Lipid profile among controlled and uncontrolled type-2 diabetic patients in a rural tertiary care center: a comparative study

Background: Diabetes mellitus is one of the major health problem and endemic with rapidly increasing prevalence in both developed and developing countries. It has strong association with dyslipidaemias in relation to glycaemic control and duration of the disease. Dyslipidaemias make diabetic patients more susceptible to coronary artery disease (CAD) which is the major cause of increased mortality and morbidity. Objectives were to estimate the blood glucose levels and lipid profiles among diabetics and to compare the lipid profiles among controlled and uncontrolled diabetic subjects.Methods: A cross sectional study was done including 100 diabetic subjects aged between 40 to 60 years of either sex. Patients were classified into 2 groups with 50 subjects in each group as per their glycemic index. Group 1 was controlled diabetic patients (HbA1c?7.5%) and Group 2 was uncontrolled diabetic patients (HbA1c>7.5%). Venous blood samples were collected from the subjects. The serum was used for analyzing FBS, PPBS, HbA1c and lipid profiles.Results: FBS, PPBS, HbA1c, total cholesterol, triglycerides and LDL were more in females than male patients but the mean values were not significant statistically except FBS and total cholesterol. All the lipid parameters were elevated among uncontrolled diabetic patients compared to controlled diabetic patients which was statistically significant.Conclusions: Present study concluded that the blood glucose levels and lipid parameters were elevated among uncontrolled diabetics compared to controlled diabetics strongly depicting the co-relation between the glycemic levels and lipid abnormalities. Patients should be educated to monitor regularly and control blood glucose and lipid levels.

Ciprofloxacin induced erythema multiforme: a case report.

Erythema multiforme (EM) is an acute, self-limited, and sometimes recurring skin condition that is considered to be a type IV hypersensitivity reaction associated with certain infections, medications, and other various triggers like flavorings and preservatives, such as benzoic acid and cinnamon, immunologic disorders, such as transient selective C4 deficiency of infancy, collagen diseases, vasculitides, sarcoidosis, non-Hodgkin lymphoma, leukemia, multiple myeloma, myeloid metaplasia, and polycythemia, physical or mechanical factors, such as tattooing, radiotherapy, cold, and sunlight, foods, including salmon berries and margarine, malignancy, and hormonal. EM may be present within a wide spectrum of severity. EM minor represents a localized eruption of the skin with minimal or no mucosal involvement. According to a consensus definition, Stevens-Johnson syndrome (SJS) was separated from the EM spectrum and added to toxic epidermal necrolysis (TEN). The two spectra are now divided into the following: (1) EM consisting of erythema minor and major and (2) SJS/TEN. Ciprofloxacin is a second generation fluoroquinolone. Fluoroquinolones are rapidly bactericidal in vitro and are considerably potent against Escherichia coli and various species of Salmonella, Shigella, Enterobacter, Campylobacter, and Neisseria. Mainly used in urinary tract infections, prostatitis, sexually transmitted diseases, gastrointestinal and abdominal infections, respiratory tract infections, bone-joint and soft tissue infections. Metronidazole is a nitroimidazole antimicrobial medication used particularly for anaerobic bacteria and protozoa. It is on the World Health Organizations list of essential medicines, a list of the most important medications needed in a basic health system. Here we report the case of a 39-year-old male patient who presented with EM to the dermatology outpatient department, Adichunchanagiri Hospital and Research Centre. The patient gave a history of taking antimicrobials ciprofloxacin and metronidazole for the treatment of a non-healing wound on the right leg which he sustained in a road traffic accident. The review of the literature has revealed very rare associations of metronidazole and pantoprazole with EM, but cases of ciprofloxacininduced EM have been reported. Hence, the reported adverse drug reaction has been attributed to ciprofloxacin. In this event, casualty assessment using Naranjo’s scale revealed that ciprofloxacin was a probable cause for the adverse drug reaction.

Effect of oxidative stress on serum and antioxidant enzymes in liver and kidney of rats and their modulation through dietary factors.

Modulatory effect of a formulated diet based on cereals, pulses and spices incorporated with crude palm oil (CPO), soybean oil (SBO) or cod liver oil (CLO) at 10% dietary level on oxidative stress and antioxidant enzymes was studied in liver and kidney tissues. Activity of alkaline phosphatase (ALP) and acid phosphatase (ACP) increased significantly in serum in various experimental groups. Significant increase in hepatic antioxidant enzymes, catalase, glutathione peroxidase (GPx) was also seen in the experimental groups. SOD activity showed a mixed response. Further, kidney antioxidant enzymes did not show much change compared to those in liver. The results indicated dietary lipid as the key players in determining cellular susceptibility to oxidative stress, which could be modulated by cereals, pulses and spices in the diet.

Assessment of protein quality of infant milk food formula supplemented with lactulose.

To examine the protein quality of infant food formula supplemented with lactulose (bifidogenic factor), groups of 21 day male weanling rats were fed diet containing lactulose at 0.5% for 4 weeks. The gain in body weight of rats fed lactulose supplemented diet were similar to that of rats fed lactulose free and skim milk powder fed diet as controls. No difference in overall acceptability pattern was also observed in studies conducted with human subjects for organoleptic evaluation. The results suggest that supplementation of lactulose in infant food formula does not affect either the protein quality as indicated by protein efficiency ratio in rats as compared to control formulae or overall acceptability by human subjects.

Long-term feeding effect of thermally oxidised oils on antioxidant enzymes in rats.

Long term feeding effect of thermally oxidised oils on activities of hepatic antioxidant enzymes viz. catalase, glutathione peroxidase (GPX), glutathione-S-transferase (GST) and superoxide dismutase (SOD) at 5 and 20% level for 20 weeks was studied in laboratory rats. Activity of catalase increased in heated and fried oil fed group of rats, whereas activities of GPX, GST and SOD decreased in both heated and fried oil groups. Increase or decrease in activities of these enzymes may be related to several factors like heating and frying conditions, nature of fat, extent of peroxidation, presence of antioxidants, duration of feeding, beside other factors.

Absence of in vivo mutagenic potency of heated and fried oils in mice.

The mutagenic potency of heated and fried oils (under laboratory conditions), viz. peanut, sesame and coconut oils were studied employing two well validated in vivo mammalian assays, viz. bone marrow micronucleus assay and the sperm morphology assay in albino mice. In the bone marrow micronucleus assay oral doses of fresh, heated and fried oils (7.5 ml and 30.0 ml/kg body weight) did not induce any increase in the incidence of micronucleated polychromatic erythrocytes. Intragastric administration of oils at the highest dose (30.0 ml/kg body weight/day) for 5 consecutive days in male mice did not produce any morphological effect either on the testicular or epididymal weights and histology. No significant alterations were observed in the caudal sperm counts at any of the sampling intervals and also there was no treatment related increase in the incidence of sperm head abnormalities. It is concluded that controlled thermal treatment as well frying of these oils did not produce appreciable amount of mutagens which could be detected under in vivo situations.