Knowledge of physical activity, physical activity level and waist-to-hip ratio in adults with diabetes in a Ghanaian municipality

Objectives: To investigate the knowledge about physical activity, physical activity levels and waist-to-hip ratio among persons living with diabetes in the Ho Municipality. Design: Cross-sectional observation study. Setting: The researcher collected data from two diabetes clinics in the Ho Municipality of Ghana. Participants: Consenting persons living with diabetes who attended the diabetes clinics. Main outcome measures: Participants' waist-to-hip ratio, knowledge of the physical activity and level of activity according to the International Physical Activity Questionnaire. Results: There were 106 participants, and the modal age was 60 years or older (50.94% (n= 54)). Of the total, 62.3% (n = 66) were women, and the mean knowledge level was 12.7±1.58 (range: 0-17). Mean waist-to-hip ratio was 0.92 ± 0.10) with 25.5% (n = 27) men and 48.1% (n = 51) women recording abnormally increased waist-to-hip ratios. Additionally, 44% of participants engaged in low physical activity levels, whereas 10% participated in high levels. There were no significant associations between physical activity levels and waist-to-hip ratios (r = 0.176, p=0.071). Conclusion: Persons with diabetes in the Ho Municipality mostly engaged in low and moderate physical activity levels and had abnormally increased waist-to-hip ratios suggesting abdominal obesity. Knowledge of physical activity may be associated with physical activity performance and waist-to-hip ratio, bearing an inverse association with physical activity levels.

Cardiovascular risk factors and renal impairment among young adults in a tertiary institution in Southwest Nigeria

Background: Specific research is sparse on renal dysfunction among homogenous group of young adults. This study estimated the prevalence of renal dysfunction among apparently healthy young adults and determine association (if any) between renal dysfunction and some cardiovascular risk factors. Methodology:Undergraduates (18-37 years) of a tertiary institution were studied on 2017 World Kidney Day. Their biodata, blood pressure, anthropometry, total cholesterol and estimated glomerular filtration rate were determined. Data was analyzed using SPSS version 20.0. Results:A total of 640 students were studied (M:F=1:3.8). Their mean age was 23.1±2.8 years. Thirty-three(5.2%) participants had renal dysfunction (eGFR < 60ml/min/1.73m2). The mean age of subjects with renaldysfunction (eGFR < 60ml/min/1.73m2) was significantly higher with an inverse association to renal function (p = 0.005). Two hundred and fifty-seven(40.2%) and 58 (9.1%) participants were pre-hypertensive and hypertensive respectively; overweight, abdominal obesity and hypercholesterolaemia were found among 12.2%, 14.2% and 8.1% of subjects respectively. The mean body mass index (p = 0.009) and serum total cholesterol (p = 0.003) were significantly higher among females. There was a higher prevalence of renal dysfunction among females even though this was not to the significant level (5.9 v 2.2%, p = 0.12). Conclusions:The prevalence of renal dysfunction among young adults is lower than current global estimates. The prevalence of cardiovascular risk factors for CKD were lower than that of older adults with no significant association to renal dysfunction. Increasing age was found to be significantly associated with reduced renal function.

Maternal age and miscarriage: A unique association curve in Sudan

This study's aim was to estimate the prevalence and maternal age and other risk factors of miscarriage among Sudanese women. Across-sectional study was conducted at the Saad Abuelela Tertiary Hospital in Khartoum, Sudan, from February to December 2019. Sociodemographic, obstetric and clinical data were collected. A multivariate logistic regression analysis was performed. Four hundred thirteen (20.5%) women reported experiencing a miscarriage. Risk factors included older age, high parity, histories of caesarean delivery, and obesity. Logistic regression showed that the lowest risk for women aged less than 20 years (adjusted odds ratio [AOR], 0.33) or 20 to 24 years (AOR, 0.57), primiparas (AOR, 0.42) and women educated below the secondary level (AOR, 0.78). Unlike the global age-associated risk of miscarriage, the risk of miscarriage among Sudanese women follows a unique curve in relation to maternal age. Interestingly, the curve showed a lower risk for women less than 20 years and at 40 years. (Afr J Reprod Health 2022; 26 [7]: 15-21).

Predictors of weight reduction in a Nigerian family practice setting

Objectives: This study identified the predictors of weight reduction among adult obese patients in a Family Practice Setting and developed a statistical model to predict weight reduction. Design: A prospective cohort design. Setting: The Family Practice Clinic, University College Hospital, Ibadan, Nigeria Participants and study tools: Obese adults were recruited into a three-month weight reduction program. Patient Information Leaflets were used for counselling, while questionnaires were administered to obtain socio-demographic and lifestyle factors. Potential predictors were assessed using the Multidimensional Scale of Perceived Social Support, Zung Depression Scale, Rosenberg Self-Esteem scale, Garner's Eating Attitude Test-26 (EAT-26), 24-hour dietary recall and International Physical Activity Questionnaire-short form. Anthropometric indices, blood pressure and Fasting Lipid Profile were assessed. Descriptive and inferential statistics were used for analysis with a significance set at α0.05. Results: Most 99(76.2%) of the 130 participants achieved weight reduction and had a median weight change of -2.3kg (IQR-4, -0.5), with 66 (66.7%) out of 99 attaining the weight reduction target of 10%. The regression model showed predictors of weight reduction to be Total Cholesterol [TC] (p=0.01) and Low-Density Lipoprotein Cholesterol [LDLC] (p=0.03). The statistical model derived for Weight reduction = 0.0028 (LDL-C) -0.029 (TC)-0.053 (EAT-26) +0.041(High-Density Lipoprotein Cholesterol). The proportion of variance of the model tested was R 2 = 0.3928 (adjusted R2 = 0.2106). Conclusion: Predictors of weight reduction among patients were eating attitude score, Total Cholesterol, Low-Density Lipid and High-Density Lipoprotein Cholesterol levels. A statistical model was developed for managing obesity among patients

Presentation and character for adult patients with diabetes in Libya

Diabetes is a global issue, the diabetes epidemic is expected to continue, and the burden of diabetes causes catastrophic expenditure for healthcare system. The current study aimed to determine the presentation, the clinical feature and cardio-vascular risk factors in patients with diabetes. A retrospective observational study had been conducted in out-patients department at Almustaqpal Almosherq Centre during September, 2013 till September, 2020, the total number of attended out-patients department were 1 024, 820 patients who were selected for this study. A special perform was completed for every patient, which included details about patient's demographics, points in clinical history, relevant investigations and clinical examinations were recorded. The study reported that out of 820 patients, 66% (n = 538) was female and their age range was between 14 - 87 years with a mean age of 56.53 ± 13.49 years, 96% (n = 791) were clinically diagnosed as type II diabetes, 07% of the patients were diagnosed as pre-diabetes, the duration of diabetes ranged from newly diagnosed to more than 10 years, with 46% (n = 379) of the studied population were more than 10 years diabetes duration, 70% (581) were presented with classical symptoms of diabetes. Initial treatment for diabetes also different in the studied sample, were absent of anti-diabetic medications in 30% (n = 248) of the patients, they refused to start glucose lowering drugs, 34.6% (n = 284) of them have morbid obesity (body mass index is more than 40), 80% (n = 662) have high HBA1c (more than 8 g%), 40.3% (n = 240/596) were uncontrolled hypertension on anti-hypertension drugs, 95.6% (n = 682/713) were controlled on treatment of lipid lowering drugs. This study showing the presentation of diabetes were the common, type II diabetes, at age group between 41 - 66 years about 65%, female sex, with high body mass index, high glycated hemglobulin and uncontrolled hypertension. There is concern that diabetic patients were occurring at a high frequency in younger adults, where longer duration of illness could increase the risk of developing more complications in later life. The rate of coexist cardiovascular risk factors (hypertension, dyslipidaemia and obesity) in Libyan patients with diabetes is highlighted.

Baseline anthropometric measurements and obesity among students in Sagamu, Ogun State, southwest, Nigeria

Objectives: This study was designed to determine the anthropometric characteristics and prevalence of obesity among secondary and undergraduate students in Sagamu. Methods: This cross-sectional study involved a selection of 260 students aged 10 to 33 years in Sagamu using a convenience sampling method. The weight, height, and waist and hip circumferences of each subject were measured. The body mass index was then calculated. Data were analyzed using SPSS version 25.0 and p-values< 0.05 were considered statistically significant. Results: The age ranges were 1o to 17 years (Secondary school (SS) students) and 14 to 33 years (undergraduate students). There were 130 students in each group, comprising 52.7% males and 47.4% females. Underweight was commoner among the SS students (20.8% versus 6.2%). Most of the subjects were of normal weight 52.3% in SS and 68.5% in undergraduates. Only 3.1% of SS students were obese compared to 4.6% of undergraduate students. The mean BMI of SS students (22.2± 0.39 versus 23.24±0.34) was statistically lower (p=0.019). The mean waist circumference of SS students (66.92±0.44 versus 74.64±0.67) was also statistically lower (p=0.000). The mean BMI of SS students was higher in females than in male subjects (23.14±0.62 versus 20.86±0.42). The mean waist and hip circumferences and BMI were lower in female subjects for both study groups. Conclusions: The mean BMI and hip circumferences were higher in female subjects while the mean waist circumferences were lower in females than males in both study groups.

Fibromyalgie associée à la gonarthrose: prévalence, caractéristiques épidémiologiques, et son impact sur le traitement / Fibromyalgia associated with knee osteoarthritis: prevalence, epidemiological characteristics, and impact on its treatment

Contexte et objectifs. Les patients souffrant de syndrome fibromyalgique sont fréquemment rencontrés en pratique clinique et déconcertent bien souvent les médecins. Notre étude a pour but de déterminer la prévalence de la fibromyalgie chez les patients gonarthrosiques, son impact sur la présentation clinique et radiologique ainsi sur le cours évolutif de gonarthrose. Méthodes. Il s'agissait d'une étude transversale analytique portant sur les patients atteints de gonarthrose définie selon les critères ACR, suivis au service de rhumatologie de l'hôpital militaire Moulay Ismail à Meknès ; entre novembre 2018 et avril 2019. La fibromyalgie était retenue chez les patients remplissant les critères ACR 2010. Résultats. Au total 101 patients (âge moyen : 57+11,5 ans, femmes : 65,3 % ; surpoids : 35.6% ; et obésité stade 1 (35,6 %) ont été examinés. La prévalence de la fibromyalgie était de 34,7%. Un tiers des patients fibromyalgiques avaient une réponse partielle au traitement (AINS et paracétamol). L'analyse bivariée a montré une association positive avec le sexe féminin (p =0,006) et l'IMC (p=0,017). Par contre on n'a pas noté de relation entre la fibromyalgie, l'âge, le stade radiologique de la gonarthrose, la présence d'un syndrome métabolique, et l'EVA douleur. Conclusion. La fibromyalgie est relativement fréquence chez les patients gonarthrosiques. Sa reconnaissance permet de mieux prendre en charge les patients gonarthrosiques et d'éviter les abus de traitements symptomatiques notamment les AINS.

Context and objective. Fibromyalgia syndrome cases are frequent in clinical practice and often disconcert physicians. The aim of the present study was to determine the prevalence of fibromyalgia in patients with osteoarthritis, and its impact on the clinical and radiological presentation, as well as its evolutionary course. Methods. This was an analytical cross-sectional study including all patients followed for gonarthrosis in the Department of Rheumatology of the Moulay Ismail Military Hospital between November 2018 and April 2019. Fibromyalgia was retained in patients meeting the ACR 2010 criteria. Results. One hundred one patients (57 + 11.5 years old; Women 65.3%; overweight: 35.6%, obesity grade 1: 35.6 %; were examined. The prevalence of fibromyalgia was 34.7%. One third of fibromyalgia patients had a partial response to treatment. The bivariate analysis showed a positive correlation with the female sex (p = 0.006) and the BMI (p = 0.017). There was no correlation between fibromyalgia, age, the radiological class of gonarhtrosis, the presence of metabolic syndrome, and VAS pain. Conclusion. The fibromyalgia is relatively common in patient with gonarthrosis, especially in obese women. Early diagnostic of fibromyalgia offers the possibility of a better management of gonarthrosis patients and thus avoiding the abusive use of symptomatic treatments, notably NSAIDs

Dynamique de la prise en charge thérapeutique et préventive de la Covid-19 chez les patients adultes vulnérables / Dynamics of therapeutic and preventive management of Covid-19 in vulnerable adult patients

La pandémie à Covid-19 continue sa progression et interpelle aujourd'hui toute l'humanité particulièrement le corps médical. A la date du 30 Juin 2020, le monde entier compte 10185374 cas confirmés avec 563862 décès [1]. La recherche scientifique intense a pu rapidement séquencer ce virus à ARN, partager sur sa clinique et son évolution. Mais six mois après il persiste encore beaucoup d'inconnues concernant son pouvoir pathogène, sa physiopathologie mais surtout sa prise en charge thérapeutique particulièrement chez les sujets âgés ou ayant des facteurs de risqué qui ont une mortalité significativement plus élevée [1, 2, 3]. La Covid-19 pose ainsi un problème de prise en charge thérapeutique chez les sujets vulnérables. Cette situation préoccupante pour tous, justifie la poursuite de la réflexion, de la recherche et surtout le partage d'expériences pour une meilleure prise en chargechez ces patients à risque

Prévalence de l'obésité et du surpoids en milieu scolaire, oasis de Tafilalet, sud-est du Maroc

Introduction: l'obésité représente un sérieux problème de santé publique qui a un impact direct sur la santé physique et psychologique des individus. L'objectif du présent travail est de déterminer la prévalence de l'obésité et du surpoids en milieu scolaire urbain et rural, chez une population infantile oasienne.Méthodes: nous avons entrepris une étude transversale descriptive au sein des établissements scolaires publics urbains et ruraux de l'oasis de Tafilalet. Nous avons recruté un échantillon représentatif de 3684 enfants scolarisés appartenant à 39 écoles publiques primaires. Résultats: la moyenne d'âge était de 9,81 ± 2,13 ans. L'échantillon total s'est réparti en 1794 garçons (48,70) et 1890 filles (51,30). 2309 appartenant à l'urbain (62,70%) et 1375 au rural (37,30%). Selon les références de l'organisation mondiale de la santé, notre étude a révélé un taux d'obésité de 1,9% et 10,8 pour le surpoids. L'obésité et le surpoids n'étaient pas significativement associés avec le sexe des enfants.Conclusion: la prévalence de l'obésité dans l'oasis de Tafilalet est inférieure aux données nationales et internationales, le mode de vie et les habitudes alimentaires de cette population semblent être un facteur protecteur contre l'obésité et le surpoids

Diagnostic accuracy of tri-ponderal mass index and body mass index in estimating overweight and obesity in South African children

Background: Prevalence of obesity in youths has drastically increased in both industrialised and non-industrialised countries, and this transition resulted in an increased prevalence of chronic diseases. Aim: The study aimed to comparatively examine prevalence of overweight and obesity status based on tri-ponderal mass index and body mass index in estimating body fat levels in South African children. Setting: The study was conducted in Limpopo and Mpumalanga provinces of South Africa. Methods: A cross-sectional survey of 1361 (boys: n = 678; girls: n = 683) children aged 9­13 years was undertaken. The children's age and sex-related measurements of body weight, waist-to-height ratio, waist-to-hip ratio, triceps skinfold, subscapular skinfolds and sum of skinfold were taken using the International Society for Advancement of Kinanthropometry protocol. TMI and BMI calculations classified children according to weight and age categories. Descriptive statistics, Spearman's correlations and multiple linear regression analyses were set at ≤ 0.05. Results: Obesity classifications on TMI and BMI among children were as follows: Boys: 7.3%, 2.6%; 2.2%, 0.7%; Girls: 4.0%, 1.0%; 1.8%, 0.6%. Body weight, WHtR, WHpR, TSKF, SSKF and Σ SKF significantly correlated with TMI (r = 0.40, p < 0.001; r = 0.73, p < 0.001; r = -0.09, p < 0.001; r = 0.50, p < 0.001; r = 0.51, p < 0.001 and r = 0.52, p< 0.001) and BMI (r = 0.81, p < 0.001; r = 0.59, p < 0.001; r = -0.22, p < 0.001; r = 0.63, p < 0.001; r = 0.67, p < 0.001 and r = 0.66, p < 0.001). Regression analysis revealed that body weight, WHtR, WHpR, TSKF, SSKF and Σ SKF accounted for 65% and 85% of variance in children's TMI (R 2 = 0.647, F[6 1354] = 413.977, p < 0.001) and BMI (R 2 = 0.851, F[6 1354] = 1288.218, p< 0.001). Conclusion: TMI revealed strikingly higher incidence of overweight and obesity in South African boys and girls than BMI. Future studies are needed to clarify sensitivity of TMI over BMI in quantifying obesity prevalence in children and adolescents

Weight bias and eating behaviours of persons with overweight and obesity attending a general medical practice in Durban, South Africa

Background: The consequences of obesity for physical health and non-communicable illnesses are well established, but the impact on psychosocial well-being in persons with obesity is much less understood. This study aimed to assess psychosocial constructs such as weight bias affecting the eating behaviours of persons with overweight and obesity attending a general practice in South Africa Methods: An observational study was conducted at a private general medical practice situated in a peri-urban area of Durban, KwaZulu-Natal, South Africa. A sample of 100 persons with overweight and obesity, and with a BMI ≥ 25 kg/m2, were recruitedby a convenience sampling method. Frequency tables for BMI, sociodemographic factors, perceptions and eating behaviours were described. Spearman's rank-order correlation was run to assess the relationship between sociodemographic factors, perceptions, knowledge, attitudes and eating behaviours.Results: About 90% were below 60 years and 83% were females. The mean BMI of males was 41.7 kg/m2 (SD = 7.38) and of females was 39.9 kg/m2 (SD = 7.91). It was found that weight stigma (are overweight people discriminated against) and the average household income were associated with abnormal eating behaviours such as compulsive eating, obsession with eating and psychological problems. A significant correlation was demonstrated between 'Are people with overweight discriminated against?' and abnormal eating behaviours such as compulsive eating (p = 0.049), obsession with eating (p = 0.009) and psychological problems (p = 0.051) Conclusion: Psychosocial factors such as weight bias affect the eating behaviours of persons with overweight and obesity in South Africa. Research should be done exploring promotion of the psychosocial well-being of patients while trying to manage their obesity

Induction of anaesthesia with propofol according to the adjusted ideal body mass in obese and non-obese patients: an observational study

Background: Obesity changes body composition including fat free mass (FFM), regarded as the "pharmacologically active mass". Scaling drug doses to obese patients by total body mass (TBM) results in overdose. We aimed to determine the success rate of inducing anaesthesia in normal, overweight and obese patients with propofol, using an adjusted body mass scalar (ABM), which embodies the increased FFM of obese patients. Methods: Ninety-six patients were divided into three groups according to body mass index (BMI): normal, overweight and obese. Propofol 2 mg/kg ABM was administered according to the equation: ABM = IBM + 0.4(TBM ­ IBM), where IBM = ideal body mass. Induction success was assessed clinically and by electroencephalographic spectral entropy. Results: The groups were similar regarding gender, age, height and IBM. One patient was morbidly obese (BMI = 44). State entropy (SE) decreased to < 60 in 33/33, 28/29 and 33/34 patients in the normal-weight, overweight and obese groups respectively, an overall success rate of 97.5% (95% confidence interval 92.7% to 99.4%). Median lowest achieved SE values and median times that SE remained < 60 did not differ between groups, however the individual values ranged widely in allthree groups. Induction failed in the two patients whose SE did not decrease to < 60 (one overweight and one obese). Conclusions: The ABM-based propofol induction dose has a high success rate in normal, overweight and obese patients. Further studies are required to determine the feasibility among morbidly obese patients

Dosage of sugammadex according to the calculated lean body mass in obese female patients: time to reverse moderate neuromuscular blockade induced by rocuronium

Background: Sugammadex is a selective relaxant binding agent for antagonism of prolonged rocuronium-induced neuromuscular blockade. The recommended dose is 2 mg/kg. Based on the pharmacological characteristics of sugammadex in obese patients, the calculated lean body mass (CLBM) should be used to determine the dose to reverse moderate neuromuscular blockade induced by rocuronium. Objective: A study was undertaken to prove that sugammadex can be used according to CLBM to reverse moderate neuromuscular blockade in obese female patients. Methods: This is a prospective, non-randomised, observational study. Sugammadex was used at the end of bariatric surgery on obese patients with a body mass index > 32 kg/m2. The dose was calculated according to the lean body mass. Muscle blockade was assessed using train-of-four monitoring. Results: Twenty women were included in this study. All patients were female and ASA 2. The age of patients ranged between 20 and 50 years with a mean age of 35.74 (±10) years. The mean CLBM was 50 kg. The mean time from administration of sugammadex to reverse neuromuscular blockade from two responses of TOF to T4/T1 > 90% was 167.25 seconds (2.8 minutes) (60­285 seconds). Conclusion: It is concluded that the calculated lean body mass can be used to calculate the dose of sugammadex for obese female patients to reverse moderate neuromuscular blockade induced by rocuronium

Vitamin B12 status among pregnant women and Its association with obesity and gestational diabetes

Background: pregnant women in resource-poor areas are at risk of multiple micronutrient deficiencies, and diets that are low in animal products place women at increased risk of vitamin B12 deficiency. Aim of the Work: to investigate the vitamin B12 status of pregnant women in Egypt and its relationship with obesity and gestational diabetes mellitus (GDM). Patients and Methods: this clinical observational prospective study has been conducted at Bab Al-Shaaria University Hospital Obstetrics and Gynecological Department from April 2018 to January 2019. To assess vitamin B12 status among pregnant woman and its association with obesity and gestational diabetes. 80 pregnant women attended to out-patient clinic were included in the study. The evaluation included data collection through: history taking, examination, anthropometric measurement, maternal blood vitamin B12 level estimation at second and third trimester and blood glucose level. Results: vitamin B12 deficiency in pregnancy is common particularly in obese women and those with GDM. Conclusion: vitamin B12 deficiency is silent and common in general population. Causes of vitamin B12 deficiencies are multifactorial and associated with many health problems. Also, obesity is common and its prevalence is increasing in the world. Therefore, both health problems have gained importance in family medicine practice in the last decades

Rachianesthésie pour le cerclage du col utérin

Introduction :Notre étude avait pour but d'évaluer la rachianesthésie à faible dose de bupivacaïne et de fentanyl pour le cerclage du col de l'utérus chez des patientes en surpoids ou obèses. Le cerclage du col utérin est indiqué dans le traitement de l'incompétence cervicale, généralement réalisé sous anesthésie générale et en chirurgie ambulatoire. Méthodes : Il s'agissait d'une étude prospective observationnelle et multicentrique réalisée sur une période de 18 mois portant sur la rachianesthésie pour cerclage du col utérin. Etaient inclues les patientes de classes ASA 1 et 2, ayant un indice de masse corporelle supérieur ou égal à 25 Kg/m2. La rachianesthésie était réalisée avec une association de 5 mg de bupivacaïne et de 25 µg de fentanyl. Les principales variables étudiées étaient la qualité du bloc sensitif et moteur, les paramètres hémodynamiques, le délai de sortie de l'hôpital. L'analyse statistique a été faite à l'aide du logiciel SPSS 21.0. Résultats : Cinquante-neuf patientes d'un âge moyen de 27 ± 7 ans avec un âge de grossesse de 16 ± 4 semaines d'aménorrhée (SA) ont été inclues. Le délai d'installation du bloc sensitif était de 3,86±1,06 minutes, pour un niveau d'anesthésie à T11 chez 86,44% des patientes, et un score de Bromage à 1 à la mise en position gynécologique. Aucune plainte douloureuse n'a été exprimée à la préhension du col. La durée moyenne du cerclage était de 22,83 ± 5,04 min. Aucun cas d'hypotension artérielle ou de bradycardie n'a été observé. La récupération postopératoire était complète (score de Bromage 0) à la 2ème heure. La sortie était faite à la fin de la 3ème heure post-opératoire chez toutes les patientes. Conclusion : La rachianesthésie à faible dose de bupivacaïne et de fentanyl est suffisante et efficace pour le cerclage du col, chez des patientes à terrain particulier, permettant ainsi une récupération post interventionnelle précoce

Obesity and response to neoadjuvant chemotherapy in breast cancer

The prevalence of obesity is rising worldwide including Sub-Saharan Africa just as the incidence of breast cancer is rising in same region with increasing morbidity and mortality. Obesity or overweight has been identified as a risk factor for breast cancer and both have been associated with poor outcome of breast cancer treatment. The objective of this study was to assess the effect of obesity /overweight on clinical response to Adriamycin Cyclophosphamide-Paclitaxel (AC-P) regimen neoadjuvant chemotherapy in patients with breast cancer. A prospective observational of 39 female patients with breast cancer. A prospective observational study of newly diagnosed breast cancer patients with palpable breast lumps on neoadjuvant chemotherapy of AC-P regime. Age of the patients, tumour size, stage, estrogen, progestogen and HER2 receptor status were noted. Height measured in metres and weight measured in Kilograms were recorded and Body Mass Index (BMI) calculated .Tumour size measured at presentation, then after first, third, sixth and eighth doses to determine response as defined by the UICC method such as complete clinical response, partial clinical response, stable disease and progressive disease. BMI was then categorized into Normal weight 25kg/m2 and Overweight 25-30kg/m2 and Obese 30kg/m2. 43.6% were obese, 33.3% were overweight and 23.1% were normal weight. Thirty percent of overweight /obese patients had complete clinical response 2 compared with 77% of low/normal weight patients and this was statistically significant (X2 =6.53, p 0.015). 76.7% of the overweight/obese were premenopausal compared with 23.3% who were post menopausal, and this is statistically significant.(X2 =5.84, p 0.024). Obesity/ overweight is associated with poorer clinical response to neoadjuvant chemotherapy in the cohort of patients studied

Increased prevalence of obesity, diabetes mellitus and hypertension with associated risk factors in a mine-based workforce, Democratic Republic of Congo

Introduction: the burden of non-communicable diseases (NCDs) is increasing rapidly in low- and middle-income countries, with the largest portion occurring in Africa. Results from earlier baseline measures on obesity, diabetes and hypertension (ODH) in the Tenke Fungurume Mining (TFM) workforce in 2010 showed high proportions of overweight, pre-diabetic and pre-hypertensive individuals, predicting an upward trend in the burden of ODH over time. The 2010-2015 longitudinal trends on ODH and related risk factors among the TFM workforce is presented herein, and projects the consequent burden of these diseases on the workforce by 2025 if an effective prevention program is not implemented.Methods: a longitudinal, retrospective cohort study with 3-time intervals was conducted using occupational health records collected on all employees and contractors who had a pre-employment or follow up medical checkups covering the period between January 2010 and December 2015. Repeated paired t tests measured changes in mean values of quantitative risk factors, while a chi-square test assessed changes in prevalence and categorical risk factors over time. A linear projection model was used to predict the consequent morbidity of ODH for the subsequent 10 years up to 2025.Results: between 2010 and 2015, prevalence increased from 4.5% to 11.1% for obesity, 11.9% to 15.6% for diabetes, and 18.2% to 26.5% for hypertension. By 2025, provided no prevention program is implemented, prevalence is predicted to reach 25%, 24% and 42% respectively for obesity, diabetes and hypertension.Conclusion: without implementation of a comprehensive NCD prevention plan, the burden of ODH and other NCDs is predicted to increase dramatically in the TFM workforce. Alone or combined, NCDs have the potential to dramatically increase operational costs while decreasing productivity over time

Obesity and metabolic surgery in South Africa - review

There is a worldwide steady increase in obesity prevalence, and in South Africa 70% of adult females are classified as overweight (BMI >25 kg/m2), the highest recorded numbers in Sub-Saharan Africa. The morbidity associated with being overweight includes diabetes, hypertension, gastro-esophageal reflux disease, and nonalcoholic fatty liver disease amongst others. Accordingly, life expectancy is decreased. Metabolic surgery is currently the most effective treatment for weight loss and type 2 diabetes, and is being performed increasingly in South African private and public hospitals. Physicians should be aware of indications for, and outcomes and complications after metabolic surgery. This report reviews current evidence and the role of metabolic surgery in South Africa

Obesity and metabolic surgery in South Africa

There is a worldwide steady increase in obesity prevalence, and in South Africa 70% of adult females are classified as overweight (BMI >25 kg/m2), the highest recorded numbers in Sub-Saharan Africa. The morbidity associated with being overweight includes diabetes, hypertension, gastro-esophageal reflux disease, and nonalcoholic fatty liver disease amongst others. Accordingly, life expectancy is decreased. Metabolic surgery is currently the most effective treatment for weight loss and type 2 diabetes, and is being performed increasingly in South African private and public hospitals. Physicians should be aware of indications for, and outcomes and complications after metabolic surgery. This report reviews current evidence and the role of metabolic surgery in South Africa

Double trouble: Addressing stunting and obesity via school nutrition

Background. South Africa (SA), as a middle-income country, faces the nutrition transition and associated double burden of undernutrition and obesity. School feeding programmes are one way of ensuring that malnutrition in children is addressed, but questions remain about whether they can address both undernutrition and obesity.Objectives. To compare the obesity and stunting outcomes for children receiving different combinations of school feeding programmes in a rural district of SA.Methods. The evaluation involved a comparative design that compared the stunting obesity levels of three groups of children. Group 1 received one lunch meal a day for a prolonged period, group 2 both lunch and breakfast, and group 3 had started receiving a daily lunch shortly before the commencementofthresearch.Results. Group 1 had stunting levels in line with the national average. Group 2 had lower stunting levels than those receiving only the lunch meal. Children from group 3 had lower stunting levels than groups 1 and 2. Rates of obesity and overweight were markedly different between the groups. Group 3 had very high rates of overweight and obesity ­ above the national average of 28%. In contrast, group 1 had far lower rates of overweight and obesity, and group 2exhibited the lowest levels. There was a significant decrease in the percentage of learners classified as overweight in group 3 over the 6-month period, from 26.1% to 19.2%.Conclusion. One lunch meal a day is associated with positive outcomes in relation to rates of stunting and obesity, and the lowest rates of obesity were measured when a breakfast meal was added. The addition of a breakfast meal to a lunch feeding programme shows promise,but this requires further investigation to understand whether causal linkages exist