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Srivastava PR, Khare J, Saxena A, Jindal S. Correlation between acne and insulin resistance; experience from central India. J Family Med Prim Care 2024; 13:723-725. [PMID: 38605790 PMCID: PMC11006054 DOI: 10.4103/jfmpc.jfmpc_1232_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/24/2023] [Accepted: 10/03/2023] [Indexed: 04/13/2024] Open
Abstract
Introduction Acne is a common dermatological condition primarily seen in teenage and adolescent patients and is a major concern for cosmological issues. Along with environmental factors, the proliferation of basal keratinocytes in the sebaceous-pilosebaceous unit, abnormal desquamation of follicular corneocytes, and metabolic abnormalities play a significant role in the pathogenesis of acne development. Aim To study the causal relation between acne vulgaris and insulin resistance by calculating Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and identify the relation between insulin resistance and the severity of acne. Materials and Methods This was a retrospective study, where the data of patients with persistent Acne Vulgaris who were referred to the Endocrine department for evaluation of the hormonal and metabolic causes for acne vulgaris were analysed. The patient's clinical records were evaluated in whom there was no significant hormonal or metabolic abnormality identified known to cause persistent acne were included after proper consent and HOMA-IR was calculated. Results Of several patients with persistent acne, 150 patients were included in our study with the male-to-female ratio was 23:27. The mean age of patients was 33.2 years. The mean HOMA-IR in our acne patients was 1.62 ranging from 0.9-3.7. Sixty four (42.67%) patients had HOMA-IR more than 2.0, thereby suggesting insulin resistance. Conclusion Our study suggests the prevalence of insulin resistance in 42.67% of patients with acne, thereby providing the possibility of use of insulin modifiers as an adjunct acne treatment and stratifying the possible risk of metabolic syndrome in patients with acne. Also recommended is the control of dietary factors and lifestyle modification for the management of acne with insulin resistance.
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Affiliation(s)
- Prachi R. Srivastava
- Department of Dermatology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Jaideep Khare
- Department of Endocrinology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Animesh Saxena
- Department of Dermatology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Sushil Jindal
- Department of Endocrinology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
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Marbaniang I, Sangle S, Nimkar S, Zarekar K, Salvi S, Chavan A, Gupta A, Suryavanshi N, Mave V. The burden of anxiety among people living with HIV during the COVID-19 pandemic in Pune, India. BMC Public Health 2020; 20:1598. [PMID: 33097028 PMCID: PMC7582417 DOI: 10.1186/s12889-020-09656-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/07/2020] [Indexed: 01/18/2023] Open
Abstract
Introduction Globally, India has the third largest population of people living with HIV (PLHIV) and the second highest number of COVID-19 cases. Anxiety is associated with antiretroviral therapy (ART) nonadherence. It is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during the COVID pandemic, but data are limited. Methods During the first month of government mandated lockdown, we administered an anxiety assessment via telephone among PLHIV registered for care at a publicly funded antiretroviral therapy (ART) center in Pune, India. Generalized anxiety was defined as GAD-7 score ≥ 10. Sociodemographic and clinical variables were compared by anxiety status (GAD-7 score ≥ 10 vs GAD-7 score < 10). Qualitative responses to an open-ended question about causes of concern were evaluated using thematic analysis. Results Among 167 PLHIV, median age was 44 years (IQR 40–50); the majority were cisgender women (60%) and had a monthly family income < 200 USD (81%). Prior history of tuberculosis and other comorbidities were observed in 38 and 27%, respectively. Overall, prevalence of generalized anxiety was 25% (n = 41). PLHIV with GAD-7 score ≥ 10 had fewer remaining doses of ART than those with lower GAD-7 scores (p = 0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. Conclusions The burden of anxiety was high during COVID lockdown in our population of socioeconomically disadvantaged PLHIV in Pune and appeared to be influenced by concerns about ART availability. The burden of anxiety among PLHIV will likely increase with the worsening pandemic in India, as sources of anxiety are expected to persist. We recommend the regular use of short screening tools for anxiety to monitor and triage patients as an extension of current HIV services.
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Affiliation(s)
- Ivan Marbaniang
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site, Jai Prakash Narayan Road, Maharashtra, 411001, Pune, India. .,Department of Epidemiology, McGill University, Purvis Hall, 1020 Pine Avenue, Montreal, QC, H3G 1A2, Canada.
| | - Shashikala Sangle
- Department of General Medicine, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India
| | - Smita Nimkar
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site, Jai Prakash Narayan Road, Maharashtra, 411001, Pune, India
| | - Kanta Zarekar
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site, Jai Prakash Narayan Road, Maharashtra, 411001, Pune, India
| | - Sonali Salvi
- Department of General Medicine, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India
| | - Amol Chavan
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site, Jai Prakash Narayan Road, Maharashtra, 411001, Pune, India
| | - Amita Gupta
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site, Jai Prakash Narayan Road, Maharashtra, 411001, Pune, India.,Department of Medicine and Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA
| | - Nishi Suryavanshi
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site, Jai Prakash Narayan Road, Maharashtra, 411001, Pune, India
| | - Vidya Mave
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site, Jai Prakash Narayan Road, Maharashtra, 411001, Pune, India.,Department of Medicine and Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA
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Marbaniang I, Sangle S, Nimkar S, Zarekar K, Salvi S, Chavan A, Gupta A, Suryavanshi N, Mave V. The burden of anxiety among people living with HIV during the COVID-19 pandemic in Pune, India. RESEARCH SQUARE 2020:rs.3.rs-45412. [PMID: 36575764 PMCID: PMC9793829 DOI: 10.21203/rs.3.rs-45412/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Introduction : Globally, India has the third largest population of people living with HIV (PLHIV) and the second highest number of COVID-19 cases. Anxiety is associated with antiretroviral therapy (ART) nonadherence. It is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during the COVID pandemic, but data are limited. Methods: During the first month of government mandated lockdown, we administered an anxiety assessment via telephone among PLHIV registered for care at a publicly funded antiretroviral therapy (ART) center in Pune, India. Generalized anxiety was defined as GAD-7 score ≥10. Sociodemographic and clinical variables were compared by anxiety status (GAD-7 score≥10 vs GAD-7 score<10). Qualitative responses to an open-ended question about causes of concern were evaluated using thematic analysis. Results : Among 167 PLHIV, median age was 44 years (IQR 40-50); the majority were cisgender women (60%) and had a monthly family income <200 USD (81%). Prior history of tuberculosis and other comorbidities were observed in 38% and 27%, respectively. Overall, prevalence of generalized anxiety was 25% (n=41). PLHIV with GAD-7 score ≥10 had fewer remaining doses of ART than those with lower GAD-7 scores (p=0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. Conclusions : The burden of anxiety was high during COVID lockdown in our population of socioeconomically disadvantaged PLHIV in Pune and appeared to be influenced by concerns about ART availability. The burden of anxiety among PLHIV will likely increase with the worsening pandemic in India, as sources of anxiety are expected to persist. We recommend the regular use of short screening tools for anxiety to monitor and triage patients as an extension of current HIV services.
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Affiliation(s)
- Ivan Marbaniang
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | | | - Smita Nimkar
- Byramjee Jejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | - Kanta Zarekar
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | | | - Amol Chavan
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | | | - Nishi Suryavanshi
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | - Vidya Mave
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
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Marbaniang I, Sangle S, Nimkar S, Zarekar K, Salvi S, Chavan A, Gupta A, Suryavanshi N, Mave V. The burden of anxiety among people living with HIV during the COVID-19 pandemic in Pune, India. RESEARCH SQUARE 2020:rs.3.rs-45412. [PMID: 32818219 PMCID: PMC7430601 DOI: 10.21203/rs.3.rs-45412/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction Globally, India has the third largest population of people living with HIV (PLHIV) and the second highest number of COVID-19 cases. Anxiety is associated with antiretroviral therapy (ART) nonadherence. It is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during the COVID pandemic, but data are limited. Methods During the first month of government mandated lockdown, we administered an anxiety assessment via telephone among PLHIV registered for care at a publicly funded antiretroviral therapy (ART) center in Pune, India. Generalized anxiety was defined as GAD-7 score ≥10. Sociodemographic and clinical variables were compared by anxiety status (GAD-7 score≥10 vs GAD-7 score<10). Qualitative responses to an open-ended question about causes of concern were evaluated using thematic analysis. Results Among 167 PLHIV, median age was 44 years (IQR 40-50); the majority were cisgender women (60%) and had a monthly family income <200 USD (81%). Prior history of tuberculosis and other comorbidities were observed in 38% and 27%, respectively. Overall, prevalence of generalized anxiety was 25% (n=41). PLHIV with GAD-7 score ≥10 had fewer remaining doses of ART than those with lower GAD-7 scores (p=0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. Conclusions The burden of anxiety was high during COVID lockdown in our population of socioeconomically disadvantaged PLHIV in Pune and appeared to be influenced by concerns about ART availability. The burden of anxiety among PLHIV will likely increase with the worsening pandemic in India, as sources of anxiety are expected to persist. We recommend the regular use of short screening tools for anxiety to monitor and triage patients as an extension of current HIV services.
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Affiliation(s)
- Ivan Marbaniang
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | | | - Smita Nimkar
- Byramjee Jejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | - Kanta Zarekar
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | | | - Amol Chavan
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | | | - Nishi Suryavanshi
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
| | - Vidya Mave
- Byramjee Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site
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