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The intricate relationship between the gut and the brain has long captured the imagination of scientists, philosophers, and clinicians alike. Over the past few decades, research has unveiled a complex and bidirectional communication network that connects these seemingly distinct organs, giving rise to the concept of the gut-brain axis. This axis represents a dynamic and multifaceted system through which the gut and the brain exchange signals, impacting not only digestive processes but also a wide array of physiological and neurological functions. From influencing appetite and mood to playing a role in metabolic regulation, the gut-brain axis has emerged as a crucial nexus in understanding human health and well-being. This chapter delves into the intricate mechanisms that underlie the gut-brain axis, exploring its components and pathways with a special focus on the role played by glucagon. By unraveling the mysteries of this axis, we gain valuable insights into how our body's diverse systems collaborate to maintain a delicate balance and how disturbances within this axis can contribute to a range of health conditions. [ABSTRACT FROM AUTHOR]

The first description of patients with clustering of various metabolic abnormalities was as early as 1923 but it was more than five decades later, in 1988, that Reaven coined the term 'syndrome X' for this entity. The last two decades have brought forth a number of definitions and criteria to identify this condition. Various studies have demonstrated disparities in these definitions and a few researchers have questioned the utility of these criteria and even the existence of such a syndrome. A few important definitions are reviewed in this paper and, at the end, a simplified clinical definition is given and a simple parameter -- lipid accumulation product -- is been described that can be used to identify this condition. [ABSTRACT FROM AUTHOR]

Context: Though India has been thought to be an ideal destination for conduct of clinical drug trials, other smaller countries seem to be doing better. The pace of growth observed during 2005-2009 seems to be plateaued in 2010. Aims: There is an urgent need for introspection and corrective actions. Materials and Methods: An online survey was conducted among various stakeholders from clinical drug trial industry in India regarding their perception about clinical drug trial industry in India. Respondents were requested to rate training of investigator sites, industry, performance of regulatory, etc. Results: Majority of respondent felt that the clinical drug trial industry in India is growing, though India is not utilizing its full potential. Lack of trained investigators and delay in regulatory approvals came out as biggest hurdles. Conclusions: Urgent steps need to be taken in terms of proper training of all stakeholders. Regulatory bodies ought to bring about some radical changes in the system so as to match the other competing nations. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To study prevalence and pattern of dyslipidemia in Indian type 2 diabetic patients. Materials and methods: Fasting serum lipid profiles of 788 consecutive patients with type 2 diabetes were retrieved from hospital records. Patients having one or more parameters (TG, HDL cholesterol or LDL cholesterol) outside the targets recommended by American Diabetes Association (ADA) were considered to have dyslipidemia. Those with dyslipidemia were further classified into mixed dyslipidemia, combined two parameter dyslipidemia and isolated single parameter dyslipidemia (TG, HDL or LDL). Results: Prevalence of dyslipidemia among diabetic patients at baseline was 85.5% among males and 97.8% among females. Among the males with dyslipidemia the proportion of patients with mixed dyslipidemia, combined dyslipidemia and single parameter dyslipidemia were 14.1%, 44.9% and 41%, respectively. Figures for the same among female patients stood at 24.6%, 47.8% and 27.7%, respectively. Combined dyslipidemia with high LDL and low HDL was the most common pattern among males and females both, contributing to 22.7% and 33% patients of diabetic dyslipidemia, respectively. Second most common pattern among males was isolated high LDL, contributing to 21.3% of males with dyslipidemia. While among females isolated low HDL emerged as the second most common pattern affecting 13.4% dyslipidemic females. Conclusions: Majority of Indian type 2 diabetic patients are dyslipidemic at baseline. The most common pattern of dyslipidemia is high LDL and low HDL among both males and females. The most prevalent problem among males is high LDL while among females low HDL emerged as a bigger threat. [Copyright &y& Elsevier]

A letter to the editor is presented in response to the article "Anthropometric variables to coronary artery disease risk factors" published in a previous issue.

Background: HIV & antiretroviral (ARV) therapy is known to be associated with metabolic derangements like diabetes & dyslipidemia. In present study we evaluated metabolic abnormalities in a cohort of ARV treated HIV patients. Methods: A total of 145 HIV patients (122 on ARV, 23 therapy naive HIV cases) were evaluated metabolic. After clinical examinations & auxology, investigations like blood sugars, complete lipid profiles and Dual Energy X-ray Absorptiometry (DEXA) were performed. For analysis ARV treated patients were divided into protease inhibitor (PI) & non-PI (d4T) subgroup. Results: In non-PI (d4T) subgroup of ARV treated patients, 71 out of 94 (75.5%) patients had TG > 150 mg/dL, 4 (4.2%) patients had impaired fasting glucose (IFG i.e. FBS >100 mg/dL) & 44 (46.8%) patients developed lipoatrophy. Among 38 patients in PI subgroup, 12 (31.5%) had TG >150 mg/dL, 9 (23.6%) patients had low HDL (<40 mg/dL for males & <50 mg/dL for females) while 4 (10.5%) had elevated LDL of >100 mg/dL. IFG was seen in 14 (36.8%) out of 38 patients in PI subgroup, while 1 (2.6%) patient developed frank diabetes. In PI subgroup 21 (55.2%) patients had central obesity (waist circumference >80 cm in females, >90 cm for males), while 31 (81.5%) patients had total body fat >25%. Conclusions: PI therapy is associated with significant abnormalities of lipid profile, impaired glucose tolerance & abnormal body fat composition. In non-PI (d4T) treated patients lipoatrophy is the commonest abnormality followed by hypertriglyceridemia. [ABSTRACT FROM AUTHOR]