Search results for: diabetes mellitus

Authors: Muhammad Zeeshan UlHaque, Peng Du, Leo K. Cheng, Marc D. Jacobs

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Sensory nerves in the foot play an important part in the diagnosis of various neuropathydisorders, especially in diabetes mellitus.However, a detailed description of the anatomical distribution of the nerves is currently lacking. A computationalmodel of the afferent nerves inthe foot may bea useful tool for the study of diabetic neuropathy. In this study, we present the development of an anatomically-based model of various major sensory nerves of the sole and dorsal sidesof the foot. In addition, we presentan algorithm for generating synthetic somatosensory nerve networks in the big-toe region of a right foot model. The algorithm was based on a modified version of the Monte Carlo algorithm, with the capability of being able to vary the intra-epidermal nerve fiber density in differentregionsof the foot model. Preliminary results from the combinedmodel show the realistic anatomical structure of the major nerves as well as the smaller somatosensory nerves of the foot. The model may now be developed to investigate the functional outcomes of structural neuropathyindiabetic patients.

Keywords: Diabetic neuropathy, Finite element modeling, Monte Carlo Algorithm, Somatosensory nerve networks

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Authors: Lily Ingsrisawang, Tasanee Nacharoen

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The problems arising from unbalanced data sets generally appear in real world applications. Due to unequal class distribution, many researchers have found that the performance of existing classifiers tends to be biased towards the majority class. The k-nearest neighbors’ nonparametric discriminant analysis is a method that was proposed for classifying unbalanced classes with good performance. In this study, the methods of discriminant analysis are of interest in investigating misclassification error rates for classimbalanced data of three diabetes risk groups. The purpose of this study was to compare the classification performance between parametric discriminant analysis and nonparametric discriminant analysis in a three-class classification of class-imbalanced data of diabetes risk groups. Data from a project maintaining healthy conditions for 599 employees of a government hospital in Bangkok were obtained for the classification problem. The employees were divided into three diabetes risk groups: non-risk (90%), risk (5%), and diabetic (5%). The original data including the variables of diabetes risk group, age, gender, blood glucose, and BMI were analyzed and bootstrapped for 50 and 100 samples, 599 observations per sample, for additional estimation of the misclassification error rate. Each data set was explored for the departure of multivariate normality and the equality of covariance matrices of the three risk groups. Both the original data and the bootstrap samples showed nonnormality and unequal covariance matrices. The parametric linear discriminant function, quadratic discriminant function, and the nonparametric k-nearest neighbors’ discriminant function were performed over 50 and 100 bootstrap samples and applied to the original data. Searching the optimal classification rule, the choices of prior probabilities were set up for both equal proportions (0.33: 0.33: 0.33) and unequal proportions of (0.90:0.05:0.05), (0.80: 0.10: 0.10) and (0.70, 0.15, 0.15). The results from 50 and 100 bootstrap samples indicated that the k-nearest neighbors approach when k=3 or k=4 and the defined prior probabilities of non-risk: risk: diabetic as 0.90: 0.05:0.05 or 0.80:0.10:0.10 gave the smallest error rate of misclassification. The k-nearest neighbors approach would be suggested for classifying a three-class-imbalanced data of diabetes risk groups.

Keywords: Bootstrap, diabetes risk groups, error rate, k-nearest neighbors.

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Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

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To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87±7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032) in the two groups (sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statistically significant (p<0.004) and diabetic, dyslipidemic patients having true positive which were statistically significant (p<0.032 & 0.030).True positive patients had family history were 68(83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant (p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138) and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90 %) followed by LCX 42 (51.85%), RCA 36 (44.44%), and the LMCA was 9 (11.11%). 40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients, resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetes, dyslipidemia, family history and smoking are likely to have a true positive treadmill test result.

Keywords: Exercise tolerance test, Coronary artery disease, Coronary angiography, True positive, False positive.

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Authors: N. Tadrisi Parsa, A. R. Vali, R. Ghasemi

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Diabetes is a growing health problem in worldwide. Especially, the patients with Type 1 diabetes need strict glycemic control because they have deficiency of insulin production. This paper attempts to control blood glucose based on body mathematical body model. The Bergman minimal mathematical model is used to develop the nonlinear controller. A novel back-stepping based sliding mode control (B-SMC) strategy is proposed as a solution that guarantees practical tracking of a desired glucose concentration. In order to show the performance of the proposed design, it is compared with conventional linear and fuzzy controllers which have been done in previous researches. The numerical simulation result shows the advantages of sliding mode back stepping controller design to linear and fuzzy controllers.

Keywords: Back stepping, Bergman Model, Nonlinear control, Sliding mode control.

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Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: Geocoding, chronic disease management, quality of diabetes care, rate ratio.

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Authors: D. O. Omondi, M. K. Walingo, G. M. Mbagaya, L. O. A. Othuon

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Understanding patient factors related to physical activity behavior is important in the management of Type 2 Diabetes. This study applied the Theory of Planned Behavior model to understand physical activity behavior among sampled Type 2 diabetics in Kenya. The study was conducted within the diabetic clinic at Kisii Level 5 Hospital and adopted sequential mixed methods design beginning with qualitative phase and ending with quantitative phase. Qualitative data was analyzed using grounded theory analysis method. Structural equation modeling using maximum likelihood was used to analyze quantitative data. The common fit indices revealed that the theory of planned behavior fitted the data acceptably well among the Type 2 diabetes and within physical activity behavior {¤ç2 = 213, df = 84, n=230, p = .061, ¤ç2/df = 2.53; TLI = .97; CFI =.96; RMSEA (90CI) = .073(.029, .08)}. This theory proved to be useful in understanding physical activity behavior among Type 2 diabetics.

Keywords: Physical activity, Theory of Planned Behavior, Type2 diabetes, Kenya.

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Authors: Mukhtar H. Hassan, Muhammed A. Basher, Elhadi E. Saad, Almahdi M. Almahdi

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The aim of this study was to demonstrate the possible effect of some variables such as age, gender, blood sugar level, and duration of diabetes on the serum level of zinc in diabetic individuals from Murzuk area. Serum zinc (Zn), Fasting blood sugar (FBS), hemoglobin HbA1c (HbA1c) were evaluated in 46 type I diabetic subjects (group 1), 48 type II diabetic subjects (group 2) and 43 healthy individuals (control) of both genders aged (30-81) years. Data showed that both diabetic groups have significantly higher (P<0.05) serum levels of Zn, FBS and HbA1c compared with controls. No significant (p>0.05) differences in serum Zn levels were observed between Males and Females. Serum Zn levels were non-significantly decreased with increasing age. In type II diabetic subjects, serum Zn levels were non-significantly decreased with increasing duration of disease whereas those in type I were non-significantly increased.

Keywords: Blood sugar, diabetes, HbA1c, zinc.

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Authors: S. Nurdiana, A. S. Nor Haziqah, M. K. Nur Ezwa Khairunnisa, S. Nurul `Izzati, Y. Siti Amna M. J. Norashirene, I. Nur Hilwani

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Azadirachta excelsa or locally known as sentang are frequently used as a traditional medicine by diabetes patients in Malaysia. However, less attention has been given to their toxicity effect. Thus, the study is an attempt to examine the protective effect of A. excelsa on the pancreas and to determine possible toxicity mediated by the extract. Diabetes was induced experimentally in rats by high-fat-diet for 16 weeks followed by intraperitoneal injection of streptozotocin at dosage of 35 mg/kg of body weight. Declination of the fasting blood glucose level was observed after continuous administration of A. excelsa for 14 days twice daily. This is due to the refining structure of the pancreas. However, surprisingly, the plant extract reduced the leukocytes, erythrocytes, hemoglobin, MCHC and lymphocytes. In addition, the rat treated with the plant extract exhibited increment in AST and eosinocytes level. Overall, the finding shows that A. excelsa possesses antidiabetic activity by improving the structure of pancreatic islet of Langerhans but involved in ameliorating of hematology and biochemical parameters.

Keywords: Azadirachta excelsa, diabetes, pancreas, hematobiochemical parameters.

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Authors: Turki Alotaibi

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Student counseling programs can provide many benefits to students in schools all around the world. In theory, the government of the Kingdom of Saudi Arabia (Saudi Arabia) has committed itself to school counseling programs in educational institutions throughout the country. Student counselors face a number of burdens and obstacles that impact student counseling programs. It is also widely known that Saudi Arabia has extremely high prevalence rates for overweight and obesity, anxiety and depression, and diabetes in children. It has also been demonstrated that teachers and staff are inadequately prepared when dealing with health issues relating to diabetes in schools in Saudi Arabia. This study will clearly demonstrate how student counselors in Saudi Arabia could become 'New Educators' in Saudi schools in relation to these health issues. This would allow them to leverage their position as student counselor to improve the management of these health issues in Saudi schools, to improve the quality of care provided to school children, and to overcome burdens and obstacles that are currently negatively affecting student counseling in Saudi schools.

Keywords: Anxiety, depression, diabetes, overweight, obesity, policy recommendations, student counseling, The Kingdom of Saudi Arabia.

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Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

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The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL), its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know how to cope with having a family member with hepatitis C and more importantly to know what should you say and what shouldn’t you say as a positive hopeful attitude is essential for combating HCV chronic infection.

Keywords: Hepatitis C virus chronic infection, physical health component and mental health component of QoL, total quality of life.

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Authors: Raad Nari, Maura Moriaty, Maha T. Barakat

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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.

Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection.

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Authors: O. Soji-Omoniwa, N. O. Muhammad, L. A. Usman, B. P. Omoniwa

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This study was conducted to investigate the effect of the leaf essential oil of C. sinensis harvested at 7.00a.m and 4.00p.m on some Liver and Kidney function indices of diabetic rats as well as investigate the effect of time of harvest on the observed effect. Experimental animals were divided into 4 groups (A, B, C and D). Diabetes mellitus was induced in all animals, except the normal control group (Group A), by injecting 150mg/kg body weight of alloxan monohydrate intraperitoneally. Group A received distilled water while group B (diabetic control group) was not treated. Group C and D were treated with leaf essential oil of C. sinensis harvested at 7.00 a.m and 4.00p.m respectively at a dose of 110 mg/kg body weight every other day for 15 days. Alkaline phosphatase (ALP), Alanine Transaminase (ALT) and Aspartate Transaminase (AST) activity was evaluated in the serum, Liver and Kidney of studied animals. Total and Direct Bilirubin level, Total Protein and Globulin, Creatinine and Urea level were also evaluated. Result showed that creatinine and urea, serum ALP, AST and ALT levels was significantly reduced (p < 0.05), while the levels of total Protein and Globulin increased significantly (p < 0.05) for the treated animals compared to the diabetic control group. In conclusion, the leaf essential oil of Citrus sinensis ameliorated the impaired renal and liver function; however, the time of harvest of the leaf does not significantly affect its ameliorative effect.

Keywords: C. sinensis, Function indices, Harvest time, Leaf essential oil.

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Authors: Negar Khezri, Golnaz Yaghoubnezhadzanganeh, Amirreza Attarzadeh

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Type 2 Diabetes (T2DM) and Alzheimer's disease (AD) are two main health problems influencing millions of people in the world. Neuron loss and synaptic impairment that interfere with cognition and memory cause for the behavioral indications of AD. While it is now accepted that insulin has central neuromodulatory purpose, it was contemplated for many years that brain is insusceptible to insulin, involving its function in memory and learning, which are impaired in AD. The common characteristics of both AD and T2D are impaired insulin signaling, oxidative stress, the excitation of inflammatory pathways and unqualified glucose metabolism. This review summarizes how the recognition of these mechanisms may lead to the development of alternative therapeutic approaches. Here we summarize how the recognition of these mechanisms may lead to the development of alternative therapeutic approaches.

Keywords: Alzheimer’s disease, diabetes, insulin resistance, neurodegenerative.

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Authors: Loai AbdAllah, Mahmoud Kaiyal

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Missing values in real-world datasets are a common problem. Many algorithms were developed to deal with this problem, most of them replace the missing values with a fixed value that was computed based on the observed values. In our work, we used a distance function based on Bhattacharyya distance to measure the distance between objects with missing values. Bhattacharyya distance, which measures the similarity of two probability distributions. The proposed distance distinguishes between known and unknown values. Where the distance between two known values is the Mahalanobis distance. When, on the other hand, one of them is missing the distance is computed based on the distribution of the known values, for the coordinate that contains the missing value. This method was integrated with Wikaya, a digital health company developing a platform that helps to improve prevention of chronic diseases such as diabetes and cancer. In order for Wikaya’s recommendation system to work distance between users need to be measured. Since there are missing values in the collected data, there is a need to develop a distance function distances between incomplete users profiles. To evaluate the accuracy of the proposed distance function in reflecting the actual similarity between different objects, when some of them contain missing values, we integrated it within the framework of k nearest neighbors (kNN) classifier, since its computation is based only on the similarity between objects. To validate this, we ran the algorithm over diabetes and breast cancer datasets, standard benchmark datasets from the UCI repository. Our experiments show that kNN classifier using our proposed distance function outperforms the kNN using other existing methods.

Keywords: Missing values, distance metric, Bhattacharyya distance.

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Authors: Pranee Suecharoen, Jaturat Kanpittaya

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Background: The incidence of adverse reactions to iodinated contrast media has risen. The dearth of reports on reactions to the administration of iso- and low-osmolar contrast media should be addressed. We, therefore, studied the profile of adverse reactions to iodinated contrast media; viz., (a) the body systems affected (b) causality, (c) severity, and (d) preventability. Objective: To study adverse reactions (causes and severity) to iodinated contrast media at Srinagarind Hospital. Method: Between March and July, 2015, 1,101 patients from the Department of Radiology were observed and interviewed for the occurrence of adverse reactions. The patients were classified per Naranjo’s algorithm and through use of an adverse reactions questionnaire. Results: A total of 105 cases (9.5%) reported adverse reactions (57% male; 43% female); among whom 2% were iso-osmolar vs. 98% low-osmolar. Diagnoses included hepatoma and cholangiocarcinoma (24.8%), colorectal cancer (9.5%), breast cancer (5.7%), cervical cancer (3.8%), lung cancer (2.9%), bone cancer (1.9%), and others (51.5%). Underlying diseases included hypertension and diabetes mellitus type 2. Mild, moderate, and severe adverse reactions accounted for 92, 5 and 3%, respectively. The respective groups of escalating symptoms included (a) mild urticaria, itching, rash, nausea, vomiting, dizziness, and headache; (b) moderate hypertension, hypotension, dyspnea, tachycardia and bronchospasm; and (c) severe laryngeal edema, profound hypotension, and convulsions. All reactions could be anticipated per Naranjo’s algorithm. Conclusion: Mild to moderate adverse reactions to low-osmolar contrast media were most common and these occurred immediately after administration. For patient safety and better outcomes, improving the identification of patients likely to have an adverse reaction is essential.

Keywords: Adverse reactions, contrast media, computed tomography, iodinated contrast agents.

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Authors: Manish Kumar Gautam, Raj Kumar Goel

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Delayed wound healing in diabetes is primarily associated with hyperglycemia, over-expression of inflammatory marker, oxidative stress and delayed collagen synthesis. This unmanaged wound is producing high economic burden on the society. Thus research is required to develop new and effective treatment strategies to deal with this emerging issue. Our present study incorporates the evaluation of wound healing effects of 50% ethanol extract of Ocimum sanctum (OSE) in streptozotocin (45mg/kg)-induced diabetic rats with concurrent wound ulcer. The animals showing diabetes (Blood glucose level >140 and <250 mg/dL) will be selected for wound healing study using standard dead space wound model. Wounds were created by implanting two polypropylene tubes (0.5 x 2.5 cm2 each), one on either side in the lumbar region on the dorsal surface of each rat. On the 10th postwounding day, the animals were sacrificed and granulation tissue formed on the implanted tubes was carefully dissected out and study the status of antioxidants (Superoxide dismutase, SOD and Glutathione, GSH) free radicals (Lipid peroxidation, LPO and nitric oxide, NO) acute inflammatory marker (myeloperoxidase, MPO) connective tissue determinants, hydroxyproline, hexosamine and hexuronic acid, which play a major role in wound healing and diabetes. Besides the anti-diabetic parameters (estimation of serum blood glucose, triglycerides and total cholesterol), the above parameters for wound healing were studied both in normal, untreated and OSE treated diabetic rats. The effects of extract on above parameters will be compared with known standard antioxidant (Vitamin E) and anti-diabetic (Glybenclamide) drugs. OSE 400 mg/kg substantiated by significantly decreased serum blood glucose, triglycerides and total cholesterol. OSE also decrease granulation tissue free radicals (LPO, 58.1% and NO, 52.7%) and myeloperoxidase (MPO, 63.3%), and enhanced antioxidants (GSH, 116.4% and SOD, 201.1%)

Keywords: Wound healing, diabetes, Ocimum sanctum, Antioxidant, Free radical, Myeloperoxidase

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Authors: Jianyin Lu, Masayoshi Seike, Wei Liu, Peihong Wu, Lihua Wang, Yihua Wu, Yasuhiro Naito, Hiromu Nakajima, Yasuhiro Kouchi

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To extract the important physiological factors related to diabetes from an oral glucose tolerance test (OGTT) by mathematical modeling, highly informative but convenient protocols are required. Current models require a large number of samples and extended period of testing, which is not practical for daily use. The purpose of this study is to make model assessments possible even from a reduced number of samples taken over a relatively short period. For this purpose, test values were extrapolated using a support vector machine. A good correlation was found between reference and extrapolated values in evaluated 741 OGTTs. This result indicates that a reduction in the number of clinical test is possible through a computational approach.

Keywords: SVM regression, OGTT, diabetes, mathematical model

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Authors: D.O. Omondi, M.K. Walingo, G.M. Mbagaya, L.O.A. Othuon

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This study applied the Theory of Planned Behavior model in predicting dietary behavior among Type 2 diabetics in a Kenyan environment. The study was conducted for three months within the diabetic clinic at Kisii Hospital in Nyanza Province in Kenya and adopted sequential mixed methods design combing both qualitative and quantitative phases. Qualitative data was analyzed using grounded theory analysis method. Structural equation modeling using maximum likelihood was used to analyze quantitative data. The results based on the common fit indices revealed that the theory of planned behavior fitted the data acceptably well among the Type 2 diabetes and within dietary behavior {χ2 = 223.3, df = 77, p = .02, χ2/df = 2.9, n=237; TLI = .93; CFI =.91; RMSEA (90CI) = .090(.039, .146)}. This implies that the Theory of Planned Behavior holds and forms a framework for promoting dietary practice among Type 2 diabetics.

Keywords: Dietary practice, Kenya, Theory of PlannedBehavior, Type 2 diabetes, Mixed Methods Design.

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Authors: Aditya Arya, Hairin Taha, Ataul Karim Khan, Nayiar Shahid, Hapipah Mohd Ali, Mustafa Ali Mohd

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This study has investigated the antidiabetic and antioxidant potential of Pseudovaria macrophylla bark extract on streptozotocin–nicotinamide induced type 2 diabetic rats. LCMSQTOF and NMR experiments were done to determine the chemical composition in the methanolic bark extract. For in vivo experiments, the STZ (60 mg/kg/b.w, 15 min after 120 mg/kg/1 nicotinamide, i.p.) induced diabetic rats were treated with methanolic extract of Pseuduvaria macrophylla (200 and 400 mg/kg·bw) and glibenclamide (2.5 mg/kg) as positive control respectively. Biochemical parameters were assayed in the blood samples of all groups of rats. The pro-inflammatory cytokines, antioxidant status and plasma transforming growth factor βeta-1 (TGF-β1) were evaluated. The histological study of the pancreas was examined and its expression level of insulin was observed by immunohistochemistry. In addition, the expression of glucose transporters (GLUT 1, 2 and 4) were assessed in pancreas tissue by western blot analysis. The outcomes of the study displayed that the bark methanol extract of Pseuduvaria macrophylla has potentially normalized the elevated blood glucose levels and improved serum insulin and C-peptide levels with significant increase in the antioxidant enzyme, reduced glutathione (GSH) and decrease in the level of lipid peroxidation (LPO). Additionally, the extract has markedly decreased the levels of serum pro-inflammatory cytokines and transforming growth factor beta-1 (TGF-β1). Histopathology analysis demonstrated that Pseuduvaria macrophylla has the potential to protect the pancreas of diabetic rats against peroxidation damage by downregulating oxidative stress and elevated hyperglycaemia. Furthermore, the expression of insulin protein, GLUT-1, GLUT-2 and GLUT-4 in pancreatic cells was enhanced. The findings of this study support the anti-diabetic claims of Pseudovaria macrophylla bark.

Keywords: Diabetes mellitus, Pseuduvaria macrophylla, alkaloids, caffeic acid.

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Authors: Muhibul Haque Bhuyan

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Diabetes disease that arises from the higher glucose level due to insulin shortage or insulin opposition in the human body has become a common disease in the world. No medicine can cure it completely. However, by taking medicine, maintaining diets, and having exercises regularly, a diabetes patient can keep his glucose level within the specified limits and in this way, he/she can lead a normal life like a healthy person. But to control glucose levels, a patient needs to monitor them regularly. Various techniques are being used over the last four decades. This modern review article aims to provide a comparative study report on various blood glucose monitoring techniques in a very concise and organized manner. The review mainly emphasizes working principles, cost, technology, sensors, measurement types, measurement accuracy, advantages, and disadvantages, etc. of various techniques and then compares among each other. Besides, the use of algorithms and simulators for the growth of this technology is also presented. Finally, current research trends of this measurement technology have also been discussed.

Keywords: blood glucose measurement, sensors, measurement devices, invasive and non-invasive techniques

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Authors: Vahid Nademi

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In response to widely used wearable medical devices equipped with a continuous glucose monitor (CGM) and insulin pump, the advanced control methods are still demanding to get the full benefit of these devices. Unlike costly clinical trials, implementing effective insulin-glucose control strategies can provide significant contributions to the patients suffering from chronic diseases such as diabetes. This study deals with a key role of two-layer insulin-glucose regulator based on model-predictive-control (MPC) scheme so that the patient’s predicted glucose profile is in compliance with the insulin level injected through insulin pump automatically. It is achieved by iterative optimization algorithm which is called an integrated perturbation analysis and sequential quadratic programming (IPA-SQP) solver for handling uncertainties due to unexpected variations in glucose-insulin values and body’s characteristics. The feasibility evaluation of the discussed control approach is also studied by means of numerical simulations of two case scenarios via measured data. The obtained results are presented to verify the superior and reliable performance of the proposed control scheme with no negative impact on patient safety.

Keywords: Blood glucose monitoring, insulin pump, optimization, predictive control, diabetes disease.

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Authors: Tayyab Hassan, Talha Rehman, Qasim Abdul Aziz, Ahmad Salman

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The constant monitoring of blood glucose level is necessary for maintaining health of patients and to alert medical specialists to take preemptive measures before the onset of any complication as a result of diabetes. The current clinical monitoring of blood glucose uses invasive methods repeatedly which are uncomfortable and may result in infections in diabetic patients. Several attempts have been made to develop non-invasive techniques for blood glucose measurement. In this regard, the existing methods are not reliable and are less accurate. Other approaches claiming high accuracy have not been tested on extended dataset, and thus, results are not statistically significant. It is a well-known fact that acetone concentration in breath has a direct relation with blood glucose level. In this paper, we have developed the first of its kind, reliable and high accuracy breath analyzer for non-invasive blood glucose measurement. The acetone concentration in breath was measured using MQ 138 sensor in the samples collected from local hospitals in Pakistan involving one hundred patients. The blood glucose levels of these patients are determined using conventional invasive clinical method. We propose a linear regression classifier that is trained to map breath acetone level to the collected blood glucose level achieving high accuracy.

Keywords: Blood glucose level, breath acetone concentration, diabetes, linear regression.

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Authors: Mike Climstein, Joe Walsh, John Best, Ian Timothy Heazlewood, Stephen Burke, Jyrki Kettunen, Kent Adams, Mark DeBeliso

Abstract:

Recently, the health of retired National Football League players, particularly lineman has been investigated. A number of studies have reported increased cardiometabolic risk, premature cardiovascular disease and incidence of type 2 diabetes. Rugby union players have somatotypes very similar to National Football League players which suggests that rugby players may have similar health risks. The International Golden Oldies World Rugby Festival (GORF) provided a unique opportunity to investigate the demographics of veteran rugby players. METHODOLOGIES: A cross-sectional, observational study was completed using an online web-based questionnaire that consisted of medical history and physiological measures. Data analysis was completed using a one sample t-test (<50yrs versus >50yrs) and Chi-square test. RESULTS: A total of 216 veteran rugby competitors (response rate = 6.8%) representing 10 countries, aged 35-72 yrs (mean 51.2, S.D. ±8.0), participated in the online survey. As a group, the incidence of current smokers was low at 8.8% (avg 72.4 cigs/wk) whilst the percentage consuming alcohol was high (93.1% (avg 11.2 drinks/wk). Competitors reported the following top six chronic diseases/disorders; hypertension (18.6%), arthritis (OA/RA, 11.5%), asthma (9.3%), hyperlipidemia (8.2%), diabetes (all types, 7.5%) and gout (6%), there were significant differences between groups with regard to cancer (all types) and migraines. When compared to the Australian general population (Australian Bureau of Statistics data, n=18,000), GORF competitors had a significantly lower incidence of anxiety (p<0.01), arthritis (p<0.06), depression (p<.01) however, a significantly higher incidence of diabetes (p<0.03) and hypertension (p<0.01). The GORF competitors also reported taking the following prescribed medications; antihypertensive (13%), hypolipidemics (8%), non-steroidal anti-inflammatory (6%), and anticoagulants (4%). Significant differences between groups were observed in antihypertensives, anticoagulants and hypolipidemics. There were significant (p<0.05) differences between groups (<50yrs versus >50yrs) with regard to height (180 vs 177cm), weight (97.6 vs 93.1Kg-s), BMI (30 vs 29.7kg/m2) and waist circumference (85.7 vs 93.1cm) however, there were no differences in subsequent parameters of systolic blood pressure, diastolic blood pressure, total cholesterol, HDL-C, LDL-C, triglycerides-C or fasting plasma glucose. CONCLUSIONS: This represents the first collection of demographics on this cohort. GORF participants demonstrated increased cardiometabolic risk with regard to the incidence of hypercholesterolemia, hypertension and type 2 diabetes. Preventative strategies should be developed to reduce this risk with education of these risks for future participants.

Keywords: Masters athlete, rugby union, risk factors, chronic disease

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Authors: E. F. Aransiola, M.O. Daramola, E. O. Iwalewa, A. M. Seluwa, O. O. Olufowobi

Abstract:

Diabetes is a chronic metabolic disorder that affects the quality of life in terms of physical health, social and psychological well-being. In spite of the enormous progress in the treatment of diabetes using existing commercial drugs, such as, insulin and oral hypoglycemic agents, the quest and search for new drugs is imperative due to several limitations of the commercial drugs. In addition, the existing diabetic drugs are expensive and unaffordable by the rural populace in the developing countries. The present study demonstrates the anti-diabetic property of aqueous extract of Bryophyllum pinnatum (BP) leaves using diabetic rats (albino rats) as models. At the same time, the anti-diabetic effect of the aqueous extract was compared to that of a sample containing a mixture of the extract and a commercial diabetic medicine, glibenclamide. A specified dosage of aqueous extract of Bryophyllum pinnatum (BP) leaves was administered on the experimental diabetic rats, and their BGL was measured and recorded. The results showed a significant drop in the BGL of the diabetic rats to a value close to normal blood glucose level within 120 minutes when only aqueous extract from BP leaves was used. When a sample containing a mixture of the aqueous extract and glibenclamide was administered, a further drop in BGL was observed. Therefore, the results reveal that aqueous extract of Bryophyllum pinnatum leaves have significant anti-diabetic properties, and that the performance of the existing drugs (glibenclamide) could be enhanced with the use of the aqueous extract.

Keywords: Anti-diabetics, Bryophyllum pinnatum, Blood glucose level, albino rats.

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Authors: Intan Maisarah Abd Rahim, Herlina Abdul Rahim, Rashidah Ghazali

Abstract:

Diabetes is a medical condition that can lead to various diseases such as stroke, heart disease, blindness and obesity. In clinical practice, the concern of the diabetic patients towards the blood glucose examination is rather alarming as some of the individual describing it as something painful with pinprick and pinch. As for some patient with high level of glucose level, pricking the fingers multiple times a day with the conventional glucose meter for close monitoring can be tiresome, time consuming and painful. With these concerns, several non-invasive techniques were used by researchers in measuring the glucose level in blood, including ultrasonic sensor implementation, multisensory systems, absorbance of transmittance, bio-impedance, voltage intensity, and thermography. This paper is discussing the application of the near-infrared (NIR) spectroscopy as a non-invasive method in measuring the glucose level and the implementation of the linear system identification model in predicting the output data for the NIR measurement. In this study, the wavelengths considered are at the 1450 nm and 1950 nm. Both of these wavelengths showed the most reliable information on the glucose presence in blood. Then, the linear Autoregressive Moving Average Exogenous model (ARMAX) model with both un-regularized and regularized methods was implemented in predicting the output result for the NIR measurement in order to investigate the practicality of the linear system in this study. However, the result showed only 50.11% accuracy obtained from the system which is far from the satisfying results that should be obtained.

Keywords: Diabetes, glucose level, linear, near-infrared (NIR), non-invasive, prediction system.

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Authors: Chhaya Gangwal, R. N. Bhaumik, Shishir Kumar

Abstract:

Some properties of Intuitionistic Fuzzy (IF) rough relational algebraic operators under an IF rough relational data model are investigated and illustrated using diabetes and heart disease databases. These properties are important and desirable for processing queries in an effective and efficient manner.

 

Keywords: IF Set, Rough Set, IF Rough Relational Database, IF rough Relational Operators.

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Authors: Orkide Donma, Mustafa M. Donma, Muhammet Demirkol, Murat Aydin, Tuba Gokkus, Burcin Nalbantoglu, Aysin Nalbantoglu, Birol Topcu

Abstract:

Obesity in childhood establishes a ground for adulthood obesity. Especially morbid obesity is an important problem for the children because of the associated diseases such as diabetes mellitus, cancer and cardiovascular diseases. In this study, body mass index (BMI), body fat ratios, anthropometric measurements and ratios were evaluated together with different laboratory indices upon evaluation of obesity in morbidly obese (MO) children. Children with nutritional problems participated in the study. Written informed consent was obtained from the parents. Study protocol was approved by the Ethics Committee. Sixty-two MO girls aged 129.5±35.8 months and 75 MO boys aged 120.1±26.6 months were included into the scope of the study. WHO-BMI percentiles for age-and-sex were used to assess the children with those higher than 99^th as morbid obesity. Anthropometric measurements of the children were recorded after their physical examination. Bio-electrical impedance analysis was performed to measure fat distribution. Anthropometric ratios, body fat ratios, Index-I and Index-II as well as insulin sensitivity indices (ISIs) were calculated. Girls as well as boys were binary grouped according to homeostasis model assessment-insulin resistance (HOMA-IR) index of <2.5 and >2.5, fasting glucose to insulin ratio (FGIR) of <6 and >6 and quantitative insulin sensitivity check index (QUICKI) of <0.33 and >0.33 as the frequently used cut-off points. They were evaluated based upon their BMIs, arms, legs, trunk, whole body fat percentages, body fat ratios such as fat mass index (FMI), trunk-to-appendicular fat ratio (TAFR), whole body fat ratio (WBFR), anthropometric measures and ratios [waist-to-hip, head-to-neck, thigh-to-arm, thigh-to-ankle, height/2-to-waist, height/2-to-hip circumference (C)]. SPSS/PASW 18 program was used for statistical analyses. p≤0.05 was accepted as statistically significance level. All of the fat percentages showed differences between below and above the specified cut-off points in girls when evaluated with HOMA-IR and QUICKI. Differences were observed only in arms fat percent for HOMA-IR and legs fat percent for QUICKI in boys (p≤ 0.05). FGIR was unable to detect any differences for the fat percentages of boys. Head-to-neck C was the only anthropometric ratio recommended to be used for all ISIs (p≤0.001 for both girls and boys in HOMA-IR, p≤0.001 for girls and p≤0.05 for boys in FGIR and QUICKI). Indices which are recommended for use in both genders were Index-I, Index-II, HOMA/BMI and log HOMA (p≤0.001). FMI was also a valuable index when evaluated with HOMA-IR and QUICKI (p≤0.001). The important point was the detection of the severe significance for HOMA/BMI and log HOMA while they were evaluated also with the other indices, FGIR and QUICKI (p≤0.001). These parameters along with Index-I were unique at this level of significance for all children. In conclusion, well-accepted ratios or indices may not be valid for the evaluation of both genders. This study has emphasized the limiting properties for boys. This is particularly important for the selection process of some ratios and/or indices during the clinical studies. Gender difference should be taken into consideration for the evaluation of the ratios or indices, which will be recommended to be used particularly within the scope of obesity studies.

Keywords: Anthropometry, childhood obesity, gender, insulin sensitivity index.

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Authors: Sh. Khoshemehry, M. J. Pourvaghar, M. E. Bahram

Abstract:

In modern life, daily physical activity is relatively reduced, which is why the incidence of some diseases associated with overweight and obesity, such as hypertension, diabetes and other chronic illnesses, even in young people are observed. Obesity and overweight is one of the most common metabolic disorders in industrialized countries and in developing countries. One consequence of pathological obesity is cardiovascular disease and metabolic syndrome. In the past, it was believed that adipose tissue was ineffective and served only for storing triglycerides. In this review article, it was tried to refer to the esteemed scientific sources about physical activity and responses of leptin.

Keywords: Disease, leptin, obesity, physical activity.

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Authors: Climstein Mike, Walsh Joe, John Best, Heazlewood Ian Timothy, Burke Stephen, Kettunen Jyrki, Adams Kent, DeBeliso Mark

Abstract:

Recently, the health of retired National Football League players, particularly lineman has been investigated. A number of studies have reported increased cardiometabolic risk, premature ardiovascular disease and incidence of type 2 diabetes. Rugby union players have somatotypes very similar to National Football league players which suggest that rugby players may have similar health risks. The International Golden Oldies World Rugby Festival (GORF) provided a unique opportunity to investigate the demographics of veteran rugby players. METHODOLOGIES: A cross-sectional, observational study was completed using an online web-based questionnaire that consisted of medical history and physiological measures. Data analysis was completed using a one sample t-test (<50yrs versus >50yrs) and Chi-square test. RESULTS: A total of 216 veteran rugby competitors (response rate = 6.8%) representing 10 countries, aged 35-72 yrs (mean 51.2, S.D. ±8.0), participated in the online survey. As a group, the incidence of current smokers was low at 8.8% (avg 72.4 cigs/wk) whilst the percentage consuming alcohol was high (93.1% (avg 11.2 drinks/wk). Competitors reported the following top six chronic diseases/disorders; hypertension (18.6%), arthritis (OA/RA, 11.5%), asthma (9.3%), hyperlipidemia (8.2%), diabetes (all types, 7.5%) and gout (6%), there were significant differences between groups with regard to cancer (all types) and migraines. When compared to the Australian general population (Australian Bureau of Statistics data, n=18,000), GORF competitors had a Climstein Mike, Walsh Joe (corresponding author) and Burke Stephen School of Exercise Science, Australian Catholic University, 25A Barker Road, Strathfield, Sydney, NSW, 2016, Australia (e-mail: [email protected], [email protected], [email protected]). John Best is with Orthosports, 160 Belmore Rd., Randwick, Sydney,NSW 2031, Australia (e-mail: [email protected]). Heazlewood, Ian Timothy is with School of Environmental and Life Sciences, Faculty Education, Health and Science, Charles Darwin University, Precinct Yellow Building 2, Charles Darwin University, NT 0909, Australia (e-mail: [email protected]). Kettunen Jyrki Arcada University of Applied Sciences, Jan-Magnus Janssonin aukio 1, FI-00550, Helsinki, Finland (e-mail: [email protected]). Adams Kent is with California State University Monterey Bay, Kinesiology Department, 100 Campus Center, Seaside, CA., 93955, USA (email: [email protected]). DeBeliso Mark is with Department of Physical Education and Human Performance, Southern Utah University, 351 West University Blvd, Cedar City, Utah, USA (e-mail: [email protected]). significantly lower incidence of anxiety (p<0.01), arthritis (p<0.06), depression (p<.01) however, a significantly higher incidence of diabetes (p<0.03) and hypertension (p<0.01). The GORF competitors also reported taking the following prescribed medications; antihypertensive (13%), hypolipidemics (8%), non-steroidal anti-inflammatory (6%), and anticoagulants (4%). Significant differences between groups were observed in antihypertensives, anticoagulants and hypolipidemics. There were significant (p<0.05) differences between groups (<50yrs versus >50yrs) with regard to height (180 vs 177cm), weight (97.6 vs 93.1Kg-s), BMI (30 vs 29.7kg/m2) and waist circumference (85.7 vs 93.1cm) however, there were no differences in subsequent parameters of systolic blood pressure, diastolic blood pressure, total cholesterol, HDL-C, LDL-C, triglycerides-C or fasting plasma glucose. CONCLUSIONS: This represents the first collection of demographics on this cohort. GORF participants demonstrated increased cardiometabolic risk with regard to the incidence of hypercholesterolemia, hypertension and type 2 diabetes. Preventative strategies should be developed to reduce this risk with education of these risks for future participants.

Keywords: Masters athlete, rugby union, risk factors, chronic disease.

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Authors: Z. Zainuddin, W. K. Lye

Abstract:

In this paper, a clustering algorithm named KHarmonic means (KHM) was employed in the training of Radial Basis Function Networks (RBFNs). KHM organized the data in clusters and determined the centres of the basis function. The popular clustering algorithms, namely K-means (KM) and Fuzzy c-means (FCM), are highly dependent on the initial identification of elements that represent the cluster well. In KHM, the problem can be avoided. This leads to improvement in the classification performance when compared to other clustering algorithms. A comparison of the classification accuracy was performed between KM, FCM and KHM. The classification performance is based on the benchmark data sets: Iris Plant, Diabetes and Breast Cancer. RBFN training with the KHM algorithm shows better accuracy in classification problem.

Keywords: Neural networks, Radial basis functions, Clusteringmethod, K-harmonic means.

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