Malabsorption,Orocecal Transit Time and Small Intestinal Bacterial Overgrowth in Type 2 Diabetic Patients: A Connection

Type 2 diabetes mellitus consists of dysfunctions characterized by hyperglycemia and resulting from combination of resistance to insulin action and inadequate insulin secretion. Most of diabetic patients report significant gastrointestinal symptoms. Entire GI tract can be affected by diabetes from oral cavity to large bowel and anorectal region. Proteins, carbohydrates, fats, and most fluids are absorbed in small intestine. Malabsorption may occurs when proper absorption of nutrients does not take place due to bacterial overgrowth or altered gut motility. The present study was planned to measure various malabsorption parameters in type 2 diabetic patients. 175 patients and 175 age and sex matched healthy controls attending Endocrinology Clinic in PGI, Chandigarh were enrolled. Lactose intolerance was measured by using non-invasive lactose hydrogen breath test. Urinary d-xylose and fecal fat were estimated using standard methods. Orocecal transit time and small intestinal bacterial overgrowth were measured using non-invasive lactulose and glucose breath test respectively. Out of 175 diabetic patients enrolled, 87 were males while among 175 healthy subjects 88 were males. SIBO was observed in 14.8 % type 2 diabetic patients and in 2.8 % of controls. There was statistically significant increase (p < 0.002) in OCTT in type 2 diabetic patients compared with controls. OCTT was observed to be more delayed (p < 0.003) in patients who were found to have SIBO than in patients without SIBO. Lactose intolerance was observed in 60 % diabetic patients and 39.4 % in controls. Urinary d-xylose levels were also lower in case of diabetic patients but no significant difference was found in 72 h fecal fat excretion among diabetic patients and controls. Urinary d-xylose and lactose intolerance in SIBO positive type 2 diabetic patients was more severe as compared to SIBO negative diabetic patients. From this study we can conclude that delayed OCTT may have led to SIBO which may have instigated the process of malabsorption among type 2 diabetic patients.     

Potential immunomodulation effect of the extract of Nigella sativa on ovalbumin sensitized guinea pigs

Several different pharmacological effects have been described for Nigella sativa (Siah-Daneh), including an anti-inflammatory effect. In the present study, the effect of the extract of N. sativa on lung pathology and blood interleukin-4 (IL-4) and interferon-γ (IFN-γ) of sensitized guinea pigs was examined. Three groups (n=8 for each group) of guinea pigs sensitized to ovalbumin (OA) were given drinking water alone, and drinking water containing low and high concentrations of the plant extract, respectively. The animals of the control group (n=8) were treated with saline instead of OA and were given drinking water. The pathological changes of the lung, including infiltration of eosinophils and lymphocytes, local epithelial necrosis, the presence of oedema, thickening of the basement membrane, smooth muscle layer hypertrophy, mucosal secretion, and the presence of mucosal plug, and blood IL-4 and IFN-γ of sensitized guinea pigs were evaluated. The lungs of the sensitized group showed significant pathological changes (P<0.001). Blood IL-4 and IFN-γ were increased in sensitized animals compared to the controls (P<0.01 and P<0.001, respectively). Treatment of sensitized animals with the extract led to a significant decrease in pathological changes of the lung (P<0.01 to P<0.001), except for the oedema in the sensitized group treated with low concentration of the extract, but an increased IFN-γ. These results confirm a preventive effect of N. sativa extract on lung inflammation of sensitized guinea pigs.     

Google glass adoption in the educational environment: A case study in the Gulf area

Education and Information Technologies - The rapid changes in recent years witnessed the development of technology-based education environment where teachers and learners can interact by adopting...     

Evaluating biometrics for online banking: The case for usability

Rising cyber-crimes have heightened existing concerns about e-banking security. However currently the use of biometric technology in the banking sector is not prevalent. We developed a biometric system for authenticating e-banking and applied the established System Usability Scale (SUS) to evaluate its effectiveness from the perspective of potential users. The case demonstrates that on the whole users are very favourable towards a biometric banking system and ostensibly found the system developed usable. We found that when evaluating the biometric system, its different components needed to be considered – namely the biometric technology and the institutional process that supports verification and authentication.     

Antral and duodenal disaccharidases in patients of duodenal ulcer and non-ulcer dyspepsia

Duodenal ulcer is a common disease and is considered acid-peptic disease. Duodenal ulcer patients are known to have higher incidence of antral gastritis and duodentitis than general population. Thus one can expect some alteration in the enzyme products of mucosal cells of antrum and duodenum in this condition. The present study was planned in 30 patients of duodenal ulcer and 30 of non-ulcer dyspepsia. After overnight fast, upper gastrointestinal endoscopy was done using forward viewing fibreoptic endoscope. Two pairs of biopsies were taken from the antrum and two from the descending duodenum using standard biopsy forceps. One pair of biopsy from each site was taken in 10% formal saline for histopathological examination. One pair of biopsies from each site was collected in saline for the measurement of disaccharidases by Dahlquist method. Activities of lactase, sucrase and maltase were significantly higher in descending duodenum mucosa as compared to antral mucosa in both groups. Activities of these enzymes in antrum and duodenum of both groups did not differ significantly. No significant difference was found in disaccharidases in antrum and descending duodenum in patients with or without histological gastritis. This study suggests that the disaccharidases do not change in antrum and duodenum of ulcer patients as compared to the patients with non-ulcer dyspepsia.     

Study of enzyme activities in the descending part of the duodenum in patients of duodenal ulcer

The aim of this study was to measure the levels of lactase, sucrase, maltase, leucine amino peptidase and gamma-glutamyl transpeptidase in duodenum of Indian patients with duodenal ulcer. The effect of duodenum inflammation on these brush border enzymes has also been analysed in this study. Levels of lactase, sucrase, maltase, leucine amino peptidase and gamma-glutamyl transpeptidase were assessed in duodenal biopsies of 20 patients of duodenal ulcer and 20 non-ulcer dyspepsia. The duodenal biopsy specimens were also examined histopathologically for presence or absence of inflammation. There was no significant difference (p>0.05) in the activity of above mentioned enzyme levels in both the groups. Only levels of gamma-glutamyl transpeptidase were significantly decreased in patients of duodenal ulcer with duodenal inflammation. This study shows that only the levels of gamma-glutamyl transpeptidase were significantly decreased in patients of duodenal ulcer with inflammation but no change in duodenal enzymes due to duodenal ulcer as compared to non-ulcer dyspepsia.     

Extinction of a saccharin—lithium association: Assessment by consumption and taste reactivity

Extinction of a conditioned palatability shift preceded extinction of conditioned taste avoidance whether rats were tested using a within-subjects design or a between-subjects design. In each of two experiments, consumption of 0.1% saccharin was paired with either 20 ml/kg of 0.15 M LiCl or equivolume physiological saline on a single trial. In Experiment 1, on each of 10 extinction trials, rats were given a taste reactivity test immediately prior to a consumption test. In Experiment 2, half of the rats were extinguished by taste reactivity testing and half of the rats were extinguished by a consumption test on each of 10 extinction trials. In both experiments, the aversive reactions of gaping and passive dripping were extinguished in a single trial and the suppression of ingestive reactions was extinguished in 2 trials; however, extinction of taste avoidance required 4–5 trials. These results suggest that rats continue to avoid a lithium-paired flavor even when they do not have an aversion to the taste.     

Review on COVID-19 Etiopathogenesis,Clinical Presentation and Treatment Available with Emphasis on ACE2

In December 2019, Wuhan city in the Hubei province of China reported for the first time a cluster of patients infected with a novel coronavirus, since then there has been an outburst of this disease across the globe affecting millions of human inhabitants. Severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), is a member of beta coronavirus family which upon exposure caused a highly infectious disease called novel coronavirus disease-2019 (COVID-19). COVID-19, a probably bat originated disease was declared by World Health Organization (WHO) as a global pandemic in March 2020. Since then, despite rigorous global containment and quarantine efforts, the disease has affected nearly 56,261,952 laboratory confirmed human population and caused deaths of over 1,349,506 lives worldwide. Virus passes in majority through respiratory droplets and then enters lung epithelial cells by binding to angiotensin converting enzyme 2 (ACE2) receptor and there it undergoes replication and targeting host cells causing severe pathogenesis. Majority of human population exposed to SARS-CoV-2 having fully functional immune system undergo asymptomatic infection while 5–10% are symptomatic and only 1–2% are critically affected and requires ventilation support. Older people or people with co-morbidities are severely affected by COVID-19. These categories of patients also display cytokine storm due to dysfunctional immune response which brutally destroys the affected organs and may lead to death in some. Real time PCR is still considered as standard method of diagnosis along with other serology, radiological and biochemical investigations. Till date, no specific validated medication is available for the treatment of COVID-19 patients. Thus, this review provides detailed knowledge about the different landscapes of disease incidence, etiopathogenesis, involvement of various organs, diagnostic criteria’s and treatment guidelines followed for management of COVID-19 infection since its inception. In conclusion, extensive research to recognize novel pathways and their cross talk to combat this virus in precarious settings is our future positive hope.     

COVID-19 and Gut Microbiota: A Potential Connection

Currently, world is facing a global outbreak causing a pandemic threat known as COVID-19. This infectious disease is triggered by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Gut microbiota harbours multi species community with a strong impact on host immune homeostasis. However, our knowledge about this gut microbiota and its symbiotic relationship with immune activation in association with SARS-CoV-2 is limited. Unbalanced bacterial flora with too many opportunistic infections can shift immune system towards a cascade of inflammatory responses leading to multi organ damage. This review will highlight immune-regulation via various mechanisms in SARS-CoV-2 infection. Diet has an unbelievable influence on gut microbiome that allows a new state of homeostasis to be reached through timing, frequency and duration of intake. This review article focuses on gut, lung microbiota and immunomodulation with specific attention on immune activation by gut microbiota.     

Real-time,evidence-based medicine instruction: a randomized controlled trial in a neonatal intensive care unit

Purpose: The study assesses potential for improving residents'' evidence-based medicine searching skills in MEDLINE through real-time librarian instruction.Subjects: Ten residents on a rotation in a neonatal intensive care unit participated.Methodology: Residents were randomized into an instruction and a non-instruction group. Residents generated questions from rounds and searched MEDLINE for answers. Data were collected through observation, search strategy analysis, and surveys. Librarians observed searches and collected data on questions, searching skills, search problems, and the test group''s instruction topics. Participants performed standardized searches before, after, and six-months after intervention and were scored using a search strategy analysis tool (1 representing highest score and 5 representing lowest score). Residents completed pre- and post-intervention surveys to measure opinions about MEDLINE and search satisfaction.Results: Post-intervention, the test group formulated better questions, used limits more effectively, and reported greater confidence in using MEDLINE. The control group expressed less satisfaction with retrieval and demonstrated more errors when limiting. The test and control groups had the following average search scores respectively: 3.0 and 3.5 (pre-intervention), 3.3 and 3.4 (post-intervention), and 2.0 and 3.8 (six-month post-intervention).Conclusion: Data suggest that measurable learning outcomes were achieved. Residents receiving instruction improved and retained searching skills six-months after intervention.