Diabetes Risk Score in Indian Population: Experience from Central India

Introduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently,77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ≥60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality

Diabetes Risk Score in Indian Population: Experience from Central India

ntroduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently, 77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ≥60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which  proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality

Diabetes Risk Score in Indian Population: Experience from Central India

Introduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently, 77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ≥60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality

A Practitioner’s Toolkit for Insulin Motivation in Adults with Type 1 and Type 2 Diabetes Mellitus: Evidence-Based Recommendations from an International Expert Panel

Aim To develop an evidence-based expert group opinion on the role of insulin motivation to overcome insulin distress during different stages of insulin therapy and to propose a practitioner’s toolkit for insulin motivation in the management of diabetes mellitus (DM). Background Insulin distress, an emotional response of the patient to the suggested use of insulin, acts as a major barrier to insulin therapy in the management of DM. Addressing patient-, physician- and drug-related factors is important to overcome insulin distress. Strengthening of communication between physicians and patients with diabetes and enhancing the patients' coping skills are prerequisites to create a sense of comfort with the use of insulin. Insulin motivation is key to achieving targeted goals in diabetes care. A group of endocrinologists came together at an international meeting held in India to develop tool kits that would aid a practitioner in implementing insulin motivation strategies at different stages of the journey through insulin therapy, including pre-initiation, initiation, titration and intensification. During the meeting, emphasis was placed on the challenges and limitations faced by both physicians and patients with diabetes during each stage of the journey through insulinization. Review Results After review of evidence and discussions, the expert group provided recommendations on strategies for improved insulin acceptance, empowering behavior change in patients with DM, approaches for motivating patients to initiate and maintain insulin therapy and best practices for insulin motivation at the pre-initiation, initiation, titration and intensification stages of insulin therapy. Conclusions In the management of DM, bringing in positive behavioral change by motivating the patient to improve treatment adherence helps overcome insulin distress and achieve treatment goals

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Search for stop and higgsino production using diphoton Higgs boson decays

Results are presented of a search for a "natural" supersymmetry scenario with gauge mediated symmetry breaking. It is assumed that only the supersymmetric partners of the top-quark (stop) and the Higgs boson (higgsino) are accessible. Events are examined in which there are two photons forming a Higgs boson candidate, and at least two b-quark jets. In 19.7 inverse femtobarns of proton-proton collision data at sqrt(s) = 8 TeV, recorded in the CMS experiment, no evidence of a signal is found and lower limits at the 95% confidence level are set, excluding the stop mass below 360 to 410 GeV, depending on the higgsino mass

Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia

Search for anomalous production of events with three or more leptons in pp collisions at √s = 8TeV

Published by the American Physical Society under the terms of the Creative Commons Attribution 3.0 License. Further distribution of this work must maintain attribution to the author(s) and the published articles title, journal citation, and DOI.A search for physics beyond the standard model in events with at least three leptons is presented. The data sample, corresponding to an integrated luminosity of 19.5fb-1 of proton-proton collisions with center-of-mass energy s=8TeV, was collected by the CMS experiment at the LHC during 2012. The data are divided into exclusive categories based on the number of leptons and their flavor, the presence or absence of an opposite-sign, same-flavor lepton pair (OSSF), the invariant mass of the OSSF pair, the presence or absence of a tagged bottom-quark jet, the number of identified hadronically decaying τ leptons, and the magnitude of the missing transverse energy and of the scalar sum of jet transverse momenta. The numbers of observed events are found to be consistent with the expected numbers from standard model processes, and limits are placed on new-physics scenarios that yield multilepton final states. In particular, scenarios that predict Higgs boson production in the context of supersymmetric decay chains are examined. We also place a 95% confidence level upper limit of 1.3% on the branching fraction for the decay of a top quark to a charm quark and a Higgs boson (t→cH), which translates to a bound on the left- and right-handed top-charm flavor-violating Higgs Yukawa couplings, λtcH and λctH, respectively, of |λtcH|2+|λctH|2<0.21

Measurement of associated W plus charm production in pp collisions at √s=7 TeV

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