The results from my systematic review indicate emerging evidence that a 10g/d increased intake of soluble cereal fibre can reduce blood pressure in older (>50yrs) and hypertensive adults by between 5 and 7mmHg. This reduction is clinically comparable to the expected effects of a salt reduced diet.
Obesity and hyperlipidemia is international /worldwide problem causing heart disease leading to major predisposing factor for morbidity and death. Conventional medicine used in allopathy include statins, fibrates, niacin and resins but are going to defame due to their adverse effects. Herbal medicine ginger has proved itself as one of the potent anti hyperlipidemic and anti obesity herb with least adverse effects. We did try to compare its hypolipidemic effects with placebo effects when used in mild to moderate hyperlipidemic patients. It was placebo-controlled single blind research study. Research was conducted at National hospital, Lahore, from July to November 2016. Consent was taken from sixty hyperlipidemic patients age range from 25 to 60 years. Both gender male and female patients were enrolled. Patients were randomly divided in two groups, 30 patients were on drug ginger pasted-powder advised to take 5 grams in divided doses with their normal diet for the period of three months. Thirty patients were on placebo pasted-wheat powder, with same color as of ginger powder, advised to take 5 grams in divided doses with their normal diet for the period of three months. Their base line lipid profile and body weight was recorded at start of treatment and were advised to come for check-up, fortnightly.
International Journal of Medical Science in Clinical Research and Review Vol 03, Issue 02,April – 2020 Page |
229
When duration of study was over, their lipid profile and body weight was measured and compared statistically with pre-treatment values. Three months treatment with 5 grams of ginger decreased total cholesterol from 233.11±1.53 mg/dl to 198.44±1.23 mg/dl, LDL cholesterol reduced from 202.21±1.88 mg/dl to 187.72± 1.98 mg/dl, reduced body weight from 76.01±2.66 kg to 72.80±1.87 kg. Both plasma total cholesterol and LDL cholesterol reduction was statistically significant, but body weight decrease was non-significant when analyzed biostatistically.
THERAPEUTIC EFFECT OF SOYA BEAN CHUNKS SUPPLEMENTION DURING HEMODIALYSISNeeleshkumar Maurya
The present study was conducted during the year 2016-17 on 30 ckd-5 patients on hemodialysis admitted in various medical wards of the MLB, Medical College, Jhansi (U.P.) India. The primary data were obtained from all CKD patients 30 days intervals and three times first time proper medication with hemodialysis therapy and second time same condition patients with additional dietary counseling. The data was collected in all the patients, thorough anthropometric measurement, dietary history and blood are collected for analysis of Hb, serum albumin, blood urea, cholesterol and cretonne. The Proper dietary counseling along with high biological protein (20 gm) given during hemodialysis superior the nutritional value of undernourished chronic kidney disease patient. About proper diet counseling of the patients showed significant statistical positive (<0.005) response in a various nutritional factor like BMI, MUAC, Serum Albumin, hemoglobin, total calorie intake while the only medication and dialysis therapy showed an undergoing undernourished in their nutritional value. The patients undergoing hemodialysis often develop protein-energy malnutrition which is related to mortality and morbidity rate increases. Special nutritional care is required for the dialysis patient to improve the net protein anabolism. The nutritional value of soya bean chunks in patients on HD requirements more attention providing one-to-one nutrition psychotherapy could be improvements in the patients. Key words : Dialysis, malnutrition, soybean chunks, high biological protein.
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
Obesity and hyperlipidemia is international /worldwide problem causing heart disease leading to major predisposing factor for morbidity and death. Conventional medicine used in allopathy include statins, fibrates, niacin and resins but are going to defame due to their adverse effects. Herbal medicine ginger has proved itself as one of the potent anti hyperlipidemic and anti obesity herb with least adverse effects. We did try to compare its hypolipidemic effects with placebo effects when used in mild to moderate hyperlipidemic patients. It was placebo-controlled single blind research study. Research was conducted at National hospital, Lahore, from July to November 2016. Consent was taken from sixty hyperlipidemic patients age range from 25 to 60 years. Both gender male and female patients were enrolled. Patients were randomly divided in two groups, 30 patients were on drug ginger pasted-powder advised to take 5 grams in divided doses with their normal diet for the period of three months. Thirty patients were on placebo pasted-wheat powder, with same color as of ginger powder, advised to take 5 grams in divided doses with their normal diet for the period of three months. Their base line lipid profile and body weight was recorded at start of treatment and were advised to come for check-up, fortnightly.
International Journal of Medical Science in Clinical Research and Review Vol 03, Issue 02,April – 2020 Page |
229
When duration of study was over, their lipid profile and body weight was measured and compared statistically with pre-treatment values. Three months treatment with 5 grams of ginger decreased total cholesterol from 233.11±1.53 mg/dl to 198.44±1.23 mg/dl, LDL cholesterol reduced from 202.21±1.88 mg/dl to 187.72± 1.98 mg/dl, reduced body weight from 76.01±2.66 kg to 72.80±1.87 kg. Both plasma total cholesterol and LDL cholesterol reduction was statistically significant, but body weight decrease was non-significant when analyzed biostatistically.
THERAPEUTIC EFFECT OF SOYA BEAN CHUNKS SUPPLEMENTION DURING HEMODIALYSISNeeleshkumar Maurya
The present study was conducted during the year 2016-17 on 30 ckd-5 patients on hemodialysis admitted in various medical wards of the MLB, Medical College, Jhansi (U.P.) India. The primary data were obtained from all CKD patients 30 days intervals and three times first time proper medication with hemodialysis therapy and second time same condition patients with additional dietary counseling. The data was collected in all the patients, thorough anthropometric measurement, dietary history and blood are collected for analysis of Hb, serum albumin, blood urea, cholesterol and cretonne. The Proper dietary counseling along with high biological protein (20 gm) given during hemodialysis superior the nutritional value of undernourished chronic kidney disease patient. About proper diet counseling of the patients showed significant statistical positive (<0.005) response in a various nutritional factor like BMI, MUAC, Serum Albumin, hemoglobin, total calorie intake while the only medication and dialysis therapy showed an undergoing undernourished in their nutritional value. The patients undergoing hemodialysis often develop protein-energy malnutrition which is related to mortality and morbidity rate increases. Special nutritional care is required for the dialysis patient to improve the net protein anabolism. The nutritional value of soya bean chunks in patients on HD requirements more attention providing one-to-one nutrition psychotherapy could be improvements in the patients. Key words : Dialysis, malnutrition, soybean chunks, high biological protein.
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
The Role of Gedunin Against Aquaporin 2 for the Possible Treatment of Diabete...YogeshIJTSRD
Diabetes is one of the major causes of death in the world, affecting around 422 million people or 8.5 percent of the worlds population . Diabetes mellitus, or diabetes, is a disease that causes excessive blood sugar levels. Diabetes mellitus is a condition where a person does not produce enough insulin or does not link directly to insulin, and resulting in excessively high blood sugar glucose levels. Diabetes is classified into several types Prediabetes, Type 1 diabetes, Type 2 diabetes and gestational diabetes. In diabetes research, numerous bioinformatics technologies are used. The current research was carried to study the effect of naturally occurring compounds against Aquaporin 2 as the target protein molecule with the help of molecular docking for diabetes diagnosis. AQP2 is found in the apical cell of the main ducts of the kidney and in the vesicles intracellular in the cells. Docking experiment were performed out by using aquaporin 2 4nef . The technique of molecular docking was utilized to investigate the potential of naturally occurring compounds such as aglycone, gedunin, and harman with the target protein Aquaporin 2 4nef . In diabetes, gedunin may function as a therapeutic drug against the disease causing protein Aquaporin 2 4nef . Further research and then certain clinical and pre clinical studies may be allowed to discover drugs that can be used to treat diabetes. Ayushi Chaudhary | Noopur Khare | Tripti Bhatnagar | Abhimanyu Kumar Jha "The Role of Gedunin Against Aquaporin 2 for the Possible Treatment of Diabetes: An In Silico Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd43788.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/43788/the-role-of-gedunin-against-aquaporin-2-for-the-possible-treatment-of-diabetes-an-in-silico-study/ayushi-chaudhary
Does the Mediterranean diet predict longevity in the elderly? A Swedish persp...Gianluca Tognon
My paper describing the association between adherence to a Mediterranean-like dietary pattern and longevity in 70 year-old men and women sampled in Gothenburg
This study is the first one to show the effect of dietary intervention in the secondary prevention of CHD. It is meal pattern study even if very often labelled as sole fat modification study
Now a days everybody wants evidence or proof for any purpose.so govt.of india introduces AYUSH research portal for the devalopment and taking awareness regarding ayurveda where it consists of clinical trial and pre-clinical trial data.
The Role of Gedunin Against Aquaporin 2 for the Possible Treatment of Diabete...YogeshIJTSRD
Diabetes is one of the major causes of death in the world, affecting around 422 million people or 8.5 percent of the worlds population . Diabetes mellitus, or diabetes, is a disease that causes excessive blood sugar levels. Diabetes mellitus is a condition where a person does not produce enough insulin or does not link directly to insulin, and resulting in excessively high blood sugar glucose levels. Diabetes is classified into several types Prediabetes, Type 1 diabetes, Type 2 diabetes and gestational diabetes. In diabetes research, numerous bioinformatics technologies are used. The current research was carried to study the effect of naturally occurring compounds against Aquaporin 2 as the target protein molecule with the help of molecular docking for diabetes diagnosis. AQP2 is found in the apical cell of the main ducts of the kidney and in the vesicles intracellular in the cells. Docking experiment were performed out by using aquaporin 2 4nef . The technique of molecular docking was utilized to investigate the potential of naturally occurring compounds such as aglycone, gedunin, and harman with the target protein Aquaporin 2 4nef . In diabetes, gedunin may function as a therapeutic drug against the disease causing protein Aquaporin 2 4nef . Further research and then certain clinical and pre clinical studies may be allowed to discover drugs that can be used to treat diabetes. Ayushi Chaudhary | Noopur Khare | Tripti Bhatnagar | Abhimanyu Kumar Jha "The Role of Gedunin Against Aquaporin 2 for the Possible Treatment of Diabetes: An In Silico Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd43788.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/43788/the-role-of-gedunin-against-aquaporin-2-for-the-possible-treatment-of-diabetes-an-in-silico-study/ayushi-chaudhary
Does the Mediterranean diet predict longevity in the elderly? A Swedish persp...Gianluca Tognon
My paper describing the association between adherence to a Mediterranean-like dietary pattern and longevity in 70 year-old men and women sampled in Gothenburg
This study is the first one to show the effect of dietary intervention in the secondary prevention of CHD. It is meal pattern study even if very often labelled as sole fat modification study
Now a days everybody wants evidence or proof for any purpose.so govt.of india introduces AYUSH research portal for the devalopment and taking awareness regarding ayurveda where it consists of clinical trial and pre-clinical trial data.
На семинаре рассматривается, как организовать создание сайта, откуда брать нужную информацию, как организовать взаимодействие исполнителей на разных этапах и на что стоит обращать особое внимание. Будут приведены практические примеры использования тех или иных практик на примерах существующих сайтов.
На семинаре вы узнаете:
Почему созданию сайтов не нужно учиться пять лет
Как контролировать исполнителей
Почему управленческие навыки важнее технических
Почему нельзя подходить к сайту только как к инструменту продаж
Как создавать действительно большие и сложные продукты, меняющие жизнь людей.
Подробнее: https://www.cybermarketing.ru/seminar44.html
Šokolādes ceļš: Pasaules lielākā mācību stunda Lizuma vidusskolas 5.klasēliela_stunda
Lai apzinātos globalizācijas procesu klātesamību ikdienā, iegūtu pārliecību, ka, atbalstot godīgās tirdzniecības preces, ir iespējams mazināt netaisnību pasaulē, Lizuma vidusskolas 5.klasē Pasaules lielākajā mācību stundā tika pētīts šokolādes ceļš. Plašāk lasiet:
"Inspiruj i daj się zainspirować" - wykład motywacyjny Konrada Gadziny o samorozwoju, roli inspiracji w osiąganiu celów, znaczeniu społeczności i networkingu w gamedevie.
Zobacz również na YT: http://bit.ly/1Mhck8q
Statistical analysis of risk factors associated withanamjavaid13
Gallstones are crystal like collections that formed by merging of normal and abnormal gallbladder content. Usually there are two types of gallstones exist i.e. cholesterol stones & pigment stones. The current paper focuses on symptoms of the disease, major cause for the disease and on the treatments that majority of patients preferred. For this purpose, sample of size 170 data from different hospitals in Multan is collected by using convenience sampling. Main demographic factors involved in this study are Gender, Age group, marital status for patients of GSD. Frequency distribution has been formed for these different demographic and social factors and a bar chart is constructed for differentiating between gender as gender is also an important factor in GSD. For weight factor, paired t test is applied to see the difference between before and after weight after having treatment. Findings show that 67 percent people prefer govt. hospitals because of the people suffering from this disease were from backward areas or villages & their income not meet to pay the private hospitals expense.
Statistical analysis of risk factors associated withanamjavaid13
Gallstones are crystal like collections that formed by merging of normal and abnormal gallbladder content. Usually there are two types of gallstones exist i.e. cholesterol stones & pigment stones. The current paper focuses on symptoms of the disease, major cause for the disease and on the treatments that majority of patients preferred. For this purpose, sample of size 170 data from different hospitals in Multan is collected by using convenience sampling. Main demographic factors involved in this study are Gender, Age group, marital status for patients of GSD. Frequency distribution has been formed for these different demographic and social factors and a bar chart is constructed for differentiating between gender as gender is also an important factor in GSD. For weight factor, paired t test is applied to see the difference between before and after weight after having treatment. Findings show that 67 percent people prefer govt. hospitals because of the people suffering from this disease were from backward areas or villages & their income not meet to pay the private hospitals expense.
Clinical Question: Does meat consumption affect mortality?
Evidence: All-cause mortality is higher for increased daily consumption of red meat, especially processed meat. However, the compiled evidence does not link other meat products to all-cause mortality.
Recommendation: Physicians should encourage patients to limit animal products when possible, and substitute red meat and processed red meat with plant-based foods. Patients may supplement a plant-based diet with moderate amounts of fish, poultry, eggs, and dairy if desired.
Hypoglycaemia and improved testicular parameters in Sesamum radiatum treated ...lukeman Joseph Ade shittu
The development of a new dietary adjunct with a novel natural antioxidant impact on diabetes mellitus with prevention of its long term deleterious effect on the male fertility in general has been increasingly expressed in recent time. Hence, we aim to evaluate the effects of aqueous extract of Sesame radiatum leaves on adult male Sprague Dawley rats’ testis using unbiased stereological, biochemical and hormonal studies. Thirty adult male rats were divided into three groups of 10 rats each. The treated groups; 1 and 2 received 28.0 and 14 mg/kg bwt of aqueous extract of sesame leaves via oral garvage, respectively, while the control group received equal volume of 0.9% (w/v) normal saline per day for 6 weeks. Serum follicle-stimulating hormone (FSH), testosterone and blood glucose were assayed. In addition five microns of uniformly random transverse sections of processed testicular tissues were equally analyzed using an un-biased stereological study. The result showed that the mean percentage volume fractions (Vf) of epithelial cells and lumen of the testis were 76% (P<0.05)><0.05),>0.05) higher than the control in a dose related manner. Serum testosterone and FSH were significantly higher and lower, respectively, in the high dose sesame when compared to control. Sesame leaves intake improved glucose profile and testicular parameters in a dose related manner via possible improved insulin activity on the cells with a stimulatory impact on sperm production. This also confirmed its folkloric claims.
Managing DM and thyroid disease in shift workersNemencio Jr
This slide deck discusses the effects of shift work on physiology and behavior of thyroid axis and beta cell function and risk of diabetes, including glucose control among those with diabetes. Management strategies are also discussed
Plant-based Eating: Enhancing Health Benefits, Minimizing Nutritional RisksRobin Allen
Learning Objectives
At the end of the session, the participants will be able to:
1. Know there is no single definition of a plant-based diet.
2. Discuss health aspects of vegetarian and vegan diets and quality of evidence supporting health claims.
3. Assess nutritional adequacy/status of vegetarians and/or vegans throughout the life cycle and provide strategies for meeting dietary recommendations for vitamin B12, DHA calcium, and zinc.
Weight reduction with improvement of serum lipid profile and ratios of Sesamu...lukeman Joseph Ade shittu
Development of novel natural dietary adjunct/agent with significant therapeutic effects on metabolic disease conditions such as obesity and heart disease raises concern in recent times. We studied chronic toxicity of the combined active ingredients present in the sesame leaves and their interaction on the fasting serum lipid profiles with their ratios in thirty adult male non-obese Sprague Dawley (SD) rats. Such that, both treated groups received 14.0 and 28.0 mg/kg body weight doses of aqueous leaves extract of Sesamum radiatum respectively on a daily basis via gastric gavage, while, the control received equal volume of normal saline daily for six weeks. Significant (P < 0.05) weight loss observed in the treated groups was associated with significant (P < 0.05) reductions in both serum cholesterol and triglycerides (TG). The effect on the serum lipoprotein cholesterol components and ratios were significant in a dose related manner, such that increase in HDL accompanied a corresponding decrease in both LDL and LDL/HDL ratio. In addition, to increased in TG/HDL ratio. However, no significant differences in the relative reduction level of VLDL and triglycerides in the treated groups were found compared to control. Thus, LDL/HDL ratio is significantly a better indicator than the TG/HDL ratio in assessing the impact of sesame treatment with evidence of weight loss and hypolipidaemia especially in hypertensive heart diseases.
Plant sterols and stanols as cholesterol-lowering ingredients: fact or market...Mark O'Donovan
Content: Literature review.
Overview: To research the extent of scientific support for the claim that high intakes of plant sterols and stanols lowers cholesterol; and the practicality, safety and health implications pertaining to this dietary intake.
Please Note
- This essay was improved in terms of clarity and writing in 2017 but no new sources of information have been used since the original 2014 version.
- This essay is purely academic and I will not accept legal responsibility for any information, interpretations or options contained herein.
- Feel free to utilise, critique, print or reference any of this content :)
Coauthors: Dr Gilda Philip, Dr Michael Oludipe, Dr Christa Maria Joel, Ms Philo Mary Hilary Fernandez, Dr Qudroh Arowolo, Dr Hira Zahid.
Module: Effects of Lifestyle on Health
Supervisor: Ms Jane Tobias and Dr Daniel Boakye
University of the West of Scotland
This presentation was prepared for few of my colleagues at PSI working with me on a large scale diabetes and hypertension prevention program. The intent was to give them basic understanding of evidences around the impact of few lifestyle modification strategies particularly for caloric restriction and physical activity on health and lifespan.
How to prevent heart disease and diabetesEsserHealth
Heart disease is the leading cause of death in men and women in America today. Learn how the food you eat can radically alter your risk of both heart disease and type two diabetes. You can achieve better health starting today.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Cereal fibre and hypertension: could it be the new salt?
1. ‘High blood pressure is the biggest single cause of death in the world’ ‘Reducing salt intake by 6g a day …could prevent approximately 2.6 million stroke and heart attack deaths each year worldwide’ World Action on Salt and Health (WASH) Cereal Fibre: could it be the new salt?
2. Cereal Fibre in Hypertension: could it be the new salt? Michelle Broom APD
3. Hypertension 1 in 3 Australian adults has hypertension Less than half have blood pressure controlled with medication* What would you recommend? ↓Salt -5 mmHg ↑ Fruit and Veg -2.8 mmHg ? Cereal fibre Weight loss * BP > 140/90; AUSDIAB study 2000
8. Study Selection Number of publications retrieved from database searches (n=59) Number of publications from manual search strategies (n= 24) Number of publications retrieved (n=83) Duplicates removed (n=11) Number of publications screened (n=72) Papers excluded on basis of exclusion criteria (n=50) Papers excluded after discussion between two investigators on basis of exclusion criteria (n=4) Number of publications included (n=22) Number of publications on blood pressure included in review (n=18)
19. Evidence to Practice Is this realistic? Australian Dietary Guidelines 25 & 30g/day (AI) 28 & 38g/day (SDT) Australian adults consume 20 & 27 g/day (1995 NNS) Australian adults consume 8 – 11g less fibre than recommended to reduce risk of chronic disease ↑ soluble cereal fibre by 7 – 12g / day would help Australians meet the Dietary Guidelines
20. Could cereal fibre have an effect equal to that of salt? To find more answers we need to ask more questions…. Could insoluble cereal fibre also play a role? Is our current definition of fibre confounding the story? Soluble, insoluble, resistant starch, prebiotics…. Is the physiology of aging altering the effect of fibre? Evidence into Practice Not always Black and White
21. Hypertension What would you recommend? ↓Salt -5 mmHg ↑ Fruit and Veg -2.8 mmHg ? Cereal fibre Weight loss ↑ Soluble cereal fibre -5 to -7 mmHg
23. References Brownlee IA et al. British Journal of Nutrition. 2010;104(01):125-134. Burke V et al. Hypertension. Oct 2001;38(4):821-826. Cicero AFGet al. Clinical & Experimental Hypertension (New York). Aug 2007;29(6):383-394. Flint AJ et al. AJCN 2009; 90: 493-498 Jenkins DJA et al. AJCN. May 2002;75(5):834-839. Maki KC et al. European Journal of Clinical Nutrition. Jun 2007;61(6):786-795. Parks EJ. British Journal of Nutrition. 2002;87(SupplementS2):S247-S253. Pereira M et al. Arch Intern Med. 2004;164(4):7. Pins JJet al. Journal of Family Practice. Apr 2002;51(4):353-359. Qi, L et al A comparison of the Literature on the association between intakes of bran, cereal fibre and whole grains and risk and biomarkers of heart disease. Experimental Biology (2011) presentation StreppelMT et al. Arch Intern Med. 2005;165(2):150-156. TighePet al. Effect of increased consumption of whole-grain foods on blood pressure and other cardiovascular risk markers in healthy middle-aged persons: a randomized controlled trial. AJCN Ahead of print 2010. WheltonS et al. Journal of Hypertension. 2005;23(3):7.
24. ↑ soluble cereal fibre by 7 – 12g / day What would this look like in a diet? Breakfast swap toast & jam for high soluble fibre cereal = 5.1g Snack swap 2 cream biscuits for an 2 oatmeal biscuits = 2.3g Dinner Add barley to soup or casseroles = 0.8g Dessert swap ice-cream for oat crusted apple crumble = 1.4g Total ↑ soluble cereal fibre = 9.6g
Editor's Notes
Thank you to the chair and to audience. Presenting today the key findings of a research undertaken while I was a Masters student at Sydney University under the supervision of Michelle Celander with the Kellogg Nutrition Team. The research findings have been written up and we are in the process of submitting the manuscript to a peer reviewed journal.
Which is why dietary modification is so important. These are well established evidence-based lifestyle modifications. What I’d like to do today is suggest that perhaps cereal fibre has a place in this group of recommendations.
To give you an understanding of what first led me to think that cereal fibre might help reduce blood pressure let’s first take a look at the existing body of evidence.
The NHF states that there is moderate evidence of an association between cereal fibre intake and CHD, of which HTN is a key indicator. More recently a review presented at the Experimental Biology conference reported consistent evidence of an association between increased cereal fibre intakes and reduced risk of CVD which may be mediated in part through a reduction blood pressureTwo cohort studies have looked specifically at cereal fibre and hypertension and both found a reduced risk of hypertension with increased cereal fibre intake. So the observational evidence appears to indicate a possible role of cereal fibre, but is this backed up with evidence from clinical trials?
To date the only reviews on the topic have looked at dietary fibre intake as a whole rather than specifically cereal fibre. Both meta-analyses indicate a moderate reduction of between 3 to almost 6 mm Hg in older and hypertensive populations. However, no systematic review of intervention studies has to date been conducted to look at the role of cereal fibre in hypertension. So that is what I set out to do.
A search of Medline and Cinahl databases yielded 59 publications of intervention trials of cereal fibre and its effect on BP. 18 publications met the inclusion criteria and were of good quality
Of the 18 studies 8 reported that increased intake of cereal fibre led to a significant reduction in BP, and 10 studies did not report a significant reduction. So, overall there is no consistent evidence of an effectHowever, if we dig a little deeper and it seems that like salt, cereal fibre may have a greater effect in specific population groupsFour of the 18 studies in the review recruited only people with hypertension (BP > 140/90). All four of theses studies in hypertensive populations reported a significant reduction, however the same effect was seen in only a few of the normotensive groups. Similarly, there appears to be an effect of cereal fibre on the blood pressure of older people. The mean age of the 18 studies was 50 years. Most of the studies in older people reported a significant reduction in BP
From this small number of studies there appears to be some emerging evidence: Soluble cereal fibre may reduce blood pressure in hypertensive people by up to 7mmHg This is indicated by the evidence from 4 studies which increased soluble cereal fibre intake by between 7 and 12 g/dOf particular interest is the possibility that soluble cereal fibre may have an effect even for people already taking antihypertensive medication. In 3 of the studies all subjects were on medicatio and those with increased cereal fibre intake had a significant reduction in blood pressure below the level they attained with medication. One study was specifically designed to measure the reduction in medication usage.
There also appears to be emerging evidence that Soluble cereal fibre may reduce blood pressure in people over 50 years by up to 6.5 mmHg Again, 7 to 12 g /d of soluble fibre lead to reductions in SBPWhile this may seem the result of hypertension being more prevalent in older populations, one well-designed study of normotensive older people did find a significant reduction. More study is warranted to
Now a test to see if you’ve been paying attention – who can remember the effect of salt? And that of soluble cereal fibre?So could it be that cereal fibre could have an effect equal to that of salt on blood pressure reduction? While this research does indicate emerging evidence of soluble cereal fibre playing a role in reduction blood pressure we don’t yet have a definitive answer that we can put into practice. It took almost 100 years between the first report in 1904 of an effect of salt on blood pressure before the DASH trials in the 1990s proved conclusively the effect of reduced salt on blood pressure. Scientists continued to ask questions and to figure out the effect. I’m hoping it won’t take us 100 years, to find out more answers about the role of cereal fibre we need to ask more questions.
So back to our patient Merv….I would expect that you would still be suggesting he try all these lifestyle modifications, but would you also be adding soluble cereal fibre to those suggestions? The evidence suggests that we should consider it.
