Gene Mutations in Cushing's Syndrome.

Background: Prolonged exposure to glucocorticoids can result in the development of Cushing's syndrome. Excess serum cortisol can occur due to several factors including exogenous steroids, pituitary and adrenal adenoma, and ectopic ACTH secretion. Summary: The last 2 decades have seen significant progress in identifying new genetic and molecular mechanisms underlying hypercortisolemia. This has implicated mutations seen in a multitude of aberrant pathways that underpin the pathophysiology of Cushing's syndrome. Key Messages: There is much overlap between the different, with mutations affecting well-understood molecular pathways such as the cAMP/PKA/MAPK and Wnt signalling systems. Further work should delineate the exact involvement of specific mutations in Cushing's syndrome and the effect of epigenetic/microenvironmental interactions. This could have implications for screening, as the identification of specific mutations may lead to earlier identification and subsequently improved prognosis.

Color removal from model dye effluent using PVA-GA hydrogel beads.

A low cost polyvinyl alcohol-glutaraldehyde cross-linked hydrogel beads were prepared and used for color removal from model industrial effluent containing Congo Red dye, using adsorption technique. The adsorption studies were performed using batch and fixed-bed reactor. Developed adsorbent, achieved adsorption capacity as high as ~34 mg of dye per gram of bead (condition: pH 6 and 45 °C). These beads were re-used for 7 times (many more runs possible) to remove the color from model dye effluent, without much loss in removal efficiency. Batch studies revealed a multi-layer adsorption governed by Harkins Jura model. Whereas the adsorption kinetics followed fractal like pseudo second order model, controlled by intraparticle diffusion phenomena. The fixed bed studies revealed steeper break through curves during adsorption operation when high dye influent rates and low bed height were used. This behaviour by the fixed bed reactor was best explained by the Thomas mathematical model. Studies further demonstrated that an external and internal mass diffusion become no more rate limiting during these experiments.

Role of AYUSH Therapies in Modern Medicine: A Qualitative Study to Explore the Awareness and Attitudes of Doctors Towards the Utilization of Alternate System of Medicine for Diabetes Mellitus.

OBJECTIVE: To understand doctors' attitude to and awareness of AYUSH therapies for the treatment of diabetes mellitus (DM). METHODS: This qualitative study, using a usage-and-attitude survey, was conducted in secondary centers across Mumbai, India. The study surveyed 77 physicians, including those specializing in diabetes. RESULTS: The majority of doctors were aware of Ayurveda (69%) and Homeopathy (52%). Some doctors were aware of Unani (34%) and Siddha (32%). Most doctors (60%) thought that Ayurveda was effective in some way. Almost all doctors (97%) thought that allopathic medicine was effective for DM. The majority of doctors (68%) had not recommended AYUSH therapies as an adjunct to modern medicines. Approximately half of the doctors (52%) believed that AYUSH therapies posed a safety concern for patients and 46% thought that AYUSH therapies could not be used to manage any form of DM. A large group of doctors thought that the main barrier preventing AYUSH therapies from being integrated into current allopathic management of DM was the lack of strong scientific evidence and clinical trials. CONCLUSION: The majority of doctors are aware to some degree of Ayurveda and homeopathic forms of treatment. The majority believe that AYUSH therapies pose a safety concern for patients and have no role in treatment for any form of DM. The most common barrier preventing AYUSH therapies from becoming a mainstream treatment option for DM is the lack of scientific evidence. From this sample, it seems that greater efforts are required to conduct research into the efficacy and safety of AYUSH therapies to ensure that doctors are able to provide holistic care for patients with DM.

Current perspective on the role of insulin and glucagon in the pathogenesis and treatment of type 2 diabetes mellitus.

According to the World Health Organization, 422 million adults worldwide live with diabetes mellitus (DM), a significant portion of whom have type 2 diabetes. The discovery of insulin as a key regulator of glucose metabolism has revolutionized our understanding of DM and provided several therapeutic avenues. Most studies have so far predominantly focused on the role of insulin in type 2 diabetes. However, the balance between insulin and glucagon is essential in ensuring glucose homeostasis. In this review, we begin by evaluating the principal differences between insulin and glucagon with regard to their mechanism and control of their secretion. Next, we discuss their mode of action and effects on metabolism. We further explore how the two hormones impact the natural history of type 2 diabetes. Finally, we outline how current and emerging pharmacological agents attempt to exploit the properties of insulin and glucagon to benefit patients with type 2 diabetes.