Hypoglycemic Effect of Nelumbo Nucifera Seed Extract on GLUT-4 mRNA and GLUT-4 Protein in Streptozotocin-Induced Diabetic Rats.

Background: To investigate the effect of N. nucifera hydroalcoholic seed extract on fasting blood glucose (FBG) levels, glucose transporter (GLUT)-4 mRNA, and GLUT-4 protein in the adipose tissue of streptozotocin (STZ)-induced diabetic rats. Materials and Methods: Male Sprague Dawley (SD) rats were first fed with a high-fat diet (HFD) for three weeks, and then, diabetes was induced by intraperitoneal injection of STZ at a dose of 35 mg/kg bw. Rats were divided into four groups: group 1: normal rats (NC), group 2: STZ-induced diabetic rats (DC), group 3: diabetic rats with N. nucifera hydroalcoholic seed extract at a dose of 400 mg/kg bw (NN), and group 4: diabetic rats with metformin at a dose of 100 mg/kg bw (MET) for 28 days. Results: FBG level was significantly lower in the NN group than in the DC group (P < 0.05). Also, the NN group increased GLUT-4 mRNA expression and GLUT-4 protein in the adipose tissue when compared to the diabetic group. Conclusion: We conclude that the observed hypoglycemic effect of N. nucifera seed extraction in STZ-induced diabetic rats could be due to insulinomimetic activity.

Epidemic of Vitamin D Deficiency and Its Management: Awareness among Indian Medical Undergraduates.

Vitamin D deficiency is prevalent across all age groups in epidemic proportions. The purpose of this study was to acquire a baseline assessment and create awareness among medical students regarding vitamin D. A cross-sectional, voluntary survey was conducted among undergraduate medical students. Data were collected using a questionnaire which assessed the level of knowledge students had with regard to where vitamin D comes from, what it does for health, how much is recommended, factors that affect its levels, and deficiency management. Majority of students were unaware that vitamin D deficiency has attained epidemic proportions. Though bone and skeletal disorders as a complication of vitamin D deficiency were known, a large number were unaware of systemic consequences (diabetes mellitus, cardiovascular diseases, and cancers). Only one-third of respondents were aware of duration and timing of sun exposure required for adequate serum vitamin D levels. However, we observed lack of awareness among students regarding the various biochemical forms, dose, and duration of vitamin D supplementation for treatment of nutritional deficiency. Our study highlighted a lack of knowledge about the importance of vitamin D, worldwide prevalence of vitamin D deficiency, and its management among medical students. Promoting vitamin D health awareness, if replicated across populations, could lead to positive health outcomes globally.

Pediatric Off-Label and Unlicensed Drug Use and Its Implications.

BACKGROUND: Worldwide, in the absence of standard pediatric prescribing information, clinicians often use medicines in children in a dosage form or for an indication that has not been approved for use. Inadequate clinical trials increase exposure to drugs that lack safety-efficacy data in pediatric population. Hence, off-label and unlicensed drug use must be regarded as a patient safety-issue that is known to be associated with increased risks of adverse drug reactions apart from under- or overdosing due to lack of pharmacokinetic data. This review aims to give an overview of the worldwide reported rates of off-label and unlicensed drug use in different patient populations in pediatric settings, with a brief summary of the related adverse drug reactions (ADRs) and a discussion of the existing regulatory provisions and possible solutions for ensuring safe use of medicines in children. METHOD: Literature searches were conducted and we included studies that evaluated unlicensed or off-label drug use in various pediatric patient populations. The definition of off-label drug use and unlicensed drug varied between different studies. RESULTS: Fourteen studies from different countries were included in the review and were grouped as: studies conducted in the patients admitted in neonatal intensive care units, in pediatric wards, in hospitalized children and in pediatric outpatient settings. The number of patients studied ranged from 34 in neonatal intensive care units to 355 409 hospitalized children. Many studies reported high rates of off-label (9% to 78.7%) and unlicensed (0.3% to 35%) drug use in different pediatric patient settings. CONCLUSION: Given the prevalence of unlicensed and off-label drug use, the cooperation of various stakeholders including health professionals, pediatric population and their parents/caregivers, regulatory authorities, and the pharmaceutical industry is integral to instituting individual measures to avoid exposing children to unnecessary risks and avoid depriving them of potentially effective pharmacotherapy. Initiatives to encourage clinical trials for licensing drug use in children by providing market exclusivity and patent extension could aid in bridging the gap between approval and contemporary drug prescribing practices. Enforcement of legislations in the drug development process and subsequent pharmacovigilance could improve the quality of information and accountability of pharmaceutical industry to support and facilitate drug research in children.

Breast filariasis.

Filarial involvement of breast is a rare entity. Here is an unusual case of an old lady with right breast lump with axillary lymphadenopathy mimicking breast carcinoma, cytologically diagnosed as filarial mastitis. The patient subsequently received antihelmenthic therapy and showed marked clinical response within few weeks.