New Frontier in the Treatment of Diabetes

Diabetes mellitus is a group of metabolic diseases recognized by chronic hyperglycemia resulting from defects in secretion in insulin, insulin action or both. There are different types of diabetes like Type 1, type 2, gestational diabetes, secondary diabetes, wolfram syndrome and autoimmune polyglandular syndrome. Type 1 and type 2 diabetes are most common type of diabetes. Polydipsia, polyuria, polyphagia, weight loss slow wound healing, etc. are common symptoms of Diabetes. Diabetes can be genetic; autoimmune, medical related or even diet related. In this article causes and treatment of diabetes is discussed in detail. It includes glimpse of novel technologies like patches, pump and pens, etc. It also includes momentary of other treatment like oral and Injectable hypoglycemic drug and surgical treatments. A glance of latest innovation for measuring glucose level in body with help of sweat, breath and saliva are explained. Keywords: Diabetes; Type 2 Diabetes Mellitus (TY2DM), Polydipsia, polyuria, polyphagia, clicksoft microinjection, insulin pen, v-g

Drug utilization study in patients of COPD in TB and Chest department in a tertiary care teaching hospital

Background: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. It is the fourth leading cause of death in the world, and further increase in its prevalence and mortality can be predicted in the coming decades. Many people die prematurely from it or its complications. Total deaths from COPD are projected to increase by more than 30% in the next 10 years unless urgent action is taken to reduce the underlying risk factors, especially tobacco use. Estimates show that in 2020 COPD will become the third leading cause of death worldwide. A wide range of drugs are prescribed for COPD but not strictly according to established guidelines.Methods: A prospective observational study of drugs prescribed in COPD was conducted in outdoor patients at TB and Chest department at Sheth L. G. General Hospital.Results: Total 90 prescriptions of COPD patient were collected and studied for drug utilization. The results revealed that the ratio of prevalence in males was higher than females, which was 73% and 27% respectively. Theophylline (93.3%) and chlorpheniramine (71.1%) were most prescribed drugs.Conclusions: According to the results, prevalence was higher in males than females and was higher in smokers than nonsmokers and most common prescribed class of drug was methylxanthine

Leukocytosis- A tight roped walk

It is common for patients to reveal a leukocytosis (increased white blood cell count) within twenty four hours of initiation of a glucocorticoid. It is important for clinicians to be aware of this expected side effect and to understand the rationale for such an increase. Here, we present a case of nine years old boy with intracranial space occupying lesion (medulloblastoma) posted for surgery who was on oral steroids and had leucocytosis which gradually subsided on stopping steroids

A drug utilization study in glaucoma patients in ophthalmology out patient department in a tertiary care hospital

Background: According to World Health Organization (WHO) studies Glaucoma is a chronic progressive symptomatic disease that damages retinal cells and is one of the leading cause of preventable blindness worldwide. Availability of newer topical agents has modernized the management of glaucoma.Methods: A prospective observational study was carried out from August 2016 to December 2016 at ophthalmology Out Patient Department of L.G General Hospital, Ahmedabad by authours after the approval of the Institutional Ethics Committee.Results: Out of total 101 patients, 71 were males and 30 were females. Average age of patient is 54 years. Common variant of Glaucoma was Primary Open Angle Glaucoma in 57.4% of patients. Average number of drugs per prescription was 2 (45%). Most commonly used Fixed Dose Combination was Brimonidine +Timolol Drops which was used in 87 (86.1%) patients. Most commonly used adjuvant drug was Tab. Acetazolamide (60% of patients).Conclusions: Common variant of Glaucoma was Primary Open Angle Glaucoma in 57.4% of patients. Most commonly used Fixed Dose Combination was Brimonidine+Timolol Drops which was used in 87 (86.1%) patients and commonly used Single drug therapy is Tab. Acetazolamide in (60% of patients)

Antibacterial Evaluation of Plant Extracts: an insight into Phytomedicine

This study was carried out to evaluate the antibacterial activity of petroleum ether, methanol and aqueous extract of the two plant Ocimum sanctum and pepper nigrum extract using agar well diffusion and broth dilution method against gram-positive bacterial strains (B. firmus, B. megaterium and B. cereus) and gram-negative bacterial strains (Escherichia coli, Enterobacter sp. and Klebsiella pneumoniae). The results indicate that petroleum ether extract compare to methanol and aqueous extract of O. sanctum and P. nigrum exhibited significant antibacterial activity against gram-positive bacteria with minimum inhibitory concentration (MIC) ranging from 0.13 to 0.21x 10-4 mg/well concentration. Moreover, gram-negative bacteria were less susceptible against petroleum ether, methanol and aqueous extract of O. sanctum and P. nigrum and their MIC ranging from 0.13 to 0.21x 10-2. The most susceptible organism to the organic extracts from both studied plants was B. firmus and the most resistant organism was Enterobacter sp. The result obtained with B. cereus and K. pneumoniae were particularly interesting, since it was inhibited by antibiotic ampicillin used and susceptibility was observed with the individual extracts, where higher antibacterial activity with petroleum ether and aqueous extracts of O. sanctum and P. nigrum respectively.  The presence of phytochemicals such as alkaloids, tannins, saponin, triterpenoids, steroids and glycosides in the extracts of these plants supports their traditional uses as medicinal plants for the treatment of various ailments. The present study reveals potential use of these plants for developing new antibacterial herbal drugs against pathogenic microorganisms

Antibacterial Evaluation of Plant Extracts: an insight into Phytomedicine

This study was carried out to evaluate the antibacterial activity of petroleum ether, methanol and aqueous extract of the two plant Ocimum sanctum and pepper nigrum extract using agar well diffusion and broth dilution method against gram-positive bacterial strains (B. firmus, B. megaterium and B. cereus) and gram-negative bacterial strains (Escherichia coli, Enterobacter sp. and Klebsiella pneumoniae). The results indicate that petroleum ether extract compare to methanol and aqueous extract of O. sanctum and P. nigrum exhibited significant antibacterial activity against gram-positive bacteria with minimum inhibitory concentration (MIC) ranging from 0.13 to 0.21x 10-4 mg/well concentration. Moreover, gram-negative bacteria were less susceptible against petroleum ether, methanol and aqueous extract of O. sanctum and P. nigrum and their MIC ranging from 0.13 to 0.21x 10-2. The most susceptible organism to the organic extracts from both studied plants was B. firmus and the most resistant organism was Enterobacter sp. The result obtained with B. cereus and K. pneumoniae were particularly interesting, since it was inhibited by antibiotic ampicillin used and susceptibility was observed with the individual extracts, where higher antibacterial activity with petroleum ether and aqueous extracts of O. sanctum and P. nigrum respectively.  The presence of phytochemicals such as alkaloids, tannins, saponin, triterpenoids, steroids and glycosides in the extracts of these plants supports their traditional uses as medicinal plants for the treatment of various ailments. The present study reveals potential use of these plants for developing new antibacterial herbal drugs against pathogenic microorganisms

Socio-Economic Inequalities in the Use of Postnatal Care in India

OBJECTIVES: First, our objective was to estimate socio-economic inequalities in the use of postnatal care (PNC) compared with those in the use of care at birth and antenatal care. Second, we wanted to compare inequalities in the use of PNC between facility births and home births and to determine inequalities in the use of PNC among mothers with high-risk births. METHODS AND FINDINGS: Rich-poor ratios and concentration indices for maternity care were estimated using the third round of the District Level Household Survey conducted in India in 2007-08. Binary logistic regression models were used to examine the socio-economic inequalities associated with use of PNC after adjusting for relevant socio-economic and demographic characteristics. PNC for both mothers and newborns was substantially lower than the care received during pregnancy and child birth. Only 44% of mothers in India at the time of survey received any care within 48 hours after birth. Likewise, only 45% of newborns received check-up within 24 hours of birth. Mothers who had home births were significantly less likely to have received PNC than those who had facility births, with significant differences across the socio-economic strata. Moreover, the rich-poor gap in PNC use was significantly wider for mothers with birth complications. CONCLUSIONS: PNC use has been unacceptably low in India given the risks of mortality for mothers and babies shortly after birth. However, there is evidence to suggest that effective use of pregnancy and childbirth care in health facilities led to better PNC. There are also significant socio-economic inequalities in access to PNC even for those accessing facility-based care. The coverage of essential PNC is inadequate, especially for mothers from economically disadvantaged households. The findings suggest the need for strengthening PNC services to keep pace with advances in coverage for care at birth and prenatal services in India through targeted policy interventions

Infant and Child Mortality in India in the Last Two Decades: A Geospatial Analysis

Studies examining the intricate interplay between poverty, female literacy, child malnutrition, and child mortality are rare in demographic literature. Given the recent focus on Millennium Development Goals 4 (child survival) and 5 (maternal health), we explored whether the geographic regions that were underprivileged in terms of wealth, female literacy, child nutrition, or safe delivery were also grappling with the elevated risk of child mortality; whether there were any spatial outliers; whether these relationships have undergone any significant change over historical time periods.The present paper attempted to investigate these critical questions using data from household surveys like NFHS 1992-1993, NFHS 1998-1999 and DLHS 2002-2004. For the first time, we employed geo-spatial techniques like Moran's-I, univariate LISA, bivariate LISA, spatial error regression, and spatiotemporal regression to address the research problem. For carrying out the geospatial analysis, we classified India into 76 natural regions based on the agro-climatic scheme proposed by Bhat and Zavier (1999) following the Census of India Study and all estimates were generated for each of the geographic regions.This study brings out the stark intra-state and inter-regional disparities in infant and under-five mortality in India over the past two decades. It further reveals, for the first time, that geographic regions that were underprivileged in child nutrition or wealth or female literacy were also likely to be disadvantaged in terms of infant and child survival irrespective of the state to which they belong. While the role of economic status in explaining child malnutrition and child survival has weakened, the effect of mother's education has actually become stronger over time

Wellen’s syndrome: Challenges in diagnosis

Wellen’s syndrome is a pre-infarction stage of coronary artery disease characterised by predefined clinical and electrocardiographic (ECG) criteria of a subgroup of patients with myocardial ischaemia. Early recognition and appropriate intervention of this syndrome carry significant diagnostic and prognostic value. We report this unusual syndrome in an elderly man who presented with recurrent angina and characteristic ECG changes as T-waves inversion in the precordial leads, especially in V2–V6 during pain-free periods and ECG obtained during episodes of pain demonstrating upright T-waves with possible elevated ST segments from V1–V4. Cardiac enzymes were positive and coronary angiography revealed critical stenosis in the proximal left anterior descending artery. It is important to timely identify this condition and intervene appropriately as these patients may develop extensive myocardial infarction that carries a significant morbidity and mortalit

The Need for Artificial Intelligence Based Risk Factor Analysis for Age-Related Macular Degeneration: A Review

In epidemiology, a risk factor is a variable associated with increased disease risk. Understanding the role of risk factors is significant for developing a strategy to improve global health. There is strong evidence that risk factors like smoking, alcohol consumption, previous cataract surgery, age, high-density lipoprotein (HDL) cholesterol, BMI, female gender, and focal hyper-pigmentation are independently associated with age-related macular degeneration (AMD). Currently, in the literature, statistical techniques like logistic regression, multivariable logistic regression, etc., are being used to identify AMD risk factors by employing numerical/categorical data. However, artificial intelligence (AI) techniques have not been used so far in the literature for identifying risk factors for AMD. On the other hand, artificial intelligence (AI) based tools can anticipate when a person is at risk of developing chronic diseases like cancer, dementia, asthma, etc., in providing personalized care. AI-based techniques can employ numerical/categorical and/or image data thus resulting in multimodal data analysis, which provides the need for AI-based tools to be used for risk factor analysis in ophthalmology. This review summarizes the statistical techniques used to identify various risk factors and the higher benefits that AI techniques provide for AMD-related disease prediction. Additional studies are required to review different techniques for risk factor identification for other ophthalmic diseases like glaucoma, diabetic macular edema, retinopathy of prematurity, cataract, and diabetic retinopathy