Successful lifestyle modifications may underlie umbilical cordmesenchymal stromal cell effects in type 2 diabetes mellitus

Type 2 diabetes mellitus(T2DM)is a lifelong condition and a grave threat to human health.Innovative efforts to relieve its detrimental effects are acutely needed.The sine qua non in T2DM management is consistent adherence to a prudent lifestyle and nutrition,combined with aerobic and resistance exercise regimens,together repeatedly shown to lead to complete reversal and even longterm remission.Non-adherence to the above lifestyle adjustments condemns any treatment effort and ultimately the patient to a grim fate.It is thus imperative that every study evaluating the effects of innovative interventions in T2DM objectively compares the novel treatment modality to lifestyle modifications,preferably through double-blind controlled randomization,before claiming efficacy.

Effect of lifestyle modification on hepatocellular carcinoma incidence and mortality among patients with chronic hepatitis B

BACKGROUND Research exploring the influence of healthier lifestyle modification(LSM)on the risk of hepatocellular carcinoma(HCC)in patients with chronic hepatitis B(CHB)is limited.AIM To emulate a target trial to determine the effect of LSM on HCC incidence and mortality among patients with CHB by large-scale population-based observational data.METHODS Among the patients with CHB enrolled in the Korean National Health Insurance Service between January 1,2009,and December 31,2017,those aged≥20 years who drank alcohol,smoked cigarettes,and were sedentary were analyzed.Exposure included at least one LSM,including alcohol abstinence,smoking cessation,and regular exercise.The primary outcome was HCC development,and the secondary outcome was liver-related mortality.We used 2:1 propensity score matching to account for covariates.RESULTS With 48766 patients in the LSM group and 103560 in the control group,the adjusted hazard ratio(HR)for incident HCC and liver-related mortality was 0.92[95%confidence interval(CI):0.87-0.96]and 0.92(95%CI:0.86-0.99)in the LSM group,respectively,compared with the control group.Among the LSM group,the adjusted HR(95%CI)for incident HCC was 0.84(0.76-0.94),0.87(0.81-0.94),and 1.08(1.00-1.16)for alcohol abstinence,smoking cessation,and regular exercise,respectively.The adjusted HR(95%CI)for liver-related mortality was 0.92(0.80-1.06),0.81(0.72-0.91),and 1.15(1.04-1.27)for alcohol abstinence,smoking cessation,and regular exercise,respectively.CONCLUSION LSM lowered the risk of HCC and mortality in patients with CHB.Thus,active LSM,particularly alcohol abstinence and smoking cessation,should be encouraged in patients with CHB.

Global lung cancer mortality trends and lifestyle modifications:preliminary analysis

Background:According to the Independent High-level Commission on Non-communicable Diseases(NCD)of the World Health Organization(WHO),global reduction in lung cancer mortality has been achieved since the year 2000,although this effect is not sufficient to reach the 30%reduction of mortality from NCDs by the year 2030,as stipulated by the United Nations Sustainable Development Goal 3.4.The objective of this study was to analyze whether the lifestyle changes implemented by the WHO at country level could have an impact on mortality from this form of cancer.Methods:WHO statistics,based on the unified mortality and causes-of-death reports of Member-State countries,were used to evaluate global lung cancer mortality trends and make comparisons and assessments of different types of community-based,country-wide interventions.Results:The lung cancer mortality decline was associated with the anti-tobacco campaign initiated by the WHO in the last 15 to 20 years.Comprehensive tobacco control remained the major and most successful lifestyle modification measure.In countries with declining lung cancer mortality,91%of countries had decreasing tobacco prevalence in males and 82%in females.Country-wide measures to increase physical activity had a strong tendency to be better implemented in countries with declining lung cancer mortality(t=1.79,P>0.05).Other WHO"best-buy"lifestyle modification campaigns(diet and alcohol)had been carried out for shorter periods,and their associations with lung cancer were less strong than tobacco.There was no significant difference between countries with declining and increasing lung cancer mortality in the measures for reduction of harmful alcohol use(t=0.92,P>0.05)and unhealthy diet reduction measures(t=0.84,P>0.05).Conclusion:Following WHO"best-buys"should facilitate to move countries towards the NCD including lung cancer mortality reduction targets.Governments and communities must embrace these targets with coordinated effective action for better health.

Effects of lifestyle modification on liver enzyme and Fibroscan in Indian patients with non-alcoholic fatty liver disease

Background and aims:Non-alcoholic fatty liver disease(NAFLD)is remarkably increasing in developing countries like India,in parallel with the increasing incidence of obesity.Lifestyle modification is a recommended treatment for NAFLD.In most of the previous studies,improvement after lifestyle modification was assessed by liver fibrosis through liver biopsy,but we cannot do a serial liver biopsy in every NAFLD patient.Liver fibrosis can also be assessed by fibroscan non-invasively in NAFLD.This study was designed to evaluate the effect of lifestyle modification on liver enzymes and Fibroscan values in a population with NAFLD.Methods:Initially,50 NAFLD patients were included in this prospective follow-up study;however,after 6 months of lifestyle modification,only 39 participants were studied.During both the first and second consultations,Fibroscan was carried out.All participants underwent a careful interview,anthropometry measurements and radiological and biochemical tests during every consultation.Results:After 6 months of lifestyle modification,Fibroscan values improved significantly(8.3160.11kPa vs 7.8760.12kPa,p¼0.009).Alanine aminotransferase(ALT)values also showed improvement during the second consultation(97.2562.62 U/L vs 66.6963.95 U/L,p<0.001).Conclusion:Measured by Fibroscan and liver enzymes,it has been found that lifestyle modification is an effective therapy to downgrade hepatic injury in NAFLD patients.Serial Fibroscan can be used to assess the treatment response in NAFLD patients due to its non-invasive nature.

Factors Facilitating Adherence to Recommended Lifestyle-Modification amongst Hypertensive Clients at Malamulo Hospital, Thyolo, Malawi

Background: Adherence to recommended lifestyle modification regarding hypertension control remains a serious problem in Malawi, leading to poor blood pressure control. Objective: This study examined factors that facilitate adherence to recommended lifestyle modification among hypertensive clients’ at Malamulo hospital in Thyolo Malawi. Methods: A descriptive cross-sectional quantitative study was conducted with 108 clients who were recruited through a systematic sampling method. Data were collected through face-to-face interviews using a pre-tested structured questionnaire. Using statistical Packages for Social Sciences (SPSS) version 22, Chi-Square (x2) test was applied to test each predictor variable for statistical significance. The significant predictors were entered into the logistic regression model to determine the independent predictors of recommended lifestyle modifications amongst clients. Odds ratio (OR) at 95% Confidence Interval (CI) was used to declare the independent effect of each variable on the outcome variable. Results: 108 respondents were enrolled in the study, the majority of who were women (60.2%). Findings demonstrated that clients had adequate knowledge of lifestyle modification with an overall knowledge rate of 92% though the overall adherence rate was poor at 53.8%. Having family support (OR = 4.587, 95% CI: 1.625, 12.947, p = 0.004) and support groups (OR = 4.043, 95% CI: 1.496, 10.926, p = 0.006) are more likely to facilitate adherence to recommended lifestyle modification unlike situations of non-involvement of family and lack of support groups. Conclusion: Clients demonstrated adequate knowledge of recommended lifestyle modifications with poor adherence to them. The presence of support groups and a strong family support system are important factors for fostering adherence to the recommended lifestyle modifications regarding hypertension control.

Effects of traditional Chinese medicine on symptoms of patients with spleen and stomach deficiency-related tinnitus

BACKGROUND Tinnitus affects 10%-30%of the population.Recent evidence suggests that tinnitus is associated with spleen deficiency.However,compared with kidney deficiency-related tinnitus,less research has been conducted on the impact of spleen defi-ciency-related tinnitus.AIM To investigate the clinical efficacy of using Guipi Wan and dietary and lifestyle modification based on traditional Chinese medicine for treatment of patients with spleen and stomach deficiency-related tinnitus.METHODS We enrolled 110 patients with spleen and stomach deficiency-related tinnitus who were distributed into treatment(58 cases)and control(52 cases)groups.Tinnitus severity,sleep quality and emotional state were assessed by questionnaires[Tinnitus Evaluation Questionnaire(TEQ);Pittsburgh Sleep Quality Index(PSQI);Depression-Anxiety-Stress Scale-21(DASS-21)]that were used for analysis in the two groups during the initial and intervention and after.In the treatment group,patients were treated with oral administration of Guipi Wan and consulted for healthy dietary and lifestyle modification.In the control group,patients were only assessed and not treated.RESULTS At the end of the 6-months,TEQ scores decreased significantly in the treatment group(P=0.021)but not in the Control group.Significant effects in the treatment group were noted for PSQI total score(P=0.043)and several PSQI component scores in the treatment group(P<0.05).After treatment,the DASS-21 scores were significantly reduced in the treatment group(P<0.05).CONCLUSION Guipi Wan combined with dietary and lifestyle modification based on regulating the spleen and stomach can be considered core to the treatment of tinnitus related to spleen and stomach deficiency.

Irritable bowel syndrome in children: Pathogenesis, diagnosis and evidence-based treatment

Irritable bowel syndrome (IBS) is the commonest cause of recurrent abdominal pain (RAP) in children in both more developed and developing parts of the world. It is defined by the Rome III criteria for functional gastrointestinal disorders. It is characterized by abdominal pain that is improved by defecation and whose onset is associated with a change in stool form and or frequency and is not explained by structural or biochemical abnormalities. It is estimated that 10%-15% of older children and adolescents suffer from IBS. IBS can be considered to be a brain-gut disorder possibly due to complex interaction between environmental and hereditary factors. The diagnosis of IBS is made based on the Rome III criteria together with ruling out organic causes of RAP in children such as inflammatory bowel disease and celiac disease. Once the diagnosis of IBS is made, it is important to explain to the parents (and children) that there is no serious underlying disease. This reassurance may be effective treatment in a large number of cases. Lifestyle modifications, stress management, dietary interventions and probiotics may be beneficial in some cases. Although there is limited evidence for efficacy of pharmacological therapies such as antispasmodics and antidiarrheals; these have a role in severe cases. Biopsychosocial therapies have shown encouraging results in initial trials but are beset by limited availability. Further research is necessary to understand the pathophysiology and provide specific focused therapies.

Management strategy of infertility in polycystic ovary syndrome

Polycystic ovary syndrome(PCOS)is the most common endocrine and metabolic disease in women of reproductive age.PCOS is characterized by ovulatory disruption,which can lead to infertility.Patients with PCOS are also more likely to have poor pregnancy outcomes.For obese women,lifestyle interventions are recommended first,which have general health benefits.For women who have difficulty changing their lifestyle,drugs for the treatment of obesity or bariatric surgery could be considered.Clomiphene citrate is the first-line medication after weight loss that has been utilized in the past.Letrozole is supplanting clomiphene as the best option for ovulation induction for now,particularly in patients with PCOS.Metformin can improve ovulation and pregnancy rates;however,it has minimal effects in terms of raising live birth rates.Second-line therapies include gonadotropins and laparoscopic ovary drilling.In vitro fertilization can be utilized as a third-line treatment for patients with PCOS who have failed ovulation induction therapy or have other infertility factors.In summary,to achieve fertility,patients with PCOS require standardized individualized therapy.

Upshots of health education among patients with type 2 diabetes mellitus: A field study in Mysuru

Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru,India from July to December 2022.Participants were assigned to two groups:intervention(n=52)and control(n=52),and their data were collected.The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed,whereas the participants in the control group were asked to continue their routine health checkups.The body mass index(BMI),weight,fasting blood sugar(FBS),knowledge about the disease,and behavior changes were recorded and compared between the two groups before and after 6 months.Results:The mean FBS value,BMI and weight decreased significantly in the intervention group after 6 months(FBS:164.79±47.59 mg/dL vs.141.92±25.63 mg/dL,P<0.001;BMI:22.97±3.75 kg/m2 vs.22.62±3.29 kg/m2,P<0.05;weight:62.82±11.92 kg vs.61.54±10.67 kg,P<0.05).The posttest period also showed an improvement in physical activity,diet,and medication adherence in the intervention group compared to the control group(P<0.05).The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test(P<0.05).Conclusions:The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before.The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.

Concept of health and disease in naturopathy: an overview in the context of COVID-19 pandemic

Naturopathy is a traditional health care science having its own concepts of health and healing rooting through nature.It is a non-pharmacological system of health care which derives its disease causing and health keeping principles from fundamental natural elements(Panchamahabhutas)viz.Prithvi,Jala,Vayu,Agni,and Akash.The imbalance among these five elements individually or in respect to others creates disease and in turn also forms the basis of healing if such imbalances are corrected.This paper reviews the simple concepts of naturopathy referring to health and disease and contextualises them to the on-going pandemic which has affected the entire world.An extensive manual and digital search of the relevant literature was done related to naturopathy in order to compile the review.This review is important from the perspectives that in the current pandemic the cure is still not evident from any corner of the world and from any system of medicine.Therefore such simple health keeping strategies from naturopathy seem to be of much relevance.

Current Evidence Concerning Effects of Ketogenic Diet and Intermittent Fasting in Patients with Nonalcoholic Fatty Liver

Nonalcoholic fatty liver disease (NAFLD) is emerging globally, while no therapeutic medication has been approved as an effective treatment to date, lifestyle intervention through dietary modification and physical exercise plays a critical role in NAFLD management. In terms of dietary modification, Mediterranean diet is the most studied dietary pattern and is recommended in many guidelines, however, it may not be feasible and affordable for many patients. Recently, a ketogenic diet and intermittent fasting have gained public attention and have been studied in the role of weight management. This article reviews specifically whether these trendy dietary patterns have an effect on NAFLD outcomes regarding intrahepatic fat content, fibrosis, and liver enzymes, the scientific rationales behind these particular dietary patterns, as well as the safety concerns in some certain patient groups.

Effectiveness and safety of red yeast rice predominated by monacolin Kβ-hydroxy acid form for hyperlipidemia treatment and management

OBJECTIVE:To assess the lipid-lowering activity and safety of a dietary supplement containing monacolin Kβ-hydroxy acid form(MKA),Heye(Folium Nelumbinis),and Cangzhu(Rhizoma Atractylodis Lanceae),compared to lifestyle modifications.METHODS:Totally 117 subjects with moderate to severe dyslipidemia(according to Chinese guidelines)and low CV risk were randomly assigned into three treatment groups:lifestyle modification(LM),LM plus a low dosage of MKA,LM plus a high dosage of MKA,and treated for 60 d.The primary endpoint was the reduction of low density lipoprotein cholesterol(LDL-C)and total cholesterol(TC).Safeties along with Traditional Chinese Medicine Syndromes were assessed through the study.RESULTS:A low dosage of MKA along with lifestyle modifications caused a significant decrease in LDL-C by 15.6%on average(95%CI,9.6%to 21%)with,a decrease in TC by 15.3%on average(95%CI,9.26%to 21.4%),and a decrease in non-HDL-C by 35.4%(95%CI,25.76%to 41.34%).Weak evidence of a reduction of triglycerides but an increment of HDL-C was observed in patients with severe hyperlipidemia.No severe adverse events occurred during the study.CONCLUSION:Our results confirm the LDL-C and TC lowering properties of MKA is clinically meaningful.It also produces a significant reduction of non-HDL-C,and slightly effects on TG and HDL-C as well.