ABSTRACT
Background: Non communicable diseases have taken over previously life threatening infections in the demographic transition. As the burden of NCDs including diabetes is increasing at an alarming rate the complications related to these diseases are also increasing leading to huge morbidity. Likewise, blindness/ visual impairment due to diabetic retinopathy is now slowly and steadily replacing refractive errors and cataracts as a cause of morbidity.Methods: This cross sectional study was carried over a period of one year in an ophthalmic unit of a tertiary health care institute in which known diabetic patients were screened for diabetic retinopathy besides various modifiable and non-modifiable risk factors.Results: Overall prevalence of diabetic retinopathy in our study population was found to be 29.0%. Among various risk factors duration of diabetes, hypertension, HbA1C >6.5% and serum creatinine >1.1 mg/dl were found to be significantly associated with diabetic retinopathy.Conclusion: Regular screening for diabetic retinopathy besides prevention and strict control of risk factors is key to prevention and progression of blindness/ visual impairment due to diabetic retinopathy.
ABSTRACT
Background: Night shift workers have altered circadian pattern of blood pressure/heart rate and hormones like melatonin and cortisol. Due to this variation, night shift worker suffers from various cardiovascular disorders and hormonal disturbances. Methods: The Present study was aimed to investigate the effects of rotating night shift on 24 hours chronomics of BP/HR and its relation with 6-sulfatoxy melatonin levels. 62 healthy nursing professionals, aged 20-40 year, performing day and night shift duties were recruited. Each month scheduled to continuous 9 days night shift (12 hours in regular 9 nights, from 20:00 to 08:00); after 9 days night shift they perform remaining duties in day shift and 4 days off in each month. Results: Ambulatory BP and HR were recorded at every 30 min intervals in day time and each hour in night time synchronically with circadian pattern of 6 sulfatoxy melatonin during shift duties. Highly Significant difference was found in double amplitude (2DA) of blood pressure between night and day shift (p<0.001). In night shift, hyperbaric index (HBI) of mean systolic blood pressure was found to be increased at 00-03 am (midnight) while during day shift, peak was found at 06-09 am. Peak melatonin was to be found in early morning as compared to mid night in both the shift. Conclusions: The present study concluded that the desynchronization was appeared during night shift and entrainment of circadian rhythm in the day shift.
ABSTRACT
Background: Type 2 diabetes is a fast growing epidemic affecting people globally. Good glycemic control helps in reducing the risk of macro and microvascular complications in diabetics. Alternative medicines have been used since ancient times in India to achieve good glycemic control. Tinospora cordifolia (Tc) is a well reported plant possessing anti-diabetic property. Therefore, we undertook this study to evaluate the effectivity of Tc in reducing the blood glucose levels of Type 2 diabetic patients in the form of add-on therapy. Methods: In the present study, we enrolled 100 Type 2 diabetic patients who met our inclusion criteria. These patients were then randomly divided into two Groups, A and B. Patients in Group A were treated as controls and they continued with their anti-diabetic medications. In Group B, Tc was added to the conventional treatment at a dose of 500 mg 3 times daily along with meals. The fasting and postprandial blood glucose levels and glycosylated hemoglobin (HbA1c) were recorded baseline and after 6 months. Results: During the course of study, we observed a decrease in the fasting, postprandial, and HbA1c levels of the patients. However, this decrease was found to be more statistically significant (p≤0.005) in Group B. Conclusion: The results obtained from the present study conclude that Tc, when given in the form of add-on therapy, was found to be synergistic and effective in the better management of Type 2 diabetes. The drug was well tolerated by the patients and no adverse drug event was recorded.
ABSTRACT
Objectives: The objective of the present study was to investigate the effects of rotating night shift and light exposure at night on circadian pattern of salivary cortisol and urinary melatonin levels. Methods: 62 healthy nursing professionals of both genders performing day and night shifts (continuous 9 days night shift with alternate day shifts) were recruited. Each month scheduled to continuous 9 days night shift (12 hours in regular 9 nights, from 20:00 to 08:00); after 9 days night shift they perform remaining duties in day shift and 4 days off. Saliva and Urine samples were collected at around 8 hours interval while they were performing night duties and repeated when they were assigned day duties. Saliva and Urine samples were analyzed by the ELISA method. Results: Significant difference was found in night cortisol among night (4.34 ± 3.37) vs day shift (2.70 ± 2.32), (p<0.001). Alteration in morning cortisol was also found between night (3.73 ± 2.47) vs day shift (5.00 ± 2.73). Night melatonin level was decreased as compared to morning melatonin. Significant deference were observed when compared night melatonin between night (16.71 ± 11.98) vs day shift (22.71 ± 13.25) (p<0.001), morning melatonin between night (20.07 ± 14.13) vs day shifts (28.26 ± 14.14) (p<0.001). The circadian pattern of cortisol and melatonin was altered by rotating night shift particularly at night and in the morning time. Conclusion: The present study concluded that the desynchronization was appeared during night shift and entrainment of circadian rhythm in the day shift.