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Lal M, Zhu C, McClurkan C, Koelle DM, Miller P, Afonso C, Donadeu M, Dungu B, Chen D. Development of a low-dose fast-dissolving tablet formulation of Newcastle disease vaccine for low-cost backyard poultry immunisation. Vet Rec 2014; 174:504. [PMID: 24591479 DOI: 10.1136/vr.101926] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The immunisation of backyard poultry is critical for maintaining healthy flocks to provide nutrition and income for low-resource farmers worldwide. A vaccine presentation for flocks of less than 50 birds could make it more affordable and accessible, increasing uptake and impact. Fast-dissolving tablets (FDT) of Newcastle disease virus (NDV) vaccine were produced by freeze drying the LaSota NDV strain combined with excipients into tablets containing a small number of doses and packaged in polymer blister sheets. The NDV-FDT vaccine maintained virus stability for more than six months at 4°C, based on plaque assay and egg infectivity dose data. Stability was further confirmed in a challenge study, where the tablet vaccine elicited a strong immune response and provided 100 per cent protection to vaccinated chickens infected with a virulent strain of NDV. The vaccine tablet can be diluted in water (no needle or syringe required) and administered either in drinking water or with a dropper via an intraocular and/or intransal route. Results indicate that FDTs containing a small number of doses are a feasible presentation for backyard poultry farmers. The compact packaging of the FDTs will also provide cost savings in storing and distributing the vaccine in the cold chain.
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White JA, Blum JS, Hosken NA, Marshak JO, Duncan L, Zhu C, Norton EB, Clements JD, Koelle DM, Chen D, Weldon WC, Steven Oberste M, Lal M. Serum and mucosal antibody responses to inactivated polio vaccine after sublingual immunization using a thermoresponsive gel delivery system. Hum Vaccin Immunother 2014; 10:3611-21. [PMID: 25483682 PMCID: PMC4514067 DOI: 10.4161/hv.32253] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/23/2014] [Accepted: 08/04/2014] [Indexed: 01/27/2023] Open
Abstract
Administering vaccines directly to mucosal surfaces can induce both serum and mucosal immune responses. Mucosal responses may prevent establishment of initial infection at the port of entry and subsequent dissemination to other sites. The sublingual route is attractive for mucosal vaccination, but both a safe, potent adjuvant and a novel formulation are needed to achieve an adequate immune response. We report the use of a thermoresponsive gel (TRG) combined with a double mutant of a bacterial heat-labile toxin (dmLT) for sublingual immunization with a trivalent inactivated poliovirus vaccine (IPV) in mice. This TRG delivery system, which changes from aqueous solution to viscous gel upon contact with the mucosa at body temperature, helps to retain the formulation at the site of delivery and has functional adjuvant activity from the inclusion of dmLT. IPV was administered to mice either sublingually in the TRG delivery system or intramuscularly in phosphate-buffered saline. We measured poliovirus type-specific serum neutralizing antibodies as well as polio-specific serum Ig and IgA antibodies in serum, saliva, and fecal samples using enzyme-linked immunosorbent assays. Mice receiving sublingual vaccination via the TRG delivery system produced both mucosal and serum antibodies, including IgA. Intramuscularly immunized animals produced only serum neutralizing and binding Ig but no detectable IgA. This study provides proof of concept for sublingual immunization using the TRG delivery system, comprising a thermoresponsive gel and dmLT adjuvant.
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Key Words
- CT, cholera toxin
- DPBS, Dulbecco's phosphate-buffered saline
- DU, D-antigen units
- ELISA, enzyme-linked immunosorbent assay
- IM, intramuscular
- IPV, inactivated poliovirus vaccine
- IgA, immunoglobulin A
- IgG, immunoglobulin G
- OPV, oral poliovirus vaccine
- PBS, phosphate-buffered saline
- RT, room temperature
- SL, sublingual
- SSI, Staten Serum Institute
- TMB, tetramethylbenzidine
- TRG, thermoresponsive gel
- adjuvants
- dmLT
- dmLT, double mutant heat-labile toxin
- mucosal immune response
- poliovirus
- sublingual immunization
- thermoresponsive gel
- vaccine delivery
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Lal M, Raheja S, Kale S, Das N, Gogia AR, Bhowmik KT. An experience with 156 patients attending a newly organized pain and palliative care clinic in a tertiary hospital. Indian J Cancer 2013; 49:293-7. [PMID: 23238147 DOI: 10.4103/0019-509x.104491] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT Pain and palliative care clinic (PCC). AIMS The primary object of this study was to enumerate the demographic characteristics of patients attending a newly organized PCC. The secondary purpose was to detect symptom prevalence and frequency of different cancers in these patients. SETTINGS AND DESIGN Prospective cross-sectional descriptive study. MATERIALS AND METHODS A prospective cross-sectional descriptive study was done on patients referred to the PCC of a tertiary hospital in North India. Comprehensive details of all patients were recorded systematically on the first visit on a proforma specially prepared for the newly established palliative care clinic. STATISTICAL ANALYSIS USED The descriptive statistics of palliative care data was presented in terms of frequencies and percentages (%) for categorical variables. RESULTS The data collected at our PCC showed that out of 156 patients, 87 were males and 69 were females. Patients of all ages varying from 6 to 85 years were seen. Most patients (82.1%) lived with their families, and 28 (17.1%) patients lived alone and had no financial support. The most common primary diagnoses were head and neck cancers (38.5%), carcinoma cervix (15.4%), breast cancer (10.3%), colorectal cancer (6.4%), and lung cancer (4.5%). Frequency of seven most common symptoms was pain (100%), insomnia (64.1%), loss of appetite (34.6%), nausea (32.7%), vomiting (32.1%), constipation (31.4%) and sore mouth (28.8%). CONCLUSIONS Population-based studies determine the actual magnitude of sufferers and suffering and show that palliative care services should be included as an essential component in a tertiary care hospital. The objective should be to reach out to the patient and help in improving the patent's quality of life in every way possible.
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Lal M, Priddy S, Bourgeois L, Walker R, Pebley W, Brown J, Desai J, Darsley MJ, Kristensen D, Chen D. Development of a fast-dissolving tablet formulation of a live attenuated enterotoxigenic E. coli vaccine candidate. Vaccine 2013; 31:4759-64. [DOI: 10.1016/j.vaccine.2013.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/28/2013] [Accepted: 08/05/2013] [Indexed: 12/29/2022]
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Lal M, Pattison HM, Allan TF, Callender R. Does post-caesarean dyspareunia reflect sexual malfunction, pelvic floor and perineal dysfunction? J OBSTET GYNAECOL 2012; 31:617-30. [PMID: 21973137 DOI: 10.3109/01443615.2011.594915] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim was to define post-caesarean dyspareunia as a sexual and pelvic-perineal symptom. Post-caesarean (80 elective, 104 emergency) and 100 vaginally delivered primiparae had domiciliary interviews at 10 months postpartum. A total of 50 (28% and 27%) post-caesarean and 46 (46%) vaginally delivered, reported dyspareunia. Severely impaired general sexual health occurred in 82 (24% elective, 25% emergency, 35% vaginally delivered) as category 3 (dyspareunia with sexual symptoms) and 27 (10% elective, 7% emergency, 12% vaginally delivered) as category 4 (reduced frequency < 6). The risk of dyspareunia (RR 1.14, CI 0.73, 1.77) or impaired general sexual health (RR 0.93, CI 0.32, 2.74) was similar among those with or without perineal trauma. Both caesarean and perineal scars were associated with sexual malfunction. Primiparae with new incontinence had a lower risk of dyspareunia than impaired general sexual health. Awareness of the associations of post-caesarean dyspareunia and impaired general sexual health with incontinence would facilitate appropriate obstetric decision-making. Further research is indicated.
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Rizvi SAH, Naqvi SAA, Zafar MN, Hussain Z, Hashmi A, Hussain M, Akhtar SF, Ahmed E, Aziz T, Sultan G, Sultan S, Mehdi SH, Lal M, Ali B, Mubarak M, Faiq SM. A renal transplantation model for developing countries. Am J Transplant 2011; 11:2302-7. [PMID: 21883911 DOI: 10.1111/j.1600-6143.2011.03712.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The estimated incidence of end-stage renal disease (ESRD) in Pakistan is 100 per million population. Paucity and high costs of renal replacement therapy allows only 10% to get dialysis and 4-5% transplants. Our center, a government organization, started a dialysis and transplant program in 1980s where all services were provided free of charge to all patients. It was based on the concept of community government partnership funded by both partners. The guiding principles were equity, transparency, accountability and development of all facilities under one roof. This partnership has sustained itself for 30 years with an annual budget of $25 million in 2009. Daily 600 patients are dialyzed and weekly 10-12 receive transplants. One- and 5-year graft survival of 3000 transplants is 92% and 85%, respectively. The institute became a focus of transplantation in Pakistan and played a vital role in the campaign against transplant tourism and in promulgation of transplant law of 2007, and also helped to increase altruistic transplants in the country. This model emphasizes that in developing countries specialized centers in government sector are necessary for transplantation to progress and community support can make it available to the common man.
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Prasad PN, Bhawalkar JD, Kumar ND, Lal M, Cheng PC. Multifunctional polymers as multi-role materials for photonics. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/masy.19971180162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lal M, Abraham S. Adolescent development and eating disorder related quality of life in Indian females. Eat Weight Disord 2011; 16:e56-60. [PMID: 21727783 DOI: 10.1007/bf03327522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To study the relationship of adolescent development and eating disorder related quality of life in Indian females. METHOD 461 female school students (aged 12-17 yrs) were recruited from middle to high socio-economic status (SES), English speaking schools in Delhi, India. Adolescent development was measured by Tanner stage and months since menarche. Subjects completed the Quality of Life for Eating Disorders questionnaire (QOL ED), which included six subscores. Correlation and partial correlation coefficient analysis to control for Body Mass Index (BMI) were performed. RESULTS After controlling for BMI, all adolescent development measures were correlated with the psychological feelings (PSY) subscore. This subscore contained items relating to confusion, social unease, sadness, difficulty coping, desiring perfection and loss of control. Tanner breast stage was correlated with the eating behaviour (EB) subscore. DISCUSSION During adolescent development, Indian girls became more aware of their psychological feelings and emotions. Only those reporting breast development were using behaviours to control their body, weight and shape. These behaviours are not associated with the presence of disordered eating thoughts, such as preoccupation with food, eating, body weight or shape.
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Abstract
ABSTRACTMeasurements of the equilibrium electrical conductivity of Ca-doped BaTiO3indicate a highly acceptor-doped behavior when y > 1 in the general formula (Ba1−xCaxO)yTiO2. It has been suggested that when there is an excess of alkaline earth oxides, some Ca++occupies Ti-sites, where it acts as a doubly charged acceptor, CaTi''. This possibility has been checked with a recently developed technique for determining the crystallographic site occupancy of impurity atoms. Known as ALCHEMI (Atom Location Using Channeling-Enhanced Microanalysis), the technique relies on the dependence of the characteristic X-ray emission on the incident electron beam direction. A significant channeling effect was observed for slightly positive and negative excitations of the [100] reflection. The results indicate that for the composition (Ba0,85Ca0.15O)1.02TiO2.00, a substantial fraction of the total calcium (> 20%) occupies Ti sites.
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Lal M, Joshi M, Kumar DN, Friend CS, Winiarz J, Asefa T, Kim K, Prasad PN. Inorganic- Organic Hybrid Materials For Photonics. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-519-217] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractMolecular materials comprised of inorganic:organic composites are of considerable interest in photonics, optoelectronics and biophotonics. We report broad band lasing and tunable filters in sol-gel processed poly (p-phenylene vinylene) PPV: Silica composites. Optical power limiting in near IR wavelength region is also reported in dye doped PPV: silica multiphasic nanocomposites. For making hybrid inorganic: organic composites the reverse micelle mediated synthesis technique has been exploited to synthesize dye encapsulated metal oxide particles, thiocresol capped CdS clusters, Cul and AgI nanoparticles. These particles were dispersed in polymeric matrix for applications in photoconductivity and photorefractive measurements.
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Chen D, Kapre S, Goel A, Suresh K, Beri S, Hickling J, Jensen J, Lal M, Preaud J, LaForce M, Kristensen D. Thermostable formulations of a hepatitis B vaccine and a meningitis A polysaccharide conjugate vaccine produced by a spray drying method. Vaccine 2010; 28:5093-9. [DOI: 10.1016/j.vaccine.2010.04.112] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 04/28/2010] [Accepted: 04/30/2010] [Indexed: 11/26/2022]
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Kashyap S, Lal M. S-31 Alkaptonuric Ochronosis – A Review of 8 Cases. J Biomech 2010. [DOI: 10.1016/s0021-9290(10)70084-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lal M. I181 Violence against women: The role of the obstetrician/gynaecologist in prevention and care. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60181-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Braun LJ, Jezek J, Peterson S, Tyagi A, Perkins S, Sylvester D, Guy M, Lal M, Priddy S, Plzak H, Kristensen D, Chen D. Characterization of a thermostable hepatitis B vaccine formulation. Vaccine 2009; 27:4609-14. [DOI: 10.1016/j.vaccine.2009.05.069] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2009] [Revised: 05/19/2009] [Accepted: 05/26/2009] [Indexed: 10/20/2022]
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Lal M, Kaur H. A microbiological study of bottled mineral water marketed in Ludhiana. Indian J Public Health 2006; 50:31-2. [PMID: 17193757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
The microbiological quality of bottled mineral water marketed in Ludhiana was examined, Twenty three brands were analyzed for presumptive coliform count by multiple tube tests, and E. coli count was confirmed by Eijkman test. Bacterial and fungal loads were tested by membrane filtration test. Out of 23 only one sample (4.4%) showed the presumptive coliform count to be 460 most probable number (MPN)l 1 00ml,and 1 was found to be positive when tested by Eijkman test for Ecoli. In the membrane filtration test three samples (13%) showed more than two types of bacteria. Different types of bacteria isolated included Bacillus sp (19/23). Pseudomonas spp (13123), Ecoli, Klebsiella sp and S.albus one each Fungi was isolated from five of twenty three. (22%) samples. Only one brand of mineral water was unfit for human consumption. The rest of the samples were contaminated with non pathogenic flora.
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Lal M. Invasiveness - An indicator of differentiation of virulent and non virulent isolates of Yersinia enterocolitica. Indian J Med Microbiol 2005; 23:69-70. [PMID: 15928432 DOI: 10.4103/0255-0857.13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Asuzu MC, Ram BP, Salusalu M, Lal M, Tuqa S. Participatory operational research of the dynamics of the primary health care programme in Fiji. PACIFIC HEALTH DIALOG 2004; 11:31-37. [PMID: 18181439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
To review the history of primary health care (PFIC) in Fiji, to find out the present PHC policy situation at all the management levels as well as the dynamics of community mobilization and PHC service extension. Findings are to be used to propose the strengthening of the implementation of PHC in the country as the case may be. This is a mail questionnaire study of managers at all three levels of the health services for the historical study and those at the district health system for the PHC implementation. Fiji has had a very active primary health care programme. Community mobilization and health service extension was initially very active and health status indices improved greatly. However, this momentum has dropped due to reduction in following the initial directives for this purpose as at the early part of the programme. It is recommended that the programme of community health service extension be restored as a matter of a national written policy. The medical officers in charge of PHC should be trained in community medicine as before, in order to regain the lost momentum.
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Lal M, Kaur H, Gupta LK. Differentiation between Virulent and Avirulent Y.enterocolitica Isolates using Congo Red Magnesium Oxalate Agar. Indian J Med Microbiol 2003. [DOI: 10.1016/s0255-0857(21)03081-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lal M, Kaur H, Gupta LK. Anticryptococcal activity of garlic extract - a preliminary report. Indian J Med Microbiol 2003; 21:214. [PMID: 17643027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Lal M, Kaur H, Gupta LK. Y. enterocolitica gastroenteritis - a prospective study. Indian J Med Microbiol 2003; 21:186-8. [PMID: 17643016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Two thousand faecal samples were collected from diarrhoeal patients of all age groups and processed by using MacConkey agar and Yersinia selective agar [Cefsulodin-Irgasan-Novobiocin (CIN) media]. One hundred and seventy faecal samples from non-diarrhoeal (healthy controls) were also processed. Samples were subjected to cold enrichment before processing. Three hundred and seventy-four (18.7%) faecal samples were positive for bacterial pathogens, of which 41 (2.05%) had Y. enterocolitica infection. Y. enterocolitica was more common in patients above 16 years of age 23/41 (56%). Higher rates of isolation were recorded during winter months. Of the typable isolates 21.9% belonged to 0:3 serotype followed by 01, 2a, 3 (17%) serotype. Twelve (29.2%) isolates were untypable. 51.2% isolates of Y. enterocolitica belonged to biotype IV whereas 24.4%, 19.5%, 4.9% belonged to type I, II and III respectively. Majority of the isolates were found sensitive to chloramphenicol, gentamicin, amikacin, ciprofloxacin, ampicillin, netromycin, cefoperazone, tobramycin and pefloxacin. All isolates were resistant to ofloxacin.
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Kaur H, Lal M. Cryptosporodium infection in patients of diarrhoea in Ludhiana. TROPICAL GASTROENTEROLOGY : OFFICIAL JOURNAL OF THE DIGESTIVE DISEASES FOUNDATION 2002; 23:206. [PMID: 12833715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Bergey EJ, Levy L, Wang X, Krebs LJ, Lal M, Kim K, Pakatchi S, Liebow C, Prasad PN. Biomed Microdevices 2002; 4:293-299. [DOI: 10.1023/a:1020906307053] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Dhanjal TS, Lal M, Haynes R, Lip G. A comparison of cardiovascular risk factors among Indo-Asian and caucasian patients admitted with acute myocardial infarction in Kuala Lumpur, Malaysia and Birmingham, England. Int J Clin Pract 2001; 55:665-8. [PMID: 11777289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Indo-Asians in the UK are at an increased risk of coronary artery disease (CAD); this may be a reflection of their cardiovascular risk factor profile as well as of a more sedentary lifestyle. We hypothesised that Indo-Asians in Malaysia and the UK may exhibit a similar cardiovascular risk factor and physical activity profile, which would be more adverse compared with caucasians. We studied 70 consecutive Indo-Asian patients admitted to hospitals in Kuala Lumpur, Malaysia (n=42; 35 males; mean age 60.6 years, SD 11.8); and Birmingham, England (n=28; 20 males; mean age 60.8 years, SD 12.9). Both groups of Indo-Asian patients were compared with 20 caucasian patients (13 males; mean age 62.7 years, SD 9.4) admitted with myocardial infarction from Birmingham. There was a higher prevalence of diabetes among Indo-Asians in both countries than among caucasians (p=0.0225). By contrast, caucasians had a higher prevalence of hypercholesterolaemia (p=0.0113), peripheral vascular disease (p=0.0008), regular alcohol consumption (p<0.0001) and family history of CAD (p=0.0041). There were no significant differences in mean age, body mass index or blood pressures. There was a significantly lower leisure activity score (p=0.001) and total physical activity score (p=0.003) among Indo-Asians in both countries than among caucasians. This survey has demonstrated differences in cardiovascular risk factors among Indo-Asian and caucasian patients. The high prevalence of diabetes, as well as the lower physical activity and sedentary lifestyles among Indo-Asians, in both Malaysia and the UK, may in part contribute to the high incidence of CAD in this ethnic group.
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Aizman O, Uhlén P, Lal M, Brismar H, Aperia A. Ouabain, a steroid hormone that signals with slow calcium oscillations. Proc Natl Acad Sci U S A 2001; 98:13420-4. [PMID: 11687608 PMCID: PMC60886 DOI: 10.1073/pnas.221315298] [Citation(s) in RCA: 222] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2001] [Indexed: 12/20/2022] Open
Abstract
The plant-derived steroid, digoxin, a specific inhibitor of Na,K-ATPase, has been used for centuries in the treatment of heart disease. Recent studies demonstrate the presence of a digoxin analog, ouabain, in mammalian tissue, but its biological role has not been elucidated. Here, we show in renal epithelial cells that ouabain, in doses causing only partial Na,K-ATPase inhibition, acts as a biological inducer of regular, low-frequency intracellular calcium ([Ca(2+)](i)) oscillations that elicit activation of the transcription factor, NF-kappa B. Partial inhibition of Na,K-ATPase using low extracellular K(+) and depolarization of cells did not have these effects. Incubation of cells in Ca(2+)-free media, inhibition of voltage-gated calcium channels, inositol triphosphate receptor antagonism, and redistribution of actin to a thick layer adjacent to the plasma membrane abolished [Ca(2+)](i) oscillations, indicating that they were caused by a concerted action of inositol triphosphate receptors and capacitative calcium entry via plasma membrane channels. Blockade of ouabain-induced [Ca(2+)](i) oscillations prevented activation of NF-kappa B. The results demonstrate a new mechanism for steroid signaling via plasma membrane receptors and underline a novel role for the steroid hormone, ouabain, as a physiological inducer of [Ca(2+)](i) oscillations involved in transcriptional regulation in mammalian cells.
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Sircar AR, Kumar A, Lal M. Clinical evaluation of sibutramine in obese type 2 diabetic patients refractory to dietary management. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2001; 49:885-8. [PMID: 11837755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
MATERIAL AND METHODS An open, non-comparative study was carried out to assess the efficacy and toleration profile of sibutramine, a new antiobesity drug, in promoting weight loss in obese type 2 diabetes mellitus subject who failed to reduce weight after strict dietary control. Twenty seven patients completed the study. Sibutramine was started as a single morning dose of 10 mg and was subsequently increased to 15 mg daily if weight loss was not satisfactory. The total duration of the study was twelve weeks with followup at every four weeks. Effect of drug was monitored in terms of weight reduction, changes in body mass index, waist circumference, hip circumference, waist/hip ratio and other metabolic parameters. A fixed dietary prescription and concomitant therapy with drugs, if required and not likely to interfere with the trial therapy, was permitted but was not changed during the study period. RESULTS At the end of 12 week, mean weight reduction in study subjects was 4.16 kg (p < 0.001), the corresponding BMI decreased by 1.6 (p < 0.0001) and hip circumference by 3.68 (p < 0.001). However, there was no significant change in fasting blood glucose and Hb(A1c) values. CONCLUSION The study indicates sibutramine to be an effective and well tolerated agent leading to significant reduction in parameter of obesity in obese type 2 diabetic subjects.
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