Type II diabetes is the main cause of premature illness or death, mainly due to the increased risk of CVD. In which the blood glucose levels are high enough for a person. The diabetes may also leads to the blindness, amputation and kidney failure. 7
The majority of clinical trials reported the effects of botanicals on inflammatory biomarkers in diabetic patients. These patients deserve special attention for intensive management of hyperglycemia & other metabolic disorders.6 In this disease the primary goal of antihyperglycemic therapy is to decrease hemoglobin A1C to less than 7 %. These patients are given some drugs to prevent from the major metabolic disorders such as obesity, insulin resistance.7 Diabetes is the hereditary disorder in which the glucose level is raised in the patient’s body due to the less enzymatic action or deficiency of some enzymes that helps in the metabolism of glucose.7 In this disease, the person’s weight is loss at very short intervals. Glucose is not absorbed by cells and remain in blood that causes the release of more and more insulin and the production of extra amount of insulin weakens the body and may eventually wear out the beta cells.6 Once the pancreas is no longer able to produce enough insulin than a person becomes hyperglycemic and will be diagnosed with type II diabetes.2
An elevation of systolic and diastolic pressure is another metabolic disorder.1 These patients have normal blood pressure levels about 140/90 mm Hg are considered as elevated. Those patients are highly at risk of CVD.7 In this category, patients are mostly suffer from diabetes mellitus, chronic kidney diseases, coronary artery diseases.7
Obesity is related to the insulin resistance. It contributes to hypertension, hyperglycemia, high serum cholesterol and low HDL-C and these lead to the CVD.4 In this disorder the person’s BMI is increased due to the increase in body mass, and the fatty deposits on the abdomen. Adipose tissues are considered to be the site of energy that could be generate if needed, that’s why they are the active source of inflammatory cytokines and substances that can promote the atherosclerosis. This tissue can cause the abnormalities in liver and muscles owning to alternations or levels of fatty acids within the cells and related changes in fatty acid oxidation.2
It is the another metabolic syndrome caused by the increased in triglycerides level, low HDL-C, and high LDL-C. These patients have elevated concentration of apoB, a lipoprotein whose concentration indicates the presence of highest atherogenic potential. However, apoB concentration may give the clear representation of CVD than LDL-C.3
Fibrinogen and other activators and inhibitors, and C- reactive proteins and elevated with high levels in some patients with some metabolic disorders, resulting in prothrombotic and pro-inflammatory effect. C-reactive protein is highly sensitive protein i-e greater than about 3mg/dl represent the state of inflammation and highly risk of ASCVD.4
It is the state in which normal tissues do not able to target their respective tissues. In this disease, insulin is not able to promote glucose uptake, inhibit hepatic glucose production and suppress lipolysis.7Hyperinsulinemia is developing in this state, and pancreas is unable to secrete sufficient amount of insulin to maintain glucose hemostasis. This disease is associated with increased risk of ASCVD, and it also relates with the type II diabetes.6
The inborn error of galactose metabolism, which is caused by the deficiency of enzyme galactose 1-phosphate uridyltransferase, resulting in accumulation of metabolites galactitol and galactose 1-phosphate. Patients take galactose which cannot be digested by enzymes and remain in blood. Mason and Turner now invented the galactose free milk for infants to prevent them from this condition. The most troubling situation is that when the person continuously takes the galactose free diet is becomes suffer from the long term diseases and the metabolic syndromes.8

It has been declared that the association of individual components of the metabolic syndromes is with breast cancer. The mechanism by which the breast cancer is associated with metabolic syndromes is still unknown. Insulin may exert its effect directly on epithelial cells by activating AKT and ERK pathways which have important roles in tumorigenisis, it also stimulate the breast cancer cells synergistically with oestradiol. 9
In this disease, inflammation occurs in peripheral tissues that lead to multiple impairing or cell functions and body metabolism. In AD, tumors necrosis levels and reactive oxygen species increases in the brain tissues. Neurotoxicity and neurodegeneration occurs in metabolic stress. Metabolic stress also includes disturbances in proteostasis and activation of signaling pathways that mediate cellular stress.11
It is a chronic stress which is due to either reduced uptake of glucose by cells or increased synthesis of glucose. To maintain glucose hemostasis, the adrenocorticotropic activity is elevated during stress; due to this all glucose pathways would be affected.7 In the glycolytic pathway under stressful condition, the pyruvate produce higher amount of lactate anaerobically because of the reduced activity of pyruvate dehydrogenase, in spite of this the TCA cycle activity will be high because of the availability of substrates for TCA cycle by the oxidation of lipids.11
In women and men, metabolic syndromes were seen in 10% and 15% of subjects with NGT, 42% and 64% of those with type II diabetes. The risk of coronary heart diseases and stroke was increased threefold in subjects with the syndromes (P

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1.1- Depending on the situation I am in at work will require a different type of communication. For example, written communication methods like emails, letters and reports are all generally used in a more formal setting; when needing to inform a member of staff about information, while verbal communication will often be appropriate for informal situations – this situation is also obviously used in a meeting setting, but then a report/agenda (written) will be created for the meeting detailing what is to happen or what has been addressed in the meeting. Non-verbal communication involves the use and understanding of body language, this mainly happens when 2 or more people are together. The method of communication I use will always depend on who I am communicating with and also the type of information I am passing over.
1.2- As vaguely mentioned, depending who I am talking to will depend on the method of communication. For example, if I was communicating with a group of children I would change the way I speak so that the children understand the words I am saying, whereas if I was talking with my head of department then it would be a whole different situation.
1.3- a- The aim of having correct grammar is to ensure what is written is correctly understood. When a sentence contains grammatical errors it can be difficult to read and can cause misunderstandings. It is always important to use correct grammar when writing or speaking effectively to help people get a better understanding of what is said and to express communication more precisely and effectively.
b. It is important to use correct sentence structure in business communication so your writing has variation and isn’t always the same. Using a variety of sentence types can emphasise different points and ideas. A good sentence structure allows the communication to be correctly interpreted whereas a poor sentence structure can be easily misinterpreted.
c. It is essential to use correct punctuation to enable the communication to be readable and easy to understand. Correct punctuation is used is a variety of ways in written communication, for example, it is used to separate sentences and to clarify the meaning of something. An error in punctuation can convey an incorrect meaning to what was initially intended.
d. It is important to use the correct spelling in business communications as precise spelling makes it a lot clearer to understand the text. Incorrect spelling can lead to a lot of confusion, mistakes being made and communications being misconstrued. One misspelled word can change the entre meaning of a sentence giving the reader the wrong message or impression, this is called homophones, for example – To,/two/too, know/no, stare/stair and also the most common one there/their/they’re.
1.4- a large part of face to face communication is made up of non-verbal information and is expressed by body language and tone of voice. The tone of your voice includes the volume which you speak, the type of emotion you have will affect the way the words are said and the tone will change. This can lead to being misinterpreted and misjudges on how you say something, passing over the wrong information and impression – especially if you are talking to a manager. Body language reveals subconscious messages when communicating. Examples of body language include eye contact, facial expressions composure and gestures. Body language is recognised as instinctively. Without having to be told what it means. When relaying messages a lot of the time it isn’t what you say it is how you say it, if your body language contradicts this, the message will not be clear to whom you’re talking to.

1.5 Significance of the study
The study revealed sufficient information to the public on how integrity, objectivity, confidentiality and competence of internal auditors influence internal audit effectiveness. Hence, public institutions will benefit from the study findings to improve their internal audit functions.
Also, the study provided useful information which assist national and international professional bodies in reviewing and recommending best approaches of applying code of ethics for internal auditors in their public sectors.
Likewise, the study provided reference materials for students on internal audit courses and consequently contributes to their professional development.
Furthermore, the study is very important to academic researchers as the information provided will assist them in developing research papers focusing on the relationship between internal audit effectiveness and code of ethics for internal auditors. The findings of the study show that, there is a slightly linear relationship between the effectiveness of internal audit function and the elements of the code of ethics for internal auditors. Thus, this kind of findings will ultimately help academic researchers in the fields of auditing and accounting.


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