Examining liver function in adults with diabetes in the United States

Purpose: Hyperglycemia is the hallmark of various types of diabetes and considered to be a risk factor for several chronic disorders including liver function. Though liver is a dynamic organ, incessant glucotoxicity can lead to altered liver function. The goals of the present study were to examine the association between diabetes with liver functions amongst adults in the United States. Methods: We analyzed 14,948 adults with diabetes in the National Health and Nutrition Examination Survey (NHANES) conducted from 2007 to 2016. Diabetes and prediabetes were defined in accordance with the American Diabetes Association 2021 guidelines. The association of demographic characteristics with glycemic levels was analyzed using the Chi-square test. A multivariate logistic regression model was constructed to evaluate the associations of glycemic levels with abnormal liver enzyme levels. Regression model was adjusted for age, sex, and ethnicity. The statistical analyses were performed using STATA ver. 14. A p value of ≤0.05 or ≤0.001 was considered statistically significant. Results: A total of 14,948 adults (20 years and above) were included in this study. Sample mean age was 45.5± 0.33 yrs., 54% were female, 53% were non-Hispanic White, and 60% had some college or graduate level education. In the overall sample, 19% adults were diabetic and 34% were pre-diabetic. Pre-diabetic glycemic levels were associated over one and half times higher odds of ALT (OR: 1.45, 95% CI: 1.31, 1.60, p\u3c0.001) and over 1.3 times of higher odds AST (OR: 1.30, 95% CI: 1.14, 1.49, p\u3c0.001). On the other hand, diabetic glycemic levels were associated with close to one and half times higher odds of ALT (OR: 1.37, 95% CI: 1.18, 1.59, p\u3c0.001) and AST (OR: 1.48, 95% CI: 1.24, 1.76, p\u3c0.001). On regression analysis, after adjustment, pre-diabetic and diabetic status was associated with high ALT (OR: 1.21, 95%CI: 1.11, 1.32, p\u3c0.001), AST (OR: 1.14, 95%CI: 1.04, 1.27, p\u3c0.05), ALP (OR: 1.40, 95%CI: 1.16, 1.68, p\u3c0.001) and GGT (OR: 1.42, 95%CI: 1.24, 1.63, p\u3c0.001). Conclusions: Our results indicated that diabetes is significantly associated with liver function. This observed association deserves further exploration to understand the longitudinal impact of diabetes on liver function

ROLE OF JALAUKA AVACHARAN (LEECH THERAPY) IN THE MANAGEMENT OF LIPODERMATOSCLEROSIS: A CASE STUDY

Lipodermatosclerosis (Sclerosing Panniculitis) is uncommon and is associated with venous or arterial insufficiency. It presents as tender, indurated plaques in the lower legs. Lipomembranous panniculitis is a form of fat necrosis associated not only with stasis but also with autoimmune diseases, peripheral vascular diseases, and infection. There is fat necrosis, sclerosis, and a lymphocytic infiltrate in a lobular pattern. It appears to be a consequence of ischemia and venous stasis. It most frequently occurs in women and are usually accompanied by signs of venous insufficiency It primarily treated with compression therapy to improve venous insufficiency. Venous insufficiency is also managed by leg elevation; regular exercise; not sitting or standing in one place for long period of time; and weight loss if overweight. A 65 years old male patient was having complaints of swelling over bilateral leg, wound over rt. leg since 8 month. Total 19 sittings of Jalauka Avacharan are done on alternate day. Guduchi Churna, Londra Churna, Haridra Churna, Daruharidra Churna, Kusta Churna, Bakuchi Churna all 100 gm each are mixed and divided into 120 parts. 5 gm of this mixture is given in BD dose for 60 days. Cleaning and dressing of wound done every day with Vranshodhan tail

Genome SEGE: A database for 'intronless' genes in eukaryotic genomes

BACKGROUND: A number of completely sequenced eukaryotic genome data are available in the public domain. Eukaryotic genes are either 'intron containing' or 'intronless'. Eukaryotic 'intronless' genes are interesting datasets for comparative genomics and evolutionary studies. The SEGE database containing a collection of eukaryotic single exon genes is available. However, SEGE is derived using GenBank. The redundant, incomplete and heterogeneous qualities of GenBank data are a bottleneck for biological investigation in comparative genomics and evolutionary studies. Such studies often require representative gene sets from each genome and this is possible only by deriving specific datasets from completely sequenced genome data. Thus Genome SEGE, a database for 'intronless' genes in completely sequenced eukaryotic genomes, has been constructed. Availability: DESCRIPTION: Eukaryotic 'intronless' genes are extracted from nine completely sequenced genomes (four of which are unicellular and five of which are multi-cellular). The complete dataset is available for download. Data subsets are also available for 'intronless' pseudo-genes. The database provides information on the distribution of 'intronless' genes in different genomes together with their length distributions in each genome. Additionally, the search tool provides pre-computed PROSITE motifs for each sequence in the database with appropriate hyperlinks to InterPro. A search facility is also available through the web server. CONCLUSIONS: The unique features that distinguish Genome SEGE from SEGE is the service providing representative 'intronless' datasets for completely sequenced genomes. 'Intronless' gene sets available in this database will be of use for subsequent bio-computational analysis in comparative genomics and evolutionary studies. Such analysis may help to revisit the original genome data for re-examination and re-annotation

Activity and interactions of antibiotic and phytochemical combinations against Pseudomonas aeruginosa in vitro

In this study the in vitro activities of seven antibiotics (ciprofloxacin, ceftazidime, tetracycline, trimethoprim, sulfamethoxazole, polymyxin B and piperacillin) and six phytochemicals (protocatechuic acid, gallic acid, ellagic acid, rutin, berberine and myricetin) against five P. aeruginosa isolates, alone and in combination are evaluated. All the phytochemicals under investigation demonstrate potential inhibitory activity against P. aeruginosa. The combinations of sulfamethoxazole plus protocatechuic acid, sulfamethoxazole plus ellagic acid, sulfamethoxazole plus gallic acid and tetracycline plus gallic acid show synergistic mode of interaction. However, the combinations of sulfamethoxazole plus myricetin shows synergism for three strains (PA01, DB5218 and DR3062). The synergistic combinations are further evaluated for their bactericidal activity against P. aeruginosa ATCC strain using time-kill method. Sub-inhibitory dose responses of antibiotics and phytochemicals individually and in combination are presented along with their interaction network to suggest on the mechanism of action and potential targets for the phytochemicals under investigation. The identified synergistic combinations can be of potent therapeutic value against P. aeruginosa infections. These findings have potential implications in delaying the development of resistance as the antibacterial effect is achieved with lower concentrations of both drugs (antibiotics and phytochemicals)

ASSESSMENT OF TIME IN THERAPEUTIC RANGE WITH WARFARIN THERAPY IN PHARMACIST VERSUS USUAL CARE GROUP: A RETROSPECTIVE COHORT STUDY

Objective: Anticoagulation management with warfarin is a familiar challenge seen in primary care settings. A greater time in the therapeutic range (TTR) has shown improved health benefits in patients treated with warfarin for atrial fibrillation. The aim of this study was to assess the level of anticoagulation control achieved with warfarin therapy measured by TTR. Methods: Patients attending anticoagulation service at a medical center were included in this retrospective cohort study. Patients with at least two international normalized ratio (INR) values not more than 4 weeks apart were included and placed in a usual care group or a pharmacist care group based on the care received. Anticoagulation control was measured by calculating TTR according to Roosendaal’s linear interpolation method. A TTR of >70% was considered high-quality and >60% was considered moderate coagulation control. The data were analyzed for descriptive statistics, associations, and for identifying predictors of TTR. A p value of <0.05 was considered statistically significant. Results: Mean age of patients was 58±9 years; 57% were male; 48% were White Caucasian, and 43% had a CHADS2 score of ≥3. Patients in the pharmacist group had a high TTR (67.6% vs. 43.4%, p<0.0001) and an INR in a significantly lower sub-therapeutic range than the usual care group (5.6% vs. 14.8%; p<0.0001). Half of the patients in the pharmacist group were able to achieve a TTR threshold of 60% and greater compared to less than one-third among the usual care group. Age and pharmacist care were found to be great predictors of TTR after adjusting for gender, ethnicity, and CHADS2 score (p<0.001). Conclusion: Our findings confirmed that pharmacist led anticoagulation care positively improved patients’ TTR with warfarin