Introduction: Inadequate control of glycemia in type-II diabetic patients is an important community health issue and a risk factor for the progression of problems among diabetic patients. Hypertension is a common disease accompanying diabetes. Among patients with diabetes mellitus; high blood pressure is an important factor involved in poor glycemic control which has not been adequately assessed in Pakistan. Aim: The main goal was to evaluate the glycemic control status in type II diabetic patient depending on the basis of blood pressure levels. Place and Duration: In Medicine Department of Islamic International Hospital and Medical College, Islamabad for the duration of six months from January 2021 to June 2021. Methods: 220 adult patients >18 years of age with type-II diabetes mellitus were included. Patients with conditions such as liver cirrhosis, systemic infection, pregnant females, end-stage renal disease and those who were not observing diabetes treatment, counting exercise, dietary restrictions and medication, they were omitted from the anlaysis. By evaluating medical records; the patient’s demographic information was obtained which includes medical history, patient age, clinical history, gender, hypertension and type of DM in addition to the assessment of blood sugar level control. Statistical analysis was performed by using the SPSS 20.0. Results: The patients mean age was 58.10 ± 10.94 years with 35-80 years of age range. Of 220 patients, 145 (65.9%) had hypertension and 75 (34.1%) had normal blood pressure, and 7.72 ± 1.28 years was the patient’s mean duration of hypertension. The males have the HbA1c levels of 7.11 ±1.34 and 7.81 ±1.58 in females. In the hypertensive group of patients; mean HbA1c was higher significantly in comparison to the normal blood pressure group (p = 0.003). The HbA1c mean levels were also higher significantly among hypertensive patients with duration for over ten years (p = 0.04) and in subjects using diuretics (p = 0.03) and beta-blockers (p = 0.006) as an antihypertensive drug. Among patients with normal body mass index and nutritional recommendations, the mean (± SD) HbA1c in patients with hypertension was 5.13 ± 0.03 compared with patients with normal blood pressure (p = 0.00007). Conclusions: The control of Glycemia in type II diabetic patients is poor with hypertension. There is a complex relation of various factors, including gender, age, hypertension duration, and drugs that strongly effect control of glycemia among hypertensive patients and type-II diabetes mellitus. Keywords: Hypertension, Type 2 diabetes, HbA1c
The objective of this qualitative study is to examine the content of the fifth-year social studies textbook taught by the country, whether the content is relevant to the country's goal of a Single National Curriculum, and whether it addresses the future needs of society. The textbook contains Pakistan studies, history, geography, and economics. The findings show that the contents of the social studies textbook were relevant to the objectives of SNC but activities and model work were not as mental age of students as per psychological development mentioned in Piaget's theory of cognitive development. Children of age 7-11 can learn rules and responsibilities effectively, but logically in the developing stage, they might experience difficulty in grasping the legitimate implications of those standards in uncommon environments. It was recommended that content distribution should follow Piaget's developmental stage- based model and content selection should be based on the breadth and depth of concepts contained in the SNC.
Purpose The purpose of this study is to examine the impact of paradoxical leader behavior (PLB) on leader effectiveness (LE). The authors propose an underlying mechanism of this relationship and examine if the stated relationship is moderated by job-related and structural uncertainty in the organization. Design methodology approach The authors draw on survey data from 127 employees working in public and privately owned organizations and analyze data using AMOS and SPSS. Findings Results offer partial support to the authors’ hypotheses indicating that paradoxical leader behavior is positively associated to LE. As expected, the relationship is negatively moderated by structural uncertainty indicating that LE is weakened where there is structural uncertainty in the organization. However, in contrast to our other assumption, the authors find a positive (rather than negative) moderating role of job-related uncertainty in the PLB–LE relationship. Originality value Paradoxes are everywhere and inherently embedded in complex and dynamic organizational systems. To deal with paradoxes, organizational leaders often seek to act paradoxically. However, not every leader has a paradoxical mindset, and where a leader has such, it remains unclear if they will prove to be effective leaders. What can further influence the effectiveness of such leaders is the uncertainty that organizations face in the today’s dynamic environments. In this study, the authors contribute to paradox theory and the paradoxical leadership literature by unfolding the boundary conditions which can influence paradoxical leader’s effectiveness.
The aim of present study was to relate the urine bilirubin with milk likeliness Bilirubin is a substance of yellow color produced during normal process of body when red blood cells are broken down. It is fluid present in the liver. It helps in the digestion process of body. If bilirubin is present in the urine it may be sign of liver disordered. A urine test was performed by using urine strips for this purpose. The students which show positive sign for urine bilirubin had more attention towards milk drinking as compare to the students with negative sign.
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