Hypoglycemic effect of gelatin microspheres with entrapped insulin and protease inhibitor in normal and diabetic rats

Insulin containing gelatin microspheres (IGM) with and without soyabean trypsin inhibitor (TI) were pre-pared and coated with enteric polymers to protect them from degradation in stomach and to release the insulin upon reaching the intestine. Four types of coated IGM were prepared: (i) IGM coated with natural polymers (chitosan inner coat-alginate outer coat), (ii) IGM-TI coated with cellulose acetate phthalate; (iii) IGM-TI coated with cellulose acetate butyrate, and (iv) IGM-TI coated with natural polymers (chitosan inner coat-alginate outer coat). The protective efficiency of uncoated and four types of coated microspheres to-ward digestive enzymes such as pepsin and trypsin was evaluated under simulated physiological conditions. The microspheres were characterized for their insulin content and particle size. The morphology of the micro-spheres was studied using scanning electron micros-copy. The in vitro release studies of insulin from uncoated and coated microspheres indicated that the release followed a zero-order pattern, prolonging for 6 days from 2 days in the case of uncoated spheres. The uncoated and coated microspheres containing insulin (20 IU/kg) were orally administered to albino Wistar rats by stomach tube, and insulin absorption was evaluated by assessing the hypoglycemic effect in normal and diabetic rats. A significant and continuous hypoglycemic effect was observed in diabetic rats following oral administration of coated IGM containing TI when compared to the effect following administration of coated IGM without TI.     

Representation of spatial frequency and orientation in the visual cortex

Knowledge of the response of the primary visual cortex to the various spatial frequencies and orientations in the visual scene should help us understand the principles by which the brain recognizes patterns. Current information about the cortical layout of spatial frequency response is still incomplete because of difficulties in recording and interpreting adequate data. Here, we report results from a study of the cat primary visual cortex in which we employed a new image-analysis method that allows improved separation of signal from noise and that we used to examine the neurooptical response of the primary visual cortex to drifting sine gratings over a range of orientations and spatial frequencies. We found that (i) the optical responses to all orientations and spatial frequencies were well approximated by weighted sums of only two pairs of basis pictures, one pair for orientation and a different pair for spatial frequency; (ii) the weightings of the two pictures in each pair were approximately in quadrature (1/4 cycle apart); and (iii) our spatial frequency data revealed a cortical map that continuously assigns different optimal spatial frequency responses to different cortical locations over the entire spatial frequency range.     

Molecular epidemiology of norovirus variants detected in children under five years of age in Hyderabad,India

PurposeNoroviruses are common viral agents in acute diarrhea in all age groups worldwide. Norovirus has been classified into 10 genogroups, GI to GX with over 48 genotypes among them the GII.4 genotype has evolved over time with a clear pattern of periodic variant replacement. Immunity is strain or genotype specific with little or no protection conferred across genogroups. The present study was aimed to determine the epidemiology, prevalent genotypes of norovirus in children below five years of age in the Hyderabad region, India.MethodsThe stool samples and clinical data were collected from 458 children below 5 years of age comprising of cases with acute gastroenteritis (n ?= ?366) and a control group (n ?= ?92) admitted to the pediatric ward. All the samples were tested for Norovirus by ELISA and RT-PCR. Sequencing was done for predominant strains.Results10.3% (n ?= ?38) of cases and 3.2% (n ?= ?3) of the control group were found to be Norovirus positive. Predominant genotypes were GII-82.5% followed by GI-12.5%.ConclusionSequencing and Phylogenetic analyses of 20 GII.4 strains was done. All of the isolates are clustered away from published the GII.4 variants thus suggesting the appearance of a new variant.     

Supravital staining: It's role in detecting early malignancies

The efficacy of supravital staining in the detection of malignancies in oro and oropharyngeal lesions and its role in the detection of malignant changes in premalignant lesions were studied. This prospective study comprises 90 cases of clinically suspicious lesions and it was done over a period of 3 years. Most of the patients had multiple risk factors for the development of malignancy. All underwent staining with a modified solution of 1% toluidine blue (TB). In our study the overall sensitivity was 97.29% and the specificity was 62.5%.     

Follicular bronchiolitis in primary ciliary dyskinesia

Ciliary dysfunction in primary ciliary dyskinesia (PCD) may be associated with bronchiolitis. Diffuse bronchiolitis has been reported in a subset of PCD patients who have Kartagener''s syndrome in Japan. We report a case of follicular bronchiolitis (FB) in a case of PCD presenting with recurrent episodes of cough, dyspnea, and bronchiectasis. This may motivate researchers to study rarer variants and presentations in PCD.     

A critical analysis of the concept of secondary Oral Hypoglycemic Agent (OHA) failure in type 2 diabetes at a tertiary care hospital

Data from UKPDS study suggests that the onset of ß cell dysfunction in diabetes occurs well before the development of hyperglycemia. To study the concept of secondary OHA failure in type 2 diabetes patients of more than 10 years duration in a tertiary care hospital. A retrospective analysis of all the cases of type 2 diabetes mellitus of more than 10 years duration from 2002 to 2003 was done and the data was divided into three groups: oral hypoglycemic agents (OHA) only, Insulin only, OHA + insulin. ANOVA/Students t test was the primary statistical test used. Odds ratio and 95% CI were calculated to compare risks of other diseases and drug use. 62.35% were on only OHAs, 8.82% on only insulin and 28.82% on both insulin and OHAs. This confirms good efficacy of OHAs. Diabetic population in our study tends to have a preserved beta cell function and secondary OHA failure is a late feature.     

Biochemical Urine Testing of Medication Adherence and Its Association With Clinical Markers in an Outpatient Population of Type 2 Diabetes Patients: Analysis in the DIAbetes and LifEstyle Cohort Twente (DIALECT)

OBJECTIVETo assess adherence to the three main drug classes in real-world patients with type 2 diabetes using biochemical urine testing, and to determine the association of nonadherence with baseline demographics, treatment targets, and complications.RESEARCH DESIGN AND METHODSAnalyses were performed of baseline data on 457 patients in the DIAbetes and LifEstyle Cohort Twente (DIALECT) study. Adherence to oral antidiabetics (OADs), antihypertensives, and statins was determined by analyzing baseline urine samples using liquid chromatography–tandem mass spectrometry. Primary outcomes were microvascular and macrovascular complications and treatment targets of LDL cholesterol, HbA_1c, and blood pressure. These were assessed cross-sectionally at baseline.RESULTSOverall, 89.3% of patients were identified as adherent. Adherence rates to OADs, antihypertensives, and statins were 95.7%, 92.0%, and 95.5%, respectively. The prevalence of microvascular (81.6% vs. 66.2%; P = 0.029) and macrovascular complications (55.1% vs. 37.0%; P = 0.014) was significantly higher in nonadherent patients. The percentage of patients who reached an LDL cholesterol target of ≤2.5 mmol/L was lower (67.4% vs. 81.1%; P = 0.029) in nonadherent patients. Binary logistic regression indicated that higher BMI, current smoking, elevated serum LDL cholesterol, high HbA_1c, presence of diabetic kidney disease, and presence of macrovascular disease were associated with nonadherence.CONCLUSIONSAlthough medication adherence of real-world type 2 diabetes patients managed in specialist care was relatively high, the prevalence of microvascular and macrovascular complications was significantly higher in nonadherent patients, and treatment targets were reached less frequently. This emphasizes the importance of objective detection and tailored interventions to improve adherence.     

Relationship between white blood cell count and in-hospital outcomes in acute coronary syndrome patients from the Middle East

We evaluated the relationship between admission white blood cell (WBC) count and in-hospital outcomes in acute coronary syndrome (ACS) patients from the Middle East. Data were analyzed from 7806 consecutive patients with ACS who were divided into 4 groups (G) according to their WBC count (× 10(9)/L; G1: < 6.00; G2: 6.00-9.99; G3: 10.00-11.99; G4: ≥ 12.00). After significant covariate adjustment, those in G4 were 68% more likely to have cardiogenic shock than those in G1 (95% confidence interval [CI]: 1.05-2.68; P = .030) and G2 (odds ratio [OR], 2.02; 95% CI: 1.51-2.71; P < .001). Those in G4 were 2.02 times (95% CI: 1.11-3.67; P = .021) and 65% (95% CI: 1.17-2.32; P = .004) more likely to die in hospital than those in G1 and G2, respectively. Admission WBC count is an independent risk factor for in-hospital cardiogenic shock and mortality, in Middle Eastern patients with ACS. Novel therapeutic agents targeting WBCs in patients with ACS may improve outcomes.