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Monocytes are associated with human cardiovascular disease progression. Monocytes are segregated into three major subsets: classical (cMo), intermediate (iMo), and nonclassical (nMo). Recent studies have identified heterogeneity within each of these main monocyte classes, yet the extent to which these subsets contribute to heart disease progression is not known. Peripheral blood mononuclear cells (PBMC) were obtained from 61 human subjects within the Coronary Assessment of Virginia (CAVA) Cohort. Coronary atherosclerosis severity was quantified using the Gensini Score (GS). We employed high-dimensional single-cell transcriptome and protein methods to define how human monocytes differ in subjects with low to severe coronary artery disease. We analyzed 487 immune-related genes and 49 surface proteins at the single-cell level using Antibody-Seq (Ab-Seq). We identified six subsets of myeloid cells (cMo, iMo, nMo, plasmacytoid DC, classical DC, and DC3) at the single-cell level based on surface proteins, and we associated these subsets with coronary artery disease (CAD) incidence based on Gensini score (GS) in each subject. Only frequencies of iMo were associated with high CAD (GS > 32), adj.p = 0.024. Spearman correlation analysis with GS from each subject revealed a positive correlation with iMo frequencies (r = 0.314, p = 0.014) and further showed a robust sex-dependent positive correlation in female subjects (r = 0.663, p = 0.004). cMo frequencies did not correlate with CAD severity. Key gene pathways differed in iMo among low and high CAD subjects and between males and females. Further single-cell analysis of iMo revealed three iMo subsets in human PBMC, distinguished by the expression of HLA-DR, CXCR3, and CD206. We found that the frequency of immunoregulatory iMo_HLA-DR+CXCR3+CD206+ was associated with CAD severity (adj.p = 0.006). The immunoregulatory iMo subset positively correlated with GS in both females (r = 0.660, p = 0.004) and males (r = 0.315, p = 0.037). Cell interaction analyses identified strong interactions of iMo with CD4+ effector/memory T cells and Tregs from the same subjects. This study shows the importance of iMo in CAD progression and suggests that iMo may have important functional roles in modulating CAD risk, particularly among females. [ABSTRACT FROM AUTHOR]

The study of Sufism, the mystical aspect of Islam, known as I ta awwuf i to those closer to the sources and practices, has come a long way since Richard Eaton complained in 1978 that it was mainly studied as doctrine.[1] Eaton noted that scholars tended to study the ideas of individual Sufis, with no attention to the societies and polities in which the Sufi saints lived. The simple answer is that the relationship was close, in particular with Sufi saints of the Chishti order who supported the Mughal policy of religious toleration. As the following chapters show, subsequent generations of the Mughal dynasty approached other Sufi orders, such as the Qadiris, as with the "liberal" Prince Dara Shukoh, and also went back to the Naqshbandis, as with the "conservative" Prince, later Emperor, Awrangzeb. [Extracted from the article]

A necessarily widespread feature of language practice in the Persianate world was the need for translation of speech and text, with a range of lexical and semantic challenges involved in taking meaning from one language to another. This article focusses on legal translation, with its highly functional aims, by following the career of a pair of Indo-Persian legal forms known as tamassuk and fārigh-khaṭṭī , used for recording obligation and requital respectively. Tracing their reincarnations from Persian into Marathi, Hindi and Bengali, this article reveals several forms of boundary-crossing: doctrinal, jurisdictional, political and linguistic. In doing so, it explores the legal mindscapes in the early modern Indo-Persian world, spilling from the late Mughal into the colonial, and shows how multilingualism functioned within specific parts of the Persianate cosmopolis. [ABSTRACT FROM AUTHOR]

The collection of essays in this volume examines forms of business documentation in the late Persianate world and the Indian Ocean, between the seventeenth and twentieth centuries. Looking upon business in its broadest sense, the themes range from property disputes within families to inter-polity and inter-imperial deals, all of which is captured within the notion of the bazaar. Presenting documents and documentary forms written in Persian, but also the associated languages of Arabic, Bengali, Gujarati, Hindi, Marathi and Rajasthani, the articles collectively enrich the idea of the Persianate, delineating its specific dispensations within regional contexts, and also its boundaries and limitations. This is also a contribution to the study of Persographia, in this case Persianate rather than just Persian writing. The articles study specific language combinations, lexical elements and usages that came to be deployed in different areas and the legal cultures they provide evidence for. [ABSTRACT FROM AUTHOR]

This paper looks at a Persian-language documentary form called the mahzar-nama that was widely used in India between the seventeenth and nineteenth centuries to narrate, represent, and record antecedents, entitlements, and injuries with a view to securing legal rights and redressing legal wrongs. Mahzars were a known documentary form in Islamic law and used by qazis (Islamic judges) in many other parts of the world, but in India they took a number of distinctive forms. The specific form of Indian mahzar-namas that I focus on here was, broadly speaking, a legal document of testimony, narrated in the first person, in a form standardized by predominantly non-Muslim scribes, endorsed in writing by the author's fellow community members and/or professional or social contacts, and notarized by a qazi's seal. This specific legal form was part of a much broader genre of declarative texts that were also known as mahzars in India. I examine the legal mahzar-namas together with the other kinds of mahzars, and situate them in relation to Indo-Islamic jurisprudential texts and Persian-language formularies. What emerges is a distinctive Indo-Islamic legal culture in contact with the wider Islamic and Persianate worlds of jurisprudence and documentary culture, but responsive to the unique socio-political formations of early modern India. I also reflect on the meanings of law, including Islamic law, for South Asians and trace the evolution of that understanding across the historical transition to colonialism. [ABSTRACT FROM AUTHOR]

A study was conducted to delineate the groundwater potential zones of Nawada district of Southern Bihar using satellite-derived information layers, namely, elevation, slope, drainage density, land use, fractional impervious surface (FIS) and also using existing thematic maps (lithology, soil, pre- and post-monsoon water level) based on the weighted linear combination method. On the basis of the relative contribution of each datum towards groundwater potential, the weight of each thematic map has been computed. The normalized weights of the individual themes and their different features were obtained through Saaty's analytical hierarchy process. Results showed that zones of 'very high' and 'high' groundwater potential are present in the central and northeastern part of the study area. 'Very low' and 'low' groundwater potential zones are found in the southeastern and very small pockets of the eastern corner of the district. Thus surface investigation of groundwater has proved that an integrated approach involving remote sensing and geographic information system (GIS) technique can be successfully used in identifying potential groundwater zones in a short time and at low cost, while the yield could be ascertained with some sample ground truth 'test drillings'. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus and its impact on the human body have been extensively dissected over the years. However, skin which is the largest organ in the body, has received minimum attention. Therefore, this study was designed to analyze the prevalence and pattern of skin disorders among diabetic patients from Eastern region of India. Materials and Methods: This is an observational study, conducted in the General Medicine and Endocrinology departments of a Medical College and Hospital in Eastern India. The data were collected prospectively and systematically in a pre-established proforma designed by us, where clinical findings along with investigations were recorded. Results: Six hundred and eighty (680) diabetic patients were examined, there were (64.8%) male and (35.1%) were female, of them 95.3% were Type 2 diabetics while 4.7% were Type 1. Five hundred and three patients (503) out of six hundred and eighty. i.e. 73.9% were found to have skin lesions. Thirteen (13) (41%) Type1 diabetics demonstrated skin lesions commonest being diabetic xerosis, infections and diabetic hand. Among Type2 diabetics 490(75.61%) showed skin lesions. Here infections, xerosis, hair loss beneath the knees, diabetic dermopathy were the most frequent. Majority of patients (67%) had combination of more than one type of skin lesion. There was statistically significant correlation of skin lesions with duration of diabetes, however similar correlation could not be demonstrated regarding metabolic control. Conclusion: Involvement of skin is inevitable and multifarious in diabetes mellitus. Higher prevalence is seen in Type 2 diabetic population. The duration of diabetes is positively correlated with lesions and infective dermatologic manifestations were associated with higher HbA1C values. [ABSTRACT FROM AUTHOR]

The article focuses on British colonial courts in India during the nineteenth-century and how they handled the religious aspects of family disputes. The author discusses a case involving the custody of a teenage girl and her estate, explaining that the girl's mother lost her parental rights because she converted her religion. She explores how personal status laws were interpreted and enforced in India and compares colonial law with Hindu law.

Background: Hyponatremia is one of the commonest electrolyte disturbances encountered in medical wards and contributes to substantial morbidity and mortality. However, early recognition and management drastically alters prognosis. Therefore, this observational study was taken up to explore the clinical profile of hyponatremia. Aim: To assess the incidence and clinical profile of hyponatremia in medically ill patients. Materials and Methods: This observational study was conducted in the medical ward of a tertiary care hospital from March 2010 to April 2011. All patients underwent routine hemogram, blood biochemistry, serum electrolytes, thyroid function tests, and morning serum cortisol estimation. This was followed by a plasma and urinary osmolality determination (osmometer 800 CL) as well as urinary sodium estimation. Patients were diagnosed to have syndrome of inappropriate antidiuretic hormone secretion (SIADH) if they satisfied the Bartter and Schwartz criteria. Results: 201 patients (16.4%) had a serum Na < 135 meq/l. There were 126 (62.69%) male patients and 75 (37.31%) female patients. Severe hyponatremia (Na < 120 meq/l) was detected in 30 patients (2.4%). The largest group of hyponatremic patients were euvolemic [102 (50.74%)], followed by hypervolemic [54 (26.86%)] and hypovolemic [45 (22.4%)]. Sixty-six patients fulfilled the criteria for SIADH. The most common underlying predisposing factor for hyponatremia in our case series was fluid loss by vomiting/diarrhea. During the hospital stay, 13.5% (15/201) hyponatremic patients died, while the corresponding figure in normonatremic patients was 8.5% (87/1020). Conclusion: The incidence of hyponatremia in our series was higher than values mostly reported in western literature. Euvolemic hyponatremia was the most common type, a significant fraction of which is SIADH. [ABSTRACT FROM AUTHOR]

One of the most contentious political issues in postcolonial India is the unfulfilled project of a ‘uniform civil code’ which would override the existing ‘personal laws’ or religion-based laws of domestic relations, inheritance and religious institutions. If the personal laws are admitted to be preserved (if somewhat distorted) remnants of ‘religious laws’, then the legitimacy of state intervention is called into question, especially since the Indian state claims to be secular. This paper, by discussing the history of the lesser-known Christian personal law, demonstrates that this conundrum is of considerable heritage. From the earliest days of British imperial rule in India, the quest to establish a universal body of law conflicted with other legal principles which upheld difference: that of religion, as well as race. It was the historical role of Indian Christians to occasion legal dilemmas regarding the jurisdictions of British and ‘native’ law, and concurrently about the identity of people subject to those different laws. In trying to discover who the Indian Christians were, and what laws ought to apply to them, British judges had perforce to reflect on who the ‘British’ were, whilst also dealing with conflicting collective claims made by Hindus, Muslims, Parsis, and Christians themselves about their own identity and religious rights. The Indian Christian personal law was an unintended by-product of this process, a finding which throws light both on the dynamics of colonial legislation, and on the essentially modern nature of Indian personal laws. [ABSTRACT FROM AUTHOR]

The article presents an examination of changes in marriage laws in 19th century England and British India. It argues that these changes, as well as the development of civil marriage, were not established as part of a secularization movement, but rather they were made in an effort to provide a legal tool to Christians who were not members of the Anglican Church and wished to be married. This effectively increased the range over which civil marriage laws held power, but was not part of a secular movement.

Quarrying of basalt stone in the Early Cretaceous Rajmahal Trap region of eastern India is increasing at an alarming pace. The quarries have created an extensive ugly landscape of pits and overburden dumps. The stone workshops continuously emit dust. These quarries generate year-round employment in an impoverished terrain. The workforce mostly comprises the socio-economically deprived indigenous tribal population. They are an important source of income to the State Governments of Jharkhand and West Bengal. While the need for building stone cannot be denied in a region that is rapidly industrialising and urbanising, issues of land degradation and health cannot be ignored. The paper offers measures to contain environmental degradation and generate alternative sources of income with bio-fuel crops such as Jatropha curcas. [ABSTRACT FROM AUTHOR]

Spontaneous rupture of the spleen with hemoperitoneum is a very rare, but serious manifestation of dengue fever (DF). We report a case of a young female who was presented with atraumatic abdominal pain, hypovolemic shock, anemia, ascites and hepatosplenomegaly with a recent history of a febrile illness. Subsequent investigations proved the presence of hemoperitoneum with spontaneous splenic rupture with seropositivity for DF. Early diagnosis and conservative management in this case resulted in a favorable outcome. [ABSTRACT FROM AUTHOR]

Background: Considering enterococci as an emerging important cause of nosocomial infections, and antibiotic resistance by Enterococcus as a major obstacle for treatment, determination of the prevalence of various Enterococcus species and their antibiotic resistance pattern among urinary isolates is very crucial and need of the hour. The present study tried to identify the burden of urinary tract infections (UTIs) caused by Enterococcus species and analyze the current antibiotic susceptibility patterns of the uropathogenic isolates and evaluate the risk factors. Methods: A cross-sectional study included all clinico-microbiologically diagnosed cases of admitted UTI cases. Hospital records were analyzed for the clinical background of the UTI cases, and urine sample was collected and processed for antibiotic susceptibility testing. Data were statistically analyzed. Results: Out of the 372 urine samples, Enterococcus spp. was identified in 13.44% of isolates as the causal uropathogen. Enterococcus faecalis was the predominant species identified, followed by Enterococcus faecium. Cases were mostly observed in clinical settings of sepsis followed by pyelonephritis and cystitis. Antimicrobial susceptibility profile showed that resistance was most frequently observed with norfloxacin followed by levofloxacin, ciprofloxacin, ampicillin, and high-level gentamicin. Linezolid showed maximum sensitivity, followed by vancomycin, nitrofurantoin, and others. Conclusion: The rise of multidrug-resistant (MDR) Enterococcus species is of particular concern in terms of antibiotic therapy. Speciation along with routine culture and sensitivity is essential to gather knowledge about the available antibiotics in MDR uropathogenic Enterococcus species, particularly oral choices. [ABSTRACT FROM AUTHOR]

Prescribing cascades entail misinterpreting drug-related adverse events as new medical problems, resulting in unnecessary prescriptions and potential harm, especially in the elderly, leading to adverse outcomes like falls, cognitive defects, and increased health-care costs. For geriatric patients with complex medical histories, the intricacies of symptom differentiation and polypharmacy poses further challenges. This report focuses on managing a geriatric patient with multiple conditions, highlighting the risks and complexities of prescribing cascades. [ABSTRACT FROM AUTHOR]

An increasing body of research implies that emergency department (ED) physicians fail to identify drug-related ED visits due to the department's hectic workflow. In cases of poisoning or drug intoxications, the offending agent(s) may not be identified during the acute and possibly critical period of the exposure. For cases of suicidal incidents, laboratory assistances in identifying the offending chemical are not promptly available. The diagnosis of "toxidromes" is, therefore, an acceptable clinical diagnostic method that has been pioneered by clinical toxicologists. The present case has emphasized the need for applying clinical pharmacology principles in the early detection of drug-induced ED visits. [ABSTRACT FROM AUTHOR]

An introduction is presented to the issue of the journal that discusses topics such as the role of law in the history of imperialism, Islamic jurisprudence in colonial India, and piracy in the Indian Ocean.

This article examines the career and ideas of a late Mughal administrator, a Shi'a Muslim called Ali Ibrahim Khan, who was appointed magistrate of the north Indian city of Banaras after its conquest by the East India Company in 1781, and remained in that position until his death in 1792. Engaging with recent research on legal pluralism on the one hand, and on legal and cultural intermediaries on the other, this paper examines the imagination of imperial, religious and legal spaces by this prolific historian, poet and legal ethnographer, an under-studied protagonist of the process of transition to colonialism in India. Using a range of Persian-language manuscript sources in addition to archival and published material in Urdu and English, the article reveals the principles of Ali Ibrahim Khan's pragmatic but principled efforts to reconcile recognisably Islamic legal principles and procedures with the demands of the emerging colonial situation, and his systematic reference to locality and custom in order to do so. [ABSTRACT FROM AUTHOR]

Tetralogy of Fallot (TOF) presenting with superior vena cava (SVC) syndrome is an exceedingly rare scenario. The diagnosis of this condition is still a difficult task due to its unspecific clinical features and unclear recommendations for the best diagnostic tools. We report an interesting case of a 23‑year‑old male who was found to have TOF with the presentation of SVC syndrome after a sequential diagnosis. The timely diagnosis helped in the successful management of the patient. Through this case, we want to make clinicians aware of such a rare association and its diagnosis. [ABSTRACT FROM AUTHOR]

Alzheimer’s disease (AD) is a progressive neurodegenerative disease with no cure till today. Aberrant activation of cell cycle regulatory proteins is implicated in neurodegenerative diseases including AD. We and others have shown that Cyclin dependent kinase 4 (Cdk4) is activated in AD brain and is required for neuron death. In this study, we tested the efficiency of commercially available Cdk4 specific inhibitors as well as a small library of synthetic molecule inhibitors targeting Cdk4 as neuroprotective agents in cellular models of neuron death. We found that several of these inhibitors significantly protected neuronal cells against death induced by nerve growth factor (NGF) deprivation and oligomeric beta amyloid (Aβ) that are implicated in AD. These neuroprotective agents inhibit specifically Cdk4 kinase activity, loss of mitochondrial integrity, induction of pro-apoptotic protein Bim and caspase3 activation in response to NGF deprivation. The efficacies of commercial and synthesized inhibitors are comparable. The synthesized molecules are either phenanthrene based or naphthalene based and they are synthesized by using Pschorr reaction and Buchwald coupling respectively as one of the key steps. A number of molecules of both kinds block neurodegeneration effectively. Therefore, we propose that Cdk4 inhibition would be a therapeutic choice for ameliorating neurodegeneration in AD and these synthetic Cdk4 inhibitors could lead to development of effective drugs for AD. [ABSTRACT FROM AUTHOR]

Background : Type 2 diabetes is a significant public health concern that affects over 537 million adults worldwide. Oral antidiabetic (OAD) failure can be a complex management issue in patients with type 2 diabetes. Insulin glargine U-300 is a newer type of basal insulin with more consistent pharmacological effects than traditional insulin glargine.This study aimed to assess the safety and effectiveness of insulin glargine U-300 as compared to insulin glargine U-100 in Indian type 2 diabetes patients who had experienced OAD failure.This is a record-based observational study conducted on type 2 diabetes patients who had experienced OAD failure.The study involved 389 cases (189 on insulin glargine U-300 and 200 on insulin glargine U-100). It was found that 56.6% and 58.1% of patients had reduced fasting glucose levels below 130 mg/dl after 1 month of treatment, and 78.8% and 76.1% had a reduction after 3 months following the use of insulin glargine U-300 and insulin glargine U-100, respectively. In patients on glargine U-300 and insulin glargine U-100, the mean fasting plasma glucose decreased from 241.05 ± 65.93 mg/dl at baseline to 142.61 ± 55.19 mg/dl (p < 0.05) and similarly from 250.68 ± 61.41 to 140.27 ± 48.29 mg/dl (p < 0.05) at the end of the first month, respectively. The incidence of hypoglycemia was comparatively fewer in patients using insulin glargine U-300 as compared to those using insulin glargine U-100 (8.1% vs. 6.7%, p < 0.05).The results suggest that insulin glargine U-300 is an effective and safer treatment option than insulin glargine U-100 for Indian patients with OAD failure. These findings have the potential to improve the management of type 2 diabetes patients with OAD failure globally.Objective: Type 2 diabetes is a significant public health concern that affects over 537 million adults worldwide. Oral antidiabetic (OAD) failure can be a complex management issue in patients with type 2 diabetes. Insulin glargine U-300 is a newer type of basal insulin with more consistent pharmacological effects than traditional insulin glargine.This study aimed to assess the safety and effectiveness of insulin glargine U-300 as compared to insulin glargine U-100 in Indian type 2 diabetes patients who had experienced OAD failure.This is a record-based observational study conducted on type 2 diabetes patients who had experienced OAD failure.The study involved 389 cases (189 on insulin glargine U-300 and 200 on insulin glargine U-100). It was found that 56.6% and 58.1% of patients had reduced fasting glucose levels below 130 mg/dl after 1 month of treatment, and 78.8% and 76.1% had a reduction after 3 months following the use of insulin glargine U-300 and insulin glargine U-100, respectively. In patients on glargine U-300 and insulin glargine U-100, the mean fasting plasma glucose decreased from 241.05 ± 65.93 mg/dl at baseline to 142.61 ± 55.19 mg/dl (p < 0.05) and similarly from 250.68 ± 61.41 to 140.27 ± 48.29 mg/dl (p < 0.05) at the end of the first month, respectively. The incidence of hypoglycemia was comparatively fewer in patients using insulin glargine U-300 as compared to those using insulin glargine U-100 (8.1% vs. 6.7%, p < 0.05).The results suggest that insulin glargine U-300 is an effective and safer treatment option than insulin glargine U-100 for Indian patients with OAD failure. These findings have the potential to improve the management of type 2 diabetes patients with OAD failure globally.Methods: Type 2 diabetes is a significant public health concern that affects over 537 million adults worldwide. Oral antidiabetic (OAD) failure can be a complex management issue in patients with type 2 diabetes. Insulin glargine U-300 is a newer type of basal insulin with more consistent pharmacological effects than traditional insulin glargine.This study aimed to assess the safety and effectiveness of insulin glargine U-300 as compared to insulin glargine U-100 in Indian type 2 diabetes patients who had experienced OAD failure.This is a record-based observational study conducted on type 2 diabetes patients who had experienced OAD failure.The study involved 389 cases (189 on insulin glargine U-300 and 200 on insulin glargine U-100). It was found that 56.6% and 58.1% of patients had reduced fasting glucose levels below 130 mg/dl after 1 month of treatment, and 78.8% and 76.1% had a reduction after 3 months following the use of insulin glargine U-300 and insulin glargine U-100, respectively. In patients on glargine U-300 and insulin glargine U-100, the mean fasting plasma glucose decreased from 241.05 ± 65.93 mg/dl at baseline to 142.61 ± 55.19 mg/dl (p < 0.05) and similarly from 250.68 ± 61.41 to 140.27 ± 48.29 mg/dl (p < 0.05) at the end of the first month, respectively. The incidence of hypoglycemia was comparatively fewer in patients using insulin glargine U-300 as compared to those using insulin glargine U-100 (8.1% vs. 6.7%, p < 0.05).The results suggest that insulin glargine U-300 is an effective and safer treatment option than insulin glargine U-100 for Indian patients with OAD failure. These findings have the potential to improve the management of type 2 diabetes patients with OAD failure globally.Results: Type 2 diabetes is a significant public health concern that affects over 537 million adults worldwide. Oral antidiabetic (OAD) failure can be a complex management issue in patients with type 2 diabetes. Insulin glargine U-300 is a newer type of basal insulin with more consistent pharmacological effects than traditional insulin glargine.This study aimed to assess the safety and effectiveness of insulin glargine U-300 as compared to insulin glargine U-100 in Indian type 2 diabetes patients who had experienced OAD failure.This is a record-based observational study conducted on type 2 diabetes patients who had experienced OAD failure.The study involved 389 cases (189 on insulin glargine U-300 and 200 on insulin glargine U-100). It was found that 56.6% and 58.1% of patients had reduced fasting glucose levels below 130 mg/dl after 1 month of treatment, and 78.8% and 76.1% had a reduction after 3 months following the use of insulin glargine U-300 and insulin glargine U-100, respectively. In patients on glargine U-300 and insulin glargine U-100, the mean fasting plasma glucose decreased from 241.05 ± 65.93 mg/dl at baseline to 142.61 ± 55.19 mg/dl (p < 0.05) and similarly from 250.68 ± 61.41 to 140.27 ± 48.29 mg/dl (p < 0.05) at the end of the first month, respectively. The incidence of hypoglycemia was comparatively fewer in patients using insulin glargine U-300 as compared to those using insulin glargine U-100 (8.1% vs. 6.7%, p < 0.05).The results suggest that insulin glargine U-300 is an effective and safer treatment option than insulin glargine U-100 for Indian patients with OAD failure. These findings have the potential to improve the management of type 2 diabetes patients with OAD failure globally.Conclusion: Type 2 diabetes is a significant public health concern that affects over 537 million adults worldwide. Oral antidiabetic (OAD) failure can be a complex management issue in patients with type 2 diabetes. Insulin glargine U-300 is a newer type of basal insulin with more consistent pharmacological effects than traditional insulin glargine.This study aimed to assess the safety and effectiveness of insulin glargine U-300 as compared to insulin glargine U-100 in Indian type 2 diabetes patients who had experienced OAD failure.This is a record-based observational study conducted on type 2 diabetes patients who had experienced OAD failure.The study involved 389 cases (189 on insulin glargine U-300 and 200 on insulin glargine U-100). It was found that 56.6% and 58.1% of patients had reduced fasting glucose levels below 130 mg/dl after 1 month of treatment, and 78.8% and 76.1% had a reduction after 3 months following the use of insulin glargine U-300 and insulin glargine U-100, respectively. In patients on glargine U-300 and insulin glargine U-100, the mean fasting plasma glucose decreased from 241.05 ± 65.93 mg/dl at baseline to 142.61 ± 55.19 mg/dl (p < 0.05) and similarly from 250.68 ± 61.41 to 140.27 ± 48.29 mg/dl (p < 0.05) at the end of the first month, respectively. The incidence of hypoglycemia was comparatively fewer in patients using insulin glargine U-300 as compared to those using insulin glargine U-100 (8.1% vs. 6.7%, p < 0.05).The results suggest that insulin glargine U-300 is an effective and safer treatment option than insulin glargine U-100 for Indian patients with OAD failure. These findings have the potential to improve the management of type 2 diabetes patients with OAD failure globally. [ABSTRACT FROM AUTHOR]

Background: An improved understanding in transmission variation of kala-azar is fundamental to conduct surveillance and implementing disease prevention strategies. This study investigated the spatio-temporal patterns and hotspot detection for reporting kala-azar cases in Vaishali district based on spatial statistical analysis. Methods: Epidemiological data from the study area during 2007-2011 was used to examine the dynamic space-time pattern of kala-azar outbreaks, and all cases were geocoded at a village level. Spatial smoothing was applied to reduce random noise in the data. Inverse distance weighting (IDW) is used to interpolate and predict the pattern of VL cases distribution across the district. Moran's I Index (Moran's I) statistics was used to evaluate autocorrelation in kala-azar spatial distribution and test how villages were clustered or dispersed in space. Getis-Ord Gi " (d) was used to identify the hotspot and cold spot areas within the study site. Results: Mapping kala-azar cases or incidences reflects the spatial heterogeneity in the incidence rate of kala-azar affected villages in Vaishali district. Kala-azar incidence rate map showed most of the highest endemic villages were located in southern, eastern and northwestern part of the district; in the middle part of the district generally show the medium occurrence of VL. There was a significant positive spatial autocorrelation of kala-azar incidences for five consecutive years, with Moran's I statistic ranging from 0.04-0.17 (P <0.01). The results revealed spatially clustered patterns with significant differences by village. The hotspots showed the spatial trend of kala-azar diffusion (P < 0.01). Conclusions: The results pointed to the usefulness of spatial statistical approach to improve our understanding the spatio-temporal dynamics and control of kala-azar. The study also showed the north-western and southern part of Vaishali district is most likely endemic cluster region. To employ exact and geographically suitable risk-reduction programmes, apply of such spatial analysis tools should suit a vital constituent in epidemiology research and risk evaluation of kala-azar. [ABSTRACT FROM AUTHOR]

Scrub typhus is a mite borne zoonosis, caused by Orientia tsutsugamushi , a gram-negative intracellular organism. This infection usually presents in high prevalence in the rural areas of East Asia and Western pacific islands. It usually presents with fever, chill, myalgia, headache, skin rashes, having pathognomonic and skin lesion i.e. eschar in ~10% cases in Indian subcontinent. It can present with life-threatening complications on occasional. The simultaneous presentation of more than two complications is uncommon, rarely reported in literature. Here we report a case of 37-year-old woman with acute febrile illness, complicated with myocarditis, acute liver failure and leukemoid reaction. She was diagnosed promptly and successfully treated with doxycycline with full recovery of the complications. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM), a common medical condition affecting a high number of pregnant women worldwide, is characterized by high blood glucose levels that develop during pregnancy, usually in the second or third trimester, in women with no prior history of diabetes. While GDM usually resolves after delivery, it can have significant short-term and long-term adverse effects on both the mother and the fetus. Though insulin therapy is the recommended primary treatment, there exists limited evidence comparing the safety and effectiveness of different long-acting insulin analogues, including glargine U-100 and detemir insulin.The study aimed to compare the effectiveness and safety of long-acting insulin analogs, glargine U-100 and detemir insulin, in hyperglycemic pregnancy.This record-based observational study involved 64 subjects, with data collected from medical records. The study assessed demographic data, glycaemic parameters, incidence of hypoglycemia, and neonatal outcomes.The results showed that both insulins were effective in reducing glycaemic levels, but glargine U-100 was associated with better glycemic control, fewer hypoglycemic episodes and less need for dose intensification. The results showed that both insulins were safe when considering infants’ health assessed at 6 months.The study concluded that glargine U-100 may be a preferred treatment option for hyperglycemic pregnancy. Further studies are needed for optimizing treatment strategies in hyperglycemic pregnancies.Objective: Gestational diabetes mellitus (GDM), a common medical condition affecting a high number of pregnant women worldwide, is characterized by high blood glucose levels that develop during pregnancy, usually in the second or third trimester, in women with no prior history of diabetes. While GDM usually resolves after delivery, it can have significant short-term and long-term adverse effects on both the mother and the fetus. Though insulin therapy is the recommended primary treatment, there exists limited evidence comparing the safety and effectiveness of different long-acting insulin analogues, including glargine U-100 and detemir insulin.The study aimed to compare the effectiveness and safety of long-acting insulin analogs, glargine U-100 and detemir insulin, in hyperglycemic pregnancy.This record-based observational study involved 64 subjects, with data collected from medical records. The study assessed demographic data, glycaemic parameters, incidence of hypoglycemia, and neonatal outcomes.The results showed that both insulins were effective in reducing glycaemic levels, but glargine U-100 was associated with better glycemic control, fewer hypoglycemic episodes and less need for dose intensification. The results showed that both insulins were safe when considering infants’ health assessed at 6 months.The study concluded that glargine U-100 may be a preferred treatment option for hyperglycemic pregnancy. Further studies are needed for optimizing treatment strategies in hyperglycemic pregnancies.Methods: Gestational diabetes mellitus (GDM), a common medical condition affecting a high number of pregnant women worldwide, is characterized by high blood glucose levels that develop during pregnancy, usually in the second or third trimester, in women with no prior history of diabetes. While GDM usually resolves after delivery, it can have significant short-term and long-term adverse effects on both the mother and the fetus. Though insulin therapy is the recommended primary treatment, there exists limited evidence comparing the safety and effectiveness of different long-acting insulin analogues, including glargine U-100 and detemir insulin.The study aimed to compare the effectiveness and safety of long-acting insulin analogs, glargine U-100 and detemir insulin, in hyperglycemic pregnancy.This record-based observational study involved 64 subjects, with data collected from medical records. The study assessed demographic data, glycaemic parameters, incidence of hypoglycemia, and neonatal outcomes.The results showed that both insulins were effective in reducing glycaemic levels, but glargine U-100 was associated with better glycemic control, fewer hypoglycemic episodes and less need for dose intensification. The results showed that both insulins were safe when considering infants’ health assessed at 6 months.The study concluded that glargine U-100 may be a preferred treatment option for hyperglycemic pregnancy. Further studies are needed for optimizing treatment strategies in hyperglycemic pregnancies.Results: Gestational diabetes mellitus (GDM), a common medical condition affecting a high number of pregnant women worldwide, is characterized by high blood glucose levels that develop during pregnancy, usually in the second or third trimester, in women with no prior history of diabetes. While GDM usually resolves after delivery, it can have significant short-term and long-term adverse effects on both the mother and the fetus. Though insulin therapy is the recommended primary treatment, there exists limited evidence comparing the safety and effectiveness of different long-acting insulin analogues, including glargine U-100 and detemir insulin.The study aimed to compare the effectiveness and safety of long-acting insulin analogs, glargine U-100 and detemir insulin, in hyperglycemic pregnancy.This record-based observational study involved 64 subjects, with data collected from medical records. The study assessed demographic data, glycaemic parameters, incidence of hypoglycemia, and neonatal outcomes.The results showed that both insulins were effective in reducing glycaemic levels, but glargine U-100 was associated with better glycemic control, fewer hypoglycemic episodes and less need for dose intensification. The results showed that both insulins were safe when considering infants’ health assessed at 6 months.The study concluded that glargine U-100 may be a preferred treatment option for hyperglycemic pregnancy. Further studies are needed for optimizing treatment strategies in hyperglycemic pregnancies.Conclusion: Gestational diabetes mellitus (GDM), a common medical condition affecting a high number of pregnant women worldwide, is characterized by high blood glucose levels that develop during pregnancy, usually in the second or third trimester, in women with no prior history of diabetes. While GDM usually resolves after delivery, it can have significant short-term and long-term adverse effects on both the mother and the fetus. Though insulin therapy is the recommended primary treatment, there exists limited evidence comparing the safety and effectiveness of different long-acting insulin analogues, including glargine U-100 and detemir insulin.The study aimed to compare the effectiveness and safety of long-acting insulin analogs, glargine U-100 and detemir insulin, in hyperglycemic pregnancy.This record-based observational study involved 64 subjects, with data collected from medical records. The study assessed demographic data, glycaemic parameters, incidence of hypoglycemia, and neonatal outcomes.The results showed that both insulins were effective in reducing glycaemic levels, but glargine U-100 was associated with better glycemic control, fewer hypoglycemic episodes and less need for dose intensification. The results showed that both insulins were safe when considering infants’ health assessed at 6 months.The study concluded that glargine U-100 may be a preferred treatment option for hyperglycemic pregnancy. Further studies are needed for optimizing treatment strategies in hyperglycemic pregnancies. [ABSTRACT FROM AUTHOR]

Background: Tropical pyomyositis is characterized by suppuration within skeletal muscles, manifesting as single or multiple abscesses. Though primarily a disease of tropics, it is increasingly being reported from temperate regions in immunosuppressed patients. However, India has only few sporadic case reports. Aims: The aim of this study is to evaluate the causative organisms, clinical presentations, diagnostic modalities, treatment protocols and outcome data in tropical pyomyositis patients. Subjects and Methods: The study was carried out in Nilratan Sircar Medical College and Hospital, Kolkata over 3 years (July 2010 to June 2013). A total of 12 patients were diagnosed with tropical pyomyositis (confirmed with aspiration and culture of pus from muscle). All the investigation and treatment data were recorded systematically. Results: The presenting feature was high fever and myalgia in all 12 patients. Quadriceps femoris was the most commonly involved muscle (50%); followed by iliopsoas (25%). Culture of the aspirate showed Staphylococcus aureus in nine patients (75%), Klebsiella pneumonia in one patient (8.33%) and no growth in two patients (16.67%) even after tubercular and fungal culture. Conclusions: Tropical pyomyositis can affect immune-competent individuals. S. aureus is the most commonly cultured organism. Immediate initiation of appropriate antibiotics and surgical debridement are required to avoid complications. The prognosis remains excellent if promptly treated. [ABSTRACT FROM AUTHOR]

Background: An improved understanding in transmission variation of kala-azar is fundamental to conduct surveillance and implementing disease prevention strategies. This study investigated the spatio-temporal patterns and hotspot detection for reporting kala-azar cases in Vaishali district based on spatial statistical analysis.Methods: Epidemiological data from the study area during 2007-2011 was used to examine the dynamic space-time pattern of kala-azar outbreaks, and all cases were geocoded at a village level. Spatial smoothing was applied to reduce random noise in the data. Inverse distance weighting (IDW) is used to interpolate and predict the pattern of VL cases distribution across the district. Moran's I Index (Moran's I) statistics was used to evaluate autocorrelation in kala-azar spatial distribution and test how villages were clustered or dispersed in space. Getis-Ord Gi*(d) was used to identify the hotspot and cold spot areas within the study site.Results: Mapping kala-azar cases or incidences reflects the spatial heterogeneity in the incidence rate of kala-azar affected villages in Vaishali district. Kala-azar incidence rate map showed most of the highest endemic villages were located in southern, eastern and northwestern part of the district; in the middle part of the district generally show the medium occurrence of VL. There was a significant positive spatial autocorrelation of kala-azar incidences for five consecutive years, with Moran's I statistic ranging from 0.04-0.17 (P <0.01). The results revealed spatially clustered patterns with significant differences by village. The hotspots showed the spatial trend of kala-azar diffusion (P < 0.01).Conclusions: The results pointed to the usefulness of spatial statistical approach to improve our understanding the spatio-temporal dynamics and control of kala-azar. The study also showed the north-western and southern part of Vaishali district is most likely endemic cluster region. To employ exact and geographically suitable risk-reduction programmes, apply of such spatial analysis tools should suit a vital constituent in epidemiology research and risk evaluation of kala-azar. [ABSTRACT FROM AUTHOR]