Manipal University

About: Manipal University is a education organization based out in Manipal, Karnataka, India. It is known for research contribution in the topics: Population & Medicine. The organization has 9525 authors who have published 11207 publications receiving 110687 citations.

Factors that Correlate with Poor Glycemic Control in Type 2 Diabetes Mellitus Patients with Complications.

Abstract: Objectives: Inadequate glycemic control amongst patients with Type 2 diabetes mellitus (T2DM) indicates a major public health problem and a significant risk factor for the progression and complications caused by diabetes. Glycemic control is the main therapeutic objective for the prevention of organ damage and other complications arising from diabetes. Methods: This was a retrospective observational study of T2DM patients with complications, who were aged 40 years and older. The study was conducted retrospectively on medical records (in-patient and out-patient) obtained from a South Indian teaching hospital, Manipal, India. The patients included in the study had fasting blood sugar, postprandial blood sugar and HbA1c measured at least twice during follow-ups the previous year. Patients’ HbA1c levels were categorized into good control ≤7% (≤53mmol/ mol), and poor control >7% (>53mmol/mol), and patients’characteristics were analyzed. Results: A total of 657 patients were included in the study. The mean age was 59.67 (SD = 9.617) years, with 152 (23.1%) females and 505 (76.9%) males, and 514 (78.2%) patients had poor glycemic control. Most of the patients were on insulin mono-therapy [n = 271 (42.1%)], about a third of the patients were on combination therapy that included an oral hypoglycemic agent and insulin [n = 236 (36.6%)]. Patients with a history of more than 10 years of diabetes [n = 293 (44.6%)], had a family history of diabetes [n = 256 (39%)] and obesity [n = 95 (14.5%)], all had poor glycemic control. Conclusion: This present study indicated a significant association of gender (female), age, high-density lipoprotein level, duration of diabetes and type of medication, with poor glycemic control in T2DM patients that had secondary medical complications.

Effects of exercise training on exercise capacity in pulmonary arterial hypertension: A systematic review of clinical trials

Abstract: Background Pulmonary arterial hypertension (PAH) causes profound functional limitations and poor quality of life. Yet, there is only a limited literature available on the role of exercise training. This paper systematically reviews the effects of exercise training on exercise capacity in PAH. Methods A systematic search of databases (PubMed, CINAHL, CENTRAL, Web of Science and PEDRo) was undertaken for English language articles published between 1 st January 1980 and 31 st March 2015. Quality rating for all articles was done using the Downs and Black scoring system. Results Fifteen articles of good (n=4), moderate (n=6) and poor (n=5) quality were included in the review. Exercise interventions included aerobic, resistance, inspiratory muscle training or a combination, for 6-18 weeks. Improvements were seen in exercise capacity (six minute walk distance (6MWD) and peak VO2) by 17-96m and 1.1-2.1ml/Kg/min, functional class by one class and quality of life, with minimal adverse events. Conclusions There is evidence to recommend the use of exercise training as an adjunct to medical treatment in PAH. More clinical trials and research are required to assess the effects of different types of exercise programs in patients with PAH, while focussing on strong exercise endpoints to quantify the improvements seen with exercise training.

Identification and tuning of active sites in selected mixed metal oxide catalysts for cyclic carbonate synthesis from epoxides and CO2

Abstract: The reaction of CO2 with epoxides to produce cyclic carbonate is one of the important transformations of CO2 which has commercial applications. In this study, several mixed metal oxides were explored as potential catalysts for CO2 cycloaddition reaction with epoxides. The catalytic activities of these catalysts were correlated with their physicochemical properties. It is found that the catalytic activity in terms of cyclic carbonate yield has a good correlation with the number of weak and medium acid-base sites irrespective of type of metal oxides used indicating that a combination of acidity and basicity is an important factor for this reaction. Among, different mixed metal oxides, Mn-Ba and Sn-Ni mixed metal oxides were found to be effective solid catalysts for the synthesis of cyclic carbonate from epoxide and CO2. These mixed metal oxides showed higher activity compared to individual oxides and physical mixture of respective metal oxides. Different compositions of mixed metal oxides and the effect of calcination temperature of the catalyst on cycloaddition of epoxide and CO2 were studied. Mn-Ba oxide and Sn-Ni oxide catalysts with metal ratios of 4.3:1 and 1.5:1 respectively, showed better activity compared to other compositions. The effect of various reaction parameters was studied to know the influence on the conversion and yield. Under optimized reaction conditions, Mn-Ba and Sn-Ni mixed oxides gave 96.0 and 90.2% yield respectively for propylene carbonate. Thus, mixed oxides were shown to be highly efficient catalysts with good recyclability for propylene oxide and CO2 reaction and also can be applied to some other epoxides effectively to make cyclic carbonates.

Evidence-Based practice knowledge, attitudes, practice and perceived barriers among nurses in Oman

Abstract: Objectives: The aim of this study was to describe nurses’ practices, attitudes, knowledge/skills and perceived barriers in relation to evidence-based practice (EBP) in Oman. Methods: This descriptive cross-sectional study was conducted between February and November 2012. A self-reported 24-item questionnaire was used to measure EBP practices, attitudes and knowledge/skills among a convenience sample of 600 nurses working in four governmental hospitals in Muscat, Oman. Responses were scored on a one to seven rating scale. Barriers to EBP were measured on a five-point Likert scale using two subscales. Descriptive statistics and general linear regression were used to analyse the data. Results: A total of 414 nurses were included in the study. The greatest barriers to developing EBP among nurses were insufficient time for research (3.51 ± 0.97) and insufficient resources to change practices (3.64 ± 0.99). Nurses with more years of experience reported increased use of EBP (P <0.01), more positive attitudes towards EBP (P <0.001) and fewer barriers to research (P <0.01). Significant positive correlations were found between years of experience and practice (r = 0.16) and attitudes (r = 0.20). Nurses with a baccalaureate degree reported fewer barriers to research than those qualified at a diploma level (P <0.001). Nurses who perceived more barriers to research reported less use of EBP (P <0.001), less positive attitudes towards EBP (P <0.001) and limited EBP knowledge/skills (P <0.001). Conclusion: These findings provide a basis for enhancing nursing practices, knowledge and skills. Continuing education for nurses and minimising barriers is crucial to increasing the use of EBP in Oman.

Effect of Climate Change on Invasion Risk of Giant African Snail (Achatina fulica Férussac, 1821: Achatinidae) in India

Abstract: The Giant African Snail (Achatina fulica) is considered to be one the world’s 100 worst invasive alien species. The snail has an impact on native biodiversity, and on agricultural and horticultural crops. In India, it is known to feed on more than fifty species of native plants and agricultural crops and also outcompetes the native snails. It was introduced into India in 1847 and since then it has spread all across the country. In this paper, we use ecological niche modeling (ENM) to assess the distribution pattern of Giant African Snail (GAS) under different climate change scenarios. The niche modeling results indicate that under the current climate scenario, Eastern India, peninsular India and the Andaman and Nicobar Islands are at high risk of invasion. The three different future climate scenarios show that there is no significant change in the geographical distribution of invasion prone areas. However, certain currently invaded areas will be more prone to invasion in the future. These regions include parts of Bihar, Southern Karnataka, parts of Gujarat and Assam. The Andaman and Nicobar and Lakshadweep Islands are highly vulnerable to invasion under changed climate. The Central Indian region is at low risk due to high temperature and low rainfall. An understanding of the invasion pattern can help in better management of this invasive species and also in formulating policies for its control.