Oral glucose tolerance test clearance in type 2 diabetes patients who underwent remission following intense lifestyle modification: A quasi-experimental study.

Achieving diabetes remission (HbA1c<48mmol/mol without the use of anti-diabetic medication for 3 months) might not assure restoration of a normal glycemic profile [fasting blood sugar level <5.6 mmol/L and Post-Prandial (PP) blood glucose <7.8mmol/L]. The study investigates the factors associated with OGTT clearance in patients under type 2 diabetes remission. Four hundred participants who achieved remission during a one-year online structured lifestyle modification program, which included a plant-based diet, physical activity, psychological support, and medical management (between January 2021 and June 2022), and appeared for the OGTT were included in the study. OGTT clearance was defined by fasting blood glucose < 5.6 mmol/L and 2-hour post-prandial blood glucose <7.8 mmol/L post-consumption of 75g glucose solution. Of the 400 participants, 207 (52%) cleared OGTT and 175 (44%) had impaired glucose tolerance (IGT). A shorter diabetes duration (<5 years) was significantly associated with OGTT clearance (p<0.05). Pre-intervention use of glucose-lowering drugs showed no association with OGTT clearance (p<0.1). Post-intervention, the OGTT-cleared group showed significantly higher weight loss (p<0.05) and a decrease in HbA1c compared to the IGT group (p<0.05). Improvement in Insulin resistance and ß-cell function was also higher in the OGTT-cleared group compared to the IGT group (p<0.05). In conclusion, clearing the OGTT is a possibility for those achieving remission through lifestyle interventions. Higher weight loss, a shorter duration of diabetes, and improvement in insulin resistance were significantly associated with OGTT clearance in participants in remission. Future randomized controlled trials with longer follow-ups may help substantiate our findings.

A systematic review on iron-based nanoparticle-mediated clean-up of textile dyes: challenges and prospects of scale-up technologies.

The projected increase of the global textile industry to USD1002.84 billion in 2027 indicates a simultaneous increase in water pollution due to textile dye-rich voluminous effluents highlighting the requirement of source clean-up. This review analyzes the colossal amount of literature on lab-scale nanoremediation technologies involving iron-based nanoparticles and the mechanistic aspects. However, not many studies are in place with regard to execution because there are several bottlenecks in the scale-up of the technology. This review attempts to identify the limitations of scale-up by focusing on each step of nanoremediation from synthesis of iron-based nanoparticles to their applications. The most prominent appears to be the low economic viability of physico-chemical synthesis of nanoparticles, lack of appropriate toxicity studies of iron-based nanoparticles, and dearth of studies on field applications. It is recommended that above studies should be made not only on lab scale but also on field samples preferably utilizing microbial products based green synthesized iron-based nanoparticles and conducting toxicity studies. Besides, immobilization of the nanoparticles on renewable material greatly enhances the sustainability and economic value of the process. Furthermore, since the chemical composition of dye-rich effluents varies among industries, effluent specific optimization of process parameters and kinetics thereof is also a major prerequisite for scale-up. The value of this review lies in the fact that it brings, for the first time, a comprehensive and critical systematization of various aspects needing attention in order to scale-up such effective nanoremediation processes.

Beyond Maternal Mortality: A Systematic Review of Evidences on Mistreatment and Disrespect During Childbirth in Health Facilities in India.

The aim of this systematic review is to examine current evidence on the nature and extent of disrespect and abuse (D&A), mistreatment and practices of respectful maternity care of women during childbirth in India. Electronic databases were searched for published studies relevant to the topic. The search was conducted from May to September 2018. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct the review. A results synthesis was done using the Bowser and Hill landscape analytical framework for D&A of women during childbirth. Eleven studies are included in this review of which six were cross-sectional, four were qualitative, and one used a mixed-method approach. The type of abuse most frequently reported was the lack of respect and dignity (nondignified care) experienced by the women, usually in the form of negative and unfriendly attitudes of the providers. The least frequent form of mistreatment was physical abuse and detention in the facilities. The frequency of reported D&A was high, ranging from 10% to 77.3%. These behaviors were influenced by lack of education and empowerment of the women, their low socioeconomic status, poor training of providers and supervision, and a lack of accountability. Overall, disrespectful and abusive behavior had adverse impact on the utilization of health facilities for childbirth. It created a psychological distance between women and health providers. To our knowledge, this is the first systematic literature review to be conducted on respectful maternity care in India.