Challenges in Diabetes Care in India : Sheer Numbers, Lack of Awareness and Inadequate Control

Abstract With an estimated 40 million people suffering from the condition, the largest in any country in the world, diabetes has become a major health care problem in India. Recent epidemiological studies from India point to the great burden due to diabetes and its micro and macrovascular complications. This is primarily because the status of diabetes control in India is far from ideal. Based on the available data, the mean glycated hemoglobin levels are around 9% which is at least 2% higher than the goal currently suggested by international bodies. The IMPROVE study has helped identify the barriers to good control of diabetes both among patients as well as physicians in today’s practice. However the recent ACCORD study points to the dangers of overaggressive treatment, especially in high risk in elderly patients. A balanced approach to improve awareness about diabetes and its control both among patients and the medical fraternity is urgent need of the hour in India. The associated risks of tight control in high risk groups should also be kept in mind

Unexpected and Abnormally Low Hdl Cholesterol Levels on Combination Hypolipidemic Therapy

Abstract In general, Indians have low HDL cholesterol levels. Fenofibrate, a drug widely used in the treatment of hypertriglyceridemia, usually also increases HDL cholesterol. There have been a few reports in the literature of a paradoxical decrease in serum HDL-cholesterol in patients treated with fenofibrate, either alone or in combination with a statin. We report three cases of paradoxical decrease in serum HDL- cholesterol in type 2 diabetic patients treated with a statin-fenofibrate combination

Electrocardiogram of Clinically Healthy Mithun (Bos frontalis): Variation among Strains

A study was conducted to establish the normal electrocardiogram in four different genetic strains of mithun (Bos frontalis). Electrocardiography, cardiac electrical axis, heart rate, rectal temperature and respiration rate were recorded in a total of 32 adult male mithun of four strains (n = 8 each). It was found that the respiration and heart rates were higher (P < .05) in Manipur than other three strains. Amplitude (P < .05) and duration of P wave and QRS complex differed (P < .01) among the strains. Mizoram strain had the highest amplitude and duration of P wave and QRS complex. On the other hand, higher (P < .05) amplitude and duration of T wave were recorded in Arunachalee and Mizoram strains. The mean electrical axis of QRS complex that were recorded for Arunachalee and Manipur strains were similar to that reported for other bovine species; whereas the electrical axis of QRS for Nagamese and Mizoram strains were more close to feline and caprine species, respectively. In conclusion, electrocardiogram of mithun revealed that the amplitude and duration of P wave, QRS complex and T wave were different among four different genetic strains of mithun and the electrical axis of QRS complex for Nagamese and Mizoram mithuns are dissimilar to bovine species

Alteration in peripheral muscle strength among overweight and obese individuals: A systematic review

© Journal of Krishna Institute of Medical Sciences University. Peripheral muscle dysfunction in Overweight (OW) and Obesity (OB) leads to fatigue and activity limitations. However, there are contradictory views regarding the exact level with regard to hand grip and quadriceps muscle strength in OW and OB. The main objective of the present systematic review was to synthesize the literature for the strength part of the hand grip and quadriceps muscle strength among OW and OB. Literature search of Scopus, EBSCO and PubMed databases from 01.01.2004 to 30.06.2016, was performed. We set our search strategy using the terms “overweight OR obesity” AND “muscle strength” AND “grip OR quadriceps”. Two reviewers administered established eligible criteria and extracted the data. Strengthening the Reporting of Observational studies in Epidemiology (STROBE) was used to assess the risk of bias. Sixteen articles which were included identified Handgrip Strength (HGS), shoulder flexor, elbow flexor and knee extensor were found to be altered. There were consistent results with an increase in quadriceps muscle strength, whereas differed results were found in hand grip to increase and decrease in muscle strength in the presence of OW and OB. It is concluded that HGS appeared to be diversified with findings of increased and decrease strength, whereas regarding the quadriceps muscles, the findings were homogeneous

Design, synthesis and characterisation of a disulphide appended sugar bis-triazole

1364-1368In this work, sugar-based bis-triazole appended disulfide was synthesized, characterized and the molecular structure is confirmed through different spectral techniques like NMR (1H, 13C), FTIR and mass spectroscopy. Since the target molecule possesses suitable core moiety, we anticipate that the synthesized sugar-based bis-triazole appended disulfide derivative can act as a sensor

Design, synthesis and characterisation of a disulphide appended sugar bis-triazole

In this work, sugar-based bis-triazole appended disulfide was synthesized, characterized and the molecular structure is confirmed through different spectral techniques like NMR (1H, 13C), FTIR and mass spectroscopy. Since the target molecule possesses suitable core moiety, we anticipate that the synthesized sugar-based bis-triazole appended disulfide derivative can act as a sensor

Convective thundercloud development over the western ghats mountain slope in Kerala

Studies were carried out on the data from Braemore mountain observatory (lat. 8°45'N, long. 77°5'E) using a single-lens ceilometer (LIDAR), an electric field mill and a portable automatic weather station throughout the year 2010. The simultaneous data collected using the above instruments indicate the existence of strong updrafts followed by the formation of thunderclouds, a characteristic of the mountain slopes, during the thunderstorm months. Changes in atmosphere related to condensation and formation of water droplets during updraft events on the mountain slope could be detected from the ceilometer scattering data. Results of the study point to the cause of relatively more thunderstorm activity in that zone. This seems to be due to excessive updraft, which is strongly related to lightning activity in the region

The ORNATE India project: Building research capacity and capability to tackle the burden of diabetic retinopathy-related blindness in India

The ORNATE India project is an interdisciplinary, multifaceted United Kingdom (UK)–India collaborative study aimed to build research capacity and capability in India and the UK to tackle the burden of diabetes-related visual impairment. For 51 months (October 2017–December 2021), this project built collaboration between six institutions in the UK and seven in India, including the Government of Kerala. Diabetic retinopathy (DR) screening models were evaluated in the public system in Kerala. An epidemiological study of diabetes and its complications was conducted through 20 centers across India covering 10 states and one union territory. The statistical analysis is not yet complete. In the UK, risk models for diabetes and its complications and artificial intelligence-aided tools are being developed. These were complemented by joint studies on various aspects of diabetes between collaborators in the UK and India. This interdisciplinary team enabled increased capability in several workstreams, resulting in an increased number of publications, development of cost-effective risk models, algorithms for risk-based screening, and policy for state-wide implementation of sustainable DR screening and treatment programs in primary care in Kerala. The increase in research capacity included multiple disciplines from field workers, administrators, project managers, project leads, screeners, graders, optometrists, nurses, general practitioners, and research associates in various disciplines. Cross-fertilization of these disciplines enabled the development of several collaborations external to this project. This collaborative project has made a significant impact on research capacity development in both India and the UK

Differentiation of murine colon pathology by optical and mechanical contrast using optical coherence tomography and elastography

Colon pathologies including colon cancer and ulcerative colitis afflict hundreds of thousands of people in the United States. Clinical detection of colon diseases is generally performed through colonoscopy. However, these methods usually lack the sensitivity or resolution to detect diseased tissue at early stages. Even high resolution optical techniques such as confocal microscopy and optical coherence tomography (OCT) rely on structural features to detect anomalies in tissue, which may not be sufficient for early disease detection. If changes in tissue biomechanical properties precede morphological changes in tissue physiology, then mechanical contrast would enable earlier detection of disease. In this work, we utilized optical coherence elastography (OCE) to assess the biomechanical properties of healthy, cancerous, and colitis tissue. Additionally, the optical properties of each sample were also assessed as a secondary feature to distinguish tissue types. The Young’s modulus, as measured by the propagation of an elastic wave, of the healthy, cancerous, and colitis tissue was 10.8 ± 1.0 kPa, 7.12 ± 1.0 kPa, and 5.1 ± 0.1 kPa, respectively. The variations in the OCT signal intensity over depth, as measured by the slope-removed standard deviation of each A-scan was 5.8 ±.0.3 dB, 5.1 ± 0.4 dB, and 5.5 ± 0.2 dB for healthy, cancerous, and colitis tissue, respectively. This work shows OCT structural imaging combined with OCE can detect minute changes in colon tissue optical scattering and elastic properties, which may be useful for detection various colon diseases, such as colitis and colon cancer

A proprietary black cumin oil extract (Nigella sativa) (BlaQmax®) modulates stress-sleep-immunity axis safely: Randomized double-blind placebo-controlled study

ObjectiveStress, sleep, and immunity are important interdependent factors that play critical roles in the maintenance of health. It has been established that stress can affect sleep, and the quality and duration of sleep significantly impact immunity. However, single drugs capable of targeting these factors are limited because of their multi-targeting mechanisms. The present study investigated the influence of a proprietary thymoquinone-rich black cumin oil extract (BCO-5) in modulating stress, sleep, and immunity.MethodsA randomized double-blinded placebo-controlled study was carried out on healthy volunteers with self-reported non-refreshing sleep issues (n = 72), followed by supplementation with BCO-5/placebo at 200  mg/day for 90  days. Validated questionnaires, PSQI and PSS, were employed for monitoring sleep and stress respectively, along with the measurement of cortisol and melatonin levels. Immunity markers were analyzed at the end of the study.ResultsIn the BCO-5 group, 70% of the participants reported satisfaction with their sleep pattern on day 7 and 79% on day 14. Additionally, both inter- and intra- group analyses of the total PSQI scores and component scores (sleep latency, duration, efficiency, quality, and daytime dysfunction) on days 45 and 90 showed the effectiveness of BCO-5 in the improvement of sleep (p &lt; 0.05). PSS-14 analysis revealed a significant reduction in stress, upon both intra (p &lt; 0.001) and inter-group (p &lt; 0.001) comparisons. The observed reduction in stress among the BCO-5 group, with respect to the placebo, was significant with an effect size of 1.19 by the end of the study (p &lt; 0.001). A significant correlation was also observed between improved sleep and reduced stress as evident from PSQI and PSS. Furthermore, there was a significant modulation in melatonin, cortisol, and orexin levels. Hematological/immunological parameters further revealed the immunomodulatory effects of BCO-5.ConclusionBCO-5 significantly modulated the stress-sleep-immunity axis with no side effects and restored restful sleep