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Background Tuberculosis of the adrenal glands may cause overt or subclinical adrenal insufficiency. An algorithm-based approach including assessment of paired basal cortisol and plasma adrenocorticotropic hormone (ACTH), short Synacthen, and plasma renin activity assays could be useful to diagnose all forms of adrenal insufficiency. Methods This cross-sectional study included consecutive, treatment-naive subjects diagnosed with pulmonary tuberculosis. Tuberculosis severity was classified by radiological criteria. Baseline parameters plus morning (8 am) serum cortisol and paired plasma ACTH were measured in all patients. Synacthen stimulation tests and plasma renin activity assays were performed as required. Results Eighty-four treatment-naive consecutive cases of pulmonary tuberculosis were evaluated for adrenal insufficiency. Twenty-seven (32.14%) subjects had normal adrenocortical function and 8 (9.5%), 7 (8.3%), 40 (47.6%), and 2 (2.4%) subjects had stage 1, stage 2, stage 3, and stage 4 adrenal insufficiency, respectively. Serum cortisol was negatively correlated with radiological severity (P = .01) and duration of illness (P = .001). Adrenal dysfunction was present in 27.3%, 82.5%, and 80% of those with radiologically minimal, moderately advanced, and far-advanced disease, respectively. Mean cortisol was 19.74 ± 5.52, 17.42 ± 8.53, and 15.71 ± 7.14 (μg/dL) in the 3 groups, respectively (P = .042). Hyponatremia was present in 83.3% of the patients. Serum sodium was negatively correlated with severity but not with the duration of disease. Conclusion The prevalence of overt and subclinical adrenal dysfunction in pulmonary tuberculosis was high and was correlated with disease severity and duration. An algorithmic approach may be useful to detect the same and may have important clinical implications.

IntroductionRenal involvement in type 2 diabetes mellitus (T2DM) may be due to diabetes (diabetic kidney disease (DKD)), causes other than diabetes (non-diabetic kidney disease (NDKD)) or overlap of DKD and NDKD (mixed kidney disease group). Prevalence of NDKD and predictive value of clinical or biochemical indicators have been explored in retrospective cohorts with preselection biases warranting the need for prospectively conducted unbiased renal biopsy study.Research design and methodsConsecutive subjects aged >18 years with T2DM and renal involvement with estimated glomerular filtration rate of 30–60 mL/min/m2and/or albumin:creatinine ratio of >300 mg/g were offered renal biopsy. Prevalence of DKD, NDKD and mixed kidney disease was documented. Clinical/laboratory parameters of subjects were recorded and compared between groups and were tested for ability to predict histopathological diagnosis.ResultsWe screened 6247 subjects with T2DM of which 869 fulfilled inclusion criteria for biopsy. Of the 869 subjects, biopsy was feasible in 818 subjects. Out of 818, we recruited first 110 subjects who agreed to undergo renal biopsy. Among those 110 subjects, 73 (66.4%) had DKD; 20 (18.2 %) had NDKD; and 17 (15.4 %) had mixed kidney disease. Subjects with NDKD as compared with DKD had shorter duration of diabetes (pConclusionNDKD and mixed kidney disease in T2DM with renal involvement are very common and traditionally used parameters to select biopsies are of limited value in clinical decision making.

Studies evaluating endocrine and exocrine functions in fibrocalculous pancreatic diabetes (FCPD) are scarce.Insulin, C-peptide, glucagon, incretin hormones (glucagon-like peptide 1 [GLP-1] and gastric inhibitory peptide [GIP]), and dipeptidyl peptidase IV (DPP-IV) were estimated in patients with FCPD (n = 20), type 2 diabetes mellitus (T2DM) (n = 20), and controls (n = 20) in fasting and 60 minutes after 75 g glucose.Fasting and post-glucose C-peptide and insulin in FCPD were lower than that of T2DM and controls. Plasma glucagon decreased after glucose load in controls (3.72, 2.29), but increased in T2DM (4.01, 5.73), and remained unchanged in FCPD (3.44, 3.44). Active GLP-1 (pmol/L) after glucose load increased in FCPD (6.14 to 9.72, P =.001), in T2DM (2.87 to 4.62, P .001), and in controls (3.91 to 6.13, P .001). Median active GLP-1 in FCPD, both in fasting and post-glucose state (6.14, 9.72), was twice that of T2DM (2.87, 4.62) and 1.5 times that of controls (3.91, 6.13) (P .001 for all). Post-glucose GIP (pmol/L) increased in all: FCPD (15.83 to 94.14), T2DM (21.85 to 88.29), and control (13.00 to 74.65) (P .001 for all). GIP was not different between groups. DPP-IV concentration (ng/mL) increased in controls (1578.54, 3012.00) and FCPD (1609.95, 1995.42), but not in T2DM (1204.50, 1939.50) (P = .131). DPP-IV between the three groups was not different. Fecal elastase was low in FCPD compared with T2DM controls.In FCPD, basal C-peptide and glucagon are low, and glucagon does not increase after glucose load. GLP-1, but not GIP, in FCPD increases 1.5 to 2 times as compared with T2DM and controls (fasting and post glucose) without differences in DPP-IV.背景: 评价纤维结石性胰腺糖尿病(FCPD)内分泌和外分泌功能的研究很少。 方法: 测定FCPD组(n=20)、2型糖尿病(T2 DM)组(n=20)和对照组(n=20)空腹和75g葡萄糖后60min的胰岛素、C肽、胰高血糖素、肠泌素(胰高血糖素样肽1[GLP-1]和胃抑制肽[GIP])、二肽基肽酶IV(DPP-IV)水平。 结果: FCPD组空腹和糖负荷后C肽、胰岛素水平均低于T2 DM组和对照组。对照组糖负荷后胰高血糖素(pmol/L)降低(3.72; 2.29); T2 DM组升高(4.01; 5.73); FCPD组(3.44; 3.44)无明显变化。FCPD组(6.14~9.72; P=0.001)、T2 DM组(2.87~4.62; P0.001)和对照组(3.91~6.13; P0.001)糖负荷后活性GLP-1(pmol/L)升高。FCPD组空腹和糖负荷后GLP-1(pmol/L)活性中位数(6.14; 9.72)是T2 DM组(2.87; 4.62)的两倍; 是对照组(3.91; 6.13)的1.5倍(P0.001)。糖负荷后GIP(pmol/L)在所有组别中都升高:FCPD(15.83~94.14)、T2DM(21.85~88.29)、对照组(13.00~74.65), P0.01。不同组间GIP差异无统计学意义。对照组(1578.54,3012.00)和FCPD组(1609.95,1995.42)的DPP-IV浓度(ng/mL)升高; 而T2 DM组(1204.50,1939.50)的DPP-IV浓度无明显变化(P=0.131)。DPP-IV于三组间差异无统计学意义。FCPD组中粪弹性蛋白酶低于T2 DM组对照组。 结论: FCPD患者糖负荷后基础C肽和胰高血糖素降低; 在糖负荷后胰高血糖素不升高。FCPD的GLP-1; 而不是GIP; 与T2 DM和对照组(空腹和糖负荷后)相比升高了1.5-2倍; 而DPP-IV没有差异.

Altered expression of long noncoding RNA (lncRNA), longer than 200 nucleotides without potential for coding protein, has been observed in diverse human diseases including viral diseases. It is largely unknown whether lncRNA would deregulate in SARS-CoV-2 infection, causing ongoing pandemic COVID-19. To identify, if lncRNA was deregulated in SARS-CoV-2 infected cells, we analyzed in silico the data in GSE147507. It was revealed that expression of 20 lncRNA like MALAT1, NEAT1 was increased and 4 lncRNA like PART1, TP53TG1 was decreased in at least two independent cell lines infected with SARS-CoV-2. Expression of NEAT1 was also increased in lungs tissue of COVID-19 patients. The deregulated lncRNA could interact with more than 2800 genes/proteins and 422 microRNAs as revealed from the database that catalogs experimentally determined interactions. Analysis with the interacting gene/protein partners of deregulated lncRNAs revealed that these genes/proteins were associated with many pathways related to viral infection, inflammation and immune functions. To find out whether these lncRNAs could be regulated by STATs and interferon regulatory factors (IRFs), we used ChIPBase v2.0 that catalogs experimentally determined binding from ChIP-seq data. It was revealed that any one of the transcription factors IRF1, IRF4, STAT1, STAT3 and STAT5A had experimentally determined binding at regions within -5kb to +1kb of the deregulated lncRNAs in at least 2 independent cell lines/conditions. Our analysis revealed that several lncRNAs could be regulated by IRF1, IRF4 STAT1 and STAT3 in response to SARS-CoV-2 infection and lncRNAs might be involved in antiviral response. However, these in silico observations are necessary to be validated experimentally., Long non-coding RNA; NEAT1; MALAT1; Interferon regulatory factors; SARS-CoV-2; COVID-19

Background: Kidney damage is considered to be one of the risk factors for severity and mortality among COVID-19 patients. However, molecular nature of such observations remains unknown. Hypothesis: Altered gene expressions due to infection and in chronic kidney disease could explain severity in COVID-19 with kidney defects. Methods: We collected gene expression data from publicly available resources Gene Expression Omnibus CKD, Enrichr for deregulated genes in SARS-CoV infected cells in vitro, DisGeNET and others and carried out enrichment analysis using Enrichr. Result: Number of common genes altered in chronic kidney disease (CKD) and SARS-CoV infected cells was 2834. Enrichment analysis revealed that biological processes related viral life cycle and growth, cytokines, immunity, interferon, inflammation, apoptosis, autophagy, oxidative stress and others were significantly enriched with common deregulated genes. Similarly, significantly enriched pathways related to viral and bacterial infections, immunity and inflammation, cell cycle, ubiquitin mediated proteolysis, signaling pathways like Relaxin signaling pathway, mTOR signaling pathway, IL-17 signaling pathway, NF-kappa B signaling pathway were enriched with the common deregulated genes. These processes and pathways are known to be related to kidney damage. DisGeNET terms enriched include and related to Dengue fever, chronic Hepatitis, measles, retroviridae infections, respiratory syncytial virus Infections and many others. Kidney dysfunction related terms ischemia of kidney, renal fibrosis and diabetic nephropathy. Conclusion: Common deregulated genes in SARS-CoV infected cells and chronic kidney disease, as well as their enrichment with molecular processes and pathways relevant for viral pathogenesis and renal dysfunctions, could explain the severity of COVID-19 with kidney disease. This observation not only provides molecular relation of severity in COVID-19 with renal dysfunctions but might also help in the management and treatment targets for these cases.

The risk factors associated with COVID-19 related severity, morbidity, and mortality, i.e., obesity (often associated with NAFLD), hyperglycemia, hypertension and dyslipidemia all cluster together as metabolic syndrome (MetS). Instead of studying association of these risk factors with COVID-19, it makes sense studying the association between MetS on one hand and COVID-19 on the other. This study explores a molecular basis underpinning the above association. Severity of COVID-19 patients with MetS could be due to functional alterations of host proteins due to their interactions with viral proteins. We collected data from Enrichr (https://amp.pharm.mssm.edu/Enrichr/), DisGeNET (https://www.disgenet.org/) and others and carried out enrichment analysis using Enrichr. Various biological processes and pathways associated with viral protein interacting partners are known to involve in metabolic diseases. The molecular pathways underlying insulin resistance, insulin signaling and insulin secretion are not only involved in diabetes but also in CVD and obesity (associated with non-alcoholic fatty liver disease; NAFLD). Lipid metabolism/lipogenesis, fatty acid oxidation and inflammation are associated with MetS. Viral interacting host proteins are associated and enriched with terms like hyperglycemia, coronary artery disease, hypertensive disease related to CVD and liver diseases in DisGeNET. Association of viral interacting proteins with disease-relevant biological processes, pathways and disease-related terms suggests that altered host protein function following interaction with viral proteins might contribute to frequent occurrence and/or severity of COVID-19 in subjects with MetS. Such analysis not only provides a molecular basis of comorbidity but also incriminates host proteins in viral replication, growth and identifies possible drug targets for intervention.

Leadership since the ancient times is considered to be an inherently moral endeavour. The conventional leadership theories considered leadership to be an innate talent, and the later theories suggested leadership can be adapted or learnt. A vital strand of leadership research deals with leadership in the organizational context. Ever since the advent of the global financial crisis, stalwarts in the field of leadership research are calling for a new kind of leadership which will ensure organizations become sufficiently resilient and be well prepared to deal with any sort of unforeseen adversities. Sustainable leadership assumes significance in this context. Sustainable leadership is based on the humanistic approach towards management, which takes into account the human factor in the organizational settings as the facilitator establish the overall well-being of the business firm. Such leadership practices create a self-reinforcing leadership system that enhances the organizational performance and longevity. Visser and Courtice (2011) developed a model on sustainable leadership precisely known as the Cambridge Sustainability Leadership (CSL) Model. The model was developed on the basis of the diverse tenants of sustainable leadership. The study attempts to evaluate the effectiveness of the CSL leadership model based on the qualitative data. It is a single-subject study based on qualitative research and case study research methodology. The study is based on an intensive interview of a senior male executive working in a department under the central government of India to understand the significance of the ‘individual leader’ factor as illustrated in the CSL model. An effort has also been made to understand the perception of the subordinates towards the male executive. It appears to emerge from the interview data of the male executive that he embodies a blend of the diverse components of the ‘individual leader’ factor as described in the Visser and Courtice’s (2011) CSL model. The interview data of the subordinates seems to suggest the male executive is perceived to exhibit the various characteristics of the ‘individual leader’ dimension. More specifically, the interview data of the subordinates appears to suggest that the male executive demonstrates sustainable leadership behaviour. Therefore, proactive measures by global business firms embracing sustainable leadership at the workplace will ensure overall organizational growth.

The Indian sub-continent since the ancient times has been the epicentre of rich cultural heritage. The ethos of the ancient Indian texts holds true to the present day. Some of the well-known ancient Indian texts are the Upanishads, the Vedas and the epics: Ramayana and Mahabharata. The Bhagavad Gita is an intrinsic part of the great Indian epic Mahabharata. It was written by Sage Vyasa. The Bhagavad Gita gets decoded at the battleground of Kurukshetra. It is based on the conversation between Arjuna, the warrior prince and Krishna, his charioteer. Initially, Arjuna was reluctant to fight the battle and Krishna assumed the role of an ideal mentor to counsel Arjuna to fight for the right cause. Eventually Arjuna was transformed into a determined warrior and ready to take on his rivals. At the end of the battle, Arjuna along with his brothers accomplished victory over their opponents. The eternal philosophy embedded in the verses of the Bhagavad Gita has been adorned by renowned world leaders. Organizational management has evolved since the onset of the industrial revolution. The advent of globalization has led to reshaping the management scenario in every organization across the territories. Every business house is striving hard to enhance the organizational performance to ensure sustainable growth. At a time of globalization it is imperative for organizations to look for alternative paradigms to match up to the constantly evolving management practices. Since the last few decades the Bhagavad Gita has attracted the attention of the management researchers. The present study attempts to evaluate the diverse aspects of the organizational management as reflected in the Bhagavad Gita based on the systematic review of academic literature. The finding of the present study seems to suggest Bhagavad Gita is the store house of ideal solutions to deal with the various issues related to organizational management. More specifically, it emerges from past studies that the Bhagavad Gita is an effective management tool in the field of leadership and provides sustainable solutions to overcome challenges pertaining to the constantly evolving business environment. In the present day business context, organizational leaders and management practitioners may imbibe the ethos of the Bhagavad Gita for the long term survival of their organizations. Thus, it may be said that since the ancient times, the Indian worldview as noted down in the different texts has benefited the human race and will do so for the years to come.

Organizational management practices have witnessed immense transformation over the past several years. Green HRM is defined as an environment friendly HR practice that subscribes to the sustainable use of resources in the industrial sectors all over the world. The present paper attempts to evaluate the impact of Green HRM management on business organizations from a cross country perspective. The present paper follows the systematic review of relevant academic literature related to Green HRM practices in the global scenario. The findings of the study appear to suggest organizations across the globe are absorbing Green HRM as a proactive step towards protecting the environment. It is also noted in the study that the implementation of Green HRM seems to benefit the diverse industrial sectors on a worldwide scale. Additionally, the findings of the present paper seem to show that by incorporating Green HRM in the workplace arena, organizations are earning financial and non-financial rewards. Therefore, it may be concluded that Green HRM in all likelihood is playing a crucial role in reshaping the age old management practices and contributing in the process of protecting the ecosystem for the future generations.

Background Type 1 diabetes is associated with several disease-related and other organ-specific autoimmune disorders. Data related to various auto-antibodies in Type 1 diabetes in India is limited. Materials and methods In this cross sectional study, 92 subjects with T1DM (33 males, 59 females) were evaluated for T1DM related antibodies (autoantibodies to glutamic acid decarboxylase (anti-GAD), autoantibodies to protein tyrosine phosphatise (anti-IA2), anti-islet cell antibody (ICA), insulin autoantibody (IAA), anti-Zinc Transporter(ZnT8) and other organ specific auto antibodies like anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (TgAb), IgA anti-tissue transglutaminase (IgA anti-tTG), anti-21-hydroxylase, and anti-ovarian antibody (in females). Results Anti-GAD, IA-2, islet cell antibody, insulin autoantibodies (IAA), ZnT8 antibody were present in 79.3%, 32.6%, 61.9%, 63%, and 20.65% subjects, respectively. Only 2.2% patients with Type 1 diabetes were antibody negative. At least one antibody was found in 97.8% and at least two antibodies in 67.3%. The presence of anti-TPO, anti-thyroglobulin, IgA anti-tissue transglutaminase, anti 21-hydroxylase were found in 51%, 25%, 22.8%, and 2.1%, respectively. Anti-ovarian antibody was absent in all females of our study population. The duration of diabetes positively correlated with the number of T1DM specific antibody and also with GAD antibody positivity. Anti TPO positivity correlated with the age of onset of T1DM, but not with the duration of disease or presence of other T1DM specific autoantibody. Conclusions T1DM is associated with a high prevalence of autoantibodies and antibody negative T1DM is rare. The association with other organ specific antibody (especially thyroid and adrenal glands) and celiac disease is also substantial, which reinforces the importance of regular thyroid and celiac disease screening in T1DM subjects. The duration of diabetes positively correlated with number of T1DM specific antibodies.

Background and Objectives: Nonalcoholic fatty liver disease (NAFLD) and dysglycemia are public health challenges. There is urgent need for anthropometric surrogates for NAFLD screening. This study evaluated role of neck circumference (NC) and neck-height ratio (NHtR) as predictors of liver stiffness measure (LSM) in individuals with prediabetes (IPD). Methods: In a cross-sectional study, 188 IPD from 1130 screened individuals underwent anthropometry, ultrasonography, Fibroscan® for LSM, dyslipidemia, insulin resistance (IR), and fetuin-A assessment. Results: Hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), metabolic syndrome (MetS), NAFLD, and significant liver stiffness (SLS) (LSM >8.5kPa) were observed in 53.7%, 31.4%, 71.3%, 73.9%, 24.5%, and 11.2% prediabetes individuals, respectively. Prediabetes with NAFLD had significantly higher body mass index (BMI), NC, NHtR, glycated hemoglobin, triglycerides, fatty liver index (FLI), and LSM. Prediabetes in highest NHtR quartile had significantly higher BMI, hypertension, MetS, fasting glucose, glycated hemoglobin, homeostatic model assessment-IR, NAFLD, LSM, SLS, and lower HDL-C. Stepwise forward linear regression revealed that NHtR, FLI, and LDL-C were best predictors of LSM, at baseline (Model-1), after adjusting for age and sex (Model-2), and adjusting model-2 plus systolic and diastolic blood pressure (Model-3). NHtR and NC (in females) and NHtR and BMI (in males) had largest area under the curves for predicting LSM, NAFLD, and MetS. NHtR ≥21.54 cm/m (sensitivity: 90%; specificity: 52.5%; females) and ≥21.62 cm/m (sensitivity: 80%; specificity: 49.4%; males) was best predictor of SLS. Interpretation and Conclusion: NHtR is a reliable tool for community screening of NAFLD and liver stiffness in prediabetes.