scholarly journals A Prospective Study on Type-2 Diabetic Complications and Efficacy of Integrated Yoga: A Pan India 2017

2021 ◽  
pp. 097275312110162
Author(s):  
Suchitra S. Patil ◽  
Nagarathna Raghuram ◽  
Amit Singh ◽  
S. K. Rajesh ◽  
Sabzar Ahmed ◽  
...  
Keyword(s):  
High Risk ◽  
Urban Areas ◽  
Mobile App ◽  
Control Group ◽  
Mortality And Morbidity ◽  
Rural And Urban ◽  
History Of ◽  
Cluster Randomized ◽  
A Prospective Study

Background: Type 2 diabetes (T2DM) contributes to high mortality and morbidity because of its major complications related to kidney, heart, brain, and eyes. It also poses a high risk for mortality because of COVID-19. Studies suggest the possible implications of Yoga in delaying or attenuating such complications. Methodology: This was a pan-India multi centered cluster-randomized (4 level) two-armed trial in the rural and urban population of all populous states of India. Data were obtained using mobile app in all adults in the household of the selected clusters. Results: We report the diabetes related complications in 16623 adults (48% males, 52% females) from 65 districts (1 in 10 districts, 2011 census) of 29 (out of 35) states and Union Territories of India; mean age was 48.2 ± 12.46 years. Out of this 40% lived in rural and 62% in urban locations. In high risk diabetes individuals (scored ≥ 60 points on Indian diabetes risk score key), 18.0% had self-reported history of (peripheral neuropathy, 6.1% had h/o major strokes, 5.5% had minor strokes (transient ischemic episodes), 18.1% had lower limb claudication, 20.5% leg ulcers, 4.4% had h/o cardiac surgery, 4.8% angioplasty, and 15.1% had diabetes retinopathy. Complications were higher in rural than in urban areas, higher in people with extended duration of diabetes. Integrated yoga module for three months (one hour daily) showed significantly better reduction in symptoms related to complications as compared to control group ( P < .001) Conclusion: The alarming high prevalence of complications in diabetes population calls for urgent action, where yoga may show the benefits in reduction of symptoms of complications.

Elevated BNP and High Brachial Pulse Pressure in Patients with Diabetes

2021 ◽  
Author(s):  
Jean-Guillaume Dillinger ◽  
Charlotte Patin ◽  
Philippe Bonnin ◽  
Tiphaine Vidal-Trecan ◽  
Elise Paven ◽  
...  
Keyword(s):  
High Risk ◽  
Pulse Pressure ◽  
Daily Practice ◽  
Diabetic Patients ◽  
Brachial Blood Pressure ◽  
Patients With Diabetes ◽  
History Of ◽  
A Prospective Study

Abstract Background Heart failure (HF) is frequent in patients with diabetes mellitus (DM), and early detection improves prognosis. We investigated whether analysis of brachial blood pressure (BP) in daily practice can identify patients with DM and high risk for subsequent HF, as defined by brain natriuretic peptide (BNP) &gt; 50 pg/ml. Methods 3,367 Outpatients with DM without a history of cardiovascular disease were enrolled in a prospective study. Results Age (mean±SD) was 56±14 years, 57% were male, 78% had type 2 DM and HbA1C was 7.4%±1.4%. A history of hypertension was recorded in 43% of patients and uncontrolled BP was observed in 13%. BNP concentration (mean±SD) was 21±21 ng/L and 9% of patients had high risk of incident HF. Brachial pulse pressure (PP) was the best BP parameter associated with high risk of incident HF compared to diastolic, systolic or mean BP (area under the ROC curve: 0.70, 0.65, 0.57 and 0.57 respectively). A multivariate analysis demonstrated that elevated PP was independently associated with high risk of incident HF (odds ratio [95%CI]: 2.1 [1.5–2.8] for PP ≥65mmHg). Study of central aortic BP and pulse wave velocity on 117 patients demonstrated that high risk of incident HF was associated with increased arterial stiffness and subendocardial ischemia. After a mean follow-up of 811days, elevated PP was associated with increased all-cause mortality (hazard ratio [95%CI]: 1.7 [1.1–2.8]). Conclusions Brachial PP is powerful and independent “easy to record” BP parameter associated with high risk of incident HF in diabetic patients.

THE RISK FACTORS OF MOLAR PREGNANCY

2017 ◽  
pp. 53-58
Author(s):  
Lam Huong Le
Keyword(s):  
High Risk ◽  
Gestational Trophoblastic Disease ◽  
Living Standard ◽  
Control Group ◽  
Uterine Perforation ◽  
Molar Pregnancy ◽  
Health It ◽  
Pregnancy Risk ◽  
History Of ◽  
And Control

Objectives: Molar pregnancy is the gestational trophoblastic disease and impact on the women’s health. It has several complications such as toxicity, infection, bleeding. Molar pregnancy also has high risk of choriocarcinoma which can be dead. Aim: To assess the risks of molar pregnancy. Materials and Methods: The case control study included 76 molar pregnancies and 228 pregnancies in control group at Hue Central Hospital. Results: The average age was 32.7 ± 6.7, the miximum age was 17 years old and the maximum was 46 years old. The history of abortion, miscarriage in molar group and control group acounted for 10.5% and 3.9% respectively, with the risk was higher 2.8 times; 95% CI = 1.1-7.7 (p<0.05). The history of molar pregnancy in molar pregnancy group was 9.2% and the molar pregnancy risk was 11.4 times higher than control group (95% CI = 2.3-56.4). The women having ≥ 4 times births accounted for 7.9% in molar group and 2.2% in control group, with the risk was higher 3.8 times, 95% CI= 1.1-12.9 (p<0.05). The molar risk of women < 20 and >40 years old in molar groups had 2.4 times higher than (95% CI = 1.1 to 5.2)h than control group. Low living standard was 7.9% in molar group and 1.3% in the control group with OR= 6.2; 95% CI= 1.5-25.6. Curettage twice accounted for 87.5%, there were 16 case need to curettage three times. There was no case of uterine perforation and infection after curettage. Conclusion: The high risk molar pregnancy women need a better management. Pregnant women should be antenatal cared regularly to dectect early molar pregnancy. It is nessecery to monitor and avoid the dangerous complications occuring during the pregnancy. Key words: Molar pregnancy, pregnancy women

scholarly journals AB0420 RISK OF DEVELOPING TYPE 2 DIABETES MELLITUS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1510.2-1510
Author(s):  
L. Kondrateva ◽  
T. Popkova ◽  
E. Nasonov ◽  
A. Lila
Keyword(s):  
Abdominal Obesity ◽  
Lupus Erythematosus ◽  
Antihypertensive Drugs ◽  
Control Group ◽  
Systemic Lupus ◽  
Type 2 Dm ◽  
History Of ◽  
Systemic Rheumatic Diseases ◽  
Very High

Background:Patients with systemic lupus erythematosus (SLE) have higher than in general population prevalence of diabetes mellitus (DM). Hyperinsulinemia is a predictor of developing type 2 DM, however routine measurement of insulin levels for DM risk assessment is uncomfortable in daily clinical practice. International Diabetes Federation recommends the use of patient questionnaires to quickly identify people who may be at a higher risk of DM development.Objectives:To determine the 10-years risk of developing type 2 DM in SLE patients using dedicated questionnaire - Finnish Type 2 Diabetes Risk Assessment Form (FINDRISK) data.Methods:The study included 92 SLE patients without DM (83 women, 9 men, 39 [34; 47] years old). The median disease duration was 6 [2,14] years, SLEDAI-2K was 4[2;8]. SLE pts were treated with glucocorticoids (GC) (89%) and hydroxychloroquine (78%), immunosuppressive drugs (28%) and biological agents (10%). The control group consisted of 88 subjects without systemic rheumatic diseases, inflammatory arthritis or DM, matched by age and sex with SLE patients. Eight items of FINDRISK questionnaire (age, overweight, abdominal obesity, family history of diabetes, physical inactivity, eating habits, history of antihypertensive drugs treatment, history of hyperglycemia) were taken into account to calculate the total risk score (TS). The risk of developing DM within following 10 years is regarded as low (1%) or slightly elevated (4%) with TS ≤11 points, as moderate (17%), high (33%) or very high (50%) with TS ≥12 points.Results:The risk of developing DM was low or slightly elevated in 65 (71%) SLE pts and moderate, high or very high in 27 (29%) pts. The difference was significant compared with the control group, in which 76 (86%) subjects had a low or slightly elevated risk and 12 (14%) had a moderate, high or very high risk (p=0,01). The number of risk factors (4[2;5]) and the median TS of SLE pts (9[5;12] points) were higher than values in control subjects (3[2,4] factors and 6[3;9] points, respectively) (p<0,01 for both). DM risk factors profiles were similar in two groups, except for higher prevalence of abdominal obesity (66% vs 41%, p<0,01) and history of antihypertensive drugs treatment (57% vs 17%, p<0,01) in SLE. There were positive correlations between TS and CRP levels (r=0,25, p=0,02), SLICC (r=0,36, p<0,01), HAQ (r=0,29, p<0,01), and negative correlations between TS and SLEDAI-2K (r= -0,32, p<0,01), glomerular filtration rate by CKD-EPI (r=-0,23, p=0,03). Current GC use had no influence on TS values in SLE.Conclusion:Patients with SLE were more likely than individuals without systemic rheumatic diseases to have a moderate, high and very high risk of developing DM, and therefore, required interventions to prevent the metabolic disease. Increased risk of developing DM was associated with most common traditional factors, especially by abdominal obesity and regular use of antihypertensive drugs that can be considered a kind of equivalent to the presence of hypertension. Curtain contribution of inflammation, lupus activity and irreversible damage index can’t be ignored. Clarification of SLE-specific phenomena in DM pathogenesis requires further research.Disclosure of Interests: :None declared

scholarly journals Peculiarities of pregnansy and childbirth in patients with a burdened gynecological anamnesis

2020 ◽  
Vol 5 ◽  
pp. 5-10
Author(s):  
T. P. Andriichuk ◽  
A. Ya. Senchuk ◽  
V. I. Chermak
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Pregnant Women ◽  
Postpartum Period ◽  
Control Group ◽  
Careful Monitoring ◽  
Pregnancy And Childbirth ◽  
History Of ◽  
High Level ◽  
Adaptive Reactions

The objective: to study the features of pregnancy, childbirth, postpartum period, fetal status and newborns in patients with a history of chronic salpingo-оophoritis.Materials and methods. Conducted a retrospective study of 150 birth histories and neonatal development maps. All patients were divided into two groups. The main group includes 100 patients with chronic salpingo-оophoritis, for which they received anti-inflammatory treatment from 1 to 3 times before pregnancy. The control group included 50 pregnant women who did not suffer from chronic salpingo-оophoritis.Results. Our analysis of pregnancy, childbirth, fetal and neonatal status in women with chronic salpingo-оophoritis indicates that such patients have a complicated obstetric and gynecological and somatic history, which forms an unfavorable basic condition of organs and systems, imperfect adaptation to pregnancy, high risk of failure of adaptive reactions. The result is a violation of the formation and development of the mother-placenta-fetus system and, as a consequence, a high level of complications during pregnancy, childbirth and perinatal pathology.Conclusion. Patients suffering from chronic salpingo-oophoritis should be considered at high risk of possible complications during pregnancy and childbirth. This category of women needs quality preconception training and careful monitoring during pregnancy.

Pioglitazone for the Primary and Secondary Prevention of Cardiovascular and Renal Outcomes in Patients with or at High Risk of Type 2 Diabetes Mellitus: A Meta-Analysis

2019 ◽  
Vol 105 (5) ◽  
pp. 1670-1681 ◽  
Author(s):  
Yue Zhou ◽  
Yajing Huang ◽  
Xiaoyun Ji ◽  
Xiang Wang ◽  
Liyan Shen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
High Risk ◽  
Meta Analysis ◽  
Cardiovascular Death ◽  
Primary And Secondary Prevention ◽  
All Cause Mortality ◽  
History Of

Abstract Context The goal of the meta-analysis was to evaluate the effect of pioglitazone on the primary and secondary prevention of cardiovascular diseases (CVDs) and renal adverse events in patients with or at high risk of type 2 diabetes mellitus (T2DM). Design Randomized controlled trials (RCTs) comparing pioglitazone with any control were identified through PubMed, Embase, and the Cochrane Library. Cardiovascular outcomes included major adverse cardiovascular events (MACEs, defined as the composite of nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death), hospitalization for heart failure, and all-cause mortality. Renal outcomes included change in urinary albumin to creatinine ratio and 24-hour urinary protein excretion. Weighted mean difference (WMD) and risk ratio (RR) with 95% confidence intervals (CIs) were pooled. Results A total of 26 studies with 19 645 participants were enrolled. Pioglitazone reduced the risk of MACE (RR, 0.8 [95% CI, 0.7–0.9]), with benefit only seen in patients with a history of established CVDs (0.8 [0.7–0.9]) and not in those without (1.0 [0.7–1.3]). Regarding the individual components, pioglitazone reduced the risk of nonfatal myocardial infarction (0.8 [0.6–1.0]) and nonfatal stroke (0.8 [0.7–0.9]), which was confined to patients with a history of established CVDs, whereas no treatment effect was found on cardiovascular death (1.0 [0.7–1.2]) regardless of the presence of established CVDs. Pioglitazone increased the risk of hospitalization for heart failure (1.3 [1.1–1.6]) and had no treatment effect on all-cause mortality (1.0 [0.8–1.1]). Pioglitazone reduced albuminuria by 18.5% (WMD 18.5% [95% CI, 21.1-16.0]), with a similar benefit in patients with different renal function categories. Conclusions Pioglitazone should be considered in patients with or at high risk of T2DM for the prevention of cardiovascular endpoints, especially in those with a history of established CVD who might benefit the most. Robust reductions in progression of renal disease are seen regardless of baseline renal function degree.

scholarly journals Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1373 ◽  
Author(s):  
Kazue Yamaoka ◽  
Asuka Nemoto ◽  
Toshiro Tango
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Lifestyle Modification ◽  
Meta Analysis ◽  
Intervention Group ◽  
Control Group ◽  
Lifestyle Modifications ◽  
Randomized Controlled ◽  
Indirect Comparisons

Background: Many clinical trials have been conducted to verify the effects of interventions for prevention of type 2 diabetes (T2D) using different treatments and outcomes. The aim of this study was to compare the effectiveness of lifestyle modifications (LM) with other treatments in persons at high risk of T2D by a network meta-analysis (NMA). Methods: Searches were performed of PUBMED up to January 2018 to identify randomized controlled trials. The odds ratio (OR) with onset of T2D at 1 year in the intervention group (LM, dietary, exercise, or medication) versus a control group (standard treatments or placebo) were the effect sizes. Frequentist and Bayesian NMAs were conducted. Results: Forty-seven interventions and 12 treatments (20,113 participants) were used for the analyses. The OR in the LM was approximately 0.46 (95% CI: 0.33 to 0.61) times lower compared to the standard intervention by the Bayesian approach. The effects of LM compared to other treatments by indirect comparisons were not significant. Conclusions: This meta-analysis further strengthened the evidence that LM reduces the onset of T2D compared to standard and placebo interventions and appears to be at least as effective as nine other treatments in preventing T2D.

36. Anal cytology and HPV genotyping in women with lower genital tract neoplasia

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 587 ◽  
Author(s):  
Katina Robison ◽  
Beth Cronin ◽  
Christine Luis ◽  
Paul DiSilvestro ◽  
Melissa Clark
Keyword(s):  
High Risk ◽  
Genital Tract ◽  
Exposed Group ◽  
Control Group ◽  
High Grade ◽  
Hpv Genotyping ◽  
Lower Genital Tract ◽  
Anal Cytology ◽  
History Of ◽  
High Risk Hpv

Objective To compare the prevalence of abnormal anal cytology and high-risk HPV among women with a recent history of HPV-related genital neoplasia to women without a history of HPV-related genital neoplasia. Methods: A cross-sectional pilot study was performed. Women with a history of high-grade cervical, vulvar, or vaginal dysplasia or cancer within the past 2 years were eligible for the exposed group. Women without a history of high-grade anogenital dysplasia or cancer were eligible for the control group. Anal cytology and HPV genotyping were performed after informed consent was obtained. Results: 127 women were enrolled in the exposed group and 45 in the control group. The control group was slightly older and less likely to be current smokers. There was no difference between groups in history of anal intercourse. Forty-four per cent of the exposed group had abnormal anal cytology compared with 21.6% of the control group (P = 0.03). High-risk HPV was detected in the anal canal of 6 in the exposed group compared with none in the control group (P = 0.2). Fourteen per cent of the anal cytology results were read as insufficient in both groups. HPV results were insufficient in 29.2% of exposed versus 43.5% of control (P = 0.2). Conclusions: Women with a history of lower genital tract dysplasia are more likely to have a positive anal cytology result compared with women without a history. Additional information is needed to determine the best method of anal cancer screening among women with a history of lower genital tract dysplasia.

A Six Year Follow-Up Study of Sixty-Five Adolescent Patients: Predictive Value of Presenting Clinical Picture

1969 ◽  
Vol 115 (529) ◽  
pp. 1437-1441 ◽  
Author(s):  
Lucy J. King ◽  
Glen D. Pittman
Keyword(s):  
Urban Areas ◽  
Psychiatric Patients ◽  
Public Hospitals ◽  
Private Hospitals ◽  
State Hospitals ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Adolescent Patients ◽  
History Of

Diagnosis of adolescent psychiatric patients is complicated by the absence of history of function in an adult role and by the assumed presence of psychological turmoil, thought to be normal at this age. Information about prognosis, always a useful part of clinical management, is especially important in counselling adolescent patients and their families about the prospects for education, vocation, and marriage.†Patients came from both rural and urban areas of several neighbouring states. Parents or guardians of approximately one-third were teachers, salesmen, or shopkeepers and of another third, skilled labourers or farmers. The remainder were approximately equally divided between the well-to-do at one extreme and unskilled labourers at the other. That this sample provided a wider distribution among social strata than most private hospitals or most public hospitals is borne out by the fact that some patients who were subsequently hospitalized again were treated in private hospitals while others were admitted to public facilities (state hospitals).

Educational Services for Students with Intellectual Disabilities in Rural and Urban Areas of the Republic of Ireland

1996 ◽  
Vol 15 (3) ◽  
pp. 20-24 ◽  
Author(s):  
Hugh Gash ◽  
Mark O'reilly ◽  
Patricia Noonan Walsh
Keyword(s):  
Intellectual Disabilities ◽  
Service Provision ◽  
Urban Areas ◽  
Educational Services ◽  
Educational Systems ◽  
Republic Of Ireland ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
History Of ◽  
The Republic

We have examined the history of education service provision in the Republic of Ireland for persons with intellectual disabilities. We distinguished between children with mild or general learning difficulties and those with severe and profound intellectual disabilities as the development of educational services for these two groups has differed dramatically. Distinctions between rural and urban educational systems were made where appropriate. We have purposefully neglected to address services for students with moderate intellectual disabilities as we believe that those services for students with mild and severe intellectual disabilities will give the reader an overall flavour of educational services in Ireland within the context of this brief report. The current context of educational service provision in Ireland has also been highlighted with recent debates and suggestions for future development presented.

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