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.

The sensor chips, processes and devices enable ultra-sensitive detection / determination, evaluation and quantitative measurement of analytes and are useful for high throughput and miniaturized assays, which enable a user to perform multiple, accurate, experiments in parallel with minimum amount; of reagents resulting in low waste generation. The method enables screening of fluid samples to meet regulatory standards. The device comprises a pitted chip having a silicon-based substrate, optionally provided with an integrated heating element, a biosensor and a receptor immobilized on a cross linking element fixed to an inert metal layer in the chip. The analyte is detected up to 5 parts per trillion of the fluid sample and quantitatively measured up to 10 parts per trillion of the fluid sample by the device of the present disclosure.

Analyte sensor chips

Escherichia coli serotyping from animal wounds in Mathura region

The present study aims at the development and evaluation of dental gel containing metronidazole non-biodegradable polymers for targeted delivery of drug and thus prolonging the action. Hot Method was used for the preparation of gel. Natural polymers like, Guar gum, Sodium alginate, Chitosan, Xanthan gum, Gellan gum were used in the formulations of gel. Prepared gels were evaluated for pH, rheological study, spreadability study, gelation, and gel melting study. At last Field Emission Scanning Electron Microscopy FESEM, Differential Scanning Calorimetry (DSC), Thermo Gravimetric Analysis (TGA), Texture Profile Analysis (TPA) have been done on an optimized gel formulation. All gels revealed pH ranged between 6.16 to 6.47, spreadability between 28.37 to 45.03 g.cm/sec, drug content between 90.01 to 99.10 % viscosity ranged between 3108.44 cps and 3645.47 cps and formulations F3 and F10 showed gelation temperature 39±0.12OC and 37±0.13OC respectively which is similar to the temperature of the body. Surface of the sample gels showed no drug particles, indicating a homogeneous mixture of polymers of drugs as well as natural agents. Formulation F10 containing Guar gum showed slower degradation in all media as compared to gels made of Sodium alginate, Xanthan gum, Chitosan, Gellan gum. DSC results revealed that the drug has the same state in the optimized formulation. TGA results showed that the formulation was found to have high stability in high-temperature settings. TPA results of optimized F10 revealed the parameters Mucoadhesive strength 92.54 ± 2.65 g, Hardness 25.34 ± 0.01N/mm², Compressibility 57.75 ± 0.40N mm, Adhesiveness−4.56 ± 0.26 N mm, Cohesiveness 0.83 ± 0.06. Hence, it is concluded that Metronidazole gel with gellan gum showed a longer degradation time and guar gum showed slower degradation in all over polymers used in gel formulations.

Development and qualitative evaluation of periodontal gel containing an antibacterial agent for periodontal disease

BACKGROUND
Migraine is a common neurological condition marked by frequent mild to extreme headaches that last 4 to 72 hours. A migraine headache may cause a pulsing or concentrated throbbing pain in one part of the brain. Nausea, vomiting, excessive sensitivity to light and sound, smell, feeling sick, vomiting, painful headache, and blurred vision are all symptoms of migraine disorder. Females are more affected by migraines in comparison to males.


OBJECTIVE
The present review article summarizes preventive and therapeutic measures including allopathic and herbal remedies for the treatment of migraine.


RESULTS
Review has highlighted the current aspects of migraine pathophysiology, covered an understanding of the complex workings of the migraine state. Therapeutic agents which could give an effective treatment have also been discussed.


CONCLUSION
It can be concluded that different migraines could be treated based on their type and severity.

An Insight of Preventive and Therapeutic aspects of Migraine for Patient Care.

Background: Cutting-edge issues for nanomedicine involve knowledge of the problems associated with toxicity and environmental effect of nanoscale substances (substances whose structure is on the dimensions of nanometers, i.e. billionths of a meter). Nanoparticles are able to reach inner biomolecules, which is not possible for larger debris. Materials and Methods: The nanosuspension turned into analytically characterized and subjected to regulatory aspects. Scientific facts used to make regulatory decisions about merchandise starting from cosmetics to chemotherapy agents to food packaging, FDA has lengthy encountered the combination of promise, threat and uncertainty that accompanies emerging technologies. Nanotechnology is not specific on this regard. Present article covered about regulatory aspects of Abbreviated New Drug Application (ANDA) and Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH). Conclusion: The objective of this review is to know about the FDA regulations towards nanotechnology and various techniques used to analyze this tiny technology for

Ruchi Tiwari

Papers

Analyte sensor chips

Escherichia coli serotyping from animal wounds in Mathura region

Development and qualitative evaluation of periodontal gel containing an antibacterial agent for periodontal disease

An Insight of Preventive and Therapeutic aspects of Migraine for Patient Care.

Ethical and Administrative Implications of Nanoscale Technology for Efficient and Safe Delivery of Drugs: Analytical and Regulatory Aspects