The prevalence of Diabetes Mellitus (DM) in the Caribbean is high. BMI has been criticized as a measure for predicting T2 DM development because it does not discern between fat mass and muscle mass, nor does it reect an individual's fat distribution. The primary objective of the study was to determine the association between Indices using height, waist, hip, thigh, arm, and wrist circumference (cm) with development of T2 DM by comparing it to existing markers in test subjects and assessing their feasibility as predictive indicators for the development of Type 2 DM. In a cross-sectional study, a total of 331 subjects were involved in the study utilizing health centers and health camps in St Kitts (West Indies). Height was measured using Stadiometer, Weight using a calibrated digital weighing scale. Waist, hip, thigh, arm, and wrist circumference (cm) was measured using calibrated tape. ABI (Arav Body Index) is measured using a ratio of Waist and Combined Thigh & Height, Thigh to waist ratio (TWR) and Wrist to arm ratio (WAR) was compared to WHtR, WHR and BMI. ABI had the highest AUROC value among the ve adiposity indices (0.803, 95% condence interval [CI], 0.755 to 0.851; 0.785, 95% CI, 0.735 to 0.835 for WHtR; WHtR (0.785), WTR (0.672), WAR (0.652) and BMI (0.626). The cutoff values for ABI were 0.43. Among subjects with ABI less than 0.42, 83.8% (129) did not have type 2 DM and ABI more than 0.48, 90.2 % (51) had T2 DM. Hence, higher ABI strongly correlates with development of T2 DM. We conclude that ABI could be a more reliable tool for identifying individuals at risk of developing type 2 DM. This will help at-risk individuals to take preventive measures like lifestyle modication.
Introduction: The prevalence of hypertension in the Caribbean is high [26% in Saint (St.) Kitts]. It contributes to 51% of deaths secondary to ischemic heart disease and hence being a leading cause of death in the Caribbean region. Aim: To determine the association between Indices using height, waist, hip, thigh, arm, and wrist circumference (cm) with development of hypertension and to compare existing markers in test subjects and assessing their feasibility as predictive indicators for the development of hypertension. Materials and Methods: In the present cross-sectional study, a total of 635 subjects were involved in the study which included health centres and health camps in St. Kitts (West Indies). Study was conducted from December 2019 to November 2020. Height to Waist Ratio (HtWR), Arav Body Index (ABI), Waist to Thigh Ratio (WTR) and Wrist to Arm Ratio (WAR) was compared to common existing markers such as Waist to Height Ratio (WHtR), Waist to Hip Ratio (WHR) and Body Mass Index (BMI). Statistical analysis was done using using IBM Statistical Package for the Social Sciences (SPSS) version 23.0. Results: A total of 635 participants were included with most of the participants (n=540) between age group of 40 to 70 years, 35.4% (n=225) of participants were males and 64.6% (n=410) were females. In the present study, 47.92% (n=304) were non hypertensive and 52.1% (n=331) were hypertensive. In males, Area Under Receiver Operating Curve (AUROC) of HtWR (0.690) and Inverse ABI (0.632) was superior as compared to other anthropometric markers for predicting the development of hypertension and Waist to Thigh Ratio (WTR) (0.687) was superior in females. Among females recommended cut-off values for WTR is 1.6 and among males for HtWR and Inverse ABI were 2.3 and 2.84, respectively. Conclusion: Height to waist ratio and inverse ABI were more reliable markers in males for predicting the development of hypertension whereas, WTR being more reliable in females in population of St. Kitts. This will help at risk individuals to take preventive measures like lifestyle modification.
WHO has estimated expected cases of T2DM to rise to 57.2 million by the year 2025 and 80.9 million by the year 2030. Since past two decades there has been constant marked increase in the prevalence of diabetes in urban population of India with noticeable rise in southern part of India. The Prevalence of T2DM ranges from 10-16 % from region to region. The primary objective of the study was to determine the association between Indices using height, waist, hip, thigh, arm, and wrist circumference (cm) with development of T2DM and compare it to existing markers in test subjects and assessing their feasibility as predictive indicators for the development of T2DM. In a cross-sectional study, a total of 605 subjects were involved in the study which included health centers and health camps in Jaipur, India. The study duration was of 1 years (December 2019 to November 2020). Height-to-waist ratio (HtWR), ABI (Arav Body Index), Thigh to waist ratio (TWR) and Wrist to arm ratio (WAR) was compared to common existing markers such as WHtR, WHR and BMI.
Brain metastasis is rare occurrence with metastatic prostate cancer whereas bones, lung, pleura are the most common organs to be involved. During our cadaver dissection, it was found that the patient had a subdural hematoma secondary to brain metastasis as a result of metastatic prostate cancer. The case report presents with the dissection of Brain showing clear cut midline shift and Obliteration of anterior and posterior horn of ventricles. The symptoms in brain metastasis may not occur initially but may appear in late involvement. SubDural hematoma is of common occurrence in andropause age group especially who are receiving anti-coagulants or had minor head injury. The incidence of brain metastases may be increasing due to better imaging techniques. In such patients, use of anti-coagulants, anti-platelets or anti-VEGF therapy can increase the risk of intracranial hemorrhage hence used with caution.
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