A virtual assistance-based lifestyle intervention was effective, cost-effective and acceptable in reducing risk factors for diabetes in young employees in the information technology industry, and is potentially scalable.

Background/Objectives: Vitamin B 12 (B 12 ) deficiency is common in Indians and a major contributor to hyperhomocysteinemia, which may influence fetal growth, risk of type II diabetes and cardiovascular disease. The purpose of this paper was to study the effect of physiological doses of B 12 and folic acid on plasma total homocysteine (tHcy) concentration. Subjects/Methods: A cluster randomized, placebo-controlled, double-blind, 2 Â 3 factorial trial, using the family as the randomization unit. Results: From 119 families in the Pune Maternal Nutrition Study, 300 individuals were randomized. There was no interaction between B 12 and folic acid (P ¼ 0.14) in relation to tHcy concentration change and their effects were analyzed separately: B 0 vs. B 2 vs. B 10 ; and F 0 vs. F 200 . At 12 months, tHcy concentration reduced by a mean 5.9 (95% CI: À7.8, À4.1) mmol/l in B 2 , and by 7.1 (95% CI: À8.9, À5.4) mmol/l in B 10 , compared to nonsignificant rise of 1.2 (95% CI: À0.5, 2.9) mmol/l in B 0 . B 2 and B 10 did not differ significantly. In F 200 , tHcy concentration decreased by 4.8 (95% CI: À6.3, À3.3) mmol/l compared to 2.8 (95% CI: À4.3, À1.2) mmol/l in F 0 . Conclusion: Daily oral supplementation with physiological doses of B 12 is an effective community intervention to reduce tHcy. Folic acid (200 mg per day) showed no additional benefit, neither had any unfavorable effects.

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India is experiencing an escalating epidemic of diabetes for which the most cost-effective solution is prevention. Awareness is the first step towards prevention. We undertook a questionnaire-based study to evaluate gaps in awareness of different implications of diabetes among various sections of the urban population of Pune. Individuals aged ≥13 years (378 diabetic, 1122 non-diabetic) from different socio-economic backgrounds were interviewed using a structured questionnaire. Awareness regarding causes, symptoms, complications, treatment and preventive measures, curability of diabetes and long-term implications of diabetes in pregnancy was evaluated. An awareness score was calculated based on the percent of total questions correctly answered. Of those surveyed, 78 % scored less than 50 %, 44 % did not know the meaning of diabetes, 30 % could not name any of the risk factors, symptoms, complications and preventive measures for diabetes, and 70 % were unaware of the long-term risks of diabetes in pregnancy. As a group, diabetic participants scored marginally better than non-diabetic participants (mean score 39 vs. 31 %; P<0.001). Participants at high risk of diabetes (sedentary workers, non-diabetic participants with first-degree family history of diabetes and non-diabetic hypertensive participants) had poor knowledge about the condition (mean scores <40 %). Lower age, lower education and male gender were independently associated with poor awareness; education was the strongest predictor. Awareness regarding different implications of diabetes is poor in the population of Pune. There is a need for widespread and extensive public education campaigns to raise awareness and contribute to the national diabetes prevention initiatives.

Summary:Oral prazosin hydrocholoride (2-20 mglday) was administered to 38 patients with chronic congestive heart failure due to ischemic heart disease for 6-18 months. Half (19) of the patients were hypertensive and half ( 19) nonhypertensive. All were receiving furosemide (80 nig/day, orally) and 19 were receiving digoxin (0.25-0.5 mglday, orally) in addition to prazosin. Clinical radiological, mechanocardiographic, echocardiographic, and biochemical observations were made initially, at peak response, and at the end of 6 months. Prazosin improved left ventricular function indexes at rest, relieved symptoms and signs of congestion, and remained effective for 6-18 months with little or no increase in dose. There was no reflex tachycardia, tension-time indexes fell in all patients, angina was relieved in 8 patients who complained of it, and dyskinesia of left ventricular wall was corrected in 8 of 13 patients. The New York Heart Association functional class improved in all patients, but to a greater extent in hypertensive patients and in those not receiving concomitant digoxin. Mild, transient side effects occurred in 6 patients.