Sustained anti-obesity effects of life-style change and anti-inflammatory interventions after conditional inactivation of the activin receptor ALK7

Life-style change and anti-inflammatory interventions have only transient effects in obesity. It is not clear how benefits obtained by these treatments can be maintained longer term, specially during sustained high caloric intake. Constitutive ablation of the activin receptor ALK7 in adipose tissue enhances catecholamine signaling and lipolysis in adipocytes, and protects mice from diet-induced obesity. Here, we investigated the consequences of conditional ALK7 ablation in adipocytes of adult mice with pre-existing obesity. Although ALK7 deletion had little effect on its own, it synergized strongly with a transient switch to low-fat diet (life-style change) or anti-inflammatory treatment (Na-salicylate), resulting in enhanced lipolysis, increased energy expenditure, and reduced adipose tissue mass and body weight gain, even under sustained high caloric intake. By themselves, diet-switch and salicylate had only a temporary effect on weight gain. Mechanistically, combination of ALK7 ablation with either treatment strongly enhanced the levels of β3-AR, the main adrenergic receptor for catecholamine stimulation of lipolysis, and C/EBPα, an upstream regulator of β3-AR expression. These results suggest that inhibition of ALK7 can be combined with simple interventions to produce longer-lasting benefits in obesity.

Pemeriksaan Kesehatan Gratis sebagai Upaya Peningkatan Kesadaran Masyarakat terhadap Deteksi Dini Penyakit Tidak Menular

AbstrakPenyakit tidak menular (PTM) merupakan penyakit yang bersifat kronis dan tidak ditularkan dari orang ke orang. Prevalensi PTM terus mengalami peningkatan seiring dengan perubahan pola hidup masyarakat kearah yang kurang seimbang. Faktor risiko PTM di Provinsi NTB antara lain adalah hipertensi, obesitas dan diabetes. Kurangnya pengetahuaan dan kesadaran terhadap bahaya PTM menyebabkan deteksi dini berbasis pelayanan kesehatan kurang efektif. Hal ini juga disebabkan oleh enggannya masyarakat memeriksakan diri selama belum merasa sakit. Penanggulangan faktor resiko PTM dan pencegahan berbasis masyarakat menjadi salah satu solusi yang dapat dilakukan untuk menekan resiko atau angka kematian akibat PTM. Kegiatan ini bertujuan untuk meningkatkan kesadaran masyarakat terhadap pentingnya tes kesehatan secara berkala sebagai upaya deteksi dini PTM. Kegiatan ini kemudian dilakukan dengan dua metode, yaitu diskusi dan praktik langsung untuk memeriksa kesehatan peserta. Secara keseluruhan, hasil pemeriksaan kesehatan cukup baik dengan rata-ata hasil pemeriksaan normal. Hanya saja dari kegiatan ini dijumpai dua peserta dengan hasil gula darah diatas 300 mg/dL. Dengan adanya kegiatan semacam ini, masyarakat menjadi semakin sadar akan pentingnya tes kesehatan secara berkala untuk deteksi dini PTM. �Kata Kunci: PTM, Pemeriksaan Kesehatan, Gula Darah, Asam Urat.Abstract�Non-communicable Diseases (NCD) are a chronic and not transmitted from preson to person. The prevalence of NCDs seems to be increased along with life style change into unbalance style. Risk factors of PTM in NTB are hypertension, obesity and diabetes. Less of knowledge and awareness to NCD�s risk lead early detection and prevention based on health facilities to be less effective. This is also caused by the reluctance of people to check themselves before they feel sick. Management of PTM risk factors and community-based prevention is a solution that can be done to reduce the risk or mortality rate due to PTM. This community service activities aims to increase people awareness due to the importance of periodicly doing medical check-up in order to screen NCDs. We conduct this activity in two methods, discussion and practically check people health status. Overall, the result was fine. But, two of the participant have blood glucose more than 300 mg/dL. By this community services, peoples become aware about the importance of medical check-up in early detection of NCD.��Keywords : NCD; Medical Check Up; Blood Glucose; Uric Acid.

Awareness about Life-style Modication in Hypertensive Patients Residing in Natore District, Bangladesh

Objective: For better control of hypertension, behavior (knowledge, attitude and practice) of hypertensive patients about life-style change is essential. This study was done to determine the level of knowledge, attitude and practice of hypertensive patients regarding life-style change needed to control of hypertension. Methods: The present cross-sectional study was conducted in Natore General Hospital, Natore over a period of 4 months from September to December, 2015. A total of 50 adult hypertensive patients suffering from the disease for at least six months were included in the study. Of them 20 were selected from patients attending at the Outpatient Department of Medicine, Natore General Hospital and 30 were selected by snowballing. Data were collected using a semi-structured questionnaire and the levels of knowledge and practice status were measured on Likert Scale (0-4). Score ‘1’ was assigned for each correct answer and score ‘0’ for each wrong answer, except for two knowledge-related questions where highest score was ‘2’ and the lowest was ‘0’. As there were more than one question in assessing respondents’ perception and practice, combined scores were used to measure the intended behaviour. Results: The result showed that about two-thirds (66%) of the respondents lie between 4th and 5th decades of life with mean age being 48.4 years (range: 17 – 80 ears). Male to female ratio was roughly 1:1. Majority (96%) of the respondents was married. Primary level educated formed about one-third (32%) of the respondents followed by HSC (20%), graduation (18%) and illiterate (16%). Nearly half (46%) of the respondents was poor. Seventy percent of the respondents’ blood pressure was beyond control at the time of interview with mean systolic and diastolic blood pressures being 140 and 92 mmHg respectively. More than half (54%) of the respondents’ duration of hypertension was < 5 years with median duration being 3 years. Over one-quarter (28%) was adequately aware and two-thirds (68%) were partially aware of lifestyle modification and most (88%) of the respondents’ source of information was doctor. Although majority (84%) was informed of life-style change from their doctors, only 28.6% of them considered those advices to be adequate to bring about effective change in their life-style. Majority (92%) held the view that additional salt to be avoided followed by smoking cessation or tobacco chewing (88%), diet control (84%) and having regular exercise (82%). A substantial proportion (72%) also put emphasis to weight reduction. In terms of practice, over two-thirds (70%) adopted change in their life-style to control blood pressure. Of them 20(57.1%) were practicing diet control, another 20(57.1%) avoiding added salt with meals and 10(28.5%) quitted smoking for reducing the chance of having heart attack or stroke in future. Ten (20%) respondents were used to smoking at the time of interview. Of them 7(70%) intended to give up the habit. Half (52%) of the respondents took exercise but the rate of performing regular exercise (5 days in a week) was only 19.3%. Those who were not used to taking exercise, 16.7% of them told that they did not have spare time to have exercise, about 30% told that the role of exercise on blood pressure control was not known to them, another 30% tried but failed to continue and 20.8% were reluctant to take exercise. More than half (56%) of the respondents’ level of knowledge was satisfactory, followed by 30% more or less satisfactory and 14% poor. However, about one-third (32%) of the respondents’ practice level was satisfactory, 34% more or less satisfactory, 24% poor, 8% very poor and only 2% highly satisfactory. Conclusion: The knowledge level of hypertensive patients about their life-style change is far below the desired level. The practice level is even low meaning that not all the respondents having knowledge about life-style modification translated the same into practice This indicates that there lies a gap between perception & practice which act as a barrier to motivation. Ibrahim Card Med J 2017; 7 (1&2): 23-30

Coping ways of the medical cost in Ischemic Heart Disease patients of Bangladesh

Background : Ischemic Heart Disease (IHD) requires long term treatment which poses huge financial burden.It is very difficult for the patients of developing countries to maintain the treatment costs of IHD.Objectives : To estimate the medical treatment cost and to find out the coping ways of that in Ischemic Heart Disease patients.Methods: A descriptive type of cross sectional study was done during January 2014 to December 2014 at medical out-patient department of National Institute of Cardiovascular Disease (NICVD), Dhaka. Data were collected by using a pre-tested, semi-structured Questionnaire. Medical cost was calculated by drug cost, consultation cost, laboratory investigation cost, surgical cost, hospital cost and food cost. Data analysis was performed by using SPSS software version 20.Results : Out of 201 patients, majority (64.7%) were in the age group of 40-59 years. Most (92.54%)of them were male. Majority (56.2%) of the respondents had monthly family income of Tk. 10001-20000. Among all patients 43.8%spent total medical cost was with a range from Tk.50001-180000. 85.71%, 81.8%, 69.9% and 66.71% had coped with families by life style change whose monthly Tk. 20001-50000,Tk. 50001-100000, Tk. 10001-20000, Tk. 5000-10000 respectively. Coping ways in family by compromising treatment cost of other family members was minimum 0.0% within the income group Tk.5000-10000, which was statistically significant (p<0.05).Conclusion : The study concluded that the largest component of medical cost of IHD was the surgical cost which includes coronary angiogram, PTCA and bypass surgery. The patient compensate the burden of medical treatment cost of IHD from family savings, personal income, selling of property, personal loan, donation, health insurance and by Life style change, Reduction of food cost,and reducing social contact.Northern International Medical College Journal Vol.9(1) July 2017: 258-260