[ Diabetes Solutions ]

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It is important to note that having a risk factor does not mean that one will get the condition. Among 1961 diabetic patients, 19 (0.97%) demonstrated cranial nerve palsies. The evaluation of neuromuscular diplopia is reviewed here. Medications included insulin andenalapril. Although, both the Italian and Japanese studies have shown the third cranial nerve palsy to be the most frequently affected nerve [4, 6], other case report studies from USA, France and UK support our findings that, sixth cranial nerve palsy is the most frequently affected nerve among diabetic patients [13–15]. His past medical history included hypercholesterolaemia for which he was taking regular statin therapy. Variables studied were: Clinical features including edema and granulations in external auditory canal (EAC), presence of otalgia, exudate, bony erosions of EAC, mastoid or petrous apex on CT scan and diabetes mellitus or other immunocompromised state.

sleep apnea: The walls of your airways can thicken and cause breathing difficulties associated with sleep apnea. At that time, a gallium study showed no scintigraphic evidence of skull osteomyelitis and swabs taken from the right ear were culture negative. Pathologic Conditions of the Lower Cranial Nerves IX, X, XI, and XII. Infective: Herpes simplex, herpes zoster, Lyme’s disease. The upper eyelid is droopy (ptosis). Noise is a common cause of hearing loss in the US. Selection criteria were based on the good preservation of the brain and good quality material for dissection.

In contrast, there is an 8-fold increased odds of having coexistent diabetes and hypertension in cases of sixth nerve palsy over controls. It runs upward between the pons and the clivus, (cisternal segment of the abducent nerve) (Figure 3) and then pierces the duramatter to run between the dura and the skull into Dorello’s canal (the bow-shaped canal through which courses the abducens nerve before reaching the cavernous sinus. CIDP is characterized by the occurrence of symmetrical weakness in both proximal and distal muscles, which progressively increases for more than 2 months1. The laboratory data, other aspects of the medical history, and the review of systems were in the normal range. All patients recovered on corticosteroid therapy and resolution of the masses was documented on follow-up MRI studies in five patients. In the cavernous sinus, the oculomotor, trochlear, ophthalmic branch of the trigeminal nerves is place in the lateral wall. There was suspicion of orbital apex involvement and C.T.

The affected eye will tend to deviated inward because of the unopposed action of the medial rectus muscle. Vitimin B12 is not easily found in a vegetarian diet, it can also be caused by taking metformin. Pediatric patients with no apparent trauma should undergo magnetic resonance imaging of the brain with contrast enhancement to rule out a central nervous system structural lesion (tumor or aneurysm). In agreement with the recommendations mentioned above, in type 2 diabetic patients the use of botulinum toxin A at the very beginning of diplopia and nerve lesion also seems to be more effective than in patients with a long duration of symptoms. Investigation with CT scanning is the current modality of choice 1 for defining the anatomical extent of the disease in malignant otitis externa. For reasons that are not clear, the virus may begin to multiply again (re-activate). Figure 4: Lateral view of the base of the skull from the inside showing the path of the abducent nerve in the cavernous sinus and its relation with the internal carotid artery.

On the right upper corner a frontal section through the cavernous sinus showing the cranial nerves, III oculomotor, IV trochlear, V (ophthalmic and maxillary branches of the trigeminal) in the lateral wall and VI abducent n running through it.

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[ Diabetes Type 2 ]

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Gongronema latifolium leaves have been used in folklore medicine to manage diabetes mellitus and alleviate dyspepsia. here is an try and make clear some of the muddy waters. On abdominal computed tomographic imaging, there was gas throughout the wall of the stomach but no evidence of gastric perforation. Animals were injected streptozotocin (STZ: 70 mg kg(-1), i.p.) and used after 5, 10 and 15 weeks of diabetes with blood glucose levels of > 350 mg dl(-1). Diabetes was induced in rats by single injection of STZ (70 mg/kg i.p.) four weeks prior to production of gastric ulcers by acetic acid method or induction of stress lesions by 3.5 hours of WRS. The prolongation of the healing in diabetic animals was associated with an increase in gastric mucosal expression and release of TNFalpha, interleukin-1 beta (IL-1 beta), suppression of the vascular endothelial growth factor (VEGF), platelet endothelial cell adhesion molecule-1 (PECAM-1) and the mucosal overexpression of heat shock protein 70 (HSP 70). This increase in ulcer area in diabetic mice was significantly reversed by the treatment with OPB-9195 without affecting blood glucose levels.

This high blood sugar produces the classical symptoms of – frequent urination, increased thirst and increased hunger. Blood glucose level remained stable in mild diabetic rats from 3rd day onwards after streptozotocin administration (taken as 1st day for treatment) and EJE (200 mg/kg) showed anti-hyperglycemic effect on 10th day of its administration. It has been reported that the enhancement of cell proliferation during ulcer healing may be mediated by increased release of EGF and TGF-α. Cancer has ranked number-one cause of death in Taiwan since 1982, and average age of those diagnosed with it shows trend a downward. Amongst renal function tests, blood urea nitrogen was 34 mg/dl and serum creatinine of 3.4 mg/dl. Read it carefully. This may not be a complete list of all interactions that may occur.

The NSAID decreases prostaglandins that cause pain and inflammation, relieving joint pain. The H2 blocker works to reduce stomach acid by blocking one of the chemicals (histamine) that stimulates the release of acid into the stomach. Read it carefully. nit. If you have not had chickenpox, shingles, or measles, avoid contact with anyone who does. pylori. For example, although metformin is the drug of choice, its use may not be tolerated by cachexic patients or by those with lypoatrophy.


But a small fraction of patients develop infections, leaking from the stomach into the abdominal cavity, or gallstones, and it can cause nutritional deficiencies: There is less intestine to absorb vitamins and minerals, raising the possibility of osteoporosis and anemia. Post-mortem blood culture did not show any growth. Hence a diagnosis of isolated gastrointestinal mucormycosis leading to gastric perforation was made. Patients with a low risk of rebleeding and mortality are discharged home and subsequently undergo diagnostic endoscopy on the next available list. They cause infection only in immuno-compromised states and mucormycosis is commonly associated with diabetic ketoacidosis, immunosuppression following organ transplantation, severe malnutrition, haematological malignancies, chronic debilitating diseases and desferrioxamine therapy in patients requiring haemodialysis 1, 2. Therefore, by recruiting a population undergoing bidirectional endoscopies as part of a medical examination, we determined the prevalence of GI symptoms and endoscopic abnormalities in association with DM. Five forms of the disease have been recognised as rhinocerebral, pulmonary, cutaneous, gastrointestinal and disseminated 3.

Rhinocerebral form is common in diabetics and pulmonary and disseminated forms are seen with haematological malignancies, whereas gastrointestinal infection is thought to arise from the ingestion of spores and has been traditionally linked to extreme malnutrition 2. In contrast, equivalent manipulations of the proximal intestine among patients without diabetes yield the opposite effects on glucose tolerance. In the absence of alarm features, we perform early endoscopy (within two weeks) in patients of age ≥55 years. When the gastrointestinal tract is involved, the stomach is the most common site and rarer intestinal form has a predilection for the terminal ileum and caecum 3. Barry Marshall, that stomach ulcers are not due, as commonly supposed, to a faulty diet or psychological factors such as stress or anxiety, but caused by the bacterium Helicobacter pylori. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. In a series of seven cases of invasive gastric mycosis reported in literature, all presented with perforated viscous either intra-operatively or at autopsy 5.

In a study of gastrointestinal mucormycosis of 58 cases only one case showed involvement of stomach, small and large intestine 4. In another study of 14 cases of only intestinal mucormycosis after excluding gastric forms, gastric involvement was seen in only one case along the involvement of small and large intestines 6. However, the amount of alcohol in recommended doses of this medicine does not usually cause problems in nursing babies. Though some of the reported cases have been in diabetics, in the literature there is no clear association of diabetes with isolated gastrointestinal mucormycosis as is with rhinocerebral forms 4, 6, 7. The disease is reported both in adults and in neonates and infants where it can present as necrotising enterocolitis and intestinal perforation 6, 7. In a study of 8 cases of gastrointestinal mucormycosis, 5 were premature babies and prematurity was also postulated as risk factor for this infection 7. The usual symptoms of gastrointestinal mucormycosis include vomiting, bloody diarrhoea, upper gastrointestinal bleeding, abdominal lump and abdominal distension 7.

This patient presented with pain in abdomen and gradual distension of abdomen. In a case report describing the upper gastrointestinal endoscopy findings, the lesions appeared as ulcerated plaques with raised edges and were covered with black necrotic slough 8. Limited reports in literature are available describing the radiologic findings of mucormycosis. Contrast enhanced CT studies may show diffuse circumferential wall thickening with areas of both intense and poor contrast enhancement in intestinal wall correlating with areas of congestive changes and of necrosis and infarction caused by fungal proliferation respectively 3. The clinical diagnosis is difficult as the symptoms are non-specific and antemortem diagnosis can be achieved by demonstrating broad, non-septate hyphae with right angle branching in histopathology in the resection or biopsy material 5, 7. Mucormycosis can be just colonisation of peptic ulcers in stomach to infiltrative disease or vascular invasion with dissemination 5, 7. Fungal elements at the base of chronic peptic ulcers may enhance the degree of necrosis and that these cases have protracted disease and deeper ulcers with more perforations 9.

Common to all forms of mucormycosis is vascular invasion with production of necrotic tissue. But in our case we do not think that it is a peptic ulcer complicated by mucormycosis as rest of the gastrointestinal tract was also showing gangrenous changes due to invasive mucormycosis. Successful treatment consists of early diagnosis, intensive systemic antifungal therapy with amphotericin B and surgical resection 5. Only non resectional surgery carries high mortality whereas surgery followed by antifungal therapy provides improved survival. In this case, the clinicians’ diagnosis was peptic ulcer disease and hence the line of management of only non resectional surgery did not help the patient. Hence a high index of suspicion is required along with histopathological confirmation for diagnosis of isolated gastrointestinal mucormycosis and greater awareness of the clinical settings in which it develops is a pre-requisite to improved survival and reducing the high mortality in such cases.

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[ Diabetes Type 1 ]

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To investigate the hypoglycemic and antioxidant effects of methanolic extract from the leaves of Cecropia pachystachya. The nutritional properties of developed fibre-enriched cake and its protective potential against diabetic induced neurotoxicity in rats were investigated. Diabetes was induced in the experimental rats with alloxan (70 mg kg-1 body weight). A significant reduction in the serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) levels of diabetic rats following OA treatment was also observed. Glutathione peroxidase, catalase and superoxide dismutase activities were significantly decreased in homogenates of liver and kidney, while malondialdehyde levels were increased in tissue homogenates of liver and kidney. Asian-Indians have been identified as one of the ethnic groups with a high prevalence of diabetes mellitus and a high familial aggregation of type 2 diabetes. In streptozotocin-diabetic rats, renal beta-glucuronidase and beta-N-acetyl glucosaminidase activities were reduced while cathepsin D activity was similar to that of controls.

Alloxan (150 mg/kg as a 5% solution in normal saline) was given to rabbits via marginal ear vein. The high dose (450 mg/kg BW) was found to have more potential antioxidant activities compared with glibenclamide. (2011) Antihyperglycemic and Glycogenesis Effects of Different Fractions of Brassica oleracea in Alloxan Induced Diabetic Rats. aristata, collected from the local area of Rishikesh, Uttranchal. The plant was authenticated by Dr. New Zealand white rabbits three months of age and weighing about 1–1.5 kg were utilized in the study. J.


Chaudhary, Director of Botanical Survey of India, Govt. of India, Dehradun Bsi/Nc/6(4)/06-07. The stem bark was dried in shade at room temperature. Dried stem bark was coarsely powdered by using grinder, and latter was packed into soxhlet column and that was defatted with petroleum ether then extracted with ethanolic and dried in vacuum. The presence of alkaloids were confirmed by qualitative examination. Male Wistar albino rats (150–250 g) housed in a spacious cage for ten days after obtaining approval from ‘Institutes Ethical Committee’ 997/c/06/CPCSEA. During the experiments rats were feeded with standard pellet diet.

After randomization into various groups, the rats were acclimatized for 2–3 days in environment before initiation of experiment. Rats were divided into four groups containing six animals in each group. All animals fasted before treatment. Group I was kept as vehicle control which received 5% Tween 80 p.o., group II received glucose only, group III received ethanolic extract 25 mg/kg and group IV received only extract only in a vehicle respectively .The rats of group II and III were loaded with glucose (3 g/kg, p.o.) 30 min after drug administration. Blood samples were collected from puncturing the retro orbital sinus just prior to drug administration, and 30, 90, 150 min after loading glucose. Serum glucose level was measured immediately by using glucose estimation kit (Span Diagnostic Pvt. Ltd.

Surat, India) 8 . All the animals were randomly divided into five groups with six animals in each group. The kidney exhibits a characteristic pattern of changes during diabetes [48]. Group II, III, IV and V were made diabetic by single intraperitoneal injection of alloxan monohydrate (125 mg/kg; Rollex, India) and served as diabetic control, standard and treatment groups respectively. Rats exhibited in plasma glucose levels >250 mg/dl, 48 h after administration of alloxan were included in the study. Treatment for diabetes (B. The rats were divided into four groups (10 per each).

Blood samples were collected retro-orbitally from the inner canthus of the eye under light ether anesthesia using capillary tubes (Micro Hematocrit Capillaries, Mucaps). Blood was collected in fresh micro centrifuge tube and plasma separated in a T8 electric centrifuger (Remi Udyog, New Delhi) at 2000 rpm for 15 min. Coskun et al. Ltd. Surat, India). Liver glycogen content was estimated by the method of Carrol et al.,1955 9 .

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[ Diabetes Solutions ]

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A major collaboration of UK scientists has provided an insight into the genetics underlying a number of diseases including Crohn’s disease, a type of inflammatory bowel disease, and type 1 diabetes. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. A buildup of plaque inside the arteries, which is called atherosclerosis, can cause chronic, or long-term, IC. Ulcerative colitis is a type of inflammatory bowel disease (IBD). Rather than take the mickey, people would try to help me, so I was able to get by reasonably well. There are many ways to improve your quality of life. butyricum upon entry to a hospital, as a preventative for these dangerous and highly-contagious acquired infections.

Instead, it’s carbon that’s been superheated in order to create tiny crevices that can soak up substances, explained Dr. People with Ls can go on to develop diabetes and other auto immune problems, or may already have them. After my initial admission, I was in and out of the hospital and was on and off prednisone for a few years. In addition, it might be developed to elucidate molecular mechanisms underlying the disease. You can have FAP even if there are no other cases in your family. The abdomen was distended with fundal height at 35 week. If you have sugar diabetes, or if you have an eye condition called glaucoma.

The two fetal heart sounds were normal. Three months later, he slurped down another 1,000 eggs. Ook had ze bloed in haar ontlasting. Blood sugar results while on insulin were 5.1 mmol/L fasting and 5.9 mmol/L random. It has been claimed that carrisyn directly kills various types of viruses, including herpes and measles, and possibly HIV. Hemoglobin A1C (HbA1C) was 5.1% (Reference range 4.8-6%). Immunohistochemical staining of Lewis a indicated increased expression in the cryptic epithelium of inflammatory lesions in UC patients than the normal mucosa of patients with benign colonic polyps (P = 0.028), although there was no difference of Lewis a expression in surface epithelium between the two groups.

Stool culture was positive for E. If similar results are obtained, it would indicate a role for this class of food additive in driving the epidemic of obesity, its inter-related consequences and a range of diseases associated with chronic gut inflammation. Clostridium difficile toxin-A was negative in stool. Thyroid function tests (TFT) revealed Thyroid stimulating hormone (TSH) 6.32 ulU/L (normal 0.27-4.2), free T4 (FT4) 13.36 pmol/L (normal 12-22) and free T3 (FT3) 3.17 pmol/L (normal 2.8-7). Accessed Jan.6, 2016. The liver enzymes were elevated: Aspartate Aminotransferase (AST) 181U/L (normal 15-37), alanine aminotransfersase (ALT) 379U/L (normal 30-65), alkaline phosphatase (ALP) was normal 109U/L, Total Bilirubin (TBIL) was normal 9umol/L and Albumin (Alb) 23g/L (normal 34-50). Hepatitis serology was positive for HCV Ab but hepatitis C virus Polymerase chain reaction (PCR) was negative for detection.

Shortly after starting GAPS, I began researching fluoridated water. She was given one week course of ceftriaxone. The day after the first enema, I saw normal stools for the first time in over a year. She was started on intravenous fluid infusion to avoid dehydration. She was also given trials of loperamide, cholestyramine and subcutaneous injections of octreotide but the diarrhea did not improve. The other group included patients who had concomitant coeliac disease [11], had undergone an acute gastroenteritis shortly before the diagnostic colonoscopy [4], had had only one episode of severe diarrhoea, or had had a normal biopsy after the initial pathological intestinal biopsy, and were in clinical remission (MC2, n = 60). Upper gastrointestinal endoscopy (OGD) was performed and it was normal.


Duodenal mucosal biopsy showed no evidence of celiac disease. Especially for younger patients, I’d say don’t be ashamed, you can still lead an active life. The colonic biopsy was consistent with inflammatory bowel disease. It showed chronic inflammatory cells infiltrate cryptitis and no evidence of vasculitis. http://www.merckmanuals.com/professional/print/sec02/ch018/ch018c.html. Then intravenous Hydrocortisone 100mg TID was added. Over three days the frequency of bowel motions improved from 15-20/day to 5-8/day.

However over one week of treatment she had dramatic weight gain of 20 kg and massive edema. The BP was normal and the test for 24 hour urine protein was 0.4.g. I had lost 15 pounds and was malnourished; I think I might have healed better if I hadnt been so sick. and that water constantly flows ‘outward’ as it evaporates off the skin osmosis pulls more water into the cell from the inside. The frequency of bowel motions was 1-2/day and the liver enzymes improved to normal. Five weeks after the diagnosis of IBD she had cesarean section delivery of her 6th baby girl 2.72 kg and her first baby boy 2.63 kg. Colitis: Pseudomembranous, microscopic and radiation.

Because these drugs can cause serious side effects, the dosage is lowered as soon as possible. Azathioprine(AZA) 50 mg daily was started and prednisolone was gradually stopped. On her latest follow up she remained asymptomatic maintained on AZA 50mg daily and solofalk 500mg TID. The above presentation of inflammatory bowel disease is unusual. Most of the patients with pregnancy associated IBD are diagnosed before pregnancy and the target in these patients are to keep the disease in remission1, 4. During our search we did not come across a case of Crohn’s (CD) disease with an onset during pregnancy. Only few cases of ulcerative colitis (UC) were diagnosed during pregnancy 6.

The presence of low grade fever and positive stool culture raises the possibility of infectious diarrhea. However the long duration and unresponsiveness to antibiotic make that unlikely. Experiments have been conducted at the Municipal Hospital at Santo Andre, Sao Paulo using Pau D’Arco in the treatment of respiratory problems, ulcers and a variety of other ailments. OGD and colonoscopy are known to be safe during pregnancy with minimal fetal risk7,8. Adult onset celiac disease can also present with watery diarrhea but the duodenal mucosa in the OGD was normal with normal small intestinal biopsy. Positive ANA raised vasculitis as another possibility but the P-ANCA and the C-ANCA were negative and the colonic biopsy did not show evidence of vasculitis. Functional symptoms from Irritable Bowel Syndrome (IBS) can be aggravated by pregnancy but though the patient is of type a nervous personality, she did not report past symptoms of IBS.

The severity of diarrhea together with unresponsiveness to trial anti-diarrheal medication made IBS unlikely to be the cause of this patient diarrhea. She had low albumin level and low hemoglobin level. This could be explained by the chronicity of diarrhea but may be part of physiological changes related to pregnancy. The leaves of Bael are anti-diabetic in nature. Presence of secretory diarrhea, skip pattern on colonoscopic examination and the poor response to Mesalamine support the diagnosis of CD more than UC. Small bowel examination by enteroclysis and abdominal Computed Tomograph (CT) were delayed until after delivery. The patient had remarkable improvement on systemic steroids but on the other hand she had poor control of the blood sugar and massive fluid retention with 20 kg weight gain over one week.

Preeclampsia was excluded and she responded to fluid restriction, frusemide and gradual reduction of steroid. The patient symptoms were controlled on oral prednisolone and mesalamine until she had elective cesarean section delivery five weeks after diagnosis. Previous reports on the use of immunomodulators during breast feeding were discouraging but more recently the data showed no significant risk on the infants9. After delivery she was maintained on AZA 50 mg daily and mesalamine 500 TID she chose not to breast fed her infants. Though IBD are commonly associated with pregnancy, new onset disease during pregnancy is very rare. The use of the diagnostic modalities like radiological investigations may be limited during pregnancy. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

The response to treatment is similar to non pregnant patients. Close monitoring of the treatment and early diagnosis and management of exacerbation during pregnancy is important to avoid complications.

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[ Diabetes Solutions ]

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There has been much interest in the role of free radicals and oxidative stress in the pathogenesis of diabetes mellitus (DM). Glutathione S-transferase family of enzymes protects tissue from oxidative damage which is discussed in the context of T1D. A total of 30 healthy subjects served as controls. These antioxidants include enzymes like superoxide dismutase , catalase, glutathione peroxidase and glutathione reductase, minerals such as selenium, manganese, copper and zinc, vitamins such as vitamins A, C and E and other compounds such as glutathione, uric acid and flavonoids. Serum lipid profile, blood-glucose level, glycated hemoglobin (HbA1c) and body mass index (BMI) were measured. Maximum decrease was observed in the poorly controlled diabetic group for all parameters. There was a significantly higher erythrocyte MDA levels in patients with gestational diabetes when compared to controls (21.0 ± 4.7 vs.

GMBF was not influenced by diabetes. The study was conducted on patients who are members of the Rivers State Chapter of Diabetes Association of Nigeria ( DAN ) after informed and written consent was obtained from them and was approved by the Ethical Clearance Committee of the Institution. The study group consisted of eighty (80) adult type 2 diabetic patients, on diet and various hypoglycemic agents. A prominent function of these enzymes is the conjugation of GSH to toxic hydrophobic compounds provided by an electrophilic center.19 This reaction facilitates toxin inactivation and renal elimination.20 Red blood cells express almost exclusively a single GST isoenzyme, GST-P1-1,21 which represents more than 95% of the erythrocyte GST (e-GST) pool (Figure 1). “These findings suggest a new cause of insulin resistance and argues against the general belief that antioxidants are beneficial to insulin function,” says Lei, who notes that this is the first study to show that an antioxidant actually promotes insulin resistance, a precursor of type 2 diabetes. Exclusion criteria included those with history of allergy to the study medication and existence of other illnesses requiring administration of other drugs. Neither diet nor hypoglycemic agent was changed in dose throughout the study.

At baseline, their clinical and biochemical characteristics were evaluated. Since SOD enzyme is part of the first line of defense against free radicals, it is expected that the activity of this enzyme may be affected by stress oxidative before the other antioxidant enzymes [25]. The ingredients in Ultimate GLX have also been show to improve glucose tolerance, facilitate excretion of heavy metals, provide neuroprotective effects, slow progression of chronic kidney disease, slow the progression of HIV infection, support intestinal and immune cell function and provide antioxidant protection to many tissues. Sustained hyperglycemia is associated with low cellular levels of the antioxidant glutathione (GSH), which leads to tissue damage attributed to oxidative stress. About 6.0mls of venous blood were obtained from the patients after an overnight fast. Fasting plasma glucose was measured using commercially available kits ( Randox Laboratories Manual Procedures,1996)6. It has been postulated that release of NO upon platelet activation acts as a negative feedback to further platelet activation/recuitment, thereby raising the threshold of stimulus necessary to cause aggregation, and helping to prevent inappropriate thrombus formation.

by-products of reactive oxygen species activity) and exogenous (e.g. In case you’re not familiar with hormesis, here’s a major example. Vitamin E concentration was measured using the reverse phase high pressure liquid chromatography method10. All assays were performed in triplicate. Statistical analyses were performed using statistical package for social sciences ( SPSS ) software version. Pearson’s correlation analysis was used to determine the relationships between variables and the extent of correlation was determined using regression analysis. All results are expressed as means ± SD.

A P-value less than 0.05 was considered statistically significant.

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[ Herbal Remedies ]

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Introduction: Type 2 diabetes mellitus (T2DM) is associated with increased production of reactive oxygen species and a reduction in antioxidant defenses leading to oxidative stress. Although glutathione (GSH) and the enzymes included by glutathione redox cycle have an important role for protection of cells against free radical-mediated damage, they may be susceptible to oxidation themselves. Statistical analysis between controls and patients was performed by the unpaired t-test using the stat-view package. This was accompanied by a 50% decrement in mucosal content of glutathione; 48 hours after streptozotocin, the decrement of glutathione was only of 25% and no gastric damage was observed. On the addition of melatonin, the hormone exhibiting antioxidative properties, the control values of HFR production were restored, suggesting that this compound might be beneficial during diabetes therapy. In addition, several effects of diabetes (increased hepatic glutathione peroxidase activity, increased superoxide dismutase activity in kidney and heart, decreased renal and increased cardiac catalase activity) were not mimicked in galactosemic rats, and glutathione concentration in both liver and heart was affected in opposite ways in diabetic rats and galactose-fed rats. The development of kidney injury in patients with type 2 diabetes mellitus (T2DM) is likely secondary to complex interactions of metabolic and hemodynamic factors.

from Cornell this spring and is now a diabetes researcher at a U.S. These data also suggest that the impairment of glutathione metabolism weakens the defense mechanism against oxidative stress in erythrocytes of diabetics. The study was conducted on patients who are members of the Rivers State Chapter of Diabetes Association of Nigeria ( DAN ) after informed and written consent was obtained from them and was approved by the Ethical Clearance Committee of the Institution. NAC and TAU are able to partially protect from oxidative stress and GSH decrease, while enhancing GSH synthesis and restricting GSH loss. Aldibasi and his colleagues performed a study on 100 diabetic patients with retinopathy and 60 diabetics without retinopathy as the control group. Many experts believe that the new chemical environment in which we live is a major contributing factor to the high incidence of many degenerative diseases in the modern era. 10.8 ± 1.2 pg/ml; P < 0.001).

Neither diet nor hypoglycemic agent was changed in dose throughout the study. At baseline, their clinical and biochemical characteristics were evaluated. Instead, we surmise that the antioxidant effect of NAC is primarily mediated through its ability, as a biosynthetic precursor, to boost production of intra-platelet GSH, consistent with previous studies in other cell types (for example [23]). The human glutathione S-transferases (GSTs) are a family of enzymes known to act in the body as the defense systems for neutralize free radicals. Sinha is a huge exercise advocate and low-carb diet proponent. About 6.0mls of venous blood were obtained from the patients after an overnight fast. The ability of a cell to resist damage caused by oxidative stress is determined by the capacity of an array of antioxidant defense systems, among which reduced glutathione (GSH) is the most ubiquitous and abundantly available within human cells.

The glycated hemoglobin concentration was estimated using commercially available kits 7 . MDA was measured as TBARS by the method of Wilbur et al 8 . Erythrocyte reduced GSH levels were determined in whole blood by adopting the method described by Beutler et al 9 . Vitamin E concentration was measured using the reverse phase high pressure liquid chromatography method 10 . All assays were performed in triplicate. Statistical analyses were performed using statistical package for social sciences ( SPSS ) software version. Pearson’s correlation analysis was used to determine the relationships between variables and the extent of correlation was determined using regression analysis.

All results are expressed as means ± SD. A P-value less than 0.05 was considered statistically significant.

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[ Diabetes Solutions ]

Internet Scientific Publications

The use of volatile anesthetics has been reported to alter cerebrovascular carbon dioxide (CO2) reactivity. Specifically we hypothesized that patients with a low functional capacity, decreased plasma volume, or significant cardiac comorbidity would be at high risk for intraoperative hypotension and those with a history of severe hypertension would be at risk for intraoperative hypertension. The authors retrospectively evaluated the influence of diabetes, body mass index (BMI), age, and sex on the success of supraclavicular block (SCB) placed with a landmark-based paresthesia technique. As autonomic dysfunction is commonly encountered in many of the endocrine disorders such as diabetes, adrenal disease, and other, pre-operative assessment and intra-operative vigilance is important.[3,4,5,6,7,10] Equally, crucial is the assessment of cardiovascular status, neuro-muscular functions, renal parameters and various other organ systems, which are directly or indirectly affected by various endocrinopathies. The Vmca was measured using transcranial Doppler ultrasonography during isoflurane-nitrous oxide anesthesia. Insulin is critical in modulating maternal glucose, fat, and protein metabolism. Fibreoptic intubation is the safest course of action for these patients.

We conclude that the Vellore regimen is simple, effective, and safe for intraoperative blood glucose control. There was no relationship between cardiovascular autonomic function and hemodynamic behavior during anesthetic induction. In addition, improvement of touch thresholds was also observed at the other four assessment sites, together with a decreased vibration threshold at 125 Hz. The addition of both mechanisms may result in transient or permanent nerve injury in diabetic patients (Fig 1). For Patients Taking Coumadin/Warfarin:  Prior to your procedure, a consultation with your regular physician will determine whether there is a need to temporarily stop your Coumadin/Warfarin therapy. Studies showed that a fraction of non-diabetic patients were found to have glucose intolerance due to the stressful situation of anesthesia and cardiopulmonary bypass 4 and 5. As such, nowadays, a multidisciplinary approach involving endocrinologist, anesthesiologist, intensivist and surgeon is needed for better patient outcome in perioperative period.

Although it is difficult to link between ischemia – edema produced by local anesthetics toxicity and that seen in diabetic myelopathy and radiculopathy probably the addition of both mechanisms may cause the emergence of transient or permanent nerve injury after neuraxial anesthesia. Poupat KU et al (1) did not consider the role of local anesthetics toxicity, diabetic myelopathy/radiculopathy, and alcohol neuropathy as possible risk factors that contributed to paraplegia in their patients. For minor surgeries, hospitalisation should be done only in those diabetic patients with poor glycaemic control. “About thirty minutes in”, he explains, “your pump started going nuts. In addition, literature is poor and studies are needed to determine whether neuraxial anesthesia/analgesia in diabetic patients with spinal cord and DRG involvement needs reduced local anesthetic volume and concentration.

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[ Diabetes Type 2 ]

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Methods and results: The anti-diabetic properties of cashew plant parts were studied using differentiated C2C12 myoblasts (myotubes) and rat liver mitochondria. Other parts of the cashew plant – including leaves, barks and apples – were also tested, but were not found to have an effect on glucose uptake. For growing, cashew nuts need humid and hot climate, so that’s why some countries, such as Tanzania, Nigeria, Brazil, and Mozambique, are the biggest producers of Cashew Nuts on the planet. My phosphorous levels have risen from 2.03 mmol/L to 2.34 mmol/L. A West African country noted for farming. The bark is the part used for medicinal applications though. In South America, the leaves and/or the bark are used in for eczema, psoriasis, scrofula, dyspepsia, genital problems, and venereal diseases, as well as for impotence, bronchitis, cough, asthma, vaginitis, intestinal colic and syphilis-related skin disorders.


They represent a true international effort of testing around the world. About 3½ years after his diagnosis, after a long streak of excellent blood sugar readings, a friend suggested he was cured. 3. Vitamin K found in it has ability to suppress the tumor cells growth. The homogenate was allowed in the refrigerator at 4ºC for 48hours. David Jenkins, one of the pioneers of the glycemic index. The most obvious interpretation of the findings is to attribute them to differing effects of MUFA and PUFA on baroreflex sensitivity, Schutte and her team note.

GOOD FOR: The heart health-conscious and people with high cholesterol. The yield was 47.4g (6.24%) of an oily brown substance which was kept refrigerated until use. You can look at the support groups for the insulins and find a lot of great information on dosing protocol, testing, feeding. Vinegar Vinegar has all sorts of hidden health benefits. That’s because HDL cholesterol travels through your body, picking up bad bits of LDL cholesterol along the way, leaving it off at the liver, which breaks it down and gets rid of it. Sterker nog, om nu al cashewnootextract als medicijn te verkopen, zou misschien zelfs gevaarlijk zijn. Diabetic group D rats received subcutaneous injection of 5IU of insulin as used by Sonia and Srinivasan (1999).

The experiment, which lasted for 28 days, was carried out in the Department of Anatomy, University of Calabar, Nigeria with the approval of the Ethics Committee of the university. Anti-oxidant: Contains Copper, which is a key segment of the compound superoxide dismutase, imperative in vitality creation and antioxidant defense, producing greater flexibility in blood vessels, bones and joints. This is the so-called bad cholesterol, which I like to think of as the lousy lipid. 72hours post-induction fasting blood sugar was measured and only rats with fasting blood glucose greater than 13.3mmol/l were adjudged to be diabetic (Cetto et al., 2000) and were used for this study. Quantitative proximate composition was done using methods described by Chang (2003) for percentage protein content, Kirk and Sawyer (1998) for percentage fat content, James (1995) for percentage fibre and carbohydrate contents.

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[ Diabetes Type 2 ]

Internet Scientific Publications


Objectives To assess the prevalence of metabolic syndrome and evaluate proinflammatory status in patients with type 1 diabetes, and to analyse the relationship between inflammation, metabolic control and insulin resistance in these patients. While the existence of a “dawn phenomenon” is widely recognized, the present study sought to establish whether diurnal basal insulin patterns exist in Type-1 diabetes, and whether these patterns vary by age and gender. The DRB1*03.DQA1*05.DQB1*02 haplotype was positively associated with the disease, occurring in 78% of diabetic children compared with 22.6 % of healthy children (p(c) < 2.4 x 10(-5)). Diabetes is a disease that involves high blood glucose levels. For example, arterioles isolated from biopsy samples of fat from patients with type 2 diabetes fail to constrict in response to pressure but constrict normally in response to norepinephrine. PPI-specific CD8(+) T cells in type 1 diabetic patients include central memory and target different epitopes in new-onset versus long-standing disease. In this issue of Diabetes, Mojibian et al. As recently as four decades ago there was a debate as to whether or not males could have eating disorders at all, especially AN (e.g., [6]). It has long been recognised that multiple autoantibody-positive individuals have a high risk of type 1 diabetes [8, 9, 22], which can be further stratified by antibody characteristics such as target specificity [23, 24], titre [24, 25] or age at autoantibody seroconversion [4]. There was significant positive correlation between HbA(IC) concentration and scores of the psychological functioning indices. The results show that family resilience characteristics that are significantly correlated with family adaptation are affirming communication in the family; the family’s willingness to accept change as positive; and family time spent together and routines followed in the family.

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[ Nutrition ]

Internet Scientific Publications

In 2011 a 60-year-old Caucasian man was admitted to the Emergency Department of our hospital due to scrotal and perineal pain and fever (39°C). They had been out of touch for some time. Gangrene can also occur in organs such as the gallbladder, intestines and muscles. A 56-year-old man with history of poorly controlled diabetes mellitus and alcoholism presents with severe scrotal pain and fever for 3 days. [8] WIfI: Risk stratification based on three major factors that impact amputation risk and clinical management: Wound, Ischemia, and foot Infection. Each 1g/L increase of hemoglobin was associated with 2.8% lower prevalence of diabetes foot complications. An injury such as a burn, frostbite or a crush injury (where the body is subjected to a high degree of force or pressure, usually after being squeezed between two heavy objects) can suddenly restrict the flow of blood to tissue.

So, a tiny blister may turn into a stubborn ulcer. He also received symptomatic treatment for gangrene and CDI. As he notes, the skin develops a hard, dry eschar because of a lack of subcutaneous capillary flow to the area. Then, he was referred to RNL Bio to seek treatment with his preserved stem cells for treatment on September 15, 2010. This is more commonly seen in middle aged having immunosuppressive disorder like diabetes mellitus, malignancy and chronic alcoholism2. He was also affected by severe diabetic complications, including peripheral neuropathy and nephropathy leading to end-stage renal disease (ESRD) with daily urine output of less than 300 ml and was hemodialysis-dependent for the last one year. The study was approved by the Institutional Ethics Committee.

Arteriogram had a vasoocclusive disorder at the digital femoral artery an d CT abdomen showing a supra renal mass (8x6x5) cm border of head and body of pancreas displacing the right kidney inferiorly. The nerve damage can make it difficult for you to know if you have an open wound making it easy for it to go untreated. Special attention should be given to the feet of those with diabetes each day. In 1950 Smith and Krichner3 gave the following criteria for the clinical diagnosis of mucormycosis: (i) a blood tinged nasal discharge and facial pain, both on the same side, (iii) soft peri-orbital or peri-nasal swelling, going on to discoloration, induration and progressive vascular occlusion, (iii) ptosis of the eyelid, proptosis of the eyeball and complete ophthalmoplegia, (iv) multiple unrelated cranial nerve palsies, and (v) black, necrotic turbinates, easily mistaken for dried, crusted blood. Treatment involves removing all dead and diseased tissue and administering antibiotics. The dermis and subcutaneous tissue showed oedema, necrosis, bacterial colonies, acute inflammatory cell infiltrate in all the cases while thrombotic capillaries were observed in 3 cases. The most important benefits of this therapy include a reduction in the wound area together with induction of new granulation tissue, effective wound cleaning, and the continuous removal of wound exudate.

He did not realise the great opportunity that Swami had offered him by His Grace. One case required transverse colostomy with restoration of bowel continuity at a later stage. Five patients developed acute renal failure which was managed, while one patient died. The disease is classified as Type 1 when caused by a mixed anaerobic flora and other bacteria, and Type 2 when caused by Group A Streptococcus alone or in association with Staphylococcus aureus 7. Predisposing factors include –chronic and malignant diseases, psoriasis, surgery, and opened or closed trauma, among others8,9,10. The three main types of blood vessels are veins, arteries and capillaries.Antibiotics Antibiotics are medicines that can be used to treat infections caused by micro-organisms, usually bacteria or fungi. But one thing is for sure: it is vital to stick to your treatment routine, refrain from smoking, select appropriate footwear and regularly get a therapeutic pedicure to minimise complications or postpone their onset.

The differential diagnosis includes cellulitis at initial stage. He does note this is an off-label use. The confirmation is mainly by histopathological examination of excised surgical material. The key feature in distinguishing necrotizing fasciitis from cellulitis is the location of the inflammation. In the former, the inflammation involves the subcutaneous fat, fascia, and muscle in addition to the dermis. Bacteriological tests from the wound exudates, blister fluid, excised tissue and aspirate material are essential for appropriate microbiologic diagnosis12. In our study, the culture was sterile in 5 cases.

This could be attributed to inadequate antibiotic therapy received from outside before coming to our hospital or fastidious anaerobic organisms. Without treatment, the infection can spread further and destroy increasing amounts of tissue. Treatment outcome is good when the disease is anatomically confined to the sinuses. The treatment options include radical surgical debridement of the entire necrotic tissue, frequent wound dressings with hypertonic saline, hyperbaric oxygen therapy, broad spectrum parenteral antibiotic therapy, and general and aggressive patient support measures12, 17,18 . The prognosis of necrotizing fascitiis depends on age, co-morbodities and severity of the septic syndrome. For patients under the age of 35, the mortality rate is significantly lower (0%) when compared to mortality in patients over 70 years of age (65%). Mortality may reach 100 % in surgically non treated patients19.

In conclusion, Fournier’s gangrene is an abrupt, rapidly progressive, gangrenous infection of the external genitalia and perineum and a real urologic emergency. Prompt diagnosis and early surgical intervention is required for a better outcome of these patients. References 1. Basoglu M, Gul O, Yildigran I, Balik AA, Ozbey I, Oren D. Fournier’s gangrene: review of fifteen cases. Am Surg 1997; 63(11):1019-21. 2.

Although researchers have shown that topical anesthetics in high concentrations can inhibit collagen synthesis and delay healing in experimental wounds, Dr. Fournier’s gangrene: Necrotizing fasciitis of the male genitalia. Br J Urol 1983; 55:85-88. 3. Paty R, Smith AD. Gangrene and Fournier’s gangrene. Urol Clin North Am 1992; 19:149-62.


4. Laucks SS. Fournier’s gangrene. Surg Clin North Am 1994; 74: 1339-52. 5. Vijay R. Fournier’s gangrene.

Available at: http://www Meditune Fournier’s Gangrene. htm. Accessed 15 DEC 2005 6. Morantes MC, Lipsky BA. “Flesh-eating bacteria”: return of an old nemesis. Dermatol 1995; 34(7)461-63. Dr.

Fink S, Chaudhuri TK, Davis HH. Necrotizing fasciitis and malpractice claims. South Med J 1999; 92(8):770-4. 8. Grubb RL, Figenshau RS. Urologic surgery. In: Doherty GM, Lowney JK, Reznik SI, Smith MA eds.

The Washington manual of surgery. 3rd ed . New York: Lippincott Williams and Wilknis; 2002: 687-705. 9. Nambiar PK, Lander S, Midha M, Ha C. Fournier’s gangrene in spinal cord injury: a case report. J Spinal Cord Med 2005; 28(2): 121-4.

10. Jiang T, Covington JA, Haile CA, Murphy JB, Rotolo FS, Lake AM. Fournier gangrene associated with Crohn disease. Mayo Clin Proc 2000; 75(6):647-9. 11. Benizri E, Fabiani P, Migliori G, et al. Gangrene of the perineum.

Urology1996; 47(6):935-9. 12. Flanigan RC. Diagnosis and treatment of gangrenous genitalia. Surg Clin North Am 1984; 64: 715-20. 13. Uppot RN, Levy HM, Patel PH.

Case54: Fournier’s gangrene. Radiology 2003 ; 226(1): 115-17. 14. Begley MG, Shawker TH, Robertson CN, Bock SN, Wei JP, Lotze MT. Fournier’s gangrene: diagnosis with scrotal USG. Radiology 1988; 169:387-9. 15.

Cumming MJ, Levi CS, Ackerman TE. US case of the day: Fournier gangrene. Radiographics 1994; 14:1423-24. 16. Atakan IH, Kaplan M, Kaya E, Aktoz T, Inci O. A life threatening infection: Fournier’s gangrene. Int Urol Nephrol 2002; 34(3): 387-92.

17. Sutherland ME, Merger AA. Necrotizing soft tissue infections. Surg Clin North Am 1994; 74: 591-607. 18. Lucca M, Unger HD, Devenny AMR. Tretment of Fournier’s gangrene with adjunctive hyperbaric oyygen therapy.

Am J Emer Med 1990; 8:385-7. 19. Kaul R, McGear A, Low DE, Green K, Scwartz B. Population-based surveillance for group A streptococcal necrotizing fasciitis: clinical features, prognostic indicators, and microbiologic analysis of seventy-seven cases. Am J Med 1997; 103:18-24.

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