Triangulating evidence for the causal impact of single-dose zinc supplement on glycemic control for type-2 diabetes

Background: Although previous studies suggested the protective effect of zinc for type-2 diabetes, the unitary causal effect remains inconclusive. Objective: We investigated the causal effect of zinc as a single intervention on glycemic control in type-2 diabetes patients, using a systematic review of RCTs and two-sample Mendelian randomization (MR). Methods: Four outcomes were identified: fasting blood glucose/fasting glucose, hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), and serum insulin/fasting insulin level. In the systematic review, four databases were searched up to June 2021. Results were synthesized through the random-effects meta-analysis. Single nucleotide polymorphisms (SNPs) that are independent and are strongly related to zinc supplements were selected from MR-base to perform the two-sample MR with inverse-variance weighted (IVW) coefficient. Results: In the systematic review, 14 trials were included. The zinc supplement led to a significant reduction in the post-trial mean of fasting blood glucose (mean difference (MD): -26.52, 95%CI: -35.13, -17.91), HbA1C (MD: -0.52, 95%CI: -0.90, -0.13), and HOMA-IR (MD: -1.65, 95%CI: -2.62, -0.68), compared to the control group. In the two-sample MR, zinc supplement with 2 SNPs associated with lower fasting glucose (IVW coefficient: -2.04, 95%CI: -3.26, -0.83), but not specified type-2 diabetes. Conclusion: Although the study was limited by the few trials (review) and SNPs (two-sample MR), we demonstrated that the single zinc supplementary improved glycemic control among type-2 diabetes patients with causal evidence to a certain extent.

Effect of Zinc Supplement on Severity Of Acute Diarrhea Among Childern Under Five Years Of Age

According to World Health Organization (WHO) approximately four million children less than 5 years of age in Asia, Africa, and Latin America die annually from diarrhea; and 80% of these deaths occur in the first year of life. Objective: To see how a zinc supplement influences the severity of acute diarrhea in children under the age of five. Methods: In current study, we analyze the effect of zinc on diarrheal patients. Zinc was randomly assigned to diarrheal patients in different concentration 5 mg, 10 mg, 15 mg and 20 mg. There were two groups in our study, treatment and control group. Results: The results are presented in the form of descriptive and inferential statistics. In T1 (Treatment Group) number of Diarrhea patients < 1 Year of age were 16, 2-4 years of age were 45, 4-5 years of age and maximum no of patients in T1 < 2 year of age were 57. Number of male patients were 84 while female patients were 67 in T1.In T2 (Control Group) number of male patients were 92 while female patients were In T1 number of patients residing in urban area were 51 while rural were 100. In T2 number of urban were 69 while rural were 82.Number of patients stay in the hospital for one day were 67 ,15 for Four days and only 1 for seven days in T1. In T2 number of patients stay in the hospital for one day were 29, 17 for four days and only 6 for seven days. In T1 number of Patients with watery diarrhea were 87, Mucoid consistency of stool were 31,soft consistency of stool were 23 and formed consistency of stool were 9.In T2 watery diarrhea were 92,Mucoid consistency of stool were 25,soft consistency of stool were 31 and formed consistency of stool were 4. Frequency of stool significantly reduced (P<0.005) at 7th day of zinc treatment while consistency of stool was significantly improved (P<0.005) at day 3 and day 5 of zinc treatment. Children who received zinc supplements showed a marked improvement in all outcome measures, suggesting that this deficiency is amenable to correction by replacement.

Formulation and Efficacy of Plaksha (Ficus lacor) Ointment in the Management of Non-Healing Ulcer

Chronic infected wound or non healing ulcer is commonly encountered problem faced in surgico-clinical cases. Wound healing property is most important pharmacological activity of Plaksh or Ficus lacor described by acharya Charaka and Bhavprakash, in an ancient compendia. A male patient aged 55 years, having non healing ulcer on right leg medially above the ankle joint due to trauma, reported to OPD. Wound was irregular with hyper keratinized edges, purulent discharge with foul smell, itching, redness and inflammation. Wound was cleaned with normal saline aseptically and ‘malhar’ or ointment which was prepared by using stem bark of Ficus lacor, was applied locally every day, for thirty days followed by alternate day for next fifteen days. ‘Malhar’ or ointment was prepared as per the formulation mentioned in ‘Ras tarangini’, an ancient compendia. Vitamin C, B complex and Zinc supplement was given orally. After forty five days, wound healed with healthy granulation tissue, purulent discharge and foul smell was totally absent .Bark contains phytochemicals like tannins, polyphenols caffiec acid. It possesses antioxident, anti-inflammatory, antibacterial, astringent activities. Caffeic acid have regulatory mechanism on glucose metabolism in diabetes.

​Expression Profiling of Cytokine-related Genes in the Small Intestine of Healthy Pre and Post-weaned Piglets Administered Orally with Probiotic and Zinc

Background: The present study was designed to evaluate alterations in the immunological status of the small intestine after dietary inclusion of probiotic and zinc in pre and post-weaned piglets. Methods: For the present study, 18 healthy Large White Yorkshire (LWY) piglets, irrespective of sex, were divided into three different age groups [pre-weaning (20 days old, n = 3), weaning (30 days old, n = 3) and post-weaning (60 days old, n = 3)]. The piglets were weaned at 28 days of age. They were divided into control group (C) fed with basal diet and treatment group (T) fed with combined probiotic and zinc oral supplement along with the basal diet. A probiotic mixture consisted of Lactobacillus acidophilus, Lactobacillus rhamnosus and Bifidobacterium longum (1.25x109cfu/d for 10 days) along with zinc supplement (ZnO @ 2000 ppm/d for 10 days) administered orally to the treatment group of piglets. Result: The relative expression of TNF-α, IL-1β and IL-6 genes was significantly higher (P less than 0.05) in the treatment group of piglets as compared to the control group. However, the expression of IL-8, IL-12p40 and IL-18 genes were significantly lower (P less than 0.05) after oral administration of probiotic and zinc to the piglets.

COVID-19 associated mucormycosis during the second wave of pandemic in South India

Background: The incidence of mucormycosis has risen more rapidly during the second wave compared with the first wave of COVID-19 in India. As with the other parts of the country, our state also experience surge of mucormycosis cases among COVID-19 patients admitted in our hospitals. The surge of COVID-19 associated mucormycosis (CAM) which was new for the whole medical community with no prior experience. In this context a prospective descriptive study was conducted.Methods: The study was done at a public sector tertiary care hospital in Kerala, South India from April to June 2021 prospectively.Results: During our study period of three months total 40 cases were reported with diagnosis of mucormycosis. Sex wise 29 (72.5%) were males and 11 (27.5%) were females. The mean age was 55.8+16 years. Thirty three (83%) cases were confirmed to be CAM by real time reverse transcriptase polymerase chain reaction (RTPCR) test. Thirty one (79%) of them have got associated risk factor diabetes mellitus. Twenty six (65%) had undergone steroid treatment. Other associated risk factors were hypoxia 10 (25%), zinc supplement 30 (75%), steam inhalation 14 (35%), and intensive care unit (ICU) admission 6 (15%). All the cases were rhino orbito cerebral type. Majority 26 (65%) received medical and surgical treatment. The outcome wise 16 (40%) patients were discharged after cure and case fatality rate was 4 (10%).Conclusions: In our study CAM was highly associated with increasing age above 50, diabetes, steroid use and zinc supplementation. The health care workers and patients should be made aware of the importance of glycemic control, over use of steroids.

A Physiological Approach to Study the Interaction of Cadmium and Zinc in Groundnut (Arachis hypogaea L.) Seedlings

Background: Heavy metal toxicity affects plant growth and alters physiological processes. Soils in many areas are often contaminated by cadmium and zinc which show varied response on plants by their interactive effects. The experiment was done to study the effect of cadmium and zinc as sole presence and in combination in groundnut seedlings. Methods: The laboratory experiment was conducted on groundnut cultivar TG 51 in sand culture using modified Hoagland solution. After initial screening, three concentrations of cadmium (Cd 100, Cd 300 and Cd 500 µM) and two concentrations of zinc (Zn 50 and Zn 150 ìM) were selected for studying their effects individually and in combination on physiological and biochemical parameters. Result: The reduction in root length increased over control as the concentration of cadmium in the medium increased. Cadmium or zinc alone led to a decrease in chlorophyll a, b and relative water content of the leaf. Zinc supplement at 150 µM not only mitigated the negative effect of Cd 100 µM and 300 µM, but also increased the chlorophyll content above control level. Zinc supplement not only increased the protein content over the control but also mitigated to some extent the adverse effects of cadmium in protein content when applied in combination. Under both cadmium and zinc treatment, the inhibition of nitrate reductase (NR) activity over unstressed control was found. Different treatment combinations, however, reduced the negative effects of cadmium, although zinc could not completely override such damage, change the level of toxicity. Treatment with Cd 100 µM and 300 µM induced an increase in phenol content over the control, while higher concentration (500 µM) of the metal led to a decrease in this potent antioxidant compound. Presence of Zinc in the growing medium significantly enhanced the accumulation of phenolic compounds highlighting its protective role against oxidative damage.

Evaluation of Zinc Supplement on Biochemical Parameters among Pulmonary Tuberculosis Patients

Introduction: Zinc (Zn) is an essential micronutrient in humans, and its deficiency is reported in many disorders, including tuberculosis (TB). The current study's goal is to evaluate the anti-TB effect of Zn supplementation among pulmonary tuberculosis patients. Material and Methods: In this study, 74 newly diagnosed tuberculosis patients referred to Qom Health Center were distributed into two groups of receiving 50 mg of zinc sulfate and placebo. All patients in both groups received the same antituberculosis antibiotics. Before starting treatment and after two and six months of treatment with antituberculosis drugs, the serum levels of zinc and biochemical parameters were measured by atomic absorption spectrophotometry and a RA1000 Auto Analyzer, respectively. Results: After two months of treatment, the serum Zn concentration in the Zn receiving group was higher than the placebo group. After anti-TB treatment, body mass index (BMI) and serum albumin were significantly higher than pretreatment in both groups. The serum alkaline phosphatase changes, uric acid, creatinine, and urea were not significantly different in both groups at different times. Conclusion: The supplementation of Zn micronutrient results in improved BMI, serum Zn, and other biochemical parameters compared to before treatment.