Search results for: obesity metabolic syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1798

Search results for: obesity metabolic syndrome

1618 Factors Associated to Down Syndrome Causes in Patients of Cytogenetics Laboratory, Faculty of Medicine, Universitas Padjadjaran in 2014─2015

Authors: Bremmy Laksono, Nurul Qomarilla, Riksa Parikrama, Dyan K. Nugrahaeni, Willyanti Soewondo, Dadang S. H. Effendi, Eriska Rianti, Arlette S. Setiawan, Ine Sasmita, Risti S. Primanti, Erna Kurnikasari, Yunia Sribudiani

Abstract:

Down syndrome is a chromosomal abnormality of chromosome 21 which can appear in man or woman. Maternal age and paternal age, history of radiation are the common risk factors. This study was conducted to observe risk factors which related as causes of Down syndrome. In this case control study using purposive sampling technique, 84 respondents were chosen from Cell Culture and Cytogenetics Laboratory patients in Faculty of Medicine, Universitas Padjadjaran, Indonesia. They were used as study samples and divided into 42 Down syndrome cases and 42 control respondents. This study used univariate and bivariate analysis (chi-square). Samples population were West Java residents, the biggest province in Indonesia in number of population. The results showed maternal age, paternal age, history of radiation exposure and family history were not significantly related to Down syndrome baby. Moreover, all of those factors also did not contribute to the risk of having a child with Down syndrome in patients at Cell Culture and Cytogenetics Laboratory, Faculty of Medicine, Universitas Padjadjaran. Therefore, we should investigate other risk factors of Down syndrome in West Java population.

Keywords: down syndrome, family history, maternal age, paternal age, risk factor

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1617 Assessment of Hepatosteatosis Among Diabetic and Nondiabetic Patients Using Biochemical Parameters and Noninvasive Imaging Techniques

Authors: Tugba Sevinc Gamsiz, Emine Koroglu, Ozcan Keskin

Abstract:

Aim: Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the general population. The higher mortality and morbidity among NAFLD patients and lack of symptoms makes early detection and management important. In our study, we aimed to evaluate the relationship between noninvasive imaging and biochemical markers in diabetic and nondiabetic patients diagnosed with NAFLD. Materials and Methods: The study was conducted from (September 2017) to (December 2017) on adults admitted to Internal Medicine and Gastroenterology outpatient clinics with hepatic steatosis reported on ultrasound or transient elastography within the last six months that exclude patients with other liver diseases or alcohol abuse. The data were collected and analyzed retrospectively. Number cruncher statistical system (NCSS) 2007 program was used for statistical analysis. Results: 116 patients were included in this study. Diabetic patients compared to nondiabetics had significantly higher Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM) and fibrosis values. Also, hypertension, hepatomegaly, high BMI, hypertriglyceridemia, hyperglycemia, high A1c, and hyperuricemia were found to be risk factors for NAFLD progression to fibrosis. Advanced fibrosis (F3, F4) was present in 18,6 % of all our patients; 35,8 % of diabetic and 5,7 % of nondiabetic patients diagnosed with hepatic steatosis. Conclusion: Transient elastography is now used in daily clinical practice as an accurate noninvasive tool during follow-up of patients with fatty liver. Early diagnosis of the stage of liver fibrosis improves the monitoring and management of patients, especially in those with metabolic syndrome criteria.

Keywords: diabetes, elastography, fatty liver, fibrosis, metabolic syndrome

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1616 Impact of Obesity on Female Fertility

Authors: A. Chennai, M. Yahia, H. Boussenan

Abstract:

Our study was designed to highlight changes in certain biochemical parameters such as (CH, TG, HDL, TGO, TGP, LDL, and CRP), hormones (FSH, LH, PRL, TSH, and leptin), in women who suffer from over weight and fertile controls as well as the research for potential pathophysiological link between obesity and infertility in this population of women. This practical work has been focused on a population of 24 over weight infertile women, compared to control subjects without any pathology causing disturbance parameters to be studied to determine the contribution of obesity in the etiology of infertility. The assay results revealed a highly significant difference between the two groups in the serum levels of CH, TG, HDL, and TGO TGP (P <0.0001) as well as the rate of LDL (p=0.0017) and CRP (p=0.02). Hormonal profile also shows a significant difference between the two groups (P<0.0001) for LH and leptin but no difference was found for serum TSH. A significant correlation between leptin and FSH, LH, and FSH, age and LH, PRL and age and between HDL and CRP. The present study suggests that obesity is associated with infertility, but no direct pathophysiological link between obesity and infertility has been determined. More in-depth studies are needed to determine the exact mechanism by which overweight leads to female infertility.

Keywords: fertility, obesity, hormones, biochemical, pathophysiological

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1615 Transition of Nutrition Style and Obesity: A Kuwaiti Case Study

Authors: Othman Saleh Al-Razgan

Abstract:

Obesity establishes an epidemic along with an array of comorbidities and this call for careful clinical assessment, to identify causal factors and comprehensive management. In Kuwait, this epidemic reflects the progressive, socio-economic and age-related issues, along with the shift of nutrition from traditional to modern-style. The current research attempts to narrate the obesity and related health issues in Kuwait, with a special emphasis on the magnitude of the issue in Kuwait, nutrition transition over the past three decades, change in life-style, and possible solution for this issue.

Keywords: clinical assessment, comorbidities, obesity, socio-economic

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1614 Prevalence of Obesity in Kuwait: A Case Study among Kuwait University Students

Authors: Mohammad Alnasrallah, Muhammad Almatar

Abstract:

This study seeks to understand the relationship between the effect of geography and obesity prevalence among Kuwait University students. The sample involved 735 participants, 231 male, and 504 females, where there is a high percentage of them are overweight and obese. The percentage of overweight is 21% (BMI >25 - 30) while the percentage of obesity is 13.7% (BMI > 30). Both overweight and obese people account for 34.7%. In the study area, there are 327 fast food restaurants located in different places of in the urban area. This study uses the Geographic Information System to analyze the distribution of obesity and fast food restaurants. The study found that within half kilometers of fast food outlets, there are 33% of normal weight (BMI < 25), 30% of overweight while for the obese people there are 43 %, which shows that obesity is linked to the location of fast food restaurants. One of the significant tools that were used in this study hot and cold spots. The study found that areas of hot spots of fast food restaurants tend to be located in areas of hot spots of obese people. In conclusion, studying the prevalence of obesity from geographical perspective help to understand this public health issue and its relation to the effect of geography.

Keywords: obesity prevalence, GIS, fast food, Kuwait

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1613 Association of Overweight and Obesity with Breast Cancer

Authors: Amir Ghasemlouei, Alireza Khalaj

Abstract:

In women, cancer of the breast is one of the most common incident cancer and cause of death from cancer .we reviewed the prevalence of obesity and its association with breast cancer. In this study, a total of 25 articles regarding the subject matter of the article have been presented in which 640 patients were examined that 320 patients with breast cancer and 320 were controls. The distribution of breast cancer patients and controls with respect to their anthropometric indices in patients with higher weight, which was statistically significant (60.2 ± 10.2 kg) compared with control group (56.1 ± 11.3 kg). The body mass index of patients was (26.06+/-3.42) and significantly higher than the control group (24.1+/-1.7). Obesity leads to increased levels of adipose tissue in the body that can be stored toxins and carcinogens to produce a continuous supply. Due to the high level of fat and the role of estrogen in a woman is endogenous estrogen of the tumor and regulate the activities of growth steroids, obesity is a risk factor for breast cancer is confirmed. Our study and other studies show that obesity is a risk factor for breast cancer. And with a weight loss intervention for breast cancer can be prevented in the future.

Keywords: breast cancer, review study, obesity, overweight

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1612 Case Report and Discussion of Natural History of Bouveret Syndrome

Authors: Parul Garg

Abstract:

Bouveret Syndrome is a rare presentation described as Gastric Outlet Obstruction secondary to Gallstone Ileus. Here we describe the 3-year progression of disease from cholelithiasis to gallstone ileus with relevant imaging findings. The patient was treated under an Upper Gastrointestinal Surgery service with surgical intervention in the form of a laparoscopic assisted procedure with midline laparotomy. She recovered well and was discharged 1 week post operatively. No complications occurred.

Keywords: Cholelithiasis, Bouveret syndrome, Gallstone Ileus, gastric outlet obstruction

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1611 The Increase of Adolescent Obesity Rates after the COVID-19 Pandemic and Possible Obesity Prevention Programs for Implementation

Authors: Tatiana Pratt, Benyamin Hanasabzadeh, Panayiota Courelli

Abstract:

The COVID-19 pandemic is one of the largest global public health issues of this current century. COVID-19 puts people diagnosed with obesity at higher risk of not only contracting the virus but also being hospitalized and dying, making this a vital time to implement obesity prevention programs. However, COVID-19 is predicted to rapidly increase the obesity rate in the United States due to the mandatory sedentary lifestyle the pandemic demands; this is especially harmful to adolescent-aged children because it creates lifelong unhealthy habits and behaviors. Adolescent obesity prevention programs have been rigorously implemented throughout the last century to help diminish the ever-increasing adolescent obesity rate. Since the pandemic kept adolescents inside and away from in-person school, many programs have now become ineffective due to their in-person participation. Examples of in-person participation programs include school lunch programs, OSNAP and New Moves. Therefore, online programs or remote intervention measures are now more essential. This leads to programs such as Time2bHealthy, HEALTH[e]TEEN, and SWITCH should be looked at with more vitality. Adolescents have intertwined their lives with technology and screen usage. Therefore, online and remote prevention programs will continue to play a large role in the post-pandemic era. This literature review will be reviewing past and current adolescent obesity prevention programs and their effectiveness with the new remote, sedentary lifestyle adolescents. Furthermore, it will suggest new ways to more productively decrease adolescent obesity rates by analyzing the harmful factors that COVID-19 introduced into their lifestyles.

Keywords: adolescent, obesity, overweight, COVID-19, preventative care, public health, public policy, obesity prevention programs, online programs

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1610 Literature Review of the Management of Parry Romberg Syndrome with Fillers

Authors: Sana Ilyas

Abstract:

Parry-Romberg syndrome is a rare condition clinically defined by slowly progressive atrophy of the skin and soft tissues. This usually effects one side of the face, although a few cases have been documented of bilateral presentation. It is more prevalent in females and usually affects the left side of the face. The syndrome can also be accompanied by neurological abnormalities. It usually occurs in the first two decades of life with a variable rate of progression. The aetiology is unknown, and the disease eventually stabilises. The treatment options usually involve surgical management. The least invasive of these options is the management of facial asymmetry, associated with Parry Romberg syndrome, through the use of tissue fillers. This paper will review the existing literature on the management of Parry Romberg syndrome with tissue filler. Aim: The aim of the study is to explore the current published literature for the management of Parry Romberg syndrome with fillers. It is to assess the development that has been made in this method of management, its benefits and limitations, and its effectiveness for the management of Parry Romberg syndrome. Methodology: There was a thorough assessment of the current literature published on this topic. PubMed database was used for search of the published literature on this method of the management. Papers were analysed and compared with one another to assess the success and limitation of the management of Parry Romberg with dermal fillers Results and Conclusion: Case reports of the use of tissue fillers discuss the varying degrees of success with the treatment. However, this procedure has it’s limitation, which are discussed in the paper in detail. However, it is still the least invasive of all the surgical options for the management of Parry Romberg Syndrome, and therefore, it is important to explore this option with patients, as they may be more comfortable with pursuingtreatment that is less invasive and can still improve their facial asymmetry

Keywords: dermal fillers, facial asymmetry, parry romberg syndrome, tissue fillers

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1609 Vitamin D Deficiency and Insufficiency in Postmenopausal Women with Obesity

Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Dzerovych, Roksolana Povoroznyuk, Oksana Ivanyk

Abstract:

Deficiency and insufficiency of Vitamin D is a pandemic of the 21st century. Obesity patients have a lower level of vitamin D, but the literature data are contradictory. The purpose of this study is to investigate deficiency and insufficiency vitamin D in postmenopausal women with obesity. We examined 1007 women aged 50-89 years. Mean age was 65.74±8.61 years; mean height was 1.61±0.07 m; mean weight was 70.65±13.50 kg; mean body mass index was 27.27±4.86 kg/m2, and mean 25(OH) D levels in serum was 26.00±12.00 nmol/l. The women were divided into the following six groups depending on body mass index: I group – 338 women with normal body weight, II group – 16 women with insufficient body weight, III group – 382 women with excessive body weight, IV group – 199 women with obesity of class I, V group – 60 women with obesity of class II, and VI group – 12 women with obesity of class III. Level of 25(OH)D in serum was measured by means of an electrochemiluminescent method - Elecsys 2010 analyzer (Roche Diagnostics, Germany) and cobas test-systems. 34.4% of the examined women have deficiency of vitamin D and 31.4% insufficiency. Women with obesity of class I (23.60±10.24 ng/ml) and obese of class II (22.38±10.34 ng/ml) had significantly lower levels of 25 (OH) D compared to women with normal body weight (28.24±12.99 ng/ml), p=0.00003. In women with obesity, BMI significantly influences vitamin D level, and this influence does not depend on the season.

Keywords: obesity, body mass index, vitamin D deficiency, vitamin D insufficiency, postmenopausal women, age

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1608 Reversal of Testicular Damage and Subfertility by Resveratrol

Authors: Samy S. Eleawa, Mahmoud A. Alkhateeb, Fahaid H. Alhashem, Ismaeel bin-Jaliah, Hussein F. Sakr, Hesham M. Elrefaey, Abbas O. Elkarib, Mohammad A. Haidara, Abdullah S. Shatoor, Mohammad A. Khalil

Abstract:

This effect of Resveratrol (RES) against CdCl2- induced toxicity in the rat testes was investigated. Seven experimental groups of adult male rats were formulated as follows: A) Controls + NS, B) Control+ vehicle (saline solution of hydroxypropyl cyclodextrin), C) RES treated, D) CdCl2 +NS, E) CdCl2+ vehicle, F) RES followed by CdCl2 and M) CdCl2 followed by RES. At the end of the protocol, serum levels of FSH, LH, and testosterone were measured in all groups. Testicular levels of TBARS and Super Oxide Dismutase (SOD) activity were also measured. Epidydidimal semen analysis was performed and testicular expression of Bcl-2, p53 and Bax were assessed by RT-PCR. Also, histopathological changes of testes were examined microscopically and described. Pre and Post administration of RES in cadmium chloride-intoxicated rats improved semen parameters including count, motility, daily sperm production and morphology, increased serum concentrations of gonadotropins and testosterone, decreased testicular lipid peroxidation and increased SOD activity. Not only RES attenuated cadmium chloride induced testicular histopathology but was also able to protect against the onset of cadmium chloride testicular toxicity. Cadmium chloride downregulated the anti-apoptotic gene Bcl2 and upregulated the expression of both pro-apoptotic genes p53 and Bax. Resveratrol protected from and partially reversed cadmium chloride testicular via upregulation of Bcl2 and down regulation of p53 and Bax gene expression. Antioxidant activity of RES protects against cadmium chloride testicular toxicity and partially reverses its effect via upregulation of BCl2 and downregulation of p53 and Bax expression. These findings have far reaching implications on subfertility and impotency frequently seen in hypertensive as well as metabolic syndrome patients.

Keywords: resveratrol, cadmium, infertility, sperm, testis, metabolic syndrome

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1607 Concentrations of Leptin, C-Peptide and Insulin in Cord Blood as Fetal Origins of Insulin Resistance and Their Effect on the Birth Weight of the Newborn

Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

Abstract:

Obesity is associated with an increased risk of developing insulin resistance. Insulin resistance often progresses to type-2 diabetes mellitus and is linked to a wide variety of other pathophysiological features including hypertension, hyperlipidemia, atherosclerosis (metabolic syndrome) and polycystic ovarian syndrome. Macrosomia is common in infants born to not only women with gestational diabetes mellitus but also non-diabetic obese women. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age (LGA) are more likely to be obese in childhood. It is also established from previous studies that Asian populations have higher percentage body fat at a lower body mass index compared to Caucasians. High leptin levels in cord blood have been reported to correlate with fetal adiposity at birth. Previous studies have also shown that cord blood C-peptide and insulin levels are significantly and positively correlated with birth weight. Therefore, the objective of this preliminary study was to determine the relationship between parameters of fetal insulin resistance such as leptin, C-peptide and insulin and the birth weight of the newborn in a study population in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns and the concentration of insulin, leptin, and C-peptide were measured by ELISA technique. Birth weight, length, occipital frontal, chest, hip and calf circumferences of newborns were measured and characteristics of the mother such as age, height, weight before pregnancy and weight gain were collected. The relationship between insulin, leptin, C-peptide, and anthropometrics were assessed by Pearson’s correlation while the Mann-Whitney U test was used to assess the differences in cord blood leptin, C-peptide, and insulin levels between groups. A significant difference (p < 0.001) was observed between the insulin levels of infants born LGA (18.73 ± 0.64 µlU/ml) and AGA (13.08 ± 0.43 µlU/ml). Consistently, A significant increase in concentration (p < 0.001) was observed in C-peptide levels of infants born LGA (9.32 ± 0.77 ng/ml) compared to AGA (5.44 ± 0.19 ng/ml). Cord blood leptin concentration of LGA infants (12.67 ng/mL ± 1.62) was significantly higher (p < 0.001) compared to the AGA infants (7.10 ng/mL ± 0.97). Significant positive correlations (p < 0.05) were observed among cord leptin levels and the birth weight, pre-pregnancy maternal weight and BMI between the infants of AGA and LGA. Consistently, a significant positive correlation (p < 0.05) was observed between the birth weight and the C peptide concentration. Significantly high concentrations of leptin, C-peptide and insulin levels in the cord blood of LGA infants suggest that they may be involved in regulating fetal growth. Although previous studies suggest comparatively high levels of body fat in the Asian population, values obtained in this study are not significantly different from values previously reported from Caucasian populations. According to this preliminary study, maternal pre-pregnancy BMI and weight may contribute as significant indicators of cord blood parameters of insulin resistance and possibly the birth weight of the newborn.

Keywords: large for gestational age, leptin, C-peptide, insulin

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1606 Preliminary Efficacy of a Pilot Paediatric Day Hospital Program Project to Address Severe Mental Illness, Obesity, and Binge Eating

Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

Abstract:

Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

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1605 Correlations between Obesity Indices and Cardiometabolic Risk Factors in Obese Subgroups in Severely Obese Women

Authors: Seung Hun Lee, Sang Yeoup Lee

Abstract:

Objectives: To investigate associations between degrees of obesity using correlations between obesity indices and cardiometabolic risk factors. Methods: BMI, waist circumference (WC), fasting insulin, fasting glucose, lipids, and visceral adipose tissue (VAT) area using computed tomographic images were measured in 113 obese female without cardiovascular disease (CVD). Correlations between obesity indices and cardiometabolic risk factors were analyzed in obese subgroups defined using sequential obesity indices. Results: Mean BMI and WC were 29.6 kg/m2 and 92.8 cm. BMI showed significant correlations with all five cardiometabolic risk factors until the BMI cut-off point reached 27 kg/m2, but when it exceeded 30 kg/m2, correlations no longer existed. WC was significantly correlated with all five cardiometabolic risk factors up to a value of 85 cm, but when WC exceeded 90 cm, correlations no longer existed. Conclusions: Our data suggest that moderate weight-loss goals may not be enough to ameliorate cardiometabolic markers in severely obese patients. Therefore, individualized weight-loss goals should be recommended to such patients to improve health benefits.

Keywords: correlation, cardiovascular disease, risk factors, obesity

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1604 Carbohydrate Intake and Physical Activity Levels Modify the Association between FTO Gene Variants and Obesity and Type 2 Diabetes: First Nutrigenetics Study in an Asian Indian Population

Authors: K. S. Vimal, D. Bodhini, K. Ramya, N. Lakshmipriya, R. M. Anjana, V. Sudha, J. A. Lovegrove, V. Mohan, V. Radha

Abstract:

Gene-lifestyle interaction studies have been carried out in various populations. However, to date there are no studies in an Asian Indian population. Hence, we examined whether lifestyle factors such as diet and physical activity modify the association between fat mass and obesity–associated (FTO) gene variants and obesity and type 2 diabetes (T2D) in an Asian Indian population. We studied 734 unrelated T2D and 884 normal glucose-tolerant (NGT) participants randomly selected from the Chennai Urban Rural Epidemiology Study (CURES) in Southern India. Obesity was defined according to the World Health Organization Asia Pacific Guidelines (non-obese, BMI < 25 kg/m2; obese, BMI ≥ 25 kg/m2). Six single nucleotide polymorphisms (SNPs) in the FTO gene (rs9940128, rs7193144, rs8050136, rs918031, rs1588413 and rs11076023) identified from recent genome-wide association studies for T2D were genotyped by polymerase chain reaction-restriction fragment length polymorphism and direct sequencing. Dietary assessment was carried out using a validated food frequency questionnaire and physical activity was based upon the self-report. Interaction analyses were performed by including the interaction terms in the model. A joint likelihood ratio test of the main SNP effects and the SNP-diet/physical activity interaction effects was used in the linear regression analyses to maximize statistical power. Statistical analyses were performed using STATA version 13. There was a significant interaction between FTO SNP rs8050136 and carbohydrate energy percentage (Pinteraction=0.04) on obesity, where the ‘A’ allele carriers of the SNP rs8050136 had 2.46 times higher risk of obesity than those with ‘CC’ genotype (P=3.0x10-5) among individuals in the highest tertile of carbohydrate energy percentage. Furthermore, among those who had lower levels of physical activity, the ‘A’ allele carriers of the SNP rs8050136 had 1.89 times higher risk of obesity than those with ‘CC’ genotype (P=4.0x10-5). We also found a borderline interaction between SNP rs11076023 and carbohydrate energy percentage (Pinteraction=0.08) on T2D, where the ‘A’ allele carriers in the highest tertile of carbohydrate energy percentage, had 1.57 times higher risk of T2D than those with ‘TT’ genotype (P=0.002). There was also a significant interaction between SNP rs11076023 and physical activity (Pinteraction=0.03) on T2D. No further significant interactions between SNPs and macronutrient intake or physical activity on obesity and T2D were observed. In conclusion, this is the first study to provide evidence for a gene-diet and gene-physical activity interaction on obesity and T2D in an Asian Indian population. These findings suggest that the association between FTO gene variants and obesity and T2D is influenced by carbohydrate intake and physical activity levels. Greater understanding of how FTO gene influences obesity and T2D through dietary and exercise interventions will advance the development of behavioral intervention and personalised lifestyle strategies predicted to reduce the development of metabolic diseases in ‘A’ allele carriers of both SNPs in this Asian Indian population.

Keywords: dietary intake, FTO, obesity, physical activity, type 2 diabetes, Asian Indian.

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1603 Improving Neonatal Abstinence Syndrome Assessments

Authors: Nancy Wilson

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In utero, fetal drug exposure is prevalent amongst birthing facilities. Assessment tools for neonatal abstinence syndrome (NAS) are often cumbersome and ill-fitting, harboring immense subjectivity. This paradox often leads the clinical assessor to be hypervigilant when assessing the newborn for subtle symptoms of NAS, often mistaken for normal newborn behaviors. As a quality improvement initiative, this project led to a more adaptable NAS tool termed eat, sleep, console (ESC). This function-based NAS assessment scores the infant based on the ability to accomplish three basic newborn necessities- to sleep, to eat, and to be consoled. Literature supports that ESC methodology improves patient and family outcomes while providing more cost-effective care.

Keywords: neonatal abstinence syndrome, neonatal opioid withdrawal, maternal substance abuse, pregnancy, and addiction, Finnegan neonatal abstinence syndrome tool, eat, sleep, console

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1602 Exploring the Food Environments and Their Influence on Food Choices of Working Adults

Authors: Deepa Shokeen, Bani Tamber Aeri

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Food environments are believed to play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. The relationship between the food environment and obesity is complex. While there is little research linking food access with obesity as an outcome measure in any age group, with the help of this article we will try to understand the relationship between what we eat and the environmental context in which these food choices are made. Methods: A literature search of studies published between January 2000 and December 2013 was undertaken on computerized medical, social science, health, nutrition and education databases including Google, PubMed etc. Reports of organisations such as World Health Organisation (WHO), Centre for Chronic Disease Control (CCDC) were studied to project the data. Results: Studies show that food environments play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. Evidence indicates that the food environment may help explain the obesity and cardio-metabolic risk factors among young adults. Conclusion: Cardiovascular disease is the ever growing chronic disease, the incidence of which will increase markedly in the coming decades. Therefore, it is the need of the hour to assess the prevalence of various risk factors that contribute to the incidence of cardiovascular diseases especially in the work environment. Research is required to establish how different environments affect different individuals as individuals interact with the environment on a number of levels. We need to ascertain the impact of selected food and nutrition environments (Information, organization, community, consumer) on food choice and dietary intake of the working adults as it is important to learn how these food environments influence the eating perceptions and health behaviour of the adults.

Keywords: food environment, prevalence, cardiovascular disease, India, worksite, risk factors

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1601 Identifying Metabolic Pathways Associated with Neuroprotection Mediated by Tibolone in Human Astrocytes under an Induced Inflammatory Model

Authors: Daniel Osorio, Janneth Gonzalez, Andres Pinzon

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In this work, proteins and metabolic pathways associated with the neuroprotective response mediated by the synthetic neurosteroid tibolone under a palmitate-induced inflammatory model were identified by flux balance analysis (FBA). Three different metabolic scenarios (‘healthy’, ‘inflamed’ and ‘medicated’) were modeled over a gene expression data-driven constructed tissue-specific metabolic reconstruction of mature astrocytes. Astrocyte reconstruction was built, validated and constrained using three open source software packages (‘minval’, ‘g2f’ and ‘exp2flux’) released through the Comprehensive R Archive Network repositories during the development of this work. From our analysis, we predict that tibolone executes their neuroprotective effects through a reduction of neurotoxicity mediated by L-glutamate in astrocytes, inducing the activation several metabolic pathways with neuroprotective actions associated such as taurine metabolism, gluconeogenesis, calcium and the Peroxisome Proliferator Activated Receptor signaling pathways. Also, we found a tibolone associated increase in growth rate probably in concordance with previously reported side effects of steroid compounds in other human cell types.

Keywords: astrocytes, flux balance analysis, genome scale metabolic reconstruction, inflammation, neuroprotection, tibolone

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1600 Childhood Obesity: Future Direction and Education Priorities

Authors: Zahra Ranjbar

Abstract:

Interpretive structural modeling (ISM) is a well-established methodology for identifying relationships among specific variables, which define a problem or an issue. In this study most important variables that have critical role in children obesity problem were introduce by ISM questionnaire technique and their relationships were determine. Our findings suggested that sedentary activities are top level variables and school teachers and administrators, public education and scientific collaborations are bottom level variables in children obesity problem. Control of dietary, Physical education program, parents, government and motivation strategies variables are depend to other variables. They are very sensitive to external variables. Also, physical education program, parents, government, motivation, school teachers and administrators, public education and collaboration variables have strong driving power. They are linkage factors; it means that they can be effective on children obesity problem directly.

Keywords: ISM, variable, obesity, physical education, children

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1599 Intimate Partner Violence and Risk of Obesity among Women

Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

Abstract:

Both obesity and intimate partner violence (IPV) are growing health threats. This study aimed to assess the prevalence and risk factors of both IPV and obesity and their association. In this cross-sectional study, 530 women aged 16-65 years attending Mazandaran primary health centers were recruited through the stratified random sampling method (2019-2020). Data were collected using the modified World Health Organization Domestic Violence questionnaire, Perceived Stress Scale, and socio-demographic, obstetric, and anthropometric questionnaires. The data were analyzed using descriptive statistics, the chi-square test, and multiple logistic regression. The prevalence of overweight, obesity and psychological, physical, and sexual IPV were 47.6%, 26.7%, 70.4%, 17.9%, and 6.4%, respectively. Increasing women’s educational level and exposure to violence during their lifespan increased the odds of any type of IPV while living in a nuclear family reduced it. In groups of women who were subjected to any type of IPV and only psychological IPV, experiencing violence during the lifespan was significant in predicting obesity. The alarming prevalence of IPV and obesity-overweight in this study points to the need for collaborative socio-political and health intervention. The link between experiencing violence during lifespan and obesity in some subgroups of women highlights the detrimental consequences of chronic violence and the urgent need for effective preventive programs.

Keywords: intimate partner violence, body mass index, obesity, risk factor, women

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1598 Brain Stem Posterior Reversible Encephalopathy Syndrome in Nephrotic Syndrome

Authors: S. H. Jang

Abstract:

Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurologic symptoms (visual loss, headache, altered mentality and seizures) and by typical imaging findings (bilateral subcortical and cortical edema with predominatly posterior distribution). Nephrotic syndrome is a syndrome comprising signs of proteinuria, hypoalbuminemia, and edema. It is well known that hypertension predispose patient with nephrotic syndrome to PRES. A 45-year old male was referred for suddenly developed vertigo, disequilibrium. He had previous history of nephrotic syndrome. His medical history included diabetes controlled with medication. He was hospitalized because of generalized edema a few days ago. His vital signs were stable. On neurologic examination, his mental state was alert. Horizontal nystagmus to right side on return to primary position was observed. He showed good grade motor weakness and ataxia in right upper and lower limbs without other sensory abnormality. Brain MRI showed increased signal intensity in FLAIR image, decreased signal intensity in T1 image and focal enhanced lesion in T1 contrast image at whole midbrain, pons and cerebellar peduncle symmetrically, which was compatible with vasogenic edema. Laboratory findings showed severe proteinuria and hypoalbuminemia. He was given intravenous dexamethasone and diuretics to reduce vasogenic edema and raise the intra-vascular osmotic pressure. Nystagmus, motor weakness and limb ataxia improved gradually over 2 weeks; He recovered without any neurologic symptom and sign. Follow-up MRI showed decreased vasogenic edema fairly. We report a case of brain stem PRES in normotensive, nephrotic syndrome patient.

Keywords: posterior reversible encephalopathy syndrome, MRI, nephrotic syndrome, vasogenic brain edema

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1597 Anomalous Course of Left Ovarian Vein Associated with Pelvic Congestion Syndrome

Authors: Viyango Pandian, Kumaresh Athiyappan

Abstract:

Pelvic congestion Syndrome (PCS) is usually seen in multiparous women who give history of chronic dull-aching pelvic pain. We report a case of a 17 year old unmarried female, who presented with acute onset of chronic dull-aching abdominal pain in the left iliac fossa, which particularly increased during menstruation and was finally diagnosed to be pelvic congestion syndrome. On ultrasonography, multiple tortuous and dilated veins were observed in the left adnexa. Both ovaries appeared normal in size, volume and echotexture. Computed tomography (CT) angiography was performed to precisely delineate the venous pathway and to assess any associated abnormality; which showed a dilated and tortuous left ovarian vein with an anomalous course around the left kidney and draining into the left renal vein. Clinical parameters and hormonal levels were within normal limits. This is a rare case of anomalous course of left ovarian vein associated with pelvic congestion syndrome.

Keywords: anomalous course of ovarian vein, computed tomography, pelvic congestion syndrome, ultrasonography

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1596 Application of KL Divergence for Estimation of Each Metabolic Pathway Genes

Authors: Shohei Maruyama, Yasuo Matsuyama, Sachiyo Aburatani

Abstract:

The development of the method to annotate unknown gene functions is an important task in bioinformatics. One of the approaches for the annotation is The identification of the metabolic pathway that genes are involved in. Gene expression data have been utilized for the identification, since gene expression data reflect various intracellular phenomena. However, it has been difficult to estimate the gene function with high accuracy. It is considered that the low accuracy of the estimation is caused by the difficulty of accurately measuring a gene expression. Even though they are measured under the same condition, the gene expressions will vary usually. In this study, we proposed a feature extraction method focusing on the variability of gene expressions to estimate the genes' metabolic pathway accurately. First, we estimated the distribution of each gene expression from replicate data. Next, we calculated the similarity between all gene pairs by KL divergence, which is a method for calculating the similarity between distributions. Finally, we utilized the similarity vectors as feature vectors and trained the multiclass SVM for identifying the genes' metabolic pathway. To evaluate our developed method, we applied the method to budding yeast and trained the multiclass SVM for identifying the seven metabolic pathways. As a result, the accuracy that calculated by our developed method was higher than the one that calculated from the raw gene expression data. Thus, our developed method combined with KL divergence is useful for identifying the genes' metabolic pathway.

Keywords: metabolic pathways, gene expression data, microarray, Kullback–Leibler divergence, KL divergence, support vector machines, SVM, machine learning

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1595 Risk Factors Associated with Obesity Among Adults in Tshikota, Makhado Municipality, Limpopo Province, South Africa

Authors: Ndou Rembuluwani Moddy, Daniel Ter Goon, Takalani Grace Tshitangano, Lindelani Fhumudzani Mushaphi

Abstract:

Obesity is a global public health problem. The study aimed to determine the risk factors associated with and the consequences of obesity among residents of Tshikota, Makhado Municipality, Limpopo Province, South Africa. A cross-sectional study involving 318 randomly selected adults aged 18-45 years residing at Tshikota, Makhado Local Municipality, South Africa. Sociodemographic information includes age, gender, educational level, occupation, behavioral lifestyle, environmental, psychological, and family history. Anthropometric, blood pressure, and blood glucose measurements followed standard procedure. The prevalence of obesity and overweight was 35.5% and 28.6%, respectively. About 75.2% of obese do not engage in physical activity. Most participants (63.5%) take meals three times a day, and 19.2% do not skip breakfast. Most participants do not have access to fruits and vegetables. Participants who were pre-hypertensive were 92(28.9%) and 32(10.1%) were in Stage 1 hypertension. Of the participants with Class 1 obesity, 40.9% were pre-hypertensive, and 15.2% were in Stage 1 hypertension. In Class 2 obesity, 37.8% were pre-hypertensive, and 26.7% were in Stage 1 hypertension. There was a significant difference between BMI and blood pressure among participants (p=0.00). About 6.1% of the participants in Class 1 obesity were at high risk, and 3.0% were at very high risk of glucose levels. Regarding cholesterol levels, 65 (20.4%) were at borderline, and 17(5.3%) were at high risk. There was no significant difference in BMI and cholesterol levels among participants (p= 0.20). The prevalence of obesity and overweight was high among residents of this setting. Age, marital and educational status, and employment were significantly associated with obesity. An obesity awareness campaign is crucial, and the availability of supermarkets and full-service grocery stores would provide accessibility to healthy food such as fruits and vegetables.

Keywords: obesity, overweight, risk factors, adults.

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1594 An Unusual Fracture Pattern: Fracture of the Distal Radius (Colles') along with Fracture of the Ipsilateral Scaphoid & Capitate Bones

Authors: Srikanta Tagore Sarkar, Prasanta Kumar Mandal, Dibakar Roy

Abstract:

The association of a capitate fracture with a scaphoid fracture has been termed as the naviculocapitate syndrome. The existence of some nondisplaced fractures of scaphoid and capitate with or without the fracture of lunate or radius suggests that there is a spectrum of these injuries, and this confuses the terminology. With our case; we report an unusual variety of this naviculocapitate syndrome with distal radial Colles fracture in addition to the nondisplaced fractures of the scaphoid, capitate and the dorsal lip of radial fracture. When we looked at the literature there is no another Colles fracture reported together with undisplaced scapho-capitate syndrome. The coronal and sagittal images that obtained from the MDCT (Multidetector computed tomography) is useful and effective imaging modality to diagnose complex wrist fractures with more details that are not detected in X-rays.

Keywords: scaphoid, capitate, Colles’ fracture, syndrome, MDCT, unusual

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1593 Relationship and Comorbidity Between Down Syndrome and Autism Spectrum Disorder

Authors: Javiera Espinosa, Patricia López, Noelia Santos, Nadia Loro, Esther Moraleda

Abstract:

In recent years, there has been a notable increase in the number of investigations that establish that Down Syndrome and Autism Spectrum Disorder are diagnoses that can coexist together. However, there are also many studies that consider that both diagnoses present neuropsychological, linguistic and adaptive characteristics with a totally different profile. The objective of this research is to question whether there really can be a profile that encompasses both disorders or if they can be incompatible with each other. To this end, a review of the scientific literature of recent years has been carried out. The results indicate that the two lines collect opposite approaches. On the one hand, there is research that supports the increase in comorbidity between Down Syndrome and Autism Spectrum Disorder, and on the other hand, many investigations show a totally different general development profile between the two. The discussion focuses on discussing both lines of work and on proposing future lines of research in this regard.

Keywords: disability, language, speech, down syndrome

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1592 Bone Marrow Edema Syndrome in the Foot and Ankle

Authors: S. Alireza Mirghasemi, Elly Trepman, Mohammad Saleh Sadeghi, Narges Rahimi Gabaran, Shervin Rashidinia

Abstract:

Bone marrow edema syndrome (BMES) is an uncommon and self-limited syndrome characterized by atraumatic extremity pain with unknown of etiology. Symptom onset may include sudden or gradual swelling and pain at rest or during activity, usually at night. This syndrome mostly affects middle-aged men and younger women who have pain in the lower extremities. The most common sites involved with BMES, in decreasing order of frequency, are the bones about the hip, knee, ankle, and foot. The diagnosis of BMES is made with magnetic resonance imaging to exclude other causes of bone marrow edema. The correct diagnosis often is delayed because of the low prevalence and nonspecific signs in the foot and ankle. This delay may intensify bone pain and impair patient function and quality of life. The goal of BMES treatment is to relieve pain and shorten disease duration. Treatment options are limited and may include symptomatic treatment, pharmacologic treatment, and surgery.

Keywords: transient osteoporosis, bone marrow edema syndrome, iloprost, bisphosphonates

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1591 Polycystic Ovarian Syndrome (PCOS) as an Evolutionary Mismatch Disorder: An Argument for the Significance of Hyperandrogenism on Reproductive Fitness in Ancestral Populations

Authors: Courtney Manthey-Pierce, Anna Warrener

Abstract:

Polycystic ovarian syndrome (PCOS) is the most common endocrine disruptive disorder in females. PCOS is primarily characterized by polycystic ovaries, anovulation, hirsutism, insulin resistance, and hyperandrogenism. Despite negative reproductive consequences for females from anovulation and endocrine dysfunction, genes associated with the pathogenesis of PCOS are highly hereditable (h2 = 0.72). An evolutionary mismatch occurs when a trait that evolved in one environment has become maladaptive in another environment. The idea that PCOS is an evolutionary mismatch disease has been promoted by several researchers. Each trait of the resulting PCOS phenotype should be investigated individually in order to demonstrate an evolutionary mismatch. Hyperandrogenism is often regarded as the main characteristic of PCOS Hyperandrogenism may have aided with conception in older females, increased bone mineral density, and supported prolonged breastfeeding in nutritionally distressed populations. Because of the high prevalence of PCOS in the modern world, approximately 6%, it is often argued that PCOS emerged in an ancestral population prior to the migration out of Africa approximately 200,000 years ago. This environment would be characterized by sporadic periods of nutrition deficit and resource hardships as the climate began changing. Presently, modern society is characterized by obesity and sedentary lifestyles. The prevalence of obesity renders hyperandrogenism PCOS useless as there are no periods of nutritional distress requiring androgens for increased reproductive rates. In an ancestral environment, hyperandrogenism would likely lead to sporadic anovulation and mild secondary symptoms, however high levels of androgens in a modern environment led to prolonged if not permanent infertility and excessive secondary problems. Thus, hyperandrogenism related to PCOS appears to meet evolutionary mismatch criteria. Seen in this light, PCOS may be effectively treated as a probably evolutionary mismatch.

Keywords: evolutionary mismatch, heritability, hyperandrogenism, mismatch disorder

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1590 The Endocrinology of Obesity and Dejenerative Joint Disease

Authors: Kebret Kebede, Anthony Scinta

Abstract:

Obesity is the most prevalent global problem that continues to rise at alarming rates both in the industrialized and developing countries. Adipose tissue is an endocrine tissue that secretes numerous chemical signals, hormones, lipids, cytokines and coagulation factors as well as prompting insulin resistance which is a primary contributor to Type II Diabetes- one of its most common adverse effects on health. Other hormones whose levels are linked to obesity and nutritional state are leptin, IGF-1, and adiponectin. Several studies indicate that obesity is the leading cause of high levels of cholesterol that leads to fatty liver disease, gallstones, hypertension, increased risk for cancer and degenerative joint disease that primarily affects the weight bearing joints of the lower extremities. The activation of inflammatory pathways promotes synovial pathology that results in accelerated degeneration of the joints. The study examines the prevalence of obesity in the US female population in comparison to that of the developing world and its emergence as a significant and potentially modifiable risk factor in degenerative disease of the hip and knee joints that has resulted in staggering healthcare cost. Studies have shown that as the prevalence of obesity rises, we continue to see a rise in degenerative joint disease. The percentage of arthritis cases linked directly to obesity has risen from 3 percent in 1971 to 18 percent in 2002. A person with obesity is around 60 percent more likely to develop arthritis than someone of normal body weight. In women, obesity is associated with increased mortality from breast, cervical, endometrial and ovarian cancer that may accompany debilitating joint diseases and restricted mobility.

Keywords: obesity, endocrine, degenerative, mortality, joint diseases, cancer, debilitating, mobility

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1589 Joubert Syndrome in Children as Multicentric Screening in Ten Different Places in World

Authors: Bajraktarevic Adnan, Djukic Branka, Sporisevic Lutvo, Krdzalic Zecevic Belma, Uzicanin Sajra, Hadzimuratovic Admir, Hadzimuratovic Hadzipasic Emina, Abduzaimovic Alisa, Kustric Amer, Suljevic Ismet, Serafi Ismail, Tahmiscija Indira, Khatib Hakam, Semic Jusufagic Aida, Haas Helmut, Vladicic Aleksandra, Aplenc Richard, Kadic Deovic Aida

Abstract:

Introduction: Joubert syndrome has an autosomal recessive pattern of inheritance. It is referred as the brain malfunctioning and caused due to the underdevelopment of the cerebellar vermis. Associated conditions involving the eye, the kidney, and ocular disease are well described. Aims: Research helps us better understand this diseases, Joubert syndrome and can lead to advances in diagnosis and treatment. Methods: Different several conditions have been described in which the molar tooth sign and characteristics of Joubert syndrome in ten different places in the world. Carrier testing and diagnosis are available if one of these gene mutations has been identified in an affected family member. Results: Authors have described eleven cases during twenty years of Joubert syndrome. It is a clinically and genetically heterogeneous group of disorders characterized by hypoplasia of the cerebellar vermis with the characteristic neuroradiologic molar tooth sign, and accompanying neurologic symptoms, including dysregulation of breathing pattern and developmental delay. We made confirmation of diagnosis in twin sisters with Joubert syndrome with renal anomalies. Ocular symptoms have existed in seven cases (63.64%) from total eleven. Eleven cases were different sex, five boys (45.45%) and six girls (54.44%). Conclusions: Joubert syndrome is inherited as an autosomal recessive genetic disorder with several features of the disease.

Keywords: Joubert syndrome, cerebellooculorenal syndrome, autosomal recessive genetic disorder (ARGD), children

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