Peroxisome proliferator-activated receptors and thiazolidinediones in diabetic nephropathy

Diabetic nephropathy is global problem with several drugs into trial without much success the current article highlights the role of thiazolidinedione’s in diabetic nephropathy by scrutinizing and reconnoitring the cellular and intracellular mechanism and shielding action and the role of peroxisome proliferator-activated gamma receptors (PPAR?) receptors. Not only anti-diabetic action but renal protective effect with evidence based study has been highlighted. PPAR ?-is versatile target having numerous benefits and mainly preventing fibrosis in diabetic experimental model and some clinical case report yet, the benefits are not up to mark, since renal failure itself causes volume expansion and the thiazolidinedione’s (TZDs) also preserve salt and water and lead to congestive heart failure which constraints its clinical application. Dual activators and balaglitazone selective PPAR modulator are having upcoming potential for treatment of diabetic nephropathy. Further detail investigation on such drug is needed to explore. However adverse effect like heart failure, osteoporosis and volume expansion effect over-rides the beneficial effect thus limiting its clinical use of currently available TZDs.

Antipathogenic potential of marine Bacillus sp. SS4 on N-acyl-homoserine-lactone-mediated virulence factors production in Pseudomonas aeruginosa (PAO1).

Antipathogenic therapy is an outcome of the quorum-sensing inhibition (QSI) mechanism, which targets autoinducerdependent virulent gene expression in bacterial pathogens. N-acyl homoserine lactone (AHL) acts as a key regulator in the production of virulence factors and biofilm formation in Pseudomonas aeruginosa PAO1 and violacein pigment production in Chromobacterium violaceum. In the present study, the marine bacterial strain SS4 showed potential QSI activity in a concentration-dependent manner (0.5–2 mg/ml) against the AHL-mediated violacein production in C. violaceum (33–86%) and biofilm formation (33–88%), total protease (20–65%), LasA protease (59– 68%), LasB elastase (36–68%), pyocyanin (17–86%) and pyoverdin productions in PAO1. The light and confocal laser scanning microscopic analyses confirmed the reduction of the biofilm-forming ability of PAO1 when treated with SS4 extract. Furthermore, the antibiofilm potential was confirmed through static biofilm ring assay, in which ethyl acetate extract of SS4 showed concentration-dependent reduction in the biofilm-forming ability of PAO1. Thus, the result of this study clearly reveals the antipathogenic and antibiofilm properties of the bacterial isolate SS4. Through 16S rDNA analysis, the strain SS4 was identified as Bacillus sp. (GenBank Accession Number: GU471751).

Treatment outcome and two and half years' follow-upstatus of new smear positive patients treated under RNTCP.

Setting: Revised National Tuberculosis Control Programme emphasizing on DOTS in the metropolitan city of Bangalore. Objective: 1) To evaluate the treatment outcome of new smear positive patients supported with pre and post-treatment bacteriological profile 2) To assess their bacteriological and clinical status two and half years after treatment initiation. Design: A prospective cohort study of 271 new smear and culture positive patients initiated on Cat I from April to December 1999 and followed up till treatment outcome and 21/2 years thereafter. Results: Treatment success (cured and treatment completed) of the study group was 67.9% as 24.7% patients defaulted from treatment. Treatment failures and deaths during treatment were 5.2% and 2.2% respectively. Initial drug susceptibility status did not influence the treatment outcome of the study group except in six patients, who were multi-drug resistant. The development of drug resistance during treatment was seen in 1.3%. The proportion of bacteriological positivity and mortality during follow up was significantly higher among patients who defaulted from treatment. Relapses during the intervening period were 11.4%. Conclusion: Fully intermittent CAT I regimen was effective in programme conditions, irrespective of the pre-treatment drug susceptibility status. Treatment success of the cohort was vitiated by a high proportion of defaults in a metropolitan city, where the programme was recently implemented. The study findings underscore the importance of strict adherence to the programme guidelines for successful treatment completion and a lasting cure.