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EDITORIAL |
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Obesity pandemic: An earnest appeal for the transdisciplinary persuasion in research and management
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p. 199 |
Ashok D. B. Vaidya DOI:10.4103/2347-9906.146795 |
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ORIGINAL ARTICLES |
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Risk factors profile for noncommunicable diseases among adult urban population of puducherry in India
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p. 201 |
RC Chauhan, AJ Purty, M Natesan, A Velavan, Z Singh DOI:10.4103/2347-9906.146796 Introduction and Objectives: Almost two-thirds of all deaths worldwide are due to noncommunicable diseases (NCDs), which are primarily associated with tobacco-use, alcohol consumption, physical inactivity, unhealthy diet, obesity and raised blood pressure and are largely preventable. Despite the increasing burden of NCDs and their risk factors in India, information on the prevalence of preventable risk factors is restricted to some areas. This study was done to assess the prevalence and distribution of various risk factors for NCD in population of an urban area of Puducherry, in South India. Methodology: This population-based survey was conducted using the "World Health Organization step-wise approach to surveillance of NCDs" (steps) methodology. All the eligible subjects in systematic randomly selected households were interviewed. Standardized protocols were used to assess major behavioral risk factors (tobacco-use, alcohol consumption, unhealthy diet and physical inactivity) and physiological risk factors (overweight, abdominal obesity and raised blood pressure) for NCDs. Means and proportions were calculated for measured variables, and Chi square test was applied to find the associations. Results: Among 569 study subjects interviewed, almost half (48%) were aged <40 years and 52% (n = 295) were men. The prevalence of various risk factors was; tobacco-use (13.4%), alcohol consumption (14.2%), physical inactivity (51.5%), unhealthy diet (86.5%), overweight (36.0%), obesity (21.3%), abdominal obesity (63.3), hypertension (25.3%) and prehypertension (47.8%). Tobacco-use and alcohol consumption was significantly more prevalent among males (p < 0.05). Almost half of the study subjects had two or more risk factors. Conclusion: Present community-based study reveals the high burden of NCDs risk factors in urban population of Puducherry and the burden was particularly higher among males. This also reiterates the need to address these issues comprehensively as a part of NCDs prevention and control strategy. Further, multi-sectoral efforts like ban on sale or raising the tax on alcohol and tobacco products, health education and communication activities, enabling environment for people to engage in physical activities and other measures to lower the burden of NCDs risk factors in community have to be encouraged. |
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A comparative, randomized pilot study of insulin glargine versus insulin detemir as add-on therapy in uncontrolled type 2 diabetic patients |
p. 209 |
Deepak S Bhosle, Jyoti A Bobde, Anant D Patil, Abhijeet Bhagat, Alimuddin Shaikh DOI:10.4103/2347-9906.146797 Objective: The aim was to compare the efficacy and safety of insulin glargine versus insulin detemir as add-on therapy in type 2 diabetes patients inadequately controlled on oral hypoglycemic agents. Materials and Methods: A total of 40 patients were randomized in two groups to receive either insulin glargine or insulin detemir in addition to their current medications. The dose of insulin was titrated to achieve glycosylated hemoglobin (HbA1c) targets of <7%. After randomization of patients, oral hypoglycemic medications were unchanged. Patients were followed for 24 weeks. The number of patients achieving target HbA1c (<7%), mean reduction in fasting and predinner blood glucose and number of hypoglycaemic events were observed in both the groups. Results: Significantly more number of patients in the glargine group (60%) achieved target HbA1c of <7% (p < 0.05) compared with detemir (25%) group. Mean reductions in the fasting and predinner blood glucose were similar in both the group (p > 0.05). Significantly less number of hypoglycemic episodes were observed in glargine group (14 versus 2). Conclusion: In uncontrolled type 2 diabetes patients, insulin glargine is better suited for achieving glycemic control compared with insulin detemir with less incidence of hypoglycemia. |
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Assessment of coronary artery disease risk factors among adolescents in Kanpur, India |
p. 214 |
Samarjeet Kaur, Praveen Katiyar, Dinesh Singh Martolia, Tanu Midha DOI:10.4103/2347-9906.146799 Objective: To study the occurrence of coronary artery disease risk factors among adolescents attending Chatrapati Shahu Ji Maharaj University, Kanpur, India. Materials and Methods: The present study was cross-sectional in nature, conducted among students in the 1 st year of the Institute of Paramedical Sciences, Chatrapati Shahu Ji Maharaj University, Kanpur. Study participants included 185 adolescents. Among them, 94 were males, and 91 were females, between the age group of 17 and 19 years. Results: The mean systolic blood pressure (BP) of male adolescents was 123 mmHg ± 8 mmHg, which is in the prehypertensive range. Mean systolic BP and mean diastolic BP of males was significantly higher than that in females. The mean cholesterol level among males was 166.5 ± 39.0 mg/dl, which was very close to an acceptable limit for cholesterol among adolescents. There was no significant difference between the mean values of pulse rate, total cholesterol, high-density lipoprotein, and low-density lipoprotein cholesterol of males and females. Males had significantly higher mean levels of triglycerides, very-low-density lipoprotein and fasting blood sugar as compared to females. Conclusion: Mean levels of BP and serum cholesterol are on the higher side in the adolescents; therefore, they need to be targeted for lifestyle modification. |
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Assessment of association of periodontal disease status with obesity and various other factors among a population of South India
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p. 218 |
Sarthak Bhola, Siddhartha Varma, Shilpa Shirlal, Haziel Diana Jenifer, Rashmi Gangavati, Shivraj Warad DOI:10.4103/2347-9906.146800 Background: Growing prevalence of obesity has raised significant public health concern. Obesity has been implicated as a risk for several chronic health conditions. The association between obesity and periodontal disease (PD) has been shown in many studies. The purpose of this study is to examine the relation between obesity and PD among a population of north Karnataka. Materials and Methods: A total of 2,000 subjects aged 20 years and above was enrolled for the study. Periodontal status of the subjects was recorded using community periodontal index. Body mass index (BMI) and waist circumference were used as measures to assess obesity. Other variables like age, occupation, smoking status, tobacco chewing, diabetic status, educational status, previous visit to dentist, sedentary/nonsedentary lifestyle, daily exercise and physical activity, family history of obesity were also recorded. Results: A significant association between measures of body fat and PD was found among the study subjects. In younger age group the prevalence of PD was significantly higher in obesity type-I category (odds ratio [OR] = 12.72 and 95% confidence interval (CI) 6.54-24.75) and obesity type-II category (OR = 10.83 and 95% CI 2.63-44.65), in middle age group the prevalence of PD was significantly higher in obesity type-I category (OR = 11.19 and 95% CI 4.85-25.84) and obesity type-II category (OR = 3.45 and 95% CI 1.46-8.15) and in older age group the prevalence of PD was significantly higher in overweight at risk category (OR = 12.52 and 95% CI 2.85-54.94) and obesity type-I category (OR = 2.47 and 95% CI 0.79-7.74) as compared to normal range BMI category. Conclusion: The prevalence of PD is higher among obese subjects. Obesity could be a potential risk factor for PD in all age groups. |
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Relation between metabolic syndrome and psoriasis: A multicenter, hospital-based, case-control study from West Bengal, India |
p. 225 |
Somak Kumar Das, Tanusree Nath, Anirban Ghosal, Rajesh Kumar Mondal, Chanchal Kumar Jana DOI:10.4103/2347-9906.146801 Introduction: Psoriasis is a chronic, inflammatory, immune-mediated skin disease affecting approximately 2-3% of the global population. Besides traditional co-morbidities associated with psoriasis, an emerging co-morbidity is metabolic syndrome. Psoriasis and metabolic syndrome are likely linked together due to underlying chronic inflammatory nature of psoriasis, in large part, to the increased tumor necrosis factor-alpha. Aim: To study the association between psoriasis and metabolic syndrome and its components. Materials and Methods: A case-control, hospital-based multicenter study was designed including 173 consecutive psoriatic patients and 184 nonpsoriatic subjects as control during a period of 2 years. In this study, we statistically compared the components of metabolic syndrome (using National Cholesterol Education Program Adult Treatment Panel criteria) in case and control groups. Results: Out of 173 psoriatic patients, there were 91 men (52.6%) and 82 women (44.56%); and in the control group, there were 93 men (50.54%) and 91 women (49.45%). We found a higher proportion of psoriatic patients having features of metabolic syndrome compared to the control group (40.46% vs. 22.28%), the difference was statistically significant (p < 0.0001). Prevalence of obesity in terms of waist circumference (p = 0.001) and body mass index (p = 0.001), and dyslipidemia (p = 0.004) were significantly associated with psoriasis, whereas prevalence of hypertension (p = 0.11) and diabetes (p = 0.93) were not associated with psoriasis. Conclusion: Psoriasis is statistically positively associated with metabolic syndrome in our study. |
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Evaluation of effects of diet on serum obestatin levels in over-weight patients with polycystic ovary syndrome
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p. 230 |
Gülsüm Yildiz, Aykan Yücel, Volkan Noyan, Mehmet Suhha Bostanci, Nevin Sa söz DOI:10.4103/2347-9906.146802 Objective: The aim was to evaluate effects of diet on serum obestatin levels in overweight or obese patients with polycystic ovary syndrome. Materials and Methods: This was prospective case-control study (preliminary study). Twenty-two overweight and obese women diagnosed with polycystic ovary syndrome (PCOS) and 22 body mass index (BMI) and age-matched non-PCOS controls. Serum obestatin levels were measured using enzyme-linked immunosorbent assay. Effects of weight loss on obestatin level and relationships between obestatin levels and hormonal and biochemical parameters were evaluated in PCOS. Results: In PCOS group, there was no significant difference in the obestatin levels between before and after the diet. In controls, there was no significant difference in the weight loss or the obestatin levels at baseline and after the diet. In both groups, there was no correlation between obestatin levels and homeostasis model assessment-insulin resistance or BMI before or after the diet. In PCOS group, obestatin levels were negatively correlated with high-density lipoprotein before the diet and obestatin levels were negatively correlated with waist-hip ratio after the diet. Conclusions: To the best of our knowledge, this is the first study to investigate the effects of weight loss on obestatin levels in over-weight and obese women with PCOS. We found no difference in the obestatin levels before and after the diet in PCOS and control groups. Our findings suggest that different mechanisms play critical roles in the regulation of obestatin levels when BMI is relatively higher. There is a need for large-scale and long-term follow-up, prospective studies to evaluate the effects of obestatin in PCOS. |
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REVIEW ARTICLES |
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Metabolic syndrome in pediatric age - A group requiring intensive review |
p. 238 |
Vanita L Das, Purvi Purohit, Praveen Sharma, Anand Das DOI:10.4103/2347-9906.146803 Metabolic syndrome or MS as it is called is a compilation of most of the non-communicable disease components which is a life style disease with strong genetic predisposition, culminating in a morbid adulthood. The increasing number of subjects under the umbrella of MS is alarming. Diabetes mellitus, hypertension is the end result of this insulin resistance as it is sometimes called. Apart from genes, it also has strong inflammatory components that are responsible for early onset of MS. MS is marked by a gamut of inflammatory and non-inflammatory markers. If diagnosed early by screening the population, the percentage of florid cases of this debilitating syndrome can be brought down. Active intervention and constant monitoring of affected or predisposed young subjects will curtail the progress of MS and prevent full blown diabetes and hypertension, thus reducing cardiovascular complications, other morbidity and early mortality. Prevention is always better than cure. |
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COMMENTARY |
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Role of metabolic control to prevent and treat sight threatening diabetic retinopathy in diabetic cases
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p. 245 |
Bodhraj Dhawan, Vipan Vig DOI:10.4103/2347-9906.146804 Metabolic control is the first step in managing microvascular complications of diabetes including diabetic retinopathy. Important parameters proved to be of the key role in managing diabetic retinopathy and preventing sight-threatening complications thereof include blood sugar levels, serum lipid profile, hemoglobin levels and renal function tests. The severity of hyperglycemia and hypertension are main modifiable factors which may prevent the development of diabetic retinopathy. Thus, all the diabetics have to be compliant in having a good metabolic control which not only prevents or slows down risk of visual loss, but also is associated with a better cardiovascular activity ultimately contributing to a better quality-of-life in these subjects. |
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CASE REPORT |
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Mauriac syndrome: A preventable complication of type 1 diabetes mellitus
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p. 247 |
Yadav Vijay, Sharma Minoo, Bhardwaj Parveen DOI:10.4103/2347-9906.146805 Type 1 diabetes mellitus (T1DM) is a common pediatric endocrine condition and Mauriac syndrome (MS) is described as one of the manifestation of poorly controlled diabetes. It manifests as hepatomegaly, growth delay, elevated liver enzymes, and serum lipids and glycogen accumulation in hepatocytes. We report a 7-year-old child of MS with poorly controlled T1DM. With appropriate management, the patient showed improvement symptomatically and in liver size. The fasting blood sugar and triglycerides showed a reduction. |
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RESEARCH DIGEST |
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Research Digest |
p. 250 |
Ashok D. B. Vaidya DOI:10.4103/2347-9906.146806 |
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BRIEF COMMUNICATION |
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Biomechanical variation of joint angles in overweight females
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p. 251 |
Pooja P Popat, Ankur R Parekh DOI:10.4103/2347-9906.146807 Background: An increase in body weight is considered to cause overload of the foot, which represents the interface between the body and ground. This can induce various stress and strain during walking that can predispose to overuse injuries of the lower limb. The purpose of the present study is to determine biomechanical variation of the joint angles of the lower limb such as calcaneal eversion (CE), gastrocnemius extensibility (GE), angle of toe-out (ATO), and Q-angle in overweight females. Methodology: The total of 25 overweight female subjects (body mass index [BMI] =25-29.9) were assigned as test group to determine biomechanical variation CE, GE, ATO and Q-angle. While 25 healthy female subjects (BMI = 18.5-24.9), were selected as a control group. CE and GE were measured in the prone position. While, Q-angle was measured in weight bearing and ATO was measured in walking position. Result: Independent Student's t-test was performed for comparing age, BMI, various angles among both normal and overweight female subjects. Significant increase in CE and ATO were found among overweight females as compared to normal females. While GE was significantly decreased among overweight female. Conclusion: Within limits of the present study, significant variation was found in CE, ATO (increase) and GE (decrease) in overweight females. |
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BOOK REVIEW |
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Microscopic profile of drugs used in indian system of medicine (volume 3 - seed drugs - Part I and II)
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p. 255 |
Suparna S De, Ashok J Amonkar DOI:10.4103/2347-9906.146808 |
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NEWS AND VIEWS |
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News and Views |
p. 257 |
Suparna S De DOI:10.4103/2347-9906.146809 |
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CONFERENCE ANNOUNCEMENTS |
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Conference Announcements
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p. 258 |
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CULINARY CLUES |
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Break-The- Fast |
p. 259 |
Hiteshi Dhami-Shah DOI:10.4103/2347-9906.146811 |
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LETTERS TO EDITOR |
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Obstructive sleep apnea: Coexistence with thyroid dysfunction and diabetes mellitus |
p. 260 |
Varun Baslas, Simranjeet Kaur, Pooran Chand, Pradeep Kumar, Himanshi Aggarwal DOI:10.4103/2347-9906.146812 |
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