Background: Eighty percent of premature mortality from cardiovascular disease occurs in low-and middleincome countries. Hypertension, diabetes, and smoking are the top risk factors causing this disease burden. Objectives: The study aimed to test the hypothesis that utilizing community health workers (CHWs) to manage hypertension, diabetes and smoking in an integrated manner would lead to improved control of these conditions. Methods: This was a 2-year cluster (n ¼ 12) randomized controlled trial of 3,556 adults (35 to 70 years of age) in a single town in India, who were screened at home for hypertension, diabetes, and smoking. Of these adults, 1,242 (35%) had at least 1 risk factor (hypertension ¼ 650, diabetes ¼ 317, smoking ¼ 500) and were enrolled in the study. The intervention group had behavioral change communication through regular home visits from community health workers. The control group received usual care in the community. The primary outcomes were changes in systolic blood pressure, fasting blood glucose, and average number of cigarettes/ bidis smoked daily among individuals with respective risk factors. Results: The mean AE SD change in systolic blood pressure at 2 years was À12.2 AE 19.5 mm Hg in the intervention group as compared with À6.4 AE 26.1 mm Hg in the control group, resulting in an adjusted difference of e8.9 mm Hg (95% confidence interval [CI]: e3.5 to e14.4 mm Hg; p ¼ 0.001). The change in fasting blood glucose was À43.0 AE 83.5 mg/dl in the intervention group and À16.3 AE 77.2 mg/dl in the control group, leading to an adjusted difference of e21.3 mg/dl (95% CI: 18.4 to e61 mg/dl; p ¼ 0.29). The change in mean number of cigarettes/bidis smoked was nonsignificant at þ0.2 cigarettes/bidis (95% CI: 5.6 to e5.2 cigarettes/bidis; p ¼ 0.93). Conclusions: A population-based strategy of integrated risk factor management through community health workers led to improved systolic blood pressure in hypertension, an inconclusive effect on fasting blood glucose in diabetes, and no demonstrable effect on smoking. (Study of a Community-Based Approach to Control Cardiovascular Risk Factors in India [SEHAT]; NCT02115711).

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To study the relationship of Differential Leucocyte Count (DLC) with glycemic status in new cases of Type 2 Diabetes Mellitus (T2D) having normal Total Leucocyte Count (TLC) after it was noted that macrophages and monocytes have possible role in genesis of new diabetes in Covid-19 cases.Patients and Methods: Adult subjects with no history of T2D or any comorbidity having normal TLC were selected and classified as normal, prediabetes or T2DM based on OGTT. Demographics, glycemic status and hematological parameters were measured. Statistical analysis of the data was done using SPSS version 21.Results: 102 cases of new T2D mellitus and 164 non-diabetes controls (73 newly diagnosed prediabetes and 91 normal subjects) were compared. Absolute Monocyte Count (AMC) was significantly higher in T2D as compared to normal and PDM though values were within normal limits.Lymphocyte Monocyte Ratio (LMR) showed a decrease from normal to PDM to T2D; however only T2D was significantly different from normal. Monocytes and AMC showed significant but weak association with T2D. There was significant correlation between 1hrPG and AMC (r= 0.176, p<0.01), 1hrPG and LMR (r= -0.169, p<0.01); 2hrPG and AMC (r= 0.179, p<0.01), 2hrPG and LMR (r= -0.142, p<0.05). Conclusion:Early T2D cases with normal TLC have shown that immunological and inflammatory profile in early T2D is definitely different from established T2D of long duration and has few similarities with findings in Covid-19 cases: 1) Neutrophil Lymphocyte Ratio (NLR) is not raised in early T2D, 2) LMR is not increased in early T2D but definitely decreased, 3) absolute counts of monocytes are

Abdominal massage and heat application are prevalent non pharmacological interventions for reliving high gastric residual volume, abdominal distension and other some gastro intestinal functioning. It helps to boost the nutritional transition through the gastro intestinal tract, induces peristaltic movement, and consequently lowers the intra abdominal pressure. Moreover, it has been shown to be safe, effective, no pharmacological and non-invasive methods with no side effects. The aim of the study was to determine the effectiveness of multi interventional components on gastric residual volume, abdominal distension and gastro intestinal functioning among patients with nasogastric tube feeding admitted in Intensive Care Units. Subjects: patients who are admitted in the ICU and have nasogastric tube for feeding during the period of data collection. They are divided randomly (cover slip method) in to four groups of 15 in each group (three experimental groups and one control group).Setting: The study was conducted in the ICU’s of selected hospital .Results:  gastric residual volume, abdominal distension and gastro intestinal functioning were analysed for 4 groups and statistical significant improvement were found among the study groups than their control group. The frequency of vomiting episode was significantly reduced among study groups than the control group.