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  1. Clinical profile, outcomes, and progression to type 2 diabetes among Indian women with gestational diabetes mellitus seen at a diabetes center in south India

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    Manni Mohanraj Mahalakshmi

    2014-01-01

    Full Text Available Aim: To describe the clinical profile, maternal and fetal outcomes, and the conversion rates to diabetes in women with gestational diabetes mellitus (GDM seen at a tertiary care diabetes center in urban south India. Materials and Methods: Clinical case records of 898 women with GDM seen between 1991 and 2011 were extracted from the Diabetes Electronic Medical Records (DEMR of a tertiary care diabetes center in Chennai, south India and their clinical profile was analyzed. Follow-up data of 174 GDM women was available. To determine the conversion rates to diabetes, oral glucose tolerance test (OGTT was done in these women. Glucose tolerance status postpartum was classified based on World Health Organization (WHO 2006 criteria. Results: The mean maternal age of the women was 29 ± 4 years and mean age of gestation at first visit were 24 ± 8.4 weeks. Seventy percent of the women had a family history of diabetes. Seventy-eight percent of the women delivered full-term babies and 65% underwent a cesarean section. The average weight gain during pregnancy was 10.0 ± 4.2 kg. Macrosomia was present in 17.9% of the babies, hypoglycemia in 10.4%, congenital anomalies in 4.3%, and the neonatal mortality rate was 1.9%. Mean follow-up duration of the 174 women of whom outcome data was available was 4.5 years. Out of the 174, 101 women who were followed-up developed diabetes, of whom half developed diabetes within 5 years and over 90%, within 10 years of the delivery. Conclusions: Progression to type 2 diabetes mellitus (T2DM in Indian women with GDM is rapid. There is an urgent need to develop standardized protocols for GDM care in India that can improve the maternal and fetal outcomes and help prevent future diabetes in women with GDM.

  2. Endothelial Nitric Oxide Synthase Gene Polymorphism (G894T and Diabetes Mellitus (Type II among South Indians

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    T. Angeline

    2011-01-01

    Full Text Available The objective of the study is to find out whether the endothelial nitric oxide synthase (eNOS G894T single-nucleotide polymorphism is associated with type 2 diabetes mellitus in South Indian (Tamil population. A total number of 260 subjects comprising 100 type 2 diabetic mellitus patients and 160 healthy individuals with no documented history of diabetes were included for the study. DNA was isolated, and eNOS G894T genotyping was performed using the polymerase chain reaction followed by restriction enzyme analysis using Ban II. The genotype distribution in patients and controls were compatible with the Hardy-Weinberg expectations (P>0.05. Odds ratio indicates that the occurrence of mutant genotype (GT/TT was 7.2 times (95% CI = 4.09–12.71 more frequent in the cases than in controls. Thus, the present study demonstrates that there is an association of endothelial nitric oxide synthase gene (G894T polymorphism with diabetes mellitus among South Indians.

  3. Diabetes mellitus in a young Amazon Indian child

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    Mônica Andrade Lima Gabbay

    Full Text Available CONTEXT: Although type 2 diabetes has been described among American Indian children, no case of type 1 diabetes has been reported in the literature. CASE REPORT: We report the first case of diabetes in a South American Indian child from the tropical rainforest, who was positive for IA2 autoantibodies and genetic markers of susceptibility to type 1 diabetes, but also demonstrated residual beta cell function four years after diagnosis.

  4. SOD1 Gene +35A/C (exon3/intron3 Polymorphism in Type 2 Diabetes Mellitus among South Indian Population

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    K. Nithya

    2016-01-01

    Full Text Available Superoxide dismutase is an antioxidant enzyme that is involved in defence mechanisms against oxidative stress. Cu/Zn SOD is a variant that is located in exon3/intron3 boundary. The aim of the present study was to investigate whether the Cu/Zn SOD (+35A/C gene polymorphism is associated with the susceptibility to type 2 diabetes mellitus among south Indian population. The study included patients with type 2 diabetes mellitus (n=100 and healthy controls (n=75. DNA was isolated from the blood and genotyping of Cu/Zn SOD gene polymorphism was done by polymerase chain reaction based restriction fragment length polymorphism method. Occurrence of different genotypes and normal (A and mutant (C allele frequencies were determined. The frequency of the three genotypes of the total subjects was as follows: homozygous wild-type A/A (95%, heterozygous genotype A/C (3%, and homozygous mutant C/C (2%. The mutant (C allele and the mutant genotypes (AC/CC were found to be completely absent among the patients with type 2 diabetes mellitus. Absence of mutant genotype (CC shows that the Cu/Zn SOD gene polymorphism may not be associated with the susceptibility to type 2 diabetes mellitus among south Indian population.

  5. Increased risk of type 2 diabetes with ascending social class in urban South Indians is explained by obesity: The Chennai urban rural epidemiology study (CURES-116).

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    Skar, Mette; Villumsen, Anne Berg; Christensen, Dirk Lund; Petersen, Joergen Holm; Deepa, Mohan; Anjana, Ranjit Mohan; Pradeepa, Rajendra; Mohan, Viswanathan

    2013-11-01

    The aim of this study is to determine the factors responsible for differences in the prevalence of diabetes mellitus (DM) in subjects of different social class in an urban South Indian population. Analyses were based on the cross-sectional data from the Chennai Urban Rural Epidemiology Study of 1989 individuals, aged ≥20 years. Entered in the analyses were information obtained by self-report on (1) household income; (2) family history of diabetes; (3) physical activity; (4) smoking status; (5) alcohol consumption. Biochemical, clinical and anthropometrical measurements were performed and included in the analyses. Social class was classified based on income as low (Rs. social class, respectively (P social class (Intermediate class: Odds ratio [OR], 1.7 [confidence interval [CI], 1.2-2.3]; High class: OR, 2.0 [CI-1.4-2.9]). The multivariable adjusted logistic regression analysis revealed that the effect of social class on the risk of diabetes remained significant (P = 0.016) when age, family history of diabetes and blood pressure were included. However, with the inclusion of abdominal obesity in the model, the significant effect of social class disappeared (P = 0.087). An increased prevalence of DM was found in the higher social class in this urban South Indian population, which is explained by obesity.

  6. Assessment of cost of illness for diabetic patients in South Indian tertiary care hospital

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    Leelavathi D Acharya

    2016-01-01

    Full Text Available Background: The impact of diabetes on health-care expenditures has been increasingly recognized. To formulate an effective health planning and resource allocation, it is important to determine economic burden. Objective: The objective of this study is to assess the cost of illness (COI for diabetic inpatients with or without complications. Methodology: The study was conducted in the medicine wards of tertiary care hospital after ethical approval by the Institutional Ethical Committee. A total of 116 each diabetic with or without complications were selected and relevant data were collected using COI questionnaire and data were analyzed using SPSS version 20. Mann–Whitney U test is used to assess the statistical significant difference in the cost of treatment of diabetes alone and with complications'. P ≤ 0.05 was considered statistically significant. Results: Total COI includes the cost of treatment, investigation, consultation fee, intervention cost, transportation, days lost due to work, and hospitalization. The median of total COI for diabetic care without any complication was Rs. 22,456.97/- per patient per annum and with complication was Rs. 30,634.45/-. Patients on dialysis had to spend 7.3 times higher, and patients with cardiac intervention had to spend 7.4 times higher than diabetic patients without any complication. Conclusion: Treatment costs were many times higher in patients with complications and with cardiac and renal interventions. Complications in diabetic patients will increase the economic burden to family and also to the society.

  7. Increased risk of type 2 diabetes with ascending social class in urban South Indians is explained by obesity: The Chennai urban rural epidemiology study (CURES-116)

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    Skar, Mette; Villumsen, Anne Berg; Christensen, Dirk Lund

    2013-01-01

    Rural Epidemiology Study of 1989 individuals, aged ≥20 years. Entered in the analyses were information obtained by self-report on (1) household income; (2) family history of diabetes; (3) physical activity; (4) smoking status; (5) alcohol consumption. Biochemical, clinical and anthropometrical.......001). A significant increase in the risk of diabetes was found with ascending social class (Intermediate class: Odds ratio [OR], 1.7 [confidence interval [CI], 1.2-2.3]; High class: OR, 2.0 [CI-1.4-2.9]). The multivariable adjusted logistic regression analysis revealed that the effect of social class on the risk......AIM: The aim of this study is to determine the factors responsible for differences in the prevalence of diabetes mellitus (DM) in subjects of different social class in an urban South Indian population. MATERIALS AND METHODS: Analyses were based on the cross-sectional data from the Chennai Urban...

  8. Increased risk of type 2 diabetes with ascending social class in urban South Indians is explained by obesity: The Chennai urban rural epidemiology study (CURES-116

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    Mette Skar

    2013-01-01

    Full Text Available Aim: The aim of this study is to determine the factors responsible for differences in the prevalence of diabetes mellitus (DM in subjects of different social class in an urban South Indian population. Materials and Methods: Analyses were based on the cross-sectional data from the Chennai Urban Rural Epidemiology Study of 1989 individuals, aged ≥20 years. Entered in the analyses were information obtained by self-report on (1 household income; (2 family history of diabetes; (3 physical activity; (4 smoking status; (5 alcohol consumption. Biochemical, clinical and anthropometrical measurements were performed and included in the analyses. Social class was classified based on income as low (Rs. <2000 intermediate (Rs. 2000-5000` and high (Rs. 5000-20000. Results: The prevalence rates of DM were 12.0%, 18.4% and 21.7% in low, intermediate and high social class, respectively (P < 0.001. A significant increase in the risk of diabetes was found with ascending social class (Intermediate class: Odds ratio [OR], 1.7 [confidence interval [CI], 1.2-2.3]; High class: OR, 2.0 [CI-1.4-2.9]. The multivariable adjusted logistic regression analysis revealed that the effect of social class on the risk of diabetes remained significant (P = 0.016 when age, family history of diabetes and blood pressure were included. However, with the inclusion of abdominal obesity in the model, the significant effect of social class disappeared (P = 0.087. Conclusion: An increased prevalence of DM was found in the higher social class in this urban South Indian population, which is explained by obesity.

  9. Identification of novel variants in the hepatocyte nuclear factor-1alpha gene in South Indian patients with maturity onset diabetes of young

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    Radha, V; Ek, J; Anuradha, S

    2009-01-01

    . There are very few data on MODY mutations from India. OBJECTIVE: The objective was to screen coding and promoter regions of HNF1A gene for mutations in unrelated South Indian subjects in whom a clinical diagnosis of MODY was made. DESIGN: This was an observational cross-sectional study. SETTING: The study...... studies revealed reduced transcriptional activity of the HNF1A promoter for two promoter variants. We also observed cosegregation with diabetes of the Arg263His coding region mutation in eight members of one MODY family, whereas it was absent in nondiabetic subjects of this family. CONCLUSION: This study...... suggests that mutations in the HNF1A gene comprise about 9% of clinically diagnosed MODY subjects in southern India and a novel Arg263His mutation cosegregates with MODY in one family....

  10. Prevalence of Charcot Arthropathy in Type 2 Diabetes Patients Aged over 50 Years with Severe Peripheral Neuropathy: A Retrospective Study in a Tertiary Care South Indian Hospital.

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    Salini, Dharmadas; Harish, Kumar; Minnie, Pillay; Sundaram, Karimassery R; Arun, Bal; Sandya, Chirukandath J; Mangalanandan, Thacho S; Vivek, Lakshmanan; Praveen, Valiyaparambil P

    2018-01-01

    Available literature on the prevalence of Charcot arthropathy (CA) represents mainly Western population. No study has been reported from India so far. Hence we attempted to study the prevalence of CA in patients with type 2 diabetes mellitus and severe peripheral neuropathy (T2DMPN), belonging to Indian population amongst whom type 2 diabetes is on the rise in alarming proportions. Medical records of 3387 patients who performed an objective vibration perception threshold test during the year 2015 were screened for T2DMPN. Out of these, 1475 T2DMPN patients above 50 years were selected and analyzed in detail for CA. CA was diagnosed based on clinical features and/or radiological investigations. The anatomical localization of the disease distribution of the affected foot was done according to Brodsky's classification. The prevalence of CA in T2DMPN patients was found to be 9.8%. The mean age of patients diagnosed with CA was 63 ± 8.36 years, and mean duration of DM for CA to develop was 18.01 ± 8.23 years. About 62.5% of the patients were male and 37.5% female. Bilateral presentation of CA was observed in 20.8% of patients. Multiple sites of the foot were affected in 48.6% of patients and belonged to type 4 classification of Brodsky. A high prevalence of CA (9.8%) was observed in the present study conducted on T2DMPN patients who presented to the endocrinology department of a tertiary care South Indian hospital. In the majority of patients, the area of foot affected belonged to type 4 classification of Brodsky.

  11. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Special Diabetes Program for Indians Division of Diabetes Treatment and Prevention Special Diabetes Program for Indians (SDPI) About SDPI ... On Demand IHS Diabetes Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools for Diabetes ...

  12. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Special Diabetes Program for Indians Division of Diabetes Treatment and Prevention Special Diabetes Program for Indians (SDPI) ... On Demand IHS Diabetes Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools for Diabetes ...

  13. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Us Special Diabetes Program for Indians Division of Diabetes Treatment and Prevention Special Diabetes Program for Indians (SDPI) ... and On Demand IHS Diabetes Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools for Diabetes ...

  14. Knowledge and awareness about diabetes mellitus and diabetic retinopathy in suburban population of a South Indian state and its practice among the patients with diabetes mellitus: A population-based study.

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    Hussain, Rameez; Rajesh, Bindu; Giridhar, Anantharaman; Gopalakrishnan, Mahesh; Sadasivan, Sanjai; James, Justin; Vijayan, Pradeep Padickal; John, Nelson

    2016-04-01

    Ocular complications due to diabetes mellitus (DM) were on the rise despite good literacy levels in South India. To assess the knowledge and attitude toward DM and diabetic retinopathy of the general population in a suburban town of South India. Door-to-door population survey in suburban town of South India in May 2013. A 30-point questionnaire was prepared and the data were collected and analyzed to determine statistically the knowledge, attitude, and practice (KAP) scores of the general and diabetic population and also to determine significant demographic associations. In this study, 6211 people (3528 [56.8%] women and 2683 [43.2%] men) with a mean age of 55.6 ± 11.7 years (range 21-98 years) were included. Good knowledge and positive attitude were observed in 3457 (55.6%) and 3280 (52.8%) people. Among 1538 (25.4%) people known to have DM, only 619 (40.7%) had good knowledge, 828 (53.8%) had a positive attitude, and 886 (57.6%) had good practice patterns. Although half of them followed general diabetic care, only 9.6% had undergone screening for retinopathy. Literacy showed a significant association with good KAP (P knowledge (P < 0.001). Better literacy, especially among women, is contributory to better public awareness; however, the trend for poor practice patterns needs to be radically changed with aggressive public motivation emphasizing on the necessity of retinopathy screening and periodic follow-ups.

  15. Anthropometry of south Indian industrial workmen.

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    Fernandez, J E; Uppugonduri, K G

    1992-11-01

    This paper presents the results of an anthropometric survey conducted on South Indian male workers in the electronic industry. The data were collected as part of a project to modify work stations that utilized equipment from other countries. A set of 27 body dimensions were taken from a sample of 128 workmen (aged 18-35 years). The anthropometric measurements are compared with those of Indian men from Central, Western, and Northern parts of India and with those of the American, German, and Japanese men. The results indicate that in general the South Indian man is smaller than Central, Western, and Northern Indian men, as well as smaller than men in America, Germany, Japan, and Africa. This difference needs to be allowed for when considering buying and subsequently using imported equipment for the electronics industry in South India.

  16. Comparison of the world health organization and the International association of diabetes and pregnancy study groups criteria in diagnosing gestational diabetes mellitus in South Indians

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    Sivagnanam Nallaperumal

    2013-01-01

    Full Text Available Aim: We aimed to compare the International Association of Diabetes and Pregnancy Study Groups (IADPSG and the World Health Organization (WHO criteria to diagnose gestational diabetes mellitus (GDM in Chennai, India. Materials and Methods: We reviewed the retrospective data of 1351 pregnant women who underwent screening for GDM at four selected diabetes centers at Chennai (three private and one government. All women underwent an oral glucose tolerance test using 75g glucose load and fasting, 1-h, and 2-h samples were collected. The IADPSG and WHO criteria were compared for diagnosis of GDM. Results: A total of 839 women had GDM by either the IADPSG or the WHO criteria, of whom the IADPSG criteria identified 699 and the WHO criteria also identified 699 women as having GDM. However, only 599/839 women (66.6% were identified by both criteria. Thus, 140/839 women (16.7% were missed by both the IADPSG and the WHO criteria. 687/699 (98.2% of the women with GDM were identified by the WHO criteria. In contrast, each value of IADPSG criteria i.e., fasting, 1 h, and 2 h identified only 12.5%, 14%, and 22%, respectively. Conclusions: A single WHO cut-point of 2 h > 140 mg/dl appears to be suitable for large-scale screening for GDM in India and other developing countries.

  17. Demographic details, clinical features, and nutritional characteristics of young adults with Type 1 diabetes mellitus - A South Indian tertiary center experience.

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    Joseph, Mini; Shyamasunder, Asha H; Gupta, Riddhi D; Anand, Vijayalakshmi; Thomas, Nihal

    2016-01-01

    Type 1 diabetes mellitus (T1DM) accounts for 5-10% of all diagnosed diabetes and the highest incidence is found in India. The main objectives were to study the demographic, clinical, and nutritional characteristics of young adults with T1DM and its effect glycosylated hemoglobin levels. This cross-sectional study was conducted among young adults with T1DM (18-45 years of age) in a tertiary hospital in South India. Data were obtained from updated medical records. The dietary data were assessed from food diaries and 24 h recall method. Anthropometry was determined. The analysis revealed that socio-economic variables did not affect the glycosylated hemoglobin levels. The mean glycosylated hemoglobin value was 8.81 ± 2.38%. Nearly, half the patients were malnourished. The overall dietary intake was inadequate. The multivariate regression model, adjusted for confounding factors such as gender, age, and body mass index, revealed that only duration of diabetes and protein intake were significant predictors of glycosylated hemoglobin status ( P diabetes management. However, there is an urgent need to educate our patients on nutrition therapy. T1DM patients need specialized advice to ensure appropriately balanced nutrition that has a significant impact on their long-term glycemic control.

  18. Postpartum development of type 1 diabetes in Asian Indian women with gestational diabetes.

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    Unnikrishnan, Ranjit; Shanthi Rani, Coimbatore Subramanian; Anjana, Ranjit Mohan; Uthra, Subash Chandrabose; Vidya, Jaydeep; Sankari, Ganesan Uma; Venkatesan, Ulagamathesan; Rani, Saravanan Jeba; Mohan, Viswanathan

    2016-01-01

    To study the postpartum conversion of gestational diabetes mellitus (GDM) to different types of diabetes among Asian Indian women. Using data from electronic medical records, 418 women with GDM seen at a tertiary diabetes care center for diabetes in Chennai in South India between 1991 and 2014 were evaluated for development of diabetes postpartum. Of the 418 GDM women followed up postpartum, 388 progressed to diabetes. Of these 359 (92.5%) developed type 2 diabetes (T2DM) and 29 women (7.5%) developed type 1 diabetes (T1DM). The median time to development of T1DM was 2 years (interquartile range 2 [IQR]) while for T2DM it was 5 years (IQR 6). Women who developed T1DM had significantly lower mean body mass index (BMI) (20.4 ± 2.8 vs. 27.5 ± 4.4 kg/m 2 , P = 0.001), and higher fasting plasma glucose (222 ± 105 vs. 165 ± 62 mg/dl P = 0.008) and glycated hemoglobin levels (10.2 ± 2.7 vs. 8.5 ± 2.1% P women who developed T1DM. A small but significant proportion of women with GDM progress to T1DM postpartum. Measurement of GAD antibodies in leaner women with more severe diabetes could help to identify women who are likely to develop T1DM and thus prevent their presentation with acute hyperglycemic emergencies after delivery.

  19. Correlates of lifestyle: physical activity among South Asian Indian immigrants.

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    Daniel, Manju; Wilbur, JoEllen; Fogg, Louis F; Miller, Arlene Michaels

    2013-01-01

    South Asian immigrants are at increased risk for cardiovascular disease and diabetes, but little is known about their physical activity patterns. In this cross-sectional study, 110 participants were recruited to describe lifestyle physical activity behavior of this at-risk population. Education (p = .042), global health (p = .045), and self-efficacy (p = .000) had significant positive independent effects on leisure-time physical activity. Depression (p = .035) and waist circumference (p = .012) had significant negative independent effects, and frequency of experiencing discrimination a significant positive independent effect (p = .007) on daily step counts. Culture-sensitive physical activity interventions need to target South Asian Indian immigrants who are less educated, in poor health, concerned about racial discrimination, and have low self-efficacy.

  20. Evaluation of gestational diabetes mellitus risk in South Indian women based on MTHFR (C677T and FVL (G1691A mutations

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    Imran Ali Khan

    2015-05-01

    Full Text Available We aimed to scrutinize the extent to which single amino acid substitutions in the MTHFR and FVL genes affect the risk of GDM in pregnant women of South Indian descendant. This case-control study was implemented once the ethical approval has been obtained. Overall 237 women were recruited in this study: 137 had been diagnosed with GDM and the remaining 100 women were used as normal controls or non-GDM. The diagnosis of GDM was confirmed with biochemical analysis i.e., GCT and OGTT tests. Five milliliters of peripheral blood was collected and used for biochemical and molecular analyses. DNA was isolated and genotyping for MTHFR (C677T and FVL (G1691A mutations was performed using PCR-RFLP. FVL (G1691A locus was not polymorphic in the investigated sample. There was no significant difference in the allele and genotype frequencies of C677T polymorphism between GDM and non-GDM women (p=0.8892

  1. A case-control analysis of common variants in GIP with type 2 diabetes and related biochemical parameters in a South Indian population

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    Kumar Harish

    2010-07-01

    Full Text Available Abstract Background Glucose-dependent insulinotropic polypeptide (GIP is one of the incretins, which plays a crucial role in the secretion of insulin upon food stimulus and in the regulation of postprandial glucose level. It also exerts an effect on the synthesis and secretion of lipoprotein lipase, from adipocytes, important for lipid metabolism. The aim of our study was to do a case-control association analysis of common variants in GIP in association with type 2 diabetes and related biochemical parameters. Method A total of 2000 subjects which includes 1000 (584M/416F cases with type 2 diabetes and 1000 (470M/530F normoglycemic control subjects belonging to Dravidian ethnicity from South India were recruited to assess the effect of single nucleotide polymorphisms (SNPs in GIP (rs2291725, rs2291726, rs937301 on type 2 diabetes in a case-control manner. The SNPs were genotyped by using tetra primer amplification refractory mutation system-PCR (ARMS PCR. For statistical analysis, our study population was divided into sub-groups based on gender (male and female. Association analysis was carried out using chi-squared test and the comparison of biochemical parameters among the three genotypes were performed using analysis of covariance (ANCOVA. Result Initial analysis revealed that, out of the total three SNPs selected for the present study, two SNPs namely rs2291726 and rs937301 were in complete linkage disequilibrium (LD with each other. Therefore, only two SNPs, rs2291725 and rs2291726, were genotyped for the association studies. No significant difference in the allele frequency and genotype distribution of any of the SNPs in GIP were observed between cases and controls (P > 0.05. Analysis of biochemical parameters among the three genotypes showed a significant association of total cholesterol (P = 0.042 and low density lipoprotein (LDL with the G allele of the SNP rs2291726 in GIP (P = 0.004, but this was observed only in the case of female

  2. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Program for Indians Division of Diabetes Treatment and Prevention Special Diabetes Program for Indians (SDPI) About SDPI ... Country Conference IHS Division of Diabetes Treatment and Prevention August 6-9, 2019 | Oklahoma City Conference Center | ...

  3. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Foot Care Training Tools for Diabetes Educators and Community Members Diabetes Educator Tools Diabetes Education Lesson Plan ... prevention and treatment in American Indian/Alaska Native communities. IHS Headquarters, Indian Health Service, 5600 Fishers Lane, ...

  4. Postpartum development of type 1 diabetes in Asian Indian women with gestational diabetes

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    Ranjit Unnikrishnan

    2016-01-01

    Full Text Available Aim: To study the postpartum conversion of gestational diabetes mellitus (GDM to different types of diabetes among Asian Indian women. Materials and Methods: Using data from electronic medical records, 418 women with GDM seen at a tertiary diabetes care center for diabetes in Chennai in South India between 1991 and 2014 were evaluated for development of diabetes postpartum. Results: Of the 418 GDM women followed up postpartum, 388 progressed to diabetes. Of these 359 (92.5% developed type 2 diabetes (T2DM and 29 women (7.5% developed type 1 diabetes (T1DM. The median time to development of T1DM was 2 years (interquartile range 2 [IQR] while for T2DM it was 5 years (IQR 6. Women who developed T1DM had significantly lower mean body mass index (BMI (20.4 ± 2.8 vs. 27.5 ± 4.4 kg/m 2 , P = 0.001, and higher fasting plasma glucose (222 ± 105 vs. 165 ± 62 mg/dl P = 0.008 and glycated hemoglobin levels (10.2 ± 2.7 vs. 8.5 ± 2.1% P < 0.001 compared to those who developed T2DM. Glutamic acid decarboxylase (GAD autoantibodies were present in 24/29 (82.7% of women who developed T1DM. Conclusion: A small but significant proportion of women with GDM progress to T1DM postpartum. Measurement of GAD antibodies in leaner women with more severe diabetes could help to identify women who are likely to develop T1DM and thus prevent their presentation with acute hyperglycemic emergencies after delivery.

  5. Nutritional Intake in Low Body Mass Index (BMI Males with Type 1 Diabetes and Fibrocalcific Pancreatic Diabetes: What are the Unmet Needs? A Cross-Sectional Study from a South Indian Tertiary Care Hospital

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    Mini Joseph

    2017-10-01

    Full Text Available Introduction: There is paucity of data on the nutritional intake in low Body Mass Index (BMI Asian Indians with diabetes. Aim: To study the difference in the nutrient intake pattern in low-BMI Type 1 Diabetes Mellitus (T1DM and Fibrocalcific Pancreatic Diabetes (FCPD patients. Materials and Methods: This cross-sectional study consisted of T1DM (n=40 and FCPD (n=20 male patients with similar BMI. Nutritional data was collected using the 24 hour recall method and food diaries. Fasting blood samples were analysed for lipid profile, serum creatinine, glycosylated haemoglobin, albumin, calcium and vitamin D. Stool samples were analysed for pancreatic elastase. Percentage analysis, Independent sample t-test and Pearson coefficient correlation were used to analyse the data. A p-value<0.05 was considered as statistically significant. Results: The FCPD patients, on biochemical analysis, had significantly lower vitamin D levels compared to the T1DM group (p=0.035. However, haemoglobin, triglycerides, low density lipoproteins, creatinine, albumin and calcium were similar between the groups. In the nutrient data, FCPD patients had a significant higher intake of fat (p=0.039, fibre (p<0.001, calcium (p=0.047, phosphorous (p=0.035, and niacin (p=0.001 and calories from fat (p=0.047. The T1DM group had a significantly higher intake of thiamine (p=0.047 and carbohydrates (p=0.014. Conclusion: T1DM and FCPD groups have similar dietary pattern deficit in fibre, calories, macronutrients and micronutrients. Malabsorption and poor glycaemic control in FCPD patients can be attributed to a higher dietary fat intake. A balanced diet can ensure better glycaemic control.

  6. Barriers and Facilitators for Type-2 Diabetes Management in South Asians: A Systematic Review.

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    Sohal, Tanveer; Sohal, Parmjit; King-Shier, Kathryn M; Khan, Nadia A

    2015-01-01

    Although South Asian populations have among the highest burden of type 2 diabetes in the world, their diabetes management remains poor. We systematically reviewed studies on South Asian patient's perspectives on the barriers and facilitators to diabetes management. We conducted a literature search using OVID, CINHAL and EMBASE (January, 1990 -February, 2014) evaluating the core components of diabetes management: interactions with health care providers, diet, exercise, and medication adherence. South Asian patients were self-reported as Indian, Pakistani, Malaysian-Indian or Bangladeshi origin. From 208 abstracts reviewed, 20 studies were included (19 qualitative including mixed methods studies, 1 questionnaire). Barriers and facilitators were extracted and combined using qualitative synthesis. All studies included barriers and few facilitators were identified. Language and communication discordance with the healthcare provider was a significant barrier to receiving and understanding diabetes education. There was inconsistent willingness to partake in self-management with preference for following their physician's guidance. Barriers to adopting a diabetic diet were lack of specific details on South Asian tailored diabetic diet; social responsibilities to continue with a traditional diet, and misconceptions on the components of the diabetic diet. For exercise, South Asian patients were concerned with lack of gender specific exercise facilities and fear of injury or worsening health with exercise. Patients reported a lack of understanding about diabetes medication management, preference for folk and phytotherapy, and concerns about the long-term safety of diabetes medications. Facilitators included trust in care providers, use of culturally appropriate exercise and dietary advice and increasing family involvement. Overall themes for the barriers included lack of knowledge and misperceptions as well as lack of cultural adaptation to diabetes management. Diabetes

  7. Barriers and Facilitators for Type-2 Diabetes Management in South Asians: A Systematic Review.

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    Tanveer Sohal

    Full Text Available Although South Asian populations have among the highest burden of type 2 diabetes in the world, their diabetes management remains poor. We systematically reviewed studies on South Asian patient's perspectives on the barriers and facilitators to diabetes management.We conducted a literature search using OVID, CINHAL and EMBASE (January, 1990 -February, 2014 evaluating the core components of diabetes management: interactions with health care providers, diet, exercise, and medication adherence. South Asian patients were self-reported as Indian, Pakistani, Malaysian-Indian or Bangladeshi origin. From 208 abstracts reviewed, 20 studies were included (19 qualitative including mixed methods studies, 1 questionnaire. Barriers and facilitators were extracted and combined using qualitative synthesis.All studies included barriers and few facilitators were identified. Language and communication discordance with the healthcare provider was a significant barrier to receiving and understanding diabetes education. There was inconsistent willingness to partake in self-management with preference for following their physician's guidance. Barriers to adopting a diabetic diet were lack of specific details on South Asian tailored diabetic diet; social responsibilities to continue with a traditional diet, and misconceptions on the components of the diabetic diet. For exercise, South Asian patients were concerned with lack of gender specific exercise facilities and fear of injury or worsening health with exercise. Patients reported a lack of understanding about diabetes medication management, preference for folk and phytotherapy, and concerns about the long-term safety of diabetes medications. Facilitators included trust in care providers, use of culturally appropriate exercise and dietary advice and increasing family involvement. Overall themes for the barriers included lack of knowledge and misperceptions as well as lack of cultural adaptation to diabetes management.Diabetes

  8. Strategic Stability in South Asia: An Indian?s Perspective.

    Energy Technology Data Exchange (ETDEWEB)

    Kanwal, Gurmeet [Inst. for Defence Studies and Analyses, New Delhi (India)

    2017-05-01

    The security environment in South Asia has been marked by instability for several decades. The foremost causes of regional instability are the nuclear weapons-cum-missile development program of China, North Korea and Pakistan, the strident march of Islamist fundamentalism, the diabolical nexus between narcotics trafficking and terrorism, the proliferation of small arms and the instability inherent in the rule of despotic regimes. Instability on the Indian sub-continent is manifested, first and foremost, in the continuing conflict in Afghanistan, its tense relations with Iran and the Central Asian Republics (CARs); Pakistan’s struggle against the Taliban, the emerging fissiparous tendencies in Balochistan and Pakhtoonkhwa, the rise of Jihadi Islam and what some fear is Pakistan’s gradual slide towards becoming a ‘failed state’ despite some economic gains in the last five years. Also symptomatic of an unstable and uncertain security environment in the South Asian region are what some see as Sri Lanka’s inability to find a lasting solution to its internal challenges; the potential for Bangladesh’s gradual emergence as the new hub of Islamist fundamentalist terrorism and its struggle for economic upliftment to subsistence levels; the continuing negative impact of Maoist insurgency on Nepal’s fledgling democracy; the simmering discontent in Tibet and Xinjiang and what some see as a low-key uprising against China’s regime; and, the Myanmar peoples’ nascent movement for democracy. In all these countries, socio-economic development has been slow and, consequently, per capita income is alarmingly low. Transborder narcotics trafficking – the golden triangle lies to the east of South Asia and the golden crescent to its west – and the proliferation of small arms, make a potent cocktail. Ethnic tensions and fairly widespread radicalization, worsened by the advent of the vicious ideology of the Islamic state, add further to regional instability.

  9. Drug addiction and diabetes: South Asian action.

    Science.gov (United States)

    Singh Balhara, Yatan Pal; Kalra, Sanjay

    2017-06-01

    Both diabetes and drug addiction are common phenomena across the world. Drug abuse impacts glycaemic control in multiple ways. It becomes imperative, therefore, to share guidance on drug deaddiction in persons with diabetes. The South Asian subcontinent is home to specific forms and patterns of drug abuse. Detailed study is needed to ensure good clinical practice regarding the same. This communication provides a simple and pragmatic framework to address this issue, while calling for concerted action on drug deaddiction in South Asia.

  10. in a Family of South Indian Descent

    Directory of Open Access Journals (Sweden)

    Muthiah Subramanian

    2015-01-01

    Full Text Available Inherited channelopathies are a heterogeneous group of disorders resulting from dysfunction of ion channels in cellular membranes. They may manifest as diseases affecting skeletal muscle contraction, the conduction system of the heart, nervous system function, and vision syndromes. We describe a family of South Indian descent with hypokalemic periodic paralysis in which four members also have idiopathic generalized epilepsy. Hypokalemic periodic paralysis is a genetically heterogeneous channelopathy that has been linked to mutations in genes encoding three ion channels CACNIAS, SCN4A, and KCNJ2 predominantly. Although data on specific gene in idiopathic generalized epilepsy is relatively scarce, mutations of voltage gated sodium channel subunit genes (CACNB4 and nonsense mutations in voltage gated calcium channels (CACNA1A have been linked to idiopathic generalized epilepsy in two families. We speculate that gene mutations altering the ability of the beta subunit to interact with the alpha subunit of the CaV1.1 channel and mutations in the pore-forming potassium channel subunit may be possible explanations for the combined manifestation of both diseases. Functional analysis of voltage gated calcium channel and other ion channels mutations may provide additional support and insight for the causal role of these mutations. The understanding of mutations in ion-channel genes will lead to improved diagnosis and treatment of such inherited channelopathies.

  11. Journal of Endocrinology, Metabolism and Diabetes of South Africa ...

    African Journals Online (AJOL)

    Journal of Endocrinology, Metabolism and Diabetes of South Africa. ... Management of diabetic ketoacidosis · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... Prediabetes: a focus on the role of diabetes education in prevention of type 2 ...

  12. Drift pumice in the Indian and South Atlantic oceans

    International Nuclear Information System (INIS)

    Frick, C.; Kent, L.E.

    1984-01-01

    Sixty-three samples of drift pumice, collected at the coasts of South Africa, East Africa, Madagascar, Mauritius, the Cocos Islands, Australia, Indonesia, Brazil, Marion Island and Bouvet Island, were investigated petrographically and geochemically with a view to establishing the possible source areas. Geochemically five distinct groups could be distinguished and some could be liked to specific eruptions in the Indian, Atlantic and Pacific oceans. Group A pumice originated from a submarine eruption off Zavodovski Island in the South Sandwich Island Group in 1962. The pumice in Group B occurs mainly on the beaches bordering the Atlantic Ocean, and was found on the west coast of South Africa, on the sea floor south-west of South Africa, and in Brazil. The source of this group is unknown, but all the evidence indicates that it must have been from the Mid-Atlantic Ridge in the South Atlantic Ocean. The Group C pumice was found in the southern Indian Ocean, probably from the Mid-Indian Ridge. The fourth group originated from a submarine eruption along the Tonga Trench in the Pacific Ocean. Group E, which is by far the most homogeneous, includes samples from Australia, the Indian Ocean islands, East and South Africa and samples of the undisputed Krakatoan origin. Specimens from the Krakatoan eruption are still the most abundant type of drift pumice that can be found

  13. Diabetes-specific genetic effects on obesity traits in American Indian populations: the Strong Heart Family Study

    Directory of Open Access Journals (Sweden)

    Howard Barbara V

    2008-10-01

    Full Text Available Abstract Background Body fat mass distribution and deposition are determined by multiple environmental and genetic factors. Obesity is associated with insulin resistance, hyperinsulinemia, and type 2 diabetes. We previously identified evidence for genotype-by-diabetes interaction on obesity traits in Strong Heart Family Study (SHFS participants. To localize these genetic effects, we conducted genome-wide linkage scans of obesity traits in individuals with and without type 2 diabetes, and in the combined sample while modeling interaction with diabetes using maximum likelihood methods (SOLAR 2.1.4. Methods SHFS recruited American Indians from Arizona, North and South Dakota, and Oklahoma. Anthropometric measures and diabetes status were obtained during a clinic visit. Marker allele frequencies were derived using maximum likelihood methods estimated from all individuals and multipoint identity by descent sharing was estimated using Loki. We used variance component linkage analysis to localize quantitative trait loci (QTLs influencing obesity traits. We tested for evidence of additive and QTL-specific genotype-by-diabetes interactions using the regions identified in the diabetes-stratified analyses. Results Among 245 diabetic and 704 non-diabetic American Indian individuals, we detected significant additive gene-by-diabetes interaction for weight and BMI (P P Conclusion These results suggest distinct genetic effects on body mass in individuals with diabetes compared to those without diabetes, and a possible role for one or more genes on chromosome 1 in the pathogenesis of obesity.

  14. Palmar Dermatoglyphs of South Mrican Indians

    African Journals Online (AJOL)

    1974-03-09

    Mar 9, 1974 ... Interracial Comparisons. Indian males had a significantly higher (O,OOS>P>. 0,001) number of thenar features than had Black males, although, taken separately, the right and left hands were not significantly different. There was no such discrepancy between Indian and Coloured males, and there were no.

  15. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... IHS Diabetes Audit Audit/SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians Division of Diabetes Treatment ...

  16. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... IHS Diabetes Audit Clinician Resources Audit/SOS Login Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians Division of Diabetes Treatment ...

  17. Genetic studies of type 2 diabetes in South Asians: a systematic overview.

    Science.gov (United States)

    Chowdhury, Ritam; Narayan, Kabayam M Venkat; Zabetian, Azadeh; Raj, Suraja; Tabassum, Rubina

    2014-01-01

    Diabetes Mellitus, which affects 366 million people worldwide, is a leading cause of mortality, morbidity, and loss of quality of life. South Asians, comprising 24% of the world's population, suffer a large burden of type 2 diabetes. With intriguing risk phenotypes, unique environmental triggers, and potential genetic predisposition, South Asians offer a valuable resource for investigating the pathophysiology of type 2 diabetes. Genomics has proven its potential to underpin some of the etiology of type 2 diabetes by identifying a number of susceptibility genes, but such data are scarce and unclear in South Asians. We present a systematic review of studies on the genetic basis of type 2 diabetes or its complications in South Asians published between 1987-2012, and discuss the findings and limitations of the available data. Of the 91 eligible studies meeting our inclusion criteria, a vast majority included Indian populations, followed by a few in those of Pakistani origin, while other South Asian countries were generally under-represented. Though a large number of studies focused on the replication of findings from genome-wide association studies (GWAS) in European populations, a few studies explored new genes and pathways along with GWAS in South Asians and suggested the potential to unravel population- specific susceptibility genes in this population. We find encouraging improvements in study designs, sample sizes and the numbers of genetic variants investigated over the last five years, which reflect the existing capacity and scope for large-scale genetic studies in South Asians.

  18. Marketplace Clinics Complementing Diabetes Care for Urban Residing American Indians.

    Science.gov (United States)

    Rick, Robert; Hoye, Robert E; Thron, Raymond W; Kumar, Vibha

    2017-10-01

    For several decades, the Minneapolis American Indian population has experienced limited health care access and threefold diabetes health disparity. As part of an urban health initiative, the marketplace clinics located in nearby CVS, Target, and Supervalu stores committed financial support, providers, certified educators, and pharmacy staff for a community-based diabetes support group. To measure the extent to which collaborating marketplace clinics and the community-based support group expanded diabetes care and provided self-management education for this largely urban Indian neighborhood. A controlled quasi-experimental study and 3-years retrospective analysis of secondary data were used to test whether the Minneapolis marketplace clinics and the community diabetes support group participants (n = 48) had improved diabetes health outcomes relative to the comparison group (n = 87). The marketplace complemented intervention group employed motivational interviewing and the patient activation measure (PAM®) in coaching diabetes self-care and behavioral modification. The federally funded comparison group received only basic self-management education. T tests and effect sizes were used to quantify the difference between the study intervention and comparison groups. Statistical significance was determined for the following outcome variables: A1C ( P < .01), body mass index ( P < .04), and PAM® ( P < .001). Includes strengths, limitations, and future study recommendations. Positive effects of marketplace clinics and community health complementation were found with regard to improved blood glucose control, weight loss, and healthful lifestyle adaptation. Primary care and community health improvements could be realized by incorporating patient activation with diabetes prevention programs for the urban Indian two-thirds majority of the United States 5 million American Indian population.

  19. Economic Burden of Diabetes in Urban Indians

    OpenAIRE

    Chandra, Pablo; Gogate, Bageshri; Gogate, Parikshit; Thite, Nilesh; Mutha, Abhay; Walimbe, Amit

    2014-01-01

    Purpose : To find out the average economic burden of medical care on a patient with diabetes in Pune, India Methods : A semi-open ended questionnaire followed by interview was conducted with patients attending diabetes and ophthalmic out-patient departments. They were asked regarding the duration of diabetes, methods undertaken for blood sugar control and the amount they spend on consultations, laboratory tests, medicines and procedures if any within past year. Expenditure was classified as d...

  20. Seasonal variation of the South Indian tropical gyre

    NARCIS (Netherlands)

    Aguiar-González, B.; Ponsoni, Leandro; Ridderinkhof, H.; van Aken, H.M.; de Ruijter, W.P.M.; Maas, L.R.M.

    2016-01-01

    Based on satellite altimeter data and global atlases of temperature, salinity, wind stress and wind-driven circulation we investigate the seasonal variation of the South Indian tropical gyre and its associated open-ocean upwelling system, known as the Seychelles–Chagos Thermocline Ridge (SCTR).

  1. Association of paraoxonase-1 gene polymorphisms with insulin resistance in South Indian population.

    Science.gov (United States)

    Gomathi, Panneerselvam; Iyer, Anandi Chandramouli; Murugan, Ponniah Senthil; Sasikumar, Sundaresan; Raj, Nancy Bright Arul Joseph; Ganesan, Divya; Nallaperumal, Sivagnanam; Murugan, Maruthamuthu; Selvam, Govindan Sadasivam

    2018-04-15

    Insulin resistance plays a crucial role in the pathogenesis of type 2 diabetes and cardiovascular diseases. Recently, paraoxonase-1(PON1) is reported to have an ability to reduce insulin resistance by promoting glucose transporter-4 (GLUT-4) expression in vitro. Single nucleotide polymorphism (SNP) in PON1 is associated with variability in enzyme activity and concentration. Based on this we aimed to investigate the association of PON1 (Q192R and L55M) polymorphisms with the risk of developing insulin resistance in adult South Indian population. Two hundred and eighty seven (287) Type 2 diabetes patients and 293 healthy controls were enrolled in this study. All the study subjects were genotyped for PON1 (Q192R and L55M) missense polymorphisms using polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) method. Fasting serum insulin level was measured by ELISA. The distribution of QR/RR and LM/MM genotypes were significantly higher in type 2 diabetes patients compared with healthy controls. Moreover, the R and M alleles were significantly associated with type 2 diabetes with an Odds Ratio of 1.68 (P  R genotypes were found to be significantly associated with higher BMI, cholesterol, triglycerides, LDL, fasting serum insulin and HOMA-IR. Further, the mutant allele or genotypes of PON1 L55M were associated with higher BMI, triglycerides, VLDL, fasting serum insulin and HOMA-IR among adult type 2 diabetes patients. PON1 (Q192R and L55M) polymorphisms may play a crucial role in pathogenesis and susceptibility of insulin resistance thus leads to the development of type 2 diabetes in South Indian population. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Journal of Endocrinology, Metabolism and Diabetes of South Africa ...

    African Journals Online (AJOL)

    Diabetes distress and related factors in South African adults with type 2 diabetes · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Samantha Ramkisson, Basil Joseph Pillay, Benn Sartorius, 35-39 ...

  3. Diabetes distress and related factors in South African adults with ...

    African Journals Online (AJOL)

    aDepartment of Behavioural Medicine, School of Nursing and Public Health, College of ... Keywords: adults, depression, diabetes-related distress, glycaemic index, South Africa ... self-care and glycaemic control.7,8 Diabetes-related distress is.

  4. Anthropometric analysis of the hip joint in South Indian population using computed tomography

    Directory of Open Access Journals (Sweden)

    Vetrivel Chezian Sengodan

    2017-01-01

    Conclusion: This study indicates that there are significant differences in anthropometric parameters of proximal femur among the South Indian population compared with Western population. Even within the Indian population, the anthropometric parameters vary region to region.

  5. Management of type 2 diabetes in Asian Indians: a review of the literature.

    Science.gov (United States)

    Joseph, Letha M; Berry, Diane; Jessup, Ann

    2015-04-01

    Type 2 diabetes mellitus (T2DM) is increasing in Asian Indians globally. In this article, we review published studies of interventions designed to prevent T2DM or improve self-management in South Asian Indians. A PubMed, CINAHL, Medline, EMBASE, Psycinfo, Family & Society Studies Worldwide, Web of Science, and Consumer Health Complete search was conducted using the following search terms: type 2 diabetes mellitus, Asian Indian continental ancestry group, therapy, treatment, management, care, intervention, self-care, exercise, diet, and lifestyle. The review included pilot or full intervention studies examining the prevention and/or management of T2DM and qualitative studies analyzing the influence of various ethnic factors on the prevention and management of T2DM. Seventeen studies met the inclusion criteria. They examined the influence of culture and religion and the effectiveness of individual and community-based education and lifestyle improvement programs, exercise, and complementary therapies. Few programs led to the improved long-term management of T2DM. Further research is needed to develop ethnic-specific interventions. © The Author(s) 2014.

  6. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Treatment for the Prevention of Diabetes Richard Arakaki, MD Area Diabetes Consultant Phoenix Area IHS Stay Connected ... Headquarters, Indian Health Service, 5600 Fishers Lane, Rockville, MD 20857 - Find a Mail Stop Office Mail Stops ...

  7. Intestinal helminths in lowland South American Indians: some evolutionary interpretations.

    Science.gov (United States)

    Confalonieri, U; Ferreira, L F; Araújo, A

    1991-12-01

    Data on intestinal parasite infections for South American Indians in prehistoric times as revealed by coprolite analysis are being used to support transoceanic migration routes from the Old World to the New World. These same findings on modern semi-isolated aborigines, considered persisting prehistoric patterns, are also of great importance as indicators of pre-Columbian peopling of South America. This is the case for the Lengua Indians from Paraguay, studied in the 1920s, and the Yanomami and the Salumã from Brazil, studied in the 1980s. The intestinal parasitic profile of these groups can be empirically associated with culture change, but no clear correlations with the population biology of their hosts can be made at present because of scarcity of data.

  8. Economic burden of diabetes in urban indians.

    Science.gov (United States)

    Chandra, Pablo; Gogate, Bageshri; Gogate, Parikshit; Thite, Nilesh; Mutha, Abhay; Walimbe, Amit

    2014-01-01

    To find out the average economic burden of medical care on a patient with diabetes in Pune, India. A semi-open ended questionnaire followed by interview was conducted with patients attending diabetes and ophthalmic out-patient departments. They were asked regarding the duration of diabetes, methods undertaken for blood sugar control and the amount they spend on consultations, laboratory tests, medicines and procedures if any within past year. Expenditure was classified as direct cost (cost of medicines, doctor's fees, investigations, lasers and surgery) and indirect cost (travel, diet control, health classes and loss of wages). Data was collected regarding the socioeconomic status according to Kuppaswamy classification. 219 patients participated of whom 129 were males (58.9%). Average annual direct cost of diabetes treatment was Rs 8,822 of which 52.1% was spend on medicines, 3.2% was spend on lasers, 12.6% was spend on surgical procedures, 11.6% spent on investigations and 10.4% was spend on clinician fees. Average annual indirect cost was Rs. 3949 of which 3.4% was spend on travelling purpose, 0.4% was spent on health classes, 4.9% was spent on diet control and 91.3% was loss of wages. Average expenditure done by lower middle class was 23.7% of their income. Average percentage of income for direct and indirect cost was 3.6% and 1.4% respectively. The cost of the treatment formed1.3% of the annual income for those in Socio-economic class I, 1.7% in class II, 3.7% in class III and 23.7% in class IV. The cost of managing diabetes was a significant proportion of the patients' income, especially for those on lower socio-economic scale (class IV).

  9. The accuracy of polyuria, polydipsia, polyphagia, and Indian Diabetes Risk Score in adults screened for diabetes mellitus type-II

    OpenAIRE

    Shivshakti D Pawar; Poonam Thakur; B K Radhe; Harshal Jadhav; Vivek Behere; Vikrant Pagar

    2017-01-01

    Context: The World Health Organization report suggests that over 19% of the world's diabetic population currently resides in India. Unfortunately, >50% of the diabetics in India are unaware about their diabetic status. In the poor income country like India, it is essential to use cost-effective methods for screening for diabetes, and traditionally using three classical symptoms and Indian Diabetes Risk Score (IDRS) tool is helpful but, data regarding their diagnostic accuracy is very less. Ob...

  10. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... addition of new diabetes-related topics. New SDPI Fact Sheet Infographic! [PDF – 776 KB] See how SDPI has helped changed the course of diabetes over the past 20 years by reducing diabetes and its costly complications. Share with others today! 2017 Diabetes in Indian Country Conference Exit ...

  11. Journal of Endocrinology, Metabolism and Diabetes of South Africa

    African Journals Online (AJOL)

    JEMDSA) is published by the South African Medical Association and publishes papers related to endocrinology, metabolism and diabetes. Other websites related to this journal: http://www.jemdsa.co.za ...

  12. Efficacy of cheiloscopy in determination of sex among South indians.

    Science.gov (United States)

    Kautilya D, Vijay; Bodkha, Pravir; Rajamohan, Naveen

    2013-10-01

    Human identification plays a vital role in any crime investigation. Along with the various other established methods, cheiloscopy also plays a key role in linking the criminal with the crime. The ability of a technique in differentiating the sex of a person in the field can help in screening a large number of suspects. This study evaluated the efficacy of cheiloscopy in determination of sex among South Indians. It also studied the pattern of dimorphism in the lips and lip prints of south Indians. Lip prints from 100 medical students (50 males and 50 females) were obtained and were analyzed, based on Tsuchihashi and Suzuki classification, to check for dimorphism. Lip dimensions were studied by using standard sliding calipers for dimorphism. The most common pattern of lip print among males was Type III as compared to Type I in females. The outer four portions of the lip showed statistically significant differences in males and females. Middle portion of the lip was statistically insignificant in sex determination, based on lip print patterns. Thickness of the lip was significantly larger in males as compared to that in females and this criterion could be used to establish a logistic regression for determination of sex of a person. Lips not only significantly differ among the males and females in the pattern of the lip print that they present, but they also differ in their size. These features can effectively be used to determine the sex of a person accurately.

  13. Community-Specific BMI Cutoff Points for South Indian Females

    Directory of Open Access Journals (Sweden)

    K. B. Kishore Mohan

    2011-01-01

    Full Text Available Objective. To analyze multiparameters related to total body composition, with specific emphasis on obesity in South Indian females, in order to derive community-specific BMI cutoff points. Patients and Methods. A total number of 87 females (of age 37.33±13.12 years from South Indian Chennai urban population participated in this clinical study. Body composition analysis and anthropometric measurements were acquired after conducting careful clinical examination. Results. BMI demonstrated high significance when normal group (21.02±1.47 kg/m2 was compared with obese group (29.31±3.95 kg/m2, <0.0001. BFM displayed high significance when normal group (14.92±4.28 kg was compared with obese group (29.94 ± 8.1 kg, <0.0001. Conclusion. Community-specific BMI cutoffs are necessary to assess obesity in different ethnic groups, and relying on WHO-based universal BMI cutoff points would be a wrong strategy.

  14. Premature mortality patterns among American Indians in South Dakota, 2000-2010.

    Science.gov (United States)

    Christensen, Mathew; Kightlinger, Lon

    2013-05-01

    American Indians in South Dakota have the highest mortality rates in the nation compared to other racial and ethnic groups and American Indians in other states. Cause-related and age-specific mortality patterns among American Indians in South Dakota are identified to guide prevention planning and policy efforts designed to reduce mortality within this population, in both South Dakota and other parts of the U.S. Death certificate data from South Dakota (2000-2010), on 5738 American Indians and 70,580 whites, were used to calculate age-specific mortality rates and rate ratios. These values were examined in order to identify patterns among the leading causes of death. Analyses were completed in 2011 and 2012. Within the South Dakota population, 70% of American Indians died before reaching age 70 years, compared to 25% of whites. Fatal injuries and chronic diseases were the leading causes of premature mortality. Nine leading causes of death showed consistent patterns of mortality disparity between American Indians and whites, with American Indians having significantly higher rates of mortality at lower ages. Premature mortality among American Indians in South Dakota is a serious public health problem. Unified efforts at the federal, tribal, state, and local levels are needed to reduce premature death within this population. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Quality assurance in diabetic retinal screening in South Africa | Cook ...

    African Journals Online (AJOL)

    ... external quality assurance (EQA) on graders registered in the Ophthalmological Society of South Africa DR screening programme. Methods. Graders registered on the South African (SA) Diabetic Register website were invited to participate in the study. The Scottish EQA software system was used to enable on-line grading ...

  16. Traditional Indian Medicines Used for the Management of Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Syed Ibrahim Rizvi

    2013-01-01

    Full Text Available Plants have always been a source of drugs for humans since time immemorial. The Indian traditional system of medicine is replete with the use of plants for the management of diabetic conditions. According to the World Health Organization, up to 90% of population in developing countries use plants and its products as traditional medicine for primary health care. There are about 800 plants which have been reported to show antidiabetic potential. The present review is aimed at providing in-depth information about the antidiabetic potential and bioactive compounds present in Ficus religiosa, Pterocarpus marsupium, Gymnema sylvestre, Allium sativum, Eugenia jambolana, Momordica charantia, and Trigonella foenum-graecum. The review provides a starting point for future studies aimed at isolation, purification, and characterization of bioactive antidiabetic compounds present in these plants.

  17. Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes

    OpenAIRE

    Walls, Melissa L.; Sittner, Kelley J.; Aronson, Benjamin D.; Forsberg, Angie K.; Whitbeck, Les B.; al’Absi, Mustafa

    2017-01-01

    American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical...

  18. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Event Calendar Indian Health Manual Key Leaders Legislation Organizational Structure Our Employees Locations Headquarters Alaska Area Albuquerque ... be a favorite to share with friends and family. Order yours today! Find Tools for Diabetes Educators! ...

  19. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... selected presentation recordings. Good news: Reduction in Kidney Failure in AI/AN People Exit Disclaimer: You Are ... ihs.gov showing a dramatic decrease in kidney failure from diabetes among American Indians and Alaska Natives. ...

  20. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Recruiter Newsroom Announcements Congressional Testimony Contact Us Director's Speeches Fact Sheets IHS Blog Press Releases Reports to ... DSMES Into Your Practice [PDF – 275 KB] In the Spotlight Save the Date! 2019 Diabetes in Indian ...

  1. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians ... Prevention Program Toolkit, Program Spotlights, and more! Announcing Online Lesson Plan Outlines for Educators New or seasoned ...

  2. Prevalence of primary glaucoma in an urban South Indian population

    Directory of Open Access Journals (Sweden)

    Jacob Aby

    1998-01-01

    Full Text Available Glaucoma is fast emerging as a major cause of blindness in India. In order to estimate the prevalence of primary open angle glaucoma (POAG and primary angle closure glaucoma (PACG in an urban South Indian population, we examined 972 individuals aged 30-60 years, chosen using a cluster sampling technique from 12 census blocks of Vellore town. They underwent a complete ocular examination, including applanation tonometry and gonioscopy, at the Medical College Hospital. Characteristic field defects on automated perimetry was a diagnostic requisite for POAG. Prevalence (95% CI of POAG, PACG, and ocular hypertension were 4.1 (0.08-8.1, 43.2 (30.14-56.3, and 30.8 (19.8-41.9 per 1,000, respectively. All the PACG cases detected were of the chronic type. Hitherto unavailable community-based information on primary glaucoma in our study population indicates that PACG is about five times as common as POAG.

  3. A lightning climatology of the South-West Indian Ocean

    Directory of Open Access Journals (Sweden)

    C. Bovalo

    2012-08-01

    Full Text Available The World Wide Lightning Location Network (WWLLN data have been used to perform a lightning climatology in the South-West Indian Ocean (SWIO region from 2005 to 2011. Maxima of lightning activity were found in the Maritime Continent and southwest of Sri Lanka (>50 fl km−2 yr−1 but also over Madagascar and above the Great Lakes of East Africa (>10–20 fl km−2 yr−1. Lightning flashes within tropical storms and tropical cyclones represent 50 % to 100 % of the total lightning activity in some oceanic areas of the SWIO (between 10° S and 20° S.

    The SWIO is characterized by a wet season (November to April and a dry season (May to October. As one could expect, lightning activity is more intense during the wet season as the Inter Tropical Convergence Zone (ITCZ is present over all the basin. Flash density is higher over land in November–December–January with values reaching 3–4 fl km−2 yr−1 over Madagascar. During the dry season, lightning activity is quite rare between 10° S and 25° S. The Mascarene anticyclone has more influence on the SWIO resulting in shallower convection. Lightning activity is concentrated over ocean, east of South Africa and Madagascar.

    A statistical analysis has shown that El Niño–Southern Oscillation mainly modulates the lightning activity up to 56.8% in the SWIO. The Indian Ocean Dipole has a significant contribution since ~49% of the variability is explained by this forcing in some regions. The Madden–Julian Oscillation did not show significative impact on the lightning activity in our study.

  4. Lifestyle Choices Fuel Epidemics of Diabetes and Cardiovascular Disease Among Asian Indians.

    Science.gov (United States)

    O'Keefe, Evan L; DiNicolantonio, James J; Patil, Harshal; Helzberg, John H; Lavie, Carl J

    2016-01-01

    Within the next 15years, India is projected to overtake China as the world's most populous nation. Due to the rapid pace of urbanization and modernization fueling population growth, in conjunction with a genetic predisposition to insulin resistance, India is suffering a rising epidemic of non-communicable diseases (NCDs), including coronary artery disease (CAD), type 2 diabetes mellitus (T2DM), and stroke. In addition to the genetic predisposition, major negative lifestyle factors are contributing to the alarming outbreak of cardiovascular disease (CVD) among the Asian Indian population; these factors include: 1) a diet high in added sugar, refined grains and other processed foods, 2) physical inactivity, 3) vitamin D deficiency (VDD), and 4) smoking/pollution. These risk factors are all highly modifiable, and steps to improve these issues should be taken urgently to avoid a worsening NCD crisis among the inhabitants of the South Asian subcontinent as well as for people with Asian Indian ethnicity worldwide. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Association analysis of nine candidate gene polymorphisms in Indian patients with type 2 diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Govindarajan Gowthaman

    2010-11-01

    Full Text Available Abstract Background Diabetic retinopathy (DR is classically defined as a microvasculopathy that primarily affects the small blood vessels of the inner retina as a complication of diabetes mellitus (DM.It is a multifactorial disease with a strong genetic component. The aim of this study is to investigate the association of a set of nine candidate genes with the development of diabetic retinopathy in a South Indian cohort who have type 2 diabetes mellitus (T2DM. Methods Seven candidate genes (RAGE, PEDF, AKR1B1, EPO, HTRA1, ICAM and HFE were chosen based on reported association with DR in the literature. Two more, CFH and ARMS2, were chosen based on their roles in biological pathways previously implicated in DR. Fourteen single nucleotide polymorphisms (SNPs and one dinucleotide repeat polymorphism, previously reported to show association with DR or other related diseases, were genotyped in 345 DR and 356 diabetic patients without retinopathy (DNR. The genes which showed positive association in this screening set were tested further in additional sets of 100 DR and 90 DNR additional patients from the Aravind Eye Hospital. Those which showed association in the secondary screen were subjected to a combined analysis with the 100 DR and 100 DNR subjects previously recruited and genotyped through the Sankara Nethralaya Hospital, India. Genotypes were evaluated using a combination of direct sequencing, TaqMan SNP genotyping, RFLP analysis, and SNaPshot PCR assays. Chi-square and Fisher exact tests were used to analyze the genotype and allele frequencies. Results Among the nine loci (15 polymorphisms screened, SNP rs2070600 (G82S in the RAGE gene, showed significant association with DR (allelic P = 0.016, dominant model P = 0.012, compared to DNR. SNP rs2070600 further showed significant association with DR in the confirmation cohort (P = 0.035, dominant model P = 0.032. Combining the two cohorts gave an allelic P HTRA1, rs11200638 (G>A, showed marginal

  6. Type 2 diabetes after gestational diabetes mellitus in South Asian women in the United States.

    Science.gov (United States)

    Gadgil, Meghana D; Oza-Frank, Reena; Kandula, Namratha R; Kanaya, Alka M

    2017-07-01

    Gestational diabetes mellitus (GDM) is a major risk factor for type 2 diabetes. The incidence of both GDM and type 2 diabetes is exceedingly high in South Asian populations. However, the risk of type 2 diabetes after GDM in South Asian women in the United States is unknown. South Asians aged 40 to 84 years without known cardiovascular disease were enrolled in a community-based cohort called Mediators of Atherosclerosis in South Asians Living in America study. A history of GDM was elicited through self-report, and type 2 diabetes was ascertained by an oral glucose tolerance test. We performed a multivariable logistic regression analysis to examine the odds of type 2 diabetes after GDM history in this cross-sectional analysis. About 9.7% of women in the Mediators of Atherosclerosis in South Asians Living in America study self-reported a history of GDM, and were significantly younger, with higher mean diastolic blood pressure and self-reported weight at age 20 and 40 years than women without a history of GDM. In a model adjusted for age, weight at age 40, family history of diabetes, education, income, physical activity, caloric intake, alcohol use, and cigarette smoking, women with a history of GDM had increased odds of having type 2 diabetes compared with women without GDM (OR 3.2; 95% CI 1.3, 7.5). A history of GDM further increases the risk of type 2 diabetes in US South Asian women. Our findings underscore the importance of early postpartum screening in a population at high risk for type 2 diabetes. Copyright © 2017 John Wiley & Sons, Ltd.

  7. North-south diversity of Scolecithricidae species (Copepoda: Calanoida) in the Indian Ocean

    Digital Repository Service at National Institute of Oceanography (India)

    Gopalakrishnan, T.C.; Balachandran, T.

    The effectiveness of north-south hydrographical barriers in restricting the distributions of Scolecithricidae species (Copepoda:Calanoida) in the euphotic zone of the Indian Ocean was studied. Twenty seven species belonging to 7 genera were...

  8. Excerpt from The Red Land to the South: American Indian Writers and Indigenous Mexico

    Directory of Open Access Journals (Sweden)

    James H. Cox

    2013-09-01

    Full Text Available Excerpted from James H. Cox, The Red Land to the South: American Indian Writers and Indigenous Mexico (Minneapolis: University of Minnesota Press, 2012.Reprinted with permission from University of Minnesota Press.

  9. The Indian Ocean Experiment : Widespread air pollution from South and Southeast Asia

    NARCIS (Netherlands)

    Lelieveld, J; Crutzen, PJ; Ramanathan, A.; Andreae, MO; Brenninkmeijer, CAM; Campos, T; Cass, GR; Dickerson, RR; Fischer, H; de Gouw, JA; Hansel, A; Jefferson, A; Kley, D; de Laat, ATJ; Lal, S; Lawrence, MG; Lobert, JM; Mayol-Bracero, OL; Mitra, AP; Novakov, T; Oltmans, SJ; Prather, KA; Reiner, T; Rodhe, H; Scheeren, HA; Sikka, D; Williams, J

    2001-01-01

    The Indian Ocean Experiment (INDOEX) was an international, multiplatform field campaign to measure Long-range transport of air pollution from South and Southeast Asia toward the Indian Ocean during the dry monsoon season in January to March 1999. Surprisingly high pollution Levels were observed over

  10. Comparison of dietary profile of a rural south Indian population with the current dietary recommendations for prevention of non-communicable diseases (CURES 147

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    Narasimhan Sowmya

    2016-01-01

    Interpretation & conclusions: The dietary profile of this rural south Indian population reflected unhealthy choices, with the high consumption of refined cereals in the form of polished white rice and low intake of protective foods like fruits, vegetables, n-3 poly and monounsaturated fatty acids. This could potentially contribute to the increase in prevalence of NCDs like diabetes, hypertension and cardiovascular diseases in rural areas and calls for appropriate remedial action.

  11. Reframing Diabetes in American Indian Communities: A Social Determinants of Health Perspective

    Science.gov (United States)

    Mitchell, Felicia M.

    2012-01-01

    American Indians and Alaska Natives (AI/ANs) experience some of the greatest health inequities of any group within the United States. AI/ANs are diagnosed with diabetes more than twice as often as non-Hispanic white Americans. Diabetes is a chronic preventable disease often associated with individual risk factors and behaviors that indicate what…

  12. Vitamin D receptor gene polymorphisms and risk of polycystic ovary syndrome in South Indian women.

    Science.gov (United States)

    Siddamalla, Swapna; Reddy, Tumu Venkat; Govatati, Suresh; Erram, Nagendram; Deenadayal, Mamata; Shivaji, Sisinthy; Bhanoori, Manjula

    2018-02-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive age women. Emerging evidence suggests that Vitamin D Receptor (VDR) might be a causal factor for characteristics associated with PCOS such as obesity and type 2 diabetes. Present study investigated association between VDR gene BsmI A/G (rs1544410), ApaI A/C (rs7975232) and TaqI T/C (rs731236) single nucleotide polymorphisms and PCOS risk in South Indian women. Genotyping of VDR gene SNPs was carried out in PCOS patients (n = 95) and controls (n = 130) by PCR-RFLP method and confirmed by sequencing analysis. Haplotype frequencies for multiple loci and the standardized disequilibrium coefficient (D') for pairwise linkage disequilibrium (LD) were assessed by Haploview software. Results showed significantly increased frequencies of BsmI G/G (p = .0197), ApaI C/C (p = .048), TaqI C/C (p = .044) genotypes and BsmI G (p = .0181), ApaI C (p = .0092), TaqI C (p = .0066) alleles in patients compared to controls. In addition, the frequency of the 'BsmI G, ApaI C, TaqI C' haplotype was also significantly elevated in patients (p = .0087). In conclusion, the VDR gene BsmI A/G ApaI A/C TaqI T/C and haplotype may constitute an inheritable risk factor for PCOS in South Indian women.

  13. Assessment of Diabetes Risk in an Adult Population Using Indian Diabetes Risk Score in an Urban Resettlement Colony of Delhi.

    Science.gov (United States)

    Acharya, Anita Shankar; Singh, Anshu; Dhiman, Balraj

    2017-03-01

    Diabetes mellitus is one of the non-communicable diseases which has become a major global health problem whose prevalence is increasing worldwide and is expected to reach 4.4% by 2030. The risk of diabetes escalates with increase in the number of risk factors and their duration as well. The Indian Diabetic Risk Score (IDRS) is a simple, low cost, feasible tool for mass screening programme at the community level. To assess the risk score of diabetes among the study subjects using IDRS. A cross sectional survey was conducted on adults >30 years (n=580) on both gender in an urban resettlement colony of Delhi during December 2013 to March 2015. A Semi-structured interview schedule consisting of Socio-demographic characteristics, risk factor profile and Indian Diabetes Risk Score was used. Data was entered and analyzed in SPSS. Out of 580 subjects, 31 (5.3%) study subjects were not at risk of having diabetes, rest 94.5% were at moderate or high risk of diabetes.A statistically significant association of diabetes risk with marital status(p=0.0001), education(0.005),body mass index(0.049) and systolic blood pressure was seen.(p=0.006). More than 90% of the study subjects were at risk of having diabetes, hence screening is of utmost importance so that interventions can be initiated at an early stage.

  14. Diabetes prevention in the New York City Sikh Asian Indian community: a pilot study.

    Science.gov (United States)

    Islam, Nadia S; Zanowiak, Jennifer M; Wyatt, Laura C; Kavathe, Rucha; Singh, Hardayal; Kwon, Simona C; Trinh-Shevrin, Chau

    2014-05-19

    India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.). Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs have shown the benefits of using lifestyle intervention to reduce diabetes risk, yet there have been no culturally-tailored programs for diabetes prevention in the Sikh community. Using a quasi-experimental two-arm design, 126 Sikh Asian Indians living in New York City were enrolled in a six-workshop intervention led by community health workers. A total of 108 participants completed baseline and 6-month follow-up surveys between March 2012 and October 2013. Main outcome measures included clinical variables (weight, body mass index (BMI), waist circumference, blood pressure, glucose, and cholesterol) and health behaviors (changes in physical activity, food behaviors, and diabetes knowledge). Changes were significant for the treatment group in weight, BMI, waist circumference, blood pressure, glucose, physical activity, food behaviors, and diabetes knowledge, and between group differences were significant for glucose, diabetes knowledge, portion control, and physical activity social interaction. Retention rates were high. Findings demonstrate that a diabetes prevention program in the Sikh community is acceptable, feasible, and efficacious.

  15. Diabetes Prevention in the New York City Sikh Asian Indian Community: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Nadia S. Islam

    2014-05-01

    Full Text Available India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.. Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs have shown the benefits of using lifestyle intervention to reduce diabetes risk, yet there have been no culturally-tailored programs for diabetes prevention in the Sikh community. Using a quasi-experimental two-arm design, 126 Sikh Asian Indians living in New York City were enrolled in a six-workshop intervention led by community health workers. A total of 108 participants completed baseline and 6-month follow-up surveys between March 2012 and October 2013. Main outcome measures included clinical variables (weight, body mass index (BMI, waist circumference, blood pressure, glucose, and cholesterol and health behaviors (changes in physical activity, food behaviors, and diabetes knowledge. Changes were significant for the treatment group in weight, BMI, waist circumference, blood pressure, glucose, physical activity, food behaviors, and diabetes knowledge, and between group differences were significant for glucose, diabetes knowledge, portion control, and physical activity social interaction. Retention rates were high. Findings demonstrate that a diabetes prevention program in the Sikh community is acceptable, feasible, and efficacious.

  16. ETHNICITY AND TYPE 2 DIABETES IN ASIAN INDIAN MIGRANTS IN AUCKLAND, NEW ZEALAND

    Directory of Open Access Journals (Sweden)

    Jowitt Ljiljana

    2014-12-01

    Full Text Available The aim of this review was to present ethnic differences in body size and body composition in Asian Indian migrants in New Zealand, associated with metabolic syndrome and type 2 diabetes, through the comparison with other ethnic groups in New Zealand. International databases including PubMed and Google scholar were consulted, as well as the websites of the World Health Organization and International Diabetes Federation. About 74 studies out of 128 publications were selected to ensure relevance to the topic of the review. Seven research projects were presented for the body size and body composition of Asian Indian migrants in New Zealand. The prevalence of type 2 diabetes of 8.6% in Asian Indians in New Zealand is still higher than in their homeland, owing to their ethnicity, genetic predisposition, sedentary lifestyle and altered nutrition, and other psychosocial factors related to migration and living conditions like stress at work and depression. For the same body mass index, in comparison with people of other ethnic groups in New Zealand Asian Indians had more total body fat, higher percent body fat, more central fat, less lean mass and appendicular skeletal muscle mass. Central obesity was associated with insulin resistance and low grade systemic inflammation. Considering the evidence that type 2 diabetes develops ten years earlier in Asian Indians than in other populations, further studies are warranted to shed some light on the still incompletely understood metabolic syndrome and “thin-fat” Indian phenotype.

  17. Psychosocial stress in South African patients with type 2 diabetes

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    Samantha Ramkisson

    2016-11-01

    Full Text Available Objective: Diabetes mellitus is considered an emotionally and behaviourally demanding condition which adds to the stress of a patient’s daily living. There is a paucity of literature in South Africa regarding stress and diabetes. This study therefore aims to identify the areas and contributory factors of psychosocial stress in South African patients with diabetes. Method: A cross-sectional study was conducted at two public facilities and five private medical practices on the north coast of KwaZulu-Natal, South Africa. The Questionnaire on Stress in Diabetes – Revised was administered to 401 participants. Results: Eighteen percent of the sample reported having extreme psychosocial stress. Depression, physical complaints and self-medication/diet were the main areas which contributed to high psychosocial stress. Factors that also contributed to high levels of psychosocial stress were low educational level, unemployment, female gender, attending the public sector and high HbA1c levels. Conclusion: Psychosocial stress affects metabolic control in patients with diabetes, thereby increasing the risks of long-term complications.

  18. Journal of Endocrinology, Metabolism and Diabetes of South Africa ...

    African Journals Online (AJOL)

    The Achievement of Glycaemic, Blood Pressure and LDL Cholesterol Targets in Patients with Type 2 Diabetes Attending a South African Tertiary Hospital Outpatient Clinic · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Y Pinchevsky, V Shukla, N Butkow, FJ Raal, ...

  19. Latent Autoimmune Diabetes of the Adult (LADA in a Brazilian Indian

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    João Paulo Botelho Vieira Filho

    Full Text Available CONTEXT: Latent autoimmune diabetes of the adult (LADA as originally described represents perhaps as many as 10 -- 20% of adult-onset patients with diabetes. DESIGN: case report. CASE REPORT: A 38-year-old Brazilian Xavante-Jê Indian with Latent Autoimmune Diabetes of the Adult (LADA is described, coming from the Sangradouro community in Poxoréu, Mato Grosso. The onset of diabetes after reaching 25 years of age, the evolution to insulin deficiency after a period of insulin-independence and the presence of auto-antibodies to glutamic acid decarboxylase (GAD characteristic of LADA were present. This patient may represent the first case of LADA in a Brazilian with full Indian heritage. Further studies are necessary to verify the prevalence of this new type of diabetes in this population that does not have Caucasoid admixture and has a particular environmental background.

  20. Depression in diabetes mellitus-A comprehensive systematic review of literature from an Indian perspective.

    Science.gov (United States)

    Naskar, Subrata; Victor, Robin; Nath, Kamal

    2017-06-01

    Diabetes and depression are rapidly growing chronic health conditions that have significant negative impact upon the physical, psychological, social and occupational functioning, quality of life and often leads to socio-economic burden. Presence of both these comorbid diseases results in various short term and long term complications and increases the mortality as compared to those with depression or diabetes alone. Systematic review of the epidemiological data, risk factors and relationship between depression and glycaemic control among the Indian studies. We searched Pubmed, Pubmed Central, Google Scholar and Directory of Open Access Journal (DOAJ) databases to identify relevant Indian studies. Substantial variation in the prevalence of depression in people with diabetes was found across the 41 selected studies; according to this review the range is 2% to 84% (T1DM - 2-7%; T2DM - 8%-84%). Correlates of depression in diabetic patients are advancing age, female gender, low literacy rate, burden of being from a lower socioeconomic status, rural domicile, marriage and duration of diabetes of >2years, diabetes related complications and poor glycaemic control. Sedentary life without adequate physical activities, lack of self-care are often the factors that precipitates depression in a T2DM patient and vice versa. According to this review, among Indian population there is a significant association between depression and diabetes. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Diabetes in South and Central America: an update.

    Science.gov (United States)

    Aschner, Pablo; Aguilar-Salinas, Carlos; Aguirre, Loreto; Franco, Laercio; Gagliardino, Juan Jose; de Lapertosa, Sylvia Gorban; Seclen, Segundo; Vinocour, Mary

    2014-02-01

    The estimated population of the South and Central America (SACA) Region is 467.6 million and 64% is in the age range of 20-79 years but the population pyramid and age distribution are changing. The average prevalence of diabetes in the Region is 8.0% and is expected to reach 9.8% by the year 2035. Prevalence is much lower in rural settings than in urban and the differences attributed to lifestyle changes may be a target for intervention. The indigenous population is a particularly vulnerable group needing special attention. On average, 24% of the adult cases with diabetes are undiagnosed but in some countries this is still as high as 50%. Health expenditure due to diabetes in the Region is around 9% of the global total. Inadequate glycemic control, defined as HbA1c >7%, is a strong predictor of chronic complications which increase resource use in the Region and less than half of the patients enrolled in diabetes care programmes are at target. Fifty percent or more of the adult population is overweight/obese and around one third of the adult population has metabolic syndrome using regional cutoffs for waist circumference. The number of people with IGT is almost equal to those with diabetes presenting an additional challenge for prevention. Children with type 1 diabetes represent only 0.2% of the total population with diabetes but the incidence may be increasing. In many places they have limited access to insulin, and even when available, it is not used appropriately. The available epidemiological data provide the background to act in developing national diabetes programmes which integrate diabetes care with cardiovascular prevention and promote diabetes prevention as well. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Quality assurance in diabetic retinal screening in South Africa.

    Science.gov (United States)

    Cook, Steve; Staff, Roger T; Goatman, Keith A; Olson, John A

    2014-09-03

    Diabetic retinopathy (DR) is an important biomarker for microvascular disease and blindness. Digital fundus photography is a cost-effective way of screening for DR. Access to DR screening is difficult for many South Africans with diabetes. To perform external quality assurance (EQA) on graders registered in the Ophthalmological Society of South Africa DR screening programme. Graders registered on the South African (SA) Diabetic Register website were invited to participate in the study. The Scottish EQA software system was used to enable on-line grading of 100 retinal photographs. Expert National Health Service graders provided the consensus expert grading for the image set. Two hundred and sixty-one participants completed the EQA process, including nine ophthalmologists, 243 optometrists, and nine other graders. A wide range of outcomes were demonstrated, with a mean sensitivity of 0.905 (range 0.286 - 1.000) and mean specificity of 0.507 (0.000 - 0.935). The mean diagnostic odds ratio was calculated to be 12.3 (range 0.147 - 148.2). This is the first quality assurance study conducted with SA healthcare professionals. The outcomes are of interest to all stakeholders dealing with the diabetes epidemic. The disparity in grader performance indicates room for improvement. The results demonstrate a high referral rate to ophthalmology, suggesting that on average graders are performing safely, but with a high number of inappropriate referrals.

  3. South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

    OpenAIRE

    Sarita Bajaj; Fatema Jawad; Najmul Islam; Hajera Mahtab; Jyoti Bhattarai; Dina Shrestha; Chandrika Wijeyaratne; Dimuthu T Muthukuda; Niranjala Weegoda Widanage; Than Than Aye; Moe Wint Aung; Bharti Kalra; R M Anjana; Aswathy Sreedevi; Komal Verma

    2013-01-01

    Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultur...

  4. A diabetes self-management program designed for urban American Indians.

    Science.gov (United States)

    Castro, Sarah; O'Toole, Mary; Brownson, Carol; Plessel, Kimberly; Schauben, Laura

    2009-10-01

    Although the American Indian population has a disproportionately high rate of type 2 diabetes, little has been written about culturally sensitive self-management programs in this population. Community and clinic partners worked together to identify barriers to diabetes self-management and to provide activities and services as part of a holistic approach to diabetes self-management, called the Full Circle Diabetes Program. The program activities and services addressed 4 components of holistic health: body, spirit, mind, and emotion. Seven types of activities or services were available to help participants improve diabetes self-management; these included exercise classes, educational classes, and talking circles. Ninety-eight percent of program enrollees participated in at least 1 activity, and two-thirds participated in 2 or more activities. Program participation resulted in a significant improvement in knowledge of resources for managing diabetes. The Full Circle Diabetes Program developed and implemented culturally relevant resources and supports for diabetes self-management in an American Indian population. Lessons learned included that a holistic approach to diabetes self-management, community participation, and stakeholder partnerships are needed for a successful program.

  5. Aldehyde dehydrogenase polymorphism in North American, South American, and Mexican Indian populations.

    Science.gov (United States)

    Goedde, H W; Agarwal, D P; Harada, S; Rothhammer, F; Whittaker, J O; Lisker, R

    1986-01-01

    While about 40% of the South American Indian populations (Atacameños, Mapuche, Shuara) were found to be deficient in aldehyde dehydrogenase isozyme I (ALDH2 or E2), preliminary investigations showed very low incidence of isozyme deficiency among North American natives (Sioux, Navajo) and Mexican Indians (mestizo). Possible implications of such trait differences on cross-cultural behavioral response to alcohol drinking are discussed. PMID:3953578

  6. In Search of Agency: South Indian Percussion in a Globalized India

    OpenAIRE

    Jones, Erica Suzanne

    2017-01-01

    South Indian classical (Karnatic) music and dance are essential representations of a globalized Indian identity and culture. They are emblematic of and perpetuate socio-cultural ideals of masculinity and femininity within nationalist and performance spaces. I examine the current performance space as a heritage tradition, revived and reclaimed in the 1940s-Nationalist Period. My dissertation focuses on the performance of gender within Karnatic music from a postcolonial decolonized perspective....

  7. Associations of variants in FTO and near MC4R with obesity traits in South Asian Indians.

    Science.gov (United States)

    Vasan, Senthil K; Fall, Tove; Neville, Matthew J; Antonisamy, Belavendra; Fall, Caroline H; Geethanjali, Finney S; Gu, Harvest F; Raghupathy, Palany; Samuel, Prasanna; Thomas, Nihal; Brismar, Kerstin; Ingelsson, Erik; Karpe, Fredrik

    2012-11-01

    Recent genome-wide association studies show that loci in FTO and melanocortin 4 receptor (MC4R) associate with obesity-related traits. Outside Western populations the associations between these variants have not always been consistent and in Indians it has been suggested that FTO relates to diabetes without an obvious intermediary obesity phenotype. We investigated the association between genetic variants in FTO (rs9939609) and near MC4R (rs17782313) with obesity- and type 2 diabetes (T2DM)-related traits in a longitudinal birth cohort of 2,151 healthy individuals from the Vellore birth cohort in South India. The FTO locus displayed significant associations with several conventional obesity-related anthropometric traits. The per allele increase is about 1% for BMI, waist circumference (WC), hip circumference (HC), and waist-hip ratio. Consistent associations were observed for adipose tissue-specific measurements such as skinfold thickness reinforcing the association with obesity-related traits. Obesity associations for the MC4R locus were weak or nonsignificant but a signal for height (P work poorly in the Indian "thin-fat" phenotype.

  8. Barriers and Motives to PA in South Asian Indian Immigrant Women.

    Science.gov (United States)

    Daniel, Manju; Abendroth, Maryann; Erlen, Judith A

    2017-03-01

    The high prevalence of chronic illnesses in South Asian Indian immigrant women underscores the need for identifying factors that could influence their PA. The purpose of this qualitative study was to examine the perspectives of South Asian Indian immigrant women related to barriers to and motives for lifestyle PA within the PA Framework for South Asian Indian Immigrants. Forty women participated in focus groups that were conducted in English and Hindi. Focus group questions were open-ended and semistructured. Transcribed and de-identified audiotaped sessions were coded and analyzed using Atlas.ti software. Role expectation was a core theme for barriers with four subthemes: lack of time, loss of interest, diminished social support, and environmental constraints. Self-motivation was a core theme for motives with three subthemes: optimal physical and psychological health, emphasis on external beauty, and strong social support. Future PA interventions need to target these culturally sensitive factors.

  9. Association of diabetes and cancer mortality in American Indians: the Strong Heart Study.

    Science.gov (United States)

    Best, Lyle G; García-Esquinas, Esther; Yeh, Jeun-Liang; Yeh, Fawn; Zhang, Ying; Lee, Elisa T; Howard, Barbara V; Farley, John H; Welty, Thomas K; Rhoades, Dorothy A; Rhoades, Everett R; Umans, Jason G; Navas-Acien, Ana

    2015-11-01

    The metabolic abnormalities that accompany diabetes mellitus are associated with an increased risk of many cancers. These associations, however, have not been well studied in American Indian populations, which experience a high prevalence of diabetes. The Strong Heart Study is a population-based, prospective cohort study with extensive characterization of diabetes status. Among a total cohort of 4,419 participants who were followed for up to 20 years, 430 cancer deaths were identified. After adjusting for sex, age, education, smoking status, drinking status, and body mass index, participants with diabetes at baseline showed an increased risk of gastric (HR 4.09; 95% CI 1.42-11.79), hepatocellular (HR 2.94; 95% CI 1.17-7.40), and prostate cancer mortality (HR 3.10; 95% CI 1.22-7.94). Further adjustment for arsenic exposure showed a significantly increased risk of all-cause cancer mortality with diabetes (HR 1.27; 95% CI 1.03-1.58). Insulin resistance among participants without diabetes at baseline was associated with hepatocellular cancer mortality (HR 4.70; 95% CI 1.55-14.26). Diabetes mellitus, and/or insulin resistance among those without diabetes, is a risk factor for gastric, hepatocellular, and prostate cancer in these American Indian communities, although relatively small sample size suggests cautious interpretation. Additional research is needed to evaluate the role of diabetes and obesity on cancer incidence in American Indian communities as well as the importance of diabetes prevention and control in reducing the burden of cancer incidence and mortality in the study population.

  10. Diabetes Outcomes in the Indian Health System During the Era of the Special Diabetes Program for Indians and the Government Performance and Results Act

    Science.gov (United States)

    Wilson, Charlton; Gilliland, Susan; Cullen, Theresa; Moore, Kelly; Roubideaux, Yvette; Valdez, Lorraine; Vanderwagen, William; Acton, Kelly

    2005-01-01

    Objectives. We reviewed changes in blood glucose, blood pressure, and cholesterol levels among American Indians and Alaska Natives between 1995 and 2001 to estimate the quality of diabetes care in the Indian Health Service (IHS) health care delivery system. Methods. We conducted a cross-sectional analysis of data from the Indian Health Service Diabetes Care and Outcomes Audit. Results. Adjusted mean Hemoglobin A1c (HbA1c) levels (7.9% vs 8.9%) and mean diastolic blood pressure levels (76 vs 79 mm Hg) were lower in 2001 than in 1995, respectively. A similar pattern was observed for mean total cholesterol (193 vs 208 mg/dL) and triglyceride (235 vs 257 mg/dL) levels in 2001 and 1995, respectively. Conclusions. We identified changes in intermediate clinical outcomes over the period from 1995 to 2001 that may reflect the global impact of increased resource allocation and improvements in processes on the quality of diabetes care, and we describe the results that may be achieved when community, health program, and congressional initiatives focus on common goals. PMID:16051933

  11. Risk factors of diabetes in North Indians with metabolic syndrome.

    Science.gov (United States)

    Pratyush, Daliparthy D; Tiwari, Shalbha; Singh, Saurabh; Singh, Surya K

    2016-01-01

    Metabolic syndrome progresses to diabetes and determinants of this progression like hyperinsulinemia, hypertriglyceridemia and genetic factors have been speculative. The present study was aimed at quantifying the insulin resistance and influence of family history of diabetes in subjects with metabolic syndrome developing prediabetes and diabetes. Consecutive subjects attending the endocrine clinic were evaluated for metabolic syndrome as per definition of International Diabetes Federation, 2005. The family history of diabetes in their first degree relatives was ascertained and Homeostasis model assessment of Insulin resistance (HOMA-IR), Homeostasis model assessment for beta cell function (HOMA-B) and Quantitative insulin sensitivity check index (QUICKI) were calculated in 163 subjects enrolled. HOMA-IR was higher (pmetabolic syndrome+prediabetes or diabetes compared to metabolic syndrome with normal glucose tolerance. HOMA-B was lower and prevalence of prediabetes and diabetes was higher in metabolic syndrome subjects with family history of diabetes than in those without such family history (pmetabolic syndrome having prediabetes and diabetes had more severe insulin resistance than those with metabolic syndrome only. Beta cell dysfunction was remarkable and prevalence of prediabetes was high in metabolic syndrome subjects with family history of diabetes. Both the severity of the insulin resistance and family history of diabetes are therefore proposed to be determinants of diminished Beta cell function leading to diabetes in metabolic syndrome. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  12. Overview of the Diabetes Initiative of South Carolina.

    Science.gov (United States)

    Colwell, J A; Keisler, D; Jenkins, C; Boateng, Y; Arnold, P; Lackland, D; Zheng, D; Wheeler, F C; Rosebrock, G; Smith, S H

    1998-11-01

    Implementation is underway for many of these programs, and there are descriptions of activities elsewhere in this symposium. The Board recognizes that in dealing with the complications of a chronic disease like diabetes, many years of intense effort will be needed before significant results may be appreciated. Progress will be monitored regularly by the Surveillance Council and SCDCP/DHEC, and modifications of the plan will be made by the Board at intervals after review of the data. We are optimistic that over the next decade, this system will make a significant impact to reduce mortality, morbidity, and costs of diabetes, and the result will be an increased quality of life for people affected by diabetes in South Carolina.

  13. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... watch selected presentation recordings. Good news: Reduction in Kidney Failure in AI/AN People Exit Disclaimer: You Are ... www.ihs.gov showing a dramatic decrease in kidney failure from diabetes among American Indians and Alaska Natives. ...

  14. Investigation of Factors Contributing to Diabetes Risk in American Indian/Alaska Native Youth

    Science.gov (United States)

    Islam-Zwart, Kayleen; Cawston, Alvina

    2008-01-01

    This study investigated the relationship between family history, sedentary behaviors, and childhood risk for type 2 diabetes. Participants were 480 students attending schools on or near an American Indian reservation. Data were collected through survey and BMI measurement. Children who frequently watched television or played video games did not…

  15. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Science.gov (United States)

    ... SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians Division ... 07E57B Office of Management Services - 09E70 Office of Public Health Support - ... of Resource Access and Partnerships - 10E85C Office of Tribal Self Governance - ...

  16. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians Division ... 07E57B Office of Management Services - 09E70 Office of Public Health Support - ... of Resource Access and Partnerships - 10E85C Office of Tribal Self Governance - ...

  17. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Press Releases Reports to Congress Tribal Leader Letters Urban Leader Letters IHS Home Division of Diabetes Treatment ... Office of Tribal Self Governance - 08E05 Office of Urban Indian Health Programs - 08E65C Accessibility Budget Contact Information ...

  18. Neurocysticercosos in South-Central America and the Indian Subcontinent: a comparative evaluation

    Directory of Open Access Journals (Sweden)

    Gagandeep Singh

    1997-09-01

    Full Text Available Neurocysticercosis is an important public health problem in South-Central America and South Asia. A review of the differences in epidemiological and clinical attributes of cysticercosis and taeniasis in South Central America and India, respectively, is undertaken in the present communication. Intestinal taeniasis is hyperendemic in several American countries. In comparison, the prevalence of Taenia solium infestation is lower in India. The clinical manifestations in several American neurocysticercosis series comprise epilepsy, intracranial hypertension and meningeal - racemose cysticercosis, in roughly equal proportions. An overwhelming majority of the Indian subjects present with seizures. The commonest pathological substrate of the disorder in Indian patients is the solitary parenchymal degenerating cyst. The reasons for the predominance of solitary forms in India, and of multilesional forms in South Central America are discussed. The magnitude of Taenia solium infestation and the frequency of pork consumption in a given population appear to influence the quantum of cyst load in affected individuals.

  19. Serum AGEs in black South African patients with type 2 diabetes

    African Journals Online (AJOL)

    T2D and 81 non-diabetic patients at Dr George Mukhari Academic Hospital in Pretoria, South Africa. Outcome ... Subjects. In total, 138 subjects with type 2 diabetes (T2D) and 81 control subjects were ..... loss of glucose tolerance associated with the diabetic state, treatment ..... fracture risk in older adults with type 2 diabetes.

  20. Common Polymorphisms in the Adiponectin Gene ACDC Are Not Associated With Diabetes in Pima Indians

    DEFF Research Database (Denmark)

    de Courten, Barbora; Hanson, Robert L; Funahashi, Tohru

    2005-01-01

    associated with plasma adiponectin levels, obesity, insulin resistance, and type 2 diabetes. To determine the role of genetic variation in ACDC in susceptibility to obesity and type 2 diabetes in Pima Indians, we screened the promoter, exons, and exon-intron boundaries of the gene to identify allelic...... diabetes, BMI, serum lipid levels, serum adiponectin levels, and measures of insulin sensitivity and secretion. None of the ACDC variants were associated with type 2 diabetes, BMI, or measures of insulin sensitivity or secretion. One variant, single nucleotide polymorphism (SNP)-12823, was associated...... with serum adiponectin levels (P = 0.002), but this association explained only 2% of the variance of serum adiponectin levels. Our findings suggest that these common ACDC polymorphisms do not play a major role in susceptibility to obesity or type 2 diabetes in this population....

  1. Evidence of a southward eddy corridor in the South-West Indian ocean

    CSIR Research Space (South Africa)

    Ansorge, IJ

    2015-09-01

    Full Text Available Mesoscale eddies and meanders have been shown to be one of the dominant sources of flow variability in the world s ocean. One example of an isolated eddy hotspot is the South-West Indian Ridge (SWIR). Several investigations have shown that the SWIR...

  2. Spirits of the Air: Birds and American Indians in the South

    Directory of Open Access Journals (Sweden)

    E. N. Anderson

    2010-08-01

    Full Text Available Review of Spirits of the Air: Birds and American Indians in the South. Shepard Krech III. 2009. University of Georgia Press, Athens. Pp. 245, copiously illustrated. $44.95 (hardbound. ISBN-13 978-0-8203-2815-7.

  3. Multiple environments: South Indian children’s environmental subjectivities in formation

    NARCIS (Netherlands)

    de Hoop, E.

    2017-01-01

    This article explores the formation of South Indian children’s (11–15 years old) environmental subjectivities based on five months of qualitative fieldwork with children in their school and non-school lives. By doing so, this paper aims to widen the scope of the existing literature on children’s

  4. Rajend Mesthrie. A Lexicon of South African Indian English, 1st edition

    African Journals Online (AJOL)

    with biryani) and the House of Deli-goats (House of Delegates). More positive contributions will emerge from politics, music, arts, culture, literature, diplo- macy and tourism. Moreover, as Mesthrie concedes, "the early history of South. African Indian English has yet to be fully uncovered" (p. xxiii). To this, one could add that a ...

  5. U.S. Engineering Degrees for Improving South Indian Graduate Students' Marriage and Dowry Options

    Science.gov (United States)

    Yakaboski, Tamara; Sheridan, Robyn Stout; Dade, Kristin

    2014-01-01

    The article examines improved marriage opportunities as an unexplored motivator for pursuing international education via U.S. graduate engineering degrees and stresses the need to centralize gender in analyzing academic mobility and international education. This interdisciplinary qualitative study explores how South Indian men and women's…

  6. Case management to reduce cardiovascular disease risk in American Indians and Alaska Natives with diabetes: results from the Special Diabetes Program for Indians Healthy Heart Demonstration Project.

    Science.gov (United States)

    Moore, Kelly; Jiang, Luohua; Manson, Spero M; Beals, Janette; Henderson, William; Pratte, Katherine; Acton, Kelly J; Roubideaux, Yvette

    2014-11-01

    We evaluated cardiovascular disease (CVD) risk factors in American Indians/Alaska Natives (AI/ANs) with diabetes in the Special Diabetes Program for Indians Healthy Heart (SDPI-HH) Demonstration Project. Multidisciplinary teams implemented an intensive case management intervention among 30 health care programs serving 138 tribes. The project recruited 3373 participants, with and without current CVD, between 2006 and 2009. We examined data collected at baseline and 1 year later to determine whether improvements occurred in CVD risk factors and in Framingham coronary heart disease (CHD) risk scores, aspirin use, and smoking status. A1c levels decreased an average of 0.2% (P risk scores also decreased significantly. Aspirin therapy increased significantly, and smoking decreased. Participants with more case management visits had significantly greater reductions in LDL cholesterol and A1c values. SDPI-HH successfully translated an intensive case management intervention. Creative retention strategies and an improved understanding of organizational challenges are needed for future Indian health translational efforts.

  7. Ocean transport and variability studies of the South Pacific, Southern, and Indian Oceans

    Science.gov (United States)

    Church, John A.; Cresswell, G. R.; Nilsson, C. S.; Mcdougall, T. J.; Coleman, R.; Rizos, C.; Penrose, J.; Hunter, J. R.; Lynch, M. J.

    1991-01-01

    The objectives of this study are to analyze ocean dynamics in the western South Pacific and the adjacent Southern Ocean and the eastern Indian Ocean. Specifically, our objectives for these three regions are, for the South Pacific Ocean: (1) To estimate the volume transport of the east Australian Current (EAC) along the Australian coast and in the Tasman Front, and to estimate the time variability (on seasonal and interannual time scales) of this transport. (2) To contribute to estimating the meridional heat and freshwater fluxes (and their variability) at about 30 deg S. Good estimates of the transport in the western boundary current are essential for accurate estimates of these fluxes. (3) To determine how the EAC transport (and its extension, the Tasman Front and the East Auckland Current) closes the subtropical gyre of the South Pacific and to better determine the structure at the confluence of this current and the Antarctic Circumpolar Current. (4) To examine the structure and time variability of the circulation in the western South Pacific and the adjacent Southern Ocean, particularly at the Tasman Front. For the Indian Ocean: (5) To study the seasonal interannual variations in the strength of the Leeuwin Current. (6) To monitor the Pacific-Indian Ocean throughflow and the South Equatorial and the South Java Currents between northwest Australia and Indonesia. (7) To study the processes that form the water of the permanent oceanic thermocline and, in particular, the way in which new thermocline water enters the permanent thermocline in late winter and early spring as the mixed layer restratifies. For the Southern Ocean: (8) To study the mesoscale and meridional structure of the Southern Ocean between 150 deg E and 170 deg E; in particular, to describe the Antarctic frontal system south of Tasmania and determine its interannual variability; to estimate the exchanges of heat, salt, and other properties between the Indian and Pacific Oceans; and to investigate the

  8. The accuracy of polyuria, polydipsia, polyphagia, and Indian Diabetes Risk Score in adults screened for diabetes mellitus type-II

    Directory of Open Access Journals (Sweden)

    Shivshakti D Pawar

    2017-01-01

    Full Text Available Context: The World Health Organization report suggests that over 19% of the world's diabetic population currently resides in India. Unfortunately, >50% of the diabetics in India are unaware about their diabetic status. In the poor income country like India, it is essential to use cost-effective methods for screening for diabetes, and traditionally using three classical symptoms and Indian Diabetes Risk Score (IDRS tool is helpful but, data regarding their diagnostic accuracy is very less. Objective: (1 To assess the diagnostic accuracy of polyuria, polydipsia, polyphagia, and IDRS for detecting diabetes. Settings and Design: Six hundred and seventy-seven adult individuals> 20 years of age were screened for diabetes and assessed polyuria, polydipsia, polyphagia, and IDRS score. All were subjected for postprandial blood glucose level. Subjects and Methods: For diagnostic accuracy sensitivity, specificity, positive and negative predictive values, likelihood ratios (LRs, for positive and negative tests, and accuracy was calculated for each symptom. Similarly, by receiver operative curve (ROC curve analysis, we carried out sensitivity and specificity of IDRS. Results: There was statistically significant association between these three classical symptoms and diabetes status of individuals. When present, all these three symptoms carried 7.34% sensitivity and 98.42% specificity with positive predictive value 47.06% and NPV 84.70%, LR+4.36, LR−0.94 with accuracy of 85%. The optimum cutoff value of IDRS score was> 50, which carried sensitivity 73%, specificity 58.7%, and area under curve for ROC was 68% (P < 0.001. Conclusions: This study has shown highest specificity for these three classical symptoms in diagnosing diabetes, but these symptoms were insensitive to detect all diabetic subjects.

  9. Oxygen isotope records of Globigerina bulloides across a north-south transect in the south-western Indian Ocean

    Digital Repository Service at National Institute of Oceanography (India)

    Khare, N.; Chaturvedi, S.K.; Saraswat, R

    , Washington, D.C). Lutjeharms, J.R.E., N.M. Walters and B.R. Allanson. 1985. Oceanic frontal systems and biologicalenhancement. p.11-21. In: Antarctic Nutrient Cycles and Food Webs. ed. by W.R. Siegfried et al., Springer-Verlag, NewYork. Matsumoto, K., J...: Ocean Sci. J.: 44(2); 2009; 117-123 OXYGEN ISOTOPE RECORDS OF GLOBIGERINA BULLOIDES ACROSS A NORTH-SOUTH TRANSECT IN THE SOUTH-WESTERN INDIAN OCEAN N. Khare 1* , S. K. Chaturvedi 2 and R. Saraswat 3 1. Ministry of Earth Sciences, Block...

  10. Dietary modifications to improve micronutrient status of Indian children and adolescents with type 1 diabetes.

    Science.gov (United States)

    Parthasarathy, Lavanya S; Chiplonkar, Shashi A; Khadilkar, Anuradha V; Khadilkar, Vaman V

    2015-01-01

    Diet plays a crucial role for maintaining normal growth and development while optimizing glycemic control in children with diabetes. Dietary restrictions, in a diabetic child's diet may lead to micronutrient deficiencies. To examine dietary nutritional deficiencies of Asian Indian children with Type 1 diabetes mellitus and develop micronutrient-rich recipes suitable for them. Anthropometry, diet (3-day recall) of 70 children with diabetes (24 boys) was recorded. Daily nutrient intakes and nutrient content of recipes were estimated using CDIET version 2.0. Mean intake amongst children for energy was 79% of Indian Recommended Dietary Allowance (RDA), protein was 105% RDA, but fat intakes were high (143% RDA). Mean intakes of riboflavin, β carotene, zinc, iron were less than 50%, and thiamin and calcium were around 60% RDA suggesting a possible multiple micronutrient deficiency. Based on popularly consumed snacks, 20 healthy recipes were devised that can be incorporated in children's diet. Mean energy content of new recipes was similar to routine snacks (281±28 kcal/100 g vs 306±27 kcal/100 g cooked weight). However, the mean vitamin and mineral content of new recipes was significantly higher (pcontent (zinc, calcium and iron) and twofold increase in total vitamin content (β carotene, vitamin C, vitamin B-1, B-2, and B-3) in new recipes compared with the routine snacks. Multiple dietary micronutrient deficiencies are observed in diabetic children. Addition of newly developed recipes in their everyday diet may help to enhance micronutrient intakes without increasing their energy load.

  11. Diabetes guidelines and clinical practice: is there a gap? The South ...

    African Journals Online (AJOL)

    Objectives: The objective of this survey was to determine the therapeutic management of patients with diabetes in the South African private healthcare environment. Design: The International Diabetes Management Practices Study is an international multicentre and observational study. In this paper, the local South African ...

  12. South Dakota NASA Space Grant Consortium Creating Bridges in Indian Country

    Science.gov (United States)

    Bolman, J. R.

    2004-12-01

    The South Dakota Space Grant Consortium (SDSGC) was established March 1, 1991 by a NASA Capability Enhancement Grant. Since that time SDSGC has worked to provide earth and space science educational outreach to all students across South Dakota. South Dakota has nine tribes and five tribal colleges. This has presented a tremendous opportunity to develop sustainable equitable partnerships and collaborations. SDSGC believes strongly in developing programs and activities that highlight the balance of indigenous science and ways of knowing with current findings in contemporary science. This blending of science and culture creates a learning community where individuals, especially students, can gain confidence and pride in their unique skills and abilities. Universities are also witnessing the accomplishments and achievements of students who are able to experience a tribal college environment and then carry that experience to a college/university/workplace and significantly increase the learning achievement of all. The presentation will highlight current Tribal College partnerships with Sinte Gleska University and Oglala Lakota College amongst others. Programs and activities to be explained during the presentation include: Native Connections, Scientific Knowledge for Indian Learning and Leadership (SKILL), Bridges to Success Summer Research Program, Fire Ecology Summer Experience, and dual enrolled/college bridge programs. The presentation will also cover the current initiatives underway through NASA Workforce Development. These include: partnering program with the Annual He Sapa Wacipi, American Indian Space Days 2005, NASA research/internship programs and NASA Fellow Summit. An overview of recent American Indian student success will conclude the presentation. The South Dakota School of Mines and Technology has struggled over many years to develop and implement sustainable successful initiatives with Tribal Colleges and Communities. The motivating philosophy is the

  13. Human leukocyte Antigen-B*27 allele subtype prevalence and disease association of ankylosing spondylitis among south indian population

    Directory of Open Access Journals (Sweden)

    Vikram Haridas

    2018-01-01

    Conclusion: The current study indicates that a majority of South Indian AS patients are associated with HLA-B*27 alleles. In addtion we found that HLA-B*27 associated AS patients presented with more severe axial manifestations.

  14. Genetic polymorphisms of multidrug and toxin extrusion proteins (MATE1 and MATE2 in South Indian population

    Directory of Open Access Journals (Sweden)

    Gerard Marshall Raj

    2017-02-01

    Conclusion: Thus, the allele and genotype distributions of SLC47A1 and SLC47A2 gene polymorphisms were established in South Indian population and were found to be different from the frequencies of other ethnicities.

  15. Peroxisome proliferator activated receptor gamma polymorphism Pro12Ala in polycystic ovary syndrome (PCOS of South Indian Population

    Directory of Open Access Journals (Sweden)

    Raichel Jacob

    2016-05-01

    Conclusion: PPARγ2 gene Pro12Ala polymorphism was supposed to be susceptible genes in PCOS. The present study demonstrated that there is a statistical difference between the distributions of PPAR gamma Pro12Ala polymorphism in South Indian Population.

  16. Prediabetes in South Indian rural adolescent school students.

    Science.gov (United States)

    Taranikanti, Madhuri; Panda, Sanghamitra; Sukanya M; Swamy, P N; Khan, Mohd Siddique A; Tabassum, Hajira

    2014-01-01

    Prediabetes is a condition with blood glucose levels higher than normal but not high enough to be diagnosed as diabetes. Most people with prediabetes are asymptomatic but are considered to be at a high risk of developing heart disease and stroke. 140 students of both sexes between ages 14-18 years were given a predesigned questionnaire to obtain information on socio-economic status and family history of Diabetes mellitus. A fasting plasma glucose level was measured and 6.8% of students were in the prediabetic range (> 100 mg/dl). No significant correlation was found between fasting plasma glucose and Body Mass Index or waist to hip ratio. 41.5% of the boys and 10.3% of the girls had a family history of DM but were in euglycemic range. It is beneficial to identify people with prediabetes so that appropriate lifestyle modification may be done to prevent or postpone onset of Diabetes mellitus.

  17. Renal outcome of type 2 diabetes in South Africa - a 12-year follow ...

    African Journals Online (AJOL)

    Aims. Previous studies of type 2 diabetes mellitus have indicated a benign renal outcome after long-term follow-up. The aim of this study was to determine how often renal failure due to diabetic nephropathy was a cause of death in patients with type 2 diabetes. Methods. Prospective observational study of 59 South African ...

  18. Diabetes training for community health workers on an American Indian reservation.

    Science.gov (United States)

    Policicchio, Judith M; Dontje, Katherine

    2018-01-01

    To improve the knowledge and skills of community health workers (CHWs) on an American Indian (AI) Reservation related to the management of diabetes to allow CHWs, with no prior formal diabetes education to work more effectively with individuals in the community with diabetes. Training was provided in six "face-to-face" sessions with the CHWs using the Centers for Disease Control and Prevention CHW Training Resource on Heart Disease and Stroke. This is a quality improvement program guided by the Model for Improvement: Plan, Do, Study, Act and using a pre-post evaluation design. Ten AI CHWs were recruited for the training. Knowledge and attitudes, participation rates, and participant satisfaction were measured. Knowledge increased overall with largest changes in diabetes, depression and cholesterol. Diabetes attitudes were high and consistent with those found in caregivers who support patient-centered care. Participants reported learning, liking the class, and finding the materials helpful. This QI program provided by a public health nurse improved CHW's knowledge of diabetes and the management of diabetes. Next steps include formalizing the Reservation's CHW training program, expanding this training to other AI Health Service areas, and measuring the impact of CHWs in the community. © 2017 Wiley Periodicals, Inc.

  19. Abdominal obesity and type 2 diabetes in Asian Indians: dietary strategies including edible oils, cooking practices and sugar intake.

    Science.gov (United States)

    Gulati, S; Misra, A

    2017-07-01

    Obesity and type 2 diabetes are increasing in rural and urban regions of South Asia including India. Pattern of fat deposition in abdomen, ectopic fat deposition (liver, pancreas) and also low lean mass are contributory to early-onset insulin resistance, dysmetabolic state and diabetes in Asian Indians. These metabolic perturbations are further exacerbated by changing lifestyle, diet urbanization, and mechanization. Important dietary imbalances include increasing use of oils containing high amount of trans fatty acids and saturated fats (partially hydrogenated vegetable oil, palmolein oil) use of deep frying method and reheating of oils for cooking, high intake of saturated fats, sugar and refined carbohydrates, low intake of protein, fiber and increasing intake of processed foods. Although dietary intervention trials are few; the data show that improving quality of carbohydrates (more complex carbohydrates), improving fat quality (more monounsaturated fatty acids and omega 3 polyunsaturated fatty acids) and increasing protein intake could improve blood glucose, serum insulin, lipids, inflammatory markers and hepatic fat, but more studies are needed. Finally, regulatory framework must be tightened to impose taxes on sugar-sweetened beverages, oils such as palmolein, and dietary fats and limit trans fats.

  20. Nutritional profile of the morbidly obese patients attending a bariatric clinic in a South Indian tertiary care centre

    Directory of Open Access Journals (Sweden)

    Mini Joseph

    2017-09-01

    Full Text Available Background: Obesity is sweeping across continents and is a major public health concern of the modern society. Aims: The main objective of this study was to study the demographic, anthropometric and dietary patterns of the morbidly obese and study region wise variation in their nutrient intake. Materials and Methods: The study was conducted on 101 morbidly obese individuals from different regions of India who attended the Bariatric clinic of a tertiary care hospital in India. Their socio-demographic details, anthropometric measurements were collected. The dietary assessment was done using a 24 hour dietary recall and a food frequency questionnaire. The study was approved by the Institutional review board and informed consent was obtained from them. Results: More than 3/4th of the patients were females and 61 per cent had Type 2 diabetes mellitus. The mean age of the male and female population was 41.3 + 15.5 years and 36.7 + 11.9 years respectively. Their mean BMI was 41kg/m2. The mean daily intake of calories was more than 2200kcal/day with a gross deficit in the intake of micronutrients. Bonferroni Test showed that there was region wise variation in dietary intake, South Indian female population had the lowest intake of the micronutrients and those from East India had the highest intake. In the male population, there was a significant regional difference in intake of Proteins (p=0.039 and Energy (p=0.024. Independent Sample T test showed that South Indian had the highest intake of Energy and proteins. Anthropometric measures showed positive relation with various macronutrient intakes. Conclusion: The obese patients require intense counselling by a dedicated team of an endocrinologist, psychiatrist, dietician, bariatric surgeon and a social worker to make achievable changes in the quality of life of the morbidly obese patients. Regional influences must be considered when counselling the patient.

  1. Neighborhood characteristics and lifestyle intervention outcomes: Results from the Special Diabetes Program for Indians.

    Science.gov (United States)

    Jiang, Luohua; Chang, Jenny; Beals, Janette; Bullock, Ann; Manson, Spero M

    2018-06-01

    Growing evidence reveals various neighborhood conditions are associated with the risk of developing type 2 diabetes. It is unknown, however, whether the effectiveness of diabetes prevention interventions is also influenced by neighborhood characteristics. The purpose of the current study is to examine the impact of neighborhood characteristics on the outcomes of a lifestyle intervention to prevent diabetes in American Indians and Alaska Natives (AI/ANs). Year 2000 US Census Tract data were linked with those from the Special Diabetes Program for Indians Diabetes Prevention Program (SDPI-DP), an evidence-based lifestyle intervention implemented in 36 AI/AN grantee sites across the US. A total of 3394 participants started the intervention between 01/01/2006 and 07/31/2009 and were followed by 07/31/2016. In 2016-2017, data analyses were conducted to evaluate the relationships of neighborhood characteristics with intervention outcomes, controlling for individual level socioeconomic status. AI/ANs from sites located in neighborhoods with higher median household income had 38% lower risk of developing diabetes than those from sites with lower neighborhood income (adjusted hazard ratio = 0.65, 95% CI: 0.47-0.90). Further, those from sites with higher neighborhood concentrations of AI/ANs achieved less BMI reduction and physical activity increase. Meanwhile, participants from sites with higher neighborhood level of vehicle occupancy made more improvement in BMI and diet. Lifestyle intervention effectiveness was not optimal when the intervention was implemented at sites with disadvantaged neighborhood characteristics. Meaningful improvements in socioeconomic and other neighborhood disadvantages of vulnerable populations could be important in stemming the global epidemic of diabetes. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Genetic spectrum of low density lipoprotein receptor gene variations in South Indian population.

    Science.gov (United States)

    ArulJothi, K N; Suruthi Abirami, B; Devi, Arikketh

    2018-03-01

    Low density lipoprotein receptor (LDLR) is a membrane bound receptor maintaining cholesterol homeostasis along with Apolipoprotein B (APOB), Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) and other genes of lipid metabolism. Any pathogenic variation in these genes alters the function of the receptor and leads to Familial Hypercholesterolemia (FH) and other cardiovascular diseases. This study was aimed at screening the LDLR, APOB and PCSK9 genes in Hypercholesterolemic patients to define the genetic spectrum of FH in Indian population. Familial Hypercholesterolemia patients (n=78) of South Indian Tamil population with LDL cholesterol and Total cholesterol levels above 4.9mmol/l and 7.5mmol/l with family history of Myocardial infarction were involved. DNA was isolated by organic extraction method from blood samples and LDLR, APOB and PCSK9 gene exons were amplified using primers that cover exon-intron boundaries. The amplicons were screened using High Resolution Melt (HRM) Analysis and the screened samples were sequenced after purification. This study reports 20 variations in South Indian population for the first time. In this set of variations 9 are novel variations which are reported for the first time, 11 were reported in other studies also. The in silico analysis for all the variations detected in this study were done to predict the probabilistic effect in pathogenicity of FH. This study adds 9 novel variations and 11 recurrent variations to the spectrum of LDLR gene mutations in Indian population. All these variations are reported for the first time in Indian population. This spectrum of variations was different from the variations of previous Indian reports. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Helicobacter pylori infection in apparently healthy South Indian children

    International Nuclear Information System (INIS)

    Kurpad, A.V.; Caszo, B.; Raj, T.; Vaz, M.

    2000-01-01

    Helicobacter pylori infection has been established as a major cause of chronic gastritis in adults, and it has been implicated in the genesis of gastric carcinomas and the development of gastric and duodenal ulcers. It is now postulated that neatly 90% of the adult population in developing countries may be affected with the infection since childhood. Earlier studies on Indians using serology and endoscopic biopsy have shown a high incidence of H. pylori infection in small numbers of patients. The 13 C-urea breath test, which is simple, specific and non-invasive, is also increasingly being used to determine the presence of Helicobacter pylori infection. Preliminary data from India has shown a high prevalence in the urban Indian environment, and there is an urgent need to quantify the prevalence of H. pylori infections on an epidemiological basis in both urban and rural settings. It is also important to study the possible impact of this infection on growth in children, particularly in environments with low sanitation and high crowding. In this paper, we outline a proposal to study the prevalence of Helicobacter pylori infections in children from the following different environments: urban middle socio-economic class, urban slum, rural middle socio-economic class and rural village. (author)

  4. Impact of gestational diabetes on the risk of diabetes following pregnancy among Chinese and South Asian women.

    Science.gov (United States)

    Mukerji, G; Chiu, M; Shah, B R

    2012-08-01

    Ethnicity and gestational diabetes mellitus (GDM) are both risk factors for the development of type 2 diabetes. However, it is uncertain whether ethnicity modifies the effect of GDM on diabetes risk. We aimed to determine the risk of diabetes following pregnancy with and without GDM for Chinese and South Asian women compared with white women. Using healthcare databases, all 1,050,108 women aged 20-49 with live births between January 1995 and June 2008 in Ontario were identified. They were followed for up to 15 years for the diagnosis of diabetes. The age-standardised prevalences of GDM were 4.1%, 7.1% and 2.9% for Chinese, South Asian and white women, respectively. The cumulative incidence of diagnosed diabetes at the median follow-up time of 7.6 years was 16.5% and 1.8% for Chinese women with and without GDM, 31.8% and 3.6% for South Asian women with and without GDM, and 25.7% and 1.8% for white women with and without GDM. The presence of GDM conferred an increase in the risk for diabetes after pregnancy of more than 13-fold in white women, but only a nine- to tenfold increase among Chinese and South Asian women. Although one-third of South Asian women with GDM were diagnosed with diabetes within 8 years postpartum, the incremental impact of GDM on diabetes risk was not as strong among Chinese and South Asian women as it was among white women.

  5. Eruption age of permanent mandibular first molars and central incisors in the south Indian population

    Directory of Open Access Journals (Sweden)

    Gupta Rakhi

    2007-01-01

    Full Text Available Objective: The existing eruption schedules for permanent and deciduous dentition are based on studies in the Western population. Since Indians differ from Westerners racially, genetically, and environmentally, these studies fail to provide relevant guidance on the eruption schedule in the Indian population. This study aims at determining the eruption pattern of permanent mandibular molars and central incisors in the south Indian population. Materials and Methods: 10,156 apparently healthy Indian children in the age-group of 6-9 years were examined with mouth mirror and probe under adequate illumination for the status of the eruption of the permanent mandibular first molar and permanent mandibular central incisor. Pearson′s Chi-square test with Yates′ continuity correction was used to calculate the P -value for comparison of proportion between girls and boys. The values obtained in our study were compared with the standard values. The Z-test with continuity correction was used to calculate the P -value. Results: As per our study, the permanent mandibular first molars and central incisors erupted one to two years later compared to the values reported in Westerners. The earlier eruption of the permanent mandibular first molars compared to the permanent mandibular central incisors, as well as the earlier eruption of both the teeth in girls compared to boys, were in accordance with the existing literature. Conclusion: The eruption age reported by us may form a standard reference for eruption age in Indians.

  6. Prevalence of radix entomolaris in mandibular permanent first molars: a study in a South Indian population.

    Science.gov (United States)

    Chandra, Saurabh S; Chandra, Supriya; Shankar, Padmanabhan; Indira, Rajamani

    2011-09-01

    Anatomical racial variations are an acknowledged characteristic in permanent molars. Generally, mandibular first molars have 2 roots; however, the presence of a third root, radix entomolaris (RE), is a major anatomic variant among many population groups. This study evaluated the prevalence of permanent mandibular first molars featuring a distolingual root in a South Indian population. Five hundred patients of South Indian origin possessing bilateral mandibular first molars were selected. The radiographs of these patients were evaluated under optimal conditions. A total of 1000 mandibular first molars were screened and the incidence of 3-rooted mandibular first molars and the correlation between left and right side occurrence and between either gender was recorded. The prevalence of 3-rooted mandibular first molars was 18.6% of the patients examined and 13.3% of the teeth examined. There was no statistically significant difference between genders or side of occurrence (P > .05). The bilateral incidence of a symmetric distribution was 43.01%. RE is considered an Asiatic trait. The occurrence of this macrostructure in the South Indian population was 13.3%, which was lower than that of other patients of Mongoloid origin. The clinician must thoroughly examine the radiograph before initiation of endodontic therapy. Copyright © 2011 Mosby, Inc. All rights reserved.

  7. Distribution of Tritium and {sup 137}CS in South Indian Ocean Waters - Implications of Water Transport Processes

    Energy Technology Data Exchange (ETDEWEB)

    Povinec, P. P.; Jeskovsky, M.; Sykora, I. [Comenius University, Faculty of Mathematics, Physics and Informatics, Bratislava (Slovakia); Aoyama, M. [Meteorological Research Institute, Tsukuba (Japan); Gastaud, J.; Levy, I. [International Atomic Energy Agency, Marine Environment Laboratories (Monaco); Hamajima, Y. [Kanazawa University, Low-Level Radioactivity Laboratory, Nomi (Japan); Hirose, K. [Sophia University, Faculty of Science and Technology, Tokyo (Japan); Sanchez-Cabeza, J. A. [Universitat Autonoma de Barcelona, Bellaterra (Spain)

    2013-07-15

    The World Ocean, and specifically the Indian Ocean, plays a significant role in the better understanding of the climate. The distribution of global fallout {sup 3}H, {sup 14}C, {sup 90}Sr, {sup 129}I and {sup 137}Cs in the seawater of the Indian Ocean, after their main injection from atmospheric nuclear weapons tests during the 1960s, have been investigated. Results obtained in the framework of the SHOTS (Southern Hemisphere Ocean Tracer Studies) project are evaluated and compared with previously published data. The enhanced {sup 3}H and {sup 137}Cs levels observed in the south Indian ocean indicate transport of water masses labelled with these radionuclides from the central Pacific Ocean via the Indonesian Seas to the Indian Ocean. The observed surface gradients and presence of several water masses in the south Indian ocean makes this ocean one of the most dynamic parts of the World ocean. (author)

  8. Hypertensive disorders of pregnancy and risk of diabetes in Indian women: a cross-sectional study.

    Science.gov (United States)

    Agrawal, Sutapa; Fledderjohann, Jasmine

    2016-08-05

    Epidemiological data from high-income countries suggest that women with hypertensive disorders of pregnancy (HDP) are more likely to develop diabetes later in life. We investigated the association between pre-eclampsia and eclampsia (PE&E) during pregnancy and the risk of diabetes in Indian women. Cross-sectional study. India. Data from India's third National Family Health Survey (NFHS-3, 2005-2006), a cross-sectional survey of women aged 15-49 years, are used. Self-reported symptoms suggestive of PE&E were obtained from 39 657 women who had a live birth in the 5 years preceding the survey. The association between PE&E and self-reported diabetes status was assessed using multivariable logistic regression models adjusting for dietary intake, body mass index (BMI), tobacco smoking, alcohol drinking, frequency of TV watching, sociodemographic characteristics and geographic region. The prevalence of symptoms suggestive of PE&E in women with diabetes was 1.8% (n=207; 95% CI 1.5 to 2.0; pwomen who did not report any PE&E symptoms. In the multivariable analysis, PE&E was associated with 1.6 times (OR=1.59; 95% CI 1.31 to 1.94; pIndian women. These findings are important for a country which is already tackling the burden of young onset of diabetes in the population. However, longitudinal medical histories and a clinical measurement of diabetes are needed in this low-resource setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Obesity, Diabetes, and Birth Outcomes Among American Indians and Alaska Natives.

    Science.gov (United States)

    Anderson, Kermyt G; Spicer, Paul; Peercy, Michael T

    2016-12-01

    Objectives To examine the relationships between prepregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), and prepregnancy body mass index, with several adverse birth outcomes: preterm delivery (PTB), low birthweight (LBW), and macrosomia, comparing American Indians and Alaska Natives (AI/AN) with other race/ethnic groups. Methods The sample includes 5,193,386 singleton US first births from 2009-2013. Logistic regression is used to calculate adjusted odds ratios controlling for calendar year, maternal age, education, marital status, Kotelchuck prenatal care index, and child's sex. Results AI/AN have higher rates of diabetes than all other groups, and higher rates of overweight and obesity than whites or Hispanics. Neither overweight nor obesity predict PTB for AI/AN, in contrast to other groups, while diabetes predicts increased odds of PTB for all groups. Being overweight predicts reduced odds of LBW for all groups, but obesity is not predictive of LBW for AI/AN. Diabetes status also does not predict LBW for AI/AN; for other groups, LBW is more likely for women with DM or GDM. Overweight, obesity, DM, and GDM all predict higher odds of macrosomia for all race/ethnic groups. Conclusions for Practice Controlling diabetes in pregnancy, as well as prepregnancy weight gain, may help decrease preterm birth and macrosomia among AI/AN.

  10. Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Melissa L. Walls

    2017-09-01

    Full Text Available American Indian (AI communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose–response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients.

  11. Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes.

    Science.gov (United States)

    Walls, Melissa L; Sittner, Kelley J; Aronson, Benjamin D; Forsberg, Angie K; Whitbeck, Les B; al'Absi, Mustafa

    2017-09-16

    American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose-response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients.

  12. Etiology and outcome determinants of intracerebral hemorrhage in a south Indian population, A hospital-based study

    Directory of Open Access Journals (Sweden)

    Sunil K Narayan

    2012-01-01

    Full Text Available Background: There is paucity of methodologically sound published studies on intracerebral hemorrhage (ICH from India, on pub med/embase search. Aims: To explore etiology of ICH and correlate the causes, location, and size of hemorrhage to clinical outcome. Materials and Methods: A hospital-based descriptive study from South Indian eastern coastal town of Puducherry; 60 consecutive subjects aged > 12 years, predominantly of inbred Tamil population, with head CT evidence of intracerebral hemorrhage not associated with trauma and brain tumors, were recruited. Outcome at three months was measured using Glasgow Outcome scale, NIHSS and mortality. SPSS v 19 was used for statistical analysis. Results: Commonest etiological factor was hypertension, followed by bleeding diathesis, thrombolysis for myocardial infarction, and cortical vein thrombosis. Most frequent locations of hematoma were basal ganglia, thalamus, internal capsule, and cerebral and cerebellar parenchyma. Hematoma volume correlated significantly with systolic and mean arterial pressure but not with diastolic blood pressure. Poor outcome was correlated to size (P < 0.05 and intraventricular extension of hematoma (P < 0.05, and to systolic, diastolic and mean arterial pressure, but not to age, gender, smoking, alcoholism, ischemic heart disease, and blood sugar level. Among diabetic patients with ICH, the size of hematoma (P = 0.04 and severity of coma (P = 0.01 at admission were significantly worse compared to the non-diabetic, but not the outcome at three months [Glasgow outcome scale or mortality (P = 0.94 and 0.14]. Conclusions: The location of hemorrhage and correlation with outcome agreed with the patterns described for the non-white races in prior reports. Independence of outcome to diabetic status despite a more severe initial presentation may indicate importance of good care, even in high risk groups.

  13. Glacial-interglacial vegetation dynamics in South Eastern Africa coupled to sea surface temperature variations in the Western Indian Ocean

    NARCIS (Netherlands)

    Dupont, L.M.; Caley, T.; Kim, J.H.; Castañeda, I.S; Malaize, B.; Giraudeau, J.

    2011-01-01

    Glacial-interglacial fluctuations in the vegetation of South Africa might elucidate the climate system at the edge of the tropics between the Indian and Atlantic Oceans. However, vegetation records covering a full glacial cycle have only been published from the eastern South Atlantic. We present a

  14. PATTERNS OF INTERNET USE AND THEIR IMPLICATIONS IN INDIAN MEDICAL STUDENTS: A STUDY FROM A SOUTH INDIAN MEDICAL COLLEGE

    Directory of Open Access Journals (Sweden)

    Ravi Kishore

    2016-05-01

    Full Text Available BACKGROUND Internet has become a platform for recent advances, innovative learning methods and self-assessment. Medical students spend significant time using Internet for academic and non-academic purposes. There is a dearth of clear evidence regarding patterns of internet use among Indian Medical students. An internet usage patterns study in First Year Medical students would help identify the necessity to train students in Internet access in the initial phase of Medical course. AIM To assess the Internet usage patterns in First Year Indian Medical Students. MATERIALS AND METHODS A cross-sectional study in which 132 students studying in First Year undergraduate medical course at MVJ Medical College and Research Hospital, Bangalore, a cosmopolitan city in South India, participated. Data related to internet use was captured using a pretested questionnaire. Statistical analysis was performed using Microsoft Excel version 2007. RESULTS 70% of students used internet for academic and non-academic purposes. Slow internet speed (31% and lack of time (23% were most common amongst impediments to internet use. Majority of students (57% used internet for greater than 7 hours per week. Understanding a topic better (62% seems to be most important motive for academic use of internet. 36% of students did not use any academic website. CONCLUSIONS First Year Indian Medical students spent significant amounts of time using internet for multiple purposes. There is a lack of awareness regarding academic websites and online animations among significant portion of students. Students in our study may be guided appropriately by Internet training sessions at the beginning of the Medical course to enable the best use of internet for academic purpose.

  15. Family history of type 2 diabetes and prevalence of metabolic syndrome in adult Asian Indians.

    Science.gov (United States)

    Das, Mithun; Pal, Susil; Ghosh, Arnab

    2012-04-01

    Our objective was to test the association between familial risk of type 2 diabetes mellitus (T2DM) and the prevalence of metabolic syndrome (MS) in adult Asian Indians. A total of 448 adult (>30 years) individuals (257 males and 191 females) participated in the study. Familial risk of T2DM was classified into three groups viz., 1=both parents affected; 2=parent and/or siblings affected and 3=none or no family history for T2DM. Anthropometric measures, blood pressures, fasting blood glucose and metabolic profiles were studied using standard techniques. MS was defined accordingly. The prevalence of MS phenotypes was estimated and compared among the three familial risk strata. Individuals with a history of both parents affected from diabetes had significantly higher (Pfamily history of T2DM. Significant difference was also noticed between individuals with and without MS according to the family history of diabetes (Pfamily history of T2DM. Family history of T2DM had significant effect on individuals with MS as compared to their counterparts (individuals having no family history of T2DM). It therefore seems reasonable to argue that family history of T2DM could be useful as a predictive tool for early diagnosis and prevention of MS in Asian Indian population.

  16. The oral disposition index is a strong predictor of incident diabetes in Asian Indian prediabetic men.

    Science.gov (United States)

    Ram, Jagannathan; Snehalatha, Chamukuttan; Selvam, Sundaram; Nanditha, Arun; Shetty, Ananth Samith; Godsland, Ian F; Johnston, Desmond G; Ramachandran, Ambady

    2015-08-01

    In this analysis, we sought to examine the prospective association of the disposition index (DIo) derived from oral glucose tolerance test with incident diabetes in Asian Indian men with impaired glucose tolerance (IGT). These post hoc analyses used data from a 2-year prospective study in primary prevention of diabetes using lifestyle intervention among 517 men with IGT. All the participants received standard lifestyle advice at baseline. The surrogate insulin sensitivity and insulin secretion measures were tested for their hyperbolic relationship. Predictive associations of various surrogate measures with incident diabetes were determined using receiver operating characteristic curves. The combination of total area under the curve of insulin-to-glucose ratio (AUCinsulin/glucose) and Matsuda's insulin sensitivity index was the best equation to depict DIo [β: -0.954 (95 % CI -1.015 to -0.893)] compared to other measures tested in this cohort. There was an inverse association between change in DIo at the final follow-up and development of incident diabetes. Among the surrogate insulin measures studied, DIo [AUC (0.717 (95 % CI 0.675-0.756))] as a composite measure was superior than other surrogate indices. Among the surrogate indices studied, DIo was the best measure associated with incident diabetes.

  17. Prevalence of dyslipidemia in adult Indian diabetic patients: A cross sectional study (SOLID

    Directory of Open Access Journals (Sweden)

    Ambrish Mithal

    2014-01-01

    Full Text Available Context: India leads the world with largest number of diabetic patients and is often referred to as the diabetes capital of the world. Diabetic dyslipidemia in India is one of the main cause for Coronary Artery Disease (CAD mortality. Although diabetes continues to be a major lifestyle condition in India, there is a lack of studies in India on whether dyslipidemia in Indian diabetics is being adequately controlled. Our study provides critical insights into the insights into proportion of diabetes patients achieving lipid goal in India. Aims: The primary objective of our study was to assess the control of dyslipidemia in the Indian diabetic population treated with lipid lowering drugs (LLDs, as per American Diabetes Association (ADA 2010 guidelines. Settings and Design: The study was carried out in a real world Indian clinical setting involving 178 sites. This is a multicenter, noninterventional, and cross-sectional observational study. Materials and Methods: A total of 5400 adult subjects with established type-2 diabetes mellitus (T2DM and dyslipidemia were recruited for the study. Patients in the study were on LLD at a stable dose for at least last 3 months before the designated study visit. Routine lipid profile tests were conducted for all patients. Statistical Analysis Used: Descriptive statistics was used to analyze qualitative and discrete variables. Chi-square test and t-test were conducted to assess the existence of statistically significant association between the variables. Results: A total of 5400 patients with T2DM from 178 centers across India were recruited. Out of the total population, 56.75% (N = 3065 of them were males. Primary end-point of low-density lipoprotein cholesterol (LDL-C level below ADA 2010 target was achieved in a total of 48.74% (N = 2632 patients. Gender was significantly associated with lipid levels and age was significantly (P < 0.05 correlated with all lipid levels. Control rates of other lipid parameters like

  18. Impact of classical risk factors of type 2 diabetes among Asian Indian, Chinese and Japanese populations.

    Science.gov (United States)

    He, L; Tuomilehto, J; Qiao, Q; Söderberg, S; Daimon, M; Chambers, J; Pitkäniemi, J

    2015-11-01

    This review investigated the population impact of major modifiable type 2 diabetes (T2D) risk factors, with special focus on native Asian Indians, to estimate population attributable risks (PARs) and compare them with estimates from Chinese and Japanese populations. Information was obtained on risk factors in 21,041 Asian Indian, 17,774 Chinese and 17,986 Japanese populations from multiple, large, cross-sectional studies (the DECODA project) of T2D. Crude and adjusted PARs were estimated for the major T2D risk factors. Age had the highest crude and adjusted PARs among Asian Indians and Chinese in contrast to waist-hip ratio among Japanese. After adjusting for age, the PAR for body mass index (BMI) in Asian Indians (41.4% [95% CI: 37.2%; 45.4%]) was second only to triglycerides (46.4% [95% CI: 39.5%; 52.8%]) compared with 35.8% [95% CI: 29.9%; 41.4%] in Japanese and 38.4% [95% CI: 33.5%; 43.2%] in Chinese people. The PAR for BMI adjusted for age, LDL and triglycerides (39.7% [95% CI: 31.6%; 47.2%]) was higher than for any other factor in Asian Indians, and was much higher than in the Chinese (16.8% [95% CI: 3.0%; 30.9%]) and Japanese (30.4% [95% CI: 17.5%; 42.2%]) populations. This review provides estimates of the association between major risk factors and prevalences of T2D among Asian populations by examining their PARs from large population-based samples. From a public-health point of view, the importance of BMI in Asian Indians is especially highlighted in comparison to the other Asian populations. Given these results and other recent findings on the causality link between BMI and T2D, it can be postulated that obesity may be involved in the aetiology of T2D through interaction with ethnic-specific genetic factors, although ethnicity itself is not a direct risk factor for T2D as people of all ethnic backgrounds develop diabetes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Foraminifera Population from South Africa Coast Line (Indian and Atlantic Oceans

    Directory of Open Access Journals (Sweden)

    Engin Meriç

    2014-11-01

    Full Text Available Cape Town is the second-largest city of the Republic of South Africa. Research is conducted in 3 different stations: Maori Bay, which lies in the southwest of Cape Town, and Pyramid Rock and Partridge Points which lies in the False Bay, southeast part of Cape Town. Samples are taken from young sediments at 10.00 and 20.00 m depths, and collected by scuba-diving method. The aim of the study is to investigate the living benthic foraminifera assemblages in the Atlantic Ocean, and to compare these assemblages with the southeastern part of the Atlantic Ocean, the Arabian Sea, Indian Ocean and Western Pacific assemblages. Moreover, the aim of the study is to determine whether there are any benthic foraminifera forms reaching to the Mediterranean from Pacific Ocean, Indian Ocean or Red Sea via Suez Channel.

  20. Ethnic-Specific Criteria for Classification of Body Mass Index: A Perspective for Asian Indians and American Diabetes Association Position Statement.

    Science.gov (United States)

    Misra, Anoop

    2015-09-01

    Definitions for overweight and obesity are universally applied using body mass index (BMI), based on morbidity and mortality data derived from white populations. However, several studies have shown higher body fat, excess metabolic perturbations, and cardiovascular risk factors at lower value of BMI in Asian versus white populations. Definitive guidelines have been published to classify a BMI of ≥23 kg/m(2) and ≥25 kg/m(2) as overweight and obese, respectively, by the Indian Consensus Group (for Asian Indians residing in India) and a BMI of ≥23 kg/m(2) for screening for diabetes by the National Institute of Health and Care Excellence of the United Kingdom (for migrant south Asians) and, in an encouraging initiative recently (2015), by the American Diabetes Association (for all Asian ethnic groups in the United States). Overall, multiple studies, and now several guidelines, emphasize early intervention with diet and physical activity in Asian ethnic groups for prevention and management of obesity-related noncommunicable diseases. By application of these guidelines, an additional 10-15% of the population in India would be labeled as overweight/obese, and more South Asians/Asians will be diagnosed with diabetes in the United Kingdom and the United States. Additional health resources need to be allocated to deal with increasing numbers of Asians with obesity-related noncommunicable diseases, and research is needed to evolve cost-effective interventions. Finally, consensus based on data is needed so that the World Health Organization and other international agencies could take definitive steps for revision of classification of BMI for Asian populations globally.

  1. Studies on insulin secretion and insulin resistance in non-insulin-dependent diabetes in young Indians

    International Nuclear Information System (INIS)

    Naidoo, C.

    1986-01-01

    Patients with Non-insulin-dependent diabetes mellitus (NIDDM) have defects in insulin secretion and insulin action. In the discrete genetic syndrome of NIDDY (non-insulin-dependent diabetes in the young), the situation is less clear and these aspects is the subject of this thesis. This study included Indian pasients with three generation transmission of NIDDM via one parent. The insulin and C-peptide responses to oral and intravenous glucose in patients with NIDDY were studied. The insulin and glucose responses to non-glucose secretogogues glucagon, tolbutamide and arginine, in NIDDY were also investigated. The following aspects with regard to insulin resistance in NIDDY were examined: glucose and free fatty acid response to intravenous insulin administration, insulin binding to circulating erythrocytes and monocytes, 125 I-insulin binding to the solubilized erythrocyte membrane receptor and 125 I-insulin binding to fibroblasts in culture

  2. Studies on insulin secretion and insulin resistance in non-insulin-dependent diabetes in young Indians

    Energy Technology Data Exchange (ETDEWEB)

    Naidoo, C

    1986-01-01

    Patients with Non-insulin-dependent diabetes mellitus (NIDDM) have defects in insulin secretion and insulin action. In the discrete genetic syndrome of NIDDY (non-insulin-dependent diabetes in the young), the situation is less clear and these aspects is the subject of this thesis. This study included Indian pasients with three generation transmission of NIDDM via one parent. The insulin and C-peptide responses to oral and intravenous glucose in patients with NIDDY were studied. The insulin and glucose responses to non-glucose secretogogues glucagon, tolbutamide and arginine, in NIDDY were also investigated. The following aspects with regard to insulin resistance in NIDDY were examined: glucose and free fatty acid response to intravenous insulin administration, insulin binding to circulating erythrocytes and monocytes, /sup 125/I-insulin binding to the solubilized erythrocyte membrane receptor and /sup 125/I-insulin binding to fibroblasts in culture.

  3. Allele and Genotype Distributions of DNA Repair Gene Polymorphisms in South Indian Healthy Population

    Directory of Open Access Journals (Sweden)

    Katiboina Srinivasa Rao

    2014-01-01

    Full Text Available Various DNA repair pathways protect the structural and chemical integrity of the human genome from environmental and endogenous threats. Polymorphisms of genes encoding the proteins involved in DNA repair have been found to be associated with cancer risk and chemotherapeutic response. In this study, we aim to establish the normative frequencies of DNA repair genes in South Indian healthy population and compare with HapMap populations. Genotyping was done on 128 healthy volunteers from South India, and the allele and genotype distributions were established. The minor allele frequency of Xeroderma pigmentosum group A ( XPA G23A, Excision repair cross-complementing 2 ( ERCC2 /Xeroderma pigmentosum group D ( XPD Lys751Gln, Xeroderma pigmentosum group G ( XPG His46His, XPG Asp1104His, and X-ray repair cross-complementing group 1 ( XRCC1 Arg399Gln polymorphisms were 49.2%, 36.3%, 48.0%, 23.0%, and 34.0% respectively. Ethnic variations were observed in the frequency distribution of these polymorphisms between the South Indians and other HapMap populations. The present work forms the groundwork for cancer association studies and biomarker identification for treatment response and prognosis.

  4. A foot risk classification system to predict diabetic amputation in Pima Indians.

    Science.gov (United States)

    Mayfield, J A; Reiber, G E; Nelson, R G; Greene, T

    1996-07-01

    To quantify the contribution of various risk factors to the risk of amputation in diabetic patients and to develop a foot risk scoring system based on clinical data. A population case-control study was undertaken. Eligible subjects were 1) 25-85 years of age, 2) diabetic, 3) 50% or more Pima or Tohono O'odham Indian, 4) lived in the Gila River Indian Community, and 5) had had at least one National Institutes of Health research examination. Case patients had had an incident lower extremity amputation between 1983 and 1992; control subjects had no amputation by 1992. Medical records were reviewed to determine risk conditions and health status before the pivotal event that led to the amputation. Sixty-one people with amputations were identified and compared with 183 control subjects. Men were more likely to suffer amputation than women (odds ratio [OR] 6.5, 95% CI 2.6-15), and people with diabetic eye, renal, or cardiovascular disease were more likely to undergo amputation than those without (OR 4.6, 95% CI 1.7-12). The risk of amputation was almost equally associated with these foot risk factors: peripheral neuropathy, peripheral vascular disease, bony deformities, and a history of foot ulcers. After controlling for demographic differences and diabetes severity, the ORs for amputation with one foot risk factor was 2.1 (95% CI 1.4-3.3), with two risk factors, 4.5 (95% CI 2.9-6.9), and with three or four risk factors, 9.7 (95% CI 6.3-14.8). Male Sex, end-organ complications of eye, heart, and kidney, and poor glucose control were associated with a higher amputation rate. Peripheral neuropathy, peripheral vascular disease, deformity, and a prior ulcer were similarly equally associated with an increased risk of lower extremity amputation.

  5. SCREENING FOR UNDIAGNOSED DIABETIC SUBJECTS USING A SIMPLIFIED INDIAN DIABETES RISK SCORE [IDRS] IN KHAMMAM URBAN

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    Pothukuchi Madhavi

    2016-07-01

    Full Text Available BACKGROUND The rising prevalence of diabetes in developing countries is closely associated with industrialisation and socioeconomic development. The major determinants of diabetics in these countries are population growth, age structure, and urbanisation, prevalence of obesity because of increased intake of junk food, lack of physical activity, and stress among urban dwellers. Diabetes is increasingly concentrated in the urban areas. Hence, the present study was undertaken. METHODOLOGY A community based cross-sectional study was carried out in Raghunadhapalem, an urban area of Khammam with a total population of 1552. List of areas under Khammam (urban was obtained from Municipal Corporation and the present study area Raghunadhapalem, was chosen by simple random sampling technique. Duration of the study was 4 months. RESULTS Majority 232 (74.3% of study participants are at risk of developing Diabetes in future. Majority 291 (93.3% of the study participants do not have family history of diabetes. CONCLUSIONS IDRS is a simple, useful and cost-effective screening tool for diabetes in resource limited settings. By identifying the high & medium risk individuals using IDRS, we could make screening programs more cost effective.

  6. How to offer culturally relevant type 2 diabetes screening: lessons learned from the South asian diabetes prevention program.

    Science.gov (United States)

    van Draanen, Jenna; Shafique, Ammara; Farissi, Aziz; Wickramanayake, Dilani; Kuttaiya, Sheela; Oza, Shobha; Stephens, Neil

    2014-10-01

    The literature on diabetes mellitus in the South Asian population clearly states the high-risk status of this group, yet there is a lack of effective models of culturally relevant, community-based screening and education programs for such a group. The South Asian Diabetes Prevention Program (SADPP) was developed to enhance equitable access to diabetes prevention resources for the South Asian communities in Toronto by offering language-specific and culturally relevant services. The SADPP model works through 3 participant education sessions plus an additional attachment and enrolment component. The screening tool that SADPP uses to provide participants with their individual risk score at the first education session is derived from the multiculturally validated Canadian Diabetes Risk Assessment Questionnaire (CANRISK), which has been modified to reflect the distinctive characteristics of the South Asian population. After analyzing the risk scores, 32% of participants were at increased risk, 40% were at high risk, 21% were at very high risk and only 7% were found to be at low risk of diabetes development. Evaluations of the program conducted in 2010 and 2013 revealed that the program is achieving its objectives and that participants increase their knowledge and self-efficacy related to diabetes prevention after program participation. Participants reported that the presentation from the nurse and dietitian, the question-and-answer time, the healthy eating demonstration, the multiple languages of delivery and the convenient location were especially beneficial. Those working in the field are encouraged to adapt this model and to contribute to the development of culturally relevant, community-driven diabetes prevention programs. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  7. American Indian Parents’ Assessment of and Concern About Their Kindergarten Child’s Weight Status, South Dakota, 2005-2006

    OpenAIRE

    Arcan, Chrisa; Hannan, Peter J.; Himes, John H.; Fulkerson, Jayne A.; Holy Rock, Bonnie; Smyth, Mary; Story, Mary

    2012-01-01

    Introduction Obesity is highly prevalent among American Indians, and effective prevention efforts require caregiver involvement. We examined American Indian (AI) parents' assessment of and level of concern about their kindergarten child's weight status. Methods We collected baseline data (fall of 2005 and fall of 2006) on children and their parents or caregivers for a school-based obesity prevention trial (Bright Start) on an AI reservation in South Dakota. The current study uses 413 parent-c...

  8. The management of diabetes among the rural poor in South Africa ...

    African Journals Online (AJOL)

    The management of diabetes among the rural poor in South Africa. ... have been found to lead to a diet that has very high carbohydrate, high in saturated fatty acids, ... to facilitate good self-management of diabetes among the rural people.

  9. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools for Diabetes Educators and Community Members Diabetes Educator Tools Diabetes Education Lesson Plan ...

  10. Skin lightening practices: an epidemiological study of South African women of African and Indian ancestries.

    Science.gov (United States)

    Dlova, N C; Hamed, S H; Tsoka-Gwegweni, J; Grobler, A

    2015-07-01

    Cutaneous adverse sequelae of skin lightening creams present with myriad skin complications and affect dermatology practice, particularly in sub-Saharan Africa where such products are widely used, with a prevalence of 25-67%. To examine the skin lightening practices of both African and Indian women living in South Africa. A cross-sectional survey was undertaken in the general outpatient departments of two regional university hospitals in Durban, South Africa. All consenting African and Indian women aged 18-70 years were recruited and asked to complete a questionnaire. Six hundred women completed the questionnaire, of whom 32·7% reported using skin lightening products. The main reasons cited were treatment of skin problems (66·7%) and skin lightening (33·3%). Products were purchased from a variety of sources. Twenty-five percent reported using sunscreen. The use of skin lightening cosmetics is common among darkly pigmented South African women, including those of both African and Indian ancestries. Despite more than 20 years of governmental regulations aimed at prohibiting both the sale of cosmetics containing mercury, hydroquinone and corticosteroids, and the advertising of any kind of skin lightener, they are far from having disappeared. The main motivations for using these products are the desire to treat skin disorders and to achieve a lighter skin colour. Television and magazine advertisements seem to influence women's choice of these products and, thus, would be efficient channels for raising public awareness about the dangers of using uncontrolled skin lighteners. © 2015 The Authors BJD © 2015 British Association of Dermatologists.

  11. Genetic variation in South Indian castes: evidence from Y-chromosome, mitochondrial, and autosomal polymorphisms

    Directory of Open Access Journals (Sweden)

    Tirupati S

    2008-12-01

    Full Text Available Abstract Background Major population movements, social structure, and caste endogamy have influenced the genetic structure of Indian populations. An understanding of these influences is increasingly important as gene mapping and case-control studies are initiated in South Indian populations. Results We report new data on 155 individuals from four Tamil caste populations of South India and perform comparative analyses with caste populations from the neighboring state of Andhra Pradesh. Genetic differentiation among Tamil castes is low (RST = 0.96% for 45 autosomal short tandem repeat (STR markers, reflecting a largely common origin. Nonetheless, caste- and continent-specific patterns are evident. For 32 lineage-defining Y-chromosome SNPs, Tamil castes show higher affinity to Europeans than to eastern Asians, and genetic distance estimates to the Europeans are ordered by caste rank. For 32 lineage-defining mitochondrial SNPs and hypervariable sequence (HVS 1, Tamil castes have higher affinity to eastern Asians than to Europeans. For 45 autosomal STRs, upper and middle rank castes show higher affinity to Europeans than do lower rank castes from either Tamil Nadu or Andhra Pradesh. Local between-caste variation (Tamil Nadu RST = 0.96%, Andhra Pradesh RST = 0.77% exceeds the estimate of variation between these geographically separated groups (RST = 0.12%. Low, but statistically significant, correlations between caste rank distance and genetic distance are demonstrated for Tamil castes using Y-chromosome, mtDNA, and autosomal data. Conclusion Genetic data from Y-chromosome, mtDNA, and autosomal STRs are in accord with historical accounts of northwest to southeast population movements in India. The influence of ancient and historical population movements and caste social structure can be detected and replicated in South Indian caste populations from two different geographic regions.

  12. Prevalence and Impact of Diabetes Mellitus Among Patients with Active Pulmonary Tuberculosis in South Korea.

    Science.gov (United States)

    Lee, Eun Hye; Lee, Jung Mo; Kang, Young Ae; Leem, Ah Young; Kim, Eun Young; Jung, Ji Ye; Park, Moo Suk; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Kim, Song Yee

    2017-04-01

    South Korea has an increasing prevalence of diabetes and a relatively high burden of tuberculosis. We aimed to determine the prevalence of diabetes in patients with active pulmonary tuberculosis (PTB) and examine the effect of diabetes on tuberculosis treatment outcomes. Data from patients ≥30 years diagnosed with and treated for PTB between January 2010 and December 2012 at Severance Hospital, a 2000-bed tertiary referral hospital in Seoul, South Korea, were analyzed and compared with data from a contemporaneous general population sample extracted from KNHANES V. Diabetes prevalence was 24.2% (252/1044) among patients with PTB and 11.6% (1700/14,655) among controls. Diabetes [odds ratios (OR) 2.56, 95% confidence interval (CI) 1.56-4.21, P Diabetes was the only factor associated with unsuccessful treatment outcomes (OR 1.67, 95% CI 1.03-2.70, P = 0.039). The prevalence of diabetes was markedly higher in patients with PTB than in a sample of the general South Korean population. Diabetes may delay sputum conversion and adversely affect treatment outcomes; detection and management of diabetes in patients with PTB is crucial.

  13. Bone mineral density and factors influencing it in Asian Indian population with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sadishkumar Kamalanathan

    2014-01-01

    Full Text Available Objective: To assess bone mineral density (BMD in type 2 diabetes mellitus (T2DM patients and its relation, if any, to clinical, hormonal and metabolic factors. Materials and Methods: A prospective evaluation of 194 T2DM patients (97 men and 97 women was carried out. BMD was done with dual energy X-ray absorptiometry (DXA at the lumbar spine and total hip. Physical activity, nutritional intake and sunlight exposure were calculated. Biochemical and hormonal tests included serum 25 hydroxy vitamin D [25(OH D], parathyroid hormone, estrogen, testosterone and urinary calcium-creatinine ratio. Glycosylated hemoglobin and complete lipid profiles were done in patients with diabetes. Five hundred and seventy one non-diabetic controls (262 males and 309 females were evaluated for BMD alone. Results: BMD was normal (Z score > -2 in 156 (80.5% and low (Z score ≤ -2 in 38 (19.5% patients in the diabetes study group. BMD in the diabetes group was significantly higher than the control group in both sexes at the hip and spine. The difference was no longer significant on analysis of a BMI matched control subgroup. Weight and BMI showed significant correlation to BMD. Duration of T2DM, degree of glycemic control, use of drugs like statins and thiazolidinediones, 25(OH D levels, calcium intake, sunlight exposure and physical activity did not significantly affect BMD in this cohort of individuals with diabetes. Conclusions: Bone mineral density of Asian Indian T2DM subjects was similar to that of healthy volunteers in this study.

  14. A prevalent amino acid polymorphism at codon 98 (Ala98Val) of the hepatocyte nuclear factor-1alpha is associated with maturity-onset diabetes of the young and younger age at onset of type 2 diabetes in Asian Indians

    DEFF Research Database (Denmark)

    Anuradha, Shekher; Radha, Venkatesan; Deepa, Raj

    2005-01-01

    Among Europeans, mutations in the hepatocyte nuclear factor-1alpha (HNF1alpha) gene are associated with the most common form of maturity-onset diabetes of the young (MODY)3. In Asian Indians, type 2 diabetes occurs earlier and often overlaps with MODY, but the genetics of the latter are unknown....... The aim of this study was to estimate the prevalence of Ala98Val polymorphism of the HNF1alpha gene in different types of diabetes in Asian Indians....

  15. A longitudinal study of structural risk factors for obesity and diabetes among American Indian young adults, 1994-2008.

    Science.gov (United States)

    Marley, Tennille L; Metzger, Molly W

    2015-05-07

    American Indian young adults have higher rates of obesity and type 2 diabetes than the general US population. They are also more likely than the general population to have higher rates of structural risk factors for obesity and diabetes, such as poverty, frequent changes of residence, and stress. The objective of this study was to investigate possible links between these 2 sets of problems. Data from the American Indian subsample of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used to examine potential links between obesity and type 2 diabetes and structural risk factors such as neighborhood poverty, housing mobility, and stress. We used logistic regression to explore explanatory factors. American Indians in the subsample had higher rates of poor health, such as elevated hemoglobin A1c levels, self-reported high blood glucose, self-reported diabetes, and overweight or obesity. They also had higher rates of structural risk factors than non-Hispanic whites, such as residing in poorer and more transient neighborhoods and having greater levels of stress. Self-reported stress partially mediated the increased likelihood of high blood glucose or diabetes among American Indians, whereas neighborhood poverty partially mediated their increased likelihood of obesity. Neighborhood poverty and stress may partially explain the higher rates of overweight, obesity, and type 2 diabetes among American Indian young adults than among non-Hispanic white young adults. Future research should explore additional neighborhood factors such as access to grocery stores selling healthy foods, proximity and safety of playgrounds or other recreational space, and adequate housing.

  16. OPHTHALMIC MANIFESTATIONS OF TAKAYASU ARTERITIS IN SOUTH INDIAN POPULATION

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    Nandhini Arumugam

    2017-06-01

    Full Text Available BACKGROUND Takayasu arteritis is a chronic inflammatory vasculopathy mainly affecting the aorta and its main branches and rarely the pulmonary artery. It usually affects females of the childbearing age group and is more prevalent in the South East Asian countries. 1 Ocular manifestations are not uncommon in cases of Takayasu arteritis. They may be ischaemic ocular manifestations when aorta and its branches are involved and get stenosed or hypertensive retinopathy when renal or suprarenal aorta is involved. 2 Uyama and Asayama broadly classified the ocular manifestations into three types. 3 Type 1 comprised of the ischaemic ocular manifestations of Takayasu arteritis, termed as Takayasu Retinopathy which has been further classified into four stages. Stage one is characterised by the distention of veins, stage two consists of microaneurysm formation, occurrence of arteriovenous anastomoses indicates stage three and complications like retinal ischaemia, neovascularisation, rubeosis iridis and vitreous haemorrhage occurs in stage four. Type two ocular findings have features of mixed retinopathy and type three had retinal manifestations due to hypertension which occurs due to the involvement of the renal and abdominal aorta. Since this disease occurs predominantly in younger individuals it causes severe ocular morbidity in the young if not diagnosed and intervened at an early stage. The aim of this study was to evaluate the clinical spectrum of ocular findings in patients with Takayasu arteritis and to describe the Fundus Fluorescein angiographic characteristics of various retinal findings in patients with Takayasu arteritis. MATERIALS AND METHODS 63 patients who were diagnosed as Takayasu Arteritis who attended our tertiary eye care centre in the time period of November 2014 to march 2017 were included in our study. RESULTS This cross-sectional study consisted of 63 patients. The mean age of the presentation of the study population was 27.8 years

  17. Knowledge and screening of head and neck cancer among American Indians in South Dakota.

    Science.gov (United States)

    Dwojak, Sunshine; Deschler, Daniel; Sargent, Michele; Emerick, Kevin; Guadagnolo, B Ashleigh; Petereit, Daniel

    2015-06-01

    We established the level of awareness of risk factors and early symptoms of head and neck cancer among American Indians in South Dakota and determined whether head and neck cancer screening detected clinical findings in this population. We used the European About Face survey. We added questions about human papillomavirus, a risk factor for head and neck cancer, and demographics. Surveys were administered at 2 public events in 2011. Participants could partake in a head and neck cancer screening at the time of survey administration. Of the 205 American Indians who completed the survey, 114 participated in the screening. Mean head and neck cancer knowledge scores were 26 out of 44. Level of education was the only factor that predicted higher head and neck cancer knowledge (b = 0.90; P = .01). Nine (8%) people had positive head and neck cancer screening examination results. All abnormal clinical findings were in current or past smokers (P = .06). There are gaps in American Indian knowledge of head and neck cancer risk factors and symptoms. Community-based head and neck cancer screening in this population is feasible and may be a way to identify early abnormal clinical findings in smokers.

  18. Radiocarbon Content of Dissolved Organic Carbon in the South Indian Ocean

    Science.gov (United States)

    Bercovici, S. K.; McNichol, A. P.; Xu, L.; Hansell, D. A.

    2018-01-01

    We report four profiles of the radiocarbon content of dissolved organic carbon (DOC) spanning the South Indian Ocean (SIO), ranging from the Polar Front (56°S) to the subtropics (29°S). Surface waters held mean DOC Δ14C values of -426 ± 6‰ ( 4,400 14C years) at the Polar Front and DOC Δ14C values of -252 ± 22‰ ( 2,000 14C years) in the subtropics. At depth, Circumpolar Deep Waters held DOC Δ14C values of -491 ± 13‰ ( 5,400 years), while values in Indian Deep Water were more depleted, holding DOC Δ14C values of -503 ± 8‰ ( 5,600 14C years). High-salinity North Atlantic Deep Water intruding into the deep SIO had a distinctly less depleted DOC Δ14C value of -481 ± 8‰ ( 5,100 14C years). We use multiple linear regression to assess the dynamics of DOC Δ14C values in the deep Indian Ocean, finding that their distribution is characteristic of water masses in that region.

  19. Global warming and South Indian monsoon rainfall-lessons from the Mid-Miocene.

    Science.gov (United States)

    Reuter, Markus; Kern, Andrea K; Harzhauser, Mathias; Kroh, Andreas; Piller, Werner E

    2013-04-01

    Precipitation over India is driven by the Indian monsoon. Although changes in this atmospheric circulation are caused by the differential seasonal diabatic heating of Asia and the Indo-Pacific Ocean, it is so far unknown how global warming influences the monsoon rainfalls regionally. Herein, we present a Miocene pollen flora as the first direct proxy for monsoon over southern India during the Middle Miocene Climate Optimum. To identify climatic key parameters, such as mean annual temperature, warmest month temperature, coldest month temperature, mean annual precipitation, mean precipitation during the driest month, mean precipitation during the wettest month and mean precipitation during the warmest month the Coexistence Approach is applied. Irrespective of a ~ 3-4 °C higher global temperature during the Middle Miocene Climate Optimum, the results indicate a modern-like monsoonal precipitation pattern contrasting marine proxies which point to a strong decline of Indian monsoon in the Himalaya at this time. Therefore, the strength of monsoon rainfall in tropical India appears neither to be related to global warming nor to be linked with the atmospheric conditions over the Tibetan Plateau. For the future it implies that increased global warming does not necessarily entail changes in the South Indian monsoon rainfall.

  20. Immigrant Asian Indians in the U.S.: A Population at Risk for Diabetes and Cardiovascular Disease

    Science.gov (United States)

    Misra, Ranjita

    2009-01-01

    Asian Indians are the third largest and fastest growing Asian subgroup in the U.S. and considered the model minority due to their high education and income level. Unlike other Asian immigrants, they are a more heterogeneous group with a genetic predisposition for diabetes and cardiovascular disease. Current national surveys are incapable of…

  1. Dyslipidemias in type 2 diabetes mellitus patients in Nnewi South ...

    African Journals Online (AJOL)

    Ramakantb

    Conclusion: Dyslipidemia is highly prevalent among type 2 diabetic patients in Nigeria with the majority of the patients having ... in type 2 diabetic patients seen in the medical unit of the ... informed consent obtained in each case and then.

  2. Evaluation of arch width variations among different skeletal patterns in South Indian population.

    Science.gov (United States)

    Prasad, Mandava; Kannampallil, Senny Thomas; Talapaneni, Ashok Kumar; George, Suja Ani; Shetty, Sharath Kumar

    2013-01-01

    Anterior cranial base can be taken as a reference line (SN) to determine the steepness of mandibular plane. Subjects with high mandibular plane angle tend to have a long face and one with low MP-SN angle has a shorter face. This study was done to investigate if dental arch widths correlated with vertical facial types and if there are any differences in arch widths between untreated male and female adults in South Indian population. Lateral cephalogram and dental casts were obtained from 180 untreated South Indian adults (90 males and 90 females) above 18 year old with no cross bite, minimal crowding and spacing. The angle between the anterior cranial base and the mandibular plane was measured on lateral cephalogram of each patient. Dental casts were used to obtain comprehensive dental measurements including maxillary and mandibular inter canine, inter premolar and inter molar widths, as well as amount of crowding or spacing. The results showed that male arch widths were significantly larger than those of females (P population. The results obtained in our study when compared with studies done in other population groups showed that there is difference in inter arch widths according to ethnicity and race. It was concluded that the dental arch width is associated with gender, race and vertical facial morphology. Thus using individualized arch wires according to each patient's pre treatment arch form and width is suggested during orthodontic treatment.

  3. Association between Dental Health and Osteoporosis: A Study in South Indian Postmenopausal Women.

    Science.gov (United States)

    Kapoor, Nitin; Cherian, Kripa Elizabeth; Pramanik, Binay Kumar; Govind, S; Winford, Manna Elizabeth; Shetty, Sahana; Thomas, Nihal; Paul, Thomas Vizhalil

    2017-01-01

    This study aims to objectively assess the dentition status in South Indian postmenopausal women and compare the dental health of osteoporotic participants with nonosteoporotic individuals. A total of 150 consecutive ambulatory South Indian postmenopausal women (>50 years of age) were assessed for their dental health using an internationally validated scoring system. Bone mineral density (BMD) was assessed using a dual-energy X-ray absorptiometry scanner. About 39% of the participants were found to have osteoporosis and 23% had osteopenia at any site. More than half of them (57%) had poor dental health, and the predominant problems were cavities (43.5%) and loss of teeth (75%). Among 112 women who had tooth loss, the mean tooth loss was 4.8. The mean tooth loss among patients with normal BMD was 1.09 ± 1.2, in osteopenia was 2.1 ± 2, and in osteoporosis was 5.4 ± 2.8 ( P women with osteoporosis had significantly higher number of tooth loss. Tooth loss may thus be used as a surrogate marker to predict osteoporosis.

  4. Prevalence of Catalase (-21 A/T Gene Variant in South Indian (Tamil Population

    Directory of Open Access Journals (Sweden)

    A. Lourdhu Mary

    2014-01-01

    Full Text Available Catalase, an endogenous antioxidant enzyme, is responsible for regulating reactive species levels. Several epidemiologic studies have suggested that single nucleotide polymorphism in catalase gene may be associated with many diseases. The genotype of CAT (-21 A/T point mutation in promoter region of catalase gene was determined by polymerase chain based restriction fragment length polymorphism analysis in the DNA of 100 healthy volunteers. The frequency of CAT (-21 A/T gene polymorphism AA, AT, and TT genotypes was found to be 7, 23, and 70 percent, respectively. The mutant “T” allele frequency was found to be 0.82 among the south Indian (Tamil population. Chi square analysis showed that the study population lies within the Hardy-Weinberg equilibrium. The wild type genotype (AA was found to be very low (7% and the mutant genotype (AT/TT was found to be more prevalent (93% among the south Indian population. This suggests that the high prevalence of mutant genotype may increase the susceptibility to oxidative stress associated diseases.

  5. Nonassociation of homocysteine gene polymorphisms with treatment outcome in South Indian Tamil Rheumatoid Arthritis patients.

    Science.gov (United States)

    Muralidharan, Niveditha; Gulati, Reena; Misra, Durga Prasanna; Negi, Vir S

    2018-02-01

    The aim of the study was to look for any association of MTR 2756A>G and MTRR 66A>G gene polymorphisms with clinical phenotype, methotrexate (MTX) treatment response, and MTX-induced adverse events in South Indian Tamil patients with rheumatoid arthritis (RA). A total of 335 patients with RA were investigated. MTR 2756A>G gene polymorphism was analyzed by PCR-RFLP, and MTRR 66A>G SNP was analyzed by TaqMan 5' nuclease assay. The allele frequencies were compared with HapMap groups. MTR 2756G allele was found to be associated with risk of developing RA. The allele frequencies of MTR 2756A>G and MTRR 66A>G SNPs in controls differed significantly when compared with HapMap groups. Neither of the SNPs influenced the MTX treatment outcome and adverse effects. Neither of the SNPs seems to be associated with MTX treatment outcome and adverse events in South Indian Tamil patients with RA.

  6. Clinical characteristics of non-insulin-dependent diabetes mellitus among southwestern American Indian youths.

    Science.gov (United States)

    Coddington, D A; Hisnanick, J J

    2001-03-01

    The clinical characteristics and presentation of non-insulin-dependent diabetes mellitus (NIDDM) among 22 youths, aged less than 20 years, of an American Indian tribe Tohono O'odham Nation in the southwestern United States were studied. Ten males and 12 females (7-20 years old) were identified with a 13.7-year mean age of onset of diabetes. Over 80% (18/22) of the patients were obese at diagnosis having a body mass index greater than the 95th percentile for their age and sex, and there was a strong family history of NIDDM; eight patients were born to mothers who had gestational diabetes, and 19 patients had at least one parent with NIDDM. At the time of diagnosis, plasma glucose levels ranged from 10.3 mmol/L to 33 mmol/L, with nearly 60% (13/22) of the patients having a glucose reading greater than 16.8 mmol/L. C-peptide levels were done on 10 patients, and these were in the normal to elevated range. Clinical management of the 22 patients varied. To control hyperglycaemia and symptoms, such as nocturia and polyuria, 14 patients were on oral hypoglycaemic medication, and five were on insulin therapy. Compliance with dietary management was very difficult for these patients as evidenced by the fact that only three patients were on dietary control for their diabetes. The cases described in this series demonstrate NIDDM in childhood and illustrate the importance of accurate classification of diabetes during childhood, particularly in children from populations at high risk for NIDDM.

  7. The Paleo-Indian Entry into South America According to Mitogenomes.

    Science.gov (United States)

    Brandini, Stefania; Bergamaschi, Paola; Cerna, Marco Fernando; Gandini, Francesca; Bastaroli, Francesca; Bertolini, Emilie; Cereda, Cristina; Ferretti, Luca; Gómez-Carballa, Alberto; Battaglia, Vincenza; Salas, Antonio; Semino, Ornella; Achilli, Alessandro; Olivieri, Anna; Torroni, Antonio

    2018-02-01

    Recent and compelling archaeological evidence attests to human presence ∼14.5 ka at multiple sites in South America and a very early exploitation of extreme high-altitude Andean environments. Considering that, according to genetic evidence, human entry into North America from Beringia most likely occurred ∼16 ka, these archeological findings would imply an extremely rapid spread along the double continent. To shed light on this issue from a genetic perspective, we first completely sequenced 217 novel modern mitogenomes of Native American ancestry from the northwestern area of South America (Ecuador and Peru); we then evaluated them phylogenetically together with other available mitogenomes (430 samples, both modern and ancient) from the same geographic area and, finally, with all closely related mitogenomes from the entire double continent. We detected a large number (N = 48) of novel subhaplogroups, often branching into further subclades, belonging to two classes: those that arose in South America early after its peopling and those that instead originated in North or Central America and reached South America with the first settlers. Coalescence age estimates for these subhaplogroups provide time boundaries indicating that early Paleo-Indians probably moved from North America to the area corresponding to modern Ecuador and Peru over the short time frame of ∼1.5 ka comprised between 16.0 and 14.6 ka. © The Author 2017. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

  8. Perceptions and Concerns Regarding Diabetes Mellitus During Pregnancy Among American Indian Women.

    Science.gov (United States)

    Carson, L D; Henderson, J Neil; King, Kama; Kleszynski, Keith; Thompson, David M; Mayer, Patricia

    2014-12-01

    Diabetes among American Indian (AI) people is a. condition that creates excessive morbidity and mortality and is a significant health disparity. This research delineated culturally constructed models of diabetes mellitus (DM) among 97 pregnant women in 2 large AI Nations to Oklahoma. Analysis of data revealed intense anxiety, fear, and dread related to DM during pregnancy. The sample was stratified by DM status: (a) absence of DM ( n = 66), (b) DM prior to pregnancy ( n = 4), and (c) gestational ( n = 27). Structured and semistructured interviews elicited patient culturally based explanatory models (EMs) of etiology, course, and treatment. The research incorporated an integrated phenomenologic and ethnographic approach and yielded both quantitative and qualitative data. General findings comprised the following main categories of patients' concerns regarding DM as an illness: (a) care-seeking behaviors, (b) medical management, (c) adherence and self-management, (d) complications, and (e) the conceptual sense of DM as a "severe" and feared condition. Many findings varied according to acculturation status, but all included significant fear and anxiety surrounding (a) the health and well-being of the unborn child, (b) the use of insulin injections, (c) blindness, (d) amputation, and (e) death, but with (f) a paradoxically lowered anxiety level about diabetes severity overall, while at the same time expressing extreme dread of specific outcomes. The latter finding is considered consistent with the presence of chronic conditions that can usually be managed, yet still having risk if severe.

  9. Perceived racial discrimination in health care, completion of standard diabetes services, and diabetes control among a sample of American Indian women.

    Science.gov (United States)

    Gonzales, Kelly L; Lambert, William E; Fu, Rongwei; Jacob, Michelle; Harding, Anna K

    2014-01-01

    The purpose of this study is to examine perceived experiences of racial discrimination (perceived discrimination) in health care and its associations with completing standards of care for diabetes management and diabetes control. This cross-sectional study included 200 adult American Indian (AI) women with type 2 diabetes from 4 health care facilities located on tribal reservations in the Pacific Northwest. Participants completed a survey, and medical records were abstracted. Logistic regression was completed to assess associations. Sixty-seven percent of AI women reported discrimination during their lifetime of health care. After adjusting for patient characteristics, perceived discrimination was significantly associated with lower rates of dental exam; checks for blood pressure, creatinine, and total cholesterol; and pneumococcal vaccination. The association between perceived discrimination and total number of diabetes services completed was not statistically significant. Perceived discrimination was associated with having A1C values above target levels for diabetes control in unadjusted and adjusted models, but no association was observed for blood pressure or total cholesterol. In our sample of AI women with diabetes, two-thirds reported experiencing racial discrimination in their health care experience. Those reporting perceived discrimination completed fewer diabetes services and therefore may be at increased risk for comorbidities of diabetes. This finding supports the continued need for culturally responsive health care and programs of diabetes education to recognize perceived discrimination and its potential to impact success in self-management and services utilization. © 2014 The Author(s).

  10. Heat flow, heat generation and crustal thermal structure of the northern block of the South Indian Craton

    Science.gov (United States)

    Gupta, Mohan L.; Sharma, S. R.; Sundar, A.

    Heat flow values and heat generation data calculated from the concentration of heat producing radioactive elements, U, Th and K in surface rocks were analyzed. The South Indian Craton according to Drury et al., can be divided into various blocks, separated by late Proterozoic shear belts. The northern block comprises Eastern and Western Dharwar Cratons of Rogers (1986), Naqvi and Rogers (1987) and a part of the South Indian granulite terrain up to a shear system occupying the Palghat-Cauvery low lands. The geothermal data analysis clearly demonstrates that the present thermal characteristics of the above two Archaean terrains of the Indian and Australian Shields are quite similar. Their crustal thermal structures are likely to be similar also.

  11. Heat flow, heat generation and crustal thermal structure of the northern block of the South Indian Craton

    Science.gov (United States)

    Gupta, Mohan L.; Sharma, S. R.; Sundar, A.

    1988-01-01

    Heat flow values and heat generation data calculated from the concentration of heat producing radioactive elements, U, Th and K in surface rocks were analyzed. The South Indian Craton according to Drury et al., can be divided into various blocks, separated by late Proterozoic shear belts. The northern block comprises Eastern and Western Dharwar Cratons of Rogers (1986), Naqvi and Rogers (1987) and a part of the South Indian granulite terrain up to a shear system occupying the Palghat-Cauvery low lands. The geothermal data analysis clearly demonstrates that the present thermal characteristics of the above two Archaean terrains of the Indian and Australian Shields are quite similar. Their crustal thermal structures are likely to be similar also.

  12. Genome-Wide DNA Methylation in Mixed Ancestry Individuals with Diabetes and Prediabetes from South Africa

    Science.gov (United States)

    Pheiffer, Carmen; Humphries, Stephen E.; Gamieldien, Junaid; Erasmus, Rajiv T.

    2016-01-01

    Aims. To conduct a genome-wide DNA methylation in individuals with type 2 diabetes, individuals with prediabetes, and control mixed ancestry individuals from South Africa. Methods. We used peripheral blood to perform genome-wide DNA methylation analysis in 3 individuals with screen detected diabetes, 3 individuals with prediabetes, and 3 individuals with normoglycaemia from the Bellville South Community, Cape Town, South Africa, who were age-, gender-, body mass index-, and duration of residency-matched. Methylated DNA immunoprecipitation (MeDIP) was performed by Arraystar Inc. (Rockville, MD, USA). Results. Hypermethylated DMRs were 1160 (81.97%) and 124 (43.20%), respectively, in individuals with diabetes and prediabetes when both were compared to subjects with normoglycaemia. Our data shows that genes related to the immune system, signal transduction, glucose transport, and pancreas development have altered DNA methylation in subjects with prediabetes and diabetes. Pathway analysis based on the functional analysis mapping of genes to KEGG pathways suggested that the linoleic acid metabolism and arachidonic acid metabolism pathways are hypomethylated in prediabetes and diabetes. Conclusions. Our study suggests that epigenetic changes are likely to be an early process that occurs before the onset of overt diabetes. Detailed analysis of DMRs that shows gradual methylation differences from control versus prediabetes to prediabetes versus diabetes in a larger sample size is required to confirm these findings. PMID:27555869

  13. Replication of type 2 diabetes candidate genes variations in three geographically unrelated Indian population groups.

    Science.gov (United States)

    Ali, Shafat; Chopra, Rupali; Manvati, Siddharth; Singh, Yoginder Pal; Kaul, Nabodita; Behura, Anita; Mahajan, Ankit; Sehajpal, Prabodh; Gupta, Subash; Dhar, Manoj K; Chainy, Gagan B N; Bhanwer, Amarjit S; Sharma, Swarkar; Bamezai, Rameshwar N K

    2013-01-01

    Type 2 diabetes (T2D) is a syndrome of multiple metabolic disorders and is genetically heterogeneous. India comprises one of the largest global populations with highest number of reported type 2 diabetes cases. However, limited information about T2D associated loci is available for Indian populations. It is, therefore, pertinent to evaluate the previously associated candidates as well as identify novel genetic variations in Indian populations to understand the extent of genetic heterogeneity. We chose to do a cost effective high-throughput mass-array genotyping and studied the candidate gene variations associated with T2D in literature. In this case-control candidate genes association study, 91 SNPs from 55 candidate genes have been analyzed in three geographically independent population groups from India. We report the genetic variants in five candidate genes: TCF7L2, HHEX, ENPP1, IDE and FTO, are significantly associated (after Bonferroni correction, ppopulation. Interestingly, SNP rs7903146 of the TCF7L2 gene passed the genome wide significance threshold (combined P value = 2.05E-08) in the studied populations. We also observed the association of rs7903146 with blood glucose (fasting and postprandial) levels, supporting the role of TCF7L2 gene in blood glucose homeostasis. Further, we noted that the moderate risk provided by the independently associated loci in combined population with Odds Ratio (OR)<1.38 increased to OR = 2.44, (95%CI = 1.67-3.59) when the risk providing genotypes of TCF7L2, HHEX, ENPP1 and FTO genes were combined, suggesting the importance of gene-gene interactions evaluation in complex disorders like T2D.

  14. Vildagliptin vs sulfonylurea in Indian Muslim diabetes patients fasting during Ramadan.

    Science.gov (United States)

    Shete, Abhijit; Shaikh, Aheson; Nayeem, K Javeed; Rodrigues, Lily; Ali, Mohamed Sheikamunadeen Sadiq; Shah, Parag; Khanna, Rajiv; Majid, Sarfaraj; Rasheed, Sabeer A; Shaikh, Shehla; Rahman, Tawfiqur

    2013-12-15

    To compare the use of vildagliptin and sulfonylurea with or without metformin in Indian Muslim patients with type 2 diabetes mellitus, fasting during Ramadan. This was a 4-wk, multicenter, non-interventional, open-label, observational study. Incidence of hypoglycemic events (HEs), adverse events, and changes in glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose, postprandial plasma glucose and body weight were measured pre- and post-Ramadan. Totally, 97 patients were recruited and all completed the study (vildagliptin group, n = 55; sulfonylurea group, n = 42). HEs were reported in low frequencies in both the vildagliptin and the sulfonylurea groups [0 vs 2 (4.8%) patients, respectively]. Interestingly, HbA1c reduced by -0.43% (-4.71 mmol/mol) in the vildagliptin group [8.75% (72.10 mmol/mol) to 8.32% (67.38 mmol/mol), P = 0.009] while in the sulfonylurea group there was a small increase by 0.01% [0.08 mmol/mol; 8.64% (70.92 mmol/mol) to 8.65% (71.00 mmol/mol), P = 0.958]. Higher percentage of vildagliptin-treated patients achieved HbA1c < 7.0% (< 53 mmol/mol) compared with sulfonylurea (16.4% vs 4.8%). Mean decrease in the body weight was 1.2 kg and 0.03 kg, respectively (P < 0.001). Both treatment groups were well tolerated during Ramadan. Vildagliptin is an attractive treatment option for Indian patients with type 2 diabetes mellitus who are fasting during Ramadan.

  15. Replication of type 2 diabetes candidate genes variations in three geographically unrelated Indian population groups.

    Directory of Open Access Journals (Sweden)

    Shafat Ali

    Full Text Available Type 2 diabetes (T2D is a syndrome of multiple metabolic disorders and is genetically heterogeneous. India comprises one of the largest global populations with highest number of reported type 2 diabetes cases. However, limited information about T2D associated loci is available for Indian populations. It is, therefore, pertinent to evaluate the previously associated candidates as well as identify novel genetic variations in Indian populations to understand the extent of genetic heterogeneity. We chose to do a cost effective high-throughput mass-array genotyping and studied the candidate gene variations associated with T2D in literature. In this case-control candidate genes association study, 91 SNPs from 55 candidate genes have been analyzed in three geographically independent population groups from India. We report the genetic variants in five candidate genes: TCF7L2, HHEX, ENPP1, IDE and FTO, are significantly associated (after Bonferroni correction, p<5.5E-04 with T2D susceptibility in combined population. Interestingly, SNP rs7903146 of the TCF7L2 gene passed the genome wide significance threshold (combined P value = 2.05E-08 in the studied populations. We also observed the association of rs7903146 with blood glucose (fasting and postprandial levels, supporting the role of TCF7L2 gene in blood glucose homeostasis. Further, we noted that the moderate risk provided by the independently associated loci in combined population with Odds Ratio (OR<1.38 increased to OR = 2.44, (95%CI = 1.67-3.59 when the risk providing genotypes of TCF7L2, HHEX, ENPP1 and FTO genes were combined, suggesting the importance of gene-gene interactions evaluation in complex disorders like T2D.

  16. Estimating the burden of disease attributable to diabetes in South Africa in 2000.

    Science.gov (United States)

    Bradshaw, Debbie; Norman, Rosana; Pieterse, Desiréé; Levitt, Naomi S

    2007-08-01

    To estimate the burden of disease attributable to diabetes by sex and age group in South Africa in 2000. The framework adopted for the most recent World Health Organization comparative risk assessment (CRA) methodology was followed. Small community studies used to derive the prevalence of diabetes by population group were weighted proportionately for a national estimate. Population-attributable fractions were calculated and applied to revised burden of disease estimates. Monte Carlo simulation-modelling techniques were used for uncertainty analysis. South Africa. Adults 30 years and older. Mortality and disability-adjusted life years (DALYs) for ischaemic heart disease (IHD), stroke, hypertensive disease and renal failure. Of South Africans aged >or= 30 years, 5.5% had diabetes which increased with age. Overall, about 14% of IHD, 10% of stroke, 12% of hypertensive disease and 12% of renal disease burden in adult males and females (30+ years) were attributable to diabetes. Diabetes was estimated to have caused 22,412 (95% uncertainty interval 20,755 - 24,872) or 4.3% (95% uncertainty interval 4.0 - 4.8%) of all deaths in South Africa in 2000. Since most of these occurred in middle or old age, the loss of healthy life years comprises a smaller proportion of the total 258,028 DALYs (95% uncertainty interval 236,856 - 290,849) in South Africa in 2000, accounting for 1.6% (95% uncertainty interval 1.5 - 1.8%) of the total burden. Diabetes is an important direct and indirect cause of burden in South Africa. Primary prevention of the disease through multi-level interventions and improved management at primary health care level are needed.

  17. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools for Diabetes Educators and Community Members Diabetes Educator Tools Diabetes Education Lesson Plan Outlines Integrating Case Management Into Your Practice [PDF – 290 KB] Integrating DSMES ...

  18. Gestational Diabetes in General Practice | Notelovitz | South African ...

    African Journals Online (AJOL)

    The role of the general practitioner in the diagnosis and management of the gestational diabetic is defined. Recognition of this condition is important for improving the perinatal mortality; as is advice regarding steroid contraception; and as a means of predicting the development of overt diabetes. Methods of diagnosis are ...

  19. Asymptomatic Bacteriuria in Diabetes Mellitus | Joffe | South African ...

    African Journals Online (AJOL)

    A study was undertaken to determine the frequency of asymptomatic bacteriuria among 100 ambulant diabetic patients attending a diabetic outpatient clinic. At the same time, we assessed the reliability of the Uricult dip-slide method for detecting urinary bacterial growth. Significant bacteriuria occurred in 9% of the total ...

  20. Journal of Genetics | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Lack of association of PTPN1 gene polymorphisms with type 2 diabetes in south Indians · Dhanasekaran Bodhini Venkatesan Radha Saurabh Ghosh Partha P. Majumder Viswanathan Mohan · More Details Fulltext PDF. Volume 94 Issue 1 March 2015 pp 105-113 Research Article. Comparative analyses of genetic risk ...

  1. Risk factors for choledocholithiasis in a south Indian population: a case-control study.

    Science.gov (United States)

    Chandran, Alexander Palapatti; Sivarajan, Ramya Ramakrishnan; Srinivas, Melpakkam; Srinivasan, Vijaya; Venkataraman, Jayanthi

    2013-11-01

    To identify risk factors for common bile duct (CBD) stones in a south Indian population. Demographic characteristics and diet details were obtained from patients with isolated CBD stones (Gp I) and those with combined CBD and gallstones (Gp II) and age- and sex-matched controls. The risk factors were compared between the two groups. The demographic characteristics were similar between the two groups and matched controls. The significant risk factors for Gp I were infrequent consumption of green vegetable (odds ratio (OR), 2.3; p 3 times per week) of spices (OR, 2.8; p oil (p oil intake (251 + 105 vs. 292 + 89 mL; p CBD stones in both groups were associated with reduced intake of sugar and green vegetables. Our findings need to be validated in larger studies.

  2. Ectodermal Dysplasia: Report and Analysis of Eleven South Indian Patients with Review of Literature

    Directory of Open Access Journals (Sweden)

    Renuka Ammanagi

    2010-01-01

    Full Text Available Ectodermal dysplasia represents a rare syndrome affecting two or more ectodermally derived structures. The condition is thought to occur in approximately 1 in every 100,000 live births. It affects men more frequently and severely, while women being the carriers and heterozygote usually show minor defects. There are more than 150 different variants of ectodermal dysplasia (ED reported in the literature. Most commonly encountered among them is hypohidrotic ED which frequently exhibits the most severe dental anomalies like hypodontia or anodontia along with hypohidrosis and hypotrichosis. Here we make an attempt to collectively report and discuss eleven South Indian patients who reported to our department during the year 1998 to 2004. An added emphasis is laid on family history of consanguineous marriage among the parents of these patients.

  3. Population Growth and Sprawl on the Pine Ridge Indian Reservation, South Dakota

    Science.gov (United States)

    Campbell, R. L.

    2006-05-01

    The most important impact on global land cover is human use and development. With the recent population growth occurring on the reservations in South Dakota, especially Pine Ridge Indian Reservation, the towns and agricultural areas of the reservation are undergoing a change. Although urban sprawl certainly is not a consideration on the reservations, the population explosion currently underway has seen a subsequent increase in rural sprawl. In this case, rural sprawl is defined as exponential population growth and geographic expansion of remote reservation communities. Using satellite imagery and software to render these images is a cost effective way to investigate this growth. Also, using remotely sensed data and a GIS (geographic information system) package can address different issues that concern people and communities in and around the Pine Ridge area. The objective of my project is to observe land use change on the Pine Ridge Indian reservation using Geographic Information Systems such as; ARCGis 9, ENVI, and Multispec, along with Landsat 4, 5, and 7 imagery over the past 20 years.

  4. Prevalence of specific learning disabilities among primary school children in a South Indian city.

    Science.gov (United States)

    Mogasale, Vijayalaxmi V; Patil, Vishwanath D; Patil, Nanasaheb M; Mogasale, Vittal

    2012-03-01

    To measure the prevalence of specific learning disabilities (SpLDs) such as dyslexia, dysgraphia and dyscalculia among primary school children in a South Indian city. A cross-sectional multi-staged stratified randomized cluster sampling study was conducted among children aged 8-11 years from third and fourth standard. A six level screening approach that commenced with identification of scholastic backwardness followed by stepwise exclusion of impaired vision and hearing, chronic medical conditions and subnormal intelligence was carried out among these children. In the final step, the remaining children were subjected to specific tests for reading, comprehension, writing and mathematical calculation. The prevalence of specific learning disabilities was 15.17% in sampled children, whereas 12.5%, 11.2% and 10.5% had dysgraphia, dyslexia and dyscalculia respectively. This study suggests that the prevalence of SpLDs is at the higher side of previous estimations in India. The study is unique due to its large geographically representative design and identification of the problem using simplified screening approach and tools, which minimizes the number and time of specialist requirement and spares the expensive investigation. This approach and tools are suitable for field situations and resource scarce settings. Based on the authors' experience, they express the need for more prevalence studies, remedial education and policy interventions to manage SpLDs at main stream educational system to improve the school performance in Indian children.

  5. Pioglitazone utilization, efficacy & safety in Indian type 2 diabetic patients: A systematic review & comparison with European Medicines Agency Assessment Report.

    Science.gov (United States)

    Pai, Sarayu A; Kshirsagar, Nilima A

    2016-11-01

    With pioglitazone ban and subsequent revoking in India along with varying regulatory decisions in other countries, it was decided to carry out a systematic review on its safety, efficacy and drug utilization in patients with type 2 diabetes mellitus (T2DM) in India and compare with the data from the European Medicines Agency Assessment Report (EMA-AR). Systematic review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching Medline/PubMed, Google Scholar and Science Direct databases using 'pioglitazone AND India AND human' and 'pioglitazone AND India AND human AND patient' and compared with EMA-AR. Spontaneous reports in World Health Organization VigiBase from India were compared with VigiBase data from other countries. Sixty six publications, 26 (efficacy), 32 (drug utilization) and eight (safety), were retrieved. In India, pioglitazone was used at 15-30 mg/day mostly with metformin and sulphonylurea, being prescribed to 26.7 and 8.4 per cent patients in north and south, respectively. The efficacy in clinical trials (CTs) was similar to those in EMA-AR. Incidence of bladder cancer in pioglitazone exposed and non-exposed patients was not significantly different in an Indian retrospective cohort study. There were two cases and a series of eight cases of bladder cancer published but none reported in VigiBase. In India, probably due to lower dose, lower background incidence of bladder cancer and smaller sample size in epidemiological studies, association of bladder cancer with pioglitazone was not found to be significant. Reporting of CTs and adverse drug reactions to Clinical Trials Registry of India and Pharmacovigilance Programme of India, respectively, along with compliance studies with warning given in package insert and epidemiological studies with larger sample size are needed.

  6. Diversity of palatal rugae patterns and their reliability in sex discrimination in a South Indian population

    Directory of Open Access Journals (Sweden)

    Sai Madhavi Nallamilli

    2015-01-01

    Full Text Available Introduction and Aims: Array of palatal rugae in the realm of forensic odontology has been constantly explored owing to their individual uniqueness and resistance to postmortem procedures, while their scope in sex determination and racial profiling remains understated. In this context, the present study aimed to record the diversity of palatal rugae patterns in a South Indian population. Materials and Methods: A descriptive cross-sectional study was conducted among people who reported to the outpatient department of a dental institution. Sample comprised a total of 200 subjects divided into two groups of 100 each, based upon gender. Impressions of anterior maxilla were made of all the study subjects and casts obtained subsequently. Outline of palatal rugae pattern was traced on these models and the data computed. Z test and unpaired t-test were used for statistical analysis and the probability value calculated. In addition, logistic regression analysis was performed to estimate the accuracy of sex allocation. Results: The shape of rugae exhibited highly significant sex difference in the curved type, which was found to be higher in males, and in the wavy type which was higher in females, enabling sex differentiation using palatal rugae patterns. Logistic regression analysis predicted high power of sex allocation for males rather than females in the study population. Conclusion: This study highlighted the uniqueness and greater sex discrimination potential of curved shape of palatal rugae in categorizing males of South Indian population, substantiating their use in the identification of deceased, by relating the antemortem and postmortem dental records.

  7. Arrival of Paleo-Indians to the southern cone of South America: new clues from mitogenomes.

    Directory of Open Access Journals (Sweden)

    Michelle de Saint Pierre

    Full Text Available With analyses of entire mitogenomes, studies of Native American mitochondrial DNA (MTDNA variation have entered the final phase of phylogenetic refinement: the dissection of the founding haplogroups into clades that arose in America during and after human arrival and spread. Ages and geographic distributions of these clades could provide novel clues on the colonization processes of the different regions of the double continent. As for the Southern Cone of South America, this approach has recently allowed the identification of two local clades (D1g and D1j whose age estimates agree with the dating of the earliest archaeological sites in South America, indicating that Paleo-Indians might have reached that region from Beringia in less than 2000 years. In this study, we sequenced 46 mitogenomes belonging to two additional clades, termed B2i2 (former B2l and C1b13, which were recently identified on the basis of mtDNA control-region data and whose geographical distributions appear to be restricted to Chile and Argentina. We confirm that their mutational motifs most likely arose in the Southern Cone region. However, the age estimate for B2i2 and C1b13 (11-13,000 years appears to be younger than those of other local clades. The difference could reflect the different evolutionary origins of the distinct South American-specific sub-haplogroups, with some being already present, at different times and locations, at the very front of the expansion wave in South America, and others originating later in situ, when the tribalization process had already begun. A delayed origin of a few thousand years in one of the locally derived populations, possibly in the central part of Chile, would have limited the geographical and ethnic diffusion of B2i2 and explain the present-day occurrence that appears to be mainly confined to the Tehuelche and Araucanian-speaking groups.

  8. Identifying postpartum intervention approaches to reduce cardiometabolic risk among American Indian women with prior gestational diabetes, Oklahoma, 2012-2013.

    Science.gov (United States)

    Jones, Emily J; Peercy, Michael; Woods, J Cedric; Parker, Stephany P; Jackson, Teresa; Mata, Sara A; McCage, Shondra; Levkoff, Sue E; Nicklas, Jacinda M; Seely, Ellen W

    2015-04-02

    Innovative approaches are needed to reduce cardiometabolic risk among American Indian women with a history of gestational diabetes. We assessed beliefs of Oklahoma American Indian women about preventing type 2 diabetes and cardiovascular disease after having gestational diabetes. We also assessed barriers and facilitators to healthy lifestyle changes postpartum and intervention approaches that facilitate participation in a postpartum lifestyle program. In partnership with a tribal health system, we conducted a mixed-method study with American Indian women aged 19 to 45 years who had prior gestational diabetes, using questionnaires, focus groups, and individual interviews. Questionnaires were used to identify women's cardiometabolic risk perceptions and feasibility and acceptability of Internet or mobile phone technology for delivery of a postpartum lifestyle modification program. Focus groups and individual interviews were conducted to identify key perspectives and preferences related to a potential program. Participants were 26 women, all of whom completed surveys; 11 women participated in focus group sessions, and 15 participated in individual interviews. Most women believed they would inevitably develop diabetes, cardiovascular disease, or both; however, they were optimistic that they could delay onset with lifestyle change. Most women expressed enthusiasm for a family focused, technology-based intervention that emphasizes the importance of delaying disease onset, provides motivation, and promotes accountability while accommodating women's competing priorities. Our findings suggest that an intervention that uses the Internet, text messaging, or both and that emphasizes the benefits of delaying disease onset should be tested as a novel, culturally relevant approach to reducing rates of diabetes and cardiovascular disease in this high-risk population.

  9. Insights into the genetic structure and diversity of 38 South Asian Indians from deep whole-genome sequencing.

    Directory of Open Access Journals (Sweden)

    Lai-Ping Wong

    2014-05-01

    Full Text Available South Asia possesses a significant amount of genetic diversity due to considerable intergroup differences in culture and language. There have been numerous reports on the genetic structure of Asian Indians, although these have mostly relied on genotyping microarrays or targeted sequencing of the mitochondria and Y chromosomes. Asian Indians in Singapore are primarily descendants of immigrants from Dravidian-language-speaking states in south India, and 38 individuals from the general population underwent deep whole-genome sequencing with a target coverage of 30X as part of the Singapore Sequencing Indian Project (SSIP. The genetic structure and diversity of these samples were compared against samples from the Singapore Sequencing Malay Project and populations in Phase 1 of the 1,000 Genomes Project (1 KGP. SSIP samples exhibited greater intra-population genetic diversity and possessed higher heterozygous-to-homozygous genotype ratio than other Asian populations. When compared against a panel of well-defined Asian Indians, the genetic makeup of the SSIP samples was closely related to South Indians. However, even though the SSIP samples clustered distinctly from the Europeans in the global population structure analysis with autosomal SNPs, eight samples were assigned to mitochondrial haplogroups that were predominantly present in Europeans and possessed higher European admixture than the remaining samples. An analysis of the relative relatedness between SSIP with two archaic hominins (Denisovan, Neanderthal identified higher ancient admixture in East Asian populations than in SSIP. The data resource for these samples is publicly available and is expected to serve as a valuable complement to the South Asian samples in Phase 3 of 1 KGP.

  10. Insights into the genetic structure and diversity of 38 South Asian Indians from deep whole-genome sequencing.

    Science.gov (United States)

    Wong, Lai-Ping; Lai, Jason Kuan-Han; Saw, Woei-Yuh; Ong, Rick Twee-Hee; Cheng, Anthony Youzhi; Pillai, Nisha Esakimuthu; Liu, Xuanyao; Xu, Wenting; Chen, Peng; Foo, Jia-Nee; Tan, Linda Wei-Lin; Koo, Seok-Hwee; Soong, Richie; Wenk, Markus Rene; Lim, Wei-Yen; Khor, Chiea-Chuen; Little, Peter; Chia, Kee-Seng; Teo, Yik-Ying

    2014-05-01

    South Asia possesses a significant amount of genetic diversity due to considerable intergroup differences in culture and language. There have been numerous reports on the genetic structure of Asian Indians, although these have mostly relied on genotyping microarrays or targeted sequencing of the mitochondria and Y chromosomes. Asian Indians in Singapore are primarily descendants of immigrants from Dravidian-language-speaking states in south India, and 38 individuals from the general population underwent deep whole-genome sequencing with a target coverage of 30X as part of the Singapore Sequencing Indian Project (SSIP). The genetic structure and diversity of these samples were compared against samples from the Singapore Sequencing Malay Project and populations in Phase 1 of the 1,000 Genomes Project (1 KGP). SSIP samples exhibited greater intra-population genetic diversity and possessed higher heterozygous-to-homozygous genotype ratio than other Asian populations. When compared against a panel of well-defined Asian Indians, the genetic makeup of the SSIP samples was closely related to South Indians. However, even though the SSIP samples clustered distinctly from the Europeans in the global population structure analysis with autosomal SNPs, eight samples were assigned to mitochondrial haplogroups that were predominantly present in Europeans and possessed higher European admixture than the remaining samples. An analysis of the relative relatedness between SSIP with two archaic hominins (Denisovan, Neanderthal) identified higher ancient admixture in East Asian populations than in SSIP. The data resource for these samples is publicly available and is expected to serve as a valuable complement to the South Asian samples in Phase 3 of 1 KGP.

  11. A study to evaluate the prevalence of hypogonadism in Indian males with Type-2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Pankaj Kumar Agarwal

    2017-01-01

    Full Text Available Background: A high prevalence of hypogonadism in men with Type-2 diabetes mellitus (T2DM has been reported worldwide. Objectives: To evaluate the prevalence of hypogonadism in Indian males with T2DM and assess the primary and secondary hypogonadism along with androgen deficiency. Materials and Methods: In this cross-sectional study, 900 men with T2DM were evaluated using androgen deficiency in aging male questionnaire. They were screened for demographic characteristics, gonadal hormone levels, lipid profile, and glycosylated hemoglobin. Results: The prevalence of hypogonadism in T2DM patients was found to be 20.7% (186 out of 900. Hypogonadism was of testicular origin (primary in 48/186 (25.8% patients, of pituitary or hypothalamic origin (secondary in 14/186 (7.53%, and remaining 124/186 (66.67% patients were found to have low testosterone with the inappropriate normal level of luteinizing hormone and Follicle-stimulating hormone. 451/900 (50.1% patients were only symptomatic but had normal testosterone levels. Further 263 patients out 900 were asymptomatic, of which 51/900 (5.7% patients had low levels of testosterone and 212/900 (23.5% patients had normal testosterone level without symptoms. There were no deaths or other serious adverse events except mild pyrexia which was not related to the study. Conclusion: Hypogonadism diagnosis, at times, might not be validated with the help of androgen deficiency questionnaire or symptoms only. Given the large number of patients of T2DM in India, the incidence of hypogonadism is more in diabetic patients as compared to the general population. Hence, implementation of screening programs in diabetic patients is necessary to understand and detect individuals with low serum total testosterone at any early stage and to supplement testosterone accordingly.

  12. Concepts and treatment for diabetes among traditional and faith healers in the northern province, South Africa.

    Science.gov (United States)

    Peltzer, K; Khoza, L B; Lekhuleni, M E; Madu, S N; Cherian, V I; Cherian, L

    2001-05-01

    The purpose of the study was to assess the concepts and treatment modalities for diabetes among traditional and faith healers in the Northern Province in South Africa. The sample consisted of 50 traditional healers (13 females and 37 males) and 50 faith healers (12 females and 38 males). They were interviewed on local terminology, clinical manifestations, causes, curability, and treatment for diabetes, help-seeking behaviour of diabetes patients, and the healers' sources of information about diabetes. Results indicate that all healers were familiar with "diabetes", however, not all of them had seen patients suffering from diabetes. The perceived causes of diabetes by both traditional and faith healers could be divided into (1) diet (especially too much of sugar), (2) heredity, (3) supernatural, and (4) psychological causes. Most traditional healers (92%) and faith healers (90%) indicated that diabetes is curable. Treatments used by the healers in this study included the use of prayer, diet, and herbs. The authors conclude that the concepts and treatment modalities for diabetes among traditional and faith healers should be taken note of by health workers while developing health education programmes in the Province.

  13. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... site content U.S. Department of Health and Human Services Indian Health Service The Federal Health Program for American Indians and ... Indian/Alaska Native communities. IHS Headquarters, Indian Health Service, 5600 Fishers Lane, Rockville, MD 20857 - Find a ...

  14. Clinical characteristics, angiographic profile and in hospital mortality in acute coronary syndrome patients in south indian population

    Directory of Open Access Journals (Sweden)

    Rajni Sharma

    2014-01-01

    Full Text Available Aims: The aim was to study the clinical profile, risk factors prevalence, angiographic distribution, and severity of coronary artery stenosis in acute coronary syndrome (ACS patients of South Indian population. Materials and Methods: A total of 1562 patients of ACS were analyzed for various risk factors, angiographic pattern and severity of coronary heart disease, complications and in hospital mortality at Sri Jayadeva Institute of Cardiovascular Research and Sciences, Bengaluru, Karnataka, India. Results: Mean age of presentation was 54.71 ± 19.90 years. Majority were male 1242 (79.5% and rest were females. Most patients had ST elevation myocardial infarction (STEMI 995 (63.7% followed by unstable angina (UA 390 (25% and non-STEMI (NSTEMI 177 (11.3%. Risk factors; smoking was present in 770 (49.3%, hypertension in 628 (40.2%, diabetes in 578 (37%, and obesity in (29.64% patients. Angiography was done in 1443 (92.38% patients. left anterior descending was most commonly involved, left main (LM coronary artery was least common with near similar frequency of right coronary artery and left circumflex involvement among all three groups of ACS patients. Single-vessel disease was present in 168 (45.28% UA, 94 (56.29% NSTEMI and 468 (51.71% STEMI patients. Double-vessel disease was present in 67 (18.08% UA, 25 (14.97% NSTEMI and 172 (19.01% STEMI patients. Triple vessel disease was present in 28 (7.55% UA, 16 (9.58% NSTEMI, 72 (7.95% STEMI patients. LM disease was present in 12 (3.23% UA, 2 (1.19% NSTEMI and 9 (0.99% STEMI patients. Complications; ventricular septal rupture occurred in 3 (0.2%, free wall rupture in 2 (0.1%, cardiogenic shock in 45 (2.9%, severe mitral regurgitation in 3 (0.2%, complete heart block in 11 (0.7% patients. Total 124 (7.9% patients died in hospital after 2.1 ± 1.85 days of admission. Conclusion: STEMI was most common presentation. ACS occurred a decade earlier in comparison to Western population. Smoking was most prevalent

  15. Temperature Data From AUSTRALIA STAR and Other Platforms From Indian Ocean and South Pacific Ocean From 19860929 to 19890106 (NODC Accession 8900196)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Temperature data from Australia Star and other ships from Indian Ocean and South Pacific Ocean from September 29, 1986 to January 6, 1989. The data were collected by...

  16. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... for Diabetes Educators and Community Members Diabetes Educator Tools Diabetes Education Lesson Plan Outlines Integrating Case Management Into Your Practice [PDF – 290 KB] Integrating ...

  17. Notes on some Indo-Pacific Pontoniinae III-IX descriptions of some new genera and species from the Western Indian Ocean and the South China Sea

    NARCIS (Netherlands)

    Bruce, A.J.

    1967-01-01

    CONTENTS Introduction................... 1 III. Anapontonia denticauda Bruce, 1966, from the western Indian Ocean . . 2 IV. Mesopontonia gorgoniophila gen. nov., sp. nov., from the South China Sea 13 V. Metapontonia fungiacola gen. nov., sp. nov., from the western Indian Ocean 23 VI. The genus

  18. Community reintegration in rehabilitated South Indian persons with spinal cord injury.

    Science.gov (United States)

    Samuelkamaleshkumar, Selvaraj; Radhika, Somasundaram; Cherian, Binu; Elango, Aarumugam; Winrose, Windsor; Suhany, Baby T; Prakash, M Henry

    2010-07-01

    To explore community reintegration in rehabilitated South Indian persons with spinal cord injury (SCI) and to compare the level of community reintegration based on demographic variables. Survey. Rehabilitation center of a tertiary care university teaching hospital. Community-dwelling persons with SCI (N=104). Not applicable. Craig Handicap Assessment and Reporting Technique (CHART). The mean scores for each CHART domain were physical independence 98+/-5, social Integration 96+/-11, cognitive independence 92+/-17, occupation 70+/-34, mobility 65+/-18, and economic self sufficiency 53+/-40. Demographic variables showed no statistically significant difference with any of the CHART domains except for age and mobility, level of education, and social integration. Persons with SCI in rural South India who have completed comprehensive, mostly self-financed, rehabilitation with an emphasis on achieving functional ambulation, family support, and self-employment and who attend a regular annual follow-up show a high level of community reintegration in physical independence, social integration, and cognitive independence. CHART scores in the domains of occupation, mobility, and economic self-sufficiency showed lower levels of community reintegration. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Polycystic ovary syndrome, blood group & diet: A correlative study in South Indian females

    Directory of Open Access Journals (Sweden)

    Rahul Pal, Pratik Kumar Chatterjee, Poulomi Chatterjee, Vinodini NA, PrasannaMithra, Sourjya Banerjee, Suman VB2, Sheila R. Pai

    2014-07-01

    Full Text Available Aim: To find out the co-relation between polycystic ovary syndrome (PCOS with blood group & diet in South Indian females, between the age-group of (20-30 years. Objectives: Correlative analysis of ABO & Rh system, dietary habits & alcohol consumption with PCOS. Materials & Methods: 100 patients between (20-30 years, diagnosed with PCOS were selected. A standard PCOS questionnaire was given. Blood group & dietary status data were collected. Patients were grouped according to ABO & Rh system considering their diet & alcohol intake (p≤0.05 significant. Result: Our data revealed that the highest risk of PCOS was observed in females with blood group ‘O’ positive followed by ‘B’ positive who were on mixed diet & used to consume alcohol. Our study also suggests that Rh negative individuals didn’t show any association with PCOS. Conclusion: The results of our study suggest that ‘O’ positive females, are more prone to PCOS. Though the relative frequency of B positive individuals are more in India, females with blood group O positive are more susceptible to PCOS, contributing factors being mixed diet & alcohol intake. So, early screening of ‘O’ positive &‘B’ positive females of reproductive age-group in South-India, could be used as a measure for timely diagnosis of PCOS, better management &also prevention of complications. However, further research should be done to investigate the multifaceted mechanisms triggering these effects.

  20. Outward Bound with Ayyappan: Work, Masculinity, and Self-Respect in a South Indian Pilgrimage Festival

    Directory of Open Access Journals (Sweden)

    Elizabeth (Liz Wilson

    2016-06-01

    Full Text Available The annual pilgrimage festival dedicated to the god Ayyappan has become immensely popular in the past sixty years. As many as fifty million pilgrims participate each year. This paper draws on interviews of pilgrims conducted in South India in 2012–2013. My fieldwork suggests that the increasing popularity of the event relates to the contemporary South Indian work environment, an environment in which traditional gender roles are being reshaped by the challenges posed by migration for work opportunities. Interviews of English-speaking pilgrims show that their interpretations of the pilgrimage festival highlight the complexities of manhood in a time of rapidly changing work roles for men and women. Specifically, my fieldwork demonstrates that pilgrims perceive Ayyappan as a source of aid for those who struggle to succeed as financial providers and heads of the family unit. Pilgrims anxious about the loss of traditional models of masculinity amidst rapid change find solace in the blessings the god Ayyappan yields.

  1. Natural radionuclides in the South Indian foods and their annual dose

    Energy Technology Data Exchange (ETDEWEB)

    Shanthi, G., E-mail: shanthidickson@gmail.co [Department of Physics, Women' s Christian College, Nagercoil 629001, Tamil Nadu (India); Thampi Thanka Kumaran, J. [Department of Physics, NM Christian College, Marthandam 629165, Tamil Nadu (India); Gnana Raj, G. Allan [Department of Chemistry and Research Centre, Scott Christian College, Nagercoil 629003, Tamil Nadu (India); Maniyan, C.G [Health Physics Unit, Indian Rare Earths, Manavalakurichi 629252, Tamil Nadu (India)

    2010-07-21

    The study was carried out to evaluate the radioactivity concentration in the food crops grown in high-level natural radioactive area (HLNRA) in south west India. Food samples collected were analysed by means of a gamma spectroscopy and estimated annual dietary intakes of the radioisotopes {sup 226}Ra, {sup 228}Ra, {sup 228}Th and {sup 40}K. The annual intake of the food stuffs was estimated on the basis of their average annual consumption. Calculations were also made to determine the effective dose to an individual consuming such diets. The intakes of these radionuclides were calculated using the concentrations in south Indian foods and daily consumption rates of these foods. Daily intakes of these radionuclides were as follows: {sup 226}Ra, 0.001-1.87; {sup 228}Ra, 0.0023-1.26, {sup 228}Th, 0.01-14.09 {sup 40}K, 0.46-49.39 Bq/day. The daily internal dose resulting from ingestion of radionuclides in food was 4.92 {mu}Sv/day and the annual dose was 1.79 mSv/yr. The radionuclides with highest consumption is {sup 40}K.

  2. Convective Lofting Links Indian Ocean Air Pollution to Recurrent South Atlantic Ozone Maxima

    Science.gov (United States)

    Chatfield, R. B.; Guan, H.; Thompson, A. M.; Witte, J.

    2003-12-01

    We extend on our analysis of equatorial tropospheric ozone to illustrate the contributions of South Asian pollution export in forming episodes of high O3 over the Atlantic Ocean. We amplify on an earlier description of a broad resolution of the "Atlantic Paradox," for the Jan-Feb-March period, which included initial indications of a very long-distance contribution from South Asia. The approach has been to describe typical periods of significant maximum and minimum tropospheric ozone for early 1999, exploiting TOMS tropospheric ozone estimates jointly with characteristic features of the SHADOZ (Southern Hemisphere Additional Ozonesondes) ozone soundings. Further investigation of the Total Tropospheric Ozone (TTO) record for all of 1999 suggests that there are repeated periods of very long-distance Asian influence crossing Africa, with an apparent effect on those portions of the Atlantic Equatorial troposphere which are downwind. Trajectory analyses suggest that the pattern over the Indian Ocean is complex: a sequence invoving multiple or mixed combustion sources, low level transport, cumulonimbus venting, and high-level transport to the west seem to be indicated by the TTO record. Biomass burning, fossil and biofuel combustion, and lighting seem to all contribute. For the Atlantic, burning and lighting on adjacent continents as well as episodes of this cross-Africa long-distance transport are all linked in a coordinated seasonal march: all are related by movement of the sun. However, interseasonal tropical variability related to the Madden-Julian oscillation allows intermittent ozone buildups that depart from the seasonal norm.

  3. Natural radionuclides in the South Indian foods and their annual dose

    International Nuclear Information System (INIS)

    Shanthi, G.; Thampi Thanka Kumaran, J.; Gnana Raj, G. Allan; Maniyan, C.G

    2010-01-01

    The study was carried out to evaluate the radioactivity concentration in the food crops grown in high-level natural radioactive area (HLNRA) in south west India. Food samples collected were analysed by means of a gamma spectroscopy and estimated annual dietary intakes of the radioisotopes 226 Ra, 228 Ra, 228 Th and 40 K. The annual intake of the food stuffs was estimated on the basis of their average annual consumption. Calculations were also made to determine the effective dose to an individual consuming such diets. The intakes of these radionuclides were calculated using the concentrations in south Indian foods and daily consumption rates of these foods. Daily intakes of these radionuclides were as follows: 226 Ra, 0.001-1.87; 228 Ra, 0.0023-1.26, 228 Th, 0.01-14.09 40 K, 0.46-49.39 Bq/day. The daily internal dose resulting from ingestion of radionuclides in food was 4.92 μSv/day and the annual dose was 1.79 mSv/yr. The radionuclides with highest consumption is 40 K.

  4. "I'm Managing My Diabetes between Two Worlds": Beliefs and Experiences of Diabetes Management in British South Asians on Holiday in the East--A Qualitative Study.

    Science.gov (United States)

    Patel, Neesha R; Kennedy, Anne; Blickem, Christian; Reeves, David; Chew-Graham, Carolyn

    2016-01-01

    Diabetes is disproportionately high among British South Asians compared to the general UK population. Whilst the migrant British South Asians group has received most attention on research related to diabetes management, little consideration has been given to impact of travel back to the East. This study aimed to explore the role of social networks and beliefs about diabetes in British South Asians, to better understand their management behaviours whilst holidaying in the East. Semistructured interviews were conducted in Greater Manchester. Forty-four participants were recruited using random and purposive sampling techniques. Interviews were analysed thematically using a constant comparison approach. Migrant British South Asians expressed a strong preference to be in a hot climate; they felt they had a healthier lifestyle in the East and often altered or abandoned their diabetes medication. Information acquisition on diabetes and availability of social networks in the East was valued. Social networks in the East are a valued source of information and support for diabetes. The lack of adherence to medication whilst abroad suggests that some migrant British South Asians have a poor understanding of diabetes. Future research needs to explore whether patients are seeking professional advice on diabetes management prior to their extended holiday.

  5. A genome-wide association study in American Indians implicates DNER as a susceptibility locus for type 2 diabetes.

    Science.gov (United States)

    Hanson, Robert L; Muller, Yunhua L; Kobes, Sayuko; Guo, Tingwei; Bian, Li; Ossowski, Victoria; Wiedrich, Kim; Sutherland, Jeffrey; Wiedrich, Christopher; Mahkee, Darin; Huang, Ke; Abdussamad, Maryam; Traurig, Michael; Weil, E Jennifer; Nelson, Robert G; Bennett, Peter H; Knowler, William C; Bogardus, Clifton; Baier, Leslie J

    2014-01-01

    Most genetic variants associated with type 2 diabetes mellitus (T2DM) have been identified through genome-wide association studies (GWASs) in Europeans. The current study reports a GWAS for young-onset T2DM in American Indians. Participants were selected from a longitudinal study conducted in Pima Indians and included 278 cases with diabetes with onset before 25 years of age, 295 nondiabetic controls ≥45 years of age, and 267 siblings of cases or controls. Individuals were genotyped on a ∼1M single nucleotide polymorphism (SNP) array, resulting in 453,654 SNPs with minor allele frequency >0.05. SNPs were analyzed for association in cases and controls, and a family-based association test was conducted. Tag SNPs (n = 311) were selected for 499 SNPs associated with diabetes (P associated with T2DM (odds ratio = 1.29 per copy of the T allele; P = 6.6 × 10(-8), which represents genome-wide significance accounting for the number of effectively independent SNPs analyzed). Transfection studies in murine pancreatic β-cells suggested that DNER regulates expression of notch signaling pathway genes. These studies implicate DNER as a susceptibility gene for T2DM in American Indians.

  6. Psychosocial Predictors of Weight Loss among American Indian and Alaska Native Participants in a Diabetes Prevention Translational Project

    Directory of Open Access Journals (Sweden)

    Edward J. Dill

    2016-01-01

    Full Text Available The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs in a diabetes prevention translational project was investigated. Participants (n=3,135 were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components.

  7. Depression among patients with diabetes: A community-based study in South India

    Directory of Open Access Journals (Sweden)

    Abdullahi S Aminu

    2017-01-01

    Full Text Available Background: Depression is one of the more common mental health conditions found among people suffering from chronic diseases. Its presence in patients with type 2 diabetes could hinder the adherence to and effectiveness of treatment. Most studies on depression among patients with diabetes are hospital-based suggesting the need for a community-based study to assess the correlates of depression among patients with diabetes. Aim: This study aimed to estimate the prevalence and to identify the factors influencing depression among patients with type 2 diabetes in Udupi taluk situated in southern India. Subjects and Methods: This study recruited 200 patients with type 2 diabetes from both rural and urban areas. Demographic, clinical, and diabetes-related information were collected using a semi-structured questionnaire. Depression was assessed using Patient Health Questionnaire-9; a standardized questionnaire developed in the United States of America and validated in the Indian population. Results: The prevalence of depression among patients with diabetes in the community was found to be 37.5%. Most frequently, depression was mild (42, 21% in nature with severe depression (9, 4.5% seen the least. Several factors were found to be positively associated with depression including female gender, rural residence, unemployment, and the status of being unmarried. The presence of diabetic complications and other chronic diseases such as hypertension and obesity also were found to be associated with depression. Conclusion: Depression was found to be particularly high among the study population. Since depression could significantly hinder patient's adherence to treatment, there is an urgent need for early diagnosis and treatment. This calls for the integration of mental health care into the management of diabetes.

  8. Risk factors for mortality in a south Indian population on generic antiretroviral therapy.

    Science.gov (United States)

    Rupali, Priscilla; Mannam, Sam; Bella, Annie; John, Lydia; Rajkumar, S; Clarence, Peace; Pulimood, Susanne A; Samuel, Prasanna; Karthik, Rajiv; Abraham, Ooriapadickal Cherian; Mathai, Dilip

    2012-12-01

    Antiretroviral treatment (ART) programs from low-income countries utilizing standardized ART regimens, simplified approaches to clinical decision making and basic lab monitoring have reported high mortality rates. We determined the risk factors for mortality among HIV-infected adults following the initiation of ART from a single center in south India. ART-naive HIV-infected south Indian adults attending the Infectious Diseases clinic in a 2000-bed academic medical center in south India who were initiated on ART (generic, fixed-dose combinations) as per the national guidelines were followed up. Cases (32 patients who died) were compared with age and sex matched controls. Eight-hundred and twenty-two patients were started on ART from January 1, 2000 to December 31, 2008. The cumulative mortality was 6.8% (56/822). Among the cases mean age was 44 years, 18% were women and mean CD4 counts was 107 cells/microl. Among the controls mean age was 41 years, 18% were women and mean CD4 counts were 113 cells/microl. Stavudine based ART was predominant 62.5% in the cases vs 37.5% in the controls, followed by zidovudine based therapy in 31.2% of cases and 43.7% in the controls. Tenofovir based therapy was used in 6.2% of cases vs 18.7% in the controls. The commonest causes of death were drug toxicity 19%, advanced Acquired Immunodeficiency Syndrome (AIDS) in 37%, Immune Reconstitution Inflammatory Syndrome (IRIS) in 16%, non AIDS related deaths in 22% and malignancies 6%. In a univariate analysis, absolute lymphocyte count ART (p=0.001) were significantly associated with mortality. The mortality among our patients was comparable to that reported from other low-income countries. Earlier initiation of ART may reduce the high mortality rates observed.

  9. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Congress Tribal Leader Letters Urban Leader Letters IHS Home Division of Diabetes Treatment and Prevention Division of ... Live and On Demand IHS Diabetes Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools ...

  10. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Demand IHS Diabetes Standards of Care Diabetes Treatment Algorithms Diabetes Foot Care Training Tools for Diabetes Educators ... OK More information coming soon! Updated Glucose Management Algorithm Now Available! Check out the updated "Glucose Management ...

  11. Management issues in hypertensive diabetics | Ker | South African ...

    African Journals Online (AJOL)

    South African Family Practice. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 53, No 2 (2011) >. Log in or Register to get access to full text downloads.

  12. Health education on diabetes at a South African national science ...

    African Journals Online (AJOL)

    ... with a major negative impact on the health and development of South Africans. ... To determine the effects of a health education programme on increasing ... models, word-search games, information leaflets and a computer-based quiz ...

  13. Pelagic communities of the South West Indian Ocean seamounts: R/V Dr Fridtjof Nansen Cruise 2009-410

    Science.gov (United States)

    Rogers, A. D.; Alvheim, O.; Bemanaja, E.; Benivary, D.; Boersch-Supan, P.; Bornman, T. G.; Cedras, R.; Du Plessis, N.; Gotheil, S.; Høines, A.; Kemp, K.; Kristiansen, J.; Letessier, T.; Mangar, V.; Mazungula, N.; Mørk, T.; Pinet, P.; Pollard, R.; Read, J.; Sonnekus, T.

    2017-02-01

    The seamounts of the southern Indian Ocean remain some of the most poorly studied globally and yet have been subject to deep-sea fishing for decades and may face new exploitation through mining of seabed massive sulphides in the future. As an attempt to redress the knowledge deficit on deep-sea benthic and pelagic communities associated mainly with the seamounts of the South West Indian Ridge two cruises were undertaken to explore the pelagic and benthic ecology in 2009 and 2011 respectively. In this volume are presented studies on pelagic ecosystems around six seamounts, five on the South West Indian Ridge, including Atlantis Bank, Sapmer Seamount, Middle of What Seamount, Melville Bank and Coral Seamount and one un-named seamount on the Madagascar Ridge. In this paper, existing knowledge on the seamounts of the southwestern Indian Ocean is presented to provide context for the studies presented in this volume. An account of the overall aims, approaches and methods used primarily on the 2009 cruise are presented including metadata associated with sampling and some of the limitations of the study. Sampling during this cruise included physical oceanographic measurements, multibeam bathymetry, biological acoustics, and net sampling of phytoplankton, macrozooplankton and micronekton/nekton. The studies that follow reveal new data on the physical oceanography of this dynamic region of the oceans, and the important influence of water masses on the pelagic ecology associated with the seamounts of the South West Indian Ridge. New information on the pelagic fauna of the region fills an important biogeographic gap for the mid- to high-latitudes of the oceans of the southern hemisphere.

  14. When HIV is ordinary and diabetes new: remaking suffering in a South African township.

    Science.gov (United States)

    Mendenhall, Emily; Norris, Shane A

    2015-01-01

    Escalation of non-communicable diseases (NCDs) among urban South African populations disproportionately afflicted by HIV/AIDS presents not only medical challenges but also new ways in which people understand and experience sickness. In Soweto, the psychological imprints of political violence of the Apartheid era and structural violence of HIV/AIDS have shaped social and health discourses. Yet, as NCDs increasingly become part of social and biomedical discussions in South African townships, new frames for elucidating sickness are emerging. This article employs the concept of syndemic suffering to critically examine how 27 women living with Type 2 diabetes in Soweto, a township adjacent to Johannesburg known for socio-economic mobility as well as inequality, experience and understand syndemic social and health problems. For example, women described how reconstructing families and raising grandchildren after losing children to AIDS was not only socially challenging but also affected how they ate, and how they accepted and managed their diabetes. Although previously diagnosed with diabetes, women illustrated how a myriad of social and health concerns shaped sickness. Many related diabetes treatment to shared AIDS nosologies, referring to diabetes as 'the same' or 'worse'. These narratives demonstrate how suffering weaves a social history where HIV becomes ordinary, and diabetes new.

  15. High prevalence of abnormal liver enzymes in South African patients ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of liver function test abnormalities in South African black and Indian adult patients with type 2 diabetes mellitus attending a tertiary diabetes clinic. iabetes clinic. Recorded data included the past medical and drug history, history of alcohol abuse, anthropometry, lipid profile and liver ...

  16. Effect of iron status on iron absorption in different habitual meals in young south Indian women

    Directory of Open Access Journals (Sweden)

    Suneeta Kalasuramath

    2013-01-01

    Full Text Available Background & objectives: Iron deficiency (ID affects a large number of women in India. An inverse relationship exists between iron (Fe status and Fe absorption. Dietary inhibitory and enhancing factors exert a profound influence on bioavailability of Fe. Although the current recommended dietary allowance (RDA for Fe is based on 8 per cent bioavailability, it is not clear if this holds good for the usual highly inhibitory Indian diet matrix. This study was aimed to determine Fe absorption from several habitually consumed south Indian food and to evaluate the interaction of Fe status with absorption. Methods: Four Fe absorption studies were performed on 60 apparently healthy young women, aged 18-35 years. Based on blood biochemistry, 45 of them were ID and 15 were iron replete (IR. The habitual meals assessed were rice, millet and wheat based meals in the ID subjects and rice based meal alone in the IR subjects. Each subject received the test meal labelled with 3 mg of [57] Fe and Fe absorption was measured based on erythrocyte incorporation of isotope label 14 days following administration. Results: Mean fractional Fe absorption from the rice, wheat and millet based meals in the ID subjects were 8.3, 11.2 and 4.6 per cent, respectively. Fe absorption from the rice-based meals was 2.5 per cent in IR subjects. Interpretation & conclusions: Fe absorption is dictated by Fe status from low bioavailability meals. Millet based meals have the lowest bioavailability, while the rice and wheat based meals had moderate to good bioavailability. In millet based meals, it is prudent to consider ways to improve Fe absorption.

  17. Common Variants of Homocysteine Metabolism Pathway Genes and Risk of Type 2 Diabetes and Related Traits in Indians

    Directory of Open Access Journals (Sweden)

    Ganesh Chauhan

    2012-01-01

    Full Text Available Hyperhomocysteinemia, a risk factor for cardiovascular disorder, obesity, and type 2 diabetes, is prevalent among Indians who are at high risk of these metabolic disorders. We evaluated association of common variants of genes involved in homocysteine metabolism or its levels with type 2 diabetes, obesity, and related traits in North Indians. We genotyped 90 variants in initial phase (2.115 subjects and replicated top signals in an independent sample set (2.085 subjects. The variant MTHFR-rs1801133 was the top signal for association with type 2 diabetes (OR=0.78 (95%  CI=0.67–0.92, P=0.003 and was also associated with 2 h postload plasma glucose (P=0.04, high-density lipoprotein cholesterol (P=0.004, and total cholesterol (P=0.01 in control subjects. These associations were neither replicated nor significant after meta-analysis. Studies involving a larger study population and different ethnic groups are required before ruling out the role of these important candidate genes in type 2 diabetes, obesity, and related traits.

  18. Geochemistry of the mantle beneath the Rodriguez Triple Junction and the South-East Indian Ridge

    International Nuclear Information System (INIS)

    Michard, A.; Montigny, R.; Schlich, R.

    1986-01-01

    Rare earth element abundances and SR, Nd, Pb isotope compositions have been measured on zero-age dredge samples from the Rodriguez Triple Junction (RTJ) and the South-East Indian Ridge (SEIR). Along the SEIR, the geochemical ''halo'' of the St. Paul hot spot has a half-width of about 400 km and the data may be fairly well accounted for by a binary mixing between an Indian MORB-type component ( 87 Sr/ 86 Sr=0.7028, 143 Nd/ 144 Nd=0.51304, 206 Pb/ 204 Pb=17.8) and the plume type St. Paul component (0.7036, 0.5129 and 18.7 respectively). The alignment of the lead isotope data is particularly good with age of 1.95+-0.13 Ga and Th/U source value of 3.94. One sample dredged on the ridge 60 km southeast of St. Paul bears a definite Kertguelen isotopic signature. The RTJ has distinctive geochemical properties which contrast with those of the adjacent ridge segments. Low 206 Pb/ 204 Pb ratios which plots to the left of the geochron, rather high 208 Pb/ 204 Pb and 87 Sr/ 86 Sr ratios (17.4, 37.4, and 0.7031 respectively) a striking isotopic homogeneity, and variable LRE/HREE fractionation with (LA/S)sub(N) 0.3-0.8 make this triple junction an anomalous site. The geochemical properties of the Indian Ocean basalts have been examined using a three-component mantle model involving (a) a normal MORB-type source though to represent the depleted upper mantle matrix, (b) an OIB-type source of uncertain parentage (recycled oceanic crust), and (c) a component with low μ, Low Sm/Nd, high Rb/Sr (time-averaged value) which is tentatively assigned to ancient hydrothermal and abyssal sediments recycled in the mantle. The high 208 Pb/ 204 Pb and 87 Sr/ 86 Sr ratios typical of the Dupal anomaly are likely due to the widespread distribution of this latter component in the basalt source from this area, including that for MORBs. (orig.)

  19. Geochemistry of the mantle beneath the Rodriguez Triple Junction and the South-East Indian Ridge

    Science.gov (United States)

    Michard, A.; Montigny, R.; Schlich, R.

    1986-05-01

    Rare earth element abundances and Sr, Nd. Pb isotope compositions have been measured on zero-age dredge samples from the Rodriguez Triple Junction (RTJ) and the South-East Indian Ridge (SEIR), Along the SEIR. the geochemical "halo" of the St. Paul hot spot has a half-width of about 400 km and the data may be fairly well accounted for by a binary mixing between an Indian MORB-type component ( 87Sr/ 86Sr = 0.7028. 143Nd/ 144Nd = 0.51304. 206Pb/ 204Pb = 17.8) and the plume-type St. Paul component (0.7036, 0.5129, and 18.7 respectively). The alignment of the lead isotope data is particularly good with an apparent age of 1.95 ± 0.13 Ga and Th/U source value of 3.94. One sample dredged on the ridge 60 km southeast of St. Paul bears a definite Kerguelen isotopic signature. The RTJ has distinctive geochemical properties which contrast with those of the adjacent ridge segments. Low 206Pb/ 204Pb ratios which plots to the left of the geochron, rather high 208Pb/ 204Pb and 87Sr/ 87Sr ratios (17.4. 37.4, and 0.7031 respectively), a striking isotopic homogeneity, and variable LREE/HREE fractionation with (La/Sm) N, = 0.3-0.8 make this triple junction an anomalous site. The geochemical properties of the Indian Ocean basats have been examined using a three-component mantle model involving (a) a normal MORB-type source though to represent the depleted upper mantle matrix, (b) an OIB-type source of uncertain parentage (recycled oceanic crust?), and (c) a component with low μ. low Sm/Nd. high Rb/Sr (time-averaged value) which is tentatively assigned to ancient hydrothermal and abyssal sediments recycled in the mantle. The high 208Pb/ 204Pb and 87Sr/ 86Sr ratios typical of the Dupal anomaly are likely due to the widespread distribution of this latter component in the basalt source from this area. including that for MORBs.

  20. Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: qualitative study using a multi-level theoretical approach.

    Science.gov (United States)

    Greenhalgh, Trisha; Clinch, Megan; Afsar, Nur; Choudhury, Yasmin; Sudra, Rita; Campbell-Richards, Desirée; Claydon, Anne; Hitman, Graham A; Hanson, Philippa; Finer, Sarah

    2015-05-21

    Diabetes in pregnancy is common in South Asians, especially those from low-income backgrounds, and leads to short-term morbidity and longer-term metabolic programming in mother and offspring. We sought to understand the multiple influences on behaviour (hence risks to metabolic health) of South Asian mothers and their unborn child, theorise how these influences interact and build over time, and inform the design of culturally congruent, multi-level interventions. Our sample for this qualitative study was 45 women of Bangladeshi, Indian, Sri Lankan, or Pakistani origin aged 21-45 years with a history of diabetes in pregnancy, recruited from diabetes and antenatal services in two deprived London boroughs. Overall, 17 women shared their experiences of diabetes, pregnancy, and health services in group discussions and 28 women gave individual narrative interviews, facilitated by multilingual researchers, audiotaped, translated, and transcribed. Data were analysed using the constant comparative method, drawing on sociological and narrative theories. Key storylines (over-arching narratives) recurred across all ethnic groups studied. Short-term storylines depicted the experience of diabetic pregnancy as stressful, difficult to control, and associated with negative symptoms, especially tiredness. Taking exercise and restricting diet often worsened these symptoms and conflicted with advice from relatives and peers. Many women believed that exercise in pregnancy would damage the fetus and drain the mother's strength, and that eating would be strength-giving for mother and fetus. These short-term storylines were nested within medium-term storylines about family life, especially the cultural, practical, and material constraints of the traditional South Asian wife and mother role and past experiences of illness and healthcare, and within longer-term storylines about genetic, cultural, and material heritage - including migration, acculturation, and family memories of food

  1. Screening for gestational diabetes mellitus in a South African ...

    African Journals Online (AJOL)

    plethora of algorithms for the screening and diagnosis of GDM. In. 2010, the International Association of Diabetes in Pregnancy Study. Groups (IADPSG) proposed ..... Hypertension (BP >135/85 mmHg), n (%). No. 311 (75.7). 94 (65.7). 0.210.

  2. Dyslipidemias in type 2 diabetes mellitus patients in Nnewi South ...

    African Journals Online (AJOL)

    Background: Dyslipidemia has been noted to play an integral role in the pathogenesis and progression of micro and macrovascular complications in diabetes mellitus patients. The complications exemplified by renal vascular and cardiovascular disease cause the most morbidity and mortality in this group of patients.

  3. Health inequalities among urban children in India: a comparative assessment of Empowered Action Group (EAG) and South Indian states.

    Science.gov (United States)

    Arokiasamy, P; Jain, Kshipra; Goli, Srinivas; Pradhan, Jalandhar

    2013-03-01

    As India rapidly urbanizes, within urban areas socioeconomic disparities are rising and health inequality among urban children is an emerging challenge. This paper assesses the relative contribution of socioeconomic factors to child health inequalities between the less developed Empowered Action Group (EAG) states and more developed South Indian states in urban India using data from the 2005-06 National Family Health Survey. Focusing on urban health from varying regional and developmental contexts, socioeconomic inequalities in child health are examined first using Concentration Indices (CIs) and then the contributions of socioeconomic factors to the CIs of health variables are derived. The results reveal, in order of importance, pronounced contributions of household economic status, parent's illiteracy and caste to urban child health inequalities in the South Indian states. In contrast, parent's illiteracy, poor economic status, being Muslim and child birth order 3 or more are major contributors to health inequalities among urban children in the EAG states. The results suggest the need to adopt different health policy interventions in accordance with the pattern of varying contributions of socioeconomic factors to child health inequalities between the more developed South Indian states and less developed EAG states.

  4. Cytotoxic, Antimitotic, and Antiproliferation Studies on Rasam: A South Indian Traditional Functional Food.

    Science.gov (United States)

    Devarajan, Agilandeswari; Mohan Maruga Raja, M K

    2017-10-01

    Rasam is a traditional South Indian food, prepared using tamarind juice as a base, with a variety of spices. Rasam , with all its ingredients medicinally claimed for various ailments, is a functional food. Systematic consumption of traditional functional food provides an excellent preventive measure to ward off many diseases. To study rasam for cytotoxic, antimitotic, and antiproliferation potential beyond its culinary and nutritional effect. Brine shrimp lethality assay, onion root tip inhibition assay, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay in Calu-6, HeLa, MCF-7 cell lines for four stage-wise samples in the preparation of rasam (RS1, RS2, RS3, and RS4) were studied. RS4, the end product of rasam showed high lethality with an LC 50 value of 38.7 μL/mL. It showed maximum antimitotic activity in a dose-dependent manner compared to other samples with an IC 50 value of 189.86 μL/mL. RS4 also showed an IC 50 value of 350.22 and 410.15 μL/mL in MCF-7 and Calu-6 cell lines, respectively. From this study, we suggest that rasam is a classic example of traditional functional food and it can treat breast and lung cancer on chronic use. Rasam , a South Indian traditional functional food, showed high lethality (LC 50 = 38.7 mL/mL) against brine shrimps Rasam also showed potential antimitotic activity (IC 50 = 189.86 mL/mL) by inhibiting the onion root tips Rasam showed an IC 50 value of 350.22 and 410.15 mL/mL against MCF-7 and Calu-6 cell lines respectively Rasam , when consumed on daily dietary basis, can treat breast and lung cancer. Abbreviations used: SS 316: Stainless Steel 316 grade; MTT: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide; DMEM: Dulbecco's modified Eagle medium; FBS: Fetal bovine serum media; TPVG: Trypsin phosphate versene glucose; EDTA: Ethylene diamine tetra acetic acid; PBS: Phosphate buffered saline; DMSO: Dimethyl sulfoxide.

  5. Morphology of Sigmoid Colon in South Indian Population: A Cadaveric Study.

    Science.gov (United States)

    Michael, Stelin Agnes; Rabi, Suganthy

    2015-08-01

    Sigmoid volvulus is a common etiological factor in acute large bowel obstruction. The increased length of sigmoid colon is attributed as one of the causes of sigmoid volvulus. The aim of this study was to find the morphology of sigmoid colon in South Indian population using cadavers. The present study was performed with 31 cadavers used for teaching purpose. The sigmoid colon was classified into classical, long-narrow and long- broad types by their disposition in the abdominal cavity. The sigmoid loop's relation to pelvic brim was also observed and grouped as pelvic and suprapelvic in position. The length of sigmoid colon along the mesenteric and antimesenteric border, height and width of sigmoid mesocolon in relation to the pelvic brim and the root of mesentery were measured in the study. The study showed that the majority of the sigmoid colons fell into the classical type (47.6%). The sigmoid colon in pelvic position was significantly more prevalent. The mean length of sigmoid colon was 15.2 ± 4.4cm and 19.2 ± 6cm considering the pelvic brim and root of mesentery as reference points of measurement respectively. The mean length along antimesenteric border was 22.3 ± 7.9cm and 25 ± 8.7cm along the same reference points. The mean length of mesocolon height was 6.5 ± 3cm with reference to pelvic brim and 7.3 ± 3cm with reference to root of Sigmoid mesocolon respectively. The mean width of mesocolon was 7.4 ± 3cm (pelvic brim) and 8 ± 2cm (root of Sigmoid mesocolon) There was a positive correlation of sigmoid colon length with the height of the mesocolon. The gender analysis showed that males had statistically significant longer sigmoid colon and mesocolon. This study documents that the South Indian population has a more classical type of sigmoid colon and that the anatomical dimensions of sigmoid colon and its mesocolon is significantly longer in males.

  6. South Asian women with diabetes: Psychosocial challenges and management: Consensus statement.

    Science.gov (United States)

    Bajaj, Sarita; Jawad, Fatema; Islam, Najmul; Mahtab, Hajera; Bhattarai, Jyoti; Shrestha, Dina; Wijeyaratne, Chandrika; Muthukuda, Dimuthu T; Widanage, Niranjala Weegoda; Aye, Than Than; Aung, Moe Wint; Kalra, Bharti; Anjana, R M; Sreedevi, Aswathy; Verma, Komal

    2013-07-01

    Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death. Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier. There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect of sexual issues

  7. South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

    Directory of Open Access Journals (Sweden)

    Sarita Bajaj

    2013-01-01

    Full Text Available Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death.Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier.There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect

  8. South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

    Science.gov (United States)

    Bajaj, Sarita; Jawad, Fatema; Islam, Najmul; Mahtab, Hajera; Bhattarai, Jyoti; Shrestha, Dina; Wijeyaratne, Chandrika; Muthukuda, Dimuthu T.; Widanage, Niranjala Weegoda; Aye, Than Than; Aung, Moe Wint; Kalra, Bharti; Anjana, R. M.; Sreedevi, Aswathy; Verma, Komal

    2013-01-01

    Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death. Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier. There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect of sexual issues

  9. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... to site content U.S. Department of Health and Human Services Indian Health Service The Federal Health Program for American Indians and Alaska Natives Search IHS A to Z Index × A to Z ...

  10. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available Skip to site content U.S. Department of Health and Human Services Indian Health Service The Federal Health Program for American Indians and Alaska Natives Search IHS A to Z Index × A ...

  11. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available Skip to site content U.S. Department of Health and Human Services Indian Health Service The Federal Health Program for American Indians and Alaska Natives Search IHS A to Z Index × ...

  12. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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  14. Diabetes prevention among American Indians: the role of self-efficacy, risk perception, numeracy and cultural identity.

    Science.gov (United States)

    Simonds, Vanessa W; Omidpanah, Adam; Buchwald, Dedra

    2017-10-02

    According to the Risk Perception Attitude (RPA) framework, classifying people according to their perceptions of disease risk and their self-efficacy beliefs allows us to predict their likelihood for engaging in preventive behaviors. Health interventions can then be targeted according to RPA group. We applied the framework to type 2 diabetes prevention behaviors among American Indians and expanded it to include culture and numeracy. Using a cross-sectional study design, we surveyed a sample of Northern Plains American Indians in a reservation community setting on self-reported perceptions of diabetes risk, objective diabetes risk, self-efficacy, engagement in healthy behaviors, knowledge of diabetes risk factors, and covariates including demographics, numeracy, and cultural identity. We used the RPA framework to classify participants into four groups based on their perceptions of risk and self-efficacy. Analyses of variance and covariance estimated inter-group differences in behaviors associated with type 2 diabetes prevention. Among 128 participants, our only finding consistent with the RPA framework was that self-efficacy and risk perception predicted knowledge about diabetes risk factors. We found limited evidence for the influence of cultural identity within the RPA framework. Overall, participants had lower numeracy skills which tended to be associated with inaccurate perceptions of higher levels of risk. The theoretical framework may benefit from inclusion of further contextual factors that influence these behaviors. Attention to numeracy skills stands out in our study as an important influence on the RPA framework, highlighting the importance of attending to numeracy when targeting and tailoring risk information to participants segmented by the RPA framework.

  15. Impacts of urbanisation on the lifestyle and on the prevalence of diabetes in native Asian Indian population.

    Science.gov (United States)

    Ramachandran, A; Snehalatha, C; Latha, E; Manoharan, M; Vijay, V

    1999-06-01

    Recent studies from the Asian subcontinent show an increasing prevalence of diabetes. This increase has been attributed to factors related to lifestyle changes related to modernisation. A periurban rural population resembling the rural in their occupation, but with access to certain urban facilities was chosen for this study. The aim of the study was to assess the impact of modernisation on the rising prevalence of diabetes in the native Indians. A total of 1637 adults aged 20 years and above (749 men and 888 women) were tested for diabetes and impaired glucose tolerance (IGT) by 2 h post-glucose challenge. Demographic, anthropometric, dietary and occupational details, were recorded. Dietary habits were similar in all categories of socio-economic strata. In the present study group, the age standardised prevalence of Type 2 diabetes was 5.9%, which was intermediate to that in the urban (11.6%) and rural (2.4%) populations. The prevalence data of the latter two population were available from previous surveys. Prevalence of impaired glucose tolerance (IGT) was high (6.9%) and similar in all three population samples. In the periurban population, a large percentage of subjects were doing only routine household work and had a sedentary life-style. After correcting for the age and BMI, sedentary work and occupation had a significant association with diabetes, suggesting that sedentary lifestyle may be an important determinant for the higher prevalence of diabetes in an urbanising population.

  16. Spicing up your advice for South Asian and Anglo-Australians with type 2 diabetes and CVD: Do cultural constructions of diet matter?

    Science.gov (United States)

    Gupta, Sabrina S; Teede, Helena; Aroni, Rosalie

    2018-01-01

    South Asians are a growing migrant population, both globally and in Australia. This group are at higher risk for both cardiovascular disease and type 2 diabetes. The aim of this qualitative study was to compare dietary practices of South Asians, n = 41 (Indian, n = 25; Sri Lankan, n = 16) and Anglo-Australians, n = 16, with these conditions, using semi-structured in-depth interviews. Findings suggest that both groups had a high level of awareness of dietary practices necessary for optimum disease management, both prior to and post diagnosis. Bi-directional effects of migration were noted in the dietary practices of both groups suggesting hybrid diets are evident in Australia. A key barrier to implementing dietary changes highlighted by both groups of participants was a lack of specific, timely and detailed dietary advice from clinicians. Both groups expressed that advice should be repeated and reinforced throughout the course of their disease. In addition, South Asian participants wanted more culturally relevant advice. Clinicians providing dietary advice need to recognise that preferences for staple food items are resistant to change and may affect adherence. Acculturation was evident in the dietary practices of the South Asian participants. Nevertheless, many maintained traditional food practices which were tied to their cultural identity. It is recommended that clinicians consider these factors when offering advice. Copyright © 2017. Published by Elsevier Ltd.

  17. Family communication as strategy in diabetes prevention: an observational study in families with Dutch and Surinamese South-Asian ancestry.

    Science.gov (United States)

    van Esch, Suzanne C M; Cornel, Martina C; Geelhoed-Duijvestijn, Petronella H L M; Snoek, Frank J

    2012-04-01

    To explore the possibility of utilizing family communication as a diabetes prevention strategy, specifically targeting high-risk families with South-Asian ancestry in The Netherlands. In a cross-sectional study, type 2 diabetes patients from Dutch (n=311) and Surinamese South-Asian (n=157) origin filled in a questionnaire assessing socio-demographic characteristics, beliefs and concerns about familial diabetes risk, primary prevention, and diabetes-related family communication. Discussing diabetes is regarded acceptable in most families. Especially Surinamese South-Asian patients (68%) seemed motivated to convey risk messages to their relatives; they reported a higher risk perception and expressed more concern than Dutch patients. While 40% in both groups thought relatives are able to prevent developing diabetes, 46% in Dutch and 33% in Surinamese South-Asian patients were unsure. Promoting family communication appears a feasible strategy in diabetes prevention in high-risk (Surinamese South-Asian) families. Health care providers should address patients' concern and emphasize opportunities for prevention. Findings favor training of clinicians in utilizing a family approach as prevention strategy. Patients (particularly Surinamese South-Asians) are in need of professional help in the process of family risk disclosure. (Online) Educational tools should be made available at which patients can refer their relatives. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Estimating the burden of disease attributable to diabetes South ...

    African Journals Online (AJOL)

    ... World Health Organization comparative risk assessment (CRA) methodology was ... Monte Carlo simulation-modelling techniques were used for uncertainty analysis. ... uncertainty interval 236 856 - 290 849) in South Africa in 2000, accounting ... of the disease through multi-level interventions and improved management ...

  19. Journal of Endocrinology, Metabolism and Diabetes of South Africa ...

    African Journals Online (AJOL)

    Diagnosis and management of Addison's disease: insights gained from a large South African cohort · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. IL Ross, NS Levitt, 86-92. http://dx.doi.org/10.1080/22201009.2011.10872256 ...

  20. Incidence of Diabetes and Prediabetes and Predictors of Progression Among Asian Indians: 10-Year Follow-up of the Chennai Urban Rural Epidemiology Study (CURES).

    Science.gov (United States)

    Anjana, Ranjit Mohan; Shanthi Rani, Coimbatore Subramanian; Deepa, Mohan; Pradeepa, Rajendra; Sudha, Vasudevan; Divya Nair, Haridas; Lakshmipriya, Nagarajan; Subhashini, Sivasankaran; Binu, Valsalakumari Sreekumarannair; Unnikrishnan, Ranjit; Mohan, Viswanathan

    2015-08-01

    There are few data on the incidence rates of diabetes and prediabetes (dysglycemia) in Asian Indians. This article presents the incidence of diabetes and prediabetes and the predictors of progression in a population-based Asian Indian cohort. Data on progression to diabetes and prediabetes from 1,376 individuals, a subset of 2,207 of the Chennai Urban Rural Epidemiology Study (CURES) cohort (phase 3) with normal glucose tolerance (NGT) or prediabetes at baseline, who were followed for a median of 9.1 years (11,629 person-years), are presented. During follow-up, 534 died and 1,077 with NGT and 299 with prediabetes at baseline were reinvestigated in a 10-year follow-up study. Diabetes and prediabetes were diagnosed based on the American Diabetes Association criteria. Incidence rates were calculated and predictors of progression to prediabetes and/or diabetes were estimated using the Cox proportional hazards model. The incidence rates of diabetes, prediabetes, and "any dysglycemia" were 22.2, 29.5, and 51.7 per 1,000 person-years, respectively. Among those with NGT, 19.4% converted to diabetes and 25.7% to prediabetes, giving an overall conversion rate to dysglycemia of 45.1%. Among those with prediabetes, 58.9% converted to diabetes. Predictors of progression to dysglycemia were advancing age, family history of diabetes, 2-h plasma glucose, glycated hemoglobin (HbA1c), low HDL cholesterol, and physical inactivity. Asian Indians have one of the highest incidence rates of diabetes, with rapid conversion from normoglycemia to dysglycemia. Public health interventions should target modifiable risk factors to slow down the diabetes epidemic in this population. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  1. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... be a favorite to share with friends and family. Order yours today! Find Tools for Diabetes Educators! See what the IHS Division of Diabetes has to offer for those who provide diabetes education. Find Guides for Diabetes Programs, Diabetes Prevention Program ...

  2. Morphometric study of tensor of vastus intermedius in South Indian population.

    Science.gov (United States)

    Veeramani, Raveendranath; Gnanasekaran, Dhivyalakshmi

    2017-03-01

    Tensor of vastus intermedius is a newly discovered muscle located between vastus lateralis and vastus intermedius. The purpose of this study was to investigate the detailed morphology of tensor of vastus intermedius, specifically to provide data pertaining to the attachments, innervations, variation in the types and its morphometry in South Indian population. The tensor of vastus intermedius was studied in thirty six cadaveric lower limbs using macrodissection techniques. The origin of the muscle was from upper part of intertrochanteric line and anterior part of greater trochanter of femur inserted to medial aspect of upper border of patella. The muscle was classified into four types based on the origin and also the aponeurosis course with independent type (type 1) being common. The mean and standard deviation of the length of tensor of vastus intermedius and aponeurosis were 145.40±37.55 mm and 193.55±42.32 mm, respectively. The results of the study suggest that tensor of vastus intermedius is variable and the information provided regarding the attachments, types and quantitative data will contribute to the existing knowledge of the muscle.

  3. The HLA polymorphism of two distinctive South-American Indian tribes: the Kaingang and the Guarani.

    Science.gov (United States)

    Petzl-Erler, M L; Luz, R; Sotomaior, V S

    1993-05-01

    The HLA-A, B, C, DR and DQ antigens of 240 Kaingang and 98 Guarani individuals have been characterized. The most frequent antigens found among the Kaingang are A31, 2, 24; B35, 51, 39, 48; Cw4, 7, 3, 1; DR8, 4, 2; DQ blank, 3. In the Guarani, they are A2, 28, 31; B40, 62, "53G"; Cw3, 4; DR2, 4, 8, 6; DQ3, blank. B " 53G" is an unusual antigen of the B5 cross-reactive group. DQ blank possibly corresponds to DQ4, not tested in this study. The reaction patterns of B35, B40 and DR4 indicate intra-tribal (of B35 and B40), and inter-tribal (DR4, B40 and B35) heterogeneity of these antigens. 408 Kaingang and 141 Guarani haplotypes were defined by segregation analysis. Of the commonest 10 Guarani and 9 Kaingang haplotypes, only one is shared by both tribes. Significant, positive linkage disequilibrium values for HLA-A,B; HLA-A,C; HLA-B,DR and most HLA-B,C antigen pairs were also different for the two populations. Genetic distance estimates between these two and another seven South-American Indian populations, and relative to the major human races (negroids, caucasoids, and mongoloids) reveal a comparatively high degree of divergence between the Kaingang and the Guarani, which is uncommon for Amerindian populations living close one to another.

  4. Assessing Children with Language Impairments: A Study on Kannada, a South Indian Language

    Directory of Open Access Journals (Sweden)

    Srimani Chakravarthi

    2012-12-01

    Full Text Available Purpose: This is one of the first comprehensive studies to assess receptive and expressive language skills in a South Indian language, Kannada. It demystifies language impairments and provides a model for future research to understand other languages in India and in countries around the world.Method: Language impairments were identified in 68 students of Grades 3 and 4, in elementary schools where Kannada was the medium of instruction. The children were assessed in different language components. The results were analysed in terms of their ages and their levels of functioning in each language component and sub-component.Results: As a group, the subjects showed no significant deficits in phonological and semantic skills; however, individual deficits and deficits within sub-component skills of semantics were noted. Mean and individual deficits in auditory reception, aural comprehension and receptive vocabulary were also noted. Deficits in syntax & verbal expression were notably significant. The extent of language delay increases with age, and plateaus at higher ages.Conclusion: Children with language impairments in Kannada, display many similar characteristics in terms of problems in different components of language. Early intervention is called for because the language delay increases as age advances. A thorough assessment reveals specific strengths and weaknesses in language components and skills. This can be used as a starting point to base remediation activities.doi: 10.5463/dcid.v23i3.134

  5. Barriers to and Facilitators of South Asian Indian-Americans’ Engagement in Advanced Care Planning Behaviors

    Science.gov (United States)

    Radhakrishnan, Kavita; Saxena, Shubhada; Jillapalli, Regina; Jang, Yuri; Kim, Miyong

    2018-01-01

    Purpose To identify barriers to and facilitators of older South Asian Indian-Americans’ (SAIAs’) engagement in behaviors associated with advance care planning (ACP). Methods Using a descriptive qualitative design guided by the transcultural nursing assessment model, data were collected in focus groups of community-dwelling older SAIA participants, SAIA family caregivers, and SAIA physicians. A directed approach using predetermined coding categories derived from the Transcultural Nursing Assessment model and aided by NVivo 10 software (Melbourne, Australia) facilitated the qualitative data analysis. Results Eleven focus groups with 36 older SAIAs (61% female, 83% 70+ years old), 10 SAIA family caregivers, and 4 SAIA physicians indicated prior lack of awareness of ACP, good health status, lack of access to linguistically and health literacy–tailored materials, healthcare provider hesitation to initiate discussions on ACP, trust in healthcare providers’ or oldest sons’ decision making, busy family caregiver work routines, and cultural assumptions about filial piety and after-death rituals as major barriers to engaging in ACP. Introducing ACP using personal anecdotes in a neutral, group-based community setting and incentivizing ACP discussions by including long-term care planning were suggested as facilitators to engage in ACP. Clinical Relevance The study’s findings will guide development of culturally sensitive interventions to raise awareness about ACP among SAIAs and encourage SAIA older adults to engage in ACP. PMID:28388828

  6. A Comparative Rugoscopic Study of the Dentate and Edentulous Individuals in the South Indian Population

    Directory of Open Access Journals (Sweden)

    Jagdish Prasad Rajguru

    2014-01-01

    Full Text Available This study analyzes the rugae pattern in dentulous and edentulous patients and also evaluates the association of rugae pattern between males and females. Aims and Objectives. This study aims to investigate rugae patterns in dentulous and edentulous patients of both sexes in South Indian population and to find whether palatoscopy is a useful tool in human identification. Materials and Methods. Four hundred outpatients from Sree Balaji Dental College and Hospital, Chennai, were included in the study. The study group was equally divided between the sexes, which was further categorized into 100 dentulous and edentulous patients, respectively. Results. The edentulous male showed the highest mean of wavy pattern and total absence of circular pattern while the edentulous female group showed the highest mean of curved pattern and total absence of nonspecific pattern, while dentate population showed similar value as that of the overall population such as straight, wavy, and curved patterns. Conclusion. The present study concludes that there is similar rugae pattern of distribution between male and female dentate population while there is varied pattern between the sexes of edentulous population. However, the most predominant patterns were straight, wavy, and circular patterns.

  7. Barriers to and Facilitators of South Asian Indian-Americans' Engagement in Advanced Care Planning Behaviors.

    Science.gov (United States)

    Radhakrishnan, Kavita; Saxena, Shubhada; Jillapalli, Regina; Jang, Yuri; Kim, Miyong

    2017-05-01

    To identify barriers to and facilitators of older South Asian Indian-Americans' (SAIAs') engagement in behaviors associated with advance care planning (ACP). Using a descriptive qualitative design guided by the transcultural nursing assessment model, data were collected in focus groups of community-dwelling older SAIA participants, SAIA family caregivers, and SAIA physicians. A directed approach using predetermined coding categories derived from the Transcultural Nursing Assessment model and aided by NVivo 10 software (Melbourne, Australia) facilitated the qualitative data analysis. Eleven focus groups with 36 older SAIAs (61% female, 83% 70+ years old), 10 SAIA family caregivers, and 4 SAIA physicians indicated prior lack of awareness of ACP, good health status, lack of access to linguistically and health literacy-tailored materials, healthcare provider hesitation to initiate discussions on ACP, trust in healthcare providers' or oldest sons' decision making, busy family caregiver work routines, and cultural assumptions about filial piety and after-death rituals as major barriers to engaging in ACP. Introducing ACP using personal anecdotes in a neutral, group-based community setting and incentivizing ACP discussions by including long-term care planning were suggested as facilitators to engage in ACP. The study's findings will guide development of culturally sensitive interventions to raise awareness about ACP among SAIAs and encourage SAIA older adults to engage in ACP. © 2017 Sigma Theta Tau International.

  8. Palmaris Longus Muscle in the South Indian Population – A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    Lydia S. Quadros

    2017-07-01

    Full Text Available Introduction: Palmaris longus, one of the superficial flexor muscles of the anterior compartment of the forearm is the most variable muscle of the upper limb. Purpose: To note the variations of palmaris longus for tendon grafts. Methods: Forty formalin-fixed upper limb specimens of South Indian population were dissected to note the variations of Palmaris longus muscle. Results: Out of the forty upper limb specimens, two variants of the palmaris longus were noted. In one specimen, a reversed palmaris longus was noted. It had a long tendinous origin with a muscle belly and a short flat tendon at insertion. The tendon inserted partly into the flexor retinaculum and partly into palmar aponeurosis. In another specimen, apart from the normal palmaris longus muscle, an additional smaller muscle was noted. It was the Palmaris profundus. This muscle took origin in the form of a tendon from the middle of the shaft of the radius, continued as a muscle belly and then terminated as a tendon which later inserted into the flexor retinaculum, close to the tendon of palmaris longus muscle. At its insertion, the superficial palmar branch of radial artery hooked it. The anterior interosseous nerve supplied the Palmaris profundus. Conclusion: These variations are worthy to be noted for tendon grafts.

  9. Radio-morphometric Analysis of Sella Turcica in the South Indian Population: A Digital Cephalometric Study

    Directory of Open Access Journals (Sweden)

    Ch. Sai Kiran

    2017-06-01

    Results: A higher percentage of both males (70.0% and females (67.7% were presented with normal sella. The second best sella presentation was the shallow sella in males (16.2%. The mean antero-posterior diameter was significantly higher in females (12.25 mm than males (11.74 mm. The mean depth of sella turcica was greater in females (8.08 mm than males (7.68mm. Discriminant function analysis was done with gender as a grouping variable and antero-posterior dimensions and sella depth as independent variables. The formula obtained was D = 0.452 (x +0.295(y-7.753. (Where “D” is the discriminant score “x” is antero-posterior diameter of sella “y” is sella depth.The present study revealed an overall accuracy rate of58.1% in identifying correct gender using sella measurements. Conclusion: The present study was the first of its kind in the South Indian population and has presented results that justify the use of sella turcica for sex determination.

  10. Epidemiology of Oral Lichen Planus in a Cohort of South Indian Population: A Retrospective Study

    Science.gov (United States)

    Varghese, Soma Susan; George, Giju Baby; Sarojini, Sreenivasan Bargavan; Vinod, Sankar; Mathew, Philips; Mathew, Deepu George; Sebastian, Joseph; George, Arun

    2016-01-01

    Background: Oral lichen planus (OLP) is an immune-mediated potentially malignant disorder of the oral cavity. Dysplastic OLP has an altered cytogenic profile and can progress into oral squamous cell carcinoma. The epidemiology of OLP is well-described in several relatively large series from various geographic locations, whereas such series from southern India is rare. The aim of the present study was to determine the epidemiology of OLP in a cohort of South Indian population. Methods: All the case data records of 29,606 patients who visited Mar Baselios Dental College and Hospital, Kerala, India from 2014 to 2015 were retrospectively reviewed. For data review, 122 patients of OLP were selected Estimated were type, number, and location of lesions, clinical manifestation, age of the patient, gender, onset and duration of lesion, stressful life style, habits, skin involvement and associated systemic illness, and presence/absence of dysplasia. Results: When the distribution of OLP among the gender was considered, we found more prevalence in females than males. Fifty-seven percent of patients were associated with stressful lifestyle. Reticular lichen planus was the most common clinical subtype found. Bilateral buccal mucosal was the common site, when the distribution of sites of OLP were compared (P lichen planus lesions. Conclusions: OLP patients had high incidence of hypersensitivity reactions and 5% of OLP lesions showed anaplasia. Long term follow-up is necessary to monitor the recurrence, prognosis, and malignant transformation of OLP. PMID:27051650

  11. The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM among the Indian community in Chatsworth, South Africa

    Directory of Open Access Journals (Sweden)

    Raidoo Deshandra M

    2004-02-01

    Full Text Available Abstract Background The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM, attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors. Methods Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents. Results The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%. Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US$50. Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9% of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary. Conclusion The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different

  12. Glacial-interglacial vegetation dynamics in South Eastern Africa coupled to sea surface temperature variations in the Western Indian Ocean

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    L. M. Dupont

    2011-11-01

    Full Text Available Glacial-interglacial fluctuations in the vegetation of South Africa might elucidate the climate system at the edge of the tropics between the Indian and Atlantic Oceans. However, vegetation records covering a full glacial cycle have only been published from the eastern South Atlantic. We present a pollen record of the marine core MD96-2048 retrieved by the Marion Dufresne from the Indian Ocean ∼120 km south of the Limpopo River mouth. The sedimentation at the site is slow and continuous. The upper 6 m (spanning the past 342 Ka have been analysed for pollen and spores at millennial resolution. The terrestrial pollen assemblages indicate that during interglacials, the vegetation of eastern South Africa and southern Mozambique largely consisted of evergreen and deciduous forests. During glacials open mountainous scrubland dominated. Montane forest with Podocarpus extended during humid periods was favoured by strong local insolation. Correlation with the sea surface temperature record of the same core indicates that the extension of mountainous scrubland primarily depends on sea surface temperatures of the Agulhas Current. Our record corroborates terrestrial evidence of the extension of open mountainous scrubland (including fynbos-like species of the high-altitude Grassland biome for the last glacial as well as for other glacial periods of the past 300 Ka.

  13. Seizure-related hospital admissions, readmissions and costs: Comparisons with asthma and diabetes in South Australia.

    Science.gov (United States)

    Bellon, Michelle L; Barton, Christopher; McCaffrey, Nikki; Parker, Denise; Hutchinson, Claire

    2017-08-01

    Seizures are listed as an Ambulatory Care Sensitive Condition (ACSC), where, in some cases, hospitalisation may be avoided with appropriate preventative and early management in primary care. We examined the frequencies, trends and financial costs of first and subsequent seizure-related hospital admissions in the adult and paediatric populations, with comparisons to bronchitis/asthma and diabetes admissions in South Australia between 2012 and 2014. De-identified hospital separation data from five major public hospitals in metropolitan South Australia were analysed to determine the number of children and adults admitted for the following Australian Refined Diagnosis Related Groups: seizure related conditions; bronchitis/asthma; and diabetes. Additional data included length of hospital stay and type of admission. Demographic data were analysed to identify whether social determinants influence admission, and a macro costing approach was then applied to calculate the financial costs to the Health Care System. The rate of total seizure hospitalizations was 649 per 100,000; lower than bronchitis/asthma (751/100,000), yet higher than diabetes (500/100,000). The highest proportions of subsequent separations were recorded by children with seizures regardless of complexity (47% +CSCC; 17% -CSCC) compared with asthma (11% +CSCC; 14% -CSCC) or diabetes (14% +CSCC; 13% -CSCC), and by adults with seizures with catastrophic or severe complications/comorbidity (25%), compared with diabetes (22%) or asthma (14%). The mean cost per separation in both children and adults was highest for diabetes (AU$4438/$7656), followed by seizures (AU$2408/$5691) and asthma (AU$2084/$3295). Following the lead of well-developed and resourced health promotion initiatives in asthma and diabetes, appropriate primary care, community education and seizure management services (including seizure clinics) should be targeted in an effort to reduce seizure related hospitalisations which may be avoidable

  14. Delayed follow-up in patients with diabetic retinopathy in South India: Social factors and impact on disease progression

    Directory of Open Access Journals (Sweden)

    Natrajan Vengadesan

    2017-01-01

    Full Text Available Purpose: To identify social factors associated with delayed follow-up in South Indian patients with diabetic retinopathy (DR and to study DR progression during the delayed follow-up period. Materials and Methods: In this cross-sectional study, 500 consecutive patients with DR returning after greater than twice the advised follow-up period were identified from a tertiary referral center in South India. A previously validated 19-item questionnaire was administered to study patients to assess causes for the follow-up delay. Patient demographics, DR status, and treatment plan were recorded at the study visit and the visit immediately before the delay. The eye with the most severe disease was included in the analysis. Results: Complete data were available for 491 (98.2% patients. Among these, 248 (50.5% cited “my eyes were okay at the time,” 201 (41.0% cited “no attender to accompany me,” and 190 (38.6% cited “financial cost” as causes of the follow-up delay. Those with vision-threatening DR (VTDR, n = 233 predominantly reported “financial cost” (47% vs. 32%, P= 0.001, whereas those with non-VTDR more frequently reported “my eyes were okay at the time” (58% vs. 42%, P= 0.001. Evidence of disease progression from non-VTDR to VTDR was seen in 67 (26% patients. Almost 1/3rd (29% of patients who were previously advised regular examination required additional intervention. Conclusion: Many patient-level factors affect poor compliance with follow-up in DR, and these factors vary by disease severity. Targeting these barriers to care through patient education and clinic procedures may promote timely follow-up and better outcomes in these patients.

  15. Risk perception is not associated with attendance at a preventive intervention for type 2 diabetes mellitus among South Asians at risk of diabetes.

    Science.gov (United States)

    Vlaar, Everlina M A; Nierkens, Vera; Nicolaou, Mary; Middelkoop, Barend J C; Stronks, Karien; van Valkengoed, Irene G M

    2015-04-01

    To evaluate the association between risk perception and attendance in a diabetes prevention programme among South Asians with a high risk for diabetes. An observational study. We measured risk perception during the baseline interview with causal beliefs, perceived susceptibility and perceived controllability. We used logistic regression to examine the relationship between risk perception and attendance. We adjusted for relevant sociodemographic factors, screening results and psychosocial factors. The Hague, the Netherlands. Five hundred and thirty-five Hindustani Surinamese (South Asians) aged 18-60 years from a lifestyle-versus-control intervention for the prevention of diabetes. In total, 68·2% attended the lifestyle or control intervention. Participants perceived lifestyle and heredity to increase the risk of diabetes and perceived increasing physical activity to decrease it. Only 44·2% of the participants perceived themselves as susceptible to diabetes and only those who perceived a family history of diabetes as a cause of diabetes appeared to be more inclined to attend. However, after adjustment for confounding, the association was not statistically significant. Risk perception was not significantly associated with attendance. The results suggest that increasing the risk perception alone in this South Asian population is unlikely to increase the attendance at a diabetes prevention programme.

  16. Development and validation of health related quality of life questionnaire (Indian scenario) in diabetic foot ulcer patients.

    Science.gov (United States)

    Kateel, Ramya; Augustine, Alfred J; Ullal, Sheetal; Prabhu, Shivananda; Bhat, Rahul; Adhikari, Prabha

    2017-12-01

    To develop and validate Health Related Quality of Life Questionnaire in Diabetic Foot Ulcer Patients (HRQLQDFU) for Indian scenario. This study was conducted in two phases. First phase was Development of HRQLQDFU which included literature search and expert interview. Second phase was validation of HRQLQDFL which included face validation, content validation and construct validation. Face validation was done by ten diabetic foot ulcer patients, ten practicing nurses and ten care givers. They were asked to read and respond to questionnaire and report any difficulty in understanding the questions. Further they were asked to add any item to the questionnaire which according to them has a significant effect on quality of life. Content validation was done by six subject experts who judged the content relevance of questionnaire with score ranging from zero to four; zero being least relevant and four being most relevant. Content validity index was calculated for each question. Questions having content validity index≥0.8 were selected for the study. Reliability was tested by calculating Cronbach's alpha. In the development phase a questionnaire containing 37 questions with six domains was developed. None of patient had difficulty in understanding questions. After content validation a new questionnaire containing 20 questions was developed. Cronbach's alpha was 0.86 which shows good reliability. The new health related quality of life questionnaire on diabetic foot ulcer patients for an Indian scenario is validated and can be a reliably measure for quality of life in diabetic foot ulcer patients. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  17. Access to Digital Communication Technology and Perceptions of Telemedicine for Patient Education among American Indian Patients with Diabetes.

    Science.gov (United States)

    Mathieson, Kathleen; Leafman, Joan S; Horton, Mark B

    2017-01-01

    Health care access for medically underserved patients managing chronic conditions is challenging. While telemedicine can support patient education and engagement, the "digital divide" may be particularly problematic among the medically underserved. This study evaluated physical access to digital devices, use of e-mail and social media tools, and perceptions of telemedicine among American Indian (AI) patients with diabetes mellitus (DM). Survey data were collected from AI patients with DM during teleophthalmology exams. Eighty-eight percent of patients had access to digital device(s), 70% used e-mail, and 56% used social media. Younger age and greater education were positively associated with e-mail and social media use (p < .05). Most (60%) considered telemedicine an excellent medium for health-related patient education. American Indian patients with DM had access enabling patient education via telemedicine. Future work should examine patient technology preferences and effectiveness of technology-based education in improving outcomes among medically underserved populations.

  18. Epigenome-wide association of DNA methylation markers in peripheral blood from Indian Asians and Europeans with incident type 2 diabetes: a nested case-control study.

    Science.gov (United States)

    Chambers, John C; Loh, Marie; Lehne, Benjamin; Drong, Alexander; Kriebel, Jennifer; Motta, Valeria; Wahl, Simone; Elliott, Hannah R; Rota, Federica; Scott, William R; Zhang, Weihua; Tan, Sian-Tsung; Campanella, Gianluca; Chadeau-Hyam, Marc; Yengo, Loic; Richmond, Rebecca C; Adamowicz-Brice, Martyna; Afzal, Uzma; Bozaoglu, Kiymet; Mok, Zuan Yu; Ng, Hong Kiat; Pattou, François; Prokisch, Holger; Rozario, Michelle Ann; Tarantini, Letizia; Abbott, James; Ala-Korpela, Mika; Albetti, Benedetta; Ammerpohl, Ole; Bertazzi, Pier Alberto; Blancher, Christine; Caiazzo, Robert; Danesh, John; Gaunt, Tom R; de Lusignan, Simon; Gieger, Christian; Illig, Thomas; Jha, Sujeet; Jones, Simon; Jowett, Jeremy; Kangas, Antti J; Kasturiratne, Anuradhani; Kato, Norihiro; Kotea, Navaratnam; Kowlessur, Sudhir; Pitkäniemi, Janne; Punjabi, Prakash; Saleheen, Danish; Schafmayer, Clemens; Soininen, Pasi; Tai, E-Shyong; Thorand, Barbara; Tuomilehto, Jaakko; Wickremasinghe, Ananda Rajitha; Kyrtopoulos, Soterios A; Aitman, Timothy J; Herder, Christian; Hampe, Jochen; Cauchi, Stéphane; Relton, Caroline L; Froguel, Philippe; Soong, Richie; Vineis, Paolo; Jarvelin, Marjo-Riitta; Scott, James; Grallert, Harald; Bollati, Valentina; Elliott, Paul; McCarthy, Mark I; Kooner, Jaspal S

    2015-07-01

    Indian Asians, who make up a quarter of the world's population, are at high risk of developing type 2 diabetes. We investigated whether DNA methylation is associated with future type 2 diabetes incidence in Indian Asians and whether differences in methylation patterns between Indian Asians and Europeans are associated with, and could be used to predict, differences in the magnitude of risk of developing type 2 diabetes. We did a nested case-control study of DNA methylation in Indian Asians and Europeans with incident type 2 diabetes who were identified from the 8-year follow-up of 25 372 participants in the London Life Sciences Prospective Population (LOLIPOP) study. Patients were recruited between May 1, 2002, and Sept 12, 2008. We did epigenome-wide association analysis using samples from Indian Asians with incident type 2 diabetes and age-matched and sex-matched Indian Asian controls, followed by replication testing of top-ranking signals in Europeans. For both discovery and replication, DNA methylation was measured in the baseline blood sample, which was collected before the onset of type 2 diabetes. Epigenome-wide significance was set at pdiabetes at baseline to estimate the potential contribution of DNA methylation to increased risk of future type 2 diabetes incidence among Indian Asians. 1608 (11·9%) of 13 535 Indian Asians and 306 (4·3%) of 7066 Europeans developed type 2 diabetes over a mean of 8·5 years (SD 1·8) of follow-up. The age-adjusted and sex-adjusted incidence of type 2 diabetes was 3·1 times (95% CI 2·8-3·6; pdiabetes, and baseline glycaemic measures. The mean absolute difference in methylation level between type 2 diabetes cases and controls ranged from 0·5% (SD 0·1) to 1·1% (0·2). Methylation markers at five loci were associated with future type 2 diabetes incidence; the relative risk per 1% increase in methylation was 1·09 (95% CI 1·07-1·11; p=1·3 × 10(-17)) for ABCG1, 0·94 (0·92-0·95; p=4·2 × 10(-11)) for PHOSPHO1, 0

  19. Genome-wide association study for type 2 diabetes in Indians identifies a new susceptibility locus at 2q21.

    Science.gov (United States)

    Tabassum, Rubina; Chauhan, Ganesh; Dwivedi, Om Prakash; Mahajan, Anubha; Jaiswal, Alok; Kaur, Ismeet; Bandesh, Khushdeep; Singh, Tejbir; Mathai, Benan John; Pandey, Yogesh; Chidambaram, Manickam; Sharma, Amitabh; Chavali, Sreenivas; Sengupta, Shantanu; Ramakrishnan, Lakshmi; Venkatesh, Pradeep; Aggarwal, Sanjay K; Ghosh, Saurabh; Prabhakaran, Dorairaj; Srinath, Reddy K; Saxena, Madhukar; Banerjee, Monisha; Mathur, Sandeep; Bhansali, Anil; Shah, Viral N; Madhu, Sri Venkata; Marwaha, Raman K; Basu, Analabha; Scaria, Vinod; McCarthy, Mark I; Venkatesan, Radha; Mohan, Viswanathan; Tandon, Nikhil; Bharadwaj, Dwaipayan

    2013-03-01

    Indians undergoing socioeconomic and lifestyle transitions will be maximally affected by epidemic of type 2 diabetes (T2D). We conducted a two-stage genome-wide association study of T2D in 12,535 Indians, a less explored but high-risk group. We identified a new type 2 diabetes-associated locus at 2q21, with the lead signal being rs6723108 (odds ratio 1.31; P = 3.32 × 10⁻⁹). Imputation analysis refined the signal to rs998451 (odds ratio 1.56; P = 6.3 × 10⁻¹²) within TMEM163 that encodes a probable vesicular transporter in nerve terminals. TMEM163 variants also showed association with decreased fasting plasma insulin and homeostatic model assessment of insulin resistance, indicating a plausible effect through impaired insulin secretion. The 2q21 region also harbors RAB3GAP1 and ACMSD; those are involved in neurologic disorders. Forty-nine of 56 previously reported signals showed consistency in direction with similar effect sizes in Indians and previous studies, and 25 of them were also associated (P < 0.05). Known loci and the newly identified 2q21 locus altogether explained 7.65% variance in the risk of T2D in Indians. Our study suggests that common susceptibility variants for T2D are largely the same across populations, but also reveals a population-specific locus and provides further insights into genetic architecture and etiology of T2D.

  20. Gestational diabetes mellitus and pregnancy outcomes among Chinese and South Asian women in Canada.

    Science.gov (United States)

    Mukerji, Geetha; Chiu, Maria; Shah, Baiju R

    2013-02-01

    To determine the association between Chinese or South Asian ethnicity and adverse neonatal and maternal outcomes for women with gestational diabetes compared to the general population. A cohort study was conducted using population-based health care databases in Ontario, Canada. All 35,577 women aged 15-49 with gestational diabetes who had live births between April 2002 and March 2011 were identified. Their delivery hospitalization records and the birth records of their neonates were examined to identify adverse neonatal outcomes and adverse maternal outcomes. Compared to infants of mothers from the general population (55.5%), infants of Chinese mothers had a lower risk of an adverse outcome at delivery (42.9%, adjusted odds ratio 0.63, 95% confidence interval 0.58-0.68), whereas infants of South Asian mothers had a higher risk (58.9%, adjusted odds ratio 1.15, 95% confidence interval 1.07-1.23). Chinese women also had a lower risk of adverse maternal outcomes (32.4%, adjusted odds ratio 0.58, 95% confidence interval 0.54-0.63) compared to general population women (41.2%), whereas the risk for South Asian women was not different (39.4%, adjusted odds ratio 0.94, 95% confidence interval 0.88-1.02) from that of general population women. The risk of complications of gestational diabetes differs significantly between Chinese and South Asian patients and the general population in Ontario. Tailored interventions for gestational diabetes management may be required to improve pregnancy outcomes in high-risk ethnic groups.

  1. Association of CAPN10 SNPs and haplotypes with polycystic ovary syndrome among South Indian Women.

    Directory of Open Access Journals (Sweden)

    Shilpi Dasgupta

    Full Text Available Polycystic Ovary Syndrome (PCOS is known to be characterized by metabolic disorder in which hyperinsulinemia and peripheral insulin resistance are central features. Given the physiological overlap between PCOS and type-2 diabetes (T2DM, and calpain 10 gene (CAPN10 being a strong candidate for T2DM, a number of studies have analyzed CAPN10 SNPs among PCOS women yielding contradictory results. Our study is first of its kind to investigate the association pattern of CAPN10 polymorphisms (UCSNP-44, 43, 56, 19 and 63 with PCOS among Indian women. 250 PCOS cases and 299 controls from Southern India were recruited for this study. Allele and genotype frequencies of the SNPs were determined and compared between the cases and controls. Results show significant association of UCSNP-44 genotype CC with PCOS (p = 0.007 with highly significant odds ratio when compared to TC (OR = 2.51, p = 0.003, 95% CI = 1.37-4.61 as well as TT (OR = 1.94, p = 0.016, 95% CI = 1.13-3.34. While the haplotype carrying the SNP-44 and SNP-19 variants (21121 exhibited a 2 fold increase in the risk for PCOS (OR = 2.37, p = 0.03, the haplotype containing SNP-56 and SNP-19 variants (11221 seems to have a protective role against PCOS (OR = 0.20, p = 0.004. Our results support the earlier evidence for a possible role of UCSNP-44 of the CAPN10 gene in the manifestation of PCOS.

  2. Cultural negotiations in health and illness: The experience of adult onset diabetes among Gujarati South Asians in England.

    OpenAIRE

    Keval, Harshad C.

    2008-01-01

    Diabetes has become a global health problem, with both physical and psycho-social impacts on people's lives. The South Asian communities in the UK have been identified as 'high risk' groups with high rates of type 2 (non-insulin dependent) diabetes. This thesis explores the experiences of type 2 diabetes among a group of Hindu Gujaratis in several locations in England. Purposive and snowball sampling was used to recruit participants and a grounded theory framework was utilised to generate and...

  3. Influence of Tropical South Atlantic Sea Surface Temperatures on the Indian Summer monsoon in CMIP5 models

    Science.gov (United States)

    Kucharski, Fred; Joshi, Manish K.

    2017-04-01

    In this study the teleconnection from the tropical south Atlantic to the Indian monsoon has been assessed in observations and in 32 models from the World Climate Research Program (WCRP) Coupled Model Intercomparison Project Phase 5 (CMIP5). All models show that the regression pattern of tropics-wide Atlantic sea surface temperature (SST) anomalies onto the tropical south Atlantic index correlates well with that in observations, even though with varying spatial standard deviations. However, only about half of the 32 models considered show the correct sign of rainfall response over India to a warm anomaly in the south tropical Atlantic, which is a reduction of rainfall. On the other hand, models generally do show large-scale responses broadly consistent with the observations, and the signal over India depends on relatively subtle changes in the response. This response to a tropical south Atlantic warm (cold) anomaly is a low-level quadrupole in streamfunction with an anticyclonic (cyclonic) anomaly over the Arabian Sea and India. This anticyclonic (cyclonic) anomaly leads to a weakening (strengthening) of the Somali jet and low-level divergence (convergence) over India, both inducing a reduction (increase) of Indian rainfall. The models which do not show the correct rainfall response over India also show a response similar to the one indicated above, but with maximum of the anticyclonic (cyclonic) response shifted to the western Pacific. The large-scale Walker circulation adjustment to the tropical south Atlantic SST anomalies is identified as one of the factors which account for the differences in the low-level streamfunction response. Models (and the observations) with the correct sign of the rainfall signal over India show the dominant upper-level convergence (divergence) as response to a warm (cold) tropical south Atlantic in the western Pacific region, whereas models with the wrong sign of the rainfall signal show it predominantly in the central-eastern Pacific

  4. Selecting SNPs informative for African, American Indian and European Ancestry: application to the Family Investigation of Nephropathy and Diabetes (FIND).

    Science.gov (United States)

    Williams, Robert C; Elston, Robert C; Kumar, Pankaj; Knowler, William C; Abboud, Hanna E; Adler, Sharon; Bowden, Donald W; Divers, Jasmin; Freedman, Barry I; Igo, Robert P; Ipp, Eli; Iyengar, Sudha K; Kimmel, Paul L; Klag, Michael J; Kohn, Orly; Langefeld, Carl D; Leehey, David J; Nelson, Robert G; Nicholas, Susanne B; Pahl, Madeleine V; Parekh, Rulan S; Rotter, Jerome I; Schelling, Jeffrey R; Sedor, John R; Shah, Vallabh O; Smith, Michael W; Taylor, Kent D; Thameem, Farook; Thornley-Brown, Denyse; Winkler, Cheryl A; Guo, Xiuqing; Zager, Phillip; Hanson, Robert L

    2016-05-04

    The presence of population structure in a sample may confound the search for important genetic loci associated with disease. Our four samples in the Family Investigation of Nephropathy and Diabetes (FIND), European Americans, Mexican Americans, African Americans, and American Indians are part of a genome- wide association study in which population structure might be particularly important. We therefore decided to study in detail one component of this, individual genetic ancestry (IGA). From SNPs present on the Affymetrix 6.0 Human SNP array, we identified 3 sets of ancestry informative markers (AIMs), each maximized for the information in one the three contrasts among ancestral populations: Europeans (HAPMAP, CEU), Africans (HAPMAP, YRI and LWK), and Native Americans (full heritage Pima Indians). We estimate IGA and present an algorithm for their standard errors, compare IGA to principal components, emphasize the importance of balancing information in the ancestry informative markers (AIMs), and test the association of IGA with diabetic nephropathy in the combined sample. A fixed parental allele maximum likelihood algorithm was applied to the FIND to estimate IGA in four samples: 869 American Indians; 1385 African Americans; 1451 Mexican Americans; and 826 European Americans. When the information in the AIMs is unbalanced, the estimates are incorrect with large error. Individual genetic admixture is highly correlated with principle components for capturing population structure. It takes ~700 SNPs to reduce the average standard error of individual admixture below 0.01. When the samples are combined, the resulting population structure creates associations between IGA and diabetic nephropathy. The identified set of AIMs, which include American Indian parental allele frequencies, may be particularly useful for estimating genetic admixture in populations from the Americas. Failure to balance information in maximum likelihood, poly-ancestry models creates biased

  5. A profile of Latinos with poorly controlled diabetes in South Florida

    Directory of Open Access Journals (Sweden)

    Sonjia Kenya

    2015-04-01

    Full Text Available Introduction: Latinos are the largest minority group in the United States and diabetes or pre-diabetes affects more than 70% of Latinos aged 45 years and older. Miami-Dade County is home to one of the highest populations of diverse Latinos. In this descriptive manuscript, we present baseline characteristics of participants enrolled in the Miami Healthy Heart Initiative (MHHI. This was a study conducted to determine the effects of a community health worker (CHW intervention among Latinos with poorly controlled diabetes in South Florida. Methods: We recruited 300 diverse Latino adults with suboptimal diabetes outcomes (HbA1c≥8 into MHHI. This randomized control trial examined the impact of a 1-year CHW-led intervention on glycemic control, blood pressure, and cholesterol levels. At baseline, physiologic measures, including HbA1c, LDL, blood pressure, and BMI, were assessed. Data on socio-demographic characteristics and additional determinants of health such as depression status, provider communication, diet, exercise, cigarette smoking, readiness to change diabetes management behaviors (stages of change, and confidence in ability to improve diabetes self-care (self-efficacy were collected. Results: Participants came from 20 different countries, with Cuban Americans representing 38% of the sample. Most had lived in the US for more than 10 years, had completed at least 12 years of school, and had high levels of health literacy, yet 48% had very low acculturation. Nearly 80% had poor self-efficacy, 80% met the criteria for depression, and 83% were not adherent to their medications. More than half the population was not at their target for blood pressure, 50% were above the recommended LDL goal, and most were obese. Conclusion: In a diverse population of Latinos with poorly controlled diabetes in Miami, we found high rates of depression, obesity, medication non-adherence, poor self-efficacy, and provider communication. These may contribute to poor

  6. A Home-Based Educational Intervention Improves Patient Activation Measures and Diabetes Health Indicators among Zuni Indians.

    Directory of Open Access Journals (Sweden)

    Vallabh O Shah

    Full Text Available One in three people will be diagnosed with diabetes by 2050, and the proportion will likely be higher among Native Americans. Diabetes control is currently suboptimal in underserved populations despite a plethora of new therapies. Patient empowerment is a key determinant of diabetes control, but such empowerment can be difficult to achieve due to resource limitation and cultural, language and health literacy barriers. We describe a home-based educational intervention using Community Health Representatives (CHRs, leading to improvement in Patient Activation Measures scores and clinical indicators of diabetes control.Sixty participants with type 2 diabetes (T2D completed a baseline evaluation including physical exam, Point of Care (POC testing, and the Patient Activation Measure (PAM survey. Participants then underwent a one hour group didactic session led by Community Health Representatives (CHRs who subsequently carried out monthly home-based educational interventions to encourage healthy lifestyles, including diet, exercise, and alcohol and cigarette avoidance until follow up at 6 months, when clinical phenotyping and the PAM survey were repeated.PAM scores were increased by at least one level in 35 (58% participants, while 24 participants who started at higher baseline score did not change. Six months after intervention, mean levels of A1C decreased by 0.7 ± 1.2%; fasting blood glucose decreased by 24.0 ± 38.0 mg/dl; BMI decreased by 1.5 ± 2.1 kg/m2; total cholesterol decreased by 12.0 ± 28.0 mg/dl; and triglycerides decreased by 52.0 ± 71.0 mg/dl. All of these changes were statistically significant (p < 0.05.This six month, CHR led and community-oriented educational intervention helps inform standards of practice for the management of diabetes, engages diabetic populations in their own care, and reduces health disparities for the underserved population of Zuni Indians.ClinicalTrials.gov NCT02339311.

  7. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Educators and Community Members Diabetes Educator Tools Diabetes Education Lesson Plan Outlines Integrating Case Management Into Your Practice [PDF – ... has to offer for those who provide diabetes education. Find Guides for Diabetes ... Online Lesson Plan Outlines for Educators New or seasoned educators can ...

  8. Demographic, medical and visual aspects of Dia- betic Retinopathy (DR and Diabetic Macular Edema (DME in South African diabetic patients*

    Directory of Open Access Journals (Sweden)

    Anusha Y. Sukha

    2009-12-01

    interactions (p = 0.01 and emotional re-action to vision loss (p = 0.018 was reported in subjects with DME. Conclusion: This study has identified possible demographic, medical and visual risk factors of DR and DME in South African diabetic patients.

  9. HTLV-I infection in the South West Indian Ocean islands, particularly in La Réunion and the Seychelles.

    Science.gov (United States)

    Aubry, P; Bovet, P; Vitrac, D; Schooneman, F; Hollanda, J; Malvy, D; Gaüzère, B-A

    2013-10-01

    Data on HTLV-I are scarce in several Southwest Indian Ocean islands except for La Réunion and The Seychelles. The two cases of HTLV-I have been confirmed by Western-Blot in La Réunion, among blood donors. In Seychelles (87 400 inhabitants in 2012), where blood donors and some other cases are screened, HTLV-I was confirmed with a line immune assay in 43 persons and at least 10-20 patients are known to have tropical spastic paraparesia or adult T-cell lymphoma associated with HTLV-I. In the south-west Indian Ocean, a possibly important other issue may be co-infection of HTLV-1 with the Strongyloides stercoralis roundworm, which is endemic in all countries of the region and which can sometimes lead to severe symptomatic infestation.

  10. Diabetes mellitus prevalence is increasing in South Asians but is stable in Chinese living in Singapore and Mauritius.

    Science.gov (United States)

    Tan, Kristin H X; Barr, Elizabeth L M; Koshkina, Vira; Ma, Stefan; Kowlessur, Sudhir; Magliano, Dianna J; Söderberg, Stefan; Chia, Kee Seng; Zimmet, Paul; Lim, Wei-Yen

    2017-09-01

    Asia is experiencing a type 2 diabetes epidemic, but prevalence differs by ethnicity and level of socioeconomic development. Singapore and Mauritius have implemented comprehensive campaigns to address this public health problem. We compared diabetes and obesity prevalence trends among Chinese and South Asians living in Singapore and Mauritius to determine the contribution of ethnicity and economic development to diabetes. Age-specific data from serial national population-based surveys in Singapore and Mauritius between 1987 and 2010 were used to estimate age-standardized diabetes and obesity prevalence. Modified Breslow-Cox proportional hazard models were used to obtain rate ratios for diabetes risk factors. In Singapore, the age-standardized prevalence of diabetes remained stable for Chinese (men: 14% in 1992, 13% in 2010; women: 12% in 1992, 10% in 2010), but increases were observed for South Asians (men: 20% in 1992, 26% in 2010; women: 18% in 1992, 20% in 2010). There were similar patterns in Mauritius. In both countries, obesity prevalence trends were stable for Chinese women, but increased for Chinese men and South Asians. Associations between obesity and diabetes were stronger in Chinese than South Asians regardless of country. Despite different socioeconomic settings in Singapore and Mauritius, we observed rising diabetes prevalence among South Asians but stable prevalence in Chinese in both countries. This provides further evidence that ethnicity contributes to the development of diabetes, and that there should be an increased emphasis on future prevention strategies targeting South Asian populations in these countries. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  11. Dietary and physical activity strategies to prevent type 2 diabetes in South Asian adults: protocol for a systematic review

    NARCIS (Netherlands)

    Muilwijk, Mirthe; Stronks, Karien; Qureshi, Samera Azeem; Beune, Erik; Celis-Morales, Carlos; Gill, Jason; Sheikh, Aziz; Jenum, Anne Karen; van Valkengoed, Irene G. M.

    2017-01-01

    Introduction Type 2 diabetes (T2D) is a major health concern among populations of South Asian ethnicity. Although dietary and physical activity interventions may reduce the risk of T2D, the effectiveness has been moderate among South Asians. This might (in part) be because this subgroup follows

  12. Pathogenesis of type 2 diabetes and cardiovascular disease in South Asians : effects of dietary interventions on metabolism and cardiovascular function

    NARCIS (Netherlands)

    Bakker, Leontine Erica Henriëtte

    2015-01-01

    People of South Asian origin have an increased risk of developing type 2 diabetes (T2D) and cardiovascular disease (CVD) compared to people of Western European descent. Not only is the prevalence of these diseases higher in South Asians, they also occur at a younger age and lower BMI, and have a

  13. Accuracy of Demirjian′s 8 teeth method for age prediction in South Indian children: A comparative study

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    Rezwana Begum Mohammed

    2015-01-01

    Full Text Available Introduction: Demirjian′s method of tooth development is most commonly used to assess age in individuals with emerging teeth. However, its application on numerous populations has resulted in wide variations in age estimates and consequent suggestions for the method′s adaptation to the local sample. Original Demirjian′s method utilized seven mandibular teeth, to which recently third molar is added so that the method can be applied on a wider age group. Furthermore, the revised method developed regression formulas for assessing age. In Indians, as these formulas resulted in underestimation, India-specific regression formulas were developed recently. The purpose of this cross-sectional study was to evaluate the accuracy and applicability of original regression formulas (Chaillet and Demirjian 2004 and India-specific regression formulas (Acharya 2010 using Demirjian′s 8 teeth method in South Indian children of age groups 9-20 years. Methods: The present study consisted of 660 randomly selected subjects (330 males and 330 females were in the aged ranging from 9 to 20 years divided into 11 groups according to their age. Demirjian′s 8 teeth method was used for staging of teeth. Results: Demirjian′s method underestimated the dental age (DA by 1.66 years for boys and 1.55 years for girls and 1.61 years in total. Acharya′s method over estimated DA by 0.21 years for boys and 0.85 years for girls and 0.53 years in total. The absolute accuracy was better for Acharya′s method compared with Demirjian method. Conclusion: This study concluded that both the Demirjian and Indian regression formulas were reliable in assessing age making Demirjian′s 8 teeth method applicable for South Indians.

  14. Political contexts and maternal health policy: insights from a comparison of south Indian states.

    Science.gov (United States)

    Smith, Stephanie L

    2014-01-01

    Nearly 300,000 women die from pregnancy-related complications each year. One-fifth of these deaths occur in India. Maternal survival rose on India's national policy agenda in the mid-2000s, but responsibility for health policy and implementation in the federal system is largely devolved to the state level where priority for the issue and maternal health outcomes vary. This study investigates sources of variation in maternal health policy and implementation sub-nationally in India. The study is guided by four analytical categories drawn from policy process literature: constitutional, governing and social structures; political contexts; actors and ideas. The experiences of two south Indian states-Tamil Nadu a leader and Karnataka a relatively slow mover-are examined. Process-tracing, a case study methodology that helps to identify roles of complex historical events in causal processes, was employed to investigate the research question in each state. The study is informed by interviews with public health policy experts and service delivery professionals, observation of implementation sites and archival document analysis. Historical legacies-Tamil Nadu's non-Brahmin social movement and Karnataka's developmental disparities combined with decentralization-shape the states' political contexts, affecting variation in maternal health policy and implementation. Competition to advance consistent political priorities across regimes in Tamil Nadu offers fertile ground for policy entrepreneurship and strong public health system administration facilitates progress. Inconsistent political priorities and relatively weak public health system administration frustrate progress in Karnataka. These variations offer insights to the ways in which sub-national political and administrative contexts shape health policy and implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Prevalence and etiological profile of short stature among school children in a South Indian population

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    Kumaravel Velayutham

    2017-01-01

    Full Text Available Background and Objectives: Short stature (SS is a common pediatric problem and it might be the first sign of underlying illness. Studies documenting the burden and etiological profile of SS are scarce from India and are mostly limited to data obtained from referral centers. Due to the lack of large-scale, community-based studies utilizing a standard protocol, the present study aimed to assess the prevalence and etiological profile of SS in school children of a South Indian district. Materials and Methods: In this cross-sectional study, children aged 4–16 years from 23 schools in Madurai district, Tamil Nadu, underwent anthropometric measurements and height was plotted in Khadilkar et al. growth chart. The cause of SS was assessed using clinical and laboratory evaluations in assigned children with a height less than third centile. Results: A total of 15644 children belonging to 23 schools were evaluated, and 448 (2.86% children had SS. Etiological evaluation was further performed in 87 randomly assigned children, and it is identified that familial SS or constitutional delay in growth was the most common cause of SS in the study population (66.67%. Hypothyroidism and growth hormone deficiency were the two most common pathological causes of SS seen in 12 (13.79% and 8 (9.20% children, respectively. Malnutrition was the cause of SS in 6 (6.9% children and cardiac disorders, psychogenic SS, and skeletal dysplasia were other identified causes of SS in the study. Interpretation and Conclusions: The overall prevalence of SS in school children was 2.86% and familial SS or constitutional delay in growth was the most common cause of SS. As a significant percentage of children with SS had correctable causes, monitoring growth with a standard growth chart should be mandatory in all schools.

  16. A STUDY ON TIBIAL TORSION IN ADULT DRY TIBIA OF EAST AND SOUTH INDIAN POPULATION

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    Jami Sagar Prusti

    2017-05-01

    Full Text Available BACKGROUND Rotational deformities of the lower limbs are very common. There is increasing evidence that abnormal torsion in the tibia is associated with severe knee and ankle arthritis. Primary knee osteoarthritis is a leading cause of disability in older persons. Varus or valgus alignment increases the risk of osteoarthritis. Coexistence of tibial torsional deformity may increase the risk further. Variability in the tibial torsion has been reported and is due to the torsional forces applied on tibia during development. The aim of the study is to estimate the angle of tibial torsion on both sides and both sexes. The present study was an attempt to provide baseline data of tibial torsion in the East and South Indian population. MATERIALS AND METHODS The study was conducted mechanically on 100 dry adult unpaired human tibia, i.e. 50 male and 50 female bones. The measurements were recorded and statistically analysed using Student’s unpaired t-test using GraphPad Prism 5.0 (free trial version. RESULTS Out of the 100 tibia undertaken, mean value of tibial torsion angle obtained is 25.8°. In males, it is 23.68° and in females it is about 27.86°. Statistical analysis revealed significant greater average angle of tibial torsion in female bones. The angle of the right-sided bones was more and this was statistically significant. CONCLUSION The gender variation for the angle could be the result of the difference in lifestyle in day-to-day activities. The knowledge of the angle in a population could be helpful in understanding the incidence of pathogenesis related to gait and knee osteoarthritis and in view of reconstructive surgeries in orthopaedic practice.

  17. Pharmacogenetic markers to predict the clinical response to methotrexate in south Indian Tamil patients with psoriasis.

    Science.gov (United States)

    Indhumathi, S; Rajappa, Medha; Chandrashekar, Laxmisha; Ananthanarayanan, P H; Thappa, D M; Negi, V S

    2017-08-01

    Despite the advent of several new systemic therapies, methotrexate remains the gold standard for the treatment of moderate to severe psoriasis. However, there exists a significant heterogeneity in individual response to methotrexate. There are no consistently reliable markers to predict methotrexate treatment response till date. We aimed to demonstrate the association of certain genetic variants in the HLA (HLA-A2, HLA-B17, and HLA-Cw6) and the non-HLA genes including T-helper (Th)-1, Th-2, Th-17 cytokine genes (IFN-γ, IL-2, IL-4, IL-10, IL-12B, and IL-23R), and T-regulatory gene (FOXP3) with the methotrexate treatment response in South Indian Tamil patients with psoriasis. Of the 360 patients recruited, 189 patients with moderate to severe psoriasis were treated with methotrexate. Of the 189 patients, 132 patients responded to methotrexate and the remaining 57 patients were non-responders. We analyzed the association of aforesaid polymorphisms with the methotrexate treatment outcome using binary logistic regression. We observed that there were significant differences between genotype frequencies of HLA-Cw6 and FOXP3 (rs3761548) among the responders compared to non-responders, with conservative estimation. We observed that pro-inflammatory cytokines such as IFN-γ, IL-2, IL-12, and IL-23 were markedly reduced with the use of methotrexate, in comparison to the baseline levels, while the plasma IL-4 levels were increased posttreatment. Our results serve as preliminary evidence for the clinical use of genetic markers as predictors of response to methotrexate in psoriasis. This might aid in the future in the development of a point-of-care testing (POCT) gene chip, to predict optimal treatment response in patients with psoriasis, based on their individual genotypic profile.

  18. Community-based game intervention to improve South Asian Indian Americans' engagement with advanced care planning.

    Science.gov (United States)

    Radhakrishnan, Kavita; Van Scoy, Lauren Jodi; Jillapalli, Regina; Saxena, Shubhada; Kim, Miyong T

    2017-07-27

    Advance care planning (ACP) allows individuals to express their preferences for medical treatment in the event that they become incapable of making their own decisions. This study assessed the efficacy of a conversation game intervention for increasing South Asian Indian Americans' (SAIAs') engagement in ACP behaviors as well as the game's acceptability and cultural appropriateness among SAIAs. Eligible community-dwelling SAIAs were recruited at SAIA cultural events held in central Texas during the summer of 2016. Pregame questionnaires included demographics and the 55-item ACP Engagement Survey. Played in groups of 3-5, the game consists of 17 open-ended questions that prompt discussions of end-of-life issues. After each game session, focus groups and questionnaires were used to examine the game's cultural appropriateness and self-rated conversation quality. Postintervention responses on the ACP Engagement Survey and rates of participation in ACP behaviors were collected after 3 months through phone interviews or online surveys. Data were analyzed using descriptive statistics, frequencies, and paired t-tests comparing pre/post averages at a .05 significance level. Of the 47 participants, 64% were female, 62% had graduate degrees, 92% had lived in the U.S. for >10 years, 87% were first-generation immigrants, and 74% had no advance directive prior to the game. At the 3-month follow-up, 58% of participants had completed at least one ACP behavior, 42% had discussed end-of-life issues with loved ones, 15% did so with their healthcare providers, and 18% had created an advanced directive. ACP Engagement Survey scores increased significantly on all four of the process subscales by 3 months postgame. SAIA individuals who played a conversation game had a relatively high rate of performing ACP behaviors 3 months after the intervention. These findings suggest that conversation games may be useful tools for motivating people from minority communities to engage in ACP behaviors.

  19. GREYBULL SANDSTONE PETROLEUM POTENTIAL ON THE CROW INDIAN RESERVATION, SOUTH-CENTRAL MONTANA

    Energy Technology Data Exchange (ETDEWEB)

    David A. Lopez

    2000-12-14

    Evaluation of the Lower Cretaceous Greybull Sandstone on the Crow Indian Reservation for potential stratigraphic traps in the valley-fill sandstone was the focus of this project. The Crow Reservation area, located in south-central Montana, is part of the Rocky Mountain Foreland structural province, which is characterized by Laramide uplifts and intervening structural basins. The Pryor and Bighorn mountains, like other foreland uplifts, are characterized by asymmetrical folds associated with basement-involved reverse faults. The reservation area east of the mountains is on the northwestern flank of the Powder River Basin. Therefore, regional dips are eastward and southeastward; however, several prominent structural features interrupt these regional dips. The nearly 4,000 mi{sup 2} reservation is under explored but has strong potential for increased oil and gas development. Oil and gas production is well established in the Powder River Basin of Wyoming to the south as well as in the areas north and west of the reservation. However, only limited petroleum production has been established within the reservation. Geologic relations and trends indicate strong potential for oil and gas accumulations, but drilling has been insufficient for their discovery. The Greybull Sandstone, which is part of the transgressive systems tract that includes the overlying Fall River Sandstone, was deposited on a major regional unconformity. The erosional surface at the base of the Greybull Sandstone is the +100 Ma, late Aptian-Early Albian regional unconformity of Weimer (1984). This lowstand erosional surface was controlled by a basin-wide drop in sea level. In areas where incised Greybull channels are absent, the lowstand erosional unconformity is at the base of the Fall River Sandstone and equivalent formations. During the pre-Greybull lowstand, sediment bypassed this region. In the subsequent marine transgression, streams began to aggrade and deposit sand of the lower Greybull Sandstone

  20. Association analysis of 31 common polymorphisms with type 2 diabetes and its related traits in Indian sib pairs.

    Science.gov (United States)

    Gupta, V; Vinay, D G; Rafiq, S; Kranthikumar, M V; Janipalli, C S; Giambartolomei, C; Evans, D M; Mani, K R; Sandeep, M N; Taylor, A E; Kinra, S; Sullivan, R M; Bowen, L; Timpson, N J; Smith, G D; Dudbridge, F; Prabhakaran, D; Ben-Shlomo, Y; Reddy, K S; Ebrahim, S; Chandak, G R

    2012-02-01

    Evaluation of the association of 31 common single nucleotide polymorphisms (SNPs) with fasting glucose, fasting insulin, HOMA-beta cell function (HOMA-β), HOMA-insulin resistance (HOMA-IR) and type 2 diabetes in the Indian population. We genotyped 3,089 sib pairs recruited in the Indian Migration Study from four cities in India (Lucknow, Nagpur, Hyderabad and Bangalore) for 31 SNPs in 24 genes previously associated with type 2 diabetes in European populations. We conducted within-sib-pair analysis for type 2 diabetes and its related quantitative traits. The risk-allele frequencies of all the SNPs were comparable with those reported in western populations. We demonstrated significant associations of CXCR4 (rs932206), CDKAL1 (rs7756992) and TCF7L2 (rs7903146, rs12255372) with fasting glucose, with β values of 0.007 (p = 0.05), 0.01 (p = 0.01), 0.007 (p = 0.05), 0.01 (p = 0.003) and 0.08 (p = 0.01), respectively. Variants in NOTCH2 (rs10923931), TCF-2 (also known as HNF1B) (rs757210), ADAM30 (rs2641348) and CDKN2A/B (rs10811661) significantly predicted fasting insulin, with β values of -0.06 (p = 0.04), 0.05 (p = 0.05), -0.08 (p = 0.01) and -0.08 (p = 0.02), respectively. For HOMA-IR, we detected associations with TCF-2, ADAM30 and CDKN2A/B, with β values of 0.05 (p = 0.04), -0.07 (p = 0.03) and -0.08 (p = 0.02), respectively. We also found significant associations of ADAM30 (β = -0.05; p = 0.01) and CDKN2A/B (β = -0.05; p = 0.03) with HOMA-β. THADA variant (rs7578597) was associated with type 2 diabetes (OR 1.5; 95% CI 1.04, 2.22; p = 0.03). We validated the association of seven established loci with intermediate traits related to type 2 diabetes in an Indian population using a design resistant to population stratification.

  1. Association of MTHFR and PPARγ2 gene polymorphisms in relation to type 2 diabetes mellitus cases among north Indian population.

    Science.gov (United States)

    Raza, Syed Tasleem; Abbas, Shania; Ahmed, Faisal; Fatima, Jalees; Zaidi, Zeashan Haider; Mahdi, Farzana

    2012-12-15

    Type 2 diabetes mellitus is a multifactorial and polygenic disease, which is considered as a major life threatening problem all over the world. There has been a worldwide effort in the identification of susceptibility genes for type 2 diabetes mellitus and its complications. At present, adequate data is not available dealing with MTHFR (rs1801133) and PPARγ2 (rs1801282) gene polymorphisms and its association with type 2 diabetes mellitus cases among north Indian populations. Thus, we conceived the need for further studies to investigate MTHFR and PPARγ2 gene polymorphisms and their susceptibility to type 2 diabetes mellitus in north Indian population. In this study, a total 175 subjects including 87 type 2 diabetes mellitus cases and 88 controls were enrolled. MTHFR and PPARγ2 gene polymorphisms in the cases and controls were evaluated by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The MTHFR gene CC, CT, TT genotype frequencies obtained were 40%, 43%, and 17% in type 2 diabetes mellitus cases and 56%, 29%, and 15% in healthy controls respectively. The OR for CC was 0.54 (95%CI 0.29-0.98, P=0.041, χ(2)=4.18, power=0.98), for CT 1.76 (95%CI 0.94-3.30, P=0.07, χ(2)=3.2, power=0.96), and for TT 1.2 (95%CI 0.53-2.70, P=0.66, χ(2)=0.198, power=0.76). The PPARγ2 gene GG CG, CC genotype frequencies obtained were 28%, 41%, and 31% in cases and 40%, 39%, and 21% in healthy controls respectively. OR for GG was 0.58 (95%CI 0.30-1.09, P=0.08, χ(2)=2.9, power=0.96), for CG 1.12 (95%CI 0.61-2.05, P=0.71, χ(2)=0.137, power=0.778), and for CC 1.63 (95%CI 0.82-3.23, P=0.156, χ(2)=2.01, power=0.92). It might be recommended that MTHFR CC genotype seems to be a good marker for the early identification of population at risk of type 2 diabetes mellitus. While we have detected significant difference in allelic frequencies of PPARγ2 C (Proline) and G (Alanine), but at genotypic level significant difference was not detected in this case

  2. Improvement in diet habits, independent of physical activity helps to reduce incident diabetes among prediabetic Asian Indian men.

    Science.gov (United States)

    Ram, Jagannathan; Selvam, Sundaram; Snehalatha, Chamukuttan; Nanditha, Arun; Simon, Mary; Shetty, Ananth Samith; Godsland, Ian F; Johnston, Desmond G; Ramachandran, Ambady

    2014-12-01

    To assess the beneficial effects of the components of lifestyle intervention in reducing incidence of diabetes in Asian Indian men with impaired glucose tolerance (IGT) in India. This analysis was based on a 2 year prospective, randomized controlled primary prevention trial in a cohort of Asian Indian men with IGT (n=537) (Clinical Trial No: NCT00819455). Intervention and control groups were given standard care advice at baseline. Additionally, the intervention group received frequent, mobile phone based text message reminders on healthy lifestyle principles. Dietary intake and physical activity habits were recorded by validated questionnaires. The lifestyle goals were: reductions in consumption of carbohydrates, oil, portion size and body mass index of at least 1 unit (1 kg/m(2)) from baseline and maintenance of good physical activity. The association between diabetes and lifestyle goals achieved was assessed using multiple logistic regression analyses. Changes in insulin sensitivity (Matsuda's insulin sensitivity index) and oral disposition index during the follow-up were assessed. At the end of the study, 123 (23.8%) participants developed diabetes. The mean lifestyle score was higher in the intervention group compared with control (2.59 ± 1.13 vs. 2.28 ± 1.17; P=0.002). Among the 5 lifestyle variables, significant improvements in the 3 dietary goal were seen with intervention. Concomitant improvement in insulin sensitivity and oral disposition index was noted. Higher lifestyle score was associated with lower risk of developing diabetes (odds ratio: 0.54 [95% CI: 0.44-0.70]; P<0.0001). Beneficial effects of intervention were associated with increased compliance to lifestyle goals. The plausible mechanism is through improvement in insulin sensitivity and beta cell preservation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women.

    Science.gov (United States)

    Lukose, Ammu; Ramthal, Asha; Thomas, Tinku; Bosch, Ronald; Kurpad, Anura V; Duggan, Christopher; Srinivasan, Krishnamachari

    2014-01-01

    Many women of reproductive age from developing countries have poor nutritional status, and the prevalence of depression during pregnancy is high. The objective of the present study was to assess the prevalence of antenatal depressive symptoms in early pregnancy, and to identify the demographic and nutritional factors associated with these symptoms in a sample of urban South Indian pregnant women. This cross-sectional study was the baseline assessment of a prospective randomized controlled trial of vitamin B12 supplementation in urban pregnant south Indian women between the ages of 18 and 40 years ( www.clinicaltrials.gov : NCT00641862). 365 women in their first trimester of pregnancy were screened for depressive symptoms at an urban clinic in Karnataka, South India, using the Kessler Psychological Distress Scale (K-10). Nutritional, clinical and biochemical factors were also assessed. Mean (SD) age of the cohort was 22.6 (3.7) years and mean (SD) BMI was 20.4 (3.3) kg/m(2). 121 (33 %) of the women in the 1st trimester had symptoms consistent with depression (K-10 score >6). In multivariate log binomial regression analysis, presence of antenatal depressive symptoms in the first trimester were positively associated with vomiting, prevalence ratio (PR) = 1.54 (95 % CI 1.10, 2.16) and negatively with anemia, PR = 0.67 (95 % CI 0.47, 0.96). Nutrient intakes, serum vitamin B12, methylmalonic acid, homocysteine and red cell folate levels were not associated with measures of depression. Antenatal depressive symptoms in early pregnancy are highly prevalent in urban Indian women and are more common in women with vomiting and without anemia. In this cross-sectional data, blood concentrations of vitamin B12 and folate were not associated with depressive symptoms. The relationship between nutritional status and depressive symptoms may require larger and longitudinal studies.

  4. Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment

    Directory of Open Access Journals (Sweden)

    Jothydev Kesavadev

    2014-01-01

    Full Text Available Treatment of type 1 diabetes is a challenging issue in South East Asia. Unlike in the developed countries, patients have to procure insulin, glucometer strips and other treatment facilities from their own pockets. Coupled with poor resources are the difficulties with diagnosis, insulin initiation, insulin storage, marital and emotional challenges. Being a disease affecting only a minority of people, it is largely ignored by the governments and policy makers. Comprehensive diagnostic, treatment and team based educational facilities are available only in the speciality diabetes centers in the private sector whereas majority of the subjects with type 1 diabetes are from a poor socio-economic background. Unlike in the Western world, being known as a diabetes patient is a social sigma and poses huge emotional burden living with the disease and getting married. Even with best of the resources, long-term treatment of type 1 diabetes still remains a huge challenge across the globe. In this review, authors from India, Pakistan, Nepal, Sri Lanka, Myanmar and Bangladesh detail the country-specific challenges and discuss the possible solutions.

  5. Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment.

    Science.gov (United States)

    Kesavadev, Jothydev; Sadikot, Shaukat M; Saboo, Banshi; Shrestha, Dina; Jawad, Fatema; Azad, Kishwar; Wijesuriya, Mahendra Arunashanthi; Latt, Tint Swe; Kalra, Sanjay

    2014-09-01

    Treatment of type 1 diabetes is a challenging issue in South East Asia. Unlike in the developed countries, patients have to procure insulin, glucometer strips and other treatment facilities from their own pockets. Coupled with poor resources are the difficulties with diagnosis, insulin initiation, insulin storage, marital and emotional challenges. Being a disease affecting only a minority of people, it is largely ignored by the governments and policy makers. Comprehensive diagnostic, treatment and team based educational facilities are available only in the speciality diabetes centers in the private sector whereas majority of the subjects with type 1 diabetes are from a poor socio-economic background. Unlike in the Western world, being known as a diabetes patient is a social sigma and poses huge emotional burden living with the disease and getting married. Even with best of the resources, long-term treatment of type 1 diabetes still remains a huge challenge across the globe. In this review, authors from India, Pakistan, Nepal, Sri Lanka, Myanmar and Bangladesh detail the country-specific challenges and discuss the possible solutions.

  6. Putting theory into practice: a case study of diabetes-related behavioral change interventions on Chicago's South Side.

    Science.gov (United States)

    Peek, Monica E; Ferguson, Molly J; Roberson, Tonya P; Chin, Marshall H

    2014-11-01

    Diabetes self-management is central to diabetes care overall, and much of self-management entails individual behavior change, particularly around dietary patterns and physical activity. Yet individual-level behavior change remains a challenge for many persons with diabetes, particularly for racial/ethnic minorities who disproportionately face barriers to diabetes-related behavioral changes. Through the South Side Diabetes Project, officially known as "Improving Diabetes Care and Outcomes on the South Side of Chicago," our team sought to improve health outcomes and reduce disparities among residents in the largely working-class African American communities that comprise Chicago's South Side. In this article, we describe several aspects of the South Side Diabetes Project that are directly linked to patient behavioral change, and discuss the theoretical frameworks we used to design and implement our programs. We also briefly discuss more downstream program elements (e.g., health systems change) that provide additional support for patient-level behavioral change. © 2014 Society for Public Health Education.

  7. Trajectories of glycaemia, insulin sensitivity and insulin secretion in South Asian and white individuals before diagnosis of type 2 diabetes

    DEFF Research Database (Denmark)

    Hulman, Adam; Simmons, Rebecca K; Brunner, Eric J

    2017-01-01

    AIMS/HYPOTHESIS: South Asian individuals have reduced insulin sensitivity and increased risk of type 2 diabetes compared with white individuals. Temporal changes in glycaemic traits during middle age suggest that impaired insulin secretion is a particular feature of diabetes development among South...... Asians. We therefore aimed to examine ethnic differences in early changes in glucose metabolism prior to incident type 2 diabetes. METHODS: In a prospective British occupational cohort, subject to 5 yearly clinical examinations, we examined ethnic differences in trajectories of fasting plasma glucose...... (FPG), 2 h post-load plasma glucose (2hPG), fasting serum insulin (FSI), 2 h post-load serum insulin (2hSI), HOMA of insulin sensitivity (HOMA2-S) and secretion (HOMA2-B), and the Gutt insulin sensitivity index (ISI0,120) among 120 South Asian and 867 white participants who developed diabetes during...

  8. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Feedback Toggle navigation About IHS Agency Overview Annual Budget Eligibility Event Calendar Indian Health Manual Key Leaders ... Office of Urban Indian Health Programs - 08E65C Accessibility Budget Contact Information Disclaimer Download Plug-Ins EEO/No ...

  9. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... quick one-page downloadable and mobile device-friendly reference to guide A1C target and medication selection at ... Indian/Alaska Native communities. IHS Headquarters, Indian Health Service, 5600 Fishers Lane, Rockville, MD 20857 - Find a ...

  10. Comparative studies on Indian traditional nanomedicine Yashadha Bhasma and zinc oxide nanoparticles for anti-diabetic activity

    Science.gov (United States)

    Durgalakshmi, D.; Ajay Rakkesh, R.; Bhargavi Ram, T.; Balakumar, S.

    2017-07-01

    Diabetes mellitus is the most common endocrine disorder due to carbohydrate metabolism. Also, zinc and its supplements have been used in Indian traditional medicines for treating urinary tract infections. In this work, an attempt has been made to compare the properties of ‘Yashadha Bhasma’ a traditional ayurvedic ZnO supplement for diabetic treatment with the laboratory-synthesized ZnO nanoparticles. The nano-sized ZnO particles are synthesized using co-precipitation method and calcined at 400 °C for further purification. Confirmation of ZnO and presence of Ca and K elements additional to Zn in Yashadha Bhasma is confirmed from XPS. The morphology of ZnO is found to be spherical with average diameter of 15 nm. TEM results show that ZnO rods of Yashadha Bhasma are porous and non-uniform. Glucose degradation studies revealed good performance with ZnO nanoparticles with 80% degradation occurring within 15 min itself. Antibacterial studies also performed well establishing efficacy of ZnO nanoparticles against both gram-positive and gram-negative bacterial strains, thereby establishing suitable material for treating diabetes mellitus and also curing bacterial wound infections arising due to diabetes mellitus.

  11. Changing food habits in a South Indian Hindu Brahmin community: a case of transitioning gender roles and family dynamics.

    Science.gov (United States)

    Mahadevan, Meena; Blair, Dorothy; Raines, Emily Rose

    2014-01-01

    This study was conducted to explore the perceptions of 20 South Indian Hindu Brahmin women on the factors influencing their food habits upon immigrating to America. The competing demands of juggling a new career and managing their family's nutritional needs at the same time, all without the support of extended family members, played an important role in steering these women away from cooking traditional healthy meals, and resorting to fast foods instead. Intervention strategies should be directed toward improving the barriers to eating healthy that were specifically identified within the confines of shifting gender roles and limited family support networks.

  12. Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

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    Nombeko Mshunqane

    2012-10-01

    Full Text Available Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive thatpatients should know to control their disease well.Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care team about the services given to patients.Method: Qualitative data were collected using two focus groups and in-depth interviews. Patient focus group (n = 10 explored patients’ knowledge about management of type 2 diabetes. Patients were recruited from Dr George Mukhari Hospital outpatients’ diabetes clinic. Professional focus group (n = 8 explored the health care team’s experiences, barriers and facilitators in managing the disease. Professional focus group participants were recruited because of their expertise in chronic disease management, working in the community (public health or working directly with patients with type 2 diabetes. Five health care professionals were interviewed using the same guide of questions as for the focus group.Results: Participants identified type 2 diabetes as a chronic disease that needs behaviour change for good control. Five major themes were identified: patients’ knowledge; education programmes; behaviour change; support; and a patient-centred approach.Conclusion: Management of type 2 diabetes may be enhanced by reinforcing patients’ knowledge, encouraging behaviour change whilst taking into consideration patients’ backgrounds. The health care team needs to utilise a patient-centred approach.

  13. Angiotensin-converting enzyme gene insertion/deletion polymorphism studies in Asian Indian pregnant women biochemically identifies gestational diabetes mellitus.

    Science.gov (United States)

    Khan, Imran A; Jahan, Parveen; Hasan, Qurratulain; Rao, Pragna

    2014-12-01

    Gestational diabetes mellitus (GDM) is defined as glucose intolerance first recognized during pregnancy. Insertion/deletion (I/D) polymorphism of a 287 bp Alu repetitive sequence in intron 16 of the angiotensin-converting enzyme (ACE) gene has been widely investigated in Asian Indian populations with different ethnic origins. The present study examined possible association between I/D polymorphism of the ACE gene and GDM in Asian Indian pregnant women. A total of 200 pregnant women (100 GDM and 100 non-GDM) were recruited in this study and I/D polymorphism of a 287 bp Alu1 element inside intron 16 of the ACE gene was examined by polymerase chain reaction (PCR)-based gel electrophoresis. The distribution of the variants like II, ID, and DD genotypes of ACE gene showed differences between normal GDM versus non-GDM subjects, and the frequency of the ID+ DD Vs II genotype was significant (p=0.0002) in the GDM group. ACE gene polymorphism was associated with GDM in Asian Indian pregnant women. © The Author(s) 2013.

  14. ABCC8 R1420H Loss-of-Function Variant in a Southwest American Indian Community: Association With Increased Birth Weight and Doubled Risk of Type 2 Diabetes.

    Science.gov (United States)

    Baier, Leslie J; Muller, Yunhua Li; Remedi, Maria Sara; Traurig, Michael; Piaggi, Paolo; Wiessner, Gregory; Huang, Ke; Stacy, Alyssa; Kobes, Sayuko; Krakoff, Jonathan; Bennett, Peter H; Nelson, Robert G; Knowler, William C; Hanson, Robert L; Nichols, Colin G; Bogardus, Clifton

    2015-12-01

    Missense variants in KCNJ11 and ABCC8, which encode the KIR6.2 and SUR1 subunits of the β-cell KATP channel, have previously been implicated in type 2 diabetes, neonatal diabetes, and hyperinsulinemic hypoglycemia of infancy (HHI). To determine whether variation in these genes affects risk for type 2 diabetes or increased birth weight as a consequence of fetal hyperinsulinemia in Pima Indians, missense and common noncoding variants were analyzed in individuals living in the Gila River Indian Community. A R1420H variant in SUR1 (ABCC8) was identified in 3.3% of the population (N = 7,710). R1420H carriers had higher mean birth weights and a twofold increased risk for type 2 diabetes with a 7-year earlier onset age despite being leaner than noncarriers. One individual homozygous for R1420H was identified; retrospective review of his medical records was consistent with HHI and a diagnosis of diabetes at age 3.5 years. In vitro studies showed that the R1420H substitution decreases KATP channel activity. Identification of this loss-of-function variant in ABCC8 with a carrier frequency of 3.3% affects clinical care as homozygous inheritance and potential HHI will occur in 1/3,600 births in this American Indian population. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  15. Hypertension and Diabetes Mellitus: A Preliminary South African Health Promotion Activity Using Service-Learning Principles.

    Science.gov (United States)

    Srinivas, Sunitha C; Paphitis, Sharli Anne

    2016-06-01

    A marked increase in the chronic non-communicable diseases such as hypertension and diabetes mellitus in the South African population is in concert with global trends. A health promotion activity carried out by pharmacy students for school learners during the Sasol National Festival of Science and Technology (SciFest) in South Africa was used as a service-learning opportunity. Pilot tested quizzes on hypertension and diabetes were used to determine the level of knowledge of attendees before and after taking the computer based quiz. Posters, information leaflets and interactive models on these two conditions were also used to reach out to the larger population. Of the 203 participants for the hypertension quiz, 169 completed both the pre- and post-intervention quizzes. Similarly, 86 of the 104 participants for the diabetes quiz, completed both the pre- and post-intervention quizzes. The results show that the post-intervention quiz resulted in a significant increase in the scores from 78.2 to 85.6 % in the case of Hypertension while a marginal increase from 94.2 to 95.5 % was obtained in the case of diabetes. The knowledge of the SciFest attendees with regard to both conditions is above average and improved further after the educational intervention. Health promotion activities which include interactive educational methods and culturally appropriate materials carried out by pharmacy students during service-learning courses are important for improving the awareness on the prevention of these chronic health conditions. Heath promotion service-learning courses can assist in addressing the health care gaps which arise because of a lack of co-ordinated efforts between NGO's and local Government to address the prevention and management of non-communicable diseases such as hypertension and diabetes mellitus.

  16. Long-term efficacy of liraglutide in Indian patients with Type 2 diabetes in a real-world setting

    Directory of Open Access Journals (Sweden)

    Parjeet Kaur

    2016-01-01

    Full Text Available Background: Long-term efficacy of liraglutide, a glucagon-like peptide-1 analog, on body weight and glycemic control has not been studied in Indian Type 2 diabetes mellitus (T2DM subjects. Aim: To evaluate the effect of liraglutide on glycemic control and body weight for 1 year in Indian T2DM patients. Methods: Liraglutide was prescribed to 96 obese patients with T2DM and followed up for 1 year. Clinical parameters were measured at baseline and 3, 6, 9, and 12 months. Dosage of liraglutide and other medications was adjusted according to clinical judgment. Results: 1 year data were available for 74 patients. Mean age was 50.9 ± 9.6 years. Mean duration of diabetes was 11.6 ± 6.3 years. Glycosylated hemoglobin (HbA1c significantly decreased from 8.9 ± 1.3% at baseline to 7.4 ± 1.2% at 1 year. Body weight significantly declined from 98.9 ± 16.0 kg at baseline to 93.8 ± 15.0 kg at 1 year. After an initial decline, subset of patients had an increase in mean HbA1c (n = 30/74 and mean body weight (n = 33/74 after 6 months of liraglutide initiation. Baseline HbA1c and baseline body weight were positively associated with a reduction of HbA1c and body weight at 1 year, respectively. No major side effects occurred. Conclusion: Liraglutide treatment resulted in a significant and sustained reduction in HbA1c and body weight over 1 year in Indian T2DM patients. Magnitude of reduction of HbA1c and body weight at 1 year was positively associated with baseline HbA1c and baseline weight, respectively.

  17. Recruiting South Asians to a lifestyle intervention trial: experiences and lessons from PODOSA (Prevention of Diabetes & Obesity in South Asians

    Directory of Open Access Journals (Sweden)

    Tuomilehto Jaakko

    2011-10-01

    Full Text Available Abstract Background Despite the growing emphasis on the inclusion of ethnic minority patients in research, there is little published on the recruitment of these populations especially to randomised, community based, lifestyle intervention trials in the UK. Methods We share our experience of recruitment to screening in the PODOSA (Prevention of Diabetes and Obesity in South Asians trial, which screened 1319 recruits (target 1800 for trial eligibility. A multi-pronged recruitment approach was used. Enrolment via the National Health Service included direct referrals from health care professionals and written invitations via general practices. Recruitment within the community was carried out by both the research team and through our partnerships with local South Asian groups and organisations. Participants were encouraged to refer friends and family throughout the recruitment period. Results Health care professionals referred only 55 potential participants. The response to written invitations via general practitioners was 5.2%, lower than reported in other general populations. Community orientated, personal approaches for recruitment were comparatively effective yielding 1728 referrals (82% to the screening stage. Conclusions The PODOSA experience shows that a community orientated, personal approach for recruiting South Asian ethnic minority populations can be successful in a trial setting. We recommend that consideration is given to cover recruitment costs associated with community engagement and other personalised approaches. Researchers should consider prioritising approaches that minimise interference with professionals' work and, particularly in the current economic climate, keep costs to a minimum. The lessons learned in PODOSA should contribute to future community based trials in South Asians. Trial Registration Current Controlled Trials ISRCTN25729565

  18. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Prevention Division of Diabetes Treatment and Prevention About Us Training IHS Diabetes Audit Clinician Resources Audit/SOS Login Education Materials and Resources (Online Catalog) Contact Us Special ...

  19. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Diabetes LISTSERV to receive updates on training opportunities, research, and resources related to diabetes ... Mail Stops Office of Clinical and Preventive Services - 08N34 A&B Office of ...

  20. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... more! Announcing Online Lesson Plan Outlines for Educators New or seasoned educators can use these topic-specific ... diabetes. Check back often for the addition of new diabetes-related topics. New SDPI Fact Sheet Infographic! [ ...

  1. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... often for the addition of new diabetes-related topics. Sunday, June 17, 2018 ... receive updates on training opportunities, research, and resources related to diabetes prevention and treatment ...

  2. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Community Members Diabetes Educator Tools Diabetes Education Lesson Plan Outlines Integrating Case Management Into Your Practice [PDF – ... Toolkit, Program Spotlights, and more! Announcing Online Lesson Plan Outlines for Educators New or seasoned educators can ...

  3. 75 FR 16142 - FY 2010 Special Diabetes Program for Indians Community-Directed Grant Program

    Science.gov (United States)

    2010-03-31

    ... older had diagnosed diabetes (unpublished IHS Diabetes Program Statistics, 2006) compared to 7.8% for... the delinquency is attributable to the failure of the grantee organization or the individual...

  4. 75 FR 1389 - FY 2010 Special Diabetes Program for Indians Community-Directed Grant Program

    Science.gov (United States)

    2010-01-11

    ... or older had diagnosed diabetes (unpublished IHS Diabetes Program Statistics, 2006) compared to 7.8... applies whether the delinquency is attributable to the failure of the grantee organization or the...

  5. Immigration and dietary patterns in South Asian Canadians at risk for diabetes.

    Science.gov (United States)

    Kandola, Kirandeep; Sandhu, Supna; Tang, Tricia

    To examine the relationship between immigration and dietary patterns among South Asian adults at risk for diabetes and living in Canada. We recruited 428 South Asian adults affiliated with Sikh and Hindu temples in Metro Vancouver. Of the total sample, 422 completed self-report surveys including demographic background information, and two brief food screeners (fruit/vegetable/fiber intake and fat intake). Food screeners were culturally tailored to include traditional foods consumed in the South Asian community. Multiple linear regressions examined the relationship between diet and immigration. All models were adjusted for age, sex, marital status, education, income, and employment. Participants reported low levels of meat, fruit and vegetable consumption. Intake of whole milk products, traditional South Asian desserts and snacks were relatively high in comparison to other fat-containing food items. Specific trends in diet were seen in relation to time following immigration with the longer duration of years living in Canada the greater consumption of fruit/vegetable/fiber, non-starchy vegetables, total fat and meat reported; and lower intake of whole milk. Acculturation appears to influence some dietary patterns in our sample of South Asian Canadian adults. These findings should be considered when designing culturally tailored lifestyle modification interventions for this community. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Pesticide concentrations in wetlands on the Lake Traverse Indian Reservation, South and North Dakota, July 2015

    Science.gov (United States)

    Carter, Janet M.; Thompson, Ryan F.

    2016-05-04

    During July 2015, water samples were collected from 18 wetlands on the Lake Traverse Indian Reservation in northeastern South Dakota and southeastern North Dakota and analyzed for physical properties and 54 pesticides. This study by the U.S. Geological Survey in cooperation with the Sisseton-Wahpeton Oyate was designed to provide an update on pesticide concentrations of the same 18 wetlands that were sampled for a reconnaissance-level assessment during July 2006. The purpose of this report is to present the results of the assessment of pesticide concentrations in selected Lake Traverse Indian Reservation wetlands during July 2015 and provide a comparison of pesticide concentrations between 2006 and 2015.Of the 54 pesticides that were analyzed for in the samples collected during July 2015, 47 pesticides were not detected in any samples. Seven pesticides—2-chloro-4-isopropylamino-6-amino-s-triazine (CIAT); 2,4–D; acetachlor; atrazine; glyphosate; metolachlor; and prometon—were detected in the 2015 samples with estimated concentrations or concentrations greater than the laboratory reporting level, and most pesticides were detected at low concentrations in only a few samples. Samples from all wetlands contained at least one detected pesticide. The maximum number of pesticides detected in a wetland sample was six, and the median number of pesticides detected was three.The most commonly detected pesticides in the 2015 samples were atrazine and the atrazine degradate CIAT (also known as deethylatrazine), which were detected in 14 and 13 of the wetlands sampled, respectively. Glyphosate was detected in samples from 11 wetlands, and metolachlor was detected in samples from 10 wetlands. The other detected pesticides were 2,4–D (4 wetlands), acetochlor (3 wetlands), and prometon (1 wetland).The same pesticides that were detected in the 2006 samples were detected in the 2015 samples, with the exception of simazine, which was detected only in one sample in 2006

  7. Clinical, immunologic and insulin secretory characteristics of young black South African patients with diabetes: Hospital based single centre study.

    Science.gov (United States)

    Ekpebegh, C O; Longo-Mbenza, B

    2013-03-01

    To classify and characterize the clinical features of various diabetes classes among young black South Africans. Cross sectional study of 60 black patients with diabetes, all less than 30 years of age and attending Nelson Mandela Academic Hospital, Mthatha, South Africa. Diabetes was classified as Types 1A, 1B and 2 based on the anti-glutamic acid decarboxylase status and serum C-peptide response to intravenous injection of glucagon. Mean age was 19.6±4.8 years (n=60) with similar gender distribution. The mean duration of diabetes was 24.2±45.1 months. Type 1A was the class of diabetes in 55% (n=33/60) of patients. Type 1B and 2 accounted for 30% (n=18/60) and 15% (n=9/60) of patients respectively. Patients classified as Type 2 had higher waist circumference and higher prevalence of acanthosis nigricans than Types 1A and 1B groups. History of diabetes in a first degree relative and hypertension were found in similar proportions of patients with Types 1A, 1B and 2 diabetes. Five Type 1A diabetes patients had body mass index of 26.2-41kg/m(2) and this included two newly diagnosed patients with body mass index of 26.7kg/m(2) and 33.2kg/m(2). The majority of our young black South Africans with diabetes are of the Type 1A class. Acanthosis nigricans was not found in any patient with Type 1 A diabetes. A minority of Type 1 A diabetes patients were obese at initial diagnosis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Vulnerability of teleosts caught by the pelagic tuna longline fleets in South Atlantic and Western Indian Oceans

    Science.gov (United States)

    Lucena-Frédou, Flávia; Kell, Laurie; Frédou, Thierry; Gaertner, Daniel; Potier, Michel; Bach, Pascal; Travassos, Paulo; Hazin, Fábio; Ménard, Frédéric

    2017-06-01

    Productivity and Susceptibility Analysis (PSA) is a methodology for evaluating the vulnerability of a stock based on its biological productivity and susceptibility to fishing. In this study, we evaluated the vulnerability of 60 stocks of tuna, billfishes and other teleosts caught by the tuna longline fleets operating in the South Atlantic and Indian Ocean using a semi-quantitative PSA. We (a) evaluated the vulnerability of the species in the study areas; (b) compared the vulnerability of target and non-target species and oceans; (c) analyzed the sensitivity of data entry; and (d) compared the results of the PSA to other fully quantitative assessment methods. Istiophoridae exhibited the highest scores for vulnerability. The top 10 species at risk were: Atlantic Istiophorus albicans; Indian Ocean Istiompax indica; Atlantic Makaira nigricans and Thunnus alalunga; Indian Ocean Xiphias gladius; Atlantic T. albacares, Gempylus serpens, Ranzania laevis and X. gladius; and Indian Ocean T. alalunga. All species considered at high risk were targeted or were commercialized bycatch, except for the Atlantic G. serpens and R. laevis which were discarded, and may be considered as a false positive. Those species and others at high risk should be prioritized for further assessment and/or data collection. Most species at moderate risk were bycatch species kept for sale. Conversely, species classified at low risk were mostly discarded. Overall, species at high risk were overfished and/or subjected to overfishing. Moreover, all species considered to be within extinction risk (Critically Endangered, Endangered and Vulnerable) were in the high-risk category. The good concordance between approaches corroborates the results of our analysis. PSA is not a replacement for traditional stock assessments, where a stock is assessed at regular intervals to provide management advice. It is of importance, however, where there is uncertainty about catches and life history parameters, since it can

  9. Constraints faced by urban poor in managing diabetes care: patients’ perspectives from South India

    Directory of Open Access Journals (Sweden)

    Upendra Bhojani

    2013-10-01

    Full Text Available Background: Four out of five adults with diabetes live in low- and middle-income countries (LMIC. India has the second highest number of diabetes patients in the world. Despite a huge burden, diabetes care remains suboptimal. While patients (and families play an important role in managing chronic conditions, there is a dearth of studies in LMIC and virtually none in India capturing perspectives and experiences of patients in regard to diabetes care. Objective: The objective of this study was to better understand constraints faced by patients from urban slums in managing care for type 2 diabetes in India. Design: We conducted in-depth interviews, using a phenomenological approach, with 16 type 2- diabetes patients from a poor urban neighbourhood in South India. These patients were selected with the help of four community health workers (CHWs and were interviewed by two trained researchers exploring patients’ experiences of living with and seeking care for diabetes. The sampling followed the principle of saturation. Data were initially coded using the NVivo software. Emerging themes were periodically discussed among the researchers and were refined over time through an iterative process using a mind-mapping tool. Results: Despite an abundance of healthcare facilities in the vicinity, diabetes patients faced several constraints in accessing healthcare such as financial hardship, negative attitudes and inadequate communication by healthcare providers and a fragmented healthcare service system offering inadequate care. Strongly defined gender-based family roles disadvantaged women by restricting their mobility and autonomy to access healthcare. The prevailing nuclear family structure and inter-generational conflicts limited support and care for elderly adults. Conclusions: There is a need to strengthen primary care services with a special focus on improving the availability and integration of health services for diabetes at the community level

  10. Endothelial nitric oxide synthase gene haplotypes and diabetic nephropathy among Asian Indians

    DEFF Research Database (Denmark)

    Ahluwalia, Tarun Veer Singh; Ahuja, Monica; Rai, Taranjit Singh

    2008-01-01

    of the constitutive endothelial nitric oxide synthase gene (eNOS) polymorphisms with type 2 diabetic nephropathy. We genotyped three polymorphisms of eNOS (Two SNPs: -786T > C, 894G > T and one 27-bp repeat polymorphism in Intron 4 (27VNTR)) in type 2 diabetic nephropathy patients (cases: n = 195) and type 2 diabetic...... without nephropathy (controls: n = 255), using validated PCR-RFLP assays. We measured serum NO levels in these subjects and examined its correlation with diabetic nephropathy and eNOS genotypes. The frequency of CC (-786T > C), TT (894G > T) and aa genotypes (27VNTR) were significantly higher in diabetic...

  11. Traditional and western medicine: cultural beliefs and practices of South African Indian Muslims with regard to stroke.

    Science.gov (United States)

    Bham, Zaheerah; Ross, Eleanor

    2005-01-01

    To investigate the beliefs of caregivers and traditional healers within the South African Indian Muslim community regarding the etiology and treatment of stroke and the persons likely to be consulted in this regard. A descriptive case study design was employed which incorporated two groups and was located within a qualitative paradigm. Data were collected within the homes of caregivers and the consulting rooms of traditional healers. Ten caregivers of persons who had sustained strokes and 10 traditional healers were interviewed. Individual interviews were held with participants. Responses to semi-structured interview schedules were analyzed using thematic content analysis and descriptive statistics. For both groups, religion and faith in God played a pertinent role in beliefs regarding etiology of illnesses such as stroke. Caregivers used a combination of traditional and Western medicine approaches. For traditional healers, treatment was based on the premise of restoring the balance between hot and cold in the body, which had been placed in disequilibrium by the stroke. Participants expressed disillusionment with referrals to Western healthcare professionals whose treatment was often regarded as culturally inappropriate. They also emphasized the integral role played by family members in the treatment of illness and disease. Results have implications for: culturally sensitive management of stroke patients in the South African Indian Muslim community; collaboration between Western and traditional healers; involvement of families in the remediation process; and further research.

  12. Role of Endothelial Nitric Oxide Synthase Gene Polymorphisms in Predicting Aneurysmal Subarachnoid Hemorrhage in South Indian Patients

    Directory of Open Access Journals (Sweden)

    Linda Koshy

    2008-01-01

    Full Text Available Endothelial nitric oxide synthase (eNOS gene polymorphisms have been implicated as predisposing genetic factors that can predict aneurysmal subarachnoid hemorrhage (aSAH, but with controversial results from different populations. Using a case-control study design, we tested the hypothesis whether variants in eNOS gene can increase risk of aSAH among South Indian patients, either independently, or by interacting with other risk factors of the disease. We enrolled 122 patients, along with 224 ethnically matched controls. We screened the intron-4 27-bp VNTR, the promoter T-786C and the exon-7 G894T SNPs in the eNOS gene. We found marked interethnic differences in the genotype distribution of eNOS variants when comparing the South Indian population with the reported frequencies from Caucasian and Japanese populations. Genotype distributions in control and patient populations were found to be in Hardy-Weinberg equilibrium. In patients, the allele, genotype and estimated haplotype frequencies did not differ significantly from the controls. Multiple logistic regression indicated hypertension and smoking as risk factors for the disease, however the risk alleles did not have any interaction with these risk factors. Although the eNOS polymorphisms were not found to be a likely risk factor for aSAH, the role of factors such as ethnicity, gender, smoking and hypertension should be evaluated cautiously to understand the genotype to phenotype conversion.

  13. A study of cranial variations based on craniometric indices in a South Indian population.

    Science.gov (United States)

    Kanchan, Tanuj; Krishan, Kewal; Gupta, Anadi; Acharya, Jenash

    2014-09-01

    Human skull has been the most extensively studied bone for establishing the taxonomies at evolutionary levels. Crania are also the most commonly used skeletal elements in population studies because they are known to be more genetically driven and less affected by environmental factors. The craniofacial indices are considered as clinical anthropometric parameters used in the investigation of craniofacial skeletal deformities and brain development. The present research is an attempt to study the cranial indices in the South Indian population. The sample for the study included 118 dry adult crania. All the osteometric measurements were taken using standard anthropometric instruments, and 3 indices, namely, cranial index, orbital index (OI), and index of foreman magnum (FMI), were calculated. Cranial index is calculated as (maximum cranial breadth / maximum cranial length) × 100, OI as (orbital height / orbital breadth) × 100, and FMI as (transverse diameter / anteroposterior diameter) × 100. The crania were further classified based on these indices. The cranial index ranged between 66.67 and 85.71 (mean, 78.57 [SD, 4.11]), the OI ranged between 68.89 and 102.63 (mean, 84.23 [SD, 6.64]), and the FMI ranged between 68.57 and 96.88 (mean, 79.71 [SD, 6.98]). Cranial index did not show any significant correlation with the OI (r = -0.162, P = 0.081) or the FMI (r = -0.045, P = 0.626). A statistically significant correlation was, however, observed between OI and FMI (r = -0.232, P = 0.012). The current study developed population-specific classification of crania using cranial indices. This craniometric baseline data pertaining to the craniofacial indices may be useful in presurgical planning and the postsurgical evaluation. It may also assist the forensic anthropologists in the categorization of human skulls, which may be an important component in identification of highly decomposed dead bodies and skeletal remains. More such studies need to be conducted to understand the

  14. Outcomes of cataract surgery in a rural and urban south Indian population

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    Vijaya Lingam

    2010-01-01

    Full Text Available Purpose: To assess the visual outcome after cataract surgery in a south Indian population. Materials and Methods: Population-based cross-sectional study of subjects aged 40 years or more. Three thousand nine hundred and twenty-four rural subjects from 27 contiguous villages and 3850 urban subjects from five randomly selected divisions were studied. All subjects underwent a comprehensive ophthalmic examination that included visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated retinal examination. Statistical Analysis: Chi square test, t test and multivariate analysis were used. Results: Five hundred and twenty-eight (216 males, 312 females, 781 eyes rural subjects (13.5%, 95% confidence interval (CI 12.4% to 14.6% and 406 (197 males, 209 females, 604 eyes urban subjects (10.5%, 95% CI 9.6-11.5% had undergone cataract surgery. Outcome of cataract surgery was defined based on visual acuity. Using best-corrected visual acuity for classification, the single most important cause for visual impairment was cystoid macular edema in the aphakic group and posterior capsule opacification in the pseudophakic group. Aphakia (visual acuity of < 20/60 to ≤ 20/400 - odds ratio (OR 1.8; 95% CI 1.3 to 2.6%, visual acuity of < 20/400 - OR 6.2; 95% 4.0 to 9.8%, rural residence (visual acuity of < 20/60 to ≤ 20/400 - OR 3.2; 95% CI 2.2 to 4.5% and visual acuity of < 20/400 - OR OR 3.5; 95% CI 2.3 to 5.5% were associated with visual impairment. The urban cataract-operated population had significantly more pseudophakics ( P < 0.001, men ( P = 0.02 and literates ( P < 0.001. In the rural group the prevalence of cataract surgery (13.5% vs. 10.5%, P < 0.001 and number of people that had undergone cataract surgery within three years prior to examination ( P < 0.001 were significantly greater. In 30% of rural and 16% of urban subjects uncorrected refraction was the cause of visual impairment. Conclusions: Surgery

  15. Clinical profile and treatment outcome of febrile infection-related epilepsy syndrome in South Indian children

    Directory of Open Access Journals (Sweden)

    Sandeep B Patil

    2016-01-01

    Full Text Available Purpose: To describe the clinical features and outcome of febrile infection-related epilepsy syndrome (FIRES, a catastrophic epileptic encephalopathy, in a cohort of South Indian children. Materials and Methods: We performed a retrospective chart review of a cohort of children with previously normal development who presented with status epilepticus or encephalopathy with recurrent seizures following a nonspecific febrile illness during the period between January 2007 and January 2012. They were divided into two groups super refractory status epilepticus (SRSE and refractory status epilepticus (RSE depending on the duration and severity of the seizures. Key Findings: Fifteen children who met the inclusion criteria were included for the final analysis. The age of the children at presentation ranged 3-15 years (median 6.3 years. All the children presented with prolonged or recurrent seizures occurring 1-12 days (median 4 days after the onset of fever. Eight children had SRSE while seven children had refractory seizures with encephalopathy. Cerebrospinal fluid (CSF analysis was done in all the children in the acute phase, and the cell count ranged 0-12 cells/μL (median 2 cells/μL with normal sugar and protein levels. Initial neuroimaging done in all children (MRI in 10 and CT in 5, and it was normal in 13 children. Treatment modalities included multiple antiepileptic drugs (AEDs (4-9 drugs (median 5 drugs. Midazolam (MDZ infusion was administered in seven patients. Eight patients required barbiturate coma to suppress the seizure activity. The duration of the barbiturate coma ranged 2-90 days (median 3 days. Steroids were used in 14 children and intravenous immunoglobulin (2 g/kg in 7 children. Three children died in the acute phase. All children were maintained on multiple AEDs till the last follow-up, the number of AEDs ranged 1-6 (median 5 AEDs. The patients with super refractory status in the acute phase were found to be more severely disabled

  16. A STUDY ON FEMORAL ANTEVERSION IN ADULT DRY FEMORA OF SOUTH INDIAN POPULATION

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    Sushma Korukonda

    2017-01-01

    Full Text Available BACKGROUND Femoral Neck Anteversion (FNA is an important parameter for diagnosis of gait abnormality in children, risk of various congenital and acquired orthopaedic disorders as well as corrective osteotomy and hip arthroplasty. Femoral anteversion is the lateral rotation of the neck of the femur to the long axis of its shaft. Variability in FNA has been reported and is due to torsional forces applied on femur during development. The aim of this study was to estimate the angle of anteversion of femur in both genders on both sides. The present study was an attempt to provide baseline data of FNA in South Indian population, in particular, Andhra Pradesh. MATERIALS AND METHODS The study was conducted mechanically on 70 dried adult unpaired human femora, i.e. 48 male and 22 female bones. The Kingsley Olmsted 1 method was used for the study and the data was analysed. Statistical analysis - Statistical analysis was done using student unpaired ‘t’ test. The data was analysed using GraphPad Prism 5.0 (Free Trial Version. RESULTS Out of the 70 femora undertaken, mean value of FNA obtained in male is 15.95, 14.1 on right and 17.8 on left sides and in female it is 19.2, 21.8 on right and 16.6 on left side. Statistical analysis revealed significant (p < 0.05 greater average anteversion in female bones and right-left variations being greater on the left side. CONCLUSION In the present study, the mean FNA was 17.8 deg. There was a gender variation for the FNA values in the population studied with females showing higher value than the male with a statistically significant difference. The reason for the difference obtained could be the small sample size of female femora due to the rarity of the donated female bodies. The value was higher on the left side than the right; 50% of the femora had the range of 16 - 25 deg of FNA. The overall mean of femoral anteversion determined is very much different from the studies in various regions in India.

  17. CYP2D6 genotype and phenotype relationship in South Indians

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    Naveen A

    2006-01-01

    Full Text Available Background : Genotypes of the drug-metabolizing enzyme CYP2D6 influence plasma levels of 25% of commonlyprescribed drugs. This is the first study in India to investigate the genotype-phenotype relationship of CYP2D6. Aim : To study the influence of some CYP2D6 genotypes on the metabolism of its substrate dextromethorphanin healthy South Indian volunteers and to assess the contribution of the CYP2D6FNx0110 and CYP2D6FNx014 alleles. Materials and Methods : Twenty-six subjects from a previous CYP2D6 genotyping study of healthy volunteerswere included for phenotyping in this study. Selected volunteers belonged to any one of three genotype groups:Group I - two normal activity alleles, Group II - one reduced activity allele and one normal activity allele andGroup III - one loss of function allele along with either a wild type or reduced activity allele. Volunteers werephenotyped for the CYP2D6 enzyme using dextromethorphan as probe drug. Concentrations of the parent drugand metabolite dextrorphan were estimated using high performance liquid chromatography. Metabolic ratioswere calculated as the ratio of parent drug to metabolite in 0-8h urine samples. Statistical Analysis : Metabolic ratios from each genotype group were compared using the Mann-Whitney testat 5% significance, to observe their difference between genotype groups. Results : The mean metabolic ratios±SD in Groups I, II and III were 0.0039±0.0031, 0.0032±0.0017 and0.0391±0.0331 respectively. The mean metabolic ratio of Group III was significantly higher when comparedwith Groups I or II. In heterozygous individuals, the FNx011 or FNx012 alleles compensated for the reduced enzymeactivity due to the FNx0110 allele. However, if a heterozygous individual had a FNx014 allele, the reduced enzyme activitycould not be compensated by the FNx011 or FNx012 alleles. Conclusions : The CYP2D6 enzyme activity was found to be decreased in individuals carrying FNx014 or FNx015 alleles.The FNx011 or FNx

  18. Modernization of the Indian Air Force: Security Implications for South Asia

    National Research Council Canada - National Science Library

    2005-01-01

    This thesis analyzes the Indian Air Force's (IAF) robust modernization campaign and explores why the IAF is on the path to transforming itself from an air force dedicated to air defense to one capable of global force projection...

  19. Impact of service quality management (SQM) practices on Indian railways : study of South Central Railways.

    Science.gov (United States)

    2010-09-01

    The main objective of this study is to present a framework developed for assisting Railways to monitor and : control the quality of services provided to passengers. The study evaluated the passenger Rail Service quality of : Indian Railways by develo...

  20. Foot Kinetics and Kinematics Profile in Type 2 Diabetes Mellitus with Peripheral Neuropathy: A Hospital Based Study from South India.

    Science.gov (United States)

    Hazari, Animesh; Maiya, Arun G; N, Shivashankara K

    2018-02-01

    A kinetic change in thefoot like altered plantar pressure is the most common etiological risk factor for causing foot ulcers among people with diabetes mellitus. Kinematic alterations in joint angle and spatiotemporal parameters of the gait have also been frequently observed in participants with diabetes peripheral neuropathy. Diabetes peripheral neuropathy is the most common long-term standing complication of type 2 diabetes mellitus. It leads to various micro and macrovascular related complication of the foot. There is a gap in theliteraturefor biomechanical evaluation and assessment in type 2 diabetes mellitus with peripheral neuropathy in Indian population. The aim of the study was to assess and determine the biomechanical changes including kinetics and kinematics of foot among diabetic peripheral neuropathy. The cross-sectional study was conducted at Diabetic Foot Clinic, Kasturba Hospital, Manipal University, Manipal, Karnataka, India. A total of 120 participants with type 2 diabetes mellitus and peripheral neuropathywere recruited under the purposive sampling method. Participants with any active ulceration or amputation were excluded from the study. The mean age, height, weight, body mass index, duration of diabetes was 57±14 year, 164±11cm, 61±18kg, 24± 3, 12±7 year respectively. There were significant changes in overall biomechanical profile along with clinical manifestations of diabetes peripheral neuropathy.The regression analysis showed statistical significance for dynamic maximum plantar pressure at forefoot with age, weight, height, duration of diabetes, body mass index, knee & ankle joint angle at toe-off phase of gait cycle,pinprick sensation and ankle reflex (R=.71,R =.55, F (12, 108)=521.9 kPa, p=.002) Conclusions: From the present study, we conclude that people with type 2 diabetes mellitus and peripheral neuropathy have significant changes in their foot kinetics and kinematicsparameters. Therefore, they could be at higher risk of foot

  1. Serum Lipoprotein (a Levels in Black South African Type 2 Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Jim Joseph

    2016-01-01

    Full Text Available Lipoprotein (a (Lp(a which is a low-density lipoprotein-like particle containing apo(a is considered as an emergent cardiovascular risk factor. Type 2 diabetes mellitus (T2DM is associated with a two- to threefold increase in the risk of cardiovascular disease (CVD. The aim of this study was to investigate the levels of Lp(a in Black South African T2DM patients and its association with other metabolic factors. 67 T2DM patients and 48 healthy control participants were recruited for the cross-sectional study. The Lp(a level was determined by ELISA and the result was analyzed using SPSS. The Lp(a level in diabetics was found to be significantly increased (P=0.001 when compared to the normal healthy group. In the diabetic group, the Lp(a levels correlated significantly with the duration of diabetes (P=0.008 and oxidized LDL (ox-LDL levels (P=0.03 and decreased total antioxidant capacity (P=0.001. The third tertile of Lp(a was significantly correlated with increased ox-LDL, C-reactive protein, and triglycerides and decreased total antioxidant capacity.

  2. Diabetes self-management education in South Auckland, New Zealand, 2007-2008.

    Science.gov (United States)

    Silva, Martha; Clinton, Janet; Appleton, Sarah; Flanagan, Pat

    2011-03-01

    Self-management education programs seek to help patients realize that they are their own principal caregivers and that health care professionals are consultants who support them in this role. The aim of this study was to evaluate a diabetes self-management education program implemented as part of a district-wide approach in South Auckland, New Zealand, which has some of the highest prevalence rates for diabetes and is one of the most ethnically diverse and deprived regions of New Zealand. Self-management attitudes and behaviors were monitored with the use of questionnaires before and after program implementation. Clinical outcomes such as hemoglobin A1c, body mass index, and blood pressure were also tracked before the program began and 3 months after the program ended. Participant focus groups and facilitator interviews were conducted to explore perceptions of the program. Participants showed improvement in attitudes toward their own ability to manage their diabetes; in diet, physical activity, and foot care; and in hemoglobin A1c levels 3 months after the end of participation. Participants also reduced their sense of isolation when dealing with their diabetes. However, catering to the needs of a multiethnic community is extremely resource-intensive because of the need to provide adequate language and cultural interpretation. Self-management education can work in multiethnic, high-needs communities in New Zealand. Programs must ensure they enable the appropriate mechanisms and have appropriate resources to support the community's needs.

  3. Pelagic ecology of the South West Indian Ocean Ridge seamounts: Introduction and overview

    Science.gov (United States)

    Rogers, A. D.

    2017-02-01

    The Indian Ocean was described by Behrman (1981) as the "Forlorn Ocean", a region neglected by science up to the late-1950s. For example, the Challenger Expedition from 1872 to 1876 largely avoided the Indian Ocean, sailing from Cape Town into Antarctic waters sampling around the Prince Edward Islands, Kerguelen Island and Crozet Islands before heading to Melbourne. From 1876 to the 1950s there were expeditions on several vessels including the Valdivia, Gauss and Planet (Germany), the Snellius (Netherlands), Discovery II, MahaBiss (United Kingdom), Albatross (Sweden), Dana and Galathea (Denmark; Behrman, 1981). There was no coordination between these efforts and overall the Indian Ocean, especially the deep sea remained perhaps the most poorly explored of the world's oceans. This situation was largely behind the multilateral effort represented by the International Indian Ocean Expedition (IIEO), which was coordinated by the Scientific Committee for Ocean Research (SCOR), and which ran from 1959-1965. Work during this expedition focused on the Arabian Sea, the area to the northwest of Australia and the waters over the continental shelves and slopes of coastal states in the region. Subsequently several large-scale international oceanographic programmes have included significant components in the Indian Ocean, including the Joint Global Ocean Flux Study (JGOFS) and the World Ocean Circulation Experiment (WOCE). These studies were focused on physical oceanographic measurements and biogeochemistry and whilst the Indian Ocean is still less understood than other large oceans it is now integrated into the major ocean observation systems (Talley et al., 2011). This cannot be said for many aspects of the biology of the region, despite the fact that the Indian Ocean is one of the places where exploitation of marine living resources is still growing (FAO, 2016). The biology of the deep Indian Ocean outside of the Arabian Sea is particularly poorly understood given the presence

  4. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... R S T U V W X Y Z # Employee Resources Feedback Toggle navigation About IHS Agency Overview Annual Budget Eligibility Event Calendar Indian Health Manual Key Leaders Legislation Organizational Structure Our Employees ...

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  9. Population pharmacokinetic modeling of glibenclamide in poorly controlled South African type 2 diabetic subjects

    Directory of Open Access Journals (Sweden)

    Rambiritch V

    2016-07-01

    Full Text Available Virendra Rambiritch,1 Poobalan Naidoo,2 Breminand Maharaj,1 Goonaseelan Pillai3 1University of KwaZulu-Natal, Durban, 2Department of Internal Medicine, RK Khan Regional Hospital, Chatsworth, South Africa; 3Novartis Pharma AG, Basel, Switzerland Aim: The aim of this study was to describe the pharmacokinetics (PK of glibenclamide in poorly controlled South African type 2 diabetic subjects using noncompartmental and model-based methods. Methods: A total of 24 subjects with type 2 diabetes were administered increasing doses (0 mg/d, 2.5 mg/d, 5 mg/d, 10 mg/d, and 20 mg/d of glibenclamide daily at 2-week intervals. Plasma glibenclamide, glucose, and insulin determinations were performed. Blood sampling times were 0 minute, 30 minutes, 60 minutes, 90 minutes, and 120 minutes (post breakfast sampling and 240 minutes, 270 minutes, 300 minutes, 330 minutes, 360 minutes, and 420 minutes (post lunch sampling on days 14, 28, 42, 56, and 70 for doses of 0 mg, 2.5 mg, 5.0 mg, 10 mg, and 20 mg, respectively. Blood sampling was performed after the steady state was reached.  A total of 24 individuals in the data set contributed to a total of 841 observation records. The PK was analyzed using noncompartmental analysis methods, which were implemented in WinNonLin®, and population PK analysis using NONMEM®. Glibenclamide concentration data were log transformed prior to fitting. Results: A two-compartmental disposition model was selected after evaluating one-, two-, and three-compartmental models to describe the time course of glibenclamide plasma concentration data. The one-compartment model adequately described the data; however, the two-compartment model provided a better fit. The three-compartment model failed to achieve successful convergence. A more complex model, to account for enterohepatic recirculation that was observed in the data, was unsuccessful. Conclusion: In South African diabetic subjects, glibenclamide demonstrates linear PK and was best

  10. Analysis of SLC16A11 Variants in 12,811 American Indians: Genotype-Obesity Interaction for Type 2 Diabetes and an Association With RNASEK Expression.

    Science.gov (United States)

    Traurig, Michael; Hanson, Robert L; Marinelarena, Alejandra; Kobes, Sayuko; Piaggi, Paolo; Cole, Shelley; Curran, Joanne E; Blangero, John; Göring, Harald; Kumar, Satish; Nelson, Robert G; Howard, Barbara V; Knowler, William C; Baier, Leslie J; Bogardus, Clifton

    2016-02-01

    Genetic variants in SLC16A11 were recently reported to be associated with type 2 diabetes in Mexican and other Latin American populations. The diabetes risk haplotype had a frequency of 50% in Native Americans from Mexico but was rare in Europeans and Africans. In the current study, we analyzed SLC16A11 in 12,811 North American Indians and found that the diabetes risk haplotype, tagged by the rs75493593 A allele, was nominally associated with type 2 diabetes (P = 0.001, odds ratio 1.11). However, there was a strong interaction with BMI (P = 5.1 × 10(-7)) such that the diabetes association was stronger in leaner individuals. rs75493593 was also strongly associated with BMI in individuals with type 2 diabetes (P = 3.4 × 10(-15)) but not in individuals without diabetes (P = 0.77). Longitudinal analyses suggest that this is due, in part, to an association of the A allele with greater weight loss following diabetes onset (P = 0.02). Analyses of global gene expression data from adipose tissue, skeletal muscle, and whole blood provide evidence that rs75493593 is associated with expression of the nearby RNASEK gene, suggesting that RNASEK expression may mediate the effect of genotype on diabetes. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  11. Illness beliefs and the sociocultural context of diabetes self-management in British South Asians: a mixed methods study.

    Science.gov (United States)

    Patel, Neesha R; Chew-Graham, Carolyn; Bundy, Christine; Kennedy, Anne; Blickem, Christian; Reeves, David

    2015-05-10

    British South Asians have a higher incidence of diabetes and poorer health outcomes compared to the general UK population. Beliefs about diabetes are known to play an important role in self-management, yet little is known about the sociocultural context in shaping beliefs. This study aimed to explore the influence of sociocultural context on illness beliefs and diabetes self-management in British South Asians. A mixed methods approach was used. 67 participants recruited using random and purposive sampling, completed a questionnaire measuring illness beliefs, fatalism, health outcomes and demographics; 37 participants completed a social network survey interview and semi-structured interviews. Results were analysed using SPSS and thematic analysis. Quantitative data found certain social network characteristics (emotional and illness work) were related to perceived concern, emotional distress and health outcomes (p work remained a significant predictor of perceived concern and emotional distress related to diabetes (p culturally appropriate interventions to modify beliefs and support self-management in this population.

  12. Phylogeny and colonization history of Pringlea antiscorbutica (Brassicaceae), an emblematic endemic from the South Indian Ocean Province.

    Science.gov (United States)

    Bartish, Igor V; Aïnouche, Abdelkader; Jia, Dongrui; Bergstrom, Dana; Chown, Steven L; Winkworth, Richard C; Hennion, Françoise

    2012-11-01

    The origins and evolution of sub-Antarctic island floras are not well understood. In particular there is uncertainty about the ages of the contemporary floras and the ultimate origins of the lineages they contain. Pringlea R. Br. (Brassicaceae) is a monotypic genus endemic to four sub-Antarctic island groups in the southern Indian Ocean. Here we used sequences from both the chloroplast and nuclear genomes to examine the phylogenetic position of this enigmatic genus. Our analyses confirm that Pringlea falls within the tribe Thelypodieae and provide a preliminary view of its relationships within the group. Divergence time estimates and ancestral area reconstructions imply Pringlea diverged from a South American ancestor ~5 Myr ago. It remains unclear whether the ancestor of Pringlea dispersed directly to the South Indian Ocean Province (SIOP) or used Antarctica as a stepping-stone; what is clear, however, is that following arrival in the SIOP several additional long-distance dispersal events must be inferred to explain the current distribution of this species. Our analyses also suggest that although Pringlea is likely to have inherited cold tolerance from its closest relatives, the distinctive morphology of this species evolved only after it split from the South American lineage. More generally, our results lend support to the hypothesis that angiosperms persisted on the sub-Antarctic islands throughout the Pliocene and Pleistocene. Taken together with evidence from other sub-Antarctic island plant groups, they suggest the extant flora of sub-Antarctic is likely to have been assembled over a broad time period and from lineages with distinctive biogeographic histories. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Assessment of two versions of regional climate model in simulating the Indian Summer Monsoon over South Asia CORDEX domain

    Science.gov (United States)

    Pattnayak, K. C.; Panda, S. K.; Saraswat, Vaishali; Dash, S. K.

    2018-04-01

    This study assess the performance of two versions of Regional Climate Model (RegCM) in simulating the Indian summer monsoon over South Asia for the period 1998 to 2003 with an aim of conducting future climate change simulations. Two sets of experiments were carried out with two different versions of RegCM (viz. RegCM4.2 and RegCM4.3) with the lateral boundary forcings provided from European Center for Medium Range Weather Forecast Reanalysis (ERA-interim) at 50 km horizontal resolution. The major updates in RegCM4.3 in comparison to the older version RegCM4.2 are the inclusion of measured solar irradiance in place of hardcoded solar constant and additional layers in the stratosphere. The analysis shows that the Indian summer monsoon rainfall, moisture flux and surface net downward shortwave flux are better represented in RegCM4.3 than that in the RegCM4.2 simulations. Excessive moisture flux in the RegCM4.2 simulation over the northern Arabian Sea and Peninsular India resulted in an overestimation of rainfall over the Western Ghats, Peninsular region as a result of which the all India rainfall has been overestimated. RegCM4.3 has performed well over India as a whole as well as its four rainfall homogenous zones in reproducing the mean monsoon rainfall and inter-annual variation of rainfall. Further, the monsoon onset, low-level Somali Jet and the upper level tropical easterly jet are better represented in the RegCM4.3 than RegCM4.2. Thus, RegCM4.3 has performed better in simulating the mean summer monsoon circulation over the South Asia. Hence, RegCM4.3 may be used to study the future climate change over the South Asia.

  14. Screening in Primary Care for Diabetic Retinopathy, Maculopathy and Visual Loss in South Africa.

    Science.gov (United States)

    Webb, Elizabeth M; Rheeder, Paul; Roux, Polla

    2016-01-01

    The aim of the study was to determine the prevalence of diabetic retinopathy, maculopathy and visual loss in primary care patients and to identify associated risk factors. We conducted a cluster randomised trial at primary care clinics in the Tshwane district in South Africa. Grades of retinopathy and maculopathy (with fundus camera) and visual acuity (Snellen chart) were assessed and, using mobile screening and teleophthalmology, clinical and biochemical testing was conducted to obtain information about glycaemic control and microvascular complications. The prevalence rates for any retinopathy, preproliferative retinopathy and proliferative retinopathy were 24.9, 19.5 and 5.5%, respectively. The prevalence rates of diabetic maculopathy, observable maculopathy and referable maculopathy were 20.8, 11.8 and 9.0%, respectively. The presence of retinopathy was associated with high body mass index, systolic blood pressure, being on insulin treatment, high HbA1c and the presence of neuropathy. High systolic blood pressure, being on insulin treatment, high HbA1c level and high low-density lipoprotein cholesterol level as well as the presence of albuminuria were significant in predicting any diabetic maculopathy. Laser photocoagulation was given to 8.3% of patients from the mobile unit and 12% of patients were referred to the nearest hospital with an outpatient eye clinic for follow-up treatment of various other eye conditions. Using the WHO categories, the study found that 78.1% of diabetes patients had normal vision, 19.3% were visually impaired and 2.2% were severely impaired or blind. High prevalence rates for diabetic retinopathy, maculopathy and visual loss were found and associations were identified. © 2016 S. Karger AG, Basel.

  15. Health system challenges in organizing quality diabetes care for urban poor in South India.

    Science.gov (United States)

    Bhojani, Upendra; Devedasan, Narayanan; Mishra, Arima; De Henauw, Stefaan; Kolsteren, Patrick; Criel, Bart

    2014-01-01

    Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes and other chronic conditions.

  16. Health system challenges in organizing quality diabetes care for urban poor in South India.

    Directory of Open Access Journals (Sweden)

    Upendra Bhojani

    Full Text Available BACKGROUND: Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. METHODS: We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. RESULT: There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. CONCLUSIONS: Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes

  17. Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages

    OpenAIRE

    Manyema, Mercy; Veerman, J. Lennert; Chola, Lumbwe; Tugendhaft, Aviva; Labadarios, Demetre; Hofman, Karen

    2015-01-01

    Introduction Type 2 diabetes poses an increasing public health burden in South Africa (SA) with obesity as the main driver of the epidemic. Consumption of sugar sweetened beverages (SSBs) is linked to weight gain and reducing SSB consumption may significantly impact the prevalence of obesity and related diseases. We estimated the effect of a 20% SSB tax on the burden of diabetes in SA. Methods and Findings We constructed a life table-based model in Microsoft Excel (2010). Consumption data fro...

  18. Socio-economic, environmental and nutritional characteristics of urban and rural South Indian women in early pregnancy: findings from the South Asian Birth Cohort (START).

    Science.gov (United States)

    Dwarkanath, Pratibha; Vasudevan, Anil; Thomas, Tinku; Anand, Sonia S; Desai, Dipika; Gupta, Milan; Menezes, Gladys; Kurpad, Anura V; Srinivasan, Krishnamachari

    2018-06-01

    High frequency of low birth weight (LBW) is observed in rural compared with urban Indian women. Since maternal BMI is known to be associated with pregnancy outcomes, the present study aimed to investigate factors associated with BMI in early pregnancy of urban and rural South Indian women. Prospective observational cohort. A hospital-based study conducted at an urban and a rural health centre in Karnataka State. Pregnant women (n 843) aged 18-40 years recruited in early pregnancy from whom detailed sociodemographic, environmental, anthropometric and dietary intake information was collected. A high proportion of low BMI (32 v. 26 %, Pwomen were younger, had lower body weight, tended to be shorter and less educated. They lived in poor housing conditions, had less access to piped water and good sanitation, used unrefined fuel for cooking and had lower standard of living score. The age (β=0·21, 95 % CI 0·14, 0·29), education level of their spouse (β=1·36, 95 % CI 0·71, 2·71) and fat intake (β=1·24, 95 % CI 0·20, 2·28) were positively associated with BMI in urban women. Our findings indicate that risk factors associated with BMI in early pregnancy are different in rural and urban settings. It is important to study population-specific risk factors in relation to perinatal health.

  19. An exploration of culture, diabetes, and nursing in the South Asian community: a metasynthesis of qualitative studies.

    Science.gov (United States)

    Fleming, Elizabeth; Gillibrand, Warren

    2009-04-01

    South Asian people are often perceived as a homogenous group whose culture is prescriptive and constraining. A metasynthesis of how culture influences diabetes self-management in the context of a South Asian population was undertaken. Theory explication was used to deconstruct and reconceptualize the findings of the studies. Eleven publications reported themes of health beliefs, individuality, context, and shared experiences. The results indicate that culture does not influence diabetes self-management in a rigid and prescriptive way; instead, individuals negotiate and interpret culture in a shifting and diverse context. An individualized approach to delivering culturally appropriate nursing care should be taken.

  20. Determinants of inhalant (whitener) use among street children in a South Indian city.

    Science.gov (United States)

    Praveen, Devarsetty; Maulik, Pallab K; Raghavendra, Bellara; Khan, Maseer; Guggilla, Rama K; Bhatia, Prakash

    2012-08-01

    A cross-sectional study was conducted in the year 2008 among 174 children in observation homes in Hyderabad, India, to estimate the distribution of inhalant (whitener) use among this population. Data were collected using an instrument developed for this purpose. About 61% of the children were boys and their mean age was 12.2 years (range 5-18 years). Whitener use was found in 35% of the children along with concurrent use of other substances. Peer pressure was the commonest cause reported for initiating substance use. The high prevalence is an important concern for the Indian policymakers given the large number of street children in Indian cities.

  1. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Available! Check out the updated "Glucose Management in Type 2 Diabetes" Algorithm, a quick one-page downloadable and mobile ... Upcoming Live CME/CE Education June 21 st @ 2 pm EDT Breastfeeding and Depression Dr. Kathleen ... the IHS Diabetes LISTSERV to receive updates on training opportunities, research, ...

  2. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... to create and implement lesson plans for educating patients with diabetes. Check back often for the addition of new diabetes-related topics. Monday, May 28, 2018 Upcoming Events Upcoming Live CME/CE Education June 21 st @ 2 pm EDT Breastfeeding and ...

  3. Usefulness of Estimation of Glycated Albumin and Glycosylated Haemoglobin in Indian Diabetic Chronic Kidney Disease Patients

    Directory of Open Access Journals (Sweden)

    Kumaresan Ramanathan

    2014-09-01

    CONCLUSION: GA estimation is a useful marker in assessment of short term glycemic control in stage III & IV (< 30 ml/min/1.73m2 diabetic CKD patients. GA: HbA1c ratio if routinely done may also become a useful marker in Diabetic CKD population in future.

  4. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Tools Diabetes Education Lesson Plan Outlines Integrating Case Management Into Your Practice [PDF – 290 KB] Integrating DSMES Into Your Practice [PDF – 275 KB] In the Spotlight Save the Date! 2019 Diabetes ... Updated Glucose Management Algorithm Now Available! Check out the updated "Glucose ...

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    Full Text Available ... Training and Resources CME/CE – Live and On Demand IHS Diabetes Standards of Care Diabetes Treatment Algorithms ... Office of Human Resources - 11E53A Office of Information Technology - 07E57B Office of Management Services - 09E70 Office of ...

  6. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... out the updated "Glucose Management in Type 2 Diabetes" Algorithm, a quick one-page downloadable and mobile device-friendly reference to guide A1C target and medication selection at the point of patient care. ... emotional journey with diabetes through a cultural perspective. This re-printed book ...

  7. Prevalence of ultrasonography proved polycystic ovaries in North Indian women with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Laway Bashir A

    2005-08-01

    Full Text Available Abstract Background Polycystic ovaries (PCO and their clinical expression (the polycystic ovary syndrome [PCOS] as well as type 2 diabetes mellitus (T2DM are common medical conditions linked through insulin resistance. We studied the prevalence of PCO and PCOS in women with diet and/or oral hypoglycemic treated T2DM and non-diabetic control women. Design Prospective study. Methods One hundred and five reproductive age group women with diet and /or oral hypoglycemic treated T2DM were the subjects of the study. Sixty age-matched non-diabetic women served as controls. Transabdominal ultrasonographic assessment of the ovaries was used to diagnose PCO. Clinical, biochemical and hormonal parameters were also noted. Results Ultrasonographic prevalence of PCO was higher in women with diabetes than in non-diabetic subjects (61.0% vs. 36.7%, P 0.1. Diabetic women with PCO had diabetes of significantly longer duration than those without PCO (4.19±2.0 versus 2.9±1.6 yrs; p Conclusion This study demonstrates a higher prevalence of PCO in women with T2DM as compared to non-diabetic subjects.

  8. Perceived experiences of discrimination in health care: a barrier for cancer screening among American Indian women with type 2 diabetes.

    Science.gov (United States)

    Gonzales, Kelly L; Harding, Anna K; Lambert, William E; Fu, Rongwei; Henderson, William G

    2013-01-01

    Breast and cervical cancer-mortality disparities are prominent among American Indian women. These disparities, in part, may result from patients perceived experiences of discrimination in health care. This report evaluates the impact of perceived discrimination on screening for breast and cervical cancer in a sample of 200 American Indian women with type 2 diabetes. Data were collected from patient report and medical records. Prevalence of breast and cervical cancer screening were assessed. Unadjusted and adjusted logistic regression analyses were used to assess associations between perceived discrimination, cancer screening status, and patients' health care-seeking behaviors. Substantial proportions of AI women in our sample were behind the recommended schedules of screening for breast and cervical cancer. Adjusted estimates revealed that perceived discrimination was significantly associated with not being current for clinical breast examination and Pap test, and was close to statistical significance with not being current for mammography. The number of suboptimal health care-seeking behaviors increased with higher mean levels of perceived discrimination. Among AI women, perceived discrimination in health care may negatively influence use of breast and cancer screening services, and health care-seeking behaviors. More research is needed among AIs to examine features of health care systems related to the phenomenon patients perceived experience of discrimination. Copyright © 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  9. Analysis of SLC16A11 Variants in 12,811 American Indians: Genotype-Obesity Interaction for Type 2 Diabetes and an Association With RNASEK Expression

    Science.gov (United States)

    Traurig, Michael; Hanson, Robert L.; Marinelarena, Alejandra; Kobes, Sayuko; Piaggi, Paolo; Cole, Shelley; Curran, Joanne E.; Blangero, John; Göring, Harald; Kumar, Satish; Nelson, Robert G.; Howard, Barbara V.; Knowler, William C.; Baier, Leslie J.

    2016-01-01

    Genetic variants in SLC16A11 were recently reported to be associated with type 2 diabetes in Mexican and other Latin American populations. The diabetes risk haplotype had a frequency of 50% in Native Americans from Mexico but was rare in Europeans and Africans. In the current study, we analyzed SLC16A11 in 12,811 North American Indians and found that the diabetes risk haplotype, tagged by the rs75493593 A allele, was nominally associated with type 2 diabetes (P = 0.001, odds ratio 1.11). However, there was a strong interaction with BMI (P = 5.1 × 10−7) such that the diabetes association was stronger in leaner individuals. rs75493593 was also strongly associated with BMI in individuals with type 2 diabetes (P = 3.4 × 10−15) but not in individuals without diabetes (P = 0.77). Longitudinal analyses suggest that this is due, in part, to an association of the A allele with greater weight loss following diabetes onset (P = 0.02). Analyses of global gene expression data from adipose tissue, skeletal muscle, and whole blood provide evidence that rs75493593 is associated with expression of the nearby RNASEK gene, suggesting that RNASEK expression may mediate the effect of genotype on diabetes. PMID:26487785

  10. Age-related proximal femur bone mineral loss in South Indian women: a dual energy X-ray absorptiometry study.

    Science.gov (United States)

    Anburajan, M; Rethinasabapathi, C; Korath, M P; Ponnappa, B G; Kumar, K S; Panicker, T M; Govindan, A; Jagadeesan, G N

    2001-04-01

    i) To collect normative data for proximal femur bone mineral density (BMD) in South Indian women using dual energy X-ray absorptiometry (DXA) and ii) to study the rate and significance of hip bone mineral loss with advancing age in this population. Forty five women, whose age ranged from 16 to 84 years were studied. This sample was drawn randomly from general medical practice at KJ Hospital, Chennai, South India during November, 1997 to April, 1998. Of these 45 cases, 21 were pre-menopausal (mean +/- SD age = 30.9+/-8.8 years) and 24 post-menopausal (mean +/- SD age = 62.1+/-11.0 years). Subjects with secondary bone diseases were excluded. Also excluded were those taking any drugs known to affect calcium metabolism e.g., thiazide diuretics, oestrogen and calcium. Subjects were divided into seven decadal age groups from 15-24 years to 75-84 years. BMD of the right proximal femur was evaluated using a QDR-1000 DXA bone densitometer (Hologic Inc., Waltham, Massachusetts, USA). Data analysis was done with SPSS/PC statistical software package. Linear regression analysis showed significant (p India women have been evaluated and it may prove useful for diagnosing osteoporosis in the women of South India.

  11. Effect of severe obesity in childhood and adolescence on risk of type 2 diabetes in youth and early adulthood in an American Indian population.

    Science.gov (United States)

    Tanamas, Stephanie K; Reddy, Sanil P; Chambers, Melissa A; Clark, Elena J; Dunnigan, Diana L; Hanson, Robert L; Nelson, Robert G; Knowler, William C; Sinha, Madhumita

    2017-12-28

    The risk of early-onset type 2 diabetes associated with the severity of obesity in youth is not well understood. This study aims to determine metabolic alterations and type 2 diabetes risk among American Indian children who are obese or severely obese. Incidence rates of diabetes before 20 years (youth-onset) and 45 years were computed in 2728 children who were from 5 to Obesity was defined as age-sex-adjusted body mass index (BMI) ≥95th percentile, and its severity was quantified as the percentage of the 95th percentile (%BMI p95 ). In the younger cohort, 0.9% of those non-obese and 2.9% of those with 100% to obese and 9.8% of those with 100% to youth-onset diabetes was 3.8 and 4.9/1000 person-years in the child and adolescent cohorts, respectively, and before the age of 45 was 12.3 and 16.8/1000 person-years, respectively. Incidence rates of youth-onset diabetes in those with the most severe obesity (≥140%BMI p95 ) were 2.3 to 5.1 times as high as in those with the least severe obesity (100 to obesity in an American Indian population is a major driver of type 2 diabetes developing in adolescents and young adults. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  12. Determinants of Intravascular Resistance in Indian Diabetic Nephropathy Patients: A Hospital-Based Study

    Directory of Open Access Journals (Sweden)

    Anubhav Thukral

    2011-01-01

    Full Text Available Aims and Objectives. Metabolic dysregulation has failed to explain clinical variability of patients with diabetic nephropathy and hence a renewed interest emerged in haemodynamic factors as determinant of progression and development of diabetic nephropathy. We therefore studied for various factors which can correlate with raised renal vascular resistance in diabetic nephropathy. Material and Methods. Renal vascular resistance was measured in patients with established and incipient diabetic nephropathy and compared with controls using noninvasive color Doppler examinations of intrarenal vasculature. Results. Renal vascular resistance correlated with age, duration of disease, GFR, serum creatinine, and stage of retinopathy. Renal vascular resistance was significantly reduced in patients on treatment with RAAS inhibitors and insulin, than those on OHA and antihypertensives other than RAAS inhibitors. Conclusion. The study implies that renal vascular resistance may help identify diabetics at high risk of developing nephropathy, and these set of patients could be candidates for RAAS inhibition and early insulin therapy even in patients without albuminuria.

  13. Service design attributes affecting diabetic patient preferences of telemedicine in South Korea.

    Science.gov (United States)

    Park, Hayoung; Chon, Yucheong; Lee, Jongsu; Choi, Ie-Jung; Yoon, Kun-Ho

    2011-01-01

    Attempts to introduce telemedicine in South Korea have failed mostly, leaving critical questions for service developers and providers about whether patients would be willing to pay for the service and how the service should be designed to encourage patient buy-in. In this study, we explore patients' valuations and preferences for each attribute of telemedicine service for diabetes management and evaluate patient willingness to pay for specific service attributes. We conducted a conjoint survey to collect data on patients' stated preferences among telemedicine service alternatives. The alternatives for diabetes-related service differed in 10 attributes, including those related to price, type of service provider, and service scope. To estimate the relative importance of attributes, patients' willingness to pay for each attribute, and their probable choice of specific alternatives, we used a rank-ordered logit model. A total of 118 respondents participated in the survey. All 10 attributes significantly affected patients' valuations and preferences, and demographic and disease characteristics, such as existence of complications and comorbidities, significantly affected patients' valuations of the attributes. Price was the most important attribute, followed by comprehensive scope of service, the availability of mobile phone-based delivery, and large general-hospital provided services. The study findings have significant implications for adoption policy and strategy of telemedicine in diabetes management care. Further, the methodology presented in this study can be used to draw knowledge needed to formulate effective policy for adoption of the necessary technology and for the design of services that attract potential beneficiaries.

  14. A prospective study of prevalence and association of peripheral neuropathy in Indian patients with newly diagnosed type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    H K Gill

    2014-01-01

    Full Text Available Background: Diabetic peripheral neuropathy (DPN predisposes to foot ulceration and gangrene. It has been reported that DPN is lower in Indians relative to Caucasians. Studies among recent onset patients with type 2 diabetes mellitus (T2DM are very few. We studied the prevalence and risk factors of DPN in patients with newly diagnosed T2DM. Materials and Methods: We prospectively studied 195 consecutive patients over age 30 with a duration of diabetes ≤6 months. All underwent a clinical and biochemical evaluation and were screened for DPN using Neuropathy Symptom Score (NSS and Neuropathy Disability Score (NDS as well as the vibration perception threshold using a biothesiometer. We compared the prevalence of peripheral neuropathy (PN in 75 age- and sex-matched healthy controls. Results: The cases had a mean age of 47.6 ± 10.2 years (59% males and duration of symptoms of 5.9 ± 8.2 months prior to presentation. The overall prevalence of DPN was 29.2% [95% CI 22.8-35.7]. PN among matched control was 10.7% (95% CI 3.5-17.8. The prevalence of DPN showed an increasing trend with age (trend chi-square 11.8, P = 0.001. Abnormal vibration perception threshold was present in 43.3% (95% CI 36.3-50.3 of cases and had a significant correlation with NDS (P = 0.000. Abnormal monofilament testing was present in 6.1% of cases (95% CI 2.7- 9.5. A logistic regression analysis showed that DPN was independently associated with age (P = 0.002 and duration of diabetes prior to presentation (P = 0.02 but not with body mass index, plasma glucose, or HbA1c. Conclusions: Our study showed high prevalence of PN in recently diagnosed patients with T2DM, which was independently associated with age and duration of symptoms of diabetes prior to the diagnosis. Screening for DPN at diagnosis of diabetes is warranted, especially among older subjects.

  15. Muslim personal law and the meaning of "law" in the South African and Indian constitutions

    OpenAIRE

    Rautenbach, Christa

    1999-01-01

    The Muslim population of South Africa follows a practice which may be referred to as Muslim personal law. Although section 15 of the Constitution of the Republic of South Africa 108 of 1996 recognises religious freedom and makes provision for the future recognition of other personal law systems, Muslim personal law is, at this stage, not formally recognised in terms of South African law. Since Muslim personal law receives no constitutional recognition the question may be asked whether the 199...

  16. Immunohistochemical localization of CYP1A, vitellogenin and Zona radiata proteins in the liver of swordfish (Xiphias gladius L.) taken from the Mediterranean Sea, South Atlantic, South Western Indian and Central North Pacific Oceans

    International Nuclear Information System (INIS)

    Desantis, S.; Corriero, A.; Cirillo, F.; Deflorio, M.; Brill, R.; Griffiths, M.; Lopata, A.L.; Serna, J.M. de la; Bridges, C.R.; Kime, D.E.; De Metrio, G.

    2005-01-01

    Cytochrome P4501A (CYP1A) monoxygenase, vitellogenin (Vtg) and Zona radiata proteins (Zrp) are frequently used as biomarkers of fish exposure to organic contaminants. In this work, swordfish liver sections obtained from the Mediterranean Sea, the South African coasts (South Atlantic and South Western Indian Oceans) and the Central North Pacific Ocean were immunostained with antisera against CYP1A, Zrp, and Vtg. CYP1A induction was found in hepatocytes, epithelium of the biliary ductus and the endothelium of large blood vessels of fish from the Mediterranean Sea and South African waters, but not from the Pacific Ocean. Zrp and Vtg were immunolocalized in hepatocytes of male swordfish from the Mediterranean Sea and from South African waters. Plasma Dot-Blot analysis, performed in Mediterranean and Pacific specimens, revealed the presence of Zrp and Vtg in males from Mediterranean but not from Pacific. These results confirm previous findings about the potential exposure of Mediterranean swordfish to endocrine, disrupting chemicals and raise questions concerning the possible presence of xenobiotic contaminants off the Southern coasts of South Africa in both the South Atlantic and South Western Indian Oceans

  17. Gut Microbial Diversity Assessment of Indian Type-2-Diabetics Reveals Alterations in Eubacteria, Archaea, and Eukaryotes.

    Science.gov (United States)

    Bhute, Shrikant S; Suryavanshi, Mangesh V; Joshi, Suyog M; Yajnik, Chittaranjan S; Shouche, Yogesh S; Ghaskadbi, Saroj S

    2017-01-01

    Diabetes in India has distinct genetic, nutritional, developmental and socio-economic aspects; owing to the fact that changes in gut microbiota are associated with diabetes, we employed semiconductor-based sequencing to characterize gut microbiota of diabetic subjects from this region. We suggest consolidated dysbiosis of eubacterial, archaeal and eukaryotic components in the gut microbiota of newly diagnosed (New-DMs) and long-standing diabetic subjects (Known-DMs) compared to healthy subjects (NGTs). Increased abundance of phylum Firmicutes ( p = 0.010) and Operational Taxonomic Units (OTUs) of Lactobacillus ( p PERMANOVA test indicated that the eubacterial component was associated with diabetes-related risk factors like high triglyceride ( p = 0.05), low HDL ( p = 0.03), and waist-to-hip ratio ( p = 0.02). Metagenomic imputation of eubacteria depict deficiencies of various essential functions such as carbohydrate metabolism, amino acid metabolism etc. in New-DMs subjects. Results presented here shows that in diabetes, microbial dysbiosis may not be just limited to eubacteria. Due to the inter-linked metabolic interactions among the eubacteria, archaea and eukarya in the gut, it may extend into other two domains leading to trans-domain dysbiosis in microbiota. Our results thus contribute to and expand the identification of biomarkers in diabetes.

  18. Gut Microbial Diversity Assessment of Indian Type-2-Diabetics Reveals Alterations in Eubacteria, Archaea, and Eukaryotes

    Science.gov (United States)

    Bhute, Shrikant S.; Suryavanshi, Mangesh V.; Joshi, Suyog M.; Yajnik, Chittaranjan S.; Shouche, Yogesh S.; Ghaskadbi, Saroj S.

    2017-01-01

    Diabetes in India has distinct genetic, nutritional, developmental and socio-economic aspects; owing to the fact that changes in gut microbiota are associated with diabetes, we employed semiconductor-based sequencing to characterize gut microbiota of diabetic subjects from this region. We suggest consolidated dysbiosis of eubacterial, archaeal and eukaryotic components in the gut microbiota of newly diagnosed (New-DMs) and long-standing diabetic subjects (Known-DMs) compared to healthy subjects (NGTs). Increased abundance of phylum Firmicutes (p = 0.010) and Operational Taxonomic Units (OTUs) of Lactobacillus (p PERMANOVA test indicated that the eubacterial component was associated with diabetes-related risk factors like high triglyceride (p = 0.05), low HDL (p = 0.03), and waist-to-hip ratio (p = 0.02). Metagenomic imputation of eubacteria depict deficiencies of various essential functions such as carbohydrate metabolism, amino acid metabolism etc. in New-DMs subjects. Results presented here shows that in diabetes, microbial dysbiosis may not be just limited to eubacteria. Due to the inter-linked metabolic interactions among the eubacteria, archaea and eukarya in the gut, it may extend into other two domains leading to trans-domain dysbiosis in microbiota. Our results thus contribute to and expand the identification of biomarkers in diabetes. PMID:28261173

  19. Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Jayawardena Ranil

    2012-05-01

    Full Text Available Abstract Background Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported. Methods Prevalence data were obtained by searching the Medline® database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic and ‘Epidemology/EP’ (MeSH subheading. Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years. The conjunction of the above results was narrowed down with country names. Results The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural, India–4.6%:12.5% (2007;Rural; Maldives–3.0%:3.7% (2004;National, Nepal–19.5%:9.5% (2007;Urban, Pakistan–3.0%:7.2% (2002;Rural, Sri Lanka–11.5%:10.3% (2005–2006;National. Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%, while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%. Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes. Conclusion A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies .

  20. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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  1. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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  2. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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  3. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... 11E53A Office of Information Technology - 07E57B Office of Management Services - 09E70 Office of Public Health Support - 09E10D Office of Resource Access and Partnerships - 10E85C Office of Tribal Self Governance - 08E05 Office of Urban Indian Health Programs - ...

  4. Gender norms in South Africa: Implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution

    Science.gov (United States)

    Mantell, Joanne E.; Needham, Sarah L.; Smit, Jennifer Ann; Hoffman, Susie; Cebekhulu, Queen; Adams-Skinner, Jessica; Exner, Theresa M.; Mabude, Zonke; Beksinska, Mags; Stein, Zena A.; Milford, Cecilia

    2009-01-01

    In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women’s ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students who are a relatively ‘privileged’ group, there is little information on gender norms that might shape responses to HIV prevention programmes. To elicit gender norms regarding women’s and men’s roles, condom and contraceptive use, sexual communication, and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students so as to understand how norms might be used to buttress HIV and pregnancy prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women’s rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women’s freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women’s protection against unintended pregnancy and HIV/STIs. PMID:19247859

  5. Gender norms in South Africa: implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution.

    Science.gov (United States)

    Mantell, Joanne E; Needham, Sarah L; Smit, Jennifer Ann; Hoffman, Susie; Cebekhulu, Queen; Adams-Skinner, Jessica; Exner, Theresa M; Mabude, Zonke; Beksinska, Mags; Stein, Zena A; Milford, Cecilia

    2009-02-01

    In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women's ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students, who are a relatively 'privileged' group, there is little information on gender norms that might shape responses to HIV-prevention programmes. To elicit gender norms regarding women's and men's roles, condom and contraceptive use, sexual communication and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students in order to understand how norms might be used to buttress HIV- and pregnancy-prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women's rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women's freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women's protection against unintended pregnancy and HIV/STIs.

  6. Association of tinnitus and hearing loss in otological disorders: a decade-long epidemiological study in a South Indian population

    Directory of Open Access Journals (Sweden)

    Santoshi Kumari Manche

    Full Text Available Abstract Introduction: Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern. Tinnitus is often associated with different forms of hearing loss of varying severity. Objective: The present study aimed to identify the association of tinnitus with hearing loss in various otological disorders of a South Indian population. Methods: A total of 3255 subjects referred to the MAA ENT Hospital, Hyderabad, from 2004 to 2014, affected with various otological diseases have been included in the present cross-sectional study. Diagnosis of the diseases was confirmed by an ear, nose, and throat (ENT specialist using detailed medical and clinical examination. Statistical analysis was performed using the χ 2 test and binary logistic regression. Results: Tinnitus was observed in 29.3% (956 of the total study subjects that showed an increased prevalence in greater than 40 years of age. There was a significant increase in risk of tinnitus with middle (OR = 1.79, 95% CI = 1.02-3.16 and inner (OR = 3.00, 95% CI = 1.65-5.45 inner ear diseases. It was noted that 96.9% (n = 927 of the tinnitus subjects was associated with hearing loss. Otitis media (60.9%, presbycusis (16.6% and otosclerosis (14.3% are the very common otological disorders leading to tinnitus. Tinnitus was significantly associated with higher degree of hearing loss in chronic suppurative otitis media (CSOM subjects. Conclusion: The present study could identify the most prevalent otological risk factors leading to development of tinnitus with hearing loss in a South Indian population.

  7. RELATIONSHIP OF ADIPOKINES AND PROINFLAMMATORY CYTOKINES AMONG ASIAN INDIANS WITH OBESITY AND YOUTH ONSET TYPE 2 DIABETES.

    Science.gov (United States)

    Gokulakrishnan, Kuppan; Amutha, Anandakumar; Ranjani, Harish; Bibin, Subramanian Y; Balakumar, Mahalingam; Pandey, Gautam Kumar; Anjana, Ranjit Mohan; Ali, Mohammed K; Narayan, K M Venkat; Mohan, Viswanathan

    2015-10-01

    It is well known that inflammation is associated with diabetes, but it is unclear whether obesity mediates this association in individuals with youth-onset type 2 diabetes mellitus (T2DM-Y). We recruited individuals with T2DM-Y (age at onset obesity and categorized as: nonobese NGT (n = 100), Obese NGT (n = 50), nonobese T2DM-Y (n = 50), and obese T2DM-Y (n = 50). We compared adipokines (adiponectin and leptin) and proinflammatory cytokines (tumor necrosis factor alpha [TNF-α] and monocyte chemotactic protein-1 [MCP-1]) across groups. Compared to nonobese NGT, the other 3 groups (obese NGT, nonobese T2DM-Y, and obese T2DM-Y) were found to have lower adiponectin (7.7 vs. 5.7, 4.2, 3.8 μg/mL, Pobese T2DM-Y (141 pg/mL, Pobese T2DM, respectively. However, adjusted for same factors, leptin, TNF-α, and MCP-1 were associated with markedly higher odds (5- to 14-fold) of nonobese and obese T2DM. In young Asian Indians, leptin and proinflammatory cytokines are positively, and adiponectin negatively, associated with both nonobese and obese T2DM-Y compared to nonobese NGT individuals.

  8. Diabetes mellitus in Zambia and the Western Cape province of South Africa: Prevalence, risk factors, diagnosis and management.

    Science.gov (United States)

    Bailey, Sarah Lou; Ayles, Helen; Beyers, Nulda; Godfrey-Faussett, Peter; Muyoyeta, Monde; du Toit, Elizabeth; Yudkin, John S; Floyd, Sian

    2016-08-01

    To determine the prevalence of and risk factors for diabetes mellitus and examine its diagnosis and management in the study communities. This is a population-based cross-sectional study among adults in 24 communities from Zambia and the Western Cape (WC) province of South Africa. Diabetes is defined as a random blood glucose concentration (RBG)⩾11.1mmol/L, or RBGdiabetes diagnosis. For individuals with a prior diagnosis of diabetes, RBGprevalence of diabetes was 3.5% and 7.2% respectively. The highest risk groups identified were those of older age and those with obesity. Of those identified to have diabetes, 34.5% in Zambia and 12.7% in WC were previously unaware of their diagnosis. Among Zambian participants with diabetes, this proportion was lower among individuals with better education or with higher household socio-economic position. Of all those with previously diagnosed diabetes, 66.0% in Zambia and 59.4% in WC were not on any diabetes treatment, and 34.4% in Zambia and 32.7% in WC had a RBG concentration beyond the recommended level, ⩾7.8mmol/L. The diabetes risk factor profile for our study communities is similar to that seen in high-income populations. A high proportion of individuals with diabetes are not on diabetes treatment and of those on treatment a high proportion have high glycaemic concentrations. Such data may assist in healthcare planning to ensure timely diagnosis and management of diabetes. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  9. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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  10. Epalrestat, an aldose reductase inhibitor, in diabetic neuropathy: An Indian perspective

    Directory of Open Access Journals (Sweden)

    Sharma S

    2008-01-01

    Full Text Available Background: A number of diabetic patients with diabetic neuropathy, in India, were treated with epalrestat, an aldose reductase inhibitor. In this study, more than 2000 patients with diabetic neuropathy, who were treated with epalrestat for 3-12 months, were analyzed to assess the efficacy and the adverse reactions of the drug. Method: We analyzed the subjective symptoms (spontaneous pain, numbness, coldness and hypoesthesia and the nerve function tests (motor nerve conduction velocity, sensory nerve conduction velocity and vibration threshold. Result: The improvement rate of the subjective symptoms was 75% (slightly improved or better and that of the nerve function tests 36%. Adverse drug reactions were encountered in 52 (2.5% of the 2190 patients, none of which was severe. Conclusion: Although data are limited, it is strongly suggested that epalrestat is a highly effective and safe agent for the treatment of diabetic neuropathy.

  11. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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  12. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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    Full Text Available ... Prevention August 6-9, 2019 | Oklahoma City Conference Center | Oklahoma City, OK ... journey with diabetes through a cultural perspective. This re-printed book is updated with ...

  13. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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  16. The South Asian genome.

    Directory of Open Access Journals (Sweden)

    John C Chambers

    Full Text Available The genetic sequence variation of people from the Indian subcontinent who comprise one-quarter of the world's population, is not well described. We carried out whole genome sequencing of 168 South Asians, along with whole-exome sequencing of 147 South Asians to provide deeper characterisation of coding regions. We identify 12,962,155 autosomal sequence variants, including 2,946,861 new SNPs and 312,738 novel indels. This catalogue of SNPs and indels amongst South Asians provides the first comprehensive map of genetic variation in this major human population, and reveals evidence for selective pressures on genes involved in skin biology, metabolism, infection and immunity. Our results will accelerate the search for the genetic variants underlying susceptibility to disorders such as type-2 diabetes and cardiovascular disease which are highly prevalent amongst South Asians.

  17. Glucose tolerance status of Asian Indian women with gestational diabetes at 6weeks to 1year postpartum (WINGS-7).

    Science.gov (United States)

    Bhavadharini, Balaji; Anjana, Ranjit Mohan; Mahalakshmi, Manni Mohanraj; Maheswari, Kumar; Kayal, Arivudainambi; Unnikrishnan, Ranjit; Ranjani, Harish; Ninov, Lyudmil; Pastakia, Sonak D; Usha, Sriram; Malanda, Belma; Belton, Anne; Uma, Ram; Mohan, Viswanathan

    2016-07-01

    To determine postpartum glucose tolerance status among women with gestational diabetes mellitus (GDM) recruited under the Women In India with GDM Strategy (WINGS) Model of Care (MOC). Through the WINGS MOC programme, 212 women with GDM were followed till delivery between November 2013 and August 2015. All women were advised to return for a postpartum oral glucose tolerance test (OGTT) 6-12weeks after delivery. A multivariate logistic regression (MLR) model was developed to identify the risk factors for postpartum dysglycemia which was defined as presence of diabetes (DM) or prediabetes. 203/212(95.8%) women completed their postpartum OGTT. Of the 161 women (79.3%) who came back for the test between 6 and 12weeks, 2(1.2%) developed DM, 5(3.1%), isolated IFG, 13(8.1%), isolated IGT and 5(3.1%) combined IFG/IGT [dysglycemia 25(15.5%)]. 136 women (84.5%) reverted to normal glucose tolerance (NGT). Of the 42 women who came back between 12weeks and a year, 5(11.9%) developed DM, 10(23.8%), isolated IFG and 1(2.4%) combined IFG/IGT [dysglycemia 16(38.1%)]. 26/42 women (61.9%) reverted to NGT. Thus overall dysglycemia occurred in 41/203 women (20.2%). MLR showed that BMI ⩾25kg/m(2) was significantly associated with postpartum dysglycemia (odds ratio: 4.47; 95% confidence interval: 1.8-11.2, p=0.001). Among Asian Indian women with GDM, over 20% develop dysglycemia within one year postpartum, and BMI ⩾25kg/m(2) increased this risk four-fold. Early postpartum screening can identify high risk women and help plan strategies for prevention of type 2 diabetes in the future. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

  18. Prevalence and risk factors for refractive errors in the South Indian adult population: The Andhra Pradesh Eye disease study

    Directory of Open Access Journals (Sweden)

    Sannapaneni Krishnaiah

    2008-12-01

    Full Text Available Sannapaneni Krishnaiah1,2,3, Marmamula Srinivas1,2,3, Rohit C Khanna1,2, Gullapalli N Rao1,2,31L V Prasad Eye Institute, Banjara Hills, Hyderabad, India; 2International Center for Advancement of Rural Eye Care, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India; 3Vision CRC, University of New South Wales, Sydney, NSW, AustraliaAim: To report the prevalence, risk factors and associated population attributable risk percentage (PAR for refractive errors in the South Indian adult population.Methods: A population-based cross-sectional epidemiologic study was conducted in the Indian state of Andhra Pradesh. A multistage cluster, systematic, stratified random sampling method was used to obtain participants (n = 10293 for this study.Results: The age-gender-area-adjusted prevalence rates in those ≥40 years of age were determined for myopia (spherical equivalent [SE] < −0.5 D 34.6% (95% confidence interval [CI]: 33.1–36.1, high-myopia (SE < −5.0 D 4.5% (95% CI: 3.8–5.2, hyperopia (SE > +0.5 D 18.4% (95% CI: 17.1–19.7, astigmatism (cylinder < −0.5 D 37.6% (95% CI: 36–39.2, and anisometropia (SE difference between right and left eyes >0.5 D 13.0% (95% CI: 11.9–14.1. The prevalence of myopia, astigmatism, high-myopia, and anisometropia significantly increased with increasing age (all p < 0.0001. There was no gender difference in prevalence rates in any type of refractive error, though women had a significantly higher rate of hyperopia than men (p < 0.0001. Hyperopia was significantly higher among those with a higher educational level (odds ratio [OR] 2.49; 95% CI: 1.51–3.95 and significantly higher among the hypertensive group (OR 1.24; 95% CI: 1.03–1.49. The severity of lens nuclear opacity was positively associated with myopia and negatively associated with hyperopia.Conclusions: The prevalence of myopia in this adult Indian population is much higher than in similarly aged white populations. These results confirm the previously

  19. Convective lofting links Indian Ocean air pollution to paradoxical South Atlantic ozone maxima

    Science.gov (United States)

    Chatfield, R. B.; Guan, H.; Thompson, A. M.; Witte, J. C.

    2005-01-01

    We describe a broad resolution of the Atlantic Parado concerning the seasonal and geographic distribution, of tropical tropospheric ozone. We highlight periods of significant maximum tropospheric O3 for Jan.- April, 1999, exploiting satellite estimates and SHADOZ (Southern Hemisphere Additional Ozonesondes). Trajectory analyses connecting sondes and Total Tropospheric Ozone (TTO) maps suggest a complex influence from the Indian Ocean: beginning with mixed combustion sources, then low level transport, cumulonimbus venting, possible stratospheric input, and finally high-level transport to the west, with possible mixing over Africa. For the Jan.-March highest column-O3 periods in the Atlantic, distinct sounding peaks trace to specific NO sources, especially lightning, while in the same episodes, recurring every 20-50 days, more diffuse buildups of Indian-to-Atlantic pollution make important contributions.

  20. Barriers to diabetes awareness and self-help are influenced by people's demographics: perspectives of South Asians with type 2 diabetes.

    Science.gov (United States)

    Pardhan, Shahina; Nakafero, Georgina; Raman, Rajiv; Sapkota, Raju

    2018-03-26

    To determine whether barriers to diabetes awareness and self-help differ in South Asian participants of different demographic characteristics (age, gender, and literacy) with type 2 diabetes living in the United Kingdom. Six focus group discussions (FGDs) were carried out in patients who were categorized according to age (30-60 years, ≥60 years), gender (male, female) and literacy status (literate, illiterate). Data were analysed following the iterative process of thematic analysis techniques. Barriers were demographic-specific. The illiterate groups reported language as the major barrier to improved diabetes awareness and self-help. The literate groups reported that information provided by healthcare providers was general, and not specific to their diet/culture. Major barriers to adherence to the recommended diet for diabetes included: insufficient knowledge/awareness about nutritional content of food (all groups); lack of self-will to resist eating sweets, especially during weddings/festivals (literate older groups/literate younger females/illiterate older males); difficulty cooking separate meals for diabetic and non-diabetic family members (illiterate/literate older females). Other barriers to seeking advice/help ranged from not wanting to disclose their diabetes as it may affect employment/work (literate groups) to fear of being singled out at social gatherings (illiterate groups). General lack of motivation to exercise was reported by all groups. Time constraints and not knowing what/how to exercise was reported by literate younger groups whilst the illiterate older groups reported to not having suitable exercising facilities at local communities. Different barriers were also reported when accessing healthcare; language barriers (illiterate groups), restricted access to doctors' appointments/difficulty attending specific appointment slots offered by General Practitioners (literate females). Different barriers exist to improved awareness about diabetes and

  1. Predictors of low diabetes risk perception in a multi-ethnic cohort of women with gestational diabetes mellitus.

    Science.gov (United States)

    Mukerji, G; Kainth, S; Pendrith, C; Lowe, J; Feig, D S; Banerjee, A T; Wu, W; Lipscombe, L L

    2016-10-01

    To determine what proportion of women with gestational diabetes underestimate their diabetes risk and identify factors associated with low diabetes risk perception. Participants included pregnant adult women with gestational diabetes between 2009 and 2012 across seven diabetes clinics in Ontario, Canada. Data were collected through chart review and a survey that included a diabetes risk perception question. Of the 614 of 902 women (68% response rate) with gestational diabetes, 89% correctly responded that gestational diabetes increases the risk for developing diabetes. However, 47.1% of women perceived themselves to be at low risk for developing diabetes within 10 years. On multivariable analysis, BMI gestational diabetes history, absent diabetes family history and absent insulin use were appropriately associated with low diabetes risk perception. However, compared with Caucasian ethnicity, high-risk ethnicity (Aboriginal, Latin American, West Indian, South Asian, Middle Eastern, Filipino, Black, Pacific Islander) [odds ratio (OR) 2.07; 95% CI 1.30-3.31] and East and South East Asian ethnicity (OR 2.01; 1.10-3.67) were associated with low diabetes risk perception. After further adjustment for immigration, only high-risk ethnicity remained a predictor of low diabetes risk perception (OR 1.86; 1.09-3.19), whereas East and South East Asian ethnicity did not (OR 1.67; 0.86-3.22). Although the majority of women recognized gestational diabetes as a risk factor for diabetes, almost half underestimated their personal high diabetes risk despite prenatal care. Furthermore, women from high-risk ethnic groups were more likely to underestimate their risk, even after adjusting for immigration. Interventions tailored to these groups are necessary to enhance perceived diabetes risk. © 2015 Diabetes UK.

  2. Prevalencia de diabetes mellitus e hiperlipidemias en indígenas otomíes Prevalence of diabetes mellitus and hyperlipemias in Otomi indians

    Directory of Open Access Journals (Sweden)

    Claudia Alvarado-Osuna

    2001-10-01

    Full Text Available Objetivo. Determinar prevalencia y factores de riesgo de la diabetes mellitus (DM e hiperlipidemias en un grupo de indígenas otomíes de Querétaro. Material y métodos. Entre 1996 y 1997, en muestreo de conveniencia se trabajó con 91 indígenas, de 15 a 77 años de edad, de las comunidades de Yosphí y El Rincón, del estado de Querétaro, México. Se tomaron muestras sanguíneas en ayuno y se determinó la concentración de glucosa, colesterol y triglicéridos. Se realizó análisis estadístico para comparación entre sexos y grupos de edad. Resultados. La prevalencia de DM fue 4.4%, la de hipercolesterolemia 7.2%, y la de hipertrigliceridemia (HTG 26%. Las concentraciones promedio de glucosa (81.0±24.4 mg/dl y triglicéridos (157.4±88.9 mg/dl se incrementaron significativamente con la edad (p=0.0279 y phttp://www.insp.mx/salud/index.htmlObjective. To determine prevalence and risk factors for diabetes mellitus (DM and hyperlipidemias in a population of Otomi Indians. Material and methods. A cross-sectional study was conducted between 1996 and 1997, in a convenience sample of 91 Otomi Indians, aged 15 to 77 years, in the comunities of Yosphi and El Rincon, Queretaro, Mexico. Fasting blood samples were obtained to measure glucose, cholesterol and triglyceride levels. Results. DM was found in 4.4% of subjects; hypercholesterolemia in 7.6%; and hypertriglyceridemia (HTG in 26%. Mean concentrations of glucose --(81.0±24.4 mg/dl and triglycerides (157.4±88.9 mg/dl increased significantly with age, p=0.0279 and phttp://www.insp.mx/salud/index.html

  3. Alpha-glucosidase inhibitor, acarbose, improves glycamic control and reduces body weight in type 2 diabetes: Findings on indian patients from the pooled data analysis

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2013-01-01

    Full Text Available Alpha-glucosidase inhibitors are widely used especially in Asian countries as a treatment option for type 2 diabetes patients with high postprandial glycemia (PPG. The higher carbohydrate in the Indian diets lead to greater prandial glycemic excursion, increased glucosidase, and incretin activity in the gut and may need special therapeutic strategies to tackle these glucose peaks. This is the subgroup analysis of Indian subjects who participated in the GlucoVIP study that investigated the effectiveness and tolerability of acarbose as add-on or monotherapy in a range of patients with type 2 diabetes mellitus. A total of 1996 Indian patients were included in the effectiveness analysis. After 12.5 weeks (mean, the mean change in 2-hour PPG from baseline was −74.4 mg/dl, mean HbA1c decreased by -1.0%, and mean fasting blood glucose decreased by -37.9 mg/dl. The efficacy of acarbose was rated "very good" or "good" in 91.1% of patients, and tolerability as "very good" or "good" in 88.0% of patients. The results of this observational study suggest that acarbose was effective and well tolerated in the Indian patients with T2DM.

  4. Seabirds indicate changes in the composition of plastic litter in the Atlantic and south-western Indian Oceans.

    Science.gov (United States)

    Ryan, Peter G

    2008-08-01

    I compare plastic ingested by five species of seabirds sampled in the 1980s and again in 1999-2006. The numbers of ingested plastic particles have not changed significantly, but the proportion of virgin pellets has decreased 44-79% in all five species: great shearwater Puffinus gravis, white-chinned petrel Procellaria aequinoctialis, broad-billed prion Pachyptila vittata, white-faced storm petrel Pelagodroma marina and white-bellied storm petrel Fregetta grallaria. The populations sampled range widely in the South Atlantic and western Indian Oceans. The most marked reduction occurred in great shearwaters, where the average number of pellets per bird decreased from 10.5 to 1.6. This species migrates between the South and North Atlantic each year. Similar decreases in virgin pellets have been recorded in short-tailed shearwaters Puffinus tenuirostris in the Pacific Ocean and northern fulmars Fulmarus glacialis in the North Sea. More data are needed on the relationship between plastic loads in seabirds and the density of plastic at sea in their foraging areas, but the consistent decrease in pellets in birds suggests there has been a global change in the composition of small plastic debris at sea over the last two decades.

  5. Atmospheric research in Southern Africa and Indian Ocean: a South Africa-France bilateral collaborative programme

    CSIR Research Space (South Africa)

    Sivakumar, V

    2009-09-01

    Full Text Available to be employed, university or institutes involved and French and South African co-ordinators for investigating the structure and dynamics of the atmosphere by utilising different in-situ, space-borne and model simulation techniques....

  6. Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages.

    Science.gov (United States)

    Manyema, Mercy; Veerman, J Lennert; Chola, Lumbwe; Tugendhaft, Aviva; Labadarios, Demetre; Hofman, Karen

    2015-01-01

    Type 2 diabetes poses an increasing public health burden in South Africa (SA) with obesity as the main driver of the epidemic. Consumption of sugar sweetened beverages (SSBs) is linked to weight gain and reducing SSB consumption may significantly impact the prevalence of obesity and related diseases. We estimated the effect of a 20% SSB tax on the burden of diabetes in SA. We constructed a life table-based model in Microsoft Excel (2010). Consumption data from the 2012 SA National Health and Nutrition Examination Survey, previously published own- and cross-price elasticities of SSBs and energy balance equations were used to estimate changes in daily energy intake and its projected impact on BMI arising from increased SSB prices. Diabetes relative risk and prevalent years lived with disability estimates from the Global Burden of Disease Study and modelled disease epidemiology estimates from a previous study were used to estimate the effect of the BMI changes on diabetes burden. Diabetes cost estimates were obtained from the South African Council for Medical Schemes. Over 20 years, a 20% SSB tax could reduce diabetes incident cases by 106 000 in women (95% uncertainty interval (UI) 70 000-142 000) and by 54 000 in men (95% UI: 33 000-80 000); and prevalence in all adults by 4.0% (95% UI: 2.7%-5.3%). Cumulatively over twenty years, approximately 21 000 (95% UI: 14 000-29 000) adult T2DM-related deaths, 374 000 DALYs attributed to T2DM (95% UI: 299 000-463 000) and over ZAR10 billion T2DM healthcare costs (95% UI: ZAR6.8-14.0 billion) equivalent to USD860 million (95% UI: USD570 million-USD1.2 billion) may be averted. Fiscal policy on SSBs has the potential to mitigate the diabetes epidemic in South Africa and contribute to the National Department of Health goals stated in the National NCD strategic plan.

  7. Factors inhibiting the franchising of Indian fast food stores in South Africa

    OpenAIRE

    2012-01-01

    M.B.A. Franchising systems in South Africa have experienced high and sustained growth over the last decade. The South African government has recognised and supports business format franchising as a low risk way of creating jobs, transferring skills and creating wealth. At the forefront of this growth, is the fast food franchising industry, which is made up of a mix of global brands and a significant few, highly successful, locally founded, franchised operations based on Portuguese or Ameri...

  8. The Effects of growing Indian military potential on South Asian stability

    Science.gov (United States)

    2017-06-09

    POTENTIAL ON SOUTH ASIAN STABILITY , by Major Hashim I. Bajwa, 116 pages. India is emerging as an economic powerhouse and its national power is on...Afghanistan, Nepal, and Myanmar due to the political and economic instability in these countries. He advocates an assertive politico-military outlook for... instability in South Asia to Glen Snyder’s “ stability / instability paradox.” He argues that the “ stability / instability paradox” is still relevant in

  9. Association of TNF promoter polymorphisms with type 1 diabetes in the South Croatian population

    Directory of Open Access Journals (Sweden)

    VESNA BORASKA

    2008-01-01

    Full Text Available Type 1 diabetes mellitus (TIDM is an autoimmune disease characterized by the destruction of pancreatic p cells. Tumor necrosis factor (TNF is a pleotropic cytokine with potent immunomodulatory and inflammatory activity. Association studies of TNF polymorphisms and type 1 diabetes (TIDM frequently demonstrated TNF involvement with TIDM. Although TNF may play an important role in the pathogenesis of TIDM, the genetic association of TNF región with the disease has not been conclusive because of the strong linkage disequilibrium with HLA genes. In this study, we examined two TNF promoter variants (rs 1800629 at position -308, and rs361525 at position -238 for TIDM association in 233 patients and 144 controls from the population of South Croatia. A higher frequency of TNF -308 A alíele and also, a more frequent specific -308A -238G haplotype in TIDM patients were observed with a limited significance. However, we did not find strong evidence of association of TNF promoter polymorphisms with TIDM. In order to elucidate the trae contribution of TNF to TIDM susceptibility in our population, more comprehensive studies with HLA adjustment in a larger sample are required.

  10. Awareness of diabetes amongst undergraduates in a Nigerian University, South West Nigeria

    Directory of Open Access Journals (Sweden)

    Olubukunola Omobuwa

    2014-01-01

    Full Text Available Background: Diabetes mellitus (DM is a disease of global public health importance whose prevention and control may be largely influenced by improved knowledge amongst populations. This study set out to examine the level of awareness, knowledge, and some risk factors for developing DM among students of the Osun State University, Nigeria. Materials and Methods: A descriptive cross-sectional study was conducted amongst students of the Osun State University in South-western Nigeria. Study participants were recruited using multistage sampling technique. A self-administered semi-structured questionnaire was used to obtain information on respondents′ socio-demographics; awareness, knowledge and perception of DM and lifestyle characteristics such as dietary habits, physical activity, use of alcohol, and tobacco smoking. Results: A total of 166 students participated in the study, 75.9% of whom have heard of DM and 40.4% of them correctly defined the condition. Seventy-two (43.4% of the study participants erroneously associated excessive intake of sugar with development of DM. Nearly one-third (30.1% of them did not know any preventive measure for DM. Fourteen (56% of the 25 respondents who had a diabetic relative said the diabetic person was their first degree relative. Sixty-one (36.7% subjects engaged in daily consumption of soft drinks, and only 8.5% engaged in regular physical exercise. Only 6.0% of the participants had ever heard of body mass index (BMI. Conclusion: This study showed high awareness level of DM among participants but the knowledge and attitude toward DM was relatively poor.

  11. Dietary Transition in the South Asian Diaspora: Implications for Diabetes Prevention Strategies.

    Science.gov (United States)

    Parackal, Sherly

    2017-01-01

    South Asians (SA) have a four to five fold higher risk for type 2 diabetes mellitus (T2DM) in comparison to other Asian migrant groups. Dietary patterns have been attributed as an important independent modifiable risk factor. The aim of this review is to document the dietary patterns of SA migrants in Western countries and to summarize the evidence for the association of dietary patterns with T2DM and its predisposing factors. Using key search words articles from 1990 onwards were sourced from MEDLINE Pro- Quest and PubMed (not MEDLINE) databases for this narrative review. A significant shift in meal pattern with frequent dining out and eating fast foods, traditional festival foods and Western desserts and snacks was common among SA. Consumption of potatoes, dairy, oil, meat and fish increased and beans, lentils, fruits and vegetables decreased post-migration. "Animal protein" and "fried snacks, sweets and high-fat dairy" were associated with greater insulin resistance and lower HDL cholesterol. A "mixed" dietary pattern was associated with obesity and hypertension and a "western" dietary pattern was associated with overall risk for Metabolic Syndrome. A 70% increase in the odds of diabetes per standard deviation in gram of protein intake was also observed. Dietary patterns pave the way to develop diabetes and other obesity related diseases among SA as duration of residence increases. The first five years since migration maybe a window of opportunity to provide targeted interventions to ensure maintenance of healthy dietary habits. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  12. Association study of 25 type 2 diabetes related Loci with measures of obesity in Indian sib pairs.

    Science.gov (United States)

    Gupta, Vipin; Vinay, Donipadi Guru; Sovio, Ulla; Rafiq, Sajjad; Kranthi Kumar, Madamchetty Venkata; Janipalli, Charles Spurgeon; Evans, David; Mani, Kulathu Radha; Sandeep, Madana Narasimha; Taylor, Amy; Kinra, Sanjay; Sullivan, Ruth; Bowen, Liza; Timpson, Nicholas; Smith, George Davey; Dudbridge, Frank; Prabhakaran, Dorairaj; Ben-Shlomo, Yoav; Reddy, Kolli Srinath; Ebrahim, Shah; Chandak, Giriraj Ratan

    2013-01-01

    Obesity is an established risk factor for type 2 diabetes (T2D) and they are metabolically related through the mechanism of insulin resistance. In order to explore how common genetic variants associated with T2D correlate with body mass index (BMI), we examined the influence of 25 T2D associated loci on obesity risk. We used 5056 individuals (2528 sib-pairs) recruited in Indian Migration Study and conducted within sib-pair analysis for six obesity phenotypes. We found associations of variants in CXCR4 (rs932206) and HHEX (rs5015480) with higher body mass index (BMI) (β=0.13, p=0.001) and (β=0.09, p=0.002), respectively and weight (β=0.13, p=0.001) and (β=0.09, p=0.001), respectively. CXCR4 variant was also strongly associated with body fat (β=0.10, p=0.0004). In addition, we demonstrated associations of CXCR4 and HHEX with overweight/obesity (OR=1.6, p=0.003) and (OR=1.4, p=0.002), respectively, in 1333 sib-pairs (2666 individuals). We observed marginal evidence of associations between variants at six loci (TCF7L2, NGN3, FOXA2, LOC646279, FLJ39370 and THADA) and waist hip ratio (WHR), BMI and/or overweight which needs to be validated in larger set of samples. All the above findings were independent of daily energy consumption and physical activity level. The risk score estimates based on eight significant loci (including nominal associations) showed associations with WHR and body fat which were independent of BMI. In summary, we establish the role of T2D associated loci in influencing the measures of obesity in Indian population, suggesting common underlying pathophysiology across populations.

  13. Association study of 25 type 2 diabetes related Loci with measures of obesity in Indian sib pairs.

    Directory of Open Access Journals (Sweden)

    Vipin Gupta

    Full Text Available Obesity is an established risk factor for type 2 diabetes (T2D and they are metabolically related through the mechanism of insulin resistance. In order to explore how common genetic variants associated with T2D correlate with body mass index (BMI, we examined the influence of 25 T2D associated loci on obesity risk. We used 5056 individuals (2528 sib-pairs recruited in Indian Migration Study and conducted within sib-pair analysis for six obesity phenotypes. We found associations of variants in CXCR4 (rs932206 and HHEX (rs5015480 with higher body mass index (BMI (β=0.13, p=0.001 and (β=0.09, p=0.002, respectively and weight (β=0.13, p=0.001 and (β=0.09, p=0.001, respectively. CXCR4 variant was also strongly associated with body fat (β=0.10, p=0.0004. In addition, we demonstrated associations of CXCR4 and HHEX with overweight/obesity (OR=1.6, p=0.003 and (OR=1.4, p=0.002, respectively, in 1333 sib-pairs (2666 individuals. We observed marginal evidence of associations between variants at six loci (TCF7L2, NGN3, FOXA2, LOC646279, FLJ39370 and THADA and waist hip ratio (WHR, BMI and/or overweight which needs to be validated in larger set of samples. All the above findings were independent of daily energy consumption and physical activity level. The risk score estimates based on eight significant loci (including nominal associations showed associations with WHR and body fat which were independent of BMI. In summary, we establish the role of T2D associated loci in influencing the measures of obesity in Indian population, suggesting common underlying pathophysiology across populations.

  14. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Available! Check out the updated "Glucose Management in Type 2 Diabetes" Algorithm, a quick one-page downloadable and mobile ... Upcoming Live CME/CE Education June 21 st @ 2 pm EDT Breastfeeding and Depression Dr. Kathleen ... Mail Stops Office of Clinical and Preventive Services - 08N34 A&B Office of ...

  15. Antidiabetic activity of traditional Indian gold containing preparation: Shadguna Balijarita Makaradhwaja on streptozotocin induced diabetic rats.

    Directory of Open Access Journals (Sweden)

    Sanjay Khedekar

    2016-06-01

    Full Text Available Background: Makaradhwaja a gold containing mercurial preparation used for diabetes mellitus in indigenous system of medicine. It is a popular aphrodisiac and rejuvenator traditional medicine. It is prepared by using processed gold, mercury and sulfur in different ratios by applying intermittent heating pattern in Valuka Yantra. Objectives: The aim of study was to evaluate anti-diabetic effect of Shadguna Balijarita Makaradhwaja on Streptozotocin induced diabetic rats. Methods: Diabetes was induced to normal rats by injecting Streptozotocin in dose 40 mg/kg. Powdered Shadguna Balijarita Makaradhwaja and dried extract of Tinospora cordifolia were mixed with honey and administered orally for 20 days at dose 2.63 mg/kg and 42.34 mg/kg body weight respectively. The effects of treatment on body weight changes and blood glucose levels were quantified on Day 1, 5, 10, 15 and 21 of the experiments. On 21st day animals were sacrificed and gross histopathological changes in liver, kidney and pancreas were illustrated. Blood sugar level, Glyacated hemoglobin, blood urea, serum cholesterol, serum creatinine, serum triglyceride, and serum protein were estimated with standard methods. Study was conducted in the year 2011. Results: Test drug observed significant decrease (P [J Complement Med Res 2016; 5(2.000: 162-167

  16. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... of new diabetes-related topics. Sunday, June 10, 2018 Upcoming Events Upcoming Live CME/CE Education June 21 st @ 2 pm EDT Breastfeeding and Depression Dr. Kathleen Kendal-Tackett, PhD, IBCLC, FAPA Health ...

  17. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... the Spotlight "Wit and Wisdom" is Back – Updated Book Now Available! Join Barbara Mora (Paiute/Diné) as ... diabetes through a cultural perspective. This re-printed book is updated with stories and pictures, and is ...

  18. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... patient care. "Wit and Wisdom" is Back – Updated Book Now Available! Join Barbara Mora (Paiute/Diné) as ... diabetes through a cultural perspective. This re-printed book is updated with stories and pictures, and is ...

  19. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Resources webpage . "Wit and Wisdom" is Back – Updated Book Now Available! Join Barbara Mora (Paiute/Diné) as ... diabetes through a cultural perspective. This re-printed book is updated with stories and pictures, and is ...

  20. Glucose patterns during the OGTT and risk of future diabetes in an urban Indian population

    DEFF Research Database (Denmark)

    Hulman, Adam; Gujral, Unjali P; Narayan, K M Venkat

    2017-01-01

    AIMS: Traditionally, fasting and 2-hour post challenge plasma glucose have been used to diagnose diabetes. However, evidence indicates that clinically relevant pathophysiological information can be obtained by adding intermediate time-points to a standard oral glucose tolerance test (OGTT). METHO...

  1. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Diabetes" Algorithm, a quick one-page downloadable and mobile device-friendly reference to guide A1C target and ... Office of Human Resources - 11E53A Office of Information Technology - 07E57B Office of Management Services - 09E70 Office of ...

  2. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... Algorithm, a quick one-page downloadable and mobile device-friendly reference to guide A1C target and medication selection at the point of patient care. "Wit and Wisdom" is Back – Updated Book Now Available! Join Barbara Mora (Paiute/Diné) as she takes you on her emotional journey with diabetes through ...

  3. Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

    Medline Plus

    Full Text Available ... on her emotional journey with diabetes through a cultural perspective. This re-printed book is updated with ... Legislative Affairs Staff - 08E37A Office of the Director/Diversity Management and Equal Employment Opportunity Staff - 08E61 Office ...

  4. The complete genome sequence of a south Indian isolate of Rice tungro spherical virus reveals evidence of genetic recombination between distinct isolates.

    Science.gov (United States)

    Sailaja, B; Anjum, Najreen; Patil, Yogesh K; Agarwal, Surekha; Malathi, P; Krishnaveni, D; Balachandran, S M; Viraktamath, B C; Mangrauthia, Satendra K

    2013-12-01

    In this study, complete genome of a south Indian isolate of Rice tungro spherical virus (RTSV) from Andhra Pradesh (AP) was sequenced, and the predicted amino acid sequence was analysed. The RTSV RNA genome consists of 12,171 nt without the poly(A) tail, encoding a putative typical polyprotein of 3,470 amino acids. Furthermore, cleavage sites and sequence motifs of the polyprotein were predicted. Multiple alignment with other RTSV isolates showed a nucleotide sequence identity of 95% to east Indian isolates and 90% to Philippines isolates. A phylogenetic tree based on complete genome sequence showed that Indian isolates clustered together, while Vt6 and PhilA isolates of Philippines formed two separate clusters. Twelve recombination events were detected in RNA genome of RTSV using the Recombination Detection Program version 3. Recombination analysis suggested significant role of 5' end and central region of genome in virus evolution. Further, AP and Odisha isolates appeared as important RTSV isolates involved in diversification of this virus in India through recombination phenomenon. The new addition of complete genome of first south Indian isolate provided an opportunity to establish the molecular evolution of RTSV through recombination analysis and phylogenetic relationship.

  5. Effect of Indian herbal hypoglycemic agents on antioxidant capacity and trace elements content in diabetic rats.

    Science.gov (United States)

    Chandra, Anu; Mahdi, Abbas Ali; Singh, Raj Kumar; Mahdi, Farzana; Chander, Ramesh

    2008-09-01

    In the present investigation we report the protective potential of some herbal hypoglycemic agents on antioxidant status and levels of metal ions in streptozotocin-induced diabetic rats. Furthermore, in vitro antioxidant activity of the herbs was also evaluated. Induction of diabetes mellitus in rats caused an increase in blood lipid peroxide levels that was associated with the reduced activity of red blood cell (RBC) antioxidant enzymes--namely, superoxide dismutase, catalase, glutathione reductase, and glutathione peroxidase--along with depletion of plasma reduced glutathione (GSH) and copper, zinc, iron, magnesium, and selenium levels. Oral treatment of diabetic rats with Allium sativum, Azadirachta indica, Momordica charantia, and Ocimum sanctum extracts (500 mg/kg of body weight) not only lowered the blood glucose level but also inhibited the formation of lipid peroxides, reactivated the antioxidant enzymes, and restored levels of GSH and metals in the above-mentioned model. The herbal extracts (50-500 microg) inhibited the generation of superoxide anions (O(2)(-.)) in both enzymatic and nonenzymatic in vitro systems. These preparations also inhibited the ferrous-sodium ascorbate-induced formation of lipid peroxides in RBCs. The in vivo and in vitro protective effects of the above-mentioned herbal drugs were also compared with that of glibenclamide. On the basis of our results, we conclude that the above-mentioned herbal plants not only possess hypoglycemic properties, but they also decrease oxidative load in diabetes mellitus. Therefore, we propose that long-term use of such agents might help in the prevention of diabetes-associated complications. However, the extrapolation of these results to humans needs further in-depth study.

  6. Rural Sprawl and the Impact of Human Land Use on the Pine Ridge Indian Reservation, South Dakota

    Science.gov (United States)

    Campbell, R.; Bennett, T.

    2005-12-01

    The most important impact on global land cover is human use and development. With the recent population growth occurring on the reservations in South Dakota, specifically Pine Ridge Indian Reservation, the towns and communities of the reservation are undergoing change. Although urban sprawl certainly is not a consideration on the reservations, the population explosion currently underway has seen a subsequent increase in rural sprawl. In this case, rural sprawl is defined as exponential population growth and geographic expansion of remote reservation communities. The capacity of satellite imagery to encompass large land tracts make the use of this technology a cost effective way to visualize and investigate population growth in rural communities. Likewise, integrating remotely sensed data into a Geographic Information Systems (GIS) can be a powerful tool to identify environmental and other land use issues that impact the people and communities in and around the Pine Ridge area. The objective of this research is to (1) observe and calculate land cover change around three communities on the Pine Ridge Indian reservation using remotely sensed data (Landsat MSS, TM and ETM+) and Geographic Information Systems over a 20 year span, and (2) to discuss the potential impacts of rural sprawl on the Pine Ridge Reservation, SD. Preliminary results indicate that land cover has changed in relationship to increased population growth within three communities on the reservation. New housing developments, roads and buildings have appeared and these changes were detectable using Landsat imagery. These results will be discussed along with the experiences and education through the NASA Goddard Internship sponsored by the North Dakota Association of Tribal Colleges.

  7. Diabetes Medicines

    Science.gov (United States)

    ... Ways to Prevent Type 2 Diabetes We Have the Power to Prevent Diabetes: Tips for American Indians & Alaska ... pressure instead of using a needle to deliver the insulin. What oral ... eating and physical activity habits to manage your type 2 diabetes. You can ...

  8. Spatial Epidemiology of Alcohol- and Drug-Related Health Problems Among Northern Plains American Indians: Nebraska and South Dakota, 2007 to 2012.

    Science.gov (United States)

    Ponicki, William R; Henderson, Jeffrey A; Gaidus, Andrew; Gruenewald, Paul J; Lee, Juliet P; Moore, Roland S; Davids, Sharice; Tilsen, Nick

    2018-03-01

    Despite high abstinence rates, American Indians experience elevated rates of many alcohol and other drug problems. American Indians also predominantly reside in poor and rural areas, which may explain some observed health disparities. We investigated whether geographic areas including reservations or large American Indian populations exhibited greater incidence of alcohol- and drug-related hospitalizations. We obtained inpatient hospitalization records for 2 Northern Plain states (Nebraska and South Dakota) for the years 2007 to 2012. We constructed zip code counts for 10 categories of hospitalization with diagnoses or injury causation commonly associated with alcohol or drug use. We related these to community sociodemographic characteristics using Bayesian Poisson space-time regression models and examined associations with and without controls for whether each zip code was located within an American Indian reservation. Controlling for other demographic and economic characteristics, zip codes with greater percentage of American Indians exhibited greater incidence for all 10 substance abuse-related health outcomes (9 of 10 well supported); zip code areas within American Indian reservations had greater incidence of self-inflicted injury and drug dependence and abuse, and reduced incidence of alcohol cirrhosis and prescription opioid poisoning. However, the analyses generally demonstrated no well-supported differences in incidence associated with local residence percentages of American Indian versus African American. In our analyses, ethnicity or heredity alone did not account for alcohol- and drug-related hospitalizations among Native populations. Aspects of social, economic, and political dimensions of Native lives must be considered in the etiology of alcohol- and drug-related problems for rural-dwelling indigenous peoples. Copyright © 2018 by the Research Society on Alcoholism.

  9. Review on herbal remedies used by the 1860 South African Indian ...

    African Journals Online (AJOL)

    The use of these plants needs to be noted. In line with the 150 year commemoration of the 1820 settlers, this paper reviews some of the ayurvedic plants being currently utilized and which were brought to South Africa along with the settlers. Key words: Ayurveda, Ocimum tenuiflorum, Tulsi, Moringa oleifera, Melia azederach, ...

  10. On the Waterfront. Water Distribution, Technology and Agrarian Change in a South Indian Canal Irrigation System

    NARCIS (Netherlands)

    Mollinga, P.P.

    2003-01-01

    This book analyses the struggle over water in a large-scale irrigation system in Raichur District, Karnataka, South India. It looks at water control as a simultaneously technical, managerial and socio-political process. The triangle of accommodation of different categories of farmers (head-enders

  11. On the waterfront : water distribution, technology and agrarian change in a South Indian canal irrigation system

    NARCIS (Netherlands)

    Mollinga, P.P.

    1998-01-01

    This book discusses water distribution in the Tungabhadra Left Bank Canal irrigation system in Raichur district, Karnataka, India. The system is located in interior South India, where rainfall is limited (approximately 600 mm annually) and extremely variable. The region suffered from failed

  12. Satellite-tracked drifting buoy observations in the south equatorial current in the Indian Ocean

    Digital Repository Service at National Institute of Oceanography (India)

    Shetye, S.R.; Michael, G.S.

    two buoys moved north and the third moved south. Over the open sea regime the buoys moved with a speed of approximately 30 cm/s at an angle of about 35 degrees to the left of the wind. The overall tendencies seen in the buoy drift are similar to those...

  13. South Indian "Solkattu" and Western Music Pedagogy: Creating New Rhythmic Perspectives

    Science.gov (United States)

    Wood, Brandon Keith

    2013-01-01

    Part of the classical music tradition of South India, "solkattu" reinforces the statement "If you can say it, you can play it." This system of percussive syllables can help young musicians approach rhythm training in a way not usually available to students in Western countries. This article offers applications for a music…

  14. The role of hip and chest radiographs in osteoporotic evaluation among south Indian women population: a comparative scenario with DXA.

    Science.gov (United States)

    Kumar, D Ashok; Anburajan, M

    2014-05-01

    Osteoporosis is recognized as a worldwide skeletal disorder problem. In India, the older as well as postmenopausal women population suffering from osteoporotic fractures has been a common issue. Bone mineral density measurements gauged by dual-energy X-ray absorptiometry (DXA) are used in the diagnosis of osteoporosis. (1) To evaluate osteoporosis in south Indian women by radiogrammetric method in a comparative perspective with DXA. (2) To assess the capability of KJH; Anburajan's Empirical formula in the prediction of total hip bone mineral density (T.BMD) with estimated Hologic T.BMD. In this cross-sectional design, 56 south Indian women were evaluated. These women were randomly selected from a health camp. The patients with secondary bone diseases were excluded. The standard protocol was followed in acquiring BMD of the right proximal femur by DPX Prodigy (DXA Scanner, GE-Lunar Corp., USA). The measured Lunar Total hip BMD was converted into estimated Hologic Total hip BMD. In addition, the studied population underwent chest and hip radiographic measurements. Combined cortical thickness of clavicle has been used in KJH; Anburajan's Empirical formula to predict T.BMD and compared with estimated Hologic T.BMD by DXA. The correlation coefficients exhibited high significance. The combined cortical thickness of clavicle and femur shaft of total studied population was strongly correlated with DXA femur T.BMD measurements (r = 0.87, P < 0.01 and r = 0.45, P < 0.01) and it is also having strong correlation with low bone mass group (r = 0.87, P < 0.01 and r = 0.67, P < 0.01) KJH; Anburajan's Empirical formula shows significant correlation with estimated Hologic T.BMD (r = 0.88, P < 0.01) in total studied population. The empirical formula was identified as better tool for predicting osteoporosis in total population and old-aged population with a sensitivity (88.8 and 95.6 %), specificity (89.6 and 90.9 %), positive predictive value (88.8 and 95.6 %) and negative

  15. Design of a modified adaptive neuro fuzzy inference system classifier for medical diagnosis of Pima Indians Diabetes

    Science.gov (United States)

    Sagir, Abdu Masanawa; Sathasivam, Saratha

    2017-08-01

    Medical diagnosis is the process of determining which disease or medical condition explains a person's determinable signs and symptoms. Diagnosis of most of the diseases is very expensive as many tests are required for predictions. This paper aims to introduce an improved hybrid approach for training the adaptive network based fuzzy inference system with Modified Levenberg-Marquardt algorithm using analytical derivation scheme for computation of Jacobian matrix. The goal is to investigate how certain diseases are affected by patient's characteristics and measurement such as abnormalities or a decision about presence or absence of a disease. To achieve an accurate diagnosis at this complex stage of symptom analysis, the physician may need efficient diagnosis system to classify and predict patient condition by using an adaptive neuro fuzzy inference system (ANFIS) pre-processed by grid partitioning. The proposed hybridised intelligent system was tested with Pima Indian Diabetes dataset obtained from the University of California at Irvine's (UCI) machine learning repository. The proposed method's performance was evaluated based on training and test datasets. In addition, an attempt was done to specify the effectiveness of the performance measuring total accuracy, sensitivity and specificity. In comparison, the proposed method achieves superior performance when compared to conventional ANFIS based gradient descent algorithm and some related existing methods. The software used for the implementation is MATLAB R2014a (version 8.3) and executed in PC Intel Pentium IV E7400 processor with 2.80 GHz speed and 2.0 GB of RAM.

  16. Prevalence of the metabolic syndrome among North Indian adolescents using Adult Treatment Panel III and pediatric International Diabetic Federation definitions

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    Riyaz Ahmad Bhat

    2015-01-01

    Full Text Available Background and Objective: Childhood obesity is an important risk factor for the development of metabolic syndrome (MS in children and adolescent. Because of high prevalence of insulin resistance and MS in Indian adult population, studies are needed to identify the prevalence of these metabolic abnormalities in the adolescent population. The objective of this study was to estimate the prevalence of MS using pediatric International Diabetic Federation (IDF definition and compare it with estimates of Adult Treatment Panel III (ATP III definition among adolescents in Northern India. Materials and Methods: At a total of 899 adolescents attending school (aged 10-18 years participated in this population-based prospective study. All the clinical and biochemical assessment were done after proper consent. The MS was determined by the National Cholesterol Education Program ATP III definition modified for age and pediatric IDF definition. Results: The prevalence of MS was 3.5% according to ATP III criteria and 1.5% based on IDF criteria. No significant gender difference was observed in the distribution of MS. Hypertriglyceridemia was the most common and abdominal obesity the least common constituent of MS. Conclusion: This study provides the first estimates of MS using pediatric IDF definition in the adolescent population from Northern India.

  17. Psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among American Indians in the Strong Heart Family Study.

    Science.gov (United States)

    Jacob, Michelle M; Gonzales, Kelly L; Calhoun, Darren; Beals, Janette; Muller, Clemma Jacobsen; Goldberg, Jack; Nelson, Lonnie; Welty, Thomas K; Howard, Barbara V

    2013-01-01

    The aims of this paper are to examine the relationship between psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among 3776 American Indians in Phase V of the Strong Heart Family Study. This cross-sectional analysis measured psychological trauma symptoms using the National Anxiety Disorder Screening Day instrument, diabetes by American Diabetes Association criteria, and treatment modality by four categories: no medication, oral medication only, insulin only, or both oral medication and insulin. We used binary logistic regression to evaluate the association between psychological trauma symptoms and diabetes prevalence. We used ordinary least squares regression to evaluate the association between psychological trauma symptoms and glucose control. We used binary logistic regression to model the association of psychological trauma symptoms with treatment modality. Neither diabetes prevalence (22%-31%; p=0.19) nor control (8.0-8.6; p=0.25) varied significantly by psychological trauma symptoms categories. However, diabetes treatment modality was associated with psychological trauma symptoms categories, as people with greater burden used either no medication, or both oral and insulin medications (odds ratio=3.1, ppsychological trauma symptoms suggests future research investigate patient and provider treatment decision making. © 2013.

  18. Circulating MiRNAs of 'Asian Indian Phenotype' Identified in Subjects with Impaired Glucose Tolerance and Patients with Type 2 Diabetes.

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    Paramasivam Prabu

    Full Text Available Several omics technologies are underway worldwide with an aim to unravel the pathophysiology of a complex phenotype such as type 2 diabetes mellitus (T2DM. While recent studies imply a clinically relevant and potential biomarker role of circulatory miRNAs in the etiology of T2DM, there is lack of data on this aspect in Indians--an ethnic population characterized to represent 'Asian Indian phenotype' known to be more prone to develop T2DM and cardiovascular disease than Europeans. We performed global serum miRNA profiling and the validation of candidate miRNAs by qRT-PCR in a cohort of subjects comprised of normal glucose tolerance (NGT, impaired glucose tolerance (IGT and patients with T2DM. Our study revealed 4 differentially expressed miRNAs (miR-128, miR-130b-3p, miR-374a-5p, miR-423-5p in subjects with IGT and T2DM patients compared to control subjects. They were positively or negatively correlated to cholesterol levels, HbA1C, HOMA-IR and fasting insulin. Interestingly, circulating level of miR-128 and miR-130b-3p were also altered in serum of diet-induced diabetic mice compared to control animals. Among the altered circulating miRNAs, miR-128 had never been described in previous studies/populations and appeared to be a 'New Lead' in Indians. It was positively correlated with cholesterol both in prediabetic subjects and in diet-induced diabetic mice, suggesting that its increased level might be associated with the development of dyslipedemia associated with T2DM. Our findings imply directionality towards biomarker potential of miRNAs in the prevention/diagnosis/treatment outcomes of diabetes.

  19. Circulating MiRNAs of 'Asian Indian Phenotype' Identified in Subjects with Impaired Glucose Tolerance and Patients with Type 2 Diabetes.

    Science.gov (United States)

    Prabu, Paramasivam; Rome, Sophie; Sathishkumar, Chandrakumar; Aravind, Sankaramoorthy; Mahalingam, Balakumar; Shanthirani, Coimbatore Subramanian; Gastebois, Caroline; Villard, Audrey; Mohan, Viswanathan; Balasubramanyam, Muthuswamy

    2015-01-01

    Several omics technologies are underway worldwide with an aim to unravel the pathophysiology of a complex phenotype such as type 2 diabetes mellitus (T2DM). While recent studies imply a clinically relevant and potential biomarker role of circulatory miRNAs in the etiology of T2DM, there is lack of data on this aspect in Indians--an ethnic population characterized to represent 'Asian Indian phenotype' known to be more prone to develop T2DM and cardiovascular disease than Europeans. We performed global serum miRNA profiling and the validation of candidate miRNAs by qRT-PCR in a cohort of subjects comprised of normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and patients with T2DM. Our study revealed 4 differentially expressed miRNAs (miR-128, miR-130b-3p, miR-374a-5p, miR-423-5p) in subjects with IGT and T2DM patients compared to control subjects. They were positively or negatively correlated to cholesterol levels, HbA1C, HOMA-IR and fasting insulin. Interestingly, circulating level of miR-128 and miR-130b-3p were also altered in serum of diet-induced diabetic mice compared to control animals. Among the altered circulating miRNAs, miR-128 had never been described in previous studies/populations and appeared to be a 'New Lead' in Indians. It was positively correlated with cholesterol both in prediabetic subjects and in diet-induced diabetic mice, suggesting that its increased level might be associated with the development of dyslipedemia associated with T2DM. Our findings imply directionality towards biomarker potential of miRNAs in the prevention/diagnosis/treatment outcomes of diabetes.

  20. Diet patterns are associated with demographic factors and nutritional status in South Indian children.

    Science.gov (United States)

    Kehoe, Sarah H; Krishnaveni, Ghattu V; Veena, Sargoor R; Guntupalli, Aravinda M; Margetts, Barrie M; Fall, Caroline H D; Robinson, Sian M

    2014-01-01

    The burden of non-communicable chronic disease (NCD) in India is increasing. Diet and body composition 'track' from childhood into adult life and contribute to the development of risk factors for NCD. Little is known about the diet patterns of Indian children. We aimed to identify diet patterns and study associations with body composition and socio-demographic factors in the Mysore Parthenon Study cohort. We collected anthropometric and demographic data from children aged 9.5 years (n = 538). We also administered a food frequency questionnaire and measured fasting blood concentrations of folate and vitamin B12. Using principal component analysis, we identified two diet patterns. The 'snack and fruit' pattern was characterised by frequent intakes of snacks, fruit, sweetened drinks, rice and meat dishes and leavened breads. The 'lacto-vegetarian' pattern was characterised by frequent intakes of finger millet, vegetarian rice dishes, yoghurt, vegetable dishes and infrequent meat consumption. Adherence to the 'snack and fruit' pattern was associated with season, being Muslim and urban dwelling. Adherence to the lacto-vegetarian pattern was associated with being Hindu, rural dwelling and a lower maternal body mass index. The 'snack and fruit' pattern was negatively associated with the child's adiposity. The lacto-vegetarian pattern was positively associated with blood folate concentration and negatively with vitamin B12 concentration. This study provides new information on correlates of diet patterns in Indian children and how diet relates to nutritional status. Follow-up of these children will be important to determine the role of these differences in diet in the development of risk factors for NCD including body composition. © 2013 The Authors. Maternal and Child Nutrition published by John Wiley & Sons Ltd.

  1. Muslim personal law and the meaning of "law" in the South African and Indian constitutions

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    C Rautenbach

    1999-12-01

    Full Text Available The Muslim population of South Africa follows a practice which may be referred to as Muslim personal law. Although section 15 of the Constitution of the Republic of South Africa 108 of 1996 recognises religious freedom and makes provision for the future recognition of other personal law systems, Muslim personal law is, at this stage, not formally recognised in terms of South African law. Since Muslim personal law receives no constitutional recognition the question may be asked whether the 1996 Constitution, and in particular the Bill of Rights as contained in chapter 2 of the 1996 Constitution, is applicable to "non-recognised" Muslim personal law. The answer to this question depends to a large extent on the meaning of "law" as contained in the 1996 Constitution.When the viewpoint of academic writers and the courts are evaluated it seems as if the meaning of law in South Africa is restricted to the common law, customary law and legislation. If such a viewpoint is to be followed, Muslim personal law is excluded from the scrutiny of the Bill of Rights. It is, however, inconceivable that there might be certain areas of "law" that are not subject to the scrutiny of the Bill of Rights. In this note it will be argued that Muslim personal law should be regarded as law in terms of the 1996 Constitution, or in the alternative, that Muslim personal law (or at least Muslim marriages should be recognised in terms of section 15 of the 1996 Constitution.Due to the historical resemblance between South Africa and India the meaning of "law" as contained in the 1996 Constitution will be compared with the meaning of "law" as contained in the Constitution of India. Although the Constitution of India indirectly gives recognition to various personal laws in India, these personal laws are not subject to the provisions of the Constitution of India. Therefore, it would be argued that one should approach the Constitution of India with caution when its provisions are

  2. Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis

    OpenAIRE

    Kumar, Kanta; Greenfield, Sheila; Raza, Karim; Gill, Paramjit; Stack, Rebecca

    2016-01-01

    Background: Prevalence of diabetes and cardiovascular (CVD) disease amongst UK South Asians is higher than in\\ud the general population. Non-adherence to medicines may lead to poor clinical outcomes for South Asian patients\\ud with diabetes and CVD. To understand the decision making processes associated with taking medicines, a qualitative systematic meta-synthesis exploring medicine taking behaviours, and beliefs was undertaken.\\ud \\ud Methods: Four databases (Medline, Embase, Science Citati...

  3. On the waterfront : water distribution, technology and agrarian change in a South Indian canal irrigation system

    OpenAIRE

    Mollinga, P.P.

    1998-01-01

    This book discusses water distribution in the Tungabhadra Left Bank Canal irrigation system in Raichur district, Karnataka, India. The system is located in interior South India, where rainfall is limited (approximately 600 mm annually) and extremely variable. The region suffered from failed harvests and famines in the past. A large scale irrigation system was constructed to solve these problems. The system is operational since 1953 and was completed in 1968. The area to be irrigated ...

  4. Changes in Anterior Segment Morphology and Predictors of Angle Widening after Laser Iridotomy in South Indian Eyes.

    Science.gov (United States)

    Zebardast, Nazlee; Kavitha, Srinivasan; Krishnamurthy, Palaniswamy; Friedman, David S; Nongpiur, Monisha E; Aung, Tin; Quigley, Harry A; Ramulu, Pradeep Y; Venkatesh, Rengaraj

    2016-12-01

    To compare anterior segment optical coherence tomography (ASOCT) angle morphology before and after laser peripheral iridotomy (LPI) in a cohort of South Indian subjects with primary angle-closure suspect (PACS) or primary angle-closure/primary angle-closure glaucoma (PAC/PACG) and to examine baseline parameters associated with angle widening. Prospective observational study. A total of 244 subjects aged ≥30 years with PACS or PAC/PACG in at least 1 eye. The ASOCT images and angle gonioscopic grades were analyzed for all subjects at baseline and 2 weeks after LPI. Multivariable linear and logistic regression models were used to determine predictors of angle widening (change in mean angle opening distance [AOD750]) and angle opening (all 4 quadrants with trabecular meshwork [TM] visible on gonioscopy after LPI). Change in ASOCT parameters with LPI and baseline predictors of angle widening. Laser peripheral iridotomy resulted in angle widening on ASOCT with significant increases in AOD750, angle recess area, and trabecular iris surface area (P gonioscopy, although some degree of persistent iridotrabecular contact was present in approximately half of PACS eyes and approximately two thirds of PAC/PACG eyes on gonioscopy. The greatest widening by ASOCT was observed in eyes with features most consistent with greater baseline pupillary block. Copyright © 2016 American Academy of Ophthalmology. All rights reserved.

  5. Hyperglycemic emergencies in Indian patients with diabetes mellitus on pilgrimage to Amarnathji yatra

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    Mohd Ashraf Ganie

    2012-01-01

    Full Text Available Background: Diabetic ketoacidosis (DKA and hyperosmolar hyperglycemic state (HHS represent two distinct metabolic derangements manifested by insulin deficiency and severe hyperglycemia, with estimated mortality rates of 2.5-9%. In patients with type 2 diabetes mellitus (DM controlled by diet or oral agents, DKA does not occur unless there is significant severe stress such as severe sepsis, major surgery, trauma, etc. We observed many such emergencies occurring in pilgrims. Objective: We analyzed the data of 13 patients with DM admitted in our endocrine department with hyperglycemic emergencies during 2 years of the annual pilgrimage (yatra to Amarnathji. Materials and Methods: We reviewed and analyzed the case records of 13 yatris with DM who were referred and admitted in our hospital with hyperglycemic emergencies during the yatra season (July-August of 2006 and 2007. Results: Eleven of 13 had DKA and 1 each had HHS and hypoglycemia. After initial clinical assessment and blood sampling for blood counts, electrolytes, blood gases, urinalysis, chest radiography, and electrocardiography, these cases were managed with standard protocol published by American Diabetes Association (ADA for the management of DKA and HHS. Average blood glucose was 466 mg/dl and nine subjects had moderate to severe ketonuria. All the cases, except one, were in stable condition at the time of discharge. Conclusion: High altitude, strenuous exertion of going uphill, withdrawal of insulin or oral hypoglycemic drugs, starvation, sepsis, and alcohol intake were recorded as predisposing factors. Therefore, there is an immense need for institution of a special health education program to all the yatris before taking the endeavor.

  6. [Knowledge of the general population about hypertension and diabetes mellitus in South Kivu, Democratic Republic of Congo].

    Science.gov (United States)

    Katchunga, P B; Malanda, B; Mweze, M C; Dupont, B; M'Buyamba-Kabangu, J R; Kashongwe, Z; Kabinda, J M; Buysschaert, M

    2012-04-01

    In the Democratic Republic of Congo (DRC), a country in a post-conflict period, high priority cannot be given to non-communicable diseases other than to emergencies. This certainly involves inadequacy in raising awareness for prevention of these diseases. To evaluate the level of knowledge of the Congolese general population on hypertension and diabetes mellitus. Responses to a questionnaire from 3% of the general population aged 15 and older in the city of Bukavu and two rural areas: Hombo and Walungu (South Kivu, eastern DRC), recruited after stratification by ward in the city of Bukavu and a group of prone villages were expected. The questions focused on identification, testing, causes, complications and treatment of hypertension and diabetes mellitus. Of the 7770 respondents, screening for hypertension and diabetes mellitus affected only 14.9% and 7.3% of subjects respectively. Knowledge of these two conditions was generally low in the general population, although better in the subgroups of patients and those with higher socioeconomic level (Pknowledge (Pknowledge about hypertension and diabetes mellitus and their testing in South Kivu is low. It is imperative that the Congolese government includes non-communicable diseases in its priorities of the millennium. Similarly, the WHO should actively contribute to screening for them in low-income countries. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  7. Barren Forests. Missing Indian villages on the South Coast of Nueva Galicia during the Colonial Period

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    Ramón Goyas Mejía

    2017-01-01

    Full Text Available This analysis focuses on the disappearance of the Indian villages during the colonial period in the town of Purification belonging to Nueva Galicia. The natural physical characterization of the region was first addressed in order to make the historical man-nature relationship relevant since pre-Columbian times. This relationship highlights the importance of the loss of population during the colonial period as a central research topic. This research not only analyzes historical demography, but also addresses the consequences of the disappearance of these entities from the geographical area in which they were located; furthermore, it is an analysis of the relationship of the people as geospatial entities and their environment. Based on the theoretical premise of so-called "nodes" and "networks" for the construction of a territory, this essay argues that as the indigenous people were disappearing, they failed to socially articulate the emergence of spaces that in theory became part of the government. These areas were ultimately "nobodyareas"; areas not controlled by survivors or new settlers who took centuries to settle in the region of study.

  8. Pharmacological evaluation of phytochemicals from South Indian Black Turmeric (Curcuma caesia Roxb.) to target cancer apoptosis.

    Science.gov (United States)

    Mukunthan, K S; Satyan, R S; Patel, T N

    2017-09-14

    Curcuma caesia Roxb. (Black turmeric), a perennial herb of the family Zingiberaceae is indigenous to India. C. caesia is used as a spice, food preservative and coloring agent commonly in the Indian subcontinent. Functional parametric pharmacological evaluations like drug ability and toxicity profile of this endangered species is poorly documented. In our present study, among all the extracts of dried C. caesia rhizome viz- hexane, ethyl acetate, methanol and water tested for free radical scavenging capacity by total antioxidant activity (TAO) method, Hexane Rhizome Extract (HRE) was found to possess remarkable activity (1200mg ascorbic acid equivalent/100g). In MTT assay across three cancer cell lines and a control cell line, HRE exhibited a dose-dependent inhibition only in cancer cells, with notable activity in HepG2 cell lines (IC50: 0976µg/mL). Further, western blotting and flow cytometry experiments proved that HRE induces cell arrest at G2/M phase along with cellular apoptosis as suggestive by multiple-point mitochondrial mediated intrinsic pathway of Programmed Cell Death (PCD). Gas Chromatography-Mass Spectrophotometry (GC-MS) analysis of HRE suggested twenty compounds that when docked in silico with Tubulin (1SA0) and Epidermal Growth Factor Receptor/ EGFR (1XKK) showed very intimate binding with the original ligands. Our results provided significant evidence of the toxicity mechanisms of HRE that may be beneficial for more rational applications of drug discovery for slowing down cancer progression. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  9. Studies of genetic variability of the hepatocyte nuclear factor-1α gene in an Indian maturity-onset diabetes of the young family.

    Science.gov (United States)

    Yang, Jing; Jiang, Feng; Guo, Hui; Soniya, Thadimacca; Yan, Chun-Xia; Tian, Zhu-Fang; Shi, Bing-Yin

    2016-01-01

    Maturity-onset diabetes of the young (MODY), one of the specific types of diabetes mellitus, is a monogenetic disorder characterized by an autosomal dominant (AD) inheritance and β-cell dysfunction. To study an Indian family with clinical diagnosis of MODY and detect the genetic mutations in the aspect of molecular mechanism, seven blood samples were obtained from the diabetic patients of this pedigree and genomic DNA was extracted from peripheral leukocytes. The exon1, exon2 and exon4 of hepatocyte nuclear factor-1α (HNF-1α) gene were amplified by polymerase chain reaction. Then the products were sequenced and compared with standard sequences on gene bank. As a result, two mutations were detected in exon1. That was CTC → CTG (Leu → Leu) in codon17 and ATC → CTC (Ile → Leu) in codon27. I27L was speculated to have a close relationship with the glycometabolism and the pathogenesis of diabetes mellitus together with the putative novel mutation existed in this Indian pedigree. Meanwhile, one mutation of GGG → GGC (Gly → Gly) in codon288 of exon4 was detected in the proband. No mutations were found in exon2 but a G → T base substitution in the intron4 region among all seven samples was detected. It may have some potential effects on the onset of diabetes in this family, but we do not have any evidence right now. Although it requires further investigation on the function of mutations found in the intron region, our research may provide some clue for this issue and it deserves more attention.

  10. Association of systemic risk factors with the severity of retinal hard exudates in a north Indian population with type 2 diabetes

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    Sachdev N

    2010-01-01

    Full Text Available Background: The various risk factors for diabetic retinopathy and its spectrum are still poorly understood in the Indian population. Aims: To study the association of various systemic risk factors with retinal hard exudates in type 2 diabetic north Indian patients and to measure the incidence of dyslipidemia in them. Settings and Design: A tertiary-hospital-based cross-sectional study. Materials and Methods: An observational case-study which included 180 type 2 diabetic patients (180 eyes of nonproliferative diabetic retinopathy (NPDR with clinically significant macular edema (CSME. In these patients the retinal hard exudates were graded on a central 500 fundus picture using modified Airlie House classification and divided into three groups of absent or minimal hard exudates (Group 1, hard exudates present (Group 2 and prominent hard exudates (Group 3. Their association with various risk factors, namely the age of onset of diabetes and its duration, gender, insulin therapy, and various systemic parameters like hypertension, blood hemoglobin, glycosylated hemoglobin, serum (s. creatinine levels, 24-h proteinuria and complete lipid profile including total s. cholesterol, low-density lipoprotein cholesterol (LDL, high-density lipoprotein cholesterol (HDL, very low-density lipoprotein cholesterol (VLDL and s. triglyceride (TG was studied. The incidence of dyslipidemia was also calculated among these groups of patients. Statistical Analysis: ANOVA test, linear regression analysis and Spearman′s correlation test. Results: On univariate analysis, the retinal hard exudates were significantly associated with s. creatinine (P=0.016, systolic blood pressure (P=0.014, s. cholesterol (P < 0.001, s. LDL (P=0.008 and s. TG (P=0.013 levels. While on linear regression analysis, s. cholesterol (P < 0.001 and s. LDL cholesterol (P=0.028 were found to be independent risk factors affecting the density of retinal hard exudates. On Spearman′s correlation test, the

  11. Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians – A population with the highest risk of premature coronary artery disease & diabetes

    Science.gov (United States)

    Enas, Enas A.; Kuruvila, Arun; Khanna, Pravien; Pitchumoni, C.S.; Mohan, Viswanathan

    2013-01-01

    Several reviews and meta-analyses have demonstrated the incontrovertible benefits of statin therapy in patients with cardiovascular disease (CVD). But the role for statins in primary prevention remained unclear. The updated 2013 Cochrane review has put to rest all lingering doubts about the overwhelming benefits of long-term statin therapy in primary prevention by conclusively demonstrating highly significant reductions in all-cause mortality, major adverse cardiovascular events (MACE) and the need for coronary artery revascularization procedures (CARPs). More importantly, these benefits of statin therapy are similar at all levels of CVD risk, including subjects at low (statins is also highly effective in delaying and avoiding expensive CARPs such as angioplasties, stents, and bypass surgeries. There is no evidence of any serious harm or threat to life caused by statin therapy, though several adverse effects that affect the quality of life, especially diabetes mellitus (DM) have been reported. Asian Indians have the highest risk of premature coronary artery disease (CAD) and diabetes. When compared with Whites, Asian Indians have double the risk of CAD and triple the risk of DM, when adjusted for traditional risk factors for these diseases. Available evidence supports the use of statin therapy for primary prevention in Asian Indians at a younger age and with lower targets for low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein (non-HDL-C), than those currently recommended for Americans and Europeans. Early and aggressive statin therapy offers the greatest potential for reducing the continuing epidemic of CAD among Indians. PMID:24434254

  12. Rajella paucispinosa n. sp., a new deep-water skate (Elasmobranchii, Rajidae) from the western Indian Ocean off South Mozambique, and a revised generic diagnosis.

    Science.gov (United States)

    Weigmann, Simon; Stehmann, Matthias F W; Thiel, Ralf

    2014-08-08

    A new species of the widely in temperate and tropical latitudes distributed skate genus Rajella is described based on an almost adult male specimen from the western Indian Ocean off South Mozambique. The holotype of R. paucispinosa n. sp. was caught during cruise 17 of RV 'Vityaz' along the deep western Indian Ocean in 1988/89. It is the northernmost record of a Rajella specimen in the western Indian Ocean. The new species is the 18th valid species of the genus and the fifth species in the western Indian Ocean. It differs from its congeners in the small maximal total length of about 50 cm and only few thorns on the dorsal surface. The new species has only two thorns on each orbit, one nuchal thorn, one right scapular thorn (left one not detectable, abraded), and one median row of tail thorns. Other species of Rajella typically have half rings of thorns on orbital rims, a triangle of thorns on nape-shoulder region, and at least three rows of tail thorns. Another conspicuous feature of the new species is the almost completely white dorsal and ventral coloration. 

  13. Effects of 16 genetic variants on fasting glucose and type 2 diabetes in South Asians: ADCY5 and GLIS3 variants may predispose to type 2 diabetes.

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    Simon D Rees

    Full Text Available BACKGROUND: The Meta-Analysis of Glucose and Insulin related traits Consortium (MAGIC recently identified 16 loci robustly associated with fasting glucose, some of which were also associated with type 2 diabetes. The purpose of our study was to explore the role of these variants in South Asian populations of Punjabi ancestry, originating predominantly from the District of Mirpur, Pakistan. METHODOLOGY/PRINCIPAL FINDINGS: Sixteen single nucleotide polymorphisms (SNPs were genotyped in 1678 subjects with type 2 diabetes and 1584 normoglycaemic controls from two Punjabi populations; one resident in the UK and one indigenous to the District of Mirpur. In the normoglycaemic controls investigated for fasting glucose associations, 12 of 16 SNPs displayed β values with the same direction of effect as that seen in European studies, although only the SLC30A8 rs11558471 SNP was nominally associated with fasting glucose (β = 0.063 [95% CI: 0.013, 0.113] p = 0.015. Of interest, the MTNR1B rs10830963 SNP displayed a negative β value for fasting glucose in our study; this effect size was significantly lower than that seen in Europeans (p = 1.29×10(-4. In addition to previously reported type 2 diabetes risk variants in TCF7L2 and SLC30A8, SNPs in ADCY5 (rs11708067 and GLIS3 (rs7034200 displayed evidence for association with type 2 diabetes, with odds ratios of 1.23 (95% CI: 1.09, 1.39; p = 9.1×10(-4 and 1.16 (95% CI: 1.05, 1.29; p = 3.49×10(-3 respectively. CONCLUSIONS/SIGNIFICANCE: Although only the SLC30A8 rs11558471 SNP was nominally associated with fasting glucose in our study, the finding that 12 out of 16 SNPs displayed a direction of effect consistent with European studies suggests that a number of these variants may contribute to fasting glucose variation in individuals of South Asian ancestry. We also provide evidence for the first time in South Asians that alleles of SNPs in GLIS3 and ADCY5 may confer risk of type 2 diabetes.

  14. Islet immunity and beta cell reserve of indigenous Black South Africans with ketoacidosis at initial diagnosis of diabetes.

    Science.gov (United States)

    Ekpebegh, Chukwuma; Longo-Mbenza, Benjamin; Blanco-Blanco, Ernesto

    2013-01-01

    Islet immunity and beta cell reserve status were utilized to classify persons with ketoacidosis as the initial manifestation of diabetes. The clinical features of the various diabetes classes were also characterized. Prospective cross sectional study. Nelson Mandela Academic Hospital, Mthatha, Eastern Cape Province, South Africa. Indigenous Black South Africans with ketoacidosis as the initial manifestation of diabetes. Islet immunity and beta cell reserve were respectively assessed using serum anti-glutamic acid decarboxylase 65 (GAD) antibody and serum C-peptide after 1 mg of intravenous glucagon. Serum anti-GAD 65 antibody > or = 5 units/L and or = 0.5 ng/mL and < 0.5 ng/mL, respectively. The proportions of patients with A+beta-, A+beta+, A-beta- and A-beta+ and their clinical characteristics were determined. Of the 38 males and 33 females who participated in the study, patients were categorized in various classes: A-beta+, 46.5% (n=33/ 71); A-beta-, 26.8% (n=19/71); A+beta-, 22.5% (n=16/71); and A+beta+, 4.2% (n=3/71). The ages of the various classes were: 41.8 +/- 13.8 years for A-beta+ (n=33); 36.5 +/- 14.6 years for A-beta- (n=19); and 20.6 +/- 7.1 years for the combination of A+beta- with A+beta+ (n=19) (P<.0001, P<.0001 for the combination of A+beta- and A+beta+ vs A-beta+, P=.001 for the combination of A+beta- and A+beta+ vs A-beta-and P=.2 for A-beta- vs A-beta+. The clinical features of type 2 diabetes were most prevalent in A-beta+ class while the A+beta- and A+beta+ groups had the clinical profile of type 1A diabetes. Most of the indigenous Black South African patients with ketoacidosis as the initial manifestation of diabetes had islet immunity, beta cell reserve status and clinical profiles of type 2 diabetes.

  15. Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages.

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    Mercy Manyema

    Full Text Available Type 2 diabetes poses an increasing public health burden in South Africa (SA with obesity as the main driver of the epidemic. Consumption of sugar sweetened beverages (SSBs is linked to weight gain and reducing SSB consumption may significantly impact the prevalence of obesity and related diseases. We estimated the effect of a 20% SSB tax on the burden of diabetes in SA.We constructed a life table-based model in Microsoft Excel (2010. Consumption data from the 2012 SA National Health and Nutrition Examination Survey, previously published own- and cross-price elasticities of SSBs and energy balance equations were used to estimate changes in daily energy intake and its projected impact on BMI arising from increased SSB prices. Diabetes relative risk and prevalent years lived with disability estimates from the Global Burden of Disease Study and modelled disease epidemiology estimates from a previous study were used to estimate the effect of the BMI changes on diabetes burden. Diabetes cost estimates were obtained from the South African Council for Medical Schemes. Over 20 years, a 20% SSB tax could reduce diabetes incident cases by 106 000 in women (95% uncertainty interval (UI 70 000-142 000 and by 54 000 in men (95% UI: 33 000-80 000; and prevalence in all adults by 4.0% (95% UI: 2.7%-5.3%. Cumulatively over twenty years, approximately 21 000 (95% UI: 14 000-29 000 adult T2DM-related deaths, 374 000 DALYs attributed to T2DM (95% UI: 299 000-463 000 and over ZAR10 billion T2DM healthcare costs (95% UI: ZAR6.8-14.0 billion equivalent to USD860 million (95% UI: USD570 million-USD1.2 billion may be averted.Fiscal policy on SSBs has the potential to mitigate the diabetes epidemic in South Africa and contribute to the National Department of Health goals stated in the National NCD strategic plan.

  16. Cross tropopause flux observed at sub-daily scales over the south Indian monsoon regions

    Science.gov (United States)

    Hemanth Kumar, A.; Venkat Ratnam, M.; Sunilkumar, S. V.; Parameswaran, K.; Krishna Murthy, B. V.

    2018-03-01

    The effect of deep convection on the thermal structure and dynamics of the tropical tropopause at sub daily scales is investigated using data from radiosondes launched over two sites in the Indian Monsoon region (Gadanki (13.5°N, 79.2°E) and Trivandrum (8.5°N, 76.9°E)) conducted between December 2010 and March 2014. The data from these soundings are classified into 5 convective categories based on the past, present and future cloudiness over the launching region after the radiosonde has reached tropopause altitude. They are denoted as category 1 (no convection), category 2 (convection may occur in any of the next 3 h), category 3 (convection occurred prior 3 h), category 4 (convection terminated within 3 h of launching) and category 5 (convection persistent throughout the considered period). The anomalies from the background in temperature, relative humidity and wind speed are grouped into the aforementioned five different convective categories for both the stations. Cooling and moisture anomalies are found during the active convection (category 5). The horizontal wind speed showed a strong anomaly indicating the presence of synoptic scale features. Vertical wind obtained simultaneously from the MST radar over Gadanki clearly showed strong updraft during the active convection. The ozone profiles from ozonesondes launched during the same period are also segregated according to the above convective categories. During the active convection, high and low ozone values are found in the upper troposphere and the lower troposphere, respectively. The cross tropopause ozone mass flux and vertical wind at the tropopause and convective outflow level estimated from the ozonesonde, and MST radar/ERA-Interim data showed positive values indicating the transport of ozone between troposphere and stratosphere during deep convection. Similarly, the total mass flux crossing the cold point tropopause over Gadanki showed upward flux during the active convection. The variability of

  17. Partial pressure (or fugacity) of carbon dioxide, salinity and other variables collected from Surface underway observations using Barometric pressure sensor, Carbon dioxide (CO2) gas analyzer and other instruments from ROGER REVELLE in the Indian Ocean, South Pacific Ocean and others from 2007-02-04 to 2007-03-16 (NCEI Accession 0144252)

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    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0144252 includes Surface underway data collected from ROGER REVELLE in the Indian Ocean, South Pacific Ocean, Southern Oceans (> 60 degrees South)...

  18. Two new marine Gastrotricha from the Indian Ocean coast of South Africa.

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    Todaro, M Antonio; Perissinotto, Renzo; Bownes, Sarah J

    2015-01-12

    The study is part of a larger research programme aimed at shedding light on the gastrotrich communities of the subtropical east coast province of KwaZulu-Natal, South Africa. In previous papers, faunistic and preliminary taxonomic data on marine and freshwater gastrotrichs found in the iSimangaliso Wetland Park, were reported. Here two new interesting marine macrodasyidan species in the families Dactylopodolidae and Thaumastodermatidae are described based on observations carried out on living specimens and using differential interference contrast microscopy. The two novel species are named in honor of two great South African icons recently deceased: Nadine Gordimer and Nelson Mandela. Dactylopodola nadine sp. n. is the third species in the genus to bear red eye-spots; it can easily be distinguished from the closely-related red-eyed D. baltica and D. roscovita by its smaller size (Total length = 230 μm vs 275 μm vs 450 μm, respectively) and the lower number of adhesive tubes of the anterior, lateral and posterior series (on each side: 3, 4 and 4 vs 5, 6 and 8 vs 2, 9 and 12-15). Pseudostomella mandela sp. n. is a fairly large species (up to 481 μm in length), with a cuticular covering made up of tetrancres and relatively long caudal pedicles (up to 44 μm in length ). The most evident autoapomorphic trait of the new species is the presence of 7 pairs of 'cirrata' tubes, two emerging in a lateral position along the pharyngeal region and five from the dorsolateral sides of the trunk. Additional relevant taxonomic characters include: 4 tubes of the anterior series, 11 tubes of the ventrolateral series and 3 tubes of the posterior series per side, 5 papillae on the dorsal margin and 6 papillae on the ventral margin of the oral palps. The high number of putative new species discovered among the South African gastrotrich fauna during our relatively short survey, highlights the relevance of this region with regard to the diversity of this group and stresses once again

  19. Knowledge of diabetes mellitus in privately- funded diabetic patients attending a rural optometric practice in Malmesbury, South Africa*

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    K. C. Phillips

    2012-12-01

    ment of DM. This study indicates that, despite access to private health care, these subjects level of knowledge of DM and its ocular effects was sub-optimal. It also indicated poor self-management practices of the diabetic patients towards diabetes care and management. Optometrists should form part of a team of health professionals to assist in the management of DM. (S Afr Optom 2012 71(2 70-77

  20. Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: Does social support matter?

    Science.gov (United States)

    Goins, R Turner; Noonan, Carolyn; Gonzales, Kelly; Winchester, Blythe; Bradley, Vickie L

    2017-04-01

    Among older American Indian women with type 2 diabetes (T2DM), we examined the association between mental health and T2DM control and if social support modifies the association. Survey data were linked to T2DM medical record information. Mental health measures were the Center for Epidemiologic Studies - Depression Scale and the National Anxiety Disorders Screening Day instrument. T2DM control was all HbA1c values taken post mental health measures. There was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support. There was a significant association between psychological trauma and higher HbA1c values 12months [mean 7.5, 95% CI 7.0-8.0 for no trauma vs. mean 7.0, 95% CI 6.3-7.6 for trauma with no symptoms vs. mean 8.4, 95% CI 7.7-9.1 for trauma with ≥1 symptom(s)] and 6months later [mean 7.2, 95% CI 6.7-7.7 for no trauma vs. mean HbA1c 6.8, 95% CI 6.2-7.4 for trauma with no symptoms vs. mean 8.4, 95% CI 7.6-9.2 for trauma with ≥1 symptom(s)]. High social support attenuated the association between psychological trauma and HbA1c values. T2DM programs may consider activities that would strengthen participants' social support and thereby building on an intrinsic community strength. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: Does social support matter?

    Science.gov (United States)

    Noonan, Carolyn; Gonzales, Kelly; Winchester, Blythe; Bradley, Vickie L.

    2017-01-01

    Aims Among older American Indian women with type 2 diabetes (T2DM), we examined the association between mental health and T2DM control and if social support modifies the association. Methods Survey data were linked to T2DM medical record information. Mental health measures were the Center for Epidemiologic Studies – Depression Scale and the National Anxiety Disorders Screening Day instrument. T2DM control was all HbA1c values taken post mental health measures. Results There was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support. There was a significant association between psychological trauma and higher HbA1c values 12 months [mean 7.5, 95% CI 7.0–8.0 for no trauma vs. mean 7.0, 95% CI 6.3–7.6 for trauma with no symptoms vs. mean 8.4, 95% CI 7.7–9.1 for trauma with =1 symptom(s)] and 6 months later [mean 7.2, 95% CI 6.7–7.7 for no trauma vs. mean HbA1c 6.8, 95% CI 6.2–7.4 for trauma with no symptoms vs. mean 8.4, 95% CI 7.6–9.2 for trauma with ≥1 symptom(s)]. High social support attenuated the association between psychological trauma and HbA1c values. Conclusions T2DM programs may consider activities that would strengthen participants’ social support and thereby building on an intrinsic community strength. PMID:28161383

  2. Rainfall variability over South-east Asia - connections with Indian monsoon and ENSO extremes: new perspectives

    Science.gov (United States)

    Kripalani, R. H.; Kulkarni, Ashwini

    1997-09-01

    Seasonal and annual rainfall data for 135 stations for periods varying from 25 to 125 years are utilized to investigate and understand the interannual and short-term (decadal) climate variability over the South-east Asian domain. Contemporaneous relations during the summer monsoon period (June to September) reveal that the rainfall variations over central India, north China, northern parts of Thailand, central parts of Brunei and Borneo and the Indonesian region east of 120°E vary in phase. However, the rainfall variations over the regions surrounding the South China Sea, in particular the north-west Philippines, vary in the opposite phase. Possible dynamic causes for the spatial correlation structure obtained are discussed.Based on the instrumental data available and on an objective criteria, regional rainfall anomaly time series for contiguous regions over Thailand, Malaysia, Singapore, Brunei, Indonesia and Philippines are prepared. Results reveal that although there are year-to-year random fluctuations, there are certain epochs of the above- and below-normal rainfall over each region. These epochs are not forced by the El Niño/La Nina frequencies. Near the equatorial regions the epochs tend to last for about a decade, whereas over the tropical regions, away from the Equator, epochs last for about three decades. There is no systematic climate change or trend in any of the series. Further, the impact of El Niño (La Nina) on the rainfall regimes is more severe during the below (above) normal epochs than during the above (below) normal epochs. Extreme drought/flood situations tend to occur when the epochal behaviour and the El Niño/La Nina events are phase-locked.

  3. When's dinner? Does timing of dinner affect the cardiometabolic risk profiles of South-Asian Canadians at risk for diabetes.

    Science.gov (United States)

    Sandhu, S K; Tang, T S

    2017-04-01

    To explore the relationship between the time dinner is consumed (dinnertime or timing of dinner) and cardiometabolic risk factors among South-Asian Canadians at risk for diabetes. We recruited 432 South-Asian adults affiliated with Sikh and Hindu Temples in Metro Vancouver. Participants deemed to be at risk of diabetes underwent a clinical and behavioural assessment. Dinnertime was measured via self-report. Clinical endpoints included HbA 1c , apolipoprotein, blood pressure, weight, BMI and waist circumference. The mean age of participants was 65 years and 59% were male. Dinnertime was categorized into three groups: early (before 18:00 h); average (18:00 to 20:00 h); and late (later than 20:00 h). Among the participants, 19% (n = 79), 44% (n = 187) and 37% (n = 157) reported early, average and late dinnertimes, respectively. Significant differences were found for dinnertime groups and years of residence in Canada, gender and employment. Compared with the early dinnertime group, the late dinnertime group lived in Canada for a shorter duration, comprised a higher proportion of males (66 vs 48%; P = 0.01) and were currently employed (37 vs 22%; P = 0.02). With regard to clinical endpoints, compared with the early dinnertime group, the late dinnertime group had lower systolic blood pressure (135.9 vs 131.7 mmHg; P = 0.03). After controlling for demographic characteristics, this difference was diminished. No significant differences were found between dinnertime and HbA 1c , apolipoprotein, diastolic blood pressure, weight, BMI and waist circumference. Findings suggest that, among this sample of South-Asian Canadians at risk of Type 2 diabetes, there was no association between timing of the evening meal and cardiometabolic profiles. © 2016 Diabetes UK.

  4. Investigation of productivity in a south Indian Malabari goat herd shows opportunities for planned animal health management to improve food security.

    Science.gov (United States)

    Sargison, N D; Ivil, S A J; Abraham, J; Abubaker, S P S; Hopker, A M; Mazeri, S; Otter, I A; Otter, N

    2017-03-18

    Here the authors report the objective veterinary clinical measurement of productivity in a representative south Indian Malabari goat herd. The authors show failure to meet pragmatic production targets that are commensurate with the animals' genetic potential or adequate to meet the demands of global food security. The authors suggest that this situation may have arisen as a consequence of animal husbandry constraints and protein undernutrition and imply the involvement of nematode parasitism. Benzimidazole resistance was detected in Haemonchus species, showing the need for better understanding of the principles of sustainable helminth parasite control within the southern Indian context. This study highlights the need to understand the true costs of goat production in seasonally resource-poor environments, while also considering its impact on the overall ecosystem in which the animals are placed. They conclude that pragmatic opportunities for improvements in goat production efficiency lie in the development of problem-focused planned animal health and nutrition management. British Veterinary Association.

  5. Assessment of chronic kidney disease using skin texture as a key parameter: for South Indian population.

    Science.gov (United States)

    Udhayarasu, Madhanlal; Ramakrishnan, Kalpana; Periasamy, Soundararajan

    2017-12-01

    Periodical monitoring of renal function, specifically for subjects with history of diabetic or hypertension would prevent them from entering into chronic kidney disease (CKD) condition. The recent increase in numbers may be due to food habits or lack of physical exercise, necessitates a rapid kidney function monitoring system. Presently, it is determined by evaluating glomerular filtration rate (GFR) that is mainly dependent on serum creatinine value and demographic parameters and ethnic value. Attempted here is to develop ethnic parameter based on skin texture for every individual. This value when used in GFR computation, the results are much agreeable with GFR obtained through standard modification of diet in renal disease and CKD epidemiology collaboration equations. Once correlation between CKD and skin texture is established, classification tool using artificial neural network is built to categorise CKD level based on demographic values and parameter obtained through skin texture (without using creatinine). This network when tested gives almost at par results with the network that is trained with demographic and creatinine values. The results of this Letter demonstrate the possibility of non-invasively determining kidney function and hence for making a device that would readily assess the kidney function even at home.

  6. Simulating the characteristics of tropical cyclones over the South West Indian Ocean using a Stretched-Grid Global Climate Model

    Science.gov (United States)

    Maoyi, Molulaqhooa L.; Abiodun, Babatunde J.; Prusa, Joseph M.; Veitch, Jennifer J.

    2018-03-01

    Tropical cyclones (TCs) are one of the most devastating natural phenomena. This study examines the capability of a global climate model with grid stretching (CAM-EULAG, hereafter CEU) in simulating the characteristics of TCs over the South West Indian Ocean (SWIO). In the study, CEU is applied with a variable increment global grid that has a fine horizontal grid resolution (0.5° × 0.5°) over the SWIO and coarser resolution (1° × 1°—2° × 2.25°) over the rest of the globe. The simulation is performed for the 11 years (1999-2010) and validated against the Joint Typhoon Warning Center (JTWC) best track data, global precipitation climatology project (GPCP) satellite data, and ERA-Interim (ERAINT) reanalysis. CEU gives a realistic simulation of the SWIO climate and shows some skill in simulating the spatial distribution of TC genesis locations and tracks over the basin. However, there are some discrepancies between the observed and simulated climatic features over the Mozambique channel (MC). Over MC, CEU simulates a substantial cyclonic feature that produces a higher number of TC than observed. The dynamical structure and intensities of the CEU TCs compare well with observation, though the model struggles to produce TCs with a deep pressure centre as low as the observed. The reanalysis has the same problem. The model captures the monthly variation of TC occurrence well but struggles to reproduce the interannual variation. The results of this study have application in improving and adopting CEU for seasonal forecasting over the SWIO.

  7. Prevalence of orofacial manifestations in HIV-positive South Indian children and the co-relation with CD4 counts

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    Rachna Kaul

    2009-01-01

    Full Text Available Objectives : Orofacial manifestations (OFMs are seen early in the course of HIV disease in children and can also act as indicators for the presence of the disease. The objective of the study were to find the prevalence of OFMs of HIV in infected children, co-relate them with their CD4 counts and establish whether OFMs could be used as markers for disease progression. Materials and Methods : Using the diagnostic criteria recommended by the European Collaborative Clearinghouse (ECC on oral problems related to HIV infection and WHO Collaborating Centre on oral manifestations of the HIV, 48 HIV-infected children were examined at the baseline and their CD4 counts were obtained. A follow-up was conducted 6 months later. Chi-Square test was used to analyse the data obtained. Results : OFM showed a high prevalence in HIV-infected children. The degree of immunosuppression was found to co-relate with the presence of OFMs. But, it could not be established that the presence of OFMs could be a marker for HIV disease progression. Conclusion : The results of our study indicated a high prevalence of OFMs in HIV-infected South Indian children. A decline in CD4 counts was found to be associated with more number of OFMs. However, we were unable to establish OFMs as markers for HIV disease progression. The sample size in our study being about 48 patients and the variability in the initiation and duration of HAART therapy, use of other drugs not being considered, may have an influence on the result of our study. Larger population groups, with parameters such as nutritional status and HAART initiation included, can probably give a more conclusive result..

  8. Circulating MiRNAs of ‘Asian Indian Phenotype’ Identified in Subjects with Impaired Glucose Tolerance and Patients with Type 2 Diabetes

    Science.gov (United States)

    Prabu, Paramasivam; Rome, Sophie; Sathishkumar, Chandrakumar; Aravind, Sankaramoorthy; Mahalingam, Balakumar; Shanthirani, Coimbatore Subramanian; Gastebois, Caroline; Villard, Audrey; Mohan, Viswanathan; Balasubramanyam, Muthuswamy

    2015-01-01

    Several omics technologies are underway worldwide with an aim to unravel the pathophysiology of a complex phenotype such as type 2 diabetes mellitus (T2DM). While recent studies imply a clinically relevant and potential biomarker role of circulatory miRNAs in the etiology of T2DM, there is lack of data on this aspect in Indians—an ethnic population characterized to represent ‘Asian Indian phenotype’ known to be more prone to develop T2DM and cardiovascular disease than Europeans. We performed global serum miRNA profiling and the validation of candidate miRNAs by qRT-PCR in a cohort of subjects comprised of normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and patients with T2DM. Our study revealed 4 differentially expressed miRNAs (miR-128, miR-130b-3p, miR-374a-5p, miR-423-5p) in subjects with IGT and T2DM patients compared to control subjects. They were positively or negatively correlated to cholesterol levels, HbA1C, HOMA-IR and fasting insulin. Interestingly, circulating level of miR-128 and miR-130b-3p were also altered in serum of diet-induced diabetic mice compared to control animals. Among the altered circulating miRNAs, miR-128 had never been described in previous studies/populations and appeared to be a ‘New Lead’ in Indians. It was positively correlated with cholesterol both in prediabetic subjects and in diet-induced diabetic mice, suggesting that its increased level might be associated with the development of dyslipedemia associated with T2DM. Our findings imply directionality towards biomarker potential of miRNAs in the prevention/diagnosis/treatment outcomes of diabetes. PMID:26020947

  9. Assessment of crown angulations, crown inclinations, and tooth size discrepancies in a South Indian population

    Directory of Open Access Journals (Sweden)

    Geeta Maruti Doodamani

    2011-01-01

    Full Text Available Aims and Objective: The aim of this study was to assess crown angulations, crown inclinations, and tooth size discrepancy in a sample population from Davangere, South India. Materials and Methods: One hundred adults (50 male and 50 female of age 18-30 years, with Angle′s class I ideal occlusion and balanced profiles, were selected for the study. Study models were prepared and crown angulations and crown inclinations were measured using a customized protractor device. Bolton′s analysis was used to measure the tooth size discrepancies. Results: Maxillary and mandibular teeth had less crown angulations. Maxillary and mandibular incisors and maxillary molars showed increased crown inclinations, whereas mandibular molars and premolars had less crown inclinations than the original Andrews sample. The mean maxillary and mandibular tooth size ratios, overall and anterior, were similar to Bolton′s ratios. Conclusions: The finding of this study indicates that there are possible racial and ethnic factors contributing to variations in crown angulations and crown inclinations.

  10. Simulation of the anthropogenic aerosols over South Asia and their effects on Indian summer monsoon

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Zhenming [Institute of Tibetan Plateau Research, Chinese Academy of Sciences, Key Laboratory of Tibetan Environment Changes and Land Surface Processes, Beijing (China); National Climate Center, Beijing (China); Graduate University of Chinese Academy of Sciences, Beijing (China); Kang, Shichang [Institute of Tibetan Plateau Research, Chinese Academy of Sciences, Key Laboratory of Tibetan Environment Changes and Land Surface Processes, Beijing (China); Chinese Academy of Sciences, State Key Laboratory of Cryospheric Science, Lanzhou (China); Zhang, Dongfeng [Shanxi Meteorological Bureau, Taiyuan (China); Zhu, Chunzi [Nanjing University of Information Science Technology, College of Atmospheric Science, Nanjing (China); Wu, Jia; Xu, Ying [National Climate Center, Beijing (China)

    2011-05-15

    A regional climate model coupled with a chemistry-aerosol model is employed to simulate the anthropogenic aerosols including sulfate, black carbon and organic carbon and their direct effect on climate over South Asia. The model is driven by the NCAR/NCEP re-analysis data. Multi-year simulations with half, normal and double emission fluxes are conducted. Results show that the model performs well in reproducing present climate over the region. Simulations of the aerosol optical depth and surface concentration of aerosols are also reasonable although to a less extent. The negative radiative forcing is found at the top of atmosphere and largely depended on emission concentration. Surface air temperature decreases by 0.1-0.5 C both in pre-monsoon and monsoon seasons. The range and intensity of cooling areas enlarge while aerosol emission increases. Changes in precipitation are between -25 and 25%. Different diversifications of rainfall are showed with three emission scenarios. The changes of precipitation are consistent with varieties of monsoon onset dates in pre-monsoon season. In the regions of increasing precipitation, monsoon onset is advanced and vice versa. In northeast India and Myanmar, aerosols lead the India summer monsoon onset advancing 1-2 pentads, and delaying by 1-2 pentads in central and southeast India. These changes are mainly caused by the anomaly of local Hadley circulations and enhancive precipitation. Tibetan Plateau played a crucial role in the circulation changes. (orig.)

  11. Estimation of Stature from Foot Dimensions and Stature among South Indian Medical Students Using Regression Models

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    Rajesh D. R

    2015-01-01

    Full Text Available Background: At times fragments of soft tissues are found disposed off in the open, in ditches at the crime scene and the same are brought to forensic experts for the purpose of identification and such type of cases pose a real challenge. Objectives: This study was aimed at developing a methodology which could help in personal identification by studying the relation between foot dimensions and stature among south subjects using regression models. Material and Methods: Stature and foot length of 100 subjects (age range 18-22 years were measured. Linear regression equations for stature estimation were calculated. Result: The correlation coefficients between stature and foot lengths were found to be positive and statistically significant. Height = 98.159 + 3.746 × FLRT (r = 0.821 and Height = 91.242 + 3.284 × FLRT (r = 0.837 are the regression formulas from foot lengths for males and females respectively. Conclusion: The regression equation derived in the study can be used reliably for estimation of stature in a diverse population group thus would be of immense value in the field of personal identification especially from mutilated bodies or fragmentary remains.

  12. Consanguineous marriages and matrimonial distance: a study among three South Indian caste groups.

    Science.gov (United States)

    Reddy, P G

    1988-12-01

    Reddy studies consanguineous marriages and matrimonial distance in 3 castes of Nellore district, Andhra Pradesh, South India. The castes include the well-to-do agricultural caste, the Desuri Kapu; the 2nd, artisan caste in the middle of the hierarchy, the Devanga; and the third caste at the bottom of the social ladder, the Mala. During field work conducted in 1978-1979, prominent elders of the villages were approached; information on the consanguinity of marriage and matrimonial distance was gathered through intensive interviews of both men and women from all the households of the 3 castes. Among the total of 979 marriages, 28.9% occurred within the village, the proportion of intra-village marriages being significantly higher in Nellore taluk than in Sullurpet. The 3 castes overall show little difference in the incidence of intra-village marriages, but there is some within caste regional variation in the incidence of intra-village marriages, the Devanga showing a significantly higher incidence in Nellore than in Sullurpet. Intra-village marriages are more common among consanguineous couples (41.5%) than among non-consanguineous (18.3%), a highly significant excess in each of the caste groups. In short, Reddy concludes that intra-village marriages are more common among consanguineous couples than non-consanguineous, and mean matrimonial distance is also lower.

  13. Studies on isozymic variation among the South Indian species of Sphaerostephanos.

    Science.gov (United States)

    Varaprasadham, Irudayaraj; Marimuthu, Johnson

    2011-08-01

    To explore the identity and phylogenetic relationships among the three medicinally important species of Sphaerostephanos from South India using isozymic profile. The young fronds were homogenized with 3.5 mL of ice-cold homogenizing buffer in a pre-chilled pestle and mortar. The supernatant was subjected to electrophoresis as described by Anbalagan poly acrylamide gel electrophoresis. Staining solutions for isoperoxidase was prepared as per Smila method for the detection of isoenzymes. A total of six different bands in five different positions with different molecular weight/Rf values and four active zones have been observed in the isoperoxidase enzyme system of Sphaerostephanos. Only one band with MW/Rf 0.399 is common to two different species i.e. Sphaerostephanos arbuscula (S. arbuscula) and Sphaerostephanos unitus (S. unitus). Among the remaining four bands, two bands (Rf. 0.23, 0.47) are present in Sphaerostephanos subtruncatus (S. subtruncatus) and one distinct band has been observed individually in S. arbuscula (Rf. 0.507) and S. unitus (Rf. 0.56). The present preliminary molecular study through isozymic analysis shows the identity of all the three species and the present results confirm distinctness of these three species based on macro-micromorphology, phytochemistry and cytology.

  14. Arbuscular Mycorrhizal and Dark Septate Endophyte Fungal Associations in South Indian Aquatic and Wetland Macrophytes

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    Kumar Seerangan

    2014-01-01

    Full Text Available Investigations on the prevalence of arbuscular mycorrhizal (AM and dark septate endophyte (DSE fungal symbioses are limited for plants growing in tropical aquatic and wetland habitats compared to those growing on terrestrial moist or dry habitats. Therefore, we assessed the incidence of AM and DSE symbiosis in 8 hydrophytes and 50 wetland plants from four sites in south India. Of the 58 plant species examined, we found AM and DSE fungal symbiosis in 21 and five species, respectively. We reported for the first time AM and DSE fungal symbiosis in seven and five species, respectively. Intermediate-type AM morphology was common, and AM morphology is reported for the first time in 16 plant species. Both AM and DSE fungal colonization varied significantly across plant species and sites. Intact and identifiable AM fungal spores occurred in root zones of nine plant species, but AM fungal species richness was low. Though no clear relationship between AM and DSE fungal colonization was recognized, a significant negative correlation between AM colonization and spore numbers was established. Our study suggests that the occurrence of AM and DSE fungal symbiosis in plants growing in hydrophytic and wetland habitats is not as common as in terrestrial habitats.

  15. Diabetes care and outcomes for American Indians and Alaska natives in commercial integrated delivery systems: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) Study.

    Science.gov (United States)

    Schmittdiel, Julie A; Steiner, John F; Adams, Alyce S; Dyer, Wendy; Beals, Janette; Henderson, William G; Desai, Jay; Morales, Leo S; Nichols, Gregory A; Lawrence, Jean M; Waitzfelder, Beth; Butler, Melissa G; Pathak, Ram D; Hamman, Richard F; Manson, Spero M

    2014-01-01

    To compare cardiovascular disease risk factor testing rates and intermediate outcomes of care between American Indian/Alaska Native (AI/AN) patients with diabetes and non-Hispanic Caucasians enrolled in nine commercial integrated delivery systems in the USA. We used modified Poisson regression models to compare the annual testing rates and risk factor control levels for glycated haemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), and systolic blood pressure (SBP); number of unique diabetes drug classes; insulin use; and oral diabetes drug medication adherence between insured AI/AN and non-Hispanic white adults with diabetes aged ≥18 in 2011. 5831 AI/AN patients (1.8% of the cohort) met inclusion criteria. After adjusting for age, gender, comorbidities, insulin use, and geocoded socioeconomic status, AI/AN patients had similar rates of annual HbA1c, LDL-C, and SBP testing, and LDL-C and SBP control, compared with non-Hispanic Caucasians. However, AI/AN patients were significantly more likely to have HbA1c >9% (>74.9 mmol/mol; RR=1.47, 95% CI 1.38 to 1.58), and significantly less likely to adhere to their oral diabetes medications (RR=0.90, 95% CI 0.88 to 0.93) compared with non-Hispanic Caucasians. AI/AN patients in commercial integrated delivery systems have similar blood pressure and cholesterol testing and control, but significantly lower rates of HbA1c control and diabetes medication adherence, compared with non-Hispanic Caucasians. As more AI/ANs move to urban and suburban settings, clinicians and health plans should focus on addressing disparities in diabetes care and outcomes in this population.

  16. Influence of tumour suppressor gene (TP53, BRCA1 and BRCA2) polymorphisms on polycystic ovary syndrome in South Indian women.

    Science.gov (United States)

    Siddamalla, Swapna; Reddy, Tumu Venkat; Govatati, Suresh; Guruvaiah, Praveen; Deenadayal, Mamata; Shivaji, Sisinthy; Bhanoori, Manjula

    2018-05-24

    Polycystic Ovary Syndrome (PCOS) is a heterogeneous multifactorial endocrine metabolic disorder. In addition to hyperandrogenism, acne, hirsutism, obesity, oligoanovulation and infertility, insulin resistance is also a common feature in women of PCOS. Tumor suppressor genes (TSGs) perform essential function in the maintenance of genomic stability and regulatory pathways influencing the activity of several replication and transcription factors. The main aim of this study was to investigate the association of Single Nucleotide Polymorphisms of TP53, BRCA1and BRCA2 genes with the susceptibility to PCOS in South Indian women. Present study investigated association between TP53 gene (rs1042522 G/C), BRCA1 (rs71361504 -/GTT, rs3092986 T/C) and BRCA2 (rs206118 A/G) and, SNPs and PCOS risk. Genotyping of TSGs was carried out on DNA from PCOS patients (n = 110) and controls (n = 130) of South Indian origin by polymerase chain reaction (PCR) and confirmed by sequencing analysis. The genotype frequency and allele distributions of cases and controls were analyzed using Fisher's exact test. Haplotype frequencies for multiple loci and the standardized disequilibrium coefficient (D') for pair wise linkage disequilibrium (LD) were assessed by Haploview Software. Significant increase in frequencies ofTP53 (rs1042522 G/C), BRCA1 (rs71361504 -/GTT, rs3092986 T/C) genotypes and alleles in patients compared to controls. In addition, the frequency of the C/T (P = 0.002) and A/C (P = 0.012) haplotype was also significantly elevated in patients. But BRCA2 (rs206118 A/G) did not show significant association with PCOS. The TP53 and BRCA1 may constitute an inheritable risk factor for PCOS in South Indian women. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Trends of overweight and obesity among white and American Indian school children in South Dakota, 1998-2010.

    Science.gov (United States)

    Hearst, Mary O; Biskeborn, Kristin; Christensen, Mathew; Cushing, Carrie

    2013-01-01

    To investigate the prevalence of overweight and obesity among white and American Indian children in a predominantly rural state. Using a repeated, cross-sectional design of school children's height and weight, the study sample included 361,352 measures of children who were 5.0-19.9 years, attending school across 13 academic calendar years. Trained staff measured height, weight, and recorded gender, age, and race. Data were voluntarily reported to the State Department of Health. American Indian children consistently had higher rates of overweight and obesity compared to white children. Across the years, 16.3% of white students were overweight, whereas 19.3% of American Indian students were overweight. In addition, 14.5% of white children were obese and 25.9% of American Indian children were obese. Examining by rural versus urban schools, prevalence of overweight had been increasing among white male and female students and American Indian female students living in rural areas. Obesity is also increasing among rural white females and male and female American Indian children. The findings here suggest that although American Indian children are at higher risk, in general, compared to white children, rural populations in general are experiencing increases in childhood overweight and obesity. Targeted rural interventions beginning at an early age are necessary to improve the health of rural children, especially in American Indian communities. Copyright © 2013 The Obesity Society.

  18. Incidence of diabetes and its mortality according to body mass index in South Koreans aged 40–79 years

    Directory of Open Access Journals (Sweden)

    Jung HH

    2017-12-01

    Full Text Available Hae Hyuk Jung, Ji In Park, Jin Seon Jeong Department of Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Gangwon-do, South Korea Purpose: The purpose of this study was to assess diabetes incidence and all-cause mortality according to baseline body mass index (BMI and to compare relative risks of mortality associated with incident diabetes across various BMI classes in a cohort of South Korean adults.Patients and methods: Based on data from the National Health Insurance database of Korean individuals aged 40–79 years without preexisting diabetes, we calculated BMI at the baseline health examination. We estimated the relative risk of mortality associated with incident diabetes using time-dependent Cox models and considering the time of diabetes diagnosis.Results: We noted 29,307 incident diabetes cases and 22,940 deaths during an 8-year follow-up of the initial cohort (n=436,692 and 73,756 incident diabetes cases and 57,556 deaths during a 10-year follow-up of the replication cohort (n=850,282. Regarding all-cause mortality, time-dependent Cox models revealed statistically significant interactions between diabetes status and baseline BMI class (P=0.018 and P<0.001 in the initial and replication cohorts, respectively. In separately conducted analyses for each BMI class, diabetes-associated relative risks for BMI values of 16.0–18.4, 18.5–22.9, 23.0–24.9, 25.0–29.9, and 30.0–34.9 kg/m2 were 1.50 (95% confidence interval [CI], 1.09–2.07, 1.39 (95% CI, 1.26–1.54, 1.20 (95% CI, 1.08–1.35, 1.18 (95% CI, 1.07–1.30, and 0.97 (95% CI, 0.74–1.28 in the initial cohort, and 1.44 (95% CI, 1.18–1.74, 1.33 (95% CI, 1.26–1.41, 1.24 (95% CI, 1.16–1.31, 1.11 (95% CI, 1.05–1.17, and 0.99 (95% CI, 0.85–1.16 in the replication cohort. The increasing trend of relative risk with decreasing BMI persisted mostly among subgroups stratified according to age or sex and smoking status

  19. Community perceptions of health and chronic disease in South Indian rural transitional communities: a qualitative study.

    Science.gov (United States)

    Hayter, Arabella K M; Jeffery, Roger; Sharma, Chitra; Prost, Audrey; Kinra, Sanjay

    2015-01-01

    Chronic diseases are now the leading cause of death and disability worldwide; this epidemic has been linked to rapid economic growth and urbanisation in developing countries. Understanding how characteristics of the physical, social, and economic environment affect behaviour in the light of these changes is key to identifying successful interventions to mitigate chronic disease risk. We undertook a qualitative study consisting of nine focus group discussions (FGDs) (n=57) in five villages in rural Andhra Pradesh, South India, to understand people's perceptions of community development and urbanisation in relation to chronic disease in rural transitional communities. Specifically, we sought to understand perceptions of change linked to diet, physical activity, and pollution (because these exposures are most relevant to chronic diseases), with the aim of defining future interventions. The transcripts were analysed thematically. Participants believed their communities were currently less healthy, more polluted, less physically active, and had poorer access to nutritious food and shorter life expectancies than previously. There were contradictory perceptions of the effects of urbanisation on health within and between individuals; several of the participants felt their quality of life had been reduced. In the present study, residents viewed change and development within their villages as an inevitable and largely positive process but with some negative health consequences. Understanding how these changes are affecting populations in transitional rural areas and how people relate to their environment may be useful to guide community planning for health. Measures to educate and empower people to make healthy choices within their community may help reduce the spread of chronic disease risk factors in future years.

  20. Applicability of transoral endoscopic parathyroidectomy through vestibular route for primary sporadic hyperparathyroidism: A South Indian experience.

    Science.gov (United States)

    Bhargav, P R K; Sabaretnam, M; Amar, V; Devi, N Vimala

    2018-05-04

    Primary hyperparathyroidism is one of the most common endocrine disorders requiring surgical parathyroidectomy for its definitive treatment. Surgical exploration is traditionally performed through conventional open neck approach. A wide range of minimal access and minimally invasive endoscopic techniques (gas less and with gas) have been attempted in the past two decades. In this context, we evaluated the feasibility and safety of an innovative transoral endoscopic parathyroidectomy (EP) technique, which represents a paradigm shift in transluminal endocrine surgery. This is a prospective study conducted at a tertiary care Endocrine Surgery Department in South India between May 2016 and August 2017. We employed a novel transoral, lower vestibular route for EP. All the clinical, investigative, operative, pathological and post-operative data were collected from our prospectively filled database. Statistical analysis was performed with SPSS 20.0 version. Under inhalational general anaesthesia, access to the neck was obtained with 3 ports (central frenulotomy and two lateral port sites), dissected in subplatysmal plane and insufflated with 6 mm Hg CO 2 for working space. Rest of surgical steps is similar to conventional open parathyroidectomy. Out of the 38 hyperparathyroidism cases operated during the study, 12 (32%) were operated by this technique. Mean operative time was 112 ± 15 min (95-160). The post-operative course was uneventful with no major morbidity, hypocalcemia or recurrent laryngeal nerve palsy. Cure and diagnosis were confirmed by> 50% fall in intraoperative parathyroid hormone levels and histopathology (all were benign solitary adenomas). Through this study, we opine that this novel transoral vestibular route parathyroidectomy is a feasibly applicable approach for primary sporadic hyperparathyroidism, especially with solitary benign adenomas.

  1. Age estimation using development of third molars in South Indian population: A radiological study.

    Science.gov (United States)

    Priyadharshini, K Indra; Idiculla, Jose Joy; Sivapathasundaram, B; Mohanbabu, V; Augustine, Dominic; Patil, Shankargouda

    2015-05-01

    To assess the estimation of chronological age based on the stages of third molar development following the eight stages (A-H) method of Demirjian et al. in Chennai population of South India. A sample consisting of 848 individuals (471 males and 377 females) aged between 14 and 30 years was randomly selected for the clinical evaluation and 323 orthopantomograms with clinically missing third molars were taken for radiological evaluation using Demirjian's method from a Chennai population of known chronological age and sex. Statistical analysis was performed using Pearson's Chi-square test and mean values were compared between the study groups using t-test or analysis of variance (ANOVA) followed by Tukey's highly significant difference (HSD). In the present study, P age of having clinically completely erupted maxillary third molars was 22.41 years in male subjects and 23.81 years in female subjects and that of mandibular third molars was 21.49 years in male subjects and 23.34 years in female subjects. Mandibular third molars were clinically missing more often in females than in males. Eruption of mandibular third molars was generally ahead of the emergence of maxillary third molars into the oral cavity. Third molar development between male and female subjects showed statistically significant differences at calcification stage F and stage G in maxillary third molars and stage F in mandibular third molars (P third molar eruption reached Demirjian's formation stages earlier in males than in females. It is suggested that in future studies, to increase the accuracy of age determination, indications of sexual maturity and ossification should also be evaluated in addition to third molar mineralization.

  2. Awareness and practice of road safety measures among undergraduate medical students in a South Indian state.

    Science.gov (United States)

    Kulkarni, Vaman; Kanchan, Tanuj; Palanivel, C; Papanna, M K; Kumar, Nithin; Unnikrishnan, B

    2013-05-01

    The UN general assembly has declared 2011-2020 as the "Decade of Action for Road Safety". The declaration holds significance because road traffic accidents (RTAs) have become a major cause of morbidity and mortality, especially among the adults and middle aged individuals who constitute economically most productive age groups of society. The importance of knowledge and practice of road safety measures needs to be emphasized in the prevention of RTAs. The present study is aimed to assess the knowledge and practice of road safety measures among the students of a medical college in coastal, South India. A total of 260 medical students were included in this cross-sectional study. A semi-structured questionnaire was used to collect the relevant information from the participants. The data collected was analyzed using SPSS version 11.5. Out of the 260 participants, 149 (57.3%) were females and 111 (42.7%) were males. The overall awareness on road safety measures was slightly higher among females (20.6%) than males (19.9%). The participants had significantly low awareness with regard to alcohol and driving (4.2%), use of seat belts (20%) and use of mobile phones without hands free device (6.1%). The participants had a better knowledge about traffic signs and more than half of them identified all the signs correctly. With regard to the road safety practices, 25% were involved in drunken driving in the past one year. The practice of using mobile phones with hands free devices while driving was admitted by 20% of them. Nearly two-third participants (68%) admitted to have crossed speed limits on multiple occasions. Observations of the study emphasize on the need to generate awareness among medical students through training and IEC activities to curb the epidemic of RTAs. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  3. Significant association of the dupA gene of Helicobacter pylori with duodenal ulcer development in a South-east Indian population

    OpenAIRE

    Alam, Jawed; Maiti, Sankar; Ghosh, Prachetash; De, Ronita; Chowdhury, Abhijit; Das, Suryasnata; Macaden, Ragini; Devarbhavi, Harshad; Ramamurthy, T.; Mukhopadhyay, Asish K.

    2012-01-01

    A novel virulence factor, duodenal ulcer-promoting gene A (dupA), in Helicobacter pylori has been found to be associated with disease in certain populations but not in others. This study analysed a South-east Indian population as part of the debate about the relevance of dupA for the prediction of clinical outcomes. A total of 140 H. pylori strains isolated from duodenal ulcer (DU) (n=83) and non-ulcer dyspepsia (NUD) patients (n=57) were screened by PCR and dot-blot hybridization to determin...

  4. Sociocultural and structural perpetuators of domestic violence in pregnancy: A qualitative look at what South Indian women believe needs to change.

    Science.gov (United States)

    D'Silva, Sahana; Frey, Sarah; Kumar, Shuba; Mohanraj, Rani; Manhart, Lisa E; Kaysen, Debra; Andu, Eaden; Rao, Deepa

    2018-02-01

    In India, reported rates of domestic violence rise as high as 31%. Abuse against pregnant women in India is associated with depressive and PTSD symptoms, and poor birth outcomes, yet no evidence-based interventions have been tested on this population. In this cross-sectional qualitative study, we sought perspective on South Indian women's concerns about abuse during pregnancy and what they believed would help. Participants cited economic dependence on husbands and sociocultural structures as factors perpetuating domestic violence. Women also described resilience factors that can protect against abuse. Our participants highlighted a requisite for interventions within health and social systems.

  5. Resource use associated with type 2 diabetes in Africa, the Middle East, South Asia, Eurasia and Turkey: results from the International Diabetes Management Practice Study (IDMPS).

    Science.gov (United States)

    Gagliardino, Juan J; Atanasov, Petar K; Chan, Juliana C N; Mbanya, Jean C; Shestakova, Marina V; Leguet-Dinville, Prisca; Annemans, Lieven

    2017-01-01

    Type 2 diabetes (T2D) and its complications form a global healthcare burden but the exact impact in some geographical regions is still not well documented. We describe the healthcare resource usage (HRU) associated with T2D in Africa, the Middle East, South Asia, Eurasia and Turkey. In the fifth wave of the International Diabetes Management Practices Study (IDMPS; 2011-2012), we collected self-reported and physician-reported cross-sectional data from 8156 patients from 18 countries across 5 regions, including different types of HRU in the previous 3-6 months. Negative binomial regression was used to identify parameters associated with HRU, using incidence rate ratios (IRRs) to express associations. Patients in Africa (n=2220), the Middle East (n=2065), Eurasia (n=1843), South Asia (n=1195) and Turkey (n=842) experienced an annual hospitalization rate (mean±SD) of 0.6±1.9, 0.3±1.2, 1.7±4.1, 0.4±1.5 and 1.3±2.7, respectively. The annual number of diabetes-related inpatient days (mean±SD) was 4.7±22.7, 1.1±6.1, 16.0±30.0, 1.5±6.8 and 10.8±34.3, respectively. Despite some inter-regional heterogeneity, macrovascular complications (IRRs varying between 1.4 and 8.9), microvascular complications (IRRs varying between 3.4 and 4.3) and, to a large extent, inadequate glycemic control (IRRs varying between 1.89 and 10.1), were independent parameters associated with hospitalization in these respective regions. In non-Western countries, macrovascular/microvascular complications and inadequate glycemic control were common and important parameters associated with increased HRU.

  6. Environmentally Driven Increases in Type 2 Diabetes and Obesity in Pima Indians and Non-Pimas in Mexico Over a 15-Year Period: The Maycoba Project.

    Science.gov (United States)

    Esparza-Romero, Julian; Valencia, Mauro E; Urquidez-Romero, Rene; Chaudhari, Lisa S; Hanson, Robert L; Knowler, William C; Ravussin, Eric; Bennett, Peter H; Schulz, Leslie O

    2015-11-01

    The global epidemics of type 2 diabetes and obesity have been attributed to the interaction between lifestyle changes and genetic predisposition to these diseases. We compared the prevalences of type 2 diabetes and obesity in Mexican Pima Indians, presumed to have a high genetic predisposition to these diseases, to those in their non-Pima neighbors, both of whom over a 15-year period experienced a transition from a traditional to a more modern lifestyle. Prevalence of diabetes, impaired fasting glucose, impaired glucose tolerance, and obesity in Mexican Pimas (n = 359) and non-Pima Mexicans (n = 251) were determined in 2010 using methods identical to those used in 1995. During this 15-year period, age-adjusted diabetes prevalence was unchanged in Pima men (5.8% in 1995 vs. 6.1% in 2010) yet increased in non-Pima men from 0.0 to 8.6% (P obesity increased significantly in all groups (6.6 vs. 15.7% in Pima men; 8.5 vs. 20.5% in non-Pima men; 18.9. vs 36.3% in Pima women; 29.5 vs. 42.9% in non-Pima women). Type 2 diabetes prevalence increased between 1995 and 2010 in non-Pima men, and to a lesser degree in women of both groups, but it did not increase in Pima men. Prevalence of obesity increased among Pimas and non-Pimas of both sexes. These changes occurred concomitantly with an environmental transition from a traditional to a more modernized lifestyle. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  7. High prevalence of type 2 diabetes melitus and its risk factors among the rural population of Pondicherry, South India.

    Science.gov (United States)

    Shrivastava, Saurabh RamBihariLal; Ghorpade, Arun Gangadhar

    2014-01-01

    We aimed to assess the prevalence of type-2 diabetes in rural Pondicherry and to study the determinants of Diabetes Mellitus (DM) in the rural population of Pondicherry, south Induia. It was a cross-sectional community-based study conducted from November 2010 to January 2012 in two of the field practice villages affiliated to a Medical College in Pondicherry. Sample size was calculated using open source software, Open Epi Version 2.3.10. The sampling frame comprised individuals aged above 25 years and single stage cluster random sampling was carried out. After obtaining the verbal informed consent each of the study participants were interviewed face-to-face using a pre-tested structured questionnaire. Data were analyzed using the SPSS version 16. The age of the study participants ranged from 25 to 98 years with mean of 42.6 (±13.7) and majority of the study participants 339 (32.5%) from the age-group of 30-39 years. The prevalence of diabetes was 19.8% (60-69 years), 17.1% (40-49 years), 16.8% (50-59 years), and 13.6% (>69 years) among study subjects. In univariate analysis, higher age, being educated, unemployed and poor was associated with higher risk of diabetes mellitus (DM). Furthermore, a high triglyceride level was significantly associated with increase in the risk of DM (adjusted odds ratio: 3.01; 95% CI: 1.86, 4.86). Type-2 diabetes mellitus (T2DM) is an important public health problem in the adults of rural Pondicherry. Among non-modifiable factors, higher age, better socio-educational background and positive family history of diabetes was significantly associated with T2DM.

  8. Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial.

    Science.gov (United States)

    Mash, Bob; Levitt, Naomi; Steyn, Krisela; Zwarenstein, Merrick; Rollnick, Stephen

    2012-12-24

    Diabetes is an important contributor to the burden of disease in South Africa and prevalence rates as high as 33% have been recorded in Cape Town. Previous studies show that quality of care and health outcomes are poor. The development of an effective education programme should impact on self-care, lifestyle change and adherence to medication; and lead to better control of diabetes, fewer complications and better quality of life. Pragmatic cluster randomized controlled trialParticipants: Type 2 diabetic patients attending 45 public sector community health centres in Cape TownInterventions: The intervention group will receive 4 sessions of group diabetes education delivered by a health promotion officer in a guiding style. The control group will receive usual care which consists of ad hoc advice during consultations and occasional educational talks in the waiting room. To evaluate the effectiveness of the group diabetes education programmeOutcomes: diabetes self-care activities, 5% weight loss, 1% reduction in HbA1c. self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c, mean total cholesterol, quality of lifeRandomisation: Computer generated random numbersBlinding: Patients, health promoters and research assistants could not be blinded to the health centre's allocationNumbers randomized: Seventeen health centres (34 in total) will be randomly assigned to either control or intervention groups. A sample size of 1360 patients in 34 clusters of 40 patients will give a power of 80% to detect the primary outcomes with 5% precision. Altogether 720 patients were recruited in the intervention arm and 850 in the control arm giving a total of 1570. The study will inform policy makers and managers of the district health system, particularly in low to middle income countries, if this programme can be implemented more widely. Pan African Clinical Trial Registry PACTR201205000380384.

  9. Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial

    Directory of Open Access Journals (Sweden)

    Mash Bob

    2012-12-01

    Full Text Available Abstract Background Diabetes is an important contributor to the burden of disease in South Africa and prevalence rates as high as 33% have been recorded in Cape Town. Previous studies show that quality of care and health outcomes are poor. The development of an effective education programme should impact on self-care, lifestyle change and adherence to medication; and lead to better control of diabetes, fewer complications and better quality of life. Methods Trial design: Pragmatic cluster randomized controlled trial Participants: Type 2 diabetic patients attending 45 public sector community health centres in Cape Town Interventions: The intervention group will receive 4 sessions of group diabetes education delivered by a health promotion officer in a guiding style. The control group will receive usual care which consists of ad hoc advice during consultations and occasional educational talks in the waiting room. Objective: To evaluate the effectiveness of the group diabetes education programme Outcomes: Primary outcomes: diabetes self-care activities, 5% weight loss, 1% reduction in HbA1c. Secondary outcomes: self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c, mean total cholesterol, quality of life Randomisation: Computer generated random numbers Blinding: Patients, health promoters and research assistants could not be blinded to the health centre’s allocation Numbers randomized: Seventeen health centres (34 in total will be randomly assigned to either control or intervention groups. A sample size of 1360 patients in 34 clusters of 40 patients will give a power of 80% to detect the primary outcomes with 5% precision. Altogether 720 patients were recruited in the intervention arm and 850 in the control arm giving a total of 1570. Discussion The study will inform policy makers and managers of the district health system, particularly in low to middle income countries, if this programme can

  10. Metabolic syndrome in South Asians

    Directory of Open Access Journals (Sweden)

    Kaushik Pandit

    2012-01-01

    Full Text Available South Asia is home to one of the largest population of people with metabolic syndrome (MetS. The prevalence of MetS in South Asians varies according to region, extent of urbanization, lifestyle patterns, and socioeconomic/cultural factors. Recent data show that about one-third of the urban population in large cities in India has the MetS. All classical risk factors comprising the MetS are prevalent in Asian Indians residing in India. The higher risk in this ethnic population necessitated a lowering of the cut-off values of the risk factors to identify and intervene for the MetS to prevent diabetes and cardiovascular disease. Some pharmacological and nonpharmacological interventions are underway in MetS to assess the efficacy in preventing the diabetes and cardiovascular disease in this ethnic population.

  11. Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis.

    Science.gov (United States)

    Kumar, Kanta; Greenfield, Sheila; Raza, Karim; Gill, Paramjit; Stack, Rebecca

    2016-05-26

    Prevalence of diabetes and cardiovascular (CVD) disease amongst UK South Asians is higher than in the general population. Non-adherence to medicines may lead to poor clinical outcomes for South Asian patients with diabetes and CVD. To understand the decision making processes associated with taking medicines, a qualitative systematic meta-synthesis exploring medicine taking behaviours, and beliefs was undertaken. Four databases (Medline, Embase, Science Citation Index and CINAHL) were searched to identify qualitative studies of South Asian patients taking diabetic medicines. Data were thematic coded and synthesised. The following themes were identified: [1] beliefs about the need for and efficacy of medicines; [2] toxicity of medicines and polypharmacy; [3] the necessity of traditional remedies versus "western medicines"; [4] stigma and social support; and [5] communication. South Asians described cultural social stigma associated with diabetes and reported fears about drug toxicity as barriers to taking medicines. Cultural beliefs about traditional remedies and interactions with healthcare professionals also appeared to play a role in the way people made decisions about medicines. Advice should be tailored provided to South Asian patients highlighting the long term consequences of diabetes and CVD.

  12. Obesity and Dyslipidemia in South Asians

    Science.gov (United States)

    Misra, Anoop; Shrivastava, Usha

    2013-01-01

    Obesity and dyslipidemia are emerging as major public health challenges in South Asian countries. The prevalence of obesity is more in urban areas than rural, and women are more affected than men. Further, obesity in childhood and adolescents is rising rapidly. Obesity in South Asians has characteristic features: high prevalence of abdominal obesity, with more intra-abdominal and truncal subcutaneous adiposity than white Caucasians. In addition, there is greater accumulation of fat at “ectopic” sites, namely the liver and skeletal muscles. All these features lead to higher magnitude of insulin resistance, and its concomitant metabolic disorders (the metabolic syndrome) including atherogenic dyslipidemia. Because of the occurrence of type 2 diabetes, dyslipidemia and other cardiovascular morbidities at a lower range of body mass index (BMI) and waist circumference (WC), it is proposed that cut-offs for both measures of obesity should be lower (BMI 23–24.9 kg/m2 for overweight and ≥25 kg/m2 for obesity, WC ≥80 cm for women and ≥90 cm for men for abdominal obesity) for South Asians, and a consensus guideline for these revised measures has been developed for Asian Indians. Increasing obesity and dyslipidemia in South Asians is primarily driven by nutrition, lifestyle and demographic transitions, increasingly faulty diets and physical inactivity, in the background of genetic predisposition. Dietary guidelines for prevention of obesity and diabetes, and physical activity guidelines for Asian Indians are now available. Intervention programs with emphasis on improving knowledge, attitude and practices regarding healthy nutrition, physical activity and stress management need to be implemented. Evidence for successful intervention program for prevention of childhood obesity and for prevention of diabetes is available for Asian Indians, and could be applied to all South Asian countries with similar cultural and lifestyle profiles. Finally, more research on

  13. Obesity and Dyslipidemia in South Asians

    Directory of Open Access Journals (Sweden)

    Anoop Misra

    2013-07-01

    Full Text Available Obesity and dyslipidemia are emerging as major public health challenges in South Asian countries. The prevalence of obesity is more in urban areas than rural, and women are more affected than men. Further, obesity in childhood and adolescents is rising rapidly. Obesity in South Asians has characteristic features: high prevalence of abdominal obesity, with more intra-abdominal and truncal subcutaneous adiposity than white Caucasians. In addition, there is greater accumulation of fat at “ectopic” sites, namely the liver and skeletal muscles. All these features lead to higher magnitude of insulin resistance, and its concomitant metabolic disorders (the metabolic syndrome including atherogenic dyslipidemia. Because of the occurrence of type 2 diabetes, dyslipidemia and other cardiovascular morbidities at a lower range of body mass index (BMI and waist circumference (WC, it is proposed that cut-offs for both measures of obesity should be lower (BMI 23–24.9 kg/m2 for overweight and ≥25 kg/m2 for obesity, WC ≥80 cm for women and ≥90 cm for men for abdominal obesity for South Asians, and a consensus guideline for these revised measures has been developed for Asian Indians. Increasing obesity and dyslipidemia in South Asians is primarily driven by nutrition, lifestyle and demographic transitions, increasingly faulty diets and physical inactivity, in the background of genetic predisposition. Dietary guidelines for prevention of obesity and diabetes, and physical activity guidelines for Asian Indians are now available. Intervention programs with emphasis on improving knowledge, attitude and practices regarding healthy nutrition, physical activity and stress management need to be implemented. Evidence for successful intervention program for prevention of childhood obesity and for prevention of diabetes is available for Asian Indians, and could be applied to all South Asian countries with similar cultural and lifestyle profiles. Finally, more

  14. Actinic keratosis and diabetes complications: A nationwide population-based study in South Korea (2009-2015).

    Science.gov (United States)

    Lee, YoungBok; Lee, JiHyun; Choi, JinYoung; Yu, DongSoo; Han, KyungDo; Park, Yong-Gyu

    2017-11-29

    As the associations between actinic keratosis (AK) and diabetes complications in patients with diabetes mellitus (DM) have never been investigated, this study aimed to evaluate any such associations in patients with DM. This retrospective cohort study analyzed clinical data for DM patients aged>40 years who had undergone the health examination recommended by the South Korea National Health Insurance Program between 2009 and 2012 (n=2,056,580). All of these patients were classified according to the presence of diabetic retinopathy (DR), end-stage renal disease (ESRD) and history of DVD; myocardial infarction, stroke, transient ischaemic attacks. Newly diagnosed AK was identified using claims data from baseline to the date of diagnosis or 31 December 2015, whichever came first. Of the 2,056,580 patients with DM, 6404 (0.31%) developed AK. Those patients in the DR, ESRD and CVD groups were more likely to be diagnosed with AK (PAK were significantly higher in the DR, ESRD and CVD groups: HR (95% CI): 1.29 (1.21-1.39), HR: 4.24 (3.28-5.47) and HR: 1.22 (1.13-1.31), respectively. This study has revealed that the incidence of AK is higher in diabetes patients with ocular, renal and cardiovascular complications. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. Place of sulfonylureas in the management of type 2 diabetes mellitus in South Asia: A consensus statement

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2015-01-01

    Full Text Available Since their introduction in clinical practice in the 1950′s, Sulfonylureas (SUs have remained the main-stay of pharmacotherapy in the management of type 2 diabetes. Despite their well-established benefits, their place in therapy is inappropriately being overshadowed by newer therapies. Many of the clinical issues associated with the use of SUs are agent-specific, and do not pertain to the class as such. Modern SUs (glimepiride, gliclazide MR are backed by a large body of evidence, experience, and most importantly, outcome data, which supports their role in managing patients with diabetes. Person-centred care, i.e., careful choice of SU, appropriate dosage, timing of administration, and adequate patient counseling, will ensure that deserving patients are not deprived of the advantages of this well-established class of anti-diabetic agents. Considering their efficacy, safety, pleiotropic benefits, and low cost of therapy, SUs should be considered as recommended therapy for the treatment of diabetes in South Asia. This initiative by SAFES aims to encourage rational, safe and smart prescription of SUs, and includes appropriate medication counseling.

  16. Association of urinary KIM-1, L-FABP, NAG and NGAL with incident end-stage renal disease and mortality in American Indians with type 2 diabetes mellitus.

    Science.gov (United States)

    Fufaa, Gudeta D; Weil, E Jennifer; Nelson, Robert G; Hanson, Robert L; Bonventre, Joseph V; Sabbisetti, Venkata; Waikar, Sushrut S; Mifflin, Theodore E; Zhang, Xiaoming; Xie, Dawei; Hsu, Chi-Yuan; Feldman, Harold I; Coresh, Josef; Vasan, Ramachandran S; Kimmel, Paul L; Liu, Kathleen D

    2015-01-01

    Kidney injury molecule 1 (KIM-1), liver fatty acid-binding protein (L-FABP), N-acetyl-β-D-glucosaminidase (NAG) and neutrophil gelatinase-associated lipocalin (NGAL) are urinary biomarkers of renal tubular injury. We examined their association with incident end-stage renal disease (ESRD) and all-cause mortality in American Indians with type 2 diabetes. Biomarker concentrations were measured in baseline urine samples in 260 Pima Indians who were followed for a median of 14 years. HRs were reported per SD of creatinine (Cr)-normalised log-transformed KIM-1, NAG and NGAL, and for three categories of L-FABP. During follow-up, 74 participants developed ESRD and 101 died. Median concentrations of KIM-1/Cr, NAG/Cr and NGAL/Cr and the proportion of detectable L-FABP were highest in those with macroalbuminuria (p associated with ESRD (HR 1.59, 95% CI 1.20, 2.11) and mortality (HR 1.39, 95% CI 1.06, 1.82); L-FABP/Cr was inversely associated with ESRD (HR [for highest vs lowest tertile] 0.40, 95% CI 0.19, 0.83). Addition of NGAL/Cr to models that included albuminuria and glomerular filtration rate increased the c-statistic for predicting ESRD from 0.828 to 0.833 (p = 0.001) and for death from 0.710 to 0.722 (p = 0.018). Addition of L-FABP/Cr increased the c-statistic for ESRD from 0.828 to 0.832 (p = 0.042). In Pima Indians with type 2 diabetes, urinary concentrations of NGAL and L-FABP are associated with important health outcomes, but they are unlikely to add to risk prediction with standard markers in a clinically meaningful way given the small increase in the c-statistic.

  17. 76 FR 56466 - Indian Gaming

    Science.gov (United States)

    2011-09-13

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an approval of the gaming compact between the Flandreau Santee Sioux Tribe and the State of South...

  18. 77 FR 43110 - Indian Gaming

    Science.gov (United States)

    2012-07-23

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Rosebud Sioux Tribe and the State of South Dakota. DATES...

  19. 76 FR 8375 - Indian Gaming

    Science.gov (United States)

    2011-02-14

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal-State Class III Gaming Compact. SUMMARY: This notice publishes an extension of the Gaming Compact between the Oglala Sioux Tribe and the State of South Dakota...

  20. 77 FR 45371 - Indian Gaming

    Science.gov (United States)

    2012-07-31

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Oglala Sioux Tribe and the State of South Dakota. DATES: Effective...

  1. 78 FR 15738 - Indian Gaming

    Science.gov (United States)

    2013-03-12

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of the gaming compact between the Rosebud Sioux Tribe and the State of South Dakota...

  2. 77 FR 59641 - Indian Gaming

    Science.gov (United States)

    2012-09-28

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal-State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Rosebud Sioux Tribe and the State of South Dakota. DATES...

  3. 76 FR 52968 - Indian Gaming

    Science.gov (United States)

    2011-08-24

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Rosebud Sioux Tribe and the State of South Dakota. DATES...

  4. 76 FR 33341 - Indian Gaming

    Science.gov (United States)

    2011-06-08

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Rosebud Sioux Tribe and the State of South Dakota. DATES...

  5. 75 FR 55823 - Indian Gaming

    Science.gov (United States)

    2010-09-14

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of approved Tribal-State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Oglala Sioux Tribe and the State of South Dakota. DATES: Effective...

  6. 78 FR 11221 - Indian Gaming

    Science.gov (United States)

    2013-02-15

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal-State Class III Gaming Compact. SUMMARY: This notice publishes an extension of the gaming compact between the Oglala Sioux Tribe and the State of South Dakota...

  7. Anxiety, depression and psychological well-being in a cohort of South African adults with Type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Samantha Ramkisson

    2016-07-01

    Full Text Available Background: The prevalence of diabetes mellitus (DM has increased at alarming rates globally. South Africa has the second highest number of people in Africa living with DM, with prevalence rates being among the top five countries in Africa. Accordingly, psychological issues associated with DM have been a growing focus of attention. Studies have found that patients with DM have elevated levels of anxiety and depression, and decreased levels of well-being. In South Africa, there is a paucity of studies on the psychological issues associated with DM. Objectives: The aim of this paper was to explore the prevalence and association of anxiety, depressive features and psychological well-being in patients with Type 2 DM. Method: In a cross-sectional survey, patients with Type 2 DM were recruited from public and private facilities. The Hospital Anxiety and Depression Scale (HADS, the General Health Questionnaire (GHQ-28 and WHO-5 Well-being Index (WHO-5 were administered. Results: Four hundred and one participants completed the questionnaires. On the WHO-5, 277 (69% reported good well-being, while 124 (31% indicated poor well-being and were considered at risk for depressive features. On the HADS, 186 (46% had mild-to-severe depressive features and 128 (32% had mild-to-severe anxiety. There was a strong negative correlation between the WHO-5, HADS and General Health Questionnaire (GHQ scales, which indicated that an increase in anxiety and depressive features decreased psychological well-being. Conclusion: Health-care providers should identify and treat anxiety and depression as a standard part of diabetes care. Patients should also be referred to the appropriate mental health professional as part of the management of diabetes. Keywords: type 2 diabetes; anxiety;depression;psychological well-being; adults

  8. Ethnic inequalities in health : why is the prevalence of type 2 diabetes higher among South Asian immigrants?

    OpenAIRE

    Mako, Robsan Sayo

    2013-01-01

    Master in International Social Welfare and Health Policy Type 2 diabetes mellitus (T2DM) is a major public health problem with the burden of the disease distributed unevenly. The prevalence of the disease is higher among South Asian immigrants in comparison to the prevalence among the population of the host countries. Studies from Norway, UK and beyond indicate that there is ethnic inequality in the prevalence of T2DM. In order to find out the reason for this high prevalence of T2DM, this ...

  9. Conversion of gestational diabetes mellitus to future Type 2 diabetes mellitus and the predictive value of HbA1c in an Indian cohort.

    Science.gov (United States)

    Gupta, Y; Kapoor, D; Desai, A; Praveen, D; Joshi, R; Rozati, R; Bhatla, N; Prabhakaran, D; Reddy, P; Patel, A; Tandon, N

    2017-01-01

    To investigate the distribution of and risk factors for dysglycaemia (Type 2 diabetes and prediabetes) in women with previous gestational diabetes mellitus in India. All women (n = 989) from two obstetric units in New Delhi and Hyderabad with a history of gestational diabetes were invited to participate, of whom 366 (37%) agreed. Sociodemographic, medical and anthropometric data were collected and 75-g oral glucose tolerance test were carried out. Within 5 years (median 14 months) of the pregnancy in which they were diagnosed with gestational diabetes, 263 (72%) women were dysglycaemic, including 119 (32%) and 144 (40%) with Type 2 diabetes and prediabetes, respectively. A higher BMI [odds ratio 1.16 per 1-kg/m 2 greater BMI (95% CI 1.10, 1.28)], presence of acanthosis nigricans [odds ratio 3.10, 95% CI (1.64, 5.87)], postpartum screening interval [odds ratio 1.02 per 1 month greater screening interval 95% CI (1.01, 1.04)] and age [odds ratio 1.10 per 1-year older age 95% CI (1.04, 1.16)] had a higher likelihood of having dysglycaemia. The American Diabetes Association-recommended threshold HbA 1c value of ≥ 48 mmol/mol (6.5%) had a sensitivity and specificity of 81.4 and 90.7%, respectively, for determining the presence of Type 2 diabetes postpartum. The high post-pregnancy conversion rates of gestational diabetes to diabetes reported in the present study reinforce the need for mandatory postpartum screening and identification of strategies for preventing progression to Type 2 diabetes. Use of the American Diabetes Association-recommended HbA 1c threshold for diabetes may lead to significant under-diagnosis. © 2016 Diabetes UK.

  10. Design of a Randomized Controlled Trial of a Web-Based Intervention to Reduce Cardiovascular Disease Risk Factors among Remote Reservation-Dwelling American Indian Adults with Type 2 Diabetes

    Science.gov (United States)

    Henderson, Jeffrey A.; Chubak, Jessica; O'Connell, Joan; Ramos, Maria C.; Jensen, Julie; Jobe, Jared B.

    2012-01-01

    We describe a randomized controlled trial, the Lakota Oyate Wicozani Pi Kte (LOWPK) trial, which was designed to determine whether a Web-based diabetes and nutritional intervention can improve risk factors related to cardiovascular disease (CVD) among a group of remote reservation-dwelling adult American Indian men and women with type 2 diabetes…

  11. Identification, prevalence, and treatment of painful diabetic neuropathy in patients from a rural area in South Carolina

    Directory of Open Access Journals (Sweden)

    Pruitt III J

    2017-04-01

    -DN received adequate pharmacological agents, though suboptimal as per clinical guidelines. More than 50% of the patients used subtherapeutic doses of their medications. Gabapentin was the most frequently used medication in our population (65.4%. Patients in rural South Carolina had a higher prevalence of DPN and p-DN with >60% undocumented cases of p-DN. More than 95% of treated patients did not receive optimum therapy according to AAN guidelines. Keywords: polysensory neuropathy, pharmacist-led diabetes clinic, diabetes educator, gabapentin, chronic pain free clinic, pain, gabapentin

  12. Cost-effectiveness of interventions to control cardiovascular diseases and diab