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The relationship between insulin resistance (IR) and polycystic ovary syndrome (PCOS) has been consistently shown by several studies but what is the cause and what is the effect remained an unsolved issue. In recent years, IR has been suggested to be a key etiological factor which contributes to the severity of metabolic and reproductive features in PCOS. The aim of the present study is to determine the etiological role of IR in PCOS.

Aunque la relación entre la resistencia a la insulina (RI) y el síndrome del ovario poliquístico (SOP) ha sido demostrada en diversos estudios, los mecanismos subyacentes de causa y efecto aún no han sido dilucidados. En los últimos años, se ha señalado que la RI podría ser un factor etiológico clave, asociado a la gravedad de los desórdenes metabólicos y reproductivos de las pacientes con SOP. El objetivo del presente estudio es determinar el papel de la RI en la etiología del SOP.

Introduction. Endothelial dysfunction has been considered as one of the important factors in pathogenesis of Metabolic Syndrome (Met S). Subclinical hypothyroidism (SCH) has also been reported to be associated with Met S. The aim of our study is to evaluate the association of raised TSH with mediators of endothelial dysfunction in Met S with Subclinical hypothyroidism as compared to healthy controls.

Background: Glycated Hemoglobin (HbA1c) is used for assessing glycemic control over the past 8-12 weeks. This is critical for determining the efficacy of diabetes treatment and predicting the progression of microvascular complications. However, in health-care situations where tests for HbA1c are either unavailable or unfeasible for any reason, clinicians rely only on plasma glucose values for assessing the glycemic control of the patient. Aims and Objectives: The purpose of this study was to determine the relationship between HbA1c and fasting, postprandial, and random plasma glucose levels. Materials and Methods: Routine blood samples obtained from the laboratory to measure HbA1c and plasma glucose (fasting/postprandial/random) were used for study. A total of 207 samples were used to investigate the relationship between HbA1c and fasting and postprandial glucose (PPG/PP). The correlation of HbA1c with random glucose values was investigated using 112 samples. HbA1c was estimated by immunoturbidimetry and glucose was estimated by hexokinase method. Pearson's correlation analysis was done by SPSS version 20 software. Results: The Pearson correlation coefficient (r) with regard to PPG/PP and HbA1c was 0.75 (P=0.01, 95% CI), fasting glucose and HbA1c was 0.73 (P=0.01, 95% CI), and random glucose and HbA1c was 0.59 (P=0.01, 95% CI). Conclusion: PPG/PP correlates with HbA1c better than fasting or random glucose. When it is impossible to perform HbA1c measurements, PPG measurements should be used instead. [ABSTRACT FROM AUTHOR]

Coronaviruses as such are known since last century. The name is derived from their shape which has crown (corona) like radiating spikes. The recent one however is a different one from the Coronavirus involved in SARS (2002–2004) and MERS (2012) in being highly infectious. Initially COVID 19 had a high case fatality rate which has now decreased to a significant extent. Many cases of COVID 19 are asymptomatic with a significant number of positive cases developing a triad of fever, breathlessness and GI symptoms. Recent travel increases the probability of infection. The pathogenesis involves ACE 2 receptors. So, it has been found that there are more cases and mortality among hypertensive individuals. Even higher among the people who use ACE inhibitor in comparison to those who use other anti-hypertensive drugs. Treatment is usually symptomatic. Antiviral drugs and vaccines against COVID-19 are being used. Deranged liver enzymes are common in COVID-19, however, serious liver injury is not much documented. Liver injury is either due to disease itself or due to antiviral drugs. Extra care like strict social distancing, avoiding unnecessary contact is needed for those with autoimmune hepatitis, liver cancer and those who are in immunosuppression because of a scheduled or already liver transplant. Further research is definitely needed in this field. The upcoming researches should also focus on liver injuries associated with disease course and derangements arising as side effects of treatment of COVID-19. [ABSTRACT FROM AUTHOR]

On November 24th, 2021 a case of a new viral variant of SARS-CoV-2 was reported by South Africa and Botswana to WHO, which later was designated as the variant of concern on 26th November 2021. It has around 60 mutations (50 non synonymous, 8 synonymous, and 2 non coding) as compared to the original parent strain of Wuhan. Different hypotheses have been put forward as an explanation for the origin like reverse zoonosis i.e. animal to human transmission, origin from an immune compromised patient or use of highly mutagenic drug like molnupiravir as treatment. A huge spike in cases around the globe is suggestive of a high rate of infectivity and transmissivity as compared to the previous known variants. With whatever cases have been documented so far, it is said that omicron causes mostly mild clinical illnesses and there is a less chance of hospitalization according to the clinicians. Among the reported cases, there were already vaccinated patients also. So there is a possibility that omicron might be able to evade the vaccine induced immunity due to a huge number of mutations (especially in the spike protein sequences). Until new vaccines specific to the pathogen are being developed, the coverage of the currently acceptable vaccines should be increased so that none is deprived of the mandatory doses and a third booster dose might help to reduce the chances of serious complications of this new strain beforehand. So an equal focus on the host and environment is required along with the pathogen. [ABSTRACT FROM AUTHOR]

To evaluate the potential of artificial intelligence in combating COVID-19 pandemic. PubMed, Embase, Cochrane Library and Google Scholar were searched for the term "Artificial intelligence and COVID-19" up to March 31, 2021. Artificial intelligence (AI) is a potential tool to contain the current pandemic. AI can be used in many fields such as early detection and respective diagnosis, supervision of treatment, projection of cases and mortality, contact tracing of individuals, development of drugs and vaccines, reduces workload on health workers, prevention of disease, analysis of mental health of people amid pandemic. AI is being updated and being improved, second by second to be able to interpret like actual human minds. This advancement in AI may lead to a completely different future of COVID-19 pandemic where most of the simpler works may be done by AI and only essential works could be done by health workers in order to increase patient care in current scenario of COVID-19 outbreak. But again one of the main constraint is of limited trustworthy and noise free sources of information. So the need for the hour is to make a free data system where most of the analysed data could be available to feed AI, which could effectively halt the current pandemic. [ABSTRACT FROM AUTHOR]

The incidence of metabolic syndrome is increasing even at younger ages. Metabolic syndrome constitutes a group of cardiovascular risk factors that include high cholesterol, triacylglycerol, hyperglycemia, central obesity, etc., which increases the risk of cardiovascular disease, diabetes mellitus, may be even cancer. Indian students enter colleges just after crossing their adolescent age and will be exposed to greater academic stress. Psychological stress or depression is associated with transient change in thyroid hormones level or dysfunction. To explore an association among serum Thyroid Stimulating Hormone (TSH) levels, fT3:fT4 ratio, psychological stress scores, and selected known cardio-metabolic risk markers. Forty first year MBBS students were included. Their demographic, anthropometric variables, and the blood pressure were documented. Serum TSH, fT3, fT4, and salivary cortisol level was quantified. The stress level was assessed using Cohen Perceived Stress Scale Scoring. Data were expressed in mean ± standard deviation. Data (parametric/non-parametric) were compared by Independent unpaired ANOVA or Kruskal Wallis test whichever is appropriate. Spearmen correlation analysis was performed. Serum TSH and Cohen stress score are negatively correlated (r=−0.152), but serum cortisol showed (r=0.763) a positive correlation. TSH levels and the marks obtained in the summative assessments were negatively correlated and the correlation was not statistically significant. The psychological stress is associated with low serum TSH, high cortisol, and poor academic performance in first year MBBS students. Blood pressure, plasma glucose, and anthropometric measures were not associated with the psychological stress. [ABSTRACT FROM AUTHOR]

To evaluate the potential relationship between COVID-19 pandemic and mucormycosis outbreak. PubMed, Embase, Cochrane Library and Google Scholar were searched for the term "COVID-19 and mucormycosis" up to May 31, 2021. After the second wave of COVID-19, the mucormycosis outbreak complicates the natural course of COVID-19. COVID-19 patients with uncontrolled diabetes mellitus with diabetic ketoacidosis, excessive glucocorticoid use, prolonged neutropenia, malnutrition and any underlying immunocompromised conditions are at risk of developing mucormycosis. Hyperglycaemia impairs the motility of phagocytes and also decreases the oxidative and non-oxidative mechanism of killing the causative pathogen. Chronic hyperglycemia also leads to the formation of advanced glycation end-products (AGE), which leads to cross-linking between key proteins of inflammation and connective tissue such as collagen which makes tissue susceptible to immunological dysregulation. The receptor for AGE (RAGE) is expressed on various inflammatory cells including neutrophils and its activation by AGEs leads to activation of many down signaling pathways which ultimately leads to impairment of the inflammatory response. Hyperglycemia also increases serum Nitric Oxide (NO), which decreases neutrophil motility and reduces the synthesis and release of various inflammatory mediators such as TNF-α and IL-1β, IL-6. It also decreases the expression of adhesion molecules such as LFA-1 and ICAM-2, on neutrophils. Steroids cause immunosuppression majorly by inhibiting the NF-κB pathway which is a transcription factor involved in the synthesis of many immunological mediators such as Interleukins, cytokines, chemokines, etc., and various adhesion molecules. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) involves a cluster of cardiovascular risk factors, including abnormal lipids, insulin resistance and hypertension. The aim of the present study is to investigate associations between thyroid profile and the pro-thrombotic mediator, plasminogen activator inhibitor-1 (PAI-1), in MetS and identify associated biochemical markers. Materials and methods: The present study was a case control study and consisted of 50 diagnosed cases of MetS and 50 healthy volunteers as controls. MetS cases were further divided into two groups based on the presence and absence of subclinical hypothyroidism (SCH). Data collected included demographic profile, clinical history and routine lab investigation. Special investigations included the thyroid function test and serum PAI-1 levels. Results: The mean serum thyroid-stimulating hormone (TSH) levels were significantly higher in MetS cases as compared to controls (5.7 ± 1.2 mIU/L vs. 2.3 ± 1.6 mIU/L, p < 0.0001), although the mean triiodothyronine (T3 ) and thyroxine (T4 ) levels were comparable in two groups. The mean levels of serum PAI-1 were significantly higher in MetS cases as compared to controls(231 ± 87 ng/mL vs. 185 ± 96 ng/mL, p = 0.013). TSH and PAI-1 levels were positively correlated with various markers of MetS and negatively correlated with high-density lipoprotein (HDL). Conclusion: The present study points towards the presence of thyroid dysfunction, in the form of subclinical hypothyroidism (SCH), in cases of MetS. In the presence of thyroid dysfunction, abnormal adipocytes may release adipokines, such as PAI-1, which lead to increased risk of thrombotic episodes in these patients. Hence, SCH should be appropriately managed. [ABSTRACT FROM AUTHOR]

Background: Many factors have been proposed to be associated with the severity of disease and mortality in COVID-19. Vitamin D had recently been reviewed as one of these factors., Aim and Objectives: To evaluate the association between Vitamin D and the disease severity and mortality in COVID-19., Materials and Methods: After approval from Institutional Ethics Committee, this prospective cohort study was carried out in selected tertiary care teaching medical institutes of Central India. Participants were COVID-19 patients of the age group of 18 years and above admitted during the study period. They were categorized into four groups as asymptomatic (Group A), mild (Group B), moderate (Group C), and severe (Group D) based on clinical symptoms, respiratory rate, oxygen saturation, and chest imaging. Serum level of Vitamin 25(OH) D was measured using chemiluminescent immunoassay. The outcome of the disease was classified as recovery and death during hospitalization. The association of sociodemographic and medical characteristics with treatment outcome was studied using an appropriate statistical test. A full logistic regression model was built for the assessment of the relationship between treatment outcomes with Vitamin D level. Further, one receiver operating characteristic curve was developed to examine the prognostic significance of Vitamin D levels in COVID-19 patients., Results: Out of 748 enrolled patients, 44 (5.88%), had severe disease (Group D). A total of 721 cases (96.39%) recovered and were discharged, whereas 27 (3.61%) died during hospitalization. Mean Vitamin D level was found to be significantly different in discharged patients compared to those who were deceased. Increasing age-adjusted odds ratio (AOR) (95% confidence interval [CI]=1.07 [1.02-1.12]), known hypertension AOR (95%CI) = 3.38 (1.13-10.08), and diabetes mellitus AOR (95%CI) =28.5 (6.04-134.13) were found to be significant predictors of death among COVID-19 patients. Increasing Vitamin D level was found to be protective against COVID-19-related death (AOR (95% CI = 0.87 [0.80-0.94])., Conclusion: Vitamin D was significantly associated with the disease severity and mortality in COVID-19., Competing Interests: None

Coronaviruses as such are known since last century. The name is derived from their shape which has crown (corona) like radiating spikes. The recent one however is a different one from the Coronavirus involved in SARS (2002-2004) and MERS (2012) in being highly infectious. Initially COVID 19 had a high case fatality rate which has now decreased to a significant extent. Many cases of COVID 19 are asymptomatic with a significant number of positive cases developing a triad of fever, breathlessness and GI symptoms. Recent travel increases the probability of infection. The pathogenesis involves ACE 2 receptors. So, it has been found that there are more cases and mortality among hypertensive individuals. Even higher among the people who use ACE inhibitor in comparison to those who use other anti-hypertensive drugs. Treatment is usually symptomatic. Antiviral drugs and vaccines against COVID-19 are being used. Deranged liver enzymes are common in COVID-19, however, serious liver injury is not much documented. Liver injury is either due to disease itself or due to antiviral drugs. Extra care like strict social distancing, avoiding unnecessary contact is needed for those with autoimmune hepatitis, liver cancer and those who are in immunosuppression because of a scheduled or already liver transplant. Further research is definitely needed in this field. The upcoming researches should also focus on liver injuries associated with disease course and derangements arising as side effects of treatment of COVID-19., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Objective: To study the endothelial dysfunction by measuring Nitric Oxide and Endothelin-1, and inter-genotypic variation of inducible Nitric Oxide Synthase gene (C150T) polymorphism among the study subjects., Methods: 50 diagnosed cases of metabolic syndrome as per International Diabetes Federation (IDF) criteria and 50 healthy volunteers as control were enrolled. Nitric Oxide, Endothelin were measured and PCR-RFLP was done to identify the iNOS gene C150T polymorphism and its effect on serum nitric oxide levels., Results: Subjects with metabolic syndrome had lower NO levels (16.3 ± 10.3 vs 20.9 ± 11 µM, p = 0.032) and higher endothelin (2.68 ± 1.73 vs 1.98 ± 0.82 fmol/ml, p = 0.011). The frequency of mutant T allele (10% vs 9%) was higher in cases. Serum nitric oxide levels were lower in cases expressing the Mutant T allele as compared to wild type C allele. However, the differences were not statistically significant., Conclusions: The present study demonstrated that iNOS C150T polymorphism did not show significant association with metabolic syndrome. Serum nitric oxide levels could be influenced by factors other than genetic polymorphism of iNOS gene (C150T) which cause endothelial dysfunction in metabolic syndrome and associated co-morbidities.

Introduction: Metabolic Syndrome (Met S) is reported to be associated with sub clinical hypothyroidism (SCH). The aim of our study is to evaluate the role of SCH in association with adiponectin levels causing insulin resistance in metabolic syndrome., Materials and Method: We recruited 100 study subjects; out of which 50 were cases of Met S, which were further divided into two groups based on presence and absence of SCH and 50 were healthy controls. Serum insulin, serum T3, T4, TSH were measured by chemiluminisence based immunoassay and serum adiponectin was measured by ELISA., Results: Mean TSH levels were significantly higher in Met S cases as compare to control. Out of 50 cases of Met S, 22 (44 %) had SCH. Mean serum adiponectin were significantly lower in Met S cases as compare to control. On Pearson's correlation analysis, TSH showed significant positive correlation with HOMA-IR and negative correlation with adiponectin levels. Strong association was found on the likelihood of low levels of adiponectin in Met S cases., Conclusions: Met S cases showed insulin resistance and underlying SCH. SCH in Met S may cause altered adipocytes physiology which is associated with decreased release of insulin sensitising adiponectin which may lead to insulin resistance and future development of type II DM and associated co morbidities. Therefore, Met S cases should be screened for SCH and adiponectin levels thereafter. Also, our recommendation is SCH should be treated appropriately to attenuate insulin resistance and development of type II DM in Met S.

Introduction: Diabetic Mellitus is the chronic metabolic illness characterised by hyperglycemia and various complications of heart, eyes, nerves, kidney etc. Diabetic Nephropathy is the leading causes of morbidity and mortality in diabetic patient. We hypothesized that decreased serum folic acid levels are associated with Diabetic Nephropathy., Materials and Method: Our study population consist of 100 subjects out of which 50 cases of Diabetes Mellitus are without Diabetic Nephropathy and 50 cases of Diabetes Mellitus with Diabetic Nephropathy. We measured various routine lab parameters, apart from that, we measured spot urinary albumin to creatinine ratio to assess diabetic nephropathy and we used chemiluminesence based immunoassay to measure serum folic acid., Result: Serum folic acid in the group with nephropathy was significantly lower than that of the group without nephropathy (4.9 ± 0.4 ng/dl) vs (6.8 ± 0.5 ng/dl) p = 0.05. We found that serum folic acid was negatively correlated with spot urinary albumin ratio and on multivariate logistic regression analysis we found that decrease in folic acid significantly (p < 0.05) increases the chances of diabetes with nephropathy by 19.9 %., Conclusion: Our study tilt toward the deficiency of serum folic acid levels in diabetes mellitus patient with nephropathy. So if we would correct folic acid deficiency in diabetic patient then we could prevent the development of various complication associated with diabetes and help in reducing the morbidity and mortality of diabetic patient., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)