management of glycemic control in associated disorders

Glycemic control is a very useful parameter for the prevention of the chronic metabolic diseases complications such as diabetes, metabolic syndrome, cardiovascular and kidney disease. Glycemic control management among chronic metabolic diseases has been an area of active research from the past decades. The glycemic index specifies that how fasting blood glucose level is elevated after consuming a high carbohydrate-containing diet. The metabolic studies among the human populations showed that glycemic index is directly related with different chronic metabolic diseases. The sturdiest associations are suggested that the low caloric diet consumption can prevents metabolic complications. Primary and tight glycemic control is compulsory to prevent and reduce the development of vascular complications in individuals with chronic disorders. The aim of this review was to provide a practical guideline on the bases of the survey of the related key studies which had reflected the clinical guidelines and current perspectives related to glycemic management. The objective of this review is also to investigate the interventions, related to glycemic control in patients with diabetes, metabolic syndrome and cardiovascular diseases. In conclusion, we can say that multidisciplinary management of glycemic control are powerful measure for the prevention of metabolic diseases complications, providing necessary support for reducing in economic burden of chronic metabolic diseases

Resistance patterns among multidrug-resistant tuberculosis patients: a multi-center study from Pakistan

Background: the high burden of multi-drug resistance tuberculosis [MDR TB] is a matter of great concern. The increasing resistance to anti tuberculosis drugs has been the area of growing concern and are posing threats to TB control. The aim of this study was to evaluate the drug resistance patterns for the first line and second line anti-Tuberculosis drugs in multiple drug resistant tuberculosis [MDR-TB] patients

Method: the study was retrospective, observational, employing purposive, non-random sampling technique for data collection conducted at the TB Clinic- of the different healthcare centers in the provinces of Pakistan Sindh and Baluchistan from December 2010 to May 2016. All bacteriologically confirmed TB patients who were found to be Rifampin Resistant [RR] on Genotypic drug susceptibility testing [GXP], or detected to be drug resistant on phenotypic Universal drug susceptibility testing were enrolled into the study

Results: out of total 3776 patients, 96.3% were resistant to Rifampicin and 94.7% were resistant to Isoniazid. 25.5% isolates were resistant to all five first line drugs. Resistances against Pyrazinamide and Ethambutol was 54.2% and 51.6% respectively. 36.3% patients were resistant to Fluoroquinolones [FQ], 9.7% were resistant to Ethionamide [Eto] and 4.1% were resistant to both FQ and Eto. 33.5% patients were MDR plus resistant to FQ. However, the resistance to both FQ plus Aminogycosides was quite low, 2.7%

Conclusion: the drug resistance rates are quiet high in MDR-TB for both first line and second line drugs. The standardized MDR TB regimen needs to be updated, based on the prevalence of drug resistance patterns in the community for the effective management of drug resistant TB

Interplay between cholesterol, SREBPs, MicroRNA-33 in dyslipidemia

Dyslipidemia is characterized by elevation of plasma cholesterol, triglycerides [TGs] or both, or a low high-density lipoprotein-cholesterol [HDL-C] level that contributes to the development of insulin resistance, Diabetes mellitus type 2 [DM2] and atherosclerosis. Dietary fat and cholesterol, genetics and other risk factors are responsible for producing variations in the lipids. The cholesterol plays a major function in the body, cholesterol homeostasis mechanism is regulated by the sterol regulatory-element binding proteins [SREBPs] and firstly introduced by Brown and Goldstein. The SREBP transcription factors act coordinately with their intronic microRNAs [miRNA-33a / miRNA-33b] to regulate both fatty acid and cholesterol homeostasis. Recently, multiple studies described microRNA-33a and SREBP2 cooperation for cholesterogenic transcription to improve intracellular cholesterol levels; suggesting that therapeutic approach of miR-33 targeting antisense would imperative for reverse cholesterol transport from atherogenic macrophages, as a result reduce atherosclerosis