Do we need a new perspective on chronic diseases? The combined effects of workplace stress and socioeconomic status as non-traditional disease risk factors in Canada

Background: Approximately 80% of Canadians over the age of 20 are at risk of developing a chronic disease (CD) such as cardiovascular disease (CVD) and type II diabetes (T2D) (Artham, Lavie, Milani, & Ventura, 2009; PHAC, 2017; Yach, 2004). The burden of CD is not distributed equally amongst Canadians either, with those from lower socioeconomic status (SES) backgrounds having higher CD outcomes and poorer health overall (Patra, 2007). Although the role of stress has often been implicated in the development of CVD and T2D, research on the combined effects of stress and SES is lacking in Canada (Cotter & Kelly, 2018; Crompton, 2011; Ferris, Kline, & Bourdage, 2012; Guan, Collet, Mazowita, & Claydon, 2018; Hughes, Lu, & Howard, 2018; Smith, Frank, & Mustard, 2008; Steptoe, Siegrist, Kirschbaum, & Marmot, 2004). The highest source of stress amongst Canadian adults is reported to be due to work instead of finances; therefore, workplace stress and SES might have cumulative effects that can increase the odds of developing CVD and T2D (Kivimaki & Kawachi, 2015). Objective: This study investigated if self-reported stress levels and measures of socioeconomic status (including household income, household education level, and occupational type) were significantly associated to self-reported diagnosis of CVD and T2D, even after controlling for traditional risk factors: smoking status, alcohol intake, fruit and vegetable intake, and physical activity (Pouwer, Kupper, & Adriaanse, 2010). Further analysis sought to investigate the combined effects of both SES and workplace stress on CD outcomes by calculating the magnitude of their multiplicative interaction and additive interaction via reporting the relative excess risk due to interaction (RERI). Methods: A cross-sectional analysis was conducted through multivariate logistic regression analysis using a bootstrapped weighted sample of 78,023 respondents from the Canadian Community Health Survey (2015-16). Models initially controlled for age, sex, race or cultural background, and body mass index (BMI), and subsequently the traditional risk factors to understand the true association between stress and SES on CD outcomes. Combined effects of both main variables were assessed using multiplicative and additive interaction analysis. Results: Outcomes from logistic regression analyses showed a significant association between perceived life stress and all aspects of SES for both CVD and T2D. Perceived life stress and SES remained significantly associated to both CD outcomes even after adjusting for traditional behaviour risk factors. A significant interaction between high life stress and low household income showed almost double the odds of reporting diabetes (OR=1.89, p=0.03), compared to the product of the individual factors alone. Results support that perceived stress and SES might have independent associations to CD outcome and together they might have cumulative effects on health. Conclusion: Our results corroborate other findings that stress and SES might have independent associations to CD outcomes, even in the absence of traditional disease risk factors. These results highlight the importance of understanding the cumulative effects social and economic factors in exascerbating CD outcomes. To our knowledge, this is the first Canadian study to show the cumulative effects of perceived stress and SES on outcomes of CVD and diabetes, and why we might need to change our approach to combat incidence of CDs

Soil Phosphorus Test Values and Wheat Production

Agronomy (Soils

Genetic diversity and evolutionary analysis of Citrus Tristeza Virus p20 gene in Pakistan: insights into the spread and epidemiology

Background: Citrus tristeza virus (CTV) is a widespread disease and the most destruction causing agent of citrus. Pakistan is ranked amongst the top ten citrus producing countries around the globe and it contributes about 2% to its foreign exchange earnings. Based on this assumption it is very important to monitor and determine the evolutionary forces and the phylogeography of Pakistani CTV population.  Methods: A total of 49 sequences of p20 gene from Pakistan were phylogenetically compared with CTV sequences worldwide. These sequences were analyzed for their genetic diversity and evolution using a Bayesian Probability approach and predicted secondary structure.Results: Phylogenetic analysis using Bayesian probability inference and predicted secondary structures diversity of CTV indicated that Pakistani isolates were not diverse from global isolates. Lineage analysis showed that CTV was introduced in Pakistan in three individual events from various parts of the world.  After that CTV dispersed in Pakistan via vector transmission or by use of infected propagating material by local farmers.Conclusions: Our study confirmed multiple introductions of CTV in Pakistan and also confirmed the dissemination of CTV within Pakistan. This study also shows that the mutations are present in the predicted secondary structure of the p20 protein, however, it is not known if it affects the pathogenicity of the virus

Relation of Lipid Profile with Ischemic Stroke

Objective: To evaluate correlation of blood total cholesterol (TC), high-density lipoprotein (HDL), triglycerides, and the TC:HDL ratio as risk factors for ischemic stroke.Materials and Methods: After ethical approval from hospital ethical board this case control study was conducted in the department of neurosurgery and neurology Lahore General Hospital Lahore/Punjab Institute of Neurosciences/ Postgraduate Medical Institute/Ameerudin Medical College Lahore. Duration of study was two years from October 2015 to October 2017. A total of 600 patients were included in the study after obtaining written consent from patients. After completion of data collection, data was entered in computer software SPSS version 23 and analyzed for continuous and categorical variables. Continuous/numerical variables were presented as mean and SD and categorical variables were presented in form of numbers and percentages. Independent t-test and chi-square test were applied to see significance of data. P value less than or equal to 0.05 was considered as significant.Results: Overall, 100% (n = 600) patients were included in this study. The study comprised of two equal groups, 50% (n = 300) in each, i.e. cases and controls. The controls had mean total cholesterol (TC), High-density lipoprotein (HDL) and triglycerides 220.76 ± 4.29 mg/dL, 54.02 ± 4.45 mg/dL and 153.99 ± 2.68 mg/dL res-pectively. The TC: HDL ratio was 5.48 ± 1.41 and 4.09 ± 1.22 for cases and controls respectively. The mean differences between total cholesterol (TC), High-density lipoprotein HDL, triglycerides and total cholesterol (TC): HCL ratios were statistically significant among both groups.Conclusion: Results of our study revealed that significant difference was observed between cases and controls regarding the levels of Total cholesterol, HDL, triglycerides and TC:HDL ratio. Cases of ischemic stroke were found with high levels of TC, Tridlycerides, And TC:HDL ratio and low HDL , this difference was found statistically significant with P value 0.001. So it was concluded that hyperlipidemia has significant relation with ischemic stroke

Phytochemical Analyses for Antibacterial Activity and Therapeutic Compounds of Convolvulus arvensis L., Collected from the Salt Range of Pakistan

Background: Pharmaceutical world is currently facing a major issue of bacterial resistance against antibiotics. For the past few years, plants being an excellent source of phytochemicals have replaced many traditional antibacterial agents. Keeping this in view, the current study was conducted to detect the antibacterial activity and the presence of various phytochemicals in Convolvulus arvensis leaves and stem extracts.Methods: Eight different organic and aqueous extracts of Convolvulus arvensis L. (C. arvensis) leaves and stem were prepared and their antimicrobial activity against 13 clinically important bacterial species was investigated using the disc diffusion assay. Phytochemical screening of the aqueous extracts of C. arvensis was performed using qualitative tests.  Results: All the thirteen bacterial species tested in this study were found sensitive to the stem and leaf extracts of C. arvensis. Highest antimicrobial activity was observed against   Escherichia coli while among all the extracts butanol extract was the most effective antimicrobial agent. Phytochemical analyses using organic and aqueous extracts confirmed the presence of various secondary plant metabolites of therapeutic value i.e. saponins, flavonoids, steroids, tannins, phlobatannins, cardiac glycosides and coumarins.Conclusion: Our results indicate that C. arvensis plant contains some phytochemicals with antimicrobial affects. These chemicals possess great potential to be used as advanced therapeutic compounds against broad range of pathogenic bacteria

Postoperative Rise in Serum Sodium Level, an Indicator of Diabetes Insipidus after Pituitary Adenoma Surgery

oai:ojs2.pakjns.org:article/8Objective: To study the efficacy of post operative rise in serum sodium level as indicator of diabetes insipidus after pituitary adenoma surgery.Materials and Methods: The study was randomized control trial. It was conducted in Department of Neuro-surgery and Biochemistry from March 2016 to December 2017 (22 Months) Punjab Institute of Neurosciences/ Lahore General Hospital/Postgraduate Medical Institute/Ameeruddin Medical College. Ethical approval was obtained from hospital Ethics Committee. Total no. of 169 patients were enrolled for transsphenoidal surgery of their pituitary adenoma. Sample size was calculated from the reference study conducted by Schreckinger M et al10. Non probability consecutive sampling technique was used to collect the sample size. Data was calculated from all the patients regarding age, gender, duration of transsphenoidal surgery, postoperative evidence of diabetes insipidus by measuring rise in serum sodium level < 145mEq. Mean and standard deviation were calculated for demographic variables like age and gender while frequency and percentage were calculated for outcome variables like type of diabetes insipidus and sensitivity and specificity of serum sodium > 145mEq test. Chi square test was applied and analysis was done using computer software SPSS version 23. P value less than 0.05 was considered significant.Results: Overall, 100% (n = 169) patients were enrolled in this study, both genders. Gender distribution showed there were 68% (n = 115) males and 32% (n = 54) females. The mean age of the patients was 40.88 ± 4.95 years. Post-operative transient noted in 13.6% (n = 23) patients. Serum sodium level (specific) observed in 92.9% (n = 157) patients. While, > 145 mEq sensitive was observed in 88.2% (n = 149) patients (Table 1). The main outcome variable of this study was diabetes insipidus permanent, in our study, it was noted in 9.5% (n = 16) patients (Table 2). There was no association between diabetes insipidus permanent and effect modifiers (Table 3).Conclusion: From this study we conclude that level of sodium > 145mEq is very sensitive and specific test which can be used to predict the outcome after pituitary adenoma surgery in the form of Diabetes Insipidus