Significant ACE Gene Haplotype Stipulates Development of Type 2 Diabetes in Women with Gestational Diabetes Mellitus.

Introduction: Angiotensin-converting enzyme (ACE) plays a key role in glucose and insulin regulation, and in the onset of diabetes. ACE gene polymorphisms A240T, C1237T, G2350A and I/D located in the promoter, coding and non-coding regions have been studied in both type-2 diabetes and gestational diabetes mellitus (GDM). However, their impact on the development of type-2 diabetes post GDM remains unknown, especially in under-represented population. Aim: We examined possible associations and networking between ACE gene polymorphism susceptibility / protection towards/against progression of type-2 diabetes post GDM in North Indian women. Methods: Two hundred and twenty four women (n = 224) were recruited in this study and genotyped for four ACE gene polymorphisms using polymerase chain reaction (PCR), followed by digestion through restriction endonuclease enzymes. Results: Study results suggest a significant association of ACE genes SNPs A240T, C1237T, G2350A and I/D haplotype with GDM cases progressing to type-2 diabetes later in life (P =.02). Individuals possessing haplotype “CAAI” derived from these SNPs had a 3.65 fold increased risk of type-2 diabetes development in GDM cases later in life relative to other haplotypes. Conclusion: Due to its pivotal role in the pathogenesis of both diseases, the current finding might be of future therapeutic value. Larger-scale studies are required to confirm this novel finding in multi-ethnic populations.

Lyme disease in Haryana, India.

Lyme disease is a multiorgan animal‑borne disease caused by the spirochete Borrelia burgdorferi. This case series highlights its presence in Haryana, a nonendemic zone. The first case was a 27‑year‑old housewife who presented with an annular erythematous patch with a central papule following an insect bite on the left upper arm. The second case was a 32‑year‑old farmer who gave a history of insect bite on the right arm followed by the development of an erythematous patch with a central blister. The third case, a 17‑year‑old boy presented with a history of tick bite over right thigh and a typical bull’s eye lesion with central ulceration. These cases were managed with oral doxycycline 100 mg twice daily for 14 days. The fourth case was a 7‑year‑old boy with typical erythema migrans on the right check and neck while the fifth case, a 30‑year‑old housewife, presented with an erythematous patch with a central papule on the right buttock. These patients were treated with oral amoxycillin 25 mg/kg, thrice daily for 14 days. All patients showed IgM antibodies to B. burgdorferi. Treatment led to clearance of lesions in all the patients. Lyme borreliosis was diagnosed in these patients based on the history of established exposure to tick bites, presence of classic signs and symptoms, serology and the response to treatment.

Ectopic intraocular lens: An unusual complication of cataract surgery.

We wish to report an unusual complication of intraocular lens (IOL) insertion following uneventful phacoemulsification. After successful phacoemulsification surgery, a hydrophobic acrylic IOL was loaded in the injector for insertion into the capsular bag. During insertion, the IOL inadvertently extended into the corneal stromal lamella. The complication was recognized at a late stage, and the foldable acrylic lens was retrieved and reinserted correctly in the bag. The anterior chamber was made viscoelastically taut and was maintained in this state for 10 min, followed by a routine viscoelastic wash and air bubble injection. Cornea was slightly edematous with stromal haze, and the corneal thickness was 908 μm. At the 1‑month follow‑up visit, the patient’s vision was 20/40, the stromal haze had subsided, the corneal thickness was 572 μm, and the patient was comfortable. Though it was unknown complication, following proper management patient recovered satisfactorily.