) the positive correlation between an individual's disease incidence and episode duration. Intermittent sampling (e.g. 12 times per year) often requires only a slightly larger sample size compared to continuous sampling, especially in cluster-randomized trials. The collection of period prevalence data can lead to highly biased effect estimates if the exposure variable is associated with episode duration. To maximize study power, recall periods of 3 to 7 days may be preferable over shorter periods, even if this leads to inaccuracy in the prevalence estimates.</p> <p>Conclusion</p> <p>Choosing the optimal approach to measure recurrent infections in epidemiological studies depends on the setting, the study objectives, study design and budget constraints. Sampling at intervals can contribute to making epidemiological studies and trials more efficient, valid and cost-effective.</p

Emergence of vancomycin resistant Staphylococcus aureus (VRSA) from a tertiary care hospital from northern part of India

BACKGROUND: Glycopeptides such as vancomycin are frequently the antibiotics of choice for the treatment of infections caused by methicillin resistant Staphylococcus aureus (MRSA). For the last 7 years incidence of vancomycin intermediate S. aureus and vancomycin resistant S. aureus (VISA and VRSA respectively) has been increasing in various parts of the world. The present study was carried out to find out the presence of VISA and VRSA in the northern part of India. METHODS: A total 1681 staphylococcal isolates consisting of 783 S. aureus and 898 coagulase negative staphylococci (CoNS) were isolated from different clinical specimens from various outpatient departments and wards. All S. aureus and 93 CoNS were subjected to MIC testing (against vancomycin, teicolplanin and oxacillin); Brain Heart Infusion (BHI) vancomycin screen agar test; disc diffusion testing, and PCR for mecA, vanA and vanB genes detection. RESULTS: Out of 783 S. aureus two S. aureus strains were found to be vancomycin and teicoplanin resistant (one strain with MIC 32 μg/ml and the other strain with MIC 64 μg/ml); six strains of S. aureus have shown to be vancomycin intermediate (two strains with MIC 16 μg/ml and four strains with MIC 8 μg/ml); and two strains with teicoplanin intermediate (MIC 16 μg/ml). One CoNS strain was resistant to vancomycin and teicoplanin (MIC 32 μg/ml), and two CoNS strains were intermediate to vancomycin and teicoplanin (MIC 16 μg/ml). All VRSA, VISA and vancomycin resistant CoNS had shown growth on BHI vancomycin screen agar (vancomycin 6 μg/ml) and were mecA PCR positive. None of these isolates have demonstrated vanA/vanB gene by PCR. CONCLUSION: The present study reveals for the first time emergence of VISA/VRSA from this part of world and indicates the magnitude of antibiotic resistance in and around the study area. The major cause of this may be unawareness and indiscriminate use of broad-spectrum antibiotics