Connective tissue proper consists of loose connective tissue (including reticular connective tissue and adipose tissue) and dense connective tissue (subdivided into dense regular and dense irregular connective tissues.)[8] Loose and dense connective tissue are distinguished by the ratio of ground substance to fibrous tissue. Loose connective tissue has much more ground substance and a relative lack of fibrous tissue, while the reverse is true of dense connective tissue. Dense regular connective tissue, found in structures such as tendons and ligaments, is characterized by collagen fibers arranged in an orderly parallel fashion, giving it tensile strength in one direction. Dense irregular connective tissue provides strength in multiple directions by its dense bundles of fibers arranged in all directions.[citation needed]

Special connective tissue consists of cartilage, bone, blood and lymph.[9] Other kinds of connective tissues include fibrous, elastic, and lymphoid connective tissues.[10] Fibroareolar tissue is a mix of fibrous and areolar tissue.[11] Fibromuscular tissue is made up of fibrous tissue and muscular tissue. New vascularised connective tissue that forms in the process of wound healing is termed granulation tissue.[12] All of the special connective tissue types have been included as a subset of fascia in the fascial system, with blood and lymph classed as liquid fascia.[13][14]


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Fiber types found in the extracellular matrix are collagen fibers, elastic fibers, and reticular fibers.[18]Ground substance is a clear, colorless, and viscous fluid containing glycosaminoglycans and proteoglycans allowing fixation of Collagen fibers in intercellular spaces. Examples of non-fibrous connective tissue include adipose tissue (fat) and blood. Adipose tissue gives "mechanical cushioning" to the body, among other functions.[19][20] Although there is no dense collagen network in adipose tissue, groups of adipose cells are kept together by collagen fibers and collagen sheets in order to keep fat tissue under compression in place (for example, the sole of the foot). Both the ground substance and proteins (fibers) create the matrix for connective tissue.

Jalra is a diabetes medicine that is used together with diet and exercise to control the blood glucose (sugar) in adults with type 2 diabetes. It is used alone when metformin (another diabetes medicine) is not suitable, or together with other diabetes medicines, including insulin, when these medicines do not provide adequate control of the blood glucose.

Type 2 diabetes is a disease in which the pancreas does not make enough insulin to control the level of glucose in the blood or when the body is unable to use insulin effectively. The active substance in Jalra, vildagliptin, is a dipeptidyl peptidase 4 (DPP-4) inhibitor. It works by blocking the breakdown of incretin hormones in the body. These hormones are released after a meal and stimulate the pancreas to produce insulin. By blocking the breakdown of incretin hormones in the blood, vildagliptin prolongs their action, stimulating the pancreas to produce more insulin when blood glucose levels are high. Vildagliptin does not work when the blood glucose is low.

Vildagliptin also reduces the amount of glucose made by the liver, by increasing insulin levels and decreasing the levels of the hormone glucagon. Together, these processes reduce blood glucose levels and help to control type 2 diabetes.

Jalra on its own or as an add-on treatment has been studied in 11 main studies involving a total of over 6,000 patients with type 2 diabetes and insufficient control of blood glucose levels. In all studies, the main measure of effectiveness was the change in blood levels of a substance called glycosylated haemoglobin (HbA1c), which gives an indication of how well blood glucose is controlled.

Studies have shown Jalra to be effective as add-on to metformin, a thiazolidinedione or a sulphonylurea (dual therapy), a sulphonylurea and metformin (triple therapy) or insulin with or without metformin. Jalra on its own has also been shown to be effective in reducing blood glucose but less so than metformin. Jalra should therefore be used only in patients for whom metformin is inappropriate either because of side effects occurring with metformin or because they have a condition that makes metformin unsuitable for them. The side effects of Jalra were mostly mild and resolved over time.

Waist circumference and body weight and height were measured according to a standard protocol. To measure the waist circumference all researchers followed these instructions: Locate the top of the hip bone (iliac crest) and take the measurement just above this bony landmark, just where one finger can fit between the iliac crest and the lowest rib. Ensure that the tape measure is positioned horizontally, parallel to the floor. Measuring at a level just above the iliac crest, and positioning the tape horizontally, irrespective of whether the umbilicus is above or below the tape, provides the correct waist circumference measurement and should correspond to the maximal abdominal diameter. Ensure that the patient is standing erect and has relaxed the abdominal muscles. Measurement must be taken at the end of normal expiration. The body mass index (BMI) was calculated as the weight (kg) divided by the square of the height (meters). ff782bc1db

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