OBJECTIVEType 2 diabetes is associated with insulin resistance and skeletal muscle mitochondrial dysfunction. We have found that subjects with early-onset type 2 diabetes show incapacity to increase Vo2max in response to chronic exercise. This suggests a defect in muscle mitochondrial response to exercise. Here, we have explored the nature of the mechanisms involved.RESEARCH DESIGN AND METHODSMuscle biopsies were collected from young type 2 diabetic subjects and obese control subjects before and after acute or chronic exercise protocols, and the expression of genes and/or proteins relevant to mitochondrial function was measured. In particular, the regulatory pathway peroxisome proliferator–activated receptor γ coactivator (PGC)-1α/mitofusin-2 (Mfn2) was analyzed.RESULTSAt baseline, subjects with diabetes showed reduced expression (by 26%) of the mitochondrial fusion protein Mfn2 and a 39% reduction of the α-subunit of ATP synthase. Porin expression was unchanged, consistent with normal mitochondrial mass. Chronic exercise led to a 2.8-fold increase in Mfn2, as well as increases in porin, and the α-subunit of ATP synthase in muscle from control subjects. However, Mfn2 was unchanged after chronic exercise in individuals with diabetes, whereas porin and α-subunit of ATP synthase were increased. Acute exercise caused a fourfold increase in PGC-1α expression in muscle from control subjects but not in subjects with diabetes.CONCLUSIONSOur results demonstrate alterations in the regulatory pathway that controls PGC-1α expression and induction of Mfn2 in muscle from patients with early-onset type 2 diabetes. Patients with early-onset type 2 diabetes display abnormalities in the exercise-dependent pathway that regulates the expression of PGC-1α and Mfn2.
The coronavirus disease 2019 (COVID-19) outbreak has caused significant destruction, claiming over three million lives worldwide. Post SARS-COV-2 invasion, immunosuppression with hyperglycemia and elevated ferritin levels along with steroidal treatment creates a perfect storm for opportunistic infections. There is increasing evidence of mucormycosis co-infection in COVID-19 patients, during or post-treatment. A worse prognosis, a late diagnosis, and limited guidelines of screening and management of COVID-19 associated mucormycosis have made healthcare professionals fear an epidemic alongside a pandemic. This review geographically reports cases of COVID-19 associated mucormycosis (CAM), evaluates characteristics, clinical manifestations, and outcomes of mucormycosis in COVID-19 active or recovered patients. It further describes preventive strategies and recommendations for optimal management therapy that can be adopted worldwide to curtail an impending threat to the healthcare system.
Abstract.Health-care workers are on the front line to combat the peculiar coronavirus disease-19 (COVID-19) pandemic and are susceptible to acquiring this infection. This study is aimed at documenting the effect of “coronaphobia” on mental well-being and to report burnout among physicians. The study was conducted as a cross-sectional survey between November 17, 2020 and January 1, 2021 via a Google form distributed among the physicians of a tertiary care hospital, in Karachi, Pakistan. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) was used to assess the mental well-being of physicians. Burnout was documented by using the Maslach Burnout Inventory Human Services Survey for Medical Personnel. Eighty-seven physicians participated in the survey (mean age, 30.9 ± 7.3 years). The mean WEMWBS score of the study participants was 51.6 ± 10.8. Regarding the WEMWBS, emotional exhaustion was observed in 54% (N = 47) of participants, depersonalization in 77% (N = 67), and low personal accomplishment was reported in 31% (N = 27) of participants. The results of the survey further highlight that depersonalization, emotional exhaustion, and low personal accomplishment were associated significantly with a history of COVID-19 infection and COVID-19 postings. Hence, immediate measures are required to reduce the burnout among physicians while battling the second wave of the pandemic.
Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.
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