Purpose: Celiac disease is a common non-communicable disease with varied presentations. Purpose of this study was to find the duodeno-endoscopic features in celiac disease and to compare duodeno-endoscopic and histological findings between typical and atypical celiac disease in children. Methods: Hospital based observational study was conducted at Sir Padampat Mother and Child Health Institute, Jaipur from June 2015 to May 2016. Patients were selected and divided in two groups- typical and atypical celiac disease based upon the presenting symptoms. Upper gastrointestinal endoscopy and duodenal biopsy was performed for serology positive patients. Results were analysed using appropriate statistical test of significance. Results: Out of 101 enrolled patients, 47.5% were male. Age ranged from 1 to 18 years. Study showed that 54.5% were typical and 45.5% were atypical. Patients presenting with atypical symptoms were predominantly of older age group. On endoscopy, scalloping, mosaic pattern, reduced fold height and absent fold height; and in histology, advanced Marsh stage were significantly higher in the typical group. Conclusion: Awareness of atypical presentations as well as duodeno-endoscopic features may have considerable practical importance for the diagnosis of celiac disease in children. Scalloping, mosaic pattern, reduced fold height and nodularity are main endoscopic markers of celiac disease in children. Endoscopic markers of duodenal mucosa may be important in early diagnosis of celiac disease, in children subjected to endoscopy for atypical presentations or indication other than suspected celiac disease.
Purpose: This study was to analyze the trend of research on intervention for patients with metabolic syndrome. Method: Using Pubmed, Medline, and CINAHL search engines, a randomized controlled trial(RCT) researching titles such as 'metabolic syndrome', 'intervention', 'lifestyle modification', or 'community-based' were collected. A total of 16 researches were analyzed based on the guidelines of the National Cholesterol Education Program - Adult Treatment Panel(NCEP-ATP III). Results: 1) The total period of the intervention was from 12 to 24 weeks, the frequency was 3 to 5 times per week, and the duration of each session was from 45 to 60 minutes. The types of intervention included exercise, diet, and medication. Among these types, diet was performed most frequently. 2) The outcomes of the intervention was measured with physical aspects such as anthropometric measures, body composition, or biological markers. No studies have evaluated psychosocial outcomes such as quality of life. 3) In terms of effectiveness of the intervention, anthropometric indicators, body composition, or serological markers showed positive effects, whereas results on endothelial or urine indicators were inconsistent. Conclusion: Methodological research developing comprehensive therapeutic lifestyle modification programs and intervention studies are needed for patients with metabolic syndrome. In addition, effects should be evaluated with multidimensional perspectives.
Short tandem repeats (STRs) loci are the genetic markers used for forensic human identity test. With multiplex polymerase chain reaction (PCR) assays, STRs are examined and measured PCR product length relative to sequenced allelic ladders. In the repeat region and the flanking region of the commonly-used STR may have DNA sequence variation. A mismatch due to sequence variation in the DNA template may cause allele drop-out (i.e., a "null" or "silent" allele) when it falls within PCR primer binding sites. The STR markers were co-amplified in a single reaction by using commercial PowerPlex$^{(R)}$ 16 system and AmpFlSTR$^{(R)}$ Identifiler$^{(R)}$ PCR amplification kits. Separation of the PCR products and fluorescence detection were performed by ABI PRISM$^{(R)}$ 3100 Genetic Analyzer with capillary electrophoresis. The GeneMapper$^{TM}$ ID software were used for size calling and analysis of STR profiles. Here, this study described a forensic human identity test in which allelic drop-out occurred in the STR system D18S51. During the course of human identity test, two samples with a homozygous (16, 16 and 21, 21) genotype at D18S51 locus were discovered using the PowerPlex$^{(R)}$ 16 system. The loss of alleles was confirmed when the samples were amplified using AmpFlSTR$^{(R)}$ Identifiler$^{(R)}$ PCR amplification kit and resulted in a heterozygous (16, 20 and 20, 21) genotype at this locus each other. This discrepancy results suggest that appropriate measures should be taken for database comparisons and that allele should be further investigated by sequence analysis and be reported to the forensic community.
Journal of agricultural medicine and community health
/
v.36
no.2
/
pp.101-112
/
2011
Objectives: The aim of this study is to determine arterial stiffness levels as measured by brachial-ankle pulse wave velocity (baPWV) and to identify the association between arterial stiffness and inflammatory markers, in healthy adults over 50 years old. Methods: The study population consisted of 4617 persons over the age of 50 years who participated in the baseline survey of the Dong-gu Study, which was conducted in 2007 and 2008. Arterial stiffness was measured using baPWV. A multiple regression analysis was performed to assess the relationship between conventional cardiovascular risk factors and inflammatory markers, including white blood cell (WBC) counts, high-sensitive C-reactive protein (hs-CRP), and gamma glutamyltransferase (GGT). Results: After adjustment for conventional cardiovascular risk factors including sex, age, smoking status, body mass index, systolic blood pressure, fasting glucose, hypertension or diabetic medication, total cholesterol, triglycerides, uric acid, and alanine aminotransferase, baPWV was significantly associated with WBC counts (${\beta}$=0.158, p<0.0001), hs-CRP (${\beta}$=0.244, p=0.026), and GGT (${\beta}$=0.003, p<0.0001). Conclusion: This study shows that arterial stiffness correlates with inflammatory markers. Arterial stiffness may be used as a composite risk factor to identify persons with higher risk for cardiovascular disease. Additionally, arterial stiffness may be a marker for future cardiovascular disease and a target for prevention.
Protein-calorie malnutrition is common in maintenance dialysis patients. Indeed, diabetic patients with chronic renal failure are considered to be at increased risk of malnutrition. The aim of this study was to compare the nutritional status and markers of inflammation of hemodialysis patients with and without type 2 diabetes. We compared nutritional parameters and C-reactive protein (CRP) as a marker of inflammation in 30 type 2 diabetic patients and age-matched 30 non-diabetic patients with hemodialysis. Serum albumin was significantly lower in patients with type 2 diabetes $(3.45\pm0.43g/dL)$ than in non-diabetic patients $(3.64\pm0.36 g/dL)$ (p<0.05). In contrast, the concentration of serum CRP was significantly higher in type 2 diabetes $(1.42\pm1.8mg/dL)$ (p<0.05). There were significant negative-relationships between serum albumin and CRP level in both diabetic (r=-0.553, p<0.01) and non-diabetic (r=-0.579, p<0.01) patients. In diabetic patients, serum albumin level was significantly correlated with hemoglobin (r = 0.488, p < 0.01) and hematocrit (r=0.386, p < 0.01). Diabetic patients as compared to non-diabetic patients showed a significant (p < 0.01) increased serum triglyceride (TG) $(153.1\pm80.1mg/dL\;vs\;101.6\pm62.4mg/dL)$ and decreased serum HDL cholesterol $(36.89\pm13.48mg/dL\;vs\;47.00\pm14.02mg/dL,\;P<0.05)$. There were significant correlations in the intake of calorie and serum albumin levels in both diabetic (r=0.438, p< 0.05) and non-diabetic (r=0.527, p<0.05) patients. Serum CRP level was negatively correlated with calorie (r= -0.468, p < 0.05), protein (r=-0.520, p < 0.01) and fat intakes (r=-0.403, p < 0.05) in diabetic patients and calorie (r=-0.534, p<0.05) and protein intakes (r=-0.559, p<0.05) in non-diabetic patients. The prevalence of protein malnutrition and the risk factors of cardiovascular disease were significantly higher in type 2 diabetic patients than in non-diabetic hemodialysis patients. Thus, we can suggest that the higher comorbidity and mortality rate in diabetic hemodialysis patients are partially explained by malnutrition and inflammation.
Objectives: This study compared the differences of postmenopausal women's bone mineral density in relation to the degree of obesity, metabolism index and dietary factors that affect bone mineral density. Methods: The subjects included in the study are 39 postmenopausal women of normal weight with body mass index less than $25kg/m^2$ and 32 postmenopausal who are obese. Anthropometry and biochemical analysis were performed and nutrient intakes and DQI-I were assessed. Results: Normal weight women were $56.03{\pm}3.76years$ old and obese women were $58.09{\pm}5.13years$ old and there was no significant difference in age between the two groups. The T-score of bone mineral density was $0.03{\pm}1.06$ in normal weight women and $-0.60{\pm}1.47$ in obese women and this was significantly different between the two groups (p<0.05). Blood Leptin concentration was significantly lower in normal weight women ($6.09{\pm}3.37ng/mL$) compared to obese women in ($9.01{\pm}4.99ng/mL$) (p<0.05). The total score of diet quality index-international was $70.41{\pm}9.34$ in normal weight women and $64.93{\pm}7.82$ in obese women (p<0.05). T-score of bone mineral density showed negative correlations with percentage of body fat (r = -0.233, p=0.05), BMI (r = -0.197, p=0.017), triglyceride (r = -0.281, p=0.020) and leptin (r = -0.308, p=0.011). The results of multiple regression analysis performed as the method of entry showed that with 22.0% of explanation power, percentage of body fat (${\beta}=-0.048$, p<0.05), triglyceride (${\beta}=-0.005$, p<0.05) and HDL-cholesterol (${\beta}=0.034$, p<0.01), moderation of DQI-I (${\beta}=-0.231$, p<0.05) affected T-score significantly. Conclusions: The results of the study showed that obese women have less bone density than those with normal weight women. In addition, the factor analysis result that affect bone mineral density showed that intake of fat is a very important factor. Therefore, postmenopausal women need to maintain normal weight and manage blood lipid levels within normal range. They also need to take various sources of protein and reduce consumption of empty calorie foods that have high calories, fat, cholesterol and sodium.
This study was conducted to compare the dietary factors which influence on the bone status of 28 women in urban and 30 women in rural area. Urinary excretion of hydroxyproline(Hpr) and Calcium(Ca) were measured as biological markers of bone resorption. Mean daily intake levels of total protein, animal protein, total calcium, calcium, calcium from milk and milk products, animal calcium, Ca / P ratio by 24 hr recall method were significantly higher in urban women. However, mean daily sodium(Na) intake levels were not significantly different between two groups. Ca Index score and Na Index score by food frequency methods were also significantly higher in urban than in rural subjects. While urinary Ca excretion elves of two groups were similar, Na excretion levels were significantly higher in rural women. Mean urniary levels of Ca / creatinine(cr) and Hpr / cr as bone status index were within normal range and not significantly different between two groups. However, prevalence of poor bone status as assessed by hydroxyproline was higher in rural women. Na Index, urinary Ca excretion and Ca / cr ratio were significantly correlated with bone status(Hpr / cr) in urban women, while only age was related to bone status in rural women. These demonstrated that high Na intake results in increased urinary excretion of Na and Ca and could cause bone resorption. Multiple regression analysis indicated that Na Index score and age have greater effect than other variables in urban women and only age has greater effect in rural women.
The purpose of this study was to investigate whether nutrition counseling and exercise could be beneficial to patients with acquired cardiac disease (ACD). Twenty-five ACD patients participated in this program, which was based on guidelines for serum lipid management. To measure the effects of the nutrition counseling and exercise education, outpatients with ACD were selected and randomly assigned to three groups which were a control group, a diet only group and a diet and exercise group. Nine diet only group patients and nine diet and exercise group patients received nutrition counseling or nutrition counseling and exercise education every other week. Patients who served as a non counseled control group did not receive any counseling during the same study period. Various markers of disease risk, including lifestyle, anthropometric indices, eating behaviors, and serum lipid levels were measured before and after the program. The program lasted up to 12 weeks, depending on the individuals involved. Database management and statistical analyses were performed using SPSS 7.5 software. As a result, BMI and %IBW showed decreased trends in the diet only and the diet and exercise group. Food habit scores were significantly increased in the diet only group and the frequency of saturated fatty acid, dietary cholesterol, salty food and instant food intake were decreased in the diet only group. Comparisons of the daily nutrient intakes of the groups showed their total calorie, carbohydrate and protein intake had decreased significantly, and also the total fat and dietary cholesterol intake had decreased in the nutrition counseling group. The serum total cholesterol and LDL-cholesterol decreased after 12 weeks in the nutrition counseling group. The diet and exercise group showed less interest in diet control than the diet only group. These results show that a well-planned nutrition counseling program would reduce the risks of ACD and cardiovascular disease and help to care such diseases.
There is a great public concern that higher consumption of eggs may increase the risk of chronic disease due to high levels of cholesterol in eggs. In contrast to this concern, limited studies have examined this relationship, and the study results have been inconsistent. This study was to evaluate the cross-sectional associations between egg consumption, blood markers and metabolic syndrome in Korean adults. We analyzed data from the combined 2007-2008 Korean National Health and Nutrition Examination Survey (KNHANES). Egg intakes were assessed using a food frequency questionnaire. Metabolic syndrome was ascertained using criteria of the NCEP ATP III (2001) and abdominal obesity criteria of the WHO. In 5,548 subjects, 937 subjects were defined as having metabolic syndrome. In linear regression models, subjects reporting one or more egg consumption per day had significantly lower levels of triglyceride, fasting blood glucose and blood pressure, and a higher level of HDL cholesterol, compared to those who rarely consumed eggs (P-trends < 0.05). After adjustments for potential confounding factors, the associations were no longer significant except for total cholesterol, showing higher levels with frequent egg consumption. More frequent intakes of egg (1 egg or more/day) were associated with lower risk of metabolic syndrome in a logistic regression model (OR: 0.69, 95% CI: 0.50-0.96), but this association also became insignificant after adjustments for multiple confounding factors (OR: 1.05, 95% CI: 0.71-1.57). In healthy Korean adults, frequent intakes of eggs did not adversely affect the risk of metabolic syndrome. Further studies are needed to confirm this finding.
Background: A number of studies have reported associations between the ambient air pollution concentrations and various health outcomes. Especially, ozone is well known for primary risk factor of asthma attacks. The results of a recent study indicate that the size of the effect on health outcomes due to air pollution varied according to several conditions, including age, gender, race and the socioeconomic status. Therefore, this study was conducted to examine the associations of ozone with the childhood asthma hospitalizations as stratified by the socioeconomic status (SES) at the community level in Seoul, Korea, 2002. Methods: SES at aggregated levels was measured on the basis of average regional health-insurance rate per citizen in the area. We applied the generalized additive model to analyze the effect of ozone on asthma after controlling for the potential confounding variables that were capable of influencing the results. Results: Our analysis showed that the number of children who were hospitalized for asthma increased as the SES of the residence area decreased. The estimated relative risks of hospitalization for asthma, as stratified by the SES of the community level, were 1.12 (95% confidence interval 1.00-1.25) in districts with the highest SES levels, 1.24 (95% CI=1.08-1.43) within the moderate SES levels, and 1.32 (95% CI=1.11-1.58) in the districts with the lowest SES levels. Conclusions: Our analysis showed that exposure to air pollution did not equally affect the health status of individuals. This suggests that not only the biological-sensitivity markers, but also the SES of the subjects should be considered as potentially confounding factors.
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