Evaluation of Oxidative status of gout patients in a Cameroonian urban hospit...J-réné Nkeck
This study evaluated the oxidative status of patients experiencing acute gout attacks compared to healthy controls in Cameroon. The study found higher levels of malondialdehyde, a marker of oxidative stress, in patients with gout attacks. However, levels of antioxidant enzymes like superoxide dismutase, glutathione peroxidase and catalase were similar between patients and controls. Thus, patients with gout attacks have evidence of elevated oxidative stress based on higher malondialdehyde levels, but their overall antioxidant defenses appear to be similar to healthy individuals.
Background: Chronic Obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality world-wide. MMP 9 is an acute phase reactant secreted by the liver in response to infection, inflammation or tissue damage. Methods: This case-control study was conducted on 35 healthy controls and 40 COPD patients at a tertiary care hospital in north India. MMP 9 levels were measured in serum by ELISA Kit. Results: The present study showed that mean MMP 9 levels in serum was significantly higher in COPD group as compared to control group (p<0.0001) and the levels increased with the increasing severity of the disease. Conclusion: Our study confirms that MMP 9 levels were significantly higher in COPD patients as compared to controls and their levels increased with the increasing severity of the disease. Measuring MMP 9 levels in combination with other biochemical markers can be helpful in monitoring disease outcome and management of the disease. Key-words- COPD, MMP 9, Inflammation, Matrix metalloproteinases (MMPs)
Abstract— Respiratory complications are major sources of morbidity and mortality in spinal cord injury (SCI). Improvement in expiratory muscle strength may be associated with improved cough and clearance of secretions. So that expiratory muscle training are advised in SCI cases to improve expiratory muscle strength. This study was conducted to compare the effect of Resistance and Sham training on pulmonary function test in spinal cord injury cases. It was found the mean value of all the parameters of PFT of Sham training was found to increase from baseline to 1st and 2nd follow up. This difference was found significant in all the parameters of PFT at 2nd follow up, but FEV1 and PIFR of 1st follow up (p value < 0.05) only. Likewise, it is also observed that the mean value of all the parameters of PFT of test group was found to increase from baseline to 1st and 2nd follow up. This difference was found highly significant (p value <0.001) in all the parameters of PFT at 1st and 2nd follow up. So it can be concluded that however both the type of training improve PFTs but the improvement of high resistance training was significantly more than they were for sham training.
Autologous mononuclear and mesenchymal stromal cells infusion in COPD patients: impact on pulmonary capacity and quality of life in a Phase I randomized clinical trial
The Effect on DNMT1 through Compounds for the Treatment of Cancer An In Silic...YogeshIJTSRD
Background Cancer is a disease that involves the abnormal gowth of the cell. After growing uncontrollably in continuation, it influences and grows in other parts of the body as well 1,2 . Benign types of Tumors doesn’t invade other body parts whereas Malignant Tumor support spreading and invading other parts of the body 3 . The main objective of this work is to use Molecular Docking method to develop a drug for the treatment of Cancer. Methods Docking was used to dock all the selected ligands with target protein i.e., DNMT1. The selected ligands were Thiophene, Sulfonamides, Chalcone, and Nitroimidazole. PyRx Software was used for the purpose of virtual screening to check various properties of these selected ligands like the Binding Affinity, RMSD Lower Bound , RMSD Upper Bound etc. PyRx and SwissADME both softwares were used for finding out the Drug Likeliness of every compound and to find out the best Compound to be docked with the target protein. Chalcone was found to be the best compound for Cancer treatment having least binding affinity.Results Molecular Docking of Chalcone with DNMT1 protein was performed with the help of AutoDock Vina Software. Output showed 9 positions of different binding affinities and RMSD values both Lower Bound and Upper Bound . Furthermore, the visualization of results was done with the help of PyMOL Software.Conclusion According to this study, Chalcone was the only compound from selected ligands that may be used to treat Cancer. Chalcone may act as a promising drug for cancer treatment in future perspectives. Mishka Tyagi | Noopur Khare | Abhimanyu Kumar Jha "The Effect on DNMT1 through Compounds for the Treatment of Cancer: An In-Silico Approach" 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/ijtsrd43765.pdf Paper URL: https://www.ijtsrd.com/pharmacy/biotechnology-/43765/the-effect-on-dnmt1-through-compounds-for-the-treatment-of-cancer-an-insilico-approach/mishka-tyagi
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.
1) Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that causes shortness of breath. It includes emphysema, chronic bronchitis, and chronic asthma. Cigarette smoking is the primary cause.
2) Exercise can help people with COPD by improving cardiovascular health, reducing symptoms like breathlessness, and enhancing quality of life. Aerobic exercise, strength training, flexibility, and neuromuscular exercises are all beneficial.
3) Pulmonary rehabilitation including ongoing exercise is effective for improving quality of life and managing COPD symptoms. An individualized exercise program tailored to a person's capabilities is important.
The 5-year follow-up study evaluated the long-term safety and efficacy of gene therapy with pl-VEGF165 in patients with peripheral artery disease. There were no significant differences in adverse events between the treatment (n=36) and control (n=12) groups over 5 years. The target limb salvage rate was higher in the treatment group (95% vs 67%). Pain-free walking distance increased 288% in the treatment group from baseline to year 5, peaking at year 3, while remaining largely unchanged in the control group. The results suggest the therapeutic effect of angiogenesis induction via gene therapy persists for at least 5 years with no safety issues.
Evaluation of Oxidative status of gout patients in a Cameroonian urban hospit...J-réné Nkeck
This study evaluated the oxidative status of patients experiencing acute gout attacks compared to healthy controls in Cameroon. The study found higher levels of malondialdehyde, a marker of oxidative stress, in patients with gout attacks. However, levels of antioxidant enzymes like superoxide dismutase, glutathione peroxidase and catalase were similar between patients and controls. Thus, patients with gout attacks have evidence of elevated oxidative stress based on higher malondialdehyde levels, but their overall antioxidant defenses appear to be similar to healthy individuals.
Background: Chronic Obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality world-wide. MMP 9 is an acute phase reactant secreted by the liver in response to infection, inflammation or tissue damage. Methods: This case-control study was conducted on 35 healthy controls and 40 COPD patients at a tertiary care hospital in north India. MMP 9 levels were measured in serum by ELISA Kit. Results: The present study showed that mean MMP 9 levels in serum was significantly higher in COPD group as compared to control group (p<0.0001) and the levels increased with the increasing severity of the disease. Conclusion: Our study confirms that MMP 9 levels were significantly higher in COPD patients as compared to controls and their levels increased with the increasing severity of the disease. Measuring MMP 9 levels in combination with other biochemical markers can be helpful in monitoring disease outcome and management of the disease. Key-words- COPD, MMP 9, Inflammation, Matrix metalloproteinases (MMPs)
Abstract— Respiratory complications are major sources of morbidity and mortality in spinal cord injury (SCI). Improvement in expiratory muscle strength may be associated with improved cough and clearance of secretions. So that expiratory muscle training are advised in SCI cases to improve expiratory muscle strength. This study was conducted to compare the effect of Resistance and Sham training on pulmonary function test in spinal cord injury cases. It was found the mean value of all the parameters of PFT of Sham training was found to increase from baseline to 1st and 2nd follow up. This difference was found significant in all the parameters of PFT at 2nd follow up, but FEV1 and PIFR of 1st follow up (p value < 0.05) only. Likewise, it is also observed that the mean value of all the parameters of PFT of test group was found to increase from baseline to 1st and 2nd follow up. This difference was found highly significant (p value <0.001) in all the parameters of PFT at 1st and 2nd follow up. So it can be concluded that however both the type of training improve PFTs but the improvement of high resistance training was significantly more than they were for sham training.
Autologous mononuclear and mesenchymal stromal cells infusion in COPD patients: impact on pulmonary capacity and quality of life in a Phase I randomized clinical trial
The Effect on DNMT1 through Compounds for the Treatment of Cancer An In Silic...YogeshIJTSRD
Background Cancer is a disease that involves the abnormal gowth of the cell. After growing uncontrollably in continuation, it influences and grows in other parts of the body as well 1,2 . Benign types of Tumors doesn’t invade other body parts whereas Malignant Tumor support spreading and invading other parts of the body 3 . The main objective of this work is to use Molecular Docking method to develop a drug for the treatment of Cancer. Methods Docking was used to dock all the selected ligands with target protein i.e., DNMT1. The selected ligands were Thiophene, Sulfonamides, Chalcone, and Nitroimidazole. PyRx Software was used for the purpose of virtual screening to check various properties of these selected ligands like the Binding Affinity, RMSD Lower Bound , RMSD Upper Bound etc. PyRx and SwissADME both softwares were used for finding out the Drug Likeliness of every compound and to find out the best Compound to be docked with the target protein. Chalcone was found to be the best compound for Cancer treatment having least binding affinity.Results Molecular Docking of Chalcone with DNMT1 protein was performed with the help of AutoDock Vina Software. Output showed 9 positions of different binding affinities and RMSD values both Lower Bound and Upper Bound . Furthermore, the visualization of results was done with the help of PyMOL Software.Conclusion According to this study, Chalcone was the only compound from selected ligands that may be used to treat Cancer. Chalcone may act as a promising drug for cancer treatment in future perspectives. Mishka Tyagi | Noopur Khare | Abhimanyu Kumar Jha "The Effect on DNMT1 through Compounds for the Treatment of Cancer: An In-Silico Approach" 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/ijtsrd43765.pdf Paper URL: https://www.ijtsrd.com/pharmacy/biotechnology-/43765/the-effect-on-dnmt1-through-compounds-for-the-treatment-of-cancer-an-insilico-approach/mishka-tyagi
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.
1) Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that causes shortness of breath. It includes emphysema, chronic bronchitis, and chronic asthma. Cigarette smoking is the primary cause.
2) Exercise can help people with COPD by improving cardiovascular health, reducing symptoms like breathlessness, and enhancing quality of life. Aerobic exercise, strength training, flexibility, and neuromuscular exercises are all beneficial.
3) Pulmonary rehabilitation including ongoing exercise is effective for improving quality of life and managing COPD symptoms. An individualized exercise program tailored to a person's capabilities is important.
The 5-year follow-up study evaluated the long-term safety and efficacy of gene therapy with pl-VEGF165 in patients with peripheral artery disease. There were no significant differences in adverse events between the treatment (n=36) and control (n=12) groups over 5 years. The target limb salvage rate was higher in the treatment group (95% vs 67%). Pain-free walking distance increased 288% in the treatment group from baseline to year 5, peaking at year 3, while remaining largely unchanged in the control group. The results suggest the therapeutic effect of angiogenesis induction via gene therapy persists for at least 5 years with no safety issues.
A 76-year-old male presented with fever, weight loss, and abdominal swelling for three months. Imaging studies revealed a large cystic mass arising from the lower pole of the right kidney measuring 9.84x9.70cm. Aspiration of the cyst yielded purulent pus that tested positive for Mycobacterium tuberculosis via PCR and Ziehl-Neelsen staining. The patient responded well to anti-tuberculosis treatment and follow-up scans showed significant reduction in the size of the residual cystic cavity. This case report presents a rare manifestation of primary renal tuberculosis presenting as a giant cyst of the lower kidney pole.
Macrolide effects on the prevention of copd exacerbguidep
This document reviews the effects of macrolide antibiotics on preventing exacerbations in patients with chronic obstructive pulmonary disease (COPD). It summarizes several studies that have examined the impact of macrolides like erythromycin and clarithromycin on the frequency and severity of COPD exacerbations. The studies found that macrolide treatment reduced the number and rate of exacerbations as well as hospitalizations related to exacerbations. The document also discusses potential anti-inflammatory and other physiological mechanisms by which macrolides may help prevent COPD exacerbations.
A Possible Role of Rosmarinic Acid against CD2 Associated Protein for the Tre...YogeshIJTSRD
Multiple sclerosis is a chronic inflammatory neurodegenerative disorder which directly affects Central Nervous System CNS . People with MS suffer with an episodic reversible memory loss during the initial stages and later it leads to the neurological deterioration. Number of research and studies has been done on the natural compounds and phytochemical compounds in order to develop the particular drug for the treatment of MS in vivo andin vitro. The present study focuses on the inhibitory effect of Rosmarinic acid against the effect of CD2 Associated protein with the help of Molecular Docking. Molecular Docking basically screens the ligand and the target protein and shows the interaction between them on the basis of the minimum binding affinities and drug likeliness properties. In our research, docking was performed between CD2 Associated protein and selected ligands with the help of docking software. Ligands were selected on the basis of their minimum Binding affinities and finally by their drug likeliness properties. Rosmarinic acid BA 5.6 was the resultant ligand of our recent study. It showed the perfect interaction with CD2 Associated protein. Therefore, we may conclude that Rosmarinic acid may act as a compound which may be used as a drug for the treatment of multiple sclerosis fromfurther in vitro and in vivostudies in future. Jitin Kumar | Tejaswee Anand | Ritika Sharma | Noopur Khare | Abhimanyu Kumar Jha | Yamini Dixit "A Possible Role of Rosmarinic Acid against CD2-Associated Protein for the Treatment of Multiple Sclerosis through in Silico Approach" 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/ijtsrd44979.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/44979/a-possible-role-of-rosmarinic-acid-against-cd2associated-protein-for-the-treatment-of-multiple-sclerosis-through-in-silico-approach/jitin-kumar
Peak Expiratory Flow Rate Changes with Relevant Variables in a Population of ...DR. SUJOY MUKHERJEE
This study analyzed peak expiratory flow rate (PEFR) values in 762 subjects aged 15-75 years from eastern India with normal spirometry results. The study found that:
1) Male subjects had higher mean PEFR (89.041%) than females (84.706%). PEFR was lower in ever-smokers compared to never-smokers and decreased with increasing age.
2) PEFR increased with height and weight but was significantly lower in the 156-165 cm height range compared to 166-191 cm.
3) The study established preliminary reference values for PEFR in the eastern Indian population and concluded various factors like gender, smoking, height, weight, and age influence PEFR
The Effect of Obesity on Pulmonary Function among Healthy Non-smoking AdultsBRNSS Publication Hub
Background: Obesity is a chronic disease characterized by the excessive accumulation of body fat which is associated with comorbidities. It is a growing health issue worldwide. Obesity is known to have significant effects on respiratory function and obese patients commonly report respiratory complaints requiring pulmonary function tests. Objectives: The objectives of the study were to determine the effects of obesity on pulmonary function in overweight and obese adults who were non-smokers and did not have any respiratory diseases. Materials and Methods: This cross-sectional study was carried out among 181 healthy adults of both sexes between 20 and 60 years, those attended master health check-up and medicine outpatient department. The study participants were divided into three body mass index (BMI) groups according to the WHO BMI classification. Forced vital capacity in liters (FVC), forced expiratory volume in the first second in liters (FEV1), FVC/FEV1, peak expiratory flow rate in liter/min (PEFR), and forced expiratory flow (FEF)25–75% were recorded. These three BMI groups were compared using one-way ANOVA, correlation was assessed by Pearson’s “r.” Linear regression analysis was applied. Results: Significant differences in lung volumes were found in three BMI groups. Obese and overweight subjects had significantly lower FVC, FEV1, FEF25%–75%, and PEFR (P < 0.0001) as compared to normal weight subjects. However, there was no statistically significant difference found in FEV1/FVC ratio. There were significant linear relationships between obesity and pulmonary function. BMI had significant negative linear association at the level of P < 0.001 with FVC% (r = −0.355), FEV1% (r = −0.361), FEF25%–75% (−0.432), and PEFR (r = −0.501). FEV1/FVC ratio was negatively correlated, but statistically not significant. Conclusion: BMI has a detrimental effect on pulmonary functions in overweight and obese subjects. Reduction in FVC and FEV1 was the most representative findings among the overweight and obese subjects, suggesting the presence of a restrictive respiratory pattern associated with obesity. It might be due to decrease in lung and chest wall compliance and increase in work of breathing.
This study analyzed the prescription patterns of antihypertensive drugs prescribed to 137 patients in India to determine adherence to JNC 7 guidelines. The most frequently prescribed classes of drugs were diuretics, followed by calcium channel blockers, beta blockers, ACE inhibitors, and ARBs. Combination drug therapy was prescribed to 72% of patients, most commonly a combination of a calcium channel blocker and beta blocker. The prescription patterns were found to adhere to JNC 7 guidelines, which recommend diuretics as first-line treatment and combination therapy including a diuretic for stage 2 hypertension.
The document summarizes research using Taiwan's National Health Insurance Research Database (NHIRD). It describes the database's creation and contents, sample population files, statistical analysis methods like odds ratios and hazard ratios, example studies on fractures in diabetes patients using thiazolidinediones and aristolochic acid exposure and urinary tract cancer, and current use of data mining techniques with the NHIRD.
This curriculum vitae summarizes the qualifications and experience of Dr. Deep Dutta. He is currently an Assistant Professor of Endocrinology at PGIMER & Dr. Ram Manohar Lohia Hospital in New Delhi, India. He has over 16 years of experience in medicine and 7 years of experience specifically in endocrinology. His qualifications include an MBBS from JIPMER, MD in Medicine, DM in Endocrinology, DNB in Endocrinology, MRCP from the UK, and FACE from the USA. He has published over 95 papers in international journals and serves on the editorial board of several journals.
Prescribing pattern in Asthma Patient in Nepal and IndiaNeeraj Ojha
1) The document compares studies on drug prescribing patterns for asthma patients in Nepal and India. In Nepal, the study found that beta-2 agonists, methylxanthines, and corticosteroids were most commonly prescribed. In India, the most common drugs were beta-2 agonists, methylxanthines, and corticosteroids.
2) Both studies found that combination drug therapy was more common than single drug therapy. The most frequent combination was methylxanthines and corticosteroids.
3) The conclusion is that prescribing practices need to follow asthma guidelines more closely and focus more on controlling asthma in addition to providing symptomatic relief.
Bactericidal and Sporicidal Activities against Pathogenic Bacteria of Direct ...science journals
The purpose of this investigation was to examine the bactericidal activity of long lifetime ozone water (LLO water) against pathogenic bacteria of medical, veterinary, and public health interest.
KATAMANI SHARIRIYAM OF CHRAKA INDRIYA STHANA - AN EXPLORATIVE STUDYPRASAD MAMIDI
This document summarizes the contents of the sixth chapter "Katamani Shaririyam" from the Indriya Sthana section of the ancient Indian medical text Charaka Samhita. The chapter describes various fatal conditions and symptoms that indicate imminent death. These include descriptions of diseases like esophageal carcinoma, Barrett's esophagus, gastroesophageal reflux disease, chronic diarrhea, intestinal tuberculosis, end-stage renal disease, cirrhosis of the liver, lung cancers, and more. The chapter also discusses concepts like comorbidities and multimorbidities. Analyzing the descriptions provides insights into the prognostic significance of various conditions for contemporary clinical practice. However, more research is needed to validate the clinical findings
This service provides free independent abstracts of medical publications. The abstracts are reviewed by the IPCRG research team to ensure relevance and accuracy. The abstracts summarize the main ideas but do not constitute treatment recommendations. Feedback on the abstracts is welcome.
Formic acid poisoning is widely used in the rubber industry in the state of Kerala. It has become a mode of suicide because of its easy availability. Our objective is to report immediate manifestations and management principles in the treatment of formic acid poisoning. Three cases are reported which presented to our Emergency Department. Out of the three patients, only one survived. Metabolic acidosis was the most common acid base abnormality observed in all the three cases. Formic acid poisoning carries a high risk of mortality and morbidity. Early correction of electrolyte imbalances holds the key to survival and preventing early complications such as cardiac arrest. Restriction should be put on the sale and the public should be made aware of its toxic manifestations and complications.
Moderate intensity exercise improves immune function and may reduce the risk and severity of infections. Intense, prolonged exercise can cause immunosuppression by increasing stress hormones and inflammation. Each bout of moderate cardiorespiratory exercise acutely mobilizes immune cells and enhances immune surveillance, while regular exercise provides longer-term benefits through anti-inflammatory effects and optimization of immune cell composition. Endurance exercise specifically promotes antioxidant defenses in muscles and tissues. Moderate exercise is an effective way to maintain immune balance, but high training workloads may lead to immune dysfunction.
exercise as determinant prevention of high blood pressure in container crane ...INFOGAIN PUBLICATION
Metabolic syndrome (Mets) is a multiple risk factor for coronary heart disease, diabetes, and several organ malfunctions that comes up from insulin resistance and metabolic dysfunctions caused of abnormal adipose deposition. One of the component criteria of metabolic syndrome is elevated blood pressure. Unhealthy lifestyle and sedentary physical activity are considered to have relationship with metabolic syndrome incidents in workers. This study aimed to analyze smoking habit, regular exercise and family’s medical history associated with blood pressure using International Diabetic Federation Criteria for Mets in a container crane operator’s population. The study was explored in a cross sectional study of 40 container crane operator. Using logistic regression for analyzing, the study found that regular exercise had significant association with blood pressure in worker adjusted with age.
This study characterized 181 patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD). The most common types of ILD were usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). The GAP model predicted mortality risk well and had good calibration, while the ILD-GAP model had poor calibration. Both models discriminated well between high and low risk patients. The study found RA-ILD is associated with decreased survival and remains a clinical challenge.
Autologous Bone Marrow Mononuclear Cell Therapy for Autism: An Open Label Pro...DrAlokSharma
Autism spectrum disorders (ASD) are a group of heterogeneous neurodevelopmental disorders characterized by
deficits in verbal and nonverbal communication, social
interaction, and presence of stereotypical repetitive behavior.
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 mellitus (DM) is a chronic metabolic and vascular disorder affecting various organs and systems. Many studies have shown impairment of pulmonary functions in diabetics subjects, whereas some studies did not show any changes in pulmonary functions. Therefore, objective of the present study is to find out alterations in the pulmonary functions. Methods Design, Setting, and Participants: This cross-sectional study was conducted in a tertiary care hospital among patients attending medicine department. The sample size was 200. A total of 100 known cases of DM without any acute or chronic lung disease and 100 healthy controls were included in the age group of 40–50 years. History of smoking was excluded in both groups. The diabetic subjects had at least 1 year of duration of disease. Intervention: Pulmonary function test (spirometry) was performed with NND TrueFlow Easy One™ diagnostic spirometer. Main Outcome Measures: The forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were the primary outcome measures to assess the pulmonary functions. Results: In Phase 1 analysis, diabetic subjects did not show any changes in both FVC and FEV1 when compared with controls. In Pearson correlation test, a significant negative correlation between duration of disease and pulmonary functions, FVC at the level of 0.05 and FEV1 at the level of 0.01 were observed. However, in Phase 2 analysis, a significant reduction in FVC and FEV1 was observed in diabetic subjects with duration of diabetes more than 5 years. Conclusion: The decline in FVC and FEV1 in diabetic subjects is more likely to be the effect of DM. The decline is more pronounced with the duration of the disease.
Background- The chronic obstructive pulmonary disease is a chronic inflammatory disease and a leading cause of morbidity and mortality worldwide. Smoking is the major risk factor in COPD. Smoking damages the air sacs, airway and the lining of the lungs and due to this lung have trouble moving enough air in and out making hard to breathe. Smoking may act as a trigger factor for many people who have COPD and can either cause an exacerbation or flare-up of symptoms. The present study aims to determine the association of smoking status with different stages of COPD and clinical symptoms in a North Indian population. Methods- The present study was conducted on 160 stable COPD patients in the department of Respiratory Medicine, King George Medical University, Lucknow. Results- Out of 160 patients enrolled there were 41.8% smokers, 24.3% non-smokers, and 33.7% ex-smokers. The present study found a significant association (p<0.02) of smoking status with different stages of COPD, although non-significant association (p=0.96) was observed between smoking status and clinical symptoms. Conclusion- The significant association of smoking status was observed with different stages of COPD while the non-significant association was observed with clinical symptoms in the present study in north Indian population. Smoking cessation will be helpful in reducing the progression and management of this disease in smokers. Key-words- Chronic Obstructive pulmonary disease, Smoking, Clinical symptoms, Gold stage
A 76-year-old male presented with fever, weight loss, and abdominal swelling for three months. Imaging studies revealed a large cystic mass arising from the lower pole of the right kidney measuring 9.84x9.70cm. Aspiration of the cyst yielded purulent pus that tested positive for Mycobacterium tuberculosis via PCR and Ziehl-Neelsen staining. The patient responded well to anti-tuberculosis treatment and follow-up scans showed significant reduction in the size of the residual cystic cavity. This case report presents a rare manifestation of primary renal tuberculosis presenting as a giant cyst of the lower kidney pole.
Macrolide effects on the prevention of copd exacerbguidep
This document reviews the effects of macrolide antibiotics on preventing exacerbations in patients with chronic obstructive pulmonary disease (COPD). It summarizes several studies that have examined the impact of macrolides like erythromycin and clarithromycin on the frequency and severity of COPD exacerbations. The studies found that macrolide treatment reduced the number and rate of exacerbations as well as hospitalizations related to exacerbations. The document also discusses potential anti-inflammatory and other physiological mechanisms by which macrolides may help prevent COPD exacerbations.
A Possible Role of Rosmarinic Acid against CD2 Associated Protein for the Tre...YogeshIJTSRD
Multiple sclerosis is a chronic inflammatory neurodegenerative disorder which directly affects Central Nervous System CNS . People with MS suffer with an episodic reversible memory loss during the initial stages and later it leads to the neurological deterioration. Number of research and studies has been done on the natural compounds and phytochemical compounds in order to develop the particular drug for the treatment of MS in vivo andin vitro. The present study focuses on the inhibitory effect of Rosmarinic acid against the effect of CD2 Associated protein with the help of Molecular Docking. Molecular Docking basically screens the ligand and the target protein and shows the interaction between them on the basis of the minimum binding affinities and drug likeliness properties. In our research, docking was performed between CD2 Associated protein and selected ligands with the help of docking software. Ligands were selected on the basis of their minimum Binding affinities and finally by their drug likeliness properties. Rosmarinic acid BA 5.6 was the resultant ligand of our recent study. It showed the perfect interaction with CD2 Associated protein. Therefore, we may conclude that Rosmarinic acid may act as a compound which may be used as a drug for the treatment of multiple sclerosis fromfurther in vitro and in vivostudies in future. Jitin Kumar | Tejaswee Anand | Ritika Sharma | Noopur Khare | Abhimanyu Kumar Jha | Yamini Dixit "A Possible Role of Rosmarinic Acid against CD2-Associated Protein for the Treatment of Multiple Sclerosis through in Silico Approach" 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/ijtsrd44979.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/44979/a-possible-role-of-rosmarinic-acid-against-cd2associated-protein-for-the-treatment-of-multiple-sclerosis-through-in-silico-approach/jitin-kumar
Peak Expiratory Flow Rate Changes with Relevant Variables in a Population of ...DR. SUJOY MUKHERJEE
This study analyzed peak expiratory flow rate (PEFR) values in 762 subjects aged 15-75 years from eastern India with normal spirometry results. The study found that:
1) Male subjects had higher mean PEFR (89.041%) than females (84.706%). PEFR was lower in ever-smokers compared to never-smokers and decreased with increasing age.
2) PEFR increased with height and weight but was significantly lower in the 156-165 cm height range compared to 166-191 cm.
3) The study established preliminary reference values for PEFR in the eastern Indian population and concluded various factors like gender, smoking, height, weight, and age influence PEFR
The Effect of Obesity on Pulmonary Function among Healthy Non-smoking AdultsBRNSS Publication Hub
Background: Obesity is a chronic disease characterized by the excessive accumulation of body fat which is associated with comorbidities. It is a growing health issue worldwide. Obesity is known to have significant effects on respiratory function and obese patients commonly report respiratory complaints requiring pulmonary function tests. Objectives: The objectives of the study were to determine the effects of obesity on pulmonary function in overweight and obese adults who were non-smokers and did not have any respiratory diseases. Materials and Methods: This cross-sectional study was carried out among 181 healthy adults of both sexes between 20 and 60 years, those attended master health check-up and medicine outpatient department. The study participants were divided into three body mass index (BMI) groups according to the WHO BMI classification. Forced vital capacity in liters (FVC), forced expiratory volume in the first second in liters (FEV1), FVC/FEV1, peak expiratory flow rate in liter/min (PEFR), and forced expiratory flow (FEF)25–75% were recorded. These three BMI groups were compared using one-way ANOVA, correlation was assessed by Pearson’s “r.” Linear regression analysis was applied. Results: Significant differences in lung volumes were found in three BMI groups. Obese and overweight subjects had significantly lower FVC, FEV1, FEF25%–75%, and PEFR (P < 0.0001) as compared to normal weight subjects. However, there was no statistically significant difference found in FEV1/FVC ratio. There were significant linear relationships between obesity and pulmonary function. BMI had significant negative linear association at the level of P < 0.001 with FVC% (r = −0.355), FEV1% (r = −0.361), FEF25%–75% (−0.432), and PEFR (r = −0.501). FEV1/FVC ratio was negatively correlated, but statistically not significant. Conclusion: BMI has a detrimental effect on pulmonary functions in overweight and obese subjects. Reduction in FVC and FEV1 was the most representative findings among the overweight and obese subjects, suggesting the presence of a restrictive respiratory pattern associated with obesity. It might be due to decrease in lung and chest wall compliance and increase in work of breathing.
This study analyzed the prescription patterns of antihypertensive drugs prescribed to 137 patients in India to determine adherence to JNC 7 guidelines. The most frequently prescribed classes of drugs were diuretics, followed by calcium channel blockers, beta blockers, ACE inhibitors, and ARBs. Combination drug therapy was prescribed to 72% of patients, most commonly a combination of a calcium channel blocker and beta blocker. The prescription patterns were found to adhere to JNC 7 guidelines, which recommend diuretics as first-line treatment and combination therapy including a diuretic for stage 2 hypertension.
The document summarizes research using Taiwan's National Health Insurance Research Database (NHIRD). It describes the database's creation and contents, sample population files, statistical analysis methods like odds ratios and hazard ratios, example studies on fractures in diabetes patients using thiazolidinediones and aristolochic acid exposure and urinary tract cancer, and current use of data mining techniques with the NHIRD.
This curriculum vitae summarizes the qualifications and experience of Dr. Deep Dutta. He is currently an Assistant Professor of Endocrinology at PGIMER & Dr. Ram Manohar Lohia Hospital in New Delhi, India. He has over 16 years of experience in medicine and 7 years of experience specifically in endocrinology. His qualifications include an MBBS from JIPMER, MD in Medicine, DM in Endocrinology, DNB in Endocrinology, MRCP from the UK, and FACE from the USA. He has published over 95 papers in international journals and serves on the editorial board of several journals.
Prescribing pattern in Asthma Patient in Nepal and IndiaNeeraj Ojha
1) The document compares studies on drug prescribing patterns for asthma patients in Nepal and India. In Nepal, the study found that beta-2 agonists, methylxanthines, and corticosteroids were most commonly prescribed. In India, the most common drugs were beta-2 agonists, methylxanthines, and corticosteroids.
2) Both studies found that combination drug therapy was more common than single drug therapy. The most frequent combination was methylxanthines and corticosteroids.
3) The conclusion is that prescribing practices need to follow asthma guidelines more closely and focus more on controlling asthma in addition to providing symptomatic relief.
Bactericidal and Sporicidal Activities against Pathogenic Bacteria of Direct ...science journals
The purpose of this investigation was to examine the bactericidal activity of long lifetime ozone water (LLO water) against pathogenic bacteria of medical, veterinary, and public health interest.
KATAMANI SHARIRIYAM OF CHRAKA INDRIYA STHANA - AN EXPLORATIVE STUDYPRASAD MAMIDI
This document summarizes the contents of the sixth chapter "Katamani Shaririyam" from the Indriya Sthana section of the ancient Indian medical text Charaka Samhita. The chapter describes various fatal conditions and symptoms that indicate imminent death. These include descriptions of diseases like esophageal carcinoma, Barrett's esophagus, gastroesophageal reflux disease, chronic diarrhea, intestinal tuberculosis, end-stage renal disease, cirrhosis of the liver, lung cancers, and more. The chapter also discusses concepts like comorbidities and multimorbidities. Analyzing the descriptions provides insights into the prognostic significance of various conditions for contemporary clinical practice. However, more research is needed to validate the clinical findings
This service provides free independent abstracts of medical publications. The abstracts are reviewed by the IPCRG research team to ensure relevance and accuracy. The abstracts summarize the main ideas but do not constitute treatment recommendations. Feedback on the abstracts is welcome.
Formic acid poisoning is widely used in the rubber industry in the state of Kerala. It has become a mode of suicide because of its easy availability. Our objective is to report immediate manifestations and management principles in the treatment of formic acid poisoning. Three cases are reported which presented to our Emergency Department. Out of the three patients, only one survived. Metabolic acidosis was the most common acid base abnormality observed in all the three cases. Formic acid poisoning carries a high risk of mortality and morbidity. Early correction of electrolyte imbalances holds the key to survival and preventing early complications such as cardiac arrest. Restriction should be put on the sale and the public should be made aware of its toxic manifestations and complications.
Moderate intensity exercise improves immune function and may reduce the risk and severity of infections. Intense, prolonged exercise can cause immunosuppression by increasing stress hormones and inflammation. Each bout of moderate cardiorespiratory exercise acutely mobilizes immune cells and enhances immune surveillance, while regular exercise provides longer-term benefits through anti-inflammatory effects and optimization of immune cell composition. Endurance exercise specifically promotes antioxidant defenses in muscles and tissues. Moderate exercise is an effective way to maintain immune balance, but high training workloads may lead to immune dysfunction.
exercise as determinant prevention of high blood pressure in container crane ...INFOGAIN PUBLICATION
Metabolic syndrome (Mets) is a multiple risk factor for coronary heart disease, diabetes, and several organ malfunctions that comes up from insulin resistance and metabolic dysfunctions caused of abnormal adipose deposition. One of the component criteria of metabolic syndrome is elevated blood pressure. Unhealthy lifestyle and sedentary physical activity are considered to have relationship with metabolic syndrome incidents in workers. This study aimed to analyze smoking habit, regular exercise and family’s medical history associated with blood pressure using International Diabetic Federation Criteria for Mets in a container crane operator’s population. The study was explored in a cross sectional study of 40 container crane operator. Using logistic regression for analyzing, the study found that regular exercise had significant association with blood pressure in worker adjusted with age.
This study characterized 181 patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD). The most common types of ILD were usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). The GAP model predicted mortality risk well and had good calibration, while the ILD-GAP model had poor calibration. Both models discriminated well between high and low risk patients. The study found RA-ILD is associated with decreased survival and remains a clinical challenge.
Autologous Bone Marrow Mononuclear Cell Therapy for Autism: An Open Label Pro...DrAlokSharma
Autism spectrum disorders (ASD) are a group of heterogeneous neurodevelopmental disorders characterized by
deficits in verbal and nonverbal communication, social
interaction, and presence of stereotypical repetitive behavior.
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 mellitus (DM) is a chronic metabolic and vascular disorder affecting various organs and systems. Many studies have shown impairment of pulmonary functions in diabetics subjects, whereas some studies did not show any changes in pulmonary functions. Therefore, objective of the present study is to find out alterations in the pulmonary functions. Methods Design, Setting, and Participants: This cross-sectional study was conducted in a tertiary care hospital among patients attending medicine department. The sample size was 200. A total of 100 known cases of DM without any acute or chronic lung disease and 100 healthy controls were included in the age group of 40–50 years. History of smoking was excluded in both groups. The diabetic subjects had at least 1 year of duration of disease. Intervention: Pulmonary function test (spirometry) was performed with NND TrueFlow Easy One™ diagnostic spirometer. Main Outcome Measures: The forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were the primary outcome measures to assess the pulmonary functions. Results: In Phase 1 analysis, diabetic subjects did not show any changes in both FVC and FEV1 when compared with controls. In Pearson correlation test, a significant negative correlation between duration of disease and pulmonary functions, FVC at the level of 0.05 and FEV1 at the level of 0.01 were observed. However, in Phase 2 analysis, a significant reduction in FVC and FEV1 was observed in diabetic subjects with duration of diabetes more than 5 years. Conclusion: The decline in FVC and FEV1 in diabetic subjects is more likely to be the effect of DM. The decline is more pronounced with the duration of the disease.
Background- The chronic obstructive pulmonary disease is a chronic inflammatory disease and a leading cause of morbidity and mortality worldwide. Smoking is the major risk factor in COPD. Smoking damages the air sacs, airway and the lining of the lungs and due to this lung have trouble moving enough air in and out making hard to breathe. Smoking may act as a trigger factor for many people who have COPD and can either cause an exacerbation or flare-up of symptoms. The present study aims to determine the association of smoking status with different stages of COPD and clinical symptoms in a North Indian population. Methods- The present study was conducted on 160 stable COPD patients in the department of Respiratory Medicine, King George Medical University, Lucknow. Results- Out of 160 patients enrolled there were 41.8% smokers, 24.3% non-smokers, and 33.7% ex-smokers. The present study found a significant association (p<0.02) of smoking status with different stages of COPD, although non-significant association (p=0.96) was observed between smoking status and clinical symptoms. Conclusion- The significant association of smoking status was observed with different stages of COPD while the non-significant association was observed with clinical symptoms in the present study in north Indian population. Smoking cessation will be helpful in reducing the progression and management of this disease in smokers. Key-words- Chronic Obstructive pulmonary disease, Smoking, Clinical symptoms, Gold stage
Impact of pulmonary rehabilitation program on health outcomes of patients wit...Alexander Decker
The study assessed the impact of a two-month home-based pulmonary rehabilitation program on health outcomes of patients with chronic obstructive pulmonary disease (COPD). 27 COPD patients received the rehabilitation program in addition to usual hospital care. The program consisted of education sessions and home exercises. Health outcomes were measured before and after the program using questionnaires, pulmonary function tests, and exercise tests. The results showed that the rehabilitation program significantly improved quality of life, functional capacity, and dyspnea for patients with moderate and severe COPD, but had less impact on patients with very severe COPD. The study concluded that pulmonary rehabilitation can effectively manage COPD symptoms and health outcomes.
This study assessed the impact of pharmacist counseling on treatment outcomes, knowledge, attitudes, and quality of life in patients with diabetes and hypertension. Patients receiving counseling showed greater improvements in blood pressure, blood sugar levels, knowledge, and physical quality of life scores compared to the control group. However, counseling had no significant effect on mental quality of life scores. The study demonstrates that pharmacist counseling can positively impact treatment outcomes and aspects of quality of life for patients managing diabetes and hypertension.
Impact of a designed nursing intervention protocol on myocardial infarction p...Alexander Decker
This study examined the impact of a designed nursing intervention protocol on myocardial infarction patients' outcomes at a university hospital in Egypt. Forty adult myocardial infarction patients were included. The study found that after exposure to the nursing intervention protocol, patients had significantly higher total mean knowledge scores and total mean practice scores. It also found that patients had medium to high levels of compliance to lifelong instructions. The results support the hypotheses that the nursing intervention protocol improved patients' knowledge, practices, and compliance. The study concluded that a nursing intervention protocol can have a positive impact on myocardial infarction patient outcomes.
Cardiopulmonary Conditions Instructions(Must be included in pape.docxannandleola
Cardiopulmonary Conditions Instructions
(Must be included in paper and discussed in presentation)
1. What population is this condition typically found in?
2. How does the condition typically occur? What is the etiology?
3. What anatomical structures are involved?
4. What medical interventions are required?
5. What precautions or contraindications must the PTA be aware of during the patient’s medical treatment and/or during recovery?
6. What is the typical time frame for patient full recovery OR how long following medical intervention until the patient is considered able to return to full functional abilities (or return to PLOF).
7. What types of PT interventions are typically used to treat the condition during the:
a. acute phase
b. functional phase
8. Are there any recommended interventions that do not fall under the PTA’s scope of work?
9. Create an example daily treatment plan for the patient 3 weeks following injury/medical intervention based on information found during your research.
Running head: AN EXPLORE OF SARCOIDOSIS: MANAGING SARCOIDOSIS CONDITION
AN EXPLORE ON SARCOIDOSIS 2
AN EXPLORE ON SARCOIDOSIS
Student’s Name
Institutional Affiliation
An Explore on Sarcoidosis
Medical experts have discovered that sarcoidosis is a sequential ailment whose cause remains a mystery yet it presents varied and numerous forms of conditions, consequences, severity, and needs for medical attention especially treatments (Liu et al., 2014). Bearing in mind that sarcoidosis ailment associated with the development of tiny chains of inflammatory cells mainly in the lungs and lymph nodes as well as eyes and skin, the presentation of this condition could be typical or in many cases, they remain non-specific hence could mislead the diagnostic outcomes. The most significant case which could present this condition is the one with the forefront of pulmonary manifestations (Alicia, 2014). Consequently, the diagnosis depends on three common criteria which are not clinically common.
The Rates of Morbidity courtesy of Sarcoidosis
Scientific researches affiliated to the Sarcoidosis deaths in the States: 1999 to 2016 courtesy of the journal Respiratory Medicine explored that, America loses about 16,665 people through sarcoidosis. The data also revealed that the mortality rates had increased from 2.1 to 3 per 1 million persons in 1999 to 2016 respectively (Blankstein et al., 2014). These rates seemed to have increased from 2.1 to 3.1 from 1999 to 2002 and remained stable in the progressing years. The data also shows that patients within the age brackets of 35 years and above died courtesy of sarcoidosis with those between 65 to 75 years recording the highest rates of 8.5 deaths per 1 million while those between 75 to 84 years reporting nine deaths per 1 million (Liu et al., 2014). Either the rate of deaths among women patients increased by 32% (2.5 to 3.3 per 1 million patients while men morbidity increased by 73.3% (from 1.5 to 2.6 deat.
This double-blind, placebo-controlled trial explored the safety and potential efficacy of hyperimmune caprine serum (AIMSPRO) in 20 patients with established diffuse cutaneous systemic sclerosis (SSc) over 26 weeks. The trial found no safety concerns with AIMSPRO. Patients receiving AIMSPRO showed a mean decrease in modified Rodnan Skin Score compared to an increase in the placebo group. Levels of PIIINP, a biomarker of fibrosis, increased less in the AIMSPRO group. The results support the safety of AIMSPRO and suggest it may provide clinical benefit for skin disease in SSc.
Evaluate of the Physical Performance of Patients Undergoing HemodialysisAhmed Alkhaqani
This study aimed to measure the physical performance of 62 patients undergoing hemodialysis using the Short Physical Performance Battery (SPPB) scale. The study found that the patients' physical performance was below predicted levels at baseline and deteriorated further over three assessments spaced four weeks apart. The results indicated poor physical performance in patients with chronic kidney disease undergoing hemodialysis. This was related to low physical activity levels in this patient population rather than demographic or clinical factors.
Low-Dose Naltrexone in Diseases’ Treatment: Global Reviewresearchinventy
Naltrexone is a non-selective opioid antagonist, which shows effects on delta, mu and kappa receptors. Its therapeutic use is designed for drug addicts’ treatment, reducing withdrawal side effects. However, several researchers have used low-dose Naltrexone (LDN) for therapeutic purposes in diseases associated to immune system deficiency and inflammatory and tumor processes. Consequently, enhance evidences that LDN use hypothesis promotes, through a compensation mechanism, an increase of endorphins and enkephalins, in addition to opioid receptors up-regulation mechanism, in Central Nervous System (CNS), becoming it a potentially effective clinical practice in these pathologies. Thus, we present a review about LDN use in different pathologies, all they published in literature, and its therapeutic effects, enabling us to conclude that 3.0-4.5mg/day dose use in humans is effective for idiopathic diseases with alterations in immune system, as well as those ones with inflammatory and tumor characteristics.
This document discusses diagnosis and treatment options for coronavirus. It begins by describing the properties and transmission of coronavirus. Diagnosis is primarily done through respiratory or blood samples that test positive for coronavirus nucleic acids on RT-PCR. Treatment involves supportive care, antiviral drugs like interferon-α, and management of symptoms. Severe cases may require oxygen therapy, ventilation, or treatment for organ dysfunction. While no specific treatment for 2019-nCoV exists, several antiviral drugs are being trialled.
Is Lignocaine Preconditioning Effective to Treat Severe Pulmonary Vasoconstri...semualkaira
Protamine is a low molecular weight protein fraction (5.5-13.0 kDa) that is rich in basic arginine (67%) and lysine amino acids. They are basic polypeptides that neutralize the strongly negatively charged heparin. This study was aimed to explore the effect of lignocaine preconditioning on protamine-induced pulmonary vasoconstriction, which is used to reverse the effect of heparin during cardiac surgery. This was a prospective, single-center, double- blind and randomized study performed among eighty pediatric patients of either sex in the age group between 1 to 12 years with a cyanotic congenital heart disease, scheduled for elective on-pump cardiac surgery under general Anaesthesia.
Anti diabetic drugs in patients with diabetespharmaindexing
This study evaluated 93 diabetic patients with comorbidities to assess rational use of antidiabetic medications. The most common comorbidity was hypertension (48% of patients). Insulin was the most prescribed antidiabetic drug (64.4% of patients). Patient information materials on diabetes management were provided. The study aims to improve treatment of diabetes and comorbidities through rational prescribing and patient education.
The document discusses multiple organ dysfunction syndrome (MODS), also known as multiple organ failure. It begins by defining MODS and listing the learning objectives of the seminar. Key points that are summarized include: MODS results from systemic inflammatory response syndrome and the failure of multiple organ systems; common causes include sepsis, trauma, and burns; and management focuses on preventing infection, maintaining tissue oxygenation, nutritional support, and supporting individual failing organs. The mortality rate for MODS is high, especially when more than four organs are affected.
Abstract—Diabetes is a disease which is on continuous increase specialy in country like India. It involve is a multisystem so intend to affect quality of life of patients. So this study was conducted on 250 Diabetes Mellitus patients to observe their quality of life on various domains viz Physical, Mental, Social and environmental through WHOQOL-Bref questionnaire. It was found that 54.4% were unable to level their quality of life, they say neither good nor bad. But 23.2% were feeling bad and 22.4 % were feeling good about their quality of life. Whereas regarding patient's satisfaction about their health 39.2% were unable to level their quality of life and 35.6% were dissatisfied and 25.2 % were satisfied with their health. Significantly more cases were unable to understand about their quality of life than their satisfaction to their health. It was also found that Physical quality of life was affected most followed by environmental, psychological and social dimension of quality of life.
The Indian Consensus Document on Cardiac BiomarkerApollo Hospitals
Despite recent advances, the diagnosis and management of heart failure evades the clinicians. The etiology of congestive heart failure (CHF) in the Indian scenario comprises of coronary artery disease, diabetes mellitus and hypertension. With better insights into the pathophysiology of CHF, biomarkers have evolved rapidly and received diagnostic and prognostic value. In CHF biomarkers prove as measures of the extent of pathophysiological derangement; examples include biomarkers of myocyte necrosis, myocardial remodeling,
neurohormonal activation, etc.
Assessing the laryngeal cough reflex and the risk of developing pneumonia aft...Lila Abreu
This document summarizes a study comparing outcomes of stroke patients who received testing of the laryngeal cough reflex (RCT) versus those who did not. The study found:
1) Of 400 patients who received the RCT, 5 developed pneumonia, whereas of 204 patients who did not receive RCT, 27 developed pneumonia.
2) Patients who did not receive RCT had significantly lower odds of not developing pneumonia compared to those who received RCT.
3) Receiving RCT allowed for stratification of pneumonia risk and improved outcomes through decreased morbidity, mortality, and costs.
Format 2016: how to get asthma control: from PubMed to the tricks of the trade.Envicon Medical Srl
This document discusses strategies for achieving asthma control. It begins by establishing the importance of a partnership between healthcare providers and patients. Effective self-regulation is key, which involves patients observing their condition, making judgments, and reacting appropriately. Motivational interviewing can help patients progress through stages of change. Active listening from providers helps address patients' cognitive and emotional needs. Both verbal and nonverbal communication impact the relationship and treatment outcomes. Involving children in their care can improve satisfaction and adherence.
Association of Hypertension and Pulmonary Functions-Association between cardiac dysfunction and abnormal pulmonary function has remained controversial since long. The objective of this study is to find out the association of hypertension and its severity on pulmonary functions. Study was conducted on 30 hypertensive (study group) and 30 non hypertensive (control group) subjects identified from Medical OPD of SMS Hospital, Jaipur. Pulmonary functions were assessed of both hypertensive (study group) and non hypertensive (control group) subjects by Medspiror). Among pulmonary function tests, difference in means of FVC, FEV1 PEFR, FEF25-75%, MVV and FVC/ FEV1 were found less with significant difference in cases group with predominantly restrictive type of effects are observed. Female’s shows lower values than male hypertensive subjects. Furthermore, FVC, FEV1, PEFR, FEF25-75%, MVV, FVC/ FEV1 were not found to be associated with severity of illness. An inverse relation is found between hypertension and pulmonary functions predominantly restrictive type of pattern. While non significant effects are observed with severity of illness.
This study assessed bronchiectasis mortality and risk factors in Port Sudan, eastern Sudan from 2014-2019. 152 patients with bronchiectasis were included. Tuberculosis was the most common cause (76.3%). Mortality was 5.3% and 5-year survival was 94.7%. Risk factors for mortality included infectious exacerbations (87%), pleuroparenchymalfibroelastosis (37.5%), cystic fibrosis (25%), bronchopleural fistula (25%), and pneumothorax (12.5%). Respiratory failure due to pulmonary fibrosis and inflammation/lung destruction or recurrent exacerbations and pulmonary sepsis were the main causes of death. Mortality of bronchiect
1) Pneumonia is a common infection seen in nephrology practice, especially in patients with nephrotic syndrome, chronic kidney disease, end-stage renal disease on dialysis, and renal transplant recipients.
2) Patients with nephrotic syndrome have increased risk of infections like pneumonia due to urinary losses of immunoglobulins and properdin factor B. One study found 36.6% of children with nephrotic syndrome developed major infections, with nearly 1/3 having pneumonia.
3) As chronic kidney disease progresses and reaches end-stage renal disease, risk of infections including pneumonia increases. Cardiovascular disease and infections are the main causes of death in end-stage
Similar to Role of duration of diabetes on ventilatory capacities and expiratory flow rates in type (20)
Abnormalities of hormones and inflammatory cytokines in women affected with p...Alexander Decker
Women with polycystic ovary syndrome (PCOS) have elevated levels of hormones like luteinizing hormone and testosterone, as well as higher levels of insulin and insulin resistance compared to healthy women. They also have increased levels of inflammatory markers like C-reactive protein, interleukin-6, and leptin. This study found these abnormalities in the hormones and inflammatory cytokines of women with PCOS ages 23-40, indicating that hormone imbalances associated with insulin resistance and elevated inflammatory markers may worsen infertility in women with PCOS.
A usability evaluation framework for b2 c e commerce websitesAlexander Decker
This document presents a framework for evaluating the usability of B2C e-commerce websites. It involves user testing methods like usability testing and interviews to identify usability problems in areas like navigation, design, purchasing processes, and customer service. The framework specifies goals for the evaluation, determines which website aspects to evaluate, and identifies target users. It then describes collecting data through user testing and analyzing the results to identify usability problems and suggest improvements.
A universal model for managing the marketing executives in nigerian banksAlexander Decker
This document discusses a study that aimed to synthesize motivation theories into a universal model for managing marketing executives in Nigerian banks. The study was guided by Maslow and McGregor's theories. A sample of 303 marketing executives was used. The results showed that managers will be most effective at motivating marketing executives if they consider individual needs and create challenging but attainable goals. The emerged model suggests managers should provide job satisfaction by tailoring assignments to abilities and monitoring performance with feedback. This addresses confusion faced by Nigerian bank managers in determining effective motivation strategies.
A unique common fixed point theorems in generalized dAlexander Decker
This document presents definitions and properties related to generalized D*-metric spaces and establishes some common fixed point theorems for contractive type mappings in these spaces. It begins by introducing D*-metric spaces and generalized D*-metric spaces, defines concepts like convergence and Cauchy sequences. It presents lemmas showing the uniqueness of limits in these spaces and the equivalence of different definitions of convergence. The goal of the paper is then stated as obtaining a unique common fixed point theorem for generalized D*-metric spaces.
A trends of salmonella and antibiotic resistanceAlexander Decker
This document provides a review of trends in Salmonella and antibiotic resistance. It begins with an introduction to Salmonella as a facultative anaerobe that causes nontyphoidal salmonellosis. The emergence of antimicrobial-resistant Salmonella is then discussed. The document proceeds to cover the historical perspective and classification of Salmonella, definitions of antimicrobials and antibiotic resistance, and mechanisms of antibiotic resistance in Salmonella including modification or destruction of antimicrobial agents, efflux pumps, modification of antibiotic targets, and decreased membrane permeability. Specific resistance mechanisms are discussed for several classes of antimicrobials.
A transformational generative approach towards understanding al-istifhamAlexander Decker
This document discusses a transformational-generative approach to understanding Al-Istifham, which refers to interrogative sentences in Arabic. It begins with an introduction to the origin and development of Arabic grammar. The paper then explains the theoretical framework of transformational-generative grammar that is used. Basic linguistic concepts and terms related to Arabic grammar are defined. The document analyzes how interrogative sentences in Arabic can be derived and transformed via tools from transformational-generative grammar, categorizing Al-Istifham into linguistic and literary questions.
A time series analysis of the determinants of savings in namibiaAlexander Decker
This document summarizes a study on the determinants of savings in Namibia from 1991 to 2012. It reviews previous literature on savings determinants in developing countries. The study uses time series analysis including unit root tests, cointegration, and error correction models to analyze the relationship between savings and variables like income, inflation, population growth, deposit rates, and financial deepening in Namibia. The results found inflation and income have a positive impact on savings, while population growth negatively impacts savings. Deposit rates and financial deepening were found to have no significant impact. The study reinforces previous work and emphasizes the importance of improving income levels to achieve higher savings rates in Namibia.
A therapy for physical and mental fitness of school childrenAlexander Decker
This document summarizes a study on the importance of exercise in maintaining physical and mental fitness for school children. It discusses how physical and mental fitness are developed through participation in regular physical exercises and cannot be achieved solely through classroom learning. The document outlines different types and components of fitness and argues that developing fitness should be a key objective of education systems. It recommends that schools ensure pupils engage in graded physical activities and exercises to support their overall development.
A theory of efficiency for managing the marketing executives in nigerian banksAlexander Decker
This document summarizes a study examining efficiency in managing marketing executives in Nigerian banks. The study was examined through the lenses of Kaizen theory (continuous improvement) and efficiency theory. A survey of 303 marketing executives from Nigerian banks found that management plays a key role in identifying and implementing efficiency improvements. The document recommends adopting a "3H grand strategy" to improve the heads, hearts, and hands of management and marketing executives by enhancing their knowledge, attitudes, and tools.
This document discusses evaluating the link budget for effective 900MHz GSM communication. It describes the basic parameters needed for a high-level link budget calculation, including transmitter power, antenna gains, path loss, and propagation models. Common propagation models for 900MHz that are described include Okumura model for urban areas and Hata model for urban, suburban, and open areas. Rain attenuation is also incorporated using the updated ITU model to improve communication during rainfall.
A synthetic review of contraceptive supplies in punjabAlexander Decker
This document discusses contraceptive use in Punjab, Pakistan. It begins by providing background on the benefits of family planning and contraceptive use for maternal and child health. It then analyzes contraceptive commodity data from Punjab, finding that use is still low despite efforts to improve access. The document concludes by emphasizing the need for strategies to bridge gaps and meet the unmet need for effective and affordable contraceptive methods and supplies in Punjab in order to improve health outcomes.
A synthesis of taylor’s and fayol’s management approaches for managing market...Alexander Decker
1) The document discusses synthesizing Taylor's scientific management approach and Fayol's process management approach to identify an effective way to manage marketing executives in Nigerian banks.
2) It reviews Taylor's emphasis on efficiency and breaking tasks into small parts, and Fayol's focus on developing general management principles.
3) The study administered a survey to 303 marketing executives in Nigerian banks to test if combining elements of Taylor and Fayol's approaches would help manage their performance through clear roles, accountability, and motivation. Statistical analysis supported combining the two approaches.
A survey paper on sequence pattern mining with incrementalAlexander Decker
This document summarizes four algorithms for sequential pattern mining: GSP, ISM, FreeSpan, and PrefixSpan. GSP is an Apriori-based algorithm that incorporates time constraints. ISM extends SPADE to incrementally update patterns after database changes. FreeSpan uses frequent items to recursively project databases and grow subsequences. PrefixSpan also uses projection but claims to not require candidate generation. It recursively projects databases based on short prefix patterns. The document concludes by stating the goal was to find an efficient scheme for extracting sequential patterns from transactional datasets.
A survey on live virtual machine migrations and its techniquesAlexander Decker
This document summarizes several techniques for live virtual machine migration in cloud computing. It discusses works that have proposed affinity-aware migration models to improve resource utilization, energy efficient migration approaches using storage migration and live VM migration, and a dynamic consolidation technique using migration control to avoid unnecessary migrations. The document also summarizes works that have designed methods to minimize migration downtime and network traffic, proposed a resource reservation framework for efficient migration of multiple VMs, and addressed real-time issues in live migration. Finally, it provides a table summarizing the techniques, tools used, and potential future work or gaps identified for each discussed work.
A survey on data mining and analysis in hadoop and mongo dbAlexander Decker
This document discusses data mining of big data using Hadoop and MongoDB. It provides an overview of Hadoop and MongoDB and their uses in big data analysis. Specifically, it proposes using Hadoop for distributed processing and MongoDB for data storage and input. The document reviews several related works that discuss big data analysis using these tools, as well as their capabilities for scalable data storage and mining. It aims to improve computational time and fault tolerance for big data analysis by mining data stored in Hadoop using MongoDB and MapReduce.
1. The document discusses several challenges for integrating media with cloud computing including media content convergence, scalability and expandability, finding appropriate applications, and reliability.
2. Media content convergence challenges include dealing with the heterogeneity of media types, services, networks, devices, and quality of service requirements as well as integrating technologies used by media providers and consumers.
3. Scalability and expandability challenges involve adapting to the increasing volume of media content and being able to support new media formats and outlets over time.
This document surveys trust architectures that leverage provenance in wireless sensor networks. It begins with background on provenance, which refers to the documented history or derivation of data. Provenance can be used to assess trust by providing metadata about how data was processed. The document then discusses challenges for using provenance to establish trust in wireless sensor networks, which have constraints on energy and computation. Finally, it provides background on trust, which is the subjective probability that a node will behave dependably. Trust architectures need to be lightweight to account for the constraints of wireless sensor networks.
This document discusses private equity investments in Kenya. It provides background on private equity and discusses trends in various regions. The objectives of the study discussed are to establish the extent of private equity adoption in Kenya, identify common forms of private equity utilized, and determine typical exit strategies. Private equity can involve venture capital, leveraged buyouts, or mezzanine financing. Exits allow recycling of capital into new opportunities. The document provides context on private equity globally and in developing markets like Africa to frame the goals of the study.
This document discusses a study that analyzes the financial health of the Indian logistics industry from 2005-2012 using Altman's Z-score model. The study finds that the average Z-score for selected logistics firms was in the healthy to very healthy range during the study period. The average Z-score increased from 2006 to 2010 when the Indian economy was hit by the global recession, indicating the overall performance of the Indian logistics industry was good. The document reviews previous literature on measuring financial performance and distress using ratios and Z-scores, and outlines the objectives and methodology used in the current study.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central19various
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Role of duration of diabetes on ventilatory capacities and expiratory flow rates in type
1. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol 2, No.6, 2012
Role of Duration of Diabetes on Ventilatory Capacities and Expiratory Flow Rates in Type
2 Diabetes Mellitus
Shravya Keerthi G1*, , Hari Krishna Bandi2, Suresh M3, Preetham J K4, Mallikarjuna Reddy N1 , Sharan B Singh M1
1. Dept. of Physiology, Narayana Medical College (NMC), Nellore, Andhra Pradesh, India. E Mail:
gsk.respublications@gmail.com
2. Dept. of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER),
Puducherry, India.
3. Dept. of Physiology, Meenakshi Medical College and Research Institute (MMCH&RI), Kanchipuram,
Tamilnadu, India.
4. Dept. of Physiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Abstract
Diabetes mellitus is a chronic debilitating problem with increasing incidence and long term complications such as
diabetic nephropathy, diabetic neuropathy, diabetic retinopathy etc. These complications are mainly a consequence
of macro vascular and micro vascular damages of the target organs. The magnitude of the complications of diabetes
is related to its duration. Less has been known about the after effects of diabetes on lungs. So this work was carried
out to know the relation between duration of diabetes and lung volumes and capacities in Type 2 DM patients. The
presence of an extensive micro vascular circulation and abundant connective tissue in the lungs raises the possibility
that lung tissue may be affected by Microangiopathy process and non-enzymatic glycosylation of tissue proteins,
induced by chronic hyperglycemia, there by rendering the lung a “target organ” in diabetic patients. This is a cross-
sectional study, the test group were Type 2 Diabetes Mellitus patients (n=50) with duration of 2-35 years, the control
group were staff of Narayana medical college (n=50). Written consent was obtained from them. The following lung
function parameters were recorded: Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second
(FEV1), Forced Expiratory Volume percent (FEV1/FVC %), Peak Expiratory Flow Rate (PEFR), Forced Expiratory
Flow 25-75% (FEF25-75%), Maximum Voluntary Ventilation (MVV). The mean FVC, FEV1, PEFR, FEF25-75%,
MVV values are low in diabetics compared to controls (p value <0.001) and the parameters showed significant
negative correlation with duration of diabetes.
Key words: Chronic hyperglycemia, Diabetes mellitus, Microangiopathy, Micro vascular circulation, Pulmonary
function tests
1. Introduction
Diabetes mellitus (DM) is a complex medical syndrome comprising of heterogenous group of diseases resulting from
diverse aetiologies predominantly of genetic and environmental origin. It is characterized by chronic hyperglycemia
with disturbances of carbohydrate, protein and fat metabolism, resulting from defects in insulin secretion or insulin
action or both[1]. According to WHO, the total number of people worldwide with diabetes is projected to rise from
150 million in 2000 to 435 million in 2030 [2, 3]. India is called Diabetic Capital of World as there are going to be
80% of all diabetics from the entire world population, concentrated here [2,3]. Greater longevity, obesity,
unsatisfactory diet, sedentary lifestyle and increasing urbanisation are main factors contributing for this. Type 2 or
NIDDM, is characterized by insulin resistance and impaired insulin receptors. It is common type of diabetes and
usually develops after the age of 40 years. It is associated with normal B cell morphology [4] . Type 2 diabetes
comprises 90% of people with diabetes all around the world, and is largely the result of excess body weight and
physical inactivity [2, 3]. There is one person in the world dying of diabetes every ten seconds and new diabetic
cases being identified every ten seconds [3].
DM is accompanied by widespread biochemical, morphological and functional abnormalities which may precipitate
certain complications that may affect neural, Cardiovascular, renal systems and also organs and tissues like skin,
liver, collagen and elastic fibers. Thus diabetes is a multisystem disorders that affect many organs of the body [5] .
These complications are mainly a consequence of macro vascular and micro vascular damages of the target organs
[1] . The micro vascular complications appear early within 5to10 years and macro vascular complications appear
within 15 to 20 years from the onset of diabetes. Like other target organs lung is also affected in diabetes[1,5]. The
presence of an extensive micro vascular circulation and abundant connective tissue in the lungs , raises the
possibility that lung tissue may be affected by Microangiopathy process and non-enzymatic glycosylation of tissue
77
2. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol 2, No.6, 2012
proteins, induced by chronic hyperglycemia, there by rendering the lung a “target organ” in diabetic patients.
Hyperglycemia causes thickening of basal lamina in pulmonary capillaries leading to decreased diffusion capacity.
The alteration in scleroproteins in turn affect mechanical properties of lungs. In this chronic disease, the
susceptibility and severity of systemic inflammation increases which may cause peripheral airway obstruction[1].
Since normal lung mechanics and gas exchange are influenced by the integrity of the pulmonary connective tissue
and microvasulature, abnormalities in either of these two structural components of the lung may lead due to the
development of measurable abnormalities of pulmonary function [6].
The duration of DM is an important factor affecting the lungs. Chronic hyperglycemia is strongly associated with
progressive neurogenic damage. In 2000, Davis et al. observed that some pulmonary functions were decreased in
type 2 diabetes and the reduction was directly proportionate to the duration of the disease [1,7]. In 2007, Meo et al.
also observed that some spirometric lung function parameters were decreased in type 2 diabetics and the decline
was more in patients with longer duration of diabetes [1]. In a Japanese study, the incidence of pulmonary pathology
was found to be 50% on autopsy. It has been suggested that pulmonary dysfunction may be one of the earliest
measurable non-metabolic alteration in diabetes. If diabetes is detected early and adequate steps are taken, it may be
possible to significantly delay the occurrence of complications and there after their progression. Although a lot of
research work is being carried out worldwide on the after effects of Diabetes on pulmonary function parameters, the
literature pertaining to this is not in abundance in India. Therefore, this study was undertaken to find out the
correlation between duration of type 2 diabetes and pulmonary function parameters.
2. Materials and Methods
This was a cross-sectional study undertaken by the Department of Physiology, Narayana medical college (NMC),
Nellore, Andhra Pradesh, India. After obtaining approval of Institutional Ethics Committee (IEC), the test group
subjects (n=50) type 2 diabetic patients were recruited from Out Patient Departments (OPD) and central laboratory
of NMC and hospital. The control group subjects (n=50) were teaching and non-teaching staff of NMC. The subjects
in the age group between 30-60 years are included. Subjects with past history of (H/O) smoking, hypertension,
respiratory diseases, chest wall injuries, congestive cardiac failure, kyphoscoliosis, and age <30 and >60 years were
excluded from the study. The subjects were properly explained about the objectives, methodology, expected outcome
and implications of the study and written informed consents were obtained from them. They were instructed to report
to Respiratory Physiology Research laboratory of Physiology department at about 9 A.M.
Following 5 minutes sitting rest in the lab, their pulmonary functions were assessed by computerized spirometer
(Spiro win Version 2.0 of Genesis Medical systems pvt Ltd) which gives ERS-93 predicted values at BTPS
conditions [8]. At the beginning, satisfactory demonstrations were given regarding the equipment and the procedure
of the study. During the procedure, the subjects inhaled deeply and then exhaled with maximum effort as much as
possible in to the mouth piece. The following parameters were recorded: Forced vital capacity(FVC), Forced
expiratory volume in the first second(FEV1), Forced expiratory volume percent(FEV1/FVC%), Peak expiratory flow
rate(PEFR), Forced expiratory flow 25-75%(FEF25-75%) and Maximum voluntary ventilation(MVV).
3. Results
The data were expressed as mean ± SD. The data was analysed by Students ‘t’ test. The p values less than 0.05 was
considered significant. In diabetic subjects, there was significant decrease in FVC (p<0.001), FEV1 (p<0.001),
FEV1/FVC% (p<0.01), PEFR (p<0.001), FEF25-75% (p<0.001) and MVV (p<0.001) compared to non-diabetic
subjects. Relationship of FVC, FEV1, FEV1/FVC%, PEFR, FEF25-75%, and MVV with duration of diabetes were
observed. The results showed negative correlation with duration of diabetes and were statistically significant (fig.1-
6)
4. Discussion
Diabetes mellitus, an incurable lifelong disease, involves multiple systems with wide-ranging and devastating
complications, which end up in severe disability and death. Despite effective interventions directed at the
complications of diabetes mellitus, including coronary artery disease, diabetic nephropathy, retinopathy, and
neuropathy, the pulmonary complications of diabetes mellitus have been poorly characterized[9,10]. Furthermore,
there have been very little data reported on whether there is an association between years of disease and pulmonary
function, and there are very few reports of pulmonary function in patients with diabetes. A study conducted by
David. A Kaminsky in 2004 speculates that abnormal lung function may precede the diagnosis of diabetes,
78
3. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol 2, No.6, 2012
suggesting that lung may contribute to or at least be commonly affected by factors involved in the pathogenesis of
diabetes [5].
4.1. Effect of duration of DM on FEV
There was significant reduction in mean FVC in all diabetic patients and the reduction was more pronounced with
increased duration of diabetes. Recent studies conducted by Lange et al. and Asanuma et al indicate that both IDDM
and NIDDM patients are associated with slight reduction in FVC and it was because of impaired defense against
environmental challenges such as smoking and airway infections in diabetes [11,12]. There was increased cross-
linkage formation between polypeptides of collagen in pulmonary connective tissue, which decreases FVC and hence
is responsible for restrictive respiratory defects. In a study by Davis A.Wendy et.al., there was a decrease in mean
FVC values as the duration of DM increased. In their study the annual rate of fall in FVC was 68 ml [5,7]. In a study
by Robert E. Walter et.al., there was a progressive decrease in mean FVC values by 109 ml/year [5]. A study by
Timothy M.E Davis, showed there was an average decrease of 9.5% in mean FVC values in diabetics [13].
4.2. Effect of duration of DM on FEV1
FEV1 is the volume of air that is exhaled in the first second during FVC manoeuvre. It is useful to detect generalized
airway obstruction. The Mean FEV1 values showed significant negative correlation with duration of diabetes. The
values of FVC and FEV1 in type 2 diabetic patients of different duration were significantly lower than those of non-
diabetic subjects. These findings were consistent with findings of Meo et al. and Davis et al [7]. In diabetes, there is a
thickening of alveolar epithelium and pulmonary capillary basal lamina leading to pulmonary microangiopathy,
reduced pulmonary elastic recoil due to non-enzymatic glycosylation of connective tissue reducing the FEV 1[9,10].
Patients with diabetes for more than 12 years experienced a significant reduction in FVC, FEV1, and FEF25–75%
relative to controls [9]. A large Danish cross-sectional population study Lange P (1989) showed a negative
association between plasma glucose & both FVC & FEV1 . The negative correlation of FVC & FEV1 with duration
of diabetes indicate that long standing hyperglycemia may intensify the devastating effect of the disease. In a small
scale six years study by Ramiriez LC, et al (1991) demonstrated that intensive treatment by subcutaneous insulin
infusion improved both FVC & FEV1 percentage predicted values[13].
4.3. Effect of duration of Type 2 DM on FEV1 /FVC%
FEV1/FVC% is the volume of air expired in the first second, expressed as percentage of FVC. It is a more sensitive
indicator of airway obstruction, than FVC or FEV1 alone. The alteration in collagen and elastin ratio is the main
factor in the diabetic patients. The decrease in FEV1/FVC% in diabetic subjects may be related with the poor
mechanical properties of the lung, like lung compliance and elastic recoil of lungs. Loss of elastic recoil leads to
dynamic collapse of small airways during expiration. In addition, myopathic or neuropathic changes affecting the
respiratory muscles further impairs the endurance, efficiency of ventilatory pump. A study conducted by Ali Mo et
al. showed similar findings but was not significant [1]. Sreeja et al. reported almost similar type of finding [11].
When FEV1/ FVC% was observed , the actual values were higher than the predicted values by 3.75% and 7.3%
which suggest of restrictive pattern in diabetics. In a study by Robert .E. Walter the ratio was increased by 1.5% in
diabetics which was statistically significant [5]. This parameter was significantly higher in 10-20 years duration of
diabetes than 5-10 years duration and also control group, finding similar to Ali MO et al.[1,10].
4.4. Effect of duration of Type 2 DM on PEFR
PEFR values were observed in all the groups, there was an absolute decrease in the mean values compared to
predicted values which was statistically significant (p<0.001). In a study by Timothy ME Davis, there was a average
decrease in mean value of PEFR by 9.5%[5,13]. As per the study of Sreeja et.al., the decrease in PEFR was
267.65L/sec[11]. The patients with diabetes complicated by autonomic neuropathy have impaired control of
bronchomotor tone. Resting vagal tone is depressed which explains the depressed bronchoconstrictory response to
both cholinergic stimuli and hyperventilation with cold air [12,14]. Thus, there is a complex alteration of both
control of ventilation and bronchomotor tone in diabetic patients with automatic neuropathy[15].
4.5. Effect of duration of diabetes on FEF25–75%
FEF25-75% is the average flow rate during middle 50% of FVC. It indicates patency of the small airways. FEF 25-
75% depends on non-bronchopulmonary factors like, neuromuscular factors and mechanical equipment factors of
inertial distortion of lungs[15]. The thickening of alveolar wall due to the increased amounts of collagen and elastin
79
4. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol 2, No.6, 2012
in basal lamina results in microangiopathy. Chronic hyperglycemia causes fibrous tissue formation in the chest wall
and bronchial tree protein by non-enzymatic glycation. This may cause reduced compliance of lung and chronic
airflow obstruction [14,15,17].There was a significant reduction in FEF 25-75% among diabetics compared to controls,
shows a lower airway caliber and higher airway resistance and this finding was similar to Ashapherwani et al and
Malcom Sandler et al [14]. As per the study of Sreeja et. al., there was decrease in FEF 25-75% by 2.45 ± 0.55[5,11].
So our results coincide with the same.
4.6. Effect of duration of diabetes on MVV
MVV is the maximum breathing capacity which is decreased in poor respiratory muscle strength, emphysema etc.
There was a significant reduction in MVV values in diabetics compared to controls, shows poor skeletal muscle
strength due to increased protein catabolism and diabetic autonomic neuropathy. A study conducted by Park SW et
al. and Meo SA et al. showed similar results. Thus, respiratory muscle endurance decreases in diabetes
mellitus[9,11].
Hyperglycemia causes over production of mitochordrial superoxides and reduction in anti-oxidant defence of the
lungs [17]. The glycation of proteins can lead to oxidative stress by direct release of O2 and H2O2, and activation of
phagocytes through a specialized receptor for advanced glycosylation end products (AGEs). Oxidants include
reactive oxygen species (ROS), reactive nitrogen species (RNS), sulphur centered radicals and others. Phagocytic
cells generate large amounts of NO and ROS. In diabetes there are alterations in antioxidant enzymes, impaired
glutathione metabolism, and decreased ascorbic acid levels. Nitric oxide is produced by nitric oxide synthase (NOS).
Three different forms of NOS expressed in lungs are neuronal (n NOS), endothelial (e NOS), and inducible (i NOS).
Excessive NO produced by i NOS and its potent oxidative derivative peroxynitrate via oxidation, hydroxylation, and
nitration is involved in acute lung injury [16,17]].
The alvelolar capillary network is the largest microvascular organ (Surface area 140 m2) and receives entire
cardiac output[18] . As the pulmonary reserves are larger, the symptoms and disability from diabetes develop earlier
in other organs than in the lungs.
The correlation graphs reflect a relation between the duration of diabetes on FVC, FEV1, FEV1/FVC%, PEF,
FEF25-75% and MVV. The correlation graphs show a negative correlation between duration of diabetes and lung
function parameter values in diabetics. FEV1/FVC% showed a positive correlation with duration of diabetes.
Similar findings were observed by Ali MO et al. and Meo et al.[1,9].
5. Conclusion
The correlation graphs in our study, reflect a relation between the effect of duration of diabetes on lung function
parameters i.e; the reduction is directly proportionate to the duration of the disease. Even though Type2 diabetic
patients did not have any respiratory symptoms, they did have underlying subclinical restrictive patterns of lung
functions. As the duration of diabetes increases the restrictive profile is more prominent. The findings of present
study suggest that, lung is a target organ for damage in diabetes and the glycemic exposure is a strong determinant of
reduced pulmonary function in type 2 diabetics. As measures of airflow limitation predict all-cause mortality in type
2 diabetes, intensive glycemic management may reduce the risk of death through improved ventilatory function
independent of other beneficial effects. The lower lung function, particularly reduced vital capacity, not only
precedes the onset of diabetes but also continues, at an accelerated pace with the onset of the disease. As pulmonary
dysfunction may be one of the earliest and easily measurable non-metabolic alteration in diabetes, the patients with
diabetes are suggested to undergo pulmonary function testing along with other investigations. Additional research is
required to identify pathophysiologic mechanisms and to determine clinical significance of this association. Hence, it
is an alarming signal to clinicians to pay heightened attention to pulmonary function in their patients with type 2
diabetes.
References
1. Ali MO, Begum S, Ali .T and Ferdousi .S, FVC, FEV1, and FEV1/FVC% in type 2 diabetes and their
relationships with duration of the disease, J. Bangladesh Soc Physiol.,4(2), 2009 Dec, 81- 87.
2. WHO Diabetes programme, 2011 Jan, Fact sheet no. 312.
3. Sarah Wild et al., Global prevalence of diabetes, Diabetes Care, 27(5) , 2005 May : 1047 – 1053.
80
5. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol 2, No.6, 2012
4. Wiliam F. Ganong, Endocrine function of pancreas and regulation of carbohydrate metabolisms, Review of
Medical Physiology, 22nd edition, (India: Mc Graw-Hil Company, 2003) Ch 19 : 340 – 354, 649.
5. Kanyakumari DH, Natraj S M et al, Correlation of duration of diabetes and pulmonary function tests in type 2
diabetes mellitus patients, Int J Biol Med Res., 2(4), 2011, 1168-1170.
6. Sandler M, Is the lung a “target organ” in diabetes mellitus? Arch int Med., Vol. 150,1990 July, 1385 – 1388.
7. Davis et al., Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes, The
Fremantle diabetes study, Diabetes Care, 27 (3), 2004 March, 752 - 757.
8. Spirown version 2.0., The Pulmonary function test system, User Manual, (Hyderabad :Genesis Medical Systems
Pvt. Ltd, 2006).
9. Sultan .A. Meo, Abdul Majeed AL-Drees et al., Lung function in type 2 saudi diabetic patients, Saudi Med J,
27(3), 2006, 338-343.
10. Sultan .A. Meo, Abdul Majeed AL-Drees et al., Effect of duration of disease on ventilatory function in an Ethnic
Saudi group of diabetic patients, J. of Diabetes science and technology. 5(1), 2007, 711-717.
11. Sreeja C.K, Elizabeth Samuel, C. Kesavachandran and Shankar Shashidhar, Pulmonary function in patients
with Diabetes Mellitus, IJPP, 47 (1), 2003 ,87 – 93.
12. P. Lange, J. Parner, P. Schnohr and G. Jensen, Copenhagen city heart study : longitudinal analysis of ventilatory
capacity in diabetic and non-diabetic adults, Eur Rspir J, 20, 2002, 1406 -1412.
13. G. Engstrom and L. Janzon, Risk of developing diabetes is inversely related to lung function : a population –
based cohort study, Diabetic Medicine, 19,2002 , 167 – 170.
14. M. Sandler, A.E. Bunn and R.I. Stewart, Pulmonary function in young insulin-dependent diabetic subjects,
Chest, 90,1986 , 670 – 675.
15. A. Kaparianos, E. Argyropoulou and F. Sampsonas, Pulmonary complications in diabetes mellitus, Chronic
respiratory disease, 5 , 2008 , 101 -108.
16. Engelgau. M.M. & Geiss L.S, The burden of diabetes mellitus, Leahy .T.L, Clark .N.G., Cefalu W.T, Medical
Management of diabetes mellitus (New York: Marcel Dekker ,2000).
17. The diabetes control and complications trial research group, The effect of intensive treatment of diabetes on the
development and progression of long-term complications in insulin-dependent diabetes mellitus, N Eng J Med,
329 ,1993, 977 – 986.
18. Mason, Murray and Nadel’s, Text book of Respiratory Medicine, 4th edition,( Saunders : Elsevier Publications,
2005).
Result fig 1-6.
Effect of duration of diabetes on
3
FVC
2.5
F V C in liters
2
FVC
1.5 (L)
Linear (FVC
1
(L))
0.5
0
0 10 20 30 40
Duration of diabetes in years
Fig.2: Regression analysis for forced expiratory
Fig.1: A significant negative correlation was
volume in 1 second against duration of disease
found, indicating that increased duration of
in diabetic patients. A significant negative
disease decreased the FVC.
correlation was found, indicating that increased
81 duration of disease decreased the FEV1.
6. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol 2, No.6, 2012
Fig.3: A significant negative correlation was Fig.4: There is slight negative correlation
found, indicating that increased duration of between duration of diabetes and PEFR
disease decreased the FEV1/FVC% . values.
Effect of duration of diabetes on
FEF25-75%
6
5 FEF25-
FEF25-75% in
75%(L/S)
liters/sec
4
3
Linear
2 (FEF25-
75%(L/S)
1 )
0
0 10 20 30 40
Duration of diabetes in years
Fig.5:A significant negative correlation was Fig.6: Graph shows a significant negative
found, indicating that increased duration of correlation of MVV values with duration of
disease decreased the FEF25–75%. diabetes.
82
7. This academic article was published by The International Institute for Science,
Technology and Education (IISTE). The IISTE is a pioneer in the Open Access
Publishing service based in the U.S. and Europe. The aim of the institute is
Accelerating Global Knowledge Sharing.
More information about the publisher can be found in the IISTE’s homepage:
http://www.iiste.org
The IISTE is currently hosting more than 30 peer-reviewed academic journals and
collaborating with academic institutions around the world. Prospective authors of
IISTE journals can find the submission instruction on the following page:
http://www.iiste.org/Journals/
The IISTE editorial team promises to the review and publish all the qualified
submissions in a fast manner. All the journals articles are available online to the
readers all over the world without financial, legal, or technical barriers other than
those inseparable from gaining access to the internet itself. Printed version of the
journals is also available upon request of readers and authors.
IISTE Knowledge Sharing Partners
EBSCO, Index Copernicus, Ulrich's Periodicals Directory, JournalTOCS, PKP Open
Archives Harvester, Bielefeld Academic Search Engine, Elektronische
Zeitschriftenbibliothek EZB, Open J-Gate, OCLC WorldCat, Universe Digtial
Library , NewJour, Google Scholar