A review on animal models for screening potential anti-stress agents

Stress is a state of threatened homeostasis that produces different physiological as well as pathological changes depending on severity, type and duration of stress. The animal models are pivotal for understanding the pathophysiology of stress-induced behavioral alterations and development of effective therapy for its optimal management. A battery of models has been developed to simulate the clinical pain conditions with diverse etiology. An ideal animal model should be able to reproduce each of the aspects of stress response and should be able to mimic the natural progression of the disease. The present review describes the different types of acute and chronic stress models including immersion in cold water with no escape, cold environment isolation, immobilization/restraint-induced stress, cold-water restraint stress, electric foot shock-induced stress, forced swimming-induced stress, food-deprived activity stress, neonatal isolation-induced stress, predatory stress, day–night light change-induced stress, noise-induced stress, model of post-traumatic stress disorder and chronic unpredictable stress models.     

Current status of low dose multi-detector CT in the urinary tract

Over the past several years,advances in the technical domain of computed tomography(CT) have influenced the trend of imaging modalities used in the clinical evaluation of the urinary system.Renal collecting systems can be illustrated more precisely with the advent of multi-detector row CT through thinner slices,high speed acquisitions,and enhanced longitudinal spatial resolution resulting in improved reformatted coronal images.On the other hand,a significant increase in exposure to ionizing radiation,especially in the radiosensitive organs,such as the gonads,is a concern with the increased utilization of urinary tract CT.In this article,we discuss the strategies and techniques availablefor reducing radiation dose for a variety of urinary tractCT protocols with metabolic clinical examples.We also reviewed CT for hematuria evaluation and related scan parameter optimization such as,reducing the number of acquisition phases,CT angiography of renal donors and lowering tube potential,when possible.     

The Ahmedabad Declaration, 2018: the family and diabetes

International Journal of Diabetes in Developing Countries - The family is the basic social unit and should be taken as the basic unit of engagement and intervention in diabetes care as well. Family...     

A novel MECP2 change in an indian boy with variant rett phenotype and congenital blindness: implications for genetic counseling and prenatal diagnosis

Mutations in MECP2 gene are the primary cause of Rett syndrome, a neurodevelopmental disorder that primarily affects girls, and affect 90% to 95% patients with classical Rett syndrome. MECP2 mutations, once thought to be lethal in males, now present a broad spectrum of clinical manifestations in males. This article reports a family with a 9-year-old boy with Rett-like phenotype and congenital blindness, who inherited a novel MECP2 variant (p.P430S) from his asymptomatic mother. The variant was also identified in the asymptomatic maternal grandfather and maternal aunts of the proband, ruling out the possibility that the p.P430S was involved in the phenotype. Findings of the study suggest that a careful evaluation of the pathogenic nature of MECP2 variants identified in males be conducted before proposing genetic counseling or prenatal diagnosis to the family and that the interference of other factors like modifier genes, environment, epigenetics, and mosaicism be taken into account.     

Endocrine Society of India management guidelines for patients with thyroid nodules: A position statement

Thyroid nodules are common. Thyroid cancer is rarer. No guidelines exist for management of thyroid nodules in the Indian context and these recommendations are intended for this purpose. The consensus committee reviewed important articles, including previously published consensus statements. Management points were scored according to the level of evidence. These guidelines cover the clinical evaluation and include the interpretation of imaging and fine needle aspiration cytology of thyroid nodules. The guidelines also cover the management of special situations like thyroid incidentalomas, cystic thyroid lesion and nodules detected during pregnancy. The consensus guidelines represent a summary of current medical evidence for thyroid nodule management and the committee has attempted to optimize the guidelines for the clinical practice setting in India.     

Choosing a gliptin

The treatment of type 2 diabetes mellitus (T2DM) has included the use of metformin and sulfonylurea (SU) as first-line anti-diabetic therapies world over since years. This remains, despite the knowledge that the combination results in a progressive decline in [beta]-cell function and by 3 years up to 50% of diabetic patients can require an additional pharmacological agent to maintain the glycosylated hemoglobin (HbA1c) <7.0% (UKPDS). Gliptins represent a novel class of agents that improve beta cell health and suppress glucagon, resulting in improved post-prandial and fasting hyperglycemia. They function by augmenting the incretin system (GLP-1 and GIP) preventing their metabolism by dipeptidyl peptidase-4 (DPP-4). Not only are they efficacious but also safe (weight neutral) and do not cause significant hypoglycemia, making it a unique class of drugs. This review focuses on gliptins (sitagliptin, vildagliptin, saxagliptin, linagliptin, and alogliptin) discussing pharmacokinetics, pharmacodynamics, efficacy, and safety.     

Pioglitazone: Indian perspective

Pioglitazone was approved in 1999 as an adjunct to exercise and diet to improve glycemic control in adults with type 2 diabetes mellitus, primarily by reducing insulin resistance. Beyond these effects on glucose metabolism, pioglitazone has positive effects on lipid metabolism, blood pressure, endothelial function, adiponectin, and C-reactive protein levels. These make pioglitazone treatment effective beyond glucose control. Pioglitazone generally has been viewed as a safer option for patients who warrant treatment with a thiazolidinedione-class drug. There has been some recent data on cancer incidence in patients on pioglitazone, which is currently being reviewed by drug regulatory authorities in the United States and in Europe. Given the benefits of pioglitazone, alone and in combination, it would be appropriate to continue judicious use of the drug in patients who may benefit from its use.