Fatigue and diabetes mellitus: a prospective study

Background: Fatigue is a common complaint among patients with diabetes mellitus (DM) that can undermine the daily functional activities of a person. The objectives of the study were to assess the fatigue in patients of newly diagnosed type 2 DM and to relate fatigue with blood glucose parameters (BGP) and glycemic control.Methods: A total 50 patients of type 2 DM, diagnosed as per American Diabetes Association 2011 criteria, were enrolled in the study group. Each subject was evaluated two times for fatigue using Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) scale. 1st assessment was at the time of enrollment and 2nd was done after achieving target control of type 2 DM. Values of Fasting blood glucose (FBG), postprandial blood glucose (PPBG), blood glucose variability (BGV) and glycosylated hemoglobin (HbA1c) were obtained for each subject at each assessment. Data collected was analyzed statistically.Results: Mean age of study group was 50.7±8.9 years with male to female ratio of 1.17:1. Mean values of MFSI-SF score at 1st and 2nd assessment were 14.10±17.97 and 4.64±14.06, respectively indicating a statistically significant improvement in fatigue (p<0.05) after achieving target control. Overall fatigue, general fatigue, emotional fatigue, and vigor score correlated significantly with glycemic control (HbA1c) with correlation coefficient (r) of 0.337, 0.351, 0 .339, and - 0.281, respectively (all p <0.05).Conclusions: Fatigue had a positive correlation with FBG, PPBG and BGV and HbA1c. A significant improvement in all the parameters of fatigue was noted after control of diabetic status.

Inhaled levosimendan versus intravenous levosimendan in patients with pulmonary hypertension undergoing mitral valve replacement

Context: Inhaled levosimendan may act as selective pulmonary vasodilator and avoid systemic side effects of intravenous levosimendan, which include decrease in systemic vascular resistance (SVR) and systemic hypotension, but with same beneficial effect on pulmonary artery pressure (PAP) and right ventricular (RV) function. Aim: The aim of this study was to compare the effect of inhaled levosimendan with intravenous levosimendan in patients with pulmonary hypertension undergoing mitral valve replacement. Settings and Design: The present prospective randomized comparative study was conducted in a tertiary care hospital. Subjects and Methods: Fifty patients were randomized into two groups (n = 25). Group A: Levosimendan infusion was started immediately after coming-off of cardiopulmonary bypass and continued for 24 h at 0.1 mcg/kg/min. Group B: Total dose of levosimendan which would be given through intravenous route over 24 h was calculated and then divided into four equal parts and administered through inhalational route 6th hourly over 24 h. Hemodynamic profile (pulse rate, mean arterial pressure, pulmonary artery systolic pressure [PASP], SVR) and RV function were assessed immediately after shifting, at 1, 8, 24, and 36 h after shifting to recovery. Statistical Analysis Used: Intragroup analysis was done using paired student t-test, and unpaired student t-test was used for analysis between two groups. Results: PASP and RV-fractional area change (RV-FAC) were comparable in the two groups at different time intervals. There was a significant reduction in PASP and significant improvement in RV-FAC with both intravenous and inhalational levosimendan. SVR was significantly decreased with intravenous levosimendan, but no significant decrease in SVR was observed with inhalational levosimendan. Conclusions: Inhaled levosimendan is a selective pulmonary vasodilator. It causes decrease in PAP and improvement in RV function, without having a significant effect on SVR.

Status of Herbal Drugs in Cardiovascular Research: A Review.

Globally, cardiovascular diseases (CVD) constitute a leading cause of mortality. Heart disease in India occurs 10 to 15 years earlier than in the west. One fifth of the deaths in India are from coronary heart disease (CHD). The global burden of disease due to cardiovascular diseases (CVDs) is escalating, principally due to a sharp rise in the developing countries which are experiencing rapid health transition. More than 2000 plants have been listed in the Traditional (Herbal/Alternative) systems of medicine and some of these are providing comprehensive relief to the people suffering from cardiovascular diseases, specially “hyperlipidemia” and “ischemic heart disease”. WHO reports indicate that around eighty percent of the global population still relies on botanical drugs and several herbal medicines have advanced to clinical use in modern times. This review work explains chemical and pharmacological status of various cardioprotective plants including phytoconstituents responsible for cardioprotection, pharmacological screening model and mechanism involved in cardioprotection.

HIV positivity in TB suspects - An observational, nonrandomized study.

Aims: The present study was carried out to determine the prevalence of TB, HIV, and TB- HIV co-infection in 618 patients who attended the health institute for TB diagnosis and treatment at a rural tertiary care hospital in Punjab. Methods: Pulmonary T.B was diagnosed by sputum smear microscopy, culture and extra-pulmonary TB was diagnosed by X-ray, CT and other methods.HIV diagnosis was made by testing the sera by 3E/R/S (ELISA/RAPID/SIMPLE) tests as per NACO guidelines. Results: Of the total 618 patients, 74(12%) were patients of pulmonary TB, out of whom 72 were diagnosed by Ziehl Neelsen (ZN) staining and two were diagnosed by culture as the ZN stained smear was negative, 169(27.3%) were cases of extra-pulmonary TB. Three out of 618 were HIV positive. 1.23% were TB- HIV co-infected. Conclusion: The risk of developing TB increases in patients with HIV. So, HIV and TB programmes should be collaborated together and should be closely integrated with medical care to curb the spread of these deadly diseases.

Role of nitric oxide in cadmium-induced stress on growth, photosynthetic components and yield of Brassica napus L.

Experiments were carried out to study the effect of cadmium (Cd) and exogenous nitric oxide (NO) on growth, photosynthetic attributes, yield components and structural features of Brassica napus L. (cv. GSL 1). Cadmium in the growth medium at different levels (1, 2 and 4 Mm) retarded plant growth viz. shoot (27%) and root (51%) length as compared to control. The accumulation of total dry matter and its partitioning to different plant parts was also reduced by 31% due to Cd toxicity. Photosynthetic parameters viz., leaf area plant-1 (51%), total Chl (27%), Chl a / Chl b ratio (22%) and Hill reaction activity of chloroplasts (42%) were greatly reduced in Cd-treated plants. Cd treatments adversely affected various yield parameters viz., number of branches (23) and siliquae plant -1 (246), seed number siliqua -1 (10.3), 1000-seed weight (2.30g) and seed yield plant-1 (7.09g). Different Cd treatments also suppressed the differentiation of various tissues like vessels in the root with a maximum inhibition caused by 4mM Cd. Exogenous application of nitric oxide (NO) improved the various morpho-physiological and photosynthetic parameters in control as well as Cd- treated plants.

Phytochemical screening and antimicrobial assay of various seeds extract of cucurbitaceae family.

The present study deals with the antimicrobial activity and phytochemical screening of seeds extract of five plants of Cucurbitaceae family- Momordica charantia (Karella), Cucumis sativa (Cucumber), Praecitrullus fistulosus (Tinda), Cucurbita pepo (Kaddu), Lagenaria siceraria (loki) that are commonly available and readily consumed in India. Results of antimicrobial activity revealed that all the seeds extracts were very effective against Serratia marcescens , E. coli, Streptococcus thermophilous, Fusarium oxysporium, Trichoderma reesei while some extracts showed no inhibition against Aspergillus niger (Cucumis sativa), Candida albicans (Praecitrullus fistulosus, Cucurbita pepo, Lagenaria siceraria). Phytochemical analysis of these plants confirms the presence of various phytochemicals like tannins, cardiac glycosides, terpenoides, carbohydrates, resins, saponins and phytosterols. While other phtochemicals like alkaloids, flavonoids, glycosides, steroidal terpenes and phylobatamins were found to be absent in all the extracts. These plants can be a source of useful drugs but further studies are required to isolate the active component from the crude plant extract for proper drug development.

Selenium, a versatile trace element: current research implications.

Selenium (Se), a trace element, has evolved from its toxic properties to an essential element. Se was known a potent antioxidant through glutathione peroxidase (selenium being part of this molecule). Later, many other selenium-binding proteins were discovered and their functions were tried to be known with unsuccessful results in many cases. Se is known to be involved in carcinogenesis, immune function, male reproduction, cardiovascular diseases etc. The specific mechanism of the involvement of the element is still not known. Recent research with application of modern research tools viz. bioinformatics, cDNA microarray and transgenesis have revealed the mechanism of selenium involvement in various processes. This review highlights mysterious and useful roles of selenium in biological processes.