The Hidden Threat: Endocrine Disruptors and Their Impact on Insulin Resistance.

The association between Insulin resistance, a global health issue, and endocrine disruptors (EDCs), chemicals interfering with the endocrine system, has sparked concern in the scientific community. This article provides a comprehensive review of the existing literature regarding the intricate relationship between EDCs and insulin resistance. Phthalates, commonly found in consumer products, are well-established EDCs with documented effects on insulin-signaling pathways and metabolic processes. Epidemiological studies have connected phthalate exposure to an increased risk of type 2 diabetes mellitus (T2DM). Perfluoroalkyl substances (PFAS), persistent synthetic compounds, have shown inconsistent associations with T2DM in epidemiological research. However, studies suggest that PFAS may influence insulin resistance and overall metabolic health, with varying effects depending on specific PFAS molecules and study populations. Bisphenol A (BPA), found in plastics and resins, has emerged as a concern for glucose regulation and insulin resistance. Research has linked BPA exposure to T2DM, altered insulin release, obesity, and changes in the mass and function of insulin-secreting ß-cells. Triclosan, an antibacterial agent in personal care products, exhibits gender-specific associations with T2DM risk. It may impact gut microbiota, thyroid hormones, obesity, and inflammation, raising concerns about its effects on metabolic health. Furthermore, environmental EDCs like polycyclic aromatic hydrocarbons, pesticides, and heavy metals have demonstrated associations with T2DM, insulin resistance, hypertension, and obesity. Occupational exposure to specific pesticides and heavy metals has been linked to metabolic abnormalities.

Navigating the Crossroads: Understanding the Link Between Chronic Kidney Disease and Cardiovascular Health.

Chronic Kidney Disease (CKD) has emerged as a global healthcare challenge affecting a significant portion of the world's population. This comprehensive narrative review delves into the intricate relationship between CKD and cardiovascular disease (CVD). CKD is characterized by kidney damage persisting for at least three months, often with or without a decline in glomerular filtration rate (GFR). It is closely linked with CVD, as individuals with CKD face a high risk of cardiovascular events, making cardiovascular-associated mortality a significant concern in advanced CKD stages. The review emphasizes the importance of precise risk assessment using biomarkers, advanced imaging, and tailored medication strategies to mitigate cardiovascular risks in CKD patients. Lifestyle modifications, early intervention, and patient-centered care are crucial in managing both conditions. Challenges in awareness and recognition of CKD and the need for comprehensive interdisciplinary care are highlighted. Recent advances in research offer promising therapies, such as SGLT2 inhibitors, MRAs, GLP-1R agonists, and selective endothelin receptor antagonists. Stem cell-based therapies, gene editing, and regenerative approaches are under investigation. Patient-physician "risk discussions" and tailored risk assessments are essential for improving patient outcomes. In conclusion, the review underscores the complexity of the interconnected CKD and cardiovascular health domains. Ongoing research, innovative therapies, and personalized healthcare will be instrumental in addressing the challenges, reducing the disease burden, and enhancing well-being for individuals facing CKD and cardiovascular issues. Recognizing the intricate connections between these conditions is imperative for healthcare providers, policymakers, and researchers as they seek to improve the quality of care and outcomes for affected individuals.

Assessment and comparison of sleep patterns among medical and non-medical undergraduates of Karachi: A cross-sectional study - SPECIAL REPORT.

To assess and compare patterns, habits and quality of sleep in undergraduate medical and non-medical students. The cross-sectional study was conducted from February to March, 2018, at Dow Medical College, Karachi, and Pakistan Air Force-Karachi Institute of Economics and Technology. Data was collected by self-reported questionnaires. Sleep quality of individuals was assessed using Pittsburg Sleep Quality Index. Data was analysed using SPSS 21. Of the 245 subjects, 137(55%) were medical students and 108(45%) were non-medical. Overall, 101(41.2%) subjects aid 8 hours of sleep was sufficient for them; 153(62.4%) reported daytime sleeping; and 168(68.5%) did not take naps. The duration of nap was >30 minutes in 118(48%) students. Factors affecting sleep were cited as electronic media 132(53.9%), caffeine 42(17.1%) and stress 126(51.4%). Of the total, 161(65.7%) subjects had poor sleep quality. There was no significant difference between medical and non-medical students (p>0.05). Majority of medical and non-medical undergraduate students were poor sleepers.

Pattern of Depression Among Patients of Myocardial Infarction in Karachi, Pakistan: A Cross-sectional Study.

Background Depression is a well-known risk factor that aggravates the chances of having various complications of acute coronary syndrome (ACS) such as cardiovascular collapse, heart failure, arrhythmia, recurrent myocardial infarction, and stroke among patients of ACS. ACS is a broad term which includes unstable angina as well as myocardial infarction (MI). The purpose of this study is to analyze the prevalence of depression among the patients of MI admitted to the tertiary care hospitals of Karachi, Pakistan. Methods and materials A hospital-based, cross-sectional study was conducted in which 375 admitted and diagnosed patients of MI with a mean age of 58 years were interviewed at the cardiology department of the Civil Hospital and National Institute of Cardio-Vascular Diseases (NICVD) Hospital, Karachi, from June to November 2017 using a self-made validated questionnaire, including patient health questionnaire-9 (PHQ-9). Results Overall, about 12.8% of the cases were screened positive for severe depression, 17.1% for moderately severe depression, 17.6% for moderate depression, and 32% for mild depression (total of 79.5%). Of 146 female subjects, 119 (81.5%) were found to be suffering from some degree of depression while 179 (78.2%) of the 229 males screened positive for some degree of depression. Furthermore, 79 (82.3%) of the 96 smokers were suffering from a range of depression while 219 (78.5%) of the 279 non-smokers suffered the same. In addition, the results of the PHQ-9 were cross-tabbed with age (p=0.34), gender (p=0.66), marital status (p=0.07), living status, smoking (p= 0.72), hypertension (p=0.55), and diabetes (p=0.19). Conclusion This study concludes that many of the patients of MI who were admitted to the tertiary care hospitals in Karachi, Pakistan, are suffering from major depressive behavioral changes following the cardiovascular event, which is known to aggravate the chances of having complications associated with it.