[Year:2024] [Month:January-April] [Volume:28] [Number:1] [Pages:1] [Pages No:iv - iv]
[Year:2024] [Month:January-April] [Volume:28] [Number:1] [Pages:7] [Pages No:1 - 7]
Keywords: Chronic kidney disease, Diabetic nephropathy, Estimated glomerular filtration rate, HbA1c, Renal anemia, Type 2 diabetes mellitus
DOI: 10.5005/jp-journals-10054-0228 | Open Access | How to cite |
Abstract
Aim and background: Hemoglobin A1c levels and complete blood count (CBC) is a diagnostic test used for diabetes and to determine the development of diabetic complications. The level of HbA1c is affected by factors, such as the Hb, the age of red blood cells (RBCs) in the blood circulation, and the Hb glycation rate. Our study aims to assess glycemic variability (GV) in diabetic patients at different stages of chronic kidney disease (CKD) and its relation to Hb and RBC levels to their HbA1c in different CKD stages. Materials and methods: This was a cross-sectional analysis of 156 adults with type 2 diabetes mellitus (T2DM) carried out in Parul Sevashram Hospital, Vadodara from November 2022 to May 2023. Chronic kidney disease stages were defined according to the modification of diet in renal disease (MDRD) equation stages I-V. HbA1c, RBC count, and RBS were estimated for the patients belonging to each stage. Statistical analyses were performed using SPSS software version 26.0 and Microsoft Excel 2019. Results: Out of the total diagnosed patients (n = 156), 58.3% were males and 41.6% were females. It was important to note that the maximum number of patients in the end-stage, that is, stage V, was detected with the HbA1c range of 4–7%. The inconsistencies in blood sugar levels with HbA1c were an alarming indication of other underlying issues such as renal anemia. Conclusion: Chronic kidney disease occurs due to diabetes and hypertension also contributes to renal anemia. In the later stages of CKD with T2DM, a low level of HbA1c ranging from 4 to 7% has been found due to low RBC count and Hb. Therefore, the clinical significance of this study is the non-reliability of HbA1c tests in advanced stages of CKD patients because of lower RBC counts giving rise to false glycated hemoglobin percentage.
[Year:2024] [Month:January-April] [Volume:28] [Number:1] [Pages:5] [Pages No:8 - 12]
Keywords: Congenital hypothyroidism, Neonatal screening, Thyroid stimulating hormone
DOI: 10.5005/jp-journals-10054-0229 | Open Access | How to cite |
Abstract
Background: Growth and differentiation of the fetal brain largely depend on the thyroidal biochemical cascade. The most common cause of congenital hypothyroidism (CH) is thyroid dysgenesis. Maternal iodine deficiency remains to be the predominant cause of underactive thyroid in neonates. Congenital hypothyroidism fulfils Wilson and Jungners criteria for newborn screening, in having a suitable test, and treatment and that the costs of screening, confirmation, and treatment are balanced against the overall costs of not screening. Aims and objectives: Aims: Assessment of possible methods for screening/early detection of CH in neonates. Primary objective: Compare and correlate cord blood (CB) thyroid stimulating hormone (TSH) with heel prick TSH, as a marker of CH. Materials and methods: In a prospective study approved by the Ethical Committee of GCS Medical College and Hospital, Ahmedabad, 100 neonates (50 males and 50 females) were assessed for thyroid status after excluding those born of known hypothyroid mothers or having a history of distress. Cord blood was collected at the time of delivery, and dried blood spots (DBS) from heel prick at 72 hours were collected and TSH was compared. Results: The findings were comparable in both samples as mean TSH CB = 6.14 ± 2.82 mIU/L vs mean TSH DBS = 6.21 ± 3.03 mIU/L; p-value = 0.9268 at 95% confidence interval and r-value for TSH = 0.9783. This was true in normal delivery as well as LSCS births.
Stem Cells in Solid Tumors: Accumulated Evidence and Future Directions
[Year:2024] [Month:January-April] [Volume:28] [Number:1] [Pages:12] [Pages No:13 - 24]
Keywords: Cancer stem cells, MicroRNA, Tumor initiating cell, Tumor microenvironments
DOI: 10.5005/jp-journals-10054-0225 | Open Access | How to cite |
Abstract
Cancer stands as a leading global cause of human mortality, predominantly driven by solid tumors that can ravage vital organs. The scientific community has made significant strides in comprehending the molecular and cellular underpinnings of cancer. However, translating these discoveries into effective, targeted therapeutics has proven challenging. This gap highlights the existence of critical bottlenecks hindering the journey from fundamental research findings to fully realized anticancer drugs. Recent insights into cancer biology have illuminated one potential bottleneck: the presence of cancer stem cells (CSCs). These represent a minority subset of cells within a tumor, believed to orchestrate the relentless growth of the entire tumor. The concept of CSCs has gained substantial traction, thanks to advancements in stem cell research. Developing more potent and precise cancer therapies hinges on our ability to identify and understand these cancer-initiating cells within solid tumors. It is essential to discern how CSCs differ from other cancer cells coexisting in the same tissue. This review endeavors to compile the accumulated scientific evidence supporting the existence of CSCs, elucidate the cell surface markers employed for their isolation, dissect the pathways governing their self-renewal and differentiation, and outline future directions for harnessing them as therapeutic targets to eradicate tumor growth comprehensively.
Metformin: A Potential Drug for COVID-19
[Year:2024] [Month:January-April] [Volume:28] [Number:1] [Pages:5] [Pages No:25 - 29]
Keywords: Adenosine monophosphate kinase, Angiotensin-converting enzyme 2, Coronavirus disease-2019, Mammalian target of rapamycin, Metformin, Severe acute respiratory syndrome
DOI: 10.5005/jp-journals-10054-0230 | Open Access | How to cite |
Abstract
Metformin is an old drug, of plant origin, primarily used in the treatment of type 2 diabetes. The main mechanism of its action is mediated through adenosine monophosphate (AMP) kinase. Though the main action of metformin is to inhibit hepatic gluconeogenesis, it is also known to increase insulin sensitivity and is used in the treatment of obesity and polycystic ovarian disease. Its varied actions on coronavirus infections, by inhibiting virus entry, preventing cytokine storm, boosting immunity by altering the gut microbiota, and decreasing virulence by inducing autophagy makes it an ideal candidate for treating coronavirus disease-2019 (COVID-19). The only serious side effect of metformin is lactic acidosis, confined to a few patients. The drug is already approved by the US Food and Drug Administration (FDA) and thus repurposing it in COVID-19 patients may be beneficial. Metformin is a drug, approved by FDA for treating diabetes mellitus with very few side effects. It is inexpensive and is known to exhibit anti-COVID-19 actions. It has also proven to be effective in treating PCOS and obesity. Thus, it has all the potential to treat COVID-19.