Assessment of depression in diabetic patients

Background: Diabetes is one of the most common chronic conditions in the world. The worldwide prevalence of diabetes mellitus (DM) has risen dramatically over the past two decades because of increasing obesity and reduced activity levels. The purpose of this study was to show the association between depression and diabetes. Methods: It was a cross-study. The study included 240 patients who were chosen randomly with no gender bias. A convenient subject of 240 diabetic patients was interviewed. Results: Out of the total 240 diabetic patients, included in this study, the majority of patients, 52.63% in the age group of 60 years had depression with a Hamilton score of >19 while 47.37% of patients in the age of 40 to 50 years had Hamilton score of >19. 84.21% of males had depression with a Hamilton score >19 as compared to females who had a Hamilton score of 15.79%. The patients within the age group of 40-59 have 2.5 times more risk of having depression as compared to the age group of 20 to 39 and patients in the age group >60 years have 4.23 times higher risk of depression as compared to patients in the age group of 20 to 39 years. The association between gender and depression shows that males have a higher rate of depression (78.17%) as compared to females (21.81%) with an odd's ratio of 3.0. Conclusions: Our study showed a high prevalence of depression and anxiety in male patients and the elderly age group. Planning and implementation of screening for mental health issues in the elderly population diagnosed with a lifestyle disease-such as type 2 diabetes mellitus-with existing comorbidities should be recognized as one of the most important goals of the public health system. It seems necessary to involve medical teams in the screening process to verify the symptoms, promptly establish the diagnosis, and initiate the appropriate depression treatment. In diabetic patients, depression remains underdiagnosed and an important aspect of the diabetic specialists would be the awareness of this quite common co-morbidity

Severe androgenetic alopecia as a maker of metabolic syndrome in male patients of androgenetic alopecia: a hospital based case control study

Background: Several previous studies have investigated the association between androgenetic alopecia (AGA) and metabolic syndrome (MS), with inconsistent results. Objectives of the study were to study the prevalence of metabolic syndrome in male patients of androgenetic alopecia and compare with control population and study the relationship of metabolic syndrome with different grades of AGA.Methods: This prospective hospital based case control study included 100 new clinically diagnosed males of androgenetic alopecia, and age and sex matched control group. Assessment for presence of various components of metabolic syndrome was done following a uniform protocol in cases and controls. AGA was classified as per Hamilton –Narwood classification, grade I to III was classified as mild –moderate and grade IV and higher as severe AGA.Results: Of the 100 male AGA patients (age range 21-50, mean 34.49), 36 had grade II AGA, 24 had grade III AGA, 20 had grade IV AGA, 15 had grade V AGA and 5 had grade VI AGA. Among AGA patients, 60 of patients had mild-moderate AGA and 40 patients had severe AGA. Metabolic syndrome was statistically significantly more common in patients with AGA compared to controls. Among patients of AGA, metabolic syndrome was statistically significantly present in severe AGA compared to mild-moderate AGA. Among the evaluated parameters, like blood pressure, fasting blood sugar, dyslipedemia, abdominal obesity, all were significantly more common in AGA patients compared to controls except abdominal obesity.Conclusions: In the present study, metabolic syndrome was found to be 4.6 times more common in patients of androgenetic alopecia as compared to controls, being statistically significant, and more common in those with severe grades. This suggests that androgenetic alopecia patients especially with severe grades are at risk of metabolic syndrome and other cardiovascular diseases

Real-World Experiences of Parkinson's Disease OFF Time and Role of Demographics

Purpose OFF periods are episodes when Parkinson’s disease (PD) medications work suboptimally, with symptoms returning and impacting quality of life. We aimed to characterize OFF periods using patient-reported frequency, severity, and duration, as well as determine these characteristics’ associations with demographics. Methods A retrospective cohort study using Fox Insight Data Exploration Network (Fox DEN) database was conducted. Eligible patients had PD and were > 18 years. The experience of OFF periods was characterized by frequency (number of episodes/day), duration (duration/episode), and severity (impact on activities). Significance level was Bonferroni-corrected for multivariate analyses. Results From a population of 6,757 persons with PD, 88% were non-Hispanic Whites (mean age: 66 ± 8.8 years); 52.7% were males versus 47.3% females; mean PD duration was 5.7 ± 5.2; and 51% experienced OFF periods. Subsequent analyses were limited to non-Hispanic Whites, as they constituted a large majority of the participants and were the subgroup that had the sample size to derive reliable inferences. The analyses showed that 67% experienced 1–2 episodes/day, 90% experienced > 15-minute episodes, and 55% reported slight–mild severity/episode. Lower age was associated with a higher frequency (incidence rate ratio [IRR]: 0.992; P < 0.001) and severity (odds ratio [OR]: 0.985; P = 0.001) of OFF episodes. Income of < $35,000 was associated with 15.1 Conclusions Lower age, income <$35,000, longer PD duration, female gender, and being unemployed are associated with a higher frequency and severity of OFF periods with no associations for duration/episode among non-Hispanic Whites with PD. In time-constrained clinic environments, clinicians should tailor OFF periods management counseling to vulnerable demographic groups to enhance care delivery.(J Patient Cent Res Rev. 2024;11:8-17.

Patterns in the spectral composition of sunlight and biologically meaningful spectral photon ratios as affected by atmospheric factors

Plants rely on spectral cues present in their surroundings, generated by the constantly changing light environment, to guide their growth and reproduction. Photoreceptors mediate the capture of information by plants from the light environment over a wide range of wavelengths, but despite extensive evidence that plants respond to various light cues, only fragmentary data have been published showing patterns of diurnal, seasonal and geographical variation in the spectral composition of daylight. To illustrate patterns in spectral photon ratios, we measured time series of irradiance spectra at two distinct geographical and climatological locations, Helsinki, Finland and Gual Pahari, India. We investigated the drivers behind variation of the spectral photon ratios measured at these two locations, based on the analysis of over 400 000 recorded spectra. Differences in spectral irradiance were explained by different atmospheric factors identified through multiple regression model analysis and comparison to spectral irradiance at ground level simulated with a radiative transfer model. Local seasonal and diurnal changes in spectral photon ratios were related to solar elevation angle, atmospheric water-vapour content and total ozone column thickness and deviated from their long-term averages to an extent likely to affect plant photobiology. We suggest that future studies should investigate possible effects of varying photon ratios on terrestrial plants. Solar elevation angle especially affects the patterns of B:G and B:R ratios. Water vapour has a large effect on the R:FR photon ratio and modelled climate scenarios predict that increasing global temperatures will result in increased atmospheric water vapour. The development of proxy models, utilising available data from weather and climate models, for relevant photon ratios as a function of solar elevation angle and atmospheric factors would facilitate the interpretation of results from past, present and future field studies of plants and vegetation.Peer reviewe

AstroSat Observations of the Dipping Low Mass X-ray Binary XB 1254-690

XB 1254-690 is a neutron star low-mass X-ray binary with an orbital period of 3.88 hrs, and it exhibits energy-dependent intensity dips, thermonuclear bursts, and flares. We present the results of an analysis of a long observation of this source using the AstroSat satellite. The X-ray light curve gradually changed from a high-intensity flaring state to a low-intensity one with a few dips. The hardness intensity diagram showed that the source is in a high-intensity banana state with a gradually changing flux. Based on this, we divide the observation into four flux levels for a flux-resolved spectral study. The X-ray spectra can be explained by a model consisting of absorption, thermal emission from the disc and non-thermal emission from the corona. From our studies, we detect a correlation between the temperature of the thermal component and the flux and we examine the implications of our results for the accretion disc geometry of this source.Accepted for publication in MNRAS; 11 pages, 12 figure

Prescription opioid use before and after kidney transplant: Implications for posttransplant outcomes

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/1/AJT14714-sup-0001-AppendixS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/2/ajt14714_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146648/3/ajt14714.pd

Progressive pulmonary fibrosis: an expert group consensus statement

This expert group consensus statement emphasises the need for standardising the definition of progressive fibrosing interstitial lung diseases (F-ILDs), with an accurate initial diagnosis being of paramount importance in ensuring appropriate initial management. Equally, case-by-case decisions on monitoring and management are essential, given the varying presentations of F-ILDs and the varying rates of progression. The value of diagnostic tests in risk stratification at presentation and, separately, the importance of a logical monitoring strategy, tailored to manage the risk of progression, are also stressed. The term “progressive pulmonary fibrosis” (PPF) exactly describes the entity that clinicians often face in practice. The importance of using antifibrotic therapy early in PPF (once initial management has failed to prevent progression) is increasingly supported by evidence. Artificial intelligence software for high-resolution computed tomography analysis, although an exciting tool for the future, awaits validation. Guidance is provided on pulmonary rehabilitation, oxygen and the use of non-invasive ventilation focused specifically on the needs of ILD patients with progressive disease. PPF should be differentiated from acute deterioration due to drug-induced lung toxicity or other forms of acute exacerbations. Referral criteria for a lung transplant are discussed and applied to patient needs in severe diseases where transplantation is not realistic, either due to access limitations or transplantation contraindications. In conclusion, expert group consensus guidance is provided on the diagnosis, treatment and monitoring of F-ILDs with specific focus on the recognition of PPF and the management of pulmonary fibrosis progressing despite initial management

Progressive pulmonary fibrosis: an expert group consensus statement.

This expert group consensus statement emphasises the need for standardising the definition of progressive fibrosing interstitial lung diseases (F-ILDs), with an accurate initial diagnosis being of paramount importance in ensuring appropriate initial management. Equally, case-by-case decisions on monitoring and management are essential, given the varying presentations of F-ILDs and the varying rates of progression. The value of diagnostic tests in risk stratification at presentation and, separately, the importance of a logical monitoring strategy, tailored to manage the risk of progression, are also stressed. The term "progressive pulmonary fibrosis" (PPF) exactly describes the entity that clinicians often face in practice. The importance of using antifibrotic therapy early in PPF (once initial management has failed to prevent progression) is increasingly supported by evidence. Artificial intelligence software for high-resolution computed tomography analysis, although an exciting tool for the future, awaits validation. Guidance is provided on pulmonary rehabilitation, oxygen and the use of non-invasive ventilation focused specifically on the needs of ILD patients with progressive disease. PPF should be differentiated from acute deterioration due to drug-induced lung toxicity or other forms of acute exacerbations. Referral criteria for a lung transplant are discussed and applied to patient needs in severe diseases where transplantation is not realistic, either due to access limitations or transplantation contraindications. In conclusion, expert group consensus guidance is provided on the diagnosis, treatment and monitoring of F-ILDs with specific focus on the recognition of PPF and the management of pulmonary fibrosis progressing despite initial management