Curcumin Mediated Gold Nanoparticles and Analysis of its Antioxidant, Anti-inflammatory, Antimicrobial Activity Against Oral Pathogens

ABSTRACT Objective: To green synthesise gold nanoparticles using curcumin and to analyse its antioxidant, anti-inflammatory, and antimicrobial activity among oral pathogens. Material and Methods: Biosynthesised Curcumin Gold nanoparticles (CuAuNP) were evaluated by UV-visible spectrophotometer (UV-Vis), Transmission Electron Microscopy (TEM), and evaluation of antioxidant, anti-inflammatory and antibacterial activity against oral pathogens. Results: Synthesized CuAuNP were characterized using UV-visible spectrophotometry and showed peak absorption at 530nm. CuAuNp showed a 90.3% maximum scavenging ability of DPPH at a concentration of 50 μg/mL. CuAuNP exhibited 79.6 % of the highest anti-inflammatory activity at 50μg/mL than the standard drug diclofenac. TEM image clearly showed uniformly dispersed spherical-shaped gold nanoparticles with a size of about 20 nm. The biosynthesized nanoparticle was tested for its antimicrobial effect, and it showed a potent effect against S. aureus, E. faecalis, and C. albicans at 100µg/ mL. Enterococcus faecalis has a maximum zone of inhibition of 14 mm at 100µg/ mL of CuAuNp. Among gram-positive bacteria, a maximum zone of inhibition of 12 mm at 100µg/ mL was seen in S. aureus compared to S mutans. Candida albicans showed a maximum zone of inhibition of 18 mm at 25 μg/mL of CuAuNp. Conclusion: Curcumin-mediated gold nanoparticles with 20 nm size were effective and had strong antioxidant and anti-inflammatory activity at 50µg/ mL, antimicrobial action inhibiting microbes at 100µg/mL concentration that can be used in treating various Oral mucosal lesions.

“Oral Manifestations of HIV in Accordance with CD4 Count” – A Cross-Sectional Study

Aims and Objectives: Mouth acts as a mirror for most of the underlying systemic diseases. Very few studies were done in south Indian population to observe the oral manifestations of human immunodeficiency virus (HIV) in relation to the cluster of differentiation 4 (CD4) count, and this study mainly highlights the presenting complaint of HIV patients during their dental visit. The study was aimed to determine the chief complaints of patients along with oral manifestations of HIV and correlate them to CD4 count. Materials and Methods: One hundred consecutive HIV?positive patients were considered for the study. All the oral manifestations and the chief complaints along with the calculated CD4 counts were noted and the results were correlated. Spearman correlation was used for CD4 count and other oral manifestations. Results: The mean CD4 counts were 421 cells/mm3 with a standard deviation (SD) of 404.34 for the most common oral manifestation of burning mouth and 176.5 cells/mm3 for the least common manifestation of malignancies. The CD4 count ranged from 120 to 1100 cells/mm3. The mean age and CD4 count were 38 years and 398.86, respectively. There was a statistically significant correlation with candidiasis and gingivitis, and the rest of the conditions were insignificant. Conclusion: The study results suggest that the chief complaint of presentation of an HIV?positive patient is pain due to carious teeth/abscess followed by burning mouth, with candidiasis being the most common disease.

Glycemic Control and its Determinants among People with Type 2 Diabetes Mellitus in Ernakulam District, Kerala

Background: Diabetes is a public health problem of colossal proportions. The National Family Health Survey 5 (2019–2020) has found high blood sugar levels among 13.5% of women and 15.6% of men in India. The high morbidity and mortality in diabetes mellitus are due to uncontrolled hyperglycemia resulting in micro- and macrovascular changes affecting multiple organs in the body. The objectives of this study were to estimate glycemic control and its determinants among type 2 diabetics in the Ernakulam district. Methods: A community-based cross?sectional study was conducted among 364 type 2 diabetics who had the disease for at least 5 years duration in the Ernakulam district of Kerala. Probability proportional to size cluster sampling technique was adopted. A semi-structured questionnaire was used to collect sociodemographic and behavioral profiles. Participants’ HbA1c levels were assessed to determine glycemic control. Results: The proportion of people with good glycemic control was 21.4%. Determinants such as female gender adjusted odds ratio (aOR = 2.36, P = 0.005), body mass index >23 kg/m² (aOR = 2.71, P = 0.002), combined drug treatment with Oral Hypoglycaemic agents (OHA) and insulin (aOR = 3.76, P = 0.004), and poor compliance with medications (aOR = 1.93, P = 0.030) were found to be significantly associated with poor glycemic control. Conclusions: Poor compliance with medications and unhealthy lifestyle choices has resulted in a high proportion of diabetics with poor glycemic control in the district. Women are particularly more vulnerable to uncontrolled hyperglycemia than males. Type 2 diabetes mellitus people should be encouraged to maintain strict glycemic control, which is an important measure for secondary prevention of complications.

Seroconversion and Side Effects After COVID Vaccination Among Persons with Type 2 Diabetes in Urban, Rural, and Tribal Areas in Kerala, India

Background: Persons with type 2 diabetes mellitus (T2DM) are at high?risk for COVID?19 infection and are a priority group for vaccination. Objectives: The objective of this study is to estimate the seroconversion and determine the side effects after COVID?19 vaccination among persons with T2DM in urban, rural, and tribal areas in Kerala. Methods: A cross-sectional study was conducted in urban, rural, and tribal field practice areas of a medical college in Central Kerala, among 396 persons with T2DM. The participants were selected by simple random sampling from the 200–250 diabetic patients visiting each health center. Qualitative and quantitative estimation of antibodies were done by WANTAI Ab enzyme?linked immunosorbent assay kit and Abbott SARS COV?2 IgG Quantitative assay, respectively. Results: The mean age of the respondents was 59.40 ± 12.25 years. A majority (65.5%) had received both doses of vaccine. About half (51.5%) experienced side effects after vaccination. Antibodies (IgG or IgM) were detected in 93.2% (95% confidence interval [CI] 90.2, 95.5) of participants. Those with a duration of diabetes ?5 years, with a single dose of vaccine, were five times (adjusted odds ratio [aOR] – 5.23,95% CI 1.86, 14.66) and four times (aOR – 4.11, 95% CI 1.66, 10.13) more likely, respectively, to be seronegative. Those who took medication for diabetes were protected against a no antibody (aOR – 0.05, 95% CI 0.02, 0.148) response. The median antibody titer in a subset (150) of participants was 365.2 (90–1587) AU/ml. Past COVID infection was an independent determinant of high IgG titers (aOR – 4.95, 95% CI 1.50, 16.36). Conclusion: Reinforcing the importance of vaccination particularly among those with longer duration of diabetes is imperative.

Stress Resilience among caregivers of patients with mental illness during Covid 19 pandemic

Background: COVID 19 has brought daily life to a standstill for almost all population across the world. The pandemic is a source of unexpected stress. The pandemic is causing huge pressures on all people. Resilience can help us to get through and overcome stressful hardship. Methodology: The present qualitative descriptive study conducted among caregivers of patients with mental illness at the inpatient and outpatient department of Amrita Institute of Medical Sciences, Kochi. The main objective of the study was to determine the level of stress resilience among caregivers of patients with mental illness. Secondary objectives were to find association of level of stress resilience among caregivers with various mental illness and to find the association of level of stress resilience and selected demographic characteristics. Tools used for data collection are Demographic data collection tool and Connor Davidson Stress Resilience scale. Totally 132 samples were collected using purposive sampling technique. Results: 4.54% of the respondents scores between 26 -50 points (first intermediate resilience), 53.78% of respondents scores between 51 -75 points (second intermediate resilience) and 41.66 % of respondents scores between 76- 100 points (highest resilience). None of the respondents shows lowest resilience (0-25 points). The study results reveal that most of the respondents shows second intermediate resilience towards stress. Conclusion: The study arouses a need for adopting coping strategies to improve the quality of life of caregivers. For improving the resilience, interventions like stress coping skill training or counseling services can be adopted.

Profile of Health Care Workers Infected with SARS-CoV-2 Infection in a Central District in Kerala with Focus on Infection Control Practices

There were reports of severe acute respiratory syndrome coronavirus 2 infection cases among health?care workers from all around the world. We did a cross sectional study among 533 COVID19 affected health?care workers. About 87.43% of participants were involved in duties not directly related to COVID?19 management. About 19.6% contracted the disease from their colleagues. About 15% of the affected health?care workers had at least one comorbidity and diabetes mellitus was the most common (5%). 57% of participants presented with fever followed by body ache in 40%. Only 0.4% of the participants needed ventilator support during treatment. 36% of the participants reported household transmission from them. Adequate personal protective equipment (PPE) usage and functioning infection control committee in their hospital were reported by most of the participants. The study points towards the need of adequate PPE use in the nonCOVID settings and the need for periodical assessment of infection control practices.

Eating Behaviour and Body Mass Index of Patients with Severe Mental Illness Attending a Tertiary Hospital, Kochi, Kerala.

Background: Persons with severe mental illness are at increased risk of overweight and obesity both from the illness itself and from its treatment. Purpose: This study aimed to examine the eating behaviour and Body Mass Index (BMI) of patients with severe mental illness and to correlate these two variables. Methods: This descriptive cross sectional study was conducted at the psychiatry outpatient department of a tertiary hospital, Kochi, among 100 patients with severe mental illness who reported for follow up. Patients were interviewed individually after ethical procedures, using Personal information schedule and Three Factor Eating Questionnaire Revised-18, a standardized measure of eating behaviours. Anthropometric measurements were taken and BMI was calculated as per the WHO guideline for Asians. Results: The mean age and BMI of the sample were 49.5± 15.24 and 26.08 ± 4.79 kg/m2 respectively. Cognitive restraint was found to be the most frequently used eating behaviour (48%). Only 39% of the subjects had normal body weight. Overweight and obesity were observed in 39% and 19% respectively. BMI was positively correlated with uncontrolled eating (r=0.244, p<0.015), emotional eating (r=0.223, p<0.026) and eating behavior total score (r=0.293, p<0.003). Uncontrolled eating was high in patients who are non-vegetarian, taking thyroid medications and who reported parental obesity (p<0.05). Stepwise linear regressions revealed parental obesity as the most significant predictor of BMI (F=4.198, p<0.002). Conclusion: The chronic mentally ill require counseling and education about the role of eating behaviours in overweight and obesity and the ways of reducing body weight.

Changes in Cardiovascular system among smokeless tobacco users attending tertiary care hospital in Andhra Pradesh, India

Background: Tobacco can be consumed as cigarettes and also as smokeless tobacco. Smokeless tobacco is a harmful tobacco product that contains over 3,000 chemicals, 7 including 28 known carcinogens (cancer-causing agents). Various forms of smokeless tobacco (mainly snuff and chewing tobacco) cause an immediate increase in heart rate and blood pressure. However, the relationship between smokeless tobacco uses on blood pressure remains unknown, especially in tertiary level hospitals. Our aim is to find out the smokeless tobacco use influence on cardiovascular parameters, for instance, pulse rate and blood pressure. Methods: This cross-sectional study was carried out to assess cardiovascular changes among adult male smokeless tobacco (ST) users. For this purpose, 50 male respondents were selected. The participants were selected from the medicine outpatient department of Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh. Pulse rate and blood pressure were measured and ST uses behavior was assessed using self-reports. Statistical analysis was done by SPSS20. Results: In this study, the mean (±SD) of pulse rate was 83.2±12.3 beats/min. The mean (±SD) of systolic blood pressure was 158.72±24.84 mm of Hg and the mean (±SD) of diastolic blood pressure was 98.78±9.87 mm of Hg in smokeless tobacco users. Conclusion: Mean systolic and diastolic blood pressures were higher in smokeless tobacco users in the tertiary level hospital. However, the mean pulse rate was within the normal range.

Vitamin D3 effect on Albuminuria in Type 2 Diabetes Mellitus patients in Northern Andhra Pradesh, India

Introduction: Vitamin D deficiency is a common disorder in diabetic patients and may be a risk factor for the progression of diabetic nephropathy. The present study aimed to assess the effects of a large dose of parenteral. Vitamin D on 24 hours albuminuria in T2DM patients. Methods: This prospective single-center study included 80 vitamin D deficient [25(OH) D <50 nmol/l] T2DM patients with an adequate glycemic control (HbA1c< 7.0%). Without any changes in anti-hyperglycemic or antihypertensive drugs, these patients were given a single high dose (600000 IU) of parenteral Vitamin D3. Then the changes in Vitamin D levels and 24 hours albuminuria were seen on follow up at 3 months. Results: Vitamin D3 supplementation improved 24 hours albuminuria. In the present study, Twenty-four-hour urinary albumin excretion decreased from 210.4 ± 101.2 to 204.6 ± 104.5. In males, it changed from 221.8 ± 99.7 to 216.1 ± 100.3 and in females, it changed from 192.3 ± 108.5 to 186.7 ± 113.1. There was a negative association of albuminuria with Vit D levels in the present study. Conclusion: Vitamin D3 supplementation significantly reduces 24-hour urinary albumin excretion in T2DM patients with Vitamin D3 deficiency.

Assessment of Nicotine Dependence Using Fagerstrom Test among Patients with Leukoplakia and Oral Submucous Fibrosis

Tobacco consumption has an influence on the oral mucosa and causes oral malignancy in the due time. On assessing nicotine dependence, appropriate counselling can be given to prevent further progression of the habit. Aim of this study was to assess the nicotine dependence levels among patients with potentially malignant disorders such as leukoplakia and Oral Submucous Fibrosis (OSMF) using fagerstrom test. This study included 140 patients from October 2019 to January 2020 in a dental hospital. Variables such as age, gender, tobacco form and lesion were assessed. Descriptive and chi square statistics were performed. Out of 140 patients, higher prevalence with tobacco usage were among 41-50 years (40%), 94.29% were males and 5.71% were females, 16.43% had low dependency, 52.86% had medium dependency and 30.71% had high dependency. Association between   age; nicotine dependency in patients with and without lesion p=0.000(p<0.05), statistically significant. Association between gender and patients with and without lesions p=0.151(p>0.05), statistically not significant. Within the limitations of the present study, males had higher prevalence of tobacco use among 41-50 years. Patients with potentially malignant disorders and smokers without lesion had medium dependence while smokeless tobacco users without lesion had a high dependence

Detection of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Desi Chickens in Andhra Pradesh

A total of 150 cloacal swabs were collected from desi chickens, 217 Enterobacteriaceae isolates were identified. The phenotypic antimicrobial resistance among Enterobacteriaceae was studied for 14 selected antibiotics by disc diffusion method. The selection of antibiotics was based on usage of antibiotics in commercial poultry farms and also based on priority of critically important antibiotics in humans. All Enterobacteriaceae isolates were subjected to multiplex PCR - I and II for detection of blaTEM, blaSHV and blaOXA genes and blaCTX-M, group 1 and 2 genes. Predominant β- Lactamase genes in gut microbiota of desi chicken include blaTEM (90.55%) followed by blaCTX-M group I (25.86%) and blaSHV (9.44%) genes. All the samples were found to be negative for blaOXA and blaCTX-M group 2 genes

Knowledge and preventive practices regarding dengue in an urban area of Palakkad

Background: Dengue is the most rapidly spreading viral disease in the world. Kerala had reported high incidence of dengue cases recently including deaths. Integrated vector management is the most effective method of vector control which requires community participation. As high incidence of dengue cases are reported in Palakkad district, it is imperative to assess the knowledge level and preventive practices followed by the community. This will help to formulate further action plans including awareness creation and behaviour change.Methods: A cross sectional study was conducted in two randomly selected wards of Palakkad municipality from July to August 2017. An adult from each household was interviewed using a semi-structured questionnaire. The household and its surroundings were also observed to identify breeding sources and calculate relevant vector indices.Results: 95.9% of informants knew that dengue is transmitted through bite of infected mosquito. 67.8% felt that dengue mosquito bites during the daytime. 53.0% of the families observed dry day practices. 15.8% used mosquito repellent creams and only 25.9% used mosquito nets. The house index, container index and breteau index were found to be 24.60%, 23.55% and 33.43% respectively.Conclusions: The awareness regarding modes of transmission and biting time of Aedes mosquito is good but the usage of personal protective measures is quite low. Although majority of the respondents had knowledge about breeding places, there were significant numbers of breeding sources especially plastic containers. Vector indices were also high indicating risk of transmission of dengue.

Neutralizing potential of Rauvolfia serpentina root extract against Naja naja venom

Snake bites are a serious health hazard occurs throughout the world especially in tropical countries like India. Anti-Snake Venom Serum is the only remedy available to treat snake bite victims successfully till date. Infusion of ASV may lead to adverse reactions ranging from severe itching of the skin, hives to potentially serious allergic reactions. Considering all above difficulties research workers all over the world is constantly in search of a cheap and readily available easy formulate remedy for treating snake bite victims. In present study aqueous extract of Rauvolfia serpentina root was checked for the antidote properties against Naja naja venom by in vitro and in vivo methods. Various in vitro neutralization tests like Acetyl cholinesterase, Protease and ATPase activity of Naja naja venom were carried out and the root extract was neutralized all the toxic effects induced by the venom. The in vivo assessment of venom lethality (LD50) of Naja naja venom was found to be 0.301 µg. The aqueous root extract was effectively neutralized the venom lethality and effective dose (ED50) was found to be 12.88 mg/ 3LD50 of Naja naja venom. LC-MS analysis from root extract of Rauvolfia serpentina was done for confirmation of the bioactive compounds.

A Comparative Evaluation Of The Efficacy Of Garlic And Propolis Extracts Against Candida Albicans With Amphotericin-B As Control - An In-Vitro Study.

Introduction: -Oral candidiasis is an infection of oral cavity caused by an over growth of candida species. The proportions of yeast in the periodontal pockets are similar to some of periodontal bacteria, thus suggesting the possible role of Candida species in pathogenesis of periodontal pocket. The plant extract such as garlic and propolis, contain bioactive components which act against these organisms with no or less side effects than by the conventional antibiotics. Objectives: - To evaluate the efficacy of garlic and propolis extracts against candida albicans and compare it with Amphotericin-B as control at 3 different concentrations Methodology: - Subgingival plaque samples were collected and selectively cultivated for candida albicans. The antimicrobial activity of propolis and garlic was assessed and compared with Amphotericin-B. Conclusion: Garlic extract can be used as a potent agent in the eradication of candida albicans in chronic periodontitis patient.

Congenital chylous ascites: a case report

Due to the rarity of congenital chylous ascites and the lack of standards in diagnosis and therapy, this disease constitutes a medical challenge and individual therapy seems to be extremely important. A late preterm newborn with antenatally diagnosed ascites was born and chylous ascites was diagnosed after feeds were started. The baby was managed initially with nil per oral, parenteral nutrition and octreotide, followed by adding MCT formula feeds. Considering the rarity of neonatal chylous ascites and the non-uniformity in management plans and follow up, more case reports need to be published. Also, MCT formula, the main stay of management has to be discontinued as soon as possible with gradual introduction into breast feeds or normal newborn formula milk as long chain fatty acids are essential for optimal brain growth in newborns.

Immunization coverage under universal immunization programme in Kozhikode district, Kerala

Background: Immunization is an important cost effective tool for preventing the morbidities and mortalities caused by vaccine preventable diseases. The objectives of this study were to assess the universal immunization programme coverage of children of 12–23 months of age in Kozhikode district and to study the factors associated with immunization coverage.Methods: A cross sectional study was conducted in 30 randomly selected electoral wards of Kozhikode district which were selected using multi stage cluster sampling technique during April 2013 to May 2014.Results: 469 children were studied from 30 clusters. 75.5% was fully immunized while 1.5% was unimmunized. Dropout rate for DPT 3 to Measles was the highest accounting to 20.2%. Most common reason for failure of immunization among unimmunized was that the parents didn’t feel the need (57.1%) and for partially immunized was the illness of the child (27.8%) followed by lack of awareness of the time of immunization (22.2%). Religion, early age of the mother at marriage and first delivery and high birth order were significantly associated with a higher proportion of partially immunized while higher education of the parents (>12th standard), health worker’s home visit in the first year of the child and presence of immunization card were significantly associated with a high full immunization coverage (p<0.05).Conclusions: Immunization coverage of 75.5% is far behind the target to be achieved. 1.5% of the children didn’t get any of the vaccinations. It is very important to increases the coverage to prevent the re-emergence of vaccine preventable diseases.

Evaluating the performance of ASHA workers in rural and tribal areas in Kurnool division of Kurnool district, Andhra Pradesh

Background: ASHA is a health activist in the communities who creates awareness on health and its social determinants and mobilizes the community towards local health planning and increased utilization and accountability of the existing health services. This study was conducted with the aim of evaluating the work performance of ASHAs in tribal and remote rural areas in Kurnool division of Kurnool district.Methods: This is a community based observational and cross sectional study carried out from July 2014 to July 2015. Six PHCs of Atmakur CHNC namely Kottalcheruvu, Bairluty, Kothapally, Yerramattam, Gokavaram, Pamulapadu were selected for the study by using multistage random sampling technique. 65 ASHAs from 20 SCs of these six PHCs had participated in the study for evaluation of their performance in the field.Results: Majority of ASHAs had average level of the performance in counselling of antenatal cases, escorting postnatal cases, motivating cases for family planning adoption, escorting family planning cases whereas the performance level was found to be good among majority of ASHAs with regard to escorting antenatal cases, counselling of postnatal cases and getting children immunized. Majority of ASHAs were not performing activities regarding creating awareness on social determinants of health, providing primary medical care for minor ailments, informing births and deaths to SC/PHC, distributing ORS, IFA and chloroquine.Conclusions: Regular on job training as well as review training for ASHAs every 6 months helps them to increase their participation in various activities with a rejuvenated enthusiasm. The incentives for ASHA must be raised and paid promptly to them to improve their performance.

Study on awareness regarding snake bite hazards among people working in agriculture sector and health education about preventive and first aid measures

Background: Snake bite is a common medical emergency and an occupational hazard, more so in tropical India, where farming is a major source of employment. In India alone, it has been estimated that as many as 2.8 million people are bitten by snakes, and 46 900 people die from snakebite every year. The objective of the present study is to study the awareness about hazards of snake bite and to educate about preventive and first aid measures for snake bite.Methods: This study was a community based longitudinal study conducted in 7 villages near Kurnool town. The sample size was 230. From each agriculture workers after obtaining consent pre-test was done to know their awareness regarding hazards of snake bites in agriculture fields and preventive and first aid measures in each village followed by post-test after health education.Results: In this study 230 agriculture workers were participated. Among them 108 (46.95%) were males and 122 (53.1%) were females. Most of the study population were in the age group of 31-40 years (36.9%). Using torch during nights was 68.7% it was increased significantly to 83% after health education, using foot wear was only in 30.4% and increased significantly to 100%, using stick was in 76% and increased to 100% significantly.Conclusions: The practice of using torch, wearing footwear, using stick while on field, avoid sleeping on ground in the field were significantly improved after health education. The first aid measure measures after snake bite like immobilization of bitten limb, reassure the person bitten by snake, avoid suctioning, avoiding tourniquet were also improved significantly after health education.

A KAP study on water, sanitation and hygiene among residents of Parla village, Kurnool district, Andhra Pradesh

Background: Ensuring access to safe drinking water and sanitation for rural people is the key catalyst for economic and human growth. However extreme poverty inhibits a significant portion of rural population from getting access to sanitation facilities and safe drinking water services. The study was conducted to assess knowledge, attitudes and Practices (KAP) with regard to water, sanitation and hygienic practices and to identify the socio-demographic factors in relation. Methods: A cross-sectional study sample comprising of 236 households was conducted in the rural field practice area after obtaining Institutional Ethics Committee approval. Proportionate sample of 20% households were taken from each ward and houses were selected by systematic random sampling method. Knowledge, attitude and practices regarding water, sanitation and hygiene were assessed using pretested semi-structured questionnaire. Results: Out of 236 households majority interviewed were females 169 (71.6%), illiterate (54.2%) and unskilled workers 122 (51.7%) belonging to class V socio-economic status 165 (69.9%). Household lavatory is absent in 114 (48.3%) households. Out of 122 (51.7%) households having sanitary lavatories only 59 (48.4%) were fully utilizing them remaining 63 (51.6%) households were going to open defecation even though sanitary lavatory was present. A significant association between defecation practice and socio-economic status, education were observed. Conclusions: This study shows that even though they have sufficient knowledge on water purification, Sanitation and hygiene this was not translated into practice because of poor attitude.

Application of multiple linear regression and machine learning algorithms to elucidate the association of poor glycemic control and hyperhomocysteinemia with microalbuminuria

Microalbuminuria is an early biomarker of general vascular dysfunction and a predictor of risk for cardiovascular and renal diseases. It is also considered as a marker of insulin resistance in both diabetic and non-diabetic patients. The rationale of this study was to elucidate threshold values of fasting blood glucose (FBS) and glycosylated hemoglobin (HbA1c) that are associated with microalbuminuria. In the parallel association of microalbuminuria with hyperhomocysteinemia was investigated. Machine learning algorithm and multiple linear regression were applied to study the association of poor glycemic control on microalbuminuria and hyperhomocysteinemia. In non-diabetic subjects with FBS <102 mg/dL and HbA1c <6.3%; and in diabetic subjects with good glycemic control (FBS: 102-118 mg/dL; HbA1c: 6.3-7.0%), urinary microalbumin levels were <40µg/mg creatinine. Poor glycemic control (FBS >172 mg/dL and HbA1c >9.0%) was associated with microalbumin >40µg/mg creatinine. Age, gender, HbA1c and FBS were shown to explain variability in urinary microalbumin to the extent of 54.4% as shown by multiple linear regression model. Analysis of variance (ANOVA) revealed higher levels of FBS (F: 39.77, P <0.0001), HbA1c (F: 64.31, P <0.0001) and total plasma homocysteine (F: 3.69, P =0.04) in microalbuminuria and clinical microalbuminuria groups when compared to subjects with normal microalbumin levels. Diabetic patients with poor glycemic index had a more B12 deficiency. Poor glycemic index and hyperhomocysteinemia were associated with clinical microalbuminuria.