Lifestyle Modification Research Articles

DNA methylation at AHRR as a master predictor of smoke exposure and a biomarker for sleep and exercise

BackgroundDNA methylation profiling may provide a more accurate measure of the smoking status than self-report and may be useful in guiding clinical interventions and forensic investigations. In the current study, blood DNA methylation profiles of nearly 800 Polish individuals were assayed using Illuminia EPIC and the inference of smoking from epigenetic data was explored. In addition, we focused on the role of the AHRR gene as a top marker for smoking and investigated its responsiveness to other lifestyle behaviors.ResultsWe found > 450 significant CpGs associated with cigarette consumption, and overrepresented in various biological functions including cell communication, response to stress, blood vessel development, cell death, and atherosclerosis. The model consisting of cg05575921 in AHRR (p = 4.5 × 10–32) and three additional CpGs (cg09594361, cg21322436 in CNTNAP2 and cg09842685) was able to predict smoking status with a high accuracy of AUC = 0.8 in the test set. Importantly, a gradual increase in the probability of smoking was observed, starting from occasional smokers to regular heavy smokers. Furthermore, former smokers displayed the intermediate DNA methylation profiles compared to current and never smokers, and thus our results indicate the potential reversibility of DNA methylation after smoking cessation. The AHRR played a key role in a predictive analysis, explaining 21.5% of the variation in smoking. In addition, the AHRR methylation was analyzed for association with other modifiable lifestyle factors, and showed significance for sleep and physical activity. We also showed that the epigenetic score for smoking was significantly correlated with most of the epigenetic clocks tested, except for two first-generation clocks.ConclusionsOur study suggests that a more rapid return to never-smoker methylation levels after smoking cessation may be achievable in people who change their lifestyle in terms of physical activity and sleep duration. As cigarette smoking has been implicated in the literature as a leading cause of epigenetic aging and AHRR appears to be modifiable by multiple exogenous factors, it emerges as a promising target for intervention and investment.

Diurnal patterns of accelerometer-measured physical activity and sleep and risk of all-cause mortality: a follow-up of the National Health and Nutrition Examination Surveys (NHANES)

BackgroundPhysical activity and sleep are established modifiable lifestyle factors, but the optimal time of the day of these behaviours for health is unknown. This study examined the independent and joint associations of diurnal patterns of physical activity and sleep with all-cause mortality.MethodsThis prospective cohort study included 6,673 participants who have attended the accelerometer assessment in the 2011–2014 National Health and Nutrition Examination Surveys (NHANES). Diurnal patterns of accelerometer-measured physical activity and sleep were identified using K-means clustering analysis. All-cause mortality was ascertained from the accelerometer measurement to December 31, 2019 (median follow-up 6.8 years). Survey-weighted Cox proportional hazard models were performed to estimate the independent and joint associations of diurnal patterns of physical activity and sleep with all-cause mortality.ResultsDiurnal patterns identified were: early-morning (32.4%), midday (42.5%), and late-afternoon (25.1%) for physical activity; and irregular sleep (37.4%), morning lark (33.6%), and night owl (29.0%) for sleep. After adjusting for volume of physical activity, sleep duration and other potential covariates, the early-morning physical activity pattern (hazard ratio 1.36, 95% confidence interval 1.13–1.64) and irregular sleep pattern (1.42, 1.01–1.99) were independently associated with higher risk of all-cause mortality, compared with midday physical activity and morning lark sleep patterns, respectively. In addition, participants with the combined pattern of early-morning physical activity and irregular sleep had higher risk of all-cause mortality compared to those with midday physical activity combined with a morning lark sleep pattern (1.92, 1.33–2.78). Several sociodemographic differences were observed in the strength of these associations.ConclusionsWearable activity-rest monitoring data showed that peak physical activity in the early morning and irregular sleep diurnal patterns are associated with increased mortality risk, and the combination of these patterns further exaggerated the risk. Public health program should acknowledge that the diurnal patterns of physical activity and sleep, in addition to their duration and frequency, may play a crucial role in lifestyle-based health promotion and management strategies.

Therapeutics Effects of the Genus Citrus in Anxiety Disorder

Background Anxiety and mood disorders are among the mental health diseases that have exponentially increased in prevalence owing to the hectic and stressful lifestyle. In addition to negatively impacting people’s physical health, this has resulted in a major psychological, social, and financial burden. A lot of emphasis has been placed on dietary and lifestyle modifications in the ongoing search for medication-free treatments. Investigating the connection between the consumption of specific fruits and vegetables and mental health issues such as depression has produced some intriguing and occasionally encouraging results. The genus Citrus with over 1300 species of plants is enriched with a plethora of polyphenolic compounds on the one hand and multicomponent volatile oil content on the other hand. Purpose The current work is centered on examining the range of phytoconstituents found in various citrus species—both underutilized and utilized—as promising avenues for future anxiolytic research. The work also details the proposed pharmacological mechanisms of isolated components and clinical trial advancements of selected citrus species. Methodology Various databases, including PubMed and ScienceDirect, were used to search and collect relevant literature published in the past 10 years (2014–2024). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria recommended for drafting methodical reviews were followed. Results Initially, 1791 articles were collected through an electronic database search, irrelevant titles/abstracts (1449) and other types of articles (05) were excluded. Out of 342 assessed reports, 187 duplicate articles were excluded. Finally, list of 67 articles was included in this narrative review. Conclusion Although research and development, as well as the commercial use of several citrus varieties, have attracted some interest recently, analyzing neglected citrus species closely can help to improve their processing into well-known anxiolytic leads by revealing their untapped potential. The work emphasizes the extensive exploration of underutilized citrus species, which have a rich bioactive pro file and enormous potential in pharmaceutical research and development.

Assessing Oral Cancer Knowledge and Awareness among Dental Patients of Bengaluru City, India

Abstract Background Oral cancer (OC) is prevalent in India, with serious social and economic ramifications on the public, often resulting in poverty and societal imbalance. Knowledge of the risk factors and signs and symptoms may reduce the OC burden on the society. Objectives To assess the knowledge regarding risk factors and clinical indicators in early detection and prevention of OC among dental patients. Methods A hospital-based cross-sectional study, interviewer-administered questionnaire was conducted among 540 adult patients attending the outpatient department of dental hospital. The questionnaire contained items about participants' characteristics, including demographics, education level, and knowledge about major risk factors: use of tobacco products, alcohol, diet/nutrition, family cancer history, oral hygiene habits and dental aspects, and clinical presentation of OC. The SPSS software was used to analyze the data, and the significance threshold was set at p = 0.05. The subjects were counseled immediately after completion of the questionnaire regarding tobacco cessation, and was given advice on diet, oral hygiene maintenance, and other lifestyle modifications. Results A solid understanding of signs and symptoms was demonstrated by 72%. However, two-thirds of this group were unaware of the symptoms associated with OC. As for OC risk factors such as tobacco use and heavy alcohol consumption, 61.6% expressed good knowledge. Of the total, 38.3% reported visiting a dentist at least once a year for dental issues in the past 3 years, yet none of them had undergone OC screening. Additionally, less than 10% of the patients received OC counseling or tobacco cessation intervention from a dentist. Conclusion Knowledge of OC risk factors and signs and symptoms were average, which may adversely affect the practices regarding prevention and early detection.

Ongoing Clinical Trials for Polycystic Ovarian Syndrome (PCOS) Afflicted Infertility in Women: A Narrative Review.

Polycystic Ovary Syndrome (PCOS) is a highly prevalent endocrine disorder that affects women of reproductive age. PCOS is further correlated with infertility, menstrual dysfunction, and hyperandrogenism. Despite the advanced understanding of reproductive biology, the exact causes of PCOS remain ambiguous. Nevertheless, several factors are believed to contribute to the development of PCOS, including insulin resistance, hyperinsulinemia, obesity, and genetic predispositions. The diagnosis of PCOS is complicated by its phenotypic heterogeneity, which manifests differently in different individuals. Presently, the therapeutic management of PCOS-afflicted infertility depends upon proper pharmaceutical-based therapies aimed at treating underlying symptoms, such as the use of clomiphene citrate, metformin, ovulation-inducing agents, anti-androgens, exogenous gonadotropin administration, laparoscopic ovarian drilling, and in vitro fertilization. The present review focuses on narrating present therapeutic interventions along with lifestyle modifications in PCOS. Furthermore, it focuses on the ongoing clinical trials of various chemotherapeutics to counter PCOS-induced infertility among women.

Non-alcohlic Fatty Liver Disease (NAFLD): Is it a Dormant Volcano or Tip of an Iceberg?

Non-alcoholic fatty liver disease (NAFLD), a major cause of chronic liver disease, is known to affect a quarter of the global adults. Natural history of NAFLD shows interindividual variation, traditionally it progresses from simple steatosis to steatohepatitis to fibrosis/cirrhosis and finally yet rarely to hepatocellular carcinoma. It is largely a lifestyle-related disease and is often labeled as the hepatic manifestation of metabolic syndrome. Both prevention and control of NAFLD include controlling risk factors (obesity, diabetes mellitus, hypertension and dyslipidemia), through lifestyle modification and medications. Drug therapy for NAFLD per se is still evolving and till date, no drugs are approved. It is clinically silent, especially in the early stages, and is a diagnosis of exclusion. Certain easily calculated indices can stratify cases into high or low risk for advanced fibrosis, thereby dictating appropriate monitoring and treatment measures. In addition to complications specific to liver disease in those who do progress to advanced fibrosis or cirrhosis, an increased risk of nonliver disease-related morbidity and mortality is also present. Challenges are manifold and include rising burden due to ever-growing epidemic of diabetes and obesity, low public awareness, fragmented healthcare, no approved drugs, and dearth of data on magnitude and epidemiology of the disease. The recent integration of NAFLD into the National Program for Prevention and Control of Non-Communicable Diseases (NPCDCS) by the Ministry of Health and Family Welfare of India is a welcome step in this direction as the contributory factors are mostly the same for all diseases and controlling any one or all of them will have a desired impact on the prevalence of all the diseases under this program.

Metabolic syndrome.

The metabolic syndrome (MetS) is a multiplex modifiable risk factor for cardiovascular disease, type 2 diabetes mellitus and other health outcomes, and is a major challenge to clinical practice and public health. The rising global prevalence of MetS, driven by urbanization, sedentary lifestyles and dietary changes, underlines the urgency of addressing this syndrome. We explore the complex underlying mechanisms, including genetic predisposition, insulin resistance, accumulation of dysfunctional adipose tissue and ectopic lipids in abdominal obesity, systemic inflammation and dyslipidaemia, and how they contribute to the clinical manifestations of MetS. Diagnostic approaches vary but commonly focus on abdominal obesity (assessed using waist circumference), hyperglycaemia, dyslipidaemia and hypertension, highlighting the need for population-specific and phenotype-specific diagnostic strategies. Management of MetS prioritizes lifestyle modifications, such as healthy dietary patterns, physical activity and management of excess visceral and ectopic adiposity, as foundational interventions. We also discuss emerging therapies, including new pharmacological treatments and surgical options, providing a forward-looking perspective on MetS research and care. This Primer aims to inform clinicians, researchers and policymakers about MetS complexities, advocating for a cohesive, patient-centred management and prevention strategy. Emphasizing the multifactorial nature of MetS, this Primer calls for integrated public health efforts, personalized care and innovative research to address this escalating health issue.

Does Online Social Support Affect the Eating Behaviors of Polish Women with Insulin Resistance?

Insulin resistance, a key factor in developing type 2 diabetes mellitus, is linked to various health conditions. The basis of its treatment is lifestyle modification. However, adherence to nutritional and other medical recommendations can be challenging for chronic disease patients due to many factors, including demographics, social context, gender, age, and the patient's baseline health condition. This study aims to evaluate the impact of online support group members on the diet quality of women with insulin resistance. This study was conducted as an online survey consisting of KomPAN (validated food frequency questionnaire) augmented with questions regarding using professional counseling and membership in support groups. The study covered 1565 women with insulin resistance, 1011 of whom were associated with the online support group. The mean pHDI (pro-health diet index) was 5.18 ± 2.69 in the support groups and 4.86 ± 2.69 in the control group (p = 0.0319. There were no significant differences in the nHDI (non-health diet index). We found that the pHDI is associated with financial situations, the household's situation, occupation education level, and medical or dietitian care, whereas occupation, medical, and dietitian care affect the nHDI. Membership in support groups is related to a higher pHDI and state of self-assessment of nutritional knowledge. Our study indicates a relationship between participation in online support groups and dietary behaviors and the subjective assessment of nutrition knowledge. Future research should focus on elucidating the mechanisms behind these influences and exploring how these communities can be optimized for broader public health initiatives.

A comprehensive lifestyle index and its associations with DNA methylation and type 2 diabetes among Ghanaian adults: the rodam study

BackgroundA series of modifiable lifestyle factors, such as diet quality, physical activity, alcohol intake, and smoking, may drive the rising burden of type 2 diabetes (T2DM) among sub-Saharan Africans globally. It is unclear whether epigenetic changes play a mediatory role in the associations between these lifestyle factors and T2DM. We assessed the associations between a comprehensive lifestyle index, DNA methylation and T2DM among Ghanaian adults.MethodsWe used whole-blood Illumina 450 k DNA methylation data from 713 Ghanaians from the Research on Obesity and Diabetes among African Migrants (RODAM) study. We constructed a comprehensive lifestyle index based on established cut-offs for diet quality, physical activity, alcohol intake, and smoking status. In the T2DM-free discovery cohort (n = 457), linear models were fitted to identify differentially methylated positions (DMPs) and differentially methylated regions (DMRs) associated with the lifestyle index after adjustment for age, sex, body mass index (BMI), and technical covariates. Associations between the identified DMPs and the primary outcome (T2DM), as well as secondary outcomes (fasting blood glucose (FBG) and HbA1c), were determined via logistic and linear regression models, respectively.ResultsIn the present study population (mean age: 52 ± 10 years; male: 42.6%), the comprehensive lifestyle index showed a significant association with one DMP annotated to an intergenic region on chromosome 7 (false discovery rate (FDR) = 0.024). Others were annotated to ADCY7, SMARCE1, AHRR, LOXL2, and PTBP1 genes. One DMR was identified and annotated to the GFPT2 gene (familywise error rate (FWER) from bumphunter bootstrap = 0.036). None of the DMPs showed significant associations with T2DM; directions of effect were positive for the DMP in the AHRR and inverse for all the other DMPs. Higher methylation of the ADCY7 DMP was associated with higher FBG (p = 0.024); LOXL2 DMP was associated with lower FBG (p = 0.023) and HbA1c (p = 0.049); and PTBP1 DMP was associated with lower HbA1c (p = 0.002).ConclusionsIn this explorative epigenome-wide association study among Ghanaians, we identified one DMP and DMR associated with a comprehensive lifestyle index not previously associated with individual lifestyle factors. Based on our findings, we infer that lifestyle factors in combination, affect DNA methylation, thereby influencing the risk of T2DM among Ghanaian adults living in different contexts.

Intense simplified strategy for newly diagnosed type 2 diabetes in patients with severe hyperglycaemia: multicentre, open label, randomised trial

ObjectiveTo evaluate whether the intense simplified strategy, which comprises short term intensive insulin therapy (SIIT) followed by subsequent oral antihyperglycaemic regimens, could improve long term glycaemic outcomes in patients with...

Integrating lifestyle modifications with physiotherapy: Evaluating the role of nutrition and psychological interventions in recovery

Physiotherapy is widely recognized for its role in rehabilitating musculoskeletal and chronic conditions through physical interventions. However, emerging evidence highlights the importance of lifestyle modifications, particularly dietary changes and psychological support, in enhancing treatment outcomes. This review evaluates the influence of such modifications on the effectiveness of physiotherapy interventions. By synthesizing literature on the integration of nutritional strategies, such as increased intake of anti-inflammatory nutrients, and psychological interventions like cognitive-behavioral therapy (CBT) and mindfulness, the study examines their impact on recovery rates, pain levels, and overall treatment success. Results indicate that dietary changes, including omega-3 fatty acids and antioxidants, promote tissue repair and reduce inflammation, while psychological support improves pain management, patient adherence, and functional recovery. The findings suggest that a holistic approach, incorporating both dietary and psychological elements into physiotherapy, can optimize patient outcomes. Future research should focus on standardized protocols to integrate these lifestyle factors with physiotherapy for sustained rehabilitation success.

Testing the Feasibility of a Newly Developed Lifestyle Practice Targeting Social Connections: Narrative Healing Circle Shared Medical Appointments.

Multi-method, voluntary recruitment of eligible patients, included referrals, flyers, hospital events page, and patients who participated in an ongoing 7-week integrative oncology SMA series. Two physicians (lifestyle medicine and chaplaincy specialists), both trained in narrative medicine, co-led one-hour long virtual NHC SMAs held every other week for a total of either 4 or 8 sessions. Sessions included a centering meditation, brief check-in, topic introduction, short writing exercise initiated with a written, musical, or visual prompt, followed by time of sharing and listening. Optional electronic pre and post participant surveys were emailed at enrollment (7-questions, response rate 29%) and after 4-8 NHC SMA sessions (12-questions, RR 34%). Virtual NHC SMA were offered from 2/23/22-8/30/23 with 62 unique participants, 266 total visits. Average age: 57years (range: 27-84 years). Gender: 85% Female, 15% Male; Ethnicity: 73% White, 16% African American, 6% Asian, 5 % Hispanic. About half lived in underserved areas (Harlem, Bronx, Queens, Brooklyn). Payor mix included 40% Medicare, 60% Commercial insurance. Session attendance: 6 participants (mean); 1-13 (range). The number of sessions attended ranged between 1-28 sessions. Anxiety or fear (89%), depression (61%) and pain (67%) were the top 3 symptoms reported in the pre-survey. After 4-8 sessions, participants reported improvements in anxiety/fear (43%), sadness/depression/hopelessness (33%), irritability/stress (33%), isolation/loneliness (33%). They reported several positive changes: restarting yoga or meditation practice, greater focus on awe, journaling, increased mindfulness, and feeling better equipped to manage stress. 94% reported goals met, 95% would recommend the series to others. The 2 clinician leaders reported increased empathy, personal well-being, and work satisfaction. Virtual NHC SMA series among mixed diagnosis population is feasible, positively affects patients' agency and well-being, and acceptable to patients and providers. A more formal study design with broader representation of diverse population and assessment of causality such as an RCT with longer follow-up is recommended.

Prevalence, risk factors and potential implications of nail biting in adults with congenital heart disease

BackgroundNail biting is a habit with potential health implications. Patients with congenital heart disease (CHD) are at increased risk of infections, with endocarditis being a particularly significant concern. Our aim was to establish the magnitude of this modifiable potential risk factor, namely nail biting, in a contemporary cohort of adult with CHD (ACHD). MethodsOur prospective study included consecutive, unselected ACHD patients, categorised on nail-biting habits, analysing background demographics, health records, and behavioural factors. ResultsOf the 310 patients enrolled, 101 (33 %) were found to be current nail biters. Univariate logistic analysis revealed that younger age (OR: 1.30/10 years, p = 0.002), male gender (OR: 1.73, p = 0.029), greater CHD complexity (OR: 2.15, p = 0.002) and learning disability (OR: 3.51, p = 0.031) were associated with a significantly higher risk of nail biting. Multivariable analysis confirmed that younger age (OR: 1.29, p = 0.010), greater CHD complexity (OR: 1.89, p = 0.016), obesity (OR: 1.75, p = 0.038) and learning disability (OR: 3,87, p = 0.030) were significant predictors for nail biting. ConclusionA third of ACHD patients attending a tertiary centre engage in nail biting, which may have detrimental effects. Such behaviour was more prevalent among younger, obese, complex CHD patients and those with learning disability. Lifestyle education and/or modifications warrant further improvement in this growing patient population.

Hypoxia and aging: molecular mechanisms, diseases, and therapeutic targets.

Aging is a complex biological process characterized by the gradual decline of cellular functions, increased susceptibility to diseases, and impaired stress responses. Hypoxia, defined as reduced oxygen availability, is a critical factor that influences aging through molecular pathways involving hypoxia-inducible factors (HIFs), oxidative stress, inflammation, and epigenetic modifications. This review explores the interconnected roles of hypoxia in aging, highlighting how hypoxic conditions exacerbate cellular damage, promote senescence, and contribute to age-related pathologies, including cardiovascular diseases, neurodegenerative disorders, cancer, metabolic dysfunctions, and pulmonary conditions. By examining the molecular mechanisms linking hypoxia to aging, we identify key pathways that serve as potential therapeutic targets. Emerging interventions such as HIF modulators, antioxidants, senolytics, and lifestyle modifications hold promise in mitigating the adverse effects of hypoxia on aging tissues. However, challenges such as the heterogeneity of aging, lack of reliable biomarkers, and safety concerns regarding hypoxia-targeted therapies remain. This review emphasizes the need for personalized approaches and advanced technologies to develop effective antiaging interventions. By integrating current knowledge, this review provides a comprehensive framework that underscores the importance of targeting hypoxia-induced pathways to enhance healthy aging and reduce the burden of age-related diseases.

Lack of progress in cancer related outcomes after Liver Transplantation: Mitigating risk & identifying future needs to move this needle

Malignancy has a crucial impact on long-term survival after liver transplantation. There has been enhanced early detection rates with refined cancer screening and improved prognosis for many cancer diagnoses in the general population with the advent of targetted anti-cancer therapies. Similar advancements have not occurred in the transplant population over this same timeframe. Individualized strategies to reduce the risk of cancer, are needed in this high risk population. Strict adherence to screening and surveillance specific to the transplant population is required. Lifestyle modifications and medication management (both immunosuppressive and non-immunosuppressive) that may impact cancer risk and outcome are highlighted here. As more effective anti-cancer therapies evolve, transplant recipient access to these agents is paramount to truly impact cancer related outcomes in this population. With adequate immunosuppression, rejection rates with immunotherapy are lower than previously purported. Prospective studies of immunosuppression modifications needed to minimize rejection and maximize cancer response are ongoing and will reduce the fear from oncology and transplant providers alike, allowing utilization of the most optimal therapy available to the individual. This review aims to assess current data to aid in clinical management and identify the needs to fascilitate further progress in this field.

Nausea and vomiting in pregnancy: a cross-sectional study of community pharmacists in the UK.

To assess the content and frequency of advice community pharmacists (CPs) provide to pregnant women with nausea and vomiting, their confidence in providing advice, and their knowledge of the safety of medication used to manage the condition. An online questionnaire of closed- and open-ended questions was distributed to CPs in the UK in May 2023. Closed-ended questions were analysed quantitatively, and conventional content analysis was utilised for open-ended responses. One hundred and eighty-one respondents completed the questionnaire, 24 responses were excluded, leaving data from 157 available for analysis. The majority (90.4%) of participants reported having experience in providing advice on nausea and vomiting with varying levels of confidence. Advice provided included using over-the-counter products, lifestyle modifications, reassurance, medication advice, and referring to other healthcare professionals. Knowledge of first-line antiemetics considered safe in pregnancy varied; cyclizine was correctly identified as safe during pregnancy by 57.3%, followed by 37.6% for promethazine and 31.2% for prochlorperazine. Self-reported confidence and having experience providing advice were related to higher medication safety identification rates. Five percent of participants reported previous training on the condition, while 70% reported wanting further education, preferably delivered via an online medium. This study showed that although 90% of CPs provide advice on nausea and vomiting in pregnancy, their medication safety knowledge varied. The majority of CPs reported wanting further education that would ensure women could access reliable information and evidence-based advice to optimise management of the condition.

Molecular Insight into Obesity-Associated Nephropathy: Clinical Implications and Possible Strategies for its Management.

Obesity is a significant health concern due to its rapid increase worldwide. It has been linked to the pathogenic factors of renal diseases, cancer, cardiovascular diseases, hypertension, dyslipidemia, and type 2 diabetes. Notably, obesity raises the likelihood of developing chronic kidney disease (CKD), leading to higher adult mortality and morbidity rates. This study explores the molecular mechanisms that underlie obesity-associated nephropathy and its clinical implications. Obesity-Associated Nephropathy (OAN) develops and worsens due to insulin resistance and hyperinsulinemia, which promote renal sodium reabsorption, glomerular hyperfiltration, and hypertension, leading to progressive kidney damage. Renal damage is further aggravated by persistent inflammation and redox damage, mediated by adipokines and proinflammatory cytokines, such as TNF-α and IL-6. Furthermore, stimulation of the sympathetic nervous system and the renin-angiotensin- aldosterone system (RAAS) intensifies glomerular hypertension and fibrosis. These elements cause glomerular hyperfiltration, renal hypertrophy, and progressive kidney damage. Clinical manifestations of obesity-associated nephropathy include proteinuria, reduced glomerular filtration rate (GFR), and ultimately, CKD. Management strategies currently focus on lifestyle modifications, such as weight loss through diet and exercise, which have been effective in reducing proteinuria and improving GFR. Pharmacological treatments targeting metabolic pathways, including GLP-1 receptor agonists and SGLT2 inhibitors, have shown renoprotective properties. Additionally, traditional RAAS inhibitors offer therapeutic benefits. Early detection and comprehensive management of OAN are essential to prevent its progression and lessen the burden of CKD.

Childhood Hypertension: A Retrospective Analysis of Causes, Treatments, and Complications.

Hypertension is prevalent in the pediatric population, with estimated rates between 2% and 5%, and its incidence is rising globally. This study offers a single-center analysis of hypertension in children. a retrospective chart review was conducted involving children aged 1 month to 13 years diagnosed with hypertension. The study included a total of 129 children. Secondary hypertension was identified in 103 patients (79.8%), while primary hypertension was noted in 26 patients (20.2%). Primary hypertension was more common among pre-teen children (50.0%), whereas secondary hypertension predominantly affected those aged 1 to 5 years. Renal parenchymal disease emerged as the most frequent etiology of secondary hypertension, followed by endocrine disorders and vascular issues. No significant correlation was found between hypertension and obesity. The primary complications associated with hypertension in these children were cardiovascular, followed by neurological issues. A small proportion (14.7%) managed their hypertension solely through lifestyle modifications, while the majority required additional antihypertensive medications. At the final follow-up, 50% of the children demonstrated improved blood pressure readings. The findings indicate a higher prevalence of secondary hypertension compared to primary hypertension among the studied population. This study underscores the necessity for heightened awareness among pediatricians regarding the early identification and management of hypertension. Larger population-based studies are warranted to further investigate the prevalence, causes, and outcomes of hypertension in this region.

Evaluation of clinical aspects of obesity among undergraduate healthcare students- a cross-sectional study at King Saud University, Riyadh, Kingdom of Saudi Arabia

BackgroundObesity among healthcare students (HCs)is a growing concern that needs to be addressed. The purpose of this study was to evaluate the knowledge, awareness, perceptions, practice, and preparedness of obesity, and associated factors among undergraduate HCs.MethodsA cross-sectional study was conducted from December 2023 to March 2024 using an online prevalidated questionnaire, to assess clinical aspects of obesity.Simple random sampling was applied for data collection from nursing, emergency medical services (EMS), and pharmacy students at Saudi University, Riyadh Saudi Arabia. All data were analyzed using statistical package for social science (SPSS).ResultsA total of 456 HCs participated in this study. Among those 68% believed eating high carbohydrates, fats, and sugars leads to obesity. At the same time, 52.2% and 57.2% were aware that smoking and stress can contribute to obesity. On the other hand, 41.9% live a healthy lifestyle and 38.65% engage in physical activity to control their obesity. The demographic variables such as age (p = 0.0001), gender (p = 0.0001), professional classification (p = 0.0001), presence of chronic diseases (p = 0.0001), history of weight loss treatment (p = 0.0001) and body mass index (BMI) (p = 0.0001) were significantly associated with knowledge of obesity(p = 0.001). Similarly, students’ age (p = 0.001), presence of chronic diseases (p = 0.004) history of weight loss treatment (p = 0.0001), BMI (p = 0.001), and active status (p = 0.0001) were significantly associated with the perception of the obesity.ConclusionUndergraduate HCs possess a good understanding of the clinical prospects of obesity. They know its causes, risks, and treatment options. Additionally, they are well-prepared to support individuals in managing their weight through lifestyle modifications and psychological counseling.

Development of quality indicators for hypertension management at the primary health care level in South Africa.

Despite many quality initiatives at the primary health care (PHC) level, little is known about the actual quality of care of patients diagnosed with hypertension in South Africa. This study aimed to develop quality indicators for hypertension management at the PHC level to improve the quality of care and patient outcomes. The RAND/UCLA Appropriateness Method, comprising two rounds, was used to develop clear, appropriate, and feasible evidence-based quality indicators for hypertension. In Round 1, a 9-point scale was used by a panel of 11 members to rate clarity and appropriateness of 102 hypertension quality indicator statements, grouped under 9 dimensions of quality hypertension management, using an online MS Excel® spreadsheet. In Round 2, 9 of the same panellists discussed all indicators and rated their appropriateness and feasibility during a remote online, interactive face-to-face MS Teams® meeting. Statements rated ≥7-9 with agreement were defined as either appropriate or feasible. The panel rated 46 hypertension quality indicator statements ≥7-9 with agreement for the appropriate and feasible measurement of the management of hypertension: monitoring (n = 16), review (n = 5), lifestyle advice (n = 9), tests (n = 7), intermediate outcomes (n = 6), referrals (n = 2) and practice/facility structures (n = 1). No indicator statements were rated both appropriate and feasible for measuring blood pressure levels and treatment. If applied, these indicators would improve monitoring and management of patients with hypertension, patient outcomes, and data quality in South Africa and result in more efficient use of scarce resources. This study can be replicable for improving care of other non-communicable diseases across Africa.