Uric acid and diabetes mellitus: an update.

The relationship between diabetes mellitus (DM) and high serum uric acid is complex and controversial. Many epidemiological studies have reported a positive association, whereas others have reported an inverse association or none. In the pathogenesis of DM it is the intracellular urate that is more important than the extracellular and dissociation between the two is possible. Evidence suggests that high serum uric acid induces insulin resistance and beta cell failure in animal models. Reduction of intracellular uric acid can be achieved by dietary measures such as reducing fructose and salt intake, and uric acid-lowering drugs. We suggest that in the Western diet, these elements play a crucial role in pathogenesis of DM. To determine the precise and exact interrelationship between intracellular and extracellular uric acid, well-designed studies are required. Besides this, clinical trials are needed to determine whether intracellular and extracellular urate reduction will provide benefit in prevention and treatment of DM and complications associated with it.

Prevalence of Hypouricemia and Hyperuricemia and Looking Beyond Serum Uric Acid in Patients with Newly Onset Type 2 Diabetes Mellitus in Eastern Part of Uttar Pradesh: A Cross-sectional Study.

INTRODUCTION: The prevalence of hyperuricemia (HU) and hypouricemia (Hypo-U) is highly variable in different parts of India and there is a lack of data from the Eastern part of Uttar Pradesh. We designed this study in order to know the exact prevalence of HU and Hypo-U. MATERIALS AND METHODS: This is a cross-sectional study conducted in Varanasi. Data were collected from newly onset diabetic patients over a period of 1 year. RESULTS: Among the 312 diabetic patients, 12.5 and 19.23% were found to have HU and Hypo-U, respectively. Hypouricemic diabetic patients are phenotypically different. They are characterized by the female sex, higher glycated hemoglobin A1c (GlyHbA1c), higher estimated glomerular filtration rate (eGFR), lower body mass index (BMI), and less insulin resistance. CONCLUSION: The prevalence of HU and Hypo-U is high in newly-onset diabetic patients. Hypouricemic diabetic patients are phenotypically different. Hence routine screening of uric acid is essential for proper diagnosis and appropriate treatment of hypouricemic diabetic patients.

Prevalence of Obesity in Newly Onset Diabetes Mellitus and Its Relationship with Uric Acid: An Indian Cross-Sectional Study.

Introduction: Prevalence of obesity is high in diabetes mellitus (DM) and is associated with hyperuricemia (HU), hypertension, metabolic syndrome, cardiovascular disease and dyslipidemia. In obesity, elevated serum uric acid (SUA) has been shown to be associated in many studies from different countries, but data from India are lacking. The aim of the present study is to know the prevalence of obesity and to know the relationship between obesity and SUA in newly onset DM. Methods: In this cross-sectional study from India, 402 consecutive newly onset diabetic patients (male: 284; female: 118) were enrolled. All patients were grouped into four based on BMI (body mass index): underweight (<18.5 kg/m2), normal weight (18.5-23 kg/m2), overweight (>23-27.5 kg/m2), and obese (>27.5 kg/m2). All participants were grouped into four quartiles based on SUA (Q1: <4.23; Q2: ≥4.24-5.19; Q3: ≥5.20-6.16; Q4: >6.16). Results: The mean age, BMI and SUA of the participants were 46.20±0.52 years, 26.35±0.21 kg/m2 and 5.24±0.007 mg/dl, respectively. Overall prevalence of generalized obesity, central obesity and hyperuricemia (HU) were 35.07%, 85.82% and 13.43%, respectively. The prevalence of generalized obesity increased across the SUA quartile. A multinomial logistic regression analysis showed that serum uric acid level was independently associated with generalized obesity (p<0.001). Conclusion: This first report from India shows a significant positive association between SUA and generalized obesity among newly onset DM. Therefore, routine estimation of SUA is recommended in newly onset DM to prevent and treat HU and its related complications.

The Deadly Duo of Hypertension and Diabetes in India: Further Affirmation from a New Epidemiological Study.

We read with great interest the article "the deadly duo of hypertension and diabetes in India: further affirmation from a new epidemiological study" by Metri et al.1 They rightly pointed out that the prevalence of hypertension in Indian patients with type 2 diabetes patients is high and therefore early screening and management of hypertension should be included in the treatment of patients with type 2 diabetes. We wish to share our study findings on the prevalence of hypertension in newly onset diabetes mellitus (DM). We find that the prevalence of hypertension in all males and females with DM was 44.59, 44.34, and 45.16%, respectively.2.

Prevalence of Hyperuricemia and the Relationship Between Serum Uric Acid and Hypertension in New Onset Diabetic Patients: A Cross-Sectional Indian Study.

Objective: Prevalence of hyperuricemia (HU) is increasing and it is associated with hypertension, metabolic syndrome, diabetes mellitus (DM), obesity, chronic kidney disease, gout and cardiovascular disease. Elevated level of serum uric acid (SUA) has been shown to be associated with hypertension and diabetes in many countries but there is lack of evidence from India. The aim of this study is to know the prevalence of HU and to know the relationship between SUA and hypertension in newly onset DM. Methods: This is a cross-sectional study from a tertiary center. A total of 305 (males: 212; females: 93) newly diagnosed diabetic patients were enrolled. All patients were categorized as normotensive (<140/90) and hypertensive (≥140/90) based on ADA criteria. Based on SUA level participants were grouped into 3 tertile (T1: <4.52; T2: 4.52-5.64; T3: >5.64 mg/dl). Results: The mean age, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the patients were 46.76 ±0.61 years, 130.6±1.06 mmHg and 84.11±0.63 mmHg, respectively. The mean level of SUA was 5.14±0.073 mg/dl and level was significantly higher in males compared with females (P <0.000). Overall prevalence of HU and hypertension was 12.13% and 44.59%, respectively. There was an increase in the prevalence of hypertension across the SUA tertile. SBP and DBP significantly increased across the SUA tertile (P <0.014 and <0.001, respectively). A multiple logistic regression analysis revealed that SUA tertile was independently associated with presence of hypertension (P <0.01). Conclusion: This first report on the population of the eastern part of India indicates a significant positive relationship between SUA and hypertension among the newly onset Indian diabetic patients. Therefore, routine measurement of SUA is recommended in newly onset hypertensive diabetic patients to prevent HU and its related complications.

Elemental characterization of antlers of various deer species using X-Ray Fluorescence (XRF): A tool for forensic examination.

Antlers are unique characteristic of males of family Cervidae. It fully regenerates each year in relation to their sexual cycles. It is primarily used as weapons in intra-specific fighting or possibly as organs displaying strength. These are formed by the calcification, beneath the velvet of the fast growing pre-osseous tissue known as velvet antlers. Continuous dividing velvet antlers replace dead antlers every year through shedding. Antlers are composed primarily of minerals, protein, carbohydrates and fatty acids. Calcium and phosphorus, primarily present as hydroxyapatite [Ca5(PO4)3OH] (Chapman 1975). In India there are nine species of deer viz. Kashmir stag (Cervus elaphus), mouse deer (Tragulus meminna), musk deer (Moschus moschiferus), swamp deer (Rucervus duvaucelii), thamin (Rucervus eldii), barking deer (Muntiacus muntjak), chital (Axis axis), hog deer (Axis porcinus) and sambar (Rusa unicolor). Mouse deer and musk deer possess only canines and antler is absent in both the deer species. Previously, the export of shed antlers and peacock feathers was allowed in India. Although, antlers are not very extensive in illegal wildlife trade but artifacts of antlers and they are used for traditional medicines for treatment of various diseases in different countries. The problem of illegal trade of antlers is mainly due to the mis-declaration of its quantity. Mostly antlers of chital, sambar and swamp deer are widely traded. Visualizing the current status of some of the deer species, trade of antler in India has been recently banned. Therefore, to provide legal protection to deer and other related species accordingly brow-antlered deer (Rucervus elidii), hog deer (Axis procinus), and swamp deer (R. duvaucelii) are included in Schedule I, whereas barking deer (Muntiacus muntjak), chital (Axis axis), and sambar (R. unicolor) were in schedule III of Wildlife (Protection) Act, 1972. To strengthen the legal measures and to protect deer species, identification of antlers in complete, pieces or pulverized form is very important. Very few scientific studies deal with identification of antlers belonging to different species. Thus, present study is aimed to identify species from antlers using species specific signature using elemental analysis. Morphological features of antlers in artiodactyls often used as a diagnostic tool to identify species. Although, morphometry is very good technique to identify antlers but as malformation in antlers is common also antlers are seized either in complete form or in small pieces or powder form, therefore, identification through morphometry becomes difficult for deformed antlers or pieces. In such cases, elemental analysis is helpful. Elemental composition of antlers of different species helps in inter-species distinction. This study will help managers, scientists and enforcement agencies to identify species from parts and products of antler.

Out-patient coverage: Private sector insurance in India.

BACKGROUND: There has been a growth of 25% in the health insurance business in India during the last few years with the expansion of the private health insurance sector. The share of the private health insurance companies has increased considerably, despite the fact that from the patients' point of view, health insurance is not a good deal. AIM: To provide information and assess the current status of private sector insurance with regard to out-patient coverage in India. MATERIALS AND METHODS: The present review was conducted after doing extensive literature search of peer review journals in Pubmed and various search engines like Google. Data of Indian private health insurance companies was also utilized. No limitation in terms of publication date and language was considered. The main focus of the present review would be on the private health insurance sector with a spotlight on the out-patient coverage and various obstacles faced by the private health insurance sector. RESULTS: Out-patient (OPD) coverage is one of the important emerging trends in the private sector health insurance. OPD cover assists the insured to claim expenses other than that incurred during hospitalization. However, it is still not a full-fledged offering under health insurance and major insurance companies are providing this cover for an additional premium. CONCLUSION: Private is strongly being advocated and receiving growing consideration by our country's policy makers that can deal with alarming health care challenges in India. However, it is not the only option.

Improved catalytic activity of laser generated bimetallic and trimetallic nanoparticles.

We report synthesis of silver nanoparticles, bimetallic (Al2O3@Ag) nanoparticles and trimetallic (Al2O3@AgAu) nanoparticles by nanosecond pulse laser ablation (PLA) in deionized water. Two-step laser ablation methodologies were adopted for the synthesis of bi- and tri-metallic nanoparticles. In this method a silver or gold target was ablated in colloidal solution of γ-alumina nanoparticles prepared by PLA. The TEM image analysis of bimetallic and trimetallic particles reveals deposition of fine silver particles and Ag-Au alloy particles, respectively, on large alumina particles. The laser generated nanoparticles were tested for catalytic reduction of 4-nitrophenol to 4-aminophenol and showed excellent catalytic behaviour. The catalytic rate was greatly improved by incorporation of additional metal in silver nanoparticles. The catalytic efficiency of trimetallic Al2O3@AgAu for reduction of 4-nitrophenol to 4-aminophenol was remarkably enhanced and the catalytic reaction was completed in just 5 sec. Even at very low concentration, both Al2O3@Ag nanoparticles and Al2O3@AgAu nanoparticles showed improved rate of catalytic reduction than monometallic silver nanoparticles. Our results demonstrate that alumina particles in the solution not only provide the active sites for particle dispersion but also improve the catalytic activity.

Comparison of the effect of different medicaments on surface reproduction of two commercially available Polyvinyl Siloxane impression materials - An Invitro Study.

OBJECTIVE: To determine the effect of different retraction cord medicaments on surface detail reproduction of polyvinyl siloxane impression materials and compare this effect on any two brands of commercially available polyvinyl siloxane impression materials. MATERIAL AND METHODS: Four stainless steel dies were made according to ADA specification no.19. Three dies were treated with aluminium chloride (5%), ferric sulphate (13.3%) and epinephrine (0.1%) while the fourth one was left untreated to serve as control. Two impression materials (Dentsply and 3M ESPE) were used. RESULTS: All the three medicaments adversely affected the surface detail reproduction of both the brands of the polyvinyl siloxane impression materials. These effects were statistically significant as compared to untreated control. The impressions of 3M ESPE brand have shown better surface detail reproduction as compared to Dentsply impression material. CONCLUSION: Surface detail reproduction of the polyvinyl siloxane impression materials is adversely affected by the retraction cord medicaments. The presence of moisture or any traces of the medicaments should be removed from the tooth surface to provide a dry field for the correct reproduction of the surface detail of these materials. Key words:Polyvinyl Siloxane, retraction cord medicaments, surface detail reproduction.

Synthetic biology: regulating industry uses of new biotechnologies.

In our view, synthetic biology is an extension of the continuum of genetic science that has been used safely for more than 40 years by the biotechnology industry in the development of commercial products. Examples of synthetic biology use by biotechnology companies illustrate the potential to substantially reduce research and development time and to increase speed to market. Improvements in the speed and cost of DNA synthesis are enabling scientists to design modified bacterial chromosomes that can be used in the production of renewable chemicals, biofuels, bioproducts, renewable specialty chemicals, pharmaceutical intermediates, fine chemicals, food ingredients, and health care products. Regulatory options should support innovation and commercial development of new products while protecting the public from potential harms.

Using morphometric and analytical techniques to characterize elephant ivory.

There is a need to characterize Asian elephant ivory and compare with African ivory for controlling illegal trade and implementation of national and international laws. In this paper, we characterize ivory of Asian and African elephants using Schreger angle measurements, elemental analysis {X-ray fluorescence (XRF), inductively coupled plasma-atomic emission spectroscopy (ICP-AES), and inductively coupled plasma-mass spectroscopy (ICP-MS)} and isotopic analysis. We recorded Schreger angle characteristics of elephant ivory at three different zones in ivory samples of African (n=12) and Asian (n=28) elephants. The Schreger angle ranged from 32 degrees to 145 degrees and 30 degrees to 153 degrees in Asian and African ivory, respectively. Elemental analysis (for Asian and African ivory) by XRF, ICP-AES and ICP-MS provided preliminary data. We attempted to ascertain source of origin of Asian elephant ivory similarly as in African ivory based on isotopes of carbon, nitrogen and strontium. We determined isotopic ratios of carbon (n=31) and nitrogen (n=31) corresponding to diet and rainfall, respectively. Reference ivory samples from five areas within India were analyzed using collagen and powder sample and the latter was found more suitable for forensic analysis. During our preliminary analysis, the range of delta13C values (-13.6+/-0.15 per thousand and -25.6+/-0.15 per thousand) and delta15N values (10.2+/-0.15 per thousand and 3.5+/-0.15 per thousand) were noted.