Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced diabetic rats

The aqueous extract of the fruits of Terminalia chebula Retz. has been evaluated for its antidiabetic activity in streptozotocin (STZ) induced mild diabetic rats and compared with a known drug, tolbutamide. The oral effective dose (ED) of the extract was observed to be 200 mg/kg body weight, which produced a fall of 55.6% (p<0.01) in the oral glucose tolerance test. Oral administration of ED of aqueous extract of T.chebula (AETC) daily once for two months reduced the elevated blood glucose by 43.2% (p<0.01) and significantly reduced the increase in glycosylated hemoglobin (HbA1c) (p<0.01). The same dose also showed a marked improvement in controlling the elevated blood lipids as well as decreased serum insulin levels in contrast to the untreated diabetic animals. Hepatic and skeletal muscle glycogen content decreased by 75% and 62.9% respectively in diabetic controls, these alterations were partly prevented (34.9% and 21.17%) in AETC treated group when compared to the healthy controls. The in vitro studies with pancreatic islets showed that the insulin release was nearly two times more than that in untreated diabetic animals. The treatment did not have any unfavorable effect on other blood parameters of liver and kidney function tests. LD 50 was found to be above 3 g/kg bw i.e. 15 times of ED, because there were no deaths of animals even at this dose indicating high margin of safety. These findings suggest further investigations for the possible use of the aqueous extract of fruits of T.chebula for the treatment of diabetes.

406. Regulation of insulin receptor and its substrates by follicle stimulating hormone in granulosa cells

Insulin receptor signalling receptor regulates the process of follicular development and maturation, however the regulation of insulin receptor (IR) and its signalling component during folliculogenesis is not well understood. This study demonstrates FSH mediated regulation of insulin receptor isoforms specially IR-B, its substrates and some of the insulin related responses like glycogen synthesis and cell proliferation. There was significant increase in mRNAs expression for insulin receptor (IR) isoforms, IR-A and IR-B in ovary in response to PMSG and in granulosa cells (GCs) in response to FSH. IR protein increased in GCs in response to FSH in a dose and time dependent manner. Interestingly, the expression of mRNAs and proteins for IRS-1 and IRS-2 increased significantly in GCs by FSH. Serine phosphorylation (Ser 636/639) of IRS-1 was decreased by FSH, thus facilitating IRS-1 activation. FSH stimulated glycogen synthesis in a dose dependent manner both by PI 3 kinase dependent and independent pathways. Insulin regulated the amount of FSH stimulated glycogen synthesis by granulosa cells. In contrast, FSH and insulin synergistically stimulated glycogen synthesis GC proliferation which was completely inhibited by LY294002. Knockdown of IRS-1 mRNA by siRNA inhibited FSH stimulated GC proliferation indicating an important role of IRS-1 downstream of FSH. Further research is required to delineate the signalling components involving IRS-1 and IRS-2 in response to FSH and thus involved in the cross-talk between FSH and insulin in GCs. Results thus demonstrate that pituitary FSH regulates insulin receptor and its substrates in rat GCs which might be important for follicular growth and oocyte development.

New steps in the control of canine rabies in India

In India, about 20,000 people die of rabies every year. The dog is the main reservoir and transmitter of the disease. A pilot rabies control programme was launched in five Indian federal states in February, 2007. This initiative is led by the Animal Welfare Board of India (AWBI) federating many animal welfare organizations and the Ministry of Agriculture. It aims at creating a "Rabies Free India." The programme combines parenteral vaccination of accessible owned and stray dogs, spaying/neutering followed by parenteral vaccination and oral vaccination of inaccessible dogs. The freeze-dried vaccine SAG2, including the bait casing, was registered in India following successful evaluation of vaccine-bait safety and efficacy (by survival after virulent challenge) in captive Indian stray dogs in the Bhopal High Security Animal Disease Laboratory. Furthermore, bait acceptance was tested under both experimental and field conditions.

Clinico-laboratory profile of haemolytic uremic syndrome

OBJECTIVE

To study the clinical profile, the spectrum of functional abnormalities, prognostic factors and outcome of children with haemolytic uremic syndrome (HUS).

MATERIALS AND METHODS

This is a prospective, descriptive, single centre, cohort study, conducted on 42 children during the period of January 2004 to January 2005.

RESULTS

The maximum numbers of cases were below 24 months of age with mean age of 26.6 months and male: female ratio of 2.8:1. Most of the cases (79%) occurred in the warmer months (April-September). The common clinical presentations were bloody diarrhoea, pallor, oliguria & anuria, fever, vomiting, abdominal distension and pain, involvement of central nervous system, chest and cardiovascular system and bleeding manifestations. The common haematological abnormalities were leucocytosis, thrombocytopenia, anaemia and features of haemolysis in the peripheral blood. Electrolyte abnormalities observed were in the form of hyponatremia, hypokalemia and hyperkalemia. Arterial blood gas analysis showed metabolic acidosis in 64% cases, where the estimations were done. The mean blood urea and serum creatinine levels were 113.7 mg/dL and 2.5 mg/dL, respectively. Stool examination showed blood in all cases. Urine examination showed microscopic haematuria and significant proteinuria in 74% and 38% cases, respectively. E. coli and Shigella were isolated in stool in three cases each and one case showed mixed growth of E. coli and Salmonella. The mortality rate was 21%. Significantly higher mortality was observed in females, patients presenting with complete anuria, leucocytosis, hyperkalemia and systemic involvement like central nervous system, cardio vascular system and chest.

CONCLUSIONS

Female sex, complete anuria, leucocytosis, extra renal involvement and hyperkalemia were associated with poor outcome.

Aerobic production of isoamyl acetate by overexpression of the yeast alcohol acetyl-transferases AFT1 and AFT2 in Escherichia coli and using low-cost fermentation ingredients

Isoamyl acetate, produced via fermentation, is a natural flavor chemical with applications in the food industry. Two alcohol acetyltransferases from Saccharomyces cerevisiae (ATF1 and ATF2) can catalyze the esterification of isoamyl alcohol with acetyl coenzyme A. The respective genes were cloned and expressed in an appropriate ack-pta(-) strain of Escherichia coli. The engineered strains produce isoamyl acetate when isoamyl alcohol is added to the culture medium. Aerobic shake flask experiments examined isoamyl acetate production over various growth times, temperatures, and initial optical densities. The strain carrying the pBAD-ATF1 plasmid exhibited a high molar ester yield from glucose (1.13) after 48 h of aerobic growth at 25 degrees C. Low-cost media components, such as fusel oil, sorghum glucose and corn steep liquor, were found to give a high yield of isoamyl acetate. High-cell-density gave an increased isoamyl acetate yield of 0.18 g/g of glucose consumed.

Metabolomics: Approaches to assessing oocyte and embryo quality

Morphological evaluation remains the primary method of embryo assessment during IVF cycles, but its modest predictive power and inherent inter- and intra-observer variability limits its value. Low-molecular weight metabolites represent the end products of cell regulatory processes and therefore reveal the response of biological systems to a variety of genetic, nutrient or environmental influences. It follows that the non-invasive quantification of oocyte and embryo metabolism, from the analyses of follicular fluid or culture media, may be a useful predictor of pregnancy outcome following embryo transfer, a potential supported by recent clinical studies working with specific classes of metabolites such as glycolytic intermediates and amino acids. Such selective approaches, however, whilst adhering closely to known cellular processes, may fail to harness the full potential of contemporary metabolomic methodologies, which can measure a wider spectrum of metabolites. However, an important technical drawback with many existing methodologies is the limited number of metabolites that can be determined by a single analytical platform. Vibrational spectroscopy methodologies such as Fourier transform infrared and near infrared spectroscopy may overcome these limitations by generating unique spectral signatures of functional groups and bonds, but their application in embryo quality assessment remains to be fully validated. Ultimately, a combination of evaluation criteria that include morphometry with metabolomics may provide the best predictive assessment of embryo viability.

Bacterial endocarditis treated with intramuscular teicoplanin

Right-sided endocarditis caused by Staphylococcus aureus in parenteral drug abusers is potentially life-threatening, more so in the presence of pulmonary embolisation, and a course of parental antibiotics is required for at least four weeks. A combination of intravenous cloxacillin and aminoglycosides has proven efficacious for more than 90 percent of the patients. Intravenous vancomycin can also be used in cases of penicillin allergy or methicillin-resistant staphylococci. Intravenous teicoplanin, a glycopeptide with a similar antimicrobial profile to vancomycin, has been used with a somewhat lesser degree of success in these cases and is not recommended as first line therapy. We describe a 37-year-old man, a parenteral drug user, who had right-sided endocarditis, where in the absence of other alternatives, teicoplanin had to be administered intramuscularly and not intravenously.

Genetic fingerprinting and identification of differentially expressed genes in isolates of Leishmania donovani from Indian patients of post-kala-azar dermal leishmaniasis

Post-kala-azar dermal leishmaniasis (PKDL) is an unusual dermatosis that develops as a sequel in 5-15% of cured cases of kala-azar (KA) after months or years of treatment in India. Molecular differences are reported to exist between the KA and PKDL isolates which may underlie the diversity in clinical manifestations of the disease. Here, arbitrary primed-PCR (AP-PCR) has been used for genetic fingerprinting of parasite isolates from dermal lesions of PKDL patients (n=14) and compared with bone-marrow derived parasites from KA patients (n=3). All isolates showed an identical AP-PCR pattern with 4 arbitrary primers. Further, AP-PCR was exploited to identify the stage regulated genes of the parasite. Six polymorphic fragments were identified in PKDL in comparison with KA isolates, and were subjected to Northern blot analysis. Five polymorphic fragments represented transcribed sequences; 4 out of 5 drew differential expression in pro- and amastigote stages, although the expression was comparable between PKDL and KA isolates. The study led to the identification of genes, which exhibit stage-regulated expression in Leishmania donovani derived from PKDL or KA patients, including a putative phosphodiesterase, DEAD box RNA helicase, iron superoxide dismutase b (fesodb) and a hypothetical protein. Demonstration of transcripts of DEAD box RNA helicase in PKDL and KA diseased tissues implicates its role in disease pathogenesis.

Design and development of batch type acetifier for wine-vinegar production

A batch type acetifier based on the principal of acetic acid fermentation was designed and tested for production of wine-vinegar from the pineapple peel waste. The pineapple peels along with starter solution was fed to the inner SS perforated peel-solid separator tank 130 mm dia having perforations of 50 mm size. The concentric perforated peel-solid separator circular tank was fitted inside the collecting tank having 255 mm dia. The pineapple peels and starter solution in perforated peel-solid separator tank was agitated and atomized by tubing agitator 200 mm long having 1 mm dia. hole to spray fermented solution at 20 rpm. The agitator was connected with stirring pump. Lift pump was fitted at the bottom of the collecting tank to lift and supply fermented solution to agitator. The capacity of the batch type Acetifier based on present working design was 3.5 liters of wine-vinegar per day for 8 hours for a quality end product at 2% acidity.

Rehydration with sodium-enriched coconut water after exercise-induced dehydration

This crossover study assessed the effectiveness of plain water (PW), sports drink (SD), fresh young coconut water (CW) and sodium-enriched fresh young coconut water (SCW) on whole body rehydration (R) and plasma volume (PV) restoration after exercise-induced dehydration. Ten healthy male subjects ran at 65% of VO2max in an environmental temperature of 32.06 +/- 0.02 degree C with a relative humidity (rh) of 53.32 +/- 0.17% for 90 minutes to lose 3% body weight (BW). During the 2-hour rehydration period, subjects drank, in randomized order, PW, SD, CW or SCW equivalent to 120% of BW lost in three boluses representing 50, 40 and 30% of the fluid lost at 0, 30, and 60 minutes, respectively. In all trials subjects were still somewhat dehydrated even after the 2-hour rehydration period. Indexes of percent rehydration with PW, SD, CW and SCW were 58 +/- 2, 68 +/- 2, 65+/- 2 and 69 +/- 1%, respectively, with significantly better rehydration with SD and SCW. The rehydration indexes for SD and SCW were significantly lower than PW (p < 0.01). PV was restored to euhydration levels after 2 hours of rehydration with SD, CW and SCW but not with PW. The plasma glucose concentration were significantly higher when SD, CW and SCW were ingested. SCW was similar in sweetness to CW and SD but caused less nausea and stomach upset compared to SD and PW. In conclusion, ingesting SCW was as good as ingesting a commercial sports drink for whole body rehydration after exercise-induced dehydration but with better fluid tolerance.

Reduced peripheral blood mitochondrial DNA content is not a risk factor for Type 2 diabetes

AIMS

Mitochondrial depletion in pancreatic beta cells is known to reduce glucose stimulated insulin secretion. We aimed to determine whether the offspring of patients with early onset Type 2 diabetes had reduced peripheral blood mitochondrial content relative to control subjects and whether this could lead to a predisposition to type 2 diabetes in later life.

METHODS

We measured the levels of mitochondria relative to a single copy genomic target by real time polymerase chain reaction in a series of peripheral blood samples taken from the offspring of Caucasian patients with Type 2 diabetes and matched controls. Measures of insulin sensitivity and beta cell function were also taken.

RESULTS

In contrast with previous studies, mitochondrial DNA content was not decreased in the offspring of patients with Type 2 diabetes relative to matched controls in our cohort. Conversely, we noted a small proliferation in mitochondrial numbers in our case subjects. In agreement with these findings, no correlations with either insulin sensitivity or beta cell function were noted.

CONCLUSIONS

Our results indicate that reduced mitochondrial DNA content in peripheral blood is not a risk factor for the development of Type 2 diabetes in the offspring of patients with early onset Type 2 diabetes.

Short communication: Post-kala-azar dermal leishmaniasis - an appraisal

This short descriptive paper assesses diagnostics, clinical characteristics and therapy of both Indian and African post-kala-azar dermal leishmaniasis.

Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery versus upfront surgery followed by chemotherapy (CT) in advanced epithelial ovarian carcinoma (EOC): A prospective randomized study—Interim results

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Background: To determine the impact of NACT on surgical debulking rate, overall and disease-free survival and quality of life (QOL) in patients with advanced EOC. Methods: Between Oct 2001 and Dec 2006, 128 previously untreated EOC patients (median age- 50 years, range 30 to 65) with FIGO stage III C & IV (pleural effusion only) have been randomized into - Arm A (n=65) upfront debulking Surgery followed by 6 cycles of Paclitaxel & carboplatin (PC) and Arm B (n=63): NACT with 3 cycles of PC followed by debulking Surgery then 3 more cycles. Eligibility criteria include - age 18 to 65 years, biopsy / cytological proven EOC, adequate hematological, renal, liver & cardiac functions, normal upper & lower GI endoscopy & CEA levels. Both groups were compared for debulking rate, duration of surgery, blood loss, intra & postoperative morbidity & mortality, overall response to treatment and QOL (FACT- O questionnaire). Results: 100 of 128 patients have completed treatment (arm A- 56, B-44). 7 patients were not evaluable; (Germ cell tumor-1, mixed Mullerian tumor-2, dual primary-1 and krukenburg-3). 93 patients are evaluable. Patients’ characteristics are similar in both arms. Grade III-IV - GIT (3% vs. 4%) & bone marrow (9% Vs 7%, p=ns) toxicity was similar in arm A & B, among 463 CT cycles administered. Patients in NACT arm had higher optimum debulking rate, p<. 0001, decreased blood loss during surgery (mean vol 520 vs 373 ml p<0.003) and reduced postoperative infections 14.8 % vs. 2.5%, p<0.04. Mean operative time (110 vs 95 minutes, p=0.12) and hospital stay (12 Vs 9.4 days, p=0.1) were similar in arm A & B. The median overall survival (arm A & B: 42 vs 29 months, p=0.07) and disease free survival (20 vs 25 months, p=0.11) is not different at a median follow up of 41 months. QOL score was significantly better in NACT arm at the end of treatment. (93 vs 114, p<. 001). Conclusions: Neoadjuvant chemotherapy in advanced epithelial ovarian cancer is associated with higher optimum debulking rate with reduced postoperative morbidity and improved quality of life.

No significant financial relationships to disclose.

Contributions of parathyroid hormone (PTH)/PTH-related peptide receptor signaling pathways to the anabolic effect of PTH on bone

PTH regulates osteoblastic function by activating PTH/PTHrP receptors (PTH1Rs), which trigger several signaling pathways in parallel, including cAMP/protein kinase A (PKA) and, via both phospholipase-C (PLC)-dependent and PLC-independent mechanisms, protein kinase C (PKC). These signaling functions have been mapped to distinct domains within PTH(1-34), but their roles in mediating the anabolic effect of intermittent PTH in vivo are unclear. We compared the anabolic effects in mice of hPTH(1-34) with those of two analogs having restricted patterns of PTH1R signaling. [G(1),R(19)]hPTH(1-28) lacks the 29-34 domain of hPTH(1-34) needed for PLC-independent PKC activation, incorporates a Gly(1) mutation that prevents PLC activation, and stimulates only cAMP/PKA signaling. [G(1),R(19)]hPTH(1-34) retains the 29-34 domain and activates both cAMP/PKA and PLC-independent PKC. Human PTH(1-34) (40 microg/kg), [G(1),R(19)]hPTH(1-34) (120 microg/kg), and [G(1),R(19)]hPTH(1-28) (800 microg/kg), at doses equipotent in elevating blood cAMP at 10 min and cAMP-dependent gene expression in bone at 6 h after s.c. injection, were administered to 10-week-old female C57BL/6J mice 5 days/week for 4 weeks. Acute blood cAMP responses, retested after 4 weeks, were not reduced by the preceding PTH treatment. The three PTH peptides induced equivalent increases in distal femoral bone mineral density (BMD), and, by microCT analysis, distal femoral and vertebral bone volume and trabecular thickness and mid-femoral cortical endosteal apposition. [G(1),R(19)]hPTH(1-34) and hPTH(1-34) increased distal femoral BMD more rapidly and augmented total-body BMD and bone volume of proximal tibial trabeculi to a greater extent than did [G(1),R(19)]hPTH(1-28). We conclude that cAMP/PKA signaling is the dominant mechanism for the anabolic actions of PTH in trabecular bone and that PLC-independent PKC signaling, attributable to the PTH(29-34) sequence, appears to accelerate the trabecular response and augment BMD at some skeletal sites. PTH1R PLC signaling pathway is not required for an anabolic effect of intermittent PTH(1-34) on bone.

A microculture technique for isolating live Leishmania parasites from peripheral blood of visceral leishmaniasis patients

Current procedures for diagnosing Leishmania parasites from patients involve invasive and dangerous tissue aspiration. We have developed a non-invasive and highly sensitive microculture method that can isolate parasites from the buffy coat of the patient's peripheral blood. The parasites were cultured in 96-well culture plates. Nineteen parasitologically proven visceral leishmaniasis (VL) patients were included in the study. Using this technique, we were able to isolate parasites from 16 (84%) samples. However, all 19 (100%) samples were positive on culture of splenic aspirates. We conclude that this technique is useful for the isolation and cryoconservation of parasites from patients' blood. This simple method could be tried as a first-instance alternative before other more sensitive procedures such as splenic aspirate; however, negative results should be confirmed by tests with higher sensitivity.