Effect of Triphala Kajjali tablet - an Ayurvedic herbomineral formulation for the management of metabolic syndrome: a single case study

Metabolic syndrome (MS) is a group of disorders that includes abdominal obesity, diabetes, hypertension, and elevated cholesterol. Approximately 25% of the adult populations are affected by MS. Gradually this number is increasing because of poor lifestyles, faulty dietary pattern, physical inactivity, stressful life and rapid urbanization. A 50-year-old female patient visited to OPD of Kayachikitsa department ITRA, Jamnagar, with the complaints of gradual weight gain with excess body fat around the abdomen and waist region, numbness and burning sensation at bilateral feet, and breathlessness on exertion. After investigation, she was diagnosed as a case of MS as per National Cholesterol Education Program (NCEP), adult treatment panel III (revised in 2005) guideline. She was treated with Triphala Kajjali tablet for 12 weeks along with lifestyle modification. After completion of treatment, investigations revealed reduction in fasting blood sugar from 113 mg/dL to 80 mg/dL, serum cholesterol level was decreased to 148 mg/dl from 216 mg/dl, serum triglycerides level was reduced to 150 mg/dL from 187 mg/dL and serum LDL was reduced to 68.3 mg/dl from 118.7 mg/dl. Her weight reduced to75 kg from 85 kg, and waist circumference reduced to 92 cm from 100cm, and blood pressures also reduced up to 122/82 mmHg from 140/90 mmHg. Hence, it can be concluded that Triphala Kajjali tablet along with lifestyle modification are effective in the management of MS, as it possesses Kapha Medohara properties.

LIPID PROFILE IN COPD PATIENTS

Background: The COPD patients are expected to have a deranged lipid profile for various reasons like smoking, aging, and using such drugs as steroids. Aims of study to estimate the lipid profile level in COPD patients. Methods: This cross-sectional study was conducted on 50 COPD patients and including 50 control were enrolled in the study. Results: The lipid profile in COPD patients, unpaired t test was performed and it was observed that COPD patients showed significantly higher serum levels of TC, TG, LDL and serum concentrations of HDL were also decreased significantly compared to controls. Conclusion: COPD patients showed significantly higher serum cholesterol level in COPD patients as compared to controls. Keywords: Total cholesterol, TG, COPD.

Development and evaluation of whey based grapes and papaya drink

Whey is nutritious by-product of cheese industry which is dumped into fields, canals and rivers in Bangladesh. It has biological active peptides, proteins and other functional characteristics, due to which it could be used in different food products such as infant formula, beverages and sports nutrition products. Grapes and papaya are rich source of sugar, vitamins, bioactive compounds, dietary antioxidants and fructo-oligosaccharide. They improve the mineral absorption, decrease the serum cholesterol level and stimulate the intestinal microflora due to their prebiotic effects. The current study is being planned to develop low cost nutritive whey-based fruit drink in Bangladesh. Grapes and papaya will be added in the whey with different ratio for development of suitable drink. The drinks will be pasteurized or unpasteurized filled in bottles and keep in refrigerator for the period of 15 days. During storage drinks will be evaluated for physicochemical attributes (ash, pH, crude fat, crude protein, acidity, solid not fat, viscosity and total solids), Microbial (TVC and Coliform) and sensory evaluation (appearance, taste, flavor and over all acceptability) will also be came out during storage. Consequently, the obtained data will be analyzed statistically following two factors under CRD design.

An audit to assess physical health monitoring of patients following their admission to the general adult psychiatric inpatient wards in Mersey Care NHS Foundation Trust

AimsThis audit aimed to establish whether patients undergo physical health monitoring within 24 hours of admission to one of the general adult inpatient wards in Mersey Care NHS Foundation Trust, as per Trust policy.BackgroundMean life expectancy in individuals with severe and enduring mental illness (SMI) is 15-20 years shorter than that of the general population. A significant proportion of excess mortality in patients with SMI is due to natural causes, e.g. cardiovascular disease and type II diabetes mellitus. Although SMI patients are at greater risk of developing chronic physical health problems, they often receive worse health care than the general population. Shared care of SMI patients between primary and secondary healthcare professionals causes uncertainty over who is responsible for monitoring the physical health of these patients.MethodA list of all inpatients on the eight general adult wards in the Trust was obtained in September 2020, producing a sample of 135 inpatients.An audit tool was designed, capturing demographic data – gender, age, ethnicity. The patient's psychiatric diagnosis was recorded. The tool captured whether each of the following were measured following admission – body mass index (BMI), blood pressure (B.P), serum cholesterol level, QRISK score and HbA1c level, and, if so, whether this was done within 24 hours of admission. For those patients who were smokers, being offered nicotine replacement therapy was documented.ResultOf the 135 inpatients, 10 didn't have any physical health monitoring completed and were excluded from the sample, making the final sample 125 inpatients. 68 of the inpatients were male, 57 were female. 98 had a diagnosis of an SMI, 27 did not. Most inpatients were of “white British” ethnicity. 91% of the sample had a BMI measured within 24 hours of admission, but only 62% had a B.P done, 59% had a serum cholesterol level done and 58% had an HbA1c level done within 24 hours of admission. 78% of eligible patients had a QRISK score calculated. 97% of inpatients who were smokers were offered nicotine replacement therapy, but only 13% accepted it.ConclusionThe majority of patients admitted to the general adult inpatient wards have an SMI. The audit findings show need for improvement in physical health monitoring following admission. Creation and implementation of a checklist of physical health parameters to be measured within 24 hours of admission could help improve performance. Use of motivational interviewing may help increase uptake of nicotine replacement therapy in smokers.

Silhouette of cardiac impairment in diabetic patients at a medical college in Rewa district

Background: The modern technology (TMT) had helped to detect cardiac impairment in diabetes patients relative to past. This study had attempted to use modern tools for detection of cardiac impairment in patients who attended OPD in a medical college of Rewa district. Objectives of the study was to evaluate cardiac dysfunction and factors associated with cardiac dysfunction (using values of TMT) in diabetic patients.Methods: A descriptive study was done with help of recording history of variables like smoking, alcohol, BMI, HBA1C value, cholesterol level and others. Chi square was done to assess test of significance.Results: Diastolic dysfunction was more in patients with diabetic complications than those without diabetic complications. Most patients having peripheral neuropathy, nephropathy and retinopathy had diastolic dysfunction. Patients had also shown high incidence of positivity to TMT. Half of the patients (50%) positive results for stress test were higher with cases who led a sedentary life style (13.64%). Most of patients (70%) had serum. cholesterol level less than 200 mg/dl but the positive results for stress test were higher in patients with Serum. cholesterol level 200 to 239 mg/dl. Conclusions: The study could shower light on the conclusion that left ventricular diastolic dysfunction in type 2 diabetes mellitus patients is more relative to systolic dysfunction.

A COMPARISON BETWEEN MEDOSARA AND MEDOVRIDDHI WITH SPECIAL REFERENCE TO LIPID PROFILE: AN OBSERVATIONAL STUDY”

Dyslipidemia is burning issue in front of society. Due to change in dietary habits & unhealthy life study it is significantly observed across the globe. To keep in mind this study was designed. Aim of this study was to compare Medosara & Medovriddhi with special reference to lipid profile. For this study 30 Medosara presons were selected & 30 Medovriddhi patients were selected from OPD. In both cases lipid profile was carried. The comparison was done on the basis of lipid profile in both groups. The result was nonsignificant in triglycerides level but it was significant in serum cholesterol level & highly significant in HDL & LDL level. Conclusion of study is by evaluating lipid profile Medovriddhi and Medosarata can be identify to a significant extent.

Pea Protein Reduce Serum Cholesterol Levels in Hypercholesterolemia Hamsters by Modulating Compositions of Gut Microbiota and Metabolites

Background: Epidemiological and experimental studies have indicated that an increase of plant proteins in diets, as well as a substitution of red meat proteins or processed meat proteins with plant proteins, was closely associated with the reduction of cardio-cerebrovascular disease (CVD)-related mortality. One of the most important ways of plant proteins to reduce the incidence rate of CVD is to lowering cholesterol concentration in serum and liver. Mounting evidences have attributed this effect of plant proteins to their regulation of gut microbiota. However, it remains to be elucidated whether gut microbiota play decisive roles in modulating host cholesterol by dietary protein from diverse sources of plant or meat. This study attempted to clarify the relevant mechanisms by comparing the difference in cholesterol metabolism modulation between pea and pork proteins intake of hypercholesterolemia hamster, as well as its relationships with gut microbiome and metabolic pathway.Results: We have verified that there are significant differences in the regulations of serum and liver cholesterol levels among different proteins intake from plants (rice, oat, soybean, pea) or meat (chicken, pork, beef), and the corresponded differences in gut microbiota were also observed. The decisive roles of gut microbiota in regulating host cholesterol were illustrated by the findings that the differences in serum cholesterol level between pea protein and pork protein disappeared in the hamsters treated with antibiotics. The experimental results of cross-over intervention of pea and pork protein showed that the serum cholesterol level was reversed with dietary exchange. Most interestingly, the corresponded changes in abundance of dominant bacteria suggested that the “beneficial” microbe Muribaculaceae were responsible for the inhibitory effect of pea protein on serum cholesterol level, while the opposite effect of pork protein was due to the “harmful” microbe Erysipelotrichaceae. Moreover, dietary pea protein supplement altered cecal metabolites including changes in arginine/histidine pathway, primary bile acid biosynthesis, short chain fatty acids or other lipid-like molecules, which involved in cholesterol metabolism.Conclusion: Dietary pea protein exerted cholesterol-lowering effects through modulating the growth of selected gut microbiota in hamsters. The substitution of pork protein with pea protein could reshape the gut microbiota, affect the contents of metabolites in caecum, and thus regulate cholesterol metabolism. These findings suggest specific bacteria and metabolites can be potential therapeutic targets of hypercholesterolemia by plant protein intervention.

Vitamin B12 Inhibits Progression of Hypercholesterolemia and Atherosclerosis in Rabbits Fed a High Cholesterol Diet

The present study was undertaken to examine the effect of vitamin B12 on serum cholesterol levels and development of aortic atherosclerosis in New Zealand White male rabbits fed a high cholesterol diet. Twenty rabbits were divided into 4 groups matched for their baseline serum cholesterol values. Groups 1 and 2 received a normal diet, whereas groups 3 and 4 had cholesterol mixed with their chow. After 5 weeks, the serum cholesterol of groups 3 and 4 increased by approximately 12 fold compared to groups 1 and 2. At that point, vitamin B12 was administered in the drinking water (1000 micrograms/l) to rabbits in groups 2 and 4. At week 8, the Vitamin B12 dose was increased to 2400 micrograms/l for group 4. At 12 weeks into the study, rabbits in group 4 (high cholesterol diet plus vitamin B12) had a serum cholesterol level of 919 +/- 270 mg/dl while those of group 3 (high cholesterol diet) had a serum cholesterol level of 1417 +/- 250 mg/dl. At the end of the study, rabbit aortas were excised, fixed, and stained with fat-red-B, a dye for lipid. Comparison of the aortas of rabbits that received the lipid rich diet revealed that animals given additional vitamin B12 had significantly decreased surface area of fat deposition. These data suggest the potential role for vitamin B12 as a safe and inexpensive pharmacological intervention for the modification of the progression of human atherosclerosis.

Association between early treatment hospitals, serum cholesterol level and cardiovascular disease risk in dyslipidemia patients

Background Studies have shown the importance of managing chronic diseases, such as cardiovascular disease (CVD), at the primary treatment level. Here, we aimed to evaluate the association between medical treatment institutions and health outcomes in patients with dyslipidemia, a major risk of CVD, to provide evidence for increasing chronic disease management at the primary care level in Korea. Methods We used National Health Insurance Sampling cohort data, of which 37 506 patients were newly diagnosed with dyslipidemia during 2009–14. CVD risk and changes in serum cholesterol level after dyslipidemia diagnosis were outcome variable examined. A generalized estimating equation model was used to identify associations between initial medical institution, CVD risk and changes in serum cholesterol levels. The Cox proportional-hazard ratio was used to assess the association between initial medical institutions and detailed CVD risk. Subgroup analyses were conducted to assess CVD risk following treatment with prescription medication. Results Our analyses demonstrate that CVD risk was lower at primary care-level community health centers and clinics compared to tertiary hospitals, with a statistically significant difference observed in clinics. Ischemic heart disease was lower at community health centers and clinics. However, all medical institution types were associated with significantly lower serum cholesterol levels compared to the baseline. Conclusions Management of patients with dyslipidemia at primary care institutions was associated with reduced CVD risk and decreased serum cholesterol levels. Therefore, policymakers should strengthen the quality of healthcare at primary care institutions and educate patients that these institutions are appropriate for managing chronic disease.