bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduction of emissions by avoided deforestation in andean high-land tropical forests
Authors: Andrade Hernán J. , Segura Milena A. , Escobar Erika A.
Published: September 2022

Deforestation and forest degradation, mainly in areas with high carbon density, is one of the most important source of greenhouse gases (GHG). The impact of deforestation on carbon storage in total biomass and its CO2 emissions is analyzed in four land covers in the Santuario de Fauna y Flora Iguaque (SFFI), Boyacá, Colombia. A total of 32 temporal sampling plots (TSP) of 250m2 was established to measure trees with diameter at breast height (dbh) ³ 10 cm whereas 17 TSP of 36m2 were established to measure total and stipe height of all frailejones (Espeletia boyacensis Cuatrec, E. tunjana Cuatrec and E. cf. Incana). Above and belowground biomass was estimated with allometric models, whereas carbon was calculated using the 0.47 fraction. The sampling area was proportional to the area of each land cover: open heathlands and moorlands (OMH), dense heathlands and moorlands (DMH), broad-leaved forest with continuous canopy, not on mire (BFCC), natural grassland prevailingly without trees and shrubs (NSWT). BFCC and DMH showed higher carbon storage in biomass (55 and 27Mg C/ha, respectively). SFFI stored around 135.9Gg C, from which 25-38Gg CO2e could be emitted to the atmosphere in the 20 next years if the deforestation rates continue. BFCC and OMH are the covers with the highest potential of CO2 emissions to the atmosphere. Therefore, prioritizing the preservation of these ecosystems by Reducing Emissions from Deforestation and Degradation (REDD+) programs, is a key to counter the effects of climate change and ensure the supply of ecosystemic services that support local communities’ livelihoods.
SIMULTANEOUS DETERMINATION OF VALSARTAN AND HYDROCHLOROTHIAZIDE BY FIRST-ORDER DERIVATIVE- ZERO CROSSING UV-VISIBLE SPECTROPHOTOMETRIC METHOD
Authors: AKTAŞ A. Hakan , MuhıAllawAhbabi Ahmed
Published: September 2022

Background: Antihypertensive drugs are widely used to treat high blood pressure in patients. The aim of this study is to prepare various mixtures of valsartan and hydrochlorothiazide, to create a matrix effect in the drug, and to determine the determination of these active substances in drug samples after optimum conditions by first-order derivative spectroscopy method.
Method: In the first-degree derivative spectrophotometry method applied, valsartan and hydrochlorothiazide were dissolved in methanol and 100 mgL-1 solutions were prepared, and then the mixtures of these solutions were determined in spectrophotometry. After mixing, tablet (drug) sample was prepared and absorbance values were recorded and the first derivative spectrophotometric method was applied to the values obtained.
Results: As a result of the spectrophotometric determination of various mixtures of valsartan and hydrochlorothiazide used in the study, it was determined that the first-order derivative spectrophotometric method applied gave very consistent results.
Conclusion: The first-order derivative spectrophotometry method used in the study can be easily applied in routine analyzes in drug research laboratories.
                      
Peer Review History:
Received: 15 July 2022; Revised: 10 August; Accepted: 7 September, Available online: 15 September 2022
Academic Editor:  Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com
UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. 
Received file:                                Reviewer's Comments:
Average Peer review marks at initial stage: 5.5/10
Average Peer review marks at publication stage: 7.0/10
Reviewers:
Dr. U. S. Mahadeva Rao, Universiti Sultan Zainal Abidin, Terengganu Malaysia, raousm@gmail.com
Prof. Cyprian Ogbonna ONYEJI, Obafemi Awolowo University, Ile-Ife, Nigeria, conyeji@oauife.edu.ng
Similar Articles:  
UV SPECTROSCOPY DETERMINATION OF CILAZAPRIL AND HYDROCHLOROTHIAZIDE ACTIVE AGENTS USED IN THE TREATMENT OF HYPERTENSION
El COVID-19: ¿Buena compañía para esta Semana Santa?
Authors: Núñez Picado Dagoberto , Pineda Sancho Andrey
Published: September 2022

Este escrito forma parte de una serie de documentos elaborados por investigadoras e investigadores del Centro de Investigación en Cultura y Desarrollo de la UNED, donde a manera de ensayo se presentan análisis y reflexiones sobre el cómo diversos aspectos de nuestra realidad cotidiana se han visto afectados a partir de la aparición del COVID-19.
COVID 19: Expresión del impacto global del capitalismo en la biodiversidad
Authors: Amaris Cervantes Orlando
Published: September 2022

Este escrito forma parte de una serie de documentos elaborados por investigadoras e investigadores del Centro de Investigación en Cultura y Desarrollo de la UNED, donde a manera de ensayo se presentan análisis y reflexiones sobre el cómo diversos aspectos de nuestra realidad cotidiana se han visto afectados a partir de la aparición del COVID-19.
Arte, cuerpo y movimiento a ritmo de COVID: Preguntas sobre la danza desde el encierro
Authors: Oliva Barboza Patricia , De La O Jiménez Vanessa
Published: September 2022

A partir de una serie de preguntas se busca repensar sobre lo que es el movimiento y lo que podría estar significando en estos momentos de encierro. El texto pretende ser una invitación para recuperar ese saber encarnado.  Es tan solo una pincelada sobre temas que nos generan dudas alrededor del arte y el cuerpo en momentos de pandemia.
Territorios: Respuestas sociales y de resistencia desde grupos LGBTIQ en la ciudad frente al COVID-19
Authors: Rojas Herra Luis Alonso
Published: September 2022

El COVID-19 ha venido a trastocar las vidas de las personas y los ordenamientos institucionales en el mundo. En tal contexto es vital comprender y dar respuestas amplias, adaptativas y de carácter territorial desde las ciencias sociales. La situación es inédita y ha generado situaciones de vulnerabilidad para múltiples grupos sociales. Ante tal contexto -del coronavirus- desde el CICDE (Centro de Investigación en Cultura y Desarrollo) y en el marco del programa PROCULTURA se han creado un conjunto de análisis propositivos relativos a la categoría de territorio como eje trasversal en las líneas de investigación. De esta forma, en una serie de tres documentos, se presentarán propuestas positivas en tiempos de crisis, entre ellas, este texto sobre las respuestas sociales y de resistencia desde grupos LGBTIQ en la ciudad frente al COVID-19.
Élites neopentecostales trasnacionales: Imaginario geoestratégico del discurso de las superestrellas
Authors: Carpio Ulloa María José
Published: September 2022

A partir de la segunda mitad de las décadas de los 70´s el continente americano viene experimentando el exponencial crecimiento del fenómeno del neopentecostalismo. Por lo tanto, este articulo como aporte derivado de una investigación hace un análisis multiescalar del discurso político-religioso del movimiento neopentecostal con el fin de comprender el imaginario y objetivo geoestratégico de las élites neopentecostales. Esto, como aporte de la ciencia geográfica al estudio del neopentecostalismo en América.
Vientos de cambio. Moral sexual en la Costa Rica contemporánea
Authors: Pineda Sancho Andrey
Published: September 2022

El presente artículo busca desentrañar y problematizar los posicionamientos morales que sobresalen hoy entre la población costarricense en materia de sexualidad (relaciones sexuales premaritales, divorcio, homosexualidad y aborto). Esto lo hace con base en datos arrojados por la encuesta “Percepción de la población costarricense sobre valores y prácticas religiosas”, realizada por el Instituto de Estudios Sociales en Población (IDESPO) y la Comunidad Epistémica de Estudios Sociorreligiosos de la Universidad Nacional de Costa Rica (UNA) en octubre del 2018. El escrito da cuenta de las diferentes posturas morales que coexisten en Costa Rica y trata de explicar dichas posturas a la luz de variables como la afiliación religiosa, el sexo, la edad y el grado de educación formal de la población costarricense.
Remesas familiares: las contribuciones a Centroamérica de quienes tuvieron que irse
Authors: Gatica López Gustavo Adolfo
Published: September 2022

En el año en el que se conmemora el bicentenario de la independencia de Centroamérica, poco más de una de cada diez personas que nacieron en la región vive fuera de ella. En este artículo se analiza la migración reciente y se discute la pregunta ¿cuáles son los aportes más importantes de estas transferencias en Centroamérica? En particular, hay dos aspectos que destacan: en primer lugar, las remesas se convierten en una especie de política social privatizada. En segundo lugar, hacen una contribución a los ingresos fiscales en los países receptores. Con excepción de Costa Rica, las remesas familiares hacen palidecer los ingresos que llegan a través de Inversión Extranjera Directa a pesar de los distintos estímulos brindados a empresarios nacionales y transnacionales.
Experiencia de la Extensión Universitaria en la Gestión del Recurso Hídrico
Authors: Vargas Meneses Catalina , Chaves Garita Olger Antonio
Published: September 2022

Costa Rica es un país lleno de grandes privilegios por la posición geográfica en la que se encuentra, uno de estos privilegios es la gran producción de recurso hídrico que se da en casi la totalidad de la extensión del territorial durante todas las épocas del año, esto ha llevado a promover asentamientos humanos en casi cualquier sitio del país. Estos asentamientos muchas veces son abastecidos de agua tanto para consumo como para el desarrollo de actividades productivas por Asociaciones Administradoras de Sistemas de Acueductos y Alcantarillados Comunales comúnmente conocidas como ASADAS, lo que ha generado que de maneras muy diversas se realicen todo tipo de actividades y acciones para cumplir con el servicio a los usuarios, como parte de una experiencia puntual como docente universitaria extensionista es que se pretende plasmar la labor que desde la institución pública de educación superior Universidad de Costa Rica, se vivió la experiencia de trabajar con comunidades donde operaban ASADAS desde un proyecto de Trabajo Comunal Universitario y el impacto que esto generó en los estudiantes que participaron.
Practical Implication of Zakat in Socio-economic Empowerment during the COVID-19 Pandemic
Authors: Lestari Meliana Eka Puji , Febiyanti Cenny Sanita , Abdul Rohman Muhammad Riyal , Hani Annisaa’ Fella Shasmita , Susanti Adilnia Fifi , Medias Fahmi
Published: September 2022

The extent to which zakat has contributed to and been implicated in the socio-economic empowerment of Muslim countries has not been the subject of a literature review. This study analyzes the practical implications of zakat in the OIC countries during the COVID-19 pandemic from the existing literature. Data were obtained from Harzing's Publish or Perish to analyze the role of zakat involvement in the socio-economic community in OIC countries from 2019 to 2021. 31 scholarly studies on the topics of economics, health, and education illustrate the economic implications of zakat. The discussion on the implications of zakat includes poverty reduction, economic empowerment, and MSMEs improvement. Zakat helps to fund community health care. Zakat provides educational scholarships, and school infrastructure, and enhances the feasibility of school arrangements. This study could assist the government to recognize the importance of zakat for socioeconomic empowerment and help policymakers develop strategic strategies to increase zakat participation, particularly in Muslim countries.
Commentary on the European Medicines Agency's extended mandate - Protecting public health in times of crisis and improving availability of medicines and medical devices
Authors: Abed Inga , Gonzalez-Quevedo Rosa , Mura Manuela , Dias Monica , Dias Silvy Da Rocha , Burgos Juan (EMA PAPERS ONLY) Garcia
Published: September 2022

The European Medicines Agency (EMA) started operating under its new
legal mandate on 1 April 2022. The mandate brings new responsibilities
to the Agency in three different areas: • Reinforcement of the role and
activities of the EMA pandemic Task Force(which is now known as the
Emergency Task Force (ETF)). • A stronger role of EMA in the monitoring
of shortages of critical medicines, medical devices and in-vitro
diagnostics, both in anticipation of and during a crisis. • A more
coordinated mechanism of European Union (EU) experts advice on medical
devices classified as high-risk (class IIa and III or class D (1)) and
in-vitro diagnostic medical devices. Here we consider the impact of the
COVID-19 pandemic on the operations of EMA and the European medicines
regulatory network, and how EMA’s new mandate will strengthen the
Agency’s and the Network’s ability to face crises. EMA’s extended
mandate brings clear benefits in terms of response to public health
emergencies at EU level, which ranges from improvements in crisis
management to avoiding medicine shortages and improving access to
diagnostics and medical devices that are safe and conform to their
expected function.
Conserved transcriptional programming across sex and species after peripheral nerve injury predicts treatments for neuropathic pain
Authors: Ghazisaeidi Shahrzad , Muley Milind , Tu YuShan , Kolahdouzan Mahshad , Sengar Ameet , Ramani Arun , Brudno Michael , Salter Michael
Published: September 2022

Background and Purpose: Chronic pain is a devastating problem
affecting 1 in 5 individuals around the globe, with neuropathic pain the
most debilitating and poorly treated type of chronic pain. Advances in
transcriptomics and data mining have contributed to cataloging diverse
cellular pathways and transcriptomic alterations in response to
peripheral nerve injury but have focused on phenomenology and
classifying transcriptomic responses. Experimental approach:
Here, with the goal of identifying new types of pain-relieving agents,
we compared transcriptional reprogramming changes in the dorsal spinal
cord after peripheral nerve injury cross-sex and cross-species and
imputed commonalities, as well as differences in cellular pathways and
gene regulation. Key Results: We identified 93 transcripts in
the dorsal horn that were increased by peripheral nerve injury in male
and female mice and rats. Following gene ontology and transcription
factor analyses, we constructed a pain interactome for the proteins
encoded by the differentially expressed genes, discovering new,
conserved signaling nodes. We interrogated the interactome with the
Drug-Gene database to predict FDA-approved medications that may modulate
key nodes within the network. The top hit from the analysis was
fostamatinib, the molecular target of which is the non-receptor tyrosine
kinase Syk, which our analysis had identified as a key node in the
interactome. Conclusions & Implications : We found that
intrathecally administrating the active metabolite of fostamatinib,
R406, significantly reversed pain hypersensitivity in both sexes. Thus,
we have identified and shown the efficacy of an agent that could not
have been previously predicted to have analgesic properties.
Case 9: Not Your Usual Diabetic Ketoacidosis
Authors: Gaba Ruchi , Samson Susan , Garber Alan
Published: September 2022

A 51-year-old Hispanic woman with no history of diabetes presented to the emergency department with several days of nausea, vomiting, abdominal pain, and shortness of breath. She also reported blurry vision, polyuria, polydipsia, and a 30 lb weight loss over the past 3 months. She had a past medical history of hypertension. Her mother and maternal grandmother had type 2 diabetes (T2D). She did not smoke or drink alcohol and did not exercise regularly. Her weight was 73.93 kg (BMI 32.5 kg/m2). Physical examination revealed signs of volume depletion. She had acanthosis nigricans at the neck. She had no clinical evidence of retinopathy, neuropathy, or nephropathy.
Case 100: High GAD Antibody Levels and Cerebellar Atrophy in a Patient with Type 1 Diabetes
Authors: Bell David
Published: September 2022

A 27-year old white woman had well-controlled type 1 diabetes (HbA1c ranging from 5.5 to 6.6%).
Case 101: Resolution of Infertility with Diabetes Therapy
Authors: Bell David
Published: September 2022

A 46-year-old Eurasian woman presented with new-onset type 2 diabetes. She had a long history of polycystic ovary disease (PCO) and for the previous year had been treated with metformin alone.
Case 102: The Initial Pregnancy Visit of a Woman with Type 1 Diabetes and Diabetes Complications
Authors: McElduff Aidan
Published: September 2022

A 31-year-old woman with a 20-year history of type 1 diabetes presents with 6 weeks of amenorrhea in her second pregnancy. The current glycemic control is good as determined by a hemoglobin A1c (HbA1c) of 6.1% and the absence of major hypoglycemia. There is a history of Graves’ disease. A preliminary prepregnancy counseling session had taken place but advice about active contraception, until a definite start date had been selected, was not followed. The patient has active proliferative retinopathy requiring laser therapy and moderate diabetic nephropathy with a recent albumin excretion rate of 58 μg/min and an estimated glomerular filtration rate (eGFR) of 55 mL/min/1.73 m2 (creatinine 105 μmol/L or 1.2 mg/dL). There is no evidence of peripheral neuropathy. The pedal pulses are palpable, and there are no bruits.
Case 18: A Common Misdiagnosis
Authors: Schauer Irene
Published: September 2022

M. is a 59-year-old Caucasian man referred to an endocrinology clinic for assistance with levothyroxine dosing for his hypothyroidism post I-131 ablation for Graves’ disease about 8 years earlier. He had been noting increasing fatigue and weight loss that he associated with his thyroid medication and requested endocrinology consultation. His primary provider had decreased his LT4 dose by 15% 1 month prior to his endocrine visit in response to a reported thyroid-stimulating hormone (TSH) of 0.25 μIU/mL. The patient had noted no improvement in his symptoms with this change. His past medical history was also notable for an extensive, largely negative evaluation for chronic gastrointestinal pain, and a diagnosis of type 2 diabetes 3.5 years earlier. His medications included metformin (500 mg twice a day), levothyroxine (175 mcg 6 days a week), omeprazole, simvastatin (20 mg once daily), and lisinopril (2.5 mg once daily). He had been tried for a time on a sulfonylurea, but had hypoglycemia during exercise and was returned to metformin. As instructed, he was only checking occasional morning blood glucose levels, and these were all low to mid-100s mg/dL. He reported regular exercise, a generally active lifestyle, and no family history of diabetes.
Case 22: Glucokinase Maturity-Onset Diabetes of the Young and Pregnancy
Authors: Apel Jill , Koh Chung-Kay
Published: September 2022

A 31-year-old woman with maturity-onset diabetes of the young (MODY) with the glucokinase gene mutation (GCK-MODY) presented for preconception counseling She was diagnosed at age 28 years after her mother was diagnosed with GCK-MODY. Her fasting blood glucose levels were mildly elevated and HbA1c ranged 6.5–6.8%. Her only sibling also was diagnosed with GCK-MODY. Her mother had mildly elevated glycemia during her pregnancies but was not treated. The birth weights of the patient and her sister were ~7 lb.
Case 23: Latent Autoimmune Diabetes of the Adult (LADA) in an Elderly Patient
Authors: Shah Monica , Sohrevardi Mahtab , Baldwin David
Published: September 2022

An 80-year-old woman presented to endocrine clinic with complaints of weight loss, anorexia, and severe bilateral lower extremity pain and numbness. Two years ago she was diagnosed with type 2 diabetes; her BMI was 17 kg/m2, blood pressure (BP) was 100/75 mmHg, and HbA1c was 7.4%. She was treated with metformin 1,000 mg twice daily, but her blood glucose levels remained in the 200s mg/dL (11.1 mmol/L). She had not tried any other medications. She had been told to limit her diet to control her diabetes and her weight decreased from 120 to 80 lb.
Case 32: Management Issues in the Syndrome of Autoantibodies to the Insulin Receptor (Type B Insulin Resistance)
Authors: Cochran Elaine , Brown Rebecca , Gorden Philip
Published: September 2022

A 29-year-old African American woman presented to her primary care provider (PCP). Over the preceding 6 months, she had experienced a dramatic change to her health, including development of insulin resistant diabetes, polycystic ovarian syndrome, hyperandrogenism (testosterone >900 ng/mL), and a 35–40 lb weight loss. She had seen three endocrinologists but did not receive a diagnosis. When seen by the PCP, she required 500–1,000 units/day of insulin, but continued to lose weight (current BMI 19.5 kg/m2) with increasing insulin requirements. The PCP suspected type B insulin resistance, an extreme form of insulin resistance caused by autoantibodies to the insulin receptor. The PCP was unable to locate a laboratory to test for antibodies to the insulin receptor and could not find guidance on treatment. By searching www.clinicaltrials.gov, the PCP located our research team at the National Institutes of Health (NIH).
Case 35: Cosecreting Adrenal Tumor Causing Severe Insulin Resistance
Authors: Rivera Kathya , Cusi Kenneth , Edwards Catherine
Published: September 2022

A 38-year-old Caucasian woman was referred to our care with a presumed diagnosis of primary hyperaldosteronism and an associated large adrenal mass. She was found by her primary care physician (PCP) to have severe hypokalemia on routine lab work although she was completely asymptomatic. Past medical history included osteoporosis, hyperlipidemia, meningioma, seizure disorder, and hypothyroidism. Family history included type 2 diabetes (T2D), hypertension, dyslipidemia, and coronary heart disease. Medications at the time of endocrine evaluation included KCl 40 mEq p.o. q.i.d., diltiazem 60 mg p.o. q.i.d., losartan 25 mg p.o. daily, spirinolactone 50 mg p.o. daily, insulin glargine 45 units subcutaneously b.i.d., insulin aspart 26 units subcutaneously before meals, and a correction scale and pioglitazone 15 mg daily. On examination, blood pressure was 177/90 mmHg and pulse was 112 bpm. She was 4′ 9″ tall, weighed 36 kg and had a BMI of 17.2 kg/m2. Physical examination revealed a young female with a round face, bilateral clavicular fullness, and proximal muscle wasting of the extremities but no acanthosis nigricans, facial plethora, acne, bruises, hirsutism, central obesity, or purple striae.
Case 36: Management of Severe Insulin Resistance in a Pregnant Patient with Type 2 Diabetes: The Use of U-500 Regular Insulin via Continuous Subcutaneous Infusion
Authors: Hor Tiffany , Baldwin David
Published: September 2022

A 33-year-old woman with type 2 diabetes presented for management of uncontrolled blood glucose. She was diagnosed with diabetes at age 25 years. Her BMI was 35.5 kg/m2. Her father and older brother also have type 2 diabetes. She was initially managed with insulin glargine once a day, insulin lispro with meals, and metformin 1,000 mg b.i.d. She was subsequently switched to lispro insulin by continuous subcutaneous insulin infusion (CSII) because of suboptimal glycemic control. She required about 225–250 units/day of insulin, but HbA1c remained 8–9%. She was disappointed with her results and was frustrated with the need to change her insulin cartridges almost daily. She was concerned about her glycemic control since she was planning to get pregnant within the next year. She wanted to know options for improving her diabetes control.
Case 38: Challenging Insights from Albuminuria Early in the Course of Disease
Authors: Demirci Cami , Lewy-Weiss Vered , Sperling Mark
Published: September 2022

The patient was a Caucasian woman diagnosed with type 1 diabetes (TID) at the age 11 years when she presented in mild DKA, pH of 7.20, and hemoglobin A1c (HbA1c) 11.5%. Testing for the presence of islet cell antibodies was not performed. She responded well to treatment, initially consisting of basal and bolus injections, and after 2 years, using insulin pump therapy, she maintained excellent metabolic control with all HbA1c values <6.5% after stabilization (Fig. 38.1). Her HbA1c values were still in the near normal range at 5.8% (N = 4.3–6.1%) several years after diagnosis, and total daily insulin varied from 0.5 to 0.7 units/kg/day. Her general health was excellent with normal systolic and diastolic blood pressures; height was at the 50th percentile, weight was at the 90th percentile with BMI in 95–97th percentile. Annual tests of thyroid function and lipid profile were normal. Because “dipstick” urine for protein was positive 3 years after diagnosis, she provided an overnight urine collection for measurement of albumin excretion rate, which was 156.8 μg/min (normal = <21 μg/min). A split day-night urine collection showed that albumin excretion was 143 mg/dL during the day and 10.6 mg/dL at night. Normal nocturnal albumin excretion is up to 1.9 mg/dL, so the nocturnal albumin excretion was increased. Her albumin-to-creatinine ratio was 1,254.4 mg/g during the day and 87.6 mg/g at night, with a normal range being 15–37 mg/g. These findings were consistent with both daytime macroalbuminuria and nighttime microalbuminuria.
Case 46: A Case of Stiff Person Syndrome in a Patient with Type 1 Diabetes
Authors: Gilbert Matthew , Nathan Muriel
Published: September 2022

The patient, a 45-year-old woman with type 1 diabetes, presented to her endocrinologist with the complaint of pain and stiffness in her back. She noticed that the discomfort was worse during stressful situations, such as giving presentations at work. The back pain and stiffness made it difficult to walk, and she reported frequent falls. She could no longer stand for an extended period of time and had difficulty bending over to tie her shoes. She had been seeing a chiropractor and was participating in physical therapy without improvement. The patient was also seen in consultation by a rheumatologist and an extensive evaluation did not reveal an etiology for the patient’s symptoms. Initial laboratory testing, including a complete blood count, metabolic panel, and thyrotropin, was normal. Anti-GAD56 antibody was found to be significantly elevated at 1,041 nmol/L (normal <0.02 nmol/L). The patient was referred to neurology with concern for possible stiff person syndrome (SPS).
Case 52: Refractory Angina in a Patient with Type 2 Diabetes
Authors: Kosiborod Mikhail
Published: September 2022

A 76-year-old man presents for a routine outpatient cardiology visit. He has a 15-year history of type 2 diabetes, with several diabetes-related microvascular complications, including stage III chronic kidney disease and mild peripheral neuropathy. He is currently on a combination of metformin and sulfonylurea (SU; sustained release glipizide) for glucose control, with last hemoglobin A1c (HbA1c) of 8.5%. Although the patient never sustained a myocardial infarction, he has a complex and longstanding history of multivessel coronary artery disease (CAD), requiring two-vessel coronary artery bypass surgery (CABG) 7 years ago, and several subsequent percutaneous interventions (PCIs). Despite multiple interventions, patient continues to have chronic Canadian Cardiovascular Society (CCS) class 2–3 angina, with typical midsternal chest pressure upon mild-to-moderate physical activity—the pattern of angina has been stable for the past 5 years, but it interferes significantly with his quality of life.
Case 57: Therapeutic Hypothermia and Severe Insulin Resistance in Patients with Diabetes and Cardiac Arrest
Authors: Seggelke Stacey , Draznin Boris
Published: September 2022

J. M., a 45-year-old man had a witnessed cardiac arrest at the airport on December 30 at 10:30 p.m. Emergency medical services (EMS) arrived at the scene and found him in pulseless electrical activity. He was intubated, and epinephrine and bicarbonate were administered en route to the hospital. Upon arrival to the emergency room, the patient had pulses and cardiac activity. He was in severe acidosis with blood glucose levels >1,400 mg/dL (77.8 mmol/L).
Case 81: Somnambulism (Sleepwalking) Caused by Nocturnal Hypoglycemia
Authors: Bell David
Published: September 2022

A 26-year-old white woman developed type 1 diabetes at the age of 17 years and had been reasonably controlled (HbA1c 7.5–7.9%) on two injections of premixed 70/30 human insulin.
Case 83: Successful Use of Plasmapheresis in the Treatment of Hypoglycemia Due to Insulin Antibody Syndrome
Authors: Sharda Pankaj , Gopan Thottathil , Zimmerman Robert , Siraj Elias
Published: September 2022

An 89-year-old man was admitted with frequent, severe hypoglycemic episodes presenting with neuroglycopenic symptoms. About 2 months before admission, he started experiencing recurrent episodes of confusion, seizures, loss of consciousness, and falls. These episodes were not preceded by adrenergic symptoms and could occur at any time, but most occurred within a few hours after meals. Blood glucose (BG) level of 30 mg/dL (1.6 mmol/L) was recorded by paramedics on two occasions, which improved after bolus injections of 50% dextrose.
Case 93: Progressive Hypoglycemia Due to Insulinoma in a Patient with Type 2 Diabetes: Treatment with Image-Guided Minimally Invasive Pancreas-Sparing Surgery
Authors: Patti Mary-Elizabeth , Callery Mark , Najarian Robert , Sawhney Mandeep , Mitzner Lyle , Goldfine Alison , Moser James
Published: September 2022

A 54-year-old man with type 2 diabetes (T2D) presented for evaluation of hypoglycemia. T2D was diagnosed at age 35 years, when the patient presented with recurrent urinary tract infections. Treatment with diet, metformin, and pioglitazone/rosiglitazone led to normalization of glucose, with hemoglobin A1c of 6%. He remained stable until age 54 years, when he developed an inferior wall myocardial infarction (MI). Postinfarction pericarditis required initiation of higher dose aspirin (650 mg t.i.d.). Patient markedly improved diet and increased exercise in the post-MI setting, achieving a rapid 24-lb weight loss. Metformin and rosiglitazone were discontinued.
Case 94: Managing Pain and Paralysis in Chronic Inflammatory Demyelinating Polyneuropathy in Diabetes
Authors: Vinik Aaron
Published: September 2022

A 61-year-old Caucasian man with poorly controlled type 2 diabetes presented to our clinic with a 5-month history of right foot drop and severe excruciating pain in the right leg that progressed to the right buttock, left buttock, and left leg resulting in left foot drop. Before the visit, a neurologist had diagnosed him with diabetic amyotrophy and ganglioside GM1 antibody–mediated autoimmune neuropathy. Magnetic resonance imaging (MRI) of the brain was unremarkable. Nerve conduction studies showed absent sural, ulnar, and radial potentials with a right peroneal motor nerve conduction velocity of 19.6 m/sec, and a right posterior tibial conduction velocity of 32.9 m/sec. The patient could walk a few steps using a cane but mainly used a wheelchair. He complained of numbness and burning sensations in his feet and legs. Pain control was inadequate using duloxetine 60 mg/d, pregabalin 75 mg in the morning and 150 mg in the afternoon and evening, gabapentin 300 mg as needed, tramadol 50 mg three times daily, and hydrocodone acetaminophen 7.5/750 mg as needed.
Impacts of COVID-19 on glycemia and risk of diabetic ketoacidosis
Authors: Sharma Anukriti , Misra-Hebert Anita D. , Mariam Arshiya , Milinovich Alex , Onuzuruike Anthony , Koomson Wilhemina , Kattan Michael W. , Pantalone Kevin M. , Rotroff Daniel M.
Published: September 2022

Reports indicate that COVID-19 may impact pancreatic function and increase type 2 diabetes (T2D) risk, although real-world COVID-19 impacts on HbA1c and T2D are unknown. We tested whether COVID-19 increased HbA1c, risk of T2D, or diabetic ketoacidosis (DKA). We compared pre- and post-COVID-19 HbA1c, and T2D risk in a large real-world clinical cohort of 8,755 COVID-19(+) patients and 11,998 COVID-19(-) matched controls. We investigated if DKA risk was modified in COVID-19(+) patients with type 1 diabetes (T1D) (N=701) or T2D (N=21,830), or by race and sex. We observed a statistically significant, albeit clinically insignificant, HbA1c increase post-COVID-19 (all patients ΔHbA1c=0.06%; with T2D ΔHbA1c=0.1%), and no increase among COVID-19(-) patients. COVID-19(+) patients were 40% more likely to be diagnosed with T2D compared to COVID-19(-) patients and 28% more likely for the same HbA1c change as COVID-19(-) patients, indicating that COVID-19 attributed T2D risk may be due to increased recognition during COVID-19 management. DKA in COVID-19(+) patients with T1D was not increased. COVID-19(+) Black patients with T2D displayed disproportionately increased DKA risk (HR:2.46[1.48-6.09], P=0.004) compared to White patients, suggesting a need for further clinical awareness and investigation. 
Topical Preparation and Antimicrobial Study of Crude Extracts of Syzygium cumini (L) Skeel Leaves
Authors: D Anita
Published: September 2022

The aim of the study is antimicrobial study of crude extracts of S. cumini leaves and further topical preparation from Methanolic extract. For this successive soxhlet extracted petroleum ether, diethyl ether, methanol and aqueous extracts of leaves of S. cumini were subjected to antimicrobial activity test (antibacterial and anti-fungal test). Antimicrobial activity testing was done by agar well diffusion method. The organism tested were gram positive organism: Staphylococcus aureus (ATCC) and MRSA and gram negative organism: E. coli, Pseudomonas aeruginosa, Klebsellapneumonia for antibacterial and candida albican for antifungal Excellent antimicrobial activity was shown by Methanolic extract in comparison to other extract. From the result of antibacterial test of plant extract further gel and ointment were formulated from Methanolic extract which too showed antibacterial activity comparable to plant extract.
Evaluation of the Effect of Sub Chronic Lead Poisoning on Bodyweight and Weight of Vital Metabolic Organs in Adult Wistar Rats; and the Role of Launaea Taraxacifolia
Authors: Eluwole Omotayo A
Published: September 2022

Background and Aim: Lead is a noxious and accumulative substance in the body system when it exceeds certain threshold concentrations. Its toxicity is multi-systemic. It is associated with a number of physiological, biochemical, and morphological changes, however, discrepancy in organ weight is usually affected by relative weight gain. This study revealed the relationship between sub chronic lead intoxication, vital metabolic organs and the role of treatment on organ changes. Methodology: Seventy three Albino rats of 10 to 12 weeks old weighing 180- 200 grams were used for the experiment. The experimental albino rats were divided into 10 groups (n = 6). One group was allowed free access to distilled water only, while eight groups were allowed free access to lead acetate (2 mg/ml) in drinking water, for 5 weeks consecutively. Seven out of the eight groups were later administered Launaea taraxacifolia (LT) extract (50, 100 and 200 mg/kg, p. o), DMSA (Dimecarptosuccinic acid), DMSA + LT, DMSA + VC and VC only for 21 days consecutively. The tenth group was administered LT (100 mg/kg) for 21 days, and later allowed free access to lead acetate in drinking water (2mg/ml) for 5 weeks. The animals were treated and monitored for 35 days and their body weight was taken weekly. Animals were sacrificed on the next day after completion of the duration. Blood was collected for BLL analysis, while respective body organs (liver and kidneys) were taken out for relative organ weight; liver was excised, cleared of adhering fat and weighed. The organs were later subjected to histological studies. Results and Discussion: There was reduction in weight of group treated with Pb and Pb + LT. but there was reduction in weight of the liver and kidneys in group treated with Pb only. However, the study revealed pathological changes and reversal of histological changes in groups treated with DMSA, LT and combination therapy (DMSA+LT, DMSA+VC); which was likely to be due to the effect of antioxidant on sub chronic lead poisoning. Conclusion: The study revealed discrepancies in organ weight with body weight but not significant; however, there was reversal of pathological changes with three doses of Launaea Taraxacifolia.
Role of Vamana (Therapeutic Emesis) and Virechana (Therapeutic Purgation) on BSL (Blood Sugar Level) in Diabetes Mellitus W.S.R. to Madhumeha: A Case Study
Authors: Mangal Gopesh
Published: September 2022

Diabetes mellitus (DM) is a clinical syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin. Long standing metabolic derangement can lead to the development of complications of diabetes, which characteristically affect the eye, kidney and nervous system. DM occurs worldwide and is a major burden upon health care facilities in all countries. The characteristic features of DM have close resemblance with Prameha (disorder with excessive urination and turbidity) in Ayurveda. Madhumeha is a type of Vataja Prameha and is most close to DM. One variety of this Madhumeha (DM) is Aavaranjanya (due to occlusion) in which Vayu aggravates due to occlusion by Pitta or Kapha. This type of Madhumeha (DM) can be managed by Samshodhana (bio-purification) Chikitsa. Panchakarma is becoming popular in the prevention and management of lifestyle disorders. Vamana (emetic therapy) and Virechana (purgation therapy) are the two Panchakarma procedures of Samshodhana Chikitsa that are compatible to overcome this Aavarana (occlusion). A study was planned to assess their combined efficacy in controlling blood sugar level in the patient with DM by adopting classical methods of Vamana and Virechana. Although this is a single case study, but the study yields some very interesting results in reducing the blood sugar levels.
Current Status of Proton Pump Inhibitors in Pharmacotherapy of Diabetes Mellitus
Authors: TR Patil
Published: September 2022

Diabetes mellitus [DM] is a chronic metabolic disorder with its associated complications. Despite the plethora of available anti diabetic drugs to treat DM search continues to discover newer drugs. Proton pump inhibitors [PPIs] are the drugs which have been tested by researchers in animal models and in clinical set up to treat DM. They appeared to be promising drugs to reduce hyperglycemia. They can be used as supportive drugs along with the primary anti diabetic drugs. PPIs enhance rebound gastrin release, increase beta cell mass and insulin release. They are not hypoglycemic drugs. They reduce blood sugar by increase in gastrin and GLP-1 levels, decrease in ghrelin levels, reduced appetite, delayed gastric emptying and enhanced satiety through action on CNS.PPIs are the inhibitors of organic cation transporters (OCTs) for which metformin is the substrate and hence the plasma levels of metformin are increased. The potential and safety of PPIs in treatment of DM should be evaluated by long term clinical trials.
Investigation of Antistress Activity of Operculina Terpethum Roots using Various Experimental Models
Authors: Galani Varsha J
Published: September 2022

The root part of Operculina terpethum has been widely used in Ayurveda to treat variety of common and stress related disorders. The antistress effect of a seven-days treatment (100 and 200 mg / kg, p.o.) of the 80% ethanolic extract of Operculina terpethum root (OTRE) was evaluated by using the swimming endurance test, anoxic tolerance test, and biochemical changes in the cold-restraint stress test. The immunomodulatory activity was also evaluated for the same doses, and treatment of OTRE using the hem agglutination test. Diazepam 1 mg/kg was used as reference standard for the comparison. Both the doses of OTRE showed anti stress activity in all the tested models. 7 days pretreatment of OTRE (100 and 200 mg / kg, p.o.) treated animals showed a decrease in immobility time and an increase in anoxic tolerance time in swimming endurance and the anoxic tolerance tests, respectively. Pretreatment with OTRE significantly ameliorated the cold restraint stress induced variation in biochemical level such as increase in plasma cholesterol, triglyceride, glucose, total protein, and cortisol. Further, OTRE treatment significantly inhibited cold restraint stress induced alteration in brain noradrenaline, dopamine and serotonin levels. In mice immunized with sheep red blood cells, the treatment groups subjected to restraint stress prevented the humoral immune response to the antigen. The immune stimulating activity of the OTRE was indicated by an increase in the antibody titer in mice pre-immunized with sheep red blood cells and subjected to restraint stress. The findings of the present investigations indicate that the OTRE has significant anti stress activity, which may be due to the immune stimulating property and increased resistance, nonspecifically, against all experimental stress conditions.
Aromatic Profiles and Antimicrobial Activities of Two Ocimum basilicum Varieties
Authors: Eldahshan Omayma A
Published: September 2022

The volatile oils isolated from both Ocimum basilicum var. purpurascens and Ocimum basilicum var. basilicum, in Yemen, were analyzed by GC/FID and GC/MS. Twenty peaks were detected (100%) in Ocimum basilicum var. basilicum oil where l-Linalool was the highest one (39.0%) followed by cis-anethole (20.0%), guaiol (8.9%) and 1,8-cineole (7.2%). Ocimum basilicum var. purpurascens chromatogram revealed the presence of twenty peaks which represented 100% of the total peaks. l-Linalool (41.8%), α-copaene (22.3%) and 1,8-cineole (10.6%) were the most representative components. Ocimum basilicum var. basilicum, was more effective as antimicrobial agent than Ocimum basilicum var. purpurascens where it showed potent activity against Bacillis subtilis (MIC is 3.90 μL/mL) and moderate activities against both Staphylococcus aureus and Escherichia coli (MIC value for both 7.8 μL/Ml). Ocimum basilicum var. basilicum induced potent antifungal activities against Saccharomyces cerevisiae (MIC 3.90 μL/mL).
Concept of Rajaswala Paricharya (Care for Woman during Menstruation) in Ayurveda: Tool to Enhance Fertility
Authors: KP Roshni
Published: September 2022

Menstruation is considered to be the mirror of reproductive health. In Ayurveda, acharyas mention different charyas for maintaining the health like garbhini charya, soothika charya, rajaswala charya, etc. The charyas or code of conduct mentioned for a rajaswala stree is termed as rajaswala charya and is the most neglected part in the society. The Rajaswala Paricharya helps women to cope up with her physiological changes taking place in the body during the rajaswala period. Acharyas mentioned aharas and acharas which are indicated and contraindicated for maintaining the health. Rajaswala paricharya help women respond healthily to the drastic physical and cyclic changes during the menstrual cycle.
Exploring of Anticariogenic Activity of Herbal Formulation from Selected Five Medicinal Plants Leaves
Authors: Ishnava Kalpeh B
Published: September 2022

Background: Oral diseases continue to be a major health problem worldwide. Plant leaves extracts of formulation have great source as anticariogenic compound against oral pathogenic microorganisms, which can be used to treat infectious diseases. Objective: The leaf and their formulation extracts were tested for their effect on anticariogenic organisms under in vitro condition. Attempt was also made to characterize bioactive compounds at primary level. Material and Methods: The dried plant leaves materials are extracted by cold extraction using hexane, ethyl acetate, methanol, and distilled water. The solvents were evaporated, and the dried masses were suspended in dimethyl sulfoxide and used for anticariogenic activity by agar well diffusion method. 12 different herbal formulations prepared and evaluation their their efficacy against anticariogenic bacteria. Minimum inhibitory concentration (MIC) was evaluated by two-fold serial broth dilution method. Preliminary phytochemical analysis of effective formulation was carried out by thin-layer chromatography (TLC). Results: Plant leaves (Lantana camara var.aculcata (L.) Mold; Manilkara hexandra (Roxb.) Dub; Mangifera indica L; Piper betle L; Syzygium rubicundum Wight & Arn extracts and twelve different formulation prepared by leaves extracts was analysis for their anticariogenic activities against oral microorganisms. All the crude plant leaves extracts and different formulation prepared by leaves extracts exhibited varying degree of growth inhibition in all the oral microorganisms. The activity was determined against, Lactobacillus acidophilus, Lactobacillus casei, Staphylococcus aureus and Streptococcus pyogenes. Maximum zone of inhibition (22 mm) was found when plant leaves extracts of formualtion tested against Lactobacillus casei. Preliminary phytochemical analysis of formulation present the Tannins, Saponins, Steroids and phenolic compound are present.
Investigation of Murine Fertility by Kampo Formula Containing Astragalus Root Enhanced Endometrial Wnt/β-catenin Signaling Factors
Authors: KOBAYASHI KYOKO
Published: September 2022

Astragalus root (Root of Astragalus membranaceaus (Fisch.) Bunge or Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao) is a prescription drug constituting Kampo formulae with the aim of cardiotonic, hidroschesis, diuresis, and hypotensive effect in Japan. In this study, we report that hot water extract of Astragalus root (AsR) increased the number of neutrophils and the secretion of mucus from the endocervical gland in ovariectomized mice treated with estradiol. These secretions block bacterial access through the uterine cavity. Moreover, AsR and its main chemical component, AstragalosideⅣ, increased the levels of uterine Wnt4 and Wnt7a involved in endometrial proliferation and the maintenance of the stromasmooth muscle boundaries of the uterus, respectively. To explore the possibility of fertility improvement, we determine the litter size of maternal mice administrated with hot-water extract of Astragalus root or Kampo formula containing Astragalus root. AsR-treated maternal mice exhibited increased litter size by natural mating, whereas Keishikaogito which is a Kampo formula containing Astragalus root showed a trend towards decreased the litter size. These results suggest that Astragalus root mediates endometrial proliferation, leading to the improved fertility; a crude drug-component of Keishikaogito, except Astragalus root, might interfere with embryo implantation. The discovery of Kampo formulae showing increase of litter size is needed for treatment of fertility in medical care.
Annona Muricata (Linn.) Acetogenins as Potent Anti-Breast Cancer Agents
Authors: D Devananda
Published: September 2022

Breast cancer is the most common type of cancer in women, globally. In India, it has been ranked number one with regard to cancer incidence in both men and women. Phytotherapy has been extensively considered against cancer, and Annona muricata is one such plant species that has gained scientific interest for decades. The acetogenins, a class of phytocompounds exclusively to the Annonaceae family of plant kingdom, are known contributors towards this biomedical significance of the A. muricata. In this review, we have identified those A. muricata acetogenins that exhibit anti-breast cancer activity.