This document summarizes a study that assessed liver function in 200 Sudanese patients with long-standing type 2 diabetes compared to 100 healthy controls. The levels of various liver enzymes and proteins were measured and compared between the two groups. The study found significantly higher levels of ALT, AST, ALP, and bilirubin and lower levels of total protein and albumin in the diabetic patients compared to controls. It also found positive correlations between the levels of ALT, AST, ALP and bilirubin and the duration of diabetes, and negative correlations between the levels of total protein and albumin and diabetes duration. The study concludes that type 2 diabetes is associated with abnormal liver function tests and that liver dysfunction increases with longer diabetes duration
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay
Prevalence of Gall Stone Disease and its Relation to Hypercholesteraemia, Hyp...Apollo Hospitals
To investigate the prevalence of gall stone disease in the affluent north Indian population and to study its
association with hypercholesteraemia, hypertension and diabetes, in isolation and together. A survey of 1000 subjects who reported to the hospital for routine health check (including physical examination, routine blood investigations and abdominal ultrasound).
A Study on Biomarkers in a Spatially Distributed Type – 2 Diabetes mellitus G...IOSRJPBS
Diabetes, a dreaded disease already ravaged a huge population worldwide, whether it is inherited through generations or invited by the people by their uncontrolled way of life is still obscure. Biomarkers assay is a boon to the diseased to opt proper prophylactic measures to curb or eradicate diseases. The elevated levels of various biomarkers related to inflammation of vital organs, liver function, kidney function and other vital parameters in our diabetic cases reveals the extent of organ(s) damage in these subjects. It is also evident that the levels of various biomarkers are similar in our diabetic subjects, irrespective of their habits or habitats.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay
Prevalence of Gall Stone Disease and its Relation to Hypercholesteraemia, Hyp...Apollo Hospitals
To investigate the prevalence of gall stone disease in the affluent north Indian population and to study its
association with hypercholesteraemia, hypertension and diabetes, in isolation and together. A survey of 1000 subjects who reported to the hospital for routine health check (including physical examination, routine blood investigations and abdominal ultrasound).
A Study on Biomarkers in a Spatially Distributed Type – 2 Diabetes mellitus G...IOSRJPBS
Diabetes, a dreaded disease already ravaged a huge population worldwide, whether it is inherited through generations or invited by the people by their uncontrolled way of life is still obscure. Biomarkers assay is a boon to the diseased to opt proper prophylactic measures to curb or eradicate diseases. The elevated levels of various biomarkers related to inflammation of vital organs, liver function, kidney function and other vital parameters in our diabetic cases reveals the extent of organ(s) damage in these subjects. It is also evident that the levels of various biomarkers are similar in our diabetic subjects, irrespective of their habits or habitats.
CholesLo shows clinical significance in
helping reduce plasma cholesterol and
homocysteine levels and therefore affects
favourably the risk of subsequent development
of cardiovascular disease. Furthermore, our
findings suggest that the dose required to cause
such improvements in plasma lipid profile is
safe enough to be considered for use in general
population.
A study on the pharmacological management of mineral bone disease in chronick...PARUL UNIVERSITY
In patients with chronic kidney disease (CKD), along with progression of CKD,
abnormalities of mineral and bone metabolism develop, which result in altered serum levels of minerals
such as calcium and phosphorus, as well as abnormalities in parathyroid hormone (PTH) or vitamin D
metabolism. Chronic Kidney Disease-Mineral Bone Disease (CKD-MBD) is a serious burden because of
increased cardiovascular mortality thus making therapeutic improvements essential in CKD-MBD. The
present study was aimed at evaluation of pharmacological management of CKD-MBD.
Methods:A retrospective study including 180 patients divided into two groups of 90 each (diabetes
mellitus and non-Diabetes) was performed in the Department of Nephrology, SVIMS, Tirupati. Patients
who were on follow up for at least 3 years (2015-2017) were considered, serum parameters were measured at every six months with a total of 6 visits. First visit was taken as baseline and sixth visit as
conclusion.
Results:The disease incidence of CKD-MBD is more common in male patients i.e. 67.8%. Serum calcium
levels were significantly increased and eGFR was significantly decreased in all patients with CKD at
conclusion compared to baseline.Further, Serum calcium levels were significantly increased at conclusion
in CKD patients without DM and eGFR was significantly decreased at conclusion compared to baseline
in CKD patients with DM. The proportion of untreated patients is high for all the drugs except vitamin D
analogues in both subgroups of CKD patients.
Conclusion:Pharmacological intervention in CKD patients helps in the effective management of mineral
bone disease by maintaining serum calcium, phosphate and calcium phosphorous product status.
Study of Endothelial Dysfunction in Type 2 Diabetes Mellitusiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Retrospective Study of Clinical and Biochemical Profile in Geriatric Patien...PARUL UNIVERSITY
The aim of the study was to evaluate the clinical and
biochemical characteristics of geriatric patients with type 2
diabetes mellitus (DM) attending tertiary care teaching hospital,
SVIMS, Tirupati. OBJECTIVES: To document clinical
features, biochemical parameters and anti-diabetic medications
received as per records. METHODOLOGY: This
retrospective study was performed in Department of
Endocrinology in SVIMS, Tirupati, over a period of 6 months.
Demograghic details, laboratory parameters and
pharmacotherapy details were collected in the pre-designed
annexure form. RESULTS: A total of 100 diabetic elderly
patients were included in the study. Out of which 57 were men,
43 were women. Most of them were under the age group of
60-64 years followed by other age groups. 28 patients were
having the diabetes duration of 11-15 years. Some of them were
having diabetic complications (such as diabetic retinopathy,
diabetic neuropathy, diabetic nephropathy). Among 100
patients, 32 patients were normal weight, 22 patients were
overweight, 28 patients were obese-I, 18 patients were obese-II.
About 85% of patients were having high lipid levels. Some
patients were on Oral Hypoglycemic Agents (OHAS), some
patients were using both Insulin & OHAS.CONCLUSION:
The present study comprised of 100 elderly type 2 diabetic
patients in which males were higher in number when compared
to females, most of the patients were in the age of group of
60-64 years. Hypertension was the most common co-morbidity
associated with DM followed by Coronary Artery Disease
(CAD). Diabetic neuropathy was the most prevalent
complication followed by Diabetic retinopathy and diabetic
nephropathy. In this study 46% of the patients were obese. Most
of the patients were on OHAS alone, some were on OHAS and
Insulin combination therapy while very few were on insulin
therapy alone. Dyslipidemia was present in 85% of the patients
and the most common form of dyslipidemia was low HDL and
high LD
A comparative analysis of biochemical and hematological parameters in diabeti...amsjournal
This study evaluated the biochemical and the hematological parameters in diabetic and non- diabetic patients. The measured biochemical parameters were fasting blood sugar, serum alanine aminotransferase (SGPT/ALT), total cholesterol, urea, creatinine and hematological parameters were hemoglobin, total white blood cell, neutrophil, lymphocyte,monocyte, eosinophil and ESR. There were 403 diabetic and 320 non-diabetic subjects included in this study and the study was carried out in BIRDEM (Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital). It was observed that the mean values of SGPT/ALT (p<0.001),><0.001)><0.001)><0.001),><0.004),><0.001) of hematological parameters were significantly higher in diabetic patients than in the non-diabetic patients. In univariate analysis, all biochemical parameters and only four hematological parameters were found significantly associated with fasting blood sugar after adjusted with age and sex. The fasting blood sugar correlates highly with the other biochemical parameters but less or none with the hematological parameters. Our findings demonstrated that control of increased biochemical parameters and abnormal hematological levels in the early stage of diabetes mellitus may help the patients to raise quality of life.
A mapping study on blood glucose recommender system for patients with gestati...journalBEEI
Blood glucose (BG) prediction system can help gestational diabetes mellitus (GDM) patient to improve the BG control with managing their dietary intake based on healthy food. Many techniques have been developed to deal with blood glucose prediction, especially those for recommender system. In this study, we conduct a systematic mapping study to investigate recent research about BG prediction in recommender systems. This study describes an overview of research (2014-2018) about BG prediction techniques that has been used for BG recommender system. As results, 25 studies concerning BG prediction in recommender system were selected. We observed that although there is numerous studies published, only a few studies took serious discussion about techniques used to incorporate the BG algorithms. Our result highlighted that only one study discusses hybrid filtering technique in BG recommender system for GDM even though it has an ability to learn from experience and to improve prediction performance. We hope that this study will encourage researchers to consider not only machine learning and artificial intelligent techniques but also hybrid filtering technique for BG recommender system in the future research.
Intake of Black Vinegar on Anthropometric Measures, Cardiometabolic Profiles,...mahendrareddychirra
Obesity and type 2 diabetes mellitus are the most important chronic diseases around the world. They are associated with huge medical expenditure and with increasing morbidity and mortality among related cardio-metabolic diseases in developing and developed countries [1,2].
Vinegar was first reported to have anti-glycemic effects since 1988 in animal and human studies [3]. Vinegar may be associated with improved insulin sensitivity and delayed gastric emptying that accompanied improved glycemic control and reduced body weight [4,5].
CholesLo shows clinical significance in
helping reduce plasma cholesterol and
homocysteine levels and therefore affects
favourably the risk of subsequent development
of cardiovascular disease. Furthermore, our
findings suggest that the dose required to cause
such improvements in plasma lipid profile is
safe enough to be considered for use in general
population.
A study on the pharmacological management of mineral bone disease in chronick...PARUL UNIVERSITY
In patients with chronic kidney disease (CKD), along with progression of CKD,
abnormalities of mineral and bone metabolism develop, which result in altered serum levels of minerals
such as calcium and phosphorus, as well as abnormalities in parathyroid hormone (PTH) or vitamin D
metabolism. Chronic Kidney Disease-Mineral Bone Disease (CKD-MBD) is a serious burden because of
increased cardiovascular mortality thus making therapeutic improvements essential in CKD-MBD. The
present study was aimed at evaluation of pharmacological management of CKD-MBD.
Methods:A retrospective study including 180 patients divided into two groups of 90 each (diabetes
mellitus and non-Diabetes) was performed in the Department of Nephrology, SVIMS, Tirupati. Patients
who were on follow up for at least 3 years (2015-2017) were considered, serum parameters were measured at every six months with a total of 6 visits. First visit was taken as baseline and sixth visit as
conclusion.
Results:The disease incidence of CKD-MBD is more common in male patients i.e. 67.8%. Serum calcium
levels were significantly increased and eGFR was significantly decreased in all patients with CKD at
conclusion compared to baseline.Further, Serum calcium levels were significantly increased at conclusion
in CKD patients without DM and eGFR was significantly decreased at conclusion compared to baseline
in CKD patients with DM. The proportion of untreated patients is high for all the drugs except vitamin D
analogues in both subgroups of CKD patients.
Conclusion:Pharmacological intervention in CKD patients helps in the effective management of mineral
bone disease by maintaining serum calcium, phosphate and calcium phosphorous product status.
Study of Endothelial Dysfunction in Type 2 Diabetes Mellitusiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Retrospective Study of Clinical and Biochemical Profile in Geriatric Patien...PARUL UNIVERSITY
The aim of the study was to evaluate the clinical and
biochemical characteristics of geriatric patients with type 2
diabetes mellitus (DM) attending tertiary care teaching hospital,
SVIMS, Tirupati. OBJECTIVES: To document clinical
features, biochemical parameters and anti-diabetic medications
received as per records. METHODOLOGY: This
retrospective study was performed in Department of
Endocrinology in SVIMS, Tirupati, over a period of 6 months.
Demograghic details, laboratory parameters and
pharmacotherapy details were collected in the pre-designed
annexure form. RESULTS: A total of 100 diabetic elderly
patients were included in the study. Out of which 57 were men,
43 were women. Most of them were under the age group of
60-64 years followed by other age groups. 28 patients were
having the diabetes duration of 11-15 years. Some of them were
having diabetic complications (such as diabetic retinopathy,
diabetic neuropathy, diabetic nephropathy). Among 100
patients, 32 patients were normal weight, 22 patients were
overweight, 28 patients were obese-I, 18 patients were obese-II.
About 85% of patients were having high lipid levels. Some
patients were on Oral Hypoglycemic Agents (OHAS), some
patients were using both Insulin & OHAS.CONCLUSION:
The present study comprised of 100 elderly type 2 diabetic
patients in which males were higher in number when compared
to females, most of the patients were in the age of group of
60-64 years. Hypertension was the most common co-morbidity
associated with DM followed by Coronary Artery Disease
(CAD). Diabetic neuropathy was the most prevalent
complication followed by Diabetic retinopathy and diabetic
nephropathy. In this study 46% of the patients were obese. Most
of the patients were on OHAS alone, some were on OHAS and
Insulin combination therapy while very few were on insulin
therapy alone. Dyslipidemia was present in 85% of the patients
and the most common form of dyslipidemia was low HDL and
high LD
A comparative analysis of biochemical and hematological parameters in diabeti...amsjournal
This study evaluated the biochemical and the hematological parameters in diabetic and non- diabetic patients. The measured biochemical parameters were fasting blood sugar, serum alanine aminotransferase (SGPT/ALT), total cholesterol, urea, creatinine and hematological parameters were hemoglobin, total white blood cell, neutrophil, lymphocyte,monocyte, eosinophil and ESR. There were 403 diabetic and 320 non-diabetic subjects included in this study and the study was carried out in BIRDEM (Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital). It was observed that the mean values of SGPT/ALT (p<0.001),><0.001)><0.001)><0.001),><0.004),><0.001) of hematological parameters were significantly higher in diabetic patients than in the non-diabetic patients. In univariate analysis, all biochemical parameters and only four hematological parameters were found significantly associated with fasting blood sugar after adjusted with age and sex. The fasting blood sugar correlates highly with the other biochemical parameters but less or none with the hematological parameters. Our findings demonstrated that control of increased biochemical parameters and abnormal hematological levels in the early stage of diabetes mellitus may help the patients to raise quality of life.
A mapping study on blood glucose recommender system for patients with gestati...journalBEEI
Blood glucose (BG) prediction system can help gestational diabetes mellitus (GDM) patient to improve the BG control with managing their dietary intake based on healthy food. Many techniques have been developed to deal with blood glucose prediction, especially those for recommender system. In this study, we conduct a systematic mapping study to investigate recent research about BG prediction in recommender systems. This study describes an overview of research (2014-2018) about BG prediction techniques that has been used for BG recommender system. As results, 25 studies concerning BG prediction in recommender system were selected. We observed that although there is numerous studies published, only a few studies took serious discussion about techniques used to incorporate the BG algorithms. Our result highlighted that only one study discusses hybrid filtering technique in BG recommender system for GDM even though it has an ability to learn from experience and to improve prediction performance. We hope that this study will encourage researchers to consider not only machine learning and artificial intelligent techniques but also hybrid filtering technique for BG recommender system in the future research.
Intake of Black Vinegar on Anthropometric Measures, Cardiometabolic Profiles,...mahendrareddychirra
Obesity and type 2 diabetes mellitus are the most important chronic diseases around the world. They are associated with huge medical expenditure and with increasing morbidity and mortality among related cardio-metabolic diseases in developing and developed countries [1,2].
Vinegar was first reported to have anti-glycemic effects since 1988 in animal and human studies [3]. Vinegar may be associated with improved insulin sensitivity and delayed gastric emptying that accompanied improved glycemic control and reduced body weight [4,5].
Abstract— Non Alcoholic Fatty Liver Disease is also becoming public health impotance nowadays. So this study was aimed to determine the association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. This study includes a total of 222 subjects were enrolled as per the inclusion/exclusion criteria, out of which 110 cases who had NAFLD with hepatic steatosis on ultrasonography and 112 subjects who did not have NAFLD were considered control. These cases and controls were interrogated and investigated further. Observations were recorded and association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. Statistical methods used were unpaired student’s t-test for continuous variables, Fischer’s and chi-sq test for categorical variables using bivariate analysis by Graph Pad Instat Version 3.10. Risk was assessed in terms of Odd's Ratio. The patients with MS and NAFLD had a higher proportion of CVD compared with those who did not have NAFLD (29.1 vs 18.1 %). This study concludes that NAFLD is significantly associated with MS; most significant with WC, followed by TG and FBS and thus can be considered as hepatic component of MS. This needs more research with large multi-centric prospective studies to evaluate NAFLD as an independent risk factor for CVD.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
efficacy and safety of Sulfad tablets in the management of NASH
patients: A randomized ,prospective, open label, multi-center,
controlled, phase III clinical trial.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Diabetes is a rapidly and serious health problem in Pakistan. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sites in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardize the pharmacists’ documentation of outcomes. Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorized according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centered on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardize the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting.
Antihyperglycemic and Anti-hyperlipidemic Effect of Herbamed, A Herbal Formul...CrimsonPublishersIOD
Diabetes mellitus is a metabolic disorder characterized by hyperglycemia and its occurrence is increasing fast in most of the countries. Herbal medicine derived from plant extracts have been utilized increasingly for the treatment of various disorders like diabetes mellitus. The present study was designed to evaluate the anti diabetic activity of ‘Herbamed’, a herbal formulation composed of Vernonia amygdalina, Ocimum gratissimum, Zingiber officinale and Allium sativum in alloxan-induced diabetic rats model.
Fasting and Caloric Restriction Show Promise for Reducing Type 2 Diabetes Bio...Premier Publishers
The global epidemic of type 2 diabetes (T2D) and its co-morbidities threatens to overwhelm public health services and urgent patient intervention is necessary. A review of mainly randomised controlled trials investigating the reduction of biochemical T2D risk markers through fasting or caloric restriction (CR) found that in T2D or where baseline fasting glucose or HbA1c were elevated, there were significant improvements in fasting glucose and HbA1c, while fasting insulin and insulin resistance may show improvement regardless of condition or baseline levels. There may, however, be ethnic differences, with a clear positive correlation found only in Caucasians. Intermittent CR (i.e. non-continuous periods of fasting) is at least as effective as isocaloric continuous CR, while CR of 400-800 kcal/day is possibly more effective than higher levels for reducing fasting glucose and HbA1c. Time restricted feeding also shows promise but there are few human studies. The findings suggest that the optimum regimen to reduce biochemical risk markers for T2D is an intermittent fasting programme employing a very low-calorie diet with the longest possible number of consecutive days of fasting. The addition of liquid meal replacements, low carbohydrate CR and supplementation of vitamin D, ω-3 PUFAs and L-carnitine may also be of benefit.
Diabetes mellitus: The Pandemic of 21st Century!RahulGupta2015
Diabetes mellitus is a major global metabolic disorder of 21 st century. This is due to its broad spectrum of associated complications with risks, like cardiac and renal disorders. The rapid growth of diabetes is becoming a major burden upon healthcare facilities in all affected countries. Due to lack of definitive preventative measures of diabetes, we must be aware of this pandemic and follow a disciplined lifestyle to limit it. In this communication, recent advances in diabetes management and current preventative measures have been concluded.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
1. Jfuas No.1 June 2013
1
Assessment of Liver Function in Sudanese patients with
Long Standing Type2 Diabetes Mellitus
Mustafa Abdalla Yahya1
and Dr. Bader Eldein Hassan Elabid2
1- Faculty of Education, University of El Fashir . Email:
tawella69@gmail.com
2- Faculty of Medical Laboratory Sciences, University of Science
and Technology. Email: dr.alabid@gmail.com .
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Abstract:
Abnormal liver function tests are not uncommonly encountered
in diabetes mellitus. The aim of this study was to assess liver function
in Sudanese diabetic patients and to determine their correlation with
the duration of diabetes. A case-control study was conducted during
the period from January 2011 to December 2012, to compare the
plasma levels of alanine transaminase, aspartate transaminase, alkaline
phosphatase, bilirubin, total protein, albumin and HbA1c of 200
Sudanese patients with long standing Type2 diabetes mellitus (as a
test group) those of 100 apparently healthy volunteers (as a control
group).Participants in this study were from Jaber Abu Elez diabetic
center in Khartoum state, Sudan. Age and sex of the test group were
matched with the control group. The plasma levels of ALT,AST, ALP,
3. Jfuas No.1 June 2013
3
bilirubin, total protein, albumin and HbA1c were measured using a
semi automated methods. The means of the plasma levels of ALT,
AST,ALP,bilirubin and HbA1c% of the diabetic group were
significantly raised compared to the control group. The means of the
plasma levels of total protein and albumin of the diabetic group were
significantly reduced when compared to the control group. In the
diabetic group the plasma levels of ALT, AST, ALP and bilirubin
showed positive correlations with the duration of diabetes, whereas
the plasma levels of total protein and albumin showed negative
correlation with the duration of diabetes. From the results of this
study, it is concluded that: in Sudanese patients, type2 diabetes
mellitus is associated with high plasma levels of ALT, AST, ALP and
bilirubin and low levels of total protein and albumin. In addition, there
is positive correlations between the plasma levels of ALT, AST, ALP
and bilirubin with the duration of diabetes, and negative correlation
between the plasma levels of total protein and albumin with the
duration of diabetes.
Keywords: Liver Function Tests, Glycosylated haemoglobin,
Nonalcoholic fatty liver disease.
Introduction:
Diabetes mellitus is a group of metabolic disorders with one
common manifestation, hyperglycemia, caused by famial disease or
acquired deficiency in production of insulin by the pancreas, or by the
ineffectiveness of the insulin produced (Jennifer, 1997).
4. اﻟﻔﺎﴍ ﺟﺎﻣﻌﺔ–ﻣﺠﻠﺔاﻟﻌﻠﻮماﻟﺘﻄﺒﻴﻘﻴﺔ-ﻳﻮﻧﻴﻮ اﻷول اﻟﻌﺪد2013م
4
In 2006 world health organization (WHO) reported, at least 171
million people worldwide were suffering from diabetes. Its incidence
is increasing rapidly, and it is estimated that by the year 2030, this
number will be doubled (Pefitti et al., 2007)
Diabetes mellitus is a disease with many complications that
represent the major cause of morbidity. Diabetes has two to four fold
greater risk of vascular disease occurrence as compared with non
diabetic diseases (Sone et al., 2002).
The liver plays a major role in regulation of carbohydrate
metabolism, as it uses glucose as a fuel, it has the capability to store
glucose as glycogen and also synthesize glucose from
noncarbohydrate sources. This key function of liver makes it
vulnerable to diseases in subjects with metabolic disorders,
particularly diabetes. In diabetes mellitus there is Increase activities of
liver enzymes, such as aspartate aminotransferase (AST), alkaline
aminotransferase (ALT) and γ- glutamyltranspeptidase (GGT) which
are indicators of hepatocellular injury (Levinthal et al., 1999 ).
Increased activity of these markers is associated with insulin
resistance, metabolic syndrome, and types 2 diabetes (Marchesini et al
2001 and Wannamethee et al., 2005). An association exists between
diabetes and liver injury. Liver pathology among diabetics is similar
to that of alcoholic liver disease, including fatty liver (steatosis),
steatohepatitis, fibrosis, and cirrhosis (Erbey et al., 2000). Elevated
serum activity of the two amino-transferases, aspartate
aminotransferase (AST) and alanine aminotransferase (ALT), is the
5. Jfuas No.1 June 2013
5
most frequently measured indicator of liver disease and occurs in
diabetics more frequently than in the general population. The same
spectrum of liver injury and enzyme changes in diabetes has also been
described among overweight individuals without diabetes. Whether an
association of liver disease with diabetes is independent of
confounding factors, such as overweight and alcohol consumption is
unknown (7). Nearly 70 to 80% of the diabetic subjects have been
reported to have hepatic fat accumulation, referred to as nonalcoholic
fatty liver (NAFL). NAFL leads to nonalcoholic steatohepatitis
(NASH), a progressive fibrotic disease, which can result in cirrhosis
or liver related death (Wong et al., 2004).
Further proof of the association of liver disease with diabetes
comes from the insulin resistance atherosclerosis study (IRAS), which
showed that liver function markers like the aspartate aminotrans-
ferase (AST) and alanine aminotransferase (ALT) are predictors of
incident diabetes (Hanley et al., 2004 ). Sudan, and most of Africa, is
believed to have one of the highest mortality rates for non infectious
disease.
One study indicated that 10% of adult patient deaths in hospitals
were caused by diabetes. The current prevalence of diabetes in Sudan
is unknown although the very initial study estimated the prevalence by
3.4%, and with no doubt the risk of morbidity due to this disease is
increasing, especially in the urban areas (Ahmed et al., 2001).
Therefore, a comprehensive study of diabetes mellitus and its impact
needs to be undertaken. The present study was aimed to evaluate the
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liver function in Sudanese patients with long standing type 2 diabetes
compared to non diabetic control group and to assess the impact of
diabetes on liver function in relation to duration of the disease.
MATERIALS AND METHODS
The current case-control study was conducted during the period
from January 2011 to November 2012 in Jaber Aboalez Diabetic
center in Khartoum to study the effect of long standing type 2 diabetes
mellitus on liver function test. A total of 200 sudanese patients
diagnosed as having type 2 diabetes mellitus for at least 10 years and
100 healthy individuals (control) were selected randomly to
participate in the study. The objective of the study were explained to
each individual under study after having his verbal consent to
participate in the study, data were collected by questionnaire then
clinical check was done by a medical practitioner to determine any
exclusion factor. Five ml of venous blood were then collected from
each participant under aseptic technique using disposable syringe. The
collected blood sample were divided into (3ml dispensed into heparin
container and the remaining 2ml into EDTA container). The blood
specimens were then centrifuged and the plasma separated into other
container and stored at -20°C in a deep freezer until tested. Plasma
were then tested for ALT, AST, ALP, Bilirubin, Total protein and
albumin using Roche diagnostic/Hitachi 902/Hitachi, Japan and using
the heparin specimen. While the EDTA blood was used to measure the
glaciated haemoglobin (HbA1c) using Nycard reader 11. Statistical
analsis of the results was done using SPSS. Data are presented as
7. Jfuas No.1 June 2013
7
group (mean ± SD). T test was used for comparison of group and
linear regression and Pearson, correlation were used to assess
correlation between two variables. Statistical significance was set as
P 0.05. Permission to conduct the study was taken from the health
authorities in the study area.
RESULTS:
In the current study both the diabetic group and the control group
were matched for age and sex.Among the patients group 112 were
males representing 56% and 88 were females representing 44%, on
the other hand, 55% of the control group were males and 45% were
females .
Table(1) Demographic characteristic of the study and control group.
P.value
Control group
n=100
Test group
n=200
Variable
0.250
0.010
0.060
0.000
59.06±11.99
38-84)(
67.45±14.04
46-96)(
157.48±15.11
137-184)(
24.07±2.94
18.5-28.9)(
60.33±7.88
(39-84)
72.02±9.37
(50-103)
159.81±1.15
(139-193)
27.15±4.02
(19-40)
Age (years )
Weight(Kg)
Height(Cm)
BMI(Kg/m²)
Table (1) shows the mean± Standard deviation, range in brackets and
probability (P).
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• t-test was used for comparison.
Table (2) Comparison between the plasma levels of ALT, AST, ALP and
bilirubin of the test group and the control group.
P.value
Control group
n=100
Test group
n=200
Variable
0.002
0.003
0.005
0.011
18.85±5.39
(10-29)
16.70±4.49
(9-27)
44.27±15.20
(40-77)
0.61±0.32
(0.220.86)
39.70±10.60
(17-66)
37.41±11.27
(15-79)
82.90±34.35
(30-180)
1.10±0.43
(0.332.10)
P.ALT(U/L)
P. AST(U/L)
P.ALP(U/L)
P.bilirubin(mg/dl)
The above table shows significant increase in the means of the
plasma levels of ALT, AST, ALP and bilirubin of the diabetic group
when compared to the control group.
Table (3) Comparison between the plasma levels of total protein ,albumin,
and HbA1c% of the test group and the control group.
P.value
Control group
n=100
Test group
n=200
Variable
0.006
0.004
0.003
8.36±2.21
(8-8.5)
4.49±0.14
(4-4.5)
5.33±0.36
(4-6.5)
7.45±0.02
(6.90-8)
3.46±0.01
(2.60-4)
8.28±0.16
(5-14)
P.total protein(g/dL)
P.albumin(g/dL)
HbA1c%
Table3 shows a significant difference between the means of the
plasma levels of total protein of the test group and the control group.
The mean of the test group is significantly reduced. The same table
9. Jfuas No.1 June 2013
9
also shows a significant decrease of the mean of the plasma levels of
albumin of the test group when compared to the control group.
Table 3 also shows a significant difference between the means
of the blood levels of total HbA1c% of the test group and the control
group. The mean of the test group is significantly raised.
Figures 1,2,3 and 4 shows significant positive correlations
between the plasma levels of ALT, AST, ALP and bilirubin with
duration of diabetes, whereas there are significant negative
correlations between the plasma level of total protein and albumin
with duration of diabetes as shown in figures 5and 6 .
Fig(1) The relationship between the plasma levels of ALT and the duration
of diabetes.
(r = 0.217 , p = 0.002 )
10. اﻟﻔﺎﴍ ﺟﺎﻣﻌﺔ–ﻣﺠﻠﺔاﻟﻌﻠﻮماﻟﺘﻄﺒﻴﻘﻴﺔ-ﻳﻮﻧﻴﻮ اﻷول اﻟﻌﺪد2013م
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Fig(2) The relationship between the plasma levels of AST
and the duration of diabetes.
(r = 0.367 , p = 0.000 )
Fig(3) The relationship between the plasma levels of ALP and the duration
of diabetes.
(r = 0.253 , p = 0.000 )
11. Jfuas No.1 June 2013
11
Fig (4) The relationship between the plasma levels of bilirubin and the
duration of diabetes.
(r = 0.208, p = 0.003)
Fig(5) The relationship between the plasma levels of T.protein and the
duration of diabetes.
(r = 0.546, p = 0.000)
12. اﻟﻔﺎﴍ ﺟﺎﻣﻌﺔ–ﻣﺠﻠﺔاﻟﻌﻠﻮماﻟﺘﻄﺒﻴﻘﻴﺔ-ﻳﻮﻧﻴﻮ اﻷول اﻟﻌﺪد2013م
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Fig (6) The relationship between the plasma levels of albumin and the
duration of diabetes.
(r = 0.239, p = 0.001)
Discussion:
Type2 diabetic patients have been reported to be associated with
higher incidence of abnormal liver function tests (LFTs) compared to
individuals without diabetes. Elevated ALT being the most common
abnormality (Harris, 2005). In our study the results showed a
significant difference between the mean of the plasma activity of ALT
and AST of the test group compared with that of the control group.
The means of the test group for both ALT and AST were both
significantly raised. These results agree with a study done by Mckenze
who found elevation in plasma ALT and AST activities in patients
with diabetes mellitus type2 (Mckenzie, 2006 ), as a result of
progressive liver cell damage as a consequence of long standing. Our
study also showed significant increase in the mean of the plasma
activity of ALP of the test group compared with the control group.
This may be due to the effect of long standing diabetes mellitus on
13. Jfuas No.1 June 2013
13
bone causing diabetic bone disease. This result agrees with a study
done by Maxwell et al who found that there was an elevation in
plasma ALP activity in patients with diabetes mellitus type 2
(Maxwell, 1986). The present result disagreed with a study done by
Tibi who reported that there was no significant difference between the
diabetic and the control group in the plasma levels of ALP (Tibi,
1988) .
The present study showed a significant difference between the
mean of plasma levels of bilirubin of the test group compared with
that of the control group. The mean of the test group is significantly
elevated as shown in table 2. This result is in agreement with a study
done by Han et al (15) who studied the liver function tests of 81
diabetic patients in whom 4.9% were found to have high bilirubin
(Han et al ., 2012 ).
Also the study showed a significant difference between the
means of the plasma level of total protein and albumin of the test
group when compared with that of the control group. These results in
agreement with a study done by Idris et al, who studied the liver
function of 50 sudanese diabetic patients and reported that plasma
total protein and albumin were significantly reduced among diabetic
sudanese compared to healthy controls. However the mean values
were within the reference range ( Idris et al ., 2011) . The current
study also showed positive correlations between glycemic control
(HbA1c%) and duration of diabetes with ALT and AST. These results
agree with Jayarama et al. Who reported positive correlations between
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FBS,PPBS,the duration of type2 diabetes and ALT levels among the
cases (Jayarama et al., 2012).
Generally the liver enzymes in diabetic patients with type 2 are
due to physiological alternative pathway that leads diabetic patients to
consume fatty acids as energy instead of glucose, this leads to increase
activity of the liver enzymes (Harris, 2005).
In conclusion, values of liver function test for ALT, AST, ALP
and bilirubin in patients with type 2 diabetes mellitus are significantly
higher than that of healthy controls; moreover, diabetic patients have
lower concentration of plasma total protein and albumins in
comparison to healthy controls. In long standing diabetes there is a
possibility of underlying fatty liver, which might need further
evaluation and early intervention to prevent progression into cirrhosis
and chronic liver disease.
REFERENCES:
1. Ahmed A M, Ahmed NH (2001). Diabetes mellitus in Sudan: the
size of the problem and the possibilities of efficient care. Pract.
Diab. Int., 18: 324327.
2. Erbey JR, Silberman C, Lydick E (2000). Prevalence of
abnormal serum alanine aminotransferase levels in obese
patients and patients with type 2 diabetes. Am. J. Med., 109:
588–590.
3. Han N, Htoo H K, Aung H (2012). Determinants of Abnormal
15. Jfuas No.1 June 2013
15
Liver Function tests in Diabetes Patients in Myanmar.
International Journal of Diabetes Research, 1(3): 36-41.
4. Hanley AJ, Williams K, Festa A, Wagenknecht LE, D’Agostino
RB Jr, Kempf J, Zinman B, Haffner SM (2004). Elevations in
markers of liver injury and risk of type 2 diabetes: the insulin
resistance atherosclerosis study. Diabetes, 53: 26232632.
5. Harris E H (2005). Elevated Liver Function tests in Type 2
Diabetes. Clinical Diabetes; 23 (3): 115-119.
6. Idris A S, Mekky K F H, Abdalla B E E, Ali K A(2011). Liver
function tests in type 2 Sudanese diabetic patients International
Journal of Nutrition and Metabolism; 3(2):17-21.
7. Jayarama N, Sudha R(2012). A Study of Non-Alcoholic Fatty
Liver Disease (NAFLD) In Type2 Diabetes Mellitus in A
Tertiary Care Centre, Southern India. Journal of Clinical and
Diagnostic Research doi: 3670.
8. Jennifer M M (1997). Diagnosis and classification of diabetes
mellitus new criteria diabetes care;20: 118397.
9. Levinthal GN, Tavill AJ (1999). Liver disease and Diabetes
Mellitus. Clin. Diabetes, 17: 73.
10. Marchesini G, Brizi M, Bianchi G (2001). Nonalcoholic fatty
liver disease. A feature of metabolic syndrome. Diabetes, 50:
18441850.
11. Maxwell D, Fisher E,Estep H(1986). Serum alkaline phosphatase
in diabetes mellitus. Journal of the American collage of
nutrition,5 ,55-59.
16. اﻟﻔﺎﴍ ﺟﺎﻣﻌﺔ–ﻣﺠﻠﺔاﻟﻌﻠﻮماﻟﺘﻄﺒﻴﻘﻴﺔ-ﻳﻮﻧﻴﻮ اﻷول اﻟﻌﺪد2013م
16
12. Mckenzie J(2006). Plasma liver enzymes. Clinical
endocrinology. Volume 65, number1, pp, 40-44 (5).
13. Pefitti DB, Imperator G Pallasl, Daniel SR, Kershnar AK,
(2007) Glucose control Archpadiatr adoles med;161 [ 2] 159.
14. Sone H , Katagiri A, Saito V, Vamadan JD, (2002) study group.
Effects of life style modification on patients with type 2 diabetes:
the Japan diabetes complication study design, baseline analysis
and three years interim report. Homebrews; 34: 50915.
15. Tibi L (1988). Plasma alkaline phosphatase iso enzymes in
diabetes mellitus. Clinical chimica acata, 177 (2):147-55.
16. Wannamethee SG, Shaper AG, Lennon L, Whincup PH (2005).
Hepatic enzymes, the metabolic syndrome, and the risk of type
2diabetes in older men. Diabetes Car., 28: 29132918.
17. Wong VW, Chan HL, Hui AY, Chan KF, Liew CT, Chan FK
(2004). Clinical and histological features of nonalcoholic fatty
liver disease in Hong Kong Chinese. Aliment Pharmacol. Ther.,
20: 4549.