Prevention and control of noncommunicable diseases role of family physicians in improving compliance to lifestyle modification

Noncommunicable diseases (NCDs) like diabetes and cardiovascular disease have already overtaken communicable diseases in terms of mortality and morbidity in India. NCDs thus pose a serious economic threat to developing countries and can have a marked impact on the quality-of-life of affected individuals. In the management of NCDs like diabetes or hypertension, lifestyle (i.e.: nondrug) measures are of paramount importance for therapy to be successful. These nondrug measures include decreasing physical inactivity, eating a healthy diet, stress management, avoidance of tobacco products, moderation in alcohol intake and most importantly increased awareness about the condition. In India, as in most parts of the world, patients usually tend to consult their Family Physician (FP) first. Although most FPs are aware of the benefits of nondrug measures, they seldom spent time on assessing patient's physical activity, diet and stress levels or even educating the patient about the same. This paper reviews and discusses different means by which the FPs can improve patient compliance to nondrug measures in the prevention and control of NCDs

Bound State Wave Functions through the Quantum Hamilton - Jacobi Formalism

The bound state wave functions for a wide class of exactly solvable potentials are found utilizing the quantum Hamilton-Jacobi formalism. It is shown that, exploiting the singularity structure of the quantum momentum function, until now used only for obtaining the bound state energies, one can straightforwardly find both the eigenvalues and the corresponding eigenfunctions. After demonstrating the working of this approach through a number of solvable examples, we consider Hamiltonians, which exhibit broken and unbroken phases of supersymmetry. The natural emergence of the eigenspectra and the wave functions, in both the unbroken and the algebraically non-trivial broken phase, demonstrates the utility of this formalism.Comment: replaced with the journal versio

Periodic Quasi - Exactly Solvable Models

Various quasi-exact solvability conditions, involving the parameters of the periodic associated Lam{\'e} potential, are shown to emerge naturally in the quantum Hamilton-Jacobi approach. It is found that, the intrinsic nonlinearity of the Riccati type quantum Hamilton-Jacobi equation is primarily responsible for the surprisingly large number of allowed solvability conditions in the associated Lam{\'e} case. We also study the singularity structure of the quantum momentum function, which yields the band edge eigenvalues and eigenfunctions.Comment: 11 pages, 5 table

The effect of a diet containing 70% protein from plants on mineral metabolism and musculoskeletal health in chronic kidney disease

BACKGROUND: Chronic Kidney Disease (CKD) is associated with alterations in phosphorus excretion, and increases in fibroblast growth factor (FGF23) and parathyroid hormone (PTH). Plant protein-based phytate-bound phosphorus, is less bioavailable than that from animal sources. Our one-week study that was conducted previously showed that a nearly 100% plant protein-based diet benefits mineral metabolism in CKD; however, this diet may not be acceptable to patients. Here we hypothesize that a diet containing 70% protein from plants has similar efficacy and is tolerated by CKD patients. METHODS: Thirteen subjects with CKD 3-4 received an omnivorous diet containing 70% protein from plants for 4 weeks. The primary outcome was change in 24 h urine phosphorus. Secondary outcomes were changes in serum phosphorus, FGF23, PTH, urine sodium excretion, grip strength and fat free mass. Repeated measures analysis of variance (ANOVA) was used to test differences in parameters over the 4 weeks. RESULTS: Mean age of subjects was 54.8 years. Median eGFR was 26 (IQR 14.7) ml/min/1.73 m(2). Over the 4-week period, urine phosphorus significantly decreased by 215 ± 232 mg/day (p < 0.001). No significant changes in serum FGF23, phosphorus or PTH were noted. Urine sodium and titratable acid decreased significantly on the diet. Hand grip strength and fat-free mass did not change. There were two hyperkalemia events both 5.8 mEq/l, corrected by food substitutions. No other adverse events were observed. CONCLUSIONS: A 70% plant protein diet is safe, tolerated, and efficacious in lowering urine phosphorus excretion and may be an alternative to phosphate binders

Soliton response to transient trap variations

The response of bright and dark solitons to rapid variations in an expulsive longitudinal trap is investigated. We concentrate on the effect of transient changes in the trap frequency in the form of temporal delta kicks and the hyperbolic cotangent functions. Exact expressions are obtained for the soliton profiles. This is accomplished using the fact that a suitable linear Schrodinger stationary state solution in time can be effectively combined with the solutions of non-linear Schrodinger equation, for obtaining solutions of the Gross-Pitaevskii equation with time dependent scattering length in a harmonic trap. Interestingly, there is rapid pulse amplification in certain scenarios

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

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 identifi ed 699 and the WHO criteria also identifi ed 699 women as having GDM. However, only 599/839 women (66.6%) were identifi ed 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 identifi ed by the WHO criteria. In contrast, each value of IADPSG criteria i.e., fasting, 1 h, and 2 h identifi ed 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

An accurate description of quantum size effects in InP nanocrystallites over a wide range of sizes

We obtain an effective parametrization of the bulk electronic structure of InP within the Tight Binding scheme. Using these parameters, we calculate the electronic structure of InP clusters with the size ranging upto 7.5 nm. The calculated variations in the electronic structure as a function of the cluster size is found to be in excellent agreement with experimental results over the entire range of sizes, establishing the effectiveness and transferability of the obtained parameter strengths.Comment: 9 pages, 3 figures, pdf file available at http://sscu.iisc.ernet.in/~sampan/publications.htm

Calculation of Band Edge Eigenfunctions and Eigenvalues of Periodic Potentials through the Quantum Hamilton - Jacobi Formalism

We obtain the band edge eigenfunctions and the eigenvalues of solvable periodic potentials using the quantum Hamilton - Jacobi formalism. The potentials studied here are the Lam{\'e} and the associated Lam{\'e} which belong to the class of elliptic potentials. The formalism requires an assumption about the singularity structure of the quantum momentum function $p$, which satisfies the Riccati type quantum Hamilton - Jacobi equation, $p^{2} -i \hbar \frac{d}{dx}p = 2m(E- V(x))$ in the complex $x$ plane. Essential use is made of suitable conformal transformations, which leads to the eigenvalues and the eigenfunctions corresponding to the band edges in a simple and straightforward manner. Our study reveals interesting features about the singularity structure of $p$, responsible in yielding the band edge eigenfunctions and eigenvalues.Comment: 21 pages, 5 table

Associations of the built environment with type 2 diabetes in Asia: a systematic review

Objectives Our study aimed to systematically review the literature and synthesise findings on potential associations of built environment characteristics with type 2 diabetes (T2D) in Asia. Design Systematic review of the literature. Data sources Online databases Medline, Embase and Global Health were used to identify peer-reviewed journal articles published from inception to 23 January 2023. Eligibility criteria Eligible studies included cohort, cross-sectional and case–control studies that explored associations of built environment characteristics with T2D among adults 18 years and older in Asia. Data extraction and synthesis Covidence online was used to remove duplicates and perform title, abstract and full-text screening. Data extraction was carried out by two independent reviewers using the OVID database and data were imported into MS Excel. Out of 5208 identified studies, 28 studies were included in this systematic review. Due to heterogeneity in study design, built environment and outcome definitions, a semiqualitative analysis was conducted, which synthesised results using weighted z-scores. Results Five broad categories of built environment characteristics were associated with T2D in Asia. These included urban green space, walkability, food environment, availability and accessibility of services such as recreational and healthcare facilities and air pollution. We found very strong evidence of a positive association of particulate matter (PM2.5, PM10), nitrogen dioxide and sulfur dioxide (p<0.001) with T2D risk. Conclusion Several built environment attributes were significantly related to T2D in Asia. When compared with Western countries, very few studies have been conducted in Asia. Further research is, therefore, warranted to establish the importance of the built environment on T2D. Such evidence is essential for public health and planning policies to (re)design neighbourhoods and help improve public health across Asian countries