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Sugar addiction and its role in obesity among adolescents residing in an urban field practice area of Bagalkot: A cross-sectional study 糖瘾及其对居住在巴加尔科特城市实地实践区的青少年肥胖症的影响:横断面研究
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.015
Suhasini R Kanyadi, Nabeel Ahmed Gadi, Kalpana Kulkarni
Obesity, a multi-factorial process is showing an increasing trend among children and adolescents leading to increased prevalence of insulin resistance, paving the way for cardio-metabolic risk factors. It has been proposed that certain food items as well as eating habits are addictive in a way that is similar to substances of abuse. Thus, this study was conducted among adolescents to determine the frequency of sugar addiction, the influencing factors and its association with obesity. A cross-sectional study was designed and 250 late adolescents (17–19 years old) chosen from colleges coming under urban field practice area of Bagalkot were enrolled in the study. A self-administered questionnaire which consisted of three sections - socio-demographic details, validated Modified Yale Food Addiction Scale (mYFAS) and Physical Activity Questionnaire for Adolescents (PAQ-A) was used to collect data regarding sugar addiction and physical activity in our study. Sugar addiction was found among 7.6%of adolescents and it was associated with overweight and obesity which was statistically significant (X=42.72, p<0.0001). Factors which significantly contributed to sugar addiction among adolescents were; adolescents staying in hostel (p<0.001), working mother’s (p<0.0001) and socio-economic status (p=0.02). Univariate analysis (unadjusted odds ratio) showed that risk factors such as sugar addiction (Odds ratio 9.6, 95% C.I. 2.18-42.8, p=0.003) and reduced physical activity (Odds ratio 3.8, 95% C.I. 2.02-7.26, p=0.0001) were associated with overweight and obesity.Incorporation of measures against hyper palatable sugary foods into public health policy recommendations and a further detailed evaluation regarding sugar addiction may provide a new insight and help in prevention and treatment of obesity.
肥胖是一个多因素的过程,在儿童和青少年中呈上升趋势,导致胰岛素抵抗的发生率增加,为心血管代谢风险因素铺平了道路。有人提出,某些食品和饮食习惯会让人上瘾,其方式与滥用药物类似。因此,本研究在青少年中开展,以确定糖瘾的频率、影响因素及其与肥胖的关系。研究设计了一项横断面研究,从巴加尔科特城市实地实践区的高校中挑选了 250 名晚期青少年(17-19 岁)参与研究。我们的研究使用了一份自填式问卷来收集有关糖瘾和体育锻炼的数据,该问卷包括三个部分--社会人口详情、经过验证的改良耶鲁食物成瘾量表(mYFAS)和青少年体育锻炼问卷(PAQ-A)。7.6%的青少年存在糖瘾,且与超重和肥胖有关,这在统计学上有显著意义(X=42.72,P<0.0001)。导致青少年食糖成瘾的重要因素是:青少年住在宿舍(p<0.001)、工作母亲(p<0.0001)和社会经济地位(p=0.02)。单变量分析(未调整的几率比)显示,糖瘾(几率比 9.6,95% C.I.2.18-42.8,p=0.003)和运动量减少(几率比 3.8,95% C.I.2.02-7.26,p=0.0001)等风险因素与超重和肥胖有关。在公共卫生政策建议中纳入针对超美味含糖食品的措施,并对糖瘾进行进一步详细评估,可为预防和治疗肥胖症提供新的见解和帮助。
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引用次数: 0
Assessment of fasting plasma glucose, insulin, insulin resistance and glycated haemoglobin as markers of glycemic control in apparently healthy older adults in Nnewi 将空腹血浆葡萄糖、胰岛素、胰岛素抵抗和糖化血红蛋白作为 Nnewi 貌似健康的老年人血糖控制指标进行评估
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.013
E. C. Ogbodo, C. E. Onah, A. Amah, Chinenye Stellamaris Okeke, Maryrose Oluchukwu Obiorah, Alozie Ogwuegbu Okezie, Romanus Ogai Ogalagu, Joy Chidinma Iwuji, Raphael Emmanuel Mbam, Samuel Chukwuemeka Meludu
: Biochemical changes in glycemic indices have been linked to aging, and many individuals have asymptomatic hyperglycemia as they get older. This leads to metabolic dysregulation, which heightens vulnerability to a number of age-related chronic conditions, such as diabetes mellitus. : This cross-sectional study assessed the levels of fasting plasma glucose, insulin, insulin resistance and glycated haemoglobin as markers of glycemic control in apparently healthy older adults in Nnewi. A total of 144 participants were involved in this study: 72 older persons and 72 control subjects. The older adults were aged 45 to 75; while the control group was composed of individuals aged 18 to 30.  Six milliliters (6 ml) of fasting venous blood samples were collected from each participant for the determination of insulin (INS), glycated haemoglobin (HbA1c), and plasma glucose (FPG) levels. Enzyme-linked immunosorbent assay was used to evaluate INS, resin ion-exchange was used to estimate HbA1c, and glucose oxidase peroxidase was used to determine FPG. The Homeostasis Model Assessment Index (HOMA-IR) was used to calculate insulin resistance. : The mean FPG, HbA1c, INS and HOMA-IR were significantly higher in the older adults compared to control subjects respectively (p<0.05). Also, the mean FPG, HbA1c, INS and HOMA-IR were significantly higher in the older adult males and females compared to the control male and female subjects respectively (p<0.05). There was significant moderate positive correlation between the level of FBS Vs HbA1c (r=0.484, P-value = 0.000) and strong positive correlation between the level of Insulin Vs HOMA-IR (r=0.980, P-value = 0.000) in the control group. Also, strong significant positive correlations were observed between FPG and HbA1c (r=0.704, P-value = 0.000), FPG and HOMA-IR (r=0.778, P-value = 0.000), Insulin and HOMA-IR (r=0.778, P-value = 0.000) with a moderate significant positive correlation found between HbA1c Vs HOMA-IR (r=0.557, P-value = 0.000) in the older adults. This study showed that glycemic indices tend to become altered with advancing in age.
:血糖指数的生化变化与衰老有关,许多人随着年龄的增长会出现无症状的高血糖。这项横断面研究评估了作为血糖控制指标的空腹血浆葡萄糖、胰岛素、胰岛素抵抗和糖化血红蛋白的水平。共有 144 人参与了这项研究:72 名老年人和 72 名对照组受试者。老年人的年龄在 45 岁至 75 岁之间;对照组的年龄在 18 岁至 30 岁之间。 研究人员从每位受试者身上采集了 6 毫升空腹静脉血样本,用于测定胰岛素(INS)、糖化血红蛋白(HbA1c)和血浆葡萄糖(FPG)水平。酶联免疫吸附测定法用于评估 INS,树脂离子交换法用于估算 HbA1c,葡萄糖氧化酶过氧化物酶用于测定 FPG。胰岛素抵抗的计算采用了平衡模型评估指数(HOMA-IR)。 结果表明:与对照组相比,老年人的平均 FPG、HbA1c、INS 和 HOMA-IR 均显著升高(P<0.05)。此外,与对照组男性和女性受试者相比,老年男性和女性受试者的平均 FPG、HbA1c、INS 和 HOMA-IR 分别明显较高(P<0.05)。对照组的 FBS 水平与 HbA1c 之间存在明显的中度正相关(r=0.484,P 值=0.000),胰岛素水平与 HOMA-IR 之间存在较强的正相关(r=0.980,P 值=0.000)。此外,在老年人中还观察到 FPG 与 HbA1c(r=0.704,P 值 = 0.000)、FPG 与 HOMA-IR (r=0.778,P 值 = 0.000)、胰岛素与 HOMA-IR (r=0.778,P 值 = 0.000)之间存在较强的显着正相关性,HbA1c 与 HOMA-IR 之间存在中等程度的显着正相关性(r=0.557,P 值 = 0.000)。这项研究表明,随着年龄的增长,血糖指数往往会发生变化。
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引用次数: 0
Navigating the intersection of psychiatry and law: Insights into insanity defense and fitness to stand trial in the Indian legal system 探索精神病学与法律的交叉点:洞察印度法律体系中的精神错乱辩护和受审资格
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.019
Prachi Nemani
In the complex landscape of forensic psychiatry, the intersection of mental health and the legal system presents challenges that demand clear guidelines for effective navigation. This letter delves into the pivotal roles psychiatrists play in assessing the insanity defense and determining fitness to stand trial, crucial aspects intertwined with the principles of justice and human rights. Moreover, we elucidate the nuanced interpretation of Section 22 of Bhartiya Nyaya Sanhita (previously Section 84 of the Indian Penal Code), which delineates the criteria for absolving individuals of criminal responsibility due to mental illness. Comparisons with McNaughten’s rule highlight subtle differences in legal frameworks and their implications for verdicts of "not guilty by reason of insanity." Furthermore, our article emphasizes the importance of interdisciplinary collaboration between psychiatry and forensic medicine to enhance comprehension of legal complexities thereby improving the management of forensic patients. With a visual aid we will facilitate understanding of the multifaceted concepts discussed herein. By fostering dialogue and collaboration, we aim to contribute to a more informed and equitable legal approach to individuals with mental health concerns within the criminal justice system.Top of Form
在复杂的法医精神病学领域,心理健康和法律体系的交叉带来了各种挑战,需要明确的指导方针才能有效地应对。这封信深入探讨了精神科医生在评估精神错乱辩护和确定是否适合受审时所发挥的关键作用,这些关键方面与正义和人权原则交织在一起。此外,我们还阐明了对《印度尼雅圣训》(Bhartiya Nyaya Sanhita)第 22 节(之前为《印度刑法典》第 84 节)的细微解释,该节规定了因精神疾病而免除个人刑事责任的标准。与麦克诺顿规则的比较凸显了法律框架的细微差别及其对 "因精神失常而无罪 "判决的影响。此外,我们的文章还强调了精神病学和法医学之间跨学科合作的重要性,以加强对法律复杂性的理解,从而改善对法医患者的管理。通过视觉辅助工具,我们将促进对本文所讨论的多方面概念的理解。通过促进对话与合作,我们旨在为在刑事司法系统中对有心理健康问题的个人采取更知情、更公平的法律手段做出贡献。
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引用次数: 0
Silent while living, speaks when dead- A case report of manual strangulation 生前无声,死后有声--一例人工扼颈病例报告
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.017
M. Z. G. Saiyed, Chetan B Jani
Victim of throttling in majority of the cases die instantaneously as the perpetrator continues to apply pressure till death ensues. In certain cases, victim may survive for some time if pressure is withdrawn due to any reason. In such cases, after the incident, he/she may not be conscious or able to speak for giving history; but the injuries produced by application of pressure by palms and fingers, if looked for them carefully, may speak by themselves about the incident. Presenting here, a case of 52 years old female, where the “made-up” history by the relatives misdirected the thinking process of the clinicians as the patient could not speak at all at the time of admission to the hospital until death. Autopsy conducted on 5 day of hospitalization revealed typical signs of the homicidal act the victim was subjected to, which could have been identified in the “fresh” stage at the time of admission and could have helped in some more detailed medico legal investigations if it could have been referred to Forensic Medicine experts of the institute. This case report stresses on the need of multi-disciplinary approach at the time of treatment of any patient with suspicious history, to have some different angle of view with regards to medico legal concerns and hence, it is discussed here.
在大多数情况下,掐脖子的受害者会当场死亡,因为施暴者会继续施压,直到受害者死亡。在某些情况下,如果由于某种原因撤去压力,受害者可能会存活一段时间。在这种情况下,受害人在事发后可能意识不清,也无法开口陈述病史;但如果仔细观察手掌和手指施压造成的伤痕,它们本身就能说明事发经过。这里要介绍的是一例 52 岁的女性病例,患者亲属 "编造 "的病史误导了临床医生的思维过程,因为患者从入院到死亡根本无法说话。入院 5 天后进行的尸检显示,受害人有典型的杀人行为迹象,这些迹象本可以在入院时的 "新鲜 "阶段发现,如果能将其移交给研究所的法医专家,本可以帮助进行更详细的医学法律调查。本病例报告强调,在治疗任何有可疑病史的病人时,都需要采用多学科方法,以便从不同角度看待医学法律问题,因此在此进行讨论。
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引用次数: 0
Pituitary neuroadenoma as an ‘Incidentaloma’ in a case of road traffic accident 道路交通事故中作为 "偶发瘤 "的垂体神经腺瘤
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.016
Boddepalli Devaraj, K. A. Rupesh, Srinivasarao Vavilapalli, J. Allu
: Pituitary adenomas are the most common tumors found in the Sella region. Functional pituitary adenomas exhibit a wide range of endocrine manifestations due to either hypo- or hyperfunction of the pituitary gland, as well as mass effect. They can have a slow but severe impact on vision due to compression of the optic nerves, optic chiasm and cavernous sinus.: A 42-year-old male, a security guard at a local dabha, was struck by a van while crossing the road. He sustained a head injury and unfortunately passed away during treatment at our tertiary case institute. At autopsy, upon examination of the skull, a mass measuring 5x5x3cm was discovered in the suprasellar area of base of skull. This mass was sent for histopathological examination, which confirmed it to be a "Pituitary neuroendocrine tumor possibly gonadotropic in nature." However, the cause of death in this case was opined as ‘Head injury’.: Forensic pathologists rarely encounter intracranial neoplasms that present as sudden and unexpected deaths. The incidence of undiagnosed fatal brain tumors detected at autopsy has been reported to range between 0.02% and 0.4%. Several studies have investigated the relationship between hormonally active pituitary adenomas and both mental health disorders and quality of life. One study by Johnson et al. found that patients with nonfunctional adenomas reported impairments in physical and emotional well-being compared to the normal population. Headache and visual symptoms are most commonly associated with pituitary adenomas.In the present case, although it was an incidental finding and not contributing to the cause of death, we cannot underestimate the effect of the tumor on the visual acuity of the decedent. Nonetheless, visual impairment due to the tumor could also have partially led to the road traffic accident.
:垂体腺瘤是蝶鞍区最常见的肿瘤。功能性垂体腺瘤因垂体功能低下或亢进以及肿块效应而表现出多种内分泌症状。由于压迫视神经、视交叉和海绵窦,它们会对视力产生缓慢但严重的影响:一名 42 岁的男性是当地一家大巴的保安,他在过马路时被一辆面包车撞倒。他头部受伤,在我们的三级病例研究所接受治疗期间不幸去世。尸检时,在检查头骨时,发现颅底上部有一个 5x5x3 厘米的肿块。这个肿块被送去进行组织病理学检查,结果证实它是一个 "垂体神经内分泌肿瘤,性质可能是促性腺激素瘤"。然而,该病例的死因被认定为 "头部受伤":法医病理学家很少遇到颅内肿瘤导致的突然死亡。据报道,尸检时发现的未确诊致命脑肿瘤的发生率在 0.02% 到 0.4% 之间。有几项研究调查了荷尔蒙活性垂体腺瘤与心理健康障碍和生活质量之间的关系。约翰逊(Johnson)等人的一项研究发现,与正常人群相比,无功能腺瘤患者的身体和情绪健康状况都有所下降。在本病例中,虽然头痛和视力症状只是偶然发现,并不是死亡原因,但我们不能低估肿瘤对死者视力的影响。尽管如此,肿瘤导致的视力损伤也可能是导致道路交通事故的部分原因。
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引用次数: 0
Profile of unnatural deaths in adult females – A retrospective study conducted at a tertiary care hospital in Haryana 成年女性非正常死亡的概况 - 在哈里亚纳邦一家三级医院进行的回顾性研究
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.014
Rishi Rajindran, Gaurav Sharma, Vandana Yadav, Himani Saini, Ravi Lamba
Unnatural deaths, including unintentional and intentional events, require post-mortem examinations to rule out foul play. Women aged 18 to 30 are particularly vulnerable to mental, physical, psychological, and social challenges, including dowry-related deaths and occupational hazards. Unfortunately, female victimization is often underreported and research on the topic is limited. This study took into account 1564 post-mortem records of cases conducted in 5 years and analysed cases of unnatural deaths in adult females aged over 18 years to understand the gravity of female victimization in the region. Of the 204 identified cases, poisoning was the leading cause of death, and suicide was the most common manner of death. Accidental deaths were the second most common manner.: The study highlights the need for policies to address socio-economic and human rights deprivation, domestic violence, and mental health issues that contribute to these deaths. Measures to promote female economic independence and effective prevention and support strategies are necessary to reduce the prevalence of unnatural deaths among women in India.
非自然死亡,包括非故意和故意事件,需要进行尸检以排除犯规行为。18 至 30 岁的女性尤其容易受到精神、身体、心理和社会挑战的影响,包括与嫁妆有关的死亡和职业危害。遗憾的是,女性受害情况往往没有得到充分报道,对这一问题的研究也很有限。本研究参考了 5 年内 1564 例尸检记录,分析了 18 岁以上成年女性非正常死亡的案例,以了解该地区女性受害的严重程度。在已确认的 204 个案例中,中毒是主要死因,自杀是最常见的死亡方式。意外死亡是第二常见的死亡方式:研究强调,有必要制定政策,解决导致这些死亡的社会经济和人权剥夺、家庭暴力和心理健康问题。有必要采取措施促进女性经济独立,并制定有效的预防和支持战略,以降低印度妇女非正常死亡的发生率。
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引用次数: 0
Impact of strengthening TB diagnostic services in Uttarakhand: A step towards TB elimination 加强北阿坎德邦结核病诊断服务的影响:向消除结核病迈出的一步
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.011
Pankaj Kumar Singh, Prashant Chaudhary, Vikash Kumar Pandey, Suraj Rawat, Bipra Bishnu
Tuberculosis (TB) poses a significant public health challenge in Uttarakhand, India. To address this, the state has implemented strategic measures aimed at increasing the presumptive TB case examination rate. Key initiatives include the deployment of 40 additional molecular diagnostic machines, facilitated by the Corporate Social Responsibility (CSR), ensuring comprehensive coverage and enhancing field-level testing capabilities. The proactive procurement of molecular diagnostic chips and consumables at the state level has ensured an uninterrupted supply, bolstering testing capacity across all blocks. Additionally, regular fortnightly reviews and monitoring at the block level have been instituted to set targets, involve local leadership, and foster continuous improvement. These combined efforts have significantly improved the diagnostic capacity and operational efficiency of TB control measures in Uttarakhand, demonstrating the state's commitment to effective TB management and eventual elimination.
结核病(TB)对印度北阿坎德邦的公共卫生构成了重大挑战。为此,该邦实施了旨在提高结核病推定病例检查率的战略措施。主要措施包括在企业社会责任(CSR)的推动下,增设 40 台分子诊断仪,确保全面覆盖并提高现场检测能力。在州一级积极采购分子诊断芯片和消耗品,确保了不间断的供应,提高了所有区块的检测能力。此外,还在区块一级开展了每两周一次的定期审查和监测,以设定目标、让地方领导参与进来并促进持续改进。这些综合努力大大提高了北阿坎德邦结核病控制措施的诊断能力和运作效率,表明了该邦对有效管理和最终消除结核病的承诺。
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引用次数: 0
Robotic surgery: Consent and medico-legal aspect 机器人手术:同意和医学法律方面
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.018
Vijayanath V, Joel V, Priyadharsan S, K. R. K. Bharathi
Robotic surgery has rapidly evolving as a ground-breaking field in medicine, revolutionizing surgical practices across various specialties like oncology, urology, gynaecology, bariatric surgery.Despite its benefits, the adoption of surgery faces significant medicolegal challenges. This article develops into the underexplored legal implications of robotic surgery and identifies distinct medicolegal problems. The article highlights the need for comprehensive guidelines, regulations, and training programs to navigate the medico legal aspects of robotic surgery effectively, thereby unlocking its full potential for the future development.
机器人手术已迅速发展成为医学领域的一个突破性领域,为肿瘤学、泌尿学、妇科、减肥手术等各专科的手术实践带来了革命性的变化。本文深入探讨了机器人手术尚未被充分探索的法律影响,并指出了明显的法律问题。文章强调了制定全面的指南、法规和培训计划的必要性,以便有效地解决机器人手术的医学法律问题,从而充分释放其未来发展的潜力。
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引用次数: 0
Cadaveric organ donation: Indian perspective 遗体器官捐赠:印度视角
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.012
Bedanta Sarma, Shreemanta Kumar Dash, P. Ghormade, Dheeraj Abhaykumar Vinod Kumar
Cadaveric organ donation in India, although started long back; its present status is not favourable. The percentage gain is very slow in comparison to most of the country even after having proper legislation. There are many reasons for this, lack of awareness being the most common. Most of the people does not know the concept of brain death. Although government and many NGOs are attached with it and are trying their level best to communicate with people for this noble cause, they have not yet reached the expected goal.To boost up the process of cadaveric organ donation, the hospitals and their staff including doctors must play a vital role. Hence, knowledge and orientation of such potential group is important for further processing because in most of the hospitals even doctors are not well-informed about the legal and ethical aspects of organ donation. If all the weak locus are addressed properly, we can definitely achieve the goals within a short span of time.
印度的遗体器官捐献虽然很早就开始了,但目前的状况并不乐观。与大多数国家相比,即使有了适当的立法,器官捐献的比例增长也非常缓慢。造成这种情况的原因有很多,其中最常见的是缺乏意识。大多数人并不知道脑死亡的概念。尽管政府和许多非政府组织都在关注这一问题,并尽最大努力与人们就这一崇高事业进行沟通,但仍未达到预期目标。因此,对这些潜在群体的了解和引导对于进一步的处理非常重要,因为在大多数医院中,即使是医生也不太了解器官捐献的法律和道德问题。如果能妥善解决所有薄弱环节,我们一定能在短时间内实现目标。
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引用次数: 0
Building green and climate-resilient healthcare facilities in Uttarakhand: A step for a sustainable climate resilient healthcare 在北阿坎德邦建设绿色和气候适应性强的医疗保健设施:实现可持续气候适应性医疗保健的一个步骤
Pub Date : 2024-07-15 DOI: 10.18231/j.ijfcm.2024.010
Pankaj Kumar Singh, Charu Chandra Devshali, Ankita Dhaundiyal, Akhilesh Tripathi
Climate change presents significant risks to human health, with healthcare facilities increasingly vulnerable to extreme weather, floods, droughts, and climate-sensitive diseases. This study examines the development of Green and Climate-Resilient Healthcare Facilities in Rudraprayag, Uttarakhand, through multi-sectoral collaboration. Key interventions include energy audits, LED lighting, solar panel installation, and rainwater harvesting, aimed at enhancing sustainability and resilience. The initiative demonstrates the importance of proactive adaptation measures and sustainable practices in healthcare infrastructure, providing a model for other regions to ensure continuous, high-quality care amid escalating climate threats. This approach underscores the critical need for innovation, collaboration, and commitment in building climate-resilient health systems.
气候变化给人类健康带来了巨大风险,医疗保健设施越来越容易受到极端天气、洪水、干旱和气候敏感性疾病的影响。本研究探讨了通过多部门合作,在北阿坎德邦的 Rudraprayag 发展绿色和气候适应性医疗保健设施的情况。主要干预措施包括能源审计、LED 照明、太阳能电池板安装和雨水收集,旨在提高可持续性和抗灾能力。该倡议表明了在医疗保健基础设施中采取主动适应措施和可持续做法的重要性,为其他地区在气候威胁不断升级的情况下确保持续、高质量的医疗保健提供了范例。这种方法强调了在建设具有气候适应能力的医疗系统过程中对创新、协作和承诺的迫切需要。
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引用次数: 0
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Indian journal of forensic and community medicine
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