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المخلص: أهداف البحث: يرتبط السلوك الخامل المرتفع بوظائف الأوعية الدموية المركزية المعاكسة والخلل الإدراكي. التدخلات لتخفيف الآثار السلبية للجلوس في مكان العمل مثيرة للاهتمام، ومع ذلك، فإن الأدلة التي تدعي فعالية مثل هذه التدخلات لا تزال تظهر. تهدف تجربة التقاطع العشوائية الحالية إلى استكشاف فعالية الجلوس لفترات طويلة مع أو بدون فواصل النشاط البدني على وظائف الأوعية الدموية المركزية والطرفية والمعرفية لدى البالغين. طرق البحث: أكمل واحد وعشرين من البالغين الأصحاء أربع ساعات من محاكاة ظروف العمل في ثلاث زيارات تجريبية: (1) الجلوس دون انقطاع؛ (2) يقطع الجلوس ثلاث دقائق سيرا على الأقدام كل ساعة؛ (3) يقطع الجلوس ثلاث دقائق من صعود السلم كل ساعة. تم قياس قطر الشريان السباتي والسطحي والسرعة ومعدل القص وتدفق الدم باستخدام الموجات فوق الصوتية المزدوجة عند 50 ميجاهرتز في ثلاث نقاط زمنية (الساعة صفر والثانية والرابعة) بينما تم تقييم الوظائف التنفيذية باستخدام إريكسن فلانكر المعتمدة على الحاسوب كل ساعة. النتائج: كان الانخفاض في أوقات رد الفعل (-30.59٪) والدقة (-10.56٪) أثناء ظروف الجلوس غير المنقطعة ذات دلالة إحصائية، بينما كان الانخفاض أقل أثناء الجلوس المتقطع بثلاث دقائق من المشي كل ساعة والجلوس بثلاث دقائق من صعود السلم كل ساعة. لم يلاحظ وجود فروق ذات دلالة إحصائية في وظائف الشريان السباتي والشريان الفخذي السطحي مع توقف الجلوس لمدة ثلاث دقائق من المشي كل ساعة والجلوس بثلاث دقائق من صعود السلم كل ساعة تدخل. الاستنتاجات: تم العثور على فواصل النشاط البدني متفاوتة الشدة أثناء الجلوس لفترات طويلة لتحسين أوقات رد الفعل. ومع ذلك، يجب تأكيد الفوائد الوعائية لفواصل النشاط البدني من خلال الدراسات المستقبلية في الوقت الفعلي. Abstract: Objectives: High sedentary behaviour is associated with adverse effects on central vascular function and cognitive function. Although interventions to mitigate the adverse effects of workplace sitting are intriguing, evidence of the efficacy of such interventions remains lacking. This randomised cross-over trial was aimed at exploring the effectiveness of prolonged sitting, with or without physical activity breaks, on central, peripheral vascular and cognitive function in adults. Methods: Twenty one healthy adults completed 4 h of simulated work conditions in three experimental visits: (1) uninterrupted sitting (SIT); (2) sitting interrupted by 3 min of walking every hour (LIT); and (3) sitting interrupted by 3 min of stair climbing every hour (MIT). Carotid (CA) and superficial femoral artery (SFA) diameter, velocity, shear rate and blood flow were measured with Duplex ultrasound at 50 MHz at three time points (hours 0, 2 and 4), and executive function was assessed with the computer based Eriksen Flanker task every hour. Results: The decreases in reaction time (−30.59%) and accuracy (−10.56%) during SIT conditions were statistically significant, and less of a decrease was observed under LIT and MIT conditions. No significant differences in CA and SFA function were observed with LIT and MIT interventions. Conclusion: Physical activity breaks of varying intensity during prolonged sitting improve reaction time. However, the vascular benefits of physical activity breaks should be confirmed in the future through long term studies in natural environment.

Summary: Background: The objective of this study is to investigate the trends of exposure and burden attributable to the four main metabolic risk factors, including high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body-mass index (BMI), and high low-density lipoproteins cholesterol (LDL) in North Africa and the Middle East from 1990 to 2019. Methods: The data were retrieved from Global Burden of Disease Study 2019. Summary exposure value (SEV) was used for risk factor exposure. Burden attributable to each risk factor was incorporated in the population attributable fraction to estimate the total attributable deaths and disability-adjusted life-years (DALYs). Findings: While age-standardized death rate (ASDR) attributable to high-LDL and high-SBP decreased by 26.5% (18.6–35.2) and 23.4% (15.9–31.5) over 1990–2019, respectively, high-BMI with 5.1% (−9.0–25.9) and high-FPG with 21.4% (7.0–37.4) change, grew in ASDR. Moreover, age-standardized DALY rate attributed to high-LDL and high-SBP declined by 30.2% (20.9–39.0) and 25.2% (16.8–33.9), respectively. The attributable age-standardized DALY rate of high-BMI with 8.3% (−6.5–28.8) and high-FPG with 27.0% (14.3–40.8) increase, had a growing trend. Age-standardized SEVs of high-FPG, high-BMI, high-SBP, and high-LDL increased by 92.4% (82.8–103.3), 76.0% (58.9–99.3), 10.4% (3.8–18.0), and 5.5% (4.3–7.1), respectively. Interpretation: The burden attributed to high-SBP and high-LDL decreased during the 1990–2019 period in the region, while the attributable burden of high-FPG and high-BMI increased. Alarmingly, exposure to all four risk factors increased in the past three decades. There has been significant heterogeneity among the countries in the region regarding the trends of exposure and attributable burden. Urgent action is required at the individual, community, and national levels in terms of introducing effective strategies for prevention and treatment that account for local and socioeconomic factors. Funding: Bill & Melinda Gates Foundation.

BACKGROUND: Fetal distress indicated as the cause for cesarean delivery based on cardiotocography findings most often does not reflect in the newborn assessment. Cardiotocography findings are just the decision indicators for cesarean delivery, in the background of labor abnormalities owing to deflexed head or occipitoposterior position. OBJECTIVE: This study aimed to investigate the association between cardiotocography findings and the attitude of fetal head and occiput position. STUDY DESIGN: We conducted a prospective observational study in a tertiary hospital in South India, including 304 women in labor with vertex presentation. Fetal attitude, the position of the head, labor abnormalities, and cardiotocography findings were noted. The chi-square test was applied using MedCalc software (version 19) to investigate the association of cardiotocography findings with the attitude of fetal head and occiput position. RESULTS: Cardiotocography findings had significant association with occipitoposterior position (relative risk, 1.70; 95% confidence interval, 1.32–2.19) and deflexed attitude of the fetal head (relative risk, 1.44; 95% confidence interval, 1.11–1.87). Among cases with occipitoposterior position, 10 of 42 (24%) had pathologic cardiotocography, and 19 of 42 (45%) had suspicious cardiotocography, whereas among cases with deflexed head position, these proportions were 12 of 61 (20%) and 24 of 61 (40%), respectively. CONCLUSION: Pathologic and suspicious cardiotocography tracings were more frequent in women with fetal occipitoposterior and deflexed head position. However, the association was not specific to any cardiotocography pattern.

Objective: The study was conducted to find the utility of three dimensional (3-D) ultrasound and Doppler sonography in differentiating benign and malignant endometrial lesions and to ascertain the association of sonology parameters with type, grade and stage of endometrial cancer. Materials and methods: Women attending the gynaecology department of a tertiary care hospital, with a provisional diagnosis of carcinoma endometrium were subjected to three dimensional power Doppler ultrasound evaluation and assessment of vascular patterns. VOCAL (Virtual Organ Computer-aided Analysis) software was used to assess volume, Vascularisation Index (VI), Flow Index (FI) and Vascularisation Flow Index (VFI). Ultrasound parameters were compared with histologic diagnosis to evaluate the diagnostic performance using Receiver Operating Characteristic (ROC) Curve. Results: Sixty-four women were included in the study, 33 with benign and 31 with malignant endometrial lesions. Larger endometrial volume and higher Doppler indices correlated with malignant lesions. The variables with good discriminatory potential between benign and malignant status were VI and VFI, having a sensitivity of 90.3% and specificity of around 80%. VFI (adjusted odds ratio of 40.4; (95% CI – 8.46–192.88), p value