Despite the well-established efficacy of injectable insulin in achieving and maintaining optimal glycaemic control, its acceptance among people living with diabetes (PWD) in India remains disproportionately low. Delayed or inadequate insulin therapy often results in prolonged poor glycaemic control, increasing the risk of diabetes-related complications and contributing to a higher healthcare burden. This review aims to examine key barriers to the initiation and intensification of injectable insulin therapy in India and to explore strategies to address these challenges. A narrative review of the existing literature was conducted to identify barriers influencing the use of injectable insulin. Barriers were categorized into patient-related, healthcare provider (HCP)-related, and healthcare system–related factors. Multiple interrelated barriers were identified. Patient-related barriers include fear of injections, social stigma, and misconceptions regarding insulin therapy. HCP-related barriers involve clinical inertia and limited time for patient education, which delay insulin initiation and intensification. System-level barriers include challenges related to access, affordability, and resource constraints within the healthcare infrastructure. Emerging strategies to overcome these obstacles include structured patient education, focused HCP training, healthcare policy interventions, and innovations such as non-invasive insulin delivery systems. Overcoming barriers to injectable insulin therapy requires a comprehensive, multi-stakeholder approach. Integration of educational, clinical, policy, and technological strategies may improve insulin acceptance and optimize diabetes management outcomes in India.
Abstract Obesity has a disproportionate impact on women’s health across the life course, influencing reproductive, metabolic, cardiovascular, and functional outcomes from menarche to menopause and beyond. This chapter examines the burden of obesity in women and its interface with polycystic ovary syndrome (PCOS), infertility, and heart failure with preserved ejection fraction (HFpEF), while positioning semaglutide as a phenotype-driven therapeutic option within women-centered obesity care. The chapter integrates epidemiologic data, women-specific pathophysiology, and contemporary clinical evidence, including PCOS literature, fertility-related weight-loss data, the 2022 American Heart Association/American College of Cardiology/HFSA heart failure guideline, and Semaglutide Treatment Effect in People with Obesity and HFpEF (STEP-HFpEF)/STEP-HFpEF with diabetes findings. Obesity in women is linked to hyperinsulinemia, hyperandrogenism, chronic inflammation, impaired ovulation, infertility, visceral and epicardial adiposity, and obesity-related HFpEF. Across these domains, semaglutide is presented as a clinically meaningful intervention that can support weight reduction, metabolic improvement, reproductive benefit, and cardiometabolic risk reduction. The chapter emphasizes early risk identification beyond body mass index alone, individualized counselling across reproductive stages, and outcomes-based monitoring relevant to women’s health. Overall, semaglutide is positioned as an important adjunct within a comprehensive strategy to optimize obesity care in women through metabolic, reproductive and cardiometabolic pathways.
Yoga has gained attention as a potential intervention for improving various aspects of health, including sleep quality. Melatonin, a hormone involved in regulating the sleep–wake cycle, has been suggested to play a key role in mediating the effects of yoga on sleep. However, the impact of yoga on melatonin levels remains unclear. The current meta-analysis aimed to evaluate the effect of yoga on melatonin levels based on existing studies. A systematic literature search was conducted to identify studies investigating the impact of yoga on melatonin levels. Five eligible studies were included, comprising a total of 196 observations. The standardized mean difference (SMD) was calculated as the effect size measure. The current meta-analysis was performed using a random-effects model to estimate the pooled SMD, along with 95% confidence intervals (CIs) in R software (version 4.3.2). Heterogeneity across studies was assessed using the I 2 statistics. Totally five studies were included in the current meta-analysis. The meta-analysis revealed a moderate certainty of evidence on the role of yogic techniques on melatonin levels, with a pooled SMD of 0.37 (95% – CI: [0.09; 0.66]). This meta-analysis provides evidence supporting the regular practice of yoga, including meditation and mantra chanting, in enhancing the melatonin levels. This increase in melatonin may contribute to improved sleep quality. These results underscore the potential of yoga as a nonpharmacological approach for enhancing sleep health and overall well-being. Further research is needed to elucidate the underlying mechanisms and optimal practices for incorporating yoga into sleep management strategies.
Biocomfort, which is shaped depending on the suitability of climate parameters, is an important criterion that affects people's comfort, peace, happiness and performance, as well as their health. Therefore, determining suitable areas in terms of biocomfort and using them as a base in the planning of residential areas is of great importance in terms of both human health and happiness and energy efficiency. In this study, suitable areas in terms of wind, temperature, relative humidity and biocomfort, which shape the biocomfort situation in Ordu, which is one of the largest cities in Turkey and whose population is constantly increasing, were determined on a monthly basis. As a result of the study, it has been determined that the wind speed, temperature and relative humidity parameters that are the subject of the study prevent the formation of biocomfort areas to a large extent. While the wind speed causes the formation of uncomfortable areas in January, February, March, April, October, November and December, there are areas where the temperature is below 15 °C in many months, and high humidity causes the formation of uncomfortable areas every month. Suitable areas in terms of biocomfort account for 0.4% of the surface area of Ordu in May, 1.36% in June, 1.45% in July, 1.77% in August, and 8.06% in September. In January, February, March, April, November and December, the entire province is within the scope of uncomfortable areas.
Several previous investigations and studies utilized silica fume (SF) or (micro silica) particles as supplementary cementitious material added as a substitute to cement-based mortars and their effect on the overall properties, especially on physical properties, strength properties, and mechanical properties. This study investigated the impact of the inclusion of silica fume (SF) particles on the residual compressive strengths and microstructure properties of cement-based mortars exposed to severe conditions of elevated temperatures. The prepared specimens were tested and subjected to 25, 250, 450, 600, and 900 °C. Their residual compressive strengths and microstructure were evaluated and compared with control samples (CS) subjected to similar conditions (the same temperature category). The outcomes indicated that including silica fume particles in mortar mixtures lowered the amount and width of microcracks, upgraded the mass-loss performance, lowered crystalline calcium hydroxide, and reinforced the cement paste, which explained the improvement in residual mechanical strengths.
