RESUMO
<p><b>INTRODUCTION</b>Metabolic heterogeneity among obese individuals is thought to translate into variations in cardiovascular risk. Identifying obese people with an unfavourable metabolic profile may allow preventive strategies to be targeted at high-risk groups. This study aimed to identify clinical, biochemical and immunological differences between insulin-sensitive and insulin-resistant obese subgroups, to understand the population-specific pathophysiological basis of the adverse cardiovascular risk profile in the latter group.</p><p><b>METHODS</b>Cardiovascular risk indicators, including anthropometric parameters, blood pressure, acanthosis nigricans area, and related biochemical, endocrine and inflammatory markers, were determined in 255 healthy South Asian volunteers aged 18-45 years, with a 2:1 ratio of obese/overweight to normal-weight individuals. Lifetime atherosclerotic cardiovascular disease (ASCVD) risk was also calculated.</p><p><b>RESULTS</b>Body mass index (BMI) and insulin sensitivity-based tertiles independently showed incremental trends in waist-hip ratio, skinfold thickness, acanthosis nigricans area, blood pressure, serum lipids, hepatic enzymes, adipokines, inflammatory markers and ten-year ASCVD risk. The anthropometric, biochemical and inflammatory parameters of obese insulin-sensitive and obese insulin-resistant groups differed significantly. Extreme group analysis after excluding the middle tertiles of both insulin resistance and BMI also showed significant difference in anthropometric indicators of cardiovascular risk and estimated lifetime ASCVD risk between the two obese subgroups.</p><p><b>CONCLUSION</b>Obese insulin-sensitive individuals had a favourable metabolic profile compared to the obese insulin-resistant group. The most consistent discriminative factor between these phenotypic classes was anthropometric parameters, which underscores the importance of clinical parameters as cardiovascular risk indicators in obesity.</p>
RESUMO
Objective: To assess the role of workshop in communication skills training of doctors resulting in better healthcare delivery
Study Design: Quasi-experimental interventional study
Place and Duration of Study: Combined Military Hospital Bahawalpur, from Jun 2013 to Aug 2013
Material and Methods: The participants were divided into two groups, those who received the intervention [n=10] and those who received the placebo [n=5]. Intervention was offered in the shape of a workshop that imparted knowledge via lectures and handouts and skill and attitude via audiovisual tapes and role playing. The placebo comprised of an academic workshop which had nothing to do with communication skills. The patients of both groups of doctors were given DISQ [Doctors interpersonal skills questionnaire] and their level of satisfaction based on their interaction with the doctors was evaluated
Results: The overall reliability of the study design and the method of its administration, pre and post the administration of the intervention was 93.2% and were deemed high enough to be considered reliable. The patients of doctors who received the intervention scored a mean of 37.2350 on DISQ with SD of +/- 8.68139 before intervention and mean of 42.0550 with SD of +/- 10.22176 after intervention. The patients of doctors who received the placebo scored a mean of 35.7100 with a SD of +/- 9.81166 before placebo and mean of 36.5900 with SD of +/- 8.55770 after placebo. The p-value was =0.001 [highly significant] when intervention group was compared before intervention and after intervention. However p-value was 0.433 [not significant] when control group was compared before and after placebo
Conclusion: Doctors who received the workshop designed to enhance the effectiveness of their communication skills were able to satisfy their patients to a greater degree compared as to those who received the placebo
RESUMO
OBJECTIVE: To determine frequency of metabolic syndrome in patients with Schizophrenia, in a tertiary care armed forces setup
STUDY DESIGN: Cross sectional study
PLACE AND DURATION: Department of Psychiatry, PNS SHIFA, Karachi from October 2009 to April 2010
MATERIALS AND METHODS: Fifty six patients with Schizophrenia reporting for management in PNS SHIFA were enrolled as subjects. Demographic variables and other confounding variables were recorded in a structured Performa, Blood Pressure [BP] and Waist Circumference [WC] were measured while Fasting Plasma Glucose [FPG], Triglycerides [TAG] and HDL-Cholesterol [HDL-C] levels were estimated by routine methods in laboratory with quality assurance
RESULTS: More than half i.e.30 [53.6%] of subjects had Metabolic Syndrome [MS] as per ATP IIIA criteria. Further 25% [n=14]of subjects were positive for two components of MS. Low HDL-C levels were most prevalent component followed by hyperglycaemia, hypertriglyceridemia and increased WC while hypertension was least common component
CONCLUSION: Metabolic Syndrome and its various components are frequently co morbidity in patients with Schizophrenia