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The rising burden of non-communicable diseases (NCDs), including mental health disorders (MHDs) such as anxiety and depression, poses a significant public health challenge globally. Evidence suggests that both diabetes and hypertension, the two most prevalent NCDs, are linked to a higher prevalence of MHDs. However, there is a lack of evidence on prevalence of generalised anxiety disorder (GAD) and depression among adults living with both diabetes and hypertension in Bangladesh. We aimed to assess the prevalence of GAD and depression and explore the associated factors among adults living with diabetes and hypertension comorbidity in rural Bangladesh.
We implemented a cross-sectional study.
The study was conducted in Chirirbandar, a sub-district of Dinajpur, Bangladesh.
We interviewed a total of 387 adults living with diabetes and hypertension comorbidity.
We had two primary outcome measures: GAD and depression. Individuals scoring ≥10 on the General Anxiety Disorder-7 scale were considered as having GAD and individuals scoring ≥10 on the Patient Health Questionnaire-9 scale were considered as having depression. The outcome variables were dichotomised based on these scores.
The prevalence of GAD was 7.24% (95% CI 5.04 to 10.29). Education level (grades 5–9) (adjusted OR (AOR): 3.40, 95% CI 1.26 to 9.19) and household wealth status (highest wealth tertile) (AOR: 0.12, 95% CI 0.02 to 0.62) were associated with GAD. The prevalence of depression was 17.83% (95% CI 14.32 to 21.98). Socioeconomic factors associated with depression included unemployment (AOR: 3.26, 95% CI 1.05 to 10.10) and household wealth status (highest wealth tertile) (AOR: 0.45, 95% CI 0.21 to 0.98). Higher odds of depression were also observed among participants with controlled hypertension (AOR: 3.88, 95% CI 1.81 to 8.35). Other factors, such as tobacco use, dietary diversity and physical activity, were not associated with GAD or depression.
A high prevalence of GAD and depression was observed among adults living with diabetes and hypertension comorbidity. The findings from the study emphasise the need for integration of mental health services into the existing non-communicable disease care. The identified factors associated with GAD or depression should be considered to develop targeted interventions for people with hypertension and diabetes comorbidity in Bangladesh.
by Mohammed Hadi Bestaoui, Ali Lounici, Amar Tebaibia, Latifa Henaoui, Nawal Brikci-Nigassa, Houssem Baghous, Amel Bensefia
BackgroundVisceral adipose tissue (VAT) is associated with several cardiometabolic risk factors, particularly metabolic syndrome and insulin resistance. Reference values for VAT vary across populations, genders, and ages. Data on visceral fat in the Algerian population are lacking. This study aimed to establish reference values for VAT in a general adult population. The secondary objectives were to determine cardiometabolic consequences and to propose suggested threshold values for VAT to predict metabolic syndrome.
Materials and methodsThis cross-sectional, analytical study randomly selected participants from the electoral list of Tlemcen, Algeria. VAT was measured using dual-energy X-ray absorptiometry (DXA) General Electric Healthcare© Lunar iDXA.
ResultsA total of 301 adults (147 men and 154 women) with a mean age of 49.3 ± 15.1 years participated. The median (25th-75th percentiles) VAT mass was 1364 g (690–2049) in men and 1060 g (585–1590) in women. Binary logistic regression analyses demonstrated that cardiometabolic risk factors, including hypertension, type 2 diabetes, dyslipidemia, metabolic syndrome, insulin resistance according to HOMA2-IR, hepatic steatosis, and sleep apnea syndrome, were significantly dependent on VAT mass. Threshold values for VAT to predict metabolic syndrome (according to International Diabetes Federation) were ≥ 1369 g in men (sensitivity: 86.2%, specificity: 74.2%, Youden’s index: 0.604) and ≥ 1082 g in women (sensitivity: 76.3%, specificity: 76.9%, Youden’s index: 0.532).
ConclusionThis study provides reference values for VAT in an urban Algerian adult population and highlights its importance in assessing cardiometabolic risk.
Pharmacogenomic testing could potentially reduce the number of adverse drug reactions and improve treatment outcomes through tailoring treatment to an individual’s genetic makeup. Despite its benefits and the ambitions to integrate into routine care, the implementation of pharmacogenomic testing in primary care settings remains limited. This study aims to qualitatively explore the views of healthcare professionals (HCPs) and patients on implementing pharmacogenomic testing in the UK National Health Service (NHS) primary care setting and to estimate the cost-effectiveness of service-delivery implementation by comparing different HCPs’ models of care.
This study consists of three workstreams (WS). WS1 is semi-structured interviews with General Practitioners, pharmacists, nurses and patients (24 participants) to explore implementation issues, including the perceived barriers and facilitators to delivering a pharmacogenomic service. WS2 consists of focus groups (between 24–36 participants) with genomic experts to develop practical pharmacogenomic-guided clinical pathways for primary care. WS3 will estimate the cost-effectiveness of implementing pharmacogenomic testing when led by different HCPs incorporating parameters from the literature, expert opinions, as well as data from WS1 and WS2.
Thematic analysis will be used to analyse the qualitative data from WS1 and WS2, mapping findings onto the Consolidated Framework for Implementation Research domains, which will also be used as the theoretical framework. WS3 will be a decision-analytic model developed in Microsoft Excel to compare the cost-effectiveness of pharmacist-led, GP-led, nurse-led or multidisciplinary pathways.
This study has been approved by the NHS Health Research Authority and Health and Care Research Wales (24/PR/1088). Findings will be disseminated through peer-reviewed publications, conference presentations and engagement with NHS policymakers and Genomics England.
by Samer Al-Battawi, Mohd Talib Latif, Vivien How, Karuppiah Thilakavathy, Haris Hafizal Abd Hamid, Chung Keat Tan, Yu Bin Ho
Motor vehicles emit most Malaysian PAHs in particulate matter of 2.5 μm (PM2.5-bound PAHs). Although traffic-related air pollution harms healthy people, there is a knowledge gap regarding PAHs’ effects on Malaysians. This study examines PM2.5-bound PAH concentrations, distribution, sources, and health risks in Malaysia’s high and low-traffic zones. Kuala Lumpur (KL) and Hulu Langat (HL) exhibit Malaysia’s high- and low-traffic areas. The high-volume air sampler collected 40 ambient PM2.5 samples at both locations. Solid-phase extraction and gas chromatography-mass spectrometry (GC-MS) assessed PAHs. The mean PM2.5-bound PAH concentrations in KL (5.85 ng m-3) were significantly higher than in HL (0.55 ng m-3) (p-3) and eleven times more high-molecular-weight PAHs (HMW-PAHs) (3.22 vs. 0.28 ng m-3) than HL. Over 51% of PM2.5 air samples at both sites included HMW-PAHs. Source apportionment tools (Diagnostic ratio, positive matrix factorization, and principal component analysis) showed that fossil fuel combustions (petrol and diesel) produced the greatest PAHs in both locations. Moreover, PAH exposure impinged higher carcinogenic health risks in KL than in HL. In conclusion, traffic and automobile pollution account for the short- and long-term health risks posed by PAHs in both regions.by Lianyu Shan, Mojdeh Matloubi, Ifeoma Okwor, Sam Kung, Mohamed Sadek Almiski, Sujata Basu, Andrew Halayko, Latifa Koussih, Abdelilah S. Gounni
Dendritic cells (DCs) are pivotal in regulating allergic asthma. Our research has shown that the absence of Sema3E worsens asthma symptoms in acute and chronic asthma models. However, the specific role of PlexinD1 in these processes, particularly in DCs, remains unclear. This study investigates the role of PlexinD1 in CD11c+ DCs using a house dust mite (HDM) model of asthma. We generated CD11c+ DC-specific PlexinD1 knockout (CD11cPLXND1 KO) mice and subjected them, alongside wild-type controls (PLXND1fl/fl), to an HDM allergen protocol. Airway hyperresponsiveness (AHR) was measured using FlexiVent, and immune cell populations were analyzed via flow cytometry. Cytokine levels and immunoglobulin concentrations were assessed using mesoscale and ELISA, while collagen deposition and mucus production were examined through Sirius-red and periodic acid Schiff (PAS) staining respectively. Our results indicate that CD11cPLXND1 KO mice exhibit significantly exacerbated AHR, characterized by increased airway resistance and tissue elastance. Enhanced mucus production and collagen gene expression were observed in these mice compared to wild-type counterparts. Flow cytometry revealed higher CD11c+ MHCIIhigh CD11b+ cell recruitment into the lungs, and elevated total and HDM-specific serum IgE levels in CD11cPLXND1 KO mice. Mechanistically, co-cultures of B cells with DCs from CD11cPLXND1 KO mice showed significantly increased IgE production compared to wild-type mice.These findings highlight the critical regulatory role of the plexinD1 signaling pathway in CD11c+ DCs in modulating asthma features.
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