Rajesh Kumar Suman

Development of an Experimental Model of Diabetes Co-Existing with Metabolic Syndrome in Rats

Background. The incidence of metabolic syndrome co-existing with diabetes mellitus is on the rise globally. Objective. The present study was designed to develop a unique animal model that will mimic the pathological features seen in individuals with diabetes and metabolic syndrome, suitable for pharmacological screening of drugs. Materials and Methods. A combination of High-Fat Diet (HFD) and low dose of streptozotocin (STZ) at 30, 35, and 40 mg/kg was used to induce metabolic syndrome in the setting of diabetes mellitus in Wistar rats. Results. The 40 mg/kg STZ produced sustained hyperglycemia and the dose was thus selected for the study to induce diabetes mellitus. Various components of metabolic syndrome such as dyslipidemia {(increased triglyceride, total cholesterol, LDL cholesterol, and decreased HDL cholesterol)}, diabetes mellitus (blood glucose, HbA1c, serum insulin, and C-peptide), and hypertension {systolic blood pressure} were mimicked in the developed model of metabolic syndrome co-existing with diabetes mellitus. In addition to significant cardiac injury, atherogenic index, inflammation (hs-CRP), decline in hepatic and renal function were observed in the HF-DC group when compared to NC group rats. The histopathological assessment confirmed presence of edema, necrosis, and inflammation in heart, pancreas, liver, and kidney of HF-DC group as compared to NC. Conclusion. The present study has developed a unique rodent model of metabolic syndrome, with diabetes as an essential component.

Myocardial Salvaging Effects of Berberine in Experimental Diabetes Co-Existing with Myocardial Infarction

INTRODUCTION Berberine, an isoquinoline alkaloid isolated from the Berberis aristata, has been shown to display a wide array of pharmacological activities (hypoglycaemic and hypolipidemic). AIM The present study was designed to investigate whether these pharmacological properties translate into the cardioprotective effects of Berberine in the setting of diabetes mellitus. MATERIALS AND METHODS Necessary approval from the Institutional Animal Ethics Committee was taken for the study. Experimental diabetes was produced with single dose of Streptozotocin (STZ): 45mg/kg ip and myocardial infarction was induced by administering Isoproterenol (ISP): 85mg/kg, sc to rats on 35(th) & 36(th) day. After the confirmation of diabetes on 7(th) day (>200mg/dl), Berberine (100 mg/kg) was administered orally to experimental rats from day 8 and continued for 30 days thereafter. Various anti-diabetic (Glucose, HbA1c), cardioprotective (CPK-MB), metabolic (lipid profile), safety {liver function (SGPT, kidney function (Creatinine)} and histopathological indices of injury were evaluated in Healthy Control, Diabetic Control and Berberine treated groups. RESULTS Administration of STZ-ISP resulted in a significant decrease in body weight (p<0.001), diabetic changes (increase in blood glucose, HbA1c), cardiac injury (leakage of myocardial CPK-MB), altered lipid profile, SGPT, creatinine levels (p<0.001) in the diabetic control group rats as compared to healthy control. Berberine treatment demonstrated significant antidiabetic as well as myocardial salvaging effects as indicated by restoration of blood glucose, HbA1c and CPK-MB levels (p<0.001) compared to diabetic control group. In addition, Berberine favourably modulated the lipid parameters (total cholesterol, triglycerides, HDL, LDL). Subsequent to ISP challenge, histopathological assessment of heart, pancreas and biochemical indices of injury confirmed the cardioprotective effects of Berberine in setting of diabetes. In addition, Berberine was found to be safe to the liver and kidney. CONCLUSION Berberine treatment produced myocardial salvaging effects in the setting of diabetes challenged with ISP induced myocardial necrosis. Cardioprotection may be attributed to anti-diabetic and hypolipidemic activities.

Comparative Study of Underlay Tympanoplasty with Temporalis Fascia and Tragal Perichondrium

Background: Hearing is a sense that enables man to establish contact with his fellows via speech to experience life more fully. Deafness in varying degrees of severity is a big impediment to the integration of a person into the social structure. The otologist in the past had not much to offer to hearing handicapped people with chronic middle ear disease. With recent times the advent of the antibiotic era, the operating microscope and modern anesthetics techniques aimed at producing a dry, magnified operating field, have radically altered the outlook. Methods: This study comprises of patients who were subjected to tympanoplasty for the treatment of chronic suppurative otits media. Each patient was subjected to a detail examination of nose, paranasal sinuses and throat to rule out any focus of infection, which could influence the result of tympanoplasty. 20 Patients were subjected to tympanoplasty with temporalis fascia while the remaining 20 patients underwent with tragal perichondrium Tympanoplasty is performed using temporalis fascia in 20 patients and tragal perichondrium in 20 patients in the age group of 15-45 years (males and females both ). Patients with the complaint of discharging ear and decreased hearing were also screened . Results: Majority of the patients shows mild to moderate hearing loss. 47.5% of them had air-one gap up to 20 dB. 52.5% of them had air-bone gap 21-40 dB. None of them had air-bone gap above 40 dB. In the postoperative hearing analysis, 77.5% of the patients showed airbone gap upto 20dB. 22.5% of the patients showed airbone gap in the range of 21-40 dB . 80% of the patients operated with temporalis fascia showed air bone gap upto 20dB. 75% of the patients operated with tragal perichondrium showed air-bone gap upto 20dB. Mean improvement in hearing temporalis fascia is 09.5 dB. Mean improvement in hearing using tragal perichondrium is 09.0 dB. Mean improvement in hearing using tragal perichondrium is 09.0 dB Cnclusion: Tympanoplasty is the most effective method for control of the tubotympanic type of CSOM disease and hearing improvement. Both temporalis fascia and tragal perichondrium are excellent graft materials for closure of perforation of tympanic membrane and hearing improvement. Improvement in hearing is not significantly influenced by duration of disease, age or sex of patients. Kew Words: Tympanoplasty, Tragal Perichondrium, Temporalis Fascia, hearing

Drug Utilization studies in Glaucoma patients at MGM medical College and Hospital

The present study evaluated the pattern of drug usage for glaucoma. A Proforma was designed specifically for the study factoring patients’ demographical profile, prescription regimen. A total of 100 prescriptions of patients suffering from glaucoma were analyzed. Maximum cases (36%) belonged of age group 40 to 50 years with a gender ratio (Male/female) of 2.3. All the patients were diagnosed as suffering from primary open angle glaucoma out of which 82% had bilateral glaucoma. The average number of drugs per prescription was 1.23. The total no. of drug prescribed was 123 and 18% of prescriptions showed polypharmacy practice. Most commonly prescribed drug was Timolol (41%), followed by Brimonidine 16.26%. Bimatoprost (12.19%), Dorzolamide (11.38%), Latanaprost (5.69%). Fixed dose combination (Latanoprost+Timolol) was encountered in 14% of the glaucoma patient’s prescription, who had high intraocular pressure. Prescription of drugs by brand names instead of the recommended generic names is a matter of concern. Drug Utilization studies in Glaucoma patients at MGM medical College and Hospital

Natural dipeptidyl peptidase-IV inhibitor mangiferin mitigates diabetes- and metabolic syndrome-induced changes in experimental rats

Background Mangiferin (MNG) is known to possess antidiabetic and antioxidant activity. However, there is no experimental evidence presently available in the literature with regard to its ameliorating effects on diabetes mellitus coexisting with metabolic syndrome. Objective The present study was designed to evaluate the protective effects of MNG on various components of metabolic syndrome with diabetes as an essential component. Material and methods Adult Wistar rats were fed high-fat diets for 10 weeks and challenged with streptozotocin (40 mg/kg) at week three (high-fat diabetic control group). After the confirmation of metabolic syndrome in the setting of diabetes, MNG 40 mg/kg was orally fed to these rats from the fourth to tenth week. Results The treatment with MNG showed beneficial effects on various components of metabolic syndrome, such as reduced dyslipidemia (decreased triglyceride, total cholesterol, low-density lipoprotein cholesterol, and increased high-density lipoprotein cholesterol) and diabetes mellitus (reduced blood glucose and glycosylated hemoglobin). In addition, an increase in serum insulin, C-peptide, and homeostasis model assessment-β and a reduction in homeostasis model assessment of insulin resistance-IR were observed in MNG-treated group compared with high-fat diabetic control group. MNG was also found to be cardioprotective (reduction in creatine phosphokinase-MB levels, atherogenic index, high-sensitivity C-reactive protein). Reduction in serum dipeptidyl peptidase–IV levels in the MNG-treated group correlated with improvement in insulin resistance and enhanced β-cell function. Conclusion The present study has demonstrated antidiabetic, hypolipidemic, and cardioprotective effects of MNG in the setting of diabetes with metabolic syndrome. Thus, MNG has the potential to be developed as a natural alternative to synthetic dipeptidyl peptidase-IV inhibitors beneficial in this comorbid condition.

An Evaluation of the effectiveness of Barron Band Ligation as a Modality of Treatment of Hemorrhoids

Objective: The ob j e c t i v e of t he s t ud y is to e v al uat e t he effectiveness of rubber band ligation in the treatment of internal hemorrhoids. Methods: This is a prospective study of 120 cases who underwent rubber band ligation as an outpatient procedure for internal haemorrhoids. Binomial probability pre-post test were used for statistical analysis, pvalue less than 0.0001 was taken as significant. Results: One hundred twenty patients underwent rubber band ligation as a outpatient procedure for internal haemorrhoids. No major post procedure complications as sepsis, vasovagal reflex were observed. Only 36 patients had moderate discomfort following procedure, which lasted for 3-4 days and none had severe discomfort, and 84 patients did not need pain relief; 84 patients returned to work just after procedure .of symptom improvement post procedure compared to at presentation only 49% patients had bleeding post procedure out of 108 patients who had bleeding at presentation p-value of which was significant as pvalue = 0.00055, 6 patients had pain post procedure out of 36 patients who had pain at presentation p-value = 0.00024 was found significant. None patient after procedure had prolapse out of 24 patients who had prolapse on presentation (p-value = 0.0025). No patient had irritation or discharge post procedure (p-value = 0.00036). Ninety-six patients assessed rubber band ligation as excellent and 24 patients as of moderate help. Conclusion: Rubber band ligation for internal haemorrhoids is an effective modality of treatment mainly in 2° grade haemorrhoid which is convenient, simple, high patient acceptance with limitations as post procedure discomfort and pain.