scholarly journals Early Bactericidal Activity Trial of Nitazoxanide for Pulmonary Tuberculosis

2020 ◽  
Vol 64 (5) ◽  
Author(s):  
K. F. Walsh ◽  
K. McAulay ◽  
M. H. Lee ◽  
S. C. Vilbrun ◽  
L. Mathurin ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bactericidal Activity ◽  
Standard Therapy ◽  
Therapy Group ◽  
Plasma Concentrations ◽  
Control Group ◽  
Standard Therapy Group ◽  
Content Type ◽  
Treatment Naïve ◽  
The Mean

ABSTRACT This study was conducted in treatment-naive adults with drug-susceptible pulmonary tuberculosis in Port-au-Prince, Haiti, to assess the safety, bactericidal activity, and pharmacokinetics of nitazoxanide (NTZ). This was a prospective phase II clinical trial in 30 adults with pulmonary tuberculosis. Twenty participants received 1 g of NTZ orally twice daily for 14 days. A control group of 10 participants received standard therapy over 14 days. The primary outcome was the change in time to culture positivity (TTP) in an automated liquid culture system. The most common adverse events seen in the NTZ group were gastrointestinal complaints and headache. The mean change in TTP in sputum over 14 days in the NTZ group was 3.2 h ± 22.6 h and was not statistically significant (P = 0.56). The mean change in TTP in the standard therapy group was significantly increased, at 134 h ± 45.2 h (P < 0.0001). The mean NTZ MIC for Mycobacterium tuberculosis isolates was 12.3 μg/ml; the mean NTZ maximum concentration (Cmax) in plasma was 10.2 μg/ml. Negligible NTZ levels were measured in sputum. At the doses used, NTZ did not show bactericidal activity against M. tuberculosis. Plasma concentrations of NTZ were below the MIC, and its negligible accumulation in pulmonary sites may explain the lack of bactericidal activity. (This study has been registered at ClinicalTrials.gov under identifier NCT02684240.)

Efficacy of Atorvastatin Plus Pegylated Interferon and Ribavirin Versus Pegylated Interferon and Ribavirin Alone in Chronic Hepatitis C Patients with Genotype-3a

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Waqas Gulzar ◽  
Zafar Niaz ◽  
Sami Ullah Mumtaz ◽  
Somia Iqtadar ◽  
Tayyeba Komal ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Standard Therapy ◽  
Therapy Group ◽  
Pegylated Interferon ◽  
Rapid Virological Response ◽  
Standard Therapy Group ◽  
The Mean ◽  
Genotype 3A

Chronic hepatitis C infection has created a huge burden of disease causing serious healtheffects. The combination therapy used to treat hepatitis C virus (HCV) infection includes Pegylatedinterferon and Ribavirin. As cholesterol biosynthesis plays a pivotal role in HCV replication, the use ofvarious statins has been associated with higher sustained viral response Objective: To compare theefficacy of atorvastatin plus pegylated interferon and ribavirin versus pegylated interferon and ribavirinalone in patients of chronic hepatitis C with genotype-3a Methods: This Randomized controlled trial wasconducted at outpatient department, Mayo Hospital Lahore for six months i.e. May to November 2017.After ethical approval, 60 patients of ages 25 to 55 years of either gender with chronic hepatitis C withgenotype 3a were included in the study. Informed consent was taken from all patients. Then patients wererandomly allocated into two groups “A” and “B” using random number table. Patients in Group A receivedstandard of care treatment for chronic hepatitis C i.e. pegylated interferon and ribavirin while the patientsin Group B also received tab atorvastatin along with the standard treatment. Patients were follow up for 4week. Blood samples were collected and HCV RNA detection. All this information were entered inproforma Results: In standard therapy group, the mean age of patients was 39.50±8.39years. Inatorvastatin plus standard therapy group, the mean age of patients was 34.30±6.78years. In standardtherapy group, there were 25 (83.3%) males and 5 (16.7%) females. In atorvastatin plus standard therapygroup, there were 16 (53.3%) males and 14 (46.7%) females. After 4 weeks, Rapid Virological Response(RVR) was achieved in 4 (13.3%) patients in standard therapy group while in 14 (46.7%) in atorvastatin plusstandard therapy group. The difference was significant (p<0.05) Conclusions: Atorvastatin incombination with Pegylated interferon and ribavirin have better efficacy as compared to Pegylatedinterferon & ribavirin alone in chronic hepatitis C-3a.

scholarly journals Controlled randomized clinical trial on using Ivermectin with Doxycycline for treating COVID-19 patients in Baghdad, Iraq

2020 ◽  
Author(s):  
Hashim A. Hashim ◽  
Mohammed F. Maulood ◽  
Anwar M. Rasheed ◽  
Dhurgham F. Fatak ◽  
Khulood K. Kabah ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Standard Therapy ◽  
Therapy Group ◽  
Group Versus ◽  
Controlled Study ◽  
Control Group ◽  
Advanced Stage ◽  
Standard Therapy Group ◽  
Curative Therapy ◽  
Critical Patients

AbstractObjectivesCOVID-19 patients suffer from the lack of curative therapy. Hence, there is an urgent need to try repurposed old drugs on COVID-19.MethodsRandomized controlled study on 70 COVID-19 patients (48 mild-moderate, 11 severe, and 11 critical patients) treated with 200ug/kg PO of Ivermectin per day for 2-3 days along with 100mg PO doxycycline twice per day for 5-10 days plus standard therapy; the second arm is 70 COVID-19 patients (48 mild-moderate and 22 severe and zero critical patients) on standard therapy. The time to recovery, the progression of the disease, and the mortality rate were the outcome-assessing parameters.Resultsamong all patients and among severe patients, 3/70 (4.28%) and 1/11 (9%), respectively progressed to a more advanced stage of the disease in the Ivermectin-Doxycycline group versus 7/70 (10%) and 7/22 (31.81%), respectively in the control group (P>0.05). The mortality rate was 0/48 (0%), 0/11 (0%), and 2/11 (18.2%) in mild-moderate, severe, and critical COVID-19 patients, respectively in Ivermectin-Doxycycline group versus 0/48 (0%), and 6/22 (27.27%) in mild-moderate and severe COVID-19 patients, respectively in standard therapy group (p=0.052). Moreover, the mean time to recovery was 6.34, 20.27, and 24.13 days in mild-moderate, severe, and critical COVID-19 patients, respectively in Ivermectin-Doxycycline group versus 13.66 and 24.25 days in mild-moderate and severe COVID-19 patients, respectively in standard therapy group (P<0.01).ConclusionsIvermectin with doxycycline reduced the time to recovery and the percentage of patients who progress to more advanced stage of disease; in addition, Ivermectin with doxycycline reduced mortality rate in severe patients from 22.72% to 0%; however, 18.2% of critically ill patients died with Ivermectin and doxycycline therapy. Taken together, the earlier administered Ivermectin with doxycycline, the higher rate of successful therapy.

scholarly journals Early Bactericidal Activity of AZD5847 in Patients with Pulmonary Tuberculosis

2016 ◽  
Vol 60 (11) ◽  
pp. 6591-6599 ◽  
Author(s):  
Jennifer J. Furin ◽  
Jeannine Du Bois ◽  
Elana van Brakel ◽  
Phalkun Chheng ◽  
Amour Venter ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bactericidal Activity ◽  
Positive Culture ◽  
Rate Of Change ◽  
Sputum Smear ◽  
Serious Adverse Events ◽  
Once Daily ◽  
Content Type ◽  
The Mean

ABSTRACTAZD5847 is an oxazolidinone antibiotic within vitroactivity againstMycobacterium tuberculosis. The objective of this study was to evaluate the antimycobacterial activity, safety, and pharmacokinetics of AZD5847 in patients with pulmonary tuberculosis. Groups of 15 treatment-naive, sputum smear-positive adults with pulmonary tuberculosis were randomly assigned to receive AZD5847 at one of four doses (500 mg once daily, 500 mg twice daily, 1,200 mg once daily, and 800 mg twice daily) or daily standard chemotherapy. The primary efficacy endpoint was the mean daily rate of change in the log10number of CFU ofM. tuberculosisper milliliter of sputum, expressed as the change in log10number of CFU per milliliter of sputum per day. The mean 14-day activity of the combination of isoniazid, rifampin, ethambutol, and pyrazinamide (−0.163 log10CFU/ml sputum/day; 95% confidence interval [CI], −0.193, −0.133 log10CFU/ml sputum/day) was consistent with that found in previous studies. AZD5847 at 500 mg twice daily significantly decreased the number of CFU on solid medium (−0.039; 95% CI, −0.069, −0.009;P= 0.0048). No bactericidal activity was detected at doses of AZD5847 of 500 mg once daily (mean early bactericidal activity [EBA], 0.02 [95% CI, −0.01, 0.05]), 1,200 mg once daily (mean EBA, 0.02 [95% CI, −0.01, 0.05]), and 800 mg twice daily (mean EBA, 0.02 [95% CI, −0.01, 0.05]). AZD5847 at doses of both 500 mg and 800 mg twice daily also showed an increase in the time to a positive culture in MGIT liquid culture medium. Two serious adverse events (grade 4 thrombocytopenia and grade 4 hyperbilirubinemia) occurred in patients receiving AZD5847 at higher doses. AZD5847 dosed twice daily kills tubercle bacilli in the sputum of patients with pulmonary tuberculosis and has modest early bactericidal activity. (This study has been registered at ClinicalTrials.gov under registration no. NCT01516203.)

scholarly journals NEW APPROACH TO ASSESSMENT AND CORRECTION OF INTESTINAL MICROBIOME IMBALANCE IN CHILDREN WITH ATOPIC DERMATITIS

2019 ◽  
Vol 4 (1) ◽  
pp. 53-57
Author(s):  
Dmitrii V. Pechkurov ◽  
Olesya N. Zaynullina ◽  
Alena A. Tyazheva ◽  
Artem V. Lyamin
Keyword(s):  
Mass Spectrometry ◽  
Atopic Dermatitis ◽  
Standard Therapy ◽  
Treatment Effectiveness ◽  
Treatment Time ◽  
Therapy Group ◽  
Intestinal Microbiome ◽  
Control Group ◽  
Standard Therapy Group ◽  
Experimental Group

Objectives - to study intestinal microbiota species for differentiated approach to treatment of atopic dermatitis (AD) in children. Material and methods. The study included 60 children, 34 girls and 26 boys aged from 3 to 12 years, with AD and concurrent intestinal dysbiosis. The experimental group consisted of 30 children assigned to differentiated correction of intestinal microbiome imbalance in addition to the standard therapy. Correction mode depended on the results of microbiological fecal examination of microbiota species using the mass spectrometry. The control group of 30 children received the standard treatment of atopic dermatitis. Results. Gut microbiome imbalance of different severity was revealed in all children with AD. The study ascertained the increase of the enterobacteria of various types, including true pathogenic ones, in atopic dermatitis. The direct correlation was revealed between the AD severity and the degree of dysbiosis with the coefficient value 0.69. As a result of complex treatment in the experimental group, the ratio of children with severe dysbiosis reduced from 60.0% to 20.0%, the proportion of children with moderate dysbiosis also decreased from 26.6% to 20.0%. The reduced treatment time was one of the study outcomes: 14 days in the experimental group and 21 days in the standard therapy group. Clinical remission was observed in 26.7% of children. Conclusion. The study supported the rationale for the differentiated approach to the treatment of AD in children. The preliminary microbiological study of feces for microbiota species by MALDI-ToF mass spectrometry is necessary. Selection of probiotics depends on the deficit or overbalance of the specific types of microorganisms in a patient. Thus the treatment effectiveness is improved and the remission period is extended.

scholarly journals Ofloxacin versus standard therapy in treatment of community-acquired pneumonia requiring hospitalization. Pneumonia Study Group.

1996 ◽  
Vol 40 (5) ◽  
pp. 1175-1179 ◽  
Author(s):  
J F Plouffe ◽  
M T Herbert ◽  
T M File ◽  
I Baird ◽  
J N Parsons ◽  
...  
Keyword(s):  
Standard Therapy ◽  
Clinical Success ◽  
Therapy Group ◽  
The United States ◽  
Community Acquired Pneumonia ◽  
Oral Antibiotic ◽  
Respiratory Pathogens ◽  
Standard Therapy Group ◽  
Empiric Treatment ◽  
The Mean

Community-acquired pneumonia occurs 3 to 4 million times per year in the United States, accounting for about 500,000 hospitalizations annually. Empiric treatment is usually instituted because of a lack of early organism-specific diagnostic tests. This study compared empiric therapy with ofloxacin to standard antibiotic regimens (usually a beta-lactam with or without a macrolide) for patients hospitalized for community-acquired pneumonia. Therapy was administered to 298 patients (146 receiving ofloxacin and 152 receiving standard therapy); 227 patients (ofloxacin, 109; standard treatment, 118) were evaluable for treatment efficacy. The most common pyogenic respiratory pathogens were Haemophilus influenzae (30 isolates) and Streptococcus pneumoniae (24 isolates). There was evidence of infection with either Mycoplasma pneumoniae (38 patients), Chlamydia pneumoniae (40 patients), or a Legionella sp. (8 patients) in a total of 79 patients (35%). The clinical success rates were similar in both groups among evaluable patients (92%, ofloxacin; 87%, standard therapy) and among patients with atypical respiratory pathogens (88%, ofloxacin; 81%, standard therapy). The mean numbers (+/- the standard deviations) of intravenous doses of antibiotics were 7.5 +/- 8.0 in the ofloxacin group and 18.4 +/- 18.5 in the standard therapy group (P < 0.001); the mean number of oral doses of ofloxacin per patient was 19.7 +/- 11.2, compared with 30.2 +/- 16.0 oral antibiotic doses in the standard therapy group (P < 0.001). All treatments were well tolerated and associated with no significant clinical or laboratory abnormalities. The findings of this study indicate that ofloxacin is active against traditional bacterial pathogens as well as the major atypical respiratory pathogens. When given as monotherapy for the empiric treatment of community-acquired pneumonia, ofloxacin is as effective as standard antimicrobial therapy.

scholarly journals EFFICIENCY OF PROTEASE INHIBITOR ULINASTATIN IN PATIENTS WITH ACUTE PANCREATITIS

2020 ◽  
pp. 33-38
Author(s):  
О. М. Клигуненко ◽  
Д. А. Кріштафор ◽  
Г. І. Лаврова
Keyword(s):  
Acute Pancreatitis ◽  
Standard Therapy ◽  
Therapy Group ◽  
Control Group ◽  
Blood Levels ◽  
Duration Of Treatment ◽  
Standard Therapy Group ◽  
Left Shift ◽  
Pathogenetic Therapy ◽  
Group 2

Introduction. Acute pancreatitis is one of the most common acute gastroenterological diseases in the world. A key element of its pathogenesis is “pancreatic self-digestion” by pancreatic enzymes. In recent years, the use of protease inhibitors has attracted considerable interest as a pathogenetic therapy of acute pancreatitis.Objective: To study the effect of ulinastatin on the severity of acute pancreatitis.Materials and methods. A total of 50 patients with acute pancreatitis were examined. Group 1 (n = 25) received standard therapy, group 2 (n = 25) additionally received intravenous ulinastatin infusion in a dose of 100,000 IU 1 time per day for 3 days. Indicators of pancreatic inflammation and mortality were studied.Results and discussion. On admission, patients had enzymatic ascites, an acute increase in blood levels of α-amylase and diastase in the urine, neutrophilic leukocytosis with a left shift and relative lymphocytopenia. Compared to standard therapy, ulinastatin reduced the frequency of abdominal drainage from 68.0% to 40.0%. Blood α-amylase and urine diastase levels in the ulinastatin group decreased 2-6 times as compared with the control group and normalized on day 5, whereas in the control group they did not reach the norm. The number of leukocytes in the ulinastatin group on day 5 decreased by 38.1% from the baseline, and in the control group – only by 26.0%. On the 5th day the left shift, LII and lymphocytopenia decreased in the ulinastatin group, but not in the control group. In the first 3 days of the disease, the diagnosis of severe acute pancreatitis was confirmed in 80.0% of patients in the control group and 48.0% in the ulinastatin group. Mortality in the control group was 20.0%, and there were no fatal cases in ulinastatin group. Ulinastatin decreased duration of treatment in ICU from 3.6 ± 1.0 to 2.3 ± 0.9 days and did not affect total hospital stay.Conclusions. Ulinastatin has a significant anti-inflammatory effect in patients with acute pancreatitis. This is manifested by a rapid and reliable reduction of signs of inflammation in the pancreas, which prevents the development of pancreatic necrosis, reduces pancreatitis severity, accelerates SIRS resolving and reduces mortality.

Determination some Immunological Aspects in Pulmonary Tuberculosis Patients in Qadisiyah Province

2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Syoof Khowman Alramahy ◽  
Akram Hadi Hamza
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Statistical Difference ◽  
Positive Culture ◽  
Control Group ◽  
Tuberculosis Patients ◽  
Significant Difference ◽  
Lowenstein Jensen ◽  
The Mean ◽  
Igg Level

This study was carried out to study of some immunological aspects among the pulmonary Tuberculosis patients infected with causative agent, Mycobacterium tuberculosis. A Total of 200 sputum samples were collected from patients attending the consultant Clinic for Chest and Respiratory disease center, Diwaniya. Control group (No=15) also included. According to acid fast stain of sputum, the patients were classified as positive (No=91,45.5%) and negative (No=109,54.5, Lowenstein Jensen medium used for the cultivation of samples, on which 70% of sputum samples where positive culture for this microorganism. The grown microorganism were identified as M. tuberculosis, based on positive A.F.B, Niacin producers ,negative for catlase at 68c. The mean IgG level was l184.053±76.684 mg/100 ml in tuberculosis group compared with 1016.533 ± 44.882 mg/100ml in control group, rendering the statistical difference significant. For IgA and IgM levels, they were at mean of 315.880±38.552 mg/100 ml and 119.527±8.464 mg/100 ml in control group compared with 396.358±38.776 mg/100 ml and 134.207±11.696 mg/100 ml in patients group respectively with significant difference

scholarly journals The Effects of Synbiotic “Bifidobacterium lactisB94 plus Inulin” Addition on Standard Triple Therapy ofHelicobacter pyloriEradication in Children

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Gonca Handan Ustundag ◽  
Halime Altuntas ◽  
Yasemin Dilek Soysal ◽  
Furuzan Kokturk
Keyword(s):  
Triple Therapy ◽  
Standard Therapy ◽  
Therapy Group ◽  
Symptom Relief ◽  
Standard Therapy Group ◽  
Bifidobacterium Lactis ◽  
Standard Triple Therapy ◽  
H Pylori ◽  
Intent To Treat ◽  
Infection Eradication

Aim. The aim of this study is to evaluate the effects of the synbioticBifidobacterium lactisB94 plus inulin addition to the standard triple therapy onHelicobacter pylori (H. pylori)infection eradication rates.Methods. Children aged 6–16 years who had biopsy provenH. pyloriinfection were randomly classified into two groups. The first group received the standard triple therapy consisting of amoxicillin + clarithromycin + omeprazole. The second group was treated with the standard triple therapy andBifidobacterium lactisB94 (5 × 109 CFU/dose) plus inulin (900 mg) for 14 days, concurrently. Eradication was determined by14C-urea breath test 4–6 weeks after therapy discontinuation.Results. From a total of 69H. pyloriinfected children (F/M = 36/33; mean ± SD = 11.2 ± 3.0 years), eradication was achieved in 20/34 participants in the standard therapy group and 27/35 participants in the synbiotic group. The eradication rates were not significantly different between the standard therapy and the synbiotic groups [intent-to-treat, 58.8% and 77.1%, resp.,p= 0.16; per-protocol, 64.5% and 81.8%, resp.,p= 0.19]. There was no difference between the groups in terms of symptom relief (p= 0.193). The reported side effects were ignorable.Conclusion. Considering the eradication rates, synbiotic addition to therapy showed no superiority over the standard triple therapy conducted alone. This trial is registered withNCT03165253.

Efficacy of multiple intraarterial papaverine infusions for improvement in cerebral circulation time in patients with recurrent cerebral vasospasm

2004 ◽  
Vol 100 (3) ◽  
pp. 414-421 ◽  
Author(s):  
James K. Liu ◽  
Michael S. Tenner ◽  
Oren N. Gottfried ◽  
Edwin A. Stevens ◽  
Joshua M. Rosenow ◽  
...  
Keyword(s):  
Cerebral Vasospasm ◽  
Cerebral Circulation ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Primary Treatment ◽  
Circulation Time ◽  
Control Group ◽  
Content Type ◽  
The Mean ◽  
Cerebral Circulation Time ◽  
Fine Print

Object. Cerebral vasospasm that is caused by aneurysmal subarachnoid hemorrhage and that is refractory to maximal medical management can be treated with selective intraarterial papaverine infusions. The effects of single papaverine treatments on cerebral circulation time are well known. The purpose of this study was to assess the efficacy of multiple, repeated papaverine infusions on the cerebral circulation time in patients with recurrent vasospasm. Methods. A retrospective study was conducted in 17 patients who received multiple intraarterial papaverine infusions in 91 carotid artery (CA) territories for the treatment of cerebral vasospasm. Cerebral circulation times were measured from the first angiographic image, in which peak contrast was seen above the supraclinoid internal CA, to the peak filling of cortical veins. Glasgow Outcome Scale (GOS) scores assessed 12 months after discharge were reviewed. Cerebral circulation times in 16 CA territories were measured in a control group of 11 patients. Seventeen patients received a total of 91 papaverine treatments. Prolonged cerebral circulation times improved after 90 (99%) of 91 papaverine treatments. The prepapaverine mean cerebral circulation time was 6.54 seconds (range 3.35–27 seconds) and the immediate postpapaverine mean cerebral circulation time was 4.19 seconds (range 2.1–12.6 seconds), an overall mean decrease of 2.35 seconds (36%, p < 0.001). Recurrent vasospasm reflected by prolonged cerebral circulation times continued to improve with subsequent papaverine infusions. Repeated infusions were just as successful quantitatively as the primary treatment (mean change 2.06 seconds). The mean cerebral circulation time in the control group was 5.21 seconds (range 4–6.8 seconds). In five patients a dramatic reversal of low-attenuation changes was detected on computerized tomography scans. The mean GOS score at 12 months after discharge was 3.4. Conclusions. The preliminary results indicate that multiple intraarterial papaverine treatments consistently improve cerebral circulation times, even with repeated infusions in cases of recurrent vasospasm.

Effectiveness of social media for weight reduction on overweight undergraduate students in Thailand

2019 ◽  
Vol 34 (2) ◽  
pp. 90-99
Author(s):  
Tummatida Pattanapongsa ◽  
Wiroj Jiamjarasrangsi ◽  
Piya Hanvoravongchai ◽  
Dumrongsak Pekthong
Keyword(s):  
Social Media ◽  
Weight Loss ◽  
Health Education ◽  
Undergraduate Students ◽  
Support Services ◽  
Control Group ◽  
Content Type ◽  
Online Social Media ◽  
The Mean ◽  
Experimental Group

Purpose Addressing overweight in the population is an important public health challenge. Use of social media such as Facebook has been proposed as a platform to deliver weight loss interventions to influence behavior change to tackle obesity. The purpose of this paper is to compare the effectiveness of weight loss education and support interventions delivered through online social media (experimental group) vs conventional method (control group). Design/methodology/approach The six-month experimental study comprised of a four-month intervention and a two-month follow up from May 2016 to October 2016. All faculties in a university were randomly selected into the experimental or control group. Then, undergraduate students (n=66) were randomly recruited from each faculty into the corresponding groups (experimental group=33 and control group=33). Both groups received health education and support services through either Facebook or the offline support system. The mean differences of main outcomes including body mass index (BMI) and waist to height ratio (WHtR) between groups at baseline and fourth month and baseline and sixth month were compared using t-test. Findings The results show those in the experimental group had significantly better outcomes in term of BMI and WHtR at the end of four-month intervention with the mean difference (95% CI) at 0.7 (0.1, 1.3) and 0.01 (0.00, 0.01), respectively. The differences at the end of the study, however, became insignificant. Originality/value The health education and support services through Facebook can be used in a weight loss promotion program for BMI and WHtR reduction. On a larger scale to replace conventional programs, a long-term continuous measure is needed.

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