The relationship between objectively measured physical activity and parameters of disease control in an African population of type 2 diabetes mellitus

Background: The incidence of type 2 diabetes mellitus (T2DM) is increasing rapidly. This is possibly due to increasing obesity, reduced level of activity, sedentary lifestyle, ageing population and industrialisation.Aim: The primary objective of this study was to ascertain the level of activity using a pedometer. The secondary objectives were: (1) to correlate the baseline level of activity with body mass index (BMI), HbA1c and blood pressure (BP), (2) to assess whether 7 000 steps a day influence HbA1c and BP over a three-month period.Method: A total of 110 patients were screened; 95 patients (n = 95) completed the study. At the first visit HbA1c, BMI and BP were measured. At the end of the first month baseline physical activity was recorded using pedometers. Patients were divided into two groups: active (n = 50) and control (n = 45). Patients in the active group were asked to walk a minimum of 7 000 steps/day. The control group were asked to continue their usual activity. These patients were followed up monthly over a period of three months. At each visit BMI, BP and step counts were recorded. HbA1c was measured only at the first and last visit.Result: Activity levels increased significantly in the active group throughout the study. Mean step count for the control group at baseline was 2 923.1 ± 1 136.9, which increased to 3 431.2 ± 1 251.7 by the end of the study. Mean step count for the active group at baseline was 4 609.9 ± 1 702.1, which increased to 7 244.8 ± 1 419.4 by the end of the study. The difference between control and active group was statistically significant (p < 0.001). Systolic and diastolic BP decreased significantly in both groups (p = 0.017) for systolic BP and (p = 0.002) for diastolic BP but no interaction was found between the groups as systolic and diastolic BP decreased at the same rate over time in both groups. HbA1c decreased by 1.04% in the active group; this difference was statistically highly significant (p < 0.001).Conclusion: Increase in activity levels decreases HbA1c by 1.04 percentage point over three months in T2DM (p < 0.001), which is statistically significant.Keywords: BMI, HbA1c, pedometers, physical activity, T2D

Prevalence and pattern of dyslipidaemia in type 2 diabetes mellitus patients at a tertiary care hospital

Background: Diabetes mellitus (DM) is a common secondary cause of dyslipidaemia, particularly if glycaemic control is poor, which in turn is an important risk factor for atherosclerosis and coronary artery disease.Objectives: (1) To study the prevalence and pattern of dyslipidaemia in patients with type 2 DM. (2) To determine the relationship (if any) between HbA1C and the lipid profile in type 2 diabetic patients.Methods: This was a cross-sectional study done in 200 type 2 diabetic patients  attending the Diabetic Clinic at the Helen Joseph Hospital. Patients suffering from other known causes of secondary dyslipidaemia were excluded. Each patient’s  HbA1C and lipid profile results were recorded from their clinic files. The lipid profile included total cholesterol (TC), triglyceride (TG), high-density lipoprotein  cholesterol (HDL-C) and calculated low-density lipoprotein cholesterol (LDL-C). Patients with one or more of the above parameters outside the targets recommended by the 2012 South African Dyslipidaemia Guidelines were considered to have uncontrolled dyslipidaemia.Results: Of the 200 type 2 DM patients studied, 86 (43%) were male and 114 (57%) female. Despite all patients being treated with lipid-lowering therapy  (simvastatin at a mean daily dose of 20 mg), 187 patients (93.5%) did not achieve all their lipid targets. The most prevalent lipid parameter not at target was an LDL-C of ≥ 1.8 mmol/l in nearly 80% of patients. The most common pattern of  dyslipidaemia was a combined dyslipidaemia (any two abnormal lipid parameters) affecting a total of 82 out of the 187 patients (43.8%) not reaching recommended  targets. No significant relationship was found between HbA1C and any of the lipid parameters.Conclusion: The vast majority of the type 2 diabetic patients studied had  dyslipidaemia not meeting recommended targets, despite the use of lipid-lowering therapy in all patients. There is a need for more intensive lipid-lowering therapy, particularly statin therapy in patients with dyslipidaemia. Measures aimed at  combating obesity and other lifestyle-related risk factors are also vital and need to be implemented for effectively controlling dyslipidaemia and reducing the burden of CVD.Keywords: combined dyslipidaemia, LDL, lipid target

Effects of diabetes mellitus on health-related quality of life at a tertiary hospital in South Africa: A cross-sectional study

Background. Diabetes mellitus (DM) is a chronic metabolic disease that potentially causes debilitating and life-threatening complications, demands a lifestyle change, and has important implications with regard to wellbeing and health-related quality of life (HRQOL).Objectives. To: (i) determine the HRQOL of a sample of patients with type 2 diabetes; (ii) describe the demographics (age, gender, and smoking and alcohol use) of the population studied; (iii) document the following parameters, which are important in determining the control and severity of type 2 diabetes: (a) glycosylated haemoglobin (HbA1c), (b) total amount of insulin required per day (if on insulin therapy), (c) body mass index (BMI), and (d) exercise compliance; (iv) determine whether there was an association between any or all of the above parameters and the HRQOL of these patients; and (v) determine whether coexisting diseases (hypertension (HT) and dyslipidaemia) were present, and compare HRQOL between diabetic patients with and without these diseases.Methods. This was a cross-sectional and descriptive study of 200 patients attending the diabetes clinic at Helen Joseph Hospital, Johannesburg, South Africa. HRQOL assessments were made using the Diabetes 39 (D-39) questionnaire, which patients filled in once consent had been obtained and if they fulfilled the inclusion criteria. Patients’ questionnaire forms were then analysed with regard to their demographics (age and gender), exercise regimen, smoking and alcohol history, employment status, living arrangements, age of diagnosis of DM, and concurrent use of antihypertensive and cholesterol-lowering drugs. The patients’ files were analysed and various clinical parameters were noted (HbA1c, lipogram, BMI, number of insulin units used per day, and whether any antihypertensive and/or lipidlowering drugs were used).Results. There was an association between HRQOL and HbA1c, and between HRQOL and HT and dyslipidaemia.Conclusions. No association was found between HRQOL and other clinical parameters, namely number of insulin units used per day, exercise, BMI, lipogram and the use of oral hypoglycaemic agents. Demographic parameters (age, gender, age at diagnosis, employment status and living arrangements) were also shown to have no impact on HRQOL. We found no association between HRQOL in patients who consumed alcohol and smoked cigarettes and in those who did not

Fodder trees and shrubs for high rainfall areas of south Western Australia

In south Western Australia, the lack of good quality feed in late summer and autumn is a major constraint to livestock production. This feed gap is usually filled by costly supplementary hand feeding of grain or hay. The ability of some trees and shrubs to provide good quality forage during summer and autumn has generated interest for many years (Corbett, 1951; Everist, 1969; Snook, 1987;Oldham et al., 1991, Lefroy, 1991). The dual benefits of reducing the need for supplementary hand feeding and deferring the grazing of annual pastures until they are well established has recently led to the recognition of tagasaste (Chamaecytisus palmensis) and saltbush (Atnp/exspecies) as important forage plants in Western Australia (Malcolm; 1986, Oldham et al., 1991

Biochar from microwave pyrolysis of selected feedstocks

This is a brief summary of work carried out by a team of researchers to produce biochar using microwave pyrolysis system developed at Bioenergy, Bioproducts Research Lab (BBRL), at UNB. Various feedstocks such as corn stalk, spruce, maple, switchgrass, and wood pellets were used to produce biochar. A batch type microwave reactor with a frequency of 2.45 GHz and a power generator of 3 kW was used in the pyrolysis experiments. The amount of biochar obtained depends on the microwave pyrolysis conditions and type of feedstock. For corn stalk briquettes, the yield of biochar ranged from 30.9 to 41.1 wt%. The average biochar yield for spruce, maple, and switchgrass was found to be 22.2 wt%, 22.0 wt%, and 24.4 wt% respectively. Please click on the file below for full content of the abstract

Localized states in sheared electroconvection

Electroconvection in a thin, sheared fluid film displays a rich sequence of bifurcations between different flow states as the driving voltage is increased. We present a numerical study of an annular film in which a radial potential difference acts on induced surface charges to drive convection. The film is also sheared by independently rotating the inner edge of the annulus. This simulation models laboratory experiments on electroconvection in sheared smectic liquid crystal films. The applied shear competes with the electrical forces, resulting in oscillatory and strongly subcritical bifurcations between localized vortex states close to onset. At higher forcing, the flow becomes chaotic via a Ruelle-Takens-Newhouse scenario. The simulation allows flow visualization not available in the physical experiments, and sheds light on previously observed transitions in the current-voltage characteristics of electroconvecting smectic films.Comment: To be published in EuroPhysics Letters, 6 pages, 6 figures: final versio

Economic Dan Emission Dispatch Pada Sistem Kelistrikan 500 KV Jawa-Bali Menggunakan Composite Generation Cost Function Dengan Metode Cuckoo Optimization Algorithm

Permintaan daya listrik yang terus bertambah menyebabkan daya listrik yang disuplai oleh pembangkit menjadi lebih besar. Kondisi beban yang harus disuplai pembangkit selalu berubah-ubah tiap waktunya, maka penyaluran energi listrik haruslah sesuai antara energi yang terbangkitkan oleh pembangkit dengan jumlah beban yang harus disuplai untuk memperoleh biaya pembangkitan yang paling ekonomis. Pada Tugas Akhir ini untuk mendapatkan biaya yang ekonomis akan dilakukan optimasi pembangkit sehingga didapatkan nilai pembangkitan yang paling optimal. Pengoptimalan pembangkit bertujuan untuk mendapatkan biaya operasional yang minimum tetapi tetap dapat memenuhi permintaan beban yang ada. Penggunaan generator dengan bahan bakar fosil dapat memberikan efek pencemaran lingkungan akibat emisi sisa dari pembakaran. Proses optimasi akan membuat jumlah bahan bakar yang digunakan dapat diminimalisir sehingga akan mengurangi emisi yang dihasilkan oleh pembangkit