European Journal of Molecular & Clinical Medicine

Overweight was defined as a BMI ≥23 kg/m² but <25 kg/m² for both genders (based on the World Health Organization Asia Pacific Guidelines) with or without Abdominal Obesity (AO). Generalized Obesity (GO) was defined as a BMI ≥ 25 kg/m² for both genders (based on the World Health Organization Asia Pacific Guidelines) with or without AO. Ghrelin is synthesized as a pre-prohormone, in the epithelial cells lining the fundus of the stomach, with smaller amounts produced in the placenta, kidney, pituitary and hypothalamus.Ghrelin is an appetite-stimulating hormone that increases growth hormone secretion and food intake in humans. Furthermore, ghrelin regulates several physiological processes, including glucose metabolism, insulin secretion, gastric emptying, cell proliferation,learning and memory, stress and anxiety

Supplementation of vitamin D with Oral hypoglycaemics is known to reduce the levels of blood glucose. This study evaluated the role of vitamin D and its combination with metformin on blood glucose level, body weight and assess the effect on serum IL-6.
Material and Methods: An experimental study was conducted in Department of Pharmacology and Therapeutics, King George’s Medical University, Lucknow. Total of 30 wistar rats divided into 5 groups with 6 rats in each group. All rats were induced type 2 diabetes after administration of high-fat diet (HFD) for 2 weeks followed by an intraperitoneal (i.p.) injection of single low dose of streptozotocin (STZ) (35mg/Kg) dissolved in cold sodium citrate buffer (pH 4.5, 0.1 M)  in a dose volume of 1ml kg−1 except the first group that served as control untreated group. A total of 6 diabetic rats treated with an oral dose of vitamin D₃ (500IU/day) with metformin (200 mg/day) for 7 weeks along with HFD comprised the Group 3 of the study while another 6 diabetic rats treated with an oral dose of vitamin D3 (100IU/day) with metformin (200mg/day) for 7 weeks along with HFD comprised Group 4 and 6 diabetic rats treated with metformin (200mg/kg) for 7 weeks along HFD who comprised Group 5 of the study.
Results: A total 6 rats were fed on normal pellet diet throughout the experiment. There was a statistically a significant difference in the blood glucose levels in this study (p<0.05). The intergroup comparison also shown the same. The intergroup comparison of IL-6 had also shown a significant difference (p<0.05). The post hoc analysis had also shown a significant difference between the groups.
Conclusion: The authors conclude that there is a significant reduction of serum glucose and IL-6 levels in rats treated with the combination of Vitamin D and Metformin than the controls.

A reliable predictive indicator for the course of critically ill patients' conditions is lactate. Metformin users have increased lactate levels at ICU admission without a concurrent rise in mortality, according to a number of small studies. In a wide range of patient populations, elevated lactate has been linked to greater mortality. The purpose of this study was to evaluate lactate levels and compare 30 days mortality in intensive caredunit patients who had and had not previously received metformin medication. Material and Method: This study included patients admitted in intensive care units of Assam medical college between June 2021 to May 2022 with at least one blood lactate level between 12 hr. before until 6 hr after ICU admission. The statistical analysis of the data was done with Microsoft Excel 2010 and the statistical package for social sciences, SPSS for Windows, version 20.0. Chicago: SPSS Inc. Results: The mean lactate in survivors was 3.05 mmol/L with a standard deviation of 2.41 and was lower than that in non-survivors, where it was 4.01 mmol/L with a standard deviation of 2.39.  Non-survivors had a higher distribution of lactate levels than do survivors. Since the p-value was 0.001, which was highly significant, it may be concluded that lactate levels and survival were related. Metformin was used by both 64% of survivors and 30% of non-survivors. 36% of those who did not take metformin lived, compared to 70% of users. The use of metformin and survival were significantly correlated, as shown by the p-value of 0.001, which was highly significant. Conclusion: Lactate concentrations were significantly correlated with mortality in this observational study. Early lactate levels were an important predictor of mortality in critically ill patients admitted to the intensive care unit, and higher preadmission metformin use in survivors demonstrated metformin's important contribution to higher survival rates.

Background: Polycystic ovary syndrome (PCOS) is a heterogenous disorder and current proposed diagnostic criteria include a number of disorders with similar phenotypes but radically different etiologies. Menstrual irregularities are the most common finding among women with PCOS. The aim of this study to determine the effect of metformin on clinical features, metabolic, endocrine profile and insulin sensitivity in polycystic ovarian syndrome (PCOS) patients at newly established tertiary care center.
Materials& Methods: A hospital based prospective study done on 30 obese women with PCOS attending in the department of Obstetrics and Gynaecology at Government Medical College, Pali, Marwar, Rajasthan, India. Thirty females aged 18-35 years having polycystic ovarian syndrome were enrolled and studied for a period of 6 months. The observations were recorded on day 0 and day 180 for various parameters and they were statistically evaluated by using student (paired) t-test for comparison from day0 to day180.
Results: Metformin treated patients showed significant improvement in all parameters i.e. Physiological parameters (Bodyweight, BMI, Systolic blood pressure except diastolic blood pressure), Metabolic parameters (Fasting blood glucose, Fasting serum insulin), Endocrinal parameters (Serum testosterone) indicating that Metformin is of benefit in reducing insulin resistance.
Conclusion: We concluded that Metformin treated patients showed significant improvement in all parameters (except diastolic blood pressure) indicating that Metformin is of benefit in reducing insulin resistance. It seems that Metformin has a direct effect on human ovarian steroidogenesis in addition to reduction of weight and body mass index.

The current work aims to determine the effect of metformin on some antibiotics' efficacy against some bacterial isolates; moreover, determination of fractional inhibitory concentration (FIC) index. Six bacterial isolates (Staphylococcus aureus, Streptococcus viridans, Proteus mirabilis, Pseudomonas aeruginosa, Klebsiella pneumoniae and E.coli) diagnosed by VITEC-2-Compact. Several metformin concentrations (100 ug, 200 ug, 300 ug, 400 ug and 500 ug) were prepared and tested for the sensitivity of selected isolates to determine the best inhibitory concentration of bacteria. Used the disc diffusion method to determine the antimicrobial activity of metformin alone and when combined with antibiotics against all isolates after preparing MIC for each antibiotic. FIC index was measured by checkerboard assays of a combination of antibiotics with metformin to determine the types of reactions. Metformin showed the best antibacterial action against the bacterial strains at a 500 μg/ml concentration, it's increased the effectiveness of the antibiotic in inhibiting bacterial isolates by the desk diffusion method with a significant difference at (P <0.05). About the FIC index, found that most of the interactions were partial synergies of 50%, metformin was recorded with amikacin as the highest reaction (partial synergy). Synergy interaction recorded in 11.11% of the tests, while additive and indifferent reactions was recorded similar rates at (16.16%), and only 5.55% of outcomes were indeterminate. Importantly, there were no antagonistic interactions between metformin and the used antibiotics. E. coli was the most bacteria that reported a synergistic reaction when metformin was combined with amikacin and gentamicin

Background: Diabetes mellitus is a metabolic disorder due to absolute or relative insulin deficiency. Polyuria in type 2 DM leads to loss of important water soluble nutrients in urine. In view of widespread deficiency of vitamin B12 in our country and increasing prevalence of diabetes mellitus type 2, it is considered worthwhile to assess vitamin B12 status of patients with diabetes mellitus type 2.
Material and methods: Present study comprises of 60 subjects of both sexes whom 30 are healthy controls and 30 are clinically confirmed cases of diabetes mellitus, age group ranges from 40-70 yrs. Serum separated from plain vial after centrifugation was used for estimation of serum vitamin B12 by ELISA, Plasma glucose estimation by GOD-POD Method, End Point, Glycated hemoglobin by Boronate Affinity chromatography (NycoCard).
Result: In our study it was found that serum vitamin B12 (218.24 ± 68.31 pg/ml) was significantly lower in type2 diabetes mellitus patients compared to serum vitamin B12 (254.20 ± 64.89 pg/ml) of controls. Serum vitamin B12 level (190.20 ± 19.44 pg/ml) is significantly lower in diabetes mellitus patients who were suffering from the disease for more than 3.5 years as compared to serum vitamin B12 level (257.18 ± 88.74 pg/ml) of diabetes mellitus patients who were suffering from the disease for less than 3.5 years.
Conclusion: Thus, it can be concluded that there is significant vitamin B12 deficiency in type 2 diabetes mellitus patients.

BACKGROUND: Gestational Diabetes mellitus (GDM) is defined as Glucose
Intolerance, the valuesof plasma glucose falling in the range of Diabetes which is
observed and detected for the first
timeduringsecondorthirdtrimesterofpregnancy.GDMisquite
oftenassociatedwithhighermaternalandneonatalmorbiditiesin theshort andlong-term
andpredisposesbothwomen andchildto laterdevelopment of type 2 Diabetes
OBJECTIVE OF THE STUDY: the objective of our study is
tocomparematernalandneonataloutcomesinGDMpatientswhoareonmetforminandinsulin.
MATERIALS &METHODS: the study on evaluation of metformin versus insulin
therapy in themanagement of gestational diabetes was conducted in dept. of OBG Adesh
Institute of
MedicalSciences,Ambalaafterobtaininginstitutionalethicalcommitteeclearanceforaperiod
ofoneyearfromJanuary 2021 to December 2021 in the age group of 26-35 years.
Maternal and neonatal outcomesrecorded include: maternal: incidence of pre-eclampsia,
PIH, neonatal outcomes include: macrosomia,birth weight, the incidence of small for
gestational age, prematurity, Apgar score at the age of 5 min,hypoglycaemia. We also
compared the mode of delivery (spontaneous, assisted or caesarean section)between the
two groups. RESULTS & CONCLUSIONS: It is quite evident from in our study
thattherewerenostatisticallysignificantdifferencesinboththegroupswithrespecttomaternalc
omplications, mode of delivery and neonatal complications. In our study, we found that
the oral antidiabetic medication metformin is equally effective as insulin in the treatment
of GDM patients andwithout higher risks for maternal or neonatal complications.
However, further randomized clinicalstudies with large number of patients and with
long-term follow-up of children is needed to
determinetheroleofMetforminasanalternativetreatmenttoinsulinin GDMpatients

BACKGROUND: Gestational Diabetes mellitus (GDM) is defined as Glucose
Intolerance, the valuesof plasma glucose falling in the range of Diabetes which is
observed and detected for the first
timeduringsecondorthirdtrimesterofpregnancy.GDMisquite
oftenassociatedwithhighermaternalandneonatalmorbiditiesin theshort andlong-term
andpredisposesbothwomen andchildto laterdevelopment of type 2 Diabetes
OBJECTIVE OF THE STUDY: the objective of our study is
tocomparematernalandneonataloutcomesinGDMpatientswhoareonmetforminandinsulin.
MATERIALS &METHODS: the study on evaluation of metformin versus insulin
therapy in themanagement of gestational diabetes was conducted in dept. of OBG Adesh
Institute of
MedicalSciences,Ambalaafterobtaininginstitutionalethicalcommitteeclearanceforaperiod
ofoneyearfromJanuary 2021 to December 2021 in the age group of 26-35 years.
Maternal and neonatal outcomesrecorded include: maternal: incidence of pre-eclampsia,
PIH, neonatal outcomes include: macrosomia,birth weight, the incidence of small for
gestational age, prematurity, Apgar score at the age of 5 min,hypoglycaemia. We also
compared the mode of delivery (spontaneous, assisted or caesarean section)between the
two groups. RESULTS & CONCLUSIONS: It is quite evident from in our study
thattherewerenostatisticallysignificantdifferencesinboththegroupswithrespecttomaternalc
omplications, mode of delivery and neonatal complications. In our study, we found that
the oral antidiabetic medication metformin is equally effective as insulin in the treatment
of GDM patients andwithout higher risks for maternal or neonatal complications.
However, further randomized clinicalstudies with large number of patients and with
long-term follow-up of children is needed to
determinetheroleofMetforminasanalternativetreatmenttoinsulinin GDMpatients

Background : This study aims to determine the effect of a combination regimen of
metformin and without metforminon the conversion of sputum smear in new cases
of pulmonary TB patients with type 2 DM.
Materials andMethods: This cross-sectional study was conducted at Wahidin Sudirohusodo
Hospital, Makassar Center for Lung Health, Kasi-Kasi, and Sudiang Community
Health Center from August 2019. This study involved 83 new cases of pulmonary
TB subjects with T2DM. New cases of pulmonary TB patients were obtained by examining AFB sputum in DM patients who had symptoms of pulmonary TB and had no history of suffering or receiving previous anti-TB drug therapy.Pulmonary TB patients receive category 1 anti-TB drugs andDM subjects were divided into 2 groups is metformin and non-metformin. Then, smear sputum is examined in the 2-month intensive phase of anti-TB drug therapy to assess the conversion of AFB sputum.
Results: From a total of 83 new cases of pulmonary TB and T2DM, 44 subjects received a combination regimen of metformin and 39 subjects non-metformin. In this study, there were 42 (95.5%) subjects who conversion sputum smear in the metformin group more higher than in the  non-metformin group but statistically it was not significant (p = 0.282).
Conclusion: There was no significant relationship between the metformin and non-metformin groups on the conversion of AFB sputum smear in new cases of pulmonary TB patients and T2DM.