Probing the wet cupping therapy (bekam) on measurable beneficial health effects

Introduction : Cupping is a form of complementary medicine practiced in many countries worldwide. It is a method involving the application of suction to certain part of the body by placing a vacuum cup or jar. Suction for vacuum effect resulted from usage of fire or suction pump. The purposes of this therapy are curing certain diseases by extracting the blood that is believed to be harmful from the body. Objective : The aim of this study was to determine the effect of wet cupping therapy in non diabetic and diabetic subjects on body mass index (BMI), blood pressure, biochemical parameters, renal function and endothelial function. Methods : Ninety three subjects aged between 30 and 60 years old participated in this study. Sixty two non diabetic individual without chronic disease were randomly and equally assigned into control and intervention group. For diabetic group, 31 subjects were included. Cupping were done on subjects in the intervention and diabetic group, whereas individual in the control group were remained unintervene. Two sessions of wet cupping had been performed; at the start of the study and at the third month. Assessments were done at baseline, first month, third month (before the >econd session of cupping) and fourth month for all participants. Results : In non diabetic cupping group, there were significant reductions in fasting blood sugar (FBS) and all renal function parameters (serum urea, creatinine and uric acid) from baseline to the first, third and fourth month. Serum triglycerides and systolic blood pressure (SBP) also showed significant reductions at first month. All serum lipid profiles except serum triglycerides showed significant improvement at third and fourth months. The Von Willebrand Factor (VWF) antigen also showed significant reduction at fourth month. At the end of the study, all the serum lipid profiles, FBS, serum urea and creatinine in cupping group were significantly differ as compared with control group. For serum HDL-C and LDL-C, the significant difference between cupping and control group were seen at the third and fourth month. In diabetic group, FBS, blood pressure and all renal function parameters showed significant reduction at the first, third and fourth month. Serum total cholesterol showed reduction at the third and fourth month. For serum HDL-C, serum LDL-C and VWF antigen, the changes were seen at fourth month. At the end of fourth month, there were significant improvements in all parameters except BMI and triglycerides. Conclusions : Wet cupping therapy showed significant improvement in blood pressure and certain component of biochemical parameters, renal function parameters and also endothelial functions. Therefore wet cupping could contribute in reducing and preventing the risk factors for cardiovascular diseas

The impact of structured healthy lifestyle program among type 2 diabetic patients in Kelantan

A non-randomised control trial was conducted with the aim to assess the impact of structured healthy life-style program among Type 2 diabetic patients in Kelantan.One hundred and forty Type 2 diabetic patients from Selising Health Centre (inteivention group) and Gaal Health Centre (control group) in Pasir Puteh District were selected using multistage sampling technique.An intervention group was given a structured health education on self-care,dietary advise and exercise.The control group was given conventional health education.Data were collected using a structured questionnaire, anthropometries measurement and blood sampling for random blood sugar and HbAlc. Statistical Package for Social Science (SPSS) version 9.0 was used for analysing the data. The patients in both health centres had a similar sociodemographic distribution (p value > 0.05).Most of them are Malay(99%),females(59% intervention,66%control), married (74% intervention,86% control),and a non-smoker (67% intervention,73% control). Their mean(+SD)age was 56:0 + 10.17 year (intervention) vs 54.2 + 11.75 year (control) and mean (SD) duration of diabetes was 5.6(4.81) year (intervention) vs. 5.4(4.23) year (control).The intervention group showed a significant improvement in mean score of ·knowledge (16.5 (4.49) vs 23.8 {1.42)),practice (14.5(2.13) vs. 15.6 (2.42)), HbAlc (10.3{2.85) vs 8.9(1.93)) and BMI level (26.1(4.08) vs 25.8(3.98)) kgm-2 after the intervention program whereas no significant different seen in the control group.The study showed that the blood glucose control and BW of Type 2 diabetic patients could be improved if they are willing to change their lifestyle.The main challenge in management of these patients is however to sustained their healthy lifestyle

Trigonella Foenum-Graecum Seeds Lowers Postprandial Blood Glucose in Overweight and Obese Individuals

This study determined the effects of fenugreek on postprandial plasma glucose (PPG) and satiety among overweight and obese individuals. Fourteen subjects were studied in the morning after overnight fasts on four separate occasions. Glycaemic responses elicited by 50 g carbohydrate portions of white bread and jam with or without 5.5 g of fenugreek and fried rice with or without 5.5 g fenugreek were determined over 2 h. The primary endpoint was the incremental area under the plasma glucose response curve (IAUC). Adding fenugreek to both foods significantly reduced the IAUC compared to the food alone: white bread and jam, 180 ± 22 versus 271 ± 23 mmol × min/L (P = 0.001); fried rice, 176 ± 20 versus 249 ± 25 mmol × min/L (P = 0.001). Fenugreek also significantly reduced the area under the satiety curve for white bread with jam (134 ± 27 versus 232 ± 33 mm × hr, P = 0.01) and fried rice (280 ± 37 versus 379 ± 36 mm × hr, P = 0.01). It is concluded that fenugreek significantly decreased the PPG response and increased satiety among overweight and obese individuals

Diabetes knowledge, attitudes, self-management, and quality of life among people with type 2 diabetes mellitus – a comparison between Australia- and Malaysia-based samples

The present study aimed to examine the levels of diabetes knowledge, attitudes, self-management and quality of life (QoL) between two countries with different cultural and language backgrounds. Data collection was conducted in two hospitals in Melbourne, Australia, and a hospital in Kelantan, Malaysia. Participants with type 2 diabetes mellitus (T2DM) were asked to complete four questionnaires, measuring diabetes knowledge, attitudes, self-management, and QoL. The differences between the samples were examined using chi-square and independent samples t-tests. The variables of gender and type of treatment (using insulin or not using insulin for treatment) based on groups were analysed using one-way ANOVA. All analyses were conducted using SPSS 22.0. The results highlighted some similarities and differences between the Australia-based sample and the Malaysia-based sample. In general, the Australia-based participants scored significantly higher in diabetes knowledge and reported more regular self-management of T2DM in exercise, blood glucose testing and foot care. The Australia-based sample also scored higher on attitudes compared to the Malaysia-based participants. On the other hand, Malaysia-based participants reported a lower level of impacts of T2DM on QoL. There was no significant difference between self-management of T2DM in terms of diet and satisfaction as an aspect of QoL related to living with diabetes between the two samples. The present study highlighted the levels of diabetes knowledge, attitudes, self-management, and QoL among Australia-based and Malaysia-based people with T2DM

Factors associated with HbA1c levels in poorly controlled type 2 diabetic patients in North-East Malaysia

Objective: A study was conducted at all the health centres in Kelantan in North-East Malaysia to determine the common factors associated with poor controlled of type 2 diabetic patients. Design: A cross-sectional study Materials and Methods: A total of 208 patients with poor diabetic control (HbA1c levels of more than 6.5%) were selected by stratified random sampling from all health centres in Kelantan. Socio-demographic data, physical examination, and fasting blood were taken from the patients to determine the related associated factors using multiple linear regression. Results: The levels of HbA1c in the poorly controlled diabetic patients were significantly associated with fasting blood glucose (b=0.236, 95%CI=0.189,0.283), educational level (primary education: b=-0.965, 95%CI=-1.550,-0.380; secondary and tertiary education: b=-0.625, 95%CI=-1.228,-0.021), marital status (b=0.933, 95%CI=0.426,1.440) and patients receiving their care in health centres with Family Medicine Specialist (b=-0.495, 95%CI=-0.913,-0.076). Conclusion: Fasting blood glucose and being married were associated with higher levels of HbA1c, while having had formal education and receiving diabetic care in health centres with Family Medicine Specialist were associated with lower levels of HbA1c in poorly controlled type 2 diabetic patients in Kelantan

The epidemiology of physical disability among elderly in Kota Bharu, Kelantan

Globally, the decline in fertility and mortality as well as improvement in life expectancy ·were said to be responsible for the aging population by the year 2020. In Malaysia, the elderly population was 1.2 million or 5. 9% of the 20 million total population in the country in 1995. This number was projected to increase to 11.3% by the year 2020. Elderly population are prone to get physical disability as well as chronic medical illnesses. This is a cross-sectional study to determine the prevalence of physical disability and its associated risk factors among elderly, aged 60 years and above. A total of 270 participants were taken randomly under 3 health clinics under Kota Bharu oper~tional !areas by using multistage sampling. Guided- questionnaire were administered and the subjects were asked to go to clinics or community centre on the appointed date for physical e~amination and blood taking for fasting blood sugar and total cholesterol. Physical disability was measured by activities of daily,living ( ADLs) and instrumental's activities of ~aily living ( IADLs). ADLs is comprise of bathing, dressing, going to toilet, transferring from bed or chair, continence, and feeding. Whereas IADLs encotnpass the following domestic function : using the telephone, using transportation, shopping, cooking, house-keeping, taking medication and budgeting. The IADLs methods offer indicators of" applied " problem that extend the disability theme of ADLs scales to include some elements of handicap concept.Physical disability was defined as the inability to accomplish one or more ADLs or IADLs.Separate multiple logistic regression was used to determine the risk factors for both physical disabilities. The prevalence of physical disabilities in ADLs and IADLs were 10.7% ( 95% CI: 7, 14) and 34.8% ( 95% CI: 29, 41) respectively. Significant risk factors of ADLs were age (OR=2.669, 95%CI: 1.1 07, 6.643), hearing impairment (OR= . 2.539, 95%CI: 1.034,6.233), diastolic blood pressure (OR= 3.803, 95%CI:1.249, 11.578), and total cholesterol (OR= 1.535, 95%CI: 1.071, 2.200).Wherea~ for IADL were age (OR=2.391, 95%CI: 1.185,4.827), income (OR= 0.219, 95%CI:0.078, 0.615),diastolic blood pressure (OR=2.023, 95°/oCI: 1.038,3.941 ), marital status (OR=2.378, 95%CI:1.227,4.609 ) and obesity (OR=4.679,95%CI:l.544, 14.182). There was a strong significant association between ADLs and IADLs (OR=9.012, 95%CI:3.400, 23.887). The prevalence of physical disability for ADLs and IADLs were 10.7% and 34.8% respectively and it was similar with others studies. These findings also suggested that certain sociodemographic characteristics ( i.e age, income & marital status ), life-style behavior ( obesity) and medical illnesses (hearing impainnent, total blood cholesterol and high diastolic blood pressure) were significant risk factors of physical' disability in elderly. Physical disability in ADLs was a strong predictor for physical disability· in IADL. The majority of predictors of physical disability that were identified by this study are potentially subject to modification either by treatment, life-style change or special device. Public health efforts to reduce prevalence of all these factors in both sexes should continue

Erectile dysfunction among diabetic patients in Kota Bharu Kelantan

A cross sectional study was conducted among diabetic patients in Kelantan, Malaysia to determine the prevalence of erectile dysfunction (ED),characteristics of diabetic patients with ED and patient's knowledge, attitude and practice towards ED. A total of 156 patients from Diabetic Clinic, Klinik Kesihatan Bandar, Kota Bharu and Hospital Universiti Sains Malaysia (USM), Kubang Kerian were selected into the study by using the availability sampling technique. Respondent were given self-administered questionnaire. ED was determined by using the International Index Of Erectile Function (IIEF-5). Statistical Program for Social Science (SPSS) version 9.0 was used for analyzing the data. The mean age was 53.2 ± 9.18 year. Majority of patients were Type 2 diabetes (97.6%). The overall prevalence of ED was 77.8% in which the prevalence of severe ED was 36.7%. There was significant correlation between age, duration of diabetes, history of smoking and retinopathy with ED (p0.05). Majority of patients (86%) had poor knowledge regarding ED.On comfort discussing about ED with the health provider, 18.2 % felt very comfortable, 32.5% felt comfortable, 15.9% felt quiet comfortable, 15.1% felt between comfortable and uncomfortable, 15.9% felt uncomfortable and 2.4% felt very uncomfortable. Regarding seeking treatment, 57.1% would do so. This study showed a high prevalence of ED in diabetic patients. The main factors associated with ED were age, duration of diabetes, history of smoking and retinopathy. Patients also considered the information on nature of ED and possible treatment were scant and generally inadequate

An interventive and kap study on healthy lifestyle of overweight and uncontrolled diabetic patients in Kota Bharu, Kelantan

OBJECTIVES: To assess the effects of a regular exercise programme on metabolic control and also knowledge, attitude and practice (KAP) of exercise and physical activity among Type 2 diabetes mellitus patients. MATERIAL AND MET{{ ODS: Forty two Type 2 diabetes patients from the community medicine and medical specialist clinics in USM were assigned . to two groups; The interventive group consisted of 13 males and 14 females, mean age 52.6(8.7) (mean (SD)), body mass index 27.2 (3.9) participated in regular group exercise sessions (3 times a week, 1 hour sessions) for 7 weeks. Exercise intensity was predetermined based on the predicted target heart rate for each subject. The control group consisted of 7 males and 8 females, mean age 56.5(11.1), body mass index 25.8(2.73). Pre and post-intervention anthropometric measurements and blood investigations were done. These include height, weight, body mass index, body fat percentage and fat free mass (FFM), blood pressure, cardiorespiratory fitness level, fasting plasma glucose level (FPG), HbA I c level, fasting lipid profile, insulin and Cpeptidelevel. RESULTS:, In the intervention group, FFM increased from 45.98(9.71) to 47.93(10.53) kg,; percentage body fat decreased from 32.37(11.02) to 30.14(10.73)%. Diastolic pressure reduced from 91(11.2) to 83.3(7.5) mmHg, cholesterol level decreased from 6.23(1.03) to 5.74(1.23) mmoVI, HDL level increased from 0.97(0.31) to 1.19(0.28) mmolll. Estimated V02max increased from 21.6(7.04) to 27.7(8.72) mllkg/min. Resting heart rate declined significantly from 80(7) to 73( II) bpm. There was no improvement in body mass index (BMI), fasting plasma glucose, insulin and C-peptide levels. Knowledge and attitude scores were higher than practice scores. CONCLUSION: Seven weeks of exercise intervention among type 2 diabetes patients resulted in an improvement in body composition, cardiorespiratory fitness, lipid profile and a reduction in blood pressure. However there is a disparity between knowledge and practice of exercise and physical activity

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions