Obesity is a serious medical condition affecting more than 30 % of Indiana, and 25 % of Unites States pregnant women. Obesity is related to maternal complications, and significantly impacts the health of pregnant women. The objective of this study was to describe the relationship between maternal complications and pre-pregnancy maternal weight.
Background: Metabolic Syndrome (MetS) is a cluster of established cardiovascular risk factors that collectively increase predisposition to major chronic diseases including heart diseases and diabetes mellitus. Citizens of developing countries such as Saudi Arabia are at risk for MetS secondary to industrialization and accessibility to fast foods. In this epidemiologic study, the kingdom-wide prevalence of MetS is determined. Methods: A total of 4578 Saudis aged 15-64 were randomly selected from 20 regions all over Saudi Arabia. Anthropometrics were collected and fasting blood samples collected ascertaining fasting blood glucose and lipid profile. Components of full MetS as defined by the International Diabetes Federation (IDF) were used for screening. Results: The overall prevalence of MetS is 28.3%. Males had a significantly higher prevalence than females (31.4 versus 25.2%; p=0.001). Prevalence of MetS showed a parallel increase with age, and inversely with educational status as well as income. The region also played a significant contributor to MetS. Conclusion: Despite accumulating evidence of an epidemic, MetS remains largely unresolved in the kingdom. Aggressive public campaigns and policies should be implemented to control future damage of MetS in the kingdom. Methods: A total of 4578 Saudis aged 15-64 were randomly selected from 20 regions all over Saudi Arabia. Anthropometrics were collected and fasting blood samples collected ascertaining fasting blood glucose and lipid profile. Components of full MetS as defined by the International Diabetes Federation (IDF) were used for screening. Results: The overall prevalence of MetS is 28.3%. Males had a significantly higher prevalence than females (31.4 versus 25.2%; p=0.001). Prevalence of MetS showed a parallel increase with age, and inversely with educational status as well as income. The region also played a significant contributor to MetS. Conclusion: Despite accumulating evidence of an epidemic, MetS remains largely unresolved in the kingdom. Aggressive public campaigns and policies should be implemented to control future damage of MetS in the kingdom.
20-hydroxyeicosatetraenoic acid (20-HETE) is an eicosanoid metabolite of that has a wide range of effects on the vascular system such as collateral cell growth, the vascular rebuilding of the heart. Metabolic syndrome and 20-HETE have been shown to be correlated together. There is a higher concentration of 20- HETE in Metabolic Syndrome patients. With a higher concentration of 20-HETE patients with metabolic syndrome have symptoms that are more severe. The effect of elevated 20-HETE is negative and can influence cell growth after a myocardial infarction. Myocardial Infarction (MI) is another term for a heart attack. In previous studies, it shows an MI size increases with an elevated level of 20-HETE. During the study, the metabolic syndrome rats and a control group of rats will be induced with an MI for about 30minutes. After rats from both groups are given an MI and 20-HETE antagonist named 20-SOLA which counteracts 20-HETE levels will be given. 20-SOLA treatment was given to the rats at 48hours, 1 week and 8 weeks. The results indicated that the AMPK antibody for both total and phosphorylated showed a significant decrease in 48hour samples. 20-SOLA was found to create equilibrium in 20-HETE levels in all tissue samples and significantly more in JCR MI rats. 20-SOLA aided the decrease in ischemia for both rats, but again results indicate a more reliable significance in JCR MI rats. These findings are relevant to the epidemic of cardiovascular diseases plaguing populations globally At the present moment; the most representative rat strain to study the metabolic syndrome seems to be the obese Zucker rats. These animals are mainly used as obesity experimental model, but they also present changes similar to those seen in human metabolic syndrome. It is mainly caused due to stress, overweight, ageing and inactivity. It creates a cluster of problems like increased blood pressure, excess fat around waist and abnormal cholesterol. Usually, a healthy lifestyle can prevent and cure this disease. Medication may be involved to manage the underlying conditions Memoir: Corinna Lozano is a junior and a second year in the Science Research program run through SUNY Albany. She is a member of peer leadership in which she is the secretary and the town of Pawling’s interact club. She is an active participant in soccer and dance team. When Corinna is out of school she enjoys spending time with her family and volunteering in her community. She is very dedicated to working hard in school and in her sports. She is very friendly and enjoys meeting new people through school programs. Pawling High School is a great environment in which has been bettered by her bright and cheery spirit. The teachers of Pawling High School all enjoy having her as she is super helpful when her fellow peers have a problem. She is currently working with her mentor on her research project that focuses on the effects of 20-HETE.
A an inflammatory disorder of the vasculature and the underlying cause of myocardial infarction and cerebrovascular accident, is responsible for more global deaths compared to any other disease. Although a slight reduction in morbidity and mortality from this disease has been achieved recently because of pharmaceutical intervention and lifestyle changes, this is expected to change in the future due to global increase in obesity and diabetes. Current pharmaceutical therapies against atherosclerosis are associated with a marked residual risk for cardiovascular disease together with other issues such as side effects and patient-dependent efficacy. In addition, many pharmaceutical agents have recently proved disappointing at the clinical level (e.g. agonists of peroxisome proliferator-activated receptors, inhibitors against cholesterol ester transfer protein and phospholipase A2). It is therefore important to develop alternative therapies for the prevention and/or treatment of atherosclerosis. Interest in nutraceuticals as preventative/therapeutic agents in atherosclerosis has recently increased considerably and therefore necessitates anin-depth understanding of their actions together with the underlying mechanisms. We have recently investigated the effects of several nutraceuticals, including hydroxytyrosol and dihomo-gamma-linolenic acid, on several key monocyte/macrophage processes associated with atherosclerosis (e.g. monocytic migration, macrophage polarization, foam cell formation, activation of inflammasome and production of reactive oxygen species). These will be presented in the context of current therapies and those that are being developed.
Background: Multiple factors are involved in the pathogenesis of hypertension in obese individuals. Recent studies have reported a strong association between blood pressure (BP) and resting metabolic rate (RMR). However, it is not known whether this relationship exists for systolic BP (SBP) and diastolic BP (DBP) in obese subjects patients with the metabolic syndrome, in whom several homeostatic mechanisms are impaired. Objective: To evaluate the relationship existing between RMR, to SBP and DBP, Fat Body Mass (FBM), Lean Body Mass (LBM), Body Mass Index (BMI), Blood parameters, in obese subjects with the metabolic syndrome. Methods: Sixty three non-diabetic subjects (27 women, 36 men) who fulfilled the ATPIII criteria for the metabolic syndrome, with a mean age of 50.4±12.5 yrs were evaluated. Mean BMI was 34.6±3.9 kg/m²; % FBM- 40.9±6.6 %; and LBM- 59±0.7%. Basal RMR was 1875.2±420.1 cal/day. Baseline assessment also included 24h ambulatory blood pressure monitoring, clinical and biochemical profiling, subcutaneous periumbilical fat biopsy, region-defined body composition with DEXA and carotid intima-media thickness. The intervention targeted all assessed risk factors and was implemented through frequent interactions with dietitians, an endocrinologists, and physiotherapist expert for physical activity. Results: At the baseline assessment RMR was significantly related to mean 24 h systolic blood pressure (r=0.3 p<0.05). There were significant inverse correlation between RMR to %FBM (r=0.45, p<0.05). RMR was also positively related to BMI (r=0.37, p<0.05) and fasting triglycerides (r=0.28, p<0.05). Conclusion: This report extends and strengthens previous findings that RMR is independently related to SBP. Prior to this study, the relationship between RMR and SBP in metabolic obese subjects had not been explored. This study expanded the findings of Brock and colleagues by showing that REE was significantly related to SBP, independent of several possible confounders found in metabolic obesity.
Labor Inspectors (SLIC) Campaign on psychosocial risks, Austria amended its Occupational Health and Safety Act in 2013 forcing all companies to evaluate and reduce psychosocial stressors. To comply with this law more than 300 companies evaluated the psychosocial risks with the Module2 of Psychosocial Stressors (PBM2). 41 of these companies with 21.216 employees already evaluated the effects of their risk-reducing measures. Data of total revenue, number of employees, and the PBM2 before (t0) and after intervention (t1) were available for 30 companies with19.403 employees at t0. All 30 companies were able to improve their working conditions and reduce work-related distress. The average improvement was 6.5% (on a 100% scale). The best overall development was made in the Work Environment, with 10.3%, followed by Social Climate with 7.6%, the Job Requirements with 5.3% and finally the Work Organization with 2.6%. In the same period, the annual revenue of these companies grew by 8.5% and the Number of employees by 4.9%. Therefore also the revenue per employee increased by 3.4%. Interventions in the context of the mandatory psychosocial risk assessment for Austrian companies led to significant reductions in psychosocial risks and sick leave days. The changes in the Austrian law and consequent implementation improved the working conditions significantly and also led to a positive development in revenue, number of employees, and revenue per employee in these companies It is a simple but potentially paradigm-shifting reality for senior business leaders: healthy employees lead to healthy business metrics. For decades, though, the health management industry has focused primarily on building a value story around medical cost savings. The reality is that for many business line management leaders — such as chief operating officers, VPs of sales or business unit general managers — medical cost savings may not be a priority. Consequently, championing health management programs internally may not align with their business objectives, either. Instead, the health management industry needs to focus on demonstrating the impact of their programs and services on key business performance metrics. These should include industry-specific operational business metrics (retail, call-centers, financial, etc.), and other metrics, such as total revenue per employee, shareholder value and earnings multiples (see Figure 1 below for industry-specific examples). By focusing on the impact of health management programs on business performance metrics, senior Human Resource leaders are more likely to get the attention and support of line management within organizations. This study aimed to find out which countries around the world require psychosocial hazards and workplace violence to be assessed by employers through a mandatory occupational risk assessment process and to compare the type of legislation between countries. We systematically searched the International Labour Office (ILO) “LEGO” database for documents published during the period between December 2017 and February 2018. The search included 132 countries, of which 23 were considered as developed and 109 as developing according to the United Nations. Our review showed that most countries (85, i.e., 64%) have not included mandatory psychosocial risk assessment and prevention in their national occupational safety and health legislation. Moreover, we found differences between developed and developing countries, showing that developed countries more frequently have legislative measures. Within developed countries, we also found differences between countries following the Scandinavian model of workplace health and safety culture and other countries. Moreover, in many countries, workplace violence was prohibited only if it involves an offense to moral or religious customs. In conclusion, the marked difference in psychosocial hazards and workplace violence regulations among countries leads to unequal levels of workers’ protection, with adverse effects on global health.
The study was conducted in a descriptive and cross-sectional manner to determine the factors that influence the sleep quality in oncology patients between December 31, 2016, and December 31, 2017. The participation of 238 patients that were hospitalized in a public hospital in Turkey. The case group consisted of 119 patients who were diagnosed with cancer and hospitalized in the surgery department. The control group consisted of 119 inpatients who were diagnosed with any acute or chronic condition other than cancer and hospitalized in other clinics. The control group was chosen to match the case group pin sociodemographic properties. The properties of the patients were determined using a 29-question survey and the PittsburghSleep Quality Index. Percentage analysis, Kruskal-Wallis test, and Mann-Whitney U test were used for evaluating the data. In the case group patients, 33.6% were diagnosed with stomach cancer, 54.6% were in Stage II of cancer, 98.3% underwent surgical treatment and 28% underwent chemotherapy, 89.7%had treatment-related pain, 52.9% had a chronic disease together with cancer, 63% had their sleep quality partially influenced by environmental factors. The median PittsburghSleepQuality Index score was 5 for the study group and 4 for the control group. It was observed that some of the sociodemographic and clinical properties influenced the Pittsburgh Sleep Quality Index scores. This study has found that both the case and control groups had good sleep quality. It is recommended that nursing interventions should be planned in the case group patients, 33.6% were diagnosed with stomach cancer, 54.6% were in Stage II of cancer, 98.3% underwent surgical treatment and 28% underwent chemotherapy, 89.7%had treatment-related pain, 52.9% had a chronic disease together with cancer, 63% had their sleep quality partially influenced by environmental factors. The median PittsburghSleep Quality Index score was 5 for the study group and 4 for the control group. It was observed that some of the sociodemographic and clinical properties influenced the Pittsburgh Sleep Quality Index scores. This study has found that both the case and control groups had good sleep quality. It is recommended that nursing interventions should be planned in±1.7. participated in the study. The mean overall score of sleep quality was 9.3 ± 3.9, which represents the average sleep quality in most participants. T-test shows that males have better sleep quality than females (t=2.1; 95%CI:0.004-0.25; P<0.01). Also, sleep quality increased with age (r=0.22, P=0.03). Results show that the amount of sleep quality was only moderate in most patients, so it is necessary to take coping strategies to improve their quality of sleep. Sleep problems have become the most common complaint among the elderly. There are a few studies that explored the prevalence of poor sleep quality and its associated factors among the elderly in nursing homes. Therefore, this study aimed to examine the prevalence of poor sleep quality and its associated factors among the Chinese elderly in nursing homes. METHODS: A total of 817 elderly residents, from 24 nursing homes, were included in this cross-sectional study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep quality was defined as PSQI >5. Multiple binary logistic regression was used to estimate the strength of the association between risk factors and poor sleep quality in terms of adjusted odds ratios (AORs) and their 95% confidence intervals (CIs), and interactions of risk factors for poor sleep quality were also examined. The prevalence of poor sleep quality was 67.3% (95% CI: 64.0, 70.5%) among the Chinese elderly in nursing homes. Multiple binary logistic regression results showed that participants with the following characteristics had an increased risk of poor sleep quality after adjustments for other confounders: being 70-79 years old (AOR: 1.78, 95% CI: 1.08, 2.92) or 80 years old and above (AOR: 2.67, 95% CI: 1.68, 4.24); having one to two kinds of chronic diseases (AOR: 2.05, 95% CI: 1.39, 3.01) or three or more kinds of chronic diseases (AOR: 2.35, 95% CI: 1.39, 4.00); depression symptoms (AOR: 1.08, 95% CI: 1.04, 1.11), anxiety symptoms (AOR: 1.11, 95% CI: 1.05, 1.18), and social support(AOR: 0.97, 95% CI: 0.95, 0.99). Additive interactions were detected between age and anxiety symptoms (AOR: 8.34, 95% CI: 4.43, 15.69); between chronic disease and anxiety symptoms (AOR: 8.61, 95% CI; 4.28, 17.31); and between social support and anxiety symptoms (AOR: 6.43, 95% CI: 3.22, 12.86). The prevalence of poor sleep quality among the elderly in nursing homes is relatively high. Besides, anxiety symptoms have additive interactions with age, chronic disease, and social support for poor sleep quality. These findings have significant implications for interventions that aim to improve sleep quality among elderly residents in nursing homes.
The spread of coronaviruses (COVID-19) universally resulted in many deaths and hospitalizations. It affects respiratory tract and causes fatal lung disease in humans. The pandemic virus can spread from patients carrying the virus through droplets, direct contact, aerosols, touching any surface contaminated surface; closed places may be a cause of spread also. All of the people are prone to have this pandemic virus, especially diabetic patients, as the increment of their blood glucose levels enhance glycosylation end-product formation, pro-inflammatory cytokines, oxidative stress and can activate the production of adhesion molecules that mediate tissue inflammation. Monitor blood glucose level is the main cause to avoid the complication of COVID-19. This review aims to discuss the relation between COVID-19 and diabetic patients and provides some solution to manage COVID-19 and diabetes
Marfan syndrome is the most common genetic disorder of connective tissue. One complication that threatens the lives of patients is progressive dilatation of the ascending aorta with development of aortic valve regurgitation or the emergence of dissection, often leading to sudden death. Until now, these patients were operated only after dilatation of the ascending aorta causing hemodynamically significant regurgitation of the aortic valve. The surgery consisted of the replacement of the ascending aorta and aortic valve or valve sparing procedure. This new method is a preventive operation. The method involves creating a custom made external support of the root and the ascending portion of the aorta. Based on the CT examination, prosthesis Extent is created. The surgery is performed from the longitudinal median sternotomy without cardiopulmonary bypass. Entire aortic root is dissected to its origin from the left ventricle, ostia of the coronary arteries are encircled, the prosthesis is pulled underneath and fixed to the root and then sutured longitudinally. It is interesting that the prosthesis was developed and as the world’s first has it sewn on himself (Mr Tal Golesworthy), 13 years ago in Oxford. Neither him nor the other 100 patients operated in this department with this disease had dilation or dissection throughout the study. It is because the prosthesis grows over time into the aortic wall thereby enforces it while maintaining the elastic properties of the wall. At our institute, we have so far experience with operations of 20 patients, with good results. This operation moves the care of patients with Marfan syndrome to qualitatively higher level Biography Jan Pirk has completed his Graduation from the Faculty of General Medicine, Charles University in Prague. After completion of his Graduation, he worked at the District Hospital in Nymburk from 1972 until 1974. He has been working in the Institute of Clinical and Experimental Medicine (IKEM) from 1974 until now. From 1991 to May 2017, he was the Head of the Clinic of Cardiovascular and Transplantation Surgery and since 1995 he has been the Head of the Cardiocentre. In 1990-1991, he worked as a Consultant at Odense University Hospital in Denmark. He is a Member of a number of national and international scientific organizations. In his free time, he is mostly engaged in sports and likes theater.
For cell therapy on myocardial infarction, many kinds of cells have been studied. In our experience since 2001, the implant of mesenchymal stem cells CD34+ obtained from peripheral blood showed inconsistent improvement in the contractile function of infarcted myocardial tissue, but better survival in long term. For improved cell therapy, in 2014 we characterized the kind of cells that were mobilized to peripheral blood in patients with acute myocardial infarction, which were identified as a response of bone marrow to myocardial insult. In 2015, we began a clinical trial with CXCR4-stem cells and specific cells markers in patients with old myocardial infarction and reduced LVFE. Cells with specific markers were separated with immune-magnetic autoMACS Pro Separator machine and implanted on infarcted myocardial tissue guided by epicardial ultrasound. Results: To the date we have evaluated 15 patients followed by 12 months, we observed a standardized respond in myocardial perfusion and LVEF at six months, as well as improvement in their functional class from NYHA III to I in all patients. Conclusion: CXCR4-stem cells with specific cells markers improve the myocardial perfusion and contraction of left ventricle in patients with old myocardial infarction in a standardized way. Biography Jose Luis Aceves Chimal has completed his MSc, PhD from Universidad Nacional Autonoma de Mexico, and Postdoctoral studies from National Nutrition Institute Salvador Subiran. He is a Cardiovascular Surgeon and Researcher in National Medical Center 20 de Noviembre ISSSTE in Mexico City. He has published more than 20 papers in reputed journals and has been serving as an Editorial Board Member of repute.
In this unprecedented period of quarantine, countless questions are purported about COVID-19. While the scientific community searches for answers, the rest of the world is desperately waiting for evidence-based methods of prevention. Yet, one method has been known in virology for decades; viral replication depends on a glucose environment in the host. In fact, pre-existing metabolic dysregulation cripples the immune system and increases susceptibility to pathogens. According to figures by the US Department of Health (30 March, 2020), diabetes, pre-diabetes, kidney disease and obesity mark the most dangerous comorbidities in COVID-19 deaths. Patients with chronic metabolic comorbidities including strokes, CHD/CVD, unregulated diabetes and hypertension comprise 95% of New York and 99% of Italy’s COVID-19 deaths [1]. Older adults and those with serious underlying medical conditions are at the highest risk for developing the most severe complications from the Coronavirus [1]. Complications arising from comorbidities often have their deepest roots in poor nutrition. Reversing metabolic pathology to increase systemic immunity via reversal of glucose dependency and restoration of metabolic inflexibility has been well established in the literature. The lethal impact of COVID-19 and of future viral pathogens could be greatly diminished by stabilization of metabolic fuel flux through nutritional modifications, which are easily measured and tracked via reductions in the following inexpensive blood tests: HgA1c, HOMA-IR (Homeostatic model assessment of Insulin Resistance-fasting blood glucose/fasting insulin), triglycerides and the triglyceride/HDL ratio. Establishing self-efficacy through patient-centered biological education with implementation of bio-individualized lifestyle coaching holds great promise to slow the worldwide trajectory of underlying metabolic conditions associated with poor COVID-19 prognosis. This review examines the physiological mechanisms of metabolic flexibility, the importance of the nutritional status of the host in viral infection and the influence of glucose dependency on viral replication, namely COVID-19
I am pleased to mention that during the year 2019, all issues of volume 8 were published online well within the time and the print issues were also brought out and dispatched within 30 days of publishing the issue online. JMS also brought out an online special issue in 2019. JMS Published 7 research Article 5 editorial and 2 short communication 2019. In 2018 JMS Published 4 Research Article, 5 Review Article and 1 short communication. The H-index of the journal, however, increased to 10. During the calendar year 2019, Jms received a total of 28 papers, out of which 14 articles (50%) were rejected in the preliminary screening due to plagiarism or being out of the format. During 2019 around 20 articles were subjected to the peer-review process and 14 of those were accepted. In the 8 Volume 14 published during the year 2019, a total of 14 articles were published (at an average of 5 articles per issue) of which, 50 % articles were by foreign authors. A total of 5 research scientists from India and abroad reviewed the 10 articles published in volume 7. Average publication lag time of an article was further reduced to 6-8 weeks. I take this opportunity to acknowledge the contribution of Liang-Kung Chen,during the final editing of articles published and the support rendered by the editorial assistant, Olivia Bratt bringing out issues of JMS in time. I would also like to express my gratitude to all the authors, reviewers, the publisher, the advisory and the editorial board of JMS, the office bearers and staff of IPA secretariat for their support in bringing out yet another volume of JMS and look forward to their unrelenting support to bring out the Volume 8 of JMS in scheduled time.
Alzheimer's disease (AD) is a global epidemic; every 3 seconds someone in the world develops dementia. An estimated 50 million people are living with a disease that cannot be prevented, treated or cured. Without novel breakthroughs, AD is predicted to exceed 130 million by 2050. Pharmaceuticals offer minimal relief with dismal evidence of reversing neurodegeneration. Research focuses on β-amyloid plaques and tau tangles; but, in clinical trial, medications designed to sop-up toxic proteins in the brain fail to impede neural decline. Instead, plaques and tangles appear to be late-arrivers in the insidious progression of dementia. The recent explosion of comorbid metabolic pathologies (global prevalence of T2DM estimated @ 463 million) invites researchers into a deeper discussion of the bioenergetics regulating cognitive impairment and metabolic dysregulation. Age-related energy deficits, driven by peripheral insulin resistance, exacerbate Aβ/tau accumulation, increase oxidative stress and impede mitochondrial function; work by Sergi et al. and Mastroeni et al. suggest that mitochondrial dysfunction with epigenetic impairment in oxidative respiration appear to be the earliest offenders in the progression of T2DM and AD [1,2]. This case report highlights a novel, integrated intervention with a 69 year-old male dually diagnosed with T2DM and Mild Cognitive Impairment (MCI). Physiological biomarkers were measured pre/mid/post intervention; the MoCA (Montreal Cognitive Assessment) measured cognitive function, pre/post. Statistically significant results were observed in the metabolic risk biomarkers, memory was restored to normal ranges, and the HbA1c normalized out of the diabetic range @ <5.6%. Furthermore, the metabolic and cognitive improvements were sustained @ 3 months post-intervention. These promising results suggest that dietary ketogenesis restores peripheral insulin sensitivity, mitigates T2DM and improves cognition by circumventing neural starvation via the restoration of metabolic flexibility.
Background: An Emergency Department (ED) is a medical treatment facility dedicated to emergency medicine with an expectedly higher mortality rate. There is no available data on the pattern of mortality in the medical emergency room of the Federal Teaching Hospital Abakaliki (FETHA), a tertiary health facility in Abakaliki South-eastern Nigeria. Hence, this study was undertaken to determine the pattern of mortality of cases seen at the Medical Emergency unit of FETHA and compare it with that elsewhere in the country with the view of using the data generated as a baseline for planning purposes and for future studies. Method: This is a retrospective, descriptive and hospital-based study of the demographics and mortality pattern of patients seen at the medical emergency unit of the Federal Teaching Hospital Abakaliki (FETHA) over an 18 months period from January 2014 to June 2015. The analysis was done using the Statistical Package for Social Sciences (SPSS) version 19 software. Result: A total number of 4,270 patients were seen over the study period with 184 deaths giving a mortality rate of 4.31%. The mortality included 104 men and 80 women. The age range and mean age of the mortality were 20108 years and 50.54 ± 12.42years respectively. Stroke accounted for 23% (43) of the mortality. Others were Heart failure, chronic liver disease, chronic kidney disease, diarrhoeal diseases, diabetes mellitus and others in descending order of frequencies. When the causes of mortality were grouped according to the systems affected, neurological disorders accounted for about 30% of the mortality while gastrointestinal, cardiovascular, respiratory and renal disorders accounted for 17%, 14%, 10%, and 7% respectively. Non-communicable diseases accounted for 70% while communicable diseases accounted for 30% of the mortality. Conclusion: The most common cause of death is a non-communicable disease at the prime productive age with male preponderance. There is a need for elaborate health education at grass root and also for the creation of separate emergency rooms for different medical specialties in tertiary health facilities to facilitate a prompt Specialist review.
Background: Warning labels on tobacco products are considered effective to make the people aware of the consequences of tobacco use, and to bring about a behavioral change like quitting and reducing tobacco use. Material and Methods: A cross-sectional study was carried out in the town of Kangra in Himachal Pradesh using a house to house survey (using Krish grid framework) to assess the effectiveness of the warnings on tobacco products with help of a questionnaire earlier used in the GATS India survey, 2010. Results: Amongst the 98% of smokers who had seen the advertisement, 64% of males had thought about quitting whereas among females 100% of smokers contemplated quitting on noticing the warnings. This association, however, was not found to be statistically significant. Sensitivity towards the warnings was higher among those above 70 years of age with 66% of the smokers contemplating quitting after seeing the warnings and among those between 10-29 years of age, 52% of the smokers thought about quitting after seeing the warnings. This again was not found to be statistically significant. Among smokeless tobacco users too only 63.9% male users thought about quitting after seeing the warnings whereas 100% female users thought about quitting after seeing the warnings. Conclusion: The effectiveness of warnings can be enhanced by making the warnings bigger, clearer with visible color contrast and easily interpretable so that the 35% population who do not contemplate quitting after seeing these warnings are also reached out.
Aim: An excessive number of calories consumed daily, in addition to a sedentary lifestyle, are the main causes of increasing Type 2 Diabetes (T2D) prevalence worldwide. Diabetes is usually accompanied by hypertension, lipid disorders, and obesity. The aim of this study is to show that the combination exercise is effective. It will compare T2D and Non-Diabetes (ND) volunteer doing combination exercise consisting of resistance and cycling. The interventions are minor and fairly short consisting of 12 episodes of exercise over 6 weeks, yet this was enough to produce measurable change and improvement. This included the re-categorization of two T2D volunteers to being ND, using normal metrics. A literature search was conducted by using electronic databases (Science direct, google scholar, Medline, Embase, Sports medicine, PubMed, CINAHL, Cochrane library, and Scopus) from April 2015 until January 2019. Results show that changes in primary and secondary outcomes are significant between the different groups. The primary outcome is HbA1c, and the secondary outcomes are weight, waist, BMI, lipid, BP, HR, lactate and body fitness. Moreover, this study focuses on the changes in incretin level in the T2D group for effects of exercise on the secretion of this hormone and compare within T2D who are using a different medication for diabetes Results: After just six weeks, there was a reduction in the HbA1c level for the T2D volunteers which is significant (P=0.000). Moreover, in ND the reduction was also significant (P=0.000). In the T2D group who are using (Metformin and SGT2-I group), their result shows elevation in GLP-1 in the assessment of the both acute and chronic effect of the programme. GLP-1 in this group was (3.9 ± 1.5) and increased to (8.4 ± 1.2), (P=0.345) after S1 and then increased more to (11.0 ± 0.8), (P=0.196) after 6 weeks of exercise. This was of interest because of the inference that incretins and exercise were linked. The crucial factor is metformin. Conclusion: In T2D and ND combination exercise has a beneficial effect on HbA1c, the improvement was higher in T2D. The anthropometric variables (weight, waist, BMI and lung capacity) improved significantly as well in T2D and ND. Exercise is also important to improve GLP-1 secretion. Despite the range of studies on incretin undertaken here, still, there is a need to compare the effect of exercise and different types of pharmacological therapy on GLP1. This study compared the effect of exercise on T2D plus medication in volunteers. It has been found that within the T2D group only Metformin and SGT2-I group was improved. Both SGLT2 inhibitors and metformin have been found to affect body weight and this may explain the improvement of GLP-1 level, suggesting an area for future investigation.
Aim: Insulin resistance is a common health disorder that contributes to developed overt diabetes among prediabetes subjects. The aim of the study is to examine the effects of a combined programme of aerobic and resistance exercise on insulin resistance among prediabetes subjects (Pre-D) using Oral Glucose Tolerance Test (OGTT) as a tool to define the improvement in insulin resistance. Method: 20 prediabetes subjects were asked to join a supervised combined exercise program consists of 30 min of resistance exercise followed by 20 min cycling twice at moderate-intensity a week for 6 weeks. Result: a significant improvement in Blood Glucose (BG) after combination exercise at two occasions when compared to BG before exercise (Pre S1), after 1st exercise session (Post S1) and at the end of intervention trial (Post S12). Conclusion: The result of this study has shown that 6 weeks of moderate-intensity exercise combined with aerobic and resistance exercise program had significantly ameliorated insulin resistance among Pre-D.
