Effects of Diaphragmatic Breathing and Systematic Relaxation on Depression, Anxiety, Stress, and Glycemic Control in Type 2 Diabetes Mellitus

2021 ◽  
Author(s):  
Abhishek Yadav ◽  
Rajeev Mohan Kaushik ◽  
Reshma Kaushik
Keyword(s):  
Glycemic Control ◽  
Well Being ◽  
Depression And Anxiety ◽  
Diaphragmatic Breathing ◽  
Group A ◽  
Student’S T ◽  
Group B ◽  
Mental Well Being ◽  
Student’S T Test

Abstract This prospective study assessed the effects of diaphragmatic breathing and systematic relaxation on depression, anxiety, and stress levels, as well as glycemic control, in patients with type 2 diabetes mellitus (T2DM). One hundred patients with T2DM were randomly assigned to two equal groups: Group A patients received conventional treatment for T2DM, and Group B patients received conventional treatment for T2DM plus training in diaphragmatic breathing and systematic relaxation and home practice of these stress-management techniques for 6 months. Stress, depression, and anxiety levels, blood sugar, and glycated hemoglobin (HbA1c) were recorded at baseline and after 6 months of treatment in all patients. Baseline characteristics were compared using the chi-square test and student’s t test. Changes in mental well-being and glycemic status were assessed for their significance in each group using student’s t test and compared between two groups using one-way analysis of covariance (ANCOVA). Baseline levels of the respective change outcome and duration of diabetes were used as covariates in the ANCOVA. A significant decrease was seen in depression, anxiety, and stress scores in Group B, but in Group A only the stress score decreased after 6 months. A significant decline occurred in blood sugar (fasting, 2-hour postprandial, and random) and HbA1c in both groups after 6 months. There was a larger decrease in depression and anxiety scores and HbA1c in Group B than in Group A. The decrease in HbA1c was significantly correlated with the decrease in anxiety and stress scores in both groups and with the depression score in Group A. Thus, the addition of diaphragmatic breathing and systematic relaxation to conventional T2DM treatment appears to have led to improvement in mental well-being and glycemic control in patients with T2DM.

scholarly journals Atenolol prevents the formation of expansive hematoma after rhytidoplasty

2014 ◽  
Vol 41 (5) ◽  
pp. 305-310 ◽  
Author(s):  
Amanda Castilho Moreira ◽  
Marcio Moreira ◽  
Sanderland José Tavares Gurgel ◽  
Yasmin Castilho Moreira ◽  
Eguimar Roberto Martins ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Standard Deviation ◽  
Continuous Variables ◽  
Hematoma Formation ◽  
Group A ◽  
The Mean ◽  
Student’S T ◽  
Group B ◽  
Student’S T Test

Objective: To evaluate the perioperative use of atenolol in reducing the incidence of hematoma after rhytidoplasty.Methods: Between January 2007 and February 2013, 80 patients were randomized into two groups: Group A (n = 26) received perioperative atenolol in order to maintain heart rate (PR) around 60 per minute; Group B (n = 54) did not receive atenolol. Both groups underwent the same anesthetic and surgical technique. We monitored blood pressure (BP), HR, hematoma formation and the need for drainage. Patients were followed-up until the 90th postoperative day. The variables were compared between the groups using the ANOVA test. Continuous variables were presented as mean ± standard deviation and the differences were compared with the Student's t test. Values of p d" 0.05 were considered significant.Results: In group A the mean BP (110-70mmHg ± 7.07) and HR (64 / min ± 5) were lower (p d" 0.05) than in group B (135-90mmHg ± 10.6) and (76 / min ± 7.5), respectively. There were four cases of expansive hematoma in group B, all requiring reoperation for drainage, and none in group A (p d" 0,001).Conclusion: The perioperative use of atenolol caused a decrease in blood pressure and heart rate and decreased the incidence of expanding hematoma after rhytidectomy.

Management of women with PCOS using myo-inositol and folic acid. New clinical data and review of the literature

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Pedro-Antonio Regidor ◽  
Adolf Eduard Schindler ◽  
Bernd Lesoine ◽  
Rene Druckman
Keyword(s):  
Placebo Group ◽  
Folic Acid ◽  
Side Effects ◽  
Embryo Quality ◽  
T Test ◽  
Group A ◽  
The Mean ◽  
Student’S T ◽  
Group B ◽  
Student’S T Test

Abstract Introduction The use of 2 × 2000 mg myo-inositol +2 × 200 μg folic acid per day is a safe and promising tool in the effective improvement of symptoms and infertility for patients with polycystic ovary syndrome (PCOS). In addition, PCOS is one of the pathological factors involved in the failure of in vitro fertilization (IVF). Typically, PCOS patients suffer of poor quality oocytes. Patients and methods In an open, prospective, non-blinded, non-comparative observational study, 3602 infertile women used myo-inositol and folic acid between 2 and 3 months in a dosage of 2 × 2000 mg myo-inositol +2 × 200 μg folic acid per day. In a subgroup of 32 patients, hormonal values for testosterone, free testosterone and progesterone were analyzed before and after 12 weeks of treatment. The mean time of use was 10.2 weeks. In the second part of this trial it was investigated if the combination of myo-inositol + folic acid was able to improve the oocyte quality, the ratio between follicles and retrieved oocytes, the fertilization rate and the embryo quality in PCOS patients undergoing IVF treatments. Twenty-nine patients with PCOS, underwent IVF protocols for infertility treatment and were randomized prospectively into two groups. Group A (placebo) with 15 patients and group B (4000 mg myo-inositol +400 μg folic acid per day) with 14 patients were evaluated. The patients of group B used 2 months’ myo-inositol + folic acid before starting the IVF protocol. For statistically analyses Student’s t-test was performed. Results Seventy percent of the women had a restored ovulation, and 545 pregnancies were observed. This means a pregnancy rate of 15.1% of all the myo-inositol and folic acid users. In 19 cases a concomitant medication with clomiphene or dexamethasone was used. One twin pregnancy was documented. Testosterone levels changed from 96.6 ng/mL to 43.3 ng/mL and progesterone from 2.1 ng/mL to 12.3 ng/mL in the mean after 12 weeks of treatment (p < 0.05) Student’s t-test. No relevant side effects were present among the patients. The women in the IVF treatment the group A showed a higher number of retrieved oocytes than group B. Nevertheless, the ratio follicle/retrieved oocyte was clearly better in the myo-inositol group (= group B). Out of the 233 oocytes collected in the myo-inositol group, 136 where fertilized whereas only 128 out of 300 oocytes were fertilized in the placebo group. With regards to the oocytes quality, better data were obtained in the myo-inositol group. More metaphase II and I oocytes were retrieved in relation to the total number of oocytes, when compared with the placebo group. Also, more embryos of grade I quality were observed in the myo-inositol group than in the placebo group. The duration of stimulation was 9.7 days (±3.3) in the myo-inositol group and 11.2 (±1.8) days in the placebo group and the number of used follicle-stimulating hormone (FSH) units was lower in the myo-inositol group in comparison to the placebo group: 1850 FSH units (mean) versus 1850 units (mean). Discussion Myo-inositol has proven to be a new treatment option for patients with PCOS and infertility. The achieved pregnancy rates are at least in an equivalent or even superior range than those reported using metformin as an insulin sensitizer. No moderate to severe side effects were observed when myo-inositol was used at a dosage of 4000 mg per day. In addition, our evidence suggests that a myo-inositol therapy in women with PCOS results in better fertilization rates and a clear trend to a better embryo quality. As by the same way the number of retrieved oocytes was smaller in the myo-inositol group, the risk of a hyperstimulation syndrome in these patients can be reduced. Therefore, myo-inositol also represents an improvement in IVF protocols for patients with PCOS.

scholarly journals Geriatric Type 2 diabetes; the risk factors and associations for medication non-adherence.

2020 ◽  
Vol 27 (02) ◽  
pp. 260-267
Author(s):  
Nadia Shams ◽  
Sadia Amjad ◽  
Naresh Kumar Seetlani ◽  
Furquana Niaz ◽  
Shazia Farhat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Glycemic Control ◽  
Functional Status ◽  
Functional Dependence ◽  
Diabetes Duration ◽  
Group A ◽  
Group B

Objectives: To determine medication adherence in geriatric type 2 diabetes cases, risk factors for non-adherence and association with functional dependence. Study Design: Descriptive cross sectional. Setting: Department of Medicine, RIHS Islamabad. Period: Sept. 2016 - Feb. 2017. Material & Methods: 100 type 2 diabetes cases (>65 years) included in group-A (geriatric group) and 100 gender matched type 2 diabetes cases (<65 years) in group-B (non-geriatric group). Type 1 diabetes cases, critically ill and with incomplete medication record were excluded. Morisky Diabetes Questionnaire (MMAS-8) applied for medication adherence. Glycemic control, diabetes duration, co-morbids, treatment regime, poly-pharmacy, alternative medicine, functional status (Katz index) and visual morbidity assessed in both groups. Data analyzed by SPSS V-20 and Chi-square test applied with significant p < 0.05. Results: Mean age was 71.43+5.58 years (group-A) vs. 49.28+6.57 years (group-B). Mean diabetes duration was 9.61+8 years (group-A) vs. 7.4+4.9 years (group B). Functional status was independent in 53%(group-A) vs. 86%(group-B), significantly dependent 40%(group-A) vs. 11%(group-B) and dependent 7% (group-A) vs. 3% (group-B). High adherence in 3% (group-A) vs. 10%(group B); medium 24%(group-A) vs. 32%(group-B) and low 73%(group-A) vs. 58% (group B). Non-adherence in 73%(group-A) vs. 58%(group-B). Poly-pharmacy, co-morbids, combination anti-diabetes regimes, visual morbidity, physical dependence and poor glycemic control was frequent in geriatric diabetes cases (p<0.05). Conclusions: Medication adherence has pivotal role to attain target glycemic control. Higher medication non-adherence in geriatric diabetes cases needs to be addressed. Counseling sessions supported by literature in local language and addressing the identified risk factors may improve medication adherence in geriatric diabetes cases, hence improved glycemic control and morbidity.

Recycling of Stoma Losses: A Good Practice for Neonates with High Output Stomas—Our Experience and Comparison with Literature

2020 ◽  
Vol 34 (4) ◽  
pp. 181-186
Author(s):  
Edoardo Bindi ◽  
Francesco Molinaro ◽  
Francesco Ferrara ◽  
Giulia Fusi ◽  
Alessandra Taddei ◽  
...  
Keyword(s):  
Intestinal Perforation ◽  
Demographic Data ◽  
Good Practice ◽  
Before And After ◽  
Group A ◽  
Student’S T ◽  
Group B ◽  
Risk Rate ◽  
Student’S T Test ◽  
High Output

Introduction: The recycling of proximal stoma losses is known as a good practice to manage patients with high output stoma. In our center, we introduced this practice about 10 years ago. We revised our series before and after recycling protocol and we reviewed the literature. Methods: This is a retrospective study. We included all neonates who underwent ileostomy between 2000 and 2019. They were divided into two groups, Group A and Group B, before and after the introduction of recycling of stoma losses. Demographic data were included. Outcomes evaluated to demonstrate the efficacy of stools recycling were: weight at the time of anastomosis and at discharge, length of total parenteral nutrition, and time (expressed in days) between anastomosis and passage of the stools. Data were analyzed using Student’s t-test. P values <.05 were considered significant. Results: A total of 85 patients (29 females, 56 males) were included—Group A: 20 (24%) (13 males/7 females); Group B: 65 (76%) (43 males/22 females); Group A: 12/enterocolitis, 5/meconium-related ileum (MRI), 3/single intestinal perforation; Group B: 45 enterocolitis, 10/MRI, 8/single intestinal perforation, 1/an ileal atresia, 1/meconial peritonitis. Outcome about weight at anastomosis and discharge and about time of canalization were significant. Conclusion: We believe that the recycling of stoma losses is a safe and effective practice in neonates with ileostomy. Our technique of recycling is simple and practical. The benefit/risk rate is certain, in our opinion, in favor of the benefits as showed from our data.

scholarly journals In Vivo Corneal Confocal Microscopy Detects Improvement of Corneal Nerve Parameters following Glycemic Control in Patients with Type 2 Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaofan Jia ◽  
Xiaogang Wang ◽  
Xiaoxia Wang ◽  
Qi Pan ◽  
Tongzhang Xian ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Confocal Microscopy ◽  
Nerve Conduction ◽  
Corneal Confocal Microscopy ◽  
Group A ◽  
Corneal Nerve ◽  
Group B

Aim. This study aimed to investigate whether in vivo corneal confocal microscopy (CCM) can detect the improvement of corneal nerve parameters following glycemic control in patients with type 2 diabetes in natural history. Methods. Thirty-two patients with diabetes complicated by DPN and 12 age-matched control subjects underwent detailed clinical examination and were assessed per the Toronto Clinical Scoring Scale for DPN, nerve conduction studies, and IVCCM at baseline and after approximately one year from the first visit. Results. At follow-up, 16 diabetic patients had improved glycemic control (group A, HbA1c < 7.0%, 7.78 ± 1.62% versus 6.52 ± 0.59%, P=0.005), while the remainder continued to have elevated HbA1c levels (group B, HbA1c ≥ 7.0%, 8.55 ± 1.57% versus 8.79 ± 1.05%, P=0.527). For patients in group A, corneal nerve fiber density (CNFD) (18.55 ± 5.25 n/mm2 versus 21.78 ± 6.13 n/mm2, P=0.005) and corneal nerve fiber length (CNFL) (11.62 ± 2.89 mm/mm2 versus 13.04 ± 2.44 mm/mm2, P=0.029) increased significantly compared to baseline. For patients in group B, sural sensory nerve conduction velocity (47.93 ± 7.20 m/s versus 44.67 ± 6.43 m/s, P=0.024), CNFD (17.19 ± 5.31 n/mm2 versus 15.67 ± 4.16 n/mm2, P=0.001), corneal nerve branch density (19.33 ± 12.82 n/mm2 versus 14.23 ± 6.56 n/mm2, P=0.033), and CNFL (11.16 ± 2.57 mm/mm2 versus 9.90 ± 1.75 mm/mm2, P=0.011) decreased significantly. Conclusions. The results of this study suggest that morphological repair of corneal nerve fibers can be detected when glycemic control improves. In vivo CCM could be a sensitive method that can be applied in future longitudinal or interventional studies on DPN.

scholarly journals TYPE 2 DIABETES;

2017 ◽  
Vol 24 (06) ◽  
pp. 899-903
Author(s):  
Muhammad Zafar Majeed Babar ◽  
Mazhar Hussain ◽  
Asma Manzur
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Glycemic Control ◽  
Post Treatment ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Group A ◽  
Treatment Changes ◽  
Group B

Background: The data among vitamin D supplementation on glycemic control isvariable and contradictory in various clinical studies. Objectives: To determine the efficacy of vitD supplementation on glycemic control in type 2 diabetic patients. Study Design: Case controlstudy. Setting: Private Clinical Set up of District, Rahim Yar Khan. Period: August to October2016. Patients and methods: 100 cases of type 2 diabetes were randomly divided into groupA and group B each contained 50 patients .The cases in group A were treated with vitamin D3at the dose of 50,000 units per week orally while cases in group B were treated with placeboalong with the standard doses of anti-diabetic drugs. The value of HbA1c and Vit D wereassayed pre and post treatment by high performance liquid chromatography. Results: Therewas significant post treatment changes observed in vitamin D level in group A vs group B inmales 20.46±2.45 vs 15.16±1.47 (p= 0.001) and females 18.32±1.44 vs 13.95±2.48 (p= 0.09)There was significant post treatment changes in HbA1c in males 6.65±0.12 vs 8.34±0.71 (p=0.01) and in females 6.81±0.43 vs 8.04±0.71 (p= 0.03) in group A and group B respectively.Similarly better improvement in vitamin D and HbA1c level was seen with respect to aged group30-50 years and duration of diabetes less than 5 years. Conclusion: Vitamin D is deficient in ourpopulation and its supplementation not only improves its own level but also glycemic control intype 2 diabetic patients.

An Efficacy and Safety Study of Remogliflozin in Obese Indian Type 2 Diabetes Mellitus Patients Who Were Inadequately Controlled on Insulin glargine plus other oral hypoglycemic agents

2020 ◽  
Vol 17 ◽  
Author(s):  
Anand Shankar
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
Therapy Group ◽  
Insulin Dose ◽  
Blood Glucose Control ◽  
Hypoglycemic Agents ◽  
Oral Drug ◽  
Group A ◽  
Group B

Aim & Objective: The objective of this retrospective study was to investigate the efficacy of adding remogliflozin to current insulin glargine plus two oral drug i.e. metformin and teneligliptin therapy in poorly controlled Indian type 2 diabetes. Material and Methods: 173 study participants were initially selected from patient database who continued on their insulin glargine or received an increased dose of insulin glargine along with other OHA based therapy (Group A) and 187 were selected who had received remogliflozin (100 mg BD) (Group B) in addition to insulin glargine along with other OHA based therapy. Glycated haemoglobin (HbA1c), total daily insulin dose, body weight, and the number of hypoglycemic events were recorded at weeks 0, 12 and 24. Result: During the study, mean values of HbA1c, FBG and P2BG were significantly reduced in both groups. Insulin requirements decreased from 45.8 ± 16.7 IU/day to 38.5 ± 13.5 IU/day (P < 0.001) and at week 24 even further decreased to 29.5 ± 14.5 IU/Day . Twenty three patients in group B were able to cease insulin treatment altogether after 24 week treatment. It has been observed to attain tight blood glucose control we need to increase insulin dose in group A from 45.5 ± 16.5 IU/Day to 51.5 ± 14.5 at week 12 (P<0.01) and which further increased to 53.8 ± 12.8 IU/Day at week 24 (P<0.01). Adding remogliflozin showed significant effect on blood pressure (P < 0.001) and weight reduction (P < 0.001). It has been observed that 38% patients has achieves targeted HbA1c (≤7%) in group B where it was 22% in group A. Conclusion: Results demonstrate that in uncontrolled T2DM patients remogliflozin 100 mg BD can successfully lay a foundation for prolonged good glycemic control. Early addition of remogliflozin with insulin glargine plus OHAs may be an alternative compare to intensive up titration of insulin daily dose in people with uncontrolled T2DM. Clinical Trial Registration Number: A 2358

scholarly journals Changes Induced by Mind–Body Intervention Including Epigenetic Marks and Its Effects on Diabetes

2021 ◽  
Vol 22 (3) ◽  
pp. 1317
Author(s):  
Hyun-Jeong Yang ◽  
Eugene Koh ◽  
Min-Kyu Sung ◽  
Hojung Kang
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Epigenetic Modifications ◽  
Cortisol Secretion ◽  
Physiological Changes ◽  
Epigenetic Marks ◽  
Reduce Blood Glucose ◽  
Early Life Events ◽  
Mental Well Being

Studies have evidenced that epigenetic marks associated with type 2 diabetes (T2D) can be inherited from parents or acquired through fetal and early-life events, as well as through lifelong environments or lifestyles, which can increase the risk of diabetes in adulthood. However, epigenetic modifications are reversible, and can be altered through proper intervention, thus mitigating the risk factors of T2D. Mind–body intervention (MBI) refers to interventions like meditation, yoga, and qigong, which deal with both physical and mental well-being. MBI not only induces psychological changes, such as alleviation of depression, anxiety, and stress, but also physiological changes like parasympathetic activation, lower cortisol secretion, reduced inflammation, and aging rate delay, which are all risk factors for T2D. Notably, MBI has been reported to reduce blood glucose in patients with T2D. Herein, based on recent findings, we review the effects of MBI on diabetes and the mechanisms involved, including epigenetic modifications.

Aesthetic outcome and patient’s quality of life in breast cancer patients undergoing mastectomy with or without immediate reconstruction.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12587-e12587
Author(s):  
Sidra Afzal ◽  
Asad Parvaiz ◽  
Nida Javed
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Well Being ◽  
Mean Difference ◽  
Breast Cancer Patients ◽  
Immediate Reconstruction ◽  
Patient’S Satisfaction ◽  
Group A ◽  
The Mean ◽  
Group B

e12587 Background: : Although post mastectomy Immediate breast reconstruction has shown to improve physical and psychosocial well-being of breast cancer patients, this is not a usual procedure in Pakistan due to limited resources and lack of awareness. The aim of our study is to evaluate patient’s satisfaction/ aesthetic outcomes between the patients undergoing mastectomy alone (Group A) and the ones undergoing mastectomy followed by immediate reconstruction (Group B). Methods: This is a prospective study conducted at Shaukat Khanum Hospital Pakistan comparing aesthetic outcome, patient’s satisfaction and Quality of life between two groups using Breast Q module. All patients undergoing mastectomy with and without reconstruction between April 2017 to July 2019 are included. Sample size of 84 was calculated (42 in each group). Results: The mean Q score of satisfaction with the breast in group B is 82.64 and in group A is 35.82 (P = 0.001). The mean Q score of Psychosocial well-being in group B is 89 vs 44.95 in group A (P = 0.001). The mean Q score of Physical well-being in group B is 98.23 vs 90.41 in group A (P = 0.002). The mean Q score of sexual well-being in group B is 81.93 vs 43 in Group A (P = 0.001). [Mean difference in score of 5-10 - little change, 10-20 - moderate change, > 20 - significant change].The mean difference between two groups in satisfaction with breast , psychosocial well-being and sexual well-being is more than 20 with a statistically significant p-value, while in physical well-being the mean difference is 7.8 which falls in little change group. Conclusions: Our study shows that reconstruction helps breast cancer patients in providing comprehensive care in a manner that they achieve a higher satisfaction with their appearance, psychological and sexual well-being without compromising oncological safety and this should be practiced more in our country. Also patients education about these procedures should be raised to help them fighting against this disease

scholarly journals Gamification as an entrepreneur well-being intervention: A study protocol for a single-blinded randomised controlled trial

2021 ◽  
Author(s):  
Waqar M. Naqvi
Keyword(s):  
Controlled Trial ◽  
Life Quality ◽  
Well Being ◽  
Likert Scale ◽  
Control Group ◽  
Group A ◽  
Measuring Scale ◽  
Group B ◽  
Randomised Controlled

Abstract Entrepreneurs usually work for long hours resulting in exhaustion, stress, and burnout. The prevalent symptoms of burnout are reduced levels of physical and mental energy, reduced job efficiency and diminished productivity. Therefore, it is important to improve the health of entrepreneurs. Gamification has a positive relationship with improvements in health and well-being as it influences positive experiences and satisfaction. This trial aims to study how 30-minutes of virtual reality game use via Kinect Azure and Oculus platforms 3-times per week, for 4 weeks, relates to differences in entrepreneur stress, burnout, subjective life quality, and downstream firm performance. We will recruit entrepreneurs over the age of 18 for the gamification analysis. Analysis of previous power using G*Power will determine the sample size. We will divide the participants into 3 groups, wherein Group A will undergo gamification on the Kinect platform, Group B will undergo the Oculus Quest intervention, and Group C will be the control group. We will conduct the study at two sites, one at the HuMen research. The outcome measures include a five-point Likert scale for measuring entrepreneurial stress, burnout-measuring scale (BMS) for burnout, five-point Likert scale for performance and SF-12 for Quality of life. Since current strains pave ways to future accomplishment, entrepreneurs' eudemonic well-being might particularly relate to forward-looking challenge stressors and burnouts. The results will provide an insight into how gamification could help entrepreneurs to deal with work stress and maintain high well-being.

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