Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and compl...Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years;81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bed-side tool, as an alternative to Syntax score, in predicting the severity and complexity of coronary artery disease.展开更多
In view of the fact that Asians have higher abdominal fat at lower levels of body mass index (BMI), measures of abdominal adiposity such as waist circumference (WC) and waist to hip ratio (WHR) were investigated as pr...In view of the fact that Asians have higher abdominal fat at lower levels of body mass index (BMI), measures of abdominal adiposity such as waist circumference (WC) and waist to hip ratio (WHR) were investigated as predictors of hypertension. Data on BMI, WC, WHR and blood pressure (BP) were recorded through a cross-sectional study on 419 urban adults (210 men and 209 women;aged 30-60 years) in Pune, India. Abdominal obesity was higher among women than men (35.9% vs. 32.4%). However, age adjusted mean systolic BP (124.3 ± 15.1 mmHg vs. 114.7 ± 17.2 mmHg), diastolic BP (82.9 ± 10.5 mmHg vs. 76.4 ± 10.7 mmHg) and prevalence of hypertension (34.3% vs. 21.5%) was significantly higher (p < 0.01) among men than among women. Although both WC and WHR increased with increase in BMI, correlation coefficient of BMI with WC was significantly (p < 0.01) higher than that with WHR in both sexes, suggesting that WC could be better for assessing adiposity. In men, odds ratio [OR (95% CI) = 2.19 (1.08-4.45)] for hypertension was significant (p < 0.05) only for those in highest tertile of WC while it was significant (p < 0.01) even in the middle tertile in case of women [8.24 (2.67-25.43) for higher and 5.71 (1.82-17.89) for middle tertile]. Optimal cutoff for identifying obesity and hypertension showed significant (p < 0.01) area under curve (AUC) and sensitivity for WC than WHR in both sexes. The risk cutoffs were lower compared to those proposed by the World Health Organization especially for men, but were comparable with reported Asian studies. Thus, it was evident that WC performed better than BMI and WHR for assessing the risk of hypertension and may be used as a simple, convenient and inexpensive screening tool in epidemiological studies.展开更多
Introduction: Management of hyperglycemia in type2 diabetes mellitus (T2DM) becomes the top priority. When single antidiabetic drug is ineffective, combination is required for good glycemic control. There is a dearth ...Introduction: Management of hyperglycemia in type2 diabetes mellitus (T2DM) becomes the top priority. When single antidiabetic drug is ineffective, combination is required for good glycemic control. There is a dearth of studies that provide head to head comparison of the ability of combinations and therefore need further study. Objectives: To assess and compare the glycemic control and physical parameter altering effect of glibenclamide, glibenclamide & Pioglitazone, glibenclamide & metformin in T2DM. Methods and materials: 100 T2DM patients were selected from outpatients department of medicine following prefixed inclusion and exclusion criteria. Fasting and postprandial blood glucose (fbg & ppbg) and physical parameters (waist, hip and thigh circumference) were measured before and after treatment with study drugs and adverse effects of these drugs were recorded. Data were analyzed by employing paired t-test and chi-square test. Results: 11 patients lost the follow up. A some total of 89 middle aged, predominantly male, non obese T2DM patients after exposure to the study drugs showed significant (p < 0.05) reduction of blood glucose from baseline. Reduction of blood glucose and waist: hip ratio were observed significantly (p < 0.05) more with glibenclamide and metformin combination with some tolerable side effects. Discussion: Metformin and Pioglitazone both are insulin sensitizer but metformin & glibenclamide combination showed significantly (p < 0.001) more reduction of fbg, ppbg and central obesity (waist: hip ratio) than Pioglitazone & glibenclamide combination. Therefore Judicious use of low dose of glibenclamide and full dose of metformin become safe, effective and cheap for the treatment of type 2 diabetes patients in poor country like India.展开更多
Background: The prevalence of lifestyle diseases is increasing rapidly in Youths (17 - 25 yrs). Factors such as poor diet, little or no physical exercise, and smoking are major contributors to this increase. Lifestyle...Background: The prevalence of lifestyle diseases is increasing rapidly in Youths (17 - 25 yrs). Factors such as poor diet, little or no physical exercise, and smoking are major contributors to this increase. Lifestyle diseases in youths present a timeline challenge as disease duration is longer and financial burden more costly. Aim: To analyse and synthesize published literature on the prevalence of and risk factors associated with four lifestyle diseases—obesity, hypertension, diabetes and cancer—in university/college students worldwide. Results: The literature indicates that among lifestyle diseases in university/college students, overweight/obesity (Body Mass Index > 25 kg/m2) had the highest prevalence of 45.6% and duration of approximately 5 years. Cardiovascular diseases and hypertension had lower prevalence rates but prehypertension which lingers >4 years was at 32.0%. Type 1 diabetes mellitus (T1DM) had a fairly high prevalence in college students (21.7%);type 2 diabetes mellitus (T2DM) was found in much lower percentage (12.95%). Cancer had the lowest prevalence of >2% but was increasing in most regions based on the presence of multiple risk factors. Conclusion: Increase prevalence of these diseases in youths indicates that young people are at high risk of developing these diseases due to poor early lifestyle habits. Early corrective measures can reduce the burden of many lifestyle diseases.展开更多
文摘Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years;81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bed-side tool, as an alternative to Syntax score, in predicting the severity and complexity of coronary artery disease.
文摘In view of the fact that Asians have higher abdominal fat at lower levels of body mass index (BMI), measures of abdominal adiposity such as waist circumference (WC) and waist to hip ratio (WHR) were investigated as predictors of hypertension. Data on BMI, WC, WHR and blood pressure (BP) were recorded through a cross-sectional study on 419 urban adults (210 men and 209 women;aged 30-60 years) in Pune, India. Abdominal obesity was higher among women than men (35.9% vs. 32.4%). However, age adjusted mean systolic BP (124.3 ± 15.1 mmHg vs. 114.7 ± 17.2 mmHg), diastolic BP (82.9 ± 10.5 mmHg vs. 76.4 ± 10.7 mmHg) and prevalence of hypertension (34.3% vs. 21.5%) was significantly higher (p < 0.01) among men than among women. Although both WC and WHR increased with increase in BMI, correlation coefficient of BMI with WC was significantly (p < 0.01) higher than that with WHR in both sexes, suggesting that WC could be better for assessing adiposity. In men, odds ratio [OR (95% CI) = 2.19 (1.08-4.45)] for hypertension was significant (p < 0.05) only for those in highest tertile of WC while it was significant (p < 0.01) even in the middle tertile in case of women [8.24 (2.67-25.43) for higher and 5.71 (1.82-17.89) for middle tertile]. Optimal cutoff for identifying obesity and hypertension showed significant (p < 0.01) area under curve (AUC) and sensitivity for WC than WHR in both sexes. The risk cutoffs were lower compared to those proposed by the World Health Organization especially for men, but were comparable with reported Asian studies. Thus, it was evident that WC performed better than BMI and WHR for assessing the risk of hypertension and may be used as a simple, convenient and inexpensive screening tool in epidemiological studies.
文摘Introduction: Management of hyperglycemia in type2 diabetes mellitus (T2DM) becomes the top priority. When single antidiabetic drug is ineffective, combination is required for good glycemic control. There is a dearth of studies that provide head to head comparison of the ability of combinations and therefore need further study. Objectives: To assess and compare the glycemic control and physical parameter altering effect of glibenclamide, glibenclamide & Pioglitazone, glibenclamide & metformin in T2DM. Methods and materials: 100 T2DM patients were selected from outpatients department of medicine following prefixed inclusion and exclusion criteria. Fasting and postprandial blood glucose (fbg & ppbg) and physical parameters (waist, hip and thigh circumference) were measured before and after treatment with study drugs and adverse effects of these drugs were recorded. Data were analyzed by employing paired t-test and chi-square test. Results: 11 patients lost the follow up. A some total of 89 middle aged, predominantly male, non obese T2DM patients after exposure to the study drugs showed significant (p < 0.05) reduction of blood glucose from baseline. Reduction of blood glucose and waist: hip ratio were observed significantly (p < 0.05) more with glibenclamide and metformin combination with some tolerable side effects. Discussion: Metformin and Pioglitazone both are insulin sensitizer but metformin & glibenclamide combination showed significantly (p < 0.001) more reduction of fbg, ppbg and central obesity (waist: hip ratio) than Pioglitazone & glibenclamide combination. Therefore Judicious use of low dose of glibenclamide and full dose of metformin become safe, effective and cheap for the treatment of type 2 diabetes patients in poor country like India.
文摘Background: The prevalence of lifestyle diseases is increasing rapidly in Youths (17 - 25 yrs). Factors such as poor diet, little or no physical exercise, and smoking are major contributors to this increase. Lifestyle diseases in youths present a timeline challenge as disease duration is longer and financial burden more costly. Aim: To analyse and synthesize published literature on the prevalence of and risk factors associated with four lifestyle diseases—obesity, hypertension, diabetes and cancer—in university/college students worldwide. Results: The literature indicates that among lifestyle diseases in university/college students, overweight/obesity (Body Mass Index > 25 kg/m2) had the highest prevalence of 45.6% and duration of approximately 5 years. Cardiovascular diseases and hypertension had lower prevalence rates but prehypertension which lingers >4 years was at 32.0%. Type 1 diabetes mellitus (T1DM) had a fairly high prevalence in college students (21.7%);type 2 diabetes mellitus (T2DM) was found in much lower percentage (12.95%). Cancer had the lowest prevalence of >2% but was increasing in most regions based on the presence of multiple risk factors. Conclusion: Increase prevalence of these diseases in youths indicates that young people are at high risk of developing these diseases due to poor early lifestyle habits. Early corrective measures can reduce the burden of many lifestyle diseases.
