An innovative state-of-the-art health storytelling technique for better management of type 2 diabetes.

Background: Type 2 diabetes (T2D) is a chronic lifelong disease that requires long-term prevention and management strategies in a community setting. A health story is a novel technique that may be used as an effective tool for better prevention and management of T2D. Objective: The main objective of this study is to develop a story to be used as a social health technique based on contemporary scientific knowledge that may be used at a community level for better communication and management of T2D. Methods: A community-academic partnership was formed with a not-for-profit Nutrition Education, Awareness, and Training (NEAT) organization in Khyber Pakhtunkhwa, Pakistan. We agreed to develop a story that may be used as a health and nutrition education communication tool for better management of patients with T2D. The following phases were followed during the story creation process: (1) the theory phase, (2) the modeling phase, and (3) the evaluation phase. Raters evaluated the story to determine its literary and scientific quality, comprehensiveness, and T2D specificity. Results: The title of the story translated into English is "The Story of Diabetes-The Story of Success." It is text based and contains 86 pages in the local language, "Pashto," with an English translation. The story is divided into five chapters and describes the initial diagnosis, fear associated with the disease, issues related to referral to certified practitioners, the importance of a balanced diet, and related lifestyle habits. After story evaluation, the raters suggested its literary and scientific quality, comprehensiveness, and T2D specificity (Pearson correlation scores of >0.8). Conclusion: This unique story was created for T2D and found to be of significant quality in terms of its literary and scientific quality, as well as its comprehensiveness and diabetes specificity. As a result, it may be suggested that it can be used in subsequent studies to improve T2D management among adult patients.

Interaction between gut microbiota metabolites and dietary components in lipid metabolism and metabolic diseases.

Gut microbiota composition has caused perplexity in developing precision therapy to cure metabolic disorders. However, recent research has focused on using daily diet and natural bioactive compounds to correct gut microbiota dysbiosis and regulate host metabolism. Complex interactions between the gut microbiota and dietary compounds disrupt or integrate the gut barrier and lipid metabolism. In this review, we investigate the role of diet and bioactive natural compounds in gut microbiota dysbiosis and also the modulation of lipid metabolism by their metabolites. Recent studies have revealed that diet, natural compounds and phytochemicals impact significantly on lipid metabolism in animals and humans. These findings suggest that dietary components or natural bioactive compounds have a significant impact on microbial dysbiosis linked to metabolic diseases. The interaction between dietary components or natural bioactive compounds and gut microbiota metabolites can regulate lipid metabolism. Additionally, natural products can shape the gut microbiota and improve barrier integrity by interacting with gut metabolites and their precursors, even in unfavourable conditions, potentially contributing to the alignment of host physiology.

Effect of Ajwa date pits powder (Phoenix dactylifera L.) on body composition, lipid profile and blood pressure in patients with hyperlipidemia: A randomized clinical trial.

Objective: To evaluate the effect of Ajwa dates pit powder (ADP) on lipid profile, body composition and blood pressure in patients with hyperlipidemia. Materials and Methods: This randomized controlled clinical study was carried out on 40 patients with total cholesterol >200 mg/dl, triglycerides >150 mg/dl and BMI >25, of either sex, aged 30-50 years, who were recruited through written consent. The patients were divided into two groups (n=20 each): the ADP and the control group (CG). All patients received the doctor's prescribed class A statin (Rosuvastatin/ Atorvastatin) 10 mg/day, while 2.7 g ADP was given on daily basis before breakfast with lukewarm water for 40 days and the control group received the same amount of wheat flour. Body composition, blood pressure and lipid profile were determined at baseline, and after 20 and 40 days. Data were analyzed by using SPSS and GraphPad Prism. Results: ADP significantly reduced body weight (p<0.001), BMI (p<0.001), fat mass, body fat percentage, visceral fat area and waist circumference compared to the control group. Similarly, ADP significantly (p=0.000) decreased the serum level of total cholesterol and low-density lipoprotein. Conclusion: ADP may have the potential to improve dyslipidemia and obesity.

Gut Microbiota and Time-Restricted Feeding/Eating: A Targeted Biomarker and Approach in Precision Nutrition.

Each individual has a unique gut microbiota; therefore, the genes in our microbiome outnumber the genes in our genome by about 150 to 1. Perturbation in host nutritional status influences gut microbiome composition and vice versa. The gut microbiome can help in producing vitamins, hormones, and other active metabolites that support the immune system; harvest energy from food; aid in digestion; protect against pathogens; improve gut transit and function; send signals to the brain and other organs; oscillate the circadian rhythm; and coordinate with the host metabolism through multiple cellular pathways. Gut microbiota can be influenced by host genetics, medications, diet, and lifestyle factors from preterm to aging. Aligning with precision nutrition, identifying a personalized microbiome mandates the provision of the right nutrients at the right time to the right patient. Thus, before prescribing a personalized treatment, it is crucial to monitor and count the gut flora as a focused biomarker. Many nutritional approaches that have been developed help in maintaining and restoring an optimal microbiome such as specific diet therapy, nutrition interventions, and customized eating patterns. One of these approaches is time-restricted feeding/eating (TRF/E), a type of intermittent fasting (IF) in which a subject abstains from food intake for a specific time window. Such a dietary modification might alter and restore the gut microbiome for proper alignment of cellular and molecular pathways throughout the lifespan. In this review, we have highlighted that the gut microbiota would be a targeted biomarker and TRF/E would be a targeted approach for restoring the gut-microbiome-associated molecular pathways such as hormonal signaling, the circadian system, metabolic regulators, neural responses, and immune-inflammatory pathways. Consequently, modulation of the gut microbiota through TRF/E could contribute to proper utilization and availability of the nutrients and in this way confer protection against diseases for harnessing personalized nutrition approaches to improve human health.

Exploring the relationship of cognitive function with and without COVID-19 recovered schizophrenic patients.

Background: The Coronavirus disease 2019 (COVID-19) is linked to the deterioration of cognitive function among individuals suffering from schizophrenia. The purpose of this study was to compare the cognitive performance of schizophrenic patients before and after COVID-19. Methods: A longitudinal cohort study involving a sample of 219 individuals diagnosed with schizophrenia was enrolled between June 2022 and May 2023. The participants were split into two groups infected with COVID-19 (n = 165) and not infected with COVID-19 (n = 54). The data were gathered via a questionnaire on demographic characteristics, the Brief Assessment of Cognition in Schizophrenia (BACS), the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Activities of Daily Living (ADL) scale, and the Insomnia Severity Index (ISI). Results: The repeated-measures ANOVA showed that Among patients diagnosed with COVID-19, there was a deterioration in global cognitive function (before COVID-19 = -2.45 vs. after COVID-19 = -3.02, p = 0.007), working memory (before COVID-19 = -2.76 vs. after COVID-19 = -3.34, p < 0.00 1), motor speed (before COVID-19 = -1.64 vs. after COVID-19 = -2.12, p < 0.001), attention and speed of information processing (before COVID-19 = -1.93 vs. after COVID-19 = -1.16, p = 0.008). multi-variable analysis showed that several factors as having a secondary grade of education (ß = 0.434), experiencing insomnia (ß = 0.411)and the interaction between COVID-19 diagnosis and cognition at baseline (ß = 0.796) were significantly associated with cognitive deficits. At the same time, no significant associations were found between global cognition and clinical symptoms, autonomy, or depression (p > 0.05). Conclusion: The COVID-19 pandemic has significantly impacted various cognitive functions, such as verbal memory, working memory, and global cognition. Insomnia has been identified as the predominant determinant of cognitive impairment, alongside the confirmation of a COVID-19 diagnosis. Additional research is imperative to elucidate the diversification of cognitive functionality observed in individuals diagnosed with schizophrenia who have acquired COVID-19.

Improvement in cardio-metabolic health and immune signatures in old individuals using daily chores (Salat) as an intervention: A randomized crossover study in a little-studied population.

Background: Decline in cardio-metabolic health, immunity, and physical activity is associated with old age. Old people also find it difficult to engage in structured exercise programs. Therefore, there is a need to investigate common daily chores as an alternative for exercise that may also help in maintaining cardio-metabolic and immune health. Objective: We aimed to investigate whether Salat, an obligatory Islamic prayer involving various physical movements and closely resembling yoga, enhances the benefits conferred by the current guidelines for physical activity. Methods: A total of 30 overweight adults (mean (SD) age of 53.5 (8.7) years) participated in this study. For a 4-week duration, we compared the effects of Salat before/after meals (Pre-MS/Post-MS) on selected immunological and metabolic parameters in serum samples. We also compared the effects of both Pre-MS/Post-MS regimens in young and old subjects to observe any age-related effects. Results: Most of the baseline metabolic parameters and the count of immune cells were normal. Post-MS resulted in a significant reduction in body weight and percent body fat (%BF). Overall, Post-MS resulted in a clear leukocytosis with a significant increase in granulocytes, monocytes, and lymphocytes. When analyzing the lymphocyte compartment, a clear numerical increase was noted for T, B, and NK cells. The number of CD8+ T cells showed a statistically significant increase. Similarly, Post-MS induced leukocytosis in both young and old individuals, while the increase in granulocytes, monocytes, and lymphocytes was statistically significant in old subjects only. Conclusion: This study demonstrated that the Islamic obligatory and congressional Salat practice is capable of mimicking desirable pro-immune and pro-metabolic health effects. Clinical trial registration: (UMIN000048901).

Effect of Chloroquine and Hydroxychloroquine on Cytokine Release Syndrome in Patients with COVID-19.

Objective: To assess the effect of chloroquine and hydroxychloroquine on cytokine release syndrome (CRS) in adult patients with coronavirus disease 2019 (COVID-19) having mild to moderate symptoms.Methods: This blinded, placebo-controlled, randomized study was conducted in the Department of Medicine, Pak Emirates Military Hospital Rawalpindi, from June 1-15, 2020. A total of 150 hospitalized patients were enrolled after diagnoses with COVID-19 through reverse transcription polymerase chain reaction (RT-PCR). They were divided into three groups: hydroxychloroquine plus general care (HGC, n=50), chloroquine plus general care (CGC, n=50); and only general care (OGC, n=50). The HGC group received treatment with hydroxychloroquine 400 mg every 12 hours for day one and 200 mg for the next 4 days. The CGC group received treatment with chloroquine 250 mg every 12 hours for 7 days. The OGC group was kept as a control with only general care. After 12 days, the patients were screened for development of CRS through detection of interleukin 6 (IL-6) in serum samples by using Roche cobas e411 electrochemiluminescence immunoassay analyzer.Results: The mean duration from onset of symptoms to randomization was 7.65 days (SD = 3.287 days; range, 2-15 days). The mean age of patients was 37.57 (range 19-63) years. Results showed that out of a total 150 patients, only 10 patients (6%, mean=1.93; CI=1.89-1.97, P=0.651) developed CRS in all study groups. Four patients (8%) developed CRS in the HGC group, 2 patients (4%) in the CGC group, and 4 patients (8%) in the OGC group. There was no significant difference in the mean level of CRS among study groups.Conclusion: Administration of hydroxychloroquine and chloroquine has no effect in reducing the development of CRS in patients with COVID-19 having mild to moderate symptoms.

Status Of Wash In Rural Health Facilities Of District Agh, Azad Kashmir: A Cross-Sectional Observational Study.

BACKGROUND: Water, sanitation, and hygiene (WASH) practices play vital role for ensuring quality of health care with the prevention of infections. Low- and middle-income health care settings have very limited WASH services and practices. Pakistan is still fighting with the burden of communicable diseases that can be prevented by health education on WASH services and their practices which is the elementary requirement for achieving national developing targets. METHODS: This was the cross-sectional study conducted at 10 rural health centres (RHCs) of district Bagh by using purposive sampling technique. The duration of the study was 3 months from March to May, 2020. The tool used for the assessment of WASH services and practices was WASH FIT (Water Sanitation for Health Facility Improvement Tool) by WHO which had three categories for assessment in five different domains. RESULTS: The findings showed that none of the facility was meeting the national standards of water quality. 50% of the facilities had separate male and female toilets while none of them have managed the menstrual hygiene needs. Only 10% of toilets facilitates the people with limited and reduce mobility. Only 10% of the facilities had well trained personal for health care waste management. None of the facility had or provided suitable protective measures for the waste management personals. Hand hygiene compliance activities were in 40% of the facilities. CONCLUSION: The improvement of WASH in health care centres plays a fundamental role in the prevention of infections, but none of them had WASH assessment tools to monitor the status of WASH.