ROLE OF ASPHOTA (HEMIDESMUS INDICUS R.BR.) KSHARASUTRA IN THE MANAGEMENT OF LOW-ANAL FISTULA

In this modern era, due to a sedentary lifestyle and improper dietary habit digestive disorder shows greater inci- dence. Among them, fistula-in-ano is troubleshooting one, which is a communicating tract between two epithelial surfaces lined by granulation tissues. Due to the higher recurrence rate and postoperative complication fistula-in- ano is a headache in the present era. In Ayurvedic classics, Ksharasutra prayoga is mentioned for the treatment of Nadi Vrana, which can be adopted in the management of anal fistula. The objective of the present study was to be evaluated the efficacy of Asphota Kshara sutra in the management of low anal fistula. The clinical trial was con- ducted in OPD and IPD of Shalyatantra department at Pankajakasthuri Ayurveda Medical College. The intervention was ligation of the fistulous tract with Asphota Ksharasutra. 25 subjects were selected satisfying inclusion and exclusion criteria. The clinical assessment was done before treatment, after treatment and follow up on the 30th day after cutting through of the tract. The assessment was done based on parameters prepared for anal fistula by Paul O Madson and Peter. Pain, burning sensation, inflammation, itching, discharge and unit cutting time was statistically analysed in different periods. Outcome variables were analysed statistically by using the Friedman test and Wilcox- son signed-rank rest, and a conclusion was drawn. Pain, burning sensation, inflammation, discharge, itching was effectively managed using Asphota Ksharasutra. The unit cutting time of Aspota ksharasutra was found to be more than standard Ksharasutra. The result showed that Aspota Ksharasutra is effective in the management of low anal fistula. Keywords: Fistula-in-ano; Asphota ksharasutra.

Cross-sectional Associations between Lifestyle Factors and Obesity among Students in a University at Gyeonggi Province

Objectives: This study examined the associations between lifestyle factors and obesity among university students.Methods: In this cross-sectional correlational study, 671 students completed measures of lifestyle factors (dietary habit, exercise, smoking, and alcohol drinking), health concern, academic stress, and anthropometric indices. Obesity was classified by body mass index (BMI) and abdominal circumference (AC). The data were analyzed with χ2 test, Mann-Whitney U test and logistic regression.Results: The frequencies of obesity and abdominal obesity were higher in male students than in female students (17.6% vs. 3.4% by BMI, 18.9% vs. 5.9% by AC). Abdominal obesity in students with diabetic parent was higher (16.8%) than in students without diabetic family history (9.2%). Obesity of BMI ≥ 25 kg/m2 associated with breakfast absence of 5-7 times/week (odds ratio, OR: 1.98, 95% confidence interval, CI: 1.05-3.71). Abdominal obesity associated with instant foods intake of 5-7 times/week (OR: 2.65, 95% CI: 1.14-6.17), fast foods intake of 3-4 times/week (OR: 2.87, 95% CI: 1.48-5.56), snacks of 3-4 times/wk (OR: 2.15, 95% CI: 1.15-4.00), and consumed alcohol of ≥ 1 glass a day (OR: 2.11, 95% CI: 1.19-3.73).Conclusions: Breakfast absence is associated with obesity. Instant foods, fast foods, snacks, and alcohol consumption are the associated factors with abdominal obesity among university students.

Undiagnosed Hypertension and Its Associated Factors Among Adult People Living in Southern Ethiopia: Discovery From Gunchire Woreda of Gurage Zone

Background: Hypertension is defined as two or more readings of systolic blood pressure measurement of 130 mm Hg or higher or diastolic blood pressure measurement of 80 mm Hg or higher. Symptoms of hypertension (HTN) are often not detectable at early stages and because of this many people with the disease are mostly left undiagnosed. Undiagnosed HTN is the one that increases the risk of complications such as renal failure, heart failure, myocardial infarction, stroke and premature death. There is no report concerning undiagnosed hypertension in the area. This study is aimed to assess prevalence of undiagnosed hypertension and its associated factors among adult peoples.Method: Community based Cross-sectional study design was conducted. English version questionnaire was used to collect data from 574 households. The data was collected and analyzed by SPSS version.23. The association between dependent and independent variables was tested by using multivariate regression at P-value less than 0.05 and 95% CI.Result: Out of 590 participants, 108 (18.8%) respondents were cigarette smokers and 143 (24.9%) were khat chewers. About 106 (18.5%) of respondents have sedentary lifestyle. A total of 260 (45.3%) of respondents were identified as having undiagnosed hypertension. Respondents having sedentary life style had about 2.24 time’s higher risk of undiagnosed HTN than those who didn’t have sedentary life style. BMI, sedentary life style, cigarettes smoking, health seeking behavior, dietary habit and monthly income were significant predictors of undiagnosed HTN.Conclusion: Based on the identified high prevalence of undiagnosed hypertension, the finding suggests awareness creation for community members about undiagnosed hypertension, its symptoms and ways of managing it.

Ambient Cumulative PM2.5 Exposure and the Risk of Lung Cancer Incidence and Mortality: A Retrospective Cohort Study

Smoking, sex, air pollution, lifestyle, and diet may act independently or in concert with each other to contribute to the different outcomes of lung cancer (LC). This study aims to explore their associations with the carcinogenesis of LC, which will be useful for formulating further preventive strategies. This retrospective, longitudinal follow-up cohort study was carried out by connecting to the MJ Health Database, Taiwan Cancer Registry database, and Taiwan cause of death database from 2000 to 2015. The studied subjects were persons attending the health check-ups, distributed throughout the main island of Taiwan. Cox proportional hazards regression models were used to investigate the risk factors associated with LC development and mortality after stratifying by smoking status, with a special emphasis on ambient two-year average PM2.5 exposure, using a satellite-based spatiotemporal model at a resolution of 1 km2, and on dietary habit including consumption of fruits and vegetables. After a median follow-up of 12.3 years, 736 people developed LC, and 401 people died of LC-related causes. For never smokers, the risk of developing LC (aHR: 1.32, 95%CI: 1.12–1.56) and dying from LC-related causes (aHR: 1.28, 95%CI: 1.01–1.63) rises significantly with every 10 μg/m3 increment of PM2.5 exposure, but not for ever smokers. Daily consumption of more than two servings of vegetables and fruits is associated with lowering LC risk in ever smokers (aHR: 0.68, 95%CI: 0.47–0.97), and preventing PM2.5 exposure is associated with lowering LC risk for never smokers.

Developing a Dietary Lifestyle Ontology (DILON) to Improve the Interoperability of Dietary Data (Preprint)

BACKGROUND Dietary habits offer crucial information on one's health and form a considerable part of the Patient-Generated Health Data (PGHD). Dietary data are collected through various channels and formats; thus, interoperability is a significant challenge to reusing the data. The vast scope of dietary concepts and colloquial style of expression add difficulty to the standardization task. Common Data Elements (CDE) with metadata annotation and ontological structuring of dietary concepts address the interoperability issues of dietary data to some extent. However, challenges remaining in making culture-specific dietary habits and questionnaire-based dietary assessment data interoperable require additional efforts. OBJECTIVE The main goal of this study was to address the interoperability challenge in dietary concepts by combining ontological curation of dietary concepts and metadata annotation of questionnaire-based dietary data. Specifically, this study aimed to develop a Dietary Lifestyle Ontology (DILON) and demonstrated the improved interoperability of questionnaire-based dietary data by annotating its main semantics with DILON. METHODS By analyzing 1158 dietary assessment data elements (367 in Korean and 791 in English), 515 dietary concepts were extracted and used to construct DILON. To demonstrate the utility of DILON in improving the interoperability of multi-cultural questionnaire-based dietary data, ten Competency Questions (CQs) were developed that identified data elements that share the same dietary topics and measurement qualities. As the test cases, 68 dietary habit data elements from Korean and English questionnaires were instantiated and annotated with the dietary concepts in DILON. The competency questions were translated into Semantic Query-enhanced Web Rule Language (SQWRL), and the query results were reviewed for accuracy. RESULTS DILON was built with 260 concept classes and 486 instances and successfully validated with ontology validation tools. A small overlap (72 concepts) in the concepts extracted from the questionnaires in two languages indicates the need to pay closer attention to representing culture-specific dietary concepts. The SQWRL queries reflecting the 10 CQs yielded the correct results. CONCLUSIONS Ensuring the interoperability of dietary lifestyle data is a demanding task due to its vast scope and variations in expression. This study demonstrated that, when combined with common data elements and semantic metadata annotation, ontology can effectively mediate the interoperability of dietary data generated in different cultural contexts and expressed in various styles.

Lipid Profile in Relation to Body Mass Index among Medical College Students in Dhaka, Bangladesh.

Introduction: In Bangladesh, adolescents have unhygienic eating habits; often eating nutritionally unbalanced and junk & fast food diet that is low in dietary fibre and high in cholesterol, simple sugars, fats and additive. These types of dietary habit lead to obesity and dyslipidaemia. Obesity is a worldwide health problem and it is associated with dyslipidaemia and other metabolic syndrome. Objectives: To observe the relationship between Body Mass Index (BMI) and lipid profile among medical college students in Bangladesh. Materials & Methods: This cross sectional observational study was conducted in Department of Medicine, Sir Salimullah Medical College & Mitford Hospital, Dhaka, among the 100 undergraduate medical students. Detailed history, clinical examination and thorough investigations were done and the findings were recorded on a proforma. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: Maximum subjects (57.0%) were in the age group 21-23 years. Mean age was 23.42±4.5 years. The prevalence of the different abnormal lipid profile including hypercholesterolaemia, low level of HDL, high level of LDL and hypertriglyceridaemia were: 22.0%, 31.0%, 30.0% and 28.0% respectively. Hypercholesterolaemia and hypertriglyceridaemia levels were significantly associated with increasing body mass index. Conclusion: Overweight and obesity is common among the study subjects and those with higher BMI particularly the older ones tend to have abnormal lipid profile. Therefore adequate dietary control, food habit & life-style modification is needed for prevention of dyslipidemia at early life. Medicine Today 2021 Vol.33(2): 114-119

A Study to Assess the Knowledge on Kangaroo Mother Care Among Post Natal Mothers of Low-Birth-Weight Babies at Selected Hospital of Vrindavan, Mathura, U.P.

According to the statistical assessment nearly 20 million low-birth-weight (LBW) babies are born each year, because of either preterm birth or impaired prenatal growth, mostly in less developed countries. They contribute substantially to a high rate of neonatal mortality whose frequency and distribution correspond to those of poverty. Kangaroo mother care (KMC) is an effective way to meet baby’s needs for warmth, breastfeeding, protection from infection, stimulation, safety and love. Kangaroo mother care is care of preterm infants carried skin-to-skin with the mother. It is a powerful, easy-to-use method to promote the health and well-being of infants born preterm as well as full-term. KMC facilitates the initiation and establishment of breastfeeding in small infants and it normalize infant physiology improves weight gain and provide sense of security to the baby. It has been demonstrated that Kangaroo Mother Care is associated with increased survival and reduced hospital. Objectives 1) To assess the level of knowledge among the post-natal mothers of low-birth-weight babies regarding kangaroo mother care in selected hospital of Vrindavan. 2) To correlate the knowledge regarding Kangaroo Mother Care among the post-natal mothers of low-birth-weight babies with selected demographic variables. Methodology: This study was conducted to assess knowledge among the post-natal mothers regarding Kangaroo mother care in selected Hospital in Vrindavan, Mathura and the descriptive study design was selected. Population selected was post-natal mothers and sample size were 60.the consent was taken. The subjects were selected by convenient sampling technique. The structured questionnaires were distributed to the mothers of selected Low birth weight babies to assess their level of regarding Kangaroo Mother Care after obtaining an informed consent. Data was collected by using Structured Knowledge Questionnaire. A significant association was found between knowledge score and type of family and dietary habit whereas no significant association was found with age, religion, occupation of father, educational status of mother, family income and residential status Results: The study revealed that the level of knowledge among the mothers is 42(70%) had inadequate knowledge and 12(20%) had moderately adequate knowledge and 06(10%) had adequate knowledge regarding Kangaroo Mother Care. The chi-square test revealed that there was no significant association with age, occupation, monthly income, place of living, type of marriage, type of family, number of children and but there was significant association between religion. Keywords: Kangaroo mother care, Postnatal, Practice

Assessment Transition of Exercise and Dietary Habit of Athletes Before and During Ramadan in the Pandemic of COVID-19

This study aims to identify the training transitions and dietary habits of volleyball athletes' before and during Ramadan in the Covid-19 pandemic. The research design used is descriptive quantitative with a sample of 12 male junior volleyball athletes in the academy Sidoarjo volleyball. The results showed that most athletes experienced a decrease in the frequency of exercise during the month of Ramadan, especially during the COVID-19 pandemic. A total of 33.3% of athletes maintained their exercise frequency, and 66.7% experienced a decrease in exercise frequency. Furthermore, during Ramadan and Covid-19, there was an increase in the frequency of eating 1-2 times a day (58.4%), snack consumption (50%), fruit and vegetables (75%), fried foods 4-7 times a week (8.4%), instant noodles 1-3 times a week (25%) and fast food 1-3 times a week (8.4%) in athletes. Concerning this, it is imperative to revitalize the program and monitor the athlete's training periodically, which is adjusted to the conditions of the COVID-19 pandemic and provide a dietitian to regulate the athlete's diet to obtain a balanced nutritional intake following the exercise portion.Assessmen transisi latihan dan pola makan atlet sebelum dan saat ramadan di masa pandemi Covid-19AbstrakTujuan dari penelitian ini adalah untuk mengidentifikasi transisi latihan dan pola makan atlet bola voli sebelum dan saat ramadan di masa pandemi Covid-19. Desain penelitian yang digunakan yaitu deskriptif kuantitatif dengan sampel 12 atlet laki-laki bola voli junior yang masih aktif dalam menjalani pemusatan latihan di Akademi Bola Voli Indomaret Sidoarjo. Hasil penelitian menunjukkan bahwa mayoritas atlet mengalami penurunan frekuensi latihan saat ramadan khususnya di masa pandemi covid-19. Sebanyak 33,3% yang mampu mempertahankan frekuensi latihan dan 66,7% mengalami penurunan frekuensi latihan. Selanjutnya, saat ramadan dan Covid-19 terjadi peningkatan frekuensi makan 1-2 sehari (58,4%), konsumsi camilan (50%), buah dan sayuran (75%), gorengan 4 – 7 kali dalam seminggu (8,4%), mie instant 1 – 3 kali dalam satu minggu (25%) serta makanan cepat saji 1 – 3 kali dalam seminggu (8,4%) pada atlet. Berdasarkan hal ini, maka sangat penting untuk melakukan revitalisasi program dan pemantauan latihan atlet secara berkala yang disesuaikan dengan masa pandemi covid-19 dan menyediakan dietisien untuk pengaturan makan atlet agar dapat memperoleh asupan gizi seimbang sesuai dengan porsi latihannya.

Plasma Ceramides Pathophysiology, Measurements, Challenges, and Opportunities

Ceramides are a family of lipid molecules, composed of sphingosine and a fatty acid, and transported by lipoproteins (primarily by low-density lipoproteins) in the bloodstream. They are not only structural lipids, but multifunctional and bioactive molecules with key roles in many important cellular pathways, such as inflammatory processes and apoptosis, representing potential biomarkers of cardiometabolic diseases as well as pharmacological targets. Recent data reported ceramide modulation by diet and aerobic exercise, suggesting nutrients and exercise-targeting sphingolipid pathways as a countermeasure, also in combination with other therapies, for risk and progression of chronic disease prevention and health maintenance. In this review, we focus on the available data regarding remarks on ceramide structure and metabolism, their pathophysiologic roles, and the effect of dietary habit and aerobic exercise on ceramide levels. Moreover, advancements and limitations of lipidomic techniques and simplification attempts to overcome difficulties of interpretation and to facilitate practical applications, such as the proposal of scores, are also discussed.

High Fructose Intake Contributes to Elevated Diastolic Blood Pressure in Adolescent Girls: Results from The HELENA Study

Background: The association between high fructose consumption and elevated blood pressure continues to be controversial, especially in adolescence. The aim of this study was to assess the association between fructose consumption and elevated blood pressure in an European adolescent population. Methods: A total of 1733 adolescents (mean ± SD age: 14.7 ± 1.2; percentage of girls: 52.8%) were analysed from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study in eight European countries. Blood pressure was measured using validated devices and methods for measuring systolic blood pressure (SBP) and diastolic blood pressure (DBP). Dietary data were recorded via repeated 24 h recalls (using specifically developed HELENA–DIAT software) and converted into pure fructose (monosaccharide form) and total fructose exposure (pure fructose + fructose from sucrose) intake using a specific fructose composition database. Food categories were separated at posteriori in natural vs. were non-natural foods. Elevated BP was defined according to the 90th percentile cut-off values and was compared according to tertiles of fructose intake using univariable and multivariable mixed logistic regression models taking into account confounding factors: centre, sex, age and z-score–BMI, MVPA (Moderate to Vigorous Physical Activity) duration, tobacco consumption, salt intake and energy intake. Results: Pure fructose from non-natural foods was only associated with elevated DBP (DBP above the 10th percentile in the highest consuming girls (OR = 2.27 (1.17–4.40); p = 0.015) after adjustment for cofounding factors. Conclusions: Consuming high quantities of non-natural foods was associated with elevated DBP in adolescent girls, which was in part due to high fructose levels in these foods categories. The consumption of natural foods containing fructose, such as whole fruits, does not impact blood pressure and should continue to remain a healthy dietary habit.