Author name: jainhospitals

Blog, Vol 2 Issue 2

The Double Burden of Malnutrition and Diabetes in India: The Paradox of theThin-Fat Phenotype

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Sankalp Ghadei 1*, Deniza Patel 2, Jankhana Patel 3 1 Research Scientist, ICMR- National Institute of Virology, Pune; MPH Student, Indian Institute of Public Health, Gandhinagar; MBBS Intern, Baroda Medical College, Vadodara;2 MPH Student, Indian Institute of Public Health, Gandhinagar; 3MBBS Intern, Baroda Medical College, Vadodara Corresponding Author: 1*Sankalp Ghadei, Research Scientist, ICMR- National Institute of Virology Pune, Maharashtra, India-411021, [email protected] Abstract: Background: India faces a unique epidemiological paradox characterized by the coexistence of persistent childhood malnutrition (35.5% stunting prevalence) and an escalating diabetes epidemic affecting 77 million adults, projected to reach 134 million by 2045. This dual burden manifests through the emergence of the “thin-fat” phenotype—individuals appearing thin by conventional anthropometric standards, yet harbouring excess visceral adiposity and elevated type 2 diabetes risk. This phenomenon challenges Western paradigms linking obesity to diabetes, as Indians develop diabetes at significantly lower BMI levels than European populations. Methods: A comprehensive literature review was conducted using PubMed, Scopus, and Web of Science databases, covering publications from 1990 to 2023. Primary data sources included the National Family Health Survey-5, ICMR-INDIAB studies, and WHO reports. Studies on Indian populations, malnutrition-diabetes relationships, thin-fat phenotype characteristics, and the health system responses were systematically analysed.Results: The thin-fat phenotype affects 43.3% of India’s population, with a higher prevalence in rural areas (46%) than in urban areas (39.6%). State-level analyses reveal an inverse relationship between malnutrition and diabetes prevalence, indicating different epidemiological transition stages. Kerala demonstrates low malnutrition (19.7% underweight) but high diabetes prevalence (25.5%), while Jharkhand exhibits severe malnutrition (39.6% stunting) with emerging diabetes concerns (7.2%). The phenomenon extends to household levels, with undernourished children and diabetic adults coexisting within families. Physiological mechanisms underlying this paradox include developmental programming through Barker’s and Pedersen’s hypotheses, altered adipose tissue distributionfavouring visceral fat accumulation, sarcopenic obesity, and unique beta-cell dysfunction characteristics in Indian populations.Health System Implications: Current approaches treating malnutrition and diabetes as separate conditions through siloed programs (ICDS and National Programme for Prevention and Control of Non-Communicable Diseases) prove inadequate. BMI-based screening protocols miss 35-42% of thin diabetics, while healthcare providers lack training on dual burden complexities. The economic burden is substantial. Diabetes care costsrange from INR 5,000 to 45,000 annually, forcing 48.5% of families into distressed financing.Conclusion: India’s dual burden requires urgent, integrated health system transformation addressing both conditions simultaneously. Success demands unified screening protocols, comprehensive healthcare worker training, and coordinated policy approaches that transcend conventional disease categories to break intergenerational malnutrition and metabolic dysfunction cycles.

Blog, Vol 2 Issue 2

The Glycaemia Outcomes of Metformin with Add-on Vildagliptin orSitagliptin in T2 Diabetes Mellitus

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Introduction:T2DM is a global health concern requiring effective glycaemia management to reduce complications. While DPP-4 inhibitors like vildagliptin and sitagliptin are widely used with metformin, limited studies have compared their efficacy in lowering plasma glucose levels. This study aims to address this gap by evaluating the effectiveness of these combinations in glycemic control.Methods:A comparative observational study on 172 Patients with T2DM (≥30 years) was done with comorbidities like hypertension, dyslipidaemia, and obesity. Inclusion required lab data (FBG, PLBS, HbA1c, Cr, TG) and consent, while exclusions included T1DM, gestational diabetes, insulin therapy, alcoholuse, and emergencies. Primary (HbA1c) and secondary (Cr, TG) outcomes were assessed. Results and Conclusion: The study showed that adding vildagliptin or sitagliptin to metformin significantly improved glycaemia control in T2DM over six months. Both combinations effectively reduced FBS, PLBS, HbA1c, and TG without affecting renal function. In this cohort, patients receiving vildagliptin + metformin demonstrated a greater reduction in blood glucose levels compared to those receiving sitagliptin + metformin. Keywords: T2DM, Metformin, Vildagliptin, Sitagliptin, Glycaemia control, HbA1C, DPP-4inhibitor

Blog, Vol 2 Issue 1

An Epidemiology study of Socio-demographic-economic & Gestational Profile of Women with Early Gestational Glucose Intolerance at 8-10 weeks of Pregnancy

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Diabetes accounts for nearly 10% of global deaths among people aged 20 to 99 and is the fourteenth leading cause of Disability-Adjusted Life Years (DALYs) worldwide. The prevalence of diabetes is increasing worldwide due to factors like urbanization, nutrition, the elderly population, genetics, and lifestyle changes.1 An often-overlooked factor is gestational diabetes mellitus, which leads to glucose intolerance during pregnancy.2 Women with gestational diabetes often develop diabetes within three to six years after delivery, perpetuating a cycle of obesity, insulin resistance, diabetes, and NCDs across generations. Breaking this cycle is now more crucial than ever.3 Gestational diabetes mellitus (GDM), according to the World Health Organization, is characterized by carbohydrate intolerance leading to elevated blood sugar levels, with variable severity, first recognized during pregnancy. It is a very common metabolic disorder in pregnancy. Insulin resistance increases during pregnancy due to the development of carbohydrate intolerance.4 Adiponectin, which has antidiabetic and anti-inflammatory effects, is present in low levels in pregnant women with gestational diabetes mellitus (GDM). This decrease is associated with increased insulin resistance during pregnancy, playing a role in the onset of GDM. Insulin resistance, resulting from the β-cells’ failure to secrete insulin properly, may also be affected by maternal adiposity.5 The rising prevalence of GDM is primarily driven by modifiable risk factors like obesity, poor diet, sedentary lifestyle, and pre-existing insulin resistance, which can be reduced through early interventions. GDM has long-term effects on both the mother and offspring, influencing health outcomes across generations.

Blog, Vol 2 Issue 2

Right Ventricular Infarction Following Inferior STEMI: A Case Report and Comprehensive Review of Management Challenges

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   Siyamak Jalal Hosseini1, Mohammadreza Shoghli2*, Hermon Eyob Fesseha3, Yosan Eyob4 1Assistant Professor at Tehran University of Medical Sciences, Tehran, Iran, [email protected]; 2Ph.D. Helsinki, Department of Population Study, University of Helsinki, Helsinki, Finland, [email protected]; 3Hermon Eyob Fesseha1, Cardiology resident, Peijas Hospital District of Helsinki and Uusimaa (HUS), University of Eastern Finland; [email protected]; 4MD, general practitioner in private clinic Pihlajalinna, Finland, [email protected]  Corresponding Author: 2*Mohammadreza Shoghli, Ph.D. Helsinki, Department of Population Study, University of Helsinki, Helsinki, Finland, [email protected] Right ventricular infarction (RVI) is a life-threatening complication of inferior ST-elevation myocardial infarction (STEMI), occurring in approximately 30–50% of such cases—typically when the proximal right coronary artery (RCA) is occluded [1,2]. While left ventricular (LV) infarction receives more clinical focus, RVI significantly worsens patient outcomes and is often underdiagnosed due to nonspecific signs [3,4]. The right ventricle (RV) is anatomically distinct from the LV, with a thinner free wall, lower systolic pressure, and greater dependence on preload. These characteristics make the RV highly susceptible to ischemic damage and volume depletion. RV dysfunction can compromise left-sided output due to interventricular dependence, thereby leading to systemic hypotension and cardiogenic shock [5,6]. Although timely revascularization is the cornerstone of STEMI therapy, standard management strategies may be inadequate in dominant RVI. In such cases, mechanical support such as right ventricular assist devices (RVADs) or extracorporeal membrane oxygenation (ECMO) can be lifesaving. Unfortunately, these are not universally accessible, particularly in resource-limited settings [7]. We present a case of inferior STEMI with RVI, highlighting the limitations of current management and the impact of unavailable mechanical RV support.

Blog, Vol 2 Issue 2

Chronic Reactive Arthritis Following Bacillus Calmette-Guérin (BCG) Instillations: A Case Report and Review

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Hermon Eyob Fesseha1*, Laura sundell2, Mari Ala-Houhala3, Alexandra Häme4, Mohammadreza Shoghli5, Siyamak Jalal Hosseini6 , Yosan Eyob7 1Hermon Eyob Fesseha1, Cardiology resident, Peijas Hospital District of Helsinki and Uusimaa (HUS), University of Eastern Finland; 2MD, internal medicine and rheumatology, chief physician in Peijas Helsinki University Hospital (HUS) department of internal medicine, [email protected]; 3MD, infectious disease specialist, Peijas Helsinki University Hospital (HUS), [email protected]; 4MD, rheumatologist, Peijas Helsinki University Hospital (HUS), [email protected]; 5 Ph.D. Helsinki, Department of Population Study, University of Helsinki, Helsinki, Finland, [email protected]; 6MD Doctor of Medicine Professor (Assistant) at Tehran University of Medical Sciences, Tehran, Iran, [email protected]; 7MD, general practitioner in private clinic Pihlajalinna, Finland, [email protected] 1*Corresponding Author: Dr Hermon Eyob Fesseha, Cardiology resident, Peijas Hospital District of Helsinki and Uusimaa (HUS), University of Eastern Finland, Finland, Email: [email protected] Abstract Background: Reactive arthritis (ReA) is an inflammatory joint condition that typically develops days to weeks after a gastrointestinal or genitourinary infection. While it is often associated with a classic triad of arthritis, urethritis, and conjunctivitis, many patients may not exhibit all three symptoms. Previously known as “Reiter syndrome,” named after Hans Reiter, ReA is thought to result from an abnormal autoimmune response to infections caused by pathogens such as Salmonella, Shigella, Campylobacter, or Chlamydia. Recognizing this connection is essential for effective diagnosis and treatment. Case Description: A 67-year-old male developed reactive arthritis (ReA) following intravesical Bacillus Calmette-Guérin (iBCG) therapy for non-muscle invasive bladder cancer. Elevated inflammatory markers and a negative HLA-B27 result were noted. The symptoms were attributed to iBCG-related ReA, leading to the discontinuation of iBCG treatment. Outcome: Initial treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids was ineffective, necessitating disease-modifying antirheumatic drugs (DMARDs) for sustained remission and symptom control. Although chronic arthritis requiring prolonged DMARD therapy is uncommon, the patient required over 1.5 years of DMARD treatment to manage symptoms effectively. Keywords: iBCG intravesical Bacillus Calmette-Guérin, DMARD disease-modifying antirheumatic drugs, NSAIDs nonsteroidal anti-inflammatory drugs

Blog, Vol 2 Issue 2

Primary and secondary Pregnancy outcomes of Rural Women with Early Gestational Glucose Intolerance (EGGI) of a Tertiary care hospital in India

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Boddu Anuja1, Sanjev Dave2*, Prashant Dahire3, Rashmi Pandey4, Anuradha Dave 5, Ridima Kamal6 1*Dr. Boddu Anuja, Department of Community Medicine, SRTR Govt Medical College, Ambejogai, Beed, Maharashtra, India 2Sanjev Dave, HOD Community Medicine, Autonomous State Medical College, Auraiya UP-206244, India 3Associate Prof, SRTR Medical College, Community Medicine, Ambajogai, India 4Department of Community Medicine, Subharti Medical College, Meerut, Uttar Pradesh, India-250005 5Assistant Professor Biochemistry, Govt Medical College, Haridwar, Uttarakhand, India, Uttar Pradesh, India 6Public Health Consultant, Department of Community Medicine, All India Institute of Medical Sciences, New Delhi Submitted: 28 June 2025; Accepted: 10 July2025; Published: 20 July 2025 Corresponding Author: 2*Prof Dr Sanjev Dave, HOD Community Medicine, Autonomous State Medical College, Auraiya, UP206244.email: [email protected] Background: The rising prevalence of GDM is primarily driven by modifiable risk factors like obesity, poor diet, sedentary lifestyle, and pre-existing insulin resistance, which can be reduced through early interventions. Aim of study: This study aimed to determine early prediction of hyperglycemia and gestational diabetes mellitus in pregnant rural women by early screening of dysglycemia in 8-10 weeks of gestation. Methodology: This study was focused on 135 antenatal care (ANC) mothers in rural areas, given the importance of this population. It explored various parameters, including demographic factors, postprandial blood sugar (PPBS) levels, and Oral Glucose Challenge Test (OGCT) at specific times. Results: It was found that elevated early PPBS levels were linked to a greater risk of adverse pregnancy outcomes, including low birth weight, large for gestational age (LGA) babies, preterm births, increased NICU admissions, and elevated rates of pregnancy-related hypertension and gestational hypertension. Conclusion: Women with elevated early PPBS levels ≥110 mg/dl who received targeted management showed improvements in controlling blood glucose levels, potentially reducing adverse maternal and neonatal outcomes. The study advocates for early detection of elevated blood glucose levels, which enables timely interventions such as dietary education and lifestyle modifications.

Blog, Vol 2 Issue 2

The effect of dog rose fruit on blood glucose and lipids in the rabbits

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Taherah Mohammadabadi1* Submitted: 1 July 2025; Accepted: 20 July 2025; Published: 20 July 2025 1* Professor, Faculty of Animal Science and Food Technology, Agricultural Sciences and Natural Resources University, Iran. Email: [email protected] Corresponding Author: 1*Professor, Faculty of Animal Science and Food Technology, Agricultural Sciences and Natural Resources University, Iran. email: [email protected] Key Words: Dog Rose Fruit, Blood Glucose, Lipids, Triglyceride Abstract The current study was conducted to study the effects of dog rose fruit on blood sugar and fat in New Zealand rabbits. The 30 New Zealand rabbits were fed a control diet, and 15 % and 25% of the dogs rose randomly. At the end of the experiment, blood samples were taken from the rabbits’ hearts, and glucose, cholesterol, triglycerides, LDL, and HDL were determined. 25% dog rose decreased the concentration of cholesterol, triglyceride, LDL, HDL, and glucose compared to the control treatment (p<0.05). This research shows that dog rose fruit can reduce blood glucose and fat. Keywords: Blood sugar, blood fat, dog rose fruit, rabbit.

Blog, Vol 2 Issue 2

Benefits of milk thistle plant for diabetes and liver health

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Taherah Mohammadabadi1* Submitted: 10 June 2025; Accepted: 20 June 2025; Published: 10 July 2025 1* Professor, Faculty of Animal Science and Food Technology, Agricultural Sciences and Natural Resources University, Iran. Email: [email protected] Key Words: Milk thistle, Diabetes, liver health, silymarin Milk thistle properties The dried seed extract of the remarkable milk thistle plant, Silybum marianum, is a powerhouse of health benefits, containing 1% to 4% silymarin—a potent compound known for its strong antioxidant and liver-protective properties. This extract consists of 65% to 80% silymarin (a complex of flavonolignans) and 20% to 35% beneficial fatty acids, including linoleic acid. Milk thistle has a long history of use in traditional medicine. Still, recent statements from Cancer Research UK emphasize the need for further rigorous scientific trials to fully understand its potential role in cancer treatment and prevention. Nevertheless, this exceptional herb has garnered attention for its impressive ability to address gastrointestinal disorders, diabetes, hyperlipidemia, toxicity, and liver irritation. Silymarin is particularly effective for lowering LDL cholesterol levels in those with hypercholesterolemia and is a valuable ally in reducing blood sugar levels for individuals with type 2 diabetes. Additionally, its neuroprotective qualities prevent brain damage caused by blood clotting by combating molecular inflammation in the brain. Silymarin also stimulates liver regeneration and serves as a vital protector of liver health. Milk  Keywords: Milk thistle, medicinal herb, liver protection, diabetes.

Blog, Vol 1 Issue 4

IDF atlas 2025: Global Diabetes Prevalence and Gestational Diabetes Mellitus

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Nilanjan Dam1, Abhishek Verma2, Abhimanyou Singh Jasrotia3, Garima4, Jaya Bajpai5, Nitin6, Rishabh kumar7. 1,2,3,4,5,6,7 PG Students, Department of Community Medicine, Rama Medical College Hospital and Research Centre, RMCHRC, Kanpur Submitted: 20 April 2025; Accepted: 26 April 2025; Published: 28 April 2025 Corresponding Author: Dr. Nilanjan Dam, MD Fellow, Department of Community Medicine, RMCHRC, Kanpur, U.P., India. Email: [email protected] Introduction India is one of the seven countries and territories in the IDF South-East Asia region, a pivotal area in the fight against diabetes. Currently, a staggering 589 million people around the globe have diabetes, with 107 million of them in the SEA region alone. Alarmingly, projections indicate that this number could surge to 185 million by 2050. We must address this growing health crisis with urgency and commitment. Diabetes in India (2024) In India, the total adult population is 947,373,600, and 10.5% of the age group 20 to 79 are suffering from Diabetes, with 89,826900 adult cases. Diabetes has reached pandemic levels, and India has become the diabetes capital, with 89.8 million people affected in 2024 (10.5% of the population). This number is projected to rise to 156.7 million by 2050(Figure 1). It is crucial to shift our focus towards the primordial prevention of diabetes. We need a reliable test for predicting gestational diabetes mellitus (GDM) so that timely and appropriate interventions can be initiated [1].

Blog, Vol 2 Issue 1

Gestational Diabetes Diagnosis by DIPSI & IADPSG Criteria in observational study in Italian Population

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Sanjev Dave, Submitted: 12 April 2025; Accepted: 21 April 2025; Published: 28 April 2025 Corresponding Author: 1Prof Dr Sanjev Dave, HOD Community Medicine, Autonomous State Medical College, Auraiya (UP-206244). [email protected] There is non-universal consensus for Diagnosis of Gestational Diabetes Mellitus around the Globe, even in same country two guidelines are followed; one observational retrospectively study done in Italy, of the 1015 pregnant women who studied, 80% were (811) Italian [1]. Gestational diabetes mellitus (GDM) was identified in 113 cases (11.1%) using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, while the Indian Diabetes in Pregnancy Study Group (DIPSI) criteria diagnosed 105 patients (10.3%).

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