Journal of Asian-african Focus in Health

High Sugar Intake and Insulin Resistance in Obesity

2026-08-31T08:32:27+00:00

High sugar intake, particularly from added sugars and sugar-sweetened beverages, is known to contribute to the increasing prevalence of obesity and insulin resistance, which are risk factors for various metabolic diseases. The Objective of the review to determine the relationship between high sugar intake and insulin resistance in obesity based on published research findings. This study used a literature review method by searching articles through the PubMed databases published between 2021 and 2026. Article selection was conducted based on the PRISMA 2020 guidelines, resulting in 12 articles that met the inclusion criteria. Literature synthesis demonstrates that high sugar consumption, particularly liquid fructose, drives insulin resistance through hepatic de novo lipogenesis (DNL), accumulation of toxic plasma ceramides, low-grade systemic inflammation (elevated CRP and IL-6), gut microbiota dysbiosis, and altered expression of lipogenic genes (e.g., MEG3 and FTO). Isocaloric fructose restriction studies showed significant improvements in insulin sensitivity and reduction of hepatic fat, independent of substantial weight loss. Furthermore, a bidirectional vicious cycle exists where higher baseline insulin resistance reinforces sensory preferences for sugar-sweetened foods. There is a strong and causal relationship between high sugar intake and insulin resistance in obesity, mediated by complex molecular and metabolic pathways. Restricting added sugar intake, especially from sugar-sweetened beverages, is highly recommended as a primary prevention and clinical management strategy for obesity.

The Role of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Preventing Cardiovascular Complications in Type 2 Diabetes Mellitus

2026-08-31T08:39:20+00:00

Type 2 diabetes mellitus is one of the leading causes of morbidity and mortality associated with cardiovascular complications. Advances in antihyperglycemic therapy have demonstrated that sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) not only improve glycemic control but also play an important role in preventing cardiovascular complications. However, evidence regarding their mechanisms of action, clinical benefits, and roles in cardiovascular prevention remains scattered across the literature. Objective of the research to review the current scientific evidence regarding the role of SGLT2 inhibitors and GLP-1 receptor agonists in preventing cardiovascular complications in patients with type 2 diabetes mellitus based on published studies. This study employed a narrative literature review using a systematic literature search approach. A literature search was conducted in the PubMed database for articles published between 2021 and 2026, following the PRISMA 2020 guidelines. A total of 15 eligible articles were included, comprising randomized controlled trials, cohort studies, observational studies, systematic reviews, meta-analyses, and post-hoc analyses. Results of the research showed that the synthesis of the included studies demonstrated that SGLT2 inhibitors consistently reduced the risk of hospitalization for heart failure, major adverse cardiovascular events (MACE), cardiovascular mortality, and the progression of chronic kidney disease. In contrast, GLP-1 receptor agonists were more effective in reducing atherosclerotic cardiovascular events through improvements in vascular function and metabolic risk factors. Several studies also suggested that combination therapy with both drug classes may provide greater cardiorenal benefits than monotherapy. SGLT2 inhibitors and GLP-1 receptor agonists have complementary roles in preventing cardiovascular complications in patients with type 2 diabetes mellitus. Therapeutic selection should be individualized according to patients' clinical characteristics and cardiovascular risk profiles to optimize cardiorenal outcomes.

The Role of Conventional Chest X-Rays in Monitoring the Therapeutic Response in Patients with Congestive Heart Failure with Cardiomegaly and Pleural Effusion: A Literature Review

2026-08-31T08:50:17+00:00

Congestive heart failure is a progressive clinical syndrome with a global prevalence of 64.3 million cases. Cardiomegaly and pleural effusion are the main radiological manifestations requiring close monitoring during hospitalization. Conventional chest X-ray is an accessible, low-cost modality that can be performed serially to assess therapy response. The objective of the research to systematically review scientific evidence regarding the role of conventional chest X-ray in monitoring therapy response in Congestive heart failure patients with cardiomegaly and pleural effusion through a literature review approach. This study used a systematic literature review design. Literature searches were conducted in PubMed, Google Scholar, Cochrane Library, and Science Direct databases using keywords: conventional chest X-ray, congestive heart failure, cardiomegaly, pleural effusion, and therapy monitoring. Inclusion criteria included articles published from 2018-2024 with RCT, cohort, cross-sectional, systematic review, and meta-analysis designs. Literature selection used the PRISMA protocol. A total of 30 articles meeting the criteria were analyzed narratively and synthetically. Results showed that literature review showed that the Cardiothoracic Ratio (CTR) and pleural effusion grading on conventional chest X-ray are valid and reliable radiological parameters for monitoring CHF therapy response. CTR change ≥0.02 significantly correlates with hemodynamic and clinical improvement. Serial chest X-rays had sensitivity of 78-85% and specificity of 80-88% in detecting changes in congestion status. Pleural effusion grading significantly correlated with echocardiographic findings (r=0.71). Conventional chest X-ray is proven to play an important role in monitoring therapy response in CHF patients with cardiomegaly and pleural effusion. Systematic use of serial chest X-rays is recommended as part of the standard monitoring protocol for hospitalized Congestive heart failure patients.

Comparison of Regional and General Anesthesia in Eclampsia Patients Undergoing Caesarean Section: A Literature Review

2026-08-31T08:57:07+00:00

Eclampsia is a life-threatening obstetric emergency requiring prompt delivery and careful anesthetic management during cesarean section. This literature review aimed to compare the safety and effectiveness of regional anesthesia, particularly spinal anesthesia, with general anesthesia in patients with preeclampsia or eclampsia undergoing cesarean section. A narrative literature review was conducted using articles retrieved from PubMed, Google Scholar, ScienceDirect, and other relevant scientific sources. Articles published between 2018 and 2025 that examined maternal hemodynamic parameters and maternal or neonatal outcomes were included. Sixteen original studies with prospective, retrospective, observational, comparative, cohort, cross-sectional, and randomized designs were reviewed. Overall, spinal anesthesia was associated with more controlled intraoperative hemodynamics, fewer postoperative maternal complications, reduced intensive care requirements, shorter hospitalization, and better neonatal outcomes than general anesthesia. Although hypotension occurred in approximately 47–50% of patients receiving spinal anesthesia, it was generally transient and manageable with vasopressors. In contrast, general anesthesia was more frequently associated with hypertensive responses during laryngoscopy and intubation, pulmonary edema, renal complications, postoperative seizures, and delayed recovery. Neonates delivered under spinal anesthesia generally had higher first- and fifth-minute APGAR scores, lower rates of neonatal asphyxia, and reduced neonatal intensive care requirements. In conclusion, spinal anesthesia demonstrates a more favorable maternal and neonatal safety profile and should be considered the preferred technique when no contraindications are present. General anesthesia remains necessary in patients with severe thrombocytopenia, impaired consciousness, coagulation disorders, airway concerns, or clinical conditions requiring immediate airway control and rapid delivery.