Regulation of protein kinases and coregulatory interplay of S-100beta and serotonin transporter on serotonin levels in diabetic rat brain

Protein kinases are critical component in the regulation of signal transduction pathways, including neurotransmitters. Our previous studies have shown that serotonin (5-HT) altered under diabetic condition was accompanied by alterations of protein kinase C-alpha (PKC-alpha) and CaMKII, and those alterations were reversed after insulin administration. The current study showed that alloxan-induced diabetic animals revealed hyperglycemia and was associated with an increase in the content of 5-HT, PKC-alpha expression and PKC activity (P < 0.05) simultaneously in striatum (ST), midbrain (MB), pons medulla (PM), cerebellum (CB), and cerebral cortex (CCX) from 7 days to 60 days. Although the 5-HT levels in hippocampus (HC) and hypothalamus (HT) were not altered, the PKC-alpha expression and PKC activity showed increases (P < 0.05) in level in HC. Insulin administration reversed all these changes to a normal level. In contrast, the in vitro study has shown that the 5-HT levels correlated with PKC-alpha expressions as well as PKC activity (P < 0.05) only in ST, MB, and CB either after induction with phorbol 12-myristate 13-acetate (PMA) or blocking with chelerythrine, whereas PM and CCX remained elevated (P < 0.05), implying a regulatory role for PKC-alpha only in ST, MB, and CB. However, our consecutive studies have shown that the 5-HT level in PM was regulated by p38-mitogen-activated protein kinase (p38-MAPK) both in vivo and in vitro, whereas the 5-HT level in CCX was coregulated by S-100beta by protein-protein interaction with serotonin transporter (SERT) via 8-bromoadenosine 3',5'-cyclic monophosphate sodium salt (8-Br-cAMP)-induced cAMP/PKAII pathway(s).

Scrub typhus in Darjeeling, India: opportunities for simple, practical prevention measures

To identify risk factors for scrub typhus in Darjeeling, India, we compared 62 scrub typhus cases (acute fever with eschar and specific IgM) with 62 neighbourhood controls. Cases were more likely to live close to bushes [matched odds ratio (MOR) 10; 95% CI 2.3-63] and wood piles (MOR 3.5; 95% CI 1.5-9.5), to work on farms (MOR 10; 95% CI 2.7-63), to observe rodents at home (MOR 3.6; 95% CI 1.4-11) and at work (MOR 9; 95% CI 2.4-57), and to rear domestic animals (MOR 2.4; 95% CI 1.1-5.7). Cases were less likely to wash after work (MOR 0.4; 95% CI 0.1-0.9) and change clothes to sleep (MOR 0.2; 95% CI 0.1-0.5). A cleaner, rodent-controlled environment may prevent exposure to scrub typhus. Personal protection measures and better hygiene could further reduce individual risk.

Increasing incidence of malaria in Kurseong, Darjeeling District, West Bengal, India, 2000-2004

In Kurseong, Darjeeling District, India, malaria caused concern but insufficient information was available. We analysed surveillance data to estimate the burden of malaria and to examine trends. Confirmed malaria reports were reviewed and climatic records were collected. The annual parasite incidence (API; number of cases/population) and the annual blood examination rate (ABER; number of slides examined/population) were calculated to assess case detection activities, and the slide positivity rate (SPR; number of slides positive/total number examined) was calculated to assess transmission trends. The API increased from 2 to 7.8 per 1000 population between 2000 and 2004 (no deaths), with a high incidence among all age groups. Two foothill areas with forests and slow-moving streams accounted for 88% of the 697 cases in 2004. The average 2000-2004 ABER was 4.8%, below the 10% examination target of the National Anti-Malaria Programme. The proportion of Plasmodium falciparum increased from 62% in 2000 to 77% in 2004. More than 50% of P. falciparum in the area were chloroquine resistant. The SPR increased from 8.1% in 2000 to 11.9% in 2004 and peaked during monsoons. Annual rainfall increased from 2000 to 2003. Malaria transmission increased, with an increasing proportion of P. falciparum in a context of resistance to chloroquine. We recommend increasing case detection and using artemisinin-based combination therapy to treat P. falciparum malaria.

Pharmacodynamic and pharmacokinetic effects of MK-0343, a GABA(A) alpha2,3 subtype selective agonist, compared to lorazepam and placebo in healthy male volunteers

The use of non-selective gamma-aminobutyric acid (GABA) enhancers, such as benzodiazepines in the treatment of anxiety disorders is still widespread but hampered by unfavourable side effects. some of these may be associated with binding properties to certain subtypes of the GABA(A) receptor that are unnecessary for therapeutic effects. MK-0343 was designed to be a less sedating anxiolytic, based on reduced efficacy at the alpha1 subtype and significant efficacy at alpha2 and alpha3 subtypes of the GABA(A) receptor. This paper is a double-blind, four-way cross-over (n = 12) study to investigate the effects of MK-0343 (0.25 and 0.75 mg) in comparison to placebo and an anxiolytic dose (2 mg) of the non-selective agonist lorazepam. Effects were measured by eye movements, body sway, Visual Analogue scales (VAS) and memory tests. Lorazepam impaired saccadic peak velocity (SPV), VAs alertness scores, postural stability and memory and increased saccadic latency and inaccuracy. MK-0343 0.75 mg was equipotent with lorazepam as indicated by SPV (-42.4 deg/s), saccadic latency (0.02 s) and VAS alertness scores (1.50 ln mm), while effects on memory and postural stability were smaller. MK-0343 0.25 mg only affected postural stability to a similar extent as MK-0343 0.75 mg. The effect profile of MK-0343 0.75 mg is different from the full agonist lorazepam, which could reflect the selective actions of this compound. Although less effect on VAS alertness was expected, diminished effects on memory and postural stability were present. Clinical studies in anxiety patients should show whether this dose of MK-0343 is therapeutically effective with a different side-effect profile.

Ulcerative keratitis associated with contact lens wear

To review the microbiological profile of ulcerative keratitis associated with contact lens (CL)-wear, 35 patients with culture-proven CL-associated microbial keratitis were studied between September 1999 and September 2002. Corneal scrapes and CL-care products were collected and were subjected to microbiological evaluation. Gram-negative bacilli alone were recovered from the corneal scrapes of all 35 (100%) patients, all 70 (100%) CL storage case wells and also from CL-care solution of six (17.14%) of the 35 patients. There was a significantly higher number of Pseudomonas aeruginosa (71.43%) isolated from eyes with CL-related keratitis than other bacterial isolates (28.57%) (P<0.001). Microbial contamination of CL storage cases was a great risk for gram-negative bacterial infection among soft CL-wearers.

Comparative bacteriology of acute and chronic dacryocystitis

AIMS

To compare the bacterial aetiology and their in vitroantibacterial susceptibilities of acute and chronic dacryocystitis.

METHODS

A retrospective analysis of patients with clinically diagnosed acute and chronic dacryocystitis who underwent microbiological evaluation presenting between January 2000 and December 2005 was carried out. Mucopurulent discharge through punctum, pus from burst abscess, incision drainage, and lacrimal sac content were taken and subjected to microbiological evaluation.

RESULTS

A total of 1891 patients of dacryocystitis were evaluated and subjected to microbiological evaluation, of which 566 (29.9%) had acute dacryocystitis and 1325 (70.1%) had chronic dacryocystitis. Of 1891 eyes, 1518 (80.3%) had pure bacterial growth and the remaining 373 (19.7%) had no growth. The percentage of culture-positivity was found to be higher in chronic dacryocystitis (90%) than in acute dacryocystitis (57.4%) (P<0.0001). A total of 1612 bacterial isolates were recovered from 325 acute and 1193 chronic dacryocystitis; in 1424 (93.8%) eyes, single bacterial species was isolated, and in the remaining 94 (6.2%) eyes, two bacterial species were isolated. The predominant bacterial pathogen isolated from acute dacryocystitis was Staphylococcus aureus(22.3%) followed by Pseudomonas aeruginosa(21.1%) and from chronic dacryocystitis was coagulase-negative staphylococci (CoNS) (44.2%), S. aureus(10.8%), and Streptococcus pneumoniae(10%). The highest percentage of bacterial isolates were susceptible to gatifloxacin (96.5%), ofloxacin (94.8%), and amikacin (91.1%). The percentage of resistance of bacterial isolates recovered from chronic dacryocystitis to gentamicin (45.7%), tobramycin (50.8%), norfloxacin (50.7%), and ciprofloxacin (30.4%) were found to be higher than that of bacterial isolates from acute infection to gentamicin (24.6%), tobramycin (35%), norfloxacin (36.5%), and ciprofloxacin (19.9%).

CONCLUSION

The proportions of S. aureusand Pseudomonasspp are higher in causing acute dacryocystitis, while the proportion of CoNS is higher in chronic dacryocystitis. The percentages of antibacterial resistant isolates were higher among bacterial species from chronic dacryocystitis.

Microbial keratitis in South India: influence of risk factors, climate, and geographical variation

PURPOSE

To determine the influence of risk factors, climate, and geographical variation on the microbial keratitis in South India.

METHODS

A retrospective analysis of all clinically diagnosed infective keratitis presenting between September 1999 and August 2002 was performed. A standardised form was filled out for each patient, documenting sociodemographic features and information pertaining to risk factors. Corneal scrapes were collected and subjected to culture and microscopy.

RESULTS

A total of 3,183 consecutive patients with infective keratitis were evaluated, of which 1,043 (32.77%) were found to be of bacterial aetiology, 1,095 (34.4%) were fungal, 33 (1.04%) were Acanthamoeba, 76 (2.39%) were both fungal and bacterial, and the remaining 936 (29.41%) were found to be culture negative. The predominant bacterial and fungal pathogens isolated were Streptococcus pneumoniae (35.95%) and Fusarium spp. (41.92%), respectively. Most of the patients (66.84%) with fungal keratitis were between 21 and 50 years old, and 60.21% of the patients with bacterial keratitis were older than 50 (p < 0.0001) (95% CI: 5.19-7.19). A majority of patients (64.75%) with fungal keratitis were agricultural workers (p < 0.0001) [odds ratio (OR): 1.4; 95% CI: 1.19-1.61], whereas bacterial keratitis occurred more commonly (57.62%) in nonagricultural workers (p < 0.0001) (OR: 2.88; 95% CI: 2.47-3.36). Corneal injury was identified in 2,256 (70.88%) patients, and it accounted for 92.15% in fungal keratitis (p < 0.0001) (OR: 7.7; 95% CI: 6.12-9.85) and 100% in Acanthamoeba keratitis. Injuries due to vegetative matter (61.28%) were identified as a significant cause for fungal keratitis (p < 0.0001) (OR: 23.6; 95% CI: 19.07-29.3) and due to mud (84.85%) for Acanthamoeba keratitis (p < 0.0001) (OR: 26.01; 95% CI: 3.3-6.7). Coexisting ocular diseases predisposing to bacterial keratitis accounted for 68.17% (p < 0.0001) (OR: 33.99; 95% CI: 27.37-42.21). The incidence of fungal keratitis was higher between June and September, and bacterial keratitis was less during this period.

CONCLUSION

The risk of agricultural predominance and vegetative corneal injury in fungal keratitis and associated ocular diseases in bacterial keratitis increase susceptibility to corneal infection. A hot, windy climate makes fungal keratitis more frequent in tropical zones, whereas bacterial keratitis is independent of seasonal variation and frequent in temperate zones. Microbial pathogens show geographical variation in their prevalence. Thus, the spectrum of microbial keratitis varies with geographical location influenced by the local climate and occupational risk factors.

A study of the spectrum ofAcanthamoebakeratitis: A three-year study at a tertiary eye care referral center in South India

PURPOSE

To determine the epidemiological and clinical characteristics of Acanthamoeba keratitis and also to determine the sensitivity and specificity of smears in the detection of Acanthamoeba.

MATERIALS AND METHODS

A retrospective review of all culture-positive cases of Acanthamoeba keratitis seen between October 1999 and August 2002 was performed. Corneal scrapes were subjected to culture and microscopy using standard protocols.

RESULTS

Out of 3183 consecutive patients with clinically diagnosed corneal ulcers evaluated, 33 (1.04%) were found to be due to Acanthamoeba. Twenty-four out of 33 (72.72%) were less than 51 years of age (P<0.001). All patients were from rural areas (P<0.001) and 26 (78.79%) of them were agricultural workers (P=0.031). All 33 had history of corneal injury (P<0.001) and 28 (84.85%) patients had injury with mud (P<0.001). All 33 (100%) patients had previous medical treatment (P=0.009) and 10 (30.3%) had used traditional eye medicines (P=0.183). A clinical pattern of ring infiltrate was characteristic in 15 (45.45%) patients. The diameter of the corneal ulcer was more than 6 mm in 27 (81.82%) eyes (P<0.001). Twenty-six (78.79%) patients had visual acuity of perception of light on initial presentation (P<0.001) and 24 (72.73%) had the same as their final visual outcome. The sensitivity of 10% potassium hydroxide (KOH) preparation was found to be higher (P<0.001) in the detection of Acanthamoeba cysts.

CONCLUSION

The incidence of Acanthamoeba keratitis amongst the corneal ulcer patients was 1% in this setting and it was mainly due to corneal injury by mud. The KOH preparation is a sensitive diagnostic tool for the detection of Acanthamoeba. Delayed diagnosis or misdiagnosis and inappropriate antimicrobial therapy results in poor visual outcome.

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM

Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease.

PATIENTS AND METHODS

We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time.

RESULTS

The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy.

CONCLUSIONS

Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.

Microbiological diagnosis of infective keratitis: comparative evaluation of direct microscopy and culture results

AIMS

To determine the sensitivity, specificity and predictive values of potassium hydroxide (KOH) wet mount, Gram stain, Giemsa stain and Kinyoun's acid-fast stain in the diagnosis of infective keratitis.

METHODS

A retrospective analysis of all patients with clinically diagnosed infective keratitis presenting between September 1999 and September 2002 was carried out. Corneal scrapes were taken and subjected to direct microscopy and culture.

RESULTS

3298 eyes of 3295 consecutive patients with infective keratitis were evaluated, of which 1138 (34.51%) eyes had fungal growth alone, 1069 (32.41%) had bacterial growth alone, 33 (1%) had Acanthamoeba growth alone, 83 (2.5%) had mixed microbial growth and the remaining 975 (29.56%) had no growth. The sensitivity of KOH wet mount was higher (99.3%; 95% confidence interval (CI) 98.6 to 99.6) in the detection of fungi, 100% (95% CI 90.4 to 100) in the detection of Nocardia and 91.4% (95% CI 75.8 to 97) in the detection of Acanthamoeba) than that of Gram-stained smears (89.2% (95% CI 87.3 to 90.8) in fungi, 87% (95% CI 73.0 to 94.6) in Nocardia and 60% (95% CI 42.2 to 75.6) in the detection of Acanthamoeba) in the detection of fungi, Nocardia and Acanthamoeba. 1764 of 3295 (53.54%) patients presented more than 7 days after onset of illness and 84.69% of the eyes had corneal ulcers with size >2 mm in diameter. Positivities of KOH (44.46%; p<0.001) and Gram-stained smears (77.37%; p<0.001) were found to be higher among eyes with larger ulcers (>2 mm) than among eyes with smaller ulcers (<2 mm).

CONCLUSION

KOH smear is of greater diagnostic value in the management of infective keratitis, and it is recommended in all clinics without exception for establishing timely treatment.

Estimation of measles vaccination coverage using the Lot Quality Assurance Sampling (LQAS) method--Tamilnadu, India, 2002-2003

INTRODUCTION

As part of the global strategic plan to reduce the number of measles deaths in India, the state of Tamilnadu aims at > or =95% measles vaccination coverage. A study was conducted to measure overall coverage levels for the Poondi Primary Health Center (PPHC), a rural health-care facility in Tiruvallur District, and to determine whether any of the PPHC's six health subcenters had coverage levels <95%.

METHODS

The Lot Quality Assurance Sampling (LQAS) method was used to identify health subcenters in the PPHC area with measles vaccination coverage levels <95% among children aged 12-23 months. Lemeshow and Taber sampling plans were used to determine that the measles vaccination status of 73 children aged 12--23 months had to be assessed in each health subcenter coverage area, with a 5% level of significance and a decision value of two. If more than two children were unvaccinated, the null hypothesis (i.e., that coverage in the health subcenter was low [<95%]) was not rejected. If the number of unvaccinated children was two or fewer, the null hypothesis was rejected, and coverage in the subcenter was considered to be good (i.e., > or =95%). All data were pooled in a stratified sample to estimate overall total coverage in the PPHC area.

RESULTS

For two (33.3%) of the six health subcenters, more than two children were unvaccinated (i.e., coverage was <95%). Combining results from all six health subcenters generated a coverage estimate of 97.7% (95% confidence interval = 95.7-98.8) on the basis of 428 (97.7%) of 438 children identified as vaccinated.

CONCLUSION

LQAS techniques proved useful in identifying small health areas with lower vaccination coverage, which helps to target interventions. Monthly review of vaccination coverage by subcenter and village is recommended to identify pockets of unvaccinated children and to maintain uniform high coverage in the PPHC area.

Optic disc morphometry with optical coherence tomography: comparison with planimetry of fundus photographs and influence of parapapillary atrophy and pigmentary conus

PURPOSE

Optical coherence tomography (OCT) is an established method for visualising macular pathology and for measuring the thickness of parapapillary retinal nerve fibre layer. The purpose of the present study was to compare OCT measurements of the optic disc with those obtained by planimetry of fundus photographs and to investigate whether OCT measurements are influenced by the amount of parapapillary atrophy or pigmentary conus at the disc margin.

MATERIALS AND METHODS

Eighty-two eyes of 41 randomly selected Asian-Indian subjects were included. The mean age was 44.2+/-14.3 years (mean+/-SD). All eyes underwent optic disc assessment by OCT (fast optical disc protocol) and digital 20 degree disc photos.. Planimetry of the discs were performed by outlining the disc and the cup. The amount of parapapillary atrophy (zone beta) was quantified as the number of clock-hours around the disc with adjacent parapapillary atrophy. The same procedure was performed to quantify the amount of pigmentary conus around the disc.

RESULTS

Mean+/-SD disc size and mean+/-SD cup size in OCT measurements (2.37+/-0.51, 1.29+/-0.55) were significantly smaller than in photographic planimetry (2.83+/-0.62, 1.56+/-0.5: P<0.001, P<0.001). Optic discs with parapapillary atrophy (P=0.2) in their relative difference of disc sizes between OCT and planimetry. Similarly, optic discs with pigmentary conus (n=12) and discs without pigmentary conus (n=70) did not differ significantly (P=0.65). The relative difference in disc size between the two measurement modalities did not correlate with the amount of parapapillary atrophy (r=-0.17, P=0.29) or with the amount of pigmentary conus (r=-0.04, P=0.9).

CONCLUSION

OCT analysis of the optic disc produces significantly smaller parameters, compared to the established method of optic disc planimetry. Neither presence, nor extent of parapapillary atrophy zone beta and pigmentary conus seems to produce a systematic error in measurements of disc size with the OCT.

Tonic eye deviation due to nonketotic hyperglycaemia induced focal seizures: case report

We report a case of intermittent tonic conjugate eye deviation due to nonketotic hyperglycaemia induced focal seizure.

Retinal nerve fibre layer thickness measurements in normal Indian population by optical coherence tomography

PURPOSE

To obtain retinal nerve fibre layer thickness measurements by optical coherence tomography (OCT) in normal Indian population.

MATERIALS AND METHODS

Total of 118 randomly selected eyes of 118 normal Indian subjects of both sex and various age groups underwent retinal nerve fiber layer thickness analysis by Stratus OCT 3000 V 4.0.1. The results were evaluated and compared to determine the normal retinal nerve fiber layer thickness measurements and its variations with sex and age.

RESULTS

Mean +/- standard deviation retinal nerve fiber layer thickness for various quadrants of superior, inferior, nasal, temporal and along the entire circumference around the optic nerve head were 138.2 +/- 21.74, 129.1 +/- 25.67, 85.71 +/- 21, 66.38 +/- 17.37 and 104.8 +/- 38.81 microm, respectively. There was no significant difference in the measurements between males and females and no significant correlation with respect to age.

CONCLUSION

Our results provide the normal retinal nerve fiber layer thickness measurements and its variations with age and sex in Indian population.

An acute hyperglycemia or acidosis-induced changes of indolamines level correlates with PKC-alpha expression in rat brain

Hyperglycemia and ketoacidosis are the two most serious factors in acute metabolic complications of both type 1 and type 2 diabetes. Dysfunction of the central nervous system is a well-documented complication of diabetes. We and others have previously reported that acute or chronic diabetes in animal's results in altered brain neurotransmitter levels. In this study, we investigated the effects of acute (7 days) glucose-induced hyperglycemia and sodium acetoacetate (NaAcAc) or ammonium chloride (NH4Cl) induced acidosis on the level of indolamines (5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA)) as well as PKC-alpha expression/activity in discrete areas of rat brain. Glucose-induced (500 mg/kg, bw) hyperglycemic ( approximately 249 mg%) rats showed significant (p<0.05) increase in 5-HT levels in mid brain (MB), pons medulla (PM) and cerebellum (CB), respectively. 5-HIAA level increased in hippocampus (HC) (p<0.05) as compared to control. The rats treated with sodium acetoacetate (NaAcAc) for 7 days (60 mg/kg, bw) showed significant decrease (p<0.05) of 5-HT level in hypothalamus (HT). Whereas, the 5-HIAA level increased in MB (p<0.05). Similarly, the PKC-alpha expression as well as the enzyme activity showed significant increase in HC, MB, PM and CB under glucose-induced hyperglycemia and that changes correlated the changes of indolamines, suggesting that the hyperglycemia may be the major metabolic disorder in diabetic complications.

Gallbladder Na+/H+ exchange activity is up-regulated prior to cholesterol crystal formation

BACKGROUND

Gallbladder Na+ and H2O absorption are increased prior to gallstone formation and may promote cholesterol nucleation. Na+/H+ exchange (NHE) isoforms NHE2 and NHE3 are involved in gallbladder Na+ transport in prairie dogs. We examined whether increased gallbladder Na+ absorption observed during early gallstone formation is the result of NHE up-regulation.

MATERIALS AND METHODS

Native gallbladder and primary cultures of gallbladder epithelial cells (GBECs) harvested from prairie dogs fed nonlithogenic (CON) or 1.2% cholesterol diet for varying lengths of time to induce cholesterol-saturated bile (PreCRYS), cholesterol crystals (CRYS), or gallstones (GS) were used. NHE activity was assessed by measuring dimethylamiloride-inhibitable 22Na+ uptake under H+ gradient in primary GBECs. HOE-694 was used to determine NHE2 and NHE3 contributions. NHE protein and mRNA expression were examined by Western and Northern blots, respectively.

RESULTS

Gallbladder total NHE activity was 25.1 +/- 1.3 nmol mg protein(-1) min(-1) in the control and increased during gallstone formation peaking at the PreCRYS stage (98.4 +/- 3.9 nmol mg protein(-1) min(-1)). There was a shift in NHE activity from NHE2 to NHE3 as the animals progressed from no stones through the PreCRYS and CRYS stages to gallstones. The increase in NHE activity was partly caused by an increased Vmax without any change in K(Na)m. Both NHE2 and NHE3 protein increased moderately during the PreCRYS stage without increases in mRNA expression.

CONCLUSIONS

Increased gallbladder Na+ absorption observed prior to crystal formation is in part caused by an increase NHE activity which is not fully accounted for by an increase in NHE proteins and mRNA levels but may be explained by enhanced localization in the membranes and/or altered regulation of NHE.

A short-term diabetes induced changes of catecholamines and p38-MAPK in discrete areas of rat brain

Chronic diabetes is associated with the alteration of second messengers and CNS disorders. We have recently identified that protein kinases (CaMKII and PKC-alpha) and brain neurotransmitters are altered during diabetes as well as in hyperglycemic and acidotic conditions. In this study, we investigated the effects of acute diabetes on the levels of dopamine (DA), norepinephrine (NE), epinephrine (E) and p38-Mitogen-Activated Protein Kinase (p38-MAPK) in striatum (ST), hippocampus (HC), hypothalamus (HT), midbrain (MB), pons medulla (PM), cerebellum (CB) and cerebral cortex (CCX). Alloxan (45 mg/kg) diabetic untreated rats that showed hyperglycemia (>260 mg%), revealed significant increases of DA level in ST (1.5 fold), HC (2.2 fold) and PM (2.0 fold) and the E level also found to be increased significantly in HT (2.4 fold), whereas the NE level was decreased in CB (0.5 fold), after 7 days of diabetes. Immunoblotting study of p38-MAPK expression under identical conditions showed significant alterations in ST, HC, HT and PM (p<0.05) correlated with the changes of catecholamines (DA and E). On the other hand, the above changes were reversed in insulin-treated diabetic rats maintained under normal glucose level (80 -110 mg %). These results suggest that p38-MAPK may regulate the rate of either the synthesis or release of DA and E in corresponding brain areas, but not NE, under these conditions.

Involvement of Ca2+/calmodulin-dependent protein kinase II in the modulation of indolamines in diabetic and hyperglycemic rats

Hyperglycemia and acidosis are the key factors in diabetic complications. It has been shown that acute or chronic diabetes alters serotonin levels in brain. However, the mechanism of hyperglycemia- or acidosis-induced changes in serotonin levels remains poorly understood. Because Ca2+-dependent protein kinases play a major role in the regulation of serotonin synthesis and release, we investigated the effect of diabetes, hyperglycemia, and acidosis on the level of indolamines [5-hydroxytryptamine (5-HT) and/or 5-hydroxyindoleacetic acid (5-HIAA)] and Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) enzyme activity or protein expression in different brain regions. Alloxan-induced (45 mg/kg bw) diabetic rats (30 days) showed increased level of 5-HT in striatum (ST; 183%), midbrain (MB; 199%), pons medulla (PM; 151%), cerebellum (CB; 214%), and cerebral cortex (CCX; 162%) compared with control (P < 0.05), and these changes were reversed after insulin administration. Rats treated with glucose (500 mg/kg bw) for 30 days showed a 146%, 183%, 208%, and 177% (P < 0.05) increase in 5-HT levels in ST, PM, CB, and CCX, respectively. 5-HIAA level increased in hippocampus (HC; 172%) and in MB (145%; P < 0.05). In addition, rats treated with sodium acetoacetate (NaAcAc) for 30 days (60 mg/kg bw) showed significant increases (P < 0.05) of 5-HT level in ST (152%) and MB (174%). However, the levels of 5-HIAA increased only in MB (151%, P < 0.05). Rats treated with NH4Cl, which induced acidosis (150 mg/kg bw), showed an increased level of 5-HT only in HC (165%, P < 0.05). The increased activity and protein expression of CaMKII in ST, MB, PM, CB, and CCX under diabetic conditions were correlated with the levels of indolamines changes during diabetic, hyperglycemic, or acidotic conditions. These results suggest that CaMKII may be involved in the regulation of indolamines in diabetic animals.

Prevalence of disability and handicaps in geriatric population in rural south India

Proportion of aged persons in India is increasing and is expected to be around 70 million by the end of the year 2000. The epidemiological consequences would be increase in the geriatric problems, particularly, impairments, disabilities and handicaps There are not many community-based studies using the International Classification of Impairments, Disabilities and Handicaps (ICIDH). The main objective of this study was to estimate the prevalence of disabled in the elderly population (aged above 60 years) in a district of south India using ICIDH classification. Thirty villages were selected using probability proportional to size linear systematic sampling (PPSLSS) from Villupuram health unit district in Tamilnadu in south India. One hundred and five households were selected from each selected village by using linear systematic sampling. A structured proforma was administered to 974 subjects to obtain information on disability as perceived by rural geriatric population. Visual disability was found to be the most important single preventable disability (56%). Only 33% of persons with visual disability wore spectacles. A decline in social interaction was reported. There was an urgent need to strengthen health care activities related to geriatric health care to improve the quality of life of the elderly population, including care of vision in particular.

PKC-alpha mediated alterations of indoleamine contents in diabetic rat brain

We previously have reported that acute or chronic diabetes in animals resulted in altered neurotransmitter levels. In this study, we investigated the concentrations of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) in discrete areas of brain viz. striatum (ST), hippocampus (HC), hypothalamus (HT), midbrain (MB), pons medulla (PM), cerebellum (CB) and cerebral cortex (CCX) of control, untreated diabetic and insulin treated diabetic rats after 30 days. Alloxan (45 mg/kg) diabetic untreated rats, which showed hyperglycemia (>250 mg%), revealed significant increases of 5-HT level in ST, MB, PM, CB and CCX and the 5-HIAA level found to be increased significantly in ST, HC and MB. Whereas the insulin treated rats, which was maintained under normal glucose level (80-110 mg%), showed no significant changes in any of the areas studied. The expressions of PKC-alpha studied by immunoblotting also showed significant changes in ST, HC, MB, PM, CB and CCX that is identical to the changes of both 5-HT and 5-HIAA under similar condition, suggesting that the PKC-alpha may regulate the synthesis and release of indoleamines in diabetic animals.