Factors associated with food safety knowledge and practices among meat handlers in Bangladesh: a cross-sectional study

BACKGROUND@#Food handlers can play a vital role into reducing foodborne diseases by adopting appropriate food handling and sanitation practices in working plants. This study aimed to assess the factors associated with food safety knowledge and practices among meat handlers who work at butcher shops in Bangladesh.@*METHODS@#A cross-sectional study was conducted among 300 meat handlers from January to March, 2021. Data were collected through in-person interviews using a structured questionnaire. The questionnaire consisted of three parts; socio-demographic characteristics, assessments of food safety knowledge, and food safety practices. A multiple logistic regression model was used to identify the factors associated with food safety knowledge and practices.@*RESULTS@#Only 20% [95% confidence interval, (CI) 15.7-24.7] and 16.3% (95% CI 12.3-20.7) of the respondents demonstrated good levels of food safety knowledge and practices, respectively. The factors associated with good levels of food safety knowledge were: having a higher secondary education [adjusted odds ratio (AOR) = 4.57, 95% CI 1.11-18.76], income above 25,000 BDT/month (AOR = 10.52, 95% CI 3.43-32.26), work experience of > 10 years (AOR = 9.31, 95% CI 1.92-45.09), ≥ 8 h per day of work (AOR = 6.14, 95% CI 2.69-13.10), employed on a daily basis (AOR = 4.05, 95% CI 1.16-14.14), and having food safety training (AOR = 8.98 95% CI 2.16-37.32). Good food safety knowledge (AOR = 5.68, 95% CI 2.33-13.87) and working ≥ 8 h per day (AOR = 8.44, 95% CI 3.11-22.91) were significantly associated with a good level of food safety practice.@*CONCLUSIONS@#Poor knowledge and practices regarding food safety were found among Bangladeshi meat handlers. Findings may help public health professionals and practitioners develop targeted strategies to improve food safety knowledge and practices among this population. Such strategies may include education and sensitization on good food safety practices.

Incidence of Atrial Fibrillation (AF) in Patients of Acute Coronary Syndrome

Introduction: Atrial fibrillation is common among patients withcardiovascular disease and is a frequent complication of theacute coronary syndrome.Objective: In this study our main goal is to assess theincidence of AF in patients of acute coronary syndrome.Method: This retrospective observational cohort study wasdone at Dhaka medical college and hospital from December2010 to December 2011 where 100 patients (male=73,female=27) were diagnosed with of ACS and AF. All data wereentered on the Statistical Package for Social Science (SPSS)and analyzed.Results: During the study most of the patients were belong to51-60 age group (53%) and 53% patients developed atrialfibrillation after admission. Also new onset AF patient’s hospitalstay rate was higher.Conclusion: After many analyses we can said that, incidenceof new-onset AF was more common in patients presenting withACS.

Antioxidant supplements and gastrointestinal diseases: a critical appraisal

The gastrointestinal tract digests and absorbs dietary nutrients, protects the body against physical and chemical damage from contents in its lumen, provides immunity against external antigens, and keeps an optimum environment for the gut microbiota. These functions cannot be performed normally in several diseases of which the following are discussed here: irritable bowel syndrome and inflammatory bowel disease, which includes Crohn's disease and ulcer-ative colitis

Because these diseases are associated with oxi-dative stress, a host of antioxidant supplements are used for maintenance and recovery of the gut functions. However, the benefits of these supplements have not been established

The available 80 human trials were rated for levels of confidence and for benefits of the antioxidant supplements. For Crohn's disease, the supplements for which clear benefits occurred in at least 2 studies were allopurinol, Boswellia serrata [frankincense or shallaki], Artemesia species [worm-Wood], Tripterygium wilfordii [lei gong teng], and omega-3 fatty acids. Similar beneficial supplements for ulcerative colitis were allopurinol, Motricorio chamomillo [chamomile], Curcuma longa [curcumin in turmeric], and omega-3 fatty acids. There was also a clear benefit for ulcerative colitis in 2 studies where a multiherbal Chinese medicine preparation and an Ayurvedic medicine preparation were used. For irritable bowel syndrome, there was only a marginal benefit of some of the antioxidant supplements. Thus, some antioxidant supplements may be beneficial at certain stages of specific diseases. This is consistent with the current concept that antioxidants act by inhibiting oxidative stress pathways in a tissue- and environment-specific manner and not by simply acting asscavengers

Association of hyperuricemia with metabolic syndrome

Uric acid levels are often increased in subjects with metabolic syndrome but it is unclear whether it plays a causal role or it is a marker for metabolic syndrome. To find the association of hyperuricemia with various components of metabolic syndrome. The cross sectional analytical study was carried out in Sir Ganga Ram Hospital, Lahore, Pakistan. Total 600 subjects of both genders aged 30-70 years were recruited in the study. Demographic, clinical and biochemical variables were recorded by using a questionnaire. Fasting blood sample was used to estimate plasma glucose, serum lipid profile and uric acid. The cut-off for hyperuricemia was serum uric acid level >/=7.0 mg/dl for males and >/=5.7 mg/dl for females. Metabolic syndrome was diagnosed if subjects had any 3 of the 5 criteria described as per ATP III guidelines. The data was analyzed using SPSS Version 20. The study included 216 [36%] males and 384 [64%] females with mean age 47 +/- 10 years. Out of total 447 subjects, 62 [13.9%] with metabolic syndrome had hyperuricemia. Whereas 62 [75.6%] subjects out of total 82 subjects with hyperuricemia had metabolic syndrome. Different parameters of metabolic syndrome were statistically correlated with hyperuricemia but none showed significant correlation. Chi square and Wald Statistic [Logistic regression algorithm] showed that by using G-to-S [general to specific] approach hyperuricemia was significantly associated with female gender but did not show any association with metabolic syndrome. There was no association present between metabolic syndrome and hyperuricemia; therefore uric acid levels might not be important in the diagnosis of metabolic syndrome

Comparative adverse effects of low-dose oral prednisolone and oral mini pulse dexamethasone in patients of vitiligo

To compare the adverse effects of low-dose oral prednisolone and oral mini pulse dexamethasone in patients of vitiligo. A clinical trial was carried out from January 2013 to December 2013. Total sixty patients of vitiligo were enrolled and 30 of group A patients were treated with low dose oral prednisolone [0.3 mg/kg body weight] daily and 30 of group B patients were treated with oral dexamethasone pulse therapy [10 mg per week] for 16 weeks. During 12 week follow-up, increased body weight, headache, dyspepsia and fatigue were more frequent in group A as compared to group B. Similarly, in group A other side effects noted were acne [33.3%], mooning of face [26.6%], striae [26.6%], hypertrichosis 13.2%, purpura [6.7%] and among the female patients, menstrual abnormality [71.4%] whereas in group B, no patient developed these problems from baseline to follow-up period [p<0.05] Low dose oral prednisolone was found to be associated with more adverse effects than oral dexamethasone pulse therapy in treating vitiligo

Asphyxial deaths: a four year retrospective study in Peshawar

The study provides epidemiological analysis of autopsy record on asphyxial deaths and different methods used to carry it out. It was a retrospective [descriptive] study done at the Department of Forensic Medicine and Toxicology, Khyber Medical College Peshawar. Analysis of autopsy record was done and cases of asphyxial deaths and the cause of asphyxia was noted. The data covers a period from January 2009 to June 2012. A total of 3,265 [males n=2839, Females n= 426] cases were presented for autopsy to Forensic Medicine and Toxicology Department of Khyber medical college Peshawar and 130 deaths were due to asphyxia compared with 2370 deaths due to firearm. Homicide was the most common manner of death. 89 cases were males and 41 were females. Approximate ages of the autopsies conducted were 0-19 years n= [18.2%], 20-40 years n= [64.5%], 41-60 years n= [13%] and 61 or above n=4 [3.0%]. Strangulation was found to be the most common method used. Asphyxial deaths are not as common as firearm deaths in Peshawar. Homicide is the most common method of death. The findings may be helpful for the security agencies in investigation of asphyxial deaths

Safety of parenteral dexamethasone vs. oral prednisolone in the treatment of pemphigus vulgaris

To observe the safety of parenteral dexamethasone compared with oral prednisolone in the treatment of pemphigus vulgaris. A clinical trial was carried out in the department of Dermatology and Venereology, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total number of patients was thirty. Among them fifteen patients were treated with injection dexamethasone [group A] and other fifteen were treated with oral prednisolone [group B]. Statistically significant improvement was observed in both groups in all clinical parameters after 6 weeks. But dexamethasone group showed statistically more significant improvement than prednisolone group in all clinical parameters except Nikolsky's sign. Most common adverse effects in both groups were weight gain, increased appetite, puffy face and hyperglycemia. In dexamethasone group other side effect was sleep disturbance. In prednisolone group other side effects were gastritis, sleep disturbance, nausea and vomiting, herpes zoster infection, reactivation of tuberculosis and mood change. Parenteral dexamethasone appears to be safer than oral prednisolone in the management of pemphigus vulgaris with an acceptable efficacy profile

MRI brain findings in patients with high serum prolactin levels

The purpose of the study was to find MRI findings in patients with Prolactin levels above1000mIU/L. Methodology: This Retrospective study was conducted in Radiology Department, Rehman Medical Institute,Peshawar, from December 2009 to October 2012. A total of 86 patients, aged 16-48 years with high Prolactinlevels, were screened with MRI for pituitary gland abnormalities. Only new undiagnosed patientswere considered for the study. Children and patients with known causes for hyperprolactinaemia wereexcluded.The most common abnormality on MRI was microadenoma [n=34, 39.5%] followed by macroadenoma[n=14, 16.3%]. 12[7%] cases of complete/partial empty sella syndrome were seen. Macroadenomawas more common in males [n=6 out of 14, 42.3%] while microadenoma was more common in females[n=32 out of 72, 44.4%]. Majority of Patients had an abnormal MRI finding, showing that MRI screening should berecommended for Prolactin levels above 1000mIU/L. Microadenoma was the most common abnormality,having higher incidence in female patients

Analysis of autopsy record of unnatural deaths in Peshawar district

This study was undertaken to describe the unnatural deaths and their causes in Peshawar and its suburbs. This descriptive study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar. Autopsy data from January 2009 to April 2012 was analyzed and only those cases were selected for the study where the cause of death was unnatural i.e., homicide, suicide, accidental or undetermined. Of a total of 3,265 autopsies due to unnatural causes during 40 months period, 2,839 [87%] were males and 426 [13%] were females. There were 2,856 cases of homicide - 2,475 [87%] were males and 381[13%] were females, 317 were accidental deaths - 281 [89%] males and 36 females [11%], 66 were suicide cases - 61 [92%] males and 5 females [8%] and 26 were undetermined deaths - 22 males [85%] and 4 [15%] females. Most victims were aged 20-40 years. Most common cause of death was firearm - 2370 cases, blunt trauma 279 cases and bomb blast/explosives 167 cases. The rate of unnatural deaths in Peshawar is very high. Autopsies done during the study period were a lot more than previous years. Homicide is the most common manner of death with firearms being the most common weapon used. Strict laws should be implemented to limit illegal weapons. Surveillance must be increased in all parts of the city to reduce the loss of precious human lives

Clinico-mycological correlation in onychomycosis in a tertiary level hospital

To correlate the clinical patterns of onychomycosis with the type of mycological agents in onychomycosis. In this cross-sectional study, 120 patients with onychomycosis, attending outpatient department, were selected by purposive type of sampling technique. They were subjected to thorough clinical examination. Nail material was collected for mycological diagnosis by microscopy and culture on dermatophyte test medium. Microscopy was positive in 47 [39.2%] cases, whereas culture yielded Trichophyton rubrum in 53 [44.2%] and T. mentagrophytes in 2 [1.7%] patients. Common clinical nail changes in mycologically proven cases were thickening of nail plate [68.9%], subungual hyperkeratosis [63.9%], onycholysis [55.7%], roughening of nail plate [29.5%], yellowish discoloration [29.5%] and brownish-yellow discoloration [21.3%]. Only, subungual hyperkeratosis was found significantly more in mycologically positive cases [63.9%] than in mycologically negative cases [37.3%], p<0.05. The validity of microscopic examination for prediction of onychomycosis revealed sensitivity [74.5%], specificity [90.8%], accuracy [83.3%], positive predictive values [87.2%] and negative predictive values [80.8%]. There is an insignificant correlation between clinical pattern and mycological diagnosis. No single clinical feature is suggestive of onychomycosis, hence, direct microscopy must always be coupled with fungal culture for accurate diagnosis.

Pattern of contact dermatitis in a tertiary level hospital in Bangladesh

To evaluate the pattern of contact dermatitis [CD] among patients in a tertiary care hospital in Dhaka, Bangladesh. In this cross-sectional study, 120 patients of contact dermatitis, diagnosed clinically were evaluated by detail history and clinical examination. The clinical patterns were correlated with the likely sources of allergens. Mean age was 32.8 +/- 14.0 years and majority of the patients were housewives 36 [30.0%] and students 33 [27.5%]. 60.0% of the patients came from low-middle class. Itching 117 [97.5%] and disfigurement 89 [74.2%] were chief complaints of the patients. 63 [52.5%] patients showed erythematous rash, 42 [35%] vesicular eruption, 34 [28.3%] pustular eruption and 16 [13.3%] post-inflammatory hyperpigmentation. Both hands 69 [57.5%], right hand 41 [34.2%], both feet 50 [41.7], neck and ear 42 [35%] and face 30 [25.0%] were the commonly involved sites. Allergic contact dermatitis [52.5%] was more common than photocontact CD [26.7%] and irritant CD [20.8%]. Regarding the source of contact dermatitis, detergents 88 [73.3%], cooking materials 67 [55.8%], shoes or sandals 61 [50.8%], cosmetics 42 [35%], gold/jewellery 38 [31.7%], insects 29 [24.2%] were the main etiological factors of contact dermatitis. The study highlighted that contact dermatitis depends on patients' occupational exposure of different substances.

Resistance and sensitivity pattern of Staphylococcus aureus; a study in lady reading hospital Peshawar

This study was done to determine the sensitivity and resistance pattern to the most common antibiotics in use. The data for this retrospective study was obtained and analysed from October 2010 to October 2011 in Lady Reading Hospital, Peshawar. Purposive sampling and univariate analysis was done. 2058 samples were cultured for sensitivity using Kirby Bauer's Diffusion technique and in a period of one year, growth of Staphylococcus aureus was obtained in 723 samples. These 723 growths were obtained from clinical isolates of pus [699], blood [16] and urine [8]. Fourteen drugs from five different classes of antibiotics were tested for sensitivity against Staphylococcus aureus. Most of the growth was obtained from pus [96.7%]. Resistance was high to all groups of antibiotics except glycopeptides. There was no case of Vancomycin Resistant Staphylococcus aureus [VRSA]. Out of 723 samples, 228 [31.5%] were Methicillin Resistant Staphylococcus aureus [MRSA]. The resistance to a representative antibiotic of each group is as follows: Ciprofloxacin [Fluor quinolone] 51.7%, Cephradine [Cephalosporin] 46.2%, Amoxicillin+Clavulanic Acid [Penicillin group] 45.6%,Imipenem+Cilastatin Sodium [Carbapenem] 42.0% and Teicoplanin [Glycopeptide] 19.8%.Resistance of Staphylococcus aureus to Teicoplanin and most of the antibiotics is high and strict guidelines are required to control unnecessary prescriptions and over the counter sale of antibiotics

Assessment of knowledge, attitude and practices pattern of hand washing in some major public sector hospitals of Pakistan [a multi-center study]

To assess knowledge, attitude and practices of hand washing in major Public sector Hospitals of Pakistan and see the differences in practices in different levels of health care workers. Cross sectional hospital based survey conducted in all provinces of Pakistan in major tertiary care hospitals. A Cross sectional hospital based survey was conducted on knowledge, attitude and practices of hand washing in doctors, nurses and paramedical staff. From each hospital 10 OPD's and 10 wards i.e. 2 medical, 2 Surgical, Gynae, Peads, Dermatology, Eye, ENT, and Causality/ICU were selected and from each unit. Four doctors, four nurses and two paramedical staff were interviewed. A total of 3243 respondents were interviewed. Of these 87.3% had knowledge of hand washing. Hand washing facilities were available at 75% places and 69% respondents practiced hand hygiene, but only 58.8% washed their hands for more than 20 seconds. Majority used antibacterial soap bought by them. Rush of the patients, shortage of time, non availability of soap and water and lack of encouragement by seniors were the major causes for low hand hygiene practice. Almost 25% sites in major public sector tertiary hospitals did not have hand washing facilities but where available most health care providers were using them. Majority despite having knowledge, need motivation and continuous education of hand hygiene. Facilities of hand hygiene should be made available

Knowledge, attitude and practices of dentists about hepatitis B and C infection in Lahore

To assess the knowledge, attitude and practices of dentists of public and private sector in Lahore about Hepatitis B and C infection. This cross-sectional analytical study was conducted on private dental practitioners and public sector dental surgeons working in hospitals of Lahore. Private sector dentists of Lahore working in Shahdara, Badami Bagh, Mughalpura, Baghbanpura, Gulberg, Shadman, Mozang, Feroz pur Road, Model Town, Multan Road, Johar Town and Tohkher Niaz Baig were selected for the study. In the public sector hospitals, dental surgeons were selected from Demont Morency Dental College and Hospital, Mayo Hospital, Services Hospital, Govt. Mozang Hospital, Jinnah Hospital, Lahore General Hospital, Mian Munshi Hospital, Sheikh Zaid Hospital, Railway Hospital, Wapda Hospital and Combined Military Hospital by using convenient sampling technique. A self-administered, close- ended questionnaire was used and information was gathered about their knowledge, attitude and practices for HBV/HCV infection and its prevention. Data was entered in the SPSS-13 computer program. Frequency and percentages were calculated for different segments and comparison between the two groups was performed by using z-test for proportion. p-value

Coverage and causes of non immunization in national immunization days for polio; a consumer and provider perspective study in Peshawar

Polio is a viral disease that may cause paralysis and infant death. Despite ongoing efforts, polio has not been eradicated from Pakistan. The purpose of this survey is to estimate the coverage of polio vaccine during National Immunization Days and to determine the factors associated with lack of immunization. A Cross-sectional survey was conducted in Peshawar, Pakistan, from 1[st] June to 9[th] June 2010. Confidence level of 95% and confidence interval of 4 was used to derive the sample size [for a population more than 20,000]. Parents of 600 children under 5 years were asked about immunization during NIDs of January - May 2010 [5 NIDs]. Questions regarding demographics, income, education, occupation, accessibility to health centers and frequency of visits from health workers was inquired. Knowledge and views on immunization were also asked. 40 health personnel involved in immunization were also interviewed and they were asked about hurdles faced in immunization. 83.7% children were vaccinated in all National Immunization Days, while 94.7% had at least, taken polio vaccine once. 5.3% had not taken polio vaccine during National immunization Days of 2010. Main reasons for not vaccinating were; Vaccinator absent/not visiting home/vaccine not available [63.36%], no awareness [17.4%], Child ill [5.8%], family problem/mother busy [3.3%] and wrong ideas/sterility [3.3%]. Many health personnel [32.5%] considered lack of awareness among people and low accessibility to vaccine as the main hurdles in immunization, besides the poor salaries and incentives. Polio vaccination during National Immunization Days 2010 was a partial success because some pockets of poor children and afghan refugees were poorly vaccinated. In order to eradicate polio, they must be vaccinated

Coverage and causes of missed Haemophilus influenzae type B vaccination in urban and rural areas of Peshawar

Haemophilus influenza type b [Hib] is a major cause of morbidity and mortality in Pakistan. Hib vaccine was introduced in 2009 in EPI programme. The purpose of this study was to find out the coverage and factors associated with non-immunization of Hib in urban and rural areas of Peshawar. Data was collected through random sampling in Peshawar University, Peshawar Saddar, Hashtnagri, Naway Kalay and Pawaka from 9th to 19th of June 2010. A questionnaire was used to interview parents of 600 children aged 1 year and below about demographics, Hib vaccination status, reasons for missed vaccination and views on immunization. Pearson's Chi-square test was used for statistical testing, and p<0.05 was considered significant. Completely vaccinated children were 64.2%, 25% not vaccinated at all, and 11% were incompletely vaccinated. The reasons for not vaccinating were lack of awareness [26%], family problem/mother busy [18%], centre too far [16.9%], wrong ideas [12.2%], fear of reaction [5.4%], child illness [8.1%] and miscellaneous causes [13.7%]. Low Hib vaccination coverage in Peshawar is mainly due to low awareness among people, poor economic conditions and illiteracy

Pulse dose of oral itraconazole is effective in the treatment of onychomycosis

Onychomycosis is a recalcitrant disease of the nails caused by dermatophytes, yeasts, and molds. To see the efficacy of pulse dose of oral itraconazole in the treatment of onychomycosis. It was an open clinical trial which was carried out for a period of 2 years from March 2009 to February 2011, in the outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University [BSMMU] Dhaka. Bangladesh. Thirty patients with onychomycosis were recruited purposively. 30 patients of onychomycosis were treated with oral itraconazole 400 mg/day, seven days a month for three months. Mean age of the respondents was 36.57 +/- 14.01 years and male to female ratio was 1:1. Among the patients, 36.7% cases had involvement of toenails and 63.3% cases had involvement of fingernails. In 6.7% cases onychomycosis was mild, 80.0% cases moderate and in 13.3% cases severe. Three months after treatment with itraconazole, improvement was found in 66.7% cases and marked improvement in 33.3%. Before treatment, culture was found positive in 30% cases and three months after treatment, culture became negative in 66.7% cases. Monthly one week cycle of oral itraconazole 400 mg daily for 3 months is effective therapeutic option for onychomycosis

Colonic inflammation increases the contribution of muscarinic M2 receptors to carbachol-induced contraction of the rat colon

Carbachol-induced contraction of the rat colon is impaired in rats with trinitrobenzene sulfonic acid [TNBS]-induced colitis. The main objective of this study was to examine the effect of colitis on the expression and function of muscarinic [M] receptor subtypes in the rat colon. Rats [n = 80] were treated with TNBS and used 5 days later for measurement of contractility, myeloperoxidase activity, histology and expression of muscarinic receptor isoforms using Western blot analysis. Carbachol produced concentration-dependent contractions of colonic segments from control [n = 40] and TNBS-treated [n = 40] rats with no significant difference in potency. However, the maximum response to carbachol was significantly reduced in colon segments of TNBS-treated rats. The selective muscarinic receptor antagonists 4-diphenylacetoxy-N-methyl piperidine [4-DAMP, M3], pirenzepine [M1] and methoctramine [M2] antagonized carbachol-induced contraction in control [9.1 +/- 0.1, 6.7 +/- 0.3 and 6.0 +/- 0.1, respectively] and TNBS-treated rats [9.2 +/- 0.2, 6.9 +/- 0.2, 6.7 +/- 0.2]. The -logKB values in control rats are consistent with an action of carbachol on muscarinic M3 receptors. There was no significant difference in -logKB values for 4-DAMP and pirenzepine in control and TNBS-treated rats, but methoctramine was fivefold more potent in TNBS-treated rats, possibly indicating an increased contribution of muscarinic M2 receptors to carbachol-induced contraction in the inflamed colon. The expression of M2 receptors was also significantly increased in colon segments from TNBS-treated rats, confirming the increased role of muscarinic M2 receptors in the inflamed colon. The data show that while only M3 receptors appeared to mediate carbachol-induced contraction in control segments, expression of both M2 and M3 receptors was increased in the inflamed rat colon

Association of insulin resistance with obesity in children

Insulin resistance is the primary metabolic disorder associated with obesity. Little is known about its role as a determinant of the metabolic syndrome in obese children. To assess the association of insulin resistance with metabolic syndrome in obese and non obese children. Study type and settings: Cross sectional analytical study conducted among children of ten Municipal Corporation high schools of Data Ganj Buksh Town Lahore. A total of 46 obese and 49 non obese children with consent were recruited for the study. Fasting blood glucose, serum insulin, high density lipoprotein cholesterol, triglycerides, cholesterol, non HDL-cholesterol LDL cholesterol were measured using standard methods. Data were analyzed by using statistical software SPSS-Version 15. A total of 95 children 49 obese and 46 non obese were recruited for the study. A significant association of serum triglyceride [p<0.001], high density lipoprotein cholesterol [p<0.001], fasting blood glucose [p<0.001], and insulin levels [p<0.001], was seen between the two groups. For each component of metabolic syndrome, when insulin resistance increased so did odds ratios for cardio metabolic risk factors. Insulin resistance was seen in 34.7% children. Metabolic syndrome was found in 31.6% children reflecting that obese children are at high risk for metabolic syndrome and have low HDL-cholesterol and high triglycerides levels