Background
Organic cation transporter 2 (OCT2) is a renal carrier transporter protein found in the basolateral membrane of proximal epithelial cells, which facilitates active secretion of Metformin. The genetic polymorphism of OCT2 influences the pharmacodynamic and pharmacokinetic effect of Metformin in type 2 diabetes mellitus (T2DM) patients. This is also mainly associated with frequencies of the associated risk allele in a particular population.
Objective
The purpose of the study is to determine the impact of OCT2 genetic polymorphism on Metformin pharmacodynamics (PD) and pharmacokinetics (PK).
Method of study
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for performing the research. Following databases were used to conduct the search: PubMed/MEDLINE, Google Scholar, and the Cochrane Library. Relevant studies were retrieved and literatures were appraised for methodology, demographic characteristics, relevant SNPs, genetic intervention trials, and outcomes.
Results
Based on the data collected, 13 OCT2 Single nucleotide polymorphisms (SNPs) were identified across various ethnic groups. There were significant differences between the frequency distribution of shared alleles and impact of thirteen SNPs on Metformin. Among the thirteen OCT2 variants studied, rs316019 variant produced the most diverse responses in population by showing positive and negative impact on PK & PD of Metformin.
Discussion and conclusion
Each population's OCT2 polymorphism had a distinct effect on Metformin responsiveness. The findings of this study could bring significant benefits to patients with OCT2 genetic polymorphism if individualised T2DM therapy is introduced. Patient-centered treatment would improve the Metformin efficacy leading to new research in personalised medicine.
Despite the possible behavioral and neurological benefits of mindfulness meditation (MM), its use in psychological distress exacerbated tinea cruris (TC) appears to be unexplored. This can be used with other interventions to reduce the distress associated with social anxiety and avoidance found in many skin conditions. MM practices shrink the amygdala, and in response, the prefrontal cortex becomes thicker which is associated with awareness, concentration, and decision-making. This case report examines the efficacy of MM in psychological distress exacerbated TC. A 33-year-old female patient with a history of recurrent TC was treated with antifungal medications at first and had no improvement due to observed psychological distress, but later with MM in conjunction with antifungals, her condition improved and complete resolution was seen after 8 weeks of treatment and no recurrence was observed with MM single-handedly without any antidepressant medication use. This case report indicates the improvement of the patient when meditation was added along with other interventions as the patient was in psychological distress, which was assessed by administering scales prior to and later to management.
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