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2. The natural history of impaired glucose regulation amongst young adults and its effect on renal function

Author

Jadhakhan, Ferozkhan

Subjects
616.6, QH301 Biology
Abstract

Introduction: The risk of chronic kidney disease (CKD) aith impaired glucose regulation (IGR) is not well characterised. It is not clear whether individuals with IGR are at risk of developing CKD or whether the risk is confined to individuals who progressed to overt diabetes. Methods: This study consists of three main parts: 1) systematic review, 2) analysis to determine incidence and prevalence of IGR, and 3) analysis to determine risk of CKD in IGR. A systematic review was undertaken using a large dataset of patient records to describe the incidence and prevalence of IGR and to investigate the relationship between IGR and CKD. Results: The systematic review found no evidence associating risk of CKD in young adults aged 18 to 40 years with IGR. The THIN database analysis shows that incidence and prevalence increased consistently throughout the study period. Incidence of CKD was 4 times higher in IGR than normoglycaemia. The incidence of CKD stage (3-5) was approximately 4 times higher than the incidence of CKD stage (1-2) in the IGR cohort. Conclusion: The systematic review demonstrates that the risk of CKD in young adults with IGR remains to be elucidated. The THIN database analyses provides evidence of an increased risk of CKD amongst young adults with IGR. It also showed that IGR patients are at higher risk of CKD stage (3-5) compared to CKD stage (1-2).

Published
2017

3. The effects of neck exercise in comparison to passive or no intervention on quantitative sensory testing measurements in adults with chronic neck pain: A systematic review.

Author

Osborne, Daniel, Jadhakhan, Ferozkhan, and Falla, Deborah

Subjects
*NECK pain, *CHRONIC pain, *RESISTANCE training, *PHYSICAL training & conditioning, *ADULTS, *CLINICAL trial registries, *BACK exercises
Abstract

Background: Previous systematic reviews have identified the benefits of exercise for chronic neck pain on subjective reports of pain, but not with objective measures such as quantitative sensory testing (QST). A systematic review was conducted to identify the effects of neck specific exercise on QST measures in adults with chronic neck pain to synthesise existing literature and provide clinical recommendations. Methods: The study protocol was registered prospectively with PROSPERO (PROSPERO CRD42021297383). For both randomised and non-randomised trials, the following databases and trial registries were searched: AMED, CINAHL, Embase, Google Scholar, Medline, PEDro, PubMed, Scopus, SPORTDiscus, Science Citation Index and Social Science Citation Index from Web of Science Core Collection, clinicaltrials.gov, GreyOpen, and ISRCTN registry. These searches were conducted from inception to February 2022 and were updated until September 2023. Reference lists of eligible studies were screened. Study selection was performed independently by two reviewers, with data extraction and quality appraisal completed by one reviewer and independently ratified by a second reviewer. Due to high heterogeneity, narrative synthesis was performed with results grouped by exercise type. Findings: Three trials were included. Risk of bias was rated as moderate and the certainty of evidence as low or moderate for all studies. All exercise groups demonstrated statistically significant improvement at an intermediate-term follow-up, with progressive resistance training combined with graded physical training demonstrating the highest certainty of evidence. Fixed resistance training demonstrated statistically significant improvement in QST measures at a short-term assessment. Interpretation: Fixed resistance training is effective for short-term changes in pain sensitivity based on low-quality evidence, whilst moderate-quality evidence supports progressive resistance training combined with graded physical training for intermediate-term changes in pain sensitivity. [ABSTRACT FROM AUTHOR]

Published
2024
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