Influence of Serum Levels of Vitamin D on Insulin Resistance in Patients with Type II Diabetes Mellitus.

BACKGROUND: Vitamin D plays an important role in bone and modulates mineral metabolism and immune function with probable link to several chronic and infectious conditions. In vivo studies have revealed that vitamin D deficiency reduces insulin secretion capacity of the islet beta cells in pancreas. Several studies have shown a correlation between vitamin D levels and insulin resistance, nonetheless, extensive studies showing the relationship between the two are lacking especially among southern Indian population. So the present study was aimed at evaluating the relationship between vitamin D and insulin resistance by using homeostatic model assessment-insulin resistance (HOMA-IR). MATERIALS AND METHODS: In a cross-sectional study, 184 people among which 92 were diabetic and 92 were nondiabetic were recruited at RL Jalappa Hospital, Kolar in the Department of Medicine between May 2018 and April 2019. Fasting serum insulin (I0), fasting plasma glucose (G0), hemoglobin A1c (HbA1C), renal function test, liver function test (LFT), lipid profile, and vitamin D levels were estimated. IBM SPSS version 22 was used for statistical analysis. RESULTS: The prevalence of vitamin D deficiency in our study was (72) 78.2% among diabetic cases and (59) 64.1% among the nondiabetic controls, with the diabetic cases showing lower levels of vitamin D than the controls, however, it was not statistically significant. There was no significant difference in homeostatic model assessment-beta-cell function (HOMA-B) and HOMA-IR between vitamin D deficient and nondeficient groups among cases and controls. CONCLUSION: Vitamin D deficiency is prevalent in both type II diabetes mellitus (T2DM) as well as nondiabetic. Furthermore, there is no association between vitamin D deficiency and insulin resistance or beta-cell function.

Refractory asthma - An old disorder: Novel approaches for effective control.

Bronchial asthma is an inflammatory disorder of airways characterized by hyper-responsiveness to a wide range of triggers and is associated with variable airflow obstruction that remits spontaneously or with the treatment. Several phenotype of asthma not responding to the currently acceptable standard therapy of high dose inhaled gluco-corticosteroids along with along acting ß2 agonists come under the purview of refractory asthma. This condition is a heterogeneous and complex disease that requires a multi-disciplinary approach to identify accurately various sub-phenotypes to enable improved understanding of the pathogenesis and development of effective management strategies including use of novel methods and targeted therapy.

Effect of background derivatization on the signal enhancement of pesticide residues extracted from edible oils.

The effect of background derivatization on the signal enhancement of pesticide residues extracted from edible oil samples was studied by GC with negative chemical ionization MS. The analytes were extracted by a solvent extraction process, and the extract was subjected to rapid low-temperature fat precipitation. The residual fatty acids were silylated by derivatization with N,O-bis(trimethylsilyl)trifluoroacetamide. The chromatograms obtained from the derivatized samples showed higher signal intensity and lower detection levels when compared to the direct analysis without derivatization. The sensitivity levels of the method are either better or comparable to that of previously reported methodologies. The LODs of the analyzed organochlorine, organophosphorus, and synthetic pyrethroid residues in sunflower, rice bran, and ground oil samples were in the range of 0.02­0.5 ng/g, and the LOQs were in the range of 0.1­2 ng/g. The intraday and interday accuracies were in the range of 81­116% with RSDs less than 14%. The recoveries obtained were in the range of 53­89% with the RSD values less than 13% for all the studied pesticide residues.

Primary gastrointestinal mucormycosis in an immunocompetent person.

In the past decade, mucormycosis has emerged as an important lethal infection in diabetics and other immunocompromised hosts. Rhinosinusitis, pansinusitis, rhino-orbital and rhinocerebral are the common classical manifestations of mucormycosis. However, primary gastrointestinal (GI) mucormycosis is an uncommon disease associated with a high mortality rate. Stomach is the most common site involved in GI mucormycosis. Reported cases of GI mucormycosis in an immunocompetent host are very few in the literature. Here we present a case of a young male with fungal sepsis secondary to GI mucormycosis in an immunocompetent person.

Hyperleukocytosis associated pulmonary leukostasis in acute leukaemia.

Leukostasis is a fatal complication in granulocytic leukaemia. Brain and lung are most commonly involved organs in leukostasis. In the lung, the clinical presentation simulates infections and haemorrhagic complications of acute leukaemia. Being a medical emergency, early recognition of leukostasis and initiation of therapy prevents mortality.

Purification of a basic phospholipase A2 from Indian saw-scaled viper (Echis carinatus) venom: characterization of antigenic, catalytic and pharmacological properties.

A major basic phospholipase A2 was purified from the Indian saw-scaled viper (Echis carinatus) venom by the combination of column chromatography and electrophoresis. The purified phospholipase A2 (EC-IV-PLA2) has a mol. wt of 14,000 by SDS-PAGE. It is a basic protein with a pI value between 7.2 and 7.6, and has a fluorescence emission maxima at 340 nm. It induces neurotoxicity and oedema in mice with an i.p. LD50 of 5 mg/kg body weight. It is devoid of direct haemolytic, myotoxic, cytotoxic and anticoagulant activities. Rabbit polyclonal antibodies prepared against EC-IV-PLA2 inhibited the in vitro enzymatic activity dose dependently, but did not neutralize the toxic effects of EC-IV-PLA2 in experimental animals.

Purification and characterization of a neurotoxic phospholipase A2 from Indian cobra (Naja naja naja) venom.

Snake venoms contain multimolecular forms of phospholipase A2 which are diverse with respect to their pharmacological properties. A neurotoxic PLA2 from Naja naja naja venom has been purified in two steps. (1) The whole venom was fractionated on CM-Sephadex C-25 column; 4.6% of the total PLA2 activity recovered was found in the NN-V fraction. (2) The NN-Vb-PLA2 fraction was purified to homogeneity by gel filtration of fraction NN-V on Sephadex G-50. It is a basic protein with a mol. wt between 10,500 and 11,000, and is more toxic than other basic PLA2s purified from Naja naja naja venom. The LD50 of NN-Vb-PLA2 is 0.27 mg/kg body wt. It induced neurotoxic symptoms in experimental mice and is devoid of myotoxic, anticoagulant and edema-inducing activities.

A platelet aggregation inhibitor phospholipase A2 from Russell's viper (Vipera russelli) venom: isolation and characterization.

Vipera russelli venom is reported to contain multiple forms of phospholipase A2 (PLA2). Three PLA2s (VRV-PL-V, VRV-PL-VI and VRV-PL-VIIIa) have been purified and characterized in this laboratory. A PLA2(VRV-PL-IIIb) inhibiting platelet aggregation was purified from the same venom in two steps involving CM-Sephadex C-25 column chromatography followed by gel filtration on Sephadex G-50. VRV-PL-IIIb is a basic (pI 7.3-7.7) isoenzyme, with a mol. wt between 14,000 and 15,000. It induced neurotoxic symptoms in experimental mice with an i.p. LD50 of 5.2 mg/kg body weight. VRV-PL-IIIb inhibits ADP-induced platelet aggregation in a dose-dependent manner. It induced oedema in the foot pads of mice and is devoid of anticoagulant, myotoxic and direct haemolytic activities. Antibodies to VRV-PL-IIIb showed a single precipitin line against the antigen as well as whole venom.

Antiamoebic activity of Piper longum fruits against Entamoeba histolytica in vitro and in vivo.

The fruits of Piper longum used in traditional remedies against intestinal distress have been tested for their efficacy against experimental caecal amoebiasis of rats. The ethanolic extract, hexane fraction, n-butanol soluble fraction exerted in vitro amoebicidal action at 1000 micrograms/mL and the chloroform fraction at 500 micrograms/mL. The ethanolic extract and piperine, a pure compound, from this plant material cured 90% and 40% of rats with caecal amoebiasis, respectively.

An expert system for diagnosis and therapy in lung transplantation.

An expert system for diagnosis and therapy after lung transplantation has been developed and evaluated by domain experts. The system captures a total of 21 diagnoses encompassing rejection, pulmonary infection, and some diseases of gastrointestinal origin. The disease hypotheses are scored and ranked by their ability to explain the patient findings. A hypothesis is accepted as a candidate disease if it is ranked high on the list and is able to account for the cardinal findings of the disease. The therapy knowledge is captured in the form of rules. The results demonstrate the feasibility of an expert system for diagnosis and therapy after lung transplantation.

Re-expansion pulmonary edema and hypotension.

A case with diagnosis of non-Hodgkin's lymphoma and superior vena cava obstruction on chemotherapy, presented with respiratory distress and massive pleural effusion of right hemithorax. On removal of 3.5 litres of fluid, he developed pulmonary edema of the same side and hypotension.

Massive pleural effusion, pseudocysts and pancreatico-pleural fistula with asymptomatic pancreatic disease.

A case of chronic pancreatitis with multiple pseudocysts of the pancreas and a pancreatico-pleural fistula causing massive left sided pleural effusion is reported, being a rare and an unusual cause of pleural effusion. This case illustrates the importance of pleural fluid amylase estimation in the diagnosis and the role of endoscopic retrograde cholangio pancreatography to elucidate the pathogenesis of such an effusion. The role of medical management is also emphasized.

Recurrent pneumothorax.

A young man with spontaneous pneumothorax who suffered from fourth recurrence, is being reported. He was treated by surgical pleural abrasion.