Quality of Life and its Determinants in Patients with Diabetes Mellitus from Two Health Institutions of Sub-himalayan Region of India.

BACKGROUND: Diabetes mellitus (DM) causes serious deterioration in general quality of life (QoL) mainly affecting the health-related quality of life (HRQOL). Routine assessment of QoL improves communication with the patient, helps to predict treatment response, and supports clinical decision-making. QoL can predict an individual's capacity to manage the disease and maintain long-term health and wellbeing. AIMS: To find out the QoL and its socio-demographic, anthropometric, and clinical determinants among DM patients attending health institutions from sub-Himalayan region, catering rural population. SETTINGS AND DESIGN: This cross-sectional study was conducted in two hospitals mostly catering rural population from 2014 to 2018. Purposive sampling technique was used. MATERIALS AND METHODS: Socio-demographic, anthropometric, and clinical data of DM patients (N = 300) were collected. They were administeredHindi translation of QoL Instrument for Indian Diabetes Patients (QOLID) and Patient Health Questionnaire-9 (PHQ-9). All statistical analyses were carried out using Statistical Package for Social Sciences (SSPS) (Version 17.0, USA). RESULTS: About 10% had very poor, 13% poor, 11% average, 16% good, and 50% very good QoL on QOLID. General health (GH) and treatment satisfaction (TS) were the most affected domains. Fatigue was the most common symptom (79%) reported in QOLID. Age more than 55 years, rural background, and PHQ-9 score of more than 7 were predictors of poorer QoL. CONCLUSION: There is a need for a holistic and collaborative care of DM patients, to maintain a good HRQoL. Screening of depression, fatigue, and regular assessment of QoL should be emphasized.

Infantile tremor syndrome: current perspectives.

Infantile Tremor Syndrome (ITS) is a self-limiting clinical state characterized by tremors, anemia, pigmentary skin disease, regression of mental development, and hypotonia of muscles in a plump looking child. Tremors are coarse in character, decreased or disappeared in sleep and resolves within 4-6 weeks in its natural course. Various etiological factors as infectious, metabolic, nutritional have been hypothesized but none is conclusive. Consensus is developing on the role of Vitamin B12 deficiency in children with ITS but is still debatable. Empirical management of ITS children has been tried in the absence of exact etiology considering child as undernourished. Nutritional management includes supplementation of Iron, Calcium, Magnesium, Vitamin B12 and other multivitamins. Tremors can be managed with administration of propranolol most commonly or phenobarbitone, phenytoin, and carbamazepine.

Investigation of the utility of Curcuma caesia in the treatment of diabetic neuropathy.

OBJECTIVES: Curcuma caesia has shown positive results in treating number of diseases, but till date no work was reported on its activity in diabetic neuropathy. So, the present review aims at exploring several hypothesis which can be proposed to explain further its utility in diabetic neuropathy by its antioxidant property, anti-inflammatory, CNS depressant effect, antibacterial and antifungal property. For finding the accurate and exact detail, a thorough review of all the available research and review article was done. A number of book chapters and encyclopaedias were taken into consideration to find out the origin, botany and genetics. The databases were searched using different keywords like antioxidant, inflammation, turmeric, diabetic neuropathy. KEY FINDINGS: After getting data on pathogenesis of diabetic neuropathy, it has been found out that its role as antioxidant will reduce the level of oxidative stress which is the main reason for the occurrence of the present complication. Apart this, the anti-inflammatory activity will further prevent the inflammation of neurons and antibacterial effect will inhibit the spread of infection. Combining all the factors together, the plant can be utilized in the treatment of diabetic neuropathy. SUMMARY: Curcuma caesia can be proved as a useful approach in the treatment of diabetic neuropathy.

Synthesis and biological evaluation of 4-oxycoumarin derivatives as a new class of antifilarial agents.

A series of 4-oxycoumarin derivatives was synthesized, characterized and evaluated in vitro and in vivo for antifilarial activity against the human lymphatic filarial parasite, Brugia malayi. A majority of the compounds studied showed potent in vitro activity with low IC50 values in the micro molar (µM) range (0.014-1.73 and 0.0056-0.43) against adult worms and microfilariae, respectively. Compounds 8 and 9 were identified to be the most promising antifilarial candidate molecules exhibiting activity in the nanomolar (nM) range. The IC50 values for compound 8 were 14 nM and 5.6 nM while for compound 9 were 94 nM and 13 nM, respectively, for adult worm and microfilaria. These two compounds also displayed promising adulticidal activity (74.9 ± 4.8% and 69.4 ± 2.8%, respectively) in the primary rodent (jird) screen. This study also serves as a starting point for investigating structure-activity relationship with different amino substituents.

Genomic insights into the fate of colistin resistance and Acinetobacter baumannii during patient treatment.

Bacterial whole-genome sequencing (WGS) of human pathogens has provided unprecedented insights into the evolution of antibiotic resistance. Most studies have focused on identification of resistance mutations, leaving one to speculate on the fate of these mutants once the antibiotic selective pressure is removed. We performed WGS on longitudinal isolates of Acinetobacter baumannii from patients undergoing colistin treatment, and upon subsequent drug withdrawal. In each of the four patients, colistin resistance evolved via mutations at the pmr locus. Upon colistin withdrawal, an ancestral susceptible strain outcompeted resistant isolates in three of the four cases. In the final case, resistance was also lost, but by a compensatory inactivating mutation in the transcriptional regulator of the pmr locus. Notably, this inactivating mutation reduced the probability of reacquiring colistin resistance when subsequently challenged in vitro. On face value, these results supported an in vivo fitness cost preventing the evolution of stable colistin resistance. However, more careful analysis of WGS data identified genomic evidence for stable colistin resistance undetected by clinical microbiological assays. Transcriptional studies validated this genomic hypothesis, showing increased pmr expression of the initial isolate. Moreover, altering the environmental growth conditions of the clinical assay recapitulated the classification as colistin resistant. Additional targeted sequencing revealed that this isolate evolved undetected in a patient undergoing colistin treatment, and was then transmitted to other hospitalized patients, further demonstrating its stability in the absence of colistin. This study provides a unique window into mutational pathways taken in response to antibiotic pressure in vivo, and demonstrates the potential for genome sequence data to predict resistance phenotypes.

Galactolipids from Bauhinia racemosa as a new class of antifilarial agents against human lymphatic filarial parasite, Brugia malayi.

Bioassay guided fractionation of ethanolic extract of the leaves of Bauhinia racemosa led to the isolation of galactolipid and catechin class of the compounds (1-7) from the most active n-butanol fraction (F4). Among the active galactolipids, 1 emerged as the lead molecule which was active on both forms of lymphatic filarial parasite, Brugia malayi. It was found to be better than the standard drug ivermectin and diethylcarbamazine (DEC) in terms of dose and efficacy.

Pharmacognostic evaluation of Cayratia trifolia (Linn.) leaf.

OBJECTIVE: To present a detailed pharmacognostic study of the leaf of Cayratia trifolia (C. trifolia) Linn. (Vitaceae), an important plant in the Indian system of medicine. METHODS: The macroscopy, microscopy, physiochemical analysis, preliminary testing, fluorescence analysis of powder of the plant and other WHO recommended methods for standardization were investigated. RESULTS: Leaves are trifoliolated with petioles (2-3 cm) long. Leaflets are ovate to oblong-ovate, (2-8 cm) long, (1.5-5 cm) wide, pointed at the tip. The leaf surface shows the anisocytic type stomata covered with guard cells followed by epidermis layer. Leaf surface contents including veins, vein islet and vein termination were also determined. Transverse section of leaf shows the epidermis layer followed by cuticle layer and vascular bandles (xylem and phloem). The mesophyll is differentiated into palisade and spongy parenchyma. Abundant covering trichomes emerge from the upper epidermis. Trichomes are uniseriate and multicellular. Strips of collenchyma are present below and upper layer of epidermis. CONCLUSIONS: It can be concluded that the pharmacognostic profile of the C. trifolia is helpful in developing standards for quality, purity and sample identification.

Antidiabetic activity of methanolic bark extract of Albizia odoratissima Benth. in alloxan induced diabetic albino mice.

OBJECTIVE: To evaluate the antidiabetic potential of methanolic extract of Albizia odoratissima Benth. bark in alloxan induced diabetic mice. METHODS: Group-I (normal control) mice received only basal diet without any treatment. In Group- II (Diabetic control) mice, diabetes was induced by alloxan (150 mg/kg i.p.) and received only Tween 80, 5% v/v in normal saline. Group- III and Group- IV mice received metformin (10mg/kg) and gliclazide (10 mg/kg) as standard drugs. Group- V and VI mice received methanolic bark extract of Albizia odoratissimaat doses of 250 and 500 mg/kg body weight p.o., respectively. RESULTS: The results of the study indicates that Albizia odoratissima bark extract significantly (P<0.01) reduced the blood sugar level. The bark extract also significantly reduced the levels of serum cholesterol, triglycerides, serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, alkaline phosphatase and decreases level of total proteins in alloxan induced diabetic mice. CONCLUSIONS: Methanolic extract of Albizia odoratissima has protective effects on the protection of vital tissues (pancreas, kidney, liver, heart and spleen), thereby reducing the causation of diabetes in experimental animals.

Assessment of cell viability, lipid peroxidation and quantification of DNA fragmentation after the treatment of anticancerous drug mitomycin C and curcumin in cultured human blood lymphocytes.

Mitomycin C (MMC) is an antineoplastic agent used to fight a number of different cancers including cancer of the stomach, colon, rectum, pancreas, breast, lung, uterus, cervix, bladder, head, neck, eye and oesophagus. It is a potent DNA cross-linker. The prolonged use of the drug may result in permanent bone marrow damage and other various types of secondary tumors in normal cells. The toxic effect of anticancerous drugs may be reduced if supplemented with natural antioxidants/plant products. With this view, the effect of 5, 10 and 15 microM of curcumin was studied against the genotoxic doses of MMC, i.e. 10 and 20 microM, in cultured human lymphocytes using cell viability, lipid peroxidation and DNA damage quantification as parameters. The treatment of curcumin with MMC results in a significant dose-dependent increase in cell viability and decrease in lipid peroxidation and DNA damage suggesting a protective role of curcumin against the anticancerous drug mitomycin C.

Detection and spread of Escherichia coli possessing the plasmid-borne carbapenemase KPC-2 in Brooklyn, New York.

A carbapenem-resistant isolate of Escherichia coli was identified that possessed a 23-kb plasmid encoding Klebsiella pneumoniae carbapenemase type 2 (KPC-2). A subsequent surveillance study involving hospitals in Brooklyn, New York, revealed that, among 1417 E. coli isolates, 7 isolates (from 3 hospitals) possessed bla(KPC-2). E. coli possessing KPC-2 is emerging in our region, and improved methods for detection are urgently needed.