Menopause is described as a transition from the state of reproductivity to infertility. It is clinically diagnosed by estimating cessation of spontaneous menstruation over a period of 12 months. Estrogen governs insulin production capacity of the pancreatic islet cells as well as glucose homeostasis by several possible pathways in animal models. In the liver, estrogen regulates insulin sensitivity by activating glycogen synthetase and glycolytic enzymes; aromatase knockout is an enzyme responsible for estrogen biosynthesis which upon inactivation, mice develops insulin resistance due to estrogen deficiency which was reversed by estrogen therapy. Estrogen receptor possesses roles in cellular glucose uptake by governing glucose transporter (GLUT) and also modulates insulin receptor substrate-1 phosphorylation. In women insulin resistance may contribute to hyper-androgenism and an ovulatory dysfunction through several pathways. The compensated phase of insulin resistance stimulates the testosterone biosynthesis of human ovarian theca cells from women with polycystic ovarian syndrome which induces the earlier or late menopause. Thus this review elucidates a bidirectional relationship between diabetes mellitus and menopause.
Irrational use of medicines is a global problem due to poor knowledge and understanding about drug utilization by healthcare professionals and patients. To assess knowledge and perceptions of drug use along with good pharmacy practice (GPP) among pharmacy students of Sri Venkateswara College of Pharmacy (SVCOP) belonging to different age groups, gender and ethnicity. This Cross-sectional study was conducted in Sri Venkateswara College of Pharmacy of Chittoor, Andhra Pradesh by using questionnaire which consists of 21 questions. Among these questions, 10 were related to the knowledge, 6 were related to attitude and the remaining 5 questions were related to the practice aspects. All statistical analyses were performed using Microsoft Excel 2010 and Graph Pad Prism 7.0 software. The response rate obtained was 84%. Among 350 students, 155 were male and 195 were female. The mean (SD) age of the studied population was found to be 19.77 (1.56) years with a median age of 20 years. The result of this research study has shown that the students possess good attitude and practice but lack appropriate knowledge in drug use and GPP. The current practice of pharmacy in Indian scenario is not adequate and it needs further improvement. Most of the pharmacists are not accessible to update their knowledge on drug information. It is necessitate for strengthening the pharmacy profession by providing trainings and continuing professional development to update their knowledge and skills to dispense, counsel and in analyzing the prescription.
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