Background: Glucagon-like peptide 1 agonists differ in chemical structure, duration of action and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. Methods: We randomly assigned patients with type 2 diabetes and cardiovascular disease to the addition of once-weekly subcutaneous injection of albiglutide (30 mg to 50 mg) or matching placebo to standard care. We hypothesized that albiglutide would be noninferior to placebo for the primary outcome of first occurrence of cardiovascular death, myocardial infarction, or stroke. If noninferiority was confirmed by an upper limit of the 95% confidence interval for the hazard ratio of less than 1.30, closed-testing for superiority was prespecified. Findings: Overall, 9463 participants were followed for a median of 1.6 years. The primary composite outcome occurred in 338 of 4731 patients (7.1%; 4.6 events per 100 person-years) in the albiglutide group and in 428 of 4732 patients (9.0%; 5.9 events per 100 person-years) in the placebo group (hazard ratio, 0.78; 95% confidence interval [CI ], 0.68 to 0.90), indicating that albiglutide, was superior to placebo (P<0.0001 for noninferiority, P=0.0006 for superiority). The incidence of acute pancreatitis (albiglutide 10 patients and placebo 7 patients), pancreatic cancer (6 and 5), medullary thyroid carcinoma (0 and 0), and other serious adverse events did not differ significantly between the two groups. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. (Funded by GlaxoSmithKline; Harmony Outcomes ClinicalTrials.gov number, NCT02465515.) noninferiority; P = 0.06 for superiority). There seems to be variation in the results of existing trials with GLP-1 receptor agonists, which if correct, might reflect drug structure or duration of action, patients studied, duration of follow-up or other factors.

In a randomized, placebo-controlled trial, the effects of treatment with fish oil (eicosapentaenoic acid, 1.08 g/day) and mustard oil (alpha-linolenic acid, 2.9 g/day) were compared for 1 year in the management of 122 patients (fish oil, group A), 120 patients (mustard oil, group B), and 118 patients (placebo, group C) with suspected acute myocardial infarction (AMI). Treatments were administered about (mean) 18 hours after the symptoms of AMI in all three groups. The extent of cardiac disease, rise in cardiac enzymes, and lipid peroxides were comparable among the groups at entry into the study. After 1 year total cardiac events were significantly less in the fish oil and mustard oil groups compared with the placebo group (24.5% and 28% vs. 34.7%, p < 0.01). Nonfatal infarctions were also significantly less in the fish oil and mustard oil groups compared with the placebo group (13.0% and 15.0% vs. 25.4%, p < 0.05). Total cardiac deaths showed no significant reduction in the mustard oil group; however, the fish oil group had significantly less cardiac deaths compared with the placebo group (11.4% vs. 22.0%, p < 0.05). Apart from the decrease in the cardiac event rate, the fish oil and mustard oil groups also showed a significant reduction in total cardiac arrhythmias, left ventricular enlargement, and angina pectoris compared with the placebo group. Reductions in blood lipoproteins in the two intervention groups were modest and do not appear to be the cause of the benefit in the two groups. Diene conjugates showed a significant reduction in the fish oil and mustard oil groups, indicating that a part of the benefit may be caused by the reduction in oxidative stress. The findings of this study suggest that fish oil and mustard oil, possibly due to the presence of n-3 fatty acids, may provide rapid protective effects in patients with AMI. However, a large study is necessary to confirm this suggestion.

Monitoring of risk factors for non-communicable diseases (NCDs) over a period of time would be useful to make an indirect assessment of the actual disease burden. A cross-sectional survey was done among males aged 15-64 years, to study the prevalence of anthropometric and behavioral risk factors of NCDs. Information was collected on the sociodemographical factors, tobacco use, alcohol intake, diet, salt consumption, and physical activity, using a predesigned and pretested interview schedule. Anthropometric measurements were taken. A study found that prevalence of current smoking and use of smokeless tobacco was 14.2 and 54.9%, respectively. Alcohol intake was present in 22.7% of the study population. Per capita salt consumption per day was 14.6 g. A sedentary lifestyle was present among 19% of the men. Prevalence of overweight and obesity was 8.8% and 9.5%, respectively. Our finding suggested that greater surveillance of the NCD risk factors should be initiated as early as possible, in parallel with surveillance for communicable diseases.

BACKGROUND: Diarrhea is one of the major causes of morbidity and mortality in under-five children in developing world like India. WHO & Integrated Management of Neonatal and Childhood Illness (IMNCI) diarrheal management guidelines encourage mothers and caretakers to treat diarrhoea at home by giving ORS and oral rehydration therapy (ORT) to reduce the duration, severity, hospitalization, overall medical costs and death. OBJECTIVES: i) to assess the Knowledge, Attitude and Practice (KAP) of mothers on home care of acute diarrhoeal diseases and ii) To find out the factors affecting it, if any. MATERIALS AND METHODS: Community based cross-sectional study was conducted for three months duration among 76 mothers of slum-dwelling under five children (2-59 months) in Bankura. Information about KAP on management of acute diarrhoeal diseases was obtained by interview of mother using schedule based on WHO & IMNCI diarrheal management guidelines. RESULTS: In this study, majority mothers (64.7%) of children were of BPL category and mean schooling years of mothers was 7.97±4.12. Majority of mothers' knowledge was average (66.2%) and favourable attitude was (76.5%). While 72.2% mothers performed average practice; only 9.3% of mothers performed good practice. Education, occupation and socioeconomic status (SES) were the influencing factors of KAP on home care of diarrhea. Conclusions: A lot of gap was still present in knowledge, attitude and practice of home management of acute diarrheal diseases in an urban slum of Bankura. Health providers are needed to be skilled, motivated to percolate the information to mothers regarding home care of diarrhea.

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Background: In many areas of the world, including India, open defecation still remains the predominant norm and poses one of the biggest threats to the health of the people particularly in rural areas.Objectives were to study the prevalence and socio-cultural determinants of open defecation in rural area of Perambalur district.Methods: The present cross-sectional was done in a three randomly selected villages falling under rural field practice area of Department of Community Medicine of Dhanalakshmi Srinivasan Medical College and Hospital in Perambalur district (Tamil Nadu). Data was collected on 330 houses using pre-tested interview schedule developed using SBM-G questionnaire/schedule for ODF verification for household surveys which was modified for present study. Statistical analysis was done using Epi Info version 7 software.Results: Most (89.1%) of the study participants were above 30 years of age. Majority of respondents (39.4%) were illiterate. Prevalence of open defecation was 78.8%. Only 70 (21.2%) houses were using household sanitary latrines. Various reasons reported for open defecation were unawareness about availability of public latrine (41.5%), inadequate water (15.3%), insufficient space for latrine construction (16.9%), inadequate money (10%), considering open defecation better (16.6%) and caste based discrimination (0.4%). The study found sex, education and occupation of head of family to be significantly associated with open defecation.Conclusions: This study highlights the need for implementation well planned behavior change communication strategy to stop the menace of open defecation.

The results suggest that gender did not affect gains in muscle strength by isometric exercise coupled with electromyographic biofeedback in patients with knee OA.

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