Scientific Program

Conference Series Ltd invites all the participants across the globe to attend Global Experts Meeting On Diabetes, Hypertension & Metabolic Syndrome Melbourne, Australia.

Day 2 :

Keynote Forum

Vivek Kamath

India

Keynote: Diabetes Cure for Type1, Type 2 and Type 3 (LADA)

Time : 09.00

Conference Series Diabetes Meet 2018 International Conference Keynote Speaker Vivek Kamath photo
Biography:

Vivek Kamath founder of heal the world organization is a Reiki Master, Mexican Healer, Melchizedek Healer, Crystal Healer and Past Life Regression Therapy Expert. He has healed many diabetic patients (Type1, Type2, Type 3/1.5/LADA) without any medicines. He has also healed blood pressure (both high and low blood pressure), heart disease (removed the heart blockages), removed kidney stones, ovarian cysts, fibrosis of the breast, fatty liver, lungs disease, cured sinusitis, sever joint pain, lumbar L5 spinal disk pain, Sciatica pain, neck pain, constipation, rheumatoid arthritis, glaucoma,migraines,headaches,insomnia,stomach related problem, IBS, diabetic gum problems, skin problems( dry skin, eczema) and chronic nasal allergies, nasal blockages without any medicines. Some of the above treatments have been completed within a week to maximum 1 month duration.  

 

 

Abstract:

Statement of the Problem: Diabetes Type1, Type 2 and Type 3 complications.

As most of us are aware Type 2 diabetes can be controlled and cured completely with the diet, workouts (yoga), effective stress management and other healing methods. However, Type 1 and Type 1.5/3/LADA diabetes healing or complete cure is a big challenge because of our body’s immune system issue.

With type 1/1.5 diabetes, the body’s immune system attacks part of its own pancreas. Scientists are not sure why. But our immune system mistakenly sees the insulin-producing cells in the pancreas as foreign, and destroys them. This attack is considered as "autoimmune" disease. These pancreatic cells – called “islets” are the ones that sense glucose in the blood and, in response, produce the necessary amount of insulin to normalize blood sugars.

How do we protect that these “Islets” and how can we ensure that these cells produce enough insulin hormones? Using Reiki Distant Healing and telepathy techniques I have reduced 2 patients glucose level. One was type1 case of a nine-year-old boy with high fasting glucose level (350 mg/dL) and a very high random glucose level (450 to 500 mg/dL) despite of taking high dosage insulin on daily basis for nearly 2 years it was not going down. With the reiki healing techniques, it has come down to normal level within a month or so. The same experiment repeated recently on another young gentleman 38 years old patient who was suffering from Type 1.5/3/LADA disease. His FB glucose level was around 350 to 400 mg/DL from the last 8 years despite of taking strong dose of insulin on daily basis; glucose level was not going down. Within a month after initialing Reiki healing treatment, his FB glucose level came down to 190 mg/DL.  He is showing recovery from diabetes. The conclusion from our healing study are that these healing and cure works mainly on 1 ) Energy level of the healer 2) Belief in self for the patients 3) Belief in Reiki Channel and universal energy 4) Intention and thought process/brain wave  frequency in alpha state matching between healer and patients. If all of these things are perfect, any disease can be healed. We have made an initial breakthrough in terms of reducing their glucose level. The above study has been followed on other healing such as Lumbar L5 Spine disk pain healing. It worked amazingly and patient has shown drastic improvement in their pain relief. 80% relief on pain has been felt. We are continuing with our research on this healing for various other chronic disease cure not only type1/3 diabetes. The recent healing on Type 2 Diabetes provides us information that even if the patient has any psychological problems, it could hamper the glucose level. A Type 2 Diabetic patient’s PPBS was not going down from 290 mg/dl although his Fasting blood glucose was showing normal. We were not able to find the reason behind it. When we did the detailed consulting with the patient he was suffering from Insomnia problem. We immediately healed his insomnia problem and within few days his PPBS level came down to 110 mg/dl from 290 mg/dl. Based on these findings, it is very clear now, doctors need to find the stress factor in patient. It could be anxiety, phobia, insomnia, greed, morbid jealousy, vengeance, insecurity, depression or any chronic psychological diseases. 

In India, we have seen most of border case diabetic patients can be healed by providing proper guidance on diet and basic workouts. Most of the rural people in India take 2 or 3 large meals per day. We have identified nearly 50 cases of people like this and suggested them to take a balanced meal and meals at intervals (splitting 3 large meals into 3 small snacks and 3 small meals). These folks followed the same and they came back with normal fasting glucose level within 2 weeks of our recommendation. 

In nut-shell, diabetes healing requires below steps

1.     Understanding the reason behind diabetes is the Key

2.     GP/Doctor needs to counsel the patient after identifying the reason

3.     If they have psychological problems such as anxiety, stress, depression, insomnia, schizophrenia, Parkinson’s disease and phobia or any other problems that needs to be cured first before healing diabetes. People with high blood glucose level or uncontrolled diabetes have also prone to psychological problems.

4.     In Western countries most of the people suffer from diabetes because of obesity, overeating, excessive alcohol consumption, smoking or drugs addiction.

5.     Counseling from the doctors/GP is the key for controlling paitent’s diabetes.

6.     Any healing methods such as Reiki, Mexican Healing, Crystal or Pranic Healing can be followed to bring back the glucose level to normal level

7.     Indian techniques such as Yoga, Mudra or western aerobic workout can also be followed to control or cure diabetes especially in TYPE2 Diabetes.

Blood Pressure Management/Cure

1.     We have used Reiki and Mexican Healing to bring down the blood pressure of our few patients

2.     It has experimented in 1 Mexican Healing we could able to bring 20 units for few patients. ( From 180/120 mmHg to 160/90 mmHg)

3.     Even people who are suffering from low blood pressure has been cured completely and their BP reading has been brought back to normal 120/80 mmHg within 21 days of Reiki Healing.

 

 

Keynote Forum

Premanidhi Panda

Dr. Panda Diabetes Institute, India

Keynote: Concept of diabetes should be changed

Time : 10.00 AM

Conference Series Diabetes Meet 2018 International Conference Keynote Speaker Premanidhi Panda photo
Biography:

Premanidhi Panda completed his MBBS from Berhampur University, India and Post-doctoral studies, MD (MED) from Utkal University School of Medicine. He is the Director of Dr. Panda Diabetes Institute, India, a premier Diabetes Hospital and Research Centre in India. He worked in Tisco Hospital (India), Benghazi Medical (Libya), and Medwin Hospital. He was awarded with India’s Best Doctor Award-2013 (diabetes) by Medgate Today Survey. He was awarded MRCP, FRCP by Royal College of Physician and Surgeon. He published more than 20 papers in reputed journals and received several national and international awards for his contribution in Diabetes.

Abstract:

Introduction:- Diabetes mellitus often simply referred to as diabetes—is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.

It is my view many things should be changed in diabetes concept.

My views in diabetes for which i have got more number of control diabetes patient.

 (1)Definition of diabetes should not be based on blood sugar. it is my observation only glycosylated  haemoglobin (hb1ac) is the criteria to diagnose as diabetes when more than 6.5%. it  depends   upon  what  type of food  taken  in the previous night.it is   my observation  if we consider that  blood  sugar  in 30%  cases will be  incorrect.so  i  used  consider  upon  hba1c   rather than  FBS and 2hr  PPBS.I have got more then 90000 patient all are having HBA1C 5.5 TO 6.4.

(2)Stop polished rice. carbohydrate in polished rice is not equal to carbohydrate contained  in wheat. particular importance for India and china scenarios.

WHEAT VS RICE

 

WHEAT

RICE

ENARGY(Kcal)

360

370

CARBOHYDRATE

51.6 gm

79 gm

Dietary Fibre

13.2 gm

1.3 gm

FAT

9.72 gm

0.66 gm

Protein

23.15 gm

7.13 gm


Thus I advised my patient to consume Wheat than rice.  Another point Indians can consume more rice than wheat. In a good items Indians will consume too much rice. Thus “ZERO RICE”.

(2)A diabetic patient will have good control with by avoiding sugar based fruits.

Know your fruits
(apple VS tomato)

*Avoid all sugar based fruits apple:-I used to advice not to take apple till blood sugar comes to normal. Previous slogan has been changed from:- “an apple a day keeps the doctor away.” To “A Tomato a Day Keeps the Doctor Away.” I have seen in my study a person with diabetes consuming apple blood sugar has increased greatly in comparison to tomato. Although apple is advised for its anti-oxidant property.  Now a days it has been seen that Tomato contains Lycopene which is more potent than any Anti-oxidant. That too it has got anti cancerous property. 

 

APPLE

TOMATO

Calories

52CAL

18CAL

PROTEIN

0.26 Gms

1.80Gms

Carbohydrate 

13.8gms

1.72gms

Fat

0.17gms

0.20gms

Dietary Fiber

3Gm

2Gm

Cholesterol

0

0

Sodium

0

13mg

Potassium

144mg

331mg

Lycopene  

0

Present

(Anti Cancerous Property),

Here  i want to emphasize  apple  does  not  contain any “Ambruta” that  is  gods  any  very beneficial things.it contains  only  phytooxidant and fibre. Thus I used to advice “tomato” and “mushroom”, lemon. avocado(HEATHIEST  FRUIT), strawberry, guava.

 

 (3)Mango should not be advised. It is  my  observation  by taking one mango  blood  sugar  increases  to 3-4 times. Please do not advice to the world  “mango” is good for  diabetes. instead  “avocado” worlds healthiest  fruit.

4) Instead of apple please advise tomato and avocado

 (5)I am against insulin in type II diabetes except six indications

 My view insulin therapy in type II diabetes: - Six conditions in type II diabetes.

  • (1)In Type II Diabetes when maximum oral hypoglycaemic drug does not work
  • (2)You are having infection
  • (3)You are undergoing surgery
  • (4)When target organs involved(brain, heart, kidney, nerves)
  • (5)Fulminating Conditions
  • (6)Gestational Diabetes   With Previous History of Type II diabetes

(6)Pioglitazone is a marvelous drug Do not blame it. i and all my family members including more than 60000 patients are under pioglitazone.no side effects till now i have received. i strongly say "Pioglitazone" never causes bladder cancer. you are not blaming polluted foods, polluted drinks, polluted environment, nuclear explosion which causes change in biomarkers. out of 61millions patient only 8 persons develop bladder cancer blame "Pioglitazone"

Pioglitazone is the golden drug 

There is great war for Pioglitazone. It Causes Bladder Cancer, Fracture, Heart Failure for which On June 9, 2011 the French Agency for the Safety of Health Products decided to withdraw pioglitazone in regards to high risk of bladder cancer. On June 10, 2011 Germany's Federal Institute for Drugs and Medical Devices also advised doctors not to prescribe the medication.
On June 15, 2011 the U.S. FDA announced that pioglitazone use for more than one year may be associated with an increased risk of bladder cancer. April 2014 The U.S District Court in western Louisiana ordered a $6 billion penalty for Takeda Pharmaceutical Company. 2013 the health ministry of India has suspended the sale of Pioglitazone. But after one month on July 2013 ban lifted. Here I want to emphasize that till now only 8 cases of Bladder cancer found out. Why we will blame Pioglitazone. In my Institute I have given >20000 Patients are under pioglitazone. alone or Mixed with other drug. Including me I am under Pioglitazone for last 8Years Except Pedal oedema and few cases of Weight gain I have not found any other serious consequences. Rather I will tell Its an Golden drug as anti diabetic drug to reduce the Postprandial Hyperglycaemia. Pioglitazone gives good glycaemic control than Voglibose.I choose Voglibose as it also reduces post Prandial hyperglycemia.
Voglibose:-
 

Voglibose is an an alpha-glucosidase inhibitor used for lowering post-prandial blood glucose levels in people with diabetes mellitus. Voglibose delays the absorption of glucose thereby reduces the risk of macrovascular complications. Voglibose is a research product of Takeda Pharma, a Japan-based company. Postprandial hyperglycemia (PPHG) is primarily due to first phase insulin secretion. Alpha glucosidase inhibitors delay glucose absorption at the intestine level and thereby prevent sudden surge of glucose after a meal. There are three drugs which belong to this class, acarobose, miglitoland vogliboseof which voglibose is the newest. Voglibose scores over both acarbose and miglitol in terms of side effect profile.Voglibose does not increase the weight or causes Pedal Oedema.
Sideffects are Hypoglycemia, delay in digestion and absorption of disaccharides, abdominal pain and swelling, increased flatus, intestinal obstruction like symptoms, fulminant hepatitis, serious hepatic dysfunction with increased AST (GOT), ALT (GPT), LDH, gamma GTP or ALP, jaundice, diarrhea, loose stools, borborygmus, anorexia, nausea, vomiting, heartburn, anemia, numbness, edema, blurred vision, hot flushes, malaise, weakness hyperkalemia, increased serum amylase. But in my study mild loose stool is the common side effects.

In my study:-
Present study was open with 2000 cases , randomized parallel group comparison of two active treatment groups over a six months period. Sixty patients of either sex in the age group of 30-75 years, suffering from type 2 DM, with FBG> 126 mg/dl and HbA1c between 7- 10 % were taken. Pioglitazone and voglibose were given to 2000 cases given 3months & 3 months trial in each drug to all. Different parameters are taken into consideration like FBS, 2Hr PPBS, HBA1C, Blood Urea, Serum Creatinine, Serum cholesterol & Triglyceride. It has been observed Pioglitazone reduces FBS,2Hr PPBS, HBA1C, Blood Urea,Serum Creatinine ,Cholesterol,Triglyceride more than Voglibose. In my study also seen in mixed drug like Glimiperide+Metformin+Pioglitazone works better than Glimiperide+Metformin+Voglibose. One case was Under Inj Humalog 78Units before breakfast 72 Before dinner Blood Sugar does not come to normal level. Only with Inj Novomixtard 14Units BBF & 8Units Before Dinner Plus Combined drug Glimeperide1Mg+Metformin500+Pioglitazone 15mg ½ Tab BID Blood sugar came down to 89FBS & 127Mg PPBS. Out of 2000 cases with voglibose FBS after taking for 3 months comes down to 90 to 136mg/dl. But with same Patient with Pioglitazne comes down to 80-120mg/dl.2Hr PPBS come down with voglibose 110- 168mg/dl.HBA1C comes down to 5.9 to 6.9.Urea,Creatinine,Cholesterol& Triglyceride remaining same .In few cases little low.
But with Pioglitazone Maximum Patients FBS comes to 78-120mg/dl.2Hr PPBS to
95 to 145mg/dl.HBA1C 6.1 to 5.4.Urea, Creatinine, Cholesterol, Triglyceride to low level. Side effects with Pioglitazone Side Effects limited to Pedal Oedema in all my Patient as description in the Many Text book. In My Opinion There is not necessary to have Panic to Patient that this will cause bladder cancer. In Every drugs many side effects are there.I have used this drug since Nine Years. I have discussed with  Several Diabetologist and Endocrinologist all have supported me. With Voglibose diarrhea, loose stools, borborygmus, anorexia, nausea, vomiting, heartburn, anemia, numbness, edema are common side effects observed.
Conclusion:-In my study shows there is no reason for any side effects OR banning this drug or writing Warning to make Patient in Panic.Pioglitazone works better than Voglibose in better control of blood sugar.Out of >45000Patients >20000Patients are under Pioglitazone.

 (7)All diabetics should be advised to take 20petals of raw garlic, two onions and one lemon a day to protect heart, kidney and liver fatty change can be reversed by taking these three.

 (8)I do not find micro vascular and macro-vascular complications Insulin vs OHD. I may request to invite me give my views in the scientific stage. 

  • Diabetes and its Treatment
    Diabetes Complications
    Diabetic Eye Disease (Diabetic Retinopathy)
    Diabetic Kidney Disease (Diabetic Nephropathy)
    Clinical Diabetes and Diagnostic Approaches
    Diabetes Management
    Advanced Technologies & Treatments for Diabetes
    Genetics of Diabetes
    Diabetes Oral Medications/Anti-Diabetic Medications
    Emerging Focus in Diabetes Research
Speaker
Biography:

 

 

Abstract:

Diabetes has become one of the epidemic diseases producing  serious physical damage and economic burden in the global population. However, Type 2 Diabetes Mellitus (T2DM) is a major kind of diabetes defined as non-insulin dependent diabetes mellitus which is more prevalent in occurring the chronic diseases and  recognized as one of the multifactorial disease. Several prospectives and case-control studies have confirmed the Q192R polymorphisms in Paraoxonase-1 (PON1) gene as disease causing variant in multiple diseases in the global wide. The earlier studies from Saudi Arabia with Q192R polymorphism has confirmed as the positive associations and the present study aims to investigate the possible association between Q192R polymorphism and T2DM in the Saudi population. In this study, we have selected 400 T2DM cases and 400 healthy controls from the Saudi subjects. Serum sample was used for the biochemical analysis and peripheral blood collected in the EDTA tube was used for molecular analysis to carry out the extraction of genomic DNA. Genotyping was performed in all the 800 samples with rs662 (Q192R) polymorphism with polymerase chain reaction-restriction fragment length polymorphism method followed by 2.5% of agarose gel. The clinical characteristics were significantly higher in T2DM cases compared with controls, and also with both allele and genotype frequencies [R vs. Q: odds ratio (OR), 1.659; 95% confidence interval (95% CI), 1.344-2.048; P = 0.0002; RR vs. QQ; OR, 2.1; 95% CI, 1.3-3.2; P = 0.001; QR+RR vs. QQ; OR, 2.101; 95% CI, 1.583-2.788; P = 0.0002)]. Multiple regression analysis showed positive correlation of lipid profile with genotype (P < 0.05).  The present findings provide robust evidence of PON1 Q192R polymorphism being associated with T2DM in a Saudi population.

Speaker
Biography:

I am basically an Internist. Now he is working as a Consultant of Medicine in the Southern part of Bangladesh. I am consulting more than fifty patients daily including OPD and inpatients for the last seven years. I have completed MBBS from Sher-E-Bangladesh Medical College Hospital, Barisal, Bangladesh in 2003. I have achieved my Fellowship (FCPS) in Internal Medicine from Bangladesh College of Physicians and Surgeons in 2011. As a researcher he has nine publications and two interesting case reports. His area of interest in research is the effects of Diabetes on degenerative Central Nervous System Diseases and Gerontology.  

Abstract:

Diabetes mellitus is considered one of the main threats to human health in the 21st century.  By 2030, the global estimate is expected to rise over 552 million - 9.9 % of the adult population. Diabetic Neuropathy is estimated to affect nearly 50% of patients with diabetes mellitus and is associated with significant increase in morbidity and mortality. A wide variety of disturbances affecting the central and peripheral nervous systems, either directly or indirectly, may be encountered in patients with diabetes mellitus. Neuropathies are common in both type 1 and type 2 diabetes and there are no major structural differences in the pathology of the nerves in the two diabetes types. Peripheral neuropathy has been the primary neuroscience focus of diabetes research. Contrary to some early impressions, however, the CNS is not spared by diabetes. The impact of diabetes mellitus on the CNS has gained attention only recently. Chronically, diabetes mellitus affects the CNS in several ways. Diabetes increases stroke risk and damage, overtreatment with insulin or oral agents can permanently damage the brain, and diabetes may increase the prevalence of seizure disorders. Diabetes changes brain barrier transport, blood flow and metabolism, and may produce a chronic encephalopathy. Acutely, glycemic extremes cause coma, seizures, focal neurological deficits, and impaired consciousness. The pathophysiological basis for these marked CNS abnormalities seen in hypoglycemia, hyperosmolar coma, and ketoacidosis are largely unknown.

 

Speaker
Biography:

M. S. Umashankar has his expertise in novel formulation development and evaluation. He is having more than 12 years of experience in formulation development including mucoadhesive drug delivery systems for various diseases along with teaching and administration positions. Two of his renowned work on Biopolymeric Pharmaceutical Applications have patented under Intellectual Property India.  Recent research publications towards patient’s health care management and well-being make new pavements to realize new ideas and novelistic approach in drug delivery design and developments.

 

Abstract:

Diabetic foot ulcers (DFUs) are a frequent complication of diabetes with a heavy bacterial load that lead to severe and persistent infections leading to amputation of extremities thereby affecting the quality of life of diabetes patients. Therapeutics currently on usage involves wound dressings which deliver drugs to alleviate pain and foul odors found ineffective until today. The necessity to develop and improve the efficacy of wound healing suitable for DFU treatment has been a challenge for both researchers and clinicians. An ideal formulation of topical nanotechnology-based drug delivery formulation is expected to bring new hope for diabetic foot ulcer treatment. The present investigation is to develop nanogel loaded with second generation cephalosporin for topical applications for the treatment of diabetic foot ulcer, to examine its significance against bacterial load of the DFU by sustained drug release conferring prolonged time of action to improve wound healing. An Innovative aspect of formulating a calcium phosphate nanocarrier system core called as aquasome capable to get coating on its surface a mono or bi lamella of sugars like trehalose or cellobiose forms a sugar coated nanocore which is capable of adsorbing the cephalosporin drug, a phenomenal drug carrying technique. This is formulated into suitable topical antibacterial nanogel. The antibacterial activity of drug-loaded aqua nanogel was tested on bacterial load of diabetic foot ulcer infection against gram-negative and gram-positive organisms using agar well diffusion. The zone of inhibition revealed total eradication of pathogens. The results in this research have confirmed that aqua nanogel can be a potential carrier system for cephalosporins drug to target gram-negative, gram-positive multi drug resistant microorganisms for the treatment of diabetic foot ulcers. The prepared NPs have been perceived to be stable as carrying positive zeta of more than +50 mV and were displaying homogeneity in both size and shape.

 

Speaker
Biography:

Saneh Khunkaew is a lecturer at Boromarajonani College of Nursing Uttaradit, Thailand. He has completed his master degree from Malardaren University, Sweden. At the moment, he is doing a doctoral degree at the University of Wollongong, School of Nursing, NSW, Australia. He is an expert on diabetic foot care. His passion is to develop the quality of life and patient outcome among people with diabetes type 2 and its complications. Also he is interested in the mixed methods design in nursing research.

Abstract:

 

Diabetes mellitus type 2 is a chronic disease which causes high blood glucose levels. It impacts on quality of life by limiting a person’s energy to carry out physical and other activities. Despite this impact, the quality of life among people with diabetes mellitus type 2 has not been studied extensively in specific ethnic groups. This study aimed to describe the quality of life and self-care management behavior relating to foot care among Thai adults with and without diabetic foot ulcers (DFUs). A total of 502 participants with and without DFUs completed the survey in 2016. There was a statistically significant difference between people with DFUs and without DFUs (P < 0.05) on all six subscales of the Diabetes-39 survey. The overall QOL and overall severity for patients with DFUs and without DFUs was 61.18 ± 18.74, and 28.45 ± 20.56 respectively. Furthermore, 51.2% of the surveyed population lacked knowledge on basic foot care, including how to use a mirror to check the undersides of their feet. In addition, 48.8% of participants did not have a mirror for this purpose. DFU’s are a significant complication of diabetes mellitus type 2, and it is important that all people with diabetes have the knowledge they require to prevent this complication. This study contributes to knowledge about foot care practices and assists the healthcare professional to develop an educational program for people with diabetes mellitus type 2. This study also contributes to knowledge about diabetes complications and how healthcare professionals can promote a better quality of life for people with diabetes.

 

Speaker
Biography:

Milton Londoño-Lemos has her expertise in neuro-pharmacology of obesity. He is currently a professor and researcher at the Vice-rectory of Research of the Physiotherapy Program at UNIVERSIDAD MANUELA BELTRÁN. Recently. His main lines of research are Neuro-Psico-Appetite Pharmacology, Coordination Chemistry, and Biochemical Medicinal Chemistry, field where he develops two postdoctoral stays. He recently published an article called  "synthesis, chemical characterization and antiadipogenic anti-obesity activity of coordination compounds derived from a serotoninergic ligand and transition metals" a book called "Obesity: Pharmacology, Neuroscience and Public Policies", which was launched at XXX international book fair of Bogota by Editorial Kinesis at 2017. He is actually working on a research project called: REGULATION OF LEPTINA IN THE SCHOOL POPULATION EXPOSED OF DEVELOPING INFANT OBESITY IN COLOMBIA-DISTRICT SCHOOLS OF BOGOTÁ.

 

Abstract:

Leptin is an adipokine secreted by adipose tissue and regulates both food intake and energy balance in normal weight subjects. Its discovery has been received with great expectation as a potential anti-obesity therapy, due to its ability to reverse excess adiposity in animal models characterized by a hormone deficiency; Leptin dramatically reduces body fat, suppresses appetitive behaviors and improves other endocrine-sensitive and metabolic leptin abnormalities in children and adults with congenital hormone deficiency.

On the other hand, in 2007, the International Diabetes Federation (IDF) proposed the latest definition of MS for children over the age of 10 years, based on the presence of increased waist circumference plus two of the following elements: hypertriglyceridemia; low HDL cholesterol; hypertension; and impaired fasting glucose or T2DM.

Therefore, in this work leptin is presented as a potential biomarker that predisposes children and adolescents to adult obesity, since it is usual for obese individuals to have higher levels of circulating leptin and more adipose tissue, consequently developing resistance to the effects of satiety of the hormone or hyperleptinemia. Likewise Leptin's role as a biomarker for metabolic syndrome has been researched in different populations. Regardless of which demographic studied, elevated leptin levels are associated with metabolic syndrome.

There are multiple factors, which include high levels of endogenous leptin or the intake of certain dietary components, such as fructose and saturated fats. What you should do is make people more sensitive to the hormone. To do this, a diet based on foods rich in leptin should be implemented to allow it to pass through the blood and later into the hypothalamus to function as a signal that induces an inhibition of appetite or employing physical activity that is an adjuvant for hormonal functionalization and regulation of body weight.

Speaker
Biography:

Abstract:

We found significant relations of serum hepcidin with estradiol, progestron, CT assessed abdominal fat subcutaneous fat (SCF),peritoneal visceral fat(PVF) and liver density, IR indices{fasting blood sugar (FBS), fasting insulin and HOMA-IR} and metabolic syndrome (MetS) among  64postmenpausal (groupI) and 96fertile women (groupII).Among groupII, hormonal assay and hepcidin (ELISA Sandwich method) were assessed during early follicular(groupIIF )and mid luteal phases (groupIIL). GroupI compared to groupIIF and groupIIL, showed significant higher hepcidin (12.8±3.8 versus 6.5±2.6 & 9.5±3.7(ng/ml),p <0.001),iron, ferritin, hepcidin/ferritin ratio(HFR), IR indices. Also theses parameters including hepcidin were significant higher among group IIL than grouIIF . Among these three groups, hepcidin had significant positive correlations with ferritin ,  IR indices ,BMI, waist hip ratio(WHR), blood pressure, lipid profile,SCF, PVF and liver density ,  and significant negative correlation with iron, HDL and eGFR. Interestingly,  hepcidin showed significant positive correlations with estradiol (p<0.001, p=0.013) and progesterone (p<0.001,p=0.003) among groupI&  groupIIF.  . Hepcidin levels increased significantly and linearly with increasing number of MetS features. Among groupIIF and group I, cut off points  of  hepcidin for prediction of MetS  were >5.8 and >10.3 ng/ml with  AUC of  0.91, sensitivity  93.3 % & 100% ; specificity  71.4%&  76.5 % respectively. Stepwise regression analysis for hepcidin as dependent factor: independent factors were: BMI, ferritin, HFR , cholesterol, creatinine among groupI &groupII;  insulin  and HOMA-IR among groupI & groupIIF;  iron ,  LDL , DBP , WHR among groupII,; SCF among groupI; liver density, PVF& Hb among  groupIIL; and SBP, FBS, progesteron , eGFR , TG and  HDL-C among groupIlF.

 

 

Speaker
Biography:

Abstract:

Type 1 diabetes mellitus is one of the most common disease in different area of world now a days. Enterovirus infections have been implicated in the development of the disease. The viral protein 2C Coxsackie is thought to be responsible for destruction of beta cells in pancreas. The blocking of 2C Coxsackie can be a milestone to decrease pathogenicity of the disease. By using different bioinformatics tools and databases, there is a need to design an inhibitor against virulence protein of diabetes.

 

  • Endocrinology: Disorders & Treatment
    Endocrine complications
    Endocrinology Research and Development
    Endocrinology and Metabolic Syndrome
    Cardiovascular Disorders
    Endocrine and Metabolic Syndrome Disorders
    Metabolic Responses and Nutrition
    Treatment & Management Of Metabolic Syndrome
    Hypertension
    Pulmonary Hypertension
    Gestational hypertension
    Hypertension and Diabetes
    Hypertension & Stroke
    Hypertensive Heart disease
    Diagnosis and Pathophysiology of Hypertension

Session Introduction

Gerald C. Hsu

eclaireMD Foundation, USA

Title: Relationship Between Glucose and Blood Pressure
Biography:

The author received an honorable PhD in mathematics and majored in engineering at MIT.  He attended different universities over 17 years and studied 7 academic disciplines. He has spent 20,000 hours in T2D research.  First, he studied six metabolic diseases and food nutrition during 2010-2013, then conducted research during 2014-2018.  His approach is “math-physics and quantitative medicine” based on mathematics, physics, engineering modeling, signal processing, computer science, big data analytics, statistics, machine learning, and AI.  His main focus is on preventive medicine using prediction tools.  He believes that the better the prediction, the more control you have. 

Abstract:

The author has been subjected to three chronic diseases since 1997.  He has maintained a disciplined lifestyle program since 2012 and collected 1.5M health and lifestyle data. This paper discusses specifically the relationship between glucose and blood pressure.

He has defined two simple equations:

(1) Daily average glucose mg/dL

= (1 FPG+3 PPG)/4

(2) Daily average blood pressure (M3: Metabolism Index 3)

= 1.0+((SBP-120)/120+(DBP-80)/80)/2

 

A 90-days moving average for both glucose and blood pressure can identify the correlation between two signals.  A spatial analysis (without time) is used to figure out a “quasi-linear” equation between them.  In this paper, 13,320 data from 1,480 days (2/8/2014 - 2/27/2018) were used for analysis.

 

He had many SBP and DBP spikes in 2014; however, after 2015, his BP (M3) has been stabilized into a healthy state.  A high correlation of 79% existed between SBP and DBP with an average of 41 mmHG gap in between.  The time series analysis of 90-days moving average of glucose vs. BP (M3) shows a strong correlation of 66%.  This correlation is further validated with a spatial analysis which shows 78% and 99% of the total collected data covered by a +/- 10% and +/- 20% variance band of BP (M3) respectively.  This “relationship band” stretched from point A (90, 0.8) to point B (190, 1.06) on a map with coordinates of x=glucose, and y=BP, M3.  Using big data analytics on an overweight patient, results show a strong relationship existing between glucose and blood pressure.  

 

  • Endocrinology: Disorders & Treatment
    Endocrine complications
    Endocrinology Research and Development
    Endocrinology and Metabolic Syndrome
    Cardiovascular Disorders
    Endocrine and Metabolic Syndrome Disorders
    Metabolic Responses and Nutrition
    Treatment & Management Of Metabolic Syndrome
    Hypertension
    Pulmonary Hypertension
    Gestational hypertension
    Hypertension and Diabetes
    Hypertension & Stroke
    Hypertensive Heart disease
    Diagnosis and Pathophysiology of Hypertension

Session Introduction

Gerald C. Hsu

eclaireMD Foundation, USA

Title: Relationship Between Glucose and Blood Pressure
Speaker
Biography:

The author received an honorable PhD in mathematics and majored in engineering at MIT.  He attended different universities over 17 years and studied 7 academic disciplines.

He has spent 20,000 hours in T2D research.  First, he studied six metabolic diseases and food nutrition during 2010-2013, then conducted research during 2014-2018.  His approach is “math-physics and quantitative medicine” based on mathematics, physics, engineering modeling, signal processing, computer science, big data analytics, statistics, machine learning, and AI.  His main focus is on preventive medicine using prediction tools.  He believes that the better the prediction, the more control you have. 

Abstract:

The author has been subjected to three chronic diseases since 1997.  He has maintained a disciplined lifestyle program since 2012 and collected 1.5M health and lifestyle data. This paper discusses specifically the relationship between glucose and blood pressure.

He has defined two simple equations:

(1) Daily average glucose mg/dL

= (1 FPG+3 PPG)/4

(2) Daily average blood pressure (M3: Metabolism Index 3)

= 1.0+((SBP-120)/120+(DBP-80)/80)/2

 

A 90-days moving average for both glucose and blood pressure can identify the correlation between two signals.  A spatial analysis (without time) is used to figure out a “quasi-linear” equation between them.  In this paper, 13,320 data from 1,480 days (2/8/2014 - 2/27/2018) were used for analysis.

 

He had many SBP and DBP spikes in 2014; however, after 2015, his BP (M3) has been stabilized into a healthy state.  A high correlation of 79% existed between SBP and DBP with an average of 41 mmHG gap in between.  The time series analysis of 90-days moving average of glucose vs. BP (M3) shows a strong correlation of 66%.  This correlation is further validated with a spatial analysis which shows 78% and 99% of the total collected data covered by a +/- 10% and +/- 20% variance band of BP (M3) respectively.  This “relationship band” stretched from point A (90, 0.8) to point B (190, 1.06) on a map with coordinates of x=glucose, and y=BP, M3.  Using big data analytics on an overweight patient, results show a strong relationship existing between glucose and blood pressure. 

 

Speaker
Biography:

Tsabang Nolé has completed his PhD at the age of 48 years from Yaounde 1 University. Author of 50 articles and principal investigator of four books published by Heifer International Project Cameroon, he has accomplished 31 years of research and has higher education experience including teaching and consulting. Besides Biodiversity and ethnopharmacological research, Dr Tsabang Nolé teaches the following undergraduate and graduate courses: Ecophysiology, Sustainable development, Ethnobotany and socio-economic aspects of Agroforestory, Ethnopharmacology and Traditional medicine, as adjunct lecturer at the Faculty of Medicine and Biomedical Science, at the university of Dschang and at the Higher Institute of Environmental Sciences.

 

Abstract:

The prevalence of diabetes is increasing more in low-income countries than in high-income countries. According to the recent WHO report, the African continent with 7.1% of diabetic patients, it ranks after Southeast Asia with 7.8% and Eastern Mediterranean with 4.5%. Overweight and obesity are more responsible factors for this dramatic increase. Diabetes in Africa is a burden for already fragile economies, especially in Cameroon where the subvention of state is insufficient for many patients. Unfortunately, as a result of lifestyle changes, diabetes is exploding on the continent. The management of this unhealed disease is a real challenge for African health systems. With arrival of complications such as cardiovascular disease that handicapped older people, diabetes requires rapid, expensive and long-term medical care. The most frequent are hypertension, hypercholesterolemia, and cigarette smoking. The objective of this study was to identify and document antidiabetic and its cardiovascular complications plants which may have effect on stroke. An ethnobotanical survey was conducted to identify these plants in three phytogeographic regions of Cameroon. 1131 randomly screened interviewees distributed in 58 socio-cultural groups were involved in this study. Twenty-five plants were recorded. They were used in the prevention and/or the treatment of at least two cardiovascular other diseases than diabetes.  Among these plants 4 of them have strong antibiotic activities. They were used to fight chronic infections and inflammation which predisposed people to cardiovascular diseases. This combined used of plants is very important in the management of diabetes and its cardiovascular complications.

 

Speaker
Biography:

Dr. Ian James Martins is an Editor/Reveiwer for Open Acess Pub/MDPI journals and other journals. Advisory Board Member for Photon Journal. Fellow of International Agency for Standards and Ratings (IASR). Conferred with the RICHARD KUHN RESEARCH AWARD-2015 ENDOCRINOLOGY AND METABOLISM. Chief Editor for International Journal of Diabetes Research (2014-2018), Research and Reviews: Neuroscience (2016-2018) and Journal of Diabetes and Clinical Studies (2017-2018). BIT Member (BIT Congress. Inc) with an H-index of 44, (ResearchGate STATs (24), Mendeley STATS (20). Citations (3429). ResearchGate’s analysis available on google, Tweet, Facebook, Lindekin under Ian James Martins’ name places publication Stats RG score higher than 96% of the international scientists.

 

Abstract:

New discoveries in medicine are required to determine the importance of food restriction with relevance to appetite regulation and defective post-prandial lipid metabolism. The repression of the calorie sensitive gene Sirtuin 1 (Sirt 1) is now critical to hepatic glucose/lipid metabolism with relevance to insulin resistance and the severity of global chronic diseases such as non alcoholic fatty liver disease (NAFLD). Defective Sirt 1 is now related to mitochondrial apoptosis in NAFLD and cardiovascular disease associated with the global diabetes epidemic. Nutritional regulation of Sirt 1 is connected to mitochondrial apoptosis and programmed cell death. Magnesium therapy with nutrition is essential to activate Sirt 1 and prevent NAFLD and cardiovascular disease. The assessment of diabetes in the developing and developed world indicate that various factors may predispose individuals to Sirt 1 transcriptional dysregulation with induction of insulin resistance, core body temperature disorders connected to organ disease. In the developed world calorie excess, caffeine diets, core body temperature/appetite dysregulation and magnesium deficiency may involve Sirt 1 repression with relevance to cell senescence and accelerated aging. Nutritional interventions are required to prevent mitophagy that is linked to NAFLD and diabetes. Caffeine doses should be reassessed with relevance to the global NAFLD epidemic with NAFLD expected to rise to 40% of the global population by 2050. In the developing world bacterial lipopolysaccharides are now connected to NAFLD and diabetes with food quality relevant to mitochondrial apoptosis in various chronic diseases.

Speaker
Biography:

Dr Ade Harrison Manju has over 2 years experience as a practicing government employed Physician in a rural community of the North West, Cameroon. Studied medicine from the faculty of health sciences in the University of Buea, graduated with 3.15 GPA. I am interested in clinical research and an extensive experience in public health policies and practices regarding cardiovascular diseases of rural communities in Sub-Saharan Africa. Chief medical officer of Awing Subdivisional Hospital with double function as the coordinator of the HIV treatment center. I am a member of the group, Clinical research, education, networking and consultancy (CRENC) and a burning desire and interest in cardiology.

Abstract:

Non- communicable diseases (NCDs) account for over 30% of global death annually and about 80% of the deaths occur in low and middle income countries. With the growing epidemic of cardiovascular diseases (CVDs) globally and in the Sub-Saharan region especially, there is need for very aggressive efforts to ensure adequate preparedness of countries to manage CVDs at the Primary health care (PHC) level.
METHODS: A descriptive cross-sectional survey of PHC facilities in the NW Region including public, private and confessional facilities. A multistage sampling was used, an adapted questionnaire was used to collect data on the availability of basic equipment, guidelines, essential CVDs medications and the cost of these medications. Data was analyzed using Epi INFO version 7.1.
RESULTS: A total of 40 PHC facilities were included with 53% rural, 22% semi-urban and 25% urban. Fifty five percent (55%) public, 18% private and 27% were confessional facilities. Guidelines for hypertension and diabetes were found in 20% and 22% of the health facilities respectively. There was a 100% availability of Glucometer and stethoscope, 97% availability of sphygmomanometer and a 25% availability of ECG machines. Spironolactone, statins, methyldopa, nitrites, digoxin, aspirin had less than 70% availability among the studied facilities. The median (monthly) cost of spironolactone ($2.54), methyldopa ($2.82), captopril ($2.82), digoxin ($0.56), nifedipine ($1.69) and aspirin ($0.56).
CONCLUSION: There was an extremely low availability of guidelines, most of the PHCs had glucometer and BP monitor, but 1 in 4 had an ECG machine. Essential medications were available in a majority of PHCs, however, not readily affordable to lowest paid unskilled worker. Much effort still needs to be done to ensure that the PHC facilities are adequately prepared for the challenges of CVDs in the region.

Speaker
Biography:

Mennatallah A. Ali is currently a Lecturer at Pharmacology & Therapeutics Department, Faculty of Pharmacy & Drug Manufacturing, Pharos University in Alexandria since 2008. I obtained my Ph.D. degree in Pharmacology from Faculty of Pharmacy, Cairo University in 2015. The Master degree of Pharmacology and Experimental Therapeutics was obtained from Medical Research Institute, Alexandria University in 2012. My Bachelor degree in Pharmaceutical Sciences was from Faculty of Pharmacy, Ain Shams University in 2007. I worked as a community pharmacist since her graduation as I am keen on patient counseling and advising. My research motivation is to explore the underlying molecular mechanisms that potentiate the therapeutic beneficial effects of any antidiabetic agent and to discover any new compounds that can be used as adjuvants to treat diabetes mellitus.

Abstract:

There has been a recent explosion of interest in the notion that metaflammation and activation of the innate immune system are closely involved in the pathogenesis of type 2 diabetes mellitus (T2DM).
Hence, we assessed the potential antidiabetic effect of leflunomide (10 mg/kg every other day) and sulfasalazine (100 mg/kg/day), in a comparison with pioglitazone (5 mg/kg/day) as a reference drug, using neonatal STZ animal model. All treatments were gavaged for 8 weeks. Leflunomide and
sulfasalazine lowered significantly the n5-STZ-induced elevation in body weight, blood glucose, and HOMA index. Moreover, they amended successfully serum lipid profile and increased serum insulin level. Additionally, leflunomide and sulfasalazine showed antioxidant (Nrf2, keap1), antiinflammatory (NF-κB, TNF-α) and anti-apoptotic (caspase-3, cytochrome c) capabilities. Both drugs showed comparable effects on almost all the parameters, however, pioglitazone effect was superior to both. On the molecular level, drugs have improved the hepatic insulin (glucokinase, pinsulin receptor, p-Akt, IRS-1), lipogenic (SREBP-1c, PGC-1α) and Wnt/β-catenin (p-GSK-3β, β- catenin, FOXO) signaling pathways. All treatments also showed decreases in the hepatic 8-oxoguanine content. The present results clearly proved that altered immune responses play a key role in T2DM and that the immunomodulatory drugs can gain insights as prospective antidiabetic
agents.

Speaker
Biography:

Abstract:

Diabetes mellitus (DM) is a global health problem affecting million people in Africa. The consumption of medicinal clay (Geophagy) by DM patients in North Eastern, Nigeria as traditional remedy for the ailment has become very popular. This paper evaluated the hypoglycaemic activity of two medicinal clay: Nzu and Ulo. The elemental constituents of the medicinal clay was also studied with a view of explain its possible mechanism Atomic Absorption Spectrophotometric (AAS) analysis was used to ascertain the levels of Zn, Pb, Mg, Ni and Cr contents in the medicinal clays using standard protocols. Hyperglycaemia was induced in 20 of 28 normoglycaemic male rats (170 – 260 g) using the Oral Glucose Tolerance Test (OGTT) protocol and the rats were shared into seven (7) groups of four rats each (4). Group I served as control group negative. Group II were hyperglycaemic control group, positive, while four other groups were treated with 100 or 200 mg kg‾¹of Nzu and Ulo to hyperglycaemic rats, respectively; another group was treated with a standard drug, Glibenclamide (600 µg/kg p.o). Elemental analysis of both clay showed the presence of Zn, Pb, Mg and Ni and were above the recommended level of WHO per day. The mean blood glucose level of the hyperglycaemic treated rats in group III, IV, V, VI and VII after administration of the medicinal clay (Nzu and Ulo) was compared with the values in control groups (I and II) and the Glibenclamide treated group. Significant reduction in the blood glucose concentrations after 1st, 2nd, 3rd hours between the hyperglycaemic treated and the hyperglycaemic untreated rats. The control drug Glibenclamide (600 µg/kg) showed much lover blood glucose concentration at 3rd above the medicinal clay. It was concluded that the likely reason for the observed hypoglycaemic effect, could be due to delayed digestion and assimilation of food, within the gut of the rat or slowed to enable a gradual absorption and catalysis of the glucose within the cells. The consumption of 100 and 200 mg/kg b.wt. Nzu and Ulo reduced blood glucose levels in hyperglycaemic rats and it justified its use in the management of diabetes mellitus amidst some health risks.

 

Speaker
Biography:

Oumer sada has expertise in assessing patients drug therapy need and optimizing patient outcome by providing clinical pharmacy service. He has also additional roles in the university teaching, advising and precepting students, conducting problem solving researches and providing community service focusing on providing drug information service in promoting rational drug use.

 

Abstract:

Diabetes mellitus (DM) is a group of metabolic disorders of fat, carbohydrate, and protein metabolism that results from defects in insulin secretion, insulin action (sensitivity), or both. The vast majority of diabetic patients are classified into one of two broad categories: type 1 diabetes caused by an absolute deficiency of insulin or type 2 diabetes defined by the presence of insulin resistance with an inadequate compensatory increase in insulin secretion..

Objective: To assess adherence of anti diabetic medications and associated factors among patient with diabetics mellitus receiving care at Zewditu Memorial Hospital chronic follow up.

Method: facility based cross sectional study was conducted at Zewditu Memorial Hospital among diabetics patients from February 20, 2017 to April 20, 2017. Structured questioner was used to collect data from the patient. Systematic random sampling technique was used. Morisky Medication Adherence Scale (MMAS) scores were used for labeling patients as adherent or nonadherent. Data was entered and analyzed using SPSS version 20.

Result: all of respondent, 79 (54.1%) and 67 (45.9) were female and male, respectively. The majority of the study participants 34 (23.3%) were in the age group of 51-60 years. One hundred one (69.2%) of respondents were married currently. A total of 129 (88.4%) of respondent were adhered to anti-diabetic medication. There was a significant association between adherence to the medication and marital status, number of medication prescribed and forgetfulness (p < 0.05).

Conclusion: The participants in the study area were good adherent to their anti-diabetic medications with non-adherence rate 11.6%. Different factor of medication non-adherence were identified such as number of medication prescribed; forgetfulness and socio-demographic factor such as education level and marital status, all of which are modifiable factors.

 

Goutam Kumar Acherjya

Upazila Health Complex, Bangladesh

Title: METABOLIC SYNDROME IS REALLY AN ALARMING ISSUE
Speaker
Biography:

I am basically an Internist. Now he is working as a Consultant of Medicine in the Southern part of Bangladesh. I am consulting more than fifty patients daily including OPD and inpatients for the last seven years. I have completed MBBS from Sher-E-Bangladesh Medical College Hospital, Barisal, Bangladesh in 2003. I have achieved my Fellowship (FCPS) in Internal Medicine from Bangladesh College of Physicians and Surgeons in 2011. As a researcher he has nine publications and two interesting case reports. His area of interest in research is the effects of Diabetes on degenerative Central Nervous System Diseases and Gerontology.  

Abstract:

Metabolic syndrome is the constellation of high blood pressure, raised blood sugar, high triglyceride level, low HDL cholesterol and abdominal obesity which increase the risk of cardiovascular diseases (CVDs), stroke and diabetes. It is intimately related to overweight or obesity and inactivity that causes insulin resistance where the body can’t use its insulin properly. Higher education, urbanization, changing occupational status, unhealthy food practice, sedentary lifestyle, digitalization and higher body mass index are directly related to the greater prevalence of the metabolic syndrome. Over the past couple of decades metabolic syndrome have reached a pandemic dimension affecting not only the population of developed countries but also that of low or middle income countries that becoming the key challenge to the public health sector. CVDs are the number one cause of death globally; an estimated more than 17.7 million people dying annually, representing 31% of all global deaths. Metabolic syndrome will be the leading risk factor of CVDs in near future as its prevalence surges gradually. In 2015, the international Diabetes Federation (IDF) reported that more than 25% of the world’s population has metabolic syndrome which may vary due the age, sex and ethnicity of the population studied. People with metabolic syndrome are 3-5 times more likely to have heart attack/stroke or type 2 diabetes compared with unaffected individuals. Gradually rising the clinical and economic burden of metabolic syndrome to the individual, family, society and national level, so early detection and meticulous management of metabolic syndrome can reduce the long-term risk of cardiovascular risk and diabetes. Moreover, behavioral changes such as Heart-Healthy Lifestyle including healthy eating, healthy body weight, physical activity and quitting smoking may modify metabolic syndrome and finally reduce the risk of CVDs.  

 

Speaker
Biography:

Zogopoulos Panagiotis is a Neurosurgeon specialized in Medical Acupuncture. He is currently the Chief of Medical Acupuncture Department at Metropolitan Hospital, Athens, Greece. He has completed his PhD from the University of Athens, School of Medicine and has received Advanced Clinical Training (Clinical Research Fellowship) at the Neurosurgery Department of Osaka University Hospital in Japan. He has published many papers in various international scientific journals.

 

Abstract:

Medical acupuncture is under extensive investigation over the last years regarding its effectiveness on a variety of symptoms, diseases and syndromes. A large number of experimental and clinical studies, as well as meta-analyses, have documented medical acupuncture's beneficial effects on various disorders, such as hyperglycemia, hyperlipidemia and hypertension. Experimental animal models of hypertension have shown that medical acupuncture can significantly reduce both systolic and diastolic blood pressure. This effect is mediated through various mechanisms, like decreased activity of sympathetic nervous system, reduction of oxidative stress in specific areas of the brainstem (e.g. medulla oblongata), increased activity of endothelial Nitric Oxide Synthase (eNOS) and reduced levels of angiotensin type-II and its receptors. Clinical studies have shown a statistically significant reduction of blood pressure levels when medical acupuncture was combined with classic anti-hypertensive drug treatment, compared to drug treatment alone. Functional MRI studies have revealed increased connectivity of the hypothalamus with other brain areas implicated in blood pressure control (frontal lobe, cerebellum, insular cortex).