To assess the role of artificial intelligence (AI)-based automated software for detection of diabetic retinopathy (DR) and sight-threatening DR (STDR) by fundus photography taken using a ...smartphone-based device and validate it against ophthalmologist's grading.
Three hundred and one patients with type 2 diabetes underwent retinal photography with Remidio 'Fundus on phone' (FOP), a smartphone-based device, at a tertiary care diabetes centre in India. Grading of DR was performed by the ophthalmologists using International Clinical DR (ICDR) classification scale. STDR was defined by the presence of severe non-proliferative DR, proliferative DR or diabetic macular oedema (DME). The retinal photographs were graded using a validated AI DR screening software (EyeArt
) designed to identify DR, referable DR (moderate non-proliferative DR or worse and/or DME) or STDR. The sensitivity and specificity of automated grading were assessed and validated against the ophthalmologists' grading.
Retinal images of 296 patients were graded. DR was detected by the ophthalmologists in 191 (64.5%) and by the AI software in 203 (68.6%) patients while STDR was detected in 112 (37.8%) and 146 (49.3%) patients, respectively. The AI software showed 95.8% (95% CI 92.9-98.7) sensitivity and 80.2% (95% CI 72.6-87.8) specificity for detecting any DR and 99.1% (95% CI 95.1-99.9) sensitivity and 80.4% (95% CI 73.9-85.9) specificity in detecting STDR with a kappa agreement of k = 0.78 (p < 0.001) and k = 0.75 (p < 0.001), respectively.
Automated AI analysis of FOP smartphone retinal imaging has very high sensitivity for detecting DR and STDR and thus can be an initial tool for mass retinal screening in people with diabetes.
An efficient visible light induced one pot three component approach for the synthesis of new quinoline bejeweled thiobarbiturates via Knoevenagel condensation and N‐alkylation using copper ...nanoparticles (CuNPs) have been reported. These copper nanoparticles due to their diverse properties, smaller size (50–100 nm), and high surface area to volume ratio exhibit promising features for the reaction response such as the shorter reaction time, simple work‐up procedure, clean reaction profiles, and excellent product yields through reusability of the catalyst upto five cycles. The recovered catalyst was successfully characterized by EDAX and AFM analysis. In silico molecular docking studies were carried out to find out the effective binding affinity of the synthesized quinoline derivatives toward PPARγ protein. The results obtained showed that compounds 4d, 4e, and 4f possess good binding interaction toward PPARγ with binding energy of −7.4, −7.2 and, −7.6 k.cal/mol which was greater than standard rosiglitazone (−6.4 k.cal/mol) and comparable to that of standard pioglitazone (−7.9 k.cal/mol). In vitro α‐amylase and α‐glucosidase assays were performed for hypoglycemic activity evaluation. The compounds 4e and 4f at a concentration of 100 μg/ml showed 82.13% and 83.26% inhibition toward α‐glucosidase, 78.30% and 84.18% inhibition toward α‐amylase which was higher than standard pioglitazone and on par to that of rosiglitazone and acarbose.
In the present work, 2-substituted benzoxazole derivatives were synthesized from 2-(benzo
d
oxazol-2-yl) aniline. All the synthesized compounds were purified and characterized by
1
H NMR,
13
C NMR, ...and mass spectroscopy. All the compounds were pharmacologically evaluated for its in vitro anti-inflammatory efficacy using membrane stabilization and proteinase inhibitory methods. In addition to this, in silico molecular docking studies were carried out to predict the binding affinity of the synthesized benzoxazole derivatives with prostaglandin H2 synthase (PGHS) protein and trypsin enzyme. The results obtained from in vitro anti-inflammatory studies showed that compound
3
,
4
, and
6a
showed good efficacy with percentage inhibition of 74.26 ± 1.04, 80.16 ± 0.24, and 70.24 ± 0.68 for membrane stabilization activity 80.19 ± 0.05, 85.30 ± 1.04, and 75.68 ± 1.28 towards proteinase inhibitory efficacy at a concentration of 100 μg/mL which was on par to that of standards aceclofenac and etodolac. Molecular docking analysis showed that compounds
3
and
4
possess good binding affinity towards PGHS protein with a docking score of − 9.4 and − 9.3 kcal/mol respectively.
To study the pattern and prevalence of dyslipidemia in a large representative sample of four selected regions in India.
Phase I of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) ...study was conducted in a representative population of three states of India Tamil Nadu, Maharashtra and Jharkhand and one Union Territory Chandigarh, and covered a population of 213 million people using stratified multistage sampling design to recruit individuals ≥20 years of age. All the study subjects (n = 16,607) underwent anthropometric measurements and oral glucose tolerance tests were done using capillary blood (except in self-reported diabetes). In addition, in every 5th subject (n = 2042), a fasting venous sample was collected and assayed for lipids. Dyslipidemia was diagnosed using National Cholesterol Education Programme (NCEP) guidelines.
Of the subjects studied, 13.9% had hypercholesterolemia, 29.5% had hypertriglyceridemia, 72.3% had low HDL-C, 11.8% had high LDL-C levels and 79% had abnormalities in one of the lipid parameters. Regional disparity exists with the highest rates of hypercholesterolemia observed in Tamilnadu (18.3%), highest rates of hypertriglyceridemia in Chandigarh (38.6%), highest rates of low HDL-C in Jharkhand (76.8%) and highest rates of high LDL-C in Tamilnadu (15.8%). Except for low HDL-C and in the state of Maharashtra, in all other states, urban residents had the highest prevalence of lipid abnormalities compared to rural residents. Low HDL-C was the most common lipid abnormality (72.3%) in all the four regions studied; in 44.9% of subjects, it was present as an isolated abnormality. Common significant risk factors for dyslipidemia included obesity, diabetes, and dysglycemia.
The prevalence of dyslipidemia is very high in India, which calls for urgent lifestyle intervention strategies to prevent and manage this important cardiovascular risk factor.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Overweight and obesity are rapidly increasing in countries like India. This study was aimed at determining the prevalence of generalized, abdominal and combined obesity in urban and rural India.
...Phase I of the ICMR-INDIAB study was conducted in a representative population of three States Tamil Nadu (TN), Maharashtra (MH) and Jharkhand (JH) and one Union Territory (UT)Chandigarh (CH) of India. A stratified multi-stage sampling design was adopted and individuals ≥ 20 yr of age were included. WHO Asia Pacific guidelines were used to define overweight body mass index (BMI) ≥ 23 kg/m 2 but < 25 kg/m 2, generalized obesity (GO, BMI ≥ 25 kg/m 2, abdominal obesity (AO, waist circumference ≥ 90 cm for men and ≥ 80 cm for women) and combined obesity (CO, GO plus AO). Of the 14,277 participants, 13,800 subjects (response rate, 96.7%) were included for the analysis (urban: n = 4,063; rural: n = 9737).
The prevalence of GO was 24.6, 16.6, 11.8 and 31.3 per cent among residents of TN, MH, JH and CH, while the prevalence of AO was 26.6, 18.7, 16.9 and 36.1 per cent, respectively. CO was present in 19.3, 13.0, 9.8 and 26.6 per cent of the TN, MH, JH and CH population. The prevalence of GO, AO and CO were significantly higher among urban residents compared to rural residents in all the four regions studied. The prevalence of overweight was 15.2, 11.3, 7.8 and 15.9 per cent among residents of TN, MH, JH and CH, respectively. Multiple logistic regression analysis showed that female gender, hypertension, diabetes, higher socio-economic status, physical inactivity and urban residence were significantly associated with GO, AO and CO in all the four regions studied. Age was significantly associated with AO and CO, but not with GO.
Prevalence of AO as well as of GO were high in India. Extrapolated to the whole country, 135, 153 and 107 million individuals will have GO, AO and CO, respectively. However, these figures have been estimated from three States and one UT of India and the results may be viewed in this light.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
Achievement of treatment targets among individuals with diabetes remains suboptimal in many parts of the globe. We aimed to assess changes in diabetes prevalence and achievement of diabetes care ...goals in South Asia using two consecutive cross‐sectional population‐based surveys.
Methods
Two representative samples of South Asian adults were recruited using identical methods from Chennai, Delhi, and Karachi in 2010‐11 (n = 16,288; response rate–94.7%) and 2015‐16 (n = 14,587; response rate–94.0%) through the Center for Cardio‐metabolic Risk Reduction in South Asia (CARRS) Study. Quality of care goals were defined as HbA1c <53 mmol/mol (7.0%), blood pressure (BP) control: <140/90 mmHg, lipid control: LDL cholesterol <2.56 mmol/l (100 mg/dl), and self‐reported non‐smoking.
Results
Weighted prevalence of self‐reported diabetes increased by 9.0% 13% (95%CI: 13–14) to 15% (14–15) while that of newly diagnosed diabetes decreased by 16% 6.1% (5.7–6.6) to 5.1% (4.6–5.6). There were improvements in achieving glycaemic (25% to 30%, p = 0.002) and lipid (34% to 45%, p < 0.001) goals, but no notable improvements in BP control or smoking status. The proportion of individuals with self‐reported diabetes meeting more than one target also increased.
Conclusions
Diabetes prevalence continues to grow among urban South Asians and large gaps still exist in the attainment of treatment targets. Concerted policy, systemic, clinical and individual efforts are needed to close these care gaps.
A series of alkoxy-substituted 2
H
-chromenes were synthesized by a one-pot three-component reaction using salicylaldehydes, acetyl acetone and alcohol as reactant and medium with ...tetra-n-butylammonium fluoride (TBAF) as catalyst. Simple reaction conditions, short reaction time and overall good yield of products make this synthetic strategy an efficient one to synthesize 2
H
-chromene molecules. All the synthesized compounds were evaluated for antioxidant activities. Among all the new compounds,
5j
and
5k
showed good inhibition
(
70.41
±
0.14
and
64.71
±
1.02
%
) at 100
μ
g/mL
concentrations.
Background & objectives: Screening of individuals for early detection and identification of undiagnosed diabetes can help in reducing the burden of diabetic complications. This study aimed to ...evaluate the performance of Madras Diabetes Research Foundation (MDRF)-Indian Diabetes Risk Score (IDRS) to screen for undiagnosed type 2 diabetes in a large representative population in India.
Methods: Data were acquired from the Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study, a large national survey that included both urban and rural populations from 30 states/union territories in India. Stratified multistage design was followed to obtain a sample of 113,043 individuals (94.2% response rate). MDRF-IDRS used four simple parameters, viz. age, waist circumference, family history of diabetes and physical activity to detect undiagnosed diabetes. Receiver operating characteristic (ROC) with area under the curve (AUC) was used to assess the performance of MDRF-IDRS.
Results: We identified that 32.4, 52.7 and 14.9 per cent of the general population were under high-, moderate- and low-risk category of diabetes. Among the newly diagnosed individuals with diabetes diagnosed by oral glucose tolerance test (OGTT), 60.2, 35.9 and 3.9 per cent were identified under high-, moderate- and low-risk categories of IDRS. The ROC-AUC for the identification of diabetes was 0.697 (95% confidence interval: 0.684-0.709) for urban population and 0.694 (0.684-0.704) for rural, as well as 0.693 (0.682-0.705) for males and 0.707 (0.697-0.718) for females. MDRF-IDRS performed well when the population were sub-categorized by state or by regions.
Interpretation & conclusions: Performance of MDRF-IDRS is evaluated across the nation and is found to be suitable for easy and effective screening of diabetes in Asian Indians.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To assess the effect of migration (rural-to-urban and vice versa) on prevalence of diabetes and metabolic disorders in Asian Indians participating in the Indian Council of Medical Research-India ...Diabetes (ICMR-INDIAB) study.
The ICMR–INDIAB study is a national study on diabetes and associated cardiometabolic disorders in individuals aged ≥20 years from 28 states and 2 union territories of India. Individuals who moved to a different place from their place of birth and had resided in the new location for at least one year were considered as migrants. Anthropometric measurements, blood pressure estimation and a capillary oral glucose tolerance test were performed.
Of the 113,043 participants, 66.4% were non-migrant rural dwellers, 19.4% non-migrant urban dwellers, 8.4% rural-urban migrants, 3.8% multiple migrants and 2.0% urban-rural migrants. Weighted prevalence of diabetes was highest in rural-urban migrants followed by urban dwellers, urban-rural migrants and rural dwellers 14.7%, 13.2%, 12.7% and 7.7% respectively (p < 0.001). Rural-urban migrants had highest prevalence of abdominal obesity (50.5%) compared to the other three groups. The risk for diabetes was 1.9 times higher in rural-urban migrants than among rural dwellers. Five risk factors hypertension, abdominal and generalized obesity, physical inactivity and low fruit and vegetable intake together explained 69.8% (partial population attributable risk) of diabetes among rural-urban migrants and 66.4% among non-migrant urban dwellers.
Rural-to-urban migration is associated with increased risk of developing diabetes and other cardiometabolic abnormalities. Adoption of healthier lifestyle patterns among migrants could help prevent/delay onset of these abnormalities in this population.
•Increased rural-urban migration in India during the last decade may increase the risk of diabetes,obesity, and hypertension.•Prevalence/risk of diabetes, obesity and hypertension are higher in non-migrant urban dwellers and rural-urban migrants.•Prevention programmes emphasizing healthy lifestyle for those living in the urban settings are the need of the hour!
Objective
This study aimed to assess the secular trends in the prevalence of diabetes and pre-diabetes from two cross-sectional studies done 11 years apart, in rural Tamil Nadu.
Methods
The
T
...elemedicine P
R
oject for scre
EN
ing
D
iabetes and its complications in rural Tamil Nadu(TREND) study is a cross-sectional survey that screened 14,117 individuals aged ≥ 18 years between 2018–2021. TREND was conducted in 30 villages of Chengalpattu/Kancheepuram districts of Tamil Nadu in Southern India. The prevalence of diabetes and prediabetes was compared with an earlier study the
C
hunampet
R
ural
D
iabetes
P
revention
P
roject(CRDPP) which screened 23,380 individuals aged ≥ 20 years between 2006–2010 using similar methodology, in 42 villages in the same area. Diabetes and prediabetes were diagnosed using the WHO criteria.
Results
Individuals screened in TREND were significantly older (43.7 ± 14.5 vs.40.5 ± 15.2 years) and had higher BMI (23 ± 5 vs.21.4 ± 4.1) compared to CRDPP participants. The age and gender adjusted prevalence of diabetes increased from 5.3% to 13.7% (158.5% increase) during this 11-year period. There was a significant increase in prevalence of both self-reported diabetes (3.8% to 9.7%) and newly diagnosed diabetes (1.5% to 4.0%), but a decrease in prevalence of prediabetes from 16.7% to 8.4% (49.7% decrease) during the 11-year period. Age, male sex, BMI, formal education, occupations other than agriculture, family history of diabetes, and systolic blood pressure were significant predictors of diabetes.
Conclusions
The prevalence of diabetes among adults in rural south India has dramatically increased while that of prediabetes, has decreased, over a 11-year period. The decrease in prevalence of prediabetes might suggest a future slowing down of the epidemic.
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