Medico Research Chronicles
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OBESITY AND BALANCED NUTRITION
Get PDFObjective: To review the evidence on the diet and nutrition causes of obesity and to recommend strategies to reduce obesity prevalence.
Design: The evidence for potential etiological factors and strategies to reduce obesity prevalence was reviewed, and recommendations for public health action, population nutrition goals and further research were made.
Results: Protective factors against obesity were considered to be: regular physical activity (convincing); a high intake of dietary non-starch polysaccharides (NSP)/fibre (convincing); supportive home and school environments for children (probable); and breastfeeding (probable). Risk factors for obesity were considered to be sedentary lifestyles (convincing); a high intake of energy-dense, micronutrient-poor foods (convincing); heavy marketing of energy-dense foodsand fast food outlets (probable); sugar-sweetened soft drinks and fruit juices (probable); adverse social and economic conditions, especially in women (probable). A broad range of strategies were recommended to reduce obesity prevalence including: influencing the food supply to make healthy choices easier; reducing the marketing of energy dense foods and beverages to children; influencing urban environments and transport systems to promote physical activity; developing community-wide programmes in multiple settings; increased communications about healthy eating and physical activity; and improved health services to promote breastfeeding and manage currently overweight or obese people.
Conclusions: The increasing prevalence of obesity is a major health threat in both low- and high income groups. Comprehensive programmes will be needed to turn the epidemic around. 
HOW BROWN FAT INTERACTS WITH WHITE FAT
Get PDFBrown adipose tissue, an essential organ for thermoregulation in small and hibernating mammals due to its mitochondrial uncoupling capacity, was until recently considered to be present in humans only in newborns. This fat is composed of several small lipid (fat) droplets and a large number of iron-containing mitochondria (the cell’s heat-burning engine). Brown adipose tissue is uniquely able to rapidly produce large amounts of heat through activation of uncoupling protein (UCP) 1. Maximally stimulated brown fat can produce 300 watts/kg of heat compared to 1 watt/kg in all other tissues. UCP1 is only present in small amounts in the fetus and in precocious mammals, such as sheep and humans; it is rapidly activated around the time of birth following the substantial rise in endocrine stimulatory factors. Brown adipose tissue is then lost and/or replaced with white adipose tissue with age but may still contain small depots of beige adipocytes that have the potential to be reactivated. In humans brown adipose tissue is retained into adulthood, retains the capacity to have a significant role in energy balance, and is currently a primary target organ in obesity prevention strategies. Thermogenesis in brown fat humans is environmentally regulated and can be stimulated by cold exposure and diet, responses that may be further modulated by photoperiod. Increased understanding of the primary factors that regulate both the appearance and the disappearance of UCP1 in early life may therefore enable sustainable strategies in order to prevent excess white adipose tissue deposition through the life cycle
REVIEW ARTICLE: CAPPING ON COMPENSATION FOR MEDICAL MALPRACTICE LAW SUITE IN INDIA
Get PDFReview Article teach US about the main people working in this field, recent major advances and discoveries in this field and significant gaps in the research. At the end the author will focus on current debates and suggest the ideas where research might go next. Medical malpractice and compensation to this effect by the court of law is a burning national issue and needs pondering. It is largely faced by health care workers among which the worst affected one includes medical practitioners and health care administrators. This issue has gone through a paradigm shift from one nation to another and has matured gradually over the last decade witnessing huge medical compensation being granted to litigants. It is also seen as a business opportunity by law professionals and media. It largely affects the sentiments and belief of general public. However, critical changes at legislative and judicial levels along with amendments in the medical curriculum can jointly reduce the agony and fear of health care providers. Sensitizing the medical practitioner’s public at large has to be taken up in mission mode by organizations like Consortium of Accredited health care organization (CAHO), National Accreditation Board for Hospitals and health care providers (NABH) and Association of health care providers India (AHPI)
PRACTICE OF ADULTS ON PREVENTION OF HYPERTENSION AND ASSOCIATED FACTORS IN DESSIE ADMINISTRATIVE CITY, ETHIOPIA, 2016
Get PDFIntroduction: Hypertension is an important public-health challenge worldwide as well as in Ethiopia. Prevention and detection of this condition should receive high priority and it is a serious warning sign that major lifestyle changes are required. Globally cardiovascular diseases accounts for approximately 17 million deaths a year, nearly one third of the total deaths. Of these, complications of hypertension account for 9.4 million deaths worldwide every year. Hypertension is responsible for at least 45% of deaths due to heart disease and 51% of deaths due to stroke. Hypertension poses an important public health challenge worldwide; including Ethiopia. In order to understand the preventive measures, evidence based information about practice in the prevention aspects of hypertension at the community level is required.
Objectives: To assess adults’ Practice on prevention of hypertension and associated factors in Dessie Administrative city, Amhara Region, Ethiopia.
Methods: Community based Cross-sectional study was conducted on above 18 years of age on 844 Participants. Multi stage sampling technique was used to select study subjects. Descriptive and analytical statistics including bivariate and multivariate analysis were applied.
Results: Out of 844 participants, 836 with the response rate of 99.1% where participate in the study. Half (50.1%) had good Practice in related to hypertension prevention. Knowledgeable Participants were practiced more as compared to individuals who were poor knowledge.
Conclusion: This study revealed a lower level of practice among the participants on the prevention of hypertension.Female practiced more preventive measures as compared to male. Health education to improve knowledge and practice on the prevention of Hypertension is neede
THE INCIDENCE RATE OF DIABETES MELLITUS AND PRE-DIABETES IN KORCA - ALBANIA, IN 2015
Get PDFBackground: The worldwide prevalence of DM has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 285 million in 2010. Based on current trends, the International Diabetes Federation project that 438 million individuals will have diabetes by the year 2030.
Aim: The aim of this study was to evaluate the incidence rate of Diabetes Mellitus and Prediabetes in Korca, during 2015.
Materials and Methods: Between January 2015 and December 2015, all consecutive individuals, referred from primary doctors in policlinic or hospital of Korca, doubting Diabetes Mellitus, were recruited and underwent diagnostic procedures. HbAâ‚c and/or fasting glucose and 2h postprandial glucose was used to diagnose Diabetes Mellitus and Pre-diabetes. The C Peptide was measured to diagnose type 1 from other types of Diabetes. Clinical and laboratory data were collected. A register of new-diagnosed Diabetic individuals was opened.
Results: 288 people were newly diagnosed with type 2 diabetes mellitus; 4 people were diagnosed with type 1 diabetes; 4 people with pre-diabetes (Impaired glucose tolerance); and 4 people with secondary forms of diabetes. The incidence of type 2 diabetes mellitus was 144/100,000 per year. The incidence of type 1 diabetes mellitus was 2/100,000 per year. The incidence rate of pre-diabetes and secondary forms of diabetes was 2/100,000 per year respectively. The most affected age was 60-69.No difference in incidence between men and women in type 2 diabetes. According time at diagnoses the most frequent months were April and December.
Conclusion: The incidence rate of type 2 diabetes mellitus was 144/100,000 per year. The incidence rate of type 1 diabetes mellitus was 2/100,000 per year. The incidence rate of pre-diabetes and secondary forms of diabetes were 2/100,000 per year respectively
SECONDARY CAROTENEMIA: CASE REPORT
Get PDFCarotenemia is the presence of excess carotenoids in the blood and causes a pigmentation of skin that resembles jaundice. Carotenoids are the yellow colored lipid-soluble compounds that are found in orange, green, red, and yellow fruits and vegetables.3 The way to clinically differentiate between jaundice and carotenemia is that the conjunctivae are not discolored in case of a person with carotenemia. Mucus membranes (in the nostrils, mouth, and eyes) are not discolored either.Carotenemia can be verified by measuring levels of serum beta-carotene. Secondary causes of carotenemia should be ruled out as well
DETERMINATES OF CHOICE OF PLACE OF DELIVERY AMONG MOTHERS WHO FOLLOW ANTINATAL CARE SERVICE IN KALU WOREDA, SOUTH WOLLO ZONE, AMHARA RIGIONAL STATE, OCTOBER - 2015
Get PDFIntroduction: Ethiopia has high maternal mortality with poor maternal health services utilization. EDHS-2011 report shows that 42% of women who gave birth were following ANC (Ante Natal Care) in health institution and only 12% of births are delivered in health facility. Many women did not deliver in hygienic place and contributing to high maternal mortality and acute and long term complications.
Objective: To identify determinant factors for choice of place of delivery among ANC follower mothers in the last one year period.
Methods: Community based unmatched case control study design triangulated with qualitative component. Sample size of 573 (191 cases and 382 controls) determined using Epi Info 7. Study subjects were selected using systematic sampling method by determines K1 and K2 for cases and controls respectively. Purposive sampling to select key informants for qualitative part. Data collected with structured questionnaire. Result: Being not formally educated (OR=2.578, 95%CI; (1.583-4.196), not satisfied the care received during ANC follow up (OR=5.36, 95%CI ;( 2.618-10.594) and having only one ANC visit (OR=3.28, 95%CI ;(1.546-6.696) were positively associated with choosing of home as place of delivery. In contrast, being rural residence (OR= 0.450, 95%CI; (.256-.789) and family decision on place of delivery (OR=0.294, 95%CI; (0.186-0.457) were negatively associated with choosing home as place of delivery. The most common reasonsfor not choosing institutions/facility as place of delivery were previous safe home delivery (41.4%), absence of health problem (19.9%) and an unfamiliar/not costumed by the society (17.3%).
Conclusion: Comprehensive/holistic services at ANC clinic and community factors like education were determinant factors for choice of place of delivery. So, health offices should consider such factors to enhance institutional delivery by training health personnel, advising and counseling of mothers regarding the dangers of home delivery at the communit, leve
SPONTANEOUS UTERINE RUPTURE RELATED TO EXCEPTIONAL RARE "TWIN PREGNANCY" - TROPHOBLASTIC PATHOLOGY AND ONGOING PREGNANCY
Get PDFBackground: The peritoneal bleeding in intrauterine ongoing pregnancy is a serious event that poses problems of identifying and stopping the source of bleeding, long-term impact of hypovolemia, anemia, operative, anesthetics, imaging acceptance.The purpose of the study: to highlight the very special circumstances and therapeutic strategies to treat a complicated "twin pregnancy"
Matherial and methods: Case presentation, 25 years old women (14-16 weeks ongoing pregnancy),arriving ED accusing abdominal pain, vomiting and a diarrheal stool from 3-4hours. Initially, hemodynamically stable, without fewer, with seemingly normal development of pregnancy, without free intraperitoneal fluid or vaginal bleeding, but uterine hypertonia. During ED surveillance gradually develops of an active intraperitoneal hemorrhage syndrome, uterine painful contractions and tenderness in the lower abdominal floor. No family agreement for abdominal invasive imagistic. At 2h extreme fetal bradycardia, progressive hemorrhagic shock, peritoneal fluid.. Laparatomy decided - extended uterine rupture with fetus expelled in peritoneal cavity and massive hemoperitoneum. Uterine structure modified by placental-site trophoblastic tumors. Balloon tamponade and hysteroraphyis.
Conclusions:- A "twin pregnancy"(a GTD coexisting with a fetus) is exceptional for placental-site trophoblastic tumors type of GTD- Spontaneous uterine rupture at this age of pregnancy is exceptional but evolving dramatic gravity, and fetus compromise
SERUM ERYTHROPOIETIN LEVEL CORRELATED WITH MICROALBUMINURIA IN DIABETIC PATIENTS
Get PDFErythropoietin has beneficial effects in diabetic nephropathy, neuropathy and retinopathy. We investigated the relationship between iron indices and erythropoietin levels in type 2 diabetics with microvascular complications. Type 2 diabetic patients with microalbuminuria, diabetic retinopathy (DRP) and neuropathy were included to the present study. Serum erythropoietin levels and iron indices were recorded besides demographic, clinic and biochemical data. Of the 59 patients included in this study, microalbuminuria was present in 29 patients (49.2 %), while DRP and diabetic neuropathy were detected in 23 (39.7%) and 20 (34.5%) patients, respectively. Erythropoietin concentration (13.17±4.48 mU/mL vs 15.77±5.16 mU/mL; p=0.04) and total iron binding capacity (TIBC) of the microalbuminuric group were lower than those without microalbuminuria, while iron levels were similar. Erythropoietin concentration was lower in patients with DRP compared to those without DRP (12.84±4.95 mU/mL vs 15.49±4.82 mU/mL; p=0.04). TIBC was higher in patients with diabetic neuropathy; while erythropoietin (13.93±4.83 mU/mL vs. 14.71±5.13 mU/mL; p=0.57), ferritin and iron levels were similar to patients without neuropathy. Lower erythropoietin concentrations observed in patients with DRP and neuropathy are consistent with the hypothesis that erythropoietin deficiency may precede microvascular complications in diabetic patients. Serum erythropoietin level was found to correlate with microalbuminuria (p: 0.006, r:-0.50) but not retinopathy and neuropathy
HYPERTENSIVE DISORDERS OF PREGNANCY AND ASSOCIATED FACTORS AMONG ADMITTED PREGNANT CASES IN DESSIE TOWN REFERRAL HOSPITAL, NORTH EAST ETHIOPIA, 2015
Get PDFIntroduction: Hypertensive disorder of pregnancy (HDP) is the most common medical problem encountered during pregnancy, which increased risk of maternal and neonatal mortality and morbidity. Despite of its significant effect, the magnitude and risk factors yet not assessed at local context.
Objective: To assess the occurrence of hypertensive disorders of pregnancy and associated factors among admitted pregnant women in obstetrics and gynecology ward in Dessie referral hospital, North East Ethiopia.
Methods: Institutional based retrospective cross sectional study in 320 admitted pregnant cases at obstetrics and gynecologic ward through one year document review and documents selected with systematic random sampling. Bivariate and multivariate logistic regression were used to identify significant risk factors for the development of hypertension disorder of pregnancy and presented by AOR and P-value.
Result: Out of 320 sample pregnant mothers, 28(8.8%) had confirmed hypertensive disorders of pregnancy (HDP). Of which 13(46.4%) were mild preeclampsia, 8(28.6%) were severe preeclampsia, 3(10.7%) were eclampsia, 4(14.2%) were gestational hypertension. Being urban residence (OR=4.409, 95%CI ;( 1.459-13.324)), nully parity (OR=11.363, 95%CI ;( 3.991-32.349)) and multiple pregnancy (OR=3.369, 95CI ;( 1.178-59.442)) were statically significant risk factors for occurrence hypertension disorder of pregnancy. Regarding past medical conditions, having pre - existing hypertension, renal disease and cardiac disease were positively associated risk factors for the development of HDP.
Conclusion: Significant numbers of pregnant mothers develop hypertensive disorder of pregnancy. To decrease this burden, health personnel’s should work extensively at static and community level in reducing risk factors which lead to hypertension disorder of pregnancy