3rd International Conference on Endocrinology November 02-04, 2015 Atlanta, Georgia, USA

Kelsey Hinther completed her Bachelor of Science in 2013 from University of Saskatchewan. She is currently a third year medical student at the University of Saskatchewan. She has profound interest in research and would like to continue to be involved in research in her future career.

This retrospective pre-post study analyzed if dialysis patients with secondary hyperparathyroidism who receive a postoperative standardized order set of intravenous calcium following a subtotal parathyroidectomy (PTX) will have shorter hospital stays. The medical records of dialysis patients who underwent subtotal PTX for symptomatic secondary hyperparathyroidism were reviewed prior to and after the introduction of a standard postoperative order set. The gender, duration of hospital stay as well as readmission rates of all patients were analyzed. The study population included 50 patients, with a mean age of 49 years. 25 patients were administered the standardized order set of intravenous calcium treatment following a subtotal PTX. There was no statistical difference (p = 0.7063) between the length of hospital stay in the group of the patients that received the post-operative standardized order set of intravenous calcium and the group that did not. Only 1 patient was readmitted during the study period. There was no statistical difference in the length of hospital stay between the dialysis patients with secondary hyperparathyroidism who received the standardized order set of intravenous calcium and the patients who did not following a PTX. This could have been largely due to limitations of the study, including a small sample size and a non-randomized study design, and not examining other metrics, including the number of inpatient episodes of significant hypocalcaemia and nursing time. Further studies are warranted to assess postoperative hypocalcaemia in the setting of PTX, including studying a larger sample size, utilizing various order sets, and taking into account patient co-morbidities.

Dhaval Save has finished his medical school from Seth GS medical College, Mumbai, India and is currently PGY-2 of his residency in Internal Medicine at John H Stroger Jr Hospital of Cook County in Chicago, IL. This clinical vignette was written under supervision of Joy Bressler MD who is an Attending Physician at department of Medicine at John H Stroger Hospital.

Introduction: The synchronous occurrence of malignancy in the TGC and thyroid gland is extremely rare. We report a case of coexistence of papillary carcinomas in the TGC and Follicular carcinoma thyroid gland. Case: 48 year old African-American female with no significant medical history presented with a neck swelling present since birth, but growing rapidly for the past 6-7 months. Physical examination was pertinent for midline, cystic, tense, mobile, illuminant neck swelling of 6 x 5 centimeter (cm), moving with swallowing and protrusion of tongue. Laboratory findings were unremarkable including normal thyroid function tests. Chest radiograph revealed a rightward deviated trachea. Thyroid Ultrasound demonstrated a 6.0 x 4.4 x 5.4 cm complex cystic mass above isthmus with internal vascularity, micro-calcifications, and a 5.4 x 3.3 x 4.3 cm hyper-echoic nodule within the lower pole of the left lobe with internal vascularity but no calcification. A Computed tomographic (CT) scan of the neck revealed a large irregular enhancing solid cystic mass, likely TGC, and a large solid mass in the left lobe of thyroid gland. Fine Needle Aspiration cytology (FNAC) of the cystic neck mass was non diagnostic. Patient underwent Sistrunk Surgery for TGC removal and a biopsy of thyroid mass. Pathology was positive for papillary carcinoma arising in a TGC with no vascular invasion and margins free of carcinoma. Biopsy of the thyroid mass showed an atypia of undetermined significance. Patient underwent total thyroidectomy. Pathology showed a follicular thyroid carcinoma variant with focal Hurthle cell differentiation. Patient was referred for radioactive iodine therapy. Discussion: Malignant transformation is a very rare(less than 1%) complication of TGC. Papillary Carcinoma is the most common type (80%) with a median age of development being 40 years. It usually presents as an asymptomatic mass but rarely as a rapidly enlarging mass causing dysphagia, voice change and draining cutaneous sinus. TGC carcinoma can be a primary malignancy or secondary to metastasis from primary thyroid gland carcinoma. Our case represents the primary TGC carcinoma for the following reasons: 1. Lack of lymph node involvement. 2. Absence of any patent tract from thyroid to TGC. 3. Fibrous encapsulated cyst on gross appearance. 4. Pathologically different malignancy in a thyroid gland with no local lymph node spread. In our case a Sistrunk operation was done as FNAC was inconclusive. Total thyroidectomy and central compartment neck lymph node dissection was performed after positive histopathology for TGC papillary carcinoma. Both malignancy diagnoses were made post-operatively on histopathology. This case is an interesting and rare clinical vignette.

Shamima Yeasmin has completed his MD from Dhaka Medical College, Bangladesh, PhD from Shimane Medical University, Japan, Postdoctoral Fellowship at University of Michigan, USA. Dr.Yeasmin has more than 25 publications (research and clinical). She has been serving is an active associate member of American Association of Cancer Society since 2009. Currently, she is doing residency in internal medicine at St Vincent’s Medical Center, Bridgeport, CT.

Introduction: Published case reports have documented the relationship between exenatide use and acute kidney injury. However, to our knowledge, few cases of this adverse effect with iraglutide, another glucagon-like peptide-1 receptor agonist approved for the treatment of type 2 diabetes mellitus, have been reported. Case: We describe a 60-year-old Caucasian woman who came to a community hospital with progressively worsening gastrointestinal symptoms for 1 week, leading to dehydration and development of acute kidney injury. No history of recent NSAID use and radiological contrast studies. 2 weeks earlier, the patient had begun liraglutide 1.8 mg/day subcutaneously for uncontrolled type 2 diabetes Laboratory results showed an increase in her serum creatinine concentration to 8.5 mg/dl. Use of the Naranjo adverse drug reaction probability scale indicated a possible relationship (score of 3) between the patient’s development of acute kidney injury and liraglutide. Laboratory testings were helpful in ruling out other potential causes of renal failure and adverse drug reactions due to other drugs. Based on clinical data, liraglutide was determined to be the most likely cause of acute tubular necrosis. The patient was successfully treated with discontinuation of liraglutide, volume repletion, and hemodialysis. Conclusion: Clinicians should be aware of this possible complication and closely follow liraglutide’s dosage titration recommendations in the package insert. Patients should also be educated about the need to report unusual or prolonged gastrointestinal symptoms.

Mariam has completed Master Degree in General Medicine in Yerevan State Medical University, Armenia. She has worked as a young scientist in Yerevan State Medical University, Division of Science during 2014-2015. Mariam Khachatryan has attended in the International Health Conference 2015, Oxford, St Hughs College. Mariam has been volunteering for humanitarian project with a group of YSMU professors to serve the community by offering them a free consultation every Saturday for already 1.5 year.

The problem of thyroid nodels is very common in thyroidology. Its probability to appear grows with aging. In most cases, thyroid nodules have no clinical signs and the thyroid function stays normal. Although thyroid nodules are so common, malignant nodules appear rarely. The annual incidence of thyroid cancer is 0.5 to 10 per 100,000 of population worldwide. Papillary thyroid cancer constitutes 75 to 80% of cases of clinically recognized thyroid cancer and can often be diagnosed by FNA biopsy. During the period of 2010-2014, 183 patients were operated on with papillary thyroid cancer (pathohistologically diagnosed too) in the clinic of general and endocrine surgery of “Erebuni” MC. 34 of the mentioned patients (18.6%) were diagnosed with Hashimoto’s thyroiditis as a premorbid status, another 51 (27.9%) had adenomatoid hyperplasia as a premorbid status while for the 98 of the patients (53.5%) papillary thyroid cancer was identified de novo. 74 (40.4%) of the patients were below 40 years old while 109 (59.6) were under 40.

Dr. Rima Abdul Razzak has completed her PhD at the age of 25 years from the University of Southampton, England in 1992 and carried out one year postdoctoral work at the same university. She is currently an assistant professor (applied for promotion to associate professor) in the Physiology Dept. at the Arabian Gulf University (AGU) in Bahrain. She has published around 12 papers in reputed journals. She is currently leading a project for implementing e-learning methods into medical education at AGU.

This study aims to assess whether glycemic control (HbA1c levels) in type 2 diabetics affects weighting of visual references during visuo-vestibular conflicts. Diabetic patients were divided into good glycemic control (HbA1c < 7% (53 mmol/mol); n=24) and poor glycemic control (HbA1c ≥ 7%; n = 25) subgroups. Alignment errors on the computerized rod-and-frame test (CRFT) were compared among the two diabetic subgroups and healthy controls (n = 29). Differences in frameless subjective visual vertical (SVV) were nonsignificant between all groups. During frame tilts, SVV errors (Comb18) were significantly larger in the good glycemic group (P < 0.01) only in comparison to the healthy group with no difference with the poor glycemic group. The good glycemic group had the highest asymmetry of visual dependence (2.70 ± 1.51) with all three groups differing significantly on that parameter: healthy controls (0.90 ± 0.92), and poor glycemic group (1.68 ± 1.13). There was no correlation between HbA1c levels and visual dependence or asymmetry index but a significant positive correlation existed between Comb18 and asymmetry index only in the good glycemic control group (r = 0.55, P = 0.007). We conclude that the increased visual dependence in diabetics with good glycemic control may be due to increased otolithic asymmetry. This may suggest that the effects of diabetes on vestibular compensatory mechanisms may be profound even in diabetics with good glycemic control. However, since HbA1c levels are not associated with the increased visual dependence, it seems that other other glycemic disorders such as long-term glucose variability may also be implicated.

Sofia Guerreiro is a in General Surgery Chief Resident in Setúbal Medical Center, Portugal and is a member of Portuguese Endocrinology Society (SPEDM) and Portuguese Surgery Society (SPCIR). She works in Setúbal Medical Center, in General Surgery Department – Endocrine Surgery Unit which is mainly focused in thyroid, parathyroid and adrenal diseases and also neuroendocrine tumors.

Thyroid nodular disease with ≥1cm have a prevalence of 50% (autopsy data). Prevalence of palpable nodules is 4-7% and the detection by ultrasound of any size nodules is about 67%. Prior to performing fine needle aspiration cytology (FNAC): only 14% operated patients had a malignant patology, with its application is over 50%. Material and methods: Retrospective study; 2-year period: July 2012 to July 2014: 1826 fine needle aspiration cytology (FNAC). Evaluated patients undergoing thyroid nodule fine needle aspiration cytology guided by ultrasound in Setúbal Medical Center correlating sonographic data, cytopathology and histopathology of the surgical specimen. The procedure was performed by the same surgeon of the Endocrine Surgery Unit. Sonographic features taken in consideration: presence of halo, irregular shape, irregular contour, microcalcifications, hypoechogenicity, AP> T, vascularization type III. Bethesda classification - the following results have been selected: III follicular lesion of undetermined significance; IV follicular neoplasm; V suspect and VI malignant. Results: Patients aged up to 35 have about 5.5 times more likely (OR: 5.47; p = 0.049) to have a malignant nodule. There is a statistically significant association of CAAF results and the risk of malignancy. When the result of the CAAF was malignant, 100% of the definitive histopathological results were concordant. When the result was suspect, 65% were actually malignant. A noteworthy % higher than reported in the literature for follicular lesions of undetermined significance: 5 to 15% (literature) to 40.7%; and Follicular tumors: 15 to 30% (literature) to 43.5%. We consider this fact important since patients whose cytological result is a FLUS follow the recommendations of Bethesda classification which is repeat cytology after 6 months. But according to our data a very significant percentage of these patients has indeed a malignant disease, and we are delaying surgical treatment. The sonographic characteristics in this study showed low sensitivity. The highest specificity values were obtained for size AP> T (100%), irregular contour (91.7%) and microcalcifications (88.9%). The highest positive predictive value was obtained with AP> T (100%). The sonographic feature with higher accuracy (higher percentage of correct cases - malignant) was vascularization type III (central). There was no statistically significant influence on the number of sonographic features in the risk of malignancy (Fisher's exact test: p = 0.137).

A.M. Bader has completed his PhD and postdoctoral studies from Cairo University, College of Pharmacy. He is a lecturer of biochemistry and molecular biology, Cairo University. Multi-year of research has focused on tumor suppressors, diabetic complications, stem cell transplantation, and molecular and cellular mechanisms of hormone action. He has published more than 10 papers in reputed journals and has been serving as a peer reviewer of 6 academic journals as Journal of Diabetes and its Complications, Anti-Cancer Drugs, and Human and Experimental Toxicology. He is a member of the editorial board of the Donnish Journal of Biomedical Research.

The interaction of advanced glycation end products (AGEs) and its receptor (RAGE) plays an important role in the pathogenesis of diabetes and its complications. A soluble form of RAGE (sRAGE) has been reported as a decoy receptor for AGEs. Oxidative stress is demonstrated in pathological condition such as atherosclerosis and diabetes mellitus. It has been suggested to be involved in the pathogenesis of macro- and microvascular complications. This study was designed to evaluate the effect of glycemic control on sRAGE and oxidative stress markers in type 2 diabetic patients. Seventy patients with type 2 diabetes and 20 healthy subjects were recruited into the study. Blood glutathione (GSH) and plasma total nitric oxide (NOx) levels were measured using commercially available colorimetric kits, blood superoxide dismutase (SOD) activity was measured by the method of Marklund and Marklund; and plasma C-peptide, oxidized LDL (ox-LDL), sRAGE, and VCAM-1 levels were measured using competitive ELISA kits. It was found that plasma sRAGE levels were significantly lower (p < 0.05) while VCAM-1 levels were significantly higher (p < 0.05) in poorly controlled diabetic patients compared with healthy control. Blood GSH levels were significantly lower in diabetic patients compared with healthy control (p < 0.05). Plasma C-peptide, NOx, ox-LDL levels, and SOD activity were not significantly different in diabetic patients compared with healthy control. Plasma levels of sRAGE were negatively associated with circulating VCAM-1 levels in diabetic patients. In conclusion, poor glycemic control decreases plasma sRAGE and increases VCAM-1 levels while good glycemic control improves these abnormalities which provides benefit to diabetic patients.

Mu Yuan is now a PhD student in his 2nd year in Zhejiang University in China. He has published 2 papers in 2015 (one of which has just been accepted).

Background Endocrine disrupting chemicals (EDCs) are chemicals that have the capacity to interfere with normal endocrine systems. One kind of EDCs, bisphenol A (BPA), is mass-produced and widespread. It has estrogenic properties and have been detected in human fluids and tissues. Methods Two hundred and seventeen infertile patients with Fallopian tube obstruction under 41 years old who underwent in vitro fertilization-embryo transfer (IVF-ET) between September 2013 and January 2014 were involved in this study. The concentration of BPA in the urine of these patients was tested. The correlation between the concentration of BPA and IVF outcome was examined. Mice model and Ishikawa cell line were used to assess the effect and study the mechanism of preimplantation exposure of BPA on embryo implantation. Results There is a significant difference of BPA urine concentration between the high and the low implantation rate group of patients (P<0.01). In mice model, preimplantation exposure to BPA on environmental relevant level can lead to less number of implantation sites compare to the control group (P<0.05). RNA-seq shows the transcription level of many genes in PI3K/PDK1/SGK1 pathway were significantly different in the uterus of the dam on embryo day 4 between the high exposure group and control group. Expression of SGK1 on the protein level was significantly lower both in the uterus of the high exposure group in mice model and Ishikawa cell model. (P<0.05) Conclusions: Preimplantation exposure to BPA may lead to implantation failure in humans. PI3K/PDK1/SGK1 pathway may play an important part in the effect of BPA on embryo implantation.

Yu An has completed her PhD of genetics at Fudan University and is a associate research fellow in Institute of Biomedical Science of medical school of Fudan University. Now she is a research scholar at center for human geneticr research of Massachusetts General Hospital of Harvard Medical School. Her research interest is to discover the genetic mechism of developmental disease.

Excessive triple CGG repeats in the FMR1 gene have been widely associated with primary ovarian failure (POF). The number of AGG interruptions and the length of uninterrupted CGG repeats were correlated with repeat instability on transmission. The FMR1 CGG repeats and AGG interruption status had been determined by Triplet-primed polymerase chain reaction（TP-PCR）in 117 POF patients and 82 matched controls. A possible relationship between CGG repeats or AGG interruption and serum FSH concentrations in POF patients and healthy controls was evaluated. We found one POF patient with a premutation allele (73 repeats) in our case-cohort (1/117) was observed, while no such mutations were observed in controls (0/82). Other patients and all controls had CGG repeats in the normal range. There was no significant difference of the incidence of intermediate mutations of CGG repeats between POF patients and controls and also no correlation of CGG repeats with the serum FSH concentrations. Moreover, more individuals with POF carried no AGG interruptions than the controls (4.27% vs 1.83%) but with no statistical significance. This small case-control study failed to find association between CGG repeat sizes or AGG interruptions in the FMR1 gene and Chinese POF women. Further large-sample-size study need to be warranted.

Mr. Lalit Kishore has done B. Pharmacy from C.T. College of Pharmacy, Jalandhar, M. Pharmacy (Pharmaceutical Chemistry) and Ph. D (Pursuing) from M.M. College of Pharmacy, M.M. University, Mullana, Ambala. He is currently Senior Research Fellow in a project funded by CCRH, Dept. of AYUSH. He has published more than 12 papers in reputed journals. He has authored two books in Pharmaceutical Sciences.

Diabetic nephropathy is a long-term complication of diabetes mellitus. Chronic hyperglycemia leads to the generation of reactive oxygen species leading to oxidative stress. Oxidative stress along with hyperglycemia leads to the development of diabetic nephropathy. Bacopa monnieri is widely used in traditional medicine in India to treat various diseases like renal disorders, blood diseases, anemia, nerve tonic and poisoning. The present study was designed to evaluate alcohol extract of B. monnieri aerial parts in diabetic nephropathy in rats. Diabetic nephropathy was induced by intraperitoneal injection of streptozotocin (65 mg/kg) 15 min after Nicotinamide (230 mg/kg, i.p.) administration. Rats were divided into six groups (n=6). Group 1 and 2 were kept normal control and diabetic control respectively whereas Groups 3–5 consist of diabetic nephropathy rats treated with different doses of extracts (100, 200 and 400 mg/kg) for 45 days. Glimipride (10 mg/kg) was used as standard. Diabetic nephropathy was assessed by determining serum glucose, urea, uric acid, creatinine level and tissue histological examination. Tissue antioxidant activity was assessed by measuring level of SOD, CAT, GSH, LPO. Alcohol extract of B. monnieri produced significant attenuation in the serum glucose level, uric acid, creatinine and lipid levels. Administration of extracts improves the level of SOD, CAT, GSH and decrease lipid peroxidation in terms of TBARS. Moreover histopathological examination also revealed the improvement in structural changes in nephrons and regeneration of β-cells. So, it can be concluded that alcohol extract of B. monnieri produced protective effect by decreasing hyperglycemia, oxidative stress and improving the structural disarrangement in kidney of rats.

Ms. Navpreet Kaur has done B. Pharmacy from Guru Nanak Dev University, Amritsar, M. Pharmacy (Pharmaceutical Chemistry) and Ph. D (pursuing) from M.M. College of Pharmacy, M.M. University, Mullana, Ambala. She is presently working as a Senior Research Fellow in a project funded by Department of Science and Technology, Govt. of India. She has published more than 16 papers in reputed journals. She has authored two books in Pharmaceutical Sciences.

Diabetic nephropathy is a chronic complication of diabetes mellitus which leads to end-stage renal disease. Dillenia indica L. (Family: Dilleniaceae) is widely used in traditional medicine to treat various diseases including diabetes. The present study was designed to evaluate the effect of hydro-alcohol extract of D. indica leaves in diabetic nephropathy in rats. Diabetic nephropathy was induced by intraperitoneal injection of streptozotocin (65mg/kg) 15 min after Nicotinamide (230mg/kg, i.p.) administration. Rats were divided into six groups (n=6). Group 1 and 2 were kept normal control and diabetic control respectively whereas Groups 3–5 consist of diabetic nephropathy rats treated with different doses of extract (100, 200 and 400 mg/kg) for 45 days. Glimipride (10 mg/kg) was used as positive control. Diabetic nephropathy was assessed by determining serum glucose, insulin, urea, uric acid, creatinine level and tissue histological examination. Tissue antioxidant enzymes (SOD, CAT, GSH, LPO) level was measured to assess the oxidative stress. Hydro-alcohol extracts of D. indica produced significant attenuation in the biochemical parameters used to assess diabetic nephropathy. Elevated serum blood glucose level was significantly reduced. Moreover, level of antioxidant enzymes was also found to be significantly augmented. So, it can be concluded that hydro-alcohol extracts of D. indica have protective effect against diabetic nephropathy.

Dr. Alexander E. Berezin has received PhD in 1994 in the State Medical University of Zaporozhye (Ukraine). He is currently working as a Professor of Medicine in the State Medical University of Zaporozhye (Ukraine). His research goals are fundamental study of biological markers, the development of cardiovascular prevention and rehabilitation. Based on this research and training in heart failure he has received several awards and honors. He has published more than 550 papers in reputed journals, 19 books/chapters and has been serving as an editorial board member of repute.

The objective of this study was to assess a relationship between insulin resistance (IR) and counts of CD45-CD34+, CD14+CD309+, and CD14+CD309+Tie2+ phenotyped circulating endothelial progenitor cells (EPCs) in patients with ischemic chronic heart failure (CHF). Methods: The study involved 300CHF patients (186 males) aged 48 to 62 years with angiografically proven coronary artery disease and/ or previously defined myocardial infarction. Insulin resistance was assessed by the homeostasis model assessment for insulin resistance (HOMA-IR). EPC populations were phenotyped by flow cytofluorimetry. Results: Circulating EPCs counts were statistically significantly lower in CHF patients with IR than in patients without IR.We found that the most valuable multivariable predictors of the depletion of the CD45+CD34+ EPCs were NT-pro-brain natriuretic peptide (BNP) (1.32; 95% CI=1.19-2.77; P=0.001), left ventricular ejection fraction (OR=1.30; 95% CI=1.09-1.60; P=0.002), NYHA class (OR=1.12; 95% CI=1.02-1.19; P=0.001). NT-pro-BNP (OR=1.45; 95% CI=1.15-2.90; P=0.003), left ventricular ejection fraction (OR=1.32; 95% CI=1.11-1.65; P=0.001) were found as powerful predictors for depletion in CD45-CD34+ EPCs. We also identified six independent variables with high predictive value for depletion of CD14+CD309+EPCs: NT-pro-BNP (OR=1.41; 95% CI=1.15-2.90; P=0.003), left ventricular ejection fraction (OR=1.18; 95% CI=1.10-1.76; P=0.036), NYHA class (OR=1.15; 95% CI=1.07-1.22; P=0.001), hs-C reactive protein(OR=1.02; 95% CI=1.01-1.05; P=0.012). As independent multivariable predictors for depletion in CD14+CD309+ Tie2+EPCs were selected five variables: NT-pro-BNP (OR=1.65; 95% CI=1.44-4.70; P=0.006), left ventricular ejection fraction (OR=1.07; 95% CI=1.02-1.12; P=0.018), NYHA class (OR=1.13; 95% CI=1.06-1.21; P=0.001), hs-C-reactive protein(OR=1.08; 95% CI=1.03-1.16; P=0.002). Conclusion: IR may be considered an additional factor contributing decreased circulating level of proangiogenic EPCs in non-diabetic CHF patients.

Faraz Farishta has completed his post graduation in Internal medicine from Prestigious Osmania Medical College and then did his masters in Endocrinology from Texilla American University and Dip in Endocrinology from university of south wales ,UK . He is the director of Sparsh Endocrinology &Diabetic centers having 5 BRANCHES in India . At the young age of 28 he was heading the department of Diabetology at Apollo Hospitals. He has published more than 20 papers in reputed journals and has more than 100 oral presentations as speaker to his credit .He has been serving as an editorial board member of repute as Reviewer for Journal of Evidence based Medicine & Health care. He is the president of Diabetes Awareness Foundation .

INTRODUCTION: The world health organization definition of diabetes is for a single raised glucose reading with symptoms, otherwise raised values on two occasions, of either (1): Fasting plasma glucose >, 7.0 mmol/l ( 126 mg / dl ) on with a glucose tolerance test, two hours after the oral dose a plasma glucose >> 11.1 mmol/l ( 200 mg / dl ). A Glycated Hemoglobin of greater than 6.5% is another method of diagnosing diabetes (2) as is random blood sugar of greater than 11.1 mmol/l ( 200 mg / dl ) in association with typical symptoms (3) .Globally as of 2010 it is estimated that there are 258 million people diabetes with type 2 making up about 90% of the cases. The term” Dementia ‘’ refers to the clinical syndrome of impairment in multiple domains of cognitive function, which must include memory in a patient who remains alert with normal arousal (4). A recent survey done by Harvard university School of public Health and the Alzheimer’s Europe consortium revealed that the second leading health concern (after cancer) among adults is Dementia (5). We will explore the complex relationship between Dementia and Diabetes in this review. DIABETES AND DEMENTIA TYPES---- RELATIONSHIP. Compared to people without diabetes, people with diabetes have a greater rate of decline in cognitive function and a greater risk of cognitive decline (6). Geert Jan Biessels et al, identified 14 eligible longitudinal population based studies if variable methodological quality to understand relationship between diabetes and major types of dementia’s.The finding of mechanistic studies suggest that vascular disease and alternations in glucose, insulin, and amyloid metabolism underlie the pathophysiology but which of these mechanisms are clinically relevant in unclear (7).Multiple interactions,some of which are yet to be elucidated may underlie the relationship.

Ana Martínez is doing her PhD in biological sciences and health at the Universidad Autónoma Metropolitana, in México, his research project is under supervision of Dr. Juana Luis at the Universidad Autónoma de México and Dr. Marcela Arteaga at the Universidad Autónoma Metropolitana.

In this study, we analyzed the effects of testosterone (T) and its metabolites, estradiol (E2) and dihydrotestosterone (DHT), on the onset of paternal behavior in virgin male Mongolian gerbils (Meriones unguiculatus). We hypothesized that T and E2, but not DHT, would facilitate the onset of paternal behavior. Seventy males displaying aggression toward pups were selected through a paternal behavior screening test. Forty males were bilaterally castrated. Of them, 10 were implanted with T, 10 with E2, and 10 with DHT, and 10 received no treatment. Another 30 males underwent a sham procedure. In these gerbils, T, E2 and DHT were measured to obtain the basal levels of these hormones. After treatment, the paternal behavior test was conducted again. Surprisingly, 100% of the males that received T, E2 and DHT implants stopped being aggressive and became paternal. Castrated and sham-operated males displayed no changes in their aggressive behaviors. This is the first time found that T and its metabolites are involved in neuroendocrine mechanisms that inhibit aggression toward pups and facilitate paternal behavior in virgin male Mongolian gerbils. In addition, this is the first report of regulation of paternal behavior in a rodent by estrogenic and androgenic pathways.

Suravi Majumder is pursuing her PhD in the Endocrinology Laboratory, Department of Zoology, University of Kalyani. She is working under Prof. Dilip Mukherjee. Her topic of interest is “Involvement of G- protein coupled estrogen receptor in oocyte maturation in carp”. She has published 2 papers in reputed journals.

Recent studies demonstrated that G- protein coupled membrane estrogen receptor (GPER) mediates 17β- estradiol activation of signal transduction pathway in the inhibition of oocyte maturation in Atlantic croaker and zebrafish. To determine the broad application of this findings to other teleosts, expression of GPER and its involvement in the estrogen induced oocyte maturation in common carp Cyprinuscarpio was investigated. 17β-estradiol and a GPER agonist, G-1 bound to carp oocyte membrane suggesting the presence of GPER which was confirmed by GPER mRNA and protein expression both in follicle enclosed and denuded oocytes of common carp. Consistent with previous findings in human GPR30, 17"β" -estradiol treatment caused activation of stimulatory G protein resulting an increased in cAMPproduction. Incubation of follicle enclosed oocytes with an aromatase inhibitor; fadrozole, GPER antagonist, G-15 and enzymatic removal of ovarian follicle cell layers significantly increased spontaneous oocyte maturation which was partially reversed by co-treatment with 17β-estradiol. The results indicate that endogenous estrogen produced by the follicle cells inhibited or delayed spontaneous oocyte maturation and this estrogen action was mediated through GPER. Treatment with 17β-estradiol also attenuated the stimulatory effect of 17, 20β-dihydroxy-4-pregnen-3-one (17,20β-P) induced oocyte maturation. Moreover, 17β-estradiol down-regulated the expression of membrane progestin receptor α (mPRα), the 17,20β-P receptor on oocyte membrane. Conversely, 17,20β-P treatment caused a decline GPER level. These results suggest that estrogen and progestin acting through GPER and mPRα control the onset of oocyte maturation in common carp.

Mr. Dipanshu Sur has been pursuing his PhD from Calcutta University. He has published 2 papers in reputed journals and has been serving as research assistant under Dr. Ratnabali Chakravoty, ILS Hospital, Kolkata

Introduction: Great efforts are ongoing in understanding and management of thyroids, the disease and disease related complications are increasingly unabated. It is known that thyroid hormones have an effect on tissue damage. The objective of this study was to determine hypothyroidism causes cellular damage in the heart, lung, thyroid gland and ovary. Methods: In the present investigation an attempt is made to study the cyto-morphological changes in the heart, lung, thyroid glands and ovary caused by methimazole (an antithyroid drug) or hypothyroidism. Twelve female Sprague Dawley rats were divided into 2groups: euthyroid (control) and methimazole-induced hypothyroidism (20mg/kg body weight in 1ml water/day). At the end of the treatments (28 days for each group), the animals were sacrificed. The heart, lung, thyroid glands and ovary were removed and were processed for embedding in paraffin wax and also measure the serum concentrations of thyroid hormones. Coronal sections were stained with hematoxylin–eosin. Results / Discussion: At the end of treatment, animals with the methimazole hypothyroidism had a significant reduction of serum concentration of thyroid hormones. Only methimazole-induced hypothyroidism causes cellular disturbances in the lung, heart, thyroid glands and ovary. Conclusions: These results indicate that tissue damage found in hypothyroidism is caused by methimazole and thyroid hormones have an effect on cyto-morphological alteration of heart, lung, thyroid glands and ovary tissue.

Background: Diabetic retinopathy is the leading cause of blindness in American adults, and between 40 to 45 percent of Americans diagnosed with diabetes have some degree of diabetic retinopathy. Prevention is a key element of primary health care, and strict screening protocols significantly reduce the progression of diabetic retinopathy. Studies have shown that service deprived patient groups presented with significantly more advanced stages of proliferative retinopathy compared to matched cohorts independent of HbA1c values. This study assessed the lack of preventive screening for diabetic retinopathy in the high risk, indigent population of Norfolk, VA. Methods: A survey of past vision care, co-morbidities, and family history of ophthalmologic disorders was administered to all patients of a student-run free clinic in Norfolk, VA (H.O.P.E.S) over a four-month period. A prospective analysis of survey data was performed. Results: Ninety unique patients were seen over the data collection period, and 76 patients were included in analysis. 14 patients were excluded due to incomplete data. Of the surveyed sample, 25% had been diagnosed with diabetes, a substantially higher percentage than the 9.3% prevalence rate reported for the U.S. as a whole. Of these surveyed diabetic patients, 52.6% were overdue for diabetic retinopathy screening according to American Diabetes Association guidelines. Conclusions: Low income, predominantly African American communities are at increased risk for preventable vision losses resulting from diabetic retinopathy. The population serviced by the H.O.P.E.S. free clinic is at severe risk for preventable vision losses, necessitating increased attention and fund allocation to overcome barriers to care.