Narsingh Verma

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• MBBS MD FRCP (london) FRCP (Edinburgh) FACP (USA)
• Professor (Full) and Head of the Department at King George's Medical University

Hypertension is one of the most prevalent non-communicable diseases, contributing significantly to global morbidity and mortality. Hypertension is becoming a major public health challenge in India, fuelled by urbanization, changing dietary habits, and increasingly sedentary lifestyles. The May Measurement Month (MMM) campaign was carried out in Ind...

Hypertension, a well-established risk factor for cardiovascular diseases, has emerged as a significant contributor to Alzheimer's disease (AD) pathogenesis. This review explores the pathophysiological mechanisms through which hypertension exacerbates neurodegeneration, with a focus on cerebrovascular dysfunction, blood-brain barrier (BBB) disruptio...

The circadian system plays a crucial role in regulating metabolic homeostasis at both systemic and tissue levels by synchronizing the central and peripheral clocks with exogenous time cues, known as zeitgebers (such as the light/dark cycle). Our body’s behavioral rhythms, including sleep-wake cycles and feeding-fasting patterns, align with these ex...

Cardiovascular diseases (CVD) continue to be the leading cause of deaths and disability worldwide and the major contributor is hypertension. Despite all the improvements in detecting hypertension together with technological advances and affordable, efficacious and relatively free of adverse effects anti-hypertensive agents, we continue to struggle...

Coffee is one of the most consumed drink, with around 2.3 billion cups being consumed every day across the world. It is the most popular drink after water. Many studies have revealed that drinking coffee regularly and within limit, can have positive effects on the nervous system, digestive system, and cardiovascular systems, as well as on the renal...

Background: This study investigated diurnal variations in spirometric parameters and their correlation with salivary cortisol levels among apparently healthy adults. Methods: Forty subjects, aged 18-22, were assessed. Spirometric parameters, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow...

Background Type 2 diabetes mellitus (T2DM) is a worldwide health issue impacting millions of individuals. In recent years, bone has been identified as an endocrine organ that regulates glucose metabolism by the release of osteocalcin, an osteoblast-specific hormone, which affects fat accumulation and blood glucose levels. Osteocalcin has been assoc...

Background: Primary hypertension is the most common (almost 95%) and it can easily be controlled through lifestyle modification by regular exercise and controlled diet plan. Magnesium and zinc supplementation can alleviate essential hypertension. Methods: 73 hypertensive patients were recruited. Thrice in a row with interval of 5 minutes, twice a d...

The Indian Society of Hypertension (InSH) highlights the urgency for India-specific guidelines on hypertension management. Hypertension affects over one billion people worldwide, with India bearing a significant burden due to its population, diversity, and demographics. In India, hypertension affects 21% of women and 24% of men, while pre-hypertens...

Background The metabolic syndrome (MetS), a cluster of cardiovascular risk factors, is associated with obstructive sleep apnea (OSA). OSA is a major contributor to cardiac, cerebrovascular, and metabolic disorders as well as to premature death. Materials and Methods This cross-sectional study was done for 1 year in 103 patients of MetS diagnosed b...

Background Flaxseed contains many phytoestrogens that share structural similarities with endogenous estrogens. It has beneficial properties that improve hormonal effects that may influence chronic disorders. Objective This study aims to evaluate the impact of flaxseed supplementation on perimenopausal syndrome symptoms and serum polyphenol metaboli...

Background and Objective Hypertension remains a significant risk factor for cardiovascular diseases in India, contributing substantially to cardiovascular mortality. Despite the rising prevalence of hypertension, blood pressure control among hypertensive patients remains low, emphasizing the need for improved hypertension management and treatment....

The Global Burden of Diseases study estimates indicate that the prevalence of heart failure (HF) in the United States and Canada is 1.5% to 1.9% of the population and in Europe 1% to 2%. In Asia, the Ram B Singh, Jan Fedacko, Narsingh Verma et al. 128 prevalence of HF may be 0.5% to 1.0%. There is evidence that HF occurs due to the interaction of c...

Hypertension is not only the most prevalent disease but also poses a global burden as well as a national burden on the health system. Coping the disease with physical means is quite common but now in emerging India the transformation in management of the disease via technology is getting popular. In the same array, Artificial Intelligence is seekin...

Raised blood pressure (BP) is the leading preventable risk factor for cardiovascular diseases that makes a major impact on early mortality and morbidity. Recognizing hypertension in the community, educating people about routine BP monitoring, and improving medication compliance are all important steps in detecting, controlling, and managing hyperte...

Introduction The role and function of P-selectin levels in various inflammatory and immune-mediated diseases have been established. Whether they have an association with inflammatory skin diseases such as vitiligo and psoriasis needs to be established. Objective The objective of this study was to assess P-selectin levels in psoriasis and vitiligo...

Tobacco use causes serious public health concerns and causes many health problems like (asthma, COPD, stroke, cancer, etc.). While a number of pharmacological treatments are used to reduce tobacco use, they often have adverse effects. Fewer studies have assessed non-pharmacological treatments {Eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA)...

Introduction: Intrinsic Physiological Regulatory mechanism brings back blood pressure to normality due to changes in external environmental and internal physiological activities performed to maintain life by getting food, shelter, security, etc., in daily life till survival. Recent advances in society have changed the basic pattern of livelihood an...

Great Moments, The year's first issue brings interesting original studies on various topics such as Sensitivity and Specificity assessment concerning Metabolic Syndrome in HWC/PHC of India, Knowledge, Attitude, and Practices regarding Risk Factors, Prevention and Treatment of Hypertension among Urban Dwellers in Chennai. Further, it publishes revie...

Time-restricted Eating (TRE) has garnered attention for its potential metabolic benefits by aligning meal timing with circadian rhythms and facilitating extended fasting periods. This narrative review explores the mechanistic underpinnings of blood pressure regulation within the context of diurnal rhythms and the potential implications of TRE on bl...

A BSTRACT Background Portal hypertension commonly occurs due to liver cirrhosis, and esophageal varices (EV) is one of the major complications associated with it. The most common cause of death in liver cirrhosis is EV bleeding. Hence, GE screening for EV is required, which is an invasive procedure. Regular use of endoscopy results in low complian...

Background Ashwagandha is a well-known Ayurvedic herb used for youthful vigor and wellbeing. This study investigated the effects of 600 mg standardized root extract (>5% withanolides) of Ashwagandha (Withania somnifera) on muscle size, strength and cardiorespiratory endurance following resistance training. Methods In this eight-week, parallel-grou...

Background Tobacco is prevalently used in smoking or smokeless forms and remains a major public health concern worldwide, with its adverse effects on overall health. Omega-3 fatty acid (FA) has shown its promising effects in various health conditions. Objective The purpose of this study was to evaluate the effect of flaxseed oil (omega-3 supplement...

Introduction: Time-restricted meal intake (TRM) has shown potential benefits such as enhanced insulin sensitivity, lowered blood sugar levels, and possible weight loss in individuals with type 2 diabetes mellitus (T2DM). Our study aimed to investigate the impact of TRM on lipid profile parameters such as total cholesterol (TC), triglycerides (TG),...

Further to our efforts in the last issue (issue 3) where we introduced the Hypertension guidelines, 2023, we are pleased to bring this issue 4 with the aim of lifestyle upliftment in terms of good health and hence, most of the articles here provide evidence-based recommendations and expect our readers to build upon more research for better and heal...

Background- Serious concerns about noncommunicable disease (NCD) healthcare services in a lower-middle-income nation like India arise from the prevalence of cardiovascular illnesses and lifestyle risk factors among middle-aged and elderly people. Women often have a lesser awareness of the risk associated with cardiovascular diseases (CVD), and thes...

Swine flu, caused by the H1N1 influenza virus, is a subtype of influenza A that affects both the upper and lower respiratory tracts. It is primarily found in pigs and can be transmitted to humans through genetic variations in the virus. The 1918 Spanish flu pandemic resulted in the deaths of 50 to 100 million individuals. In 2009, the pandemic affe...

Introduction Uric acid is produced during the metabolism of nucleotide and adenosine triphosphate and contains the final product of human purine metabolism. It acts both as an antioxidant and pro-inflammatory marker and has a positive association with visceral fat in overweight subjects. The aim of the present study is to find an association of uri...

Aims: This study aimed to investigate the impact of time-restricted meal intake (TRM) on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 400 patients diagnosed with T2DM were selected from the Endocrinology Department at King George's Medical University (KGMU), Lucknow, based on the Am...

Objective: Obesity and overweight are challenging health problems of the millennium that lead to diabetes, hypertension, dyslipidemia, nonalcoholic fatty liver disease (NAFLD), and atherosclerosis. Green coffee bean exhibited significant promise in healthy weight management, potentiating glucose-insulin sensitization and supporting liver health. T...

Background Cardiovascular dysfunction and cognitive decline are more common in traumatic spinal cord injury (SCI). Most of people with a cervical or upper-thoracic SCI usually experience orthostatic hypotension and autonomic dysreflexia, which are described by changes in systemic blood pressure (BP). Objectives The objective of the study is to eva...

R6. Diet and Nutrition in COPD: Exploring the Role of Diet in Prevention and Management

The ACC/AHA hypertension guidelines provide comprehensive recommendations for the diagnosis, measurement, goals, and treatment of hypertension. Accurate blood pressure (BP) measurement is crucial, and the guidelines emphasize the importance of confirming BP categories through multiple readings taken on separate occasions. Various techniques, includ...

This comprehensive review explores the intricate relationship between hypertension and erectile dysfunction (ED), shedding light on the shared risk factors and underlying physiological mechanisms that connect these two conditions. With a focus on recent advancements, the review discusses diagnostic techniques, lifestyle modifications, medical manag...

One‐fourth of death in India is attributed to cardiovascular disease (CVD) and more than 80% is related to ischemic heart disease and stroke. The main risk factor for CVD is hypertension. Every third person in India suffers from hypertension and the prevalence increased drastically in the past 20 years, especially among the youngest age group of 20...

For adopting recently introduced hypertension phenotypes categorized using office and out of office blood pressure (BP) for the diagnosis of hypertension and antihypertension drug therapy, it is mandatory to define the corresponding out of office BP with the specific target BP recommended by the major guidelines. Such conditions include white‐coat...

This issue is summarized with its utmost importance in bringing, for the first time, a consensus guideline for managing hypertension aiming to better adapt the knowledge, best practices, and recommendations to the Indian context.

Hypertension is a global health concern, responsible for 10 to 12% of all cause mortality worldwide. In India, hypertension affects 32.6% of women and 38.7% of men over the age of 20 years. Its prevalence varies across wealth quintiles and states. With a mission of taking the forefront in the campaign to control elevated blood pressure and its asso...

Diabetes, a rapidly increasing heterogeneous disorder, is closely linked to the epidemic of obesity and metabolic syndrome (MetS). At present, we do not understand completely the blood biomarkers, molecular aetiology, and role of lifestyle modification and interventions to combat diabetes hand in hand with obesity and the MetS epidemic. To measure...

Recent innovations in digital technology have enabled the simultaneous accumulation, and the linking and analysis of time-series big data relating to several factors that influence blood pressure (BP), including biological indicators, physical activity, and environmental information. Various approaches can be used to monitor BP: in the office/clini...

Introduction: Helicobacter pylori (H. pylori) is predominantly responsible for acute and chronic progressive gastroduodenal inflammation. Symptoms of gastric diseases vary from dyspepsia to altered bowel movements, leading to ulcers and potential gastrointestinal bleeding. Consequently, H. pylori can have a variable effect on the gastrointestinal t...

The Journals current issue is available with amazing studies on box trial review on blood-pressure management in post-cardiac arrest care, impact study of hypertensive disorders of pregnancy on cognitive functioning of the offspring, studies on high intensity statins in acute coronary syndrome presented in two parts as separate articles, an insight...

Previous studies showed a diurnal rhythm of uric acid. The mean serum uric acid value between 0800-0900 hours was higher than that observed between 1700-1800 hours. Oxidative stress is traditionally characterized as by imbalance among oxidant and antioxidant factors, occurs commonly in Mets. Antioxidant's system including enzymes like superoxide di...

Introduction: Metabolic syndrome is a significant medical morbidity progressing to cardiovascular complications both in developing and developed world. Uric acid is produced during metabolism of nucleotide and adenosine triphosphate (ATP) and contains the final product of human purine metabolism. It acts both as an antioxidant and pro-inflammatory...

Uric acid is the end product of an exogenouspool of purines and endogenous purine metabolism.Higher waist circumference and BMI are associated with higher insulin resistance and leptin production, and both reduce renal uric acid excretion, thus increasing its concentration. Among the disorders related to hyperuricemia, gout is the most representati...

Objective This study was aimed to investigate the effect of Light at night and Rotating night shift as risk factor for cardiovascular diseases. 24 hours chronomics of BP/HR in terms of Double amplitude, Acrophase and Hyperbaric index and its relation with circadian rhythm of salivary cortisol and 6 sulfatoxy melatonin levels in night shift nursing...

The year 2023’s first issue brings interesting studies on various topics that are aimed towards our plan to make a leap into the next stage of development in terms of indexing development, ethics, and global ranking growth of the journal.

Hypertension is the major cause of cardiovascular diseases and death in the world. Hypertension is the most prevalent non-communicable disease in India. The overall prevalence of hypertension in India was 29.8%. DASH refers to Dietary Approaches to Stop Hypertension. The DASH diet is a healthy eating lifelong strategy that's designed for hypertensi...

Nutrition has been recognized as an important factor in health and disease for many years. However, it is only recently that the importance of nutrition in patients with chronic lung disease has come into focus. There has been a profound link between nutrition and lung health. Malnutrition could lead to poor lung development. Various diet such as M...

Uncontrolled hypertension is a significant problem in many parts of Asia. Effective management is essential to reduce the burden of hypertension. Home blood pressure monitoring (HBPM) is a promising tool that can aid in the diagnosis and management of hypertension. Experts from 11 countries/regions in Asia conceptualized a large-scale survey to exa...

Introduction: Leptin is secreted in concentrations proportional to body fat mass. The anthropometric parameter among Sagittal Abdominal Diameter (SAD), Body Mass Index (BMI), Hip Circumference (HC), Waist Circumference (WC), Waist-Hip Ratio (WHR), and Waist-Height Ratio (WHtR) that correlates maximally with serum leptin levels could be used prefera...

Background: & Purpose of project: Awareness of hypertension and blood pressure (BP) control rates are still low in India. Home blood pressure monitoring (HBPM) is recognized as a valuable tool to diagnose and support hypertension treatment including the prevention of cardiovascular diseases(CVD) and target organ damage. We explored the prevailing...

Background : Ashwagandha is a well-known Ayurvedic herb used for youthful vigor and wellbeing. This study investigated the effects of 300 mg standardized root extract (>5% withanolides) of Ashwagandha ( Withania somnifera ) on muscle mass, strength and cardiorespiratory endurance following resistance training. Methods: In this eight-week, parallel-...

Recently, there has been revived interest within the role of the sympathetic nervous system in high blood pressure for many reasons: 1) sympathetic dysfunction will influence the event and progression of target organ dysfunction; 2) the development of recent therapeutic modalities for the management of hypertension; and 3) findings that activation...

Background: There is a bidirectional relationship between COVID-19 and diabetes. New-onset diabetes and severe metabolic complications of pre-existing diabetes in patients with COVID-19 have been observed. Steroids are medications used for treatment of several diseases, including COVID-19. Its pharmacological action increases blood glucose and pose...

This is a comprehensive management guidelines for Diabetes 2022

Our bodies function optimally when we align our eating & sleeping patterns with our circadian rhythms, the innate 24-hour cycles that tell our bodies when to wake up, when to eat and when to fall asleep. Chronically disrupting this rhythm by eating late night meals & sleep could be a recipe for Hypertension, CVD, and metabolic trouble. The aim of t...

In Asia Pacific region, 66% of deaths are caused from cardiovascular diseases (CVD) which are attributed to hypertension, and in India alone, ischemic heart disease and stroke are the top causes of death. Awareness of hypertension and blood pressure (BP) control rate are still low in India; therefore, physicians and patients hypertension education...

To investigate ABI as a surrogate marker and predictor for severity of CAD To determine the relation between ankle brachial index and angiographic findings along with major cardiovascular risk factors in patients with suspected or at risk for coronary artery disease This hospital based observational study recruited subjects from Department of cardi...

Tobacco and hypertension are respectively the first and second leading cause of preventable mortality worldwide. The effect of tobacco on blood pressure is complex with evidence that tobacco increase blood pressure acutely and increase the risk of developing hypertension. The objective of this study was to examine the impact of tobacco use on blood...

The present study was aimed to investigate effect of Light exposute at night on 24 hours chronomics of BP/HR in terms of Double amplitude, Acrophase and Hyperbaric index and its relation with circadian rhythm of salivary cortisol and 6 sulfatoxy melatonin in rotating night shift nursing professionals and actual day workers. 56 night shift nurses, a...

Flaxseed oil is considered to be a rich source of Alpha-Linolenic Acid(ALA), along with Lignans, fibers, protein, vitamins,s, and minerals. A number of studies have proved the beneficial role of ALA, EPA, and DHA found in flaxseed on health. Besides providing nutrition, they have anti-inflammatory, antihypertensive and cardioprotective properties....

High-quality Indo-Mediterranean foods are characterised with unrefined, unprocessed foods, whole grains such as dry millets and beans and porridge. Vegetables such as leaves and gourds, nuts and fruits such as apples, grapes, papaya, guava, etc are major components of this diet. It seems that healthy vegetable oils such as olive, mustard, rape seed...

Physiology of Insulin Resistance

Chronobiology of Insulin Release

This review article examines the impact of various dietary factors on individuals with type 2 diabetes, focusing on cardiometabolic risk factors and cardiovascular disease (CVD). It discusses the effects of different types of fats, the quality of carbohydrates, protein intake, vitamin and mineral supplementation, alcohol consumption, beverages, non...

The interplay between nutrition and the immune system is complex and plays a significant role in averting allergy and can manage autoimmune disorders. Various factors, including overall diet, specific nutrients, and dietary patterns, can influence immune function and disease outcomes. This review highlights the importance of diet diversity in infan...

Metabolism involves all the physical and chemical processes by which cells are produced and maintained. The chemical reactions that break down complex organic molecules into simpler ones are collectively known as catabolism. Chemical reactions that combine simple molecules and monomers to form the body’s complex structural and functional components...

Background and aims: There is a bidirectional relationship between COVID-19 and diabetes. The primary objective of this study was to estimate the prevalence of patients newly detected to have diabetes (NDD) who recovered from COVID-19 in India whilst comparing NDD with patients without diabetes (ND) and those who have known to have diabetes (KD) i...

Globally the growth and use of electronic blue-containing devices has speeded. Hence, noticeable increment has been reported in the blue light exposure which is a potential and preventable risk factor for health disorders. Since prevalence of excessive blue light exposure is recorded in children hence children and adolescents are at particular risk...

Home blood pressure (HBP) has been recognized as a prognostic predictor for cardiovascular events, and integrated into the diagnosis and management of hypertension. With increasing accessibility of oscillometric blood pressure devices, HBP monitoring is easy to perform, more likely to obtain reliable estimation of blood pressures, and feasible to d...

Recent trials have demonstrated the efficacy and safety of percutaneous renal sympathetic denervation (RDN) for blood pressure (BP)‐lowering in patients with uncontrolled hypertension. Nevertheless, major challenges exist, such as the wide variation of BP‐lowering responses following RDN (from strong response to no response) and lack of feasible an...

Morning hypertension is an important clinical target in the management of hypertension for perfect 24‐h blood pressure (BP) control. Morning hypertension is generally categorized into two types: “morning surge” type and “sustained nocturnal and morning hypertension” type. The “morning surge” type is characterized by an exaggerated morning blood pre...

Cardiovascular events are the most fearful outcome of the metabolic syndrome. Q risk2 score is an algorhythm developed for future CVD risk estimation over the next 10 years. The treatment of all risk factors of metabolic syndrome includes life style modification and exercise is the most integral part of it. Exercise of moderate intensity for 30-min...

Introduction: Cardio respiratory fitness is having a major role in reduction of incidence cardiovascular disorders among the population of India. The exercise treadmill test (ETT) can help with cardiorespiratory activity estimation, blood pressure (BP) response to heart rate during exercise, chronotropic reserve, recovery of heart rate (HRR) and my...

India is the world’s third largest tobacco producer and second largest tobacco consumer. It is well known that smoking is injurious to health but still the increase in the rate of smoking and tobacco consumption is day by day increasing due to craving effect. Studies in past state that smoking induces oxidative stress which lowers omega-3 fatty aci...

Introduction: Cardio respiratory fitness is having a major role in reduction of incidence cardiovascular disorders among the population of India. HRR is one of the prime factor which will act as indicator for cardiovascular fitness, HRR is the rate of heart rate drops after the exercise, commonly measure after 1 or 2 minutes after peak exercise The...

Objective Essential hypertension is a complex and multifactorial disorder resulting from environmental and genetic factors, and their interactions. Alpha nalysed-1 (ADD1) gene is salt sensitive gene which has its role in etiology of essential hypertension via renal sodium reabsorption. Therefore, the G460T polymorphism of ADD1 gene may be associate...

Tobacco use is widely prevalent since so many years worldwide. Tobaccos negative effects are well-known, and there is strong evidence that its constituents are responsible for cancer, oral problems, other health hazards and even deaths. Also, tobacco users with COVID-19 have higher risk of severity. Therefore, Cessation is necessary to lower this r...

The process of teaching nutritional science to an individual or community is called Nutrition Education. India has a unique double burden of malnutrition as a result of fast economic change, including increased urbanisation, dietary transition, and a sedentary lifestyle. The goals of Nutrition Education are to improve the quality of life and contri...

The United Nations Food and Agriculture Organization (FAO) and the World Health Organization (WHO) policy action for high-quality diets proposed that eating more of the nutrient-rich foods that are already being produced would result in savings in land, water, and energy consumption [13]. If this concept is tied to food production and resources use...

Background: Ambulatory blood pressure monitoring (ABPM) is a valuable tool in the diagnosis and management of hypertension and it is a good predictor of future cardiovascular events. Lack of normal threshold values of ABPM parameters and inconsistency in the sampling rate of recording are hurdles in its wider usage. The aim of the present investig...