Targeting Liver Enzyme to Control Diabetes

Liver, the chemical factory of body, responsible for regulating many functions of body through different proteins.
One of the key functions of liver is to regulate glucose, when in excess store in form of glycogen and and during need break glycogen to glucose. These require the presence of insulin.
 Image via Wikipedia

In diabetes, this regulatory mechanism goes wrong. Scientists are struggling hard to figure it out; what exactly goes wrong in liver to pump out more glucose.
Researchers at the John G. Rangos Sr. Research Center at Children's Hospital of Pittsburgh of UPMC and the University of Pittsburgh School of Medicine have identified a powerful molecular pathway that regulates the liver's management of insulin and new glucose production.
The researchers studied a family of proteins called Foxhead box or FOX in mice; and identified that too much of FOX06 gives rise to signs of metabolic syndrome; characterized by increased blood sugar, insulin resistance and impaired glucose tolerance; which can lead to frank diabetes later on.
Blocking the protein markedly reduced liver production of glucose, although blood sugar did not completely normalize. Within two weeks of treatment, there was significant improvement in blood sugar and glucose metabolism in diabetic mice.
Tests with human liver cells echoed the importance of FOX06's role in glucose production.
It is hoped that If FOX06 activity can be inhibited that may possibly slow the liver's production of glucose in patients with diabetes and better control blood sugar levels.

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Infection from Recreational Swimming-Cryptosporidiosis

Swimming is a very good form of aerobic exercise and many love to swim without any intention of doing exercising. It is also a recreational activity.
According to a new CDC report, eight people died and about 14,000 people in 38 states and Puerto Rico were sickened by bacteria and other bugs picked up during recreational swimming activities in a two-year period ending in December 2008.
 Image via Wikipedia
Again there were 134 disease outbreaks were found to be associated with recreational water illness from 2007-2008; a 72% increase since 2005-2006.
The outbreaks were linked to swimming pools, spas, lakes, rivers, and ocean water. Of the 134 outbreaks, 60.4% caused gastrointestinal illness, 17.9% skin problems, and 12.7% acute respiratory disease. Cryptosporidium was responsible for 45% of illness.
There were eight fatal cases of primary amoebic meningoencephalitis -- a rare but deadly brain infection caused by the freshwater amoeba Naegleria fowleri.
Those outbreaks resulted in at least 13,966 illnesses. Cryptosporidium was responsible for 60 of the 105 outbreaks that health officials were able confirm in a laboratory, and the largest number of victims, 12,137.
The swimming pool water is typically disinfected with chlorine and mostly recycled. Chlorine as a disinfectant has its own hazards, and cannot kill all the pathogens within the recommended level.
Cryptosporidiosis, a diarrheal disease caused by a protozoa Cryptosporidium parvum and is typically resistant to chlorine. It can live for three to 10 days in pools, fountains and water parks with a recommended level of 1 to 2 milligrams of chlorine per liter of water. The transmission is through faeco-oral route.
Symptoms develop one to 12 days (on average, seven days) after swallowing contaminated water and include:

• Profuse, watery diarrhoea, often accompanied by;

• abdominal cramping,
• Fatigue,
• Fever,
• Loss of appetite, nausea and vomiting.

There are ways to kill cryptosporidium protozoa, including ultraviolet light and ozone, but those are not employed for disinfection as are more expensive than chlorine.
Apart from this, one may acquire several other diseases; some of those can get infected by;

• E. Coli,
• Pseudonomas,
• Leptospira,
• Naegleria an amoeba

To stay safe;

• One should not shallow the pool water,
• Abstain from swimming, if suffering from diarrhea and
• Everyone should shower or at least rinse off before getting into the water

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Circumcision Devices can be Avoided to Stay Free from Clamp Related Injuries

Molly Hennessy-Fiske, Los Angeles Times, reported on September 26, 2011; Melanie Hall brought her week-old son Terrel to a Los Angeles doctor for circumcision. But after a nurse took the baby into an examining room, something went terribly wrong.
The doctor called her in from the waiting room. He had cut off most of the tip of her son's penis.
Hall sued both the doctor and the distributor of the Mogen clamp he had used to circumcise her now 8-year-old son, Terrel.
Though her claim against the physician was dismissed, Miltex Inc. and its parent company, Integra Life Sciences Holding Corp., agreed this summer to a $4.6-million settlement.
Terrel now lives with his mother in Austin, Texas. He had had two reconstructive surgeries, and will need at least two more between his teens and 20s for repair of the physical damage. Then there will be plastic surgery.
There are several such devices, which are in use for circumcision. Nearly all circumcisions in the U.S. are performed with devices like Mogen clamp, Gomco clamp or Plastibell.
Image of Plastibell Circumcision
These days, about 56% of boys born in the U.S. are circumcised in hospitals according to the Centers for Disease Control and Prevention; apart from those done by religious leaders and others.
In August 2000, the U.S. Food and Drug Administration issued a public health notice about the Mogen and Gomco clamps after receiving about 20 injury reports a year since 1996, including lacerations, Bleeding, penile amputations and urethral injuries.

But complications continued. In the 11 years between the FDA warnings and the Hall settlement, the agency has received 139 additional reports of problems related to circumcision clamps, including 51 injuries. Twenty-one of those reports were related to Mogen clamps, all but one of which involved injuries.
In India, mostly circumcision is done in some community on religious grounds and in some others on therapeutic grounds. Except very few cases of reactive bleeding, mutilation of essential parts of penis is not seen.
There is standard method of circumcision without use of the devices; that can be safely performed under a short acting general anaesthesia or local anaesthesia. The procedure allows the surgeon to cut the foreskin under direct vision. He can secure the bleeding blood vessels then and there, leaving no chance for post-operative bleeding.
Complications of greater magnitude as in this instant case may feed fuel to the fire of the opponents of circumcision, who are echoing to stop the procedure for quite some time in certain regions of the world.
But, circumcision has its own role in many circumstances. It can be made optional choice of parents of new born.

Related articles

• Dutch doctors seek to end 'painful and harmful' male circumcision (life.nationalpost.com)

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Rainbow Colored Plate is Full of Health

The American Dietetic Association is encouraging consumption of rainbow of foods, coloured fruits and vegetables.
The beneficial effects range from anti-aging to prevention of different types of cancers.
From the exhaustive list of the active ingredients in coloured fruits those can be beneficial to health, some are enumerated below.
1. Green:

• Chlorophyll.

2. Orange and deep yellow:

• Beta-carotene;

• Zeaxanthin,

• Flavonoids,

• Lycopene,

• Potassium,

• Vitamin C, etc.

3. Purple and blue:

• Lutein,

• Zeaxanthin,

• Resveratrol,

• Vitamin C,

• Fiber,

• Flavonoids,

• Ellagic acid, and

• Quercetin etc.

4. Red:

• Lycopene,

• Ellagic acid,

• Quercetin, and

• Hesperidin etc.

5. White, tan and brown:

• Beta-glucans,

• EGCG (Epigallocatechin gallate),

• SDG (Secoisolariciresinol diglucoside), and

• Lignans etc.

The beneficial effect of green leafy vegetables by providing vitamins and other trace elements has long been known.
Green leafy vegetables traditionally include cabbages, cauliflowers, lettuce, spinach, kale, broccoli, and some herbs like parsley and dill.
These contain a lot of;

• Fiber,

•  Polyphenols,

• Group B vitamins,

• Vitamin A,

• Vitamin C  and

• Trace elements.

Some of the properties of the active ingredients found in the fruits and vegetables can be;
Beta-carotene is a precursor of vitamin A, which has profound effect on the eye health and is an anti-oxidant.
Resveratrol has anti-oxidant and anti-cancer properties.
Lutein, from Latin luteus meaning "yellow" is a xanthophyll and one of 600 known naturally occurring carotenoids. It is employed by organisms as an antioxidant and for blue light absorption. It is helpful for retinal health.
Zeaxanthin is one of the two primary xanthophyll carotenoids contained within the retina of the eye. Within the central macula, zeaxanthin is the dominant component, whereas in the peripheral retina, lutein predominates.
The lignans are one of the major classes of phytoestrogens, which have estrogen-like properties and also act as antioxidants. Lignans can competitively bind to the oestrogen receptors in the breast tissue and interfere with binding of estrogen produced in body, thereby blocking the cancer promoting activity. Lignans such as podophyllotoxin are therefore being studied for their possible effects on breast, prostate and colon cancer. Lignans are also good antioxidants, scavenging free radicals that may play a role in some diseases.
The major component in a lignan called secoisolariciresinol diglucoside (SDG) is the main precursor of enterodiol and enterolactone, active phytoestrogens in humans. SDG is an antioxidant. SDG has been seen to reduce bad cholesterol and increase in HDL resulting chances of atherosclerosis.
EGCG (Epigallocatechin gallate) is a powerful anti-oxidant.
β-Glucans (beta-glucans) are polysaccharides. β-glucans can have effect in maintenance of normal blood cholesterol concentration.
Hesperidin is a flavanone glycoside (flavonoid). It contributes to the maintenance of integrity of the blood vessels. Hesperidin reduces cholesterol, blood pressure, prevents bone density loss, protective against sepsis and has anti-inflammatory effects. It is a potential sedative.
Quercetin is the aglycone form of a number of other flavonoid glycosides. It has Antiviral (inhibition against HIV-1 reverse transcriptase), Anti-Cancer (pancreas, colorectal cancer, prostate and skin) and Anti-inflammatory (Reducing prostaglandin D2 production). It eases Metabolic Syndrome by increasing energy expenditure through increased mitochondrial production; reduces blood pressure and obesity by reducing LDL cholesterol levels.
Quercetin and resveratrol combinedly inhibit production of fat cells.
Ellagic acid has antiproliferative and antioxidant properties. The anti-proliferative properties of ellagic acid can be due to its ability to directly inhibit the DNA binding of certain carcinogens; including nitrosamines and polycyclic aromatic hydrocarbons.  As with other polyphenol antioxidants, ellagic acid has a chemoprotective effect in cellular models by reducing oxidative stress.
Lycopene has been considered a potential agent for prevention of some types of cancers, particularly prostate cancer; and also has antioxidant properties.
Chlorophyll imparts green colour, which may act as an anti-oxidant.
It is paradoxical that consumption of some vegetables and fruits may create problems.

• Ingredients present in cabbage may cause hypothyroid goitre.

• Absorption of iron, calcium and certain other minerals may decrease, if taken along with green leafy vegetables.

• Fibres after fermentation in the intestine may cause flatulence and discomfort in the abdomen.

• Grape juice may be contraindicated in patients on blood thinners.

• Banana may be a bad diet for patients with end stage kidney disease due to its phosphorous content.

Balanced consumption of green leafy vegetable and fruits may help people in many ways.

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New Hope to Control Type II Diabetes-Genetic Manipulation and Protein Supplementation

In an early pre-clinical study in mice, researchers demonstrated that a dietary supplement may help inhibit development of insulin resistance and glucose intolerance, conditions involved in development of Type 2 diabetes and metabolic syndrome.
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In this early pre-clinical study, a naturally produced amino acid-like molecule called GABA (Gama Amino Butiric Acid) was given orally to mice those were obese, insulin resistant and in the early stages of Type 2 diabetes. Researchers found that GABA suppressed the inflammatory immune responses those are involved in the development of this condition.
According to study authors, GABA helped prevent disease progression and improved glucose tolerance and insulin sensitivity, even after onset of Type 2 diabetes in mice. Researchers also identified the regulatory immune cells that likely direct GABA's activity in inhibiting inflammation.
In another development, Australian researchers have isolated a ‘master gene’ that controls Type 2 diabetes and say drugs that prevent or reverse the condition by switching off the gene may be as little as five years away
A number of genes are required for the normal functioning of insulin producing Beta cells in pancreas. The gene the researchers identified is probably the master regulator of those other genes. "That is why, it would be an effective gene to target,” said Dr. Ross Laybutt, whose paper on the finding, titled ‘Inhibition of Id1 Augments Insulin Secretion and Protects Against High-Fat Diet–Induced Glucose Intolerance’, is published today in the journal Diabetes.
“If we can block this gene, we might be able to prevent or even reverse diabetes.”
Dr. Laybutt said the gene, known as Id1, was already known to play a role in cancer and that drugs targeting this gene already exist.
He is now planning tests to see if those drugs could work to ‘switch off’ Id1 and prevent or reverse Type 2 diabetes.
Genetic control of type II diabetes can be accessed here

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Bugs can Make Good Protein and Fat rich Food

Bugs are eaten in many parts of World to-day. Those can make tasty foods rich in protein and fat.
Perhaps the only concern is the allergy to the protein, some one may be.

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A Squamous Cell Papilloma of Mid-esophagus

Squamous cell papillomas of esophagus though rare are encountered mostly as an incidental finding in upper gastrointestinal endoscopy.

It is a well circumscribed raised lesion of varying size with more or less smooth surface. It may have a neck or may be sessile, without any stalk.
Though the cause of it is exactly not known, can be due to;

• Human Papilloma Virus, if the viral DNA can be identified in the specimen.
• Can be associated with esophageal reflux disease.
• May be associated with tobacco chewing.

Usually, remains benign; but can turn into malignancy in rare cases.
Treated through endoscopic snare cauterization and submitted for histopathological study to ascertain the nature of the lesion.

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Colored Fruits and Vegetables are Better for Health

 American Dietetic Association encourages the public to "eat right with color." That means the more variety of colored fruits and vegetables one chooses each day he or she infuses the diet with variety of vitamins, minerals, antioxidants and fiber.
All these different foods and different colors provide different nutrients for our bodies. More than 600 different anthocyanins found in nature; apart from which the chlorophyll and anthroxanthins give color to food.
Healthy colors
The American Dietetic Association is encouraging the public to eat a rainbow of foods, such as these fruits and vegetables:

• Green:Avocados, apples, grapes, honeydew, kiwi fruit, limes, artichokes, asparagus, broccoli, green beans, green peppers, spinach. The pigment is chlorophyll that imparts this color.
• Orange and deep yellow:Apricots, cantaloupe, grapefruit*, mangoes, papayas, peaches, pineapple, carrots, yellow peppers, yellow corn, sweet potatoes. These are rich in beta-carotene, zeaxanthin, flavonoids, lycopene, potassium, and vitamin C etc.
• Purple and blue:blackberries, blueberries, plums, raisins, eggplant, purple cabbage, purple-fleshed potatoes. These are rich in lutein, zeaxanthin, resveratrol, vitamin C, fiber, flavonoids, ellagic acid, and quercetin etc.
• Red:Cherries, cranberries, pomegranates, red/pink grapefruit*, red grapes, watermelon, beets, red onions, red peppers, red potatoes, rhubarb and tomatoes. These contain lycopene, ellagic acid, Quercetin, and Hesperidin etc.
• White, tan and brown:Bananas, brown pears, dates, white peaches, cauliflower, mushrooms, onions, parsnips, turnips, white-fleshed potatoes, white corn. Beta-glucans, EGCG, SDG, and lignans are found in these.

Main protective effect of these molecules are through anti-oxidant activity; apart for that the protective effect of vitamins, minerals and fibre add up. The beneficial effect range from anti-aging to prevention of different types of cancers.

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• Strawberries to Guard Health (drppanda.wordpress.com)

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A Muscle and Fat Cell Protein Cardiotrophin 1 Shows Promise in Treatment of Obesity

A muscle and fat cell protein Cardiotrophin 1 shows promise in treatment of obesity and metabolic syndrome. Metabolic syndrome is characterised by:

• Obesity,
• Hypertension,
• Diabetes,
• Dyslipidemia, abnormality in lipid or fat level in blood  and

• Kidney disease etc.

Cardiotrophin 1 has cell protective effect and effect in tissue regeneration. It was developed for its use in organ transplant.
 Image of Excessive Adipose Tissue in Abdomen
Researchers found that the administration of cardiotrophin 1 accelerates the elimination of fat from the adipose tissue and increases the rate at which fat is burnt in muscles.
Treatment of obese and diabetic mice with cardiotrophin 1;

• Iincreased energy expenditure,
• Reduced food intake and 
• Corrected obesity and diabetes. 

They also noticed that in addition to its effects on fat metabolism, cardiotrophin 1 promotes the entry of glucose into the cells and increases the insulin sensitivity.

Cardiotrophin 1 (CT-1) is a member of the interleukin-6 cytokine family. The use of CT-1 in liver transplantation has already been granted Orphan Drug Status by both the FDA and the EMEA.
Let us watch for new developments in this front.

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Skin Manifestation of Hook Worm Disease-Sand Worm Disease

Image of Cutaneous Larva Migrans

Helminths/Nematodes, apart from causing disorders in the digestive system and systemic complications like anemia, malnutrition, intestinal obstruction and lungs complications; those from definitive hosts like dogs and cats; and some specis from human definitive host can also cause skin lesion in human.

Certain nematodes, particularly the hook worms in their larval form preferably enter the body through the skin from soil contaminated with feces; human or animals like dog or cat. Those may also enter the body through feco-oral route.
This type of entry through skin is mostly seen in the feet and commonly in countries where people do not use foot wears in outdoors. Common in countries like Brazil, West Indies and India; and other tropical countries. Also seen in travelers visiting these countries.
The skin lesion is variously called as Cutaneous larva migrans, Creeping eruption or Sandworm disease. It is caused mostly by larvae of animal hookworms. Ancylostoma braziliense is the most common offender. Other nematodes can be U. stenocephala, A. caninum and Toxocara cani of animal hook worm and Necator American of human hook worm.
Most often, people pick up the infection by walking through contaminated areas barefoot or with open-type shoes, or by sitting in tainted soil or sand.
The main affected areas are the dorsum and sole of the feet, buttocks, pelvic waist, legs and shoulders. More than one lesion is compatible with more than one entry point. The larvae of animal hook worms migrate in wilderness in the superficial skin of human who are not the definitive hosts for the nematodes and is almost a dead end; but in the process those may get lodged in some parts of body like muscles, breasts or very rarely in retina. Necator American travel in the skin for sometime before finding a small vein to enter the system.
In definitive hosts like dog and cat those can find a channel like small vein to enter, from where those can easily get their way to lungs and ultimately to the gut; where those lodge.
The main signs and symptoms are linear and/or serpiginous lesions; which creeps or migrates from 2–3 mm to 2–3 cm per day; popularly coining the terms in describing the disease. There is pruritus/itching at the entry point as well as in the tract.
This is intensified after some days by the inflammatory reaction of the host and may even interfere with sleep. Blisters may appear and cause pain.
Eosinophilia, increased eosinphil component of White blood cell population in blood (Differential Count, DC), Lungs infiltration in X-rays examination and increased immunoglobulin E levels may be observed, but are rare.
Clinically, the diagnosis of hookworm-related cutaneous larva migrans can apparently be made easily on the basis of typical pruritic serpiginous lesion that advances in a patient with a history of sunbathing, walking barefoot on the beach, or similar activity in a tropical location.
A single dose of ivermectin (200 μg per kg bodyweight), usual adult dose 12 mg; kills the migrating larvae effectively and relieves itching quickly. Oral albendazole (400 mg daily), given for 5–7 days, shows excellent cure rates and the drug is well-tolerated by patients.
Though a self-limiting disease, very few cases of diffuse unilateral sub-acute neuroretinitis (DUSN) has been described in the literatures.
In prevention, when visiting tropical countries, especially beaches and sandy, moist areas, it is best to wear shoes that completely cover the feet. Also, one should avoid sitting or lying on bare sand, even if on a towel.
Deworming of pets is a good idea.

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• What is the difference between rhabditiform and filariform larvae of hookworms (wiki.answers.com)

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What can Affect Vitamin D Level in Body

Many people, world wide have blood levels of vitamin D below 20 nanograms per milliliter (ng/ml), the minimum blood level that the Institute of Medicine (IOM) recommends for good bone health. Some, even advocate for a higher level.
Image by julochka via FlickrApart from bone health, Vitamin D is now thought to have beneficial effect on people having asthma, diabetes, cancer of breast, cancer of ovary; and can boost immunity to fight infections.

Figuring out what can affect the blood level of vitamin D can be a difficult task. Natural source of vitamin D level is limited to a few foods like eggs, fish oil and green chillies; but the largest source is the ultraviolet B rays from sun that helps in its synthesis in the skin. Some food stuffs are being fortified with vitamin D to supplement the deficiency. The recommended daily dose is 800 IU of vitamin D 3 per day.
Vitamin D is produced by the body in a complex process that involves ultraviolet B (UVB) rays, the liver, and then the kidneys; after which the active form of vitamin D becomes available to body.
Many factors can influence a person’s vitamin D level. Some of those interesting factors are;

• The latitude where one lives; The higher is the latitudes, the less is the UVB light that can reach the surface of earth. It further decreases in the winter season because of the low angle of the sun.
• Air pollution; Carbon particulates in the air from the burning of fossil fuels, wood and other materials; scatter and absorb UVB rays.
• Use of sunscreen; Sunscreen, if applied in in correct manner can block UVB light, But, practically very few people put on enough sunscreen or use sunscreen regularly to block all UVB light.
• The color of skin; Melanin is the pigment substance in the skin cells that makes it appear dark and filters UVB rays; significantly seen in tropical countries. As a result, dark-skinned people tend to require more UVB exposure than light-skinned people to generate the same amount of vitamin D.
• The temperature skin. Warm skin is a more efficient producer of vitamin D than cool skin. So, on a sunny, hot summer days, one can make more vitamin D than on a cool one.
• Age; Compared with younger people, older people are less efficient vitamin D producers.
• The health of gut; The vitamin D that is consumed in food or as a supplement is absorbed from the small intestine, the integrity of the absorbing surface of which is important. That is why, conditions like celiac disease, chronic pancreatitis, Crohn’s disease, and cystic fibrosis, can reduce vitamin D absorption.
• The health of liver and kidneys; Some types of liver disease can reduce absorption of vitamin D and some other types, can not complete the steps essential to vitamin D metabolism. Health of the kidneys are to be sound to convert the vitamin D to its active form, so in kidney diseases, bioactive vitamin D levels decreases; and in end-stage kidney disease, the level is undetectable.
• Life style; People having jobs that force them to stay indoors having less chance of exposure to sun may not effectively produce adequate amount of vitamin D.

About 20 to 30 minutes of daily exposure to intense sun during 11 AM to 3 PM with uncovered limbs may be sufficient to produce adequate amount of vitamin D; of course for whom there is no medical contra-indication for such exposure to sun.

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