Background: Globally 1.13 billion people were living with hypertension, Out of this two-thirds of them were living in low and middle-income countries. In Ethiopia, Non-Communicable Disease deaths are estimated at around 42%. However, it remains widely undetected and poorly controlled. To resolve these, lifestyle modification approaches that are often overlooked are the cornerstone of the prevention and management of hypertension. Objective: To assess lifestyle modification practice and associated factors among hypertensive patients in selected hospitals in West Arsi Zone, Oromia Regional, Ethiopia December 7 to 21, 2019. Method: Hospital-based cross-sectional study was conducted in the selected public hospital among 299 hypertensive patients. Systemic random sampling methods were used to select the study participants. Data were collected by face-to-face interviews using a structured questionnaire by trained data collectors. Data were analyzed using descriptive statistics and multivariate logistic regression method to identify predictors of the outcome (p < 0.05). Results: Of the total participants, only 25.2% (95% CI: 18.8-32.9) of the patients were practiced recommended lifestyle modifications. Patients Age older than 65 years (AOR = 2.9, 95% CI: 1.17 - 7.0), the patients with 2-5 years’ time since diagnosed hypertension (AOR = 0.26, 95% CI: 0.07 - 0.9), multiple co-morbidity (AOR = 2.7, 95% CI: 1.25 - 5.8,) and their knowledge on hypertension management (AOR = 14.6, 95% CI: 4.6 - 45.9) have an independently associated with recommended lifestyle modification. Conclusion: Lifestyle modification practices among hypertensive patients were low in this study. Age, comorbidity, time since diagnoses of hypertension, and knowledge of lifestyle were identified as predictors of the outcome.
Siddharth Agarwal*, Sapna Agarwal, Raj Kumar Verma and Shreyash Dayal
Published on: 28th June, 2022
Introduction: The world is currently facing the SARS-CoV-2 pandemic with evolving 2nd wave. The COVID-19 patients present most commonly with Severe Acute Respiratory Illness (SARI) in an emergency room with acute onset fever, cough, and breathlessness. However, not all SARI cases as per definition are due to COVID-19 infection, which is well proven in this case series of 113 cases of SARI. This is just the opposite of the other SARI series done in the pre-COVID-19 era. Also, no previous SARI case series data has shown significant association with Diabetes Mellitus, including new-onset diabetes thus figuring out the major Pathophysiological association of COVID-19 with glucose metabolism and has a bearing on the pathogenesis, treatment, and outcome of COVID-19 infection and perpetuity of pandemic of this magnitude. Here we raise concern for the first time about the growing association of an infectious pandemic with the lifestyle disorders which are non-communicable diseases but carry with them the potential of fertile soil for rapidly spreading epidemics.Aim and objective: To find out the etiology, clinical profile, treatment outcome, and mortality rate in different sub-groups of SARI cases in a tertiary care hospital and the incidence of new-onset Diabetes Mellitus in them and to investigate theoretically the hypothesis that maintaining normal glucose metabolism could prevent progression of a mild Flu-like illness (FLI) to a severe form of Severe Acute Respiratory Illness (SARI) and consequent complications such as Cytokine Storm Syndrome and Multi-Organ failure.Design: Retrospective, single-center case series of 113 SARI patients at a tertiary care hospital in Agra India between 1 March- 30 October 2020.Main outcome: The demographics, clinical, pathological, imaging, and treatment outcome data were collected. The SARI cases analyzed were defined as “Severe acute respiratory infections (SARIs) an acute respiratory illness of recent onset (within seven days) manifested by fever (≥38°C), cough and shortness of breath or difficulty in breathing requiring hospitalization and were sub-classified according to the primary etiology producing SARI in them. The findings were compiled and compared. Conclusion: Of the 113 patients of SARI – 32.7 %were associated with Diabetes, with 9.74% new-onset Diabetes and 26 % previously known Diabetes. This was mainly due to SARS-CoV-2 (24 Diabetics out of 52 COVID-19 cases- 46.1 %).The Average hospitalization stay of SARI cases was 10 days with a maximum in SARS-CoV-2 and a minimum stay of 5.22 days in Bacterial Pneumonia and 5.66 days in Koch’s Lungs.The death rate was maximum (4 out of 26) 15.3%. Hospitalized TB/Koch’s Lung patients who presented as SARI and 3.8% in Bacterial Pneumonia, 2.43% in SARS-CoV-2, and <1% in Sepsis.Those SARI cases who were euglycemic at the time of initial presentation recovered early and carried a good prognosis with less mortality as compared to those who were hyperglycemic on presentation. Also, those FLI cases who maintained euglycemia or did not have any other risk factor which predisposes them to stress (Diabetes, Prolonged fasting, Obesity, major organ disorder, Psychological disorder, and Cancer) did not progress to SARI as the endogenous steroid secretion and sympathetic activation did not occur, the intracellular pH levels remained in the alkaline range.10.18% of cases developed new-onset diabetes (a total of 11 cases) out of which 10 were in COVID-19. Thus 19.2% incidence of new-onset diabetes in SARS-CoV-2 and a prevalence of 26.9% in SARS-CoV-2, making total diabetes 46.1% in SARS-CoV-2, and out of all SARI cases, 26 % of patients developed pulmonary fibrosis with consequent long-term complications. In COVID-19 patients, it was seen only in diabetics SARS CoV-2 male patients, thus no death in non-diabetic females in COVID-19 in this case series.
Recently announced centralized aerobic-anaerobic energy balance compensation (CAAEBC) theory has already demonstrated achievements in the treatment of arterial hypertension (AHT), diabetes myelitis (DM) and osteochondrosis. Such demonstration lifts the necessity to check the applicability of this theory to other non-communicable diseases (NCDs) and develop the proper way to model the main idea of CAAEBC.
Kirill V Zhukov, Bagrat A Gasparyan, Alexandre A Vetcher* and Alexander Y Shishonin
Published on: 26th October, 2022
We demonstrated intrinsic connections between left ventricular hypertrophy (LVH) and arterial hypertension (AHT) through the recently announced centralized aerobic-anaerobic energy balance compensation (CAAEBC) theory. CAAEBC has already demonstrated achievements in the treatment of AHT, diabetes myelitis (DM), and osteochondrosis. Such demonstration lifts the necessity to check the applicability of this theory to other non-communicable diseases (NCDs) and develop the proper way to model the main idea of CAAEBC.
Approximately 73.4% of global deaths are caused by chronic non-communicable diseases, among them, cardiovascular and cerebrovascular diseases, tumors, and chronic respiratory diseases ranked in the top 3 respectively [1]. An accumulating body of evidence showed that the risk of all-cause mortality in cancer patients with cardiovascular disease (CVD) was 3.78 times higher than that of those without CVD and 8.8% of cancer survivors died of CVD [2]. Heart failure (HF) is a serious manifestation or terminal stage of various heart diseases. Although myocardial damage and dysfunction are the main causes of HF, the cardiovascular injury caused by the tumor itself and the detrimental effect of cancer treatment also play an important role. More recently, the data has suggested that up to 25% - 30% of patients with HF have histories of cancer for about 10 years; and cancer also determines the prognosis of heart HF [3].
Renal impairment is one of the most severe non-communicable diseases around the world. Especially patients with diagnosed/newly diagnosed renal impairment who needed surgery are more focused on preoperative and postoperative preparation. Serum creatinine is the prime biochemical marker for assessing renal function and the level of impairment is widely measured by this marker as well as Glomerular Filtration Rate (GFR). Objective: Factors responsible for fluctuating serum creatinine during preoperative and postoperative periods and minimizing the process of serum creatinine is the ultimate goal of this study. Method: 37 patients participated in this cross-sectional study who were previously diagnosed/newly diagnosed. They were admitted to different tertiary-level hospitals for emergency or elective surgery. 15 patients were admitted in the renal function impairment stage and 22 were admitted as normal patients’. Values of creatinine at the pre-admission stage and 2nd/3rd post-admission follow-up were compared. Results: 0.41 was the average of 22 patients’ creatinine between pre-admission and 2nd/3rd follow-up. The responsible factor like prolonged staying, immobilization, co-morbidities, different preoperative antibiotics and NSAIDs were also inducers for creatinine elevation. After postoperative hemodialysis rapid decrease of creatinine is seen in normal patients but this decrease is very much minor in CKD-diagnosed patients.
Marlene N Aldin, Regina M Fisberg, Marcelo M Rogero, Flavia M Sarti and Nágila RT Damasceno*
Published on: 6th May, 2024
Background: Worldwide, obesity in adolescents is an epidemiological concern. Overweight and obesity are associated with comorbidities in adult life, such as increased risk of hypertension and other non-communicable diseases. This study investigated possible differences between traditional lipid markers and Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL) subfractions in a population-wide representative sample of Brazilian adolescents. Methods: The individuals included in the study comprise a subsample of the 2015 Health Survey of São Paulo (ISA-Capital 2015). LDL and HDL particle sizes were determined by the Lipoprint® System (Quantimetrix Corporation). Results: 272 Brazilian adolescents with a mean age of 15.2 ± 2.2 years, of which 47.8% (n = 130) are boys. Analysis of LDL subfractions showed an increase in LDL 2 content in girls (5.7% vs. 5.1%; p = 0.047). This result was associated with a higher content of large LDL in girls (17.8% vs. 13.5%; p < 0.001) and a significant, lower content of small LDL (1.7% vs. 3.4%; p = 0.002). When obesity was considered, we observed that regardless of being overweight, girls had higher large and small LDL than boys. However, when a large to small LDL ratio was calculated, girls with no excess weight had higher values than boys with no excess weight (10.6 vs. 9.3; p = 0.038), and these had lower LDL ratio than overweight boys (9.3 vs. 13.5; p = 0.016). On the other hand, boys had higher HDL 2 content than girls (8.9% vs. 8.0%; p = 0.017), which was associated with increased large HDL values in boys (1.9% vs. 1.7%; p = 0.047). Regression analysis was performed according to gender, the sum of very low-density lipoprotein (VLDL) + intermediate density lipoprotein (IDL) C + IDL B subfractions was adjusted for age and body mass index (BMI), showing that girls had lower atherogenic lipid profile (β = 0.987; CI = 0.977-0.998; p = 0.017) than boys. When the regression analysis was performed according to BMI, large LDL in adolescents with no excess weight presented a lower atherogenic lipid profile (β = 1.040; CI = 1.000-1.082; p = 0.049), adjusted for age and sex, than overweight adolescents.Conclusion: Regardless of excess weight, girls showed a cardioprotective profile more associated with a favorable distribution of LDL subfractions than boys, reinforcing the relevance of evaluating qualitative aspects of lipoproteins in addition to the traditional cholesterol content.
Background: Non-Communicable Diseases (NCDs) in India have increased from 37.9% in 1990 to 61.8% in 2016. They are slowly progressive are of long duration and are responsible for more than 50% of the global burden of disease Very few studies have been conducted that studied the prevalence of risk factors in non-communicable diseases among medical students. The authors observed that most of the students are at risk of developing NCDs, and the cumulative effect of risk factors bundles up and eventually leads to disease as students advance through their lives.Aim and objectives: (i) To estimate the prevalence of risk factors of NCD amongst medical students, (ii) To study the association between various risk factors and NCDs in study subjects.Settings and design: A cross-sectional analytical study involving 362 undergraduate students of Rama Medical College using simple random sampling.Material and methods: The study used a pretested structured questionnaire which was conducted by using the WHO NCD steps approach.Statistical analysis used: Data analysis was done by using M S Excel and software SPSS version 26.Results: Our study results showed that physical activity is Prevalent in female students at 51% and in male students at 48.9%, almost equal. Junk food consumption had an overall prevalence of 69.34% of females outnumbering males in junk food consumption. The association of BMI with NCD as a risk factor was statistically significant in the current 75 smokers only.Conclusion: There is a huge opportunity to reduce modifiable risk factors and NCD among our future doctors by encouraging them to change their behavior-related lifestyles such as smoking habits, alcohol use, junk food, etc.
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