Elahe Elhami is currently a Pharma D student at Visveswarapura Institute of Pharmaceutical Sciences. Her area of interest is Basic and Applied Research on Cancer.

Background: Foot infections are a common and serious problem in persons with diabetes. Diabetic foot infections (DFIs) typically begin in a wound, most often a neuropathic ulceration. While all wounds are colonized with microorganisms, the presence of infection is defined by ≥2 classic findings of inflammation or purulence. Infections are then classified into mild (superficial and limited in size and depth), moderate (deeper or more extensive), or severe. Uninfected wounds do not require antibiotic therapy, infected wounds do. Empiric antibiotic regimens must be based on available clinical and epidemiologic data, but definitive therapy should be based on cultures of infected tissue. Objective of the study is to investigate the antimicrobial susceptibility pattern of microbes in DFIs. Inclusion criteria: All diabetic patients admitted to surgery unit with foot ulcer. Exclusion criteria: All patients referred from other unit like medicine or orthopaedics or any other speciality will be excluded. Methodology: We used the patient database to conduct a retrospective observational study of hospitalized patients with diabetic foot infections. Patient record system, which contains patient demographics, diagnoses, diagnostic studies, treatments received and patient outcomes. With this information it is possible to examine the antibiotic regimens of large numbers of diabetic patients with foot infections

Naini Bhadri is pursuing her PhD in Pharmacology from Rajiv Gandhi University of Health Sciences Bangalore (Karnataka). She is a Senior Research Fellow of Indian Council of Medical Research, New Delhi. She has presented research posters in many National and International conferences.

The study was conducted to investigate the neuroprotective potential of allantoin against biochemical, behavioural and electrophysiological deficit in streptozotocin (STZ) induced peripheral neuropathy in diabetic rat. Oral administration of allantoin (100 & 200 mg/kg; per oral) began on the confirmation of diabetes after 72 hours of STZ treatment and was continued for 8 weeks in Wistar albino rats. Determination of body weight and behavioural tests were performed subsequently in every two week during allantoin treatment period. In addition sciatic nerve conduction velocity studies and biochemical parameters of nerve homogenate and serum were performed. In vitro antioxidant activity and AGE (advanced glycation end product) inhibitory assay of allantoin were also performed. Animals treated with allantoin showed a significant improvement in body weight and reduction in serum blood glucose levels as compared to vehicle-treated diabetic rats. Moreover, significant improvement was noted in hyperalgesia, grip strength muscle co-ordination and nerve conduction velocity in allantoin treated diabetic rats. In sciatic nerve there was a significant increase in MDA level and poor antioxidant levels were observed. Reduction in MDA level and NO was determined nevertheless increase in the antioxidant level was perceived in allantoin treated group. Allantoin treatment shows efficacy for preventing diabetic deterioration as seen by improvement in biochemical, behavioural and electrophysiological deficit. The neuroprotective effect of allantoin could be attributed to its anti-hyperglycemic, AGE inhibitory activity and reduction in oxidative and nitrosative stress.

Dr.NIVEDITA.E is undergoing postgraduation in General Medicine from Mahatma Gandhi Medical College and Research Institute,Pondicherry,India. She has done an oral presentation at The Association of Physician’s of India-TamilNadu chapter and has participated as a delegate in CMEs conducted by various organisations such as Pondicherry Association of Neuroscientists and Indian medical Assocaiation in 2014 at Pondicherry,Association of Surgeons of India in 2013 and 2015 at Pondicherry,Urgencies Chirurgicales in 2013 at Pondicherry,programme on advances in critical care and emergency 5th national annual conference in 2013 at pondicherry. She is also a member of the American Heart Association accredited basic life support and Advance cardiac life support course since 2013.

Objective: To report a case of diabetic muscle infarction,a rare complication of longstanding poorly controlled diabetes melltus. Case report: We describe a case of a 55-year-old male with a 10 -year history of type 2 diabetes mellitus, who presented to our casualty with complaints of sudden onset of left thigh pain and swelling. On evaluation his blood sugars were elevtated, his glycosylated haemoglobin value was high, ESR was raised, CK value was 1800 U/L. We made a presumptive diagnosis of pyomyositis and initiated intravenous antibiotics,but he showed no improvement. Blood and tissues samples were examined for microorganisms and demonstrated no white blood cells and no organisms. Then an MRI of the limb was considered for further evaluation. Results: MRI of the thigh revealed edema diffused in the anterior compartment,T1-weighted images demonstrated uniform low-intensity signal enhancement of the affected muscle,T2-weighted images demonstrate high-intensity signal changes in the intra-and perimuscular tissues secondary to edema. Gadollinium-DTPA contrast showed linear areas of decreased signal intensity surrounded by rim-enhancement. A muscle biopsy showed coagulation necrosis in skeletal muscle and thrombosis in the small blood vessels. Thus the final diagnosis of Diabetic muscle infarction was made. He was given supportive treatment and he gradually improved. Conclusion: DMI is a rare complication of diabetes that is often mistaken for infections such as cellulitis, abscess, polymyositis,traumatic,pyomyositis and necrotizing fasciitis or inflammatory thrombophlebitis. Treatment is supportive care. Although the short-term prognosis is good in these patients, the long-term prognosis is poor.

Richa Chaturvedi has submitted her PhD at the age of 29 years from Assam University and completed her JRF (2010-2012) as well as SRF (2013-2015) from DRDO, Tezpur, India. She has published two international papers and communicated two more. She has attended three national conferences and is a reviewer of many reputed Journals

High concentrations of iron in the body can inhibit phagocytosis and transporter proteins. If there is a reduction in the liver iron, it can improve the glucose/insulin axis. This study documents the effect of administration of iron rich water on hemolytic anemia in a Wistar rat’s animal model. Hemolytic anemia was induced intraperitoneally by phenyl hydrazine and diagnosed by blood hemoglobin lowering. After inducing the hemolytic anemia, 24 Wistar rats (n=6 in four groups) were randomly assigned to 1mg/l, 5 mg/l and 10 mg/l ferric oxide iron along with 1mg/l ascorbic acid administered through drinking water, a control group was treated with iron-free water. After 30 days of treatment, the hematological and biochemical parameters, iron levels in liver, spleen and kidney were estimated. A significant increase of serum iron and ferritin and a decrease of TIBC (total iron binding capacity) were observed without changes in other biochemical parameters in the group treated with 5mg/l iron and ascorbic acid. However, in the group treated with 10 mg/ml iron and ascorbic acid, hematological changes with significantly higher values for white blood cell count, glucose, splenic and liver iron content indicates potential toxicity at this supplementation level. The result suggest that the optimum concentration of iron (5 mg/l) and ascorbic acid may improve anemic conditions and may be therapeutically beneficial in the treatment of anemia without any negative impact, while 10 mg/l in drinking water seems to be the threshold for the initiation of toxicity.

Swati Waghdhare, Sangita Dogra, Ashutosh Yadav, Samreen Siddiqui, Manju Panda, Kunal Srivastava, Sumeet Kaur, Sujeet Jha. Incidence of Diabetes in India was 1.09% in the 1950s, increased to 9.7 % in 1990, and 11% by 2000. There is a cost of care associated with its management and long-term complications of the disease. We have worked incessantly towards providing improved medical care to the patients through innovative projects. Our 24*7 Telemedicine Diabetes Care Programme, a Specialized Super help line for individualized solution of patients, is based on new software design which supports patient’s full medical records across the world. National and International patients (mostly from Afghanistan) with diabetes keep in touch with our team doctors and diabetes educators on phone, web or through video calls. Our program “[email protected] Care 24*7” aims to expand access to important and much needed diabetes management services to patients across the world. This program was conceptualised in August 2013 and then the software was designed for its implementation. Our first set of patients was recruited in first quarter of 2014. Currently, we have 50 patients whom we are managing on-line and on call. We provided regular reminder services to our patients for tests and blood sugar monitoring. National and international patients who could not regularly come to our hospital call our team doctors and diabetes educators and take advice on their treatment. This improved follow-up and care of patients. “[email protected] Care 24*7”, an ingenious, practical and sustainable system for intensive diabetes management, helps patients to effectively achieve and maintain goals within established treatment guidelines, regardless of geographical barriers.

G. Suresh Kumar has completed his PhD at the age of 28 years from University of Mysuru and Postdoctoral studies from Daegu University, South Korea and McMaster University, Canada respectively. He is a Scientist at CFTRI, Mysuru working in the area of Biochemistry and specialization in obesity, diabetes and diabetic nephropathy. He has published more than 20 papers in various reputed national and international journals.

Diabetic nephropathy (DN) is the most serious microvascular complication of diabetes. Involvement of sterol regulatory binding protein (SREBP1) in the development of DN may trigger the expression of TGF-, which enhances the accumulation of extracellular matrix in diabetic kidney. Oryzanol Concentrate (OC) shown to have hypolipidemic property has been evaluated for DN complications in the current study. Animals were grouped into starch fed; High fat fed and treated control (SFC, HFC, OFC 0.1 and 0.3%) as well as respective diabetics (SFD, HFD, OFD 0.1 and 0.3%). Diabetes was induced by injecting STZ to animals. Lipid profile in the HFD groups was altered significantly when compared to SFD group and was ameliorated by oryzanol concentrate treated groups in dose dependent manner. Increased glomerular filtration rate (GFR) and kidney weight in HFD groups were reduced with OC (0.1 &0.3%) treatment by 1.09 and 1.3 fold. PAS and Immunohistochemistry of the sections showed the accumulation of glycoprotein and collagen (IV) in HFD whose intensity was reduced with OC groups. Expression of TGF-β gene was corroborated with kidney sections of HFD (2.7 fold) and in treated groups, which down regulated by 1.3 and 1.36 fold, where the expression in SFD was 1.6 fold lesser than the HFD. Content of fat in kidney was higher in HFD when compared to SFD group and was reduced by OC. In the current study oryzanol concentrate had positive effect in reducing DN and use of such an ingredient in the preparation of food may be recommended for diabetics.

Dr. Vaishali has completed his PhD in pharmaceutical science at the age of 37 years from Sardar Patel University at Gujarat. She is the professor and head of pharmaceutics department at anand pharmacy college. She has more than 15 years of teching experience and reserch experience . She has published more than 40 papers in reputed journals and also reciepient of two national level awards for best innovative reserch project by SRISTI and 3M .

Type II diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Currently, India leads the world with the largest number of diabetic patients and this is expected to further rise in the coming years. The combination therapy is used to provide an optimal level of glycerin control over non-insulin dependent diabetes mellitus (NIDDM) patient. One of the extended released formulation available in market, TRIEXER contains three oral anti-hyperglycaemic drugs namely glimepiride, pioglitazone hydrochloride and metformin hydrochloride in the management of type II diabetes (NIDDM). The disadvantages of Pioglitazone hydrochloride are weight gain, slow onset of action, liver toxicity etc. Clinical trial data shows that Sitagliptin 100 mg once daily significantly improved glycaemic control and beta-cell function in patients with type II diabetes who had inadequate glycaemic control with glimepiride or glimepiride plus metformin therapy In the light of above reserch, the objective of the present project work is to develop fixed dose triple combination of antidiabetic drugs wherein Sitagliptine and Glimepride are as immediate release form and Metformin is as extended release (ER) form. Primarily, formulation optimization of metformin was done for extended release by factorial design. In the second set of experiments, design space for process parameters ( inlet, outlet temp, atomizing pressure and flow rate) and its influence on coated tablet characteristics was developed. Result of above study was revealed that clinically relevant newer fix dose combination formulation successfully design by implementing principal of Quality By design.

Sayantan Nath has completed his M.Sc. at the age of 25 years from Dept. of Biotechnology, Assam University,Silchar, India and is currently pursuing doctoral research under Dr. Yashmin Choudhury at Dept. of Biotechnology, Assam University, Silchar. He has published 3 papers in reputed journals and has 1 book chapter.

Diabetes mellitus (DM) is one of the most rampant metabolic disorders characterized by hyperglycemia with altered carbohydrate, lipid and protein metabolism. DM is associated with the production of reactive oxygen species (ROS) thereby generating oxidative damage in different tissues. 5' adenosine monophosphate-activated protein kinase (AMPK) is a serine-threonine kinase found in all eukaryotes that regulates glucose and lipid metabolism and its dysregulation results in the development of DM. The present study demonstrates the novel observation that activation of AMPK in type I diabetic mice is gender- and tissue-specific. The study involved the use of a type 1 diabetic mouse model in both male and female Swiss albino mice by administering alloxan monohydrate (150 mg kg-1 body weight) injection intraperitoneally (i.p). Spectrophotometric analysis of DM associated oxidative stress parameters (viz. lipid peroxidation and protein carbonylation) and slot blotting of phospho-AMPK were performed using anti-phospho AMPK antibody. There was a pronounced increase in oxidative stress parameters in heart, kidney and liver tissue in male alloxan-induced diabetic mice in comparison to female. Lipid profiling also showed a steep increase in total cholesterol, triglyceride, low-density lipoproteins (LDL) and very low-density lipoproteins (LDL) with decrease in high-density lipoproteins (HDL) in both male and female DM mice. With increase in oxidative stress parameters, mean intensities of phospho-AMPK levels in heart, kidney and liver tissues of male DM mice displayed a significant decrease in comparison to that of control mice. However, in female DM mice there was an increase of phospho-AMPK level in heart tissue with respect to controls, while a decreased phospho-AMPK level was noticed for kidney and liver tissues with respect to controls

Purabi Sarkar is currently pursuing her Ph.D in Biotechnology from Gauhati University under the supervision of Dr. Sofia Banu. She has completed her Masters in Biotechnology from Bangalore University and Post Graduate Diploma in Advanced Clinical Research from ICRI, Bangalore. She has worked as Research Trainee at R & D Centre, Indian Immunologicals Ltd, Hyderabad under the DBT-BCIL training program. She has published three article in International Journals (includes Elsevier publications) and 2 popular paper articles. She has presented her work in two international conferences and two national conferences.

Type 2 diabetes (T2D) is the most prevalent and serious metabolic disease all over the world. Oxidative stress caused by increased generation of reactive oxygen species (ROS) under hyperglycemia may contribute to the development of T2D. Therefore, cells have antioxidant networks to scavenge excessively produced ROS and antioxidants neutralize these ROS and decrease oxidative stress. The present study was designed to evaluate and compare the effect on oxidative stress pathway genes upon supplementation of antioxidants Resveratrol and Estragole in L6 cell line to combat diabetic stress conditions by qPCR system. In this study the results show up- regulation of GST and SOD gene in L6 cell lines treated with Antioxidant alone ,HNE+Antioxidant, Antioxidant+Insulin and HNE+Antioxidant+Insulin combinations. When compared with the control, Resveratrol+ Insulin treatment shows 2.48 folds up-regulation in GST gene and 2.28 folds up-regulation in SOD gene as compared to other treatment set. Similarly, Estragole also up-regulate GST expression by 2.15 folds and SOD expression by 2.34 folds in the Estragole+Insulin treatment set. In case of GPx gene, Estragole up-regulate by 0.60 folds in cells treated only with Estragole and Resveratrol show down-regulation of 2.04 folds in the HNE+Antioxidant treatment set. Whereas, CAT gene down-regulate by 3.22 folds in HNE+Antioxidant+Insulin treatment set for Estragole and Resveratrol up-regulate by 0.94 folds in only Resveratrol treatment. The study demonstrates that antioxidants Resveratrol and Estragole may be effective in combating ROS scavenging in patients with T2D. We have found Insulin alone can combat diabetes but its combination with dietary antioxidant perform better and are more effective.

The incidence of type 2 diabetes has gained its identity as the most prevalent chronic disease worldwide with unavoidable burden to the healthcare system and the society. Despite the advancement in modern medicine practice the clinical effect and outcomes are unenviable which affect health related quality of life. The complication in its management is due to excessive use of medications which has increased enormously in the past time. Furthermore, the existence of co morbidity such as hypertension, CAD, obesity may increase the number of medications which may become appropriate therapy. On the top, the benefits of medications always co-exist with potential suffering, even when the right drug is prescribed and at recommended doses. With this context, the consequence of drug-drug interaction may range from serious to life-threatening clinical condition. Moreover, the inability to differentiate drug-induced manifestation such as hypoglycemia may result in reduction or deletion of dose or increment if hyperglycemia persist, which in turn increases the risk of interactions. The true incidence of drug interactions is unknown as many are not reported, even if reported are not documented as a drug interaction, but rather consider as an adverse drug reaction. Although drug interactions for a few selected drugs are well known, we often ignore the considerable evidence that potential interactions exist in many of the drug therapy prescribed today. In this review we focus on the most frequent drug-drug interactions, in type 2 diabetic patients with co-morbidities, while considering physiological, genetical and environmental factors in diverse patients.