Search results for: pediatric obesity

Authors: A. Lakshya

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The main aim of this paper is to interpret physical education for children from 5 to 18 years. Schools have the ability to promote positive mental health by developing physical education, which helps to build individual growth, goal setting, decision making, helps in muscular development, self-discipline, stresses relief, leadership qualities that can arise with new skills, prosocial behavior and problem-solving skills. But mostly the children at these early ages ought to hold the disorders as heart attack, diabetes and obesity disorders may increase in large number. The data of P.E has got a very least place, where children are with feeble minds and they acquired a state of inactiveness. Globally, 81% of adolescents aged 11-18 years were insufficiently physically active in the year 2016. Adolescent girls were less active than boys, with the percentage of 85% vs. 78% as well. A recent study of California schools found that students are sedentary most of the time during PE classes, with just four minutes of every half-hour spent in vigorous physical activity. Additionally, active PE time decreases with larger class sizes. Students in classes with more than forty-five students are half as active as students in smaller class sizes. The children in adolescence age they acquire more creative ideas hence they create new hairstyles, cooking styles and dressing styles. Instead, all the children are engaging themselves to TV (television) and video games. The development of physical quality not only improves students ’ physical fitness but is also conducive to the psychological development of the students. Physical education teaching should pay more attention to the training of physical quality in the future.

Keywords: physical education, prosocial behavior, leadership, goal setting

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Authors: Ilknur Kahriman, Hacer Kobya Bulut, Birsel C. Demirbag

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Introduction and Aim: One of the most challenging aspects of being parents of a child diagnosed with cancer is to balance their normal family life with the child's health needs and treatment requirements. Cancer covers an important part of family life and gets ahead of other matters. Families mostly feel that everything has changed in their lives with the cancer diagnosis and are obliged to make a number of adjustments in their lives. Their normal family life suddenly begins to include treatments, hospital appointments and hospitalizations. This study is a descriptive research conducted to determine the changes in the lives of families who had a child with cancer. Methods: This study was carried out with 65 families having children diagnosed with cancer in 0-17 age group at outpatient pediatric oncology clinic and polyclinic of a university hospital in Trabzon. Data were collected through survey method from August to November, 2015. In the analysis of the data, numbers, percentage and chi-square test were used. Findings: It was found out that the average age of mothers was 35.33 years, most of them were primary school graduates (44.6%) and housewives (89.2%) and the average age of fathers was 39.30 years, most of them were high school graduates (29.2%) and self-employed (43.8% ). The majority of their children were boys and their average age was 7.74 years and 77% had Acute lymphocytic leukemia (ALL) diagnosis. 87.5% of the mothers who had a child with cancer had increased fears in their lives, 84.4% had increased workload at home, 82.8% had more stressful life and 82.8% felt themselves physically tired. The mothers indicated that their healthy children could not do the social activities they had used to do before (56.5%), they no longer fed their healthy children with the food they loved eating so that the sick child did not aspire (52.3%) and their healthy children were more furious than before (53.2%). As for the fathers, the fundamental change they had was increased workload at home (82.3%), had more stressful life (80.6%) and could no longer allocate time to the activities they had been interested in and done before (77.8%). There was not a significant difference between the sick children gender and the changes in their parents lives. The communication between the mothers and their healthy children were determined to be positively affected in the families in which the sick child's disease duration was under 12 months (X2 = 6.452, p = 0.011). Conclusion: This study showed that parents having a child with cancer had more workload at home, had more stressful lives, could not allocate time to social activities, had increased fears, felt themselves tired and their healthy children became more furious and their social activities reduced.

Keywords: child, cancer, changes in lives, family

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Authors: Inna Vinokurova, N. Savvina

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The goal of research: to study the organization of multi-field hospital’s work environment in the Republic of Sakha (Yakutia), Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine. Results: Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine is a multidisciplinary, specialized hospital complex that provides specialized and high-tech medical care to children and adults in the Republic of Sakha (Yakutia) of the Russian Federation. There are 5 diagnostic and treatment centers (advisory and diagnostic, clinical, pediatric, perinatal, Republican cardiologic dispensary) with 45 clinical specialized departments with 727 cots, 5 resuscitation departments, 20 operating rooms and out-patient department with 905 visits in alternation in the National Center of Medicine. Annually more than 20,000 patients receive treatment in the hospital of the Republican Hospital of the Republic of Sakha (Yakutia), more than 70,000 patients visit out-patient sections, more than 2 million researches are done, more than 12,000 surgeries are performed, more than 2 thousand babies are delivered. National Center of Medicine has a great influence with such population’s health indicators as total mortality, birth rate, maternal, infant and perinatal mortality, circulatory system incidence. The work environment of the Republican Hospital of the Republic of Sakha (Yakutia) is represented by the following structural departments: pharmacy, blood transfusion department, sterilization department, laundry, dietetic department, infant-feeding centre, material and technical supply. More than 200 employees work in this service. The main function of these services is to provide on-time and fail-safe supply with all necessary: wear parts, medical supplies, donated blood and its components, foodstuffs, hospital linen , sterile instruments, etc. Thus, the activity of medical organization depends on the work environment, including quality health care, so it is a main part of multi-field hospital activity.

Keywords: organization of multi-field hospital’s, work environment, quality health care, pharmacy, blood transfusion department, sterilization department

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Authors: Qiaofeng Guo

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Aims: Obesity is often accompanied by insulin resistance (IR) and whole-body inflammation. Aerobic exercise is an effective treatment to improve insulin resistance and inflammation. However, the anti-inflammatory mechanisms of exercise on epididymal and subcutaneous adipose remain to be elucidated. Here, we compared the macrophage polarization between epididymal and subcutaneous adipose after aerobic exercise. Methods: Male C57BL/6 mice were fed a normal diet group or a high-fat diet group for 12 weeks and performed aerobic training on a treadmill at 55%~65% VO₂ max for eight weeks. Food intake, body weight, and fasting blood glucose levels were monitored weekly. The intraperitoneal glucose tolerance test was to evaluate the insulin resistance model. Fat mass, blood lipid profile, serum IL-1β, TNF-α levels, and CD31/CD206 rates were analysed after the intervention. Results: FBG (P<0.01), AUCIPGTT (P<0.01), and HOMA-IR (P<0.01) increased significantly for a high-fat diet and decreased significantly after the exercise. Eight weeks of aerobic exercise attenuated HFD-induced weight gain and glucose intolerance and improved insulin sensitivity. Serum IL-1β, TNF-α, CD11C/CD206 expression in subcutaneous adipose tissue were not changed before and after exercise, but not in epididymal adipose tissue (P<0.01). Conclusion: Insulin resistance is not accompanied by chronic inflammation and M1 polarization of subcutaneous adipose tissue macrophages in high-fat diet mice. Aerobic exercise effectively improved lipid metabolism and insulin sensitivity, which may be closely associated with reduced M1 polarization of epididymal adipose macrophages.

Keywords: aerobic exercise, insulin resistance, chronic inflammation, adipose, macrophage polarization

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Authors: Khadijat Ayanpeju Abdulsalam, Bolanle Mary Olawoye, Paul Babatunde Ayoola

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The potential of Baobab leaves is understudied and not yet fully documented. The purpose of this work is to highlight the important nutritional value and practical qualities of baobab leaves. In this research, proximate analysis was studied to determine the macronutrient quantitative analysis in baobab leaves. Studies were also conducted on other characteristics, such as moisture content, which is significant to the food business since it affects food quality, preservation, and resistance to deterioration. Dietary fiber, which was also studied, has important health benefits, such as lowering blood cholesterol levels by lowering low-density lipoprotein or "bad" cholesterol. It functions as an anti-obesity and anti-diabetic agent, lowering the likelihood of haemorrhoids developing. Additionally, increasing face bulk and short-chain fatty acid synthesis improves gastrointestinal health and overall wellness. Baobab leaves had a moisture content of 6.4%, fat of 16.1%, ash of 3.2%, protein of 18.7%, carbohydrate 57.2% and crude fiber of 4.1%. The minerals determined in the sample of baobab leaves are Ca, Fe, Mg, K, Na, P, and Zn with Potassium (347.6±0.70) as the most abundant mineral while Zn (9.31±0.60) is the least abundant. The functional properties studied include pH, gelation temperature, bulk density, water absorption capacity, oil absorption capacity, foaming property, emulsifying property, and stability and swelling capacity, which are 8.72, 29, 0.39, 138, 98.20, 0.80, 72.80, and 73.50 respectively. The Fourier Transform InfraRed absorption spectra show bands like C=O, C-Cl and N-H. Baobab leaves are edible, nutritious, and non-toxic, as the mineral contents are within the required range.

Keywords: dietary fibre, proximate analysis, macronutrients, minerals, baobab leaves, frequency range

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Authors: Dipanshu Sur, Ratnabali Chakravorty

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Background: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in young women of reproductive age. Low vitamin D levels were found to be associated with the development of obesity and insulin resistance in women with PCOS. Variants on vitamin D receptor (VDR) gene have also been related to metabolic comorbidities in general population. Aim: The aim of this case-control study was to investigate whether the VDR gene polymorphisms are associated with susceptibility to PCOS. Methods: Women with PCOS and a control group, all aged 16-40 years, were enrolled. Genotyping of VDR Fok-I (rs2228570), VDR Apa-I (rs7975232) as well as GC (rs2282679), DHCR7 (rs12785878) SNPs between groups were determined by using direct sequencing. Serum 25-hydroxyvitamin D [25(OH)] levels were measured by ELISA. Results: Mean serum 25(OH)D in the PCOS and control samples were 19.08±7 and 23.27±6.03 (p=0.048) which were significantly lower in PCOS patients compared with controls. CC genotype of the VDR Apa-I SNP was same frequent in PCOS (25.6%) and controls (25.6%) (OR: 0.9995; 95%CI: 0.528 to 1.8921; p= 0.9987). The CC genotype was also significantly associated with both lower E2 (p=0.031) and Androstenedione levels (p=0.062). We observed a significant association of GC polymorphism with 25(OH)D levels. PCOS women carrying the GG genotype (in GC genes) had significantly higher risk for vitamin D deficiency than women carrying the TT genotype. Conclusions: In conclusion, data from this study indicate that vitamin D levels are lower, and vitamin D deficiency more frequent, in PCOS than in controls. The present findings suggest that the Apa-I, Fok-I polymorphism of the VDR gene is associated with PCOS and seems to modulate ovarian steroid secretion. Further studies are needed to better clarify the biological mechanisms by which the polymorphism influences PCOS risk.

Keywords: vitamin D receptor, polymorphism, vitamin D, polycystic ovary syndrome

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Authors: Raul Alexis Sanchez Cornejo, Elena Ivonne Mancera Andrade, Gibran Sidney Aleman Nava, Angel Josue Arteaga Garces, Roberto Parra Saldivar

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An unhealthy diet is one of the main factors for a wide range of chronical diseases such as diabetes, obesity, cancer, cardiovascular diseases, among others. Nowadays, there is a current need to provide innovate healthy products to people in order to decrease the number of people with unhealthy diet. This study focuses on the production of two food products based on two microalgae strains: Tortillas with powder of Haematococcus pluvialis and Spirulina platensis biomass and yogurt with microencapsulated biomass of the same strains. S. platensis has been used widely as food supplements in a form of powder and pills due to its high content in proteins and fatty acids. Haematococcus pluvialis has been recognized for its ability to produce high-added value products under stressful conditions such as antioxidants (astaxanthin). Despite the benefits that those microalgae have, few efforts have been done to use them in food products. The main objective of this work is to evaluate the nutritional properties such as protein content, lipid fraction, carbohydrates, antioxidants,, and vitamins, that these microalgae strains provide to the food product. Additionally, physicochemical, and sensory evaluation were assessed to evaluate the quality of the product. The results obtained will dictate the feasibility of the product to be commercialized. These novel products will have the ability to change the nutritional intake and strength the health of the consumers.

Keywords: functional food, Haematococcus pluvialis, microalgae, Spirulina platensis, tortilla, yogurt

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Authors: Kmiecik Dominik, Kobus-Cisowska Joanna, Gramza-Michalowska Anna, Marcinkowska Agata, Korczak Józef

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The relationship between the choice of a proper diet, a diet, lifestyle man and his health has been known for a long time. Because of the increase in public awareness of food ingredients and their influence on health status, measures have been taken towards the production of food, which is designed to not only eat, but also to protect against the incidence of lifestyle diseases. For this purpose, the bio active products with healthy properties was developed. Mulberry have a very high nutritional value, rich in chemical composition and many properties used in the prevention of lifestyle diseases. In addition to basic chemical components, nutrients, mulberry fruit contain compounds having a physiological effect. The aim of this study was to assess the effect of white mulberry fruit on the sensory quality of bread to be healthy diet of people suffering from anemia, diabetes, obesity and cardiovascular disease. Sensory analysis was carried out by the profile method. Intra-operative differentiators color, aroma, taste, texture, and overall assessment. Sensory analysis showed that all test trials were characterized by a uniform and concise consistency, similar in color from dark to light beige. The taste and smell of herbal characteristic was designed in an attempt to prevention of diabetes, while the other samples were characterized by a typical taste and smell of bread grain. There were no foreign taste and odor in the test bread. It was found that the addition of white mulberry fruit does not affect the sensory quality of the newly developed bioactive bread.

Keywords: mulberry, bread, bioactive, sensory analysis

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Authors: Behnaz Farahani, Razieh Sotoudeh, Ali Vahdani, Hamed Abdi

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Individual differences in eating behavior can cause underweight or overweight and obesity. Thus influencing factors on children’s eating behavior such as mothers’ feeding practices are needed to be more investigated. The goals of this survey are to evaluate the association of (i) parental pressure and children’s food avoidant tendency, (ii) parental restriction and children’s food approach tendency, (iii) modeling of healthy eating in front of children and their children’s eating behavior. 760 mothers of children aged 7-10 from schools in Isfahan were asked to complete questionnaires including Child Feeding Questionnaire, Children’s Eating Behavior Questionnaire, Modeling Questionnaire, and self-administered demographic questionnaire in which mothers reported their children’s height and weight as well. Of those mothers, 745 completed the questionnaires for the children’s index (mean age: 8.513±1.112) during the 2011-2012 school year. The results of this quantitative, descriptive, cross-sectional analysis indicated that “parental restriction” was positively associated with child food responsiveness (P,0.000) and food enjoyment (P,0.000) and surprisingly, it was positively associated with Food Fussiness(0.000) .Parental pressure to eat was positively associated with child satiety responsiveness (P,0.000), slowness (P,0.000), and fussiness (P,0.00) and negatively associated with Food responsiveness(p,0.000)and Enjoyment of food (p,0.002), modeling of healthy eating were positively associated with Enjoyment of food / q (p,0.000) and negatively with food fussiness (P,0.000). The results of this survey will improve interventions and maternal guidance on their feeding practices and their association with children’s eating behavior and weight.

Keywords: feeding practices, eating behavior, pressure to eat, restriction, modeling, satiety responsiveness, slowness in eating, food fussiness, food responsiveness, enjoyment of food

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Authors: Jerickson Abbie Flores, Jana Fragante, Jan Paolo Dipasupil, Jan Jorge Francisco

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Malnutrition is one of the rapidly growing health problems affecting the world at present. Children affected are not only at risk for significant health problems, but are also faced with psychological and social consequences, including low self-esteem. School-age children are specifically vulnerable to develop poor self-esteem especially when their peers find them physically unattractive. Thus, malnutrition, whether obesity or undernourishment, contributes a significant role to a developing child’s health and behavior. This research aims to determine if there is a significant difference on the level of self-esteem among Filipino children ages 9-12 years old with abnormal body mass index (BMI) and those children with desirable BMI. Using a cross-sectional study design, the correlation between body mass index (BMI) and self-esteem was observed among children ages 9-12 years old. Participants took the Hare self esteem questionnaire, which is specifically designed to measure self-esteem in school age children. The lowest possible score is 15 and the highest possible score is 45. A total of 1140 students with ages 9-12 years old from Cembo Elementary School (public school) participated in the study. Among the participants, 239 out of the 1140 have desirable body mass index, 878 are underweight, and 23 are overweight. Using the test questionnaire, the computed mean scores were 36.599, 36.045 and 36.583 for normal, underweight and overweight categories respectively. Using Pearson’s Correlation Test and Spearman’s Correlation Coefficient Test, the study showed positive correlation (p value of 0.047 and 0.004 respectively) between BMI and Self-esteem scores which indicates that the higher the BMI, the higher the self-esteem of the participants.

Keywords: body mass index, malnutrition, school-age children, self-esteem

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Authors: Hung Lin-Zin, Lai Mei-Yen

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Prostate cancer is the most commonly diagnosed male cancer in the U.S. The prevalence is around 1 in 8. The etiology of prostate cancer is still unknown, but some predisposing factors, such as age, black race, family history, and obesity, may increase the risk of the disease. In 2020, a total of 7,178 Taiwanese people were nearly diagnosed with prostate cancer, accounting for 5.88% of all cancer cases, and the incidence rate ranked fifth among men. In that year, the total number of deaths from prostate cancer was 1,730, accounting for 3.45% of all cancer deaths, and the death rate ranked 6th among men, accounting for 94.34% of the cases of male reproductive organs. Looking for domestic and foreign literature on the use of OMOP (Observational Medical Outcomes Partnership, hereinafter referred to as OMOP) database analysis, there are currently nearly a hundred literature published related to nursing-related health problems and nursing measures built in the OMOP general data model database of medical institutions are extremely rare. The OMOP common data model construction analysis platform is a system developed by the FDA in 2007, using a common data model (common data model, CDM) to analyze and monitor healthcare data. It is important to build up relevant nursing information from the OMOP- CDM database to assist our daily practice. Therefore, we choose prostate cancer patients who are our popular care objects and use the OMOP- CDM database to explore the common associated health problems. With the assistance of OMOP-CDM database analysis, we can expect early diagnosis and prevention of prostate cancer patients' comorbidities to improve patient care.

Keywords: OMOP, nursing diagnosis, health problem, prostate cancer

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Authors: Abdolrasoul Daneshjoo, Fatemeh Akbari Ghara

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Background and Purpose: Obesity is an increasing factor in cardiovascular disease and serum levels of cellular adhesion molecule. It plays an important role in predicting risk for coronary artery disease. The purpose of this research was to study the effect of eight weeks moderate intensity interval training and curcumin intake on ICAM-1 & VCAM-1 levels of menopausal fat rats. Materials and methods: in this study, 28 Wistar Menopausal fat rats aged 6-8 weeks with an average weight of 250-300 (gr) were randomly divided into four groups: control, curcumin supplement, moderate intensity interval training and moderate intensity interval training + curcumin supplement. (7 rats each group). The training program was planned as 8 weeks and 3 sessions per week. Each session consisted of 10 one-min sets with 50 percent intensity and the 2-minutes interval between sets in the first week. Subjects started with 14 meters per minute, and 2 (m/min) was added to increase their speed weekly until the speed of 28 (m/min) in the 8th week. Blood samples were taken 48 hours after the last training session, and ICAM-1 A and VCAM-1 levels were measured. SPSS software, one-way analysis of variance (ANOVA) and Pearson correlation coefficient were used to assess the results. Results: The results showed that eight weeks of training and taking curcumin had significant effects on ICAM-1 levels of the rats (p ≤ 0.05). However, it had no significant effect on VCAM-1 levels in menopausal obese rates (p ≥ 0.05). There was no significant correlation between the levels of ICAM-1 and VCAM-1 in eight weeks training and taking curcumin. Conclusion: Implementation of moderate intensity interval training and the use of curcumin decreased ICAM-1 significantly.

Keywords: curcumin, interval training , ICMA, VCAM

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Authors: Kasun U. G. Palihakkara

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Although vaccine coverage in Sri Lanka is close to 100%, with the widely spreading vaccine rejection trend reaching South Asian regions, it is essential to catch on whether Sri Lankans are being misinformed from the common misconceptions regarding vaccines. As the rates of target diseases decrease, parents become less accepting of even minor common adverse events. It is essential to preserve the integrity of immunization programs and protect public health by finding out the prevalence of anti-immunization trends. The primary objective of this study was to assess the immunization practices and prevalence of trends related to anti-immunization among urban community in Sri Lanka. A descriptive cross-sectional quantitative study on 323 participants using convenient sampling with 213 self-administered questionnaires. Additionally, 110 online questionnaires were distributed. 31% of the study population does not maintain immunization records for their children. While majority seek information regarding immunization from reliable sources such as the family physician or specialist pediatricians, 30% also refer to unreliable sources such as online communities for their opinion. 31% of study population had not vaccinated for Japanese encephalitis. 73% of the study population had encountered with side effects of vaccination such as fever & 47% believed that such side effects are rare. 52% of the population had hostile attitude regarding the administration of several doses multiple vaccines within a child’s first year. Diseases like polio had been successfully eradicated from Sri Lanka with the help of vigorous vaccination programs. However, majority of the study population believe that there’s no need to keep vaccinating the children for those eradicated diseases and exposing the child for adverse effects of such vaccines. Majority of the population were aware of the existing misconceptions regarding immunization. The most popular misconceptions about vaccines popular among the study population were the MMR (Measles, Mumps, and Rubella) vaccine being a possible cause leading to autism and bowel disease and children getting infected with the disease even after they get vaccinated, may be due to the inactivated vaccine. Disturbingly 22% of the study population believed that vaccines are useless in preventing diseases nowadays. These data obtained from the urban study population reveals that even though statistically Sri Lankan immunization coverage is 100%, there is a possibility of anti-vaccination trend arising in Sri Lanka due to the prevalence of various misconceptions and rumors related to it. Therefore these data recommend the need for thorough awareness among the mothers.

Keywords: anti-vaccination, immunization, infectious diseases, pediatric health

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Authors: M. Z. Bin Mohd Ghazali, N. C. Wilson, A. F. Bin Ahmad Fuad, M. A. H. B. Musa, M. U. Mohamad Sani, F. Zulkifli, M. S. Zainal Abidin

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Physical activity levels are low in Malaysia and this study was undertaken to determine if a four week work-based intervention program would be effective in changing physical activity levels. The study was conducted in a Malaysian Government Department and had three stages: baseline data collection, four-week intervention and two-month post intervention data collection. During the intervention and two-month post intervention phases, physical activity levels (determined by a pedometer) and basic health profiles (BMI, abdominal obesity, blood pressure) were measured. Staff (58 males, 47 females) with an average age of 33 years completed baseline data collection. Pedometer steps averaged 7,102 steps/day at baseline, although male step counts were significantly higher than females (7,861 vs. 6114). Health profiles were poor: over 50% were overweight/obese (males 66%, females 40%); hypertension (males 23%, females 6%); excess waist circumference (males 52%, females 17%). While 86 staff participated in the intervention, only 49 regularly reported their steps. There was a significant increase (17%) in average daily steps from 8,965 (week 1) to 10,436 (week 4). Unfortunately, participation in the intervention program was avoided by the less healthy staff. Two months after the intervention there was no significant difference in average steps/day, despite the fact that 89% of staff reporting they planned to make long-term changes to their lifestyle. An unexpected average increase of 2kg in body weight occurred in participants, although this was less than the 5.6kg in non-participants. A number of recommendations are made for future interventions, including the conclusion that pedometers were a useful tool and popular with participants.

Keywords: pedometers, walking, health, intervention

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Authors: Dipanshu Sur, Ratnabali Chakravorty

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Introduction: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in women. Hypovitaminsis D was found to be associated with the development of obesity and insulin resistance in women with PCOS. Aim: To evaluate the association of vitamin D levels in obese and non-obese patients with PCOS in an East Indian populations. Methods: A case control study was conducted. It enrolled 100 cases of PCOS based on Rotterdam criteria and 100 ovulatory normal cases matched for their age and BMI. Vitamin D levels were compared in the obese and non-obese PCOS groups and also with the controls. Results: The mean age of subjects was 29.48 ± 3.29 years in the PCOS group and 26.24 ± 2.56 years in the control group. Hypovitaminosis D was present in 75 out of 100 PCOS women (75.0%) and 25 women (25.0%) showed sufficient 25OHD levels ≥30 ng/ml. Women with PCOS had significantly lower total serum calcium (8.4 ± 0.25 mg/dl versus 9.8 ± 0.17 mg/dl in controls), and 25 OHD (21.2 ± 2.56 ng/ml versus 32.6 ± 2.23 ng/ml in control group) than ovulatory normal women. This difference remained significant for both groups after adjustment for BMI. Obese women in both groups had significantly lower concentration of calcium and 25OHD than normal weight patients in this study. Conclusion: Our study shows majority of the patients and controls had vitamin D deficiency and there was significant difference in the vitamin D levels in PCOS group and controls as well as obese and non-obese groups. This may reflect the vitamin D deficiency status of the community. Vitamin D deficiency should demands immediate attention as it is a severe problem among the East Indian population.

Keywords: vitamin D deficiency, polycystic ovary syndrome, obese, hypovitaminsis D

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Authors: Kaveh Azadeh, Saeid Fazelifar

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The main purpose of the present study was to examine the effect of 12 weeks (3 days/week) concurrent training followed by 4 weeks detraining on insulin resistance in obese boys without dietary intervention. Methods: 24 obese children boys (body mass index> 28, age= 11- 13year old) voluntarily participated in the study. Biochemical factors, body composition, and functional physical fitness were assessed in three stages [baseline, after 12 week’s combined endurance and resistance training and 4 week’s detraining in the experimental group (n=12); baseline and after 12 weeks in control group (n=12)]. Results: Indepented - Sample T test revealed that in experimental group after 12weeks trainings the insulin resistance, and body fat mass were significantly declined, whereas endurance and strength of abdominal muscles significantly increased compared to control group (p<0/05). One-way ANOVA for three different periods showed that insulin resistance, body fat mass, strength of abdominal muscles after 12week training was significantly improved in the experimental group compared with the baseline. Following 4weeks detraining insulin resistance again significantly increased (p<0/05). After detraining disturbances of physiological adaptation in obese children have more rapid course in comparison with those anthropological and functional indices. Conclusion: Results showed that participation in the regular concurrent trainings provides a decrease of insulin resistance in obese children. It may serve as a strategy in treatment of obesity and management on insulin resistance, as well as to increase endurance and strength muscles in obese children. Adaptations resulting from regular exercises following detraining are reversible.

Keywords: endurance and resistance trainings, detraining, insulin resistance, obese children

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Authors: Michael Daly

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Background/Aims: The interplay of childhood self-control and early life social background in predicting adult health is currently unclear. We drew on rich data from two large nationally representative cohort studies to test whether individual differences in childhood self-control may: (i) buffer the health impact of social disadvantage, (ii) act as a mediating pathway underlying the emergence of health disparities, or (iii) compensate for the health consequences of socioeconomic disadvantage across the lifespan. Methods: We examined data from over 25,000 participants from the British Cohort Study (BCS) and the National Child Development Study (NCDS). Child self-control was teacher-rated at age 10 in the BCS and ages 7/11 in the NCDS. The Early life social disadvantage was indexed using measures of parental education, occupational prestige, and housing characteristics (i.e. housing tenure, home crowding). A range of health outcomes was examined: the presence of chronic conditions, whether illnesses were limiting, physiological dysregulation (gauged by clinical indicators), mortality, and perceptions of pain, psychological distress, and general health. Results: Childhood self-control and social disadvantage predicted each measure of adult health, with similar strength on average. An examination of mediating factors showed that adult smoking, obesity, and socioeconomic status explained the majority of these linkages. There was no systematic evidence that self-control moderated the health consequences of early social disadvantage and limited evidence that self-control acted as a key pathway from disadvantage to later health. Conclusions: Childhood self-control predicts adult health and may compensate for early life social disadvantage by shaping adult health behaviour and social status.

Keywords: personality and health, social disadvantage, health psychology, life-course development

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Authors: Hannah Rachel Vasanthi, Paomipem Phazang, Veereshkumar, Sali, Ramesh Parjapath, Sangeetha Marimuthu Kannan

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Garcinia indica (G. indica) fruit rind extract commonly used in South Indian culinary and Indian System of medicines is reported to exhibit various biological activities. The present study envisages the influence of the phytoconstituents in G. indica extract (Vrikshamla capsules- a herbal supplement) on diabetic condition. The condition of type 2 diabetes was triggered in experimental animals by feeding high fat diet for 8 weeks followed by a sub-diabetogenic dose of 35mg/kg bw of streptozotocin intraperitoneally. Oral supplementation of the extract at two doses (100 and 200 mg/kg body weight) for 14 days reduced hyperglycemia, hypercholesterolemia and dyslipidemia (p< 0.001). Pathophysiological changes of obesity and diabetes associated complications majorly mediated by oxidative stress were analyzed by measuring the markers of oxidative stress such as lipid peroxidation, enzymatic (SOD, Catalase, GPx) and non-enzymatic markers (GSH). Conspicuous changes markers were noticed in diabetic condition which was reverted by the G. indica extract. Screening the extract by AccuTOF-DART (MS) revealed the presence of hydroxycitric acid and garcinol in abundant quantity which probably has influenced the biological activity. This was also corroborated through docking studies of hydroxycitric acid and garcinol both individually and synergistically with the antioxidant proteins. Altogether, hydroxycitric acid and garcinol present in G. indica fruit extract alleviates the pathophysiological conditions such as hyperglycemia, dyslipidemia, insulin resistance and oxidative stress mediated by diabesity.

Keywords: antioxidants , diabesity, hydroxycitric acid, garcinol, Garcinia indica, sreptozotocin

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Authors: Olfat Shaker, Miriam Wadie, Reham Ali, Ayman Yosry

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Colorectal cancer (CRC) is a major cause of mortality and morbidity and accounts for over 9% of cancer incidence worldwide. Silent information regulator 2 homolog 1 (SIRT1) gene is located in the nucleus and exert its effects via modulation of histone and non-histone targets. They function in the cell via histone deacetylase (HDAC) and/or adenosine diphosphate ribosyl transferase (ADPRT) enzymatic activity. The aim of this work was to study the relationship between SIRT1 polymorphism and its protein level in colorectal cancer patients in comparison to control cases. This study includes 2 groups: thirty healthy subjects (control group) & one hundred CRC patients. All subjects were subjected to: SIRT-1 serum level was measured by ELISA and gene polymorphisms of rs12778366, rs375891 and rs3740051 were detected by real time PCR. For CRC patients clinical data were collected (size, site of tumor as well as its grading, obesity) CRC patients showed high significant increase in the mean level of serum SIRT-1 compared to control group (P<0.001). Mean serum level of SIRT-1 showed high significant increase in patients with tumor size ≥5 compared to the size < 5 cm (P<0.05). In CRC patients, percentage of T allele of rs12778366 was significantly lower than controls, CC genotype and C allele C of rs 375891 were significantly higher than control group. In CRC patients, the CC genotype of rs12778366, was 75% in rectosigmoid and 25% in cecum & ascending colon. According to tumor size, the percentage of CC genotype was 87.5% in tumor size ≥5 cm. Conclusion: serum level of SIRT-1 and T allele, C allele of rs12778366 and rs 375891 respectively can be used as diagnostic markers for CRC patients.

Keywords: CRC, SIRT1, polymorphisms, ELISA

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Authors: Arslan Masood Pirzada, Muhammad Naeem, Hafiz Haider Ali, Muhammad Latif, Aown Sammar Raza, Asad Hussain Bukhari, Muhammad Saqib, Muhammad Ijaz

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Cyperus rotundus (Cyperaceae), a medicinal herb, is being traditionally used as a home remedy for the treatment of various clinical conditions like diarrhea, diabetic, pyretic, inflammation, malaria, and for treating stomach and bowel disorders. Its current status is one of the most widespread, troublesome, and economically damaging agronomic weeds, growing wildly in various tropical and sub-tropical regions of the world. Tuber and rhizomes of Cyperus rotundus possess a higher concentration of active ingredients in the form of essential oils, phenolic acids, ascorbic acids and flavonoids, responsible for its remedial properties. Exploitation of any medicinal plant application depends on the crucial and comprehensive information about the therapeutic potential of a plant. Researchers have evaluated and characterized the significance of Cyperus rotundus as an anti-androgenic, anti-bacterial, anti-cancerous, anti-convulsant, anti-diabetic, anti-diarrheal, anti-genotoxic, anti-inflammatory, anti-lipidemic, anti-malarial, anti-mutagenic, anti-obesity, anti-oxidant, anti-uropathogenic, hepato-, cardio-, neuroprotective, and nootropic agent. This paper comprises a broad review to summarize the current state of knowledge about chemical constituents, potential economic uses and therapeutic aspects of Cyperus rotundus that will aid in the development of bioethanol and modern herbal medicine through latest technologies that will promote the ability of this plant in the cure of many clinical disorders.

Keywords: purple nutsedge, chemical composition, economic uses, therapeutic values, future directions

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Authors: Maria Del Carmen Millan-Linares, Ana Lemus Conejo, Rocio Toscano, Alvaro Villanueva, Francisco Millan, Justo Pedroche, Sergio Montserrat-De La Paz

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GPETAFLR (Glycine-Proline-Glutamine-Threonine-Alanine-Phenylalanine-Leucine-Arginine) is a peptide isolated from Lupinus angustifolius L. protein hydrolysate (LPH). Herein, the effect of this peptide was investigated in two different models of neuroinflammation: in the immortalized murine microglia cell line BV-2 and in a high-fat-diet-induced obesity mouse model. Methods and Results: Effects of GPETAFLR on neuroinflammation were evaluated by RT-qPCR, flow cytometry, and ELISA techniques. In BV-2 microglial cells, Lipopolysaccharides (LPS) enhanced the release of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) whereas GPETAFLR decreased pro-inflammatory cytokine levels and increased the release of the anti-inflammatory cytokine IL-10 in BV2 microglial cells. M1 (CCR7 and iNOS) and M2 (Arg-1 and Ym-1) polarization markers results showed how the GPETAFLR octapeptide was able to decrease M1 polarization marker expression and increase the M2 polarization marker expression compared to LPS. Animal model results indicate that GPETAFLR has an immunomodulatory capacity, both decreasing pro-inflammatory cytokine IL-6 and increasing the anti-inflammatory cytokine IL-10 in brain tissue. Polarization markers in the brain tissue were also modulated by GPETAFLR that decreased the pro-inflammatory expression (M1) and increased the anti-inflammatory expression (M2). Conclusion: Our results suggest that GPETAFLR isolated from LPH has significant potential for management of neuroinflammatory conditions and offer benefits derived from the consumption of Lupinus angustifolius L. in the prevention of neuroinflammatory-related diseases.

Keywords: GPETAFLR peptide, BV-2 cell line, neuroinflammation, cytokines, high-fat-diet

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Authors: Ugo Rovigatti

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Neuroblastoma (NBL) has epitomized for at least 40 years our understanding of cancer cellular and molecular biology and its potential applications to novel therapeutic strategies. This includes the discovery of the very first oncogene aberrations and tumorigenesis suppression by differentiation in the 80s; the potential role of suppressor genes in the 90s; the relevance of immunotherapy in the millennium first, and the discovery of additional mutations by NGS technology in the millennium second decade. Similar discoveries were achieved in the majority of human cancers, and similar therapeutic interventions were obtained subsequently to NBL discoveries. Unfortunately, targeted therapies suggested by specific mutations (such as MYCN amplification –MNA- present in ¼ or 1/5 of cases) have not elicited therapeutic successes in aggressive NBL, where the prognosis is still dismal. The reasons appear to be linked to Tumor Heterogeneity, which is particularly evident in NBL but also a clear hallmark of aggressive human cancers generally. The new avenue of cancer immunotherapy (CIT) provided new hopes for cancer patients, but we still ignore the cellular or molecular targets. CIT is emblematic of high-risk disease (HR-NBL) since the mentioned GD2 passive immunotherapy is still providing better survival. We recently critically reviewed and evaluated the literature depicting the genomic landscapes of HR-NBL, coming to the qualified conclusion that among hundreds of affected genes, potential targets, or chromosomal sites, none correlated with anti-GD2 sensitivity. A better explanation is provided by the Micro-Foci inducing Virus (MFV) model, which predicts that neuroblasts infection with the MFV, an RNA virus isolated from a cancer-cluster (space-time association) of HR-NBL cases, elicits the appearance of MNA and additional genomic aberrations with mechanisms resembling chromothripsis. Neuroblasts infected with low titers of MFV amplified MYCN up to 100 folds and became highly transformed and malignant, thus causing neuroblastoma in young rat pups of strains SD and Fisher-344 and larger tumor masses in nu/nu mice. An association was discovered with GD2 since this glycosphingolipid is also the receptor for the family of MFV virus (dsRNA viruses). It is concluded that a dsRNA virus, MFV, appears to provide better explicatory mechanisms for the genesis of i) specific genomic aberrations such as MNA; ii) extensive tumor heterogeneity and chromothripsis; iii) the effects of passive immunotherapy with anti-GD2 monoclonals and that this and similar models should be further investigated in both pediatric and adult cancers.

Keywords: neuroblastoma, MYCN, amplification, viruses, GD2

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Authors: Adela Penesova, Zofia Radikova, Boris Bajer, Andrea Havranova, Miroslav Vlcek

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Background: The aim of our study was to compare the effect of intensified lifestyle intervention on insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and Fibroblast growth factor (FGF) 21 after 8 weeks of lifestyle intervention. Methods: A group of 43 obese patients (13M/30F; 43.0±12.4 years; BMI (body mass index) 31.2±6.3 kg/m2 participated in a weight loss interventional program (NCT02325804) following an 8-week hypocaloric diet (-30% energy expenditure) and physical activity 150 minutes/week. Insulin sensitivity was evaluated according to the homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices according to Matsuda and Cederholm were calculated (ISImat and ISIced). Plasma ALT, AST, Fetuin-A, FGF 21, and physical fitness were measured. Results: The average reduction of body weight was 6.8±4.9 kg (0-15 kg; p=0.0006), accompanied with a significant reduction of body fat amount of fat mass (p=0.03), and waist circumference (p=0.02). Insulin sensitivity has been improved (IR HOMA 2.71±3.90 vs 1.24±0.83; p=0.01; ISIMat 6.64±4.38 vs 8.93±5.36 p ≤ 0.001). Total, LDL cholesterol, and triglycerides decreased (p=0.05, p=0.04, p=0.04, respectively). Physical fitness significantly improved after intervention (as measure VO2 max (maximal oxygen uptake) (p ≤ 0.001). ALT decreased significantly (0.44±0.26 vs post 0.33±0.18 ukat/l, p=0.004); however, AST not (pre 0.40±0.15 vs 0.35±0.09 ukat/l, p=0.07). Hepatokine Fetuin-A significantly decreased after intervention (43.1±10.8 vs 32.6±8.6 ng/ml, p < 0.001); however, FGF 21 levels tended to decrease (146±152 vs 132±164 pg/ml, p=0.07). Conclusion: 8-weeks of diet and physical activity intervention program in obese otherwise healthy subjects led to an improvement of insulin resistance parameters and liver marker profiles, as well as increased physical fitness. This study was supported by grants APVV 15-0228; VEGA 2/0161/16.

Keywords: obesity, diet, exercice, insulin sensitivity

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Authors: Hannah S. Waldron

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Background: The government has proposed sugar reduction targets in an effort to tackle childhood obesity, focussing on those of low socioeconomic status (SES). Supermarkets are a key location for reducing the amount of sugar purchased, but success so far in this environment has been limited. Building on previous research, this study will assess the impact of restricting the availability of higher sugar biscuits as a strategy to encourage lower sugar biscuit purchasing, and whether the effects vary by customer SES. Method: 14 supermarket convenience stores were divided between control (n=7) and intervention (n=7) groups. In the intervention stores, biscuits with sugar above the government’s target (26.2g/100g) were removed from sale and replaced with lower sugar ( < 26.2g sugar/100g) alternatives. Sales and customer demographic information were collected using loyalty card data and point-of-sale transaction data for 8-weeks pre and post the intervention for lower sugar biscuits, total biscuits, alternative higher sugar products, and all products. Results were analysed using three-way and two-way mixed ANOVAs. Results: The intervention resulted in a significant increase in lower sugar biscuit purchasing (p < 0.001) and a significant decline in overall biscuit sales (p < 0.001) between the time periods compared to control stores. Sales of higher sugar products and all products increased significantly between the two time periods in both the intervention and control stores (p < 0.05). SES showed no significant effect on any of the reported outcomes (p > 0.05). Conclusion: Restricting the availability of higher sugar products may be a successful strategy for encouraging lower sugar purchasing across all SES groups. However, larger-scale interventions are required in additional categories to assess the long term implications for both consumers and retailers.

Keywords: biscuits, nudging, sugar, supermarket

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Authors: Ahmed Ghachem, Johann Colomba, Denis Prud'homme, Martin Brochu

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Background: Inactive obese postmenopausal women, are at greater risk for metabolic complications. On the other hand, high levels of cardiorespiratory fitness (CRF) are associated with a lower risk of metabolic complications. Objective: To compare inactive obese postmenopausal women displaying ‘lower’ vs ‘higher’ levels of CRF for body composition, metabolic profile, inflammatory profile and measures of energy expenditure. Methods: 132 women (age: 57.6 ± 4.8 yrs; BMI: 32.3 ± 4.6 kg/m2; Peak VO2: 17.81 ± 3.02 ml O2•kg-1•min-1) were studied. They were first divided into tertiles based on their CRF. Then, women in the first (< 16.51 ml O2•min-1•kg-1) and second tertiles (16.51 to 19.22 ml O2•min-1•kg-1) were combined (N= 88), and compared with those in the third tertile (> 19.22 ml O2•min-1•kg-1) (N= 44). Variables of interest were: Peak VO2 (stationary bike), body composition (DXA), body fat distribution (CT scan), glucose homeostasis (fasting state and euglycemic/ hyperinsulinemic clamp), fasting lipids, resting blood pressure, inflammatory profile and energy expenditure (DLW). Results: Both CRF groups (lower= 16.0 ± 2.0 ml O2•kg-1•min-1 vs higher= 21.2 ± 1.7 ml O2•kg-1•min-1; p < 0.001) were similar for age. Significant differences were observed between groups for body composition; with lower values for body weight, BMI, fat mass and visceral fat in women with higher CRF (p between 0.001 and 0.005). Also, women with higher CRF had lower values for fasting insulin (13.4 ± 4.5 vs 15.6 ± 6.6 μU/ml; p = 0.03) and CRP levels (2.31 ± 1.97 vs 3.83 ± 3.24 mg/liter; p = 0.001); and higher values for glucose disposal (6.71 ± 1.78 vs 5.92 ± 1.67 mg/kg/min; p = 0.01). However, these differences were no longer significant after controlling for visceral adipose tissue accumulations. Finally, no significant difference was observed between groups for the other variables of interest. Conclusion: Our results suggest that, among inactive overweight/obese postmenopausal women, those with higher CRF levels have a better metabolic profile; which is caused by lower visceral fat accumulations.

Keywords: cardiorespiratory fitness, metabolic profile, menopause, obesity

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Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Background: Obesity, particularly abdominal type, lead to accelerated progress of atherosclerosis and thus affects the functioning of various human organs. Non-HDL cholesterol includes residual risk of the cardiovascular diseases which persists in patients after achieved recommended level of LDL cholesterol. The maintenance of normal body mass index plays a particularly important role in both the prevention and treatment of chronic diseases. Materials and Methods: The study covered 96 patients (55 females, 42 males, age 66,9 +/-10,2 years). The nutritional status was determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using the MDRD formula. Non-high-density lipoprotein cholesterol (non-HDL) is simply the difference between the total cholesterol concentration and the HDL cholesterol concentration. Results: The higher was level of non-HDL cholesterol, the lower eGFR had studied subjects (p<0.001). Significant correlation was found between higher WHtR and lower the eGFR (p=0.002). Also underweight (30% of patient) led to obtaining lower values of eGFR in subjects over 65 years old. The poorer nutrition the lower was glomerular filtration rate. Conclusions: Nutritional statuses of patients have a significant impact on the level of kidney function. Not only accumulated excess fat in the abdominal area, but also its deficiency affects the deterioration in renal filtration. Higher level of non-HDL not only raises the residual risk of the heart disease but also influences on kidney by worsening eGFR. Proper diet in connection with physical activity should lead to achieving good nutrition in these patients and protect their kidney function.

Keywords: nutrition, non-HDL cholesterol, glomerular filtration rate, lifestyle

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Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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Authors: Alyaa Farouk AbdelFattah Ibrahim, Agnes Monica, Dolores I. Cabansag

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The prevalence of diabetes mellitus is reaching epidemic proportions in many parts of the world causing an increasing public health concern. Cases of Type 2 diabetes are rapidly increasing in the Middle East region. Deprived of lifestyle deviations, a section of the Middle East’s inhabitants will be pretentious by 2035. As all sociocultural factors have created unhealthy lifestyles, which have become part of the social norms within Saudi society, thereby increased the prevalence of sedentary lifestyle and obesity in women living in Saudi Arabia. So, this study aimed to assess the impact of diabetes mellitus on quality of life of female nursing students in King Saud bin Abdulaziz University for Health Sciences, Riyadh. In a crossectional study design, 151 nursing students at King Saud bin Abdulaziz University for health sciences in Riyadh were included in the study. Biosociodemographic questionnaire and Short-Form 36 (SF-36) Health Related Quality of life Survey Arabic version were used for data collection, and all included students were screened for random blood glucose level. Results depicted that among 151 subjects included in the study 17 (11.3%) had diagnosed medical problems, and 29.4% of those participants with medical problems were diabetics. Univariate regression model for the relation between diabetes mellitus and overall percent score of SF-36 health survey domains showed no statistically significant difference between diabetic and non-diabetic subjects 0.990(0.931-1.053). In conclusion, although the diabetes prevalence was high among the study subjects it did not affect their quality of life may be due to age of the study population.

Keywords: diabetes mellitus, diabetes prevalence, quality of life, university students' health

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Authors: Fereshteh Ganjavi, Rachel Schaffer, Varsha Jorawar

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Elena’s Light is a non-profit organization focused on building brighter futures for refugees, especially women and children. Our mission is to empower refugee women and children by addressing social, legal, and public health issues that predominantly concern them. Elena’s Light offers a range of services that support refugees from structural disadvantages, cultural and social stress, marginalization, and other stressors related to migration. Using a three-pronged approach, our programs focus on legal advocacy, English language acquisition, and health and wellness. Following the Afghan humanitarian crisis, Elena’s Light has developed and intensified advocacy efforts in the legal realm to address the influx of refugees who desperately need assistance. We developed and hosted a Know Your Rights presentation with local immigration lawyers and professionals in February 2022 on the Afghan Humanitarian Parole, which was very successful with over 100 attendees. Elena’s Light is hosting the second Know Your Rights session in early August 2022 on immigration options for Afghans, including Temporary Protected Status (TPS), asylum, Special Immigrant Visa (SIV), and humanitarian parole. Lastly, EL is also leading the local initiative to develop a pro-bono committee to respond to the overwhelming need for lawyers to work on legal cases for Afghan during this crisis. Furthermore, through our other services, we provide free, in-home customizable ESL tutoring sessions to refugee women with a focus on driver’s education, facilitating acculturation, and improving employment opportunities. We also provide in-home maternal, pediatric, and mental health education and wellness services that are aimed at addressing the explicit and implicit barriers to healthcare for refugee populations. Elena’s Light’s diverse community aims to counter the structural disadvantages and anxiety-inducing emotions and experiences related to being a refugee. We would like to join this International Conference on Refugee Law since protecting refugee rights is our mission. We would like to share what we have learned from our legal initiatives for refugee rights. We would also like to listen, learn from, and discuss with experts and researchers how to better understand and advocate for refugee rights. We hope to improve our understanding of how to provide better legal aid for our clients through this conference.

Keywords: legal, advocacy, Afghan humanitarian crisis, policy, pro-bono

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Authors: E. Rama Devi Jothilingam

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Diabetes mellitus is now one of the most common non communicable diseases globally. India leads the world with largest number of diabetic subjects earning the title "diabetes capital of the world". In order to reduce the mortality rate, a fuzzy expert system is designed to predict the severity of cardiac and renal problems of diabetic patients using fuzzy logic. Since uncertainty is inherent in medicine, fuzzy logic is used in this research work to remove the inherent fuzziness of linguistic concepts and uncertain status in diabetes mellitus which is the prime cause for the cardiac arrest and renal failure. In this work, the controllable risk factors "blood sugar, insulin, ketones, lipids, obesity, blood pressure and protein/creatinine ratio" are considered as input parameters and the "the stages of cardiac" (SOC)" and the stages of renal" (SORD) are considered as the output parameters. The triangular membership functions are used to model the input and output parameters. The rule base is constructed for the proposed expert system based on the knowledge from the medical experts. Mamdani inference engine is used to infer the information based on the rule base to take major decision in diagnosis. Mean of maximum is used to get a non fuzzy control action that best represent possibility distribution of an inferred fuzzy control action. The proposed system also classifies the patients with high risk and low risk using fuzzy c means clustering techniques so that the patients with high risk are treated immediately. The system is validated with Matlab and is used as a tracking system with accuracy and robustness.

Keywords: Diabetes mellitus, fuzzy expert system, Mamdani, MATLAB

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