Objective:We sought to evaluate the incidence of metabolic syndrome and non-metabolic syndrome among type 2 diabetic patients attending the diabetic outpatient clinic at tertiary care hospital, Warangal.Materials and Methods:A cross-sectional study was conducted in a period of 6 months from January 2011 to June 2011. The study group consisted of 75 type 2 diabetic patients. They were screened for hypertension, hyperlipidemia, obesity, and clinical characteristics, and other co-morbidities were recorded. Metabolic syndrome diagnosis was made as per ATP III guidelines.Results:The prevalence of metabolic syndrome was significant in men (54.8%) compared to women (45.2%). Incidence of metabolic syndrome was found to be more in normal weight patients (43.56%). Low high density lipoprotein (HDL) levels were observed in both rural (90.63%) and urban (95.65%) patients with metabolic syndrome, followed by increase in waist circumference. The mean HDL level was found to be 23.77 mg/dl. Patients in the age group 51-60 years were found to be more affected with metabolic syndrome. Sedentary household female patients (58.3%) and illiterates (41.8%) were suffering from metabolic syndrome. Patients with metabolic syndrome had been suffering with diabetes (duration of diabetes) from 1 to 5 years. In summary, this cross-sectional study characterizes the metabolic and non-metabolic syndromes of type 2 diabetes patients living in Telangana regions, using ATP III guidelines, and generates a biological resource that enables further investigation of numerous hypotheses related to genetic exposure of both in a population.Conclusion:These results suggest that higher prevalence of metabolic syndrome was observed in non-obese male patients and was significantly associated with aging. Nevertheless, further studies are required to confirm the metabolic syndrome in larger population.
Background: Multidrug-resistant tuberculosis (MDR-TB) has become a global threat concerning to a risk of high mortality with the potential to cause adverse drug reactions (ADRs) which if not managed properly may affect patient compliance, resulting in below par treatment outcome. Aim: The aim of the study was to study, assess, and report the ADRs of patients diagnosed with MDR-TB. Subjects and Methods: An ambispective, observational study was conducted among confirmed cases of MDR-TB patients without any comorbidities during the period of January 2015–December 2018 in patients of age 15 years and above. Statistical Analysis: Data were analyzed descriptively using MS-Excel sheet 2013 and Chi-square test in GraphPad Prism 8.2.1. Results were expressed as either frequency, percentage, or mean ± standard deviation. ADRs were evaluated for causality, severity, and preventability attributes. Results: In the sample size of 400 patients, 236 (ADRs) were reported among 136 patients. The proportion of ADRs was higher in males ( P = 0.0001) and in the age group of 36–75 years ( P = 0.0211). Most commonly encountered ADRs include nausea and vomiting (35.31%) and arthralgia (14.04%), followed by peripheral neuropathy (8.93%) and giddiness (8.93%). Overall, 53% were of possible category and 60% of moderate level severity and 85% were unpreventable ADRs. Conclusion: Our study included 13 types of ADRs, of which most commonly reported were nausea and vomiting, arthralgia, and peripheral neuropathy and least common were psychosis, nephrotoxicity, and gynecomastia with a higher incidence in males. Majority of ADRs were moderate, unpreventable ADRs and had a possible relationship with the suspected drugs.
This investigation was carried out to evaluate the bioavailability of emtricitabine 200mg capsules (Test) of Aurobindo Pharma Ltd, India, relative to reference product, Emtriva 200mg capsules, manufactured by Gilead Sciences, Inc., USA. The bioavailability study was carried out on 36 healthy male volunteers who received a single dose of emtricitabine 200mg of the test (T) and the reference ( R ) products in the fasting state, in a randomized, balanced, 2-way cross-over design. After dosing, serial blood samples were collected for a period of 48 hours. Plasma obtained from blood was analyzed for emtricitabine by a sensitive and validated simultaneous liquid-chromatographic and mass-spectrometric (LC-MS/ MS) assay. The maximum plasma concentrations (C max ), area under the plasma concentration-time curve up to the last measurable concentration (AUC 0-t ), and to infinity (AUC 0-α ) and the time to maximum concentration (t max ) were analyzed statistically. The parametric confidence intervals (90%) were calculated. It was found that the test/ reference (T/R) ratios for the pharmacokinetic parameters (AUC 0-t ), (AUC 0-α ) and (C max ) were well within the Bioequivalence acceptance range of 80 -125% as per international regulatory guidelines. Therefore, the two formulations were considered to be bioequivalent.
Objectives. To measure and compare free fraction of serum levels of VPA (valproic acid) between non-malnourished and malnourished epileptic children and to evaluate the adverse effects (myopathy, hepatotoxicity). Material and methods. It is a prospective comparative observational case control study in which forty epileptic children (malnourished: 18 male/8 female, age 8.3±2.5, non-malnourished: 8 male/6 female, age 8.1±2.1) who fulfilled the inclusion criteria were recruited as study group and twenty children as control group (12male/8 female, age 6.0±2.8). Outcome measures monitored are serum VPA levels (total and free fraction of serum VPA), serum CK (creatinine kinase), SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamic pyruvic-transaminase). Using screening tool for the assessment of malnutrition in pediatrics (STAMP©), subjects are categorized into mild, moderate, severe malnourished as -1SD, -2SD, -3SD respectively Outcomes. There is an elevation in mean free fraction of VPA is 17.3±6.4 μg/ml whereas in non-malnourished group it was found to be 8.7±4.2 μg/ml with P= <0.001. While mean total drug concentration in malnourished and non-malnourished was found to be 88.6±49.9 μg/ml, 70.8±33.9 μg/ml respectively. Mean CK, SGOT, SGPT in control is 29.3±9.9IU/L, 28.5±5.4 IU/L,24.5±4.2 IU/L respectively. whereas mean CK, SGOT, SGPT in malnourished subjects is 16.9±9.1 IU/L, 28.8±8.5 IU/L,25.9±9.1 IU/L Correspondingly .while Mean CK, SGOT, SGPT in non-malnourished individuals is 15.7±11.3 IU/L,32.4±8.8 IU/L, 28.7±7.8 IU/L respectively. No correlation was observed between elevated serum drug concentrations, clinical response and side effects. Conclusion. We observed that clinical response and side effects are serum concentration independent hence our research make unnecessary to monitor serum drug concentration for every individual and drug monitoring should be restricted to subjects with severe ADR’s. Our data also suggest Valproate unveiled mitochondrial myopathy is limited to subgroup of population.
Chewing gum is an excellent drug delivery system for self medication as it is convenient, can be administered discreetly without water and offers the removal of ‘needle fear’ for the patients. As it releases insulin orally, it helps in tackling of the deprivation of insulin by digestive enzyme without adding digestive enzyme inhibitor. This can be done by binding of vitamin B12 and insulin. The vitamin B12 is protected with haptocorrin which is a salivary protein. Another chemical pathway takes over to help vitamin B12 pass into the bloodstream as haptocorrin reaches the intestines. The binding of vitamin B12 and insulin molecules makes the insulin to be protected on this supply chain. The insulin could ride all the way into the bloodstream, where it is released to do its work. By stimulating the brain, chewing gum also increases the releases of insulin. Finding simpler ways to deliver insulin into the blood stream is one important avenue for tackling the diabetes epidemic that is sweeping the developed world. The conditions in gastrointestinal tract may damage the body's protecting and absorbing mechanisms for the valuable molecules. Chewing gum would be a better delivery method in humans.
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