1.
Effects of COVID-19 in South African health system and society: An explanatory study.
Mbunge, E
Diabetes & metabolic syndrome. 2020;(6):1809-1814
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Abstract
BACKGROUND AND AIMS The underestimation of the severity of COVID-19 by the South African government resulted in delayed action against the pandemic. Ever since WHO declared COVID-19 a pandemic preventive action was comprehensively upgraded worldwide. This prompted South African authorities to implement physical distancing, self-isolation, closure of non-essential services, schools, travelling restrictions and recursive national lockdowns to mitigate the impact of COVID-19. This explanatory study sought to review the effects of COVID-19 in the South African health system and society. METHODS The study applied literature research of COVID-19 reports, policies from the National Department of Health, WHO, Africa CDC, and articles from Google Scholar, Science Direct, Web of Science, Scopus and PubMed. RESULTS The South African health system is affected by the lack of PPEs, increased mortality rates, mental health problems, substance abuse, resurgent of NCDs. The closure of international borders, global demand meltdown, supply disruptions, dramatic scaling down of human and industrial activities during lockdown cause socio-economic problems. The prolonged effects of lockdown on psychosocial support services resulted in the outbursts of uncertainties, acute panic, fear, depression, obsessive behaviours, social unrests, stigmatization, anxiety, increased gender-based violence cases and discrimination in the distribution of relief food aid. CONCLUSION To slow down the spread of COVID-19, massive testing must be adopted, contact tracing, isolation, and home quarantine guidelines for asymptomatic cases which promote behavioural change and reviewing of policy on food relief.
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Impact of lifestyle modification on some components of metabolic syndrome in persons with severe mental disorders: A meta-analysis.
Singh, VK, Karmani, S, Malo, PK, Virupaksha, HG, Muralidhar, D, Venkatasubramanian, G, Muralidharan, K
Schizophrenia research. 2018;:17-25
Abstract
BACKGROUND Metabolic syndrome (MS) is reportedly associated with high mortality from mostly cardiovascular causes in patients with severe mental disorders (SMD). Lifestyle interventions augment effective management of MS in patients with SMD. The present meta-analysis aims at updating the recent evidence on the effectiveness of lifestyle intervention for MS in patients with SMD. METHOD A literature search for English Language publications of randomized controlled trials (RCTs) from 2001 to 2016 comparing lifestyle modification (LM) with treatment as usual (TAU) in the management of MS were identified. Using PRISMA guidelines, 19 RCTs reporting data on 1688 SMD and MS patients and providing data on change in Body Weight, Body Mass Index (BMI) and waist circumference (WC) were included. Using random effects model, standardized mean difference between LM and TAU for the mean baseline-to-endpoint change in body weight, BMI and WC was calculated with a 95% confidence limit, on RevMan 5.3. The study was registered with PROSPERO (CRD42016046847). RESULTS LM had significantly superior efficacy in the reducing weight (-0.64, 95% CI -0.89, -0.39, Z = 5.03, overall effect p < 0.00001), BMI (-0.68, 95% CI -1.01, -0.35, Z = 4.05, overall effect p < 0.0001), and WC (-0.60, 95% CI -1.17, -0.03, Z = 2.06; overall effect p = 0.04), compared to TAU. LM was significantly more effective than TAU even in short duration (p = 0.0001) and irrespective of the treatment setting. CONCLUSION Interventions targeting LM in persons with SMD and MS are effective in reducing body weight, BMI and WC. It must be routinely recommended to all patients with SMD, ideally during commencement stage of second generation antipsychotic treatment.
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Red Yeast Rice (RYR) supplementation in patients treated with second-generation antipsychotics.
Bruno, A, Pandolfo, G, Crucitti, M, Troili, GM, Spina, E, Zoccali, RA, Muscatello, MRA
Complementary therapies in medicine. 2018;:167-171
Abstract
OBJECTIVE Second-generation antipsychotics (SGAs) have a negative impact on metabolic syndrome (MetS) risk factors for their effects on body weight and on metabolic parameters. Statins are widely used in the treatment of dyslipidemia; less is known on the ability of statins to treat SGAs-induced dyslipidemia, and nutraceutical approaches may represent promising strategies in SGAs-treated patients. Red Yeast Rice (RYR), the fermented product of the Aspergillaceae mold Monascus purpureus (red yeast) grown on white rice, has been shown to have a cholesterol-lowering effect which can be ascribed to monacolin K, although other active compounds may play a role management of hyperlipidemia. The present study was aimed to explore the efficacy and safety of RYR treatment on clinical and metabolic parameters in a sample of subjects receiving SGAs. METHODS Fifteen outpatients treated with SGAs assumed RYR at the oral daily dose of 200 mg/day (total monacolin K = 11.88 mg) for 30 days. Fasting levels of triglycerides, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and glucose were determined. RESULTS RYR administration resulted in a statistically significant reduction of LDL (p = 0.029), corresponding to 11.0% decrease from baseline mean value. No significant differences in clinical and in other and metabolic parameters were observed. CONCLUSIONS Our findings suggest that RYR, at the daily dose of 200 mg for 30 days, could be a promising agent to prevent and/or treat SGAs-induced hyperlipidemia. However, future adequately-powered and well-designed studies with long-term follow-up should evaluate RYR effectiveness, as an alternative option to statins, on the SGAs-induced metabolic side effects.