Natural product-based treatment potential for type 2 diabetes mellitus and cardiovascular disease

BACKGROUND Type 2 diabetes(T2D)is a metabolic disease of impaired glucose utilization and a major cause of cardiovascular disease(CVD).The pathogenesis of both diseases shares common risk factors and mechanisms,and both are significant contributors to global morbidity and mortality.Supplements of natural products for T2D mellitus(T2DM)and CVD can be seen as a potential preventive and effective therapeutic strategy.AIM To critically evaluate the therapeutic potential of natural products in T2D and coronary artery disease(CAD).METHODS By using specific keywords,we strategically searched the PubMed database.Randomized controlled trials(RCTs)were searched as the primary focus that examined the effect of natural products on glycemic control,oxidative stress,and antioxidant levels.We focused on outcomes such as low blood glucose levels,adjustment on markers of oxidative stress and antioxidants.After screening fulllength papers,we included 9 RCTs in our review that met our inclusion criteria.RESULTS In the literature search on the database,we found that various natural products like plant secondary metabolites play a diverse role in the management of CAD.American ginseng,sesame oil and cocoa flavanols proved effective in lowering blood glucose levels and controlling blood pressure,which are key factors in managing T2DM and CVD.In diabetic patients Melissa officinalis effectively reduce inflammation and shows diabetes prevention.Both fish oil and flaxseed oil reduced insulin levels and inflammatory markers,suggesting benefits for both conditions.The lipid profile and endothelial function were enhanced by Nigella sativa oil and Terminalia chebula,which is significant for the management of cardiovascular risk factors in T2DM.Additionally Bilberry extract also showed promise for improving glycemic control in patients with T2DM.CONCLUSION The high level of antioxidant,anti-inflammatory,and anti-angiogenic properties found in natural products makes them promising therapeutic options for the management of CAD,with the potential benefit of lowering the risk of CAD.

Emerging roles of microRNAs as diagnostics and potential therapeutic interest in type 2 diabetes mellitus

BACKGROUND Type 2 diabetes mellitus(T2DM)is a metabolic disease of impaired glucose utilization.Uncontrolled high sugar levels lead to advanced glycation end products(AGEs),which affects several metabolic pathways by its receptor of advanced glycation end products(RAGE)and causes diabetic complication.MiRNAs are small RNA molecules which regulate genes linked to diabetes and affect AGEs pathogenesis,and target tissues,influencing health and disease processes.AIM To explore miRNA roles in T2DM's metabolic pathways for potential therapeutic and diagnostic advancements in diabetes complications.METHODS We systematically searched the electronic database PubMed using keywords.We included free,full-length research articles that evaluate the role of miRNAs in T2DM and its complications,focusing on genetic and molecular disease mechanisms.After assessing the full-length papers of the shortlisted articles,we included 12 research articles.RESULTS Several types of miRNAs are linked in metabolic pathways which are affected by AGE/RAGE axis in T2DM and its complications.miR-96-5p,miR-7-5p,miR-132,has_circ_0071106,miR-143,miR-21,miR-145-5p,and more are associated with various aspects of T2DM,including disease risk,diagnostic markers,complications,and gene regulation.CONCLUSION Targeting the AGE/RAGE axis,with a focus on miRNA regulation,holds promise for managing T2DM and its complications.MiRNAs have therapeutic potential as they can influence the metabolic pathways affected by AGEs and RAGE,potentially reducing inflammation,oxidative stress,and vascular complications.Additionally,miRNAs may serve as early diagnostic biomarkers for T2DM.Further research in this area may lead to innovative therapeutic strategies for diabetes and its associated complications.

Indian perspective on childhood malnutrition:Prevalence,pathophysiology,risk factors,and prevention

BACKGROUND Childhood malnutrition contributes over half of the childhood mortality around the world,predominantly in South-Asian and sub-Saharan countries.AIM To summarize the childhood malnutrition epidemiology along with the comorbid factors associated with it and its management within the community.METHODS The data collection process involved conducting a comprehensive search using specific keywords such as child nutrition disorders and India with Boolean operators.The search was conducted in the Scopus and PubMed electronic databases.RESULTS Inadequate energy consumption initiates pathological alterations in the form of growth retardation,fat,visceral,and muscle loss,a reduction in basal metabolic rate,and a significant reduction in total energy expenditure.It has become evident that malnutrition shows an increased prevalence and incidence rate,despite available guidelines for the management of malnutrition.CONCLUSION Malnutrition can be a major player in the establishment of severe infections that result in significant post discharge mortalities in children.Future trials are required to fill the prime gaps in knowledge regarding the identification of other contributory factors in the pathogenesis of malnutrition and postdischarge infection.New biomarkers for early detection of malnutrition should be the priority of the scientific community for the early management of malnutrition.

Comparative analysis of Nε-carboxymethyl-lysine and inflammatory markers in diabetic and non-diabetic coronary artery disease patients

BACKGROUND Coronary artery disease(CAD)is a major cause of death worldwide,and India contributes to about one-fifth of total CAD deaths.The development of CAD has been linked to the accumulation of Nε-carboxymethyl-lysine(CML)in heart muscle,which correlates with fibrosis.AIM To assess the impact of CML and inflammatory markers on the biochemical and cardiovascular characteristics of CAD patients with and without diabetes.METHODS We enrolled 200 consecutive CAD patients who were undergoing coronary angiography and categorized them into two groups based on their serum glycosylated hemoglobin(HbA1c)levels(group I:HbA1c≥6.5;group II:HbA1c<6.5).We analyzed the levels of lipoproteins,plasma HbA1c levels,CML,interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),and nitric oxide.RESULTS Group I (81 males and 19 females) patients had a mean age of 54.2 ± 10.2 years, with a mean diabetes duration of4.9 ± 2.2 years. Group II (89 males and 11 females) patients had a mean age of 53.2 ± 10.3 years. Group I had moresevere CAD, with a higher percentage of patients with single vessel disease and greater stenosis severity in the leftanterior descending coronary artery compared to group II. Group I also exhibited a larger left atrium diameter.Group I patients exhibited significantly higher levels of CML, TNF-α, and IL-6 and lower levels of nitric oxide ascompared with group II patients. Additionally, CML showed a significant positive correlation with IL-6 (r = 0.596,P = 0.001) and TNF-α (r = 0.337, P = 0.001) and a negative correlation with nitric oxide (r=-4.16, P = 0.001). Oddsratio analysis revealed that patients with CML in the third quartile (264.43-364.31 ng/mL) were significantlyassociated with diabetic CAD at unadjusted and adjusted levels with covariates.

The Challenges of Diagnosis and Control of Enterotoxaemia Caused by <i>Clostridium perfringens</i>in Small Ruminants

Enterotoxaemia is one of the important pathologies caused by Clostridium perfringens, which produces intestinal and systemic disease in goats, sheep and other animals. These Gram-positive anaerobic bacteria are normally resident in the intestinal tract of ruminants but during favourable conditions, proliferate uncontrollably and release toxins which produce disease in the host. Different strains of C. perfringens are responsible for several clinical syndromes, including lamb dysentery, pulpy kidney disease and struck. However, the pathology and pathogenesis of caprine enterotoxaemia is not well understood, with limited studies available in goats. Caprine enterotoxaemia can be controlled with the better understanding of its risk factors and pathogenesis. The diagnosis of enterotoxaemia in animals is complex and often requires group of tests than one single test for better specificity and sensitivity. Tentative diagnosis of enterotoxaemia in sheep and goats is based on the history, clinical signs and gross lesions during post-mortem examination of animals;however, confirmatory diagnosis of enterotoxaemia requires different laboratory diagnostic tools. Toxin detection of C. perfringens in case of enterotoxaemia is furthermost accepted benchmark in establishing a definitive diagnosis of enterotoxaemia in intestinal contents. Measuring urine glucose or observing Gram-stained smears of intestinal mucosa can be used as supplementary tests. However, it is also imperative that enterotoxaemia cannot be ruled out in the event of negativity of aforementioned diagnostic tests. Hence, definitive diagnosis of enterotoxaemia in goats can be achieved with the use of molecular techniques (PCR, ELISA and immune-fluorescence) coupled with toxin detection in intestine or biological assays including mouse inoculation test (MIT). In case of goats, vaccine efficacy is poor which may be due to need of high to moderate level of serum antibodies to protect against both systemic and enteric effects because intestinal form of disease is partially independent of the circulating anti-toxin antibodies. Thus, for the prevention and control of enterotoxaemia in goats and sheep, these aspects must be considered to develop more holistic control measures.

Co-positivity of anti-dengue virus and anti-Japanese encephalitis virus IgM in endemic area:co-infection or cross reactivity?

Objective:To report high co-positivity of anti-dengue virus(DV)and anti-Japanese encephalitis virus(JEV)IgM in an area endemic for both the viruses and to discuss the possibilities of coinfection.Methods:Serum samples from the patients who presented with fever,suspected central nervous system infection and thrombocytopenia,were tested for anti-DV IgM and antiJEV IgM antibodies.Conventional reverse transcriptase polymerase chain reaction was done for detection of DV RNA and JEV RNA.Results:Of 1 410 patient sera tested for anti-DV and antiJEV antibodies,129(9.14%)were co-positive for both.This co-positivity was observed only in those months when anli-JEV IgM positivily was high.Tilers of both anli-DV IgM and anti-JEV IgM were high in most of the co-positive eases.Among these 129 co-positive cases,76 were lesled by conventional reverse Iranscriplase polymerase chain reaction for both flaviviruses,of which eight cases were co-positive for DV and JEV.Conclusions:Co-infection with more than one fluvivirus species can occur in hyperendemic areas.