Rachael Irving

Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes

BackgroundYoga has been shown to be a simple and economical therapeutic modality that may be considered as a beneficial adjuvant for type 2 diabetes mellitus. This study investigated the impact of Hatha yoga and conventional physical training (PT) exercise regimens on biochemical, oxidative stress indicators and oxidant status in patients with type 2 diabetes.MethodsThis prospective randomized study consisted of 77 type 2 diabetic patients in the Hatha yoga exercise group that were matched with a similar number of type 2 diabetic patients in the conventional PT exercise and control groups. Biochemical parameters such as fasting blood glucose (FBG), serum total cholesterol (TC), triglycerides, low-density lipoprotein (LDL), very low-density lipoproteins (VLDL) and high-density lipoprotein (HDL) were determined at baseline and at two consecutive three monthly intervals. The oxidative stress indicators (malondialdehyde – MDA, protein oxidation – POX, phospholipase A2 – PLA2 activity) and oxidative status [superoxide dismutase (SOD) and catalase activities] were measured.ResultsThe concentrations of FBG in the Hatha yoga and conventional PT exercise groups after six months decreased by 29.48% and 27.43% respectively (P < 0.0001) and there was a significant reduction in serum TC in both groups (P < 0.0001). The concentrations of VLDL in the managed groups after six months differed significantly from baseline values (P = 0.036). Lipid peroxidation as indicated by MDA significantly decreased by 19.9% and 18.1% in the Hatha yoga and conventional PT exercise groups respectively (P < 0.0001); whilst the activity of SOD significantly increased by 24.08% and 20.18% respectively (P = 0.031). There was no significant difference in the baseline and 6 months activities of PLA2 and catalase after six months although the latter increased by 13.68% and 13.19% in the Hatha yoga and conventional PT exercise groups respectively (P = 0.144).ConclusionThe study demonstrate the efficacy of Hatha yoga exercise on fasting blood glucose, lipid profile, oxidative stress markers and antioxidant status in patients with type 2 diabetes and suggest that Hatha yoga exercise and conventional PT exercise may have therapeutic preventative and protective effects on diabetes mellitus by decreasing oxidative stress and improving antioxidant status.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12608000217303

PREVALENCE OF INJURIES AND REPORTING OF ACCIDENTS AMONG HEALTH CARE WORKERS AT THE UNIVERSITY HOSPITAL OF THE WEST INDIES

OBJECTIVES This study investigated the knowledge, awareness and practices of health care workers towards universal precautions at the University Hospital of the West Indies. The study also examined the prevalence of injuries experienced by health care workers, as well as incidence of accidents and compliance with post-exposure prophylaxis. MATERIALS AND METHODS A cross sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to two hundred health care workers including medical doctors, medical technologists, nurses and porters to assess knowledge and practices regarding universal precautions, prevalence of injuries and incidence of accidents. RESULTS Almost two-thirds (62.3%) of the respondents were aware of policies and procedures for reporting accidents while one-third (33.2%) were unsure. All nurses were aware of policies and procedures for reporting accidents, followed by medical doctors (88%) and medical technologists (61.2%). The majority (81.5%) of the respondents experienced splashes from bodily fluid. Over three-quarters of medical doctors (78%) and two-thirds of nurses (64%) reported having experienced needle stick injuries, while the incidence among medical technologists was remarkably lower (26%). The majority of the respondents (59%) experienced low accident incidence while just over one-tenth (14%) reported high incidence. Eighty four respondents reported needle stick injuries; just under two-thirds (59.5%) of this group received post-exposure treatment. CONCLUSIONS The study found that majority of health care workers were aware of policies and procedures for reporting accidents. Splashes from body fluids, needle stick injuries and cuts from other objects were quite prevalent among health care workers. There is a need for monitoring systems which would provide accurate information on the magnitude of needle stick injuries and trends over time, potential risk factors, emerging new problems, and the effectiveness of interventions at The University Hospital of the West Indies and other hospitals in Jamaica.

Importance of mitochondrial haplotypes and maternal lineage in sprint performance among individuals of West African ancestry.

Mitochondrial DNA (mtDNA) is inherited solely along the matriline, giving insight into both ancestry and prehistory. Individuals of sub‐Saharan ancestry are overrepresented in sprint athletics, suggesting a genetic advantage. The purpose of this study was to compare the mtDNA haplogroup data of elite groups of Jamaican and African‐American sprinters against respective controls to assess any differences in maternal lineage. The first hypervariable region of mtDNA was haplogrouped in elite Jamaican athletes (N=107) and Jamaican controls (N=293), and elite African‐American athletes (N=119) and African‐American controls (N=1148). Exact tests of total population differentiation were performed on total haplogroup frequencies. The frequency of non‐sub‐Saharan haplogroups in Jamaican athletes and Jamaican controls was similar (1.87% and 1.71%, respectively) and lower than that of African‐American athletes and African‐American controls (21.01% and 8.19%, respectively). There was no significant difference in total haplogroup frequencies between Jamaican athletes and Jamaican controls (P=0.551 ± 0.005); however, there was a highly significant difference between African‐American athletes and African‐American controls (P<0.001). The finding of statistically similar mtDNA haplogroup distributions in Jamaican athletes and Jamaican controls suggests that elite Jamaican sprinters are derived from the same source population and there is neither population stratification nor isolation for sprint performance. The significant difference between African‐American sprinters and African‐American controls suggests that the maternal admixture may play a role in sprint performance.

The burden of gestational diabetes mellitus in Jamaican women with a family history of autosomal dominant type 2 diabetes

OBJECTIVES To determine if Jamaican women of African descent with a family history of early onset autosomal dominant type 2 diabetes have greater odds of developing gestational diabetes mellitus (GDM) than those without a family history of the disease. METHODS A comparative study was conducted of two groups of pregnant Jamaican women: the first with a family history of early onset autosomal dominant type 2 diabetes; the second with no history of the disease. Incidence, odds for developing GDM, and metabolic profiles in first and second trimesters were assessed using SPSS 11.5 (SPSS Inc., Chicago, Illinois, United States). RESULTS The incidence of GDM was 12.0% in women with a family history of early onset autosomal dominant type 2 diabetes and 1.5% in women without a family history of the disease (P<0.05). Women with a family history were nine times more likely to develop GDM than those without a family history of diabetes (95% confidence interval: 5.00-16.38, P<0.0001). CONCLUSION Family history of early onset autosomal dominant type 2 diabetes appears to increase susceptibility to GDM in Jamaican women. Pregnant women of any age with family history of early onset autosomal type 2 diabetes should be screened for GDM.

Multigenerational inheritance and clinical characteristics of three large pedigrees with early-onset type 2 diabetes in Jamaica

OBJECTIVE To document the existence and clinical characteristics of three large families with multigenerational inheritance of early-onset type 2 diabetes in Jamaica. METHODS Three probands from large families with multigenerational inheritance of early-onset type 2 diabetes in at least three generations were detected at the University Hospital of the West Indies in Jamaica. Each proband at the time of diagnosis was < 25 years of age, was lean, and did not require insulin therapy. Clinical, metabolic, and genetic assessments were undertaken to profile the diabetes in the three families. RESULTS Three pedigrees--BK, SU, and CA--consisting of 38, 48, and 113 members, respectively, with multigenerational inheritance of early-onset type 2 diabetes in at least three generations, were investigated. The mean age at diagnosis of the three pedigrees was 31.5 +/- 2.9 years, with 10 persons detected below 25 years of age. Findings suggestive of overweight, insulin resistance, low insulin secretion, dyslipidemia, and mild intra-abdominal obesity were present. Islet cell antibodies and sequence variants in MODY1 to -6 genes were absent. CONCLUSIONS Large families demonstrating multigenerational inheritance of diabetes and other characteristics consistent with early-onset type 2 diabetes are present in the Jamaican population.

LIPID PROFILE AND CLINICAL CHARACTERISTICS OF WOMEN WITH GESTATIONAL DIABETES MELLITUS AND PREECLAMPSIA

Lipid Profile and Clinical Characteristics of Women with Gestational Diabetes Mellitus and Preeclampsia Gestational diabetes mellitus (GDM) is associated with increased risk of pregnancy-induced hypertension and other maternal and foetal complications of pregnancy. The aims of the study were to evaluate the serum lipid profile of women with GDM, and determine the number of women with GDM who have preeclampsia (PE). A retrospective study of 84 women with GDM and 90 pregnant women with normal glucose tolerance (controls) was conducted. Women with GDM had significantly higher parity (p=0.047), total cholesterol (p=0.039) and triglycerides (p=0.033), but non-significantly lower HDL-cholesterol (p=0.086) when compared to controls. Systolic blood pressure was significantly elevated in women with GDM coupled with PE (GDM-PE; p=0.015), the mean birth weight of infants born to women with GDM-PE was significantly lower than that of women with only GDM (p=0.025). Women with GDM-PE had significantly higher triglycerides (p=0.020), had to be more multi-gravida (p=0.047) with significantly elevated VLDL-cholesterol (p=0.037) when compared with women with only GDM. 11.9% of women with GDM had PE. On the basis of these findings, it can be concluded that GDM is associated with hyperlipidaemia as evident by the significantly elevated total cholesterol and triglyceride concentrations. Women with dyslipidaemia and GDM are at risk of developing preeclampsia. It is imperative that blood lipids be evaluated in women with GDM during antenatal care as it would be helpful in the early detection and treatment of PE. Lipidski Profil I Kliničke Karakteristike Žena SA Gestacionim Dijabetes Melitusom I Preeklampsijom Gestacioni dijabetes melitus (GDM) povezan je sa povećanim rizikom od hipertenzije izazvane trudnoćom i drugih komplikacija trudnoće kod majke i fetusa. Ciljevi studije bili su da se odredi lipidski profil žena sa GDM, i utvrdi broj žena sa GDM koje imaju PE. Sprovedena je retrospektivna studija 84 žene sa GDM i 90 trudnica sa normalnom tolerancijom glukoze (kontrola). Žene sa GDM imale su značajno povišen paritet (p=0,047), ukupni holesterol (p=0,039) i trigliceride (p=0,033), ali i neznačajno niži HDL-holesterol (p=0,086) u poređenju sa kontrolom. Sistolni krvni pritisak bio je značajno povišen kod žena sa GDM u kombinaciji sa PE (GDM-PE; p=0,015), a prosečna težina novorođenčadi koju su rodile žene sa GDM-PE bila je značajno niža nego kod žena sa GDM (p=0,025). Žene sa GDM-PE imale su značajno povišene trigliceride (p=0,020), i sklonije su većem broju trudnoća (p=0,047) uz značajno povišen VLDL-holesterol (p=0,037), u poređenju sa ženama samo sa GDM. 11,9% žena sa GDM imalo je PE. Na osnovu tih nalaza može se zaključiti da je GDM povezan sa hiperlipidemijom, što se vidi iz značajno povišenih ukupnih koncentracija holesterola i triglicerida. Kod žena sa dislipidemijom i GDM postoji rizik od razvoja preeklampsije. Veoma je važno određivati lipide u krvi žena sa GDM u okviru prenatalne zaštite jer to pomaže ranom otkrivanju i lečenju PE.

The Effects of Homicides and Economics on Human and SocialBiology: A Mental Health Challenge for a Society?

Introduction: Violence, particularly homicide, continue to plague Jamaica making it one of the countries with the highest murder rate worldwide with escalating violent espisodes which contribute to the leading cause of death among young males. Yet, homicide is not listed among the major causes of deaths in Jamaica and left out among the non-communicable diseases causing deaths. Objective: The aims of this research is to narrow the gap in the literature by evaluating from an empirical viewpoint the effects of homicides on human and social biology of theliving from a mental health perspective. Materials and Methods: The data for this study were taken from various Jamaica Government Publications including the Demographic Statistics, which provided data on mortality, population, and deaths. Jamaica Constabulary Force and Economic and Social Survey of Jamaica (ESSJ) provided the data for murders; gross domestic product per capita (i.e., GDP per capita) and suicide. Data were recorded, stored and retrieved using the Statistical Packages for the Social Sciences (SPSS) for Windows, Version 21.0. The level of significance that is used to determine statistical significance is less than 5% (0.05) at the 2-tailed level of significance. Ordinary least square (OLS) regressions were used to determine models or factors of health-care seeking behaviour. Stepwise regression was also used to the contribution of each variable leading to the final model. Results: Homicide is strongly correlated with health demands (rxy = 0.681). Of the five variables entered in the OLS regression, three emerged as factors of health-care seeking behaviour (i.e., self-reported physical illness, exchange rate and lninflation rate). This explained 83.6% of the variance in the dependent variable. Of the three factors, only one was positively correlated with dependent variable and the other two were inversely correlated with HSB. A very strong direct statistical correlation existed between the exchange rate and HSB (rxy = 0.832, P < 0.0001) with the other factors being held constant. Conclusion: Homicide must be included in human and social biology, mental health and demographic discourse as it accounts for premature deaths, psychiatric disorders and social disruptions.

The Psychology of Homicide, Divorce and Issues in Marriages:Mental Health and Family Life Matters

Introduction: The homicide pandemic has continued unabated and no empirical enquiry has emerged in criminology, sociology, psychology or public health in Caribbean literature which evaluates whether or not divorce has any effect on homicide. Objectives: The aims of this study are to 1) evaluate factors that explain the interplay between homicide and divorce and marriages in Jamaica; and 2) provide theories for the uxoricides. Materials and methods: The data for this study was obtained from various Jamaica Government Publications. The period for this work was from 1950 through 2013. Ordinary least square (OLS) regression analyses and curve estimations were used to determine models and best fitted models. Results: The factors of divorce were homicide, population and GDP per capita, with those variables explaining 77.5% of the variance in divorce. A strong correlation between homicides and divorce still emerged after controlling for GDP per capita (or income; rxy = 0.843, P<0.0001). Poverty rate and the exchange rate accounted for 83.8% of the variance in homicides. Of the seven selected variables used at once in the OLS, three emerged as factors for divorce rate (exchange rate, mortality rate and poverty rate). Both factors determined 61.4% of the variance in the divorce rate. Poverty accounted for 47.0% of the variability in the marriage rate and was inversely related to the marriage rate. Hence, lower rates of poverty mean greater number of marriages and vice versa. Conclusion: Divorce produces issues, which are sometimes not fully captured in the data. Further studies on the psychology of divorce are needed from a qualitative perspective to unearth real meaning behind the behaviour of depressed adults and psychological deficient children following romantic relationship separation. We are therefore proposing that poverty and divorce as well as separation from sexual partner should be treated with the same degree of urgency and significance as non-communicable diseases. The destruction of families from divorce is such that we are forwarding it to be a psychosocial disease likened to an infectious disease that can cause a pandemic if not probably cauterized.

Demographic Characteristics of World Class Jamaican Sprinters

The dominance of Jamaican sprinters in international meets remains largely unexplained. Proposed explanations include demographics and favorable physiological characteristics. The aim of this study was to analyze the demographic characteristics of world class Jamaican sprinters. Questionnaires administered to 120 members of the Jamaican national team and 125 controls elicited information on place of birth, language, ethnicity, and distance and method of travel to school. Athletes were divided into three groups based on athletic disciplines: sprint (s: 100–400 m; n = 80), jump and throw (j/t: jump and throw; n = 25) and, middle distance (md: 800–3000 m; n = 15). Frequency differences between groups were assessed using chi-square tests. Regional or county distribution of sprint differed from that of middle distance (P < 0.001) but not from that of jump and throw athletes (P = 0.24) and that of controls (P = 0.59). Sprint athletes predominately originated from the Surrey county (s = 46%, j/t = 37%, md = 17, C = 53%), whilst middle distance athletes exhibited excess from the Middlesex county (md = 60%). The language distribution of all groups showed uniformity with a predominance of English. A higher proportion of middle distance and jump and throw athletes walked to school (md = 80%, j/t = 52%, s = 10%, and C = 12%) and travelled greater distances to school. In conclusion, Jamaicas success in sprinting may be related to environmental and social factors.

A Review of the Leptin Hormone and the Association with Obesity and Diabetes Mellitus

Leptin is a protein hormone that regulates food intake. It is secreted by the adipocytes and contains 167 amino acids. The hormone signals the hypothalamus and is released to reduce the desire for food thereby controlling appetite. Research shows that diet-induced obesity results in leptin resistance, so while the level of leptin may be high, it is ineffective. Leptin is also increased in type 2 diabetes mellitus which is strongly associated with obesity and insulin resistance. While leptin may be elevated in both diabetes and obesity, it is not the cause of either disease. It has been suggested that leptin mediates insulin resistance and as such may be a possible treatment for insulin resistance. Diet induced leptin resistance can be reversed through dietary changes and its administration can be effective in combating insulin resistance. Leptin levels may also decrease with increased exercise. The pathophysiology involving leptin resistance is unclear. More leptin studies are needed as it may be an unexplored treatment for diabetes and may be able to provide a more detailed understanding of the disease.