Obesity in the eye of the beholder : - body size preferences among Pakistani women in Norway with a high risk of diabetes

Executive summary Background: South Asians are known to be prone to the metabolic syndrome and the adverse effects of this. There are many hypotheses and explanations for the high vulnerability to obesity, diabetes and cardiovascular disease in this group of people. Genetics and lifestyle differences play important roles in the development of non-communicable diseases. In the prevention and treatment of these conditions emphasis is put on keeping a normal weight, by healthy diet and physical activity. However, in areas with food scarcity, overweight has traditionally been associated with being in good health and of high status, and the body ideal has been large. Pakistani women in Norway have a high prevalence of obesity and diabetes. These women have impulses both from the traditional culture in their country of origin and from the Norwegian culture. To be able to give appropriate and effective advices on weight reduction, it is of importance to know their body size preferences. Little research has been done on body size preferences in South Asian and Pakistani women. Aim: The aim of the study was to investigate which body size preferences Pakistani women in Norway have, and whether these have an impact on their weight reduction behaviour, their body mass indexes and on the intake of foods rich in fats and sugar, vegetables, fruits and legumes. Methods: The participants (Pakistani women aged 26 to 62), living in S©ªndre Nordstrand, Oslo, were part of the larger randomized controlled lifestyle intervention study InnvaDiab. The majority was first generation immigrants. Demographic data was collected and measurements of height, weight and waist circumference were done by trained staff. Bilingual interviewers filled a precoded questionnaire on diet and body size preferences at the time of inclusion by the local health centre. A figure rating scale was used to investigate the body size preferences. The women¡¯s views of which body size a healthy and a rich woman should have were studied. In addition theirs believes of the body sizes preferred by other people were explored. The diet was studied by food frequency questionnaire and weight reduction behaviour was reported by the stage in ¡°stages of change¡±, which is a construct of the Transtheoretical Model. Findings: There was found a high prevalence of people with a BMI ¡Ã 25 (80%) and BMI ¡Ã 30 (39%). The BMIs did not vary with age, number of children, years in Norway, years of education, self-reported Norwegian skills and work status. The waist circumferences were smaller for those with higher education. On average the women linked body sizes depicting normal BMI to good health and richness, and believed that Pakistani women in Norway in the age of 45 preferred a body size with a BMI of 21 to 23. Most of the participants had a higher body size than the body sizes they preferred, and reported to be trying to reduce weight but not doing so regularly. Those trying to reduce weight were less likely to eat deep-fried and sweet foods, and had a more frequent intake of fruit and berries. The intake of vegetables, fast food and sugar was not affected by the stage in weight reduction behaviour. Conclusion: The present study gives information on a field that has not been widely explored previously in Pakistani women living in Norway. This study should be an encouragement to investigate body size preferences more thoroughly. There is a need for qualitative studies on this issue

Diagnostic utility of anti-citrullinated protein antibody and its comparison with rheumatoid factor in rheumatoid arthritis

Objective: To assess the diagnostic utility of anti-citrullinated protein antibody (anti-CCP) in rheumatoid arthritis (RA) and compare it with rheumatoid factor (RF). Study Design: Analytical study. Place and Duration of Study: Section of Chemical Pathology, Department of Pathology and Microbiology and Medicine, the Aga Khan University, Karachi, from January to May 2010. Methodology: A review of medical records of patients presenting to the clinics with complaints of muscular or joint pains and who were tested for their serum anti-CCP was done. Inclusion criteria were presence of clinical synovitis in at least one joint and an absence of alternative diagnosis. Patients with arthralgia alone or with missing acute phase reactants information were excluded. Scoring and classification of RA was done using the 2010 RA Classification Criteria by the American College of Rheumatology (ACR). Results: Out of the 98 charts reviewed, ACR criteria showed 54 cases with RA. The mean age of the group was 46 ± 15 years, 82.7% being females. High titers of anti-CCP corresponded with the ACR scores. The sensitivity and specificity of anti-CCP and RF reactivity for the diagnosis of RA were 54.7% and 95.5% versus 59.3% and 88.4% respectively. Conclusion: Anti-CCP is useful for the diagnosis of RA due to its higher specificity as compared to RF and can predict disease severity

Mortality-related resource utilization in the inpatient care of hypoplastic left heart syndrome.

BACKGROUND: Quantifying resource utilization in the inpatient care of congenital heart diease is clinically relevant. Our purpose is to measure the investment of inpatient care resources to achieve survival in hypoplastic left heart syndrome (HLHS), and to determine how much of that investment occurs in hospitalizations that have a fatal outcome, the mortality-related resource utilization fraction (MRRUF). METHODS: A collaborative administrative database, the Pediatric Health Information System (PHIS) containing data for 43 children\u27s hospitals, was queried by primary diagnosis for HLHS admissions of patients ≤21 years old during 2004-2013. Institution, patient age, inpatient deaths, billed charges (BC) and length of stay (LOS) were recorded. RESULTS: In all, 11,122 HLHS admissions were identified which account for total LOS of 277,027 inpatient-days and $3,928,794,660 in BC. There were 1145 inpatient deaths (10.3%). LOS was greater among inpatient deaths than among patients discharged alive (median 17 vs. 12, p \u3c 0.0001). BC were greater among inpatient deaths than among patients discharged alive (median 4.09 × 10(5) vs. 1.63 × 10(5), p \u3c 0.0001). 16% of all LOS and 21% of all BC were accrued by patients who did not survive their hospitalization. These proportions showed no significant change year-by-year. The highest volume institutions had lower mortality rates, but there was no relation between institutional volume and the MRRUF. CONCLUSIONS: These data should alert providers and consumers that current practices often result in major resource expenditure for inpatient care of HLHS that does not result in survival to hospital dismissal. They highlight the need for data-driven critical review of standard practices to identify patterns of care associated with success, and to modify approaches objectively

Newborn screening for congenital hypothyroidism: Improvement in short-term follow-up by audit and monitoring

Objective: Newborn screening for congenital hypothyroidism (CH) at our hospital during this study was by measurement of thyroid stimulating hormone (TSH) in serum samples. This audit was conducted over a 2 year period, to determine the compliance of reporting of results greater than the screening cutoffs for serum TSH. Gaps of non-compliance were identified, and re-audit was undertaken after the corrective actions were taken.Results: The critical limit was defined as serum TSH (≥ 20 µIU/ml) following consultation with a pediatric endocrinologist. All results above this limit were reported urgently to physicians. During the audit period, 27,407 tests were performed, 0.7% had a value of ≥ 20 µIU/ml, of those only 62% were reported to the general paediatrician or neonatologist. Reasons for not reporting results included non-availability of contact information, lack of policy awareness by technologists, critical results not highlighted on the computer display, and absence of regular monitoring. Corrective measures were taken, and re-audit was done. During the re-audit period, a total of 22,985 tests was performed, 0.6% had a value of ≥ 20 µIU/ml. Of these, 77% were reported to the general paediatrician or neonatologist. Critical result reporting was improved after the audit, and further enhanced the laboratory service of CH screening

Thermal enhancement and numerical solution of blood nanofluid flow through stenotic artery

The blood flow through stenotic artery is one of the important research area in computational fluid mechanics due to its application in biomedicine. Aim of this research work is to investigate the impact of nanoparticles on the characteristics of human blood flow in a stenosed blood artery. In under consideration problem Newtonian fluid is assumed as human blood. Newtonian fluid flows through large blood vessels (more than 300 mu m). The constitutive equations together with the boundary conditions are diminished to non-dimensional form by using boundary layer approximation and similarity transfiguration to attain the solution of velocity and temperature distribution of blood flow through arterial stenosis numerically with the help of Matlab bvp4c. The results for physical quantities at cylindrical surface are calculated and their effects are also presented through tables. The heat transfer rate increases throughout the stenosed artery with the concentration of copper nanoparticle. Velocity curve decreases by increasing the values of flow parameter and nanoparticle volume fraction. Temperature curve increases due to increase in the values of nanoparticle volume fraction and decrease in Prandtl number.The work of U.F.-G. was supported by the government of the Basque Country for the ELKA-RTEK21/10 KK-2021/00014 and ELKARTEK22/85 research programs, respectively. Additionally, this work was supported by the Researchers Supporting Project Number (RSP-2021/33), King Saud University, Riyadh, Saudi Arabia

Association between environmental tobacco smoke and dental caries amongst 5-14 years old children in Karachi, Pakistan.

Objective:To determine the association between environmental tobacco smoke and dental caries.Methods:This cross-sectional study was conducted in peri-urban and urban areas of Karachi, from February to August 2014, and comprised children aged 5-14 years. A pre-coded questionnaire for environmental tobacco smoke and food frequency questionnaire for dietary habits were used. Dental examination of children was done to detect caries. Cox-proportional hazard algorithm was used to measure the association of environmental tobacco smoke with dental caries at multivariable level. STATA version 12.0 was used for statistical analysis.Result:Of the 500 children, 250(50%) each were from peri-urban and urban localities. The prevalence of dental caries was 336(67.2%).Family members of 154(30.8%) participants reported smoking. After adjusting for junk food intake, in-between meals, age, plaque index, dental visits and socio-economic status, the association between environmental tobacco smoke and dental caries remained statistically significant (p30 minutes of environmental tobacco smoke exposure, respectively.Conclusions:Environmental tobacco smoke was found to be associated with dental caries

Clinicopathological features of different Histopathological Subtypes and Stages of Wilms Tumor

Introduction: Wilms tumor is the most common pediatric renal neoplasm. Following preoperative therapy, various histological subtypes, risks and clinical stages are determined as per following SIOP 2001 protocol. To determine the clinicopathological features of different histopathological subtypes and stages of Wilms tumor after completing course of preoperative as well as postoperative chemotherapy following SIOP 2001 protocol. Methodology: This is a retrospective cross-sectional study and sample size calculated by non-probability technique. Ninety-three patients with abdominal masses in the Hematology/Oncology Department were included. After radiological and histopathological diagnosis, four weeks of preoperative chemotherapy, given to patients, followed by partial and radical nephrectomies by surgical team. Specimens received in Histopathology Department grossed and microscopically examined for different post chemotherapy histological subtypes. Further risk categorization and clinicopathological staging in accordance with SIOP 2001, done after completion of treatment. Patients called for yearly follow up for the next five years. Categorical variables are presented as frequencies and percentages. Results: Mean age of ninety-three children was 44.4 months + 30.92with predominance of males (55.9%) and more common in right sided kidney (55.9%). Majority patients completed the entire course of treatment (77.4%). Majority were intermediate risk tumors (76.3%) and most common histological subtype was Mixed Tumor subtype (23.4%). In our study majority, tumors were stage III (48.3%) and patients died due to febrile neutropenia (9.6%) Conclusion: In our study the majority of patients completed the entire course of treatment and relapse was fairly less. Patients lost to follow up after nephrectomy and deaths at home caused by febrile neutropenia were our major challenges.

Omental Patching and Purse-String Endosuture Closure after Endoscopic Full-Thickness Resection in Patients with Gastric Gastrointestinal Stromal Tumors

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, primarily arising from the stomach. With the widespread utilization of and technical advancements in endoscopy, gastric GISTs are being increasingly detected at an early stage, enabling complete endoscopic resection. Endoscopic full-thickness resection (EFTR) is an advanced technique that has been recognized as a treatment tool for neoplasms in the digestive tract in selected patients. Although a number of methods are available, closing large iatrogenic defects after EFTR can be a concern in clinical practice. If this potential problem is appropriately solved, patients with gastric GISTs would be suitable candidates for resection utilizing this technique. To our knowledge, this is the first study to propose omental patching and purse-string endosuture closure following EFTR as a feasible endoscopic option in patients with gastric GISTs

Heat transport investigation of engine oil based rotating nanomaterial liquid flow in the existence of partial slip effect

In this study, rotational nano liquid movement above a linearly stretching surface has been formulated. A two-phase model is used for this analysis. Base fluid engine oil and two distinct types of nanoparticles are used as nanoparticles, i.e. copper and aluminum oxide (Cu & Al2O3). This study is aimed to describe the changed possessions on velocity and temperature for rotational nanofluid flow above a linear enlarging surface in the existence of the slip effect. The leading structure of PDEs is converted into ODEs with a similarity transformation. Numerical findings are gained utilizing a sophisticated numerical approach. For both nanofluids, the results for rotational flow and heat transmission characteristics are emphasized with the help of graphs. At the linear extending surface, the influence of physical concentrations like heat flow rates and skin friction coefficients is investigated and visually clarified. Cunanoparticles proved to be better heat carriers than Al2O3 nanoparticles

Carnosol Is a Novel Inhibitor of p300 Acetyltransferase in Breast Cancer

Carnosol, a natural polyphenol abundant in edible plants such as sage, rosemary, and oregano, has shown promising anticancer activity against various types of cancers. Nonetheless, very little is known about its molecular mechanism of action or its downstream target(s). We have previously shown that carnosol inhibits cellular proliferation, migration, invasion, and metastasis as well as triggers autophagy and apoptosis in the highly invasive MDA-MB-231 breast cancer cells. Here, we report that carnosol induces histone hypoacetylation in MDA-MB-231 and Hs578T breast cancer cells. We show that, while carnosol does not affect HDACs, it promotes a ROS-dependent proteasome degradation of p300 and PCAF histone acetyl transferases (HATs) without affecting other HATs such as GCN5 and hMOF. Carnosol-induced histone hypoacetylation remains persistent even when p300 and PCAF protein levels were rescued from degradation by (i) the inhibition of the proteasome activity by the proteasome inhibitors MG-132 and bortezomib, and (ii) the inhibition of ROS accumulation by the ROS scavenger, N-acetylcysteine. In addition, we report that, in a cell-free system, carnosol efficiently inhibits histone acetyltransferase activity of recombinant p300 but not that of PCAF or GCN5. Molecular docking studies reveal that carnosol inhibits p300 HAT activity by blocking the entry of the acetyl-CoA binding pocket of the catalytic domain. The superimposition of the docked conformation of the p300 HAT domain in complex with carnosol shows a similar orientation as the p300 structure with acetyl-CoA. Carnosol occupies the region where the pantetheine arm of the acetyl-CoA is bound. This study further confirms carnosol as a promising anti-breast cancer therapeutic compound and identifies it as a novel natural p300 inhibitor that could be added to the existing panel of inhibitors.This work was supported by the Zayed Center for Health Sciences (ZCHS) research grant (Grant # 31R086) and by Al Jalila Foundation Research Grant (Grant # 21S102-AJF2018007)