Annex Publishers

Hyperglycaemia is a key symptom in diabetes mellitus associated with long term damages, dysfunction and eventually failure of organs, especially the eyes, kidneys, nerves, heart and blood vessels. This study is to evaluate the hypoglycaemic potential of orally administered aqueous and ethanol extracts of Zyziphus spina-christ fruit on alloxan induced hyperglycaemic Wistar rats. The plant was extracted using maceration using aqueous and 80% ethanol as extraction solvents. Qualitative phytochemical analysis was done. An in vitro assessment of both aqueous and ethanol extract to demonstrate hypoglycaemic activity via inhibition of alpha amylase enzyme and alpha glucosidase enzymes were done. Total of 45 albino rats were used in the study of both sexes divided in 9 groups. Group 1: normal control group, group 2: diabetic control group, group 3: positive control group (metformin 300mg/kg), group 4-6: (150mg/kg, 300mg/kg and 600mg/kg) aqueous extract and group 7-9: (150mg/kg, 300mg/kg and 600mg/kg) ethanol extract. Groups were compared using one way ANOVA for significant differences and Dunnet’s posthoc test was deployed were differences exit. Data were represented as mean ± SEM and p value <0.005 The aqueous and ethanol extract yielded 35.59%% and 46.68% respectively. Phytochemical analysis revealed the presence of alkaloids, flavonoids, terpenoids, tannins, Saponins, Saponins glycosides, steroids, Phytosteroids, carbohydrate and volatile oil. An in vitro assessment of aqueous and ethanol extract demonstrated hypoglycaemic activity via inhibition of both alpha amylase enzyme and alpha glucosidase enzymes. The percentage inhibition of alpha amylase was presented as IC50 of 0.14, 0.19 and 0.58 for the acarbose, ethanol extract and aqueous extract respectively. Alpha glucosidase inhibition was represented by the IC50 of 0.7mg/ml, 0.9mg/ml and 0.7mg/ml for acarbose, ethanol extracts and aqueous extracts. The aqueous and ethanol extracts significantly decrease the blood glucose level. Elevation of cholesterol and LDL was seen in diabetic control group. The results from the studies showed that Ziziphus spina-Christi fruit aqueous and ethanol extracts has an anti-hyperglycaemic potential which is not a dose dependent both in Vitro and in Vivo. Ziziphus spina-Christi fruit aqueous and ethanol extract also causes a significant reduction in cholesterol level.

Objective: To determine the prevalence of minority drug resistance variants in the protease and Gag regions among patients failing a protease inhibitor (PI) based regimen with or without a susceptible genotype based on Sanger sequencing technology. Methods: Samples were obtained from patients who were failing on a protease inhibitor-based regimen (n = 500). Sanger based sequencing was performed as part of the standard of care. Mutation analysis was performed using the Stanford HIV drug Resistance database. A subset of these patient samples was grouped into two categories: those failing a PI based with mutations in the protease region (n = 100) and those failing on a PI based regimen without mutations in the protease region (n = 128). These samples were then analyzed in the protease and Gag regions using Next Generation Sequencing (NGS) technology and analysis of the drug resistance mutations was performed at the 20% and 1% cutoffs. Results: An initial analysis of the protease region for patients failing with drug resistance mutations revealed that most patients harbored mutations that confer resistance to Lopinavir and Atazanavir, but these mutations had little effect on Darunavir. Furthermore, NGS revealed that in patients failing with and without drug resistance mutations, minority drug resistance mutations were present at each of the drug resistance codons and at codons that confer multi-drug resistance to protease inhibitors. Further analysis of the Gag gene revealed more genetic diversity among patients failing with no mutations in the protease as evidenced by the proportion of polymorphisms at each codon. Conclusion: Based on Sanger sequencing, a proportion of patients fail a PI based regimen with a susceptible genotype. However, these patients harbor minority variants in the protease and numerous polymorphisms in the Gag region which when combined these could explain their poor response to therapy. Therefore, in order to improve patient care in low resource settings, there is need to adapt NGS as the standard genotyping technique so that minority variants are captured much earlier. In addition, since mutations in the Gag region also play a role in response to PIs, this region should be included in the routine monitoring for response to therapy in patients on a PI based regimen.

An internist with an eagle’s eye can diagnose many hidden diseases through careful examination. One such hereditary metabolic disorder is Albright’s Hereditary Osteodystrophy (AHO). Characteristic presentations in an individual affected by AHO were short stature, obesity, mild mental retardation and brachydactyly especially of 4th and 5th digits, which are the phenotypic features of genetic mutation. Pseudohypoparathyroidism (PHP) is characterized by inability of the body to respond appropriately to parathormone, mainly characterized by hypocalcaemia, increased serum parathormone concentration, insensitivity to the biological activity of parathormone and hyperphosphatemia. AHO when seen in association with resistance to parathormone (PTH), it is called PHP. Here is a case report of 22-year-old female patient with AHO with distinctive physical characteristics who presented to us with recurrent hypocalcaemic tetan