Obesity is associated with UTI and pyelonephritis

Study made in 5-year period (2002-2006)claimed that obesity is associated with UTI and pyelonephritis.A total of 95,598 subjects were identified for evaluation. Gender distribution was 42.9% male and 57.1% female. In the overall study cohort, the diagnosis of a UTI or pyelonephritis occurred in 13% and 0.84%, respectively. Women were 4.2 times more likely to be diagnosed with a UTI (19.3% vs 4.6%), and 3.6 times more likely to be diagnosed with pyelonephritis (1.22% vs 0.34%), than were men. At all stratifications of obesity, the obese were significantly more likely to be diagnosed with a UTI or pyelonephritis than nonobese patients.

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Role of selenium in autoimmune thyroid disease

Autoimmune thyroid disease is gradually increasing globally. Studies conducted in the past 10 years have discovered role of selenium in the human health. Mortality , poor immune function , cognitive decline are seen with low levels while high levels are associated with antiviral effects, human reproduction and reduced risk of autoimmune thyroid disease. Supplementation of selenium above the normal reference range increases the risk of diabetes mellitus type II.

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TAK- 875 is better than glimepiride in management of Type 2 diabetes mellitus

Activation of free fatty acid receptor 1 (FFAR1; also known as G-protein-coupled receptor 40) by fatty acids stimulated glucose-dependent β-cell insulin secretion in preclinical models. Study was carried out to assess whether selective pharmacological activation of this receptor by TAK-875 in patients with type 2 diabetes mellitus improved glycaemic control without hypoglycaemia risk.

Its result was TAK-875 significantly improved glycaemic control in patients with type 2 diabetes with minimum risk of hypoglycaemia. The results show that activation of FFAR1 is a viable therapeutic target for treatment of type 2 diabetes.Based on the randomised double blind controlled trial conducted between Nov 17, 2009, and Sept 29, 2010, at 95 sites in the USA, Mexico, and Guatemala.

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non surgical management of skin neoplasms

With advancement of medicine over past few decades, varieties of treatment modalities have been developed for both cancerous and precancerous lesions in skin diseases. Topical and oral medications are available. Non surgical treatment modalities include destruction with cryogens electrodessication & curettage, chemical peeling agents and medical therapy with 5 fluorouracil including retinoids.

For chemoprevention of skin malignancies systemic and topical retinoids have been used. Oral retinoids have been found to be highly effective in treatment of actinic keratoses. Due to longer half life and teratogenic effect of etretinate it is no longer available in USA. In patients with the increased risk of skin malignancies from congenital disorders, high dose of isotretinoin can be used. It has beneficial effects in xenoderma pigmentosa and nevoid basal cell carcinoma syndrome. However, toxicity may develop with its long term use.


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precipitating factors of heart failure

Heart failure is a common syndrome and major public health problem that is increasing in incidence and prevalence. Studies have shown incidence of nearly 500,000 new cases of cardiac failure patients each year with approximately 5 million patients already having heart failure in United States. It is primarily a disease of old age, with over 75% of existing and new cases occurring in individuals over 65 years of age. The prevalence of heart failure rises from < 1% in individuals below 60 years to nearly 10% in those over 80 years of age. There are multiple risk and precipitating factors for heart failure. Modifiable factors include smoking, high blood pressure, obesity and high blood cholesterol level. Surveys have shown better prognosis of heart failure in patients whom precipitating causes are identified, treated and eliminated.

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senescent skin

Physiological age related changes in skin are most pronounced in fair persons than blacks. The major stigma of aging in the skin is wrinkling, roughness, pigmentation and cancers. Skin is composed of epidermis and dermis. Outer epidermis is dead layer of stratum corneum while the inner one is viable layer composed of keratinocytes, melanocytes and Lagerhan’s cells. Dermis is composed of collagen. Loss of elastin and collagen is a contributory factor for wrinkling. Dermal thickness is reduced to more than 20% with age. The moisture content of the aged skin is less than adult skin. Regression and disorganization of blood vessels is one of prominent feature of aging. Cutaneous sensation is reduced lesser than tactile sensitivity by the age of 80 -85 years.

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Alcohol withdrawal syndrome

Heavy drinkers will experience withdrawal symptoms following abstinence. Alcohol withdrawal syndrome includes seizures (20-30% chronic users); hallucinations (15-30% hospitalized chronic users) and 5-10% delirium tremens (fatal complication of alcohol withdrawal). After alcohol withdrawal, relapse should be prevented. Mechanism of this withdrawal syndrome isn’t understood however, metabolic changes in body may be the cause. Risk factors for developing delirium tremens include prior history of delirium tremens and seizures. Lack of access to alcohol with lack of identification of alcohol abuse is predisposing factors of withdrawal syndromes. Failure in recognition of intoxication and withdrawal syndromes can lead to mortality and morbidity. Poor outcome is associated with intercurrent illnesses, fluid and electrolyte imbalances.