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In this communication, we define and describe gut guardianship as the processes, behaviours and activities that may be followed or undertaken, so as to achieve and maintain a healthy gut, and gut microbiome. These include aspects such related to nutrition, lifestyle, rational drug use, and microbial modulation by using prebiotics and probiotics. Gut guardianship helps in optimizing various aspects of human health including metabolic health, mitogenic balance, micronutrient absorption, mood (gaity) maintenance, gut immunity, and general well-being. Keywords: Antibiotics, microbiome, microflora, prebiotics, probiotics, proton pump inhibitors, rational drug use

Diabetes is associated with a myriad of mental health challenges, ranging from distress and depression to schizophrenia and substance abuse. These conditions are associated with hyperglycaemia, and also interfere with efforts to achieve good glucose control. One way in which this can be handled is by screening, early diagnosis, and timely management of mental health dysfunction and disorders. We term this action as psychovigilance. Keywords: Anxiety, depression, diabetes distress, psychosocial aspects, type 1 diabetes, type 2 diabetes

Introduction: The silent killer, hypertension (HTN), is a significant risk factor for cardiovascular disease. In India, HTN has a major public health effect on cardiovascular health and health-care systems. Aim: The present study was aimed to evaluate the awareness of general practitioners (GPs) toward HTN management and also their approach toward management. Materials and Methods: The present study was a questionnaire-based assessment study. A total of 100 GPs were included in the study as our study sample. All the participants were well informed about the study and after that those who were willing to participate were enrolled after obtaining a written informed consent. Results: The common presenting symptoms of hypertensive patients were predominantly morning headache (71%), dizziness (41%), palpitation (39%), and fatigability (29%). Majority (84%) practiced cuff placement method covering about 2/3rd of the arm at heart level. The preferred position while blood pressure (BP) examination of patient by majority of practitioners was while sitting (53%). The number of readings usually taken for measuring BP for each patient was as follows: one (3%), two (42%), and three (55)%. Conclusion: Although GPs in our study are well informed and up to date on certain aspects of HTN diagnosis and treatment, they may still lack an appropriate approach to HTN history taking, diagnosis, and treatment.

Aim: The aim of the study was to assess the most common patterns of cementoenamel junction (CEJ) in permanent tooth and most common pattern of CEJ in males and females in permanent tooth. Materials and Methods: A total number of 120 permanent teeth were selected. The ground sections of these teeth were prepared in longitudinal plane. The cementoenamel junction of prepared ground sections was then analyzed and studied. Results: The edge-to-edge pattern of cementoenamel junction was the most common pattern observed, was followed by gap junction, cementum over enamel, and enamel over cementum. In males and females, the most common pattern of CEJ seen was same (edge-to-edge pattern), followed by gap, cementum over enamel, and enamel over cementum. Conclusion: In the present study, out of four patterns of cementoenamel junction, edge-to-edge pattern was the most commonly seen, followed by gap junction, cementum over enamel pattern, and enamel over cementum pattern.

Objective: To assess the real-world management practices of subjects with type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM) in India. Methods: This cross-sectional study was conducted between 7 March 2016 and 15 May 2016 in India as part of the seventh wave (2016) of the International Diabetes Management Practices Study (IDMPS). Adult subjects with T1DM or T2DM visiting physicians during a 2-week recruitment period were included. Results: A total of 55 physicians included 539 subjects who met eligibility criteria. Of 495 subjects with T2DM, 303 were treated with oral glucose lowering drugs (OGLDs) only, 158 were treated with OGLD + insulin, and 27 received insulin only. Among 44 subjects with T1DM receiving insulin, 13 (29.5%) were also treated with OGLD therapy. The most commonly used insulin regimens were basal alone (69/184; 37.5%) and premixed alone (63/184; 34.2%) in subjects with T2DM, and basal + prandial insulin (24/44; 54.5%) in subjects with T1DM. Proportions of subjects achieving glycemic targets were low [glycated haemoglobin (HbA1c)

This review describes the various fasts observed by adherents of the Jain religion. It attempts to classify them according to their suitability for people with diabetes and suggests appropriate regime and dose modification for those observing these fasts. The review is an endeavor to encourage rational and evidence-based management in this field of diabetology.

This communication presents verses from the Bhagavad Gita which help define a good clinician's skills and behavior. Using the teachings of Lord Krishna, these curated verses suggest three essential skills that a physician must possess: Excellent knowledge, equanimity, and emotional attributes. Three good behaviors are listed (Pro-work ethics, Patient-centered care, and Preceptive leadership) and supported by thoughts written in the Gita.

This communication is the first of a series on South Asian fasts, festivals, and diabetes, designed to spread awareness and stimulate research on this aspect of diabetes and metabolic care. It describes the various fasts observed as part of Hindu religion and offers a classification scheme for them, labeling them as infrequent and frequent. The infrequent fasts are further sub-classified as brief and prolonged, to facilitate a scientific approach to glycemic management during these fasts. Pre-fast counseling, non-pharmacological therapy, pharmacological modification, and post-fast debriefing are discussed in detail. All available drug classes and molecules are covered in this article, which provides guidance about necessary changes in dosage and timing of administration. While in no way exhaustive, the brief review offers a basic framework which diabetes care professionals can use to counsel and manage persons in their care who wish to observe various Hindu fasts.

Statins, or 3-hydroxyl-3-methylglutaryl coenzyme HMG-CoA reductase inhibitors, are cholesterol-lowering drugs which are frequently used in the primary and secondary prevention of coronary artery disease. Current research and recommendations support and encourage more extensive use of these drugs.However, statin usage is limited by many factors, including a high incidence of statin-associated myalgia and myopathy. This review focuses on the use of Coenzyme Q in statin-associated myopathy.

Background; Hyperglycemia plays an important role in etiology of vascular complications like atherosclerosis in diabetes. Oxidative modification of low density lipoprotein (LDL) plays an important role in the progression of atherosclerosis. The aim of the present study is to compare the antioxidant potential (AOP) of LDL in type 2 diabetic men and women. Materials and Methods: The study was carried out in 80 diabetic subjects and 80 control subjects. The men (40) and women (40) in the diabetic groups were studied separately and matched for age (50-60 years), body mass index (BMI), duration of diabetes, glycosylated hemoglobin, and lipid profile. LDL from the serum sample was precipitated by heparin citrate precipitation method. For the measurement of AOP in LDL, we used xanthine-xanthine oxidase method. Results: Our results showed that AOP value was significantly low in diabetic women (P < 0.05) in comparison with diabetic men. Conclusion: It is therefore suggested that LDL from type 2 diabetic women is more prone for oxidation.