Methods: We examined whether (a) PA and (b) selected nsSNPs are associated with adiposity parameters and whether PA interacts with these nsSNPs on these outcomes in adolescents from the Malaysian Health and Adolescents Longitudinal Research Team study (n = 1,151). Body mass indices, waist-hip ratio, and percentage body fat (% BF) were obtained. PA was assessed using Physical Activity Questionnaire for Older Children (PAQ-C). Five nsSNPs were included: beta-3 adrenergic receptor (ADRB3) rs4994, FABP2 rs1799883, GHRL rs696217, MC3R rs3827103, and vitamin D receptor rs2228570, individually and as combined genetic risk score (GRS). Associations and interactions between nsSNPs and PAQ-C scores were examined using generalized linear model.
Results: PAQ-C scores were associated with % BF (β = -0.44 [95% confidence interval -0.72, -0.16], p = 0.002). The CC genotype of ADRB3 rs4994 (β = -0.16 [-0.28, -0.05], corrected p = 0.01) and AA genotype of MC3R rs3827103 (β = -0.06 [-0.12, -0.00], p = 0.02) were significantly associated with % BF compared to TT and GG genotypes, respectively. Significant interactions with PA were found between ADRB3 rs4994 (β = -0.05 [-0.10, -0.01], p = 0.02) and combined GRS (β = -0.03 [-0.04, -0.01], p = 0.01) for % BF.
Conclusion: Higher PA score was associated with reduced % BF in Malaysian adolescents. Of the nsSNPs, ADRB3 rs4994 and MC3R rs3827103 were associated with % BF. Significant interactions with PA were found for ADRB3 rs4994 and combined GRS on % BF but not on measurements of weight or circumferences. Targeting body fat represent prospects for molecular studies and lifestyle intervention in this population.
Methods: This was a cross-sectional study among undergraduate students aged 18 years old and above. Anthropometric measurements, such as weight, height, body composition, and blood pressure measurements, were collected. Hypertension was defined as equal or more than 140/90 mmHg. Statistical analyses were done using IBM SPSS version 20.
Results: A total of 354 respondents participated in the study. Mean age for the respondents was 21 years (SD 1.18 years). About 40% of the respondents were overweight or obese. Prevalence of hypertension was 8.2%. Mean systolic blood pressure was 119.1mmHg (SD14.36mmHg), and the mean diastolic blood pressure was 72.6mmHg (SD 9.73mmHg). There is a significant association between male gender (odds ratio =3.519, 95% CI is 1.886-6.566), body fat percentage (odds ratio = 1.944, 95% CI is 1.050-3.601), visceral fat (odds ratio = 2.830, 95% CI is 1.346-5.951), and family history of hypertension (odds ratio= 2.366, 95% CI is 1.334-4.194) and hypertension.
Conclusion: The prevalence of hypertension was less than 10% and is associated with male gender, body composition, and family history of hypertension.
Materials and method: A comprehensive literature search was performed to identify and synthesise all relevant information, mainly from within the last decade, on the major lifestyle factors associated with male infertility and semen quality. Database searches were limited to reports published in English only. A manual search of bibliographies of the reports retrieved was conducted to identify additional relevant articles.
Results: In all, 1012 articles were identified from the database search and after reviewing the titles and abstract of the reports, 104 articles met the inclusion criteria. Of these, 30 reports were excluded as the full-text could not be retrieved and the abstract did not have relevant data. The remaining 74 reports were reviewed for data on association between a particular lifestyle factor and male infertility and were included in the present review.
Conclusion: The major lifestyle factors discussed in the present review are amongst the multiple potential risk factors that could impair male fertility. However, their negative impact may well be mostly overcome by behaviour modification and better lifestyle choices. Greater awareness and recognition of the possible impact of these lifestyle factors are important amongst couples seeking conception.
CASE PRESENTATION: A 25-year-old super morbidly obese female (body mass index = 55 kg/meter2) presented with worsening shortness of breath. For MV, pairing of a 6 mm (mm) diameter ETT to accommodate the patient's vocal cord edema, with a CSS not designed to maintain a clean catheter tip, precipitated ETT blockage and respiratory acidosis. Replacement of these devices with a 6.5 mm ETT and a CSS designed to keep the catheter tip clean resolved the complications. After use of the different ETT and CSS for approximately one week, the patient was discharged to home.
DISCUSSION: The clean-tip catheter CSS enabled a more patent airway than its counterpart device that did not have this feature. Use of a clean-tip catheter CSS was an important care development for this patient, because this individual's super morbidly obese condition minimized tolerance for MV complications that would exacerbate her pre-existing tenuous respiratory health status.
CONCLUSION: Special attention should be given to the choices of ETT size and CSS to manage super morbidly obese patients who have a history of difficult airway access.
Methods: This is a retrospective cohort review of data obtained from the Malaysian National Obstetrics and Gynaecology Registry between the year 2010 and year 2012. All women in their first pregnancy with a booking BMI in their first trimester were included in this study. The association between BMI classifications as defined by the WHO cut-offs and the potential public health action points identified by WHO expert consultations towards adverse obstetric outcomes was compared.
Results: A total of 88,837 pregnant women were included in this study. We noted that the risk of adverse obstetric outcomes was significantly higher using the public health action points identified by WHO expert consultations even among the overweight group as the risk of stillbirths was (OR 1.2; 95% CI 1.0,1.4), shoulder dystocia (OR 1.9; 95% CI 1.2,2.9), foetal macrosomia (OR 1.8; 95% CI 1.6,2.0), caesarean section (OR 1.9; 95% CI 1.8,2.0) and assisted conception (OR 1.9; 95% CI 1.6,2.1).
Conclusion: A specifically lower BMI references based on the potential public health action points for BMI classifications were a more sensitive predictor of adverse obstetric outcomes, and we recommend the use of these references in pregnancy especially among Asian population.
OBJECTIVES: The review objectives were to summarize the evidence on prevalence of childhood overweight and obesity within developing countries in Asia and to synthesise the best epidemiological association between the dietary patterns of children in the developing countries in Asia and their weight status in terms of obesity.
INCLUSION CRITERIA: This review considered any studies that included children under 18 years of age who live in developing countries in Asia.This review of epidemiological association considered any analytical observational studies (case-control studies, cohort studies and analytical cross-sectional studies).The focus was to summarise the prevalence of childhood overweight and obesity within developing countries in Asia and synthesise the best available evidence on the relationship between dietary patterns as the exposure variable and childhood overweight and obesity as the outcome.
SEARCH STRATEGY: A three-step search strategy was utilised, with an initial limited search of MEDLINE, CINAHL and EMBASE to identify search terms. A second search using all identified keywords and index terms was undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Additional electronic databases searched included: ProQuest, Web of Science, and Scopus. Each database was searched from inception to September 2011, with an English language restriction.
METHODOLOGICAL QUALITY: All papers selected for retrieval were assessed independently by two reviewers using standardised critical appraisal instruments from the Joanna Briggs Institute.
DATA COLLECTION: Data was extracted from included studies by two reviewers independently using an adapted version of the standardised data extraction form from the Joanna Briggs Institute.
DATA SYNTHESIS: Meta-analysis was not possible because of the heterogeneity of studies in terms of methodology, statistical analyses and outcomes. A narrative summary of results is provided.
RESULTS: Fifteen studies were included in the review. The prevalence rates of childhood overweight and obesity in Asian developing countries ranged from 5.1% to 19.9% with no specific trend in age or gender. Several significant but inconsistent statistical associations between dietary patterns and overweight/obesity in children and adolescents were found [high energy diet (OR: 1.80 95%CI 1.10 to 2.90, p<0.05 vs 0.80 95%CI 0.60 to 1.10, p>0.05), low intake of fruit and vegetables (OR: 2.34 95%CI 1.04 to 5.24, p<0.001; 2.00 95%CI 1.10 to 3.40, p<0.05 vs 1.33 95%CI 0.44 to 4.05, p>0.05; 0.70 95%CI 0.50 to 1.00, p>0.05), high meat consumption (RR: 2.40 95%CI 1.00 to 5.60, p<0.05 vs 1.70 95%CI 1.00 to 2.70, p>0.05), eating out (OR: 12.0 95%CI 7.7 to 18.7, p<0.001; 1.70 95%CI 1.04 to 2.90, p<0.05 vs 1.20 95%CI 0.60 to 2.40, p>0.05), fast food intake (OR: 1.50 95%CI 1.12 to 2.02, p<0.05), presence of snacking (OR: 2.34 95%CI 1.01 to 5.54, p=0.05; 1.26 95%CI 1.13 to 1.40, p<0.05 vs 0.80 95%CI 0.48 to 1.32,p=0.377; 0.60 95%CI 0.30 to 0.99, p<0.05; 0.60 95%CI 0.40 to 0.90, p<0.05) and drinking sugar sweetened beverages (OR: 1.60 95%CI 1.02 to 2.50, p<0.05; 1.70 95%CI 1.10 to 2.70, p<0.05 vs 0.93 95%CI 0.82 to 1.05, p>0.05)]. The key limitation was the heterogeneity of studies in terms of measures of dietary patterns and obesity standards.
CONCLUSIONS: The prevalence rates of childhood overweight and obesity in Asian developing countries ranged from 5.1% to 19.9% with no specific trend in age or gender. From the practice perspective, several significant yet inconsistent statistical associations between dietary patterns and childhood overweight/obesity in children and adolescents were found.This review highlights the need for clinicians to monitor the effects of dietary change on the weight and health status of children in Asian countries.There is a need for valid measures of dietary intake and use of standardised international cut-offs for overweight and obesity, and for future researchers to conduct prospective studies to determine the causal relationship between Asian children's dietary pattern and their weight status.
AIM OF THE STUDY: To determine the antidiabetic activities of chloroform fraction (CF) of Anthocleista vogelii Planch root bark in rats with diet- and alloxan-induced obesity-diabetes.
MATERIALS AND METHODS: Inhibitory activities of CF against α-amylase and α-glucosidase activities were determined in vitro. Three weeks old rats were fed with high-fat diet for 9 weeks to induce obesity prior to further induction of diabetes using alloxan (150mg/kg body weight, i.p.). Blood glucose levels and body weight were measured every 7 days throughout the experiment. Glucose tolerance was assessed in normal and CF-treated rats on day 21. Terminal blood samples were collected from sacrificed animals for the measurement of serum insulin levels. Pancreases were excised from treated and untreated animals for histopathological examination.
RESULTS: LCMS/MS chromatographic profile of CF via positive and negative modes revealed 13 and 23 compounds respectively. Further analysis revealed quebrachitol (QCT), loganin, sweroside, oleoside 11-methyl ester and ferulic acid, which have been previously reported for their antidiabetic activities, as constituents of CF. CF inhibited activities of α-amylase (IC50 = 51.60 ± 0.92µg/ml) and α-glucosidase (IC50 = 5.86 ± 0.97µg/ml) in a dose-dependent manner. Treatment of animals with obesity-diabetes with 100 and 200mg/kg CF significantly improved glucose tolerance (P<0.001) and enhanced serum insulin levels (P<0.05) compared to diabetic control rats.
CONCLUSIONS: Antidiabetic activities of CF might be mediated via inhibition of α-amylase and α-glucosidase activities, elevation of serum insulin concentration, and enhancement of insulin and leptin sensitivity in obesity-diabetes rats. This study further substantiates the traditional use of A. vogelii in the management and treatment of diabetes in Africa and encourages further studies to investigate its mechanism of action.
Presentation of case: We describe the successful management of MLL of the left medial thigh in a 35-year-old man weighing 220 kgs (BMI 80.8 kgs/m2). He underwent a concurrent laparoscopic sleeve gastrectomy with surgical resection of the MLL. He recovered well and during our last follow up six months after the operation, he is ambulating well and weighs 148 kgs (BMI 54.4 kgs/m2).
Discussion: MLL is a form of secondary lymphedema resulting in disruption or compression of normal lymphatic drainage due to fat accumulation in obese patients. Patients usually delay treatment for even up to a decade, when it becomes sufficiently large enough to restrict mobility and daily activities, or when it becomes infected. MLL is primarily a clinical diagnosis. A detailed history regarding its slow growth spanning over the years makes malignancy less likely. However, if left untreated, MLL may progress to angiosarcoma. Imaging studies such as computed tomography (CT) and a Magnetic Resonance Imaging (MRI) are usually performed to rule out malignancy or vascular malformations. A tissue biopsy is not recommended unless there are suspicious pigmented lesions.
Conclusion: MLL remains to be underdiagnosed. Due to the obesity epidemic, clinicians must be aware of this once rare disease. The role of concurrent bariatric surgery with surgical resection of MLL warrants further studies.