XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Prospective Cohort Study

https://publications.hse.ru/mirror/pubs/share/folder/myodg9xfxt/direct/143360779.pdf

Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents.

Microbiology Laboratory, Animal Health Division, Central Institute for Research on Goats, PO– Makhdoom, Farah, Mathura, Uttar Pradesh, India; Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences and Animal Husbandry, Uttar Pradesh Pandit Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwa Vidyalaya Evum Go–Anusandhan Sansthan, Mathura, Uttar Pradesh, India; Division of Pathology, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India *Corresponding author: shoorvir.singh@gmail.com; shoorvir_singh@rediffmail.com

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Dose standardization studies of 'indigenous vaccine' for the control of Mycobacterium avium subspecies paratuberculosis in naturally infected goats.

The cytotoxic T lymphocyte (CTL, Tc) is a type of T lymphocyte/ white blood cell involved in the host’s cell-mediated immune response against cancerous cells, abnormal cells and cells infected with viruses. Signals from infected cells or cancer cells lead to the release of cytotoxins: perforin, granzymes, and granulysin by the TC cells. The activation of CTLs is mediated by the interaction of various costimulatory molecules as well as immune cells. Pre-eminent role of CTLs in combating cancer can be effectively applied for the active and passive immunotherapeutic approaches. Various recombinant cytokines viz., interleukins (IL)-2, 4, 7, 10, 12, 15; tumor necrosis factor (TNF) have been found to augment the production of CTL. CTLs can also be stimulated in antigen specific manner through tumor antigens which are the molecular derivatives over expressed in tumorcells due to differentiation, point mutations or viral origin. Designing and development of vaccines based on such immunogenic candidates can be executed and in majority of cases such antigens are targets for CTLs. Identification as chemotherapy and CTL-mediated killing. and validation of these CTL-specific antigens require * Corresponding author KEYWORDS

/pdf/cytotoxic-t-cells-and-cancer-therapy-40bzi8kx1b.pdf

Cytotoxic T cells and Cancer Therapy

| Mycobacterium avium subspecies paratuberculosis, the cause of granulomatous enteritis in ruminants, has also been associated with Inflammatory Bowel disease or Crohn’s disease in human population. Present study aimed to investigate bio-presence of MAP in suspected and confirmed cases of Type 1 Diabetes in clinical samples (blood and serum) of human beings from Chattarpur district of Madhya Pradesh. Screening of 88 serum samples for the presence of MAP using ‘Indigenous ELISA’, 34 (38.6%) were positive for MAP infection. Whereas of the 71 blood samples screened, 28 (39.4%) were positive in IS900 PCR. Screening of 19 serum and 16 blood samples from 20 confirmed patients of ‘Type 1 diabetes’, 31.5 and 43.7% were positive by ‘Indigenous ELISA’ and IS900 PCR, respectively. Comparison of Indigenous ELISA and IS900 PCR revealed fair agreement between the two tests. Bio-typing of DNA of 8 positive blood samples by IS1311 PCR-RE revealed presence of ‘Indian Bison type’ biotype. Presence of MAP bacterimia in the patients suffering from Type 1 Diabetes added to the existing knowledge that MAP may provide foundation for establishing diabetes in human subjects. This is the first report of presence of MAP in human Type 1 Diabetes patients from India. ‘Indian Bison Type’ biotype in domestic livestock suggests a link and interspecies transmission through food chain.

/pdf/screening-of-human-population-for-type-1-diabetes-and-2ul5wbycoe.pdf

Screening of human population for type 1 diabetes and Mycobacterium avium subspecies paratuberculosis from Chattarpur district of Madhya Pradesh.

Adaptogens are a special class of plants which help balance, restore, and protect the body from the effects of stress. They are amphoteric in nature—meaning they work like a thermostat. One of the most important views of adaptogens which has recently been discovered is their ability to quiet a stress-activated enzyme known asstress-activated c-Jun N-terminal protein kinase 1. An adaptogen helps mediate this stress response. Adaptogens helps to simultaneously calm and energize. Their unique abilities help counteract stress and improve mood, mental clarity, and physical stamina. Ashwagandha and rhodiola are adaptogenic herbs that positively affect the hypothalamic–pituitary–adrenal axis access, thereby increasing the body's resilience to stressors. Rhodiola acts as a buffer to stress-related mental and physical fatigue. Rhodiola was used by athletes and military personnel to increase resilience to stress and to combat fatigue. Now adaptogens have various uses, but the important limitation in the assessment of herbal studies in general is variability in the composition and activity of bioactive constituents due to genetic and environmental factors. This may be due to feedback regulation of signaling systems and/or differences in threshold concentration for binding of extract constituents to receptors.

Adaptogens With a Special Emphasis on Withania somnifera and Rhodiola rosea

/pdf/avian-egg-yolk-antibodies-igy-and-their-potential-56xv3n2jnh.pdf

Ruchi Tiwari

Papers

Dose standardization studies of 'indigenous vaccine' for the control of Mycobacterium avium subspecies paratuberculosis in naturally infected goats.

Cytotoxic T cells and Cancer Therapy

Screening of human population for type 1 diabetes and Mycobacterium avium subspecies paratuberculosis from Chattarpur district of Madhya Pradesh.

Adaptogens With a Special Emphasis on Withania somnifera and Rhodiola rosea

Avian Egg Yolk Antibodies (IgY) and their Potential Therapeutic Applications for Countering Infectious Diseases of Fish and Aquatic Animals