Evaluating Histopathological Changes in Kidneys of Developing Chick Embryos Induced by Lixisenatide | Chapter 6 | Research Perspective on Biological Science Vol. 4

 

Background: Chick embryo is one of the most commonly used animals to study the adverse effects of various drugs for research purposes. For ethical reasons, animal models are frequently used in research. Currently, type 2 diabetes mellitus is treated by using the medication lixisenatide. Therapeutically, it is thought to be superior to other GLP1 receptor antagonists for the treatment of type 2 diabetes.

 

Objectives: The primary objective of this study is to understand the adverse effects of lixisenatide on the kidneys of developing chick embryos.

 

Materials and Methods: This study was conducted at the Department of Anatomy, Santosh Medical College, Ghaziabad, Uttar Pradesh, India. The starting human dose of lixisenatide was 10 mcg subcutaneously daily for 14 days and increased further to 20 mcg daily lifelong. The chick embryos were dissected after being sacrificed, and the kidneys from both sides were separated and kept in a 10% formaldehyde solution. Under flowing water, the tissues were cleaned. To learn about the typical histological characteristics of the kidneys, the sections were examined by using a light and compound microscope. The obtained data were subjected to statistical analysis.

 

Results: Minute vacuolation with or without fat globules in the cytoplasm of the lining epithelium of proximal and distal convoluted tubules was observed in experimental groups C, D, and E. The lymphocytic infiltration was higher in cortical areas of kidneys. As the dose of Lixisenatide increases with each experimental group, the histopathological changes in the kidney also show more changes with each experimental group, and these are statistically significant (p<0.05).

 

Conclusion: The medicine has some negative effects on the kidneys of the chick embryo, as evidenced by the observations (vacuolation in DCT, congestion in glomeruli, lymphocytic infiltration, etc.). Therefore, if it tend to use this vital medication carelessly patient can develop renal issues and resistance. A limitation of this study is that it was conducted solely on a chick embryo model. Further study must be performed in mammal research models for a better understanding of the effects of Lixisenatide in humans.

Author (s) Details

Amit Kumar Srivastava
Department of Anatomy, Santosh Medical College, Gaziabad, Uttar Pradesh, India.

 

Yogesh Yadav
Department of Anatomy, Noida International Institute of Medical Sciences, Noida, Uttar Pradesh, India.

 

Ashok Kumar Gupta
Department of Anatomy, Government Medical College, Saharanpur, Uttar Pradesh, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/rpbs/v4/5500

The Expression of Lipoprotein Receptor Related Protein-1 and C/Enhancer Binding Homologous Protein Genes in Individuals with Type 2 Diabetes Mellitus: A Potential Therapeutic Approach| Chapter 1 | Medical Science: Recent Advances and Applications Vol. 10

 

Diabetes is a serious chronic condition caused by either insufficient insulin production or the body's inability to effectively use the insulin it produces, leading to a persistent metabolic imbalance. Increased serum glucose can cause altered insulin signalling, and dyslipidaemia leads to several pathological alterations in neurons, glia, and vascular cells, leading to nerve dysfunction and, ultimately, neuropathy, including DNA damage and endoplasmic reticulum stress. The low-density lipoprotein receptor–related protein 1 (LRP-1) is a type I transmembrane protein belonging to the low-density lipoprotein receptor (LDL-R) family. C/EBP homologous protein (CHOP) is a major transcription factor in endoplasmic reticulum (ER)stress-mediated apoptosis and has widely documented roles in the pathogenesis of type 2 diabetes mellitus (T2DM) and diabetic complications. In this review, we are trying to determine the role of LRP1 and CHOP genes in modulating ER stress and their role in the pathophysiology of diabetes. We conducted a review using the Medline, Scopus, and Cochrane databases to examine the literature regarding the distinctions in neuropathy between type 1 and type 2 diabetes, variations in neuropathies, molecular biomarkers associated with the LRP1 gene, and CHOP expressions, along with their impact on diabetic neuropathies and related complications. This review can help establish novel therapeutic strategies for preventing and managing ER stress and diabetes.

 

 

Author(s) Details

Neha Saboo
Department of Physiology, RUHS College of Medical Sciences, Jaipur, Raj, India.

 

Sudhanshu Kacker
Department of Physiology, RUHS College of Medical Sciences, Pratap Nagar, Jaipur, Raj, India.

 

Gaurav Dalela
Department of Microbiology, RUHS College of Medical Sciences, Jaipur, Raj, India.

 

Ila Joshi
RUHS College of Medical Sciences, Jaipur, India.

 

Ambrin Zenab
Department of Physiology, RUHS-CMS, India.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v10/6139

 

Interrelation between Diabetes Mellitus and Periodontal Disease | Chapter 7| Medical Research and Its Applications Vol. 9

 The purpose of this chapter is to present scientific evidence for the links between Periodontitis and diabetes with a focus on potential common pathophysiologic pathways including those associated with inflammation, altered host responses and insulin resistance. The pathogenesis of periodontal disease is complex because it reflects a combination of the initiation and maintenance of the chronic inflammatory process by a diverse microbial flora and its numerous bacterial products. The interrelation between diabetes mellitus and inflammatory periodontal disease has been intensively studied for more than 50 years. It seems that there is a reciprocal relationship between these two illnesses: one tends to exacerbate the other, and treating one with care can help treat the other. This relationship is largely mediated by inflammation, which is responsible for the pathogeny and consequences of diabetes mellitus as well as periodontal disease. Conversely, periodontal infection can seriously impair the metabolic control of some diabetic patients. Moreover, treatment of periodontal disease and reduction of oral signs of inflammation may have a beneficial effect on diabetes. Further research is needed to clarify how inflammatory periodontal diseases may affect insulin resistance, glycemic control and the risk of developing other diabetic complications.

 

 

Author(s) Details

A. R. Gharat

Department of Periodontics, Nair Hospital Dental College, Floor no 2, Room no:202, Dr A L Nair Road, Opposite Maratha Mandir, Mumbai Central Pin: 400008, Maharashtra, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mria/v9/12567F

Histopathological Evaluation of the Teratogenic Effects of Lixisenatide on the Cerebral Cortex of Developing Chick Embryo | Chapter 5 | Innovations in Biological Science Vol. 9

 

Background and Objectives: Chick embryos are commonly used in research to investigate the negative impacts of various drugs. The drug lixisenatide is superior to other GLP1 receptor agonists for treating type 2 diabetes mellitus. It is recommended to take 20 µg of lixisenatide daily for type 2 diabetes mellitus. However, there are no clear human dose recommendations based on age and weight. It is important to conduct further research on the teratogenic effects of lixisenatide to determine the potential toxicity of the drug for human welfare.

 

Materials and Methods: It’s an experimental study conducted at the Department of Anatomy, Santosh Medical College, Ghaziabad, Uttar Pradesh. The study aimed to investigate the effects of specific parameters in two groups, a control group, and an experimental group. The expected mean ± SD of the parameter for the control and experimental groups were found to be 27±5.32 and 32±5.30, respectively, based on a literature survey and pilot study. To achieve an appropriate sample size, G*Power software was used, with an alpha level of 5% and a power of 95.36%, which resulted in an effect size of 1.961 and a sample size of 28 for each group experimental and control (A, AC, B, BC, C, CC, D, DC, E, EC), leading to a total sample size of 280. The chick embryos were first sacrificed and then dissected, and the brain was separated and kept in a 10% formaldehyde solution. To identify histological characteristics of the cerebral cortex, tissue was sectioned and stained with H & E stain then observed by the light and compound microscope were used for sections.

 

Results: During the experiment, Lixisenatide induced necrotic changes and cellular condensation in the chick embryo’s cerebral cortex, specifically in groups C, D, and E. Additionally, there was mild distortion found in the cortex indicating degenerative changes in experimental group E. There was a statistically significant increase in histopathological changes observed in the cerebral cortex as the dose of Lixisenatide increased in each experimental group (p<0.05).

 

Conclusion: Insufficient research has been conducted on the development of side effects of lixisenatide. Despite its widespread use, observations have revealed that lixisenatide has adverse effects on the cerebral cortex of chick embryos, including cellular condensation and necrotic changes, and mild distortion found in the cortex indicating degenerative changes in experimental groups C, D, and E. Therefore, it is imperative that the administration of this vital medication is carefully considered to prevent neuronal complications. Further research is necessary to fully understand the potential adverse effects of lixisenatide on brain development.

 

Author(s) Details

Amit Kumar Srivastava
Department of Anatomy, Santosh Medical College, Ghaziabad, Uttar Pradesh, India.

Yogesh Yadav
Department of Anatomy, Saraswati Institute of Medical Sciences, Hapur, Uttar Pradesh, India.

 

Swati Yadav
Department of Anatomy, Santosh Medical College, Gaziabad Jmtuyeruhj, Uttar Pradesh, India.

 

Harshita Bhardwaj
Department of Anatomy, Santosh Medical College, Gaziabad Jmtuyeruhj, Uttar Pradesh, India.

 

Ashok Kumar Gupta
Department of Anatomy, Government Medical College, Saharanpur, Uttar Pradesh, India.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/ibs/v9/1440

The Recovering Arterial Blood Flow Access to the Rhomboid Fossa Causes Restoring the HbA1c Level in Pre-Diabetic Patients | Chapter 11 | Disease and Health Research: New Insights Vol. 3

 

The present study demonstrates the recovery of cervical vertebral arterial blood flow access to the rhomboid fossa causes the restoration of HbA1c levels for patients with pre-diabetic (pre-DM) conditions. HbA1c is formed due to the chemical condensation of hemoglobin and glucose, which are present in high concentrations in red blood cells. The first research results established a relationship between HbA1c and vascular complications. The measurement method used is HPLC. When measured in an NGSP-certified laboratory, a change in HbA1c of at least 0.5% is considered statistically and clinically significant. The observation is in good agreement with the consideration of the human body as a dissipative structure. Such consideration is the focus of the recently announced theory of centralized aerobic-anaerobic energy balance compensation (TCAAEBC). According to it, observed connections between high blood pressure (HBP) and the lifted level of HbA1c can be linked to the obstruction of arterial blood flow access to rhomboid fossa (OABFARF), causing the delivery of incorrect information on blood oxygen availability. Below we provide detailed information on how in this case TCAAEBC explains the very initiation of multiple chronic non-communicable diseases (NCDs), starting with type 2 diabetes mellitus (DM). Diabetes mellitus is a metabolic disorder reflecting the complex integration of body systems, care must be taken in selecting the correct animal model for use in various in vivo experiments. Mouse models are used in experimental studies of obesity and type 2 diabetes to identify the role of inflammation, insulin resistance, and other potential treatments, and the knowledge gained from such studies has been accurately applied to humans with this diagnosis.

 

Author(s) Details

Alexander Y. Shishonin
Complementary and Integrative Health Clinic of Dr. Shishonin, 5 Yasnogorskaya Str, Moscow, 117588, Russian Federation.

Alexander A. Vasin
Complementary and Integrative Health Clinic of Dr. Shishonin, 5 Yasnogorskaya Str, Moscow, 117588, Russian Federation.

 

Kirill V. Zhukov
Complementary and Integrative Health Clinic of Dr. Shishonin, 5 Yasnogorskaya Str, Moscow, 117588, Russian Federation.

 

 

Bagrat A. Gasparyan
Complementary and Integrative Health Clinic of Dr. Shishonin, 5 Yasnogorskaya Str, Moscow, 117588, Russian Federation.

 

Alexandre A. Vetcher
Complementary and Integrative Health Clinic of Dr. Shishonin, 5 Yasnogorskaya Str, Moscow, 117588, Russian Federation and IBHTN at Peoples’ Friendship University of Russia n.a. P. Lumumba (RUDN), 6 Miklukho-Maklaya St, 117198 Moscow, Russia.

 

 Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v3/1461

Role of TNF-α Gene Polymorphism as a Biomarker of Diabetic Nephropathy: A Study among Patients of the Telangana Region, India | Chapter 13 | Medical Science: Recent Advances and Applications Vol. 7

 

Background: Diabetic Nephropathy (DN) is one of the complications in patients with prolonged diabetes. Diabetic nephropathy disorder is most commonly observed in patients with prolonged diabetes, even though other microvascular diseases due to diabetes are also observed. Among the genetic risk factors for DN, TNF-α, an anti-inflammatory cytokine, is proposed to act in a paracrine/autocrine manner and is hypothesised to be associated with insulin resistance. In the current study, the relationship of the G  C variant of the TNF-α gene in patients, associated with other biochemical parameters, with DN was investigated.

 

Aim: The aim of the study was to investigate the inflammatory markers that are involved in the pathogenesis of diabetic nephropathy and could serve as predictive or diagnostic biomarkers.

 

Methods: Demographic factors of the study group were obtained by directly interviewing the study group. Biochemical and diagnostic parameters of the study subjects, plasma glucose levels (fasting and postprandial), and renal function tests (Urea, creatinine) were obtained from the patient’s records. Genomic DNA was extracted from peripheral blood samples of 50 type II Diabetes Mellitus (T2DM) and 50 non-diabetic control subjects.

 

The TNF-α (G    C) polymorphism was analysed using polymerase chain reaction (PCR), followed by restriction fragment length (RFLP) polymorphism analysis.

 

Results: Using statistical analysis, it was possible to correlate demographic parameters with genotyping results, and it was found that 50% patients were GG homozygotes (wild type), 30% were GC heterozygotes, and 20% were CC homozygotes. This suggests that low-grade inflammation could be one of the determinants in the pathogenesis of insulin resistance and T2DM. Most of the patients (80%) in the hospital were not physically active, and these patients had much longer inpatient stays when compared to the patients who were involved in regular physical exercise. The control of inflammatory processes may be useful in the therapy of DN. As there is limited experience available for the inhibition of inflammatory cytokines in DN, it is beneficial to collect and mount evidence for the properties of inflammatory genes.

 

Conclusion: We conclude from this preliminary study that TNF-α G   C genotypes may be a useful biomarker for the early diagnosis of T2DM patients with insulin resistance and nephropathy.

 

Author(s) Details

Kaiser Jamil
Department of Genetics, Bhagwan Mahavir Medical Research Centre, Masab Tank, Hyderabad-500004, Telangana, India.

 

Owaisul Haq
Department of Genetics, Bhagwan Mahavir Medical Research Centre, Masab Tank, Hyderabad-500004, Telangana, India.

 

Zamin Ahmed
Department of Genetics, Bhagwan Mahavir Medical Research Centre, Masab Tank, Hyderabad-500004, Telangana, India.

 

Sindhu Joshi
Mahavir Hospital and Research Centre, Masab Tank, Hyderabad-500004, Telangana, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v7/5716

 

Continuous Glucose Monitoring (CGM) in Type-1 Diabetes Mellitus: A Promising Aid in Effective Management | Chapter 8 | Medical Research and Its Applications Vol. 11

Considering the large, global prevalence of diabetes mellitus, there is an increasing demand for effective and innovative management aids. Monitoring of glucose levels is an essential component of diabetes care. Continuous glucose monitoring (CGM) is becoming widely accepted as an adjunct to diabetes management. It can provide real-time data on ambulatory glucose fluctuations and carries the potential to become a very valuable tool for a large part of the population worldwide.  This chapter entails a thorough literature review of the evolution of CGM devices, its working principles, recent breakthroughs, patient selection, areas with scope for more research, merits as well as drawbacks of CGM in patients of Type-1 diabetes mellitus.

 

Author(s) Details

Kumud Dhankhar

JSS Medical College, Mysuru, Karnataka, India.

 

Rakesh Dhankhar
Department of Radiation Oncology, Pt. BD Sharma PGIMS, Rohtak, Haryana, India.

 

Kiran Dahiya
Department of Biochemistry, Pt. BD Sharma PGIMS, Rohtak, Haryana, India.

 

Kabir Dhankhar
Amdocs, Pune, Maharashtra, India.

 

Rajandeep Singh
Pt. BD Sharma PGIMS, Rohtak, Haryana, India.

 

Chandini Dash
Department of Biochemistry, Pt. BD Sharma PGIMS, Rohtak, Haryana, India.

 

Ajay Momi
Department of Biochemistry, Pt. BD Sharma PGIMS, Rohtak, Haryana, India

 

Please see the book here:- https://doi.org/10.9734/bpi/mria/v11/1582

An Overview of the Knowledge and Awareness of Type II Diabetes Mellitus Patients about the Disease, Related Risk Factors, and Complications: A Literature Review | Chapter 9 | Disease and Health Research: New Insights Vol. 5

 

Background: Diabetes mellitus (DM) is a major public health concern, leading to increased morbidity, mortality, healthcare utilization, and costs. The prevalence of diabetes has increased significantly, so knowledge and awareness are crucial for diabetes management, and self-management education is essential for successful treatment. However, knowledge of diabetes is often poor in developing countries. Illiteracy rates are higher in these countries compared to the developed countries, which contributes to lower knowledge and awareness of diabetes among diabetic patients.

 

Objectives: The objective of this study is to summarize peer-reviewed publications for a selected period (13 years) about patients' knowledge and awareness of diabetes mellitus type 2.

 

Methodology: A total of 13 articles were selected as cross-sectional studies or systemic reviews from literature review using three databases, namely Google Sholar, PubMed, and ResearchGate, and were published in 2011-2023.

 

Results: Most previous cross-sectional studies reported that educational interventions led to significant increases in participants’ knowledge of type 2 diabetes and high educational qualifications were significantly related to a better understanding of diabetes.

 

In a multivariate analysis, greater diabetes awareness, greater medication adherence and monotherapy use were significant factors in good glycemic control.

 

Other previous cross-sectional studies and systemic reviews indicated that most people with diabetes understand that lifestyle changes are necessary to treat diabetes. However, many also believe that diabetes can be permanently cured and that being overly healthy can lead to diabetes. Also, Lower frequency of HbA1c monitoring is significantly associated with poor glycemic control. Moreover, the results showed that people with diabetes may have poorer control if they have had diabetes for a longer duration.

 

Conclusion: The source of information obtained is used as a reference for knowledge and behavior formation. Providing education can be applied to increase patient knowledge about diabetic mellitus, risk factors, and complications.

 

Author (s) Details

Ali A. Alyahawi
Faculty of Clinical Pharmacy, 21 September University, Yemen.

 

Mohammed AW. Almorish
Faculty of Medicine and Health Sciences, Sana'a University, Yemen.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v5/1657

Teratogenic Effects of Lixisenatide: Anatomical Malformations and Histopathological Changes in Developing Chick Embryos | Chapter 7 | Medical Science: Recent Advances and Applications Vol. 4

Background: Lixisenatide is a peptide containing 44 amino acids, which is amidated at the C-terminal amino acid. At present Lixisenatide is the drug been used to treat type 2 diabetes mellitus. Therapeutically is been considered to be best for treatment of diabetes mellitus than other GLP1 receptor antagonists. However, there is limited available data about effect of lixisenatide on liver, kidney, stomach and cerebral cortex. Studying the teratogenic effects of lixisenatide is important for human welfare.

Objectives: This study aims to find out gross anatomical malformations due to teratogenic effects of antidiabetic drug Lixisenatide on developing chick.

Methods: It was an Interventional study conducted at the Department of Anatomy, Santosh Medical College, Ghaziabad, India. It is confirmed from the literature survey/ pilot study that the expected mean ± SD of the parameter of control and experimental groups are 27±5.32 with 32±5.30, with the help of software G* Power analysis for α 5% and Power (1-β) 95.36%. The effect size is 1.961, and the sample size for each group is 28. So, we have taken the total sample size of 280. Descriptive statistical analysis, which included frequency and percentages, was used to characterise the data. Inferential statistics included a chi-square test and an independent samples t-test for different dependent variables of the study, and p<0.05 was considered statistically significant.

Results: Gross anatomical malformation was seen after administration of lixisenatide as compared to the control group. Histological sections D and Dd (magnified at 10X and 40X, respectively) of the liver treated with a higher dose of lixisenatide on embryonic day 21 show congestion of the central vein accompanied by infiltration of inflammatory cells. The most common anatomical malformation was growth retardation followed by limbs deformity and twisted neck and it was statistically significant (p<0.05) significant decrease in the weights of treated chick embryo compared to the control groups (p<0.05).

Conclusion: The findings generated in this study show teratogenic effects like anatomical malformations and histopathological changes due to effects of high dose of Lixisenatide on developing chick embryo in liver organ and these teratogenic effects may be extrapolated to human being.

 

Author (s) Details

Yogesh Yadav
Department of Anatomy, Noida International Institute of Medical Sciences, Noida, Uttar Pradesh, India.

 

Amit Kumar Srivastava
Department of Anatomy, Santosh Medical College, Gaziabad, Uttar Pradesh, India.

 

Ashok Kumar Gupta
Department of Anatomy, Government Medical College, Saharanpur, Uttar Pradesh, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v4/2168

Alzheimer’s Disease Hypothesized as Type 3 Diabetes: A Review | Chapter 5 | Disease and Health: Research Developments Vol. 9

The precise connection between Alzheimer’s disease (AD) and type 2 Diabetes is still being debated. However, poorly controlled blood sugar may increase the risk of developing AD. Due to this strong relationship, some have referred to AD as ‘Diabetes of the brain’ or ‘type 3 Diabetes’ (T3D). Diabetes mellitus (DM), type1 (T1D) and type2 (T2D) are diseases of the peripheral organs, characterized by relative Insulin deficiency, caused by decreased synthesis or reduced signalling of Pancreatic Insulin. Recently, Alzheimer’s disease has been hypothesized to be type 3 Diabetes (T3D), deemed to be characterized by Insulin resistance. Presumably, Insulin resistance can be attributed to hyperinsulinemia, hyperlipidemia or pro-Inflammatory cytokines, through down-regulation or desensitization of cerebral Insulin receptors (IR). Brain is absolutely dependent upon glucose as fuel for ATP biosynthesis. Insulin receptor (IR), the central moiety, implicated in both DM and AD, is expressed from a single gene located on human chromosome 19p 13.2-19p 13.3. Although IR is involved in the cognitive decline of both DM and AD, the receptor subtypes in the brain and peripheral tissues differ in structure and function. Glucose uptake in the brain is mostly Insulin-independent, unlike the peripheral organs, with the exception of Insulin-sensitive neurons, in view of its absolute dependence. While the Insulin-dependent glucose uptake in the neurons depends upon the translocation of glucose transporter4 (GlUT-4) to the plasma membrane, Insulin-independent, cerebral uptake depends upon vascular-endothelial-cell glucose transporter1 (GlUT-1) and neuronal glucose transporter3 (GlUT-3). Glucose-sensitive, neuron-specific, GLUT-8 can translocate to the endoplasmic reticulum membrane, and pull out glucose, in order to maintain intra-neuronal glucose levels. Besides IRs, brain also expresses receptors for Adipokine and leptin (LR) that cross-react with IR, in neurons that co-express these receptors. Cerebral IRs and LRs subserve alternative roles in synaptic functions and cognition. Whereas AD and DM are characterized by dementia and cognitive decline, respectively, their known cellular biomarkers are different, namely, neuronal Amyloid Peptide (APβ), TAU, glial TDP-43 for AD and Islet Amyloid Polypeptide (IAPP) for DM. DM also has a genetic component, namely, HLA-DQB1, CTLA-4, INS genes. Whereas Insulin supplementation has therapeutic benefits for peripheral organs, the same does not hold true for Central Nervous System (CNS). IR, LR and GlUT-4 are co-expressed in a subset of neurons, where Leptin acts as an inhibitor of Insulin signalling. Thus, hyperleptinemia can also contribute to Insulin resistance through cross-reactivity with Insulin receptors, in GLUT-4-positive neurons. It can be surmised that the overlap between AD and DM is restricted to Insulin resistance but not glucose uptake or availability. It is suggested that, despite the overlapping features, Alzheimer’s disease may not meet the requirements of the so-called, type 3 Diabetes (T3D). The mechanism underlying peripheral Insulin resistance of DM involves desensitization of IR and reduced glucose uptake. The mechanism underlying the deemed, cerebral Insulin resistance of AD is yet a moot point. Further research is required to validate the findings of earlier studies, examine alternative etiologies and devise effective treatments for AD.

 

Author (s) Details

Manjeet K Gill-Sharma
Neuroendocrinology Department, National Institute for Research in Reproductive & Child Health, J. M. Street, Parel, India.

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v9/5073

A Comprehensive Review on Herbal Remedies for the Management of Diabetes | Chapter 8 | Achievements and Challenges of Medicine and Medical Science Vol. 4

Diabetes mellitus is a metabolic disease that presents with various signs and complications. Natural items, medicinal plants, and synthetic anti-diabetic medicines are used in the management of various disorders. Medicinal plants are less expensive and have less adverse effects than synthetic anti-diabetic medications. Clinical trials have shown that important herbs, including Gymnema (Gymnema sylvestre), bitter melon (Momordica charantia), Cinnamon (Cinnamomum cassia) and fenugreek (Trigonella foenum-graecum), have strong anti-diabetic properties. This book chapter explores the use of medicinal herbs in the herbal therapy of diabetes mellitus. The primary purpose of the chapter is to discuss the herbal plant mechanism of action and its significance in the treatment of diabetes mellitus in herbal plants in India.

 

Author (s) Details

 

Rajkumar Sironiya
Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Bilaspur (C.G.)- 495009, Chattisgarh, India.

 

Meenakshi Jaiswa
Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Bilaspur (C.G.)- 495009, Chattisgarh, India.

 

S.K. Lanjhiyana
Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Bilaspur (C.G.)- 495009, Chattisgarh, India.

 

Nidhi Agrawal
Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Bilaspur (C.G.)- 495009, Chattisgarh, India.

 

Rashmi Dewangan
Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Bilaspur (C.G.)- 495009, Chattisgarh, India.

 

Shibangi Mukhopadhyay
Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Bilaspur (C.G.)- 495009, Chattisgarh, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v4/2992 

Massive Pneumoureter and Pneumobladder in the Context of Emphysematous Pyelitis | Chapter 11 | Achievements and Challenges of Medicine and Medical Science Vol. 6

Emphysematous urinary tract infections are necrotising infections caused by gas-forming uropathogens. High levels of glucose in the tissue act as a substrate for bacteria such as E.coli (>50%), Klebsiella(21%) and Proteus spp. which in turn ferment the sugars to produce carbon dioxide. Emphysematous pyelitis refers to the collection of gas in the renal collecting system. Although gas is encountered in the pelvicalyceal system, it is quite rare to find a massive accumulation of gas in the ureter and urinary bladder. This is an interesting case of a middle-aged diabetic male who presented with flank pain and lower urinary tract symptoms and his evaluation revealed a massive right pneumo-ureter and pneumo-bladder. Prompt evaluation with computed tomography and early intervention in the form of DJ stenting and catheterisation helped to resolve the massive air pockets in the ureter and the bladder.

 

Author (s) Details

 

Santosh Patil
Department of Urology, BLDE (Deemed to be University) Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India.

 

Vinay S. Kundargi
Department of Urology, BLDE (Deemed to be University) Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India.

 

Siddanagouda B. Patil
Department of Urology, BLDE (Deemed to be University) Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India.

 

Manoj K. Vaidya
Department of Urology, BLDE (Deemed to be University) Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v6/3432

Prospects for the Use of Personalized Therapy in Patients with Coronary Heart Disease and Heterozygous FH against the Background of Diabetes Mellitus | Chapter 8 | Disease and Health Research: New Insights Vol. 9

The chapter examines the prevalence and diagnosis of familial hypercholesterolemia, its impact on the development of early coronary heart disease, identified mutations, and prospects for personalized therapy taking into account the identified mutations.

Diseases of atherosclerotic genesis still remain the number one problem worldwide. One of the most common forms of atherosclerotic cardiovascular diseases is familial heterozygous hypercholesterolemia (FH) is still rarely detected and this disease often falls out of the focus of attention of the primary health care structure not only in countries with high economic development but also in countries with medium and low economic development. Familial hypercholesterolemia is associated with a mutation in the LDLR, APOB and PCSK9 genes or, possibly, several mutations in the APOE gene and, for rare autosomal forms, in the LDLRAP1 gene, and has an autosomal dominant form of inheritance. It is the discovery of genes involved in the disease that has allowed us to improve the diagnosis and treatment of familial hypercholesterolemia, especially the introduction of statins into clinical practice after the discoveries of Brown and Goldstein, as well as the discovery of the PCSK9 protein in familial hypercholesterolemia by Abifadel et al., which made it possible to treat previously unknown forms of the disease. The diagnostic capabilities achieved recently allow not only to identify but also to effectively treat such patients, which expands the therapeutic potential of conditions previously inaccessible to therapeutic intervention. It is the improvement of diagnosis, prevention, and treatment, as well as the expansion of the availability of therapeutic interventions that helps to reduce the lifelong burden of atherosclerotic diseases.

 

Author (s) Details

 

Rano Alieva
CAD & Atherosclerosis Department, Republican Specialized Center of Cardiology, Tashkent, Uzbekistan.

 

Aleksandr Shek
CAD & Atherosclerosis Department, Republican Specialized Center of Cardiology, Tashkent, Uzbekistan.

 

Alisher Abdullaev
Center for Advanced Technologies, Ministry of Innovative Development of Uzbekistan, Tashkent, Uzbekistan.

Khurshid Fozilov
CAD & Atherosclerosis Department, Republican Specialized Center of Cardiology, Tashkent, Uzbekistan.

 

Shovkat Khoshimov
CAD & Atherosclerosis Department, Republican Specialized Center of Cardiology, Tashkent, Uzbekistan.

 

Guzal Abdullaeva
CAD & Atherosclerosis Department, Republican Specialized Center of Cardiology, Tashkent, Uzbekistan.

 

Dariya Zakirova
Center for Advanced Technologies, Ministry of Innovative Development of Uzbekistan, Tashkent, Uzbekistan.

 

Rano Kurbanova
CAD & Atherosclerosis Department, Republican Specialized Center of Cardiology, Tashkent, Uzbekistan.

 

Lilia Kan
CAD & Atherosclerosis Department, Republican Specialized Center of Cardiology, Tashkent, Uzbekistan.

 

Andrey Kim
CAD & Atherosclerosis Department, Republican Specialized Center of Cardiology, Tashkent, Uzbekistan.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v9/1721

An Overview of T2DM: A Model of Diabetes Mellitus | Chapter 9 | Disease and Health: Research Developments Vol. 2

A large part of the population suffers from a disorder in the metabolism of energy-rich substances (glucose, fats or proteins), diabetes mellitus (DM). A simple model allows us to understand the aetiology, pathophysiology and basic methods of modern treatment of the disease.

In many cases, the disease is caused by a malfunction of hormones, especially insulin.  More than 10% of cases of DM are caused by an absolute or relative lack of insulin, mainly due to an autoimmune process that destroyed insulin-producing cells - type 1 diabetes (DM1) or in the final stages of other types of diabetes due to terminal failure of regulatory mechanisms. In rare cases, DM is due to a decrease in all the effects of insulin - real insulin resistance or due to a real lack of insulin (Mody 2 for example). Metabolism takes place in cells. Hundreds of different enzymes affect the metabolism of energy-rich substances. Each of them can be damaged. However, it seems that the main cause of the disease is an inappropriate lifestyle, which secondarily damages the regulatory systems. This is the cause of type 2 diabetes (DM2). A high energy input/low energy expenditure (HEILEE) lifestyle is not compatible with a human genetic background. Deviations in glucose metabolism initially arise as a feedback, cellular defence against energy-rich substances overload, and are therefore reversible. If energy surplus persists for a long time, irreversible malfunctions occur. Untreated DM1 is characterized by intracellular starvation and lack of ATP. DM2 is characterized by “cellular overeating”. There gradually develop serious collision between intracellular regulatory mechanisms (AMPK, CD36-SR-B2, controlled by the amount of ATP, glycogen, lipid and other energy-rich substances), and cascades of hormone second messengers. Insulin deficiency and insulin resistance in DM2 are emphasized above all today. The question, of which of these disorders (or obesity) is the first, provoking the development of DM2, is discussed in the literature. Neither of them – both are the consequence of a chronic energy surplus. Chronic hyperinsulinemia is present in the early stages of the disease. Insulin ensures a high transfer of glucose from the blood to the tissues in obese people, but it is unable to maintain an adequate level of glucose in the blood. The disease is characterized by a special disorder - “Insulin uncoupling", a defect when there is a simultaneous increase in some effects and a decrease in other effects of the hormone. The ability of insulin to ensure anabolic processes is preserved. The ability to form visceral fat stores or the ability to retain sodium is increased. Hormone synthesis in DM2 gradually decreases, and the patients may become fully dependent on external insulin administration.

What therapy results from the above-mentioned principles? The goal of our efforts should be the complete restoration of the metabolism of energy-rich substances, carbohydrates, fats and other substances. Patients who are unable to synthesize insulin need this hormone (its analogues), in adequate amounts depending on needs. Patients who produce insulin but are unable to release it sufficiently will be optimally treated with sulfonylurea derivatives (MODY 2, MODY 12). Patients who are unable to release insulin depending on food intake will be optimally treated with GLP1 analogues, and incretins. The basic medical treatment for patients suffering from DM 2 reduces energy intake. The anorexic effect of GLP1 agonists is beneficial.  Metformin reduces the metabolism efficiency. This drug increases the amount of glucose processed anaerobically. Subsequently, metabolism in the Cori cycle causes significant energy losses. Currently, there are even drugs available that allow the removal of unnecessarily received energy by removing glucose from the body via urine-gliflozins. Insulin administration is appropriate to restore adequate blood glucose levels. Long-term administration of high doses of insulin is nevertheless not the optimal therapy for early-stage DM2.  A return to a lifestyle that corresponds to the conditions under which the human organism evolved - with limited food intake and relatively high energy expenditure through physical exercise- could prevent the population from developing diabetes mellitus.

 

Author (s) Details

 

Kubat K
PN Horni Berkovice, Plesivecka 912/10, 41201 Litomerice, Czech Republic, Europe.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v2/3640

Characteristics of Helicobacter Pylori-Related Dyspepsia and Dysglycemia: A Review | Chapter 2 | Disease and Health: Research Developments Vol. 3

H. pylori colonized the stomach since immemorial time as if both the stomach wall and the bacterium used to live together in peace harmless to each other. In many cases of newly discovered diabetes associated with frank history of H. pylori dyspepsia, the diabetic condition has been successfully and permanently corrected by mere eradication of colonic H. pylori strains. The world literature is considering that the world’s burden of diabetes is on the account of type II diabetes although the newly discovered diabetic condition has been successfully and readily corrected permanently in many patients. Traditional risk rules do not appear fully sufficient to explain the dramatic spread of diabetes mellitus all over the world; this could further indicate that traditional measures employed to control the problem could never be adequate or decisive. Most diabetic patients in the world are inadequately controlled in spite of regular follow-up of medications and strict carefulness about their style of life; this could also indicate the presence of a missed underlying etiologic pathological error. It has been lately emphasized that the world’s burden of diabetes is not on the account of type II diabetes but on stress diabetes due to toxic pancreatitis caused by the accumulation of potential toxins in the colon. The aim of the study is to evaluate the characteristics of Helicobacter pylori-related Dyspepsia and Helicobacter pylori-induced Dysglycemia.

 

Author (s) Details

 

Abdullah M Nasrat
Department of Surgery, Balghsoon Clinic, Jeddah, KSA.

 

Salwa AM Nasrat
Department of Physical Therapy, Cardiac Surgery Academy, Cairo, Egypt.

 

Randa M Nasrat
Department of Internal Medicine, Helwan General Hospital, Helwan, Egypt.

 

Mohammad M Nasrat
Department of Internal Medicine, Helwan General Hospital, Helwan, Egypt.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v3/3637

Atypical Diabetes- Neonatal and Monogenic Forms of Diabetes Mellitus | Chapter 10 | Medicine Essentials in Clinical Practice

Monogenic forms of diabetes are part of the group of atypical diabetes. People with atypical forms of diabetes have symptoms and signs that are different from those of type 1 or type 2 diabetes. Monogenic diabetes is a rare condition resulting from mutations (changes) in a single gene. In contrast, the most common types of diabetes—type 1 and type 2—are caused by multiple genes (and in type 2 diabetes, lifestyle factors such as obesity). The majority of monogenic diabetes cases are inherited from a parent who has the condition. It is responsible for 2–5% of all cases of diabetes mellitus. Monogenic diabetes comes in a variety of types and mostly affects young adults, primarily those under 25. Most disease types are characterized by a decrease in the body's ability to produce insulin, a hormone that helps the body use glucose (sugar) for energy. Rarely, the issue is significant insulin resistance, which occurs when the body is unable to adequately use insulin. This chapter covers the specific form of monogenic diabetes may be called also MODY (formerly, maturity-onset diabetes of the young) or neonatal diabetes, depending on when it develops. One subset of Atypical Diabetes is Latent Autoimmune Diabetes in Adults (LADA) which is also covered extensively in this chapter.

 

Author (s) Details

 

Rohit Raina
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Preeti Singh Dhoat
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Maninder Kansal
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Deepak Chaudhary
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Dinesh Prajapat
Department of General Medicine, AIIMS Bathinda, Punjab- 151001, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49238-92-3/CH10

Approaches to Emphysematous Pyelonephritis: Unresolved Questions and Management Predicaments | Chapter 9 | Newer Frontiers in Urology

Emphysematous pyelonephritis (EPN) is a life-threatening infection of the kidney characterized by the presence of gas-forming bacteria in the renal parenchyma. It is most commonly seen in patients with diabetes mellitus, but can also occur in those with urinary tract obstruction, immunocompromised states, or renal stones. EPN carries a high mortality rate, particularly in patients presenting with advanced disease or sepsis. Mortality rates range from 15% to 30%, with higher rates seen in patients with bilateral involvement, delayed diagnosis, or severe renal failure. Prognosis largely depends on early identification, the extent of renal involvement, and the patient’s overall health, with diabetes being a significant risk factor for poor outcomes. The primary treatment for EPN involves a combination of broad-spectrum antibiotics and supportive care. Percutaneous drainage has become the preferred method for managing non-complicated cases, while nephrectomy remains critical in severe cases or when renal function is irreversibly compromised. Management of EPN presents several challenges, including the difficulty of early diagnosis due to its nonspecific symptoms and the potential for rapid disease progression. Additionally, selecting the appropriate surgical approach remains contentious, as nephrectomy is often associated with high morbidity, while conservative measures may fail in severe cases. This manuscript explores unresolved questions surrounding its classification, risk stratification, and therapeutic approaches. Emphasis is placed on the role of early diagnosis through imaging, tailored antibiotic therapy, and the balance between conservative management and surgical intervention. Improved understanding of these aspects is critical to optimizing patient outcomes and reducing mortality rates.

 

Author (s) Details

Benjith Daniel F
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

Arvind Ramachandran
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Hariharasudhan Sekar
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49238-86-2/CH9

Impact of Medicinal Cannabis as an Adjunct to Conventional Therapy in Diabetic Neuropathy | Chapter 6 | Medical Science: Trends and Innovations Vol. 3

Background: Diabetes mellitus is increasing in prevalence in the Western world. Its estimated prevalence currently is about 30 percent of diabetic people making it the most common complication of diabetes. Diabetic neuropathy is unfortunately the most common complication associated with a common malady increasing in prevalence by 5% a year. None of the disease-modifying drugs that have been designed to target multiple metabolic pathways has proven effective. Thus, the treatment currently is mostly symptomatic. The current study assessed the ability of cannabis added to maximal conventional therapy to ameliorate diabetic neuropathy symptoms.

Methods: At screening, patients were assessed for the possibility of being treated by receiving cannabis therapy (CT, smoking, 20 grams per month) provided that they have completed a period of at least 12 months of optimal conventional treatment including at least one narcotic agent and at least one of following analgesic treatments: tricyclic antidepressants (amitriptyline and nortriptyline), anticonvulsants (gabapentin and pregabalin), and Serotonin- Norepinephrine Reuptake Inhibitors (SNRIs) (duloxetine and venlafaxine). Patients suitable for CT were treated for at least 3 months more with alpha lipoic acid 600 mg, vitamin B complex, duloxetine 30 mg and tramadol 100 mg up to thrice a day. If after 3 months of treatment, the patients were still in pain (BPI pain severity higher than 7) cannabis therapy was begun. Patients were followed up every 6 months for up to one year. The following Patient Reported Outcome scores (PROs) were collected: VAS pain intensity, VAS pain severity, BPI pain severity, BPI pain interference and SF12.

Results: In this study, 89 patients were screened. Out of 89, 15 improved after 3 months of maximal conventional therapy and thus did not meet the inclusion criteria of minimal pain severity. 74 patients began cannabis therapy and results are available after 6 months for 73 of them and 70 patients were followed up to 12 months. 4/74 patients stopped CT (1/74 due to ileus, 3/74 due to pain resolution). BPI pain severity decreased from 9.4±0.8 to 4.3±1.7 at six months, while pain interference decreased from 8.6±1.1 to 3.7±1.6. SF12v2 Physical Compounded Score (PCS) changed from 34±8 to 46±8 at 6M.

Conclusions: The addition of CT leads to substantial pain reduction accompanied by a decrease in HbA1C while quality of life questionnaire scores improved. The mechanism leading to improved diabetic control is not known at this time and requires further study. Further clinical research is necessary in order to define whether long-term MCT will lead to improved nerve function, as the time frame of this study is too short to allow nerve regeneration.

 

Author (s) Details

 

Mustafa Yassin
Department of Orthopedics, Hasharon Hospital and Tel Aviv University, Israel.

Dror Robinson
Department of Orthopedics, Hasharon Hospital and Tel Aviv University, Israel.

Please see the book here:- https://doi.org/10.9734/bpi/msti/v3/3957

The Significance of Diabetes in Orthodontic Patients: Treatment Modalities and Considerations | Chapter 16 | Medical Research and Its Applications Vol. 6

 

The present study highlights the significance of Diabetes in Orthodontic Patients. Diabetes mellitus, often referred to simply as diabetes, is a chronic metabolic disorder that affects millions worldwide. It's not just a medical condition; it's a journey that transforms daily life for those living with it. The classical symptoms of hyperglycemia are polyuria, polydipsia and polyphagia, blurring of vision. In severe cases results in ketoacidosis. The etiology of diabetes mellitus is multifactorial – an interplay of genetic, epigenetic and environmental factors, primary destruction of islet cells, cancer, surgery and trauma. Orthodontic treatment was more common to be performed among adolescents and young adults. Recent advances encouraged elder individuals to seek dental clinics for orthodontic interventions.

 

Author(s)details:-

 

Kumaran Vijayarangam (Associate Professor)
Department of Orthodontics, JKKN Dental College and Hospital, Kumarapalayam, Namakkal, Tamil Nadu, India.

 

Please See the book here :-  https://doi.org/10.9734/bpi/mria/v6/651

The Discrepancy between HbA1c and CGM-Derived GMI in Diabetes Management: A Retrospective Cohort Study | Chapter 8 | Medical Research and Its Applications Vol. 4

 

We performed a retrospective observational cohort study between 2020-2023 in 26 patients with type-1 and type-2 Diabetes Mellitus (DM) who were using 3-4 injections per day of Insulin and were monitored by continuous glucose monitoring (CGM). The goal was to compare the patient’s glycosylated hemoglobin (HbA1c) taken during their clinic visit by phlebotomy as a marker for diabetic control with estimated HbA1c glucose management indicator (GMI) derived from the 30-day CGM readings. The purpose of the study was to see if there is a correlation between those two values taken within 30- days of each other. To find if there is a correlation is extremely important in assuring that GMI received from the CGM can be used instead of HbA1c in patients on multiple daily injections of Insulin and be incorporated into the American Diabetic Association goals for achieving Diabetes control. Also finding such a correlation can help in reporting the control of diabetes mellitus to other healthcare organizations like Medicare etc. by using CGM data rather than HbA1c. The methodology we used was to compare CGM-derived GMI obtained within 30 – days with HbA1c which has been shown to best correlate with each other.  To assess if this difference between GMI and HbA1c was significant, a paired samples t-test was conducted. This comparison is important because of the widespread use of continuous glucose monitoring in patients with Type -1 and Type -2 Diabetes Mellitus on multiple injections of insulin to make treatment decisions. The patients with known factors that can interfere with the accurate measurement of HbA1c like anemia, and liver and kidney diseases were excluded from the study. We concluded the measured HbA1c was 0.34%(4 mmol/mol) higher than the CGM-derived GMI which was the conclusion of several other studies as well. The difference although numerically higher in favor of HbA1c was statistically non-significant.  As the use of CGM continues to grow, addressing differences between laboratory-measured HbA1c and CGM-derived GMI is critical. This can affect how we interpret the GMI in patients with CGM compared to HbA1c as well and it can be taken into consideration by different medical organizations while determining the goals of control and reporting of patients with Diabetes mellitus using CGM. Another very important part of the study was that the project was primarily driven by Internal Medicine residents in their clinic and not in a specialized endocrine clinic.

 

Author(s)details:-

 

A. Manov
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US.

 

Y. Badi
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US.

 

A. Donepudi
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US.

 

N. Holt
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US

 

M. Sharaf
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US.

 

R. Rivera
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US.

 

A. Daliwal
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US.

 

R. Haddadin
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US.

 

I. Quadir
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US.

 

K. Mefferd
Internal Medicine and Transitional Year Residency Program, Sunrise Health GME Consortium, Mountain View Hospital, Las Vegas, Nevada, US.

 

Please See the book here :-  https://doi.org/10.9734/bpi/mria/v4/503