admission. This proportion could already be greater in some parts of the country and may increase if referrals of cases of self-poisoning increase faster than the facilities for their assessment and management. The provision of social work and psychiatric expertise in casualty departments may be one means of preventing unnecessary medical admissions without risk to the patients. Dr Blake's and Dr Bramble's figures do not demonstrate, however, that any advantage would attach to medical teams taking over assessment from psychiatrists except that, by implication, assessments would be completed sooner by staff working on the ward full time. What the figures actually suggest is that if assessment of overdoses were left to house doctors there would be an increase in admissions to psychiatric units (by 19°U), outpatients (by 5O°'), and referrals to social services (by 140o). So for house doctors to assess overdoses would provide no economy for the psychiatric or social services. The study does not tell us what the consequences would have been for the six patients who the psychiatrists would have admitted but to whom the house doctors would have offered outpatient appointments. E J SALTER

Vitamin D deficiency.

Deficiency of vitamin D is emerging as one of the important nutritional risk factors for development of insulin resistance (IR) and Type 2 Diabetes Mellitus (T2DM). It is also observed to be associated with poor glycemic control and progression of complications among diabetics. In India, in spite of adequate sunlight exposure throughout year, several reports documented prevalent finding of deficiency of vitamin D. With the context of rising surge of T2DM and hypovitaminosis D among Indians, relation between vitamin D and T2DM and related studies have been reviewed in the present article. Vitamin D plays important roles in the metabolism of glucose. It directly stimulates insulin secretion from beta cells of pancreas. It increases intracellular calcium levels, which attenuates insulin synthesis. Also it improves insulin sensitivity in peripheral muscle and fats cells. T2DM is a state of chronic low-grade chronic inflammation and being anti-inflammatory in nature, vitamin D exerts beneficial effects on glycemic control and prevention of complications. Current data about vitamin D status in T2DM is based on small sporadic studies from different regions of India. Researchers have reported conflicting results about the association of hypovitaminosis D with development of T2DM and its complications. This warrants an urgent need of population based; large sample sized prospective studies to prove the role of vitamin D in every stage, from prevention to management

/pdf/vitamin-d-and-type-2-diabetes-mellitus-indian-perspectives-525p9t992q.pdf

Vitamin D and Type 2 Diabetes Mellitus: Indian Perspectives

Background: In India, 30-50% of children and 50-80% of adults are Vitamin D deficient. Limited data exists to assess the association of Vitamin D status, Type 2 diabetes (T2D), and metabolic traits in Indians. This study was conducted to assess the correlation of Vitamin D deficiency with T2D and metabolic risk factors in the Indian population.
Methods: Patients of either gender visiting medicine outpatient department over a period of 1-year and with Vitamin D deficiency (levels

/pdf/correlation-of-vitamin-d-deficiency-with-type-2-diabetes-and-14emzqyltl.pdf

Correlation of Vitamin D deficiency with Type 2 diabetes and metabolic traits in the Indian population

/pdf/correlation-of-vitamin-d-status-with-glycaemic-status-of-16rcwjj8b9.pdf

Correlation of Vitamin D Status with Glycaemic Status of Individuals- A Cross Sectional Study in a Rural Tertiary Care Hospital of North Bengal, India

Type 2 diabetes mellitus (T2DM) is a multifactorial, polygenic, and metabolically complicated disease. A large number of genes are responsible for the biogenesis of T2DM and calpain10 (CAPN10) is one of them. The association of numerous CAPN10 genetic polymorphisms in the development of T2DM has been widely studied in different populations and noticed inconclusive results. The present study is an attempt to evaluate the plausible association of CAPN10 polymorphism SNP-19 (rs3842570) with T2DM and T2DM-related anthropometric and metabolic traits in the Noakhali region of Bangladesh. This case-control study included 202 T2DM patients and 75 healthy individuals from different places in Noakhali. A significant association (p < 0.05) of SNP-19 with T2DM in co-dominant 2R/3R vs. 3R/3R (odds ratio [OR], 2.7; p=0.0014) and dominant (2R/3R) + (2R/2R) vs. 3R/3R (OR, 2.47; p=0.0011) genetic models was observed. High-risk allele 2R also showed a significant association with T2DM in the allelic model (OR, 1.67; p=0.0109). The genotypic frequency of SNP-19 variants showed consistency with Hardy-Weinberg equilibrium (p > 0.05). Additionally, SNP-19 genetic variants showed potential associations with the anthropometric and metabolic traits of T2DM patients in terms of body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, and triglycerides. Our approach identifies the 2R/3R genotype of SNP-19 as a significant risk factor for biogenesis of T2DM in the Noakhali population. Furthermore, a large-scale study could be instrumental to correlate this finding in overall Bangladeshi population.

Association of CAPN10 gene (rs3842570) polymorphism with the type 2 diabetes mellitus among the population of Noakhali region in Bangladesh: a case-control study.

Genetic research has brought a lot of new knowledge in the area of genetic predisposition of type 2 diabetes mellitus (T2DM). It has been proposed that excessive insulin resistance and obesity are also responsible for the higher incidence of type 2 diabetes. Calpain-10 (CAPN10) is a member of a large family of intracellular proteases. The polymorphism at deletion/insertion SNP19 of this gene influences susceptibility to T2DM. The aim of the study was to determine whether calpain-10 (ins/del SNP19) polymorphism contributes significantly to susceptibility to T2DM in population of Navi Mumbai. The study included randomly selected 75 patients of which 33 had T2DM and 42 served as control subjects. Mean waist-to-hip ratio, HDL, LDL, VLDL, cholesterol, and triglyceride showed no difference whereas mean of age, FBS, and body mass index showed significant differences between the control and diabetes subjects. Genotyping of calpain-10 (ins/del SNP19) polymorphism was performed by polymerase chain reaction method. Among 75 participants, for allele-specific SNP19, genotype frequencies of allele1 (2R-32 bp), heterozygous allele (2R-3R 32 bp), and allele 2 (3R-32 bp) were 20 (26.6%), 36 (48%), and 19 (25.3%) observed, respectively. The results from the present study have indicated that CAPN10 (SNP19) shows no significant association with T2DM and more extensive studies on T2DM using candidate gene approach may provide better preventive measures and potential disease diagnostic tools.

Association Study between T2DM and CAPN10 SNP-19 (rs3842570) Polymorphism in Navi Mumbai Population

Objectives: A kind of Artificial Neural Network (ANN) known as a Back Propagation Neural Network (BPNN) has been extensively applied in a variety of sectors, including medical diagnosis, optical character recognition, stock market forecasting, and others. Many studies have employed BPNN to create decision-support tools for doctors to use while making clinical diagnoses. Chronic Kidney Disease (CKD) is one such kind of disease which has been receiving due importance from the past decades due to lack of symptoms in its early stages. The goal of this work is to demonstrate the performance of Artificial Intelligent (AI) algorithms in the early detection of CKD.
Method: We received 800 patients’ real-time data from DY Patil Hospitals for this investigation. Self-Acclimation Graded Boolean PSO (SAG-BPSO), a modified version of Particle Swarm Optimization (PSO), has been proposed and used in this study to accomplish feature selection. Cuckoo Search Algorithm (CSA) has been used to optimise the weights and biases of the BPNN. Finally, this hybrid model is combined with BPNN for final predictions. Finally, a comparison is made between few state of art algorithms and the proposed approach.
Results: The accuracy noted on applying BPNN on the dataset was approximately 91.45%. The combined model of BPNN+SAGBPSO provided an accuracy of about 92.25%. The accuracy achieved for the hybrid model of BPNN+SAGBPSO+CSA was approximately near to 98.07%.
Conclusions: This research used SAGBPSO for feature selection and CSA for finalizing the weights and biases of BPNN. The research implemented BPNN, BPNN+SAGBPSO and BPNN+SAGBPSO+CSA on our real time dataset. The proposed hybrid model BPNN+SAGBPSO+CSA outperformed all the state of art deep learning algorithms in terms of performance metrics.

Design of an Optimized Self-Acclimation Graded Boolean PSO with Back Propagation Model and Cuckoo Search Heuristics for Automatic Prediction of Chronic Kidney Disease

FFN-XGB- design of a hybrid feed forward neural network and extreme gradient boosting model for early prediction of chronic kidney disease

Inflammation is known to be the root cause of the development of coronary artery disease (CAD). Subclinical inflammation is one of the key players in pathophysiology of CAD. An inflammatory response leads to the secretion of various adipokines and cytokines. There are various pro-inflammatory markers which could be used to determine the onset of disease, and one such marker is resistin adipokine. The present study evaluates and compares the circulatory concentration of resistin in CAD patients and controls for the determination of its association with CAD. In this study, 58 CAD patients were enrolled and were further subdivided into four groups as per the associated co-morbidities. Various anthropometric and biochemical parameters were assessed. The circulatory levels of resistin were found to be significantly elevated in CAD patients and their subgroups as compared to controls. We conclude that elevated resistin levels in CAD patients suggest a key role of resistin in the development of CAD. The present study also observed that co-morbidities like type 2 diabetes can act as one of the major factors for the elevated concentration of resistin in the circulation of CAD patients with diabetes.

pdf/evaluation-of-the-circulatory-levels-of-resistin-in-coronary-11u09pn6.pdf

Evaluation of the circulatory levels of resistin in coronary artery disease with associated co-morbidities

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