Prevalence of central obesity and its association with sociodemographic profile among young adults attending Outdoor Patient Department of Community Health Centre in Madurai, Tamil Nadu

Background: Obesity is an emerging public health problem in Indian population in young adults and its prevalence has risen to epidemic proportions. The most commonly used indicator is body mass index (BMI). However, this indicator takes into account only height and weight but not fat distribution. Measures of abdominal obesity are better than BMI as predictors of cardiovascular disease risk. Objectives: The objectives of the study were to estimate the prevalence of central obesity among young adults attending Outdoor Patient in a Community Health Centre (CHC) of Madurai and to find the association between central obesity and certain sociodemographic factors among the study subjects. Materials and Methods: A cross-sectional study was conducted among young adults in the age group of 18–25 who were attending Kallandhiri CHC. Using consecutive convenient sampling, 506 individuals were selected and a structured questionnaire was used to collect data about sociodemographic variables and obesity. The study was conducted between August and October 2018. Data were analyzed using SPSS, version 16.0. Simple proportions were calculated and Chi-square test was applied for statistical significance. P < 0.05 was considered as statistically significant. Results: The prevalence of central obesity among young adults was found as 20.9%. Female gender and higher socioeconomic status were found to be associated with central obesity. Conclusion: Around one-fifth young adults were found to be having central obesity. Early identification and proper intervention can reduce the burden of non-communicable diseases in future.

A study of body fat distribution and cardiovascular risk factors in Government Dharmapuri Medical College, Dharmapuri

Introduction: Cardiovascular disease is the leading cause of death in global deaths and accounts for 17 million people worldwide. Despite the favorable changes in the risk factors, new risk factors have emerged. These include abdominal obesity and physical inactivity, both of which are considered independent and mediating factors in the development of cardiovascular disease. They are also associated with type 2 Diabetes and Metabolic syndrome, growing health hazards all over the world and the major risk factors for cardiovascular disease. Aim of The Study: To determine the associations of Waist circumference and Waist Hip ratio with the risk of incident cardiovascular events and to determine the strength of association of waist and waist hip ratio with cardiovascular risk is different. Materials and methods: A total of 98 cases (49 Cases and 49 Controls) were selected. Newly diagnosed consecutive cases of myocardial infarction admitted to the department to the department of cardiology were enrolled into the study after obtaining consent. These patients were subjected to anthropometric measurements namely waist hip ratio, weight height, skin fold thickness and Lipid profile was done. Results: Both the groups were matched for age, sex and risk factors other than the one studied, namely smoking, alcoholism, diabetes, hypertension, family history. There was no statistical difference is noted between the two groups in age, sex, smoking, alcoholism, Hypertension, Diabetes, Family History. In all these parameters compared between these groups the P value was more than 0.05 which was statistically insignificant. Conclusion: BMI does not properly define obesity and the risk of cardiovascular events. BMI can be normal in a patient with cardiovascular disease. Abdominal obesity is an independent risk factor for M. Selvaraj, G. Kannan. A study of body fat distribution and cardiovascular risk factors in Government Dharmapuri Medical College, Dharmapuri. IAIM, 2017; 4(7): 179-185. Page 180 coronary heart disease. Waist hip ratio and waist circumference are better indicators of the cardiovascular risk in a given individual than BMI.

Improvement of banana cv. Rasthali (Silk, AAB) against Fusarium oxysporum f.sp. cubense (VCG 0124/5) through induced mutagenesis: Determination of LD50 specific to mutagen, explants, toxins and in vitro and in vivo screening for Fusarium wilt resistance.

Shoot tips and in vitro grown proliferating buds of banana cv. Rasthali (Silk, AAB) were treated with various concentrations and durations of chemical mutagens viz., EMS, NaN3 and DES. LD50 for shoot tips based on 50% reduction in fresh weight was determined as 2% for 3 h, 0.02% for 5 h and 0.15%for 5 h, while for proliferating buds, they were 0.6% for 30 min, 0.01% for 2 h and 0.06% for 2 h for the mutagens EMS, NaN3 and DES, respectively. Subsequently, the mutated explants were screened in vitro against fusarium wilt using selection agents like fusaric acid and culture filtrate. LD50 for in vitro selection agents calculated based on 50% survival of explants was 0.050 mM and 7% for fusaric acid and culture filtrate, respectively and beyond which a rapid decline in growth was observed. This was followed by pot screening which led to the identification of three putative resistant mutants with an internal disease score of 1 (corm completely clean, no vascular discolouration). The putative mutants identified in the present study have also been mass multiplied in vitro.

Gliptins - The Novel Players in Glucose Homeostasis.

Type 2 diabetes mellitus is a chronic metabolic disorder that results from defects in both insulin secretion and insulin action. Tight glycemic control is considered to be important in the therapy of type 2 diabetes mellitus, but treatment with a single agent is not sufficient to achieve this for the majority of patients. So, there is a need for new antidiabetic agents with favorable side effect profiles to use in combination therapy. The gliptins, an emerging new class of oral drugs for type 2 diabetes mellitus, lower blood glucose levels by a novel mechanism of inhibiting the enzyme dipeptidyl peptidase-4 (DPP-4) that inactivates incretin, released from the intestine following a meal to increase pancreatic insulin secretion. Gliptins enhance the circulating levels of incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) and improve glycemic control. This therapeutic approach carries a low-risk of interprandial hypoglycemia, does not cause weight gain and is well-tolerated. The first gliptin, sitagliptin (Januvia), was introduced in the UK in April 2007 as add-on therapy for patients with type 2 diabetes inadequately controlled with oral hypoglycemic agents. Other gliptins, notably vildagliptin (Galvus), saxagliptin and melogliptin are advanced in clinical development. This article reviews the current evidence on the effectiveness of gliptins and suggests several ways in which these agents could be used in diabetes treatment.

Risk Assessment for Congestive Heart Failure in a South Indian Population: A Clinical Pharmacist’s Perspective.

Congestive heart failure (CHF) is becoming an increasingly prevalent healthcare problem. Hypertension (HT) is a major risk factor for CHF and it commonly coexists with other cardiovascular risk factors. The quality of risk that HT represents has to be thoroughly compared with other risk factors. This could have significant implications for primary prevention strategies including drug treatment. A study was conducted in 137 heart failure patients, to assess the contribution of cardiovascular risk factors like age, sex, obesity, HT, diabetes, dyslipidemia, alcohol, smoking and family history, individually and in combination, in the progression of CHF using multivariate logistic regression analysis and odds ratio (OR) (95% confidence interval). Of the various individual factors, HT showed 3.8 times greater risk (p = 0.003; OR-3.773) for heart failure; dyslipidemia exhibited 2.5 times risk (p = 0.07; OR-2.49), followed by others. Patients with HT, but no diabetes or dyslipidemia had 1.2 times risk (OR-1.17) for CHF; patients with hypertension and diabetes had 1.7 times risk (OR-1.69) and patients with HT, diabetes and dyslipidemia had two times greater risk (OR-1.87). Though, the present study emphasizes that HT is the most common risk factor in the progression of heart failure, the risk is high when it coexists with other risk factors like diabetes and dyslipidemia. A clinical pharmacist can work in collaboration with healthcare team in achieving the goal of long-term control of hypertension and other cardiovascular risk factors in millions of patients, by providing services ranging from monitoring drug therapy and improving patients compliance to drug therapy, to, health maintenance care such as ordering screening procedures and counseling regarding lifestyle modification.

Arsenic induced oxidative stress and the role of antioxidant supplementation during chelation: a review.

Arsenic is a naturally occurring metalloid, ubiquitously present in the environment in both organic and inorganic forms. Arsenic contamination of groundwater in the West Bengal basin in India is unfolding as one of the worst natural geoenvironmental disaster to date. Chronic exposure of humans to high concentration of arsenic in drinking water is associated with skin lesions, peripheral vascular disease, hypertension, Blackfoot disease and high risk of cancer The underlying mechanism of toxicity includes the interaction with the sulphydryl groups and the generation of reactive oxygen species leading to oxidative stress. Chelation therapy with chelating agents like British Anti Lewisite (BAL), sodium 2,3-dimercaptopropane 1-sulfonate (DMPS), meso 2,3 dimercaptosuccinic acid (DMSA) etc., is considered to be the best known treatment against arsenic poisoning. The treatment with these chelating agents however is compromised with certain serious drawbacks/side effects. The studies show that supplementation of antioxidants along with a chelating agent prove to be a better treatment regimen. This review attempts to provide the readers with a comprehensive account of recent developments in the research on arsenic poisoning particularly the role of oxidative stress/free radicals in the toxic manifestation, an update about the recent strategies for the treatment with chelating agents and a possible beneficial role of antioxidants supplementation to achieve the optimum effects.

Effects of chelation therapy on hepatic glutathione, lipid peroxidation and phospholipid contents in lead-poisoned rats.

Hepatic lipid peroxidation, glutathione and phospholipid contents of homogenate prepared from the liver of lead-intoxicated male rats treated with 0.3 m mol/kg CaNa2EDTA and DMSA for 8 weeks, either alone or in combination, were investigated. A significant increase in hepatic malondialdehyde (MDA) and a reduction in glutathione levels was noticed. While a marginal decrease in phosphatidyl choline (PC) level was noticed, no effect on phospholipid contents was seen. Treatment with all the three chelating agents elicited decrease in PC level. DMSA alone was partially effective in restoring lead-induced altered hepatic glutathione and MDA levels. Combined treatment may have an adverse effects on hepatic tissue and does not seem to produce immediate recoveries in the lead-induced hepatic damage.