BACKGROUND:Though patients attending a diabetic clinic in a tertiary care hospital were given free monthly supplies of insulin, it was found that their glycemic control was poor.SETTINGS AND DESIGN:A prospective interventional study was carried out at the outpatient clinic in a tertiary care hospital.AIMS:To evaluate the effectiveness of a six month educational interventional program on the knowledge, attitude and practices (KAP) of type-1 diabetic patients receiving free monthly supplies of human insulin and to assess their adherence.METHODOLOGY:Sixty-seven type-1 diabetics, receiving free insulin vials each month, were recruited. The patients' baseline glycemic index, plasma insulin and KAP scores were determined using a validated questionnaire. The patients were educated about the disease and use of insulin for the next six months. In the seventh month, the KAP questionnaire was readministered and blood parameters measured.STATISTICAL ANALYSIS:Blood glucose, glycosylated hemoglobin and plasma insulin were compared by paired t tests. Mean KAP scores by Wilcoxon matched-pairs signed-ranks test. Difference in the proportion of patients answering the items was compared using test of proportions for dependant groups.RESULTS:The overall mean scores (± SE) increased from 30.8 ± 0.5 to 42.2 ± 0.4 (P < 0.001). The improvement in practice scores, though significant, was marginal, that is, from 17.7 ± 0.3 to 18.8 ± 0.3. In three out of the ten items under practice domain, only the manner in which vials were being stored at home showed significant improvement (P < 0.0001). The adherence to the insulin regimen increased from 82 to 86%, but was not significant. Patients cited financial reasons for nonadherence.CONCLUSION:The study showed that a planned educational intervention in type-1 diabetics, receiving monthly supplies of insulin free of charge, did not improve the key aspects of the practice component, even though the knowledge and attitude improved.

Objectives: The study was undertaken to evaluate the in vitro anti-inflammatory and anti-arthritic activity of the ethanolic extract of leaves of Pyrenacantha volubilis (EEPV) using human red blood cells (HRBCs) membrane stabilization and protein denaturation methods. Methods: In the present study, the in vitro anti-inflammatory and anti-arthritic activity of EEPV was carried out using HRBC membrane stabilization by hypotonicity-induced hemolysis and protein denaturation using egg albumin methods at various concentrations (100, 200, 400, 800, and 1000) of EEPV. Diclofenac sodium was used as reference standard. Results: P. volubilis was effective in inhibiting HRBC membrane stabilization and protein denaturation in a dose-dependent manner and was comparable to the standard drug diclofenac sodium. Conclusion: The study suggests that P. volubilis has potential anti-inflammatory and anti-arthritic activity.

Chandraprbhavati (CPV) is an Ayurvedic formulation clinically used in the management of urinary calculi. The present study was undertaken to investigate the in-vitro antiurolithic activity of CPV by artificial urine and nucleation assay. Cystone demonstrated better percentage inhibition of calcium oxalate crystals formation than CPV in nucleation assay, however CPV exhibited more inhibition of super saturation of calcium oxalate crystals in artificial urine assay than cystone. The percentage inhibition of calcium oxalate crystals formation increased in dose dependent manner for both the drugs. Thus our study demonstrates primary evidence for CPV possessing antiurolithiatic property in vitro.

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Mitogen-activated protein kinase (MAPK) pathway plays a pivotal role in cell proliferation, growth and survival process. Cyanidin is a naturally occurring flavonoid with antioxidant activity, anti-inflammatory activity, anti-apoptosis activity, anti-mutagenic activity and anti-carcinogenic activity. Though a naturally occurring anthocyanins with good anticancer, antioxidant and free radical scavenging activity the mode of these action of cyanidin is poorly established. Hence we propose that cyanidin may exhibit these activities by modulating the MAPK pathway. Thus the aim of our present study was to determine the effect of cyanidin on molecular proteins of MAPK pathway by insilico docking using Auto dock 4.2. The structure of cyanidin was imported and drawn in Marvin sketch. Nearly 12 molecular proteins of MAPK pathway were docked with cyanidin using Auto dock tools 4.2 (version 1. 5. 6) software. The present study showed that out of 12 molecular proteins of the MAPK pathway, 11 molecules namely EGF, FGF, PDGF, RTK, RAS, MEK, RAF, ERK, JUN, FOS and SOS exhibited favourable binding energy above (-5kcal/mol) and formed nearly 1-3 hydrogen bonds. Cyanidin exhibited good inhibition constant of 215.32 m with 1 hydrogen bond and binding energy of -5.00kcal/mol for PDGFR. Cyanidin did not show favourable interaction with MAPK. Cyanidin modulates MAPK kinase pathway by inhibiting PDGFR and modulating EGF, FGF, PDGF, RTK, RAS, MEK, RAF, ERK, JUN, FOS and SOS. However further insilico and invitro studies are necessary to validate this claim of modulating MAPK pathway by cyanidin.