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Sample records for attending diabetic clinic

  1. Assessment of awareness of diabetic retinopathy among the diabetics attending the peripheral diabetic clinics in melaka, malaysia.

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    Addoor, Krishna R; Krishna, R A; Bhandary, Sulatha V; Khanna, Rajesh; Rao, Lavanya G; Lingam, Kamala D; V S, Binu; Shivaji, Santhosh; Nandannaver, Manjunath

    2011-03-01

    In view of the alarming increase in the incidence of diabetes mellitus in Malaysia, we conducted a study to assess the awareness of complications of diabetes among the diabetics attending the peripheral clinics in Melaka. The study period was from January 2007 to December 2007. 351 patients were included in the study. 79.8% were aware of the complications of diabetes mellitus and 87.2% were aware that diabetes can affect the eyes. However, only 50% of the patients underwent an ophthalmological evaluation. Although awareness was good, the motivation to undergo the assessment was poor.

  2. Depression in diabetic patients attending University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia

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    Birhanu AM

    2016-05-01

    Full Text Available Anteneh Messele Birhanu,1 Fekadu Mazengia Alemu,2 Tesfaye Demeke Ashenafie,3 Shitaye Alemu Balcha,4 Berihun Assefa Dachew5 1School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, 2Department of Midwifery, 3Department of Nursing, 4Department of Internal Medicine, College of Medicine and Health Sciences, 5Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia Background: Diabetes mellitus, frequently associated with comorbid depression, contributes to the double burden of individual patients and community. Depression remains undiagnosed in as many as 50%–75% of diabetes cases. This study aimed to determine the prevalence and associated factors of depression among diabetic patients attending the University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to May 2014 among 422 sampled diabetic patients attending the University of Gondar Hospital Diabetic Clinic. The participants were selected using systematic random sampling. Data were collected by face-to-face interview using a standardized and pretested questionnaire linked with patient record review. Depression was assessed using the Patient Health Questionnaire-9. Data were entered to EPI INFO version 7 and analyzed by SPSS version 20 software. Binary logistic regression analysis was performed to identify factors associated with depression. Results: A total of 415 diabetic patients participated in the study with a response rate of 98.3%. The prevalence of depression among diabetic patients was found to be 15.4% (95% confidence interval (CI: 11.7–19.2. Only religion (adjusted odds ratio [AOR] =2.65 and 95% CI: 1.1–6.0 and duration of diabetes (AOR =0.27 and 95% CI: 0.07–0.92 were the factors associated with depression among diabetic patients. Conclusion: The prevalence of depression was low as compared to other

  3. Understanding issues associated with attending a young adult diabetes clinic: a case study

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    Snow, R; Fulop, N

    2012-01-01

    Diabet. Med. 29, 257–259 (2012) Aims To study the reasons for attendance behaviour from the patient viewpoint at a young adult diabetes outpatient clinic. Methods Attendance rates for 231 clinic appointments over 19 months for 102 patients were calculated. Semi-structured interviews were conducted with a purposive sample of 17 of the 102. The interviews encouraged participants to describe routines, thoughts and feelings around clinic appointments. Observations were made of the clinic system. Themes arising from patients’ emotional and practical issues around attendance were generated from the data. Results ‘Did not attend’ rates for the clinic over the study period were 15.7%. However, bureaucratic problems created many ‘missed’ appointments; most instances of ‘did not attend’ investigated were attributable to communication failures. Participants did not divide neatly into ‘attenders’/’non-attenders’; many had complex mixed attendance records. Most weighed the value of attendance against immediate obstacles such as incompatible work/clinic hours. Reminders were seen as important, particularly for this age group. Respondents identified fear of being judged for ‘poor control’ as a major factor in attendance decisions, suggesting that having a high HbA1c level may lead to non-attendance, rather than vice versa. Conclusions Health professionals’ supportive, non-judgemental attitude is important to patients considering clinic attendance. In this study, improved communication, reminders and flexible hours might reduce ‘did not attend’ rates. PMID:21916969

  4. Prevalence of Chronic Kidney Disease among Patients Attending a Specialist Diabetes Clinic in Jamaica

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    Ferguson, TS; Tulloch-Reid, MK; Younger-Coleman, NO; Wright-Pascoe, RA; Boyne, MS; Soyibo, AK; Wilks, RJ

    2015-01-01

    ABSTRACT Objectives: To estimate the prevalence of chronic kidney disease (CKD) among patients attending the University Hospital of the West Indies (UHWI) Diabetes Clinic and to determine the proportion of patients at high risk for adverse outcomes. Methods: We conducted a cross-sectional study among patients attending the UHWI Diabetes Clinic between 2009 and 2010. Trained nurses administered a questionnaire, reviewed dockets, and performed urinalyses. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Albuminuria was assessed using urine test strips for protein and microalbumin. Chronic kidney disease was defined as an eGFR 300 mg/g) in 62.1%. Overall prevalence of CKD was 86.3% (95% CI 80.4%, 92.2%). Based on KDIGO risk categories, 50.8% were at high risk and 17.4% at very high risk of adverse outcomes. Conclusion: Most patients at the UHWI Diabetes Clinic had CKD and were at high or very high risk of adverse outcomes. Further studies to determine the burden of CKD in other clinical settings and to identify the best strategies for preventing adverse outcomes in developing countries need to be conducted. PMID:26426170

  5. Knowledge of diabetes among type 2 diabetes patients attending a primary health care clinic in Sri Lanka.

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    Perera, D P; De Silva, R E E; Perera, W L S P

    2013-07-01

    Patients' knowledge about their illness is considered important in controlling diabetes and preventing complications. A descriptive, cross-sectional study was conducted among patients attending the diabetes clinic of a primary care level hospital in Moratuwa, Sri Lanka. During a 1-month period in 2009 all consenting patients diagnosed with type 2 diabetes who had been attending the clinic for more than 3 months were included in the study. Using an interviewer administered, structured questionnaire 150 patients (135 females, 15 males) answered 25 questions about diabetes knowledge (scored x4 to give score range 0-100). A majority of patients (70.0%) had a good score (> 65) on the knowledge test but critical gaps in knowledge were revealed, especially regarding knowledge about symptoms of poor control and importance of regular follow-up. Although patients with longer duration of diabetes had higher mean knowledge scores, they also had higher fasting blood glucose levels. Education programmes are needed to address critical gaps in patients' knowledge.

  6. Fungal infections among diabetic foot ulcer- patients attending diabetic clinic in Kenyatta National Hospital, Kenya.

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    Gitau, A M; Ng'ang'a, Z W; Sigilai, W; Bii, C; Mwangi, M

    2011-01-01

    To isolate and identify fungal pathogens associated with dermatophytoses in diabetic patients and identify the spectrum of yeasts colonising diabetic foot ulcers at Kenyatta National Hospital. A cross sectional Laboratory based study. The Kenyatta National Hospital diabetic clinic. Sixty one patients with diabetic foot ulcers from August to November 2009. The five most occurring pathogens were Biopolaris hawaiiensis (5.5%), Trichophyton schoenleinii (3.7%), Aspergillus niger (3.0%), Trichophyton rubrum (3.0%), Fusarium oxysporum (3.0%). Other moulds accounted forless than 3.0%. One suspected case (0.6%) of Penicilium marneffei was isolated although it couldnotbe ascertained due to its high containment requirement. Among the dermatophytes, the most occurring mould was Trichophyton schoenleinii (3.7%) while innon-dermatophyte was Biopolaris hawaiiensis (5.5%). Eight pathogenic yeasts were identified with C. parapsilosis (6.1%) being the most common followed by C. famata (3.0%). Fungal infestation was highest in callus formation (78.6%). Fungal aetiological agents are significant cause of diabetic woundinfection and may require antifungal intervention for successful management of diabetic foot ulcers.

  7. Prevalence of microalbuminuria and its correlates among diabetic patients attending diabetic clinic at National Guard Hospital in Alhasa

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    AlFehaid, Aneesah A.

    2017-01-01

    INTRODUCTION: Diabetes mellitus is one of the most common diseases encountered in clinical practice. Diabetic nephropathy is a common consequence of long-standing diabetes mellitus; microalbuminuria (MA) is considered an early stage of diabetic nephropathy. OBJECTIVES: To determine the prevalence of miciroalbuminuria in diabetic patients and factors associated with MA. MATERIALS AND METHODS: This cross-sectional study was conducted in the diabetic clinic of the primary health center of the National Guard Hospital. Diabetes type 2 patients between the ages of 20–60 years who attended the clinic in 2012 were included in this study. Data were collected by reviewing medical records for demographic and disease-related variables. MA was detected by measuring the albumin to creatinine ratio, and MA was diagnosed if this ratio was between 30 and 300 mg/g on two occasions. RESULTS: MA was found in 37.4% of the sample and the rate was significantly higher among females (P < 0.027). MA was positively related to body mass index (BMI) (P < 0.002), the presence of hypertension (P < 0.000), duration of diabetes (P < 0.000), glycated hemoglobin (P < 0.000), fasting plasma glucose (P < 0.000), and low-density lipoprotein (LDL) (P < 0.043). No statistically significant correlation was found between MA and age, creatinine level, high-density lipoprotein, and triglyceride. CONCLUSION: The prevalence of MA in patients with diabetes in this study was high. The study suggests the need to screen for MA early, and the active management of modifiable risk factors, in particular, hyperglycemia, hypertension, LDL, and BMI, to reduce the burden of future end-stage renal disease. PMID:28163568

  8. Prevalence of Depression among Elderly Diabetes Mellitus Patients Attending Diabetes Clinic at Bangalore Medical College and Research Institute

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    Shivaraj B Mallappa

    2016-03-01

    Full Text Available "Introduction: Depression is the most common psychiatric disorder among the elderly. Diabetes will add additional burden on occurrence of depression. The study was conducted to study the prevalence of the depression among elderly diabetics who are seeking care at a tertiary care centre. Methods: A cross sectional study held at a diabetes clinic of a tertiary care institute with the purposive sample of 100 subjects during the month of March 2013. The diabetic patients who were above the age of 60 years are surveyed.. WHO Geriatric Depression Scale (GDS short form was used to collect the data. Results: Prevalence of Depression among studied population 41%. Mean age of the study population 67.8 (+6.2 years with females constituting 72%. 39 % of the study population was illiterate and 33 % of them did primary schooling. There were significant association of depression with female gender, widows, illiterates, financially dependent and persons with multiple co-morbid conditions. Conclusion: This study has shown that geriatric depression is highly prevalent. The results of this study emphasize the need of intervention studies which can promote the physical, mental and social health of the patient attending the diabetes clinic." [Natl J Community Med 2016; 7(3.000: 198-200

  9. Cardiovascular disease among patients attending a specialist diabetes clinic in Jamaica

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    Ferguson TS

    2011-03-01

    Full Text Available Trevor S Ferguson1, Marshall K Tulloch-Reid1, Novie OM Younger1, Rosemarie A Wright-Pascoe2, Michael S Boyne1, Shelly R McFarlane1, Damian K Francis1, Rainford J Wilks11Epidemiology Research Unit and Tropical Metabolism Research Unit, Tropical Medicine Research Institute, 2Department of Medicine, The University of the West Indies, Mona, Kingston, JamaicaBackground: This study aimed to estimate the prevalence of cardiovascular disease (CVD among patients attending The University Hospital of the West Indies diabetes clinic and to examine the relationship between prevalent CVD and its risk factors.Methods: We analyzed data from 174 patients selected from the University Hospital of the West Indies diabetes clinic using gender-stratified random sampling. An interviewer-administered questionnaire was used to obtain data on self-reported CVD (coronary heart disease [CHD], cerebrovascular disease, and peripheral vascular disease [PVD], physical activity, alcohol consumption, and smoking. Trained nurses performed blood pressure and anthropometric measurements. A capillary blood sample was collected to measure glycosylated hemoglobin, and urine was tested for protein and microalbumin. Means and proportions for patient characteristics, CVD outcomes, and risk factors were calculated. Logistic regression was used to identify factors independently associated with CVD.Results: Data from 129 women and 45 men (mean age 55.7 ± 14.7 years were analyzed. The prevalence of any self-reported CVD (CHD, cerebrovascular disease, or PVD was 34.5% (95% confidence interval [CI] 27.4–41.6. PVD had the highest prevalence (25.9%, compared with CHD (6.9% and cerebrovascular disease (16.1%. There were no gender differences in the prevalence of CVD. Prevalence of CVD was higher among people ≥50 years, and those with high blood pressure, central obesity, high total cholesterol, and duration of diabetes ≥20 years. In multivariable models, duration of diabetes was the most

  10. Foot care and footwear practices among patients attending a specialist diabetes clinic in Jamaica

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    Krystal A.T. Gayle

    2012-10-01

    Full Text Available This study aimed to estimate the proportion of patients at the University Hospital of the West Indies (UHWI Diabetes Clinic who engage in recommended foot care and footwear practices. Seventy-two participants from the UHWI Diabetes Clinic completed an interviewer-administered questionnaire on foot care practices and types of footwear worn. Participants were a subset of a sex-stratified random sample of clinic attendees and were interviewed in 2010. Data analysis included frequency estimates of the various foot care practices and types of footwear worn. Participants had a mean age of 57.0±14.3 years and mean duration of diabetes of 17.0±10.3 years. Fifty-three percent of participants reported being taught how to care for their feet, while daily foot inspection was performed by approximately 60% of participants. Most participants (90% reported daily use of moisturizing lotion on the feet but almost 50% used lotion between the toes. In conclusion, approximately 85% of participants reported wearing shoes or slippers both indoors and outdoors but over 40% reported walking barefoot at some time. Thirteen percent wore special shoes for diabetes while over 80% wore shoes without socks at some time. Although much larger proportions reported wearing broad round toe shoes (82% or leather shoes (64%, fairly high proportions reported wearing pointed toe shoes (39%, and 43% of women wore high heel shoes. Approximately 60% of patients at the UHWI diabetic clinic engage in daily foot inspection and other recommended practices, but fairly high proportions reported foot care or footwear choices that should be avoided.

  11. Prevalence of obesity and systemic hypertension among diabetes mellitus patients attending an out-patient diabetes clinic in a Ghanaian Teaching Hospital.

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    Mogre, Victor; Abedandi, Robert; Salifu, Zenabankara S

    2014-01-01

    Diabetes Mellitus is now a prevalent disease in both developed and developing countries. Overweight/obesity and hypertension are potential modifiable risk factors for diabetes mellitus and persist during the course of the disease. This study was aimed at reporting the prevalence of overweight/obesity and systemic hypertension and their association to blood glucose levels in persons with diabetes mellitus attending a diabetic clinic in Ghanaian Teaching Hospital. This cross-sectional study was conducted among 100 previously diagnosed diabetes mellitus patients attending a diabetic clinic at the Tamale Teaching Hospital, Ghana. Anthropometric variables of age, weight and height were measured with appropriate instruments, computed into BMI and classified according to WHO classifications. Systolic and diastolic blood pressures were measured by an appropriate instrument and classified by WHO standards. Fasting plasma glucose levels of the study participants were recorded from their personal health folder. All data was analysed by GraphPad prism version 5. In general, 7.0% of the participants were underweight and 32.0% were overweight or obese. The mean±SD weight, height and BMI of the participants were 67.53±13.32, 1.68±0.12 and 24.18±5.32. Twenty-one percent of the studied participants were hypertensive. Mean±SD fasting plasma glucose of 7.94±2.82 was observed among the diabetic patients. As the prevalence of hyperglycaemia was higher among patients aged ≤40 years (88.9% vs. 75.8%), normoglycaemia (11.1% vs. 24.2%) was higher among those over 40 years. The differences were not significant. The prevalence of hyperglycaemia was significantly higher in participants with overweight/obese (0.0% vs. 41.6%, phypertension was found. Hyperglycaemia was more prevalent among overweight/obese participants. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  12. Improving physician's adherence to completing vaccination schedules for patients with type 2 diabetes attending non-communicable diseases clinics in West Bay Health Center, Qatar.

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    Tawfik, Hassan; Bashwar, Zelaikha; Al-Ali, Amal; Salem, Mohamed; Abdelbagi, Isameldin

    2015-01-01

    Incomplete vaccination for patients with type 2 diabetes attending non-communicable diseases (NCD) clinics is an issue that could affect patient's health and wellness negatively and puts patients at high risk of serious diseases. We aimed to improve physicians adherence to complete vaccination schedule for patients with type 2 diabetes attending NCD clinics in west bay health center according to American Diabetes Association (ADA) recommendation by 25% by January 2015. In the pre-intervention phase: the quality improvement team designed a checklist to collect the percentage of physician's adherence of prescription of the recommended vaccination for patients with type 2 diabetes. The percentage of complete vaccination in patients with diabetes attending NCD clinic in West Bay Health Center was 20% . In the intervention phase the intervention was in the form of: the creation a vaccination form and attached to the (NCD) progress note; to distribute and remind the physicians about the ADA guidelines vaccination recommendations; a summary of the vaccination schedule developed and attached to (NCD) form; development of vaccination reminder posters and posters in the waiting area, nurse station, and physician clinics and education and orientation sessions for NCD clinic staff. In the post-intervention phase the average percentage of complete vaccination in patients with diabetes attending NCD clinic in West Bay Health Center increased to 69%.

  13. High levels of self-efficacy in patients with type 2 diabetes attending a tertiary level clinic

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    K. Mostert Wentzel

    2008-02-01

    Full Text Available Self-management is a vital element in the care of type 2diabetes patients.  In turn, self-efficacy plays a major role in patients’ self-management. Self-efficacy is the patient’s personal judgement of his/herconfidence in performing aspects of diabetes self-management.  This study investigated the level of self-efficacy of patients attending the Pretoria Academic Hospital Diabetes Clinic, in the light of high levels ofre-admission due to complications, suggesting low self-efficacy levels. Eighty type 2 diabetes patients, mean age of 59 years, completed thepublished IDEA LL baseline questionnaire, to establish a self-efficacyscore.  Relationships between self-efficacy and demographic factors wereinvestigated using the chi-square test. The mean self-efficacy level of thesample population is excellent (mean = 85.44%.A lthough self-reported self-efficacy levels are excellent, in comparison to the Sarkar study (2006 in which participants only scored “fair”, it is speculated that self-efficacy is not transferred to self-management behaviour in thispopulation.  Afrikaans and English speaking participants score significantly better than those from other language categories. There is a positive relationship between self-efficacy and level of education and employment status (tendedtowards significance with p values of 0.06 and 0.07 respectively. A lthough self-efficacy scores of clients at this tertiary level outpatient clinic are excellent, further research is necessary to quantify self-management strategies andto correlate these with self-efficacy levels.

  14. Health literacy and diabetes control in patients attending a university outpatient clinic in Argentina

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    Alexander Ariza Bolivar

    2017-06-01

    Full Text Available Health literacy (HL is a measure of a patient ability to read, understand and to take decisions on medical instructions. Patients with inadequate HL have poorer health outcomes than those with adequate HL. There is little information on HL levels in diabetic patients in Argentina. The aim of this study was to explore the association between HL and glycemic control in diabetic patients from a university hospital in Argentina. HL was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA, glycemic control through glycosylated hemoglobin A1c (HbA1c; 156 patients (58% women took part in the study. Average SAHLSA score was 35 (range: 11-50. Patients with inadequate values of HL had HbA1c of 8.15% vs. 7.15% among those with adequate HL (p = 0.0001. The multiple linear regression shows that inadequate HL was significantly associated with poorer glycemic control (β = -0.05 IC 95% -0.07; -0.02, p < 0.001. Efforts should focus on developing interventions to improve glycemic control among patients with inadequate HL.

  15. [Health literacy and diabetes control in patients attending a university outpatient clinic in Argentina].

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    Ariza Bolivar, Alexander; Lanteri, Martín E; Cícero, Carla Y; Pérez, Adriana; Puchulu, Félix M; Mejía, Raúl

    2017-01-01

    Health literacy (HL) is a measure of a patient ability to read, understand and to take decisions on medical instructions. Patients with inadequate HL have poorer health outcomes than those with adequate HL. There is little information on HL levels in diabetic patients in Argentina. The aim of this study was to explore the association between HL and glycemic control in diabetic patients from a university hospital in Argentina. HL was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA), glycemic control through glycosylated hemoglobin A1c (HbA1c); 156 patients (58% women) took part in the study. Average SAHLSA score was 35 (range: 11-50). Patients with inadequate values of HL had HbA1c of 8.15% vs. 7.15% among those with adequate HL (p = 0.0001). The multiple linear regression shows that inadequate HL was significantly associated with poorer glycemic control (β = -0.05 IC 95% -0.07; -0.02, p < 0.001). Efforts should focus on developing interventions to improve glycemic control among patients with inadequate HL.

  16. Determinants of misconceptions about diabetes among Saudi diabetic patients attending diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia

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    Ahmed A. Alsunni

    2014-01-01

    Full Text Available Objective: To identify the determinants of misconceptions about diabetes in patients registered with a diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia. Materials and Methods: This cross-sectional survey was carried out at a diabetes clinic of a tertiary care hospital in Eastern Saudi Arabia, from January to December 2012. A total of 200 diabetic patients were interviewed using a questionnaire comprising 36 popular misconceptions. The total misconception score was calculated and categorized into low (0-12, moderate (13-24 and high (25-36 scores. The association of misconception score with various potential determinants was calculated using Chi-square test. Step-wise logistic regression was applied to the variables showing significant association with the misconception score in order to identify the determinants of misconceptions. Results: The mean age was 39.62 ± 16.7 and 112 (56% subjects were females. Type 1 diabetics were 78 (39%, while 122 (61% had Type 2 diabetes. Insulin was being used by 105 (52.5%, 124 (62% were self-monitoring blood glucose and 112 (56% were using diet control. Formal education on diabetes awareness had been received by 167 (83.5% before the interview. The mean misconception score was 10.29 ± 4.92 with 115 (57.5% subjects had low misconception scores (15 years since diagnosis, no self-monitoring, no dietary control and no diabetes education were all significantly (P 15 years since diagnosis, no self-monitoring, no diet control and no education about diabetes.

  17. Knowledge of and attitude to foot care amongst Type 2 diabetes patients attending a university-based primary care clinic in Nigeria

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    Rabi I. Ekore

    2010-03-01

    Full Text Available Background: Individuals living with diabetes mellitus are at an increased risk of developing foot ulcers and cardiovascular complications or a neuropathy that may result in amputations. These complications have been shown to be already present in about 10% of diabetic patients at the time of diagnosis.Objectives: This study was carried out to determine the level of awareness and attitude to foot care among adult diabetic patients attending a university health centre (i.e. a primary care centre and to emphasise the ever-present need for health education and promotion and early complication detection (especially of foot problems among diabetic patients.Method: A descriptive cross-sectional, clinic-based study was carried out at the University of Ibadan Health Centre (Jaja Clinic. The study population consisted of consenting adult diabetic patients. Data were collected by the self-administration of structured questionnaires to eligible subjects and were analysed using the SPSS v.15software. Appropriate statistics were employed to analyse the collected data.Results: A total of 137 patients participated in the study and ranged in age from 37 to 75 years, with the mean ± SD age being 58.2 ± 9.2 years. Of the participants, 98 (71.5% were men and 39 (28.5%were women; all of the participants were married. The duration of illness ranged from 1 year to 20 years, with the median duration of illness being 3 ± 1.7 years. One hundred and twenty-six (92%patients had never received any education on foot care from their healthcare providers, while 11(8% had received some form of foot care education. Among those who had never received any foot care education, 92 (73% had been diabetic for 1–5 years, while the remaining 34 (27% had been diabetic for 6 – 20 years. Of the foot care measures that were known, 35 (25.5% patients knew to wash their feet daily and dry in between the toes thoroughly, 31 (22.6% knew not to go outdoors barefooted, 27 (19.7% checked

  18. Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

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    Cárdenas-Elizalde MR

    2012-03-01

    Full Text Available Christian Díaz de León-Castañeda, Marina Altagracia-Martínez, Jaime Kravzov-Jinich, Ma del Rosario Cárdenas-Elizalde, Consuelo Moreno-Bonett, Juan Manuel Martínez-NúñezDepartment of Biological Systems and Health Care, Biological and Health Sciences Division, Universidad Autónoma Metropolitana-Xochimilco, Mexico DF, MexicoIntroduction: Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico's leading cause of death.Purpose: To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City.Design: A cross-sectional and analytic study was conducted in Mexico City.Methodology: Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled.Results: The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the

  19. Blood glucose control and medication adherence among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of eastern Nigeria

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    Iloh GU Pascal

    2012-01-01

    Full Text Available Background: Despite the evidence that goal blood glucose control reduces preventable emergency hospitalizations, the control of blood glucose has been variable in Nigeria. Aim: The study was designed to determine the blood glucose control and medication adherence among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of Eastern Nigeria. Materials and Methods: A cross-sectional study was carried out on 120 adult type 2 diabetic patients who were on treatment for at least 3 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have a goal blood glucose control if the fasting blood glucose was 70-130 mg/dL. Adherence was assessed in the previous 30 days using pretested, interviewer-administered questionnaire on self-reported therapy. Operationally, an adherent patient was one who scored 4 points in the previous 30 days. The reasons for non-adherence were documented. Results: The blood glucose control and medication adherence rates were 61.7% and 72.5%, respectively. Blood glucose control was significantly associated with adherence to treatment (P=0.025 and medication duration ≥3 years (P=0.045. The most common reason for non-adherence was financial constraints (P=0.033. Conclusion: Glycaemic control and medication adherence among the study population were good and should constitute logical targets for intervention.

  20. Prevalence, correlates, attitude and treatment seeking of erectile dysfunction among type 2 diabetic Chinese men attending primary care outpatient clinics

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    Wai Hon Lo; Sau Nga Fu; Carlos King Ho Wong; Ee San Chen

    2014-01-01

    To investigate the prevalence, correlates, attitude and treatment seeking behavior of erectile dysfunction(ED) in type2 diabetes mellitus (T2DM) patients in the primary care setting, a multi‑center cross‑sectional survey using a structured anonymous self‑administered questionnaire was performed in 10 general outpatient clinics. Of the 603 subjects(91% response rate), the prevalence of ED men, as deifned by the International Index of Erectile Function, was 79.1%. Most subjects had mild ED(28.9%), followed by mild‑to‑moderate ED(27.9%), then moderate ED(13.4%) and severe ED(9%). Nearly 55% of those with ED did not consider themselves as having ED. Less than 10% of them had ever sought medical treatment, although 76.1% of them wished to receive management from doctor(s) should they be diagnosed with ED. They considered the most important management from doctors to be clinical assessment(41.7%), followed by management of potential underlying cause(37.8%), referral to specialist(27.5%), education(23.9%), prescription of phosphodiesterase type5 inhibitors(16.9%) and referral to counseling service(6.7%). The prevalence of ED was strongly associated with subjects who thought they had ED(odds ratio(OR)= 90.49(20.00–409.48, P<0.001)) and were from the older age group(OR=1.043(1.011–1.076,P=0.008)). In conclusion, ED is highly prevalent among T2DM men. The majority of them wanted management from doctors should they have ED, but only a minority would actually voice out the request. Screening of ED among T2DM men using structural questionnaire allowed the diagnosis of more than half of the ED cases, which otherwise would have gone undiagnosed.

  1. Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

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    de León-Castañeda, Christian Díaz; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Cárdenas-Elizalde, Ma del Rosario; Moreno-Bonett, Consuelo; Martínez-Núñez, Juan Manuel

    2012-01-01

    Introduction Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico’s leading cause of death. Purpose To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA) in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City. Design A cross-sectional and analytic study was conducted in Mexico City. Methodology Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY) were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled. Results The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the following: 5.82 (glibenclamide), 3.86 (metformin), 3.5 (acarbose), and 6.76 (metformin–glibenclamide). The cost-effectiveness ratios found were US$272.63/QALY (glibenclamide), US$296.48/QALY (metformin), and US$409.86/QALY (acarbose). Sensitivity analysis did not show changes for the most cost-effective therapy when the effectiveness probabilities or

  2. Review and development of referral criteria used to identify patients with diabetes who would benefit from attending a pharmacist-led cardiovascular out-patient clinic

    OpenAIRE

    Westerhus, Ingvild Risan

    2012-01-01

    Abstract Development and validation of new referral criteria: a triangulation study at the Pharmacist-led Diabetes Cardiovascular risk Reduction Clinic, Edinburgh. The Pharmacist-led Diabetes Cardiovascular risk Reduction (DCVR) clinic has been running at the Western General Hospital (WGH), Edinburgh, for 8 years. It was decided to review the referral process of patients and the referral criteria. Semi-structured interviews were performed with nine clinicians at the diabetes clini...

  3. Characterization of diabetic foot patients attended in an army hospital in Recife

    OpenAIRE

    Isabel Cristina Ramos Vieira Santos; Juliana Magalhães Bernardino

    2011-01-01

    This research aims to characterize a profi le of diabetic foot patients attended in an army hospital in Recife, in the year 2005. It is a quantitative study, carried out by surveying all diabetic patients attended in the clinic of the mentioned hospital. The variables of interest used in the form were the following: age, sex, origin, functional situation and co-morbidities. The results found a prevalence of 3. 4% of diabetic foot patients. It was noticed a higher frequency in the age group of...

  4. Dental caries prevalence among type II diabetic and nondiabetic adults attending a hospital

    Science.gov (United States)

    Malvania, Ekta A.; Sheth, Sona A.; Sharma, Ashish S.; Mansuri, Saloni; Shaikh, Faizan; Sahani, Saloni

    2016-01-01

    Objectives: Diabetes mellitus (DM) is a common chronic metabolic disorder which affects millions of people. At present, India has the highest incidence of diabetes worldwide. Several oral lesions and conditions are associated with diabetes. However, there is a lack of consensus among researchers regarding the relationship between DM and dental caries. Hence, the present study was carried out to assess the dental caries prevalence among type II diabetic and nondiabetic adults attending a hospital in Ahmedabad city. Materials and Methods: A hospital-based cross-sectional study was conducted. One hundred and twenty diabetics individuals attending the diabetic Outpatient Department (OPD) and age and sex-matched 120 nondiabetic individuals from general OPD were included in the study. The data were gathered through semi-close-ended questionnaire and clinical examination. Dental caries was assessed by using the World Health Organization's 2013 proforma. Data was analyzed by applying Student's independent t-test or one-way analysis of variance. Results: Dental caries prevalence among the diabetic group was 73.33% and 33.33% among the nondiabetic group. Dental caries prevalence and mean dental caries was significantly higher among uncontrolled diabetic individuals than that among controlled diabetic individuals. Duration of the disease and dental caries prevalence did not show any significant difference. Conclusion: Dental caries prevalence was significantly high among diabetic individuals compared with nondiabetic individuals. Close collaboration between the patients, healthcare units, and oral health professionals could be a way of improving diabetic patients' general and oral health. PMID:28217542

  5. Suicidal ideation in UK HIV clinic attenders.

    Science.gov (United States)

    Sherr, Lorraine; Lampe, Fiona; Fisher, Martin; Arthur, Gilly; Anderson, Jane; Zetler, Sarah; Johnson, Margaret; Edwards, Simon; Harding, Richard

    2008-08-20

    HIV has been associated with elevated suicidal ideation. Although new treatments have changed prognosis, they also bring new challenges. This study measured suicidal ideation in HIV clinic attenders in the United Kingdom (London/Southeast) and explored associated factors. All 1006 attenders at five HIV clinics were approached, of which 903 met inclusion criteria and 778 participated (86% response). Participants provided detailed information on suicidal ideation, demographics, treatment, adherence, symptoms (psychological and physical on Memorial Symptom Assessment Schedule), quality of life (EuroQol) information, HIV disclosure, clinical variables, sexual risk behaviour and treatment optimism. There was a 31% prevalence of suicidal ideation. Factors associated with suicidal ideation were being a heterosexual man, black ethnicity, unemployment, lack of disclosure of HIV status, having stopped antiretroviral treatment (compared to treatment or treatment naive), physical symptoms, psychological symptoms and poorer quality of life. There was no association with sexual risk behaviour. Sex/sexuality and ethnicity were independently associated with suicidal ideation: the odds of suicidal ideation increased almost two-fold for heterosexual men compared with gay men or women and for black respondents compared with White or Asian respondents. Lack of disclosure was independently associated with a two-fold increase in odds of suicidal ideation. Elevated physical and psychological symptoms were strong independent predictors of suicidal ideation. Independent predictors of suicidal ideation were very similar among the subgroup of 492 patients on antiretroviral treatment. Despite advances in treatment, suicidal ideation rates among HIV-positive clinic attenders are high. Emotional support and attention to mental health provision and social context are strongly endorsed.

  6. Non-adherence to diet and exercise recommendations amongst patients with type 2 diabetes mellitus attending Extension II Clinic in Botswana

    Directory of Open Access Journals (Sweden)

    Adewale B. Ganiyu

    2013-01-01

    Full Text Available Background: Patients diagnosed with type 2 diabetes mellitus in Extension II Clinic in Botswana have difficulty in adhering to the lifestyle modifications recommended by healthcare practitioners. Poor adherence to lifestyle recommendations leads to poor control of the condition and consequently to complications.Objectives: The aim of the study was to determine reasons for poor adherence to lifestyle recommendations amongst the patients. The objectives were to determine: reasons for pooradherence to dietary requirements, exercise recommendations, the support they had in adhering to the recommendations, and their understanding of the role of dietary and exercise requirements in the management of their condition.Method: This was a cross-sectional descriptive study. The sample comprised of 105 participants. Data on participants’ baseline characteristics and adherence to dietary and exercise habits were analysed using the SPSS 14.0 version.Results: The sample of 104 participants comprised of 61 (58.7% women. The rates of nonadherence to diet and exercise were 37% and 52% respectively. The main reasons for nonadherence to diet were: poor self-discipline (63.4%; lack of information (33.3% and thetendency to eat out (31.7%. The main reasons for non-adherence to exercise were: lack of information (65.7%; the perception that exercise exacerbated their illness (57.6% and lack of an exercise partner (24.0%.Conclusion: There was a relatively high rate of non-adherence to both diet and exercise recommendations by patients suffering from type 2 diabetes mellitus at Extension II Clinic,Botswana, with non-adherence to exercise recommendations more common.

  7. Glycemic control in diabetic children and adolescents after attending diabetic camp

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    Erwin P. Soenggono

    2011-10-01

    Conclusion Glycemic control in T1DM children and adolescents was significantly improved 3 months after attending diabetic camp compared to that before attending camp. According to subjects’ self-assessment by PedsQL questionnaire, no subjects indicated a poor quality of life for the duration of their illness. [Paediatr Indones. 2011;51:294-7].

  8. Barriers and enablers to diabetic retinopathy screening attendance: Protocol for a systematic review.

    Science.gov (United States)

    Graham-Rowe, Ella; Lorencatto, Fabiana; Lawrenson, John G; Burr, Jennifer; Grimshaw, Jeremy M; Ivers, Noah M; Peto, Tunde; Bunce, Catey; Francis, Jill J

    2016-08-11

    Diabetic retinopathy is a serious complication of diabetes which, if left untreated, can result in blindness. Population screening among people with diabetes has been shown to be clinically effective; however, suboptimal attendance with wide demographic disparities has been reported. To develop quality improvement interventions to maximise attendance, it is important to understand the theoretical determinants (i.e. barriers and enablers) of screening behaviour. The aim of this systematic review is to identify and synthesise the modifiable barriers and enablers associated with diabetic retinopathy screening attendance. Primary and secondary studies will be included if they report perceived barriers/enablers of diabetic retinopathy screening attendance, from the perspectives of people with diabetes and healthcare providers. There will be no restrictions on study design. Studies will be identified from published and grey literature through multiple sources. Bibliographic databases will be searched using synonyms in four search domains: diabetic retinopathy; screening; barriers/enablers; and theoretical constructs relating to behaviour. Search engines and established databases of grey literature will be searched to identify additional relevant studies. Extracted data will include: participant quotations from qualitative studies, statistical analyses from questionnaire and survey studies, and interpretive descriptions and summaries of results from reports. All extracted data will be coded into domains from the Theoretical Domains Framework (TDF) and (for organisational level data) the Consolidated Framework of Implementation Research (CFIR); with domains representing theoretical barriers/enablers proposed to mediate behaviour change. The potential role of each domain in influencing retinopathy screening attendance will be investigated through thematic analysis of the TDF/ CFIR coding. Domain importance will be identified using pre-specified criteria: "frequency" and

  9. Non-attendance at a difficult-asthma clinic.

    Science.gov (United States)

    McDonough, Beverley; Mault, Susan

    Increasing demand for our weekly difficult-asthma clinic means routine appointments are at a premium. This led us to explore the reasons why patients failed to attend for appointments and whether contacting them by telephone within a week of their missed scheduled appointment increased attendance. Memory lapses were the most common reason for non-attendance. Telephoning non-attenders led to a two-fold increase in attendance at subsequent clinics. Non-attendance may be a reflection of poor concordance, which, in itself, may contribute to a patient's difficult asthma.

  10. Risk factors for type 2 diabetes mellitus among patients attending a rural Kenyan hospital

    Directory of Open Access Journals (Sweden)

    Masemiano P. Chege

    2010-03-01

    Full Text Available Background: The Diabetes Management and Information Center in Nairobi has conducted population surveys among rural and urban Kenyans during the last decade. They have reported a rise in the prevalence of diabetes among rural Kenyans from 3% in 2003 to 7% in 2007. Our study was undertaken to investigate rural factors for type 2 diabetes and determine those that could be responsible for this rise in prevalence.Objectives: To describe the risk factors for type 2 diabetes mellitus among patients attending the outpatient clinics in a rural mission hospital in Kenya.Method: Forty-five diabetics and forty-five non-diabetics, resident in this rural hospital’s catchment area for at least 10 years, were randomly selected from patients attending outpatient clinics. Diabetics in a stable condition (not requiring hospitalisation, whose fasting blood sugars were below 6.1 mmol/L, were matched for age and gender with the non-diabetics who came to the hospital for outpatient services. A pilot-tested questionnaire on demography, current and past dietary habits, social habits, and family history was used to collect data. Waist circumference, height and weight were measured and BMI calculated. Data was analysed using SPSS for Windows. The Kruskal–Wallis test was used to compare the medians for the continuous variables, while the chi-squared test was used for the categorical variables. The z-test was used to calculate the relative risk.Results: Ninety participants (26 males, 64 females. The mean age was 61.8 for diabetics and 61.4 for non-diabetics. Childhood starvation (relative risk 2.08, p = 0.0090 and use of cassava for sustenance during childhood starvation (relative risk 3.12, p = 0.0090 were identified as risk factors. Diabetes in close relatives, another risk factor for this population (relative risk 2.2, p = 0.0131. Abdominal obesity was a risk factor for this population (in females relative risk 2.0, p = 0.0010.Conclusion: The risk factors for type 2

  11. Risk factors for type 2 diabetes mellitus among patients attending a rural Kenyan hospital

    Directory of Open Access Journals (Sweden)

    Masemiano P. Chege

    2010-03-01

    Full Text Available Background: The Diabetes Management and Information Center in Nairobi has conducted population surveys among rural and urban Kenyans during the last decade. They have reported a rise in the prevalence of diabetes among rural Kenyans from 3% in 2003 to 7% in 2007. Our study was undertaken to investigate rural factors for type 2 diabetes and determine those that could be responsible for this rise in prevalence.Objectives: To describe the risk factors for type 2 diabetes mellitus among patients attending the outpatient clinics in a rural mission hospital in Kenya.Method: Forty-five diabetics and forty-five non-diabetics, resident in this rural hospital’s catchment area for at least 10 years, were randomly selected from patients attending outpatient clinics. Diabetics in a stable condition (not requiring hospitalisation, whose fasting blood sugars were below 6.1 mmol/L, were matched for age and gender with the non-diabetics who came to the hospital for outpatient services. A pilot-tested questionnaire on demography, current and past dietary habits, social habits, and family history was used to collect data. Waist circumference, height and weight were measured and BMI calculated. Data was analysed using SPSS for Windows. The Kruskal–Wallis test was used to compare the medians for the continuous variables, while the chi-squared test was used for the categorical variables. The z-test was used to calculate the relative risk.Results: Ninety participants (26 males, 64 females. The mean age was 61.8 for diabetics and 61.4 for non-diabetics. Childhood starvation (relative risk 2.08, p = 0.0090 and use of cassava for sustenance during childhood starvation (relative risk 3.12, p = 0.0090 were identified as risk factors. Diabetes in close relatives, another risk factor for this population (relative risk 2.2, p = 0.0131. Abdominal obesity was a risk factor for this population (in females relative risk 2.0, p = 0.0010.Conclusion: The risk factors for type 2

  12. Disparities in attendance at diabetes self-management education programs after diagnosis in Ontario, Canada: a cohort study

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    Cauch-Dudek Karen

    2013-01-01

    Full Text Available Abstract Background Patients newly-diagnosed with diabetes require self-management education to help them understand and manage the disease. The goals of the study were to determine the frequency of diabetes self-management education program utilization by newly-diagnosed patients, and to evaluate whether there were any demographic or clinical disparities in utilization. Methods Using population-level health care data, all 46,553 adults who were diagnosed with any type of non-gestational diabetes in Ontario, Canada between January and June 2006 were identified. They were linked with a diabetes self-management education program registry to identify those who attended within 6 months of diagnosis. The demographic and clinical characteristics of attendees and non-attendees were compared. Results A total of 9,568 (20.6% patients attended a diabetes self-management education program within 6 months of diagnosis. Younger age, increasing socioeconomic status, and the absence of mental health conditions or other medical comorbidity were associated with attendance. Patients living in rural areas, where access to physicians may be limited, were markedly more likely to attend. Recent immigrants were 40% less likely to attend self-management education programs than longer-term immigrants or nonimmigrants. Conclusion Only one in five newly-diagnosed diabetes patients attended a diabetes self-management education program. Demographic and clinical disparities in utilization persisted despite a publicly-funded health care system where patients could access these services without direct charges. Primary care providers and education programs must ensure that more newly-diagnosed diabetes patients receive self-management education, particularly those who are older, poorer, sicker, or recent immigrants.

  13. Prevalence and pattern of use of indigenous medicines in diabetic patients attending a tertiary care centre.

    Science.gov (United States)

    Sethi, Ankur; Srivastava, Saurabh; Madhu, S V

    2011-07-01

    The aim of the study was to see the pattern of use of indigenous medicines in diabetic patients and to find out its correlation with various demographic variables in patients of type 2 diabetes. A sample of 113 patients with diabetes (type 1 and type 2) was interviewed using a structured questionnaire by trained medical personnel about the intake of indigenous medicines. Correlation of intake of indigenous medicines with various demographic variables was assessed using appropriate statistical tests. Male to female ratio in the present study was 1:3. Mean duration of diabetes was 5.2 +/- 2 years. It was found that majority of patients 101/113 (89.4%) attending diabetic clinic were using indigenous medicines in one form or the other. Most common drugs used were karela (78.8%), jamun (65.5%), methi (38.9%) and neem (28.3%). Majority were taking on advice from fellow diabetics (41.6%) and were not sure (39.8%) about the effect. No significant correlation was found with their intake and demographic variables as age, sex, per capita income, duration of diabtes, occupation, cultural background and antidiabetic medicine used. There is a high percentage of indigenous drug use in patients with diabetes which is often not reported. Treating physicians need to be alert to this possibility while managing diabetic patients in order to correctly interpret glycaemic control, hypoglycaemic episodes and other unexplained comorbidities that might arise in them.

  14. Diabetes self-care behaviors and disease control in support group attenders and nonattenders.

    Science.gov (United States)

    Chiou, Chii-Jun

    2014-12-01

    The prevalence rate and mortality rate of diabetes continue to increase annually. Complications associated with poor control of diabetes include renal dialysis, amputation, heart disease, stroke, retinopathy, and vascular disease, all of which have an impact at the individual, family, and national level. This study compares diabetes self-care behavior and disease control efficacy between attenders and nonattenders of a diabetes support group. We used a questionnaire with good validity and reliability to conduct a cross-sectional survey. Diabetes support groups have been established throughout Taiwan for around 2 years. Participants for this study were recruited randomly from a register of support group participants. Support group instructors were asked to collect questionnaires from those attending and not attending their support groups. Ten groups volunteered to participate in this study. We received 147 valid questionnaires from participants attending support groups (attenders) and 93 questionnaires from participants who did not (nonattenders). There were no statistically significant differences between support group attenders and nonattenders in terms of age, educational level, or time since diagnosis of diabetes. Thus, we assumed these two groups as adequately similar to conduct statistical comparisons. Scores for diabetes self-care behavior, disease control, and use of the diabetes passport were all significantly higher among support group attenders than their nonattender peers. Results indicate that people attending diabetes support groups are more likely to have better self-care behavior and disease control than nonattenders. Therefore, we suggest that the government actively promote policies supportive of diabetes support groups.

  15. A qualitative study on why did the poorly-educated Chinese elderly fail to attend nurse-led case manager clinic and how to facilitate their attendance.

    Science.gov (United States)

    Hung, Susanna Lok Lam; Fu, Sau Nga; Lau, Po Shan; Wong, Samuel Yeung Shan

    2015-01-31

    This study explored the views, barriers and facilitators of the poorly-educated elderly who were non-attendee of the nurse-led case manager clinic. The case managers provide assessment for diabetes complication screening and can refer patients to the appropriate multidisciplinary team in public outpatient primary care setting. We adopted qualitative research method by individual semi-structured face to face interviews. Nineteen Chinese type 2 diabetes mellitus subjects aged ≥ 60 who failed to attend the nurse-led case manager clinic were interviewed. They all came from a socially deprived urban district in Hong Kong. Content and thematic analysis was performed. Seven men and twelve women aged 60 to 89 were interviewed. Nine of them received no formal education and ten of them attended up to primary school. The reasons for non-attendance included attitude and poor knowledge towards diabetes complication screening and confusion of the nurse-led clinic as an educational talk. Most respondents could not understand the reason for the screening of diabetic complications, the concept of multidisciplinary care and the procedure and outcomes of nurse assessment. Five respondents were unable to follow multiple appointments because they could not read. Other reasons included physical barriers and comorbidity, family and financial constraint. They either had a tight daily schedule because of the need to take care of family members, or the family members who brought them to clinic had difficulty in attending multiple appointments. Enhanced understanding of the importance and procedure of diabetes multidisciplinary management, a flexible appointment system and a single clear appointment sheet may facilitate their attendance. Poorly-educated Chinese elderly with DM and their care givers faced physical, social and psychological barriers when attending the nurse-led case manager clinic. Strategies targeting on their low literacy include effective communication and education

  16. Screening Response to Hepatitis C Virus Antibodies among Diabetic Patients Attending UITH Nigeria

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    J.A. Ndako

    2011-11-01

    Full Text Available Epidemiological studies have suggested that hepatitis C virus (HCV infection is a risk factor for the development of diabetes mellitus (DM type 2; hence this study was carried out to investigate the prevalence of hepatitis C Virus (HCV among diabetic patients attending University of Ilorin Teaching Hospital (UITH. A total number of one hundred and eighty diabetic patients made up of seventy five males (41.7% and one hundred and five females (58.3% were recruited for the study. Structured questionnaire on demographic data and risk factors for HCV was administered to the participants. The sera of all the subjects were assayed for antibodies to HCV using a fourth generation enzyme linked immunosorbent Assay [Forte Diagnostic Limited], All the sera were tested for antibodies to Hepatitis C virus by ELISA method. The overall prevalence of HCV infection among diabetic patients was 5.0%. Of the nine participants’ positive for anti-HCV antibodies, three were males (1.7% while six were females (3.3%. Although more female attended the diabetic clinic, there was no significant difference between HCV infection and sex (p = 0.603; p>0.05. The prevalence of HCV infection was highest in the 40-60 age categories. Two of the seropositive individuals had elevated transaminases, with one of the two being an alcoholic consumer. Type 2 diabetes is a debilitating disease condition especially in individuals above 30 years of age, with these scenario it has become very vital for screening exercise to be carried out so as to determine the prevalence rate of HCV among diabetic patient.

  17. Patient explanations for non-attendance at type 2 diabetes self-management education

    DEFF Research Database (Denmark)

    Schwennesen, Nete; Henriksen, Jan Erik; Willaing, Ingrid

    2016-01-01

    as reasons for non-attendance. CONCLUSIONS: In this study, patients cited both individual and organisational factors as explaining non-attendance at type 2 diabetes self-management education. Further studies should take into account the importance of timing and of tailoring schedules and content......AIM: To explore reasons for non-attendance at type 2 diabetes self-management education. METHODS: To elicit the main themes explaining non-attendance, 15 semi-structured interviews were conducted with persons referred to, but not attending, self-management education. Systematic text condensation......-management education....

  18. Health profiles of foreigners attending primary care clinics in Malaysia

    National Research Council Canada - National Science Library

    Ab Rahman, Norazida; Sivasampu, Sheamini; Mohamad Noh, Kamaliah; Khoo, Ee Ming

    2016-01-01

    .... Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia...

  19. HIV Prevalence amongst Clients Attending Antenatal Clinic at the ...

    African Journals Online (AJOL)

    Nigerian Journal of Medicine. Journal Home ... HIV Prevalence amongst Clients Attending Antenatal Clinic at the Federal Medical Centre, Makurdi. ET Agida, P Abu, ... 2007 to 30 April, 2007 was carried out. Information ... Article Metrics.

  20. Knowledge and Lifestyle-Associated Prevalence of Obesity among Newly Diagnosed Type II Diabetes Mellitus Patients Attending Diabetic Clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana: A Hospital-Based Cross-Sectional Study

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    Yaa Obirikorang

    2016-01-01

    Full Text Available This study aimed to determine the knowledge and prevalence of obesity among Ghanaian newly diagnosed type 2 diabetics. This cross-sectional study was conducted among diagnosed type 2 diabetics. Structured questionnaire was used to obtain data. Anthropometric measurements and fasting blood sugar levels were also assessed. Participants had adequate knowledge about the general concept of obesity (72.0% and method of weight measurement (98.6% but were less knowledgeable of ideal body weight (4.2%. The commonly known cause, complication, and management of obesity were poor diet (76.9%, hypertension (81.8%, and diet modification (86.7%, respectively. The anthropometric measures were higher among females compared to males. Prevalence of obesity was 61.3% according to WHR classification, 40.8% according to WHtR classification, 26.1% according to WC, and 14.8% according to BMI classification. Being female was significantly associated with high prevalence of obesity irrespective of the anthropometric measure used (p<0.05. Taking of snacks in meals, eating meals late at night, physical inactivity, excessive fast food intake, and alcoholic beverage intake were associated with increased prevalence of obesity (p<0.05. Prevalence of obesity is high among diabetic patient and thus increasing effort towards developing and making education programs by focusing on adjusting to lifestyle modifications is required.

  1. Identification of Individuals With Undiagnosed Diabetes and Pre-Diabetes in a Danish Cohort Attending Dental Treatment

    DEFF Research Database (Denmark)

    Holm, Niels-Christian Reimers; Belstrøm, Daniel; Østergaard, Jakob Appel

    2016-01-01

    BACKGROUND AND OBJECTIVE: It is estimated that 3.6% and 13.6% of the Danish population suffer from undiagnosed type 2 diabetes and pre-diabetes, respectively. Periodontitis is an established complication to diabetes. Identification of individuals with diabetes and pre-diabetes is important...... to reduce diabetes-related complications including periodontitis. The objective of the study was to identify individuals with undiagnosed diabetes or pre-diabetes among individuals attending a dental setting for diagnosis and treatment. METHODS: 291 adults with no history of diabetes were included...... in the study (periodontitis patients n=245, non-periodontitis control individuals n=46). Participants answered questionnaires concerning general health, including family history of diabetes. BMI, waist circumference, fat percentage, and glycated hemoglobin level (HbA1c) were recorded chair-side. Periodontal...

  2. Pre-dialysis clinic attendance improves quality of life among hemodialysis patients

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    Lam Miu

    2002-04-01

    Full Text Available Abstract Background Although previous research has demonstrated that referral to pre-dialysis clinics is associated with favourable objective outcomes, the benefit of a pre-dialysis clinic from the perspective of patient-perceived subjective outcomes, such as quality of life (QOL, is less well defined. Methods A retrospective incident cohort study was conducted to determine if pre-dialysis clinic attendance was a predictor of better QOL scores measured within the first six months of hemodialysis (HD initiation. Inclusion criteria were HD initiation from January 1 1998 to January 1 2000, diagnosis of chronic renal failure, and completion of the QOL questionnaire within six months of HD initiation. Patients receiving HD for less than four weeks were excluded. An incident cohort of 120 dialysis patients was identified, including 74 patients who attended at least one pre-dialysis clinic and 46 patients who did not. QOL was measured using the SF 36-Item Health Survey. Independent variables included age, sex, diabetes, pre-dialysis clinic attendance and length of attendance, history of ischemic heart disease, stroke, peripheral vascular disease, heart failure, malignancy, and chronic lung disease, residual creatinine clearance at dialysis initiation, and kt/v, albumin and hemoglobin at the time of QOL assessment. Bivariate and multivariate linear regression analyses were used to identify predictors of QOL scores. Results Multivariate analysis suggested that pre-dialysis clinic attendance was an independent predictor of higher QOL scores in four of eight health domains (physical function, p Conclusions We conclude that pre-dialysis clinic attendance favourably influences patient-perceived quality of life within six months of dialysis initiation.

  3. Awareness Regarding Anemia, Gestational Diabetes and Pregnancy Induced Hypertension among Antenatal Women Attending Outpatient Department in a Rural Hospital

    OpenAIRE

    George M; George N; Ramesh N

    2016-01-01

    "Introduction: Antenatal mothers should not only be aware of normal antenatal care but also be aware about common morbidities like anemia, gestational diabetes mellitus (GDM), pregnancy induced hypertension (PIH), etc., which can have adverse pregnancy outcomes. This study was conducted to assess the awareness regarding anemia, GDM and PIH among antenatal women attending outpatient clinic in a rural hospital. Methods: This was a cross sectional study done during the period of October-Novem...

  4. Comparison of Optimal Cardiovascular Risk Factor Management in Patients with Type 2 Diabetes Who Attended Urban Medical Health Center with those Attended a Tertiary Care Center: Experiences from Tehran, Iran

    Science.gov (United States)

    Moradi, Sedighe; Haji Ghanbari, Mohammad Javad; Ebrahimi, Hedyeh

    2016-01-01

    Background: Diabetes is a leading cause of cardiovascular disease (CVD). Moreover, CVD accounts for primary cause of death among diabetic patients. Physicians, especially in the primary care setting, have effective role in the management of cardiovascular risk factors. Therefore, we aimed to compare the prevalence of modifiable cardiovascular risk factors in Type 2 diabetic patients attending to an urban health center as a primary care center with Institute of Endocrinology and Metabolism Diabetes Clinic (IEMDC) as a tertiary center. Methods: This cross-sectional study was performed on 200 adult diabetic patients attending urban health center (Abouzar Health Center) and 201 diabetic patients in a tertiary center. The patients’ cardiovascular risk factors including lipid profile, systolic and diastolic blood pressure (BP), and smoking history were recorded. The number of patients who did not achieve the target according to the American Diabetes Association guidelines was determined and compared. Results: The patients in urban health center were older than those who attending IEMDC (P = 0.004). The duration of diabetes was longer among urban center patients (P glycosylated hemoglobin level, high-density lipoprotein level, and systolic BP. Conclusions: Both centers have failure in target achievement in some risk factors; however, the inability of the primary care center in controlling hyperlipidemia in comparison with the tertiary center is a serious warning to provide training about managing dyslipidemia in these centers. PMID:27761215

  5. SELF WOUND MANAGEMENT PRACTICES BEFORE ATTENDING ANTIRABIES VACCINE CLINIC

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    Amit Kumar Mishra, Smita Panda, Prakash Chandra Panda

    2015-07-01

    Full Text Available Introduction: In INDIA almost 20000 people die (40% of world death each year from rabies. Most of these deaths could be prevented by post exposure prophylaxis with wound washing, rabies immunoglobulin & vaccination. Local wound management alone can reduce viral load by up to 80%. Objective: To study self-wound management practices in animal exposure patients before attending a tertiary level ARV clinic. Methodology: Data regarding wound management was collected by individual interview of patients attending the ARV clinic during OCT 2011 to MAR 2012. The data collected in the form of a questionnaire. Analysis of data was done in the Department Of Community Medicine, V.S.S. Medical College, Burla. Results: Total 493 cases of animal exposure were attended during the study period. Most common biting animal was dog (94.5%. 31% of cases were under the age of 10 years & 23% belongs to the age of 10-19 years. Male to female ratio was 3:1. Most of the cases (91% were of category III exposure. Immediate management of wound was practiced by 63-77% of cases before visiting ARV clinic; only 2% wash the wound with running water & soap for 15 minutes. 39% of cases applied Dettol/savlon at the wound side & other 38% applied turmeric, red chilli, kerosene, Band-Aid & ghee locally. Most cases (61% reported to ARV clinic within 24hours.

  6. Predictors for attending annual eye screening for diabetic retinopathy amongst patients with diabetes in an urban community of Beijing

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    Yan-Hong Zou

    2017-07-01

    Full Text Available AIM: To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China. METHODS: A structured interview including questions on attendance of eye screening, knowledge and awareness of diabetic retinopathy was conducted. The presence and degree of retinopathy were assessed using two field non-mydriatic retinal photography. RESULTS: Totally 720 diabetes persons were recruited and 519 were enrolled in this cross-sectional study. In this urban setting of Beijing, among diabetes patients of average of 10y duration, 77% confirmed having undergone at least one eye examination and 61% reported having at least one eye examination with dilated pupil. As for the last 12mo, the number decreased to 210 (47% and 131 (30% separately. Most of the participants (95% were aware that diabetes could affect their vision and that regular eye examination was necessary. Very few of them (12% however were aware that the early stages of diabetic retinopathy presented without symptoms of vision loss. Having attended patient education on diabetes was effective in building awareness about diabetic eye disease and was a significant positive predictor for attending eye screening [education in a year, Adj. OR=0.47 (0.29-0.74, P<0.001, education years ago, Adj. OR=0.56 (0.33-0.96, P=0.036]. The duration of disease also increased the likelihood of having undergone eye screening (Adj. OR=0.96, P<0.05. CONCLUSION: Being exposed to education about the complications of diabetes increases the probability of attending diabetic eye screening. An appropriate patient knowledge building strategy should be made available to patients from the time of diagnosis.

  7. Perceived ethical acceptability of financial incentives to improve diabetic eye screening attendance

    Science.gov (United States)

    Wadge, Hester; Bicknell, Colin; Vlaev, Ivo

    2015-01-01

    Objective To test the ethical acceptability of using financial incentives to increase diabetic retinopathy screening attendance. Background Financial incentives could be an effective way to increase attendance at screening for diabetic retinopathy, although there can be ethical concerns about this approach. Design Survey of people with diabetes in North West London. Those who were due to attend a screening appointment were invited to complete a questionnaire. Key demographic variables included age, gender, and deprivation. Setting and participants A questionnaire was issued to those invited to attend screening in North West London and those who run the screening service. The questionnaire captured views on aspects of the ethical problem and different incentive types. Main variables studied It captured views on the different dimensions of the ethical problem and different types of incentive. In order to understand how views might vary within a population, demographic variables were used to analyze the results. Results and conclusions Vouchers were found to be the most acceptable form of incentive, significantly more so than cash payments. Most rejected the notion of targeting those who need incentivizing, preferring equality. Age was an important factor, with those aged between 40 and 64 the most optimistic about the potential benefits. Higher levels of deprivation were linked to increased acceptability scores. While some ethical concerns are strongly held among certain groups, there is also much support for the principle of incentivizing positive behaviors. This paves the way for future research into the effectiveness of incentivizing diabetic retinopathy screening attendance. PMID:26635964

  8. Self‑Care Activities Among Patients with Diabetes Attending a ...

    African Journals Online (AJOL)

    382 million adults and it is projected to increase to 8.8% and ... Self‑care activities among people with diabetes in coastal Southern India. 60 ..... insulin resistance, better control of blood pressure levels and .... Conflict of Interest: None declared.

  9. [Factors related to self-care in diabetes mellitus patients attended at emergency service in Mexico].

    Science.gov (United States)

    Baquedano, Irasema Romero; dos Santos, Manoel Antônio; Teixeira, Carla Regina de Souza; Martins, Tatiane Aparecida; Zanetti, Maria Lúcia

    2010-12-01

    This cross-sectional study aimed to determine the self-care ability of individuals with type 2 diabetes mellitus and to relate this capacity with some sociodemographic and clinical variables. Participants were 251 patients who attended the Emergency Service at the Mérida Regional Hospital in Yucatán, Mexico, in 2006. Data were obtained through directed home interviews, using a form, a questionnaire and the Self-Care Capacity Scale. Descriptive and correlation statistics were used for data analysis. The results showed 83 (33.5%) subjects with good and 168 (66.5%) subjects with regular ability. A directly proportional correlation was found between self-care ability and years of study (r = 0.124; p religion (rs = -0.435; p < 0.05) and evolution time of the disease (r = -0.667; p < 0.05). These variables should be taken into account to promote self-care for diabetes patients, and further research needs to be developed with a focus on other variables involved in the behavior adopted to benefit their health.

  10. [Cardiovascular risk factor control in a population with longstanding diabetes attending endocrinology departments].

    Science.gov (United States)

    Comi-Diaz, Cristina; Miralles-García, José M; Cabrerizo, Lucio; Pérez, María; Masramon, Xavier; De Pablos-Velasco, Pedro

    2010-12-01

    To determine the degree of control of cardiovascular risk factors (CVRF) in a sample of patients with diabetes mellitus (DM) attending Endocrinology and Nutrition Departments in Spain. An epidemiological, cross-sectional, multicenter and observational study involving 41 Departments of Endocrinology and Nutrition in Spain. Each department selected patients with DM with over 10 years of evolution, which were treated in outpatient settings. Demographic, anthropometric, clinical and biochemical data, including medication, were collected for each participant. 1159 patients who met the inclusion criteria were recruited. 52% of the participants were patients with type 2 DM. The mean duration of DM was 19.6 years. A proportion of 37%, 44%, 27.6% and 25.5% had good control of their blood pressure (BP), low density cholesterol (LDLc), lipids and glucose, respectively, and only 4.3% did well in all factors evaluated. The percentage of poorly controlled BP was four times higher in type 2 than in type 1 DM. Obesity, low cultural level and aggregation of cardiovascular risk factors were associated with poorer control. The degree of control of CVRF in diabetic patients with long disease duration is insufficient. Copyright © 2010 SEEN. Published by Elsevier Espana. All rights reserved.

  11. Prevalence of undiagnosed diabetes and pre-diabetes among hypertensive patients attending Kiambu district Hospital, Kenya: a cross-sectional study.

    Science.gov (United States)

    Meme, Nkatha; Amwayi, Samuel; Nganga, Ziporrah; Buregyeya, Esther

    2015-01-01

    Hypertension (HTN) and diabetes mellitus (DM) are two common non-communicable diseases (NCDs) that are closely linked: one cannot be properly managed without attention to the other. The aim of this study was to determine the prevalence of undiagnosed diabetic and pre-diabetic states that is abnormal glucose regulation (AGR) and factors associated with it among hypertensive patients in Kiambu Hospital, Kenya. We conducted a cross-sectional study from February 2014 to April 2014. Hypertensive patients aged ≥ 18 attending the out-patient medical clinic were included in the study. Pregnant and known diabetic patients were excluded. Data was collected on socio-demographics, behavior, and anthropometrics. Diabetes status was based on a Glycated Haemoglobin (HbA1C) classification of ≥ 6.5% for diabetes, 6.0-6.4% for pre-diabetes and ≤ 6.0% for normal. AGR was the dependable variable and included two diabetic categories; diabetes and pre-diabetes. We enrolled 334 patients into the study: the mean age was 59 years (Standard deviation = 14.3). Of these patients 254 (76%) were women. Thirty two percent (107/334; 32%) were found to have AGR, with 14% (46) having un-diagnosed DM and 18%(61) with pre-diabetes. Factors associated with AGR were age ≥ 45 (OR = 3.23; 95% CI 1.37 ≥ 7.62), basal metabolic index (BMI) ≥ 25 Kg/m(2) (OR = 3.13; 95% CI 1.53 - 6.41), low formal education (primary/none)(OR= 2; 95%CI 1.08 - 3.56) and family history of DM (OR = 2.19; 95%CI 1.16 - 4.15). There was a high prevalence of undiagnosed AGR among hypertensive patients. This highlights the need to regularly screen for AGR among hypertensive patients as recommended by WHO.

  12. ATTAINMENT OF TREATMENT TARGETS AMONG TYPE 2 DIABETIC PATIENTS FIRST ATTENDING A TERTIARY CARE SETTING IN SUBURBAN KERALA

    Directory of Open Access Journals (Sweden)

    Sajeeth Kumar

    2016-03-01

    Full Text Available BACKGROUND Type 2 diabetes is growing in epidemic proportions worldwide, particularly in Asian subcontinent and especially in India. The disease takes a toll on the health system of a country, especially the developing nations. AIMS AND OBJECTIVES To study the attainment of metabolic and anthropometric goals of individuals with type 2 diabetes attending a tertiary care centre. MATERIALS AND METHODS i Informed consents were obtained. ii The study subjects were subjected to a detailed clinical, anthropometrical and biochemical evaluation at baseline by a dedicated diabetologist. iii These data were collected using a structured questionnaire and were analysed using EPI INFO (Ver 3.4.1. RESULTS A total of 350 cases were studied. Overall, 76.3% of patients could not achieve ADA A1c goal and 36.3% had very poor glycaemic control as evidenced by A1c >9%. CONCLUSIONS Despite the increasing awareness of type 2 diabetes both among attending physicians and patients, attainment of treatment targets still is a challenge even at a tertiary care setting. The lifestyle and dietary habits may be a main contributing factor for this situation. More focus needs to be given to nutritional aspects and physical exercise in not only in patients with type 2 diabetes mellitus, but also in apparently healthy individuals of the productive age group so that the disease can be delayed if not prevented.

  13. clinical correlates of 6-minute walk test in type 2 diabetes patient

    African Journals Online (AJOL)

    user

    and knowledge required for safe exercise prescriptions and implementation for ... preproliferative retinopathy, nephropathy, including microalbuminuria; and ... Out of the 133 T2D patients attending the Diabetes Clinic, only 58 (aged 20-60 ...

  14. Retrospective evaluation of the clinical management of patients with periodontal abscesses attending a teaching hospital

    Directory of Open Access Journals (Sweden)

    Modupeoluwa Omotunde Soroye

    2016-01-01

    Full Text Available Aim: This study aimed to examine the clinical management of patients who attended a Nigerian teaching hospital with periodontal abscesses. Setting and Design: This is a retrospective study among patients who attended the Periodontics Clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, between January 2008 and December 2015. Patients and Methods: Information about the diagnosis was obtained from the departmental log book, and case notes were retrieved from record department. Data collection elicited information on age, sex, tribe, frequency of tooth brushing, dental attendance, medical history, clinical features, involved tooth/teeth, and treatment received. Statistical Analysis Used: Epi info version 3.5.1 was used for statistical analysis. Results: Patients aged between 15 and 87 years, with a mean age of 35.53 ± 19.30 years. Majority of patients were males, had minor ethnic extractions, had some form of education, first dental clinic attendees, indulged in once-daily toothbrushing, fully dentate, and had fair/poor oral hygiene. A total of 8.8% and 31.6% of the participants smoked cigarettes and consumed alcohol, respectively. A fifth of the participants had systemic diseases such as hypertension, diabetes mellitus, and peptic ulcer disease. Majority of the participants (91.2% had severe pain. About two-fifths had periodontal abscess around the incisors and the molars. The upper right quadrant was mostly involved (31.6%. Two-fifth of the patients had extraction done. Conclusion: Data from this study revealed periodontal abscess as a severely painful condition in naÏve dental patients, successfully treated mainly through extraction of the implicated tooth/teeth. This implies that oral health awareness and regular dental attendance may prevent its occurrence.

  15. Who attends a UK diabetes screening programme? Findings from the ADDITION-Cambridge study

    Science.gov (United States)

    Sargeant, LA; Simmons, RK; Barling, RS; Butler, R; Williams, KM; Prevost, AT; Kinmonth, AL; Wareham, NJ; Griffin, SJ

    2012-01-01

    Aims One of the factors influencing the cost-effectiveness of population screening for type 2 diabetes may be uptake. We examined attendance and practice- and individual-level factors influencing uptake at each stage of a diabetes screening programme in general practice. Methods A stepwise screening programme was undertaken among 135,825 people aged 40-69 years without known diabetes in 49 general practices in East England. The programme included a score based on routinely available data (age, sex, BMI and prescribed medication) to identify those at high risk who were offered random capillary blood glucose (RBG) and glycosylated haemoglobin tests. Those screening positive were offered fasting capillary blood glucose (FBG) and confirmatory oral glucose tolerance tests (OGTT). Results 33,539 high risk individuals were invited for a RBG screening test; 24,654 (74%) attended. 94% attended the follow-up FBG test and 82% the diagnostic OGTT. 70% of individuals completed the screening programme. Practices with higher GP staff complements and those located in more deprived areas had lower uptake for RBG and FBG tests. Male sex and a higher BMI were associated with lower attendance for RBG testing. Older age, prescription of antihypertensive medication and a higher risk score were associated with higher attendance for FBG and RBG tests. Conclusions High attendance rates can be achieved by targeted stepwise screening of individuals assessed as high risk by data routinely available in general practice. Different strategies may be required to increase initial attendance, ensure completion of the screening programme, and reduce the risk that screening increases health inequalities. PMID:20722672

  16. Maternal and fetal outcome of mothers with gestational diabetes mellitus attending BIRDEM Hospital.

    Science.gov (United States)

    Sajani, T T; Rahman, M T; Karim, M R

    2014-04-01

    Gestational diabetes mellitus, most of which progress to type-2 diabetes mellitus is increasing worldwide. Identification of gestational diabetes and control of glucose can reduce such complications and improve maternal and neonatal health. A hospital based cross sectional study was conducted to find out maternal and fetal outcome of gestational diabetes from January to July 2011. Data were collected from 109 gestational diabetes mothers attending Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) hospital for delivery. Study revealed that gestational diabetes was more common among mothers aged >25 years old and multiparaous women. Mean gestational age of diagnosis was 16.82±9.54 weeks. Sixty eight (68%) mothers were diagnosed before 20 weeks of gestation and more than 90% mothers with gestational diabetes delivered by caesarean section. Mean pregnancy weight gain was 6.8±1.18kg. Adverse maternal outcome observed in 24% cases and adverse fetal outcome was present in 34% cases. In univariate analysis weeks of delivery and fasting blood sugar were statistically significantly associated with adverse pregnancy outcome. Babies born to mothers with only diet restriction had less birth weight than mothers with insulin therapy. Pregnancy thought to be the most vulnerable stage of women's life and protecting her health along with her fetus during this period yields a positive impact on the health of future generation. Particular attention should be given during antenatal period to initiate screening programme and treatment protocol for gestational diabetic mothers.

  17. Gestational diabetes: A clinical update

    Science.gov (United States)

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov; Iversen, Ditte Smed; Moeller, Niels; Ovesen, Per

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance of clarity and consensus. If newly proposed criteria are adopted universally a significantly growing number of women will be diagnosed as having GDM, implying new therapeutic challenges to avoid foetal and maternal complications related to the hyperglycemia of gestational diabetes. This review provides an overview of clinical issues related to GDM, including the challenges of screening and diagnosis, the pathophysiology behind GDM, the treatment and prevention of GDM and the long and short term consequences of gestational diabetes for both mother and offspring. PMID:26240703

  18. Complications and characteristics of patients referred to a joint diabetes renal clinic in Ireland.

    LENUS (Irish Health Repository)

    Thabit, H

    2012-12-01

    Joint diabetes renal (JDR) clinics are recommended as the appropriate model of care to manage advanced diabetic-associated renal failure. We performed a retrospective review of clinical data and records of the first 60 patients who attended our service and their follow-up at 12 months.

  19. Correlates of depressive symptoms in individuals attending outpatient stroke clinics.

    Science.gov (United States)

    Vermeer, Julianne; Rice, Danielle; McIntyre, Amanda; Viana, Ricardo; Macaluso, Steven; Teasell, Robert

    2017-01-01

    Background and purpose Depressive symptoms are common post-stroke. We examined stroke deficits and lifestyle factors that are independent predictors for depressive symptomology. Methods A retrospective chart review was performed for patients' post-stroke who attended outpatient clinics at a hospital in Southwestern Ontario between 1 January 2014 and 30 September 2014. Demographic variables, stroke deficits, secondary stroke risk factors and disability study measures [Patient Health Questionnaire-9 (PHQ-9) and Montreal Cognitive Assessment (MoCA)] were analyzed. Results Of the 221 outpatients who attended the stroke clinics (53% male; mean age = 65.2 ± 14.9 years; mean time post-stroke 14.6 ± 20.1 months), 202 patients were used in the final analysis. About 36% of patients (mean = 5.17 ± 5.96) reported mild to severe depressive symptoms (PHQ-9 ≥ 5). Cognitive impairment (CI), smoking, pain and therapy enrollment (p depressive symptoms. Patients reporting CI were 4 times more likely to score highly on the PHQ-9 than those who did not report CI (OR = 4.72). While controlling for age, MoCA scores negatively related to depressive symptoms with higher PHQ-9 scores associated with lower MoCA scores (r= -0.39, p depressive symptoms are common in the chronic phase post-stroke and were partially related to cognition, pain, therapy enrollment and lifestyle factors. Implications for Rehabilitation Stroke patients who report cognitive deficits, pain, tobacco use or being enrolled in therapy may experience increased depressive symptoms. A holistic perspective of disease and lifestyle factors should be considered while assessing risk of depressive symptoms in stroke patients. Patients at risk for depressive symptoms should be monitored at subsequent outpatient visits.

  20. Do women requesting only contraception find attendance at an integrated sexual health clinic more stigmatizing than attendance at a family planning-only clinic?

    Science.gov (United States)

    Sauer, Ulrike; Singh, Arti; Rubenstein, Punam; Pittrof, Rudiger

    2013-01-01

    Both sexually transmitted infections and the genitourinary medicine clinics that patients attend for management of sexually transmitted infections are stigmatized by patients' perceptions. The aim of this study was to assess whether women requesting contraception only find attendance at an integrated sexual health clinic (ISHC) more stigmatizing than attendance at a family planning (FP)-only clinic. Women requesting contraception only were asked to complete a stigma assessment questionnaire in the waiting room of the clinic they attended. Ease of understanding was assessed for each item of the questionnaire prior to commencement of the survey. The questionnaire was given to women attending either an ISHC or a FP-only clinic. One hundred questionnaires that fulfilled the inclusion criteria were returned. The users of FP-only services were generally older than the users of ISHCs and were more likely than the users of ISHCs to classify themselves as UK white. Stigma perception was significantly higher for the ISHC than the FP-only clinic. The results of this research indicate that among women who request contraception only, perceived stigma is higher when they attend an ISHC than when they attend a FP-only clinic. As this survey only enrolled clinic users, the authors were unable to assess whether integration generates sufficient stigma to deter some women from accessing contraception from integrated services. Of all stigma-related issues, disclosure concerns are likely to be the most important to the service user. Stigma is not an issue of overriding concern for most service users.

  1. Managing mood disorders in patients attending pulmonary rehabilitation clinics

    Directory of Open Access Journals (Sweden)

    Selvarajah S

    2013-01-01

    Full Text Available Colleen Doyle,1–3 David Dunt,2 David Ames,1 Suganya Selvarajah11National Ageing Research Institute, Royal Melbourne Hospital Royal Park Campus, Parkville, Victoria, Australia; 2Centre for Health Policy, Programs and Economics, University of Melbourne, Parkville, Victoria, Australia; 3Australian Catholic University, Fitzroy, Victoria, AustraliaBackground: There is good evidence for the positive benefits of pulmonary rehabilitation (PR in the prevention of hospital admissions, lower mortality, and improved health-related quality of life. There is also increasing evidence about the impact of PR on mental health and, in particular, mood disorders. We aimed to identify how depression in chronic obstructive pulmonary disease (COPD patients in Victoria, Australia, is being managed in PR, to identify the prevalence of depressive symptoms among COPD patients who attend PR, and to determine whether patients with depressive symptoms or anxiety symptoms dropped out of PR early.Method: Of 61 PR clinics, 44 were invited and 22 agreed to participate. Telephone interviews were conducted to see how depression and anxiety in COPD patients were being recognized and managed in these clinics. A total of 294 questionnaires were distributed to patients by clinic coordinators to determine the prevalence of anxiety/depression, as measured by the Hospital Anxiety and Depression Scale. Coordinators were contacted to provide information on whether respondents dropped out of rehabilitation early or continued with their treatment at 2–4 months post program.Results: Seven clinics were not aware of local guidelines on assessment/treatment/management of mood. Four clinics did not use any screening tools or other aids in the recognition and management of depression and/or anxiety. Overall, eight clinics participating in this study requested advice on suitable screening tools. The patient survey indicated that the mean depression score on the Hospital Anxiety and Depression

  2. Partner change among Norwegian teenage girls attending youth health clinics.

    Science.gov (United States)

    Egil Skjeldestad, Finn; Nilsen, Stine

    2008-01-01

    To examine incidence and risk factors of partner change among Norwegian teenage girls attending youth health clinics. Prospective cohort study. Setting. Study subjects were 691 girls, aged 16 to 19 years, who participated in a study on prescription of oral contraceptives at three youth health clinics in the city of Trondheim, Norway. Eligible for analysis were participants who were sexually active, and who returned for at least one follow-up visit more than 120 days after study start. All demographic and behavior data were collected through interview by public health nurses. All analyses were performed with SPSS for Windows (version 15.0) using chi-square test, survival analyses and logistic regression. New sexual male partners. Four out of five girls (80%) did not have any new partner during the study period of 12 months. From survival analyses the 12-month incidence rate were 29.8 (95% CI: 25.3-34.1) and 10.6 per 100-women months (95% CI: 7.3-13.9) for one or two or more partners, respectively. Predictors of partner change were partner change during the last six month prior study start, being single and sexual debut within three years after menarche. CONCLUSION. Being in a regular relationship with a boyfriend reduce considerably the risk of having a new sexual partner. Recent history of partner change is the strongest predictor of future partner change.

  3. Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India.

    Science.gov (United States)

    Sendhilkumar, Muthappan; Tripathy, Jaya Prasad; Harries, Anthony D; Dongre, Amol R; Deepa, Mohan; Vidyulatha, Ashok; Poongothai, Subramanian; Venkatesan, Ulaganathan; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2017-01-01

    We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. The prevalence of high/very high stress was 35% among DM patients. Age 30-40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity.

  4. Dentoalveolar abscess among children attending a dental clinic in Nigeria.

    Science.gov (United States)

    Azodo, C C; Chukwumah, N M; Ezeja, E B

    2012-09-01

    To determine the incidence and causes of dentoalveolar abscess among children attending an outpatient dental clinic in Nigeria. This is a retrospective study of paediatric dental patients treated in University of Benin Teaching Hospital, Benin City from October 2010 to September 2011. The incidence of dentoalveolar abscess was 6.4% (53/824). However only 42 cases had their case notes retrieved for final research analysis. It occurred mostly in the lower right quadrant of the mouth. The affected children were majorly males and first or second child of monogamous family. A total 17 (40.5%) of the affected children were in the 6-11 years age group. This was the first dentist consultation among 35 (83.3%) of the children. The presenting complaint was toothache among two-thirds of the children. History of asthma, tonsillitis, peptic ulcer disease and previous surgery were medical history elicited from 6 (14.3) of the patients. The most implicated tooth was deciduous first molar. The causes of abscess include untreated dental caries 35 (83.3%), trauma 5 (11.9%), failed restoration 1 (2.4%) and periodontal diseases 1 (2.4%). Periapical radioluscency was predominant radiological finding among affected children. Tooth extraction was commonest treatment done. The incidence of dentoalveolar abscess among children was significant. The high frequency of untreated dental caries as the cause of dentoalveolar abscess indicates the need for school and community-based preventive strategies like encouraging infant oral health and preventive dentistry programs and early treatment intervention and dental health education.

  5. Physicians′ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria

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    Nahla Khamis R Ibrahim

    2010-01-01

    Full Text Available Objectives: The objectives of the study were to investigate physician′s therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. Material and Methods: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient′s knowledge and skills, patient′s compliance, doctor-patient relationship, and glycemic control. Results: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3% of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient′s knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. Conclusions: Patient′s compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient′s compliance should be improved by conducting educational and training programs.

  6. Do women requesting only contraception find attendance at an integrated sexual health clinic more stigmatizing than attendance at a family planning–only clinic?

    Directory of Open Access Journals (Sweden)

    Sauer U

    2013-02-01

    Full Text Available Ulrike Sauer,1 Arti Singh,2 Punam Rubenstein,1 Rudiger Pittrof3 1Department of Reproductive and Sexual Health Services, Enfield Community Services, London, UK; 2University Health Services, KNUST Hospital, Kumasi, Ghana, 3Guy’s and St Thomas’ NHS Trust, London, UK Purpose: Both sexually transmitted infections and the genitourinary medicine clinics that patients attend for management of sexually transmitted infections are stigmatized by patients’ perceptions. The aim of this study was to assess whether women requesting contraception only find attendance at an integrated sexual health clinic (ISHC more stigmatizing than attendance at a family planning (FP–only clinic. Patients and methods: Women requesting contraception only were asked to complete a stigma assessment questionnaire in the waiting room of the clinic they attended. Ease of understanding was assessed for each item of the questionnaire prior to commencement of the survey. The questionnaire was given to women attending either an ISHC or a FP-only clinic. Results: One hundred questionnaires that fulfilled the inclusion criteria were returned. The users of FP-only services were generally older than the users of ISHCs and were more likely than the users of ISHCs to classify themselves as UK white. Stigma perception was significantly higher for the ISHC than the FP-only clinic. Conclusion: The results of this research indicate that among women who request contraception only, perceived stigma is higher when they attend an ISHC than when they attend a FP-only clinic. As this survey only enrolled clinic users, the authors were unable to assess whether integration generates sufficient stigma to deter some women from accessing contraception from integrated services. Of all stigma-related issues, disclosure concerns are likely to be the most important to the service user. Stigma is not an issue of overriding concern for most service users. Keywords: stigma, one-stop shop, sexually

  7. Infant Feeding among Women Attending an Immunisation Clinic at a Tertiary Health Institution in Ibadan, Nigeria

    Science.gov (United States)

    Fatiregun, A. A.; Abegunde, V. O.

    2009-01-01

    Maternal characteristics can affect a mother's decision to breastfeed. This study used a cross-sectional design to assess maternal variables and infant feeding patterns among nursing mothers attending an immunisation clinic in Ibadan, Nigeria. A total of 264 mothers who consecutively attended the immunisation clinic and met certain inclusion…

  8. LIPID PROFILE OF TYPE 2 DIABETES PATIENTS ATTENDING AN URBAN HEALTH CENTRE IN GOA, INDIA

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    Nitin Y. Dhupdale

    2016-08-01

    Full Text Available The Global Diabetes Report 2016 states, “Globally, an estimated 422 million adults were living with diabetes in 2014 compared to 108 million in 1980. Diabetes is especially a significant secondary cause for the development of dyslipidaemia. Diabetes patients are prone to have an atherogenic mixture of high Triglycerides (TGs; high, small, dense Low-Density Lipoprotein (LDL fractions; and low High-Density Lipoprotein (HDL. This study is aimed at finding the prevalence of dyslipidaemia among type 2 diabetes patients residing in a suburban area of Goa. METHODOLOGY A record-based cross-sectional study design was employed to find the proportion of dyslipidaemia prevalent among the type 2 diabetes patients attending OPD of the Urban Health and Training Centre (UHTC at Santa Cruz in Goa. A sample of 100 type 2 DM patient records were randomly selected to capture the information of the type 2 DM patients. Patient records of fasting and postprandial blood sugars and fasting lipid parameters were utilised for this study. SPSS version 23 was utilised for statistical analysis; proportions, and chi-square test were used for analysis. RESULTS The overall prevalence of dyslipidaemia was 85% among the type 2 DM cases. Prevalence of hyperlipidaemia among females was high (88.7% as compared to males (78.9%. The mean level of total cholesterol was 188.78±38.25 mg/dL. Mean HDL-C level was 48.5±14.06 mg/dL. Mean value of LDL-C was 109.93±35.67 mg/dL. Mean level of LDL-C was 137.67±59.77 mg/dL. CONCLUSION The type 2 diabetes patients have very high prevalence of dyslipidaemia and should be monitored on regular basis to prevent cardiovascular events.

  9. [Effectiveness of the kit Conversation Map in the therapeutic education of diabetic people attending the Diabetes Unit in Carpi, Italy].

    Science.gov (United States)

    Ciardullo, Anna Vittoria; Daghio, Maria Monica; Fattori, Giuseppe; Giudici, Graziella; Rossii, Lorella; Vagnini, Claudio

    2010-12-01

    We implemented the "Diabetes conversations", programme of the International Diabetes Federation-Europe, characterised by the use of the Conversation Map, an educational interactive kit addressed to groups of diabetic patients on: Living with diabetes, What is diabetes, Healthy diet and physical activity, Initiating insulin therapy. After at least three month from the end of the 4-session course, clinical data of 63 participants from the first 10 groups--age (mean +/- std dev) 61.7 +/- 10.2 years, 56% women, 18.5% T1DM-improved: fasting glycemia decreased from 152.9 +/- 55.2 to 138.2 +/- 38.9 mg/dl (P Conversation Maps are useful because: (a) contribute to improve glycometabolic control; (b) educate patients on the main topics related to diabetes; (c) give to the nurse a key and active role in patients'education; (d) facilitate the connection between knowledge and behaviour; (e) involve the volunteers of the diabetic association as tutors; (f) improve the relationship and the communication between the doctor/nurse and the patient.

  10. Truth telling in medical practice: students' opinions versus their observations of attending physicians' clinical practice.

    Science.gov (United States)

    Tang, Woung-Ru; Fang, Ji-Tseng; Fang, Chun-Kai; Fujimori, Maiko

    2013-07-01

    Truth telling or transmitting bad news is a problem that all doctors must frequently face. The purpose of this cross-sectional study was to investigate if medical students' opinions of truth telling differed from their observations of attending physicians' actual clinical practice. The subjects were 275 medical clerks/interns at a medical center in northern Taiwan. Data were collected on medical students' opinions of truth telling, their observations of physicians' clinical practice, students' level of satisfaction with truth telling practiced by attending physicians, and cancer patients' distress level when they were told the truth. Students' truth-telling awareness was significantly higher than the clinical truth-telling practice of attending physicians (ptruth telling of attending physicians (mean ± SD=7.33 ± 1.74). However, our data also show that when cancer patients were informed of bad news, they all experienced medium to above average distress (5.93 ± 2.19). To develop the ability to tell the truth well, one must receive regular training in communication skills, including experienced attending physicians. This study found a significant difference between medical students' opinions on truth telling and attending physicians' actual clinical practice. More research is needed to objectively assess physicians' truth telling in clinical practice and to study the factors affecting the method of truth telling used by attending physicians in clinical practice. Copyright © 2012 John Wiley & Sons, Ltd.

  11. An Internal Audit of Diabetes Care for Type 2 Diabetic Patients in a Public Hospital Diabetes Clinic in Malaysia.

    Science.gov (United States)

    Hieng, Yung Chun

    2017-03-01

    Earlier studies have identified a gap between guidelines and actual clinical diabetes care in Malaysia. We audited the quality of care for patients with type 2 diabetes mellitus (T2DM) attending our diabetes clinic at a public hospital. A structured review of the outpatient clinic cards, prescriptions and laboratory results was conducted for patients attending the diabetes clinic at Sibu Hospital in October and November 2014. For the total of 233 patients who were audited, the levels of fasting blood sugar, blood pressure, body mass index and fasting lipid profile were satisfactory at 99.1%, 99.6%, 92.6% and 99.6% respectively. 79.7% of the subjects had had HbA1c performed at least once over the previous six months. Only 25.8% had annual foot screening, while the eye screening rate was 71.2% and the albuminuria screening rate was 93.6%. For outcome measures, the mean (SD) HbA1c level was 9.2% (1.91%), with 13 patients (6.7%) having HbA1c less than 6.5%; 36.4% of participants achieved BP < 130/80 mmHg; and 69.4% had LDL < 2.6 mmol/L. The majority of the patients were overweight or obese (91.4%). Overall, the performance of diabetic care processes at our hospital was satisfactory, except for foot examination. The glycaemic and weight control among the subjects were suboptimal and warrant an optimised and comprehensive approach on the part of the management.

  12. Transformation of the multidisciplinary diabetic foot clinic into a multidisciplinary diabetic foot day unit: results from a service evaluation.

    Science.gov (United States)

    Manu, Chris A; Mustafa, Omar G; Bates, Maureen; Vivian, Gill; Mulholland, Nicola; Elias, David; Huang, Dean Y; Deane, Colin; Cavale, Naveen; Kavarthapu, Venu; Rashid, Hisham; Edmonds, Michael

    2014-09-01

    The natural history of the diabetic foot is aggressive and complex. To counteract this, we describe the transformation of a Multidisciplinary Diabetic Foot Clinic into a Multidisciplinary Diabetic Foot Day Unit, which delivers an emergency open access system for patients, with a "one-stop," same day service in which investigations are performed, results reviewed and treatment implemented. It also provides joint clinics with vascular, orthopaedic, and plastic surgeons and specialized clinics for casting of complex neuropathic feet and for the administration of intravenous or intramuscular antibiotics on the same day. The aim was to document these increasingly wide-ranging facilities by undertaking a retrospective evaluation over a 6-week period, with analysis of notes, investigations, and an anonymous patient satisfaction survey. The clinic was visited by 597 patients who attended in 1076 appointments, of which 112 (10.4%) were emergency visits; these patients attended the clinic without a booked appointment but via an open access policy, 93 of whom were known to the clinic, but 19 were new self-referred patients to the service. Furthermore, 197 (18%) were seen in a Joint Vascular Diabetic Foot Clinic and 98 (9%) were seen in a Joint Orthopaedic Plastic Diabetic Foot Clinic, 570 (53%) were seen in an Active Ulcer Clinic and 97 (9%) in a Total Contact Casting Clinic. Forty-five percent of patients were prescribed antibiotics, including 188 (76%) as oral and 45(18%) as intravenous antibiotics and 15(6%) as intramuscular injections. Of the 1076 appointments, 150 (14%) patients were in the foot clinic for more than 4 hours. Sixty (10%) patients were reviewed 4 or more times over the 6-week period. Only 22 (2%) were admitted to hospital. Of the 125 survey responders, 98% were satisfied with this service, which has evolved from a Diabetic Foot Clinic into a Multidisciplinary Diabetic Foot Day Unit.

  13. Attendance, weight and waist circumference outcomes of patients with type 2 diabetes receiving Medicare-subsidised dietetic services.

    Science.gov (United States)

    Spencer, Lisa; O'Shea, Marie-Claire; Ball, Lauren; Desbrow, Ben; Leveritt, Michael

    2014-01-01

    The aim of the present study was to investigate the participation and weight and waist circumference outcomes of patients with type 2 diabetes (T2D) receiving Medicare-subsidised dietetic services. A prospective observational study was conducted between January and September 2011 involving three private practice dietitians who provided services at 11 medical centres in south-east Queensland. All patients with T2D who were referred by their general practitioner (GP) to one of the dietitians as part of their team care arrangements were asked to participate. Participants' attendance at consultations was recorded for the study duration. The dietitian collected weight and waist circumference measures at each consultation. In all, 129 participants (mean age 58.9 ± 15.7 years; mean body mass index 32.2 ± 5.6 kgm⁻²) were included in the study. The most frequent number of consultations allocated to a dietitian was two. Small, but significant reductions in bodyweight (1.9 ± 2.9 kg; P ≤ 0.05) and waist circumference (2.0 ± 4.8 cm; P ≤ 0.05) were observed from the initial to final consultation. Participants who attended more than two consultations lost significantly more weight than those who attended two consultations only (3.7 ± 4.2 vs 1.1 ± 1.6 kg, respectively; P ≤ 0.05). Almost one-third of participants (n=38; 29%) did not complete the allocated number of consultations available through their referral. Modest weight and waist circumference reductions are achievable for patients with T2D receiving Medicare-subsidised dietetic services. The clinical significance of these reductions requires further investigation. Patients who attend more consultations with a dietitian may experience further improvements in weight and waist circumference outcomes. However, many patients do not complete the number of consultations allocated. Further research is required to explore the determinants of attendance at consultations in order to maximise potential improvements in

  14. Prevalence of depression among women attending a primary urban care clinic in Malaysia

    National Research Council Canada - National Science Library

    Sidik, Sherina Mohd; Arroll, Bruce; Goodyear-Smith, Felicity; Ahmad, Rozali

    2012-01-01

    Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic...

  15. HIV/TB Co-infection Among HIV Positive Children Attending Clinics ...

    African Journals Online (AJOL)

    HIV/TB Co-infection Among HIV Positive Children Attending Clinics In Imo State ... of tuberculosis in children is partly attributed to the coexisting burden of human ... The factors found to affect TB development significantly were stage of HIV ...

  16. Student attendance and academic performance in undergraduate obstetrics/gynecology clinical rotations.

    Science.gov (United States)

    Deane, Richard P; Murphy, Deirdre J

    2013-12-04

    Student attendance is thought to be an important factor in the academic performance of medical students, in addition to having important regulatory, policy, and financial implications for medical educators. However, this relationship has not been well evaluated within clinical learning environments. To evaluate the relationship between student attendance and academic performance in a medical student obstetrics/gynecology clinical rotation. A prospective cohort study of student attendance at clinical and tutorial-based activities during a full academic year (September 2011 to June 2012) within a publicly funded university teaching hospital in Dublin, Ireland. Students were expected to attend 64 activities (26 clinical activities and 38 tutorial-based activities) but attendance was not mandatory. All 147 fourth-year medical students who completed an 8-week obstetrics/gynecology rotation were included. Student attendance at clinical and tutorial-based activities, recorded using a paper-based logbook. The overall examination score (out of a possible 200 points) was obtained using an 11-station objective structured clinical examination (40 points), an end-of-year written examination comprising 50 multiple-choice questions (40 points) and 6 short-answer questions (40 points), and an end-of-year long-case clinical/oral examination (80 points). Students were required to have an overall score of 100 points (50%) and a minimum of 40 points in the long-case clinical/oral examination (50%) to pass. The mean attendance rate was 89% (range, 39%-100% [SD, 11%], n = 57/64 activities). Male students (84% attendance, P = .001) and students who failed an end-of-year examination previously (84% attendance, P = .04) had significantly lower rates. There was a positive correlation between attendance and overall examination score (r = 0.59 [95% CI, 0.44-0.70]; P attendance (r = 0.50 [95% CI, 0.32-0.64]; P attendance (r = 0.57 [95% CI, 0.40-0.70]; P

  17. Knowledge of diabetes mellitus in privately- funded diabetic patients attending a rural optometric practice in Malmesbury, South Africa*

    Directory of Open Access Journals (Sweden)

    K. C. Phillips

    2012-12-01

    Full Text Available Patient knowledge about diabetes mellitus (DM and appropriate timely management with respect to the condition are important factors for limiting the complications of the disease. The aim of this study was to evaluate knowledge and practices regarding DM, its ocular effects and management protocols among privately-funded diabetic patients. A questionnaire containing questions on these issues and certain demographics was provided to 73 self-funding or privately-funded diabetic patients attending an optometric practice in a rural district of the Western Cape. Respondents ages ranged from 33 to 80 years (mean = 57 ± 11.2 years and included 59% males and 41% females. Above half(56% of the respondents knew that there were two main types of DM. Less than half (46% of the respondents reported having Type 2 DM, 4% reported having Type 1 DM and 49% did not knowwhat type of DM they had. Although 82% of the respondents reported owning a glucometer and 98% knew that controlling their blood sugar levels may help reduce diabetic complications, only 29% measured their blood sugar levels on a daily basis. Most respondents (97% agreed that DM could affect their vision yet only 37% stated that they had annual eye examinations. A significant proportion of the respondents did not know that DM could cause strabismus (57%, colour vision problems (44%, cataracts (41%, retinopathy (37% and contribute to causing glaucoma (63%. Most respondents took their medication regularly and as prescribed (89% and underwent regular medical check-ups (82%. However, a large proportion of the respondents did not exercise regularly (61%, had no regular eye testing (63% nor Body Mass Index (BMI monitoring (84% in their manage-ment of DM. This study indicates that, despite access to private health care, these subjects level of knowledge of DM and its ocular effects was sub-optimal. It also indicated poor self-management practices of the diabetic patients towards diabetes care and

  18. Knowledge of cancer symptoms among patients attending one-stop breast and rectal bleeding clinics.

    Science.gov (United States)

    Pullyblank, A M; Cawthorn, S J; Dixon, A R

    2002-08-01

    The aim of this questionnaire study was to identify knowledge of breast and colorectal cancer symptoms among 100 patients attending one-stop breast clinics and rectal bleeding clinics and to determine the source of the information. Seventy-five breast clinic (mean age 46 years, all female) and 78 colorectal clinic patients (mean age 59 years, 51% male) responded. Knowledge of breast was significantly greater than bowel cancer in both groups (Pknowledge of symptoms of breast cancer or bowel cancer between patients attending either clinic. There was a positive association between cancer knowledge, family history and female gender but no association with age. Knowledge of Bowel Cancer Awareness Week was positively associated with colorectal cancer knowledge. Knowledge of colorectal cancer is much less than breast cancer in clinic attenders. Seventy-five per cent of women attending breast clinic could name a breast cancer symptom whereas only 37% of patients attending colorectal clinic could name a bowel cancer symptom. These findings have implications when considering patients' anxiety, expectations of a cancer diagnosis and breaking bad news.

  19. STATUS OF ANTIOXIDANT AND LIVER FUNCTION IN TYPE-2 DIABETIC PATIENTS ATTENDING NEPALGUNJ MEDICAL COLLEGE

    Directory of Open Access Journals (Sweden)

    C Thanpari

    2013-01-01

    Full Text Available Objective: Diabetes mellitus (DM is one of the most common metabolic disorders characterized by hyperglycemia due to defects in insulin secretion, insulin action or both. This study aims to investigate the status of antioxidants and liver function in type-2 diabetic patients among patients attending OPD of Nepalgunj Medical College, Banke, Nepal.Methods: A total of 280 samples were recruited to evaluate aspartate aminotransferase (AST, alanine aminotransferase (ALT, alkaline phosphatase (ALP, total bilirubin (TB, glutathione (GSH, and superoxide dismutase (SOD.Determination of all biochemical parameters were carried out using Kit Methods.Results: AST level was elevated in maximum number of patients, 64 (36.57% out of175 males and 59 (56.19% out of 105 females followed by ALT elevation in females and ALP elevation in males, 50 (47.61% out of 105 and 57(32.57% out of 175 respectively.Conclusion: Antioxidants & LFTs were found to be statistically significant when compared with healthy controls.

  20. How medical residents perceive the quality of supervision provided by attending doctors in the clinical setting.

    Science.gov (United States)

    Busari, Jamiu O; Weggelaar, Nielske M; Knottnerus, Andrieke C; Greidanus, Petra-Marie; Scherpbier, Albert J J A

    2005-07-01

    The supervision of medical residents is a key responsibility of attending doctors in the clinical setting. Most attending doctors, however, are unfamiliar with the principles of effective supervision. Although inconsistent, supervision has been shown to be both important and effective for the professional development of medical residents. To examine how medical residents perceive the supervisory roles of attending doctors, in terms of what they perceive as poor supervision and what they characterise as good supervisory practice. We carried out a questionnaire survey of 38 medical residents at the Department of Paediatrics at the teaching hospital of the University of Amsterdam, the Netherlands. Attending doctors directly involved with the supervision of medical residents participated in the study. The clinical settings where supervision occurred included the neonatal and paediatric intensive care units and the general paediatric wards. Medical residents rated the quality of supervision they received in all departments positively. A majority of the attending doctors were rated highly in 'overall supervision'. Creating pleasant learning environments and being stimulated to learn and function independently were aspects of supervision characterised positively. Coaching in clinical skills and procedures, effective communication skills and clinical decision making using principles of cost-appropriate care were aspects of supervision found to be deficient. This study shows that medical residents enjoy supervision from collaborative, understanding and patient attending doctors. Medical residents prefer to be treated as adult learners and enjoy feedback that is constructive, measured and adapted to their professional needs.

  1. Gestational diabetes: A clinical update

    DEFF Research Database (Denmark)

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance ...

  2. Clinical study of diabetic dermoangiopathy

    Directory of Open Access Journals (Sweden)

    Sawhney MPS

    1990-01-01

    Full Text Available One hundred and twenty three diabetic patients and 100 non- diabetic controls were examined for lesions of diabetic dermoangiopathy. Twenty two (17.9% lesions, while simildr lesions were found in only 2 (2% controls. Age of the patients with opathy was sipifirandy higher than those derm without dermopathy, and it was more common in the fifth to the seventh decade. No statistically siicant relationship could be established with the sex, type, serverity control or duration of diabetes, diatetic neuropathy, larize vessel disease like CAD, PVD or CVA or with metabolic complications of diabetes. However, a higher percentage (59.1% of patients with dermopathy were found to have a poor control of their diabetes as compared to those without microangiopathy (50.7%. Dermopathy was also more common (23% 9 the duration of diabetes was more than 5 years, than if it was less than 5 years (14.1%. The percentage (33.3% of patients with retinopathy having dermopathy. Rubeosis was seen in 4 (3.2% patients.

  3. Glycemia and Levels of Cerebrospinal Fluid Amyloid and Tau in Patients Attending a Memory Clinic

    NARCIS (Netherlands)

    Exalto, Lieza G.; van der Flier, Wiesje M.; Scheltens, Phillip; Biessels, Geert Jan

    2010-01-01

    OBJECTIVES: To determine the association between markers of glycemia and cerebrospinal fluid (CSF) amyloid beta 1-42 (A beta 42) and tau levels in patients attending a memory clinic. DESIGN: Cross-sectional study. SETTING: Memory clinic. PARTICIPANTS: Two hundred forty-five consecutive patients atte

  4. Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic

    DEFF Research Database (Denmark)

    Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

    2015-01-01

    in a gastroenterology outpatient clinic like ours. METHODS: This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder (control group, n = 2......,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made......-attendees. The most common explanation for non-attendance in the intervention group was forgetfulness (39%). The reminder telephone call was cost-effective. CONCLUSION: In this outpatient clinic, telephone reminders were cost-effective and significantly reduced the non-attendance rate by 43%....

  5. Reasons patients leave their nearest healthcare service to attend Karen Park Clinic, Pretoria North

    Directory of Open Access Journals (Sweden)

    Agnes T. Masango- Makgobela

    2013-01-01

    Full Text Available Background: Many patients move from one healthcare provider or facility to another, disturbing the continuity that enhances holistic patient care.Objectives: To investigate the reasons given by patients for attending Karen Park Clinic rather than the clinic nearest to their homes.Methods: A cross-sectional descriptive study was conducted during 2010. Three hundred and fifty patients attending Karen Park Clinic were given questionnaires to complete, with the following variables: place of residence; previous attendance at the clinic nearest their home; services available at their nearest clinic; and their willingness to attend their nearest clinic in future.Results: Respondents were from Soshanguve (153; 43.7%, Mabopane (92; 26.3%, Garankuwa (29; 8.3% and Hebron (20; 5.7% and most were women (271; 77.4% aged 26–45 (177; 50.6%. Eighty per cent (281 of the patients had visited their nearest clinic previously and 54 of these (19.2% said they would not return. The reasons for this were: long waiting time (88; 25.1%; long queues (84; 24%; rude staff (60; 17%; and no medication (39; 11.1%.Conclusion: The majority of patients who had attended their nearest clinic were adamant that they would not return. It is necessary to reduce waiting times, thus reducing long queues. This can be achieved by having adequate, satisfied healthcare providers to render a quality service and by organising training for management. Patients can thus be redirected to their nearest clinic and the health centre’s capacity can be increased by procuring adequate drugs. There is a need to follow up on patients’ complaints about staff attitudes.

  6. Prevalence of Undiagnosed Diabetes and Quality of Care in Diabetic Patients Followed at Primary and Tertiary Clinics in Abu Dhabi, United Arab Emirates

    Science.gov (United States)

    Saadi, Hussein; Al-Kaabi, Jumaa; Benbarka, Mahmoud; Khalili, Ali; Almahmeed, Wael; Nagelkerke, Nicolaas; Abdel-Wareth, Laila; Al Essa, Awad; Yasin, Javed; Al-Dabbagh, Bayan; Kazam, Elsadig

    2010-01-01

    AIMS: To investigate the prevalence of undiagnosed type 2 diabetes (T2D) at primary health care (PHC) clinics, and to assess the quality of care of diabetic patients followed at a tertiary hospital diabetes center in Abu Dhabi, United Arab Emirates (UAE). METHODS: Between May 2009 and October 2010, adult patients attending two PHC clinics, and adult diabetic patients attending the diabetes center, were invited to participate in the study. After overnight fast, participants returned for interview and laboratory tests. Undiagnosed T2D was defined by FPG ≥ 7.0 mmol/l or HbA1c ≥ 6.5%. Quality of care was assessed by reported care practices and achievement of internationally recognized targets. RESULTS: Out of 239 patients at PHC clinics without history of T2D, 14.6% had undiagnosed T2D, and 31% had increased risk of diabetes (FPG 5.6-7.0 mmol/l or HbA1c 5.7-6.5%). The independent predictors of undiagnosed T2D were age (adjusted OR per year 1.07, 95% CI 1.04-1.11, p < 0.001) and BMI ≥ 25 (adjusted OR 4.2, 95% CI 0.91-19.7, p = 0.033). Amongst all 275 diagnosed T2D patients, including those attending PHC clinics and those followed at the diabetes center, it was found that 40.1% followed dietary recommendations, 12% reported visiting a diabetes educator, 28.2% walked for exercise, and 13.5% attained recognized targets of HbA1c < 7%, blood pressure < 130/80 mmHg, and LDL cholesterol < 2.6 mmol/l. CONCLUSIONS: Almost half of the adult patients attending PHC clinics had undiagnosed T2D, or increased diabetes risk. Care practices, and achievement of treatment targets, were suboptimal. PMID:21713317

  7. Core components of clinical education: a qualitative study with attending physicians and their residents

    Directory of Open Access Journals (Sweden)

    ALIREZA ESTEGHAMATI

    2016-04-01

    Full Text Available Introduction: In medical education, particularly in residency courses, most of the training occurs in real clinical environments. Workplace-based learning profoundly affects students’ knowledge, attitudes, and practice; therefore, it should be properly planned. Due to the extensiveness of the clinical environment and its importance in training residents, investigating how residents learn in these environments and detecting factors that influence effectiveness will help curriculum designers to promote residents’ learning by improving their learning environment. Therefore, our qualitative content analysis study, aimed to examine the experiences and perspectives of internal and surgical residents and their attending physicians about learning in clinical settings. Methods: This qualitative content analysis study was conducted through purposeful sampling. Semi-structured interviews were conducted with 15 internal and surgical residents and 15 of their attending physicians at educational hospitals of Tehran University of Medical Sciences. Results: The main categories explored in this study were hidden curriculum, learning resources, and learning conditions. In the context of clinical environment and under its individual culture, residents learn professionalism and learn to improve their communication skills with patients and colleagues. Because of clinical obligations such as priority of treating the patients for education or workload of the attending physicians, residents acquire most of their practical knowledge from colleagues, fellows, or follow-up patients in different learning conditions (such as: educational rounds, morning reports and outpatient clinics. They see some of their attending physicians as role models. Conclusion: Changing cultural and contextual factors is of prime importance to promote a learning-oriented environment in a clinical setting. The present findings will help curriculum planners and attending physicians to improve

  8. Diabetic Retinopathy Screening Ratio Is Improved When Using a Digital, Nonmydriatic Fundus Camera Onsite in a Diabetes Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Pia Roser

    2016-01-01

    Full Text Available Objective. To evaluate the effect of onsite screening with a nonmydriatic, digital fundus camera for diabetic retinopathy (DR at a diabetes outpatient clinic. Research Design and Methods. This cross-sectional study included 502 patients, 112 with type 1 and 390 with type 2 diabetes. Patients attended screenings for microvascular complications, including diabetic nephropathy (DN, diabetic polyneuropathy (DP, and DR. Single-field retinal imaging with a digital, nonmydriatic fundus camera was used to assess DR. Prevalence and incidence of microvascular complications were analyzed and the ratio of newly diagnosed to preexisting complications for all entities was calculated in order to differentiate natural progress from missed DRs. Results. For both types of diabetes, prevalence of DR was 25.0% (n=126 and incidence 6.4% (n=32 (T1DM versus T2DM: prevalence: 35.7% versus 22.1%, incidence 5.4% versus 6.7%. 25.4% of all DRs were newly diagnosed. Furthermore, the ratio of newly diagnosed to preexisting DR was higher than those for DN (p=0.12 and DP (p=0.03 representing at least 13 patients with missed DR. Conclusions. The results indicate that implementing nonmydriatic, digital fundus imaging in a diabetes outpatient clinic can contribute to improved early diagnosis of diabetic retinopathy.

  9. Sarcopenia and its relationship with falling among outpatients attending a geriatric and memory clinic at Kyorin University Hospital.

    Science.gov (United States)

    Tanaka, Masamichi; Nagai, Kumiko; Koshiba, Hitomi; Matui, Toshifumi; Kozaki, Koichi

    2017-01-01

    The aim of the present study was to investigate the prevalence of sarcopenia in outpatients attending a geriatric and memory clinic and to investigate its relationship with falling. We investigated the prevalence of sarcopenia (according to the EWGSOP criteria) among 283 outpatients that were all ≥65 years of age, and who attended the geriatric and memory clinic at Kyorin University Hospital. We also examined comorbidities, CGA items, and fall-related measures, and analyzed the relationships between these factors and sarcopenia. Seventy men (60.9%) and 88 women (52.4%) were diagnosed with sarcopenia. The sarcopenic men were older, had lower BMI values, and had a higher prevalence of dementia. The sarcopenic women had lower BMI values, and a higher prevalence of dyslipidemia. ASMI was not associated with walking speed or fall-related measures, whereas grip strength and walking speed were associated with each other and both were associated with fall-related measures. Ninety-one patients (32.2%) experienced a fall in the previous year. The prevalence of sarcopenia and ASMI among fallers and non-fallers did not differ to a statistically significant extent, whereas the fallers had lower grip strength and walking speed. A multiple logistic regression analysis revealed that weak grip strength in men and slow walking speed and the presence of diabetes in women were significant risk factors for falling. The frequency of sarcopenia in outpatients attending the geriatric and memory clinic was higher than that in the community-dwelling elderly individuals. Falls were more related to the patients' muscle strength and walking speed than their muscle mass or the presence of sarcopenia itself.

  10. Failure to attend out-patient clinics: is it in our DNA?

    LENUS (Irish Health Repository)

    Roberts, Kinley

    2012-02-01

    PURPOSE: This paper aims to determine the reasons why patients miss clinic appointments and to ascertain patients\\' views on the implementation of reminder systems and penalty fees to reduce the rates of did not attend (DNAs). Overall, the paper seeks to establish novel ways to run a more efficient out-patient department (OPD) service to improve waiting times and access for patients to limited neurology resources. DESIGN\\/METHODOLOGY\\/APPROACH: A questionnaire-based study was approved by the audit committee and was offered to 204 out-patients attending the neurology clinics over a three-month period (July to September 2009). The patients\\' demographic details and non-attendance records were reviewed. The paper aimed to ascertain, from the patients\\' perspective, why people failed to attend clinic appointments. Each participant was asked their views on how they felt their public hospital service might reduce the number of DNAs at their neurology OPD. FINDINGS: A total of 204 patients took part. Participants had a mean age of 31 years (range 25-75 years) with a modal peak in the 26 to 35 age bracket. Almost 10 per cent of those surveyed admitted to missing a hospital out-patient appointment in the past. The most common reason was that they simply "forgot" (28 per cent). DNA rates by age range were proportionally similar to the overall age profile of attenders. Over 55 per cent said they would like a pre-appointment reminder via a mobile telephone text message, 19 per cent preferred a pre-appointment telephone call, and 19 per cent an e-mail. Of those surveyed, 47 per cent said they would be willing to pay a fee on booking that could be refunded on attending for their appointment. The majority of these felt Euro 20 was the most appropriate amount (39 per cent). The rate of acceptance for various fee amounts was uniform across age ranges. Over half (52 per cent) said that they would agree to a "buddy" system whereby the appointment reminder was sent to the patient

  11. Determinants of Tuberculosis Infection among Adult HIV Positives Attending Clinical Care in Western Ethiopia: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Hatoluf Melkamu

    2013-01-01

    Full Text Available There has been a drastic rise of tuberculosis (TB infection across the world associated with the pandemic occurrence of HIV/AIDS. There are various determinants factors that increase the chance of TB infection among HIV positives (TB/HIV confection that varies contextually. This study aimed to assess the determinants of TB/HIV coinfection among adult HIV positives attending clinical care at two public health facilities in Nekemte, western Ethiopia. Unmatched case-control study was conducted from December 26, 2011, to February 29, 2012. Cases were 123 TB infected HIV positives, and controls were 246 non-TB infected HIV positives. Being divorced/widowed , 95% CI (1.70, 7.88, not attending formal education , 95% CI (2.20, 14.15, being underweight ( kg/m2 , 95% CI (2.18, 6.87, having history of diabetic mellitus , 95% CI (1.33, 9.94, and being in advanced WHO HIV/AIDS clinical staging , 95% CI (1.32, 3.98, were determinant factors associated with TB/HIV co-infection. Having a separate kitchen , 95% CI (0.28, 0.81 showed protective role. For most of these determinants interventions can be made at individual and institutional levels, whereas, factors like education and nutrition need societal level integrations.

  12. Clinic Attendance for Medication Refills and Medication Adherence amongst an Antiretroviral Treatment Cohort in Uganda: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Setor Kunutsor

    2010-01-01

    Full Text Available Background. Regular clinic attendance for antiretroviral (ARV drug refills is important for successful clinical outcomes in HIV management. Methods. Clinic attendance for ARV drug refills and medication adherence using a clinic-based pill count in 392 adult patients receiving antiretroviral therapy (ART in a district hospital in Uganda were prospectively monitored over a 28-week period. Results. Of the 2267 total scheduled clinic visits, 40 (1.8% were missed visits. Among the 392 clients, 361 (92% attended all appointments for their refills (regular attendance. Clinic attendance for refills was statistically significantly associated with medication adherence with regular attendant clients having about fourfold greater odds of achieving optimal (≥95% medication adherence [odds ratio (OR=3.89, 95% CI: 1.48 to 10.25, exact P=.013]. In multivariate analysis, clients in age category 35 years and below were less likely to achieve regular clinic attendance. Conclusion. Monitoring of clinic attendance may be an objective and effective measure and could be a useful adjunct to an adherence measure such as pill counting in resource-constrained settings. Where human resource constraints do not allow pill counts or other time-consuming measures, then monitoring clinic attendance and acting on missed appointments may be an effective proxy measure.

  13. Clinical Profile of Children and Adolescents Attending the Behavioural Paediatrics Unit OPD in a Tertiary Care Set up

    Science.gov (United States)

    Jayaprakash, R.

    2012-01-01

    Background: There are limited studies on the clinical profile of children attending child guidance clinic under Paediatric background. Aims: To study clinical profile of Children & adolescents attending the Behavioural Paediatrics Unit (BPU) OPD under department of Paediatrics in a tertiary care set up. Methods: Monthly average turnover in the…

  14. Cost-effectiveness of HIV screening of patients attending clinics for sexually transmitted diseases in Amsterdam

    NARCIS (Netherlands)

    Bos, JM; Fennema, JSA; Postma, MJ

    2001-01-01

    Objective: To estimate the cost-effectiveness of universal HIV screening of patients attending a clinic for sexually transmitted diseases (STD) in Amsterdam. Design: Cost effectiveness analysis. Methods: A Bernoulli model for the secondary transmission of HIV was linked with epidemiological data on

  15. Cost-effectiveness of HIV screening of patients attending clinics for sexually transmitted diseases in Amsterdam

    NARCIS (Netherlands)

    Bos, JM; Fennema, JSA; Postma, MJ

    2001-01-01

    Objective: To estimate the cost-effectiveness of universal HIV screening of patients attending a clinic for sexually transmitted diseases (STD) in Amsterdam. Design: Cost effectiveness analysis. Methods: A Bernoulli model for the secondary transmission of HIV was linked with epidemiological data on

  16. Comparison of Clinical Teaching by Residents and Attending Physicians in Inpatient and Lecture Settings.

    Science.gov (United States)

    Bergen, Merlynn R.; And Others

    1993-01-01

    A study examined differences in the clinical teaching of 21 medical residents and 19 attending physicians in 2 settings: inpatient care and lectures. Results indicated that ratings were generally similar for the two groups, but setting was a significant source of variance. Self-assessments were similar. Implications for instruction are discussed.…

  17. Mental health problems of men attending district-level clinical psychology services in South Africa.

    Science.gov (United States)

    Evans, Dylan J; Pillay, Anthony L

    2009-06-01

    Over a 1-yr. period, 70 men attended district level clinical psychology services in Msunduzi, South Africa. The mean age was 35.9 yr., and 80% had secondary education. Only 65.7% attended of their own accord. 51% were unemployed, 71.4% had financial problems, 44.3% admitted to substance abuse, 74.3% reported relationship problems, and 14.3% admitted to being violent toward their partners. Suicidal ideation was the commonest referral problem, while mood disorder was the most frequent diagnosis. Clinicians estimated that 75.7% of these men had low self-esteem. 45.8% (34) perceived their partner as disengaged, enmeshed, or oppressive.

  18. Contraceptive Method Choice Among Women Attending at Amtullabhai Family Planning Clinic in Dar es salaam

    OpenAIRE

    Mbando, Apaisaria Humphrey

    2011-01-01

    Contraceptive prevalence in Tanzania is low despite high knowledge of contraception. In order to understand the existing barriers, it is important to find out reasons affecting contraceptive method choices. The objective of this study was to assess contraceptive method choice among women attending at Amtullabhai family planning clinic in Dar es Salaam. A cross- sectional study was conducted between October and November, 2010 at Amtullabhai family planning clinic, Ilala District in Dar es Sala...

  19. The impact of a text messaging service on orthopaedic clinic Did Not Attend rates.

    Science.gov (United States)

    Rohman, Lebur; Maruswezki, Daniel; Boyce Cam, Nicholas

    2015-10-01

    Missed clinic appointments cause delays in treatment of other patients, under utilization of clinical manpower or facilities and impact upon hospital finances. The primary aim of this study is to evaluate whether a text messaging reminder service reduces the Did Not Attend rate. The secondary aim is to evaluate the cost-effectiveness of a mobile text message reminder service. The study focused on the outpatient department of a district general hospital. In January 2011 a patient text messaging reminder service was implemented across the outpatient departments in the trust. Data were collected prospectively 24 months prior and 24 months following the implementation of this service. A reminder was sent to patients one week prior to the scheduled appointment as a text message. All patients attending the orthopaedic department were included in the study. Patients who had an appointment and cancelled/rescheduled it prior to their original consultation date were excluded. Children were also excluded from the study. The overall Did Not Attend rate was reduced by 12% following the intervention (p < 0.0001). The new appointment follow-up rate was reduced by 2% (p = 0.74) and the follow-up rate decreased by 13.7% (p < 0.0001). The economic analysis revealed a saving of £19,853 over a two-year period following the intervention. Thus mobile technology is a feasible tool in improving attendance rates at outpatient clinics and is economically viable. © The Author(s) 2015.

  20. Is there a relation between student lecture attendance and clinical science subject examination score?

    Science.gov (United States)

    Riggs, J W; Blanco, J D

    1994-08-01

    To determine whether there is a relation between lecture attendance and factual knowledge of obstetrics and gynecology, as measured by the National Board of Medical Examiners (NBME) clinical science subject examination. We analyzed data on 197 students completing 8-week obstetrics and gynecology rotations from July 1, 1991 to June 30, 1992. Each student was expected to attend a weekly lecture series, and each completed the NBME clinical science subject examination at the end of the clerkship. Student attendance and board scores were correlated at the end of the academic year overall and by subgroups. Scores in the top and bottom 15% were defined as good and poor performance, respectively. A negative correlation (r = -0.1738, P = .0146) was found between percent absence and examination score. The odds ratio for poor performance was 5.48 (95% confidence interval 1.3-26.5; P = .015) for the subgroup of students with more than 30% absence compared to those without absences. Odds ratios for scoring in the upper 15th percentile were not significant. The negative correlation and the high odds ratio for poor performance suggest the value of monitoring attendance and identifying students at risk for poor performance (more than 30% absence). Lower absence rates did not predict performance.

  1. CLINICAL AND INVESTIGATIONAL STUDY OF DIABETIC KETOACIDOSIS

    Directory of Open Access Journals (Sweden)

    Narasimham

    2015-06-01

    Full Text Available BACKGROUND AND OBJECTIVES: To compare the clinical features and biochemical profile in DKA. To assess the response in the patients with standard treatment of DKA. Clinical descriptions of polyuric states resembling diabetes mellitus have been described in the Ebers papyrus of Egypt in 15th century BC . 1,2 A yurvedic literature from the times of Charaka and Sushrutha, the ancient Indian physicians identified two forms of “MadhuMeha” ( H oneyed Urine in 400 BC . 3 John Rolo of England in 1797 was one of 1st who coined the term diabetes mellitus. William Prout of E ngland described diabetic coma during 1810 – 20. In 1886, Dreschfeld8 described DKA and HHNS (Hyper osmolar Hyperglycemic Non - ketotic Syndrome. In 1922 Banting , Best, Collip and Macleod isolated and clinically used insulin and later won Nobel prize for that memorable invention. SETTING: Inpatients of king George Hospital attached to Andhra Medical College, Visakhapatnam . METHODS: Diagnosis of diabetic ketoacidosis was made according to the inclusion criteria. Hyperglycemia >250 mg/dl, acidosis with blood pH <7.3, serum bicarbonate <15 mEq/l, urine positive for ketones. RESULTS: Of the 100 patients admitted for diabetic ketoacidosis; 84 had type 2 diabetes (84% and 16(16% were type I diabetes. Average age at the time of presentation was 42.9±12.9 years. Th e commonest precipitating factor was infection (56% followed by other factors (28% and irregular treatment (16%. The most common clinical features at the time of presentation were vomiting, abdominal pain, acidotic breathing and dehydration. The values for RBS, HCO3, and pH were 355.3±69.1, 14.9±3.4 and 7.2±0.1 respectively. INTERPRETATION AND CONCLUSION: Most common precipitating factors are infection and omission of insulin or irregular treatment. Most common clinical features at the time of presentati on are vomiting, abdominal pain, dehydration, acidotic breathing and tachycardia. Mortality rate in diabetic

  2. Routine HIV screening of sexually transmitted disease clinic attenders has favourable cost-effectiveness ratio in low HIV prevalence settings

    NARCIS (Netherlands)

    Bos, JM; van der Meijden, WI; Swart, W; Postma, MJ

    2002-01-01

    HIV screening for attenders of clinics for sexually transmitted disease (STD) may identify individuals with high-risk sexual behaviour and avert HIV infections in partners. Extending our previous analysis in AIDS, we performed an economic evaluation of HIV screening of STD-clinic attenders in

  3. Routine HIV screening of sexually transmitted disease clinic attenders has favourable cost-effectiveness ratio in low HIV prevalence settings

    NARCIS (Netherlands)

    Bos, JM; van der Meijden, WI; Swart, W; Postma, MJ

    2002-01-01

    HIV screening for attenders of clinics for sexually transmitted disease (STD) may identify individuals with high-risk sexual behaviour and avert HIV infections in partners. Extending our previous analysis in AIDS, we performed an economic evaluation of HIV screening of STD-clinic attenders in Rotter

  4. Chlamydia trachomatis in women attending a gynaecological outpatient clinic with lower genital tract infection.

    OpenAIRE

    Svensson, L; Weström, L; Mårdh, P A

    1981-01-01

    In a study of 3794 consecutive women attending a gynaecological outpatient clinic with symptoms of lower genital tract infection (LGTI) 350 (9.2%) harboured Chlamydia trachomatis and 83 (2.2%) Neisseria gonorrhoeae. One hundred and ninety-five patients who were later found to have acute salpingitis and 109 other women in whom the chlamydial cultures were spoiled were excluded from the series. Of the remaining 3490 women, 281 were infected with C trachomatis, 42 with N gonorrhoeae, and 17 with...

  5. PATIENT SATISFACTION AND DIETARY OUTCOMES FROM ATTENDING A MULTIDISCIPLINARY CYSTINURIA CLINIC

    Directory of Open Access Journals (Sweden)

    Angela Doherty

    2012-06-01

    Patients had varying degrees of success with making changes to each dietary parameter. Multi-source diet analysis allowed us to develop tailored consultations. All patients made some positive dietary changes which may help prevent stone formation. The areas of least change were fluid (due to changes made prior to clinic attendance and vegetable protein. Our results support the need for continued dietetic input. These results should be re-audited to check that patients are maintaining the changes made.

  6. Diabetes insipidus: the basic and clinical review

    Directory of Open Access Journals (Sweden)

    Muhammad Waseem Abbas

    2016-01-01

    Full Text Available Diabetes insipidus (DI is a complex disease. DI is inability of the body to conserve water. Polydipsia and polyuria are the major manifestations of DI. DI has various variants including central diabetes insipidus (due to defect in ADH secretion, nephrogenic diabetes insipidus (due to defect in ADH receptors or urea receptors, gestational diabetes insipidus (due to catabolism of ADH by placental vasopressinase and primary polydipsia (due to massive fluid intake. The cause of various variants of DI is either acquired or congenital. High plasma osmolality due to hypotonic urine excretion can be fatal because it can cause psychosis, lethargy, seizures, coma or even death. Polyuria and polydipsia help in the diagnosis of DI. Differential diagnosis of various variants of DI can be carried out on the basis of water deprivation test, MRI and other radiological techniques. The proper management of DI is the replenishment of water loss and correction of clinical presentations produced as a result of DI, major is hypernatremia. The best management for primary polydipsia is fluid restriction while fluid intake is used for adipsic diabetes insipidus. ADH replacement therapy is widely used to treat DI. DDAVP or desmopressin is mostly preferred ADH analogue because it has less side effects and resistant to placental vasoprssinase. [Int J Res Med Sci 2016; 4(1.000: 5-11

  7. Supporting self-management after attending a structured education programme: a qualitative longitudinal investigation of type 1 diabetes patients’ experiences and views

    Directory of Open Access Journals (Sweden)

    Rankin David

    2012-08-01

    Full Text Available Abstract Background Structured education programmes for patients with diabetes and other chronic conditions are being widely adopted. However, follow-up studies suggest that course graduates may struggle to sustain the self-care practices taught on their courses over time. This study explored the support needs of patients with type 1 diabetes after attending a structured education programme promoting an empowerment approach and training in use of flexible intensive insulin therapy, a regimen now widely advocated and used to manage this condition. The objective was to inform future support offered to course graduates. Methods Repeat, in-depth interviews with 30 type 1 diabetes patients after attending Dose Adjustment for Normal Eating (DAFNE courses in the UK, and six and 12 months later. Data were analysed using an inductive, thematic approach. Results While the flexible intensive insulin treatment approach taught on DAFNE courses was seen as a logical and effective way of managing one’s diabetes, it was also considered more technically complex than other insulin regimens. To sustain effective disease self-management using flexible intensive insulin treatment over time, patients often expected, and needed, on-going input and support from health care professionals trained in the approach. This included: help determining insulin dose adjustments; reassurance; and, opportunities to trouble-shoot issues of concern. While some benefits were identified to receiving follow-up support in a group setting, most patients stated a preference or need for tailored and individualised support from appropriately-trained clinicians, accessible on an ‘as and when needed’ basis. Conclusions Our findings highlight potential limitations to group-based forms of follow-up support for sustaining diabetes self-management. To maintain the clinical benefits of structured education for patients with type 1 diabetes over time, course graduates may benefit from and

  8. Non-diabetic clinical applications of insulin.

    Science.gov (United States)

    Benni, Jyoti M; Patil, Paragouda A

    2016-09-01

    Introducing a new drug to the market is a time-consuming process, is complex, and involves consumption of a lot of resources. Therefore, discovering new uses for the old drugs (i.e. drug repurposing) benefits the patients by providing them time-tested drugs. With developments in insulin therapy still happening, it is worth keeping up to date on trends in the use of this powerful glucose-lowering agent. The aim of this article is to explore the potential non-diabetic clinical applications of insulin. Literature survey was carried out through the various scientific journals publishing experimental and clinical research papers regarding the diverse applications of insulin other than in diabetes mellitus. These applications include both therapeutic as well as diagnostic uses of insulin. The relevant information collected from these publications was paraphrased in the present paper. On studying the literature, the non-diabetic uses of insulin include the following: wound healing, parenteral nutrition, antiaging, body building, cardioprotection in acute coronary syndromes, insulin tolerance test to test the hypothalamo-pituitary-adrenal axis functioning, cell culture, cancer treatment, organ preservation, and management of septic shock, calcium channel, β-blocker overdose and other critical illnesses in intensive care units. This review attempts to survey some interesting new applications of insulin other than in diabetes mellitus.

  9. A multinational investigation of time and traveling costs in attending anticoagulation clinics.

    Science.gov (United States)

    Jowett, Sue; Bryan, Stirling; Mahé, Isabelle; Brieger, David; Carlsson, Jonas; Kartman, Bernt; Nevinson, Mark

    2008-01-01

    Anticoagulation is used in patients with atrial fibrillation to reduce the risk of ischemic stroke. The therapy requires regular monitoring and, frequently, dose adjustment. This study aimed to determine the time and traveling costs that patients incur to themselves and society in attending anticoagulation clinics. A subset of patients from 105 primary and secondary care clinics allocated to the warfarin arm of SPORTIF III (patients from Australia, France, Portugal, Spain, Sweden, and the UK) completed a questionnaire. Patients indicated the type of transport used for clinic visits, and estimated traveling expenses. Patients were also asked to estimate total traveling and clinic attendance time, and to confirm whether they were currently employed and whether they had to give up time from work to attend the clinic. Time cost of companions was also taken into consideration. Cost per visit was calculated (euro, 2003 prices). Questionnaires for a total of 381 patients were analyzed, with the majority of patients from Sweden (n = 130) and the UK (n = 101). Mean cost to patients varied widely between countries, ranging from euro6.9 (France) to euro20.5 (Portugal) per visit. For most countries, time costs (value of lost working and leisure time) were the main driver of costs. Mean time cost to society ranged from euro5.6 (France) to euro31.7 (Portugal) per visit. Patients incur considerable costs when visiting anticoagulation clinics, and these costs vary by country. The results suggest the importance of taking a broad economic perspective when considering the cost-effectiveness of warfarin.

  10. PATIENTS — THE CLINICAL IMPLICATIONS

    African Journals Online (AJOL)

    bin (HbA,¢) levels of diabetes mellitus patients as an index of glycaetnlc control. ... diabetic patients, attending a Diabetic Clinic at the Komfo Anokye Teaching ..... complications like nephropathy and retinopathy. ... technology and knowledge.

  11. Metabolic Syndrome Among Obese Patients Attending the Medical Clinics of Three Reaching Hospitals at Sana's City, Yemen

    Directory of Open Access Journals (Sweden)

    Soumeah M. AL-Ghazan

    2011-06-01

    Full Text Available Background: Yemen faces major challenges in improving the health status of its population as it is entering an epidemiological transition with rising noncommunicable diseases e.g. obesity, diabetes and cardiovascular diseases (CVDs. We designed this study to find out the prevalence of Metabolic Syndrome (MS and its components among obese Yemeni patients.Methods: All obese (waist circumference >102 cm in male and >88 cm in female attending the outpatients medical clinics at the three teaching hospitals in Sana'a city, were examined and their blood pressure (BP, fasting samples of plasma glucose, triglycerides, and HDL cholesterol were measured. The prevalence of MS obtained based on the Adult Treatment Panel III and presence of at least 3 of the following: systolic BP ≥130 mm Hg and/or diastolic BP ≥ 85 mm Hg or on treatment for high BP, fasting glucose ≥110 mg/dl or on diabetes treatment, triglycerides ≥150 mg/dl, and HDL cholesterol <40 mg/dl in men and <50 mg/dl in women.Results: 200 obese were identified during study period with an overall MS prevalence of 46%. The metabolic co-morbidities were raised BP (68%, high triglycerides (66%, reduced high density lipoprotein (64%, and raised fasting blood glucose (40%.Conclusion: Prevalence of MS is high among obese Yemeni patients and high BP was the commonest co-morbidity. These findings highlight an urgent need to develop strategies for prevention, detection, and treatment of MS that could contribute to decreasing the rising incidence of CVD and diabetes.

  12. Overcoming barriers to diabetes care: Perceived communication issues of healthcare professionals attending a pilot Diabetes UK training programme.

    Science.gov (United States)

    Mosely, Kylie; Aslam, Aysha; Speight, Jane

    2010-02-01

    As part of our evaluation of the Diabetes UK Careline workshop "Overcoming barriers to diabetes care", we received feedback from 18 healthcare professionals. Generally, they felt competent in identifying patients' psychosocial issues but less knowledgeable/skilled in handling them. Lack of time, privacy and support were barriers to addressing patients' psychosocial concerns. 2009 Elsevier Ireland Ltd. All rights reserved.

  13. [Clinical profile and 90-day mortality in centenarian patients attended in emergency departments].

    Science.gov (United States)

    Martín-Sánchez, Francisco Javier; Fernández-Alonso, Cesáreo; Hormigo, Ana Isabel; Jiménez-Díaz, Gregorio; Roiz, Honan; Bermejo-Boixareu, Cristina; Rodríguez-Salazar, Jaime; Fernández Pérez, Cristina; Gil-Gregorio, Pedro

    2016-01-01

    To determine the clinical profile and to develop a model to predict 90-day mortality in centenarian patients attended in emergency departments (ED). This was an observational, retrospective, multicentre cohort study including patients >99years attended in 5 ED in the Community of Madrid from January to December 2012. Demographic variables were recorded, as well as, comorbidities, cognitive, functional, social basal status, geriatric syndromes, acute episode, and hospital and social resources use, and 90-day mortality. The study included 209patients aged 101years (SD 1.7) of whom 161 (77.0%) were female. Sixty four (32.5%) had severe comorbidity (Charlson index≥3), 101 (49.8%) on multiple medication, 100 (52.6%) had cognitive impairment, 82 (42.3%) had severe functional dependence, 85 (40.7%) were institutionalised, and 190 (94.5%) had a geriatric syndrome. Dyspnoea (26.8%), followed by falls (12.4%) were the most common causes of attendance. One hundred and eighteen (56.5%) were admitted, and 58 out of 174 (33.3%) died in the first 90days. The model to predict 90-day overall mortality included male sex (OR 2.42 95% CI=0.97-6.04; P=.059), emergency care in the previous 3months (OR 4.08 95% CI=1.26-13.16; P=.019) and the hospitalization by index event (OR 8.63 95% CI=3.25-22.9; P<.001) and this model had an area under ROC curve of 0.776 (95% CI=0.70-0.85; P<.001). Centenarian patients attended in ED had a significant frailty and one in three cases died in the first 90days after being attended, and this was associated with male sex, emergency care in the previous 3months, and hospitalisation. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Ethnic Variation in the Prevalence of Visual Impairment in People Attending Diabetic Retinopathy Screening in the United Kingdom (DRIVE UK)

    Science.gov (United States)

    Sivaprasad, Sobha; Gupta, Bhaskar; Gulliford, Martin C.; Dodhia, Hiten; Mann, Samantha; Nagi, Dinesh; Evans, Jennifer

    2012-01-01

    Purpose To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom). Methods The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK) Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London) or August 2009 (West Yorkshire) were included in the study. Data on age, gender, ethnic group, visual acuity and diabetic retinopathy were collected. Ethnic group was defined according to the 2011 census classification. The two main ethnic minority groups represented here are Blacks (“Black/African/Caribbean/Black British”) and South Asians (“Asians originating from the Indian subcontinent”). We examined the prevalence of visual impairment in the better eye using three cut-off points (a) loss of vision sufficient for driving (approximately visual impairment (visual impairment (visual impairment in the minority ethnic groups to the age-structure of the white population. Results Data on visual acuity and were available on 50,331individuals 3.4% of people diagnosed with diabetes and attending screening were visually impaired (95% confidence intervals (CI) 3.2% to 3.5%) and 0.39% severely visually impaired (0.33% to 0.44%). Blacks and South Asians had a higher prevalence of visual impairment (directly age standardised prevalence 4.6%, 95% CI 4.0% to 5.1% and 6.9%, 95% CI 5.8% to 8.0% respectively) compared to white people (3.3%, 95% CI 3.1% to 3.5%). Visual loss was also more prevalent with increasing age, type 1 diabetes and in people living in Yorkshire. Conclusions Visual impairment remains an important public health problem in people with diabetes, and is more prevalent in the minority ethnic groups in the UK. PMID:22761840

  15. Clinical presentation and precipitating factors of diabetic ...

    African Journals Online (AJOL)

    MoZarD

    Background: Diabetic ketoacidosis (DKA), one of the common emergencies in patient with diabetes mellitus is .... Materials and Methods .... diabetes mellitus patients and therefore might have already been exposed to diabetes education.

  16. Evaluation of Smoking Status among Diabetes Patients in the State ...

    African Journals Online (AJOL)

    Evaluation of Smoking Status among Diabetes Patients in the State of Penang, Malaysia. ... Tropical Journal of Pharmaceutical Research ... diabetes patients attending Diabetes Outpatient Clinic at Penang General Hospital, Penang, Malaysia.

  17. Profile of patients attending psychogeriatric clinic in a tertiary care setting

    Directory of Open Access Journals (Sweden)

    Suresh Neethu

    2016-01-01

    Full Text Available Background: Proportion of elderly is increasing among the total population of Kerala, and mental health problems of this group are unique. Objectives: To assess the clinical and sociodemographic profile of patients attending Psychogeriatric Clinic in a tertiary care center and to study the correlation of sociodemographic and clinical variables with psychiatric diagnoses in this population. Materials and Methods: A retrospective chart review of patients, who attended the Psychogeriatric Clinic of a tertiary care center over a period of 1 year, was done. The Institutional Ethics Committee discussed and waived clearance for the review. Results: There were 85 cases with a mean age of 69.5 years (standard deviation-7.36. Majority of them were females (56.5% and belonged to low socioeconomic status (52.9%. Comorbid physical illnesses were seen in 76.5% cases. Diagnoses were made by Junior Residents in Psychiatry and confirmed by a qualified psychiatrist, as per International Classification of Diseases-10 criteria. The most common psychiatric diagnosis was organic mental disorders (24.7%, which included dementias, delirium, and organic mood disorders. This was followed by bipolar affective disorders (22.4%, schizophrenia and related disorders (20.0%, depressive and anxiety disorders (17.6% and mental and behavioral disorders due to substance use (2.4%. Occurrence of organic psychiatric disorders showed positive correlation with age (Spearman's ρ =0.253, P = 0.02 and occurrence of hypertension (ρ =0.222, P = 0.04. Conclusions: Organic psychiatric disorders are more common in elderly patients attending a tertiary care center. Comorbid physical illnesses are seen in more than three-fourths of this population. Organic psychiatric disorders are seen more commonly with increasing age and occurrence of hypertension.

  18. Primary care-public health linkages: Older primary care patients with prediabetes & type 2 diabetes encouraged to attend community-based senior centers

    Directory of Open Access Journals (Sweden)

    Polly H. Noël

    2016-12-01

    Full Text Available The Institute of Medicine (IOM suggests that primary care-public health integration can improve health outcomes for vulnerable patients, but the extent to which formal linkages may enhance patients' use of community resources, or the factors that may influence providers to encourage their patients to use these resources, remain unclear. We conducted baseline assessments in 2014–2015 with 149 older adults with prediabetes or diabetes who had recently joined three senior centers linked to a network of primary care clinics in San Antonio, Texas. In addition to collecting sociodemographic and clinical characteristics, we asked members to identify their source of primary care and whether a health care provider had encouraged them to go to the senior center. We also asked members why they had joined the senior centers and which programs interested them the most. Members' source of primary care was not associated with being encouraged to attend the senior centers by a health care professional. Multivariable analysis indicated that participants with total annual household incomes of $20,000 or less [OR = 2.78; 95% CI = (1.05, 7.14] and those reporting 12 years of education or less [OR = 3.57; 95% CI = (1.11, 11.11] were significantly more likely to report being encouraged to attend the senior center by a health care provider. Providers who are aware of community-based resources to support patient self-management may be just as likely to encourage their socioeconomically vulnerable patients with prediabetes or diabetes to use them as providers who have a more formal partnership with the senior centers.

  19. Primary care-public health linkages: Older primary care patients with prediabetes & type 2 diabetes encouraged to attend community-based senior centers.

    Science.gov (United States)

    Noël, Polly H; Parchman, Michael L; Finley, Erin P; Wang, Chen-Pin; Bollinger, Mary; Espinoza, Sara E; Hazuda, Helen P

    2016-12-01

    The Institute of Medicine (IOM) suggests that primary care-public health integration can improve health outcomes for vulnerable patients, but the extent to which formal linkages may enhance patients' use of community resources, or the factors that may influence providers to encourage their patients to use these resources, remain unclear. We conducted baseline assessments in 2014-2015 with 149 older adults with prediabetes or diabetes who had recently joined three senior centers linked to a network of primary care clinics in San Antonio, Texas. In addition to collecting sociodemographic and clinical characteristics, we asked members to identify their source of primary care and whether a health care provider had encouraged them to go to the senior center. We also asked members why they had joined the senior centers and which programs interested them the most. Members' source of primary care was not associated with being encouraged to attend the senior centers by a health care professional. Multivariable analysis indicated that participants with total annual household incomes of $20,000 or less [OR = 2.78; 95% CI = (1.05, 7.14)] and those reporting 12 years of education or less [OR = 3.57; 95% CI = (1.11, 11.11)] were significantly more likely to report being encouraged to attend the senior center by a health care provider. Providers who are aware of community-based resources to support patient self-management may be just as likely to encourage their socioeconomically vulnerable patients with prediabetes or diabetes to use them as providers who have a more formal partnership with the senior centers.

  20. Outcomes of a Nurse-Managed Diabetes Foot Clinic

    Science.gov (United States)

    2016-06-07

    Managed Diabetes Foot Clinic 5b. GRANT NUMBER HU0001-04-1-TS10 5c. PROGRAM ELEMENT NUMBER N/A 6. AUTHOR(S) 5d. PROJECT NUMBER N04-017...measured outcomes of a nurse-managed diabetes foot clinic on foot wound rates, health care costs, and changes in health status in adults with... diabetes . Design: This study reflects results of a two-group randomized, controlled trial. Sample: Participants were 126 adults with diabetes for more

  1. Clinical examination and foot pressure analysis of diabetic foot: Prospective analytical study in Indian diabetic patients.

    Directory of Open Access Journals (Sweden)

    Harshanand Popalwar

    2016-03-01

    Conclusion: Meticulous clinical examination can easily identify diabetic neuropathy and related pathological complications of diabetic foot. This shall help for early diagnosis and prevention of diabetic foot complications. Foot pressure analysis can be useful tool to screen patients of diabetic foot for abnormal high pressure point areas and can predict future risk of ulceration due to high foot pressure. This study states findings in Indian diabetic patients. [Natl J Med Res 2016; 6(1.000: 17-22

  2. Parent attitudes towards medical student attendance and interaction in the paediatric burns outpatient clinic.

    Science.gov (United States)

    Sakata, Shinichiro; McBride, Craig A; Kimble, Roy M

    2010-05-01

    Medical student attendance in the Outpatient Department is not only essential for the teaching of paediatric burns, but is also important in the recruitment of promising individuals for the growth of our speciality. In 2008, 110 consecutive parents were asked to complete written surveys before the start of their clinic appointment. Only one parent per family could choose to complete the survey. The response rate was 100%. Parents from a diverse range of cultural, educational and socioeconomic were represented in this study. Eighteen parents (16.4%), 48 parents (46.3%) and 44 parents (40.0%) considered their child's burn to be severe, moderate and mild, respectively. One hundred and nine parents (99.1%) accepted the attendance of medical students. Forty-two parents (38.5%) preferred fewer than 3 students, 35 parents (32.1%) would be comfortable with 3-5 medical students and 32 parents (29.4%) could accept more than 6 medical students. One hundred and two parents (92.7%) would allow students to physically interact with their children and 108 parents (99.2%) would allow medical students to freely ask questions in burns clinic. Using logistic regression analysis, we found that high income earners would be comfortable with fewer medical students attending clinic than low income earners (p=0.007). Also, younger parents (p=0.002) and parents from families who made less than A$25,000 a year (p=0.009), believed that they could perceive 'a lot of benefit' from observing medical students being taught, whereas older parents and parents from higher income families responded more often with a perception of only 'some benefit'. This first study in a paediatric outpatient setting shows that parents are overwhelmingly prepared to have medical students involved in the care of their child. Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved.

  3. Serological study for sexually transmitted diseases in patients attending STD clinics in Calcutta

    Directory of Open Access Journals (Sweden)

    Thawani Gopi

    2002-01-01

    Full Text Available Total 457 patients attending different STD clinics of Calcutta were studied for serological tests for STD. TPHA positivity was maximum (18.60%, followed by chlamydia infection (15.97%,VDRL reactivity (8.98%,HIV infection (6.35%, and HBs Ag (3.72%.Total 37.20% samples were positive for one or more infection. Out of these, one, two, three and fourtests positivity was seen in 65.29%,25.88%, 8.24% and 0.59% respectively. The age group which had maximum infection (20.13% was 15-30 years.

  4. The Prevalence and the Determinants of Musculoskeletal Diseases in Emiratis Attending Primary Health Care Clinics in Dubai

    OpenAIRE

    Jamal Al Saleh; Manal EL Sayed; Nahed Monsef; Ebtihal Darwish

    2016-01-01

    Objectives: To estimate the prevalence of rheumatic diseases in the Emiratis attending primary health care (PHC) clinics in Dubai. The secondary objective was to study the relationship between age, gender, and body mass index (BMI) and rheumatic diseases in the general population.  Methods: The Prevalence of Rheumatic Diseases and Osteoporosis (PRO) in Dubai study was a cross-sectional study, which randomly enrolled Emiratis’ aged between 18–85 years old who attended one of 13 PHC clinics...

  5. Clinical profile and factors associated with microalbuminuria in type 1 diabetes mellitus in children and adolescents

    Directory of Open Access Journals (Sweden)

    Kumar Amritanshu

    2015-05-01

    Full Text Available Background: The aim of this study was to determine the pattern of clinical presentation and factor associated with microalbuminuria. Methods: Urinary albumin excretion of children and adolescents diagnosed with type 1 diabetes mellitus attending diabetic clinic of Katihar medical college hospital over a period of one year. Collected blood and urine samples were analysed for glycated haemoglobin, cholesterol, triglycerides, and for 12 hour urinary albumin concentration. Blood pressures were recorded and clinical data collected. Results: During the study period 215 patients were diagnosed with type1 DM. Out of 215, fourty-three patients (20% had persistent microalbuminuria. Factor associated with microalbuminuria in diabetic patients include duration of diabetes mellitus, higher blood pressure, higher cholesterol and triglyceride levels. Conclusion: Type 1 DM is treatable and testing is acceptable and accessible to the patients. As microalbuminuria is an early microvascular complications, it is highly recommended to screen all diabetic patients for the incidence of microalbuminuria and modifiable risk factors like dyslipidemia at the onset and then yearly assessment. Efforts need to be intensified in education of health workers and population at large for quick presentation and prompt diagnosis in order to predict overt diabetic nephropathy and also to prevent its progression. [Int J Res Med Sci 2015; 3(5.000: 1247-1251

  6. [Consumption of medicinal herbs in patients attending a gastroenterology outpatient clinic].

    Science.gov (United States)

    Devesa Jordà, F; Pellicer Bataller, J; Ferrando Ginestar, J; Borghol Hariri, A; Bustamante Balén, M; Ortuño Cortés, J; Ferrando Marrades, I; Llobera Bertran, C; Sala Lajo, A; Miñana Morell, M; Nolasco Bonmatí, A; Fresquet Febrer, J L

    2004-04-01

    The consumption of medicinal herbs is one of the most important topics in alternative and complementary medicine. The widespread use of these substances among the general population gives rise to the possibility of therapeutic or toxic effects in patients seeking conventional medical assistance. To determine the frequency of medicinal herb use, the species consumed and the profile of medicinal herb consumers among patients with gastrointestinal disorders, patients attending the gastroenterology outpatient clinic of the Francesc de Borja district hospital (Gandía, Spain) over a 5-month period were interviewed and 539 valid questionnaires were obtained. A total of 34.7% of the interviewees had taken medicinal herbs at some time and 26.9% had used them in the last year. Self-prescription was reported by 67.1%. Medicinal herbs were mainly obtained in the pharmacy or herbalist's (74.7%). The results of medicinal herb therapy were considered good or excellent by 80.3% of the interviewees, average by 18.6% and poor by 1.1%. In the univariate analysis, medicinal herb consumption was positively associated with female sex (p Mentha pulegium (4.4%) and Valeriana officinalis (4.4%). The results show that consumption of medicinal herbs is frequent among patients attending the gastroenterology outpatient clinic of a district hospital. The probable profile of those showing maximum consumption is: female sex, university education, lower gastrointestinal disorder, functional gastrointestinal disorder, psychotropic drug consumption and use of TE.

  7. Eye donation – Awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia

    Science.gov (United States)

    Bhandary, Sulatha; Khanna, Rajesh; Rao, Krishna A; Rao, Lavanya G; Lingam, Kamala D; Binu, V

    2011-01-01

    Aim: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. Materials and Methods: This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions) which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance. Results: Awareness of eye donation was observed in 276 (69%) participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009). Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02) and males (P = 0.02). Educational status did not influence the willingness to donate eyes. Conclusions: Although majority of participants were aware of eye donation, willingness to donate eyes was poor. PMID:21157071

  8. Eye donation - awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia.

    Science.gov (United States)

    Bhandary, Sulatha; Khanna, Rajesh; Rao, Krishna A; Rao, Lavanya G; Lingam, Kamala D; Binu, V

    2011-01-01

    Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions) which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance. Awareness of eye donation was observed in 276 (69%) participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009). Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02) and males (P = 0.02). Educational status did not influence the willingness to donate eyes. Although majority of participants were aware of eye donation, willingness to donate eyes was poor.

  9. Prevalence of Traumatic Dental Injuries in Patients Attending University of Alberta Emergency Clinic.

    Science.gov (United States)

    Alkhadra, Thamer; Preshing, William; El-Bialy, Tarek

    2016-01-01

    This study evaluated the prevalence of dental trauma for patients attending the emergency dental clinic at the University of Alberta Hospital between 2006-2009. Patients' examination and treatment charts were reviewed. Total number of patients' charts was 1893.The prevalence of different types of trauma was 6.4 % of the total cases (117 patients). Trauma cases were identified according to Ellis classification and as modified by Holland et al., 1988. Logistic statistical model showed that 21.7% were Ellis class I trauma, 16.7% were Ellis class II trauma, and 6.7% were Ellis class III. In addition, 11.7 % presented with avulsion, 7.5 % presented with dentoalveolar fracture and 7.5% presented with sublaxation. Also, 17.55 % presented with tooth displacement within the alveolar bone, 3.3 % presented with crown fracture with no pulp involvement, 4.16 % presented with crown fracture with pulp involvement and 3.3 % presented with root fracture. In conclusion, the general prevalence of dentoalveolar trauma in patients attending the emergency clinic at the University of Alberta is less than other reported percentages in Canada or other countries.

  10. Eye donation - Awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia

    Directory of Open Access Journals (Sweden)

    Bhandary Sulatha

    2011-01-01

    Full Text Available Aim: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. Materials and Methods: This observational study was conducted on attendants who accompanied patients (n = 400 visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance. Results: Awareness of eye donation was observed in 276 (69% participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009. Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02 and males (P = 0.02. Educational status did not influence the willingness to donate eyes. Conclusions: Although majority of participants were aware of eye donation, willingness to donate eyes was poor.

  11. Prevalence of lymphoedema and quality of life among patients attending a hospital-based wound management and vascular clinic.

    LENUS (Irish Health Repository)

    Gethin, Georgina

    2012-04-01

    Lymphoedema is a chronic, incurable, debilitating condition, usually affecting a limb and causes discomfort, pain, heaviness, limited motion, unsatisfactory appearance and impacts on quality of life. However, there is a paucity of prevalence data on this condition. This study aimed to determine the prevalence of lymphoedema among persons attending wound management and vascular clinics in an acute tertiary referral hospital. Four hundred and eighteen patients meeting the inclusion criteria were assessed. A prevalence rate of 2.63% (n = 11) was recorded. Thirty-six percent (n = 4) had history of cellulitis and broken skin, 64% (n = 7) had history of broken skin and 36% (n = 4) had undergone treatment for venous leg ulcers. The most common co-morbidities were hypertension 55% (n = 6), deep vein thrombosis (DVT) 27% (n = 3), hypercholesterolemia 36% (n = 4) and type 2 diabetes 27% (n = 3). Quality of life scores identified that physical functioning was the domain most affected among this group. This study has identified the need to raise awareness of this condition among clinicians working in the area of wound management.

  12. Factors related to discontinued clinic attendance by patients with podoconiosis in southern Ethiopia: a qualitative study

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    Tora Abebayehu

    2012-10-01

    Full Text Available Abstract Background Podoconiosis is a lymphoedema of non-infectious cause which results in long-term ill health in affected individuals. Simple, effective treatment is available in certain parts of Ethiopia, but evidence indicates that not all patients continue collecting treatment supplies from clinic sites once started. We used qualitative techniques to explore factors related to discontinued attendance at outreach clinics of a non-government organization in southern Ethiopia. Methods A cross-sectional qualitative study was conducted in four clinic sites through unstructured in-depth interviews, key informant interviews and focus group discussions with the involvement of 88 study subjects. Results Discontinuation of clinic visits is common among podoconiosis patients. The reasons were: remoteness from the clinic sites, unrealistic expectation of ‘special’ aid, worry about increasing stigma, illness and misconceptions about treatment. Conclusions Several of these factors are remediable through community and individual information and education. Appropriate routes to deliver this information must be identified. Certain factors (such as distance to clinic sites and stigma require substantial expansion of services or liaison with village-level government health services.

  13. Communication About Sexual Matters With Women Attending a Danish Fertility Clinic: A Descriptive Study

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Fiil Eldridge, Katrine

    2017-01-01

    Introduction: Several studies have shown that sexuality is an important aspect of life. Nevertheless, sexual matters are only rarely discussed between patients and doctors. Other studies have suggested that women undergoing fertility treatment compose a group of patients with low satisfaction...... in their sexual life. Aim: To investigate how women at a fertility clinic desire and experience communication about sexual matters with doctors and to investigate the sexual function of these women. Methods: A cross-sectional self-administered questionnaire survey of women attending a Danish fertility clinic over...... 4 months was performed. Descriptive statistics were calculated and presented as frequencies. Main Outcome Measure: Communication about sexual matters with doctors included the women’s comfort, preferred and actual frequency of discussion, and initiation of the conversation. Sexual function included...

  14. Dermatophytosis Agents in Patients Who Attending to Dermatology Clinic of Fırat University Hospital

    Directory of Open Access Journals (Sweden)

    Nursel Dilek

    2009-06-01

    Full Text Available Objective: We aimed to investigate the types of dermatophytes and dermatophytosis in Elazığ region to provide appropriate information for therapy planning and public health prevention.Methods: A total of 652 patients who attending to outpatient clinic between June 2007 – May 2008 with clinical signs of dermatophytosis were included in this study. All samples, including with negative results on direct microscopy were cultivated in Sabouraud dextrose agar (Oxoid, mycobiotic agar (Acumedia and potato dextrose agar (Oxoid. Results: Dermatophytes were isolated in 142 (21.8% out of all samples. Of the isolates 70.4% were Trichophyton rubrum, 15.4% were Trichophyton mentagrophytes, 4.2% were , 4.2% were Microsporum canis, 2.8% were Epidermophyton floccosum, 2.11% were Trichophyton violaceum, 0.7% were Trichophyton tonsurans.Conclusion: Trichophyton rubrum was most frequently isolated dermatophytosis agent in Elazığ region.

  15. Clinical and functional correlates of foot pain in diabetic patients.

    NARCIS (Netherlands)

    Rijken, P.M.; Dekker, J.; Rauwerda, J.A.; Dekker, E.; Lankhorst, G.J.; Bakker, K.; Dooren, J.

    1998-01-01

    Purpose: patients with diabetes mellitus frequently suffer from foot pain. This pain seems to be a neglected area in studies on the diabetic foot. The purpose of this study was to identify clinical variables associated with foot pain in diabetic patients. In addition, the relationships between foot

  16. Sexual behaviour in adolescents and young people attending a sexually transmitted disease clinic, Ile Ife, Nigeria

    Directory of Open Access Journals (Sweden)

    Olasode Olayinka

    2007-01-01

    Full Text Available WHO estimates that 20% of persons living with HIV/AIDS are in their 20s and one out of twenty adolescents contract a sexually transmitted disease (STD each year. A total of 303 adolescents and youths (10-24 years of age attending an STD clinic were subjected to a questionnaire to assess sexual behavioural patterns that predisposed them to STD. Scope of the questions included age at initiation of sexual intercourse, partner at first exposure, number of sexual partners, use of condoms, exposure to commercial sex workers (CSWs, previous infection with STDs and role of alcohol. Their diagnosis was based on history, clinical findings and laboratory confirmation. Adolescents and youths accounted for 30% of the total number of patients attending the STD clinic during this period. The male to female ratio was 1:0.95. Ninety-six percent (290 were single while 4% (13 were married. Seventy-two percent (217 were students. Age at onset of sexual activity was 10-20 years in 80%, 85% practiced risky sexual behaviour, patronising casual partners was frequent especially after alcohol use, 10% had been exposed to CSWs, condom use was poor, number of sexual partners varied between 1 and 5 and previous infections were not professionally treated. Adolescents and young people are sexually active and practice risky sexual behavioural patterns. Adolescents and youths account for a high percentage of patients patronising the STD clinic. Sexual education and youth friendly reproductive health services are urgently needed to curb the spread of HIV/AIDS/STDs.

  17. Respiratory Virus Detection and Clinical Diagnosis in Children Attending Day Care.

    Directory of Open Access Journals (Sweden)

    Nina Moe

    Full Text Available Respiratory viruses often have been studied in children with respiratory tract infection (RTI, but less knowledge exists about viruses in asymptomatic children. We have studied the occurrence of a broad panel of respiratory viruses in apparently healthy children attending day care, taking into account the influence of possible confounding factors, such as age, clinical signs of respiratory tract infection (RTI, location (day-care section and season.We have studied 161 children in two day-care centers, each with separate sections for younger and older children, during four autumn and winter visits over a two-year period. A total of 355 clinical examinations were performed, and 343 nasopharyngeal samples (NPS were analyzed by semi-quantitative, real-time, polymerase chain reaction (PCR tests for 19 respiratory pathogens.Forty-three percent of all NPS were PCR-positive for ≥ 1 of 13 virus species, with high species variation during visits. Rhinovirus 26% (88/343 NPS, enterovirus 12% (40/343 and parechovirus 9% (30/343 were detected in every visit, and the rates varied in relation to age, day-care section and season. Ten other viruses were detected in ≤ 3% of the NPS. Generally, viruses occurred together in the NPS. In 24% (79/331 of the clinical examinations with available NPS, the children had clear signs of RTI, while in 41% (135/331 they had mild signs, and in 35% (117/331 the children had no signs of RTI. Moreover, viruses were found in 70% (55/79 of children with clear signs of RTI, in 41% (55/135 with mild signs and in 30% (35/117 without any signs of RTI (p < 0.001.Positive PCR tests for respiratory viruses, particularly picornaviruses, were frequently detected in apparently healthy children attending day care. Virus detection rates were related to age, presence of clinical signs of RTI, location in day care and season.

  18. Adherence to a lifestyle program for youth with type 2 diabetes and its association with treatment outcome in the TODAY clinical trial.

    Science.gov (United States)

    Berkowitz, Robert I; Marcus, Marsha D; Anderson, Barbara J; Delahanty, Linda; Grover, Nisha; Kriska, Andrea; Laffel, Lori; Syme, Amy; Venditti, Elizabeth; Van Buren, Dorothy J; Wilfley, Denise E; Yasuda, Patrice; Hirst, Kathryn

    2017-06-30

    To assess the association of proxies of behavioral adherence to the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) lifestyle program with changes in glycemic control and obesity in a multi-ethnic sample of youth with type 2 diabetes. The TODAY clinical trial included an intensive lifestyle intervention to promote weight reduction. Adherence was assessed with measures of attendance at intervention sessions and rates of self-monitoring of diet and physical activity by participants and their caregivers. The relation between participant characteristics and consistency of proxies of adherence were examined across 3 phases of intervention. A total of 234 TODAY youth were randomized to the lifestyle program. Overall rate of session attendance was approximately 60% of planned sessions. Participants with an adequate dose of session attendance (≥75% attended) did not differ from those who attended low and additional analysis was not possible. Rates of session attendance were moderate in a lifestyle program for youth with type 2 diabetes, but levels of self-monitoring, considered a key lifestyle change behavior, were low. Glycemic control was not significantly associated with session attendance but reductions in percent overweight were. Given the salience of program attendance and self-monitoring to lifestyle weight management established in other populations, future research is needed to understand, develop, and promote strategies and interventions targeting weight loss to achieve improved glycemic control in youth diagnosed with type 2 diabetes. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. A CLINICAL STUDY OF PULMONARY TUBERCULOSIS AMONG DIABETES MELLITUS PATIENTS

    Directory of Open Access Journals (Sweden)

    Mojjada Dhanunjaya

    2015-09-01

    Full Text Available Of all the non - tuberculosis complications associated with disease, Diabetes Mellitus exerts, the most adverse influence on the course of pulmonary tuberculosis. The combined diagnosis was invariably fatal before Specific anti tuberculous and anti - diabetic drugs were available. As per new diabetes guidelines, every diabetic patient should be under gone screening for Pulmonary Tuberculosis. We conducted a clinical study of 60 Patients with Diabetes and Pulmonary Tuberculosis. For establishment of Diagnosis Ch est X – ray and Sputum for AFB were done for pulmonary tuberculosis and both blood & Urine Sugar were done for Diabetes Mellitus.

  20. The effect of reminder calls in reducing non-attendance rates at care of the elderly clinics

    OpenAIRE

    2001-01-01

    BACKGROUND—DNA ("did not attend") at outpatient clinics is an important problem costing the NHS an estimated £266 million annually. The national DNA rate for 1996-1997 for all clinics was 12%. The DNA rate at Hammersmith Hospital for the same year in the care of the elderly specialty was 21%. The aim of this study was to establish why this was so, and to test the efficacy of a reminder call in increasing attendance rates at care of the elderly clinics.
METHODS—23 DNAs from seven clinics were ...

  1. An interview-based study of non-attendance at screening for cardiovascular diseases and diabetes in older women

    DEFF Research Database (Denmark)

    Dahl, Marie; Lindholt, Jes; Søgaard, Rikke

    2017-01-01

    AIMS AND OBJECTIVES: This study explored non-attendees' perspectives on a screening program for cardiovascular disease (CVD) and diabetes mellitus (DM) among women aged 60-77 years. BACKGROUND: Non-attendance in screening is a common concern and has been associated with increased morbidity...... was applied. RESULTS: All informants found the screening offer personally irrelevant, but this belief was changeable. The informants' perceptions of screening were based on subjective health and risk beliefs, personal knowledge of diseases and the screening program, and distrust in the healthcare system....... CONCLUSION: Personal experiences, beliefs, and self-protective strategies influence individuals' subjective interpretations of a screening program's relevance. The perception that screening is irrelevant seems to be rooted in non-attendees' personal health-related assessment and knowledge. Consequently...

  2. Clinico-epidemiological profile of tobacco users attending a tobacco cessation clinic in a teaching hospital in Bangalore city

    Directory of Open Access Journals (Sweden)

    George D′Souza

    2012-01-01

    Full Text Available Background: Tobacco-attributable mortality in India is estimated to be at least 10%. Tobacco cessation is more likely to avert millions of deaths before 2050 than prevention of tobacco use initiation. Objective: To describe the clinico-epidemiological profile of attendees of a tobacco cessation clinic in a teaching hospital in Bangalore city. Materials and Methods: A descriptive study of 189 attendees seen over 2 years in the Tobacco Cessation Clinic of a tertiary-care teaching hospital in Bangalore, with information on socio demographic characteristics, tobacco-use details, nicotine dependence, family/medical history, past quit attempts, baseline stage-of-change, and treatment initiated. Results: Only 5% were ′walk-in′ patients; 98% of attendees were smokers; 97% were males. The mean (±SD age of attendees was 48.0 (±14.0 years. Most participants were married (88%, and predominantly urban (69%. About 62% had completed at least 8 years of schooling. Two-thirds of smokers reported high levels of nicotine dependence (Fagerström score >5/10. About 43% of patients had attempted quitting earlier. Four-fifths (79% of tobacco-users reported a family member using tobacco. Commonly documented comorbidities included: Chronic respiratory disease (44%, hypertension (23%, diabetes (12%, tuberculosis (9%, myocardial infarction (2%, stroke (1%, sexual dysfunction (1% and cancer (0.5%. About 52% reported concomitant alcohol use. At baseline, patients′ motivational stage was: Precontemplation (14%, contemplation (48%, preparation/action (37% and maintenance (1%. Treatment modalities started were: Counseling alone (41%, nicotine replacement therapy alone (NRT (34%, medication alone (13%, and NRT+medication (12%. Conclusions: This is the first study of the baseline profile of patients attending a tobacco cessation clinic located within a chest medicine department in India. Important determinants of outcome have been captured for follow-up and prospective

  3. Management of diabetes mellitus in clinical practice.

    Science.gov (United States)

    Lawal, Muili

    Diabetes is a global health problem, with a challenging epidemiology. It is one of the major health problems affecting countries around the world, particularly the UK (World Health Organization [WHO], 2006; Department of Health [DH], 2006b). It is also a growing public health threat in the US (Mokdad et al, 2001). As a result, diabetes has become an important public health issue, prompting the WHO and International Diabetes Federation (IDF) to adopt the theme 'Diabetes for Everyone' for World Diabetes Day 2006. In 2007, on World Diabetes Day, the United Nations also launched its 'Living with Diabetes at School' campaign, in response to the growing diabetes 'epidemics' (Diabetes UK, 2007). This article provides an overview of diabetes mellitus and its acute- and long-term management, including definition, aetiology, pathophysiology, classification, signs, symptoms and complications. The role of the nurse in providing patient-centred care for people with diabetes is emphasized.

  4. Clinical management of acute diabetic Charcot foot in Denmark

    DEFF Research Database (Denmark)

    Jansen, Rasmus Bo; Svendsen, Ole Lander; Kirketerp-Møller, Klaus

    2016-01-01

    INTRODUCTION: Charcot foot is a severe complication to diabetes mellitus and treatment involves several different clinical specialities. Our objective was to describe the current awareness, knowledge and treatment practices of Charcot foot among doctors who handle diabetic foot disorders. METHODS...... and treatment practices of acute diabetic Charcot foot at diabetes foot clinics in Denmark. The responders seem to follow the international recommendations and guidelines on management of the acute diabetic Charcot foot, despite a lack of Danish guidelines. FUNDING: none. TRIAL REGISTRATION: not relevant....

  5. Predictive factors of follow-up non-attendance and mortality among adults with type 2 diabetes mellitus- an analysis of the Malaysian diabetes registry 2009.

    Science.gov (United States)

    Chew, Boon-How; Lee, Ping-Yein; Shariff-Ghazali, Sazlina; Cheong, Ai-Theng; Ismail, Mastura; Taher, Sri-Wahyu

    2015-01-01

    This study examined the factors associated with follow-up non-attendance (FUNA) and mortality among the adult patients with type 2 diabetes mellitus (T2DM). Data on 57780 T2DM patients from the 2009 diabetes registry were analyzed using multinomial logistic mixed model. Out of 57780 patients, 3140 (5.4%) were lost to follow-up and 203 (0.4%) patients had died. Compared with patients who were under active follow-up, men (OR 1.37), neither on insulin (OR 1.72), nor on antiplatelet agents (OR 1.47), having higher HbA1c (OR 1.15), higher LDL-C (OR 1.18) and complications (OR 1.33) were associated with FUNA. Older age (OR 1.09) and higher LDL-C (OR 2.27) have higher mortality. Across the four different health facilities, medication use (insulin and anti-platelet agents) to achieve better disease control in the younger age when diabetes complication is absent would not cause FUNA and might reduce mortality.

  6. Adherence to oral anti-diabetic drugs among patients attending a Ghanaian teaching hospital

    Directory of Open Access Journals (Sweden)

    Bruce SP

    2015-03-01

    Full Text Available Background: The burden of diabetes mellitus, especially Type-2, continues to increase across the world. Medication adherence is considered an integral component in its management. Poor glycemic controls due to medication nonadherence accelerates the development of long-term complications which consequently leads to increased hospitalization and mortality. Objective: This study examined the level of adherence to oral antidiabetic drugs among patients who visited the teaching hospital and explored the probable contributory factors to non-adherence. Methods: A cross-sectional descriptive study using systematic sampling to collect quantitative data was undertaken. Questionnaires were administered to out-patients of the medical department of a teaching hospital in Ghana. Logistic regression was performed with statistical significance determined at p<0.05. Results: A total of 200 diabetic patients participated in the study. Using the Morisky Medication Adherence scale, the level of adherence determined was 38.5%. There were significant correlations between level of adherence and educational level [(OR=1.508; (CI 0.805- 2.825, P=0.019, and mode of payment [(OR=1.631; (CI 0.997- 2.669, P=0.05. Conclusion: Adherence in diabetic patients was low among respondents and this can be improved through education, counseling and reinforcement of self-care. There were several possible factors that contributed to the low adherence rate which could benefit from further studies.

  7. URINARY LOSS OF MICRONUTRIENTS IN DIABETIC PATIENTS ATTENDING A TERTIARY HOSPITAL SERVICE.

    Science.gov (United States)

    da Silva Santos, Andressa Feijó; Souza Santos, Roberta Deh; Foss-Freitas, Maria Cristina; Carvalho da Cunha, Selma Freire; Marchini, Júlio Sérgio; Marques Miguel Suen, Vivian

    2015-08-01

    Introducción/objetivos: la deficiencia de micronutrientes puede contribuir a un menor control de la diabetes. El objetivo de este estudio fue evaluar la excreción urinaria de micronutrientes en pacientes con diabetes mellitus tipo 2. Métodos: los pacientes con diabetes y los controles fueron evaluados por la ingesta de alimentos, la antropometría, la pérdida urinaria de micronutrientes y comparados por Mann Whitney no paramétrico (p < 0,05). Resultados: fueron evaluados nueve sujetos diabéticos (52 ± 14 años con un IMC de 30 ± 11 kg/m² y la circunferencia de la cintura (CC) de 99 ± 25 cm) y nueve sujetos control (51 ± 16 años, IMC 26 ± 5 kg/m² y CA total de 90 ± 13 cm). La excreción de hierro más alta se observó en el grupo diabético y la mayor excreción de magnesio en el grupo de control. Conclusiones: el tipo 2 de pacientes diabéticos estudiados aquí no mostraron un aumento en la excreción de micronutrientes en la orina en comparación con los controles.

  8. Prevalence of Chlamydia trachomatis in women attending a family planning clinic in Papua New Guinea.

    Science.gov (United States)

    Theunissen, J J; Kariwiga, G; Ossewaarde, J M; van Rijsoort-Vos, J H; Stolz, E; van der Meijden, W I

    1995-10-01

    To determine the prevalence of Chlamydia trachomatis infection in women attending a family planning clinic in Papua New Guinea, in the period between April and June 1991. The outpatient department of Obstetrics and Gynaecology of Port Moresby General Hospital, Port Moresby, Papua New Guinea, the departments of Dermato-Venereology and Clinical Microbiology of the Erasmus University, Rotterdam, The Netherlands and the National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands. A total of 254 consecutive women who attended the family planning clinic at Port Moresby General Hospital, Papua New Guinea were enrolled into this study. Cervical infections with C trachomatis were diagnosed using the direct immunofluorescent assay (DFA) and the polymerase chain reaction (PCR). Serum IgM and IgG antibodies directed against C trachomatis were detected using the enzyme-linked fluorescent assay (ELFA). The prevalence of C trachomatis was 14.6% using the PCR, 9.1% using the DFA and 17.3% when the results of the PCR and the DFA were combined. An elevated IgM titre was observed in 14.2% of the women, whereas 44.1% had an elevated IgG titre. The titres of IgM or IgG were significantly higher in women who were positive using the PCR or the DFA than in those who were negative in both the PCR and the DFA (p = 0.032 and p = 0.0046, respectively). Cervical infection by C trachomatis can be considered a major health problem in at least the studied population in Papua New Guinea. The prevalence of C trachomatis infection is at least comparable with that in groups with a high prevalence in industrialized countries. Effective screening and treatment programmes are imperative to combat this problem.

  9. Use of the internet by patients attending specialist clinics in Sri Lanka: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Kommalage Mahinda

    2009-02-01

    Full Text Available Abstract Background The internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information are mainly done in developed countries and very few studies have been carried out in developing countries. Methods The Internet usage of patients who were attending specialist clinics in Teaching Hospital Karapitiya and Southern Hospital in Galle, Sri Lanka was investigated. The study was carried out on the following specialities; General Medicine, Pediatrics, General Surgery and Cardiothoracic surgery. Information was collected using an investigator-administered questionnaire while patients were waiting for a consultation. Results Three hundred and fifty five patients (or guardians in the Pediatric clinic participated in the study. One hundred seventy two (48.3% participants have heard about the Internet. There was a relationship between awareness of the Internet and age, educational level and the clinic attended. There was no difference of awareness depending on the gender or the hospital. Only three participants (0.97% have used the Internet to find information about their disease conditions. Close relatives searched the Internet about the conditions of two participants. Altogether, the Internet was used to search information on the disease condition of five participants (1.4%. Conclusion Very low usage of the Internet for health information retrieval in this study is probably due to low awareness of the Internet and low educational level. This low usage of Internet and the associated reasons shown in this study can be generalized to Sri Lanka and probably to other low-income countries that have lower educational level than Sri Lanka.

  10. Management of childhood febrile illness prior to clinic attendance in urban Nigeria.

    Science.gov (United States)

    Afolabi, B M; Brieger, W R; Salako, L A

    2004-03-01

    Parents and caregivers often try various treatment modalities for their sick children before bringing them to clinic. Many community-based studies have documented home and self-treatment practices, often with the aid of patent medicine vendors, but less is known about prior treatment behaviour of caregivers who actually reach a government clinic. This study, therefore, aimed at documenting the treatment provided by caregivers prior to their attendance at a public hospital. Beginning in April 1996, a year-long study was conducted among 1,943 sick children and their caregivers who attended the largest government-owned paediatric hospital in Lagos, Nigeria. The major complaints mentioned by the caregivers included fever, cough, and diarrhoea. Most (89%) caregivers had administered some form of medicine to the child prior to the clinic visit, and on average, 2.5 medications had been given. Associations were found between major complaint and type of medicine given: fevers were associated with antimalarial drugs and analgesics (antipyretics), cough was associated with cough syrup and analgesics, while diarrhoea was associated with antidiarrhoeal drugs. Although one-fifth of the children had received an antibiotic, provision of antibiotics was not associated with a particular complaint/illness. Since caregivers appeared to use perceived complaints/illnesses as a treatment guide, this can form the basis of safer and more appropriate recognition of illness and home management. In addition, the information obtained in this study can be used for training clinicians to inquire about home management and, thus, for making more informed decisions about their own treatment and prescribing practices.

  11. Prevalence and Characteristics of Pregnant Syphilis among Women Attending Antenatal Clinics in Shenzhen (China) in 2003

    Institute of Scientific and Technical Information of China (English)

    Yang Fan(杨帆); Zhou Hua(周华); Hong Fuchang(洪福昌); Luo Bin(罗斌); Cai Yumao(蔡于茂); Wen Lizhang(文立章); Zhang Chunlai(张春来)

    2004-01-01

    Abstract Background: The Nnewly reported cases of congenital syphilis have been increaseding substantially over the past few years. To control the epidemic, a municipal program aimed at preventing mother-to-child transmission of syphilis was introduced in July, 2001,which was designed aimed to screen all pregnant women for syphilis at their first visit to antenatal clinics or at admission to hospitals in Shenzhen.Objectives: The aim of the study is tTo determine the prevalence of syphilis among women attending antenatal clinics and other medical institutions in Shenzhen and identifies its patterns of infection.Methods: Upon giving informed consent, w Women who attended antenatal care centers in Shenzhen from January to December 2003 were included in this study subject to obtaining informed consent. A blood sample was harvested for syphilis screened for syphilising by using rapid plasma reagent test (RPR) and confirmed by TPHA for those who were RPR positive. The women with pregnant syphilispositive serology were systematically interviewed to obtain. During the interview, their demographic detailsinformation, patterns of risk behaviors and other data. Data were collected andwere analyzed retrospectively.Results: Among Of 118,235 pregnant women surveyed,555 pregnant women were confirmed to have syphilis (prevalence of 4.69%), with a incidence of 4.69‰. 123women were excluded from the analysis because of incomplete medical records. Of 432 infected subjects with complete medical records, the average age was 26.8, with a range of 19 to 41. 7.41% (32/432) of them suffered from primary syphilis, 3.24% (14/432) were ofhad secondary syphilis, and 89.35%(386/432) had latent syphilis. Without any conspicuous clinical signs and symptoms. Conclusions: The prevalence of syphilis among the pregnant women in our series was high an most of them were asymptomatic. Screening for syphilis among pregnant women in Shenzhen is of importantce for the prevention of mother

  12. Orofacial manifestations in HIV positive children attending Mildmay Clinic in Uganda.

    Science.gov (United States)

    Nabbanja, Juliet; Gitta, Sheba; Peterson, Stefan; Rwenyonyi, Charles Mugisha

    2013-01-01

    The aim of this study was to assess the orofacial manifestations and their influence on oral function in human immunodeficiency virus (HIV) positive children attending Mildmay Clinic in Uganda. This was a cross-sectional study based on clinical examination, medical records and a structured questionnaire of 368 children aged between 1.5 and 17 years. The clinical examination for dental caries was based on decayed, extracted and filled teeth (deft) and decayed, missing and filled teeth (DMFT) indices as defined by World Health Organisation. The soft tissue orofacial lesions were assessed using the classification and diagnostic criteria as described by the Collaborative Workgroup on the Oral Manifestations of Pediatric HIV Infections. Approximately 67.4% of the children were on highly active antiretroviral therapy (HAART). The majority (77.4%) of the children had at least one orofacial lesion associated with HIV, pseudomembranous candidiasis being the most prevalent. Overall, 61.7% of the children with orofacial lesions reported at least one form of discomfort in the mouth. Discomfort was particularly associated with swallowing. The prevalence of orofacial lesions was significantly higher in children with poor oral hygiene and lower in those on HAART than in their respective counterparts. The CD4+ cell count, age and gender of the children did not significantly influence the distribution of orofacial lesions. The mean deft and DMFT scores were 11.8 and 2.7, respectively. The d- and D-components contributed 54.7 and 42.1%, respectively. Consumption of sugary snacks was directly associated with dental caries. Despite these children attending an HIV care centre of excellence, they have a high prevalence of orofacial manifestations associated with HIV. The majority of the children experienced discomfort in the oral cavity, particularly during swallowing.

  13. Seroprevalence of HIV in women attending antenatal clinic at KIMS hospital, Narketpally

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    Venna Guru Prasad

    2012-12-01

    Full Text Available Background: To assess seroprevalence of HIV among antenatal women and the extent of utilization of therapeutic interventions to minimize the risk of mother to child transmission. Methods: Pregnant women attending antenatal clinic of a medical college in a rural area of Nalgonda district of Andhra Pradesh, India from August 2006 to July 2009 were tested for HIV by Rapid Test which included pre and post test counseling. Antiretroviral prophylaxis with nevirapine was given to seropositive mother-baby pairs during delivery. Results: Of the 5809 new antenatal booking visits 4848 attended pretest counseling and 4698 accepted HIV testing. Fifty three women were found to be seropositive. Sero-prevalence rate of HIV infection was 1.12%. Ten had opted for pregnancy termination. Out of forty three deliveries four were intrauterine deaths. All the newborns received nevirapine prophylaxis. Conclusions: The seroprevalence of HIV infection among antenatal women is 1.12% which was high as the institute is located in Andhra Pradesh which is a known high prevalence state. Thirty one babies tested after 18 months of age were negative. Nine babies died before they reached 18 months of age. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 17-21

  14. Polymicrobial biofilms by diabetic foot clinical isolates.

    Science.gov (United States)

    Mottola, Carla; Mendes, João J; Cristino, José Melo; Cavaco-Silva, Patrícia; Tavares, Luís; Oliveira, Manuela

    2016-01-01

    Diabetes mellitus is a major chronic disease that continues to increase significantly. One of the most important and costly complications of diabetes is foot ulceration that may be colonized by pathogenic and antimicrobial resistant bacteria, which may express several virulence factors that could impair treatment success. These bacterial communities can be organized in polymicrobial biofilms, which may be responsible for diabetic foot ulcer (DFU) chronicity. We evaluated the influence of polymicrobial communities in the ability of DFU isolates to produce biofilm, using a microtiter plate assay and a multiplex fluorescent in situ hybridization, at three time points (24, 48, 72 h), after evaluating biofilm formation by 95 DFU isolates belonging to several bacterial genera (Staphylococcus, Corynebacterium, Enterococcus, Pseudomonas and Acinetobacter). All isolates were biofilm-positive at 24 h, and the amount of biofilm produced increased with incubation time. Pseudomonas presented the higher biofilm production, followed by Corynebacterium, Acinetobacter, Staphylococcus and Enterococcus. Significant differences were found in biofilm formation between the three time points. Polymicrobial communities produced higher biofilm values than individual species. Pseudomonas + Enterococcus, Acinetobacter + Staphylococcus and Corynebacterium + Staphylococcus produced higher biofilm than the ones formed by E. faecalis + Staphylococcus and E. faecalis + Corynebacterium. Synergy between bacteria present in dual or multispecies biofilms has been described, and this work represents the first report on time course of biofilm formation by polymicrobial communities from DFUs including several species. The biological behavior of different bacterial species in polymicrobial biofilms has important clinical implications for the successful treatment of these infections.

  15. Sociodemographic profile and predictors of outpatient clinic attendance among HIV-positive patients initiating antiretroviral therapy in Selangor, Malaysia

    Science.gov (United States)

    Abdulrahman, Surajudeen Abiola; Rampal, Lekhraj; Othman, Norlijah; Ibrahim, Faisal; Hayati, Kadir Shahar; Radhakrishnan, Anuradha P

    2017-01-01

    Background Inconsistent literature evidence suggests that sociodemographic, economic, and system- and patient-related factors are associated with clinic attendance among the HIV-positive population receiving antiretroviral therapy (ART) around the world. We examined the factors that predict outpatient clinic attendance among a cohort of HIV-positive patients initiating ART in Selangor, Malaysia. Patients and methods This cross-sectional study analyzed secondary data on outpatient clinic attendance and sociodemographic, economic, psychosocial, and patient-related factors among 242 adult Malaysian patients initiating ART in Selangor, Malaysia. Study cohort was enrolled in a parent randomized controlled trial (RCT) in Hospital Sungai Buloh Malaysia between January and December 2014, during which peer counseling, medication, and clinic appointment reminders were provided to the intervention group through short message service (SMS) and telephone calls for 24 consecutive weeks. Data on outpatient clinic attendance were extracted from the hospital electronic medical records system, while other patient-level data were extracted from pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires in which primary data were collected. Outpatient clinic attendance was categorized into binary outcome – regular attendee and defaulter categories – based on the number of missed scheduled outpatient clinic appointments within a 6-month period. Multivariate regression models were fitted to examine predictors of outpatient clinic attendance using SPSS version 22 and R software. Results A total of 224 (93%) patients who completed 6-month assessment were included in the model. Out of those, 42 (18.7%) defaulted scheduled clinic attendance at least once. Missed appointments were significantly more prevalent among females (n=10, 37.0%), rural residents (n=10, 38.5%), and bisexual respondents (n=8, 47.1%). Multivariate binary logistic regression analysis showed that

  16. CLINICAL FEATURES OF ACUTE FEBRILE THROMBOCYTOPAENIA AMONG PATIENTS ATTENDING PRIMARY CARE CLINICS

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    Khairani Omar

    2006-01-01

    Full Text Available Introduction: Identifying clinical features that differentiate acute febrile thrombocytopaenia from acute febrile illness without thrombocytopaenia can help primary care physician to decide whether to order a full blood count (FBC. This is important because thrombocytopaenia in viral fever may signify more serious underlying aetiology like dengue infection.Objective: The aim of this study was to compare the clinical features of acute febrile patients with thrombocytopaenia and acute febrile patients without thrombocytopaenia.Methodology: This was a clinic-based cross-sectional study from May to November 2003. Consecutive patients presenting with undifferentiated fever of less than two weeks were selected from the Primary Care Centre of Hospital Universiti Kebangsaan Malaysia and Batu 9 Cheras Health Clinic. Clinical features of these patients were recorded and FBC examination was done for all patients. Thrombocytopaenia was defined as platelet count <150X109/L. The odds ratio of thrombocytopaenia for each presenting symptoms was calculated.Result: Seventy-three patients participated in this study. Among them, 45.2% had thrombocytopaenia. Myalgia and headache were common among all patients. However, nausea and vomiting occurred significantly more often among patients with thrombocytopaenia than in patients with normal platelet count (OR 2.2, 95% CI 1.1-4.5.Conclusion: Acute non-specific febrile patients presenting with symptoms of nausea and vomiting may have higher risk of thrombocytopaenia and should be seriously considered for FBC.

  17. Co-morbidity in a cystic fibrosis population attending a regional clinic.

    LENUS (Irish Health Repository)

    Healy, F

    2010-11-01

    Pulmonary disease remains the major cause of morbidity in patients with cystic fibrosis (CF). However, of 115 patients attending a regional CF clinic we noted 16 cases (14%) with co-morbid conditions. Of this group, 4 of 115 patients (3.5%) had renal problems including both structural and functional defects and 4 (3.5%) had neurological disorders, 3 of which were types of epilepsy. Notably, 3 of 115 patients (2.6%) had different forms of neoplasia, all of which required significant surgical and\\/or chemotherapeutic intervention. There is now increasing evidence of the association between digestive tract malignancy and CF, which further complicates management of these already complex cases.

  18. Profile of Low Vision Population Attending Low Vision Clinic in a Peripheral Eye Hospital in Nepal

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    Safal Khanal, BOptom

    2013-12-01

    Full Text Available Background: Blindness and low vision are major causes of morbidity and constitute a significant public health problem, both detrimental to the quality of life for the individual and an economic burden on the individual, family, and society in general. People with low vision have the potential for enhancement of functional vision if they receive the appropriate low vision services. The present study aims to determine the profile of the low vision population attending a low vision clinic at a peripheral eye hospital in Nepal.Methods: The low vision evaluation report cards of all the patients attending the low vision clinic at Biratnagar Eye Hospital between January 1, 2010 to March 31, 2012 were retrospectively reviewed.Results: Out of 396 low vision patients, 280 (70.71% were males and 116 (29.29% were females. The age range of patients was from six to 89 years, with a mean of 43.29 ±11.06 years. Retinitis pigmentosa (70, 18% and macular diseases except age related macular degeneration (AMD (55, 14% were the most common causes of low vision. Nystagmus and amblyopia (34, 26.36%, retinitis pigmentosa (49, 23.33% and AMD (16, 28.07% were the most common causes of low vision in the 0-15, 16-60, and >60 years age groups, respectively. Telescopes (52, 39.10% and stand magnifiers (45, 33.83% were the most commonly prescribed low vision devices.Conclusion: Hereditary anomalies and age related degeneration constitute the major causes of low vision in the study population. Telescopes and stand magnifiers were the most commonly prescribed and preferred low vision devices. The burden of visual impairment can be tackled in an effective way through the provision of quality and affordable low vision services and also provide a basis for national and regional level planning to combat visual impairment.

  19. Screening of long-term complications and glycaemic control of patients with diabetes attending Rustenburg Provincial Hospital in North West Province, South Africa

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    John M. Tumbo

    2013-01-01

    Full Text Available Background: The prevalence of diabetes mellitus (DM is increasing worldwide, with more than 90% being type 2. In South Africa, DM is common amongst all racial groups with the highest prevalence amongst the Indian population (15.8%, followed by the White (3.5% and Black (4.8% populations. Long-term cardiovascular, renal, neurovascular and retinal complications of type 2 DM are majorcauses of disability and mortality - hence the need for screening.Objective: To describe the screening practices of long-term complications amongst patients withtype 2 diabetes attending Rustenburg Provincial Hospital in North West Province (South Africa.Method: A cross-sectional quantitative study using patients’ clinical records was performed. A randomsample of 92 out of 1340 patients with type 2 diabetes attending the hospital in 2007 was selected. Demographic information on age, gender, body mass index, residence, level of education, durationof treatment and type of treatment was obtained. The recorded glycosylated haemoglobin (HbA1c,lipids and blood pressure levels were extracted, as well as the results of the dilated eye exam, footexamination, urine test for microalbumin, blood urea and creatinine. The data was analysed usingthe EPI Info version 6.05 software package.Results: The screening tests that were carried out consistently included: glycosylated haemoglobin (95.7%, blood pressure (100%, serum glucose (100%, serum cholesterol (79.3% and serum creatinine (93.5%. Aspects poorly screened for were: dilated eye examination (19.5%, foot examination (20.6%, urine test for micro-albumin (1.1%, as well as HDL and LDL cholesterol (17.4%. Abnormal resultswere mainly detected in: HbA1c (69.3%, serum creatinine (30.2%, dilated eye examination (38.9% and foot examination (52.6%. The HbA1c of 9.1% is far above the target of 6% and this predisposespatients to long-term complications.Conclusion: The screening of long-term complications of type 2 DM was poor in most

  20. Dyslipidemia and associated factors among diabetic patients attending Durame General Hospital in Southern Nations, Nationalities, and People’s Region

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    Bekele S

    2017-06-01

    Full Text Available Shiferaw Bekele, Tagesech Yohannes, Abdurehman Eshete Mohammed Department of Medical Laboratory Sciences, College of Health Sciences, Jimma University, Jimma, Ethiopia Background: Diabetes mellitus is a group of metabolic disorders that are caused by deficiency in insulin secretion or the decreased ability of insulin to act effectively on target tissues, particularly muscle, liver, and fat. As a result of insulin resistance in the target tissues, particularly in the adipocytes, free fatty acid flux is increased, leading to increased lipid synthesis in hepatocytes, which is responsible for diabetic dyslipidemia.Objective: The objective of this study was to determine the prevalence and associated factors of dyslipidemia among diabetic patients in Durame General Hospital in Kembata Tembaro zone.Methods: A cross-sectional study was conducted from September 2015 to April 2016. In total, 224 subjects were involved in the study by using convenient sampling techniques. Face-to-face interview–administered questionnaire was used to collect sociodemographic data and other possible clinical data associated with the prevalence of dyslipidemia. Fasting venous blood specimens were collected to assess serum lipid profiles. Blood pressure (BP, weight, height, and waist circumference were measured.Results: The prevalence of dyslipidemia was 65.6%. Individual lipid abnormality of elevated LDL-C, TC, TG, and reduced HDL-C were identified in 43.8%, 23.7%, 40.6%, and 41.9% of study subjects, respectively. The prevalence of dyslipidemia was significantly associated with high BP, high body mass index, aging, and longer duration of diabetes mellitus. Conclusion: High prevalence of dyslipidemia was found among diabetic patients in the study area. Therefore, a compressive mechanism is required to screen, treat, and prevent dyslipidemia. Keywords: diabetes, lipid profile, Jimma, Ethiopia

  1. The Etiology of Genital Ulcer Disease among Patients Attending Sexually Transmitted Disease Clinics in Guangzhou, China

    Institute of Scientific and Technical Information of China (English)

    GU Jin(谷进); ZENG Zhirong(曾志荣); CHEN Rongzhang(陈荣章); ZHU Huilan(朱慧兰); QIU Xiaoshan(邱晓珊)

    2002-01-01

    Objectives: To investigate the etiology of genital ulcerdisease (GUD) among patients attending sexuallytransmitted disease (STD) clinics in Guangzhou, China.Methods: Between September 8, 1998, and August 9,2001, 267 patients with a genital ulcer were clinicallyassessed. Clinical etiology of GUD was dependent onphysical appearance and microbiologic examination,including the following: dark field microscopy and serologyfor Treponema pallidum (TP), swabs of genital ulcer forHerpes simplex virus (HSV), processed quantitativefluorescent polymerase chain reaction (QF-PCR) forsimultaneous detection of HSV, TP, Haemophilus ducreyi(HD), Human papillomavirus (HPV), and serology for HIVinfection.Results: Two hundred thirty men and thirty-sevenwomen with a median age of 33.4 (range 16-74 years) wereanalyzed. The etiology of GUD was syphilis (26.59%)(71/267), genital herpes (17.60%) (47/267), condylomataacuminata (4.87%) (13/267), candidiasis (3.37%) (9/267),bacterial infection (3.75%) (10/267), and multiple infection(6.74%) (18/267). The seroprevalence of HIV was 0.75%(2/267). No etiology was identified in 50.56% (135/267).Conclusion: The etiology of GUD among STD patients inour area was multifactorial with a predominance of syphilisand genital herpes. Based on this limited data obtained atSTD clinics, HIV infection was not common.

  2. Scale-up, retention and HIV/STI prevalence trends among female sex workers attending VICITS clinics in Guatemala.

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    Sonia Morales-Miranda

    Full Text Available BACKGROUND: Since 2007, Guatemala integrated STI clinical service with an HIV prevention model into four existing public health clinics to prevent HIV infection, known as the VICITS strategy. We present the first assessment of VICITS scale-up, retention, HIV and STI prevalence trends, and risk factors associated with HIV infection among Female Sex Workers (FSW attending VICITS clinics in Guatemala. METHODS: Demographic, behavioral and clinical data were collected using a standardized form. Data was analyzed by year and health center. HIV and STI prevalence were estimated from routine visits. Retention was estimated as the percent of new users attending VICITS clinics who returned for at least one follow-up visit to any VICITS clinic within 12 months. Separate multivariate logistic regression models were conducted to investigate factors associated with HIV infection and program retention. RESULTS: During 2007-2011 5,682 FSW visited a VICITS clinic for the first-time. HIV prevalence varied from 0.4% to 5.8%, and chlamydia prevalence from 0% to 14.3%, across sites. Attending the Puerto Barrios clinic, having a current syphilis infection, working primarily on the street, and using the telephone or internet to contact clients were associated with HIV infection. The number of FSW accessing VICITS annually increased from 556 to 2,557 (361% during the period. In 2011 retention varied across locations from 7.7% to 42.7%. Factors negatively impacting retention included current HIV diagnosis, having practiced sex work in another country, being born in Honduras, and attending Marco Antonio Foundation or Quetzaltenango clinic sites. Systematic time trends did not emerge, however 2008 and 2010 were characterized by reduced retention. CONCLUSIONS: Our data show local differences in HIV prevalence and clinic attendance that can be used to prioritize prevention activities targeting FSW in Guatemala. VICITS achieved rapid scale-up; however, a better understanding

  3. [Proliferative diabetic retinopathy -- therapeutic approach (clinical case)].

    Science.gov (United States)

    Burcea, M; Muşat, Ovidiu; Mahdi, Labib; Gheorghe, Andreea; Spulbar, F; Gobej, I

    2014-01-01

    We present the case of a 54 year old pacient diagnosed with neglected insulin dependent diabetes and proliferative diabetic retinopathy. Surgery was recommended and we practiced posterior vitrectomy, endolaser and heavy silicone oil endotamponade. Post-operative evolution was favorable.

  4. Dermatomycoses In Diabetics - A Clinical Study

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    Parthiban K

    1998-01-01

    Full Text Available Two hundred diabetics including 153 non- insulin dependent diabetes mellitus and 47 insulin dependent diabetes mellitus patients, were screened for mycoses. Candidiasis was the commonest mycoses, followed by dermatophtoses and pityriasis versicolor. The fasting blood glucose level was observed to be higher in candidialsis compared to other mycoses.

  5. Profile and analysis of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, Jakarta

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    Tri J.E. Tarigan

    2015-11-01

    Full Text Available Background: Chronic complications of diabetes mellitus have a significant role in increasing morbidity, mortality, disability, and health cost. In the outpatient setting, the availability of data regarding to the chronic complications of type 2 diabetes is useful for evaluation of prevention, education, and patient’s treatment. This study aimed to describe the characteristic of type 2 diabetes chronic complications in outpatient diabetes clinic.Methods: A cross-sectional study was done using 155 patients in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital (RSCM, Jakarta in 2010. Secondary data were used from medical record based on history taking, physical examination, diabetic foot assessment, laboratory, neurologic, cardiology, opthalmology, ankle brachial index, and electrography of the patients. Characteristic profiles of the subjects, prevalence of the chronic complications, and its association with diabetes risk factors, such as glycemic control using HbA1c, fasting blood glucose, duration of diabetes, and LDL cholesterol were analyzed using chi square test.Results: Among 155 subjects participated in the study, most of them were women (59% and elderly (46%. The prevalence of diabetes chronic complications was 69% from all subjects. These chronic complications included microangiopathy, macroangiopathy and mixed complications, with prevalence of 56%, 7% and 27% respectively. Microangiopathy included nephropathy (2%, retinopathy (7%, neuropathy (38% and mixed complications (53%. Macroangiopathy included coronary heart disease (46%, peripheral arterial disease (19%, stroke (18%, and mixed complication (17%. From the analysis, we found significant association between duration of diabetes and diabetic neuropathy (p = 0.003.Conclusion: Prevalence of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, mainly dominated by microvascular-related complications including nephropathy, retinopathy

  6. NUTRITIONAL CHARACTERISTICS AND DIETARY INTAKE OF PATIENTS ATTENDING THE PRE-DIALYSIS ASSESSMENT CLINIC

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    Maria Chan

    2012-06-01

    Full Text Available Poor nutrition status at the start of dialysis is associated with morbidity and mortality. Timely management of patients with ESKD pre-dialysis including providing nutrition intervention is important. The aim of this study was to describe the baseline nutritional status and dietary intake of patients attending the pre-dialysis assessment clinic. Of the 210 patient assessed, 60.5% were male; mean age was 65.7±13.6 years and mean GFR was 17.0±4.2 ml/min. 17.1% were underweight (BMI26 kg/m2. 39.5% were rated as malnourished (SGA score B&C and 18.5% were overweight/obese and malnourished. 26.7% had MAMC 10% less than 50th percentile of the standard. Mean energy and protein intakes were 23.4±6.9 kcal/kg IBW/d and 1.16±0.43 g/kg IBW/d with 65.5% and 15.6% did not meet the recommended intake of energy and protein respectively. 48% of patients experienced symptoms (e.g. poor appetite and nausea affecting dietary intake while 15.7% of patients self-imposed dietary restriction inappropriately due to misconception of nutrition requirements in ESKD. 41.4% and 85.2% did not consume adequate fruit and vegetables of 2 and 5 serves per day respectively based on the Australian Guide to Healthy Eating. Nutrient intake (prevalence % below the Recommended Daily Intake (DRI levels were: VitB1 (36.5%, VitB2 (43.5%, Niacin (3.9%, VitC (202%, VitE (41.0%, folate (83.2%, VitA (50.5%, Mg (94.5%, Fe (36.1%, Zn (70.8% and dietary fibre (83.3%. In conclusion, patients attended the current pre-dialysis assessment clinic presented with parameters indicative of poor nutritional health. This clinic may provide an opportunity to optimise nutritional status of ESKD patients before dialysis is required.

  7. Intestinal Helminth Infections in Pregnant Women Attending Antenatal Clinic at Kitale District Hospital, Kenya

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    A. W. Wekesa

    2014-01-01

    Full Text Available Intestinal helminth infections during pregnancy are associated with adverse outcomes including low birth weight and prenatal mortality. The infections are a major public health problem in developing countries. A hospital based survey was undertaken for six months to determine the infection prevalence, intensity, and risk factors. The study involved expectant women attending antenatal clinic. Stool samples were screened microscopically for helminth ova using Kato Katz technique. Information on risk factors was collected using semistructured questionnaire and analyzed using SPSS. Epidemiological data was analysed using descriptive statistics and multivariate analysis. The overall prevalence of infection was 21 (13.8%. Ascariasis was the most prevalent 10 (6.5%, hookworm infection was 6 (3.9%, and trichuriasis was 2 (1.3%. Pregnant women aged below 29 years (OR = 3.63, CI = 0.87–11.75 and those with primary level of education (OR = 3.21, CI = 0.88–11.75 were at a higher risk of infection compared to those aged ≥ 29 years with secondary level of education. Hand washing was significantly associated with reduced likelihood of infection (OR = 0.18, 95% CI = 0.06–0.57. It was concluded that intestinal helminth infections were prevalent among pregnant women. We recommended that all expectant women visiting antenatal clinics be screened for intestinal helminth infections and positive cases be advised to seek treatment.

  8. Hepatitis B infection among patients attending a sexually transmitted diseases clinic in Rio de Janeiro, Brazil

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    Ledy HS Oliveira

    2001-07-01

    Full Text Available Hepatitis B virus (HBV has a low endemicity in Rio de Janeiro, Brazil. Sexual transmission must play an important role in this virus, but the prevalence and risk factors have never been properly investigated. The aim of this paper is to determine the prevalence and risk factors for HBV infection in patients attending a Sexually Transmitted Diseases Clinic of the Universidade Federal Fluminense, from the State of Rio de Janeiro, Brazil. In a retrospective study, HBV seroprevalence was investigated in 440 patients. Serum of each patient was assayed for antibodies against hepatitis B core antigen (anti-HBc, hepatitis B surface antigen (HBsAg and antibodies against hepatitis B surface antigen (anti-HBs. Demographic and risk factor data were extracted from clinic notes. The overall seroprevalence of exposure markers for HBV (anti-HBc, HBsAg and anti-HBs were 13%, 3.4% and 8.5% respectively. Homo/bisexual behaviour, anal intercourse, HIV infection, positive serology for syphilis and blood transfusion were predictors of the HBV exposure. Among demographic data, age and place of birth were associated with the anti-HBc seropositivity.

  9. Assessing Readiness to Lose Weight among Obese Women Attending the Nutrition Clinic

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    Fatemeh Ghannadiasl

    2014-07-01

    Full Text Available Background: Assessing individual’s readiness to change and targeting the intervention to the level of readiness may improve successful weight loss rates. This study aimed to assess readiness for weight loss in obese women using the trans theoretical model. Methods: A cross-sectional study was conducted on 90 volunteer apparently healthy obese women, in Ardabil, Iran. Participants completed the translated and validated University of Rhode Island Change Assessment questionnaire in their first visit. Subjects were categorized into one of the stages of change based on the highest of four z-transformed scale scores. The readiness to change score was calculated. Results: More than half of the participants were in early stages of weight loss and 24.5% were in the action stage. The readiness score in the precontemplation stage was significantly lower than the other stages, but no significant difference was observed among the contemplation, action and maintenance stages. The significant correlation was observed between the stages of change and waist-to-hip ratio (r=0.33, P<0.05. Conclusion: Obese women attending the nutrition clinic are in different stages to change for weight loss. Understanding person specific stages of change orientates the dietitian to use the most appropriate counseling strategies. Hence the stages and readiness to change should be considered before implementing any intervention in clinical settings for optimal outcomes.

  10. Do prerecorded lecture VODcasts affect lecture attendance of first-yearpre-clinical Graduate Entry to Medicine students?

    Science.gov (United States)

    Rae, Mark G; O'Malley, Dervla

    2017-03-01

    There is increasing concern amongst educators that the provision of recorded lectures may reduce student attendance of live lectures. We therefore sought to determine if the provision of prerecorded lecture video podcasts (VODcasts) to first-year Graduate Entry to Medicine (GEM) students, affected attendance at 21 Physiology lectures within three separate pre-clinical modules. Data on lecture attendance, utilization of VODcasts, and whether VODcasts should replace live lectures were drawn from three surveys conducted in academic years 2014-2015 and 2015-2016 on all first-year GEM students in two first-year pre-clinical modules where prerecorded Physiology VODcasts were available for viewing or downloading prior to scheduled live lectures. A total of 191/214 (89%) students responded to the three surveys, with 84.3% of students attending all 21 lectures in the study. Only 4% of students missed more than one lecture in each of the three lecture series, with 79% indicating that VODcasts should not replace lectures. Therefore, we conclude that the attendance of pre-clinical GEM students at live lectures is not significantly impacted upon by the provision of lecture VODcasts, with most students viewing them as useful revision tools rather than as a replacement for live lectures.

  11. Examining longitudinal stimulant use and treatment attendance as parallel outcomes in two contingency management randomized clinical trials

    Science.gov (United States)

    McPherson, Sterling; Brooks, Olivia; Barbosa-Leiker, Celestina; Lederhos, Crystal; Lamp, Amanda; Murphy, Sean; Layton, Matthew; Roll, John

    2015-01-01

    The primary aim of this study was to examine stimulant use and longitudinal treatment attendance in one ‘parallel outcomes’ model in order to determine how these two outcomes are related to one another during treatment, and to quantify how the intervention impacts these two on- and off-target outcomes differently. Data came from two multi-site randomized clinical trials (RCTs) of contingency management (CM) that targeted stimulant use. We used parallel multilevel modeling to examine the impact of multiple pre-specified covariates, including selected Addiction Severity Index (ASI) scores, age and sex, in addition to CM on concurrent attendance and stimulant use in two separate analyses, i.e., one per trial. In one trial, CM was positively associated with attending treatment throughout the trial (β = 0.060, p < 0.05). In the second trial, CM predicted negative urinalysis (−UA) over the 12-week treatment period (β = 0.069, p < 0.05). In both trials, there was a significant, positive relationship between attendance and −UA submission, but in the first trial a −UA at both baseline and over time was related to attendance over time (r = 0.117; r = 0.013, respectively) and in the second trial, a −UA submission at baseline was associated with increased attendance over time (r = 0.055). These findings indicate that stimulant use and treatment attendance over time are related but distinct outcomes that, when analyzed simultaneously, portray a more informative picture of their predictors and the separate trajectories of each. This ‘indirect reinforcement’ between two clinically meaningful on-target (directly reinforced behavior) and off-target (indirectly reinforced behavior) outcomes is in need of further examination in order to fully exploit the potential clinical benefits that could be realized in substance use disorder treatment trials. PMID:26456717

  12. Chronic pain and psychiatric morbidity: a comparison between patients attending specialist orthopedics clinic and multidisciplinary pain clinic.

    Science.gov (United States)

    Wong, Wing S; Chen, Phoon P; Yap, Jackequaline; Mak, Kan Hing; Tam, Barry Ka H; Fielding, Richard

    2011-02-01

    The objective of this study was to examine the associations between chronic pain and psychiatric morbidity using interview-based assessments of psychiatric symptomatology. We compared the prevalence of common mental disorder (CMD; consistent with neurotic and somatic symptoms, fatigue, and negative affect), depression, and anxiety disorder(s), and associated factors with these psychiatric illnesses among Chinese patients with chronic pain attending specialist orthopedics clinic and multidisciplinary pain clinic. A total of 370 patients with chronic pain were recruited from an Orthopedics Clinic (N=185) and a Pain Clinic (N=185) in Hong Kong. Psychiatric morbidity was assessed using the Revised Clinical Interview Schedule. Individual scores for neurotic symptoms and neurotic disorders (including depression and four types of anxiety disorders) were also calculated. The reported lifetime prevalence rates of CMD were 35.3% and 75.3% for the Orthopedics and Pain Clinic samples, respectively. Rates of depression and anxiety disorders in the Pain Clinic (57.1% and 23.2%, respectively) were significantly higher than those in the Orthopedics sample (20.2% and 5.9%, respectively) (all P<0.001). Pain characteristics including number of pain sites, pain duration, pain intensity, and pain interference were all significantly associated with psychiatric morbidity after controlling for sociodemographic factors. Pain duration and litigation/compensation status consistently predicted concurrent pain intensity and disability. Chronic pain is associated with psychiatric morbidity. The higher rate of depression than anxiety disorder(s) among patients with chronic pain is consistent with previous studies that have found depression to be highly prevalent in chronic pain. Wiley Periodicals, Inc.

  13. Demographic and Clinical Characteristics of Type 1 Diabetes Mellitus in Omani Children - Single Center Experience

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    Saif Al-Yaarubi

    2014-03-01

    Full Text Available Objectives: To describe the demographic characteristics and clinical presentation of Omani children with type 1 diabetes mellitus at Sultan Qaboos University Hospital, Muscat, Oman. Methods: A retrospective analysis of all children with type 1 diabetes mellitus attending the Pediatric Endocrine Unit at Sultan Qaboos University Hospital, Oman from June 2006 to May 2013. Results: One hundred and forty-four patients were included in the study. The mean±SD of age at diagnosis was 6.7 ± 3.7 years. The median duration of symptoms was 10 days (IQR; 5-14. The most commonly reported presenting symptoms were polyuria (94%, polydipsia (82%, and weight loss (59%. Diabetic ketoacidosis at initial presentation was diagnosed in 31% of the patients. Different insulin regimens were prescribed: multiple daily injections in 109 (76% patients, twice daily insulin regimen in 23 (16% patients, and insulin pump therapy in 12 (8% patients. Family history of type 1 diabetes mellitus was present in 31 (22% patients. There were no significant differences in presenting complaints (polyuria, p=0.182; polydipsia, p=0.848, duration of symptoms (p=0.331, reported weight loss (p=0.753, or diabetic ketoacidosis at presentation (p=0.608 between patients with and without family history of type 1 diabetes mellitus. Conclusion: Polyuria, polydipsia and weight loss are the most common presenting symptoms. Family history of type 1 diabetes mellitus is highly prevalent among the studied patients. Diabetic ketoacidosis was found to be less common in Oman compared to other diabetes centers in the Middle East.

  14. Perception of orthodox health care centers among pregnant women attending traditional birth attendants clinics in two local government areas of Lagos State

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    A Okewole

    2013-01-01

    Full Text Available Background and Objective: Adequate antenatal care and skilled obstetric assistance during delivery are important strategies that significantly reduce maternal mortality and morbidity. This study aimed to assess the awareness, attitudes and perception of orthodox health care centres among pregnant women patronizing traditional birth attendants in Mushin and Lagos Island local government areas of Lagos state. Methods: The survey was a community-based descriptive cross-sectional survey that employed interviews to collect data from 300 antenatal care attendees of seven traditional birth attendants′ clinics in Lagos Island and Mushin local government areas between December 2010 and January 2011 using a structured questionnaire. Results: The women ranged in age from 17-43 years with a mean age of 27.6 ± 4.6 SD and most of them were primigravidas (41.5%, married (88% and traders (44.1%. Most of the women (61% and their husbands (56.7% had completed their secondary education. The majority (81.7% of respondents were aware of a modern health facility around where they lived, the most commonly known being private hospitals (43.7%. Most of them (67.3% were aware of antenatal care services provided at these facilities but only 31.3% had ever made use of the antenatal services. Most of the women were not willing to deliver in hospitals because they didn′t like the attitude of the health workers (37.3% and because it was far from their houses (12.7%; the majority (75% preferring to deliver with traditional birth attendants because they give good service. However, almost all (98.5% of the women that had children took them to the orthodox health facilities for immunization, primarily the primary health care centers (55.7%. Conclusion: Traditional birth attendants are patronized by a wide array of women who are aware of orthodox health facilities but have a negative attitude towards their services. Improvements in communication and interpersonal skills of

  15. Impact of drug awareness and treatment camps on attendance at a community outreach de-addiction clinic

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    Om Prakash Giri

    2015-01-01

    Full Text Available Background: Substance misuse is an increasing problem in urban and rural India. The utility of community-based interventions and preventive strategies are increasingly emphasized in this context. The drug de-addiction and treatment center, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, has been running a drug de-addiction and treatment clinic at Kharar Civil Hospital, Kharar, District Mohali, Punjab, since 1998. As part of an effort to enhance this community outreach program, community-based drug awareness and treatment camps have been organized since March 2004 in villages in and around Tehsil Kharar of Mohali. Aim: To study the impact of the drug awareness and treatment camps on the attendance of patients at the community outreach drug de-addiction and treatment clinic at Kharar Civil Hospital. Methods: Sociodemographic and clinical variables, including treatment outcome-related variables, of patients attending the clinic at Kharar Civil Hospital, before and after the camps were compared. Discussion and Conclusion: The study showed a positive impact on drug awareness and treatment camps held in the community on outpatient attendance at a community outreach clinic, with attendance increasing more than 1.8 times.

  16. The foot-health of people with diabetes in a regional Australian population: a prospective clinical audit

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    Perrin Byron M

    2012-03-01

    Full Text Available Abstract Background There is limited understanding of the foot-health of people with diabetes in Australian regional areas. The aim of this study was to document the foot-health of people with diabetes who attend publically funded podiatric services in a regional Australian population. Methods A three month prospective clinical audit was undertaken by the publically-funded podiatric services of a large regional area of Victoria, Australia. The primary variables of interest were the University of Texas (UT diabetic foot risk classification of each patient and the incidence of new foot ulceration during the study period. Age, gender, diabetes type, duration of diabetes and the podiatric service the patients attended were the other variables of interest. Results Five hundred and seventy six patients were seen during the three month period. Over 49% had a UT risk classification at a level at least peripheral neuropathy or more serious diabetes-related foot morbidity. Higher risk at baseline was associated with longer duration of diabetes (F = 31.7, p χ2 = 40.3, p 0.001 and type 1 diabetes (χ2 = 37.3, p 0.001. A prior history of foot pathology was the overwhelming predictor for incident ulceration during the time period (OR 8.1 (95% CI 3.6 to 18.2, p Conclusions The publically funded podiatric services of this large regional area of Australia deal with a disproportionally large number of people with diabetes at high risk of future diabetes-related foot complications. These findings may be useful in ensuring appropriate allocation of resources for future public health services involved in diabetic foot health service delivery in regional areas.

  17. Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam

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    Kamuhabwa AR

    2014-10-01

    Full Text Available Appolinary R Kamuhabwa, Emmanuel CharlesUnit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaBackground: Tanzania has recently experienced a significant rise in the burden of diabetes, and it is estimated that more than 400,000 people are living with diabetes. A major concern in the management of diabetes is the occurrence of diabetic complications that occur as a result of poor glycemic control. Identification of the factors associated with poor glycemic control is important in order to institute appropriate interventions for the purpose of improving glycemic control and prevention of chronic complications.Aim: The aim of this study was to determine the level of glycemic control and explore the factors associated with poor glycemic control among patients with type 2 diabetes mellitus (T2DM.Methodology: A cross-sectional study was carried out at the diabetic clinics for T2DM patients at the national and municipal hospitals in Dar es Salaam. A total of 469 patients were enrolled over a period of 8 weeks from March 2013 to May 2013. Patients' information such as sociodemographic characteristics, self-care management behaviors, and medication adherence were obtained through interviews. Blood pressure, weight, and height were measured during the day of the interview. All available last readings for fasting blood glucose (FBG measurements, lipid profile, and other clinical characteristics were obtained from patients' records.Results: The mean age of patients was 54.93 years. The majority (63.5% of patients were females and only eight patients had records of lipid profile measurements. Out of 469 patients, 69.7% had FBG of ≥7.2 mmol/L, indicating poor glycemic control. Females aged between 40 years and 59 years had significantly higher poor glycemic control (76.1% as compared with their male counterparts. Thirty-eight percent of patients had poor medication adherence

  18. Diabetic Retinopathy: Clinical Findings and Management

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    DD Murray McGavin

    2003-01-01

    Full Text Available Diabetes mellitus is a metabolic abnormality in which there is a failure to utilise glucose and hence a state of hyperglycaemia can occur. If hyperglycaemia continues uncontrolled over time, it will lead to significant and widespread pathological changes, including involvement of the retina, brain and kidney.In industrialised countries, approximately 1% of the population is diabetic, and at least another 1% are undiagnosed diabetics. Insulin dependent diabetes (IDDM, accounts for approximately 10-15% of cases, the remainder being maturity onset or non-insulin dependent diabetics (NIDDM. Diabetes mellitus is an international public health problem with estimated prevalences ranging from 2.0% to 11.7% in studied populations across the world.

  19. Use of and Beliefs About Mobile Phone Apps for Diabetes Self-Management: Surveys of People in a Hospital Diabetes Clinic and Diabetes Health Professionals in New Zealand.

    Science.gov (United States)

    Boyle, Leah; Grainger, Rebecca; Hall, Rosemary M; Krebs, Jeremy D

    2017-06-30

    People with diabetes mellitus (DM) are using mobile phone apps to support self-management. The numerous apps available to assist with diabetes management have a variety of functions. Some functions, like insulin dose calculators, have significant potential for harm. The study aimed to establish (1) whether people with DM in Wellington, New Zealand, use apps for DM self-management and evaluate desirable features of apps and (2) whether health professionals (HPs) in New Zealand treating people with DM recommend apps to patients, the features HPs regard as important, and their confidence with recommending apps. A survey of patients seen at a hospital diabetes clinic over 12 months (N=539) assessed current app use and desirable features. A second survey of HPs attending a diabetes conference (n=286) assessed their confidence with app recommendations and perceived usefulness. Of the 189 responders (35.0% response rate) to the patient survey, 19.6% (37/189) had used a diabetes app. App users were younger and in comparison to other forms of diabetes mellitus, users prominently had type 1 DM. The most favored feature of the app users was a glucose diary (87%, 32/37), and an insulin calculator was the most desirable function for a future app (46%, 17/37). In non-app users, the most desirable feature for a future app was a glucose diary (64.4%, 98/152). Of the 115 responders (40.2% response rate) to the HPs survey, 60.1% (68/113) had recommended a diabetes app. Diaries for blood glucose levels and carbohydrate counting were considered the most useful app features and the features HPs felt most confident to recommend. HPs were least confident in recommending insulin calculation apps. The use of apps to record blood glucose was the most favored function in apps used by people with diabetes, with interest in insulin dose calculating function. HPs do not feel confident in recommending insulin dose calculators. There is an urgent need for an app assessment process to give

  20. [Prevalence and factors associated with frequent attendence in family medicine clinic].

    Science.gov (United States)

    Parejo Maestre, N; Lendínez-de la Cruz, J M; Bermúdez-Torres, F M; Gónzalez-Contero, L; Gutierrez-Espinosa de Los Monteros, M P; Espejo-Almazán María, T

    2016-01-01

    The use of health services has seen a steep rise. The frequent users are responsible for significant economic, human and social impact. The objective is to analyze the characteristics of frequent attenders in our Health Center, in order to evaluate the possibility of taking corrective measures to improve the quality of care and efficiency in the use of resources. Descriptive observational study of a sample of 379 patients over 18 years old. The dependent variables were attendance (number of visits to their family doctor during the previous year), frequent attendance (10 or more visits to the family doctor in the last year), and persistent frequent attenders (10 or more visits to the family doctor in each of the last two years). Data were collected from medical records and by telephone interview. The mean attendance was 6.83 (95%CI: 6.13-7.53), frequent attendance reached 25.4% (95%CI: 21.4-29.6), and persistent frequent attenders, 1.6% (95%CI: 0.5-2.9). Frequent attendance was associated with sex, age, marital status, educational level, family structure, existence of chronic disease, use of anxiolytic and antidepressants, request for additional tests, and referrals to other specialists, proximity to the health center, and level of satisfaction with their family doctor. The low persistent frequent attenders found suggests that frequent attendance could be largely due to factors related to professional and organization. Studies are required to address the high level of consumption of psychotropic drugs, and improving professional skills in dealing with mental problems. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. The effect of reminder calls in reducing non-attendance rates at care of the elderly clinics

    Science.gov (United States)

    Dockery, F; Rajkumar, C; Chapman, C; Bulpitt, C; Nicholl, C

    2001-01-01

    BACKGROUND—DNA ("did not attend") at outpatient clinics is an important problem costing the NHS an estimated £266 million annually. The national DNA rate for 1996-1997 for all clinics was 12%. The DNA rate at Hammersmith Hospital for the same year in the care of the elderly specialty was 21%. The aim of this study was to establish why this was so, and to test the efficacy of a reminder call in increasing attendance rates at care of the elderly clinics.
METHODS—23 DNAs from seven clinics were contacted to ascertain the reasons for non-attendance (group I). For seven further clinics, 84 patients were contacted in advance to reconfirm their appointment (group II).
RESULTS—From group II 12 patients were identified who were unaware of their appointment (14%), six of whom agreed to attend; thus six potential DNAs were prevented. Eleven vacant appointments were identified in advance. The unexpected DNA rate was reduced to 5% from a potential 21% as a result of this exercise. The DNA rate for all patients with dementia (both groups) was 44%, whereas the DNA rate for all patients without this diagnosis (both groups) was 16% (p < 0.001).
CONCLUSIONS—A preclinic phone call reminder to elderly patients is feasible, increases attendance rates, and identifies vacant appointments. Patients with dementia are more likely to miss clinic appointments; therefore they and their carers need specific reminders about appointment dates.
 PMID:11123393

  2. Ten years' trend of HIV seroprevalence among Indian pregnant women attending antenatal clinic at tertiary hospital in Dhule, Maharashtra, India

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    Vaishali Milind Patil

    2016-05-01

    Conclusions: Declining HIV seroprevalence rate is noted among pregnant women attending the antenatal clinics from 2004 to 2013. The effective implementation of prevention of parent to child transmission of HIV/AIDS (PPTCT programmed is helping in control of the spread of HIV. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1514-1519

  3. Sociodemographic profile and predictors of outpatient clinic attendance among HIV-positive patients initiating antiretroviral therapy in Selangor, Malaysia

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    Abdulrahman SA

    2017-07-01

    Full Text Available Surajudeen Abiola Abdulrahman,1,2 Lekhraj Rampal,1 Norlijah Othman,3 Faisal Ibrahim,1 Kadir Shahar Hayati,1 Anuradha P Radhakrishnan4 1Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 2Department of Public Health Medicine, Penang Medical College, George Town, Penang, 3Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 4Infectious Disease Clinic, Hospital Sungai Buloh, Sungai Buloh, Selangor, MalaysiaBackground: Inconsistent literature evidence suggests that sociodemographic, economic, and system- and patient-related factors are associated with clinic attendance among the HIV-positive population receiving antiretroviral therapy (ART around the world. We examined the factors that predict outpatient clinic attendance among a cohort of HIV-positive patients initiating ART in Selangor, Malaysia.Patients and methods: This cross-sectional study analyzed secondary data on outpatient clinic attendance and sociodemographic, economic, psychosocial, and patient-related factors among 242 adult Malaysian patients initiating ART in Selangor, Malaysia. Study cohort was enrolled in a parent randomized controlled trial (RCT in Hospital Sungai Buloh Malaysia between January and December 2014, during which peer counseling, medication, and clinic appointment reminders were provided to the intervention group through short message service (SMS and telephone calls for 24 consecutive weeks. Data on outpatient clinic attendance were extracted from the hospital electronic medical records system, while other patient-level data were extracted from pre-validated Adult AIDS Clinical Trial Group (AACTG adherence questionnaires in which primary data were collected. Outpatient clinic attendance was categorized into binary outcome – regular attendee and defaulter categories – based on the number of missed scheduled outpatient clinic appointments within a 6-month

  4. Sexually transmitted diseases among randomly selected attenders at an antenatal clinic in The Gambia.

    Science.gov (United States)

    Mabey, D C; Lloyd-Evans, N E; Conteh, S; Forsey, T

    1984-10-01

    One hundred randomly selected women attending a free government antenatal clinic in the town of Bakau, The Gambia, were examined. Vaginal swabs were taken for microscopical examination for Trichomonas vaginalis and for culture on Sabouraud's medium. Cervical swabs were taken for culture of Neisseria gonorrhoeae and Chlamydia trachomatis and, in 50 cases, Herpesvirus hominis; in addition, urethral swabs were taken for culture of N gonorrhoeae. Serum samples were tested for antibodies to Treponema pallidum by the Venereal Diseases Research Laboratory (VDRL) test and T pallidum haemagglutination assay (TPHA), and to C trachomatis and H hominis by microimmunofluorescence. The prevalence of infection with Candida albicans was found to be 35%, T vaginalis 32%, C trachomatis 6.9%, N gonorrhoeae 6.7%, T pallidum 1%, and H hominis 0%. IgG antibodies at a titre of at least 1/16 to C trachomatis serotypes D-K were found in 29.4%, and to serotypes A-C in a further 10.6%. IgG antibodies at a titre of at least 1/16 to H hominis type I were found in 94%, and to type II in 53%, although a proportion of the latter probably represent cross reacting antibodies to type I.

  5. Chlamydia trachomatis in women attending a gynaecological outpatient clinic with lower genital tract infection.

    Science.gov (United States)

    Svensson, L; Weström, L; Mårdh, P A

    1981-08-01

    In a study of 3794 consecutive women attending a gynaecological outpatient clinic with symptoms of lower genital tract infection (LGTI) 350 (9.2%) harboured Chlamydia trachomatis and 83 (2.2%) Neisseria gonorrhoeae. One hundred and ninety-five patients who were later found to have acute salpingitis and 109 other women in whom the chlamydial cultures were spoiled were excluded from the series. Of the remaining 3490 women, 281 were infected with C trachomatis, 42 with N gonorrhoeae, and 17 with both. Of the 3150 women who were infected with neither organism, 146 were randomly selected as controls. The chlamydia-positive patients were younger (P less than 0.001), did not complain of pelvic discomfort or pain (P less than 0.01), and used oral contraceptives (P less than 0.001) more frequently than did the controls; intrauterine devices were used more often (P less than 0.01) by the controls. Increased vaginal discharge was reported significantly more often in chlamydia-positive patients than in the controls (P less than 0.05). Of 266 women harbouring C trachomatis the organism was still present in 22 (8.3%) when they were followed up from two to more than eight weeks after finishing treatment with doxycycline. Of 91 male consorts of chlamydia-positive women, 53 (58.2%) were infected with C trachomatis.

  6. Malaria in rural Mozambique. Part I: Children attending the outpatient clinic

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    Macete Eusébio

    2008-02-01

    Full Text Available Abstract Background Malaria represents a huge burden for the health care services across Africa. Describing malaria attending health services contributes to quantify the burden and describe the epidemiology and clinical presentation. Methods Retrospective analysis of data collected through the Manhiça morbidity surveillance system (Mozambique on all paediatric visits (Plasmodium falciparum parasitaemia of any density in the blood smear. Results A total of 94,941 outpatient visits were seen during the study period, of which 30.5% had malaria. Children younger than three years accounted for almost half of the total malaria cases and children aged ≥ 5 years represented 36.4% of the cases. Among children who presented with malaria, 56.7% had fever and among children who presented with fever or a history of fever only 37.2% had malaria. The geometric mean parasitaemia in malaria cases was 8582.2 parasites/μL, peaking in children aged two to three years. 13% of malaria cases had a PCV Conclusion Preventive measures should be targeted at children younger than three years, as they carry the highest burden of malaria. Children aged 5–15 years represent around a third of the malaria cases and should also be included in control programmes. Concern should be raised about presumptive treatment of fever cases with artemisinin-combination therapies, as many children will, according to IMCI guidelines, receive treatment unnecessarily.

  7. Syphilis seroprevalence among patients attending a sexually transmitted disease clinic in West Bengal, India.

    Science.gov (United States)

    Maity, Susmita; Bhunia, Somesh Chandra; Biswas, Subrata; Saha, Malay Kumar

    2011-01-01

    Syphilis is a sexually transmitted disease (STD) and is a major public health concern in India. The trend of syphilis infection was studied in attendees aged 15-49 years in an STD clinic in West Bengal from 2004 to 2008. Blood samples were collected from 250 consecutive patients per year (a total of 1,250 samples over 5 years); the patients attended the STD clinic for 12 weeks (October-December) each year, and the serostatus of syphilis was determined qualitatively with the Venereal Disease Research Laboratory (VDRL) test using serum samples. A quantitative VDRL test was then performed at a dilution of 1:8 using serum samples that yielded positive results in the qualitative VDRL test. Finally, serum samples that yielded positive results in the quantitative VDRL test were also subjected to the Treponema pallidum hemagglutination assay (TPHA). The serum samples that yielded positive results in both the tests were considered syphilis seropositive. All seropositive serum samples from the quantitative VDRL test were also found to be positive results in TPHA. The total seropositivity for syphilis in the STD patients was 8.2% (women, 8.9%; men, 7.7%). Review of the data from 5 consecutive years showed a statistically significant (χ(2) = 9.968, df = 4, P < 0.05) decrease in syphilis positivity from 10.8% (2004) to 3.6% (2008). The results of the study also revealed that the highest seroprevalence was in the 20-24 age group (16.3%), and the lowest seroprevalence was in the 45-49 age group (3.3%). The study indicates the effectiveness of current interventions with a need to focus further on reducing the burden in the 20-24 age group.

  8. Familial history of diabetes and clinical characteristics in Greek subjects with type 2 diabetes

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    Apostolou Ourania

    2009-04-01

    Full Text Available Abstract Background A lot of studies have showed an excess maternal transmission of type 2 diabetes (T2D. The aim, therefore, of the present study was to estimate the prevalence of familial history of T2D in Greek patients, and to evaluate its potential effect on the patient's metabolic control and the presence of diabetic complications. Methods A total of 1,473 T2D patients were recruited. Those with diabetic mothers, diabetic fathers, diabetic relatives other than parents and no known diabetic relatives, were considered separately. Results The prevalence of diabetes in the mother, the father and relatives other than parents, was 27.7, 11.0 and 10.7%, respectively. Patients with paternal diabetes had a higher prevalence of hypertension (64.8 vs. 57.1%, P = 0.05 and lower LDL-cholesterol levels (115.12 ± 39.76 vs. 127.13 ± 46.53 mg/dl, P = 0.006 than patients with diabetes in the mother. Patients with familial diabetes were significantly younger (P 2, P = 0.08, higher prevalence of dyslipidemia (49.8 vs. 44.6%, P = 0.06 and retinopathy (17.9 vs. 14.5%, P = 0.08 compared with patients with no diabetic relatives. No difference in the degree of metabolic control and the prevalence of chronic complications were observed. Conclusion The present study showed an excess maternal transmission of T2D in a sample of Greek diabetic patients. However, no different influence was found between maternal and paternal diabetes on the clinical characteristics of diabetic patients except for LDL-cholesterol levels and presence of hypertension. The presence of a family history of diabetes resulted to an early onset of the disease to the offspring.

  9. Prescription and Cost Consideration at a Diabetic Clinic in Ibadan ...

    African Journals Online (AJOL)

    opsig

    Prescription and Cost Consideration at a Diabetic Clinic in Ibadan,. Nigeria: A Report ... drugs with proven efficacy based on best evidence, the prevailing social ... pharmacy using the current hospital drug-pricing list calculated the cost of the ...

  10. Prevalence and clinical profile of metabolic syndrome among type 1 diabetes mellitus patients in southern India.

    Science.gov (United States)

    Billow, Amy; Anjana, Ranjit Mohan; Ngai, Michelle; Amutha, Anandakumar; Pradeepa, Rajendra; Jebarani, Saravanan; Unnikrishnan, Ranjit; Michael, Edwin; Mohan, Viswanathan

    2015-07-01

    To assess the prevalence of metabolic syndrome (MetS) among patients with type 1 diabetes mellitus(T1DM) and to look at prevalence of diabetes complications in T1DM with and without MetS. We studied 451 T1DM patients attending a tertiary diabetes centre in Chennai, South India. T1DM was diagnosed based on absence of beta cell reserve and requirement of insulin from the time of diagnosis. Data on clinical and biochemical characteristics as well as complications details to study the prevalence were also extracted from electronic records. T1DM patients were divided into those with and without MetS[diagnosed according to the harmonizing the metabolic syndrome criteria(IDF/NHLBI/AHA/WHF/IAS/IASO)]. The overall prevalence of MetS among T1DM was 22.2%(100/451). Patients with MetS were older, had longer diabetes duration, acanthosis nigricans, and increased serum cholesterol. In the unadjusted logistic regression analysis, retinopathy, nephropathy and neuropathy were associated with MetS. However after adjustment for age, gender, diabetes duration, HbA1C and BMI significant association was seen only between MetS and retinopathy [odds ratio (OR) 2.82, 95% CI 1.18-6.74, p = 0.020] and nephropathy [OR 4.92, 95% CI 2.59-9.33, p reserved.

  11. Glucose: archetypal biomarker in diabetes diagnosis, clinical management and research.

    Science.gov (United States)

    Krentz, Andrew J; Hompesch, Marcus

    2016-10-13

    The clinical utility of diabetes biomarkers can be considered in terms of diagnosis, management and prediction of long-term vascular complications. Glucose satisfies all of these requirements. Thresholds of hyperglycemia diagnostic of diabetes reflect inflections that confer a risk of developing long-term microvascular complications. Degrees of hyperglycemia (impaired fasting glucose, impaired glucose tolerance) that lie below the diagnostic threshold for diabetes identify individuals at risk of progression to diabetes and/or development of atherothrombotic cardiovascular disease. Self-measured glucose levels usefully complement hemoglobin A1c levels to guide daily management decisions. Continuous glucose monitoring provides detailed real-time data that is of value in clinical decision making, assessing response to new diabetes drugs and the development of closed-loop artificial pancreas technology.

  12. Risk factor control in hypertensive and diabetic subjects attended by the Family Health Strategy in the State of Pernambuco, Brazil: the SERVIDIAH study.

    Science.gov (United States)

    Fontbonne, Annick; Cesse, Eduarda Ângela Pessoa; Sousa, Islândia Maria Carvalho de; Souza, Wayner Vieira de; Chaves, Vera Lúcia de Vasconcelos; Bezerra, Adriana Falangola Benjamin; Carvalho, Eduardo Freese de

    2013-06-01

    The SERVIDIAH study (Evaluation of Health Services for Diabetic and Hypertensive Subjects) was conducted in 2010 in the State of Pernambuco, Brazil. A multi-stage random sample of 785 hypertensive and 823 diabetic patients was drawn from 208 Family Health Strategy (FHS) units selected throughout 35 municipalities. Patients underwent a structured interview and weight, height, blood pressure and HbA1c levels (for diabetic patients) were measured. Mean age was approximately 60 years, and women were overrepresented in the sample (70%). 43.7% of hypertensive subjects and 25.8% of diabetic subjects achieved adequate blood pressure control and 30.5% of diabetic subjects had HbA1c levels below 7%. Despite 70% of the patients being overweight or obese, few had adhered to a weight-loss diet. The study of this representative sample of hypertensive and diabetic patients attended by the FHS in the State of Pernambuco shows that improvements in the management of hypertension and diabetes are needed in order to prevent the occurrence of serious and costly complications, especially given the context of increasing incidence of these two conditions.

  13. CLINICAL AND BIOCHEMICAL PROFILE OF LEAN BODY WEIGHT TYPE 2 DIABETICS, NORMAL WEIGHT AND OBESE DIABETICS

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    Krishnamoorthy

    2015-09-01

    Full Text Available BACKGROUND: Diabetes is a group of metabolic disorders with a phenomenal increase in developing countries like India . 1 When we compare the clinical profile in developed countries we find there is a remarkable difference in developing countries. In Asia the proportion of lean diabetics are relatively more when compared to developed countries . 2 Hence it is worth comparing t he clinical and biochemical profile in lean diabetic, normal and obese type 2 diabetic patients in our population . 3 OBJECTIVE: To study and compare the clinical profile in lean type 2 diabetic patients compared to normal and obese diabetics by age, sex, family history and anthropometry . We also compared the biochemical profile in lean type 2 diabetic patients with normal and obes e diabetics by estimation of blood glucose, urea, serum creatinine, glycosylated hemoglobin and lipid profile. MATERIALS AND METHODS: Observational study of 1070 patients was conducted in our hospital between June 2011 to July 2013.We have selected patient s aged 30 years and older diabetics from outpatient and inpatient departments of our hospital and compared age, sex, family history, anthropometry, blood glucose, urea, serum creatinine, glycosylated hemoglobin and lipid profile. RESULTS: There is a statis tical significant relationship between age, FBS and BMI. Lean diabetic patients were more in the age group between 41 to 50, whereas there is no statistical significant relationship between sex, HbA1C, diastolic blood pressure, HDL and BMI. There is a stat istical significant relationship between family history, skin fold thickness, waist hip ratio, systolic blood pressure, total cholesterol, triglycerides and BMI. PPBS and LDL were statistically significant in normal weight diabetics. We also found there is a significant relationship between pulmonary tuberculosis and lean diabetics. CONCLUSION: Majority of type 2 diabetic patients in our population are having normal weight with lean body

  14. Adherence to diabetes regimens: empirical status and clinical applications.

    Science.gov (United States)

    Kurtz, S M

    1990-01-01

    Adherence to diabetes treatment regimens has proved to be a conceptual and empirical enigma. Consequently, reliable and valid applications to the clinical practice of diabetes care and education have been wanting. Rates of nonadherence are staggeringly high, regardless of the methodology employed, and verification of self-reports is complicated by social desirability to appear compliant. Low intertask correlations further complicate our understanding of adherence-metabolic control relationships. Studies relating to the Health Belief Model, social learning theory, and the psychology of interpersonal relationships that have sought to identify determinants of adherence behaviors have specific relevance to the clinical practice of diabetes education.

  15. Has the internet overtaken other traditional sources of health information? Questionnaire survey of patients attending ENT outpatient clinics.

    Science.gov (United States)

    Rokade, A; Kapoor, P K D; Rao, S; Rokade, V; Reddy, K T V; Kumar, B N

    2002-12-01

    The aim of this study was to find out whether patients attending ENT clinics obtain health information about their medical condition and to assess satisfaction with the sources of health information, including the internet. Three hundred and thirty patients attending ENT outpatient clinics at District General Hospitals in Wigan and Warrington during June 2001 were asked to complete detailed questionnaires. Fifty-seven per cent of patients attempted to obtain health information before their visit to the specialist clinic. Forty-five per cent of patients had access to the internet, but only 13% used it to obtain health information. General practitioners were the source of health information for 64%, but the NHS-Direct help line was only used by 16%. Patients also trusted the health information provided by their GPs the most. In the twenty-first century, patients turn to their GP as the main source of health information.

  16. Malaria in rural Mozambique. Part I: children attending the outpatient clinic.

    Science.gov (United States)

    Guinovart, Caterina; Bassat, Quique; Sigaúque, Betuel; Aide, Pedro; Sacarlal, Jahit; Nhampossa, Tacilta; Bardají, Azucena; Nhacolo, Ariel; Macete, Eusébio; Mandomando, Inácio; Aponte, John J; Menéndez, Clara; Alonso, Pedro L

    2008-02-26

    Malaria represents a huge burden for the health care services across Africa. Describing malaria attending health services contributes to quantify the burden and describe the epidemiology and clinical presentation. Retrospective analysis of data collected through the Manhiça morbidity surveillance system (Mozambique) on all paediatric visits (history of fever in the preceding 24 hours with asexual Plasmodium falciparum parasitaemia of any density in the blood smear. A total of 94,941 outpatient visits were seen during the study period, of which 30.5% had malaria. Children younger than three years accounted for almost half of the total malaria cases and children aged > or = 5 years represented 36.4% of the cases. Among children who presented with malaria, 56.7% had fever and among children who presented with fever or a history of fever only 37.2% had malaria. The geometric mean parasitaemia in malaria cases was 8582.2 parasites/muL, peaking in children aged two to three years. 13% of malaria cases had a PCV or = 5 years. The percentage of cases admitted or transferred showed a clear decreasing trend with age. MCBIRs of outpatient malaria per 1,000 child years at risk for the whole study period were of 394 in infants, 630 in children aged 1 to <5 years and 237 in children aged five years or more. A clustering of the cases was observed, whereby most children never had malaria, some had a few episodes and very few had many episodes. Preventive measures should be targeted at children younger than three years, as they carry the highest burden of malaria. Children aged 5-15 years represent around a third of the malaria cases and should also be included in control programmes. Concern should be raised about presumptive treatment of fever cases with artemisinin-combination therapies, as many children will, according to IMCI guidelines, receive treatment unnecessarily.

  17. Diabetic ketoacidosis in type 1 and type 2 diabetes mellitus – clinical and biochemical differences

    Directory of Open Access Journals (Sweden)

    N. Krdžalić

    2007-02-01

    Full Text Available The goal of this retrospective study was to establish differences in clinical picture, biochemical parametres and precipitating factors in patiens with diabetic ketoacidosis in type 1 and type 2 diabetes. A total number of 25 patients was hospitalised in the Intensive Case Unit of the Department for Internal Diseases of the Cantonal Hospital in Zenica in the period of 14 months. Most patients had type 1 diabetes whose ketoacidosis showed symptoms of vomiting, stomachache and it was most often caused by a discontinued application of insulin or an infection. In patients with type 2 diabetes an inadequate regulation of glycemia had been noticed before hospitalisation and diabetic ketoacidosis was manifested by polyuria, polyphagia, polydipsia and weight loss. Precipitating factor in most patients with type 2 diabetes was an infection. In addition, a significant number of patients were newly discovered diabetics whose precipitating factor in most cases could not be found and the symptoms of the disease correspond to insulin dependent patients. The observed biochemical parameters did not show statistically significant differences between the groups of patients suffering from different types of diabetes. This study has shown that diabetic ketoacidosis can occur in type 2 diabetes. DKA can be prevented by education of patients, improvement of health care as well as improved communication between patients and doctors of family medicine.

  18. Diabetes knowledge among older adults with diabetes in Beijing, China.

    Science.gov (United States)

    Hu, Jie; Gruber, Kenneth J; Liu, Huaping; Zhao, Hong; Garcia, Alexandra A

    2013-01-01

    To explore the relationships of demographic and clinical variables and attendance at diabetes educational programmes with diabetes knowledge among a community sample of older Chinese adults with type 2 diabetes residing in Beijing. Knowledge of diabetes is an important component of diabetes self-management. Level of education, duration of diabetes, visits to a dietician and diabetes self-management are associated with diabetes knowledge. A few studies have examined these relationships in older Chinese with diabetes. A descriptive correlational study. The study was conducted in face-to-face interviews with 108 older adults with type 2 diabetes and an average age of 68 (SD = 8·41) years residing in six residential apartment complexes in Beijing. Along with the assessment of diabetes knowledge and diabetes self-management, assessments of glucose, blood pressure, body mass index (BMI) and waist circumference were obtained. Age and systolic blood pressure were negatively associated with diabetes knowledge. Diabetes knowledge was not related to diabetes self-care activities or glucose level. A regression model with age, education and clinical variables significantly predicted diabetes knowledge, explaining 29% of the variance in knowledge. Participants who had a family history of diabetes, visited traditional Chinese medicine (TCM) doctors and ophthalmologists and attended diabetes educational programmes were more likely to have high scores on diabetes knowledge. Age, education, a family history of diabetes, visits to TCM providers and ophthalmologists and attending diabetes class are factors associated with increased levels of diabetes knowledge. Healthcare providers need to provide age-specific, low literacy and family-focused diabetes education programmes and consider integrating principles and holistic perspectives of TCM in diabetes educational programmes for older Chinese with diabetes. © 2012 Blackwell Publishing Ltd.

  19. MANAGEMENT OF DIABETIC RETINOPATHY, PREVALENCE AND CLINICAL CLASSIFICATION.

    Science.gov (United States)

    Ajvazi, Alil; Lutaj, Pajtim; Goranci, Ilhami

    2014-01-01

    To ascertain the prevalence of diabetic retinopathy--DR, based on the duration of the diabetes mellitus--DM and to compare it with data from relevant literature and other referent clinics. In this study are included the patients with diabetes mellitus type 1 insulin-dependent--DMID and diabetes mellitus type 2 non-insulin-dependent--DMNID. The duration of diabetes in the examined patients varied from 5 till 30 years. We have applied examination by ophthalmoscope, slit lamp bio-microscopy with Volk and Goldman lens, optical coherence tomography--OCT as well as fluorescein angiography--FAG. Have been included the treated patients with DR, from September 2004-2014. In diabetic patients suffering for a period of 5 years, the prevalence of DR is 10%. In diabetic patients suffering over 30 years, the prevalence of DR is varied from 82% until 97%. Diabetic retinopathy, undertakes a multidisciplinary approach in all patients with diabetes to achieve optimal blood glucose control HbA1c levels 7.0% or lower and to adequately manage systolic blood pressure less than 140 mmHg and serum LDL cholesterol of less than 2.5 mmol/L and triglycerides of less than 2.0 mmol/L. Always should be assessed visual acuity at the time of DR examination.

  20. Spinal Disinhibition in Experimental and Clinical Painful Diabetic Neuropathy.

    Science.gov (United States)

    Marshall, Andrew G; Lee-Kubli, Corinne; Azmi, Shazli; Zhang, Michael; Ferdousi, Maryam; Mixcoatl-Zecuatl, Teresa; Petropoulos, Ioannis N; Ponirakis, Georgios; Fineman, Mark S; Fadavi, Hassan; Frizzi, Katie; Tavakoli, Mitra; Jeziorska, Maria; Jolivalt, Corinne G; Boulton, Andrew J M; Efron, Nathan; Calcutt, Nigel A; Malik, Rayaz A

    2017-02-15

    Impaired rate dependent depression (RDD) of the Hoffman-reflex is associated with reduced dorsal spinal cord potassium chloride co-transporter expression and impaired spinal GABAA receptor function, indicative of spinal inhibitory dysfunction. We have investigated the pathogenesis of impaired RDD in diabetic rodents exhibiting features of painful neuropathy and the translational potential of this marker of spinal inhibitory dysfunction in human painful diabetic neuropathy. Impaired RDD and allodynia were present in type 1 and type 2 diabetic rats but not in rats with type 1 diabetes receiving insulin supplementation that did not restore normoglycemia. Impaired RDD in diabetic rats was rapidly normalized by spinal delivery of duloxetine acting via 5HT2A receptors and temporally coincident with the alleviation of allodynia. Deficits in RDD and corneal nerve density were demonstrated in patients with painful diabetic neuropathy when compared to healthy control subjects and patients with painless diabetic neuropathy. Spinal inhibitory dysfunction and peripheral small fibre pathology may contribute to the clinical phenotype in painful diabetic neuropathy. Deficits in RDD may help to identify patients with spinally mediated painful diabetic neuropathy who may respond optimally to therapies such as duloxetine.

  1. Diabetes-Specific Antibodies and Their use in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Serpil Salman

    2011-03-01

    Full Text Available AbstractType 1A diabetes results from the destruction of the insulin-secreting islet b-cells by an immune-mediated process. In the majority of patients, the clinical course is typical and there is no doubt about the diagnosis. However, the measurement of autoimmune diabetes markers is very useful in some situations such as differential diagnosis of type 1A diabetes and early-onset type 2 diabetes, as well as in the detection of latent autoimmune diabetes in adults (LADA cases. Moreover, in the type 1A diabetes prevention studies, autoimmune markers are needed for detection of individuals under risk and for their follow-up. The autoantibodies widely used in clinical course are: ICAs, IAA, GADA and IA-2 / IA-2b. Recently, a novel marker, ZnT8A, is described as a b-cell-specific antibody. In the present paper, the assay and clinical use of diabetes-specific autoantibodies are reviewed. Turk Jem 2011; 15: 8-12

  2. Assessing Nutrient Intake and Nutrient Status of HIV Seropositive Patients Attending Clinic at Chulaimbo Sub-District Hospital, Kenya

    Directory of Open Access Journals (Sweden)

    Agatha Christine Onyango

    2012-01-01

    Full Text Available Background. Nutritional status is an important determinant of HIV outcomes. Objective. To assess the nutrient intake and nutrient status of HIV seropositive patients attending an AIDS outpatient clinic, to improve the nutritional management of HIV-infected patients. Design. Prospective cohort study. Setting. Comprehensive care clinic in Chulaimbo Sub-District Hospital, Kenya. Subjects. 497 HIV sero-positive adults attending the clinic. Main Outcome Measures. Evaluation of nutrient intake using 24-hour recall, food frequency checklist, and nutrient status using biochemical assessment indicators (haemoglobin, creatinine, serum glutamate pyruvate (SGPT and mean corpuscular volume (MCV. Results. Among the 497 patients recruited (M : F sex ratio: 1.4, mean age: 39 years ± 10.5 y, Generally there was inadequate nutrient intake reported among the HIV patients, except iron (10.49 ± 3.49 mg. All the biochemical assessment indicators were within normal range except for haemoglobin 11.2 g/dL (11.4 ± 2.60 male and 11.2 ± 4.25 female. Conclusions. Given its high frequency, malnutrition should be prevented, detected, monitored, and treated from the early stages of HIV infection among patients attending AIDS clinics in order to improve survival and quality of life.

  3. Prevalence of Hepatitis C Virus Antibody in Patients With Sexually Transmitted Diseases Attending a Harrisburg, PA, STD Clinic

    Directory of Open Access Journals (Sweden)

    Robert L. Sautter

    1994-01-01

    Full Text Available Objective: The prevalence of hepatitis B and hepatitis C in a sexually transmitted disease (STD clinic population was studied, along with the prevalence of various STD agents, in an attempt to identify possible STD markers for the hepatitis C virus and help delineate the role of hepatitis C as an STD. The hepatitis C antibody rates found in the STD clinic were also compared with those found among patients attending a local OB/GYN clinic and those enrolled in a blood donor program, all from the same geographical area.

  4. Discharge outcomes of patients referred to specialist eye clinic from diabetic retinopathy screening in Northland (2014-15).

    Science.gov (United States)

    Jagadish, Pragnya; Dalziel, David

    2017-02-17

    To determine the discharge outcomes of patients seen in specialist eye clinic after referral from diabetic retinopathy screening (DRS). Retrospective analysis of outcomes of a sample of 98 patients referred from DRS to specialist eye clinic. A sample of 98 patients were analysed following referral by DRS to specialist eye clinic from 16/4/14 to 16/4/15. Age at screening ranged from 13-88 years, with the main ethnic groups being Māori (57.1%), European (39.79%) and Indian (3.06%). A majority of the patients were referred to specialist eye clinic for diabetic retinopathy (60%) or cataracts (35%). After being seen in specialist eye clinic, 45% of the patients were enrolled back into DRS and 49.1% stayed under care of ophthalmology service for further treatment, and a further 5.9% were discharged to care of GP or optometrist without re-enrolment back to DRS. Of those referred back to DRS, 30% were re-enrolled after further imaging with optical coherence tomography (OCT), and 24% of patients were referred back to DRS due to non-attendance. Non-attendence at clinic appointments was high among the Māori population. Our study identified that 94% of patients referred to specialist eye clinic were either referred back to DRS or kept under care with only five patients not re-enrolled back into DRS. Despite good service delivery, Northland remains a high-risk population for diabetes, where non-attendance at clinic appointments remained an issue with the Māori patient population. In addition, a significant proportion of patients were re-referred back to DRS after OCT, and a consideration is to include OCT in the screening pathway.

  5. Survey of Women's Opinions on Female Genital Mutilation (FGM) in Southeast Nigeria: Study of Patients Attending Antenatal Clinic

    OpenAIRE

    Ezenyeaku, CC; Okeke, TC; Chigbu, CO; Ikeako, LC

    2011-01-01

    Background: Female genital mutilation is known to exist especially in many third world countries including Nigeria with many women being victims of this harmful practice and its complications. The practice is rife in Southeast Nigeria and efforts have been made to discourage it. Objective: To determine women's views on aspects of female genital mutilation and the prevalence among the study population. Method: Women attending the antenatal clinics of two university teaching hospitals in Southe...

  6. Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a Teaching Hospital in Nigeria

    OpenAIRE

    Lawan, Umar M.; Gboluwaga T Amole; Jahum, Mahmud G.; Abdullahi Sani

    2014-01-01

    Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ≤12 months) and caregivers was systematically selected and studied. The data were analyzed using the MINI...

  7. Cost-benefit analysis of selective screening criteria for Chlamydia trachomatis infection in women attending Colorado family planning clinics.

    Science.gov (United States)

    Humphreys, J T; Henneberry, J F; Rickard, R S; Beebe, J L

    1992-01-01

    Women attending family planning clinics in Colorado during 1988 were screened for Chlamydia trachomatis infection by enzyme immunoassay (EIA, Chlamydiazyme, Abbott Laboratories; Abbott Park, IL). Cervical specimens from 11,793 women attending 22 family planning clinics were analyzed. Patient history and physical exams were used to assess risk factors for infection. A total of 913 individuals (7.7%) had positive culture results for C. trachomatis. Multivariate analysis showed that infection was significantly related to endocervical bleeding, cervical mucopurulent discharge, a new sexual partner in the last 3 months or multiple previous sexual partners (greater than 3) in the last year, pregnancy, the use of oral contraceptives, and age. Increased odd ratios were observed for the combination of endocervical bleeding and mucopurulent discharge and sexual history that included partners over the previous year as well as the most recent 3 months. A combination of these criteria was used to selectively screen women attending Colorado family planning clinics on an ongoing basis. A cost-benefit analysis employing a model reported previously showed a significant financial benefit associated with universal screening over either selective screening or no screening for C. trachomatis in this population.

  8. Examining Longitudinal Stimulant Use and Treatment Attendance as Parallel Outcomes in Two Contingency Management Randomized Clinical Trials.

    Science.gov (United States)

    McPherson, Sterling; Brooks, Olivia; Barbosa-Leiker, Celestina; Lederhos, Crystal; Lamp, Amanda; Murphy, Sean; Layton, Matthew; Roll, John

    2016-02-01

    The primary aim of this study was to examine stimulant use and longitudinal treatment attendance in one 'parallel outcomes' model in order to determine how these two outcomes are related to one another during treatment, and to quantify how the intervention impacts these two on- and off-target outcomes differently. Data came from two multi-site randomized clinical trials (RCTs) of contingency management (CM) that targeted stimulant use. We used parallel multilevel modeling to examine the impact of multiple pre-specified covariates, including selected Addiction Severity Index (ASI) scores, age and sex, in addition to CM on concurrent attendance and stimulant use in two separate analyses, i.e., one per trial. In one trial, CM was positively associated with attending treatment throughout the trial (β=0.060, preinforcement' between two clinically meaningful on-target (directly reinforced behavior) and off-target (indirectly reinforced behavior) outcomes is in need of further examination in order to fully exploit the potential clinical benefits that could be realized in substance use disorder treatment trials.

  9. Clinical diagnosis of diabetic polyneuropathy with the diabetic neuropathy symptom and diabetic neuropathy examination scores

    NARCIS (Netherlands)

    Meijer, J.W.; Lefrandt, J.D.; Links, T.P.; Smit, J.A.; Stewart, R.E.; van der Hoeven, J.H.; Hoogenberg, K.

    2003-01-01

    OBJECTIVE - To evaluate the discriminative power of the Diabetic Neuropathy Symptom (DNS) and Diabetic Neuropathy Examination (DNE) scores for diagnosing diabetic polyneuropathy (PNP), as well as their relation with cardiovascular autonomic function testing (cAFT) and electro-diagnostic studies (EDS

  10. Best herbs for managing diabetes: a review of clinical studies

    Directory of Open Access Journals (Sweden)

    Ahmad Ghorbani

    2013-09-01

    Full Text Available Diabetes mellitus is a public health problem which leads to serious complications over time. Experimentally, many herbs have been recommended for treating diabetes. In most cases, however, the recommendations are based on animal studies and limited pieces of evidence exist about their clinical usefulness. This review focused on the herbs, the hypoglycemic actions of which have been supported by three or more clinical studies. The search was done in Google Scholar, Medline and Science Direct databases using the key terms diabetes, plants, herbs, glucose and patients. According to the clinical studies, Aegle marmelos, Allium cepa, Gymnema sylvestre, Momordica charantia, Ocimum sanctum, Nigella sativa, Ocimum sanctum, Panax quinquefolius, Salacia reticulate, Silybum marianum and Trigonella foenum-graecum have shown hypoglycemic and, in some cases, hypolipidemic activities in diabetic patients. Among them, Gymnema sylvestre, Momordica charantia, Silybum marianum and Trigonella foenum-graecum have acquired enough reputation for managing diabetes. Thus, it seems that physicians can rely on these herbs and advise for the patients to improve management of diabetes.

  11. Social persuasion in rheumatology: a randomized trial of testimonials on television in the rheumatology clinic waiting room to increase attendance for multidisciplinary education.

    Science.gov (United States)

    Tingey, Paul; Khanafer, Mohamed; Singh, Kulraj; Thompson, Andy; Le Riche, Nicole; Barra, Lillian; Haig, Sara; Rohekar, Gina; Rohekar, Sherry; Nielson, Warren; Pope, Janet E

    2014-07-01

    Multidisciplinary self-management programs are important in inflammatory arthritis as adjunctive treatment. Patients often have excuses as to why they do not attend these programs. The purpose of this study was to determine whether an intervention of televised testimonials from rheumatologists and allied health professionals increases attendance at a multidisciplinary education day for rheumatology patients seen in a large university hospital clinic. This was an RCT of intervention: playing televised interviews in the waiting room where rheumatology patients were seen versus no TV. There was a total of 6 months (3 months with and 3 without the televised interview playing). All eligible patients who attended the rheumatology outpatient clinic were then tracked to determine whether they attended a subsequent education day over the next 10 months. The sample size was calculated to have a 15% increase in attendance at the education days. There was a 20% increase in attendees at the multidisciplinary education days for patients who saw the televised testimonials. Sixty-three patients who viewed the testimonials (2.17% of 2,908) attended the education day compared to 39 who did not receive the intervention (1.80% of 2,168); however, the increase was not statistically significant (p = 0.36). Attendance of eligible patients increased using televised testimonials; however, the increase was not significant as the rates of attendance were still very low in both groups. Many eligible patients did not attend the program. Other interventions are necessary to encourage attendance in a multidisciplinary program.

  12. Clinical Guide for Family Physicians to Manage Type 2 Diabetes

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    Seyed Esmaeil Managheb

    2015-10-01

    Full Text Available Compiling clinical guidelines is one of the requirements of family physician plan and classification of health care services.1 The high prevalence of type 2 diabetes can easily be seen in general practice so that 2.5% of referrals to general practitioners are due to diabetes. More than half of the patients with Type 2 diabetes are left undiagnosed and most of them suffer from its complications at the time of diagnosis. For example, 6.2% of patients suffer from diabetic retinopathy at the time of diagnosis.2 Most patients diagnosed with diabetes take more than one type of medication to treat the complications; about 60% take only oral medications, and 14 percent take oral medications and insulin.3 Although the principles of care for people with Type 2 diabetes is well known, there is a gap between the quality of care in general practice and optimal care so that up to 50% of patients’ condition are weakly controlled.4 Chronic care model for patients with chronic diseases explains the necessary measures to improve the care of people with chronic diseases. These elements include supporting disease management by the patients themselves, patient care, and support teams. Consultation and training are often done in general practice while it is usually a brief consultation about weight, medication or exercise. There is little evidence that mere printed texts are effective in controlling the disease. Extensive training programs are designed to develop self-management skills for diabetes control.4 The implementation of clinical guidelines in medical practice is a challenging task. But, a number of evidences have been shown to accelerate effective clinical guideline implementation and care improvement.5 Management of diabetes mellitus type 2 is shown in Figure 1.

  13. Observational study identifies non-attendance characteristics in two hospital outpatient clinics

    DEFF Research Database (Denmark)

    Blæhr, Emely; Søgaard, Rikke; Kristensen, Thomas

    2016-01-01

    INTRODUCTION: Non-attended hospital appointments are receiving increasing attention in times when rapid access and efficient service delivery at public hospitals are on the agenda. The aim of this study was to investigate the extent of non-attendance in a Danish outpatient setting and its...... notice were collected from administrative systems along with appointment characteristics. Logistic regression was used for statistical analysis. RESULTS: Of the 54,987 and 31,538 appointments scheduled at the two departments, 4,524 (8%) and 5,479 (17%) were cancelled and 2,905 (5%) and 1,249 (4%) were...... unattended without notice. The latter was significantly associated with male gender, younger age and longer time since referral. Other characteristics were identified as significant, but differed between departments. CONCLUSION: There seems to be a potential for a targeted effort aiming to reduce non...

  14. Diabetes, bone and glucose-lowering agents: clinical outcomes.

    Science.gov (United States)

    Schwartz, Ann V

    2017-07-01

    Older adults with diabetes are at higher risk of fracture and of complications resulting from a fracture. Hence, fracture risk reduction is an important goal in diabetes management. This review is one of a pair discussing the relationship between diabetes, bone and glucose-lowering agents; an accompanying review is provided in this issue of Diabetologia by Beata Lecka-Czernik (DOI 10.1007/s00125-017-4269-4 ). Specifically, this review discusses the challenges of accurate fracture risk assessment in diabetes. Standard tools for risk assessment can be used to predict fracture but clinicians need to be aware of the tendency for the bone mineral density T-score and the fracture risk assessment tool (FRAX) to underestimate risk in those with diabetes. Diabetes duration, complications and poor glycaemic control are useful clinical markers of increased fracture risk. Glucose-lowering agents may also affect fracture risk, independent of their effects on glycaemic control, as seen with the negative skeletal effects of the thiazolidinediones; in this review, the potential effects of glucose-lowering medications on fracture risk are discussed. Finally, the current understanding of effective fracture prevention in older adults with diabetes is reviewed.

  15. Periodontal disease in diabetic patients - clinical and histopathological aspects.

    Science.gov (United States)

    Corlan Puşcu, Dorina; Ciuluvică, Radu Constantin; Anghel, Andreea; Mălăescu, Gheorghe Dan; Ciursaş, Adina Nicoleta; Popa, Gabriel Valeriu; Agop Forna, Doriana; Busuioc, Cristina Jana; Siloşi, Izabela

    2016-01-01

    Periodontal disease is one of the most frequent diseases affecting people all over the world. The relation between periodontal disease and diabetes mellitus raised the interest both of dentists and doctors treating metabolic diseases, as the two conditions influence one another. In our study, we analyzed a number of 75 patients with diabetes mellitus and periodontal disease that presented to the medical consultory for conditions of the dental maxillary system. The clinical study showed that periodontal disease and diabetes may affect young adults as well, still this pathological association more frequently appears after the age of 50. The disease was identified especially in the women living in urban area. The clinical examination of the dental maxillary system identified the presence of gingival ulcerations, dental calculus, gingival bleeding, radicular leftovers with anfractuous margins, fixed prostheses with an inappropriate cervical adjustment. Of the systemic diseases associated to periodontal disease and diabetes mellitus, there was observed that 66.66% of the patients also suffered from cardiovascular diseases (high blood pressure, ischemic cardiopathy, heart failure), and 37.33% suffered from obesity. The histopathological and immunohistochemical tests highlighted the presence of an inflammatory chronic, intense reaction, mainly formed of lymphocytes, plasmocytes, macrophages and granulocytes, heterogeneously disseminated and alteration of the structure of marginal and superficial periodontium. The inflammatory reaction in the patients with periodontal disease and diabetes was more intense than in the patients with periodontal disease without diabetes.

  16. Clinical management of acute diabetic Charcot foot in Denmark

    DEFF Research Database (Denmark)

    Jansen, Rasmus Bo; Svendsen, Ole Lander; Kirketerp-Møller, Klaus

    2016-01-01

    INTRODUCTION: Charcot foot is a severe complication to diabetes mellitus and treatment involves several different clinical specialities. Our objective was to describe the current awareness, knowledge and treatment practices of Charcot foot among doctors who handle diabetic foot disorders. METHODS......: This study is based on a questionnaire survey sent out to healthcare professionals, primarily doctors, working with diabetic foot ulcers and Charcot feet in the public sector of the Danish healthcare system. RESULTS: The survey obtained a 52% response rate. A temperature difference of > 2 °C between the two...... for offloading (83%). All centres use some form of a multidisciplinary team, with the most common permanent members being orthopaedic surgeons (71%), wound specialist nurses (76%), podiatrists (65%), endocrinologists (47%) and diabetes specialist nurses (41%). CONCLUSION: We conducted a survey of the diagnosis...

  17. Community to clinic navigation to improve diabetes outcomes

    Directory of Open Access Journals (Sweden)

    Nancy E. Schoenberg

    2017-03-01

    Full Text Available Rural residents experience rates of Type 2 Diabetes Mellitus (T2DM that are considerably higher than their urban or suburban counterparts. Two primary modifiable factors, self-management and formal clinical management, have potential to greatly improve diabetes outcomes. “Community to Clinic Navigation to Improve Diabetes Outcomes,” is the first known randomized clinical trial pilot study to test a hybrid model of diabetes self-management education plus clinical navigation among rural residents with T2DM. Forty-one adults with T2DM were recruited from two federally qualified health centers in rural Appalachia from November 2014–January 2015. Community health workers provided navigation, including helping participants understand and implement a diabetes self-management program through six group sessions and, if needed, providing assistance in obtaining clinic visits (contacting providers' offices for appointments, making reminder calls, and facilitating transportation and dependent care. Pre and post-test data were collected on T2DM self-management, physical measures, demographics, psychosocial factors, and feasibility (cost, retention, and satisfaction. Although lacking statistical significance, some outcomes indicate trends in positive directions, including diet, foot care, glucose monitoring, and physical health, including decreased HbA1c and triglyceride levels. Process evaluations revealed high levels of satisfaction and feasibility. Due to the limited intervention dose, modest program expenditures (~$29,950, and a severely affected population most of whom had never received diabetes education, outcomes were not as robust as anticipated. Given high rates of satisfaction and retention, this culturally appropriate small group intervention holds promise for hard to reach rural populations. Modifications should include expanded recruitment venues, sample size, intervention dosage and longer term assessment.

  18. 2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea

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    Seung-Hyun Ko

    2011-10-01

    Full Text Available As in other countries, type 2 diabetes is major health concern in Korea. A dramatic increase in the prevalence of type 2 diabetes and its chronic complications has led to an increase in health costs and economic burdens. Early detection of high risk individuals, hidden diabetic patients, and improvement in the quality of care for the disease are the first steps to mitigate the increase in prevalence. The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In the guidelines, the committee recommended active screening of high risk individuals for early detection and added the hemoglobin A1c level to the diagnostic criteria for type 2 diabetes based on clinical studies performed in Korea. Furthermore, the committee members emphasized that integrating patient education and self-management is an essential part of care. The drug treatment algorithm based on the degree of hyperglycemia and patient characteristics were also updated.

  19. Prevalence of metabolic syndrome in women with polycystic ovary syndrome attending an infertility clinic in a tertiary care hospital in south India

    Directory of Open Access Journals (Sweden)

    Kavita Mandrelle

    2012-01-01

    Full Text Available Objective: The aim of the present study was to evaluate the prevalence of metabolic syndrome in women with polycystic ovary syndrome (PCOS. Setting: Infertility clinic in a tertiary care hospital. Study Design: A prospective cross-sectional study. Materials and Methods: All the women attending the infertility clinic categorized as polycystic ovary syndrome according to Rotterdam criteria (2003 during the study period were included in the study. The women with PCOS underwent screening for metabolic syndrome as defined by the modified American Heart Association/National Heart Lung Blood Institute (AHA/NHLBI modified ATP 111 (2005 definition. A multivariate logistic regression analysis was applied and significant predictors identified for the prediction of metabolic syndrome. Results: The overall prevalence of metabolic syndrome according to the modified AHA/NHLBI ATP III (2005 criteria was 37.5%. A total of 5.8 % cases were detected to have diabetes mellitus, 8.3% had impaired fasting glucose, and 11.7 % had an impaired glucose test. Dyslipidemia was present in 93.3% cases of PCOS. Among all the risk factors, age and waist hip ratio ≥0.85 were strongly associated with the presence of metabolic syndrome. Conclusion: Infertile women with PCOS, particularly those with age ≥25 years or with central obesity (a waist hip ratio of ≥0.85, are at a higher risk of developing metabolic syndrome and should be offered screening tests.

  20. Real world clinical outcomes and patient characteristics for canagliflozin treated patients in a specialty diabetes clinic.

    Science.gov (United States)

    Johnson, June Felice; Parsa, Rahul; Bailey, Robert

    2017-01-01

    To examine characteristics and outcomes of type 2 diabetes (T2DM) patients prescribed canagliflozin (CANA) and managed in the real-world setting of a diabetes clinic. Primary outcome was change in A1c, and secondary outcomes were change in weight and blood pressure. Study was an electronic health record (EHR) review of CANA prescribed at the diabetes clinic from June 2013 to June 2015. Patients were included in the study if they were adults with T2DM, received routine follow-up diabetes care at the diabetes clinic, received an initial prescription for CANA from a diabetes clinic prescriber, and returned for at least one follow-up office visit (OV) after initial CANA prescribing. Paired t-tests were performed on the primary and secondary outcomes, and p CANA) 3.58. Men comprised 60% of patients. At baseline, 54% of patients were prescribed insulin. A1c decreased by 1.06% and 1.09% (p < .0001), weight decreased by 2.01% and 1.83% (p < .001), systolic blood pressure (SBP) decreased by 3.2% and 2.4% (p < .0001), and diastolic blood pressure (DBP) decreased by 2.59% and 2.16% (p = .0002) from baseline to first and second follow-up OV, respectively. Study limitations included retrospective design, inability to control for confounding factors (e.g. changes in nutrition, exercise, medical care plan, medications), missing information in the EHR, potential lack of generalizability of results to those in a non-specialty diabetes clinic, inability to assess adherence, and inability to assess reliable adverse event data. ANA was associated with a statistically and clinically significant reduction in A1c, weight, and blood pressure when added to multiple diabetes medication regimens by prescribers in a diabetes clinic.

  1. A randomized clinical trial of diabetes self-management for Mexican Americans: Are there serendipitous health benefits for supporters of study participants?

    Directory of Open Access Journals (Sweden)

    Sharon A Brown

    2017-01-01

    Full Text Available Objectives: Studies of social support in diabetes have focused on the effects of support on the person with type 2 diabetes. We explored diabetes prevention effects of a culturally tailored diabetes self-management intervention in individuals without diabetes who were supporters of intervention participants. Methods: This is a secondary analysis of data from a randomized clinical trial that involved 256 Mexican Americans with diabetes. Each study participant designated a supporter—spouse, relative, friend—who attended intervention sessions and assisted participants in attaining effective diabetes self-management. Supporter’s glycosylated hemoglobin (A1C data were tracked for 1 year to determine diabetes conversion rates in supporters without diabetes at baseline. Results: Fewer individuals in the intervention group (n = 9 converted to an A1C above the 7% threshold, compared to the 1-year wait-listed control group (n = 16. We found a statistically significant difference (p = .021 at 12 months in the number of individuals whose A1C was ⩽8%, with fewer supporters above threshold in the intervention group (reduction of 48%. Supporters in the intervention group with prediabetes, based on baseline A1C, experienced a slight reduction in A1C, while control group supporters with prediabetes experienced an increase. Discussion: The results suggest that there are potential benefits for family members and other supporters of persons with diabetes who participated in diabetes self-management programs.

  2. CLINICAL PROFILE OF PATTERN OF DYSLIPIDAEMIA AND ISCHAEMIC HEART DISEASE IN TYPE II DIABETES MELLITUS PATIENTS

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    Atul Vijayrao Rajkondawar

    2017-07-01

    Full Text Available BACKGROUND The present research was undertaken to study the pattern of dyslipidaemia and varied clinical manifestations of ischaemic heart disease, its risk factors in type 2 diabetes mellitus patients. Diabetes Mellitus (DM has become major public health problem in India. It is not only increasing in morbidity and mortality, but also decreases the quality of life. Also, disease and its complications are causing heavy economic burden for patients suffering from it.1,2 Diabetes is endemic globally with increasing prevalence in both developing and developed countries. Diabetes is a major cause of mortality, but several studies indicate that it is likely underreported as a cause of death. A recent estimate suggested that diabetes was the fifth leading cause of death worldwide and was responsible for almost 3 million deaths annually (1.7-5.2% of all deaths. MATERIALS AND METHODS A total of 100 patients attending the outpatient department or admitted to medical wards, ICU of tertiary care centre and fulfilling the inclusion criteria were evaluated clinically. A baseline Electrocardiogram (ECG was taken in all cases irrespective of clinical evidence of cardiac involvement. Patients with normal ECG pattern were further evaluated by Treadmill Testing (TMT or stress test for subclinical cardiac involvement. Risk factor evaluation was done in all cases. RESULTS Prevalence of IHD was found to be 41% with a male predominance (1.067:1. Evaluation of risk factors has shown its strong association with IHD. Incidence of IHD was high when low HDL (P 25 had negatively significant association with IHD in type 2 diabetics (P=0.072. Smoking was not statistically associated (P=0.577 and in male alcoholics, IHD had positive association with alcohol (P=0.193. CONCLUSION The current study points out that there exists an increased incidence of ischaemic heart disease in diabetics with few, but not all risk factors contributing to it. Early detection, optimal glycaemic

  3. A survey of genital infections in patients attending a clinic for sexually transmitted diseases.

    Science.gov (United States)

    Staerfelt, F; Gundersen, T J; Halsos, A M; Barlinn, C; Johansen, A G; Nørregaard, K M; Eng, J

    1983-01-01

    747 consecutive patients, 531 men and 216 women, attending the Division of Dermatovenerology, City Health Dept., Oslo, were screened for N. gonorrhoeae (14.5% and 18.5%), C. trachomatis (19.6% and 20.8%), G. vaginalis (0.2% and 6.5%), and C. albicans (1.1% and 21.3%). The prevalence is given in brackets for men and women, respectively. This study was undertaken in order to determine the relative prevalence of these microorganisms with particular reference to G. vaginalis, to determine the importance of concomitant infections, and the possible effect of contraceptive methods (oral contraceptives and IUD) on the prevalence of these microorganisms.

  4. Diabetic mastopathy: A clinical and radiological challenge

    Directory of Open Access Journals (Sweden)

    Debra Ardath Meerkotter

    2010-12-01

    Full Text Available A 41-year-old woman presented with a lump above the right areola. She also complained of a burning and heavy sensation of the right breast of recent onset. On further history, the patient was an insulin-dependent diabetic of 35 years’ duration. She had no family history of breast disease. On examination, a palpable thickening above the right areola was detected. Bilateral mammography revealed dense fibro-glandular tissue, denser in the right retro-areolar region than the left, with right peri-areolar skin thickening. There was no discreet mass nor suspicious microcalcifications or axillary adenopathy. Ultrasound (US demonstrated an ill-defined peri-areolar region of decreased echogenicity and posterior shadowing. Core biopsy under US guidance showed abundant thick collagen bands containing epitheloid fibroblasts and a stroma with small capillary-sized and larger muscularised blood vessls, some of which contained peri-vascular lymphocytic inflammatory cells. Small ductal elements and an occasional lobule showed a peri-ductal and a peri- and intra-lobular lymhocytic and plasma cell infiltrate. These features were in keeping with sclerosing lymphocytic mastitis, known also as diabetic mastopathy.

  5. The Prevalence and the Determinants of Musculoskeletal Diseases in Emiratis Attending Primary Health Care Clinics in Dubai

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    Jamal Al Saleh

    2016-03-01

    Full Text Available Objectives: To estimate the prevalence of rheumatic diseases in the Emiratis attending primary health care (PHC clinics in Dubai. The secondary objective was to study the relationship between age, gender, and body mass index (BMI and rheumatic diseases in the general population.  Methods: The Prevalence of Rheumatic Diseases and Osteoporosis (PRO in Dubai study was a cross-sectional study, which randomly enrolled Emiratis’ aged between 18–85 years old who attended one of 13 PHC clinics between 2 January 2009 and 31 December 2009. Demographic and health data for all participants was obtained via a questionnaire. Participants that indicated positive answers had their responses validated by a rheumatologist and underwent a thorough locomotor examination.  Results: The study included 3,985 participants with a mean age of 42.1±15.8 years. The majority (77.4% were female. Lower back pain was the most prevalent problem in our study population (32.9%. Knee osteoarthritis (OA was the most common form of arthritis seen in our cohort (25.8%. Overall, the prevalence of inflammatory arthritis was 3.1%. Age and BMI were associated with increased risk of knee OA and lower back pain.  Conclusions: Rheumatic diseases are quite common in Emirati patients attending PHC clinics. Lower back pain and knee OA were the most common musculoskeletal diseases seen in our cohort. There is a need for more population-based studies in the Middle East to have a better understanding of the epidemiology of rheumatic diseases in this region.

  6. Diabetes quality management in care groups and outpatient clinics

    NARCIS (Netherlands)

    Campmans-Kuijpers, M.J.E.

    2015-01-01

    This research project relates to diabetes quality management in Dutch care groups (40-200 GP practices) and outpatient clinics. Improvement of quality management at an organisational level on top of the existing quality management in separate general practices is expected to be associated with bette

  7. Diabetes quality management in care groups and outpatient clinics

    NARCIS (Netherlands)

    Campmans-Kuijpers, M.J.E.

    2015-01-01

    This research project relates to diabetes quality management in Dutch care groups (40-200 GP practices) and outpatient clinics. Improvement of quality management at an organisational level on top of the existing quality management in separate general practices is expected to be associated with

  8. The relationship between visual orienting responses and clinical characteristics in children attending special education for the visually impaired.

    Science.gov (United States)

    Kooiker, Marlou J G; Pel, Johan J M; van der Steen, Johannes

    2015-05-01

    We recently introduced a method based on quantification of orienting responses toward visual stimuli to assess the quality of visual information processing in children. In the present study, we examined the relationship between orienting responses and factors that are associated with visual processing impairments in current clinical practice. Response time and fixation quality to visual features such as form, contrast, motion, and color stimuli were assessed in 104 children from 1 to 12 years attending special education for the visually impaired. Using regression analysis, we investigated whether these parameters were affected by clinical characteristics of children. Response times significantly depended on stimulus type. Responses to high-contrast cartoons were significantly slower in children with a clinical diagnosis of cerebral visual impairment. Fixation quality was significantly affected by visual acuity and nystagmus. The results suggest that the quantitative measurement of orienting responses is strongly related to cerebral visual impairment in children.

  9. Clinical characteristics and mortality in patients treated in a Multidisciplinary Diabetic Foot Unit.

    Science.gov (United States)

    Rubio, José Antonio; Jiménez, Sara; Álvarez, Julia

    2017-05-01

    This study reviews the clinical characteristics of patients with diabetic foot ulcer treated in a Multidisciplinary Diabetic Foot Unit (MDFU) and analyzes the mortality and factors associated with its survival. Data from all patients who attended the MDFU for the first time for a diabetic foot ulcer during the 2008-2014 period were analized. The patients were followed until their death or until June 30, 2016, for up to 8 years. A total of 345 patients were included, with a median age (P25-P75) of 71 (61.5-80) years, and 321 (93%) had type 2 diabetes. They were characterized as patients with inadequate glycemic control, 48% had HbA1c ≥ 8% and high prevalence of chronic complications: 60.2% retinopathy, 43.8% nephropathy and 47.2% ischemic heart disease and/or cerebrovascular disease. A total of 126 (36.5%) patients died and 69 (54.8%) were due to cardiovascular disease. Survival measured by Kaplan-Meier declined over time to 69, 60 and 45% at 3, 5 and 7 years respectively. Cox's multivariate regression analysis showed the following variables associated with mortality, HR (95% CI): age 1.08 (1.05-1.11); previous amputation 2.24 (1.34-3.73); active smoking 2.10 (1.12-3.97); cerebrovascular disease 1.75 (1.05-2.92); renal dysfunction 1.65 (1.04-2.61) and ischemic heart disease 1.60 (1.01-2.51). Patients with diabetic foot ulcer are characterized by high morbidity and mortality, with cardiovascular disease being the most frequent cause of death. It is necessary to pay more attention to this risk group, tailoring objectives and treatments to their situation and life expectancy. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  10. Occurrence of Hepatitis C Virus infection in type 2 diabetic patients attending Plateau state specialist hospital Jos Nigeria

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    Paul Grace A

    2009-07-01

    Full Text Available Abstract Background Glucose intolerance is observed more in patients with HCV infection compared with control subjects with liver disease, Initial studies suggested that Hepatitis C virus infection may be an additional risk factor for the development of diabetes mellitus. This study was therefore carried out to determine the correlation of HCV infection and diabetes. Methods Three hundred (300 confirmed type 2 diabetic patients were screened for hepatitis C virus antibodies at the Plateau state specialist hospital, Jos, using Grand diagnostic test strip. Questionnaire comprising of age, sex, family history on diabetes, duration of disease and marital status were issued to subjects. Results Overall result showed that the prevalence rate of HCV infection was 33(11%. In response to diabetic status, females subjects had a higher prevalence of 178(59.3% compared to males 122(40.7%. Those aged 47–57 recorded the highest seroprevalence 10(30.3% to the Hepatitis C Virus, while Patients without family history of diabetes showed a higher seroprevalence of 13(39.4%. Subjects who never had any blood transfusion recorded a prevalence rate of 6(18.2%. Marital status showed no significant difference [(P = 0.275; P.0.05]. Considering duration of developing diabetes, patients within the range of 1–10 years diabetic status recorded the highest prevalence rate 25(75.8% compared to other ranges considered. Conclusion This study hence, suggests a relatively strong association between HCV infection and diabetes, this therefore call for an urgent approach strategy in the control and management of this disease of the endocrine system.

  11. Clinic Attendance for Antiretroviral Pills Pick-Up among HIV-Positive People in Nepal: Roles of Perceived Family Support and Associated Factors.

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    Rakesh Ayer

    Full Text Available HIV-positive people's clinic attendance for medication pick-up is critical for successful HIV treatment. However, limited evidence exists on it especially in low-income settings such as Nepal. Moreover, the role of family support in clinic attendance remains under-explored. Therefore, this study was conducted to examine the association between perceived family support and regular clinic attendance and to assess factors associated with regular clinic attendance for antiretroviral pills pick-up among HIV-positive individuals in Nepal.A cross-sectional study was conducted among 423 HIV-positive people in three districts of Nepal. Clinic attendance was assessed retrospectively for the period of 12 months. To assess the factors associated, an interview survey was conducted using a semi-structured questionnaire from July to August, 2015. Multiple logistic regression models were used to assess the factors associated with regular clinic attendance.Of 423 HIV-positive people, only 32.6% attended the clinics regularly. They were more likely to attend them regularly when they received high family support (AOR = 3.98, 95% CI = 2.29, 6.92, participated in support programs (AOR = 1.68, 95% CI = 1.00, 2.82, and had knowledge on the benefits of antiretroviral therapy (AOR = 2.62, 95% CI = 1.15, 5.99. In contrast, they were less likely to attend them regularly when they commuted more than 60 minutes to the clinics (AOR = 0.53, 95% CI = 0.30, 0.93, when they self-rated their health status as being very good (AOR = 0.13, 95% CI = 0.04, 0.44, good (AOR = 0.14, 95% CI = 0.04, 0.46, and fair (AOR = 0.21, 95% CI = 0.06, 0.70.HIV-positive individuals are more likely to attend the clinics regularly when they receive high family support, know the benefits of antiretroviral therapy, and participate in support programs. To improve clinic attendance, family support should be incorporated with HIV care programs in resource limited settings. Service providers should also

  12. Do discrimination, residential school attendance and cultural disruption add to individual-level diabetes risk among Aboriginal people in Canada?

    National Research Council Canada - National Science Library

    Dyck, Roland F; Karunanayake, Chandima; Janzen, Bonnie; Lawson, Josh; Ramsden, Vivian R; Rennie, Donna C; Gardipy, P Jenny; McCallum, Laura; Abonyi, Sylvia; Dosman, James A; Episkenew, Jo-Ann; Pahwa, Punam

    2015-01-01

    Aboriginal peoples in Canada (First Nations, Metis and Inuit) are experiencing an epidemic of diabetes and its complications but little is known about the influence of factors attributed to colonization...

  13. Brief intervention for alcohol misuse in people attending sexual health clinics: study protocol for a randomized controlled trial

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    Sanatinia Rahil

    2012-08-01

    Full Text Available Abstract Background Over the last 30 years the number of people who drink alcohol at harmful levels has increased in many countries. There have also been large increases in rates of sexually transmitted infections. Available evidence suggests that excessive alcohol consumption and poor sexual health may be linked. The prevalence of harmful alcohol use is higher among people attending sexual health clinics than in the general population, and a third of those attending clinics state that alcohol use affects whether they have unprotected sex. Previous research has demonstrated that brief intervention for alcohol misuse in other medical settings can lead to behavioral change, but the clinical- and cost-effectiveness of this intervention on sexual behavior have not been examined. Methods We will conduct a two parallel-arm, randomized trial. A consecutive sample of people attending three sexual health clinics in London and willing to participate in the study will be screened for excessive alcohol consumption. Participants identified as drinking excessively will then be allocated to either active treatment (Brief Advice and referral for Brief Intervention or control treatment (a leaflet on healthy living. Randomization will be via an independent and remote telephone randomization service and will be stratified by study clinic. Brief Advice will comprise feedback on the possible health consequences of excessive alcohol consumption, written information about alcohol and the offer of an appointment for further assessment and Brief Intervention. Follow-up data on alcohol use, sexual behavior, health related quality of life and service use will be collected by a researcher masked to allocation status six months later. The primary outcome for the study is mean weekly alcohol consumption during the previous three months, and the main secondary outcome is the proportion of participants who report unprotected sex during this period. Discussion Opportunistic

  14. The association between maltreatment in childhood and pre-pregnancy obesity in women attending an antenatal clinic in Australia.

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    Katharine Hollingsworth

    Full Text Available INTRODUCTION: Obesity in pregnancy is associated with increased risk of complications and adverse outcomes in mother and child. Childhood adverse experiences are known to have numerous negative physical and emotional sequelae. We aimed to examine if exposure to abuse and/or neglect in childhood increased the likelihood of pre-pregnancy obesity. METHODS: Demographic and clinical data including weight, height, mental health as measured by the General Health Questionnaire and exposure to childhood trauma as measured by the childhood trauma questionnaire was collected from 239 women attending antenatal care at an Australian tertiary hospital. RESULTS: More than one quarter of women were obese prior to pregnancy and approximately 20% of women self reported experiencing moderate to severe physical, sexual or emotional abuse. Almost 60% of women scored in the clinical range on the GHQ. Pre-pregnancy obesity in women attending antenatal care was associated with a self-reported history of emotional or physical abuse with those exposed to moderate or severe emotional or physical abuse having increased odds of being obese prior to pregnancy (O.R. and 95% CI: 2.40; 1.19-4.84 and 2.38; 1.18-4.79 respectively. There was no significant association between other forms of childhood maltreatment, demographic or current mental health status and pre-pregnancy obesity. CONCLUSIONS: The high rates of obesity, mental health problems and self reported childhood maltreatment in the Australian antenatal population are serious public health concerns due to the extra health risks conferred on mother and offspring. Exposure to physical or emotional abuse during childhood increases the likelihood of obesity in women attending antenatal care. Further research is required to determine reasons for this association.

  15. Prevalence of HIV among rural pregnant women attending antenatal clinics at Pravara Rural Hospital, Loni, Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Purushottam A Giri

    2012-01-01

    Full Text Available Background: Many antenatal clinics (ANC-based HIV surveillance systems in India have limited coverage of remote rural sites, a weakness that compromises adequate estimation, monitoring, and development of effective preventive and care programs. To address this void in rural area of western Maharashtra, we conducted antenatal clinic-based sentinel surveillance to know the prevalence of HIV infection among rural pregnant women. Materials and Methods: A cross-sectional study was carried out at ANC clinic, Dept. of Obstetrics and Gynaecology of Pravara Rural Hospital, Loni, Maharashtra. A total of 12,171 pregnant women from rural area accepted HIV testing after counseling who attending ANC clinic in Pravara Rural Hospital, Loni, during January 2008 to December 2011 were included in the study. Data were entered in Microsoft excel and percentage and proportion was calculated. Results: In the present study, out of 12171 pregnant women from the rural area accepted HIV testing after counseling who attending ANC clinic, only 50 (0.41% were HIV positive and remaining 12, 221 (99.59% were HIV negative. The study showed that the prevalence of HIV among pregnant women was 0.41%. Out of the 50 HIV positive pregnant women studied majority, 32 (64.0%, were primigravidas and 18 (36.0% were multigravidas. Conclusion: In our study all 12171 pregnant women from the rural area accepted HIV testing after counseling and prevalence of HIV was found to be 0.41%. The need of the hour is to provide universal access to these services by involving the NGO′s and the private sector.

  16. Evaluation of trend in semen analysis for 11 years in subjects attending a fertility clinic in India

    Institute of Scientific and Technical Information of China (English)

    P.Marimuthu; M.C.Kapilashrami; M.M.Misro; G.Singh

    2003-01-01

    Aim: The data on semen analysis of subjects attending the Fertility Clinic at NIHFW (National Institute of Health and Family Welfare) Munirka, New Delhi for the last 11 years were analyzed to verify the claims and speculations on declining sperm counts in men. Methods: Approximately 10 % of the records every year starting from 1990 to 2000 (numbering 1176 in total) were randomly selected for analysis. Subjects with azoospermia or severe oligozoospermia were excluded from analysis. Results: The average age of the men attending the infertility clinic was 31.2 years. The average semen volume and sperm count were found to be (2.6 ± 0.1) mL and (60.6 ±0.9)× 106/ml., respectively. No significant decline in sperm counts was observed in anyyear during the entire studyperiod. Only 1.8 % of the total number of sperm counts in the random sampling were less then 20×106/mL. On the basis of WHO criteria on motility, the total percentage of non-progressive and non-motile sperm in the ejaculate was higher (63 %) as compared to the combined categories of slow and rapid linear progressive. Conclusion: The present study has confmned similar findings from other different countries that declining sperm counts in humans is not a global phenomenon. ( Asian J Androl 2003 Sep; 5: 221-225)

  17. Prevalence of Trichomonas vaginalis, Mycoplasma genitalium and Ureaplasma urealyticum in men with urethritis attending an urban sexual health clinic.

    Science.gov (United States)

    Khatib, N; Bradbury, C; Chalker, V; Koh, G C K W; Smit, E; Wilson, S; Watson, J

    2015-05-01

    We conducted a study to determine the prevalence of Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) and Ureaplasma urealyticum (UU) in men with urethritis, attending an urban sexual health clinic, in order to inform screening and treatment policies. Men attending an urban sexual health clinic between June 2011 and January 2012 were evaluated. Urine samples were collected from men with urethritis and tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and TV using transcription-mediated amplification and for MG and UU using polymerase chain reaction. Eighty-three samples were analysed. The prevalence of CT was 33.7% (28/83), GC was 16.8% (14/83), TV was 3.6% (3/83), MG was 12.0% (10/83) and UU was 4.8% (4/83). Fifteen men had recurrent urethritis. Of these, three were found to have had TV, five to have had MG and none to have had UU, at initial presentation. Given the prevalence of MG in this study, there is an urgent need for further larger studies looking at optimal treatment regimens and screening strategies in urethritis.

  18. Epidemiological Investigation of Human Papillomavirus Infection in Men Attending a Sexually Transmitted Disease Clinic in Hangzhou Area

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    To investigate the epidemiological characteristics of human papillomavirus (HPV) infection in men attending a sexually transmitted diseases (STD) clinic in Hangzhou area. Methods Male subjects (n=375) aged 18-70 years,attending the STD clinic were recruited. Urethral swabs were assessed for HPV DNA using polymerase chain reaction (PCR)with the consensus primers MY09/11. HPV genotypes of positive PCR products were determined by restriction fragment length polymorphisms and direct sequence analysis. Results Of the 375 swabs collected, 305 (81.3%) yielded sufficient DNA for the subsequent HPV analysis. Among the 305 subjects, the prevalence of HPV was 13.8%. Nononcogenic HPV types were found in 8.5% (26/305) of subjects, oncogenic types in 4.3% (13/305), and multiple types in 1.0% (3/305). The prevalence of HPV infection was higher in subjects from urban area than in those from rural area (P<0.05). The prevalence was also higher in those who received fewer years of education (P<0.05) and those who had more sex partners (P<0.05). Conclusions HPV infection among men at high risk is not uncommon. The detection rate of HPV DNA is significantly related to some sociodemographic factors, such as residence, educational level and the number of sex partners.

  19. Clinical diabetes research using data mining: a Canadian perspective.

    Science.gov (United States)

    Shah, Baiju R; Lipscombe, Lorraine L

    2015-06-01

    With the advent of the digitization of large amounts of information and the computer power capable of analyzing this volume of information, data mining is increasingly being applied to medical research. Datasets created for administration of the healthcare system provide a wealth of information from different healthcare sectors, and Canadian provinces' single-payer universal healthcare systems mean that data are more comprehensive and complete in this country than in many other jurisdictions. The increasing ability to also link clinical information, such as electronic medical records, laboratory test results and disease registries, has broadened the types of data available for analysis. Data-mining methods have been used in many different areas of diabetes clinical research, including classic epidemiology, effectiveness research, population health and health services research. Although methodologic challenges and privacy concerns remain important barriers to using these techniques, data mining remains a powerful tool for clinical research. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  20. Diabetic Retinopathy Clinical Practice Guidelines: Customized for Iranian Population

    Science.gov (United States)

    Rajavi, Zhale; Safi, Sare; Javadi, Mohammad Ali; Azarmina, Mohsen; Moradian, Siamak; Entezari, Morteza; Nourinia, Ramin; Ahmadieh, Hamid; Shirvani, Armin; Shahraz, Saeid; Ramezani, Alireza; Dehghan, Mohammad Hossein; Shahsavari, Mohsen; Soheilian, Masoud; Nikkhah, Homayoun; Ziaei, Hossein; Behboudi, Hasan; Farrahi, Fereydoun; Falavarjani, Khalil Ghasemi; Parvaresh, Mohammad Mehdi; Fesharaki, Hamid; Abrishami, Majid; Shoeibi, Nasser; Rahimi, Mansour; Javadzadeh, Alireza; Karkhaneh, Reza; Riazi-Esfahani, Mohammad; Manaviat, Masoud Reza; Maleki, Alireza; Kheiri, Bahareh; Golbafian, Faegheh

    2016-01-01

    Purpose: To customize clinical practice guidelines (CPGs) for management of diabetic retinopathy (DR) in the Iranian population. Methods: Three DR CPGs (The Royal College of Ophthalmologists 2013, American Academy of Ophthalmology [Preferred Practice Pattern 2012], and Australian Diabetes Society 2008) were selected from the literature using the AGREE tool. Clinical questions were designed and summarized into four tables by the customization team. The components of the clinical questions along with pertinent recommendations extracted from the above-mentioned CPGs; details of the supporting articles and their levels of evidence; clinical recommendations considering clinical benefits, cost and side effects; and revised recommendations based on customization capability (applicability, acceptability, external validity) were recorded in 4 tables, respectively. Customized recommendations were sent to the faculty members of all universities across the country to score the recommendations from 1 to 9. Results: Agreed recommendations were accepted as the final recommendations while the non-agreed ones were approved after revision. Eventually, 29 customized recommendations under three major categories consisting of screening, diagnosis and treatment of DR were developed along with their sources and levels of evidence. Conclusion: This customized CPGs for management of DR can be used to standardize the referral pathway, diagnosis and treatment of patients with diabetic retinopathy. PMID:27994809

  1. Nutritional therapy for the management of diabetic gastroparesis: clinical review

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    Sadiya A

    2012-09-01

    Full Text Available Amena SadiyaLifestyle Clinic, Rashid Centre for Diabetes and Research, Ministry of Health, Ajman, United Arab EmiratesAbstract: Diabetic gastroparesis (DGP, or slow emptying of the stomach, is a well-established complication of diabetes mellitus and is typically considered to occur in individuals with long-standing type 1 and type 2 diabetes mellitus. Clinical consequences of DGP include induction of gastrointestinal (GI symptoms (early satiety, abdominal distension, reflux, stomach spasm, postprandial nausea, vomiting, alteration in drug absorption, and destabilization of glycemic control (due to mismatched postprandial glycemic and insulin peaks. Effective nutritional management not only helps in alleviating the symptoms, but also in facilitating better glycemic control. Although there have been no evidence-based guidelines pertaining to the nutrition care process of the DGP, the current dietary recommendations are based on expert opinions or observational studies. The dietary management of gastroparesis needs to be tailored according to the severity of malnutrition and kind of upper GI symptom by changing the volume, consistency, frequency, fiber, fat, and carbohydrates in the meal. Small frequent meals, using more liquid calories, reducing high fat or high fiber, consuming bezoar forming foods, and adjusting meal carbohydrates based on medications or insulin helps in improving the upper GI symptoms and glycemic control. Enteral nutrition can be an option for patients who fail to stabilize their weight loss, or for those who cannot gain weight with oral feedings, while total parenteral nutrition is rarely necessary for the patient with gastroparesis.Keywords: diabetic gastroparesis, delayed gastric emptying, diabetes mellitus, bezoar, GI symptoms, glycemic control

  2. Identifying risk factors for clinically significant diabetic macula edema in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Kamoi, Kyuzi; Takeda, Keiji; Hashimoto, Kaoru; Tanaka, Reiko; Okuyama, Shinya

    2013-05-01

    It is known that clinic blood pressure (BP), gender, cigarette smoking, dyslipidemia, anemia and thiazolidenediones (TZD) treatment are predictors for clinically significant diabetic macula edema (CSDME). We examined a most risky factor for CSDME in Japanese patients with type 2 diabetes mellitus (T2DM) and diabetic retinopathy (DR) confirmed using optical coherence tomography by multiple regression analysis (MRA). As the risk factors, wakening-up BP was added to such factors. Seven diabetic Japanese patients with CSDME (group 1) and 124 subjects without CSDME (group 2) assonated with DR using optical coherence tomography were studied. The durations of T2DM in groups 1 and 2 were 15±10 years and 20±15 years, respectively. There was no statistically difference in means of gender, duration, age, body mass index (BMI), HbA1c, TC, LDL and TC/HDL, serum creatinine, urinary albumin excretion rate, and clinic BP between two groups. Morning systolic home BP (MSHBP), cigarette smoking and foveal thickness were significantly (ppioglitazone as TZD treatment were significantly positive predictors for CSDME, while BMI had a significantly negative predictor. Other variables were not significantly correlated to CSDME. The review summarizes a multiple regression analysis revealed that MSHBP makes an addition to predictive factors for CSDME among risk factors reported previously in patient with T2DM.

  3. The clinical and cost-effectiveness of brief advice for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial

    Science.gov (United States)

    Crawford, Mike J; Sanatinia, Rahil; Barrett, Barbara; Byford, Sarah; Dean, Madeleine; Green, John; Jones, Rachael; Leurent, Baptiste; Sweeting, Michael J; Touquet, Robin; Greene, Linda; Tyrer, Peter; Ward, Helen; Lingford-Hughes, Anne

    2015-01-01

    Objectives To examine the clinical and cost-effectiveness of brief advice for excessive alcohol consumption among people who attend sexual health clinics. Methods Two-arm, parallel group, assessor blind, pragmatic, randomised controlled trial. 802 people aged 19 years or over who attended one of three sexual health clinics and were drinking excessively were randomised to either brief advice or control treatment. Brief advice consisted of feedback on alcohol and health, written information and an offer of an appointment with an Alcohol Health Worker. Control participants received a leaflet on health and lifestyle. The primary outcome was mean weekly alcohol consumption during the previous 90 days measured 6 months after randomisation. The main secondary outcome was unprotected sex during this period. Results Among the 402 randomised to brief advice, 397 (99%) received it. The adjusted mean difference in alcohol consumption at 6 months was −2.33 units per week (95% CI −4.69 to 0.03, p=0.053) among those in the active compared to the control arm of the trial. Unprotected sex was reported by 154 (53%) of those who received brief advice, and 178 (59%) controls (adjusted OR=0.89, 95% CI 0.63 to 1.25, p=0.496). There were no significant differences in costs between study groups at 6 months. Conclusions Introduction of universal screening and brief advice for excessive alcohol use among people attending sexual health clinics does not result in clinically important reductions in alcohol consumption or provide a cost-effective use of resources. Trial registration number Current Controlled Trials ISRCTN 99963322. PMID:24936090

  4. Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

    Directory of Open Access Journals (Sweden)

    L.F. Greca

    2012-03-01

    Full Text Available The objective of the present cross-sectional study was to assess the prevalence and the clinical and laboratory features of hepatitis C virus (HCV-positive patients with type 2 diabetes mellitus (DM attending either an outpatient clinic or hemodialysis units. Serologic-HCV testing was performed in 489 type 2 DM patients (303 outpatients and 186 on dialysis. A structured assessment of clinical, laboratory and DM-related complications was performed and the patients were then compared according to HCV infection status. Mean patient age was 60 years; HCV positivity (HCV+ was observed in 39 of 303 (12.9% outpatients and in 34 of 186 (18.7% dialysis patients. Among HCV+ patients, 32 were men (43.8%. HCV+ patients had higher serum levels of aspartate aminotransferase (0.90 ± 0.83 vs 0.35 ± 0.13 µKat/L, alanine aminotransferase (0.88 ± 0.93 vs 0.38 ± 0.19 µKat/L, gamma-glutamyl transferase (1.57 ± 2.52 vs 0.62 ± 0.87 µKat/L; P < 0.001, and serum iron (17.65 ± 6.68 vs 14.96 ± 4.72 µM; P = 0.011, and lower leukocyte and platelet counts (P = 0.010 and P < 0.001, respectively than HCV-negative (HCV- patients. HCV+ dialysis patients had higher diastolic blood pressure than HCV- patients (87.5 ± 6.7 vs 81.5 ± 6.0 mmHg; P = 0.005 and a lower prevalence of diabetic retinopathy (75 vs 92.7%; P = 0.007. In conclusion, our study showed that HCV is common among subjects with type 2 DM but is not associated with a higher prevalence of chronic diabetic complications.

  5. Prevalence of pelvic floor symptoms in female patients attending the two-week wait clinic with suspected colorectal cancer.

    Science.gov (United States)

    Bennett, J; Greenwood, A; Durdey, P; Glancy, D

    2016-07-01

    Introduction The aim of this study was to establish the prevalence of pelvic floor symptoms in women referred to a colorectal two-week wait (2WW) clinic with suspected colorectal cancer. Methods A questionnaire assessing faecal incontinence (FI) (Wexner score) and obstructed defecation syndrome (ODS) (Renzi score) was offered to 98 consecutive female patients attending a colorectal 2WW clinic at a single trust. Results Overall, 56 (57%) of the 98 patients had significant ODS and/or FI (scores >9/20), 33 (34%) had ODS and 40 (41%) had FI. Seventeen patients (17%) had both ODS and FI. Analysis of the 63 patients referred with a change in bowel habit (CIBH) showed 40 (63%) to be Renzi and/or Wexner positive compared with 16 (46%) of the 35 patients who presented without CIBH (p=0.095, Fisher's exact test). Further analysis showed that 31 (78%) of the 40 patients with FI presented with CIBH compared with 32 (55%) of the 58 without FI (p=0.032). In terms of ODS, 23 (70%) of the 33 patients with ODS presented with CIBH compared with 40 (62%) of the 65 without ODS (p=0.506). Conclusions Over half of the female patients attending our colorectal 2WW clinic had significant pelvic floor dysfunction (FI/ODS), which may account for their symptoms (especially in the CIBH referral category). While it is important for malignancy to be excluded, many patients may benefit from investigation and management of their pelvic floor dysfunction as the cause for their presenting symptoms.

  6. Attended With and Head-Turning Sign can be clinical markers of cognitive impairment in older adults.

    Science.gov (United States)

    Soysal, Pinar; Usarel, Cansu; Ispirli, Gul; Isik, Ahmet Turan

    2017-06-29

    Comprehensive neurocognitive assessment may not be performed in clinical practice, as it takes too much time and requires special training. Development of easily applicable, time-saving, and cost effective screening methods has allowed identifying the individuals that require further evaluation. The aim of present study was to assess the diagnostic value of the Attended With (AW) and Head-Turning Sign (HTS) for screening cognitive impairment (CI). Comprehensive geriatric assessment was performed in 529 elderly outpatients, and the presence or absence of AW and HTS was investigated in them all. Of the 529 patients, of whom the mean age was 75.67 ± 8.29 years, 126 patients were considered as CI (102 dementia, 24 mild CI). The patients with positive AW had significantly lower scores on Mini-Mental State Examination, Cognitive State Test, and Montreal Cognitive Assessment, and activities of daily living compared to AW (-) patients (p older adults attending the primary care settings with memory loss. Those with positive AW or HTS can be referred to the relevant centers for detailed cognitive assessment.

  7. Prevalence of Bacteriuria and Antimicrobial Susceptibility Patterns among Diabetic and Nondiabetic Patients Attending at Debre Tabor Hospital, Northwest Ethiopia

    Science.gov (United States)

    Derbie, Awoke; Adem, Yesuf; Biadglegne, Fantahun

    2017-01-01

    Background. Urinary tract infection is a major health problem especially in developing countries. Information about bacterial pathogens isolated from urinary tract infection in diabetic patients and their antimicrobial susceptibility patterns is limited in Ethiopia. Therefore, this study aimed at isolating bacterial pathogens and their antimicrobial susceptibility patterns. Methods. A hospital based comparative cross-sectional study was conducted at Debre Tabor. Urine sample was inoculated onto cysteine lysine electrolyte deficient (CLED) medium. Bacterial pathogens were identified using standard bacteriological methods. The data were cleaned and entered into SPSS version 20. P value less than 0.05 is considered statistically significant. Result. A total of 384 study participants were included in the study. Of them, 21 (10.9%) were from diabetics and 9 (4.7%) of them were from nondiabetics. Large proportion of gram positive bacteria at 18 (58.1%) were isolated compared to gram negatives at 13 (41.9%). Gram positive isolates were resistant to cotrimoxazole 10 (58.8%). Conclusion. The isolation rates of bacterial pathogens were higher in diabetic than nondiabetic patients. Bacteriuria was significantly associated with sex and type of diabetes. Multidrug resistance to two or more antibiotics was observed in 56.7% of bacterial isolates. Rational use of antimicrobial agent should be thought of to prevent the emergence of multidrug resistance.

  8. What Comes before Report Writing? Attending to Clinical Reasoning and Thinking Errors in School Psychology

    Science.gov (United States)

    Wilcox, Gabrielle; Schroeder, Meadow

    2015-01-01

    Psychoeducational assessment involves collecting, organizing, and interpreting a large amount of data from various sources. Drawing upon psychological and medical literature, we review two main approaches to clinical reasoning (deductive and inductive) and how they synergistically guide diagnostic decision-making. In addition, we discuss how the…

  9. Increases in Oral and Anal Sexual Exposure among Youth Attending STD Clinics in Baltimore, Maryland.

    OpenAIRE

    Gindi, Renee M.; Ghanem, Khalil G.; ERBELDING, EMILY J.

    2007-01-01

    We examined reports of receptive oral or anal sex among clinic patients age 12−25 over time. Odds of reporting oral sex were approximately three times higher in 2004 than in 1994; odds of anal sex were twice as high. Providers should be aware of increased risk behavior among young people.

  10. Prevalence of sexually transmitted infections among women attending antenatal clinics in Tanga, north eastern Tanzania

    DEFF Research Database (Denmark)

    Chiduo, M; Theilgaard, Z P; Bakari, V

    2012-01-01

    This study aimed to determine the prevalence of sexually transmitted infections (STIs) among HIV-infected and uninfected pregnant women in Tanga, Tanzania. Retrospective data on syphilis and HIV status during 2008-2010 were collected from antenatal clinic (ANC) records. Prospective data were...

  11. What Comes before Report Writing? Attending to Clinical Reasoning and Thinking Errors in School Psychology

    Science.gov (United States)

    Wilcox, Gabrielle; Schroeder, Meadow

    2015-01-01

    Psychoeducational assessment involves collecting, organizing, and interpreting a large amount of data from various sources. Drawing upon psychological and medical literature, we review two main approaches to clinical reasoning (deductive and inductive) and how they synergistically guide diagnostic decision-making. In addition, we discuss how the…

  12. Clinical characteristics,prognosis and indicators of glucose metabolism of liver cirrhosis complicated with diabetes

    Institute of Scientific and Technical Information of China (English)

    吴娟

    2013-01-01

    Objective To investigate clinical characteristics and outcome of patients with liver cirrhosis complicated with diabetes,and to explore the differences of clinical characteristics and prognosis between hepatogenous diabetes (HD) and type 2 diabetes mellitus (T2DM) .Methods From November 2010 to April 2012,246 patients with liver cirrhosis were collected and divided into liver cir-

  13. Brucella canis infection in dogs attended in veterinary clinics from patos, Paraíba state, Brazil

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    Annielle Regina Fonseca Fernandes

    2011-12-01

    Full Text Available To determine the frequency of anti-Brucella canis antibodies in dogs attended in veterinary clinics from Patos, Paraíba State, Brazil, as well as to identify risk factors and to isolate and identify the agent, 193 dogs were used. Agar gel immunodiffusion test (AGID was used to detect B. canis antibodies in sera. Isolation of B. canis was carried out in blood and bone marrow from seropositive animals. Six animals tested seropositive in AGID, resulting in a frequency of 3.11%. B. canis was isolated from bone marrow of one seropositive animal, with confirmation by PCR. Lack of cleaning of the dog's environment was identified as risk factor (odds ratio = 7.91. This is the first report of isolation of B. canis in dogs from the Northeast region of Brazil.

  14. Prevalence and predictors of Lymphogranuloma venereum in a high risk population attending a STD outpatients clinic in Italy

    Science.gov (United States)

    2014-01-01

    Background We evaluated LGV prevalence and predictors in a high risk population attending a STI Outpatients Clinic in the North of Italy. Methods A total of 108 patients (99 MSM and 9 women), with a history of unsafe anal sexual intercourses, were enrolled. Anorectal swabs and urine samples were tested for Chlamydia trachomatis (CT) DNA detection by Versant CT/GC DNA 1.0 Assay (Siemens Healthcare Diagnostics Terrytown, USA). RFLP analysis was used for CT molecular typing. Results L2 CT genotype was identified in 13/108 (12%) rectal swabs. All LGV cases were from MSM, declaring high-risk sexual behaviour and complaining anorectal symptoms. Patients first attending the STI Outpatient Clinic received a significant earlier LGV diagnosis than those first seeking care from general practitioners or gastroenterologists (P = 0.0046). LGV prevalence and characteristics found in our population are in agreement with international reports. Statistical analysis showed that LGV positive patients were older (P = 0.0008) and presented more STIs (P = 0.0023) than LGV negative ones, in particular due to syphilis (P < 0.001), HIV (P < 0.001) and HBV (P = 0.001). Multivariate logistic regression analysis revealed that HIV and syphilis infections are strong risk factors for LGV presence (respectively, P = 0.001 and P = 0.010). Conclusions Even if our results do not provide sufficient evidence to recommend routine screening of anorectal swabs in high-risk population, they strongly suggest to perform CT NAAT tests and genotyping on rectal specimens in presence of ulcerative proctitis in HIV and/or syphilis-positive MSM. In this context, CT DNA detection by Versant CT/GC DNA 1.0 Assay, followed by RFLP analysis for molecular typing demonstrated to be an excellent diagnostic algorithm for LGV identification. PMID:24716676

  15. Evaluation of risk factors in patients attending STI clinic in a tertiary care hospital in North India

    Science.gov (United States)

    Nayyar, Charu; Chander, Ram; Gupta, Poonam; Sherwal, B. L.

    2015-01-01

    Background: In the past few years, the interest in STDs and their management has increased tremendously because of their proven role in facilitation of HIV infection, which, in turn, also increases the risk of acquiring STIs. Sexually transmitted diseases (STDs) are a major health problem affecting mostly young people, not only in developing, but also in developed countries Male circumcision is being considered as strategy to reduce the burden of HIV/AIDS. Aims: (i) To screen the new patients attending the STI clinic for bacterial causes of STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis) and (ii) to evaluate the role of various risk factors in the prevalence of STIs. Materials and Methods: The present study was conducted on 200 patients attending the STI clinic. They were evaluated for the prevalence of HIV and bacterial STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis) along with the role of risk factors particularly circumcision. Results: The prevalence of HIV was 7% and prevalence of other STI was 20%. The causative agents were Chlamydia 8%, Gonorrhea 7.5%, Bacterial Vaginosis 2.7% and Syphilis 2%. Conclusion: The factors found to be significantly associated with the prevalence of STI were circumcision, positive HIV status, education, religion, multiple sexual partners, contact with Commercial sex workers (CSW), non use of contraception, profession involving long stay away from home, and past history of STI. The present study suggests that circumcision is a protective factor for acquisition of STIs but other factors like sexual behavior, use of barrier contraceptives, drug abuse etc., also play a role. PMID:26392654

  16. Prevalence and correlates of serostatus disclosure in HIV-infected adults attending the follow up and treatment clinic in Barbados.

    Directory of Open Access Journals (Sweden)

    Sheila Forde

    2007-04-01

    Full Text Available Objective: To determine the extent of disclosure and factors associated with disclosure of HIV status to sexual partners, we interviewed HIV infected adults attending the centralized HIV clinics seeking medical care for HIV. Methods: The subjects were patients who attended the LRU for primary care and treatment of their HIV infection during the three months period of this study enrolment. Patients were asked to participate in this study after initial clinical care was performed, in a 30-minute standardized interview concerning behavioral, medical, and social history. Results: The study patients had the following characteristics: female, 42.7%; male, 57.3%; singles, 84.5%; married, 11.8%. The median age of respondents was 35 years, and 66.4% were employed. Seventy nine percent were sexually active, and of these 72% had a steady sex partner and 61% had one or more casual partners. Over all 64 (58.2% of those interviewed, had disclosed their HIV status to significant others. Of the sixty three persons who had a steady partner 71.4% had self disclosed their HIV status to one or more steady partners. Of the fifty three persons who had one or more casual partners, 26.4% had self-disclosed their status to one or more casual partners. The most common reasons listed for nondisclosure to spouse or significant other were stigma/discrimination, fear of spread of information, rejection. Conclusion: Our findings suggest that both the knowing and unknowing sexual partners of HIV-infected persons continue to be at risk for HIV transmission.

  17. Evaluation of risk factors in patients attending STI clinic in a tertiary care hospital in North India

    Directory of Open Access Journals (Sweden)

    Charu Nayyar

    2015-01-01

    Full Text Available Background: In the past few years, the interest in STDs and their management has increased tremendously because of their proven role in facilitation of HIV infection, which, in turn, also increases the risk of acquiring STIs. Sexually transmitted diseases (STDs are a major health problem affecting mostly young people, not only in developing, but also in developed countries Male circumcision is being considered as strategy to reduce the burden of HIV/AIDS. Aims: (i To screen the new patients attending the STI clinic for bacterial causes of STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis and (ii to evaluate the role of various risk factors in the prevalence of STIs. Materials and Methods: The present study was conducted on 200 patients attending the STI clinic. They were evaluated for the prevalence of HIV and bacterial STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis along with the role of risk factors particularly circumcision. Results: The prevalence of HIV was 7% and prevalence of other STI was 20%. The causative agents were Chlamydia 8%, Gonorrhea 7.5%, Bacterial Vaginosis 2.7% and Syphilis 2%. Conclusion: The factors found to be significantly associated with the prevalence of STI were circumcision, positive HIV status, education, religion, multiple sexual partners, contact with Commercial sex workers (CSW, non use of contraception, profession involving long stay away from home, and past history of STI. The present study suggests that circumcision is a protective factor for acquisition of STIs but other factors like sexual behavior, use of barrier contraceptives, drug abuse etc., also play a role.

  18. Etiology and clinical characterization of respiratory virus infections in adult patients attending an emergency department in Beijing.

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    Xiaoyan Yu

    Full Text Available BACKGROUND: Acute respiratory tract infections (ARTIs represent a serious global health burden. To date, few reports have addressed the prevalence of respiratory viruses (RVs in adults with ARTIs attending an emergency department (ED. Therefore, the potential impact of respiratory virus infections on such patients remains unknown. METHODOLOGY/PRINCIPAL FINDINGS: To determine the epidemiological and clinical profiles of common and recently discovered respiratory viruses in adults with ARTIs attending an ED in Beijing, a 1-year consecutive study was conducted from May, 2010, to April, 2011. Nose and throat swab samples from 416 ARTI patients were checked for 13 respiratory viruses using multiple reverse transcription polymerase chain reaction(RT-PCR assays for common respiratory viruses, including influenza viruses (Flu A, B, and adenoviruses (ADVs, picornaviruses (PICs, respiratory syncytial virus (RSV, parainfluenza viruses (PIVs 1-3, combined with real-time RT-PCR for human metapneumovirus (HMPV and human coronaviruses (HCoVs, -OC43, -229E, -NL63, and -HKU1. Viral pathogens were detected in 52.88% (220/416 of patient samples, and 7.21% (30/416 of patients tested positive for more than one virus. PICs (17.79% were the dominant agents detected, followed by FluA (16.11%, HCoVs (11.78%, and ADV (11.30%. HMPV, PIVs, and FluB were also detected (<3%, but not RSV. The total prevalence and the dominant virus infections detected differed significantly between ours and a previous report. Co-infection rates were high for HCoV-229E (12/39, 30.76%, PIC (22/74, 29.73%, ADV (12/47, 25.53% and FluA (15/67, 22.39%. Different patterns of clinical symptoms were associated with different respiratory viruses. CONCLUSIONS: The pattern of RV involvement in adults with ARTIs attending an ED in China differs from that previously reported. The high prevalence of viruses (PIC, FluA, HCoVs and ADV reported here strongly highlight the need for the development of safe and

  19. Immunization Status of Young People Attending a Youth Clinic in Geneva, Switzerland.

    Science.gov (United States)

    Meynard, Anne; Genequand, Lydia Markham; Jeannot, Emilien; Wyler-Lazarevic, Claire-Anne; Cerutti, Bernard; Narring, Françoise

    2016-04-01

    Adolescent vaccination coverage is very variable in European countries and data are scarce. The aim of this study was to assess immunization status and analyze potential variations according to sociodemographic variables in a youth clinic in Geneva, Switzerland. Immunization status was assessed retrospectively: Tetanus (number of doses or in absence of data tetanus antibodies) and measles as indicators of childhood coverage as well as hepatitis B and human papillomavirus. All new patients (N = 390) of Geneva University Hospital's youth clinic were included between January 2010 and June 2011. Vaccine coverage was low for all vaccines regardless of sex or origin. 89% of young people tested (mostly recent immigrants with no available data) had tetanus antibodies indicating adequate childhood immunization but hepatitis B and HPV coverage was low especially in recent immigrants. Systematic assessment allows better adolescent vaccine coverage and can improve safety by avoiding unnecessary dosis.

  20. A clinical study of the relationship between diabetes mellitus and periodontal disease

    OpenAIRE

    Rajhans, Neelima S.; Ramesh M Kohad; Viren G Chaudhari; Nilkanth H Mhaske

    2011-01-01

    The relationship between diabetes mellitus and periodontal disease is not clear, even though studied intensively. From the available data, it seemed reasonable to believe that diabetics were more susceptible to periodontal disease than non.diabetics. Aim: The present study was to clinically evaluate the relationship of diabetes mellitus with periodontal disease along with various parameters. Materials and Methods: Fifteen hundred patients with diabetes mellitus were examined. A thorough oral ...

  1. Clinical management of concurrent diabetes and tuberculosis and the implications for patient services

    OpenAIRE

    Riza, Anca Lelia; Pearson, Fiona; Ugarte-Gil, Cesar; Alisjahbana, Bachti; van de Vijver, Steven; Panduru, Nicolae M; Hill, Philip C; Ruslami, Rovina; Moore, David; Aarnoutse, Rob; Critchley, Julia A.; van Crevel, Reinout

    2014-01-01

    Diabetes triples the risk for active tuberculosis, thus the increasing burden of type 2 diabetes will help to sustain the present tuberculosis epidemic. Recommendations have been made for bidirectional screening, but evidence is scarce about the performance of specific tuberculosis tests in individuals with diabetes, specific diabetes tests in patients with tuberculosis, and screening and preventive therapy for latent tuberculosis infections in individuals with diabetes. Clinical management o...

  2. MEDICINAL HERBS USED BY CLIENTS ATTENDING CLINICAL UNITS OF SANTA MARCELINA, PORTO VELHO RO BRAZIL

    OpenAIRE

    Caetano, Rosemeiry Soares; FACULDADE SÃO LUCAS; de Souza, Ana Cristina Ramos; FACULDADE SÃO LUCAS; Feitoza, Leiliane Ferreira; FACULDADE SÃO LUCAS

    2014-01-01

    Many people are currently using medicinal herbs as a therapeutic alternative. Current paper tries to recover and analyze popular lore on the use of medicinal plants to cure diseases. Methodology consists of data collection by interviews with clients of clinical units of the Santa Marcelina Community in Porto Velho RO Brazil. Seventy-nine species and 46 botanic families were identified with special reference to Asteraceae and Lamiaceae with 10 and 8 species each. The most mentioned species wer...

  3. Clinical and epidemiological profile of leprosy patients attended at Ceará, 2007-2011*

    Science.gov (United States)

    Queirós, Maria Iranilda; Ramos Júnior, Alberto Novaes; Alencar, Carlos Henrique Morais; Monteiro, Lorena Dias; Sena, Amanda Lima; Barbosa, Jaqueline Caracas

    2016-01-01

    Background Leprosy is an infectious chronic condition associated with potentially serious physical, social and psychological impacts. Objectives To characterize the clinical and epidemiological profile of leprosy patients treated from 2007 to 2011 in the University Hospital of Ceará, Northeastern Brazil. Methods This is a retrospective and descriptive study. The study population consisted of residents in the state of Ceará treated in a dermatology clinic between 2007-2011. Clinical and epidemiological data analyzed were obtained from medical records and from the database of national Information System for Notifiable Diseases. Results 475 cases were analyzed, mostly women (51.8%), aged 45-59 years (35.0%) - mean of 45.2 years at diagnosis - with 6.3% of children under 15 , with low education (73.7%), white color (68.8%), residency in the city of Fortaleza (82.3%), and no defined work occupation (59.6%). At diagnosis, most patients were multibacillary (MB) (65.5%), had borderline clinical form (48.0%), and 22.7% had physical disability (8.0% with grade 2), predominantly in MB cases (p <0.001). We observe worsening of disability in 5.1% of cases post-MDT. The proportion of cases with reactional episodes was 42.7%, mainly during MDT (51.2%). Conclusion This is the first study conducted in this hospital context, revealing late diagnosis, high burden of disease, hidden endemicity, and high social vulnerability in the state of Ceará. This study reinforces the need to strengthen health care network for timely diagnosis and treatment, aiming at longitudinality of assistance. PMID:27438198

  4. Sociodemographic and Clinical Characteristics of Patients attending Psychotherapy in a Tertiary Care Hospital in Oman

    Directory of Open Access Journals (Sweden)

    Zena Al-Sharbati

    2012-02-01

    Full Text Available Objectives: There is significant evidence that psychotherapy is a pivotal treatment for persons diagnosed with Axis I clinical psychiatric conditions; however, a psychotherapy service has only recently been established in the Omani health care system. This study aimed to investigate the sociodemographic and clinical characteristics of attendees at a psychotherapy clinic at a tertiary care hospital. Methods: An analysis was carried out of 133 new referrals to the Psychotherapy Service at Sultan Qaboos University Hospital, a tertiary care hospital. Results: The majority of referrals were females (59%, aged 18–34 years, employed (38%, had ≤12 years of formal education (51%, and were single (54%. A total of 43% were treated for anxiety disorders (including obsessive compulsive disorder, while 22% were treated for depression. A total of 65% were prescribed psychotropic medications. The utilisation of the Psychotherapy Service and its user characteristics are discussed within the context of a culturally diverse Omani community which has unique personal belief systems such as in supernatural powers (Jinn, contemptuous envy (Hassad, evil eye (Ain and sorcery (Sihr which are often used to explain the aetiology of mental illness and influence personal decisions on utilising medical and psychological treatments. Conclusion: Despite the low number of referrals to the Psychotherapy Service, there is reason to believe that psychotherapy would be an essential tool to come to grips with the increasing number of mental disorders in Oman.

  5. Sociodemographic and Clinical Characteristics of Patients attending Psychotherapy in a Tertiary Care Hospital in Oman.

    Science.gov (United States)

    Al-Sharbati, Zena; Hallas, Claire; Al-Zadjali, Hazar; Al-Sharbati, Marwan

    2012-02-01

    There is significant evidence that psychotherapy is a pivotal treatment for persons diagnosed with Axis I clinical psychiatric conditions; however, a psychotherapy service has only recently been established in the Omani health care system. This study aimed to investigate the sociodemographic and clinical characteristics of attendees at a psychotherapy clinic at a tertiary care hospital. An analysis was carried out of 133 new referrals to the Psychotherapy Service at Sultan Qaboos University Hospital, a tertiary care hospital. The majority of referrals were females (59%), aged 18-34 years, employed (38%), had ≤12 years of formal education (51%), and were single (54%). A total of 43% were treated for anxiety disorders (including obsessive compulsive disorder), while 22% were treated for depression. A total of 65% were prescribed psychotropic medications. The utilisation of the Psychotherapy Service and its user characteristics are discussed within the context of a culturally diverse Omani community which has unique personal belief systems such as in supernatural powers (Jinn), contemptuous envy (Hassad), evil eye (Ain) and sorcery (Sihr) which are often used to explain the aetiology of mental illness and influence personal decisions on utilising medical and psychological treatments. Despite the low number of referrals to the Psychotherapy Service, there is reason to believe that psychotherapy would be an essential tool to come to grips with the increasing number of mental disorders in Oman.

  6. Cervical Cancer Screening Knowledge and Behavior among Women Attending an Urban HIV Clinic in Western Kenya.

    Science.gov (United States)

    Rosser, Joelle I; Njoroge, Betty; Huchko, Megan J

    2015-09-01

    Cervical cancer is a highly preventable disease that disproportionately affects women in developing countries and women with HIV. As integrated HIV and cervical cancer screening programs in Sub-Saharan Africa mature, we have an opportunity to measure the impact of outreach and education efforts and identify areas for future improvement. We conducted a cross-sectional survey of 106 women enrolled in care at an integrated HIV clinic in the Nyanza Province of Kenya 5 years after the start of a cervical cancer screening program. Female clinic attendees who met clinic criteria for cervical cancer screening were asked to complete an oral questionnaire assessing their cervical cancer knowledge, attitudes, and screening history. Ninety-nine percent of women had heard of screening, 70 % felt at risk, and 84 % had been screened. Increased duration of HIV diagnosis was associated with feeling at risk and with a screening history. Nearly half (48 %) of women said they would not get screened if they had to pay for it.

  7. Clinical utility and tolerability of linagliptin in diabetic patients

    Directory of Open Access Journals (Sweden)

    Maxwell LG

    2013-03-01

    Full Text Available Lauralee Gordon Maxwell,1 M Shawn McFarland1,21Department of Veterans Affairs, TN Valley Healthcare System, Murfreesboro, 2The University of Tennessee Department of Clinical Pharmacy, Memphis, TN, USABackground: The purpose of this paper is to review the efficacy, safety, and tolerability of linagliptin in the management of hyperglycemia in adults with type 2 diabetes mellitus.Methods: A Medline search was performed using the keywords “linagliptin” and “type 2 diabetes” for articles published September 2010 through July 2012. The literature search was limited by the following criteria: articles' publication in the English language, clinical trials, randomized controlled trials, and research conducted in humans.Results: A review of the data for linagliptin in the treatment of type 2 diabetes as monotherapy or in combination with other antidiabetic therapies suggests clinical efficacy in terms of reductions in glycosylated hemoglobin, fasting plasma glucose, and postprandial glucose. Most adverse events with linagliptin are considered to be mild to moderate in nature. Although linagliptin therapy may offer a low risk of hypoglycemia, the risk increases when it is used in combination with insulin secretagogues. Linagliptin can generally be considered weight neutral, but a weight increase was observed when linagliptin was used in combination with a thiazolidinedione.Conclusion: Linagliptin is a once-daily oral medication used for the treatment of type 2 diabetes. The use of linagliptin as monotherapy or in combination with metformin, sulfonylureas, or pioglitazone led to improvement in glycemic control and was well tolerated by most patients.Keywords: type 2 diabetes, linagliptin, dipeptidyl peptidase-4 inhibitor

  8. [Sexual behavior characteristics of clients attending the Israel AIDS Task Force anonymous clinic in Tel Aviv].

    Science.gov (United States)

    Bar-On, Yaeli; Perry, Zvi H; Nof, Einav; Shiber, Asher; Risenberg, Klaris; Ben Zion, Itzhak

    2014-09-01

    Until now, research on sexual behavior and HIV in Israel has been carried out mainly on the general population, and focused primarily on defining populations at risk, without adequate consideration given to the reasons bringing these populations to be tested, and their specific sexual behaviors. In Israel, one can choose whether to take an HIV test in confidential centers (giving one's name under medical confidentiality) or in anonymous centers (Israel AIDS Task Force in Tel Aviv and Beer Sheva, Levinsky Clinic in Tel Aviv and Haparsim Clinic in Haifa]. At least 21% of the clients of the anonymous testing centers in Israel belong to a high risk population in contrast to 2.6% in confidential clinics, and so, in this study, we hypothesize that characterization of sexual behavior patterns in anonymous testing centers might enable us to better characterize sexual behavior patterns in high risk populations. In this cross-sectional study, we used questionnaires distributed in the clinics by the Israel AIDS Task Force in order to characterize their clinic's clients. The questionnaires were completed by the Israel AIDS Task Force consultants during the consultation period at which the anonymous test was performed. Data collected included: gender, age, testing history, specific sexual behaviors and reasons for applying for the current test. A total of 926 questionnaires were collected; 29.9% of them were of female patients. The average age was 29.47 years (1±8.66]; 21.3% of the clients were men who have sex with men [MSM]; only 2.3% of the clients belonged to other high risk populations. In all groups, the majority of the patients reported high risk sexual behavior (any sexual contact without a condom) and the average age for the first test was much higher than the average age of first sexual intercourse common in Israel. Women reported more participation in unprotected vaginal intercourse than heterosexual men, and a substantial part of MSM reported performing unprotected

  9. Updates on the Clinical Trials in Diabetic Macular Edema.

    Science.gov (United States)

    Demirel, Sibel; Argo, Colby; Agarwal, Aniruddha; Parriott, Jacob; Sepah, Yasir Jamal; Do, Diana V; Nguyen, Quan Dong

    2016-01-01

    In this era of evidence-based medicine, significant progress has been made in the field of pharmacotherapeutics for the management of diabetic macular edema (DME). A. number of landmark clinical trials have provided strong evidence of the safety and efficacy of agents such as anti-vascular endothelial growth factors for the treatment of DME. Decades of clinical research, ranging from the early treatment of diabetic retinopathy study to the present-day randomized clinical trials (RCTs) testing novel agents, have shifted the goal of therapy from preventing vision loss to ensuring a maximum visual gain. Systematic study designs have provided robust data with an attempt to optimize the treatment regimens including the choice of the agent and timing of therapy. However, due to a number of challenges in the management of DME with approved agents, further studies are needed. For the purpose of this review, an extensive database search in English language was performed to identify prospective, RCTs testing pharmacological agents for DME. In order to acquaint the reader with the most relevant data from these clinical trials, this review focuses on pharmacological agents that are currently approved or have widespread applications in the management of DME. An update on clinical trials presently underway for DME has also been provided.

  10. The prevalence of refractive conditions in Puerto Rican adults attending an eye clinic system.

    Science.gov (United States)

    Rodriguez, Neisha M; Romero, Angel F

    2014-01-01

    To determine the prevalence of refractive conditions in the adult population that visited primary care optometry clinics in Puerto Rico. A retrospective cross-sectional study of patients examined at the Inter American University of Puerto Rico School of Optometry Eye Institute Clinics between 2004 and 2010. Subjects considered had best corrected visual acuity by standardized subjective refraction of 20/40 or better. The refractive errors were classified by the spherical equivalent (SE): sphere+½ cylinder. Myopia was classified as a SE>-0.50D, hyperopia as a SE>+0.50 D, and emmetropia as a SE between -0.50 and +0.50, both included. Astigmatism equal or higher than 0.25 D in minus cylinder form was used. Patients with documented history of cataract extraction (pseudophakia or aphakia), amblyopia, refractive surgery or other corneal/ocular surgery were excluded from the study. A total of 784 randomly selected subjects older than 40 years of age were selected. The estimated prevalence (95%, confidence interval) among all subjects was hyperopia 51.5% (48.0-55.0), emmetropia 33.8% (30.5-37.2), myopia 14.7% (12.1-17.2) and astigmatism 69.6% (68.8-73.3). Hyperopia was more common in females than males although the difference was not statistically significant. The mean spherical equivalent values was hyperopic until 70 y/o and decreased slightly as the population ages. Hyperopia is the most common refractive error and its prevalence and seems to increase among the aging population who visited the clinics. Further programs and studies must be developed to address the refractive errors needs of the adult Puerto Rican population. Copyright © 2012 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  11. Refractive errors among children, adolescents and adults attending eye clinics in Mexico

    Science.gov (United States)

    Gomez-Salazar, Francisco; Campos-Romero, Abraham; Gomez-Campaña, Humberto; Cruz-Zamudio, Cinthia; Chaidez-Felix, Mariano; Leon-Sicairos, Nidia; Velazquez-Roman, Jorge; Flores-Villaseñor, Hector; Muro-Amador, Secundino; Guadron-Llanos, Alma Marlene; Martinez-Garcia, Javier J.; Murillo-Llanes, Joel; Sanchez-Cuen, Jaime; Llausas-Vargas, Alejando; Alapizco-Castro, Gerardo; Irineo-Cabrales, Ana; Graue-Hernandez, Enrique; Ramirez-Luquin, Tito; Canizalez-Roman, Adrian

    2017-01-01

    AIM To assess the proportion of refractive errors in the Mexican population that visited primary care optometry clinics in fourteen states of Mexico. METHODS Refractive data from 676 856 patients aged 6 to 90y were collected from optometry clinics in fourteen states of Mexico between 2014 and 2015. The refractive errors were classified by the spherical equivalent (SE), as follows: sphere+½ cylinder. Myopia (SE>-0.50 D), hyperopia (SE>+0.50 D), emmetropia (-0.50≤SE≤+0.50), and astigmatism alone (cylinder≥-0.25 D). A negative cylinder was selected as a notation. RESULTS The proportion (95% confidence interval) among all of the subjects was hyperopia 21.0% (20.9-21.0), emmetropia 40.7% (40.5-40.8), myopia 24.8% (24.7-24.9) and astigmatism alone 13.5% (13.4-13.5). Myopia was the most common refractive error and frequency seemed to increase among the young population (10 to 29 years old), however, hyperopia increased among the aging population (40 to 79 years old), and astigmatism alone showed a decreasing trend with age (6 to 90y; from 19.7% to 10.8%). There was a relationship between age and all refractive errors (approximately 60%, aged 50 and older). The proportion of any clinically important refractive error was higher in males (61.2%) than in females (58.3%; P<0.0001). From fourteen states that collected information, the proportion of refractive error showed variability in different geographical areas of Mexico. CONCLUSION Myopia is the most common refractive error in the population studied. This study provides the first data on refractive error in Mexico. Further programs and studies must be developed to address the refractive errors needs of the Mexican population. PMID:28546940

  12. Refractive errors among children, adolescents and adults attending eye clinics in Mexico

    Directory of Open Access Journals (Sweden)

    Francisco Gomez-Salazar

    2017-05-01

    Full Text Available AIM: To assess the proportion of refractive errors in the Mexican population that visited primary care optometry clinics in fourteen states of Mexico. METHODS: Refractive data from 676 856 patients aged 6 to 90y were collected from optometry clinics in fourteen states of Mexico between 2014 and 2015. The refractive errors were classified by the spherical equivalent (SE, as follows: sphere+½ cylinder. Myopia (SE>-0.50 D, hyperopia (SE>+0.50 D, emmetropia (-0.50≤SE≤+0.50, and astigmatism alone (cylinder≥-0.25 D. A negative cylinder was selected as a notation. RESULTS: The proportion (95% confidence interval among all of the subjects was hyperopia 21.0% (20.9-21.0, emmetropia 40.7% (40.5-40.8, myopia 24.8% (24.7-24.9 and astigmatism alone 13.5% (13.4-13.5. Myopia was the most common refractive error and frequency seemed to increase among the young population (10 to 29 years old, however, hyperopia increased among the aging population (40 to 79 years old, and astigmatism alone showed a decreasing trend with age (6 to 90y; from 19.7% to 10.8%. There was a relationship between age and all refractive errors (approximately 60%, aged 50 and older. The proportion of any clinically important refractive error was higher in males (61.2% than in females (58.3%; P<0.0001. From fourteen states that collected information, the proportion of refractive error showed variability in different geographical areas of Mexico. CONCLUSION: Myopia is the most common refractive error in the population studied. This study provides the first data on refractive error in Mexico. Further programs and studies must be developed to address the refractive errors needs of the Mexican population.

  13. Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia

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    Ataur R Khan

    2012-01-01

    Full Text Available Purpose: The purpose of the study was to measure the rate of non-compliance and the factors contributing to non-compliance among the diabetic patients in the Al Hasa region of Saudi Arabia. Materials and Methods: A cross-sectional survey was conducted in the Al Hasa region during the period of June 2010 to June 2011. Random sampling was carried out for the selection of 535 diabetic patients from three chronic disease centers in different parts of Al Hasa. The data were collected by means of interviewing questionnaires and file records. Any patient who had been prescribed optimum treatment and was properly advised on diet and exercise for his / her diabetes, but did not follow the medical advice, with Hb1AC of more than 7% at the time of interview, was considered as non-compliant. Results: The overall prevalence of therapeutic non-compliance of the participants was 67.9% (n = 318, 95% CI 63.59 - 72.02%. The non-compliance of males (69.34% was higher than females (65.45%, P = .003. The non-compliance among the urban participants was significantly higher than (71.04 vs. 60.15%, P = .023 in the rural participants. There was a statistically significant difference in the prevalence rate of non-compliance among the participants with different levels of education. Factors found to be significantly associated with non-compliance on bi-variate analysis were: female gender (OR = 1.90, CI =1.32-4.57,level of education (Illiteracy (OR = 5.27, CI = 4.63 - 7.19, urban population (OR =5.22, CI= 3.65 - 8.22, irregularity of the follow-up (OR = 8.41, CI = 4.90 - 11.92, non-adherence to drug prescription (OR = 4.55 , CI = 3.54 - 5.56, non-adherence to exercise regimen (OR = 5.55, CI = 4.2 6 - 6., insulin (OR = 1.29, CI = .71 - 1.87, and insulin with oral Metformin (OR = 1.20, CI = .65 - 1.75. Conclusion: The findings indicate that there is a high rate of non-compliance among the diabetes patients in the Al Hasa region of Saudi Arabia and there is a definite need

  14. Overweight and obesity among patients attending a Nigerian oral surgery clinic: implications for oral surgical practice in Nigeria.

    Science.gov (United States)

    Adeyemo, W L; Bamgbose, B O; Ogunlewe, M O; Ladeinde, A L; Taiwo, O A

    2010-03-01

    To determine the prevalence of overweight and obesity among patients attending oral and maxillofacial outpatient clinic of the Lagos University Teaching Hospital, Nigeria; and discuss the clinical and surgical implications that obesity has on the delivery of oral and maxillofacial surgical and anaesthetic care. Consecutive patients presenting to the oral and maxillofacial surgery outpatient clinic at the Lagos University Teaching Hospital, Nigeria over a 4-month period (May-August 2004) were screened for age, sex, height and weight. All of the patients were treated for dentoalveolar surgical procedures (routine and surgical extractions), incisional and excisional biopsies, and enucleation under local anaesthesia. The BMIs of the studied patients ranged from 16.7 to 39.8 kg/m(2), with a mean of 24.6 +/- 4.5 kg/m(2). Prevalence of excess weight was 39.1%. Thirty-one (11.4%) patients were obese and 75 (27.7%) patients were overweight. A significant difference was observed in the BMIs of male and female patients (P=0.000). The age groups oral and maxillofacial outpatient setting was 39.1%. Oral and maxillofacial surgeon needs to be aware of obesity-/overweight-related medical and surgical issues and take them into consideration when treating these patients.

  15. Prevalence of Trichomonas vaginalis by PCR in men attending a primary care urology clinic in South Korea.

    Science.gov (United States)

    Seo, Jun-Hyeok; Yang, Hye-Won; Joo, So-Young; Song, Su-Min; Lee, Yu-Ran; Ryu, Jae-Sook; Yoo, Eun Sang; Lee, Won Kee; Kong, Hyun-Hee; Lee, Sang-Eun; Lee, Won-Ja; Goo, Youn-Kyoung; Chung, Dong-Il; Hong, Yeonchul

    2014-10-01

    Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic nongonococcal urethritis and chronic prostatitis in men. Despite the availability of highly sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea.

  16. Depression literacy in women attending university hospital clinics in Riyadh Saudi Arabia.

    Science.gov (United States)

    Siddiqui, Amna Rehana; Mahasin, Sarah; Alsajjan, Roa; Hassounah, Marwah; Alhalees, Zeinah; AlSaif, Norah; Alosaimi, Fahad D; AlQuaiz, AlJohara

    2017-03-01

    Depression literacy in general population constitutes an ability to understand depression, with knowledge of disease, its risk factors and symptoms. High levels of depression literacy promote early intervention, potentially reducing related disability. This study investigated the depression literacy in women visitors to clinics of a tertiary care hospital in Riyadh, Saudi Arabia. Women of 18 and more years were surveyed during their visit to primary and other healthcare clinics of a public hospital in Riyadh. Knowledge on depression symptoms, causes and management approaches identified depression literate women scoring more than 30 points on a 42-item tool. Of the 409 participants, 65.5% were depression literate, 50% educated as college and above, 64.3% married, 50.7% housewives, 62.4% reported use of multiple information sources (range, 0-8) and had a mean age of 34.9 (standard deviation ( SD), 12.4) years. In a logistic regression model, participants scoring less than 30 for depression literacy were significantly associated with women having less than college-level education, divorced marital status and use of decreasing number of learning resources. Women with low education divorced; using fewer information sources need specific considerations by healthcare providers for assessment of depressive disorders in this setting.

  17. STUDY OF CLINICAL AND ENDOCRINE PROFILE OF PATIENTS WITH PITUITARY TUMOURS ATTENDING A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Binoy Kumar Mohanty

    2016-07-01

    Full Text Available BACKGROUND Pituitary tumours are relatively common endocrine tumours. They can present with symptoms related to hormone excess or hormone deficiency. They can also present with compressive symptoms like visual problems and headache. OBJECTIVE To study the various clinical presentations and endocrine profile of patients presenting with pituitary tumours to a tertiary care hospital. DESIGN Cross sectional study. MATERIAL AND METHODS We collected and analysed the clinical data including hormonal status of 33 consecutive patients who presented to our department from March 2014 to February 2016 for evaluation of pituitary tumours. RESULTS Majority of the subjects studied belonged to 40-50 years group (33.34%.The most common type of pituitary tumour in our population was non-functioning pituitary tumours (45.45%. The next common cause was somatotroph adenoma (27.27% followed by prolactinoma (15.15% and corticotroph adenomas (12.13%. There was significant male predominance (60.60% among total cases. Among all patients, headache (54.54% was most common presentation followed by features related to hormone excess (51.51%. CONCLUSIONS Pituitary tumours can present with variety of symptoms. A detailed endocrine workup is essential in each case to reach at correct diagnosis. In our cohort, non-functioning pituitary tumour was the most common tumour subtype.

  18. Oral manifestations of HIV/AIDS in clients attending TASO clinics in Uganda.

    Science.gov (United States)

    Tirwomwe, J F; Rwenyonyi, C M; Muwazi, L M; Besigye, B; Mboli, F

    2007-09-01

    The objective of the study is to establish the prevalence of oral manifestations and their influence on oral functions. A total of 514 subjects aged 18 to 58 years (mean 42 years) were randomly recruited from five The AIDS Support Organization (TASO) clinics in Uganda. They were clinically examined for oral lesions under field conditions by four trained dentists based on World Health Organization criteria. Women constituted 74.5% of the study population. Oral manifestations were recorded in 72% of the subjects, out of which 70% had candidiasis of pseudomembranous, erythematous, and angular cheilitis variants. Non-Hodgkin's lymphoma, atypical ulcers, necrotizing periodontitis, and hairy leucoplakia were least frequently observed in the subjects. Of those who had oral lesions (n = 370), 68.4% had some form of discomfort in the mouth. Tooth brushing, chewing, and swallowing were frequently associated with discomfort. Reported forms of discomfort were dry mouth, increased salivation, and burning sensation especially on taking salty and spicy foods or acidic drinks. Only 8.5% (n = 44) of the subjects were taking medications specifically for oral lesions, which included antifungal, antiviral, and antibacterial agents. None of the subjects were on antiretroviral therapy. Oral lesions associated with human immunodeficiency virus/acquired immunodeficiency syndrome in TASO clients is a major public health problem requiring education in recognition and appropriate management.

  19. Subtypes of chronic urticaria in patients attending allergy clinics in Venezuela.

    Science.gov (United States)

    Sánchez-Borges, M; Caballero-Fonseca, F; Capriles-Hulett, A

    2014-11-01

    Chronic urticaria (CU) is one of the most puzzling clinical entities confronted by the medical profession. It is a common motive for consultation, and in a sizable proportion of patients no identifiable cause is evident. Since there are relatively few publications regarding CU in developing countries, we performed a prospective 3-year study on the demographic and clinical features of patients with CU. Four hundred and twenty-three subjects were studied, 52 children and 371 adults, 295 females (69.7%), with a mean age of 38.4 ± 17.8 years. More often, wheals and angioedema (AE) were present on the head, upper and lower limbs and the trunk. AE was present in 162 patients (38.4%). The most frequent subtypes were chronic spontaneous urticaria, aspirin-exacerbated cutaneous disease, dermographic urticaria, and combinations of various subtypes. A better understanding of the characteristics of patients suffering CU is helpful for clinicians dealing with this ailment, and provides guidance for new investigations on its pathogenesis, which will hopefully result in a better management of this vexing condition.

  20. A standardized clinical evaluation of phenotypic diversity in diabetic polyneuropathy.

    Science.gov (United States)

    Scholz, Joachim; Rathmell, James P; David, William S; Chad, David A; Broderick, Alithia C; Perros, Stephen G; Shin, Naomi S; Wells, Jenna L; Davis, John B; DiMaggio, Charles J; Wang, Shuang; Tate, Simon N

    2016-10-01

    Diabetic polyneuropathy (DPN) is a major cause of neuropathic pain and a frequent target condition in analgesic treatment trials. Differences in the clinical symptoms and signs associated with DPN suggest distinct pathophysiological mechanisms underlying nerve damage and dysfunction that are likely to have therapeutic relevance. The aim of this study was to develop a tool for the bedside assessment of painful neuropathies such as DPN that captures the diversity of phenotypes. Sixty-one patients with type 2 diabetes and painful neuropathy, 19 patients with painless DPN, 25 patients with type 2 diabetes but no clinical evidence of neuropathy, and 20 healthy control subjects completed a structured interview (47 items) and a standardized physical examination (39 items). After analyzing critical features of pain and painless symptoms and examining the outcome of physical tests of sensory function, we determined principal components of the phenotypic variance among patients. Increased sensitivity to mechanical or thermal stimuli and, to a lesser extent, the sensory quality of pain or paresthesia were the most discriminating elements of DPN phenotypes. Correlation patterns of symptoms and signs indicated the involvement of functionally distinct nerve fiber populations. We combined interview questions and physical tests identifying these differences in a shortened assessment protocol that we named Standardized Evaluation of Pain and Somatosensory Function (StEPS). The protocol StEPS generates a phenotypic profile of patients with neuropathy. Separate intensity ratings for spontaneous painful symptoms and pain evoked by standard stimuli support a detailed documentation of neuropathic pain and its response to analgesic treatment.

  1. Clinical risk factors, DNA variants, and the development of type 2 diabetes

    DEFF Research Database (Denmark)

    Lyssenko, Valeriya; Jonsson, Anna Elisabet; Almgren, Peter;

    2008-01-01

    Type 2 diabetes mellitus is thought to develop from an interaction between environmental and genetic factors. We examined whether clinical or genetic factors or both could predict progression to diabetes in two prospective cohorts.......Type 2 diabetes mellitus is thought to develop from an interaction between environmental and genetic factors. We examined whether clinical or genetic factors or both could predict progression to diabetes in two prospective cohorts....

  2. Dyslipidemia and cardiovascular disease risk profiles of patients attending an HIV treatment clinic in Harare, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Zhou DT

    2015-05-01

    Full Text Available Danai Tavonga Zhou,1,2 Vitaris Kodogo,1 Kudzai Fortunate Vongai Chokuona,1 Exnevia Gomo,1 Olav Oektedalen,3 Babill Stray-Pedersen21Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Avondale, Zimbabwe; 2Institute of Clinical Medicine, University in Oslo, Oslo University Hospital, Oslo, Norway; 3Department of Infectious Diseases, Oslo University Hospital, Oslo, NorwayAbstract: The chronic inflammation induced by human immunodeficiency virus (HIV contributes to increased risk of coronary heart disease (CHD in HIV-infected individuals. HIV-infected patients generally benefit from being treated with antiretroviral drugs, but some antiretroviral agents have side effects, such as dyslipidemia and hyperglycemia. There is general consensus that antiretroviral drugs induce a long-term risk of CHD, although the levels of that risk are somewhat controversial. The intention of this cross-sectional study was to describe the lipid profile and the long-term risk of CHD among HIV-positive outpatients at an HIV treatment clinic in Harare, Zimbabwe. Two hundred and fifteen patients were investigated (females n=165, mean age 39.8 years; males n=50; mean age 42.0 years. Thirty of the individuals were antiretroviral-naïve and 185 had been on antiretroviral therapy (ART for a mean 3.9±3.4 years. All participants had average lipid and glucose values within normal ranges, but there was a small difference between the ART and ART- for total cholesterol (TC and high-density lipoprotein (HDL.Those on a combination of D4T or ZDV/NVP/3TC and PI-based ART were on average oldest and had the highest TC levels. Framingham risk showed 1.4% prevalence of high CHD risk within the next ten years. After univariate analysis age, sex, TC/HDL ratio, HDL, economic earnings and systolic BP were associated with medium to high risk of CHD. After multivariate regression analysis and adjusting for age or sex only age, sex and economic earnings

  3. The prevalence of enterobiasis in children attending mobile health clinic of Huachiew Chalermprakiet University.

    Science.gov (United States)

    Nithikathkul, C; Changsap, B; Wannapinyosheep, S; Poister, C; Boontan, P

    2001-01-01

    A cross sectional survey of Enterobius vermicularis was carried out in 808 children in the Bangkok metropolis and nearby provinces. This was accomplished in a mobile health clinic from Huachiew Chalermprakiet University provided for communities in the areas during April 1999 to May 2000. Children 5-10 years of age were investigated for infestation of Enterobius vermicularis. Diagnosis was done by means of the transparent tape swab technique to recover eggs in the perianal region for examination under a light microscope. The average infection rate in children was 21.91%. The highest infection rate (38.59%) was found in Ang Thong Province, while the lowest one (11.66%) was found in Chonburi Province. The rate of infection seemed to relate to household environmental factors. The infection rate was significantly higher (p0.05) in the incidence of infection between males and females.

  4. Breast self-examination practices in Nigerian women attending a tertiary outpatient clinic

    Directory of Open Access Journals (Sweden)

    A M Ogunbode

    2015-01-01

    Full Text Available BACKGROUND: The morbidity and mortality caused by breast cancer can be decreased by early detection with breast self-examination (BSE. The objective of this study was to determine the prevalence and the factors determining the practice of BSE. MATERIALS AND METHODS: The study was conducted on 140 women aged above 18 years who presented consecutively in a General Outpatient's clinic in a tertiary hospital in Nigeria. This was the baseline study from an intervention study which looked at the effect of demonstration of BSE on improving Clinical Breast Examination (CBE among two groups of respondents. Structured questionnaires were validated and administered by an interviewer and the data were analyzed using Statistical Package for Social Sciences (SPSS version 12. RESULTS: The overall self-reported prevalence of BSE practice was 62.1% among the respondents. Older women (16, 76.2%, married women (63, 65.6% and women with tertiary education (51, 68.9% had the highest prevalence of BSE practice. Prevalence rate was highest for civil servant (25, 78.1%, P = 0.04. The practice of BSE was higher among women with a previous history of breast disease (15, 68.2% and in respondents with a family history of breast disease (7, 63.6%, Only 11 (12.6% performed BSE as per guidelines, which was once in a month. CONCLUSION: The prevalence of BSE was found to be high, especially in those with tertiary education and in those with a past personal or family history of breast disease. In resource-constrained countries, BSE is a screening tool that can be employed to help reduce the breast cancer burden because routine mammography screening is not yet feasible. Women need to be informed about the when and how to perform BSE.

  5. Dyslipidemia and cardiovascular disease risk profiles of patients attending an HIV treatment clinic in Harare, Zimbabwe.

    Science.gov (United States)

    Zhou, Danai Tavonga; Kodogo, Vitaris; Chokuona, Kudzai Fortunate Vongai; Gomo, Exnevia; Oektedalen, Olav; Stray-Pedersen, Babill

    2015-01-01

    The chronic inflammation induced by human immunodeficiency virus (HIV) contributes to increased risk of coronary heart disease (CHD) in HIV-infected individuals. HIV-infected patients generally benefit from being treated with antiretroviral drugs, but some antiretroviral agents have side effects, such as dyslipidemia and hyperglycemia. There is general consensus that antiretroviral drugs induce a long-term risk of CHD, although the levels of that risk are somewhat controversial. The intention of this cross-sectional study was to describe the lipid profile and the long-term risk of CHD among HIV-positive outpatients at an HIV treatment clinic in Harare, Zimbabwe. Two hundred and fifteen patients were investigated (females n=165, mean age 39.8 years; males n=50; mean age 42.0 years). Thirty of the individuals were antiretroviral-naïve and 185 had been on antiretroviral therapy (ART) for a mean 3.9±3.4 years. All participants had average lipid and glucose values within normal ranges, but there was a small difference between the ART and ART-for total cholesterol (TC) and high-density lipoprotein (HDL). Those on a combination of D4T or ZDV/NVP/3TC and PI-based ART were on average oldest and had the highest TC levels. Framingham risk showed 1.4% prevalence of high CHD risk within the next ten years. After univariate analysis age, sex, TC/HDL ratio, HDL, economic earnings and systolic BP were associated with medium to high risk of CHD. After multivariate regression analysis and adjusting for age or sex only age, sex and economic earnings were associated with medium to high risk of CHD. There is small risk of developing CHD, during the next decade in HIV infected patients at an HIV treatment clinic in Harare.

  6. Clinical periodontal status and inflammatory cytokines in gestational diabetes mellitus.

    Science.gov (United States)

    Özçaka, Özgün; Ceyhan-Öztürk, Banu; Gümüş, Pınar; Akcalı, Aliye; Nalbantsoy, Ayşe; Buduneli, Nurcan

    2016-12-01

    The aim of the present cross-sectional study was to compare clinical periodontal findings as well as gingival crevicular fluid (GCF) and serum levels of tumour necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), and IL-33 between women with and without gestational diabetes mellitus (GDM). Serum and GCF samples were collected, full-mouth recordings comprising plaque index, bleeding on probing and probing depth were performed in 96 females with GDM (cases) and 65 non-diabetic pregnant females (controls). Age, smoking status, pre-pregnancy body mass index, pregnancy outcomes were recorded. Serum and GCF IL-10, IL-33, TNF-α levels were determined. The GDM group was significantly older than the control group with an age difference of 3.27 years (mean ages were 32.05 and 28.78 years, respectively) (pperiodontal health during pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Physicians' empathy and clinical outcomes for diabetic patients.

    Science.gov (United States)

    Hojat, Mohammadreza; Louis, Daniel Z; Markham, Fred W; Wender, Richard; Rabinowitz, Carol; Gonnella, Joseph S

    2011-03-01

    To test the hypothesis that physicians' empathy is associated with positive clinical outcomes for diabetic patients. A correlational study design was used in a university-affiliated outpatient setting. Participants were 891 diabetic patients, treated between July 2006 and June 2009, by 29 family physicians. Results of the most recent hemoglobin A1c and LDL-C tests were extracted from the patients' electronic records. The results of hemoglobin A1c tests were categorized into good control (9.0%). Similarly, the results of the LDL-C tests were grouped into good control (130). The physicians, who completed the Jefferson Scale of Empathy in 2009, were grouped into high, moderate, and low empathy scorers. Associations between physicians' level of empathy scores and patient outcomes were examined. Patients of physicians with high empathy scores were significantly more likely to have good control of hemoglobin A1c (56%) than were patients of physicians with low empathy scores (40%, P < .001). Similarly, the proportion of patients with good LDL-C control was significantly higher for physicians with high empathy scores (59%) than physicians with low scores (44%, P < .001). Logistic regression analyses indicated that physicians' empathy had a unique contribution to the prediction of optimal clinical outcomes after controlling for physicians' and patients' gender and age, and patients' health insurance. The hypothesis of a positive relationship between physicians' empathy and patients' clinical outcomes was confirmed, suggesting that physicians' empathy is an important factor associated with clinical competence and patient outcomes.

  8. Odontogenic infection involving the secondary fascial space in diabetic and non-diabetic patients: a clinical comparative study

    OpenAIRE

    Chang, Je-Shin; Yoo, Kil-Hwa; Yoon, Sung Hwan; Ha, Jiwon; JUNG, Seunggon; Kook, Min-Suk; Park, Hong-Ju; Ryu, Sun-Youl; Oh, Hee-Kyun

    2013-01-01

    Objectives This retrospective study was performed to evaluate the clinical impact of diabetes mellitus on the prognosis in secondary space infection. Materials and Methods Medical records, radiographic images, computed tomography, and microbial studies of 51 patients (25 diabetic patients and 26 non-diabetic patients) were reviewed. Patients were diagnosed as secondary fascial space infections with odontogenic origin and underwent treatment at Chonnam National University Hospital, in Departme...

  9. Survey of herbal cannabis (marijuana) use in rheumatology clinic attenders with a rheumatologist confirmed diagnosis.

    Science.gov (United States)

    Ste-Marie, Peter A; Shir, Yoram; Rampakakis, Emmanouil; Sampalis, John S; Karellis, Angela; Cohen, Martin; Starr, Michael; Ware, Mark A; Fitzcharles, Mary-Ann

    2016-12-01

    Cannabinoids may hold potential for the management of rheumatic pain. Arthritis, often self-reported, is commonly cited as the reason for the use of medicinal herbal cannabis (marijuana). We have examined the prevalence of marijuana use among 1000 consecutive rheumatology patients with a rheumatologist-confirmed diagnosis and compared in an exploratory manner the clinical characteristics of medicinal users and nonusers. Current marijuana use, medicinal or recreational, was reported by 38 patients (3.8%; 95% CI: 2.8-5.2). Ever use of marijuana for medical purposes was reported by 4.3% (95% CI: 3.2-5.7), with 28 (2.8%; 95% CI: 1.9-4.0) reporting current medicinal use. Current medicinal users had a spectrum of rheumatic conditions, with over half diagnosed with osteoarthritis. Medicinal users were younger, more likely unemployed or disabled, and reported poorer global health. Pain report and opioid use was greater for users, but they had similar physician global assessment of disease status compared with nonusers. Medicinal users were more likely previous recreational users, with approximately 40% reporting concurrent recreational use. Therefore, less than 3% of rheumatology patients reported current use of medicinal marijuana. This low rate of use in patients with a rheumatologist-confirmed diagnosis is in stark contrast to the high rates of severe arthritis frequently reported by medicinal marijuana users, especially in Canada. Familiarity with marijuana as a recreational product may explain use for some as disease status was similar for both groups.

  10. Perceptions of natural health products among patients attending a memory clinic.

    Science.gov (United States)

    Sharma, Papita; Herrmann, Nathan; Rochon, Paula A; Lee, Monica; Croxford, Ruth; Rothenburg, Lana; Black, Sandra E; Lanctôt, Krista L

    2006-01-01

    This study compared patient and caregiver perceptions of natural health products (NHPs) and conventional medications in a memory clinic population. A total of 620 mildly cognitively impaired patients and their caregivers participated in interviews enquiring about their perceptions of NHPs in 4 areas: (1) disclosure of NHP usage information to health care professionals, (2) safety and benefits of NHPs, (3) safety and benefits of conventional medications, and (4) physician knowledge about NHPs. Differences in responses between NHP users and nonusers and between patients and caregivers were examined. A total of 51.8% of subjects were current NHP users, with vitamin E, ginkgo biloba, and glucosamine being the most commonly used products. Multivariate analysis of variance showed that NHP use significantly influenced participant interview responses (Pillai's trace, F[4, 613] = 3.488, P = .008), while interviewee (patient or caregiver; Pillai's trace, F[8, 1228] = 1.499, P = .153) and gender (Pillai's trace, F[4, 615] = 0.528, P = .715) did not. Subsequent univariate tests showed that NHP users were significantly more likely to endorse the effectiveness and safety of NHPs compared with nonusers (F[1, 616] = 7.826, P = .005). Careful questioning during visits with health care providers and better counseling may be necessary to reduce the potential for adverse events and NHP-drug interactions.

  11. High-grade cervical lesions among women attending a reference clinic in Brazil: associated factors and comparison among screening methods.

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    Neide T Boldrini

    Full Text Available Although screening for cervical cancer is recommended for women in most countries, the incidence of cervical cancer is greater in developing countries. Our goal was to determine the prevalence and factors associated with high-grade lesions/cervical cancer among women attending a reference clinic in Brazil and evaluate the correlation of histology with cytology, colposcopy and the high-risk HPV (HR-HPV tests.A cross-sectional study of women attending a colposcopy clinic was carried out. The patients were interviewed to collect demographic, epidemiological and clinical data. Specimens were collected for cervical cytology, Chlamydia trachomatis and HPV testing using the Hybrid Capture (HC and PCR tests. Colposcopy was performed for all patients and biopsy for histology when cell abnormalities or cervical intraepithelial neoplasia (CIN were present.A total of 291 women participated in the study. The median age was 38 years (DIQ: 30-48 years. The prevalence of histologically confirmed high-grade lesions/cervical cancer was 18.2% (95%, CI: 13.8%-22.6%, with 48 (16.5% cases of CIN-2/CIN-3 and 5 (1.7% cases of invasive carcinoma. In the final logistic regression model, for ages between 30 and 49 years old [OR = 4.4 (95%: 1.01-19.04, history of smoking [OR = 2.4 (95%, CI: 1.14-5.18], practice of anal intercourse [OR = 2.4 (95%, CI: 1.10-5.03] and having positive HC test for HR-HPV [OR = 11.23 (95%, CI: 4 0.79-26, 36] remained independently associated with high-grade lesions/cervical cancer. A total of 64.7% of the cases CIN-3\\Ca in situ were related to HPV-16. Non-oncogenic HPV were only found in CIN-1 biopsy results. Compared to histology, the sensitivity of cytology was 31.8%, the specificity 95.5%; the sensitivity of colposcopy for high-grade lesions/cervical cancer was 51.0%, specificity was 91.4% and the concordance with HPV testing was high.The results confirm an association of HR-HPV with precursor lesions for cervical cancer

  12. AWARENESS ABOUT HIV/AIDS IN CLIENTS ATTENDING STI CLINIC: A CROSS SECTIONAL STUDY FROM SOUTH-EAST RAJASTHAN, INDIA

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    Atul

    2015-12-01

    Full Text Available BACKGROUND India bears a large burden of HIV/AIDS on globe. Major weapons against HIV/AIDS are treatment which is not curative, vaccine which is far from reality and accurate & adequate information about the disease which is practically acceptable and cost effective way of prevention in form of social vaccine and is a good tool for HIV/AIDS in developing countries like India. In India there is inadequate & inaccurate knowledge about the disease in general population. AIM In present study we tried to analyze the knowledge & awareness about HIV/AIDS in clients attending the STI clinic at Jhalawar Hospital and Medical College at south east part of Rajasthan, India. MATERIAL & METHODS We assessed 500 clients at STI clinic by using a predesigned questionnaire which gathers their knowledge regarding HIV/AIDS. All the clients above the age of 18 years who attended the STI clinic were enrolled for the study voluntarily. Participants were finally assessed as good/poor or unaware according to their level of knowledge. STATISTICAL ANALYSIS SPSS version 20.0 (trial was used to analyze all the data. Chi square test was used to find association between knowledge and their literacy level & occupation. RESULTS 142(28.4% of the participants had never heard about HIV/AIDS among them females were significantly more than males. Both low level of literacy and unemployment or house wives were associated with unawareness about HIV/AIDS. For the 358(71.6% participants who had heard about HIV/AIDS, mass media was the main source of information (53.07% in which television contributes the major part, followed by friends and colleagues (24.02%. While the knowledge about HIV transmission and prevention was good but the extent of misconceptions was also high (64.8%. CONCLUSION Our study is highly suggestive of the strong need to increase the level of HIV awareness among Indian population via proper education and through various resources on information.

  13. Predictive indices of empirical clinical diagnosis of malaria among under-five febrile children attending paediatric outpatient clinic

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    Hassan A Elechi

    2015-01-01

    Full Text Available Background: Malaria has remained an important public health problem in Nigeria with children under 5 years of age bearing the greatest burden. Accurate and prompt diagnosis of malaria is an important element in the fight against the scourge. Due to the several limitations of microscopy, diagnosis of malaria has continued to be made based on clinical ground against several World Health Organization (WHO recommendations. Thus, we aim to assess the performance of empirical clinical diagnosis among febrile children under 5 years of age in a busy pediatric outpatient clinic. Materials and Methods: The study was a cross-sectional study. Children aged <5 years with fever or 72 h history of fever were recruited. Children on antimalarial prophylaxis or on treatment for malaria were excluded. Relevant information was obtained from the caregiver and clinical note of the child using interviewer administered questionnaire. Two thick and two thin films were made, stained, and read for each recruited child. Data was analysed using SPSS version 16. Results: Of the 433 children studied, 98 (22.6% were empirically diagnosed as having malaria and antimalarial drug prescribed. Twenty-three (23.5% of these children were confirmed by microscopy to have malaria parasitemia, while 75 (76.5% were negative for malaria parasitemia. Empirical clinical diagnosis show poor predictive indices with sensitivity of 19.2%, specificity of 76.0%, positive predictive value of 23.5% and negative predictive value of 71%. Conclusion and Recommendations: Empirical clinical diagnosis of malaria among the under-five children with symptoms suggestive of acute malaria is highly not reliable and hence the need to strengthen parasitological diagnosis.

  14. Help Seeking Process among Children Attending Psychiatry Clinic in Tirana, Albania

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    Anastas Suli MD, Prof

    2011-09-01

    Full Text Available Objective: The goal of this study was to investigate all the potential routes to Child/Adolescent Psychiatry Clinic-University Hospital Center (CAPC-UHC in Tirana. The article provides demographic data, as well as further information on the types and amounts of services children/adolescents received during the process of seeking help related to different diagnoses .Method: The study was conducted in CAPC-UHC in Tirana, during September 2006-September 2007. Data were collected from 162 children and their parents using Strengths and Difficulties Questionnaire (SDQ and Pathways Encounter Form. The sample consisted of 53.1% (86 males and 46.9% (76 females. The mean age was 9.5 + 4.4 years .Results: Out of the total number of cases that sought care to CAPC; 55, 6% were referred by parents themselves, while the rest were referred by others. There was a significant effect of gender to intervals from the onset of problem to the first career (F = 10.803, p=0.001, as well as a significant effect of gender to total time intervals from the onset till the specialist of child mental health problem (F = 6.742, p=0.01.Conclusions: This is the first study investigating the help seeking process to psychiatric care in CAPC Tirana-Albania and may serve as a good start in generating evidence based on child/adolescent mental health service. Further multicentre studies will enhance the values of the findings, since the present study was performed in a single service, and in a setting lacking previous works with similar scope that could have served as references.

  15. Evaluation of Retention in Methadone Treatment in Patients Attending Baharan Hospital Clinic in Zahedan City

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    M.D. Mohebi

    2015-04-01

    Full Text Available Introduction & Objectives: Substance abuse and opioid dependency refers to hazardous use of psychoactive substance .Prevention and treatment of opiate dependence has not been success-ful. Most effective drug in agonist treatment of opiates is methadone maintenance therapy (MMT.But the lack of cooperation of addicts in methadone maintenance therapy has always been a big problem to continue. The purpose of this study is to investigate the retention in the MMT. Materials & Methods: This historical cohort study analyzed the medical records of patients of Baharan hospital in Zahedan. All 912 cases of methadone maintenance clinic of Baharan hos-pital in Zahedan 2011-2012 were studied and the data were analyzed using SPSS. Tables and indexes were analyzed by the Chi-square test and survival curves were plotted using Kaplan–Meier method and analyzed by Log-Rank test. Results: This study reviewed records from 912 patients with a mean age of 34.67% and stan-dard deviation of 10.88 and the range of 15-86 years. 735 were male and 177 ware female. 1-moth retention rate was 71%, 3 months was 59%, 6 months was 47%, 1 year was 30% and 2 years was 17%. Kaplan-Meier median survival time of 8 months was estimated by relation-ship. Doses higher than 60 mg/d of methadone was associated with increased survival on MMT. Conclusion: Age increase, increase of employment time, increasing of the duration of drug abuse, increasing the daily dose of methadone, oral substance abuse increased retention rate and heroin abuse and smoking were associated with decrease retention rate of methadone maintenance therapy. So, with an emphasis on each of these factors effective steps can be taken to improve the cooperation of patients in MMT. (Sci J Hamadan Univ Med Sci 2015; 22 (1:30-36

  16. Perceived Maternal Role Competence among the Mothers Attending Immunization Clinics of Dharan, Nepal

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    Shah Shrooti

    2016-04-01

    Full Text Available Background: Being a mother is considered by many women as their most important role in life. Women’s perceptions of their abilities to manage the demands of parenting and the parenting skills they posses are reflected by perceived maternal role competence. The present study was carried out to assess the perceived maternal role competence and its associated factors among mothers. Methods: A descriptive cross-sectional research study was carried out on 290 mothers of infant in four immunization clinics of Dharan, Nepal. Data were collected using a standardized predesigned, pretested questionnaire (Parent sense of competence scale, Rosenberg’s self esteem scale, Maternity social support scale. The data were analyzed using descriptive and inferential statistics and multiple regression analysis at 0.05 level of significance. Results: The mean score of the perceived maternal role competence obtained by mothers was 64.34±7.90 and those of knowledge/skill and valuing/comfort subscale were 31±6.01 and 33±3.75, respectively. There was a significant association between perceived maternal role competence and factors as the age of the mother (P<0.001, educational status (P=0.015, occupation (P=0.001 and readiness for pregnancy (P=0.022. The study findings revealed a positive correlation between perceived maternal role competence and age at marriage (r=0.132, P=0.024, per capita income (r=0.118, P=0.045, self esteem (r=0.379, P<0.001, social support (r=0.272, P<0.001, and number of support persons (r=0.119, P=0.043. The results of the step wise multiple regression analysis revealed that the major predictor of perceived maternal role competence was self esteem. Conclusion: The factors associated with perceived maternal role competence were age, education, occupation, per capita income, self esteem, social support, and the number of support persons.

  17. Hepatitis C virus infection in patients and family members attending two primary care clinics in Puebla, Mexico.

    Science.gov (United States)

    López-Colombo, Aurelio; Meléndez-Mena, Daniel; Sedeño-Monge, Virginia; Camacho-Hernández, José R; Vázquez-Cruz, Eduardo; Morales-Hernández, Eduardo R; Sosa-Jurado, Francisca; Márquez-Domínguez, Luis; Santos-López, Gerardo

    2014-01-01

    Approximately 180 million persons (~2.8%) globally are estimated to be infected by hepatitis C virus (HCV). HCV prevalence in Mexico has been estimated to be between 1.2 and 1.4%. The aim of present work was to determine the prevalence of HCV infection in patients and family members attending two primary care clinics in Puebla, Mexico. Patients and their accompanying family members in two clinics were invited to participate in this study between May and September 2010. A total of 10,214 persons were included in the study; 120 (1.17%) persons were anti-HCV reactive. Of the reactive subjects, detection of viral RNA was determined in 114 subjects and 36 were positive (31%). The more frequent risk factors were having a family history of cirrhosis (33.1%) and having a blood transfusion prior to 1995 (29%). After a multiple logistic regression analysis only transfusion prior to 1995 resulted significant to HCV transmission (p = 0.004). The overall detected HCV genotypes were as follows: 1a (29%), 1b (48.5%), 2/2b (12.8%), and 3a (6.5%). The HCV prevalence in this population is in agreement with previous studies in other regions of Mexico.

  18. Translating self-persuasion into an adolescent HPV vaccine promotion intervention for parents attending safety-net clinics.

    Science.gov (United States)

    Baldwin, Austin S; Denman, Deanna C; Sala, Margarita; Marks, Emily G; Shay, L Aubree; Fuller, Sobha; Persaud, Donna; Lee, Simon Craddock; Skinner, Celette Sugg; Wiebe, Deborah J; Tiro, Jasmin A

    2017-04-01

    Self-persuasion is an effective behavior change strategy, but has not been translated for low-income, less educated, uninsured populations attending safety-net clinics or to promote human papillomavirus (HPV) vaccination. We developed a tablet-based application (in English and Spanish) to elicit parental self-persuasion for adolescent HPV vaccination and evaluated its feasibility in a safety-net population. Parents (N=45) of age-eligible adolescents used the self-persuasion application. Then, during cognitive interviews, staff gathered quantitative and qualitative feedback on the self-persuasion tasks including parental decision stage. The self-persuasion tasks were rated as easy to complete and helpful. We identified six question prompts rated as uniformly helpful, not difficult to answer, and generated non-redundant responses from participants. Among the 33 parents with unvaccinated adolescents, 27 (81.8%) reported deciding to get their adolescent vaccinated after completing the self-persuasion tasks. The self-persuasion application was feasible and resulted in a change in parents' decision stage. Future studies can now test the efficacy of the tablet-based application on HPV vaccination. The self-persuasion application facilitates verbalization of reasons for HPV vaccination in low literacy, safety-net settings. This self-administered application has the potential to be more easily incorporated into clinical practice than other patient education approaches. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Perception of neonatal jaundice among women attending children out patient and immunization clinics of the UPTH Port Harcourt.

    Science.gov (United States)

    Eneh, A U; Ugwu, R O

    2009-06-01

    Neonatal Jaundice (NNJ) is a common disorder worldwide. Early identification and proper management is needed to prevent the serious neurological complications associated with it. To determine the knowledge of the women attending Children Outpatient (CHOP) and Immunization clinics on the causes, treatment and complications of neonatal jaundice. Women who brought their children/wards to the immunization/children out patient clinics at the University of Port Harcourt Teaching Hospital Port Harcourt were interviewed using structured questionaire. There were 255 mothers who participated in the study. Of these 30 (11.8%) have never heard of neonatal jaundice while 225 (88.2%) have heard and only those who have heard were further analyzed. The age range was from 16 to 47 yrs (mean age 27.1 +/- 3.3 years). Median parity was 2. One hundred and twenty two (54.2%) women had tertiary education. One hundred and seventy four (77.3%) correctly defined neonatal jaundice, and in 114 (44.7%) source of information was from health talk in the clinic. Seventy five (33.3%), and 50 (22.2%) erroneously believed that eating too much groundnut in pregnancy and mosquito bite respectively were the main causes while 55 (24.4%) correctly answered that it is due to mismatch of mother and baby's blood. Only a few knew that use of dusting powder on baby's cord, prematurity, and storing baby's clothes in camphor were risk factors for NNJ. One hundred and fourteen (50.7%) and 60 (26.7%), wrongly believed that exposure to sunlight and use of glucose drinks respectively were the main forms of treatment and 50 (22.2%) knew brain damage as a possible complication There is still misconception on the causes and risk factors and treatment of neonatal jaundice among our women. Also only a few women are reached by the health talk in the clinics. There is therefore urgent need for massive health enlightenment campaign.

  20. Myths about diabetes and its treatment in North Indian population

    OpenAIRE

    Rai, Mridula; Kishore, Jugal

    2009-01-01

    BACKGROUND: Myths prevailing about diabetes in the society have become a major hurdle for its proper treatment and control. AIM: To find out about various myths related to diabetes and its treatment in the population. MATERIALS AND METHODS: A cross sectional study was carried out in a teaching hospital of Delhi in 2008. 124 diabetic patients attending the regular diabetic clinic, 78 people who accompanied these patients and 214 non-diabetic people were included in the study. A pre-tested inte...

  1. Clinical impact of the temporal relationship between depression and type 2 diabetes: the Fremantle diabetes study phase II.

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    David G Bruce

    Full Text Available BACKGROUND: The clinical features of type 2 diabetes may differ depending on whether first depression episode precedes or follows the diagnosis of diabetes. METHODS: Type 2 patients from the observational community-based Fremantle Diabetes Study Phase II underwent assessment of lifetime depression using the Brief Lifetime Depression Scale (developed and validated for this study supplemented by information on current depression symptoms (Patient Health Questionnaire, 9-item version and use of antidepressants. Patients were categorized as never depressed (Group 1, having had depression before diabetes diagnosis (Group 2, diagnosed with depression and diabetes within 2 years of each other (Group 3 and having depression after diabetes diagnosis (Group 4. RESULTS: Of 1391 patients, 20.8% were assigned to Group 2, 6.0% to Group 3 and 14.5% to Group 4. In Group 2, depression occurred a median 15.6 years before diabetes onset at age 37.2±14.7 years. These patients had similar clinical characteristics to never depressed patients except for reduced self-care behaviours and having more symptomatic peripheral arterial disease. In Group 4, depression occurred a median 9.9 years after diabetes onset at age 59.8±13.0 years. These patients had long duration diabetes, poor glycaemic control, more intensive management and more diabetic complications. Group 4 patients had more current depression than Group 2 but were less likely to be receiving antidepressants. CONCLUSIONS/INTERPRETATION: The clinical features of depression and type 2 diabetes are heterogeneous depending on their temporal relationship. There may be corresponding differences in the pathogenesis of depression in diabetes that have implications for diagnosis and management.

  2. Nutritional therapy for the management of diabetic gastroparesis: clinical review.

    Science.gov (United States)

    Sadiya, Amena

    2012-01-01

    Diabetic gastroparesis (DGP), or slow emptying of the stomach, is a well-established complication of diabetes mellitus and is typically considered to occur in individuals with long-standing type 1 and type 2 diabetes mellitus. Clinical consequences of DGP include induction of gastrointestinal (GI) symptoms (early satiety, abdominal distension, reflux, stomach spasm, postprandial nausea, vomiting), alteration in drug absorption, and destabilization of glycemic control (due to mismatched postprandial glycemic and insulin peaks). Effective nutritional management not only helps in alleviating the symptoms, but also in facilitating better glycemic control. Although there have been no evidence-based guidelines pertaining to the nutrition care process of the DGP, the current dietary recommendations are based on expert opinions or observational studies. The dietary management of gastroparesis needs to be tailored according to the severity of malnutrition and kind of upper GI symptom by changing the volume, consistency, frequency, fiber, fat, and carbohydrates in the meal. Small frequent meals, using more liquid calories, reducing high fat or high fiber, consuming bezoar forming foods, and adjusting meal carbohydrates based on medications or insulin helps in improving the upper GI symptoms and glycemic control. Enteral nutrition can be an option for patients who fail to stabilize their weight loss, or for those who cannot gain weight with oral feedings, while total parenteral nutrition is rarely necessary for the patient with gastroparesis.

  3. Nutritional therapy for the management of diabetic gastroparesis: clinical review

    Science.gov (United States)

    Sadiya, Amena

    2012-01-01

    Diabetic gastroparesis (DGP), or slow emptying of the stomach, is a well-established complication of diabetes mellitus and is typically considered to occur in individuals with long-standing type 1 and type 2 diabetes mellitus. Clinical consequences of DGP include induction of gastrointestinal (GI) symptoms (early satiety, abdominal distension, reflux, stomach spasm, postprandial nausea, vomiting), alteration in drug absorption, and destabilization of glycemic control (due to mismatched postprandial glycemic and insulin peaks). Effective nutritional management not only helps in alleviating the symptoms, but also in facilitating better glycemic control. Although there have been no evidence-based guidelines pertaining to the nutrition care process of the DGP, the current dietary recommendations are based on expert opinions or observational studies. The dietary management of gastroparesis needs to be tailored according to the severity of malnutrition and kind of upper GI symptom by changing the volume, consistency, frequency, fiber, fat, and carbohydrates in the meal. Small frequent meals, using more liquid calories, reducing high fat or high fiber, consuming bezoar forming foods, and adjusting meal carbohydrates based on medications or insulin helps in improving the upper GI symptoms and glycemic control. Enteral nutrition can be an option for patients who fail to stabilize their weight loss, or for those who cannot gain weight with oral feedings, while total parenteral nutrition is rarely necessary for the patient with gastroparesis. PMID:23055757

  4. Determinants of sexual dysfunction among clinically diagnosed diabetic patients

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    Sarpong Charity

    2011-05-01

    Full Text Available Abstract Background Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD if not properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana. Method Sexual functioning was determined in 300 consecutive diabetic men (age range: 18-82 years visiting the diabetic clinic of Tema General Hospital with the Golombok Rust Inventory of Sexual Satisfaction (GRISS questionnaire, between November, 2010 and March, 2011. In addition to the socio-demographic characteristics of the participants, the level of glycosylated haemoglobin, fasting blood sugar (FBS and serum testosterone were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study. Results Out the 300 participants contacted, the response rate was 91.3% after 20 declined participation and 6 incomplete data were excluded All the respondents had at least basic education, 97.4% were married, 65.3% were known hypertensive, 3.3% smoked cigarettes, 27% took alcoholic beverages and 32.8% did some form of exercise. The 69.3% SD rate observed in this study appears to be related to infrequency (79.2%, non-sensuality (74.5%, dissatisfaction with sexual acts (71.9%, non-communication (70.8% and impotence (67.9%. Other areas of sexual function, including premature ejaculation (56.6% and avoidance (42.7% were also substantially affected. However, severe SD was seen in only 4.7% of the studied population. The perceived "adequate", "desirable", "too short" and "too long intra-vaginal ejaculatory latency time (IELT are 5-10, 5-10, 1-2 and 15-30 minutes respectively. Testosterone correlates negatively with glycated haemoglobin (HBA1c, FBS, perceived desirable, too short IELT, and weight as well as waist circumference. Conclusion SD rate from this study is high

  5. Determinants of sexual dysfunction among clinically diagnosed diabetic patients

    Science.gov (United States)

    2011-01-01

    Background Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD) if not properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana. Method Sexual functioning was determined in 300 consecutive diabetic men (age range: 18-82 years) visiting the diabetic clinic of Tema General Hospital with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire, between November, 2010 and March, 2011. In addition to the socio-demographic characteristics of the participants, the level of glycosylated haemoglobin, fasting blood sugar (FBS) and serum testosterone were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study. Results Out the 300 participants contacted, the response rate was 91.3% after 20 declined participation and 6 incomplete data were excluded All the respondents had at least basic education, 97.4% were married, 65.3% were known hypertensive, 3.3% smoked cigarettes, 27% took alcoholic beverages and 32.8% did some form of exercise. The 69.3% SD rate observed in this study appears to be related to infrequency (79.2%), non-sensuality (74.5%), dissatisfaction with sexual acts (71.9%), non-communication (70.8%) and impotence (67.9%). Other areas of sexual function, including premature ejaculation (56.6%) and avoidance (42.7%) were also substantially affected. However, severe SD was seen in only 4.7% of the studied population. The perceived "adequate", "desirable", "too short" and "too long intra-vaginal ejaculatory latency time (IELT) are 5-10, 5-10, 1-2 and 15-30 minutes respectively. Testosterone correlates negatively with glycated haemoglobin (HBA1c), FBS, perceived desirable, too short IELT, and weight as well as waist circumference. Conclusion SD rate from this study is high but similar to

  6. Diabetes.

    Science.gov (United States)

    Lomberk, Gwen

    2009-01-01

    Pancreatologists have often divided research of the pancreas based upon the origin of the function or disease, namely the endocrine or exocrine pancreas. In fact, as a result, many of our meetings and conferences have followed separate paths. Interestingly, among patients with chronic pancreatitis and pancreatic cancer, both disorders of the exocrine pancreas, diabetes is common. However, the clinical features of the diabetes associated with these two differ. Peripheral insulin resistance and hyperinsulinemia are the predominant diabetic traits in pancreatic cancer, while reduced islet cell mass and impaired insulin secretion are observed more often in chronic pancreatitis. The causal relationship between diabetes and pancreatic cancer remains an intriguing but unanswered question. Since diabetes often precedes pancreatic cancer, it is regarded as a potential risk factor for malignancy. On the other hand, there remains the possibility that pancreatic cancer secretes diabetogenic factors. Regardless of how the science ultimately illuminates this issue, there is increasing interest in utilizing screening for diabetes to aid early detection of pancreatic tumor lesions. Therefore, in this issue of Pancreatology and the Web, we explore the topic of diabetes to keep us alert to this very important association, even if we study diseases of the exocrine pancreas.

  7. CLINICO EPIDEMIOLOGICAL PROFILE OF WILD ANIMAL BITE VICTIMS ATTENDING ANTI RABIES CLINIC AT GOVERNMENT TERTIARY CARE CENTRE IN MANDYA

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    Jahnavi

    2014-11-01

    Full Text Available : INTRODUCTION: Rabies is an acute viral disease that causes fatal encephalitis in virtually all the warm blooded animals including man. In India it is estimated that annually 17.4 million animal bite cases occur and 20, 000 deaths occur due to human rabies. Dogs are responsible for about 97%of the human rabies, followed by cats (2%, jackals, mongoose and others (1%. There is scarcity of literature regarding human rabies due to wild animals. OBJECTIVES: To describe the socio- demographic characteristics of wild animal bite victims attending Anti Rabies Clinic (ARC, Mandya Institute of Medical Sciences (MIMS, Mandya and to describe the circumstances, characteristics of bite and post exposure prophylactic measures taken to prevent rabies. METHODOLOGY: This hospital based case record analysis was done for a period of 3 years from January 2011 to December 2013 at Anti Rabies Clinic (ARC, Mandya Institute of Medical Sciences, Mandya. The details regarding the socio demographic characteristics of bite victims, characteristics of the bite wound and post exposure prophylactic measures taken to prevent rabies were collected using case records of wild animal bite victims. RESULTS: A total of 12, 798 animal bite victims had attended ARC during the study period, of which 67 (0.52% cases were exposed to wild animals. Of these 67 cases, 45 (67.2% of the victims were exposed to monkey and 13 (19.4% were exposed to wild boar. 45 (67.2% of the wild animal bite victims were in the age group of 15 to 60 years, 49 (73.1% were males and 22 (32.8% belonging to class IV socio economic status. Many of the monkey bites happened when the monkey was trying to snatch food from the victims and while other wild animal bites happened when the farmers were guarding their field. 40 (59.7% had bites on upper limb. 51 (76.1% had washed the wound with soap and water before coming to ARC. RIG was advised to all victims but was taken by 49 (73.1% of the bite victims. All four doses

  8. Clinical Research on Acupuncture Treatment of Diabetic Peripheral Neuropathy

    Institute of Scientific and Technical Information of China (English)

    QIAN Wei-hua; QIAN Hong; WU Tong; BEI Yan-hui; LI Lan; QING Liang-cai

    2004-01-01

    目的:探讨针刺治疗糖尿病周围神经病变的相关机理.方法:运用针刺疗法治疗糖尿病周围神经病变,并与口服钙离子拮抗剂加维生素疗法进行随机对照观察,同时作肌电图检测分析.结果:针刺治疗糖尿病周围神经病变可不同程度地改善病人的肢体麻木、疼痛和感觉异常等临床症状,肌电图结果提示神经运动传导速度和感觉传导速度也有明显改善.结论:针刺治疗糖尿病周围神经病变的临床疗效明显优于口服钙离子拮抗剂加维生素治疗.%Purpose: To investigate the mechanism of acupuncture treatment of diabetic peripheral neuropathy. Methods: Acupuncture therapy was used to treat diabetic peripheral neuropathy, and compared with oral calcium antagonist and vitamin therapy by random control observation.Electromyography was performed for analysis at the same time. Results: Acupuncture treatment alleviated symptoms such as extremity numbness, pain and paresthesia in varying degrees in diabetic patients with peripheral neuropathy. The results of electromyography showed a marked improvement in motor and sensory conduction velocities. Conclusion: It is indicated that acupuncture therapy is markedly superior to oral calcium antagonist and vitamin therapy in clinical effect on diabetic peripheral neuropathy, and electromyographic recovery.

  9. A cross-sectional study of barriers to personal health record use among patients attending a safety-net clinic.

    Directory of Open Access Journals (Sweden)

    Joan F Hilton

    Full Text Available BACKGROUND: Personal health records (PHR may improve patients' health by providing access to and context for health information. Among patients receiving care at a safety-net HIV/AIDS clinic, we examined the hypothesis that a mental health (MH or substance use (SU condition represents a barrier to engagement with web-based health information, as measured by consent to participate in a trial that provided access to personal (PHR or general (non-PHR health information portals and by completion of baseline study surveys posted there. METHODS: Participants were individually trained to access and navigate individualized online accounts and to complete study surveys. In response to need, during accrual months 4 to 12 we enhanced participant training to encourage survey completion with the help of staff. Using logistic regression models, we estimated odds ratios for study participation and for survey completion by combined MH/SU status, adjusted for levels of computer competency, on-study training, and demographics. RESULTS: Among 2,871 clinic patients, 70% had MH/SU conditions, with depression (38% and methamphetamine use (17% most commonly documented. Middle-aged patients and those with a MH/SU condition were over-represented among study participants (N = 338. Survey completion was statistically independent of MH/SU status (OR, 1.85 [95% CI, 0.93-3.66] but tended to be higher among those with MH/SU conditions. Completion rates were low among beginner computer users, regardless of training level (70%. CONCLUSIONS: Among patients attending a safety-net clinic, MH/SU conditions were not barriers to engagement with web-based health information. Instead, level of computer competency was useful for identifying individuals requiring substantial computer training in order to fully participate in the study. Intensive on-study training was insufficient to enable beginner computer users to complete study surveys.

  10. Clinical characteristic of pulse wave velocity and arterial compliance in elderly patients with diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    张红

    2013-01-01

    Objective To explore the clinical characteristics of pulse wave velocity,arterial compliance and cardiovascular risk factors in elderly patients with type 2 diabetes mellitus.Methods A total of 363 patients were selected and divided into 4 groups:diabetic group,diabetic

  11. Usability and clinical efficacy of diabetes mobile applications for adults with type 2 diabetes: A systematic review.

    Science.gov (United States)

    Fu, Helen; McMahon, Siobhan K; Gross, Cynthia R; Adam, Terrence J; Wyman, Jean F

    2017-09-01

    To assess the usability and clinical effectiveness of diabetes mobile applications (diabetes apps) developed for adults with type 2 diabetes. A systematic review of the usability and effectiveness of diabetes apps was conducted. Searches were performed using MEDLINE, EMBASE, COMPENDEX, and IEEE XPLORE for articles published from January 1, 2011, to January 17, 2017. Search terms included: diabetes, mobile apps, and mobile health (mHealth). The search yielded 723 abstracts of which seven usability studies and ten clinical effectiveness studies met the inclusion criteria from 20 publications. Usability, as measured by satisfaction ratings from experts and patients, ranged from 38% to 80%. Usability problem ratings ranged from moderate to catastrophic. Top usability problems are multi-steps task, limited functionality and interaction, and difficult system navigation. Clinical effectiveness, measured by reductions in HbA1c, ranged from 0.15% to 1.9%. Despite meager satisfaction ratings and major usability problems, there is some limited evidence supporting the effectiveness of diabetes apps to improve glycemic control for adults with type 2 diabetes. Findings strongly suggest that efforts to improve user satisfaction, incorporate established principles of health behavior change, and match apps to user characteristics will increase the therapeutic impact of diabetes apps. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Cut Points for Identifying Clinically Significant Diabetes Distress in Adolescents With Type 1 Diabetes Using the PAID-Teen

    DEFF Research Database (Denmark)

    Hagger, Virginia; Hendrieckx, Christel; Cameron, Fergus

    2017-01-01

    (MILES) Youth-Australia Study, a national survey assessing various psychosocial indicators among self-selected National Diabetes Services Scheme registrants. Participants in the current study (n = 537) were (mean ± SD) 16 ± 2 years old, had type 1 diabetes for 6 ± 4 years, and 62% (n = 334) were girls....... They completed measures of diabetes distress (PAID-T) and depressive symptoms (Patient Health Questionnaire for Adolescents) and self-reported their most recent HbA1c and frequency of self-monitoring of blood glucose (SMBG). Relationships between the PAID-T and the psychological and clinical variables were...... examined to identify a clinically meaningful threshold for elevated diabetes distress. ANOVAs were used to test whether these variables differed by levels of distress. RESULTS: Two cut points distinguished none-to-mild (90) diabetes distress. Moderate distress...

  13. Clinical efficacy of entecavir in treatment of hepatogenous diabetes

    Directory of Open Access Journals (Sweden)

    GOU Wei

    2013-06-01

    Full Text Available ObjectiveTo observe the clinical efficacy of entecavir in the treatment of hepatogenous diabetes (HD. MethodsA retrospective analysis was performed on the clinical data of 72 HD patients, who were divided into treatment group (n=36 and control group (n=36. Both groups were given diabetic diet and received liver-protecting treatment, symptomatic treatment, and supportive treatment. In addition, the treatment group received oral entecavir (0.5 mg once daily. The therapeutic effect was assessed after 52 weeks of treatment; the serum hepatitis B virus (HBV DNA level, liver function (alanine aminotransferase, aspartate aminotransferase, total bilirubin, and albumin, blood glucose, and glycosylated hemoglobin were measured before and after treatment. The two groups were compared by t test (for measurement data and chi-square test (for numeration data. ResultsAfter 52 weeks of treatment, 29 (80.56% of the patients in treatment group had virological response, versus 7 (19.44% of those in control group (χ2 = 18.00, P<0.01; 26 (72.22% of the patients in treatment group had liver function recovery and controlled diabetes, versus 16 (44.44% of those in control group (χ2=5.774, P<0.05. The treatment group showed significant improvements in liver function and blood glucose after treatment (P<0.05; the treatment group had significantly lower glycosylated hemoglobin and fasting blood glucose than the control group (P<0.01. ConclusionIn the treatment of HBV DNA-positive hepatitis B cirrhosis with HD, entecavir not only can effectively inhibit the replication of viral DNA and promote the recovery of liver function, but also can effectively control HD.

  14. An indirect haemagglutination test for demonstration of gonococcal antibodies using gonococcal pili as antigen. II. Serological investigation of patients attending a dermato-venereological outpatients clinic in Copenhagen

    DEFF Research Database (Denmark)

    Reimann, K; Lind, I; Andersen, Klaus Ejner

    1980-01-01

    A total of 1223 serum specimens were obtained from 649 consecutive patients attending a dermatovenereological out-patient clinic in Copenhagen with a request for venereal disease control. The sera were examined for gonococcal antibodies by both a gonococcal complement fixation test (GCF) and an i...

  15. Evaluation of oral health in patients with mental disorders attended at the clinic of oral diagnosis of a public university

    Directory of Open Access Journals (Sweden)

    Marina Sena Lopes Da Silva Sacchetto

    Full Text Available INTRODUCTION: Many people suffering from mental disorders fail to adequately perform self-care, especially in relation to personal hygiene and in particular to oral hygiene. For these individuals, the prevention and ongoing clinical monitoring are essential. OBJECTIVE: To investigate the oral diseases that most affect patients with mental disorders attended in the Dental College of the Federal University of Piauí (UFPI. METHODOLOGY: Patients treated during the 2nd half of 2011 and 1st half of 2012 were examined. The DMFT index was used for evaluation of dental caries and the CPI index for periodontal evaluation. The statistical analyzes were performed with SPSS (Statistical Package for the Social Sciences, version 18.0, using a descriptive statistics to determine averages, standard deviations and frequencies. RESULT: 67.50% of the 40 patients had contact with the surgeon dentist for over one year, 95% performed their own oral hygiene and 70% did not use dental floss. The average of DMFT was 14.18. Of the patients, 49.13% needed of restorations of one surface and 60% needed dental prosthesis. Moreover, 33.75% of sextants evaluated had periodontal pockets. CONCLUSION: It can be noticed that patients with mental illness have a high risk of developing oral disorders, however, few carriers visite a dental professional regularly. In addition, the delay to seek treatment and lack of staff training, lead to solutions often crippling.

  16. Sero-Prevalence of Hepatitis B Surface Antigen Amongst Pregnant Women Attending an Antenatal Clinic, Volta Region, Ghana

    Science.gov (United States)

    Dassah, Sylvester; Lokpo, Sylvester; Ameke, Louise; Noagbe, Mark; Adatara, Peter; Hagan, Oheneba; Binka, Fred

    2017-01-01

    Hepatitis B virus (HBV) infection remains a global challenge, although there is currently a safe and effective vaccine available. HBV prevalence in Ghana is not well documented, but vary regionally from 4.8% to 12.3% in the general population, 10.8% to 12.7% in blood donors and about 10.6% in pregnant women. This puts Ghana among the high endemic countries in Africa. The study objective was to determine the sero-prevalence of HBs antigen (Ag) and HBeAg among pregnant women in the Ho municipality. Two hundred and eigh participants (pregnant women), attending Ho Municipal antenatal clinic were enrolled into the study. This study recorded a HBsAg sero-prevalence rate of 2.4% among the pregnant women, with primigravida pregnant women recording (0.98%) and multigravida (1.42%). The prevalence of HBsAg among the pregnant women can be classified as Low Intermediate; therefore there is still the need for routine screening of pregnant women during antenatal visits. Amongst HBsAg positives, HBeAg positivity was significantly high (40% of all HBsAg positive women), which suggests high chances of carrier and vertical transmission (mother to child) state. PMID:28299162

  17. Short Communication: Limited HIV Pretreatment Drug Resistance Among Adults Attending Free Antiretroviral Therapy Clinic of Pune, India.

    Science.gov (United States)

    Karade, Santosh; Patil, Ajit A; Ghate, Manisha; Kulkarni, Smita S; Kurle, Swarali N; Risbud, Arun R; Rewari, Bharat B; Gangakhedkar, Raman R

    2016-04-01

    In India, the roll out of the free antiretroviral therapy (ART) program completed a decade of its initiation in 2014. The success of first-line ART is influenced by prevalence of HIV pretreatment drug resistance (PDR) in the population. In this cross-sectional study, we sought to determine the prevalence of PDR among adults attending the state-sponsored free ART clinic in Pune in western India. Fifty-two individuals eligible for ART as per national guidelines with median CD4 cell count of 253 cells/mm(3) (inter quartile range: 149-326) were recruited between January 2014 and April 2015. Population-based sequencing of partial pol gene sequences from plasma specimen revealed predominant HIV-1 subtype C infection (96.15%) and presence of single-drug resistance mutations against non-nucleoside reverse transcriptase inhibitor in two sequences. The study supports the need for periodic surveillance, when offering PDR testing at individual level is not feasible.

  18. Mediators of the Relation Between Community Violence and Sexual Risk Behavior Among Adults Attending a Public Sexually Transmitted Infection Clinic.

    Science.gov (United States)

    Senn, Theresa E; Walsh, Jennifer L; Carey, Michael P

    2016-07-01

    Prior research shows that violence is associated with sexual risk behavior, but little is known about the relation between community violence (i.e., violence that is witnessed or experienced in one's neighborhood) and sexual risk behavior. To better understand contextual influences on HIV risk behavior, we asked 508 adult patients attending a publicly funded STI clinic in the U.S. (54 % male, M age = 27.93, 68 % African American) who were participating in a larger trial to complete a survey assessing exposure to community violence, sexual risk behavior, and potential mediators of the community violence-sexual risk behavior relation (i.e., mental health, substance use, and experiencing intimate partner violence). A separate sample of participants from the same trial completed measures of sexual behavior norms, which were aggregated to create measures of census tract sexual behavior norms. Data analyses controlling for socioeconomic status revealed that higher levels of community violence were associated with more sexual partners for men and with more episodes of unprotected sex with non-steady partners for women. For both men and women, substance use and mental health mediated the community violence-sexual risk behavior relation; in addition, for men only, experiencing intimate partner violence also mediated this relation. These results confirm that, for individuals living in communities with high levels of violence, sexual risk reduction interventions need to address intimate partner violence, substance use, and mental health to be optimally effective.

  19. An assessment of serum prolactin levels among infertile women with galactorrhea attending a gynecological clinic North-West Nigeria.

    Science.gov (United States)

    Ugwa, Emmanuel Ajuluchukwu; Ashimi, Adewale Olufemi; Abubakar, Mohammed Yusuf; Takai, Idris Usman; Lukman, Okunade Taiwo; Lawal, Hamzah Abdurrahman; Also, Muhammed Abubakar; Gift, Amadi Ngozi; Kiri, Halimat Muhammed

    2016-01-01

    Galactorrhea is a common manifestation of hyperprolactinemia but may not always be present in women with hyperprolactinemia. This study was, therefore, undertaken to assess the serum prolactin levels of infertile women presenting with galactorrhea and to determine the prevalence of hyperprolactinemia among them. This was a retrospective study of serum prolactin levels of 63 female partners of infertile couples attending the gynecological clinic of Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria, who were found to have galactorrhea from January 1, 2012, to December 31, 2013. Ethical clearance was obtained. Solid phase enzyme-linked immunosorbent assay was used to measure serum prolactin. Sociodemographic characteristics were determined. The data obtained were analyzed using SPSS version 17.0 statistical software. Absolute numbers and simple percentages were used to describe categorical variables. Similarly, quantitative variables were described using measures of central tendency (mean, median) and measures of dispersion (range, standard deviation) as appropriate. The average age of the women was 27.9 ± 5.6 years. In half of the cases (50%), galactorrhea was associated with menstrual disturbances, mainly amenorrhea (23.3%). Although most (63.3%) of the clients had normal serum prolactin level despite being galactorrheic, averagely there was a marked elevation in serum prolactin of as high as 40.3 ± 52.3 ng/mL. We conclude, therefore, that the prevalence of hyperprolactinemia in this study was low when compared with other studies and that galactorrhea does not always indicate raised serum prolactin levels.

  20. [Sociodemographic and clinical characteristic of the population attended in the Instituto Teletón de Santiago].

    Science.gov (United States)

    García P, Daniela; San Martín P, Pamela

    2015-01-01

    The Institutos Teletón care for 85% of the Chilean child population with neuromusculoskeletal disability, the large percentage concentrating in this population. However, there are no registers that enable a profile to be determined on this population. To determine the profile of patients attending the Instituto Teletón de Santiago during the year 2012. The sociodemographic characteristics were analyzed from the computerised records of the Instituto Teletón de Santiago on active patients who were seen during the year 2012. A total of 8,959 patients were seen during the study year in the Instituto Teletón de Santiago. As regards socioeconomic level, 33.3% were in extreme poverty, 28.7% to low-middle level. The main clinical diagnoses were cerebral palsy and other encephalopathies that also lead to motor disability, and accounted for 55.4% of the cases. As a result of determining this profile, it would be appropriate to encourage the need for a national register of the child population with disability, as well as their particular characteristics in order to make decisions on public policy, as a destination for funds or support programs. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  1. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Institute of Scientific and Technical Information of China (English)

    Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar

    2016-01-01

    Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre.Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond’s medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator.Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays(76.9%) and the remaining were Chinese(15.1%), Indians(2.2%)and other ethnic groups(5.8%). One hundred and thirty eight(99.3%) of the women were married and 98.6% had less than 6 children. More than half(75.5%) of the women’s last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge.Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  2. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Institute of Scientific and Technical Information of China (English)

    Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar

    2016-01-01

    Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre. Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond's medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator. Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays (76.9%) and the remaining were Chinese (15.1%), Indians (2.2%) and other ethnic groups (5.8%). One hundred and thirty eight (99.3%) of the women were married and 98.6%had less than 6 children. More than half (75.5%) of the women's last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge. Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  3. Psychosocial Characteristics and Obstetric Health of Women Attending a Specialist Substance Use Antenatal Clinic in a Large Metropolitan Hospital

    Directory of Open Access Journals (Sweden)

    Lucy Burns

    2011-01-01

    Full Text Available Objective. This paper reports the findings comparing the obstetrical health, antenatal care, and psychosocial characteristics of pregnant women with a known history of substance dependence (n=41 and a comparison group of pregnant women attending a general antenatal clinic (n=47. Method. Face-to-face interviews were used to assess obstetrical health, antenatal care, physical and mental functioning, substance use, and exposure to violence. Results. The substance-dependent group had more difficulty accessing antenatal care and reported more obstetrical health complications during pregnancy. Women in the substance-dependent group were more likely to report not wanting to become pregnant and were less likely to report using birth control at the time of conception. Conclusions. The profile of pregnant women (in specialised antenatal care for substance dependence is one of severe disadvantage and poor health. The challenge is to develop and resource innovative and effective multisectoral systems to educate women and provide effective care for both women and infants.

  4. Clinical presentation and management of diabetes mellitus in pregnancy

    Directory of Open Access Journals (Sweden)

    Al-Azemi N

    2013-12-01

    Full Text Available Nasser Al-Azemi,1 Michael F Diejomaoh,1,2 Elisavet Angelaki,1 Asiya T Mohammed2 1Maternity Hospital, Shuwaikh, Kuwait; 2Department of Obstetrics and Gynecology, Faculty of Medicine, Kuwait University, Safat, Kuwait Objective: To evaluate the clinical presentation, management, and the outcome of diabetes mellitus in pregnancy. Methods: One hundred seventy-one patients with diabetes mellitus admitted between September 1, 2006, and June 30, 2008, to the labor room at Maternity Hospital in Kuwait for induction of labor made up the study population; while an equivalent number of patients without medical complications who also were admitted for induction of labor made up the control group. The patients were assessed at admission, and their medical data were extracted. The study and control patients were monitored through labor/puerperium, and the outcome was documented. Results: Gestational diabetes mellitus was diagnosed in 71.9% of the study patients, a past history of diabetes mellitus was recorded in 81.34% of the study patients, and 49.2% of the patients were admitted at 8–12 weeks of gestation for diabetic control. The mean weight gained in pregnancy was significantly higher for control patients (11.52±5.643 versus [vs] 9.90±5.757 kg/m2; P<0.009, and the body mass index of study patients was higher (32.00±6.160 vs 28.20±5.885 kg/m2; P<0.0001. Of the study population, 64.3% of the patients were managed with diet and increased physical activity and 35.7% with insulin, diet, and increased physical activity. The incidences of maternal morbidity in both study and control groups were comparable, and the incidence of preeclampsia was low, at 2.3%. The gestational age at delivery was higher in the control group (39.02±1.834 weeks vs 38.62±1.773 weeks; P<0.0001, and the percentage of cesarean deliveries was higher in the study population (44.4% vs 33.3%; P=0.046. The Apgar scores of the both groups were comparable and in the normal range, and the

  5. Action research as a method for changing patient education practice in a clinical diabetes setting

    DEFF Research Database (Denmark)

    Voigt, Jane Rohde; Hansen, Ulla M.; Glindorf, Mette

    2014-01-01

    with researchers developed and implemented a participatory, group-based diabetes education program in a diabetes clinic in the Danish health care system. The research process included a variety of qualitative methods: workshops, classroom observations, video recordings and semi-structured interviews. These methods...... aimed at obtaining contextual sensitivity, allowing dynamic interactions with educators and people with diabetes. Despite challenges, the study demonstrates how action research methods contribute to development and change of diabetes education practice while simultaneously adding knowledge to the action...

  6. IMMUNOLOGICAL MARKERS OF DIABETES MELLITUS IN VARIOUS CLINICAL VARIANTS OF THE DISORDER

    OpenAIRE

    G. G. Baiburina

    2011-01-01

    Abstract. We studied immune markers of diabetes mellitus, as well as their relations to clinical features at the onset of disease. The patients with newly diagnosed diabetes were examined. Antibodies to glutamate decarboxylase, islet-cell cytoplasm antigen, along with antibodies to insulin and basal C-peptide were tested. Immunological markers of type 1 diabetes mellitus have been identified in 58% of cases. The immune markers of type 2 diabetes mellitus have been discovered in 47.5% of cases...

  7. mRNA and DNA detection of human papillomaviruses in women of all ages attending two colposcopy clinics.

    Directory of Open Access Journals (Sweden)

    Aris Spathis

    Full Text Available OBJECTIVE: HPV infection is a common finding, especially in young women while the majority of infections are cleared within a short time interval. The aim of this study was to examine the efficacy of HPV DNA and mRNA testing in a population attending colposcopy units of two University hospitals. METHODS: 1173 liquid based cervical samples from two colposcopy clinics were tested for HPV DNA positivity using a commercial typing kit and HPV E6/E7 mRNA positivity with a flow cytometry based commercial kit. Statistic measures were calculated for both molecular tests and morphological cytology and colposcopy diagnosis according to histology results. RESULTS: HPV DNA, high-risk HPV DNA, HPV16 or 18 DNA and HPV mRNA was detected in 55.5%, 50.6%, 20.1% and 29.7% of the cervical smears respectively. Concordance between the DNA and the mRNA test was 71.6% with their differences being statistically significant. Both tests' positivity increased significantly as lesion grade progressed and both displayed higher positivity rates in samples from women under 30 years old. mRNA testing displayed similar NPV, slightly lower sensitivity but significantly higher specificity and PPV than DNA testing, except only when DNA positivity for either HPV16 or 18 was used. CONCLUSIONS: Overall mRNA testing displayed higher clinical efficacy than DNA testing, either when used as a reflex test or as an ancillary test combined with morphology. Due to enhanced specificity of mRNA testing and its comparable sensitivity in ages under 25 or 30 years old, induction of mRNA testing in young women could be feasible if a randomized trial verifies these results.

  8. Prevalence and predictors of intimate partner violence among women attending infertility clinic in south-western Nigeria.

    Science.gov (United States)

    Aduloju, Peter O; Olagbuji, Nelson B; Olofinbiyi, Ajayi B; Awoleke, Jacob O

    2015-05-01

    The study evaluated the prevalence and predictors of intimate partner violence among infertile women attending infertility clinic of Ekiti State University Teaching Hospital, Ado-Ekiti. A cross sectional study of infertile women presenting at the clinic between 1st November 2012 and 31st October 2013 was done. A semi-structured questionnaire on violence was administered to 170 consecutive women who consented to participate. The data were analysed using SPSS 17 and significances test were performed on variables associated with violence with Student's t test and Chi square test. Logistic regression was done to determine predictive factors associated with intimate partner violence. The prevalence of intimate partner violence associated with infertility among the women was 31.2%. There were no significant differences in the age of the women, duration of marriage and duration of infertility between the women who had experienced violence and those who had not experienced it; p>0.05. Unemployment, polygamous marriage, husbands' social habits, primary infertility and prolonged duration of infertility were associated with violence in these women; pviolence; p>0.05. However with logistic regression, the unemployment status of the women and prolonged duration of infertility were the predictors of violence against women with infertility in this study, p valueviolence as the commonest form of violence experienced by them ever, since the diagnosis of infertility was made and in the past one year. All forms of violence experienced were aggravated by infertility in these women. Women with infertility are prone to intimate partner violence and this would further aggravate the challenges of infertility being faced by these women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. DRUG SAFETY MONITORING IN PATIENTS ATTENDING EPILEPSY CLINIC IN A TERTIARY CARE TEACHING HOSPITAL IN RURAL BENGAL

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    Sourav

    2016-02-01

    Full Text Available BACKGROUND Epilepsy is the second most common neurological disorder affecting fifty million people globally. Antiepileptic Drugs (AEDs are the mainstay of management in epilepsy. Use of AEDs over prolonged duration makes occurrence of multiple Adverse Drug Reactions (ADRs frequently, especially with polytherapy. OBJECTIVES To estimate the incidence of all the ADRs among patients taking AEDs and to assess their causalities and to quantify their severity. MATERIAL AND METHODS This prospective, observational study was carried out at an Outpatient Referral Epilepsy Clinic at Neurology Department at Bankura Sammilani Medical College, West Bengal, between 1st June and 30th September 2015. The demographic data, diagnosis, drugs prescribed and ADRs experienced by the patients were recorded. Causality and severity assessment was done using Naranjo’s Scale and Hartwig’s Severity Assessment Scale respectively. RESULTS Incidence of ADRs among the patients who attended the clinic was 3.3% (105 patients among 3146 experienced at least one ADR. Total 161 ADRs were detected, among which 55.3% were CNS adverse events followed by 15.5% gastrointestinal, 14.3% endocrine, 10.6% psychiatric abnormalities and 4.3% related to dermatological and allergic manifestations. Nearly one-third of the ADRs (32.3% were found to be possible and 109 (67.7% are of probable category, whereas none were deemed to be doubtful or definite. The most commonly implicated suspect drug was valproate (51.5% followed by Phenytoin (22.9%. Most of the ADRs were mild (93.2%, 5.6% were moderate and only 1.2% were deemed severe. CONCLUSION Incidence of ADRs is found to be common in patients on AEDs. Though rare, but they can be life-threatening. Routine safety assessments and pharmacovigilance is necessary in this set up to reduce the incidence and also improve pharmacotherapy and patient compliance

  10. Parvovirus B19 antibodies and correlates of infection in pregnant women attending an antenatal clinic in central Nigeria

    Directory of Open Access Journals (Sweden)

    Samuel E Emiasegen

    2011-03-01

    Full Text Available Human parvovirus B19 infection is associated with spontaneous abortion, hydrops foetalis, intrauterine foetal death, erythema infectiosum (5th disease, aplastic crisis and acute symmetric polyarthropathy. However, data concerning Nigerian patients with B19 infection have not been published yet. The purpose of this study was to establish the prevalence of B19 IgG and IgM antibodies, including correlates of infection, among pregnant women attending an antenatal clinic in Nigeria. Subsequent to clearance from an ethical committee, blood samples were collected between August-November 2008 from 273 pregnant women between the ages of 15-40 years who have given their informed consent and completed self-administered questionnaires. Recombinant IgG and IgM enzyme linked immunosorbent assay kits (Demeditec Diagnostics, Germany were used for the assays. Out of the 273 participants, 111 (40.7% had either IgG or IgM antibodies. Out of these, 75 (27.5% had IgG antibodies whereas 36 (13.2% had IgM antibodies, and those aged 36-40 years had the highest prevalence of IgG antibodies. Significant determinants of infection (p < 0.05 included the receipt of a blood transfusion, occupation and the presence of a large number of children in the household. Our findings have important implications for transfusion and foeto-maternal health policy in Nigeria. Routine screening for B19 IgM antibodies and accompanying clinical management of positive cases should be made mandatory for all Nigerian blood donors and women of childbearing age.

  11. Digital divide: variation in internet and cellular phone use among women attending an urban sexually transmitted infections clinic.

    Science.gov (United States)

    Samal, Lipika; Hutton, Heidi E; Erbelding, Emily J; Brandon, Elizabeth S; Finkelstein, Joseph; Chander, Geetanjali

    2010-01-01

    We sought to describe: (1) the prevalence of internet, cellular phone, and text message use among women attending an urban sexually transmitted infections (STI) clinic, (2) the acceptability of health advice by each mode of information and communication technology (ICT), and (3) demographic characteristics associated with ICT use. This study is a cross-sectional survey of 200 English-speaking women presenting to a Baltimore City STI clinic with STI complaints. Participants completed a self-administered survey querying ICT use and demographic characteristics. Three separate questions asked about interest in receiving health advice delivered by the three modalities: internet, cellular phone, and text message. We performed logistic regression to examine how demographic factors (age, race, and education) are associated with likelihood of using each modality. The median age of respondents was 27 years; 87% were African American, and 71% had a high school diploma. The rate of any internet use was 80%; 31% reported daily use; 16% reported weekly use; and 32% reported less frequent use. Almost all respondents (93%) reported cellular phone use, and 79% used text messaging. Acceptability of health advice by each of the three modalities was about 60%. In multivariate analysis, higher education and younger age were associated with internet use, text messaging, and cellular phone use. Overall rate of internet use was high, but there was an educational disparity in internet use. Cellular phone use was almost universal in this sample. All three modalities were equally acceptable forms of health communication. Describing baseline ICT access and the acceptability of health advice via ICT, as we have done, is one step toward determining the feasibility of ICT-delivered health interventions in urban populations.

  12. Vitamin D status among immigrant mothers from Pakistan, Turkey and Somalia and their infants attending child health clinics in Norway.

    Science.gov (United States)

    Madar, Ahmed A; Stene, Lars C; Meyer, Haakon E

    2009-04-01

    High prevalences of vitamin D deficiency have been reported in non-Western immigrants moving to Western countries, including Norway, but there is limited information on vitamin D status in infants born to immigrant mothers. We aimed to describe the vitamin D status and potentially correlated factors among infants aged 6 weeks and their mothers with Pakistani, Turkish or Somali background attending child health clinics in Norway. Eighty-six healthy infants and their mothers with immigrant background were recruited at the routine 6-week check-up at nine centres between 2004 and 2006. Venous or capillary blood was collected at the clinics from the mother and infant, and serum separated for analysis of 25-hydroxyvitamin D (s-25(OH)D) and intact parathyroid hormone (s-iPTH). The mean maternal s-25(OH)D was 25.8 nmol/l, with 57 % below 25 nmol/l and 15 % below 12.5 nmol/l. Of the mothers, 26 % had s-iPTH>5.7 pmol/l. For infants, mean s-25(OH)D was 41.7 nmol/l, with 47 % below 25 nmol/l and 34 % below 12.5 nmol/l. s-25(OH)D was considerably lower in the thirty-one exclusively breast-fed infants (mean 11.1 nmol/l; P < 0.0001). Use of vitamin D supplements and education showed a positive association with maternal s-25(OH)D. There was no significant association between mother's and child's s-25(OH)D, and no significant ethnic or seasonal variation in s-25(OH)D for mothers or infants. In conclusion, there is widespread vitamin D deficiency in immigrant mothers and their infants living in Norway. Exclusively breast-fed infants who did not receive vitamin D supplements had particularly severe vitamin D deficiency.

  13. Dental Anxiety and the Use of Oral Health Services Among People Attending Two HIV Primary Care Clinics in Miami

    Science.gov (United States)

    Singer, Richard; Cardenas, Gabriel; Xavier, Jessica; Jeanty, Yves; Pereyra, Margaret; Rodriguez, Allan; Metsch, Lisa R.

    2012-01-01

    Objectives We examined factors associated with dental anxiety among a sample of HIV primary care patients and investigated the independent association of dental anxiety with oral health care. Methods Cross-sectional data were collected in 2010 from 444 patients attending two HIV primary care clinics in Miami-Dade County, Florida. Corah Dental Anxiety Scores and use of oral health-care services were obtained from all HIV-positive patients in the survey. Results The prevalence of moderate to severe dental anxiety in this sample was 37.8%, while 7.9% of the sample was characterized with severe dental anxiety. The adjusted odds of having severe dental anxiety were 3.962 times greater for females than for males (95% confidence interval [CI] 1.688, 9.130). After controlling for age, ethnicity, gender, education, access to dental care, and HIV primary clinic experience, participants with severe dental anxiety had 69.3% lower adjusted odds of using oral health-care services within the past 12 months (vs. longer than 12 months ago) compared with participants with less-than-severe dental anxiety (adjusted odds ratio = 0.307, 95% CI 0.127, 0.742). Conclusion A sizable number of patients living with HIV have anxiety associated with obtaining needed dental care. Routine screening for dental anxiety and counseling to reduce dental anxiety are supported by this study as a means of addressing the impact of dental anxiety on the use of oral health services among HIV-positive individuals. PMID:22547875

  14. Substance-dependent women attending a de-addiction center in North India: Sociodemographic and clinical profile

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    Grover S

    2005-07-01

    Full Text Available Background: Treatment-seeking is limited in women substance abusers. Studying the sociodemographic and clinical profile of treatment-seeking substance-dependent women can help us to understand the problem better and respond appropriately in terms of primary and secondary prevention strategies. Aim: To study the sociodemographic and clinical profile of women attending a de-addiction centre in North India. Design and Methodology: Retrospective structured chart review of 35 women substance abusers. Results: The results indicated that a typical subject was urban (86%, married (63%, nuclear family (60%, based housewife (57%, educated up to school completion (54%, and having poor social support (57%. The common substances were opioids (60%, followed by alcohol (17%, and tobacco and benzodiazepines (11.5% each. The mean age at onset of substance use was 30.5 years, the mean duration of use was 9 years and mean duration to develop dependence was 5.5 years. The common reasons for initiating use were medical (63% and curiosity (34%. Comorbidity profile was: physical illness (34%, psychiatric illness (23% and dependence on another substance (14%. Only 20% had a family history of substance dependence. The social impairment ranged from 77% for social to 40% for financial and none for legal aspects. A typical subject had followed up 4.2 times in 8.4 months, while 54% were abstaining, 40% were continuing their substance dependence at the last follow up. Conclusions: The results suggest that the development of substance dependence in women is a combination of genetic, personal, and social vulnerability factors, including the drug culture of the social milieu and the poor social support. Comorbidity and impairment are common features.

  15. Pattern of Headache in School Going Children Attending Specialized Clinic in aTertiary Care Hospital in Bangladesh

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    Md Azharul Hoque

    2012-09-01

    Full Text Available Objective: To determine the pattern of headache and its associated symptoms in school going children.Methods: The data of all the school going children attending the Headache Clinic in the Dept. of Neurology, Dhaka Medical College Hospital were retrospectively reviewed. A total of 1021 patients from October 1996 to September 2011 were selected. Data were collected through a predesigned questionnaire containing information on age, sex, social status, clinical features, opthalmoscopic findings, management, and in selected cases imaging results.Result: The mean age of headache in school children was 12.6±1.08 years with relatively older age of presentation among girls. The sex ratio was 1.64:1 in favor of girls at older age. Tension type headache (71.1% was the most common form of headache, followed by migraine (18.4% and mixed headache (6.7%. Though the girls had more frequent headache of both tension type (59.4% and migraine (68.1% variety, the latter was significantly associated in girls (p<0.001. Headache was of moderate severity in 53.3%, whereas severe headache was experienced by 19.9% of the children. The children commonly had nausea and/or vomiting (47.2%, as well as photophobia (24.7% with headache. Mentalstress (34% and sunlight (30.9% were common triggering factors whereas a sound sleep relieved headache in the majority (59.4%. Paracetamol (83.3% and nor tryptyline (62.8% were the most commonly prescribed drug taken by them.Conclusion: Headache is a major health problem in school children, apart from other common health issues at this age. With increasing age, the girls more commonly suffer not only from migraine but also with other chronic headache. The direct causal association is yet to be determined.

  16. Knowledge gaps and misconceptions about over-the-counter analgesics among adolescents attending a hospital-based clinic.

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    Wilson, Karen M; Singh, Pamela; Blumkin, Aaron K; Dallas, Lindsay; Klein, Jonathan D

    2010-01-01

    Although many adolescents use over-the-counter (OTC) analgesics, their knowledge about these drugs is unclear. This study evaluates misconceptions and knowledge gaps about OTC side effects, risks, and interactions among adolescents attending a hospital-based clinic. Adolescents aged 14 to 20 years presenting to an outpatient clinic were surveyed using a computer-administered instrument. Participants answered questions regarding their use of specific OTC medications and knowledge of side effects, risks, and interactions of these drugs. A summary score of percent correct answers on knowledge questions was created, and univariate and multivariate statistical techniques examined differences between groups. Ninety-six adolescents completed the survey. Most (78%) adolescents had used OTC medications in the previous month. The most frequently reported OTC medications used were analgesics, including ibuprofen (46%), and Tylenol (45%); acetaminophen ingestion was reported by 15% of respondents. Although 35% reported knowing what acetaminophen is, 37% of these did not correctly identify acetaminophen and Tylenol as the same medication. The average overall knowledge score was 44%. In regression models including demographics, and OTC product use, older adolescents had higher overall average knowledge scores. Hispanic teens had less reported use and lower knowledge scores than adolescents of other race/ethnicities. Most adolescents use OTC analgesics, but many are confused about generic and brand name forms. There were also significant knowledge gaps about OTC use, side effects, and contraindications, especially for acetaminophen. Clinicians should be aware of the potential for OTC medication misuse by adolescent patients. 2010 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. [Clinical characteristics of 7 patients with gestational diabetes insipidus].

    Science.gov (United States)

    Wu, Li-Qun; Xiong, Chun-Qiu; Wu, Min; Dong, Ruo-Lin; Chen, Yun-Qin; Gao, Jie; Chen, Ou-Jing; Huang, Yin-Ping

    2008-04-01

    To investigate the clinical feature, treatment and prognosis of both the mother and the fetus with gestational diabetes insipidus. A total of 7 cases of gestational diabetes insipidus collected in the First Affiliated Hospital of Wenzhou Medical College, Wenzhou Combination of Traditional Chinese Medicine with Western Medicine Hospital, and Zhejiang Taizhou Hospital from June 1993 to June 2006 were analyzed retrospectively. Seven cases symptoms all characterized by excessive thirst polydipsia and polyuria. The average 24 h urinary output was between 11 L to 13 L and manifested of hypobaricuria. After effective treatment (three cases were treated with 1-deamino-8-D-arginine vasopressin, another three patients were managed with hydrochlorothiazide, and the last one was cured with antisterone), seven patients with gestational diabetes insipidus did not have any severe consequences. Their symptoms of excessive thirst, polyuria, and polydypsia disappeared from 7 days to 3 months after parturition. Urinary volume returned to normal standard of 1000-2000 ml during 24 hours. Specific gravity of urine recovered normally between a range 1.015-1.025 and serum sodium recovered between 135-147 mmol/L. The average duration of illness was 52 days. Eight newborn infants survived. Two of them were sent to neonatal intensive care unit for treatment. One was because of premature delivery caused by antepartum eclampsia, and the other case was one of the twins who had hydronephrosis. The baby of the first case left hospital after 3 weeks' treatment. The latter one's symptom disappeared 2 weeks after delivery. No obvious symptom was discovered among all the babies through follow-up telephone calls 42 days after childbirth. Gestational diabetes insipidus is a rare endocrinopathy complicating pregnancy. This disorder is characterized by excessive thirst, polydypsia, polyuria, hypobaric urine and electrolyte disturbances usually manifesting in the third trimester of pregnancy or puerperium

  18. Diabetes mellitus: Identifying the knowledge gaps and risk factors among adolescents attending a public school in Lagos State

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    Lovelyn Otammi Ubangha

    2016-01-01

    Full Text Available Background: The prevalence of diabetes mellitus (DM, a noncommunicable disease (NCD in adolescents, is on the rise worldwide; therefore, knowledge which facilitates prevention and early detection is important. The objective of this study was to determine the knowledge of DM and self-reported risk factors among adolescents in a senior secondary school, in Surulere, Lagos State. Methodology: This was a cross-sectional descriptive study of 144 male and 106 female senior secondary students with a mean age of 15.2 ΁ 1.3 years. Respondents were selected through multistage sampling technique. A structured pretested questionnaire was used to collect data. Epi Info 7.1.5 was used for data analysis and the level of statistical significance was set at 5%. Results obtained were presented with the use of frequency tables. Results: Two out of three respondents had heard of DM. Among those who were aware of the condition, 64.9% knew it referred to abnormally high blood glucose. Only (10.9% knew it was a lifelong condition and less than a third (26.7% knew the measurement of blood glucose with a device for the screening test. Less than 30% considered obesity, family history, diet, and physical inactivity as risk factors. Their main source of information was the mass media. Overall, 46% of respondents had good knowledge of DM. As regards the presence of lifestyle behavior/risk factor for DM/NCDs in the respondents, 8.4% of the respondents had a family history of DM, had consumed alcohol (28.8%, smoked tobacco (4.8%, and were overweight/obese (5.2%. Conclusion: Two-thirds were aware of DM, of which over half had inadequate knowledge of DM despite the existence of some risk factors. There should, therefore, be an inclusion of NCD education in the curriculum of secondary school students.

  19. The Clinical Importance of Changes in Diabetic Retinopathy Severity Score.

    Science.gov (United States)

    Ip, Michael S; Zhang, Jiameng; Ehrlich, Jason S

    2017-05-01

    To investigate the clinical importance of changes in diabetic retinopathy severity score (DRSS) in patients with diabetic macular edema (DME) treated with intravitreal ranibizumab. Post hoc analysis of the phase III RIDE and RISE studies of ranibizumab for treatment of DME. Four hundred sixty-eight eyes treated with ranibizumab from randomization with gradable DRSS on baseline fundus photographs. Visual and anatomic outcomes were examined in eyes grouped according to DRSS change from baseline to month 24. Mean best-corrected visual acuity (BCVA) letter score change, proportion of patients with 15 or more Early Treatment Diabetic Retinopathy Study (ETDRS) letter score change, mean contrast sensitivity change, proportion of patients with resolved macular edema, and leakage on fluorescein angiography. Most (56.8%) patients treated with ranibizumab experienced 1-step or more improvement in DRSS from baseline to month 24; 40.0% had no change, and 3.2% experienced DRSS worsening. Patients with DRSS stability or improvement had greater mean BCVA letter score changes (+15.1, +14.2, +11.3, and +11.2 letters for ≥3-step improvement, ≥2-step improvement, 1-step improvement, and no DRSS change, respectively) compared with +5.0 letters in patients who had any DRSS worsening. Best-corrected visual acuity letter score gain of 15 letters or more was more common in patients with 2-step or 3-step or more DRSS improvement (51.9% and 44.6%, respectively) compared with those with a 1-step DRSS improvement, no change, or worsening (37.9%, 39.6%, and 26.7%, respectively). A loss of 15 letters or more in BCVA was more common in patients with any DRSS worsening (13.3%) compared with patients who had stable or improved DRSS (0%-2.8%). Resolution of macular edema was more common in patients with DRSS improvement: 84.2%, 87.7%, and 92.3% of patients with 1-step, 2-step or more, and 3-step or more improvement in DRSS achieved central foveal thickness of 250 μm or less, compared with

  20. Italian Association of Clinical Endocrinologists (AME) & Italian Association of Clinical Diabetologists (AMD) Position Statement : Diabetes mellitus and thyroid disorders: recommendations for clinical practice.

    Science.gov (United States)

    Guastamacchia, Edoardo; Triggiani, Vincenzo; Aglialoro, Alberto; Aiello, Antimo; Ianni, Lucia; Maccario, Mauro; Zini, Michele; Giorda, Carlo; Guglielmi, Rinaldo; Betterle, Corrado; Attanasio, Roberto; Borretta, Giorgio; Garofalo, Piernicola; Papini, Enrico; Castello, Roberto; Ceriello, Antonio

    2015-06-01

    Thyroid disease and diabetes mellitus, the most common disorders in endocrine practice, are not infrequently associated in the same subject. An altered thyroid function may affect glucose tolerance and worsen metabolic control in patients with diabetes. Thyrotoxicosis increases the risk of hyperglycemic emergencies, while a clinically relevant hypothyroidism may have a detrimental effect on glycemic control in diabetic patients. The association of alterations in thyroid function with diabetes mellitus may adversely affect the risk of cardiovascular and microvascular complications resulting from diabetes. Moreover, the treatments used for both diabetes and thyroid disease, respectively, can impact one other. Finally, multinodular goiter, but not thyroid carcinoma, was shown to be more prevalent in type 2 diabetes mellitus. Aim of the present Position Statement is to focus on the evidence concerning the association of thyroid disease and diabetes mellitus and to provide some practical suggestions for an updated clinical management.

  1. Clinical Application of Multiplex PCR Assay for the Diagnosis of the Etiology of Genital Ulcer Disease Among Patients Attending STD Clinics in Guangzhou, China

    Institute of Scientific and Technical Information of China (English)

    朱慧兰; 苏向阳; 林路洋; 叶兴东

    2002-01-01

    Objectives: To develop a method of simultaneous PCRdetection of Haemophilus ducreyi, Treponema pallidum, andHerpes Simplex Virus Types 1 and 2 from genital ulcersamong patients attending STD clinics in Guangzhou, China;and evaluate the clinical application of multiplex PCR (M-PCR) assay for diagnosing the etiology of genital ulcerdiseases (GUD). Methods: 244 patients with a genital ulcer were evaluated.Clinical etiology of GUD was based on physical appearanceand microbiologic evaluations that included dark fieldmicroscopy examination (D-F) and serology test for syphilis(STS). Swabs of each genital ulcer were tested for HSVantigen by enzyme immunoassay (EIA) and processed in anM-PCR assay for simultaneous detection of T. pallidum, HSVand H. ducreyi. Results: The standard strains of T. pallidum, HSV and H.ducreyi were amplified by M-PCR, producing amplifiedproducts of 260bp,432bp,170bp, respectively. The sensitivityof M-PCR is 102pg DNA. M-PCR assay for T. pallidum, HSVand H. ducreyi showed good agreement when compared withD-F detection for T. pallidum, STS, H. ducreyi culture and EIAfor HSV antigen (Kappa scores are 0.774,0.704,0.793,0.756,respectively). Conclusions: The M-PCR is a convenient, accurate andreliable assay for the detection of T. pallidum, HSV and H.ducreyi from genital ulcers, and can be used as a method of diagnosing the etiology of GUD.

  2. Clinical profile, outcomes, and progression to type 2 diabetes among Indian women with gestational diabetes mellitus seen at a diabetes center in south India

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    Manni Mohanraj Mahalakshmi

    2014-01-01

    Full Text Available Aim: To describe the clinical profile, maternal and fetal outcomes, and the conversion rates to diabetes in women with gestational diabetes mellitus (GDM seen at a tertiary care diabetes center in urban south India. Materials and Methods: Clinical case records of 898 women with GDM seen between 1991 and 2011 were extracted from the Diabetes Electronic Medical Records (DEMR of a tertiary care diabetes center in Chennai, south India and their clinical profile was analyzed. Follow-up data of 174 GDM women was available. To determine the conversion rates to diabetes, oral glucose tolerance test (OGTT was done in these women. Glucose tolerance status postpartum was classified based on World Health Organization (WHO 2006 criteria. Results: The mean maternal age of the women was 29 ± 4 years and mean age of gestation at first visit were 24 ± 8.4 weeks. Seventy percent of the women had a family history of diabetes. Seventy-eight percent of the women delivered full-term babies and 65% underwent a cesarean section. The average weight gain during pregnancy was 10.0 ± 4.2 kg. Macrosomia was present in 17.9% of the babies, hypoglycemia in 10.4%, congenital anomalies in 4.3%, and the neonatal mortality rate was 1.9%. Mean follow-up duration of the 174 women of whom outcome data was available was 4.5 years. Out of the 174, 101 women who were followed-up developed diabetes, of whom half developed diabetes within 5 years and over 90%, within 10 years of the delivery. Conclusions: Progression to type 2 diabetes mellitus (T2DM in Indian women with GDM is rapid. There is an urgent need to develop standardized protocols for GDM care in India that can improve the maternal and fetal outcomes and help prevent future diabetes in women with GDM.

  3. Skilled birth attendance: what does it mean and how can it be measured? A clinical skills assessment of maternal and child health workers in Nepal.

    Science.gov (United States)

    Carlough, M; McCall, M

    2005-05-01

    The presence of a skilled birth attendant at delivery is important in averting maternal and neonatal mortality and morbidity. It has now shown that even trained traditional birth attendants (TBAs) cannot, in most cases, save women's lives effectively because they are unable to treat complications, and are often unable to refer. Qualified midwives and doctors are often not available in the rural areas and community settings where most women in developing countries deliver. Defining the minimum competency level necessary to meet the definition of skilled birth attendant is important, particularly in countries such as Nepal with limited availability of facility-based emergency obstetric care. Maternal and child health workers are local women aged 18-35 who completed a 15-week course in maternal and child health. As the role of MCHWs has expanded to meet the country's needs for skilled attendance, a 6-week "refresher" course in midwifery skills is offered. The results of this clinical skills assessment of 104 randomly selected MCHWs from 15 districts across Nepal supports the premise that MCHWs with appropriate training have an acceptable level of knowledge and skill, demonstrated in a practice situation, to meet the definition of community level skilled birth attendants. Yet, competency alone will not necessarily improve the situation. To affect maternal mortality in Nepal, MCHWs must be widely available, they must be allowed to do what they are trained to do, and they must have logistical and policy support.

  4. Investigating the role of healthcare centre accessibility on the decision to attend for screening for gestational diabetes mellitus in Ireland [presentation

    LENUS (Irish Health Repository)

    Cullinan, John

    2011-01-01

    Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with several serious maternal and neonatal complications and conditions. Screening practices for GDM vary within and across European countries, with some offering universal screening to all pregnant women and others only to selective high risk groups. In Ireland, no single policy with respect to GDM screening is implemented nationally and a debate exists as to what form such a policy should take. Within this context, the Atlantic Diabetes in Pregnancy (ATLANTIC DIP) network was established in 2005 to provide robust information on pregnancy outcomes for women with diabetes. The network includes five healthcare centres along the Atlantic seaboard and provides testing for all pregnant women at 24-28 weeks using a 75g Oral Glucose Tolerance Test. The centres are linked using a clinical information system which allows for data to be captured within a central database, containing a comprehensive range of data on screening uptake rates, maternal characteristics, outcomes for mothers and infants, healthcare resource usage over the course of pregnancy, as well as the postal address of each individual. At present it contains observations on 9,043 pregnant women offered the screening, 5,218 (58%) of whom participated in testing.\\r\

  5. Quality of life of People living with HIV and AIDS attending the Antiretroviral Clinic, University College Hospital, Nigeria

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    Oluyemisi F. Folasire

    2012-02-01

    Full Text Available Background: Quality of life (QOL is an important component in the evaluation of the well-being of people living with HIV and AIDS (PLWHA, especially with the appreciable rise in longevity of PLWHA. Moreover, limited studies have been conducted in Nigeria on how PLWHA perceive their life with the World Health Organisation Quality of Life Brief Scale (WHOQOL-Bref instrument. Objective: This study assessed the QOL of PLWHA attending the antiretroviral (ARV clinics, UCH Ibadan, Nigeria.Method: A cross-sectional study was conducted from June to September 2008 that involved 150 randomly selected HIV-positive patients who were regular attendees at the antiretroviral clinic, UCH Ibadan. An interviewer administered questionnaire was used to collect information on sociodemographic data, satisfaction with perceived social support, medical records, and QOL was assessed with WHOQOL-Bref.Results: The mean age of the respondents was 38.1 ± 9.0 years and the male : female ratio was 1:2. The mean CD4 count was higher in female patients than in male patients, 407 cells/mm3 : 329 cells/mm3 (p = 0.005. The mean QOL scores on the scale of (0–100 in three domains were similar: psychological health, 71.60 ± 18.40; physical health, 71.60 ± 13.90; and the environmental domain, 70.10 ± 12.00; with the lowest score in the social domain, 68.89 ± 16.70. Asymptomatic HIV-positive patients had significantly better mean QOL scores than symptomatic patients in the physical (74.04 ± 16.85 versus 64.47 ± 20.94, p = 0.005 and psychological domains (76.09 ± 12.93 versus 69.74 ± 15.79, p = 0.015. There was no significant difference in the mean QOL scores of men compared to those of women, in all domains assessed.Conclusion: High QOL scores in the physical, psychological and environmental domains may be reflective of the effectiveness of some of the interventions PLWHA are exposed to at the ARV clinic, UCH Ibadan (on-going psychotherapy, free antiretroviral drugs

  6. [Sex- and gender-aspects in regard to clinical practice recommendations for pre-diabetes and diabetes].

    Science.gov (United States)

    Kautzky-Willer, Alexandra; Abrahamian, Heidemarie; Weitgasser, Raimund; Fasching, Peter; Hoppichler, Fritz; Lechleitner, Monika

    2016-04-01

    Metabolic diseases dramatically affect life of men and women from infancy up to old age and are a major challenge for clinicians. Health professionals are confronted with different needs of women and men. This article aims at an increase of gender awareness and the implementation of current knowledge of gender medicine in daily clinical practice with regard to pre-diabetes and diabetes. Sex and gender affect screening and diagnosis of metabolic diseases as well as treatment strategies and outcome. Impaired glucose and lipid metabolism, regulation of energy balance and body fat distribution are related to steroid hormones and therefore impose their influence on cardiovascular health in both men and women. Furthermore, education, income and psychosocial factors relate to development of obesity and diabetes differently in men and women. Males appear to be at greater risk of diabetes at younger age and at lower BMI compared to women, but women feature a dramatic increase of their cardiometabolic risk after menopause. The estimated future years of life lost owing to diabetes is somewhat higher in women than men, with higher increase of vascular death in women, but higher increase of cancer death in men. In women pre-diabetes or diabetes are more distinctly associated with a higher number of vascular risk factors, such as inflammatory parameters, unfavourable changes of coagulation and blood pressure. Pre-diabetic and diabetic women are at much higher relative risk for vascular disease. Women are more often obese and less physically active, but may even have greater benefit from increased physical activity than males. Whereas men predominantly feature impaired fasting glucose, women often show impaired glucose tolerance. A history of gestational diabetes or the presence of a PCOS or increased androgen levels in women, on the other hand the presence of erectile dysfunction (ED) or decreased testosterone levels in men are sex specific risk factors for diabetes development

  7. Surveillance of transmitted antiretroviral drug resistance among HIV-1 infected women attending antenatal clinics in Chitungwiza, Zimbabwe.

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    Mqondisi Tshabalala

    Full Text Available The rapid scale-up of highly active antiretroviral therapy (HAART and use of single dose Nevirapine (SD NVP for prevention of mother-to-child transmission (pMTCT have raised fears about the emergence of resistance to the first line antiretroviral drug regimens. A cross-sectional study was conducted to determine the prevalence of primary drug resistance (PDR in a cohort of young (<25 yrs HAART-naïve HIV pregnant women attending antenatal clinics in Chitungwiza, Zimbabwe. Whole blood was collected in EDTA for CD4 counts, viral load, serological estimation of duration of infection using the BED Calypte assay and genotyping for drug resistance. Four hundred and seventy-one women, mean age 21 years; SD: 2.1 were enrolled into the study between 2006 and 2007. Their median CD4 count was 371cells/µL; IQR: 255-511 cells/µL. Two hundred and thirty-six samples were genotyped for drug resistance. Based on the BED assay, 27% were recently infected (RI whilst 73% had long-term infection (LTI. Median CD4 count was higher (p<0.05 in RI than in women with LTI. Only 2 women had drug resistance mutations; protease I85V and reverse transcriptase Y181C. Prevalence of PDR in Chitungwiza, 4 years after commencement of the national ART program remained below WHO threshold limit (5%. Frequency of recent infection BED testing is consistent with high HIV acquisition during pregnancy. With the scale-up of long-term ART programs, maintenance of proper prescribing practices, continuous monitoring of patients and reinforcement of adherence may prevent the acquisition and transmission of PDR.

  8. Prevalence of HBV Infection and Knowledge of Hepatitis B Among Patients Attending Primary Care Clinics in Poland.

    Science.gov (United States)

    Ganczak, Maria; Dmytrzyk-Daniłów, Gabriela; Korzeń, Marcin; Drozd-Dąbrowska, Marzena; Szych, Zbigniew

    2016-06-01

    It is well known that community awareness of hepatitis B (HB) can lead to vaccination and testing. The study objectives were to assess the prevalence of HBV infection and knowledge of HB among adult patients attending randomly selected primary care clinics. A cross-sectional sero-survey was conducted in March 2013 in the Zgorzelec region, Poland, with the use of an investigator-developed questionnaire containing 22 questions regarding HB knowledge. Serum samples were assayed for anti-HBc total and anti-HBs with enzyme immunoassay. The prevalence of anti-HBc total among 410 participants (median age 56 years) was 10.3 % (95 % CI 7.6-13.8 %), nobody was aware of an infection. The main sources of HB knowledge were the media and medical staff. The mean knowledge score was 14.8 ± 4.9; 76.7 % of the respondents had scores >50 %. Particular gaps were detected relating to knowledge of unprotected sexual intercourse and MTCT; 45.6 % patients were not aware of the potential asymptomatic course of HBV infection, 41.2 % about chronic HB treatment. A patient's low educational level was negatively associated with a high knowledge level; the willingness for further education on HB and HBV vaccination in the past were independently associated with good knowledge. In conclusion, the HBV infection remains a public health threat in Poland, since the prevalence of infection markers in asymptomatic adult patients was high. Knowledge gaps call for awareness campaigns which may increase testing and diagnosis, audiences representing lower education level should be targeted first. Knowledge on HB might serve as an effective tool in decision making regarding vaccination.

  9. Seroprevalence of hepatitis B surface antigen in pregnant women attending antenatal clinic in Honiara Solomon Islands, 2015

    Science.gov (United States)

    Getahun, Aneley; Baekalia, Margaret; Panda, Nixon; Lee, Alice; Puiahi, Elliot; Khan, Sabiha; Tahani, Donald; Manongi, Doris

    2016-01-01

    AIM To determine the seroprevalence of hepatitis B surface antigen (HBsAg) among pregnant women attending antenatal clinic in Honiara, Solomon Islands. METHODS This descriptive cross-sectional study was carried out in seven area health centers in Honiara. From March to June 2015, identification of eligible pregnant women in each site was conducted using systematic random sampling technique. A total of 243 pregnant women who gave written informed consent were enrolled. Standardized tool was used to record demographics, obstetric history and serology results. HBsAg and hepatitis B e antigen (HBeAg) were tested using point-of-care rapid diagnostic test. All HBsAg positive samples were verified using enzyme-linked immunosorbent assay. RESULTS The mean age of participants was 26 ± 6 years. The overall hepatitis HBsAg prevalence was 13.8% with higher rate (22%) reported in women between 30-34 years of age. Majority of HBsAg positive participants were Melanesians (29 out for 33). None of the pregnant women in the 15-19 years and ≥ 40 years tested positive for HBsAg. There was no statistically significant difference in HBsAg prevalence by age, ethnicity, education and residential location. The overall HBeAg seroprevalence was 36.7%. Women between 20-24 years of age had the highest rate of 54.5%. Low level of knowledge about hepatitis B vaccination was reputed. Overall, 54.6% of participants were not aware of their hepatitis B vaccination status and only 65.2% of mothers reported their child had been vaccinated. CONCLUSION Hepatitis B is a disease of public health importance in Solomon Islands and emphasize the need for integrated preventative interventions for its control. PMID:28008343

  10. An assessment of serum prolactin levels among infertile women with galactorrhea attending a gynecological clinic North-West Nigeria

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    Emmanuel Ajuluchukwu Ugwa

    2016-01-01

    Full Text Available Background: Galactorrhea is a common manifestation of hyperprolactinemia but may not always be present in women with hyperprolactinemia. This study was, therefore, undertaken to assess the serum prolactin levels of infertile women presenting with galactorrhea and to determine the prevalence of hyperprolactinemia among them. Materials and Methods: This was a retrospective study of serum prolactin levels of 63 female partners of infertile couples attending the gynecological clinic of Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria, who were found to have galactorrhea from January 1, 2012, to December 31, 2013. Ethical clearance was obtained. Solid phase enzyme-linked immunosorbent assay was used to measure serum prolactin. Sociodemographic characteristics were determined. The data obtained were analyzed using SPSS version 17.0 statistical software. Absolute numbers and simple percentages were used to describe categorical variables. Similarly, quantitative variables were described using measures of central tendency (mean, median and measures of dispersion (range, standard deviation as appropriate. Results: The average age of the women was 27.9 ± 5.6 years. In half of the cases (50%, galactorrhea was associated with menstrual disturbances, mainly amenorrhea (23.3%. Although most (63.3% of the clients had normal serum prolactin level despite being galactorrheic, averagely there was a marked elevation in serum prolactin of as high as 40.3 ± 52.3 ng/mL. Conclusion: We conclude, therefore, that the prevalence of hyperprolactinemia in this study was low when compared with other studies and that galactorrhea does not always indicate raised serum prolactin levels.

  11. Correlates of subjective transportation deficiency among older adults attending outpatient clinics in a tertiary care hospital in Mexico City.

    Science.gov (United States)

    Navarrete-Reyes, Ana Patricia; Medina-Rimoldi, Carlos Tonatiuh; Avila-Funes, José Alberto

    2017-02-11

    Older adults frequently report problems of transportation. Little is known about the correlates of transportation deficiency in Latin America. Therefore, the aim of the present study was to determine the correlates of subjective transportation deficiency (STD) among community-dwelling older adults attending a tertiary care hospital in Mexico City. Cross-sectional study of 228 participants aged ≥70 years being followed in any of the outpatient clinics of a tertiary care hospital in Mexico City. Data were obtained through a structured questionnaire. Univariate and multivariate logistic regression analyses were carried out in order to identify the correlates of STD. The mean age of the participants was 79.8 years (SD 6.4) and 67.1% were women. STD was present in 46% of participants. The multivariate logistic regression model showed that female sex, illiteracy, mobility disability and the use of an assistive walking device had an independent and statistically significant association with STD. Female sex, illiteracy, mobility disability and the use of an assistive walking device were independent correlates of STD in the present study. Identifying the frequency and correlates of transportation deficiency in vulnerable populations will allow for the identification and implementation of useful public policies, as well as for the optimization of prevention and treatment strategies in an attempt to preserve mobility and autonomy, especially in low- and middle-income countries where previous work on transportation deficiency is lacking. Geriatr Gerontol Int 2016; ••: ••-••. © 2017 Japan Geriatrics Society.

  12. Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a Teaching Hospital in Nigeria

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    Umar M Lawan

    2014-01-01

    Full Text Available Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ≤12 months and caregivers was systematically selected and studied. The data were analyzed using the MINITAB ® 12.21 (USA statistical software. Results: All the infants studied were still on breast milk. Most of the mothers demonstrated correct body positioning (89.9 and attachment (78.7% during breastfeeding, and effective suckling was demonstrated in 77.0%. Interestingly, none of the infants was either exclusively breastfed for 6 months or currently on exclusive breastfeeding. Furthermore, only 64 (58.2% of the 110 infants that were more than 6 months of age had appropriately been started on complementary feeding from 6 months of age. Overall, most caregivers (88.7% had "fair" to "good" infant feeding practices. The practices were significantly associated with their level of education, and their relationship with the infants. Up to 40.0% and 73.7% of the infants had varying degrees of wasting and stunting respectively. Infant feeding practices and the age of the infants emerged as the only factors significantly associated with stunting, while both the caregivers′ practices and age of the infants emerged as significant predictors of wasting in the infants. Conclusion and Recommendations: Barely 3 years to the 2015 target of the millennium development goals (MDGs, infant feeding and nutritional status still poses a serious threat to the dream of realizing the MDG-4. The Ministry of Health and relevant developing partners in this region should as a matter of urgency, formulate and implement a strong community-based public health intervention program to

  13. Clinical aspects and management of osteoporosis and fragility fractures in patients with diabetes

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    Manju Chandran

    2017-09-01

    Full Text Available Both diabetes and osteoporosis are assuming epidemic proportions throughout the world. Accumulating data suggest that both types 1 and 2 diabetes are associated with an increased risk of fragility fractures. This increased risk appears to be largely independent of bone mineral density (BMD which is most often noted to be low in type 1 diabetes and normal or increased in type 2 diabetes. This review explores the clinical characteristics of bone fragility in patients with diabetes and highlights studies that have evaluated BMD and fracture prediction tools in these patients. It also briefly reviews the current management principles of osteoporosis in diabetes, with special emphasis on the impact of diabetes medications on bone health as well as explores the efficacy of currently available antiosteoporosis pharmacotherapy in the diabetic population.

  14. Association between diabetes-related factors and clinical periodontal parameters in type-2 diabetes mellitus

    Science.gov (United States)

    2013-01-01

    Background Evidence consistently shows that diabetes is a risk factor for increased prevalence of gingivitis and periodontitis. But there is a controversy about the relationship between diabetes related factors and periodontal health. The aim of the present study is to explore the relationship between diabetes related factors such as glycosylated hemoglobin, fasting blood glucose, duration of diabetes and compliance to diabetes self management and periodontal health status. Methods Periodontal health of 125 participants with type-2 diabetes mellitus was measured by the number of missing teeth, community periodontal index (CPI), Russell’s periodontal index and papillary bleeding index. Information on sociodemographic factors, oral hygiene behavior, duration and compliance to self management of diabetes, levels of glycosylated hemoglobin(HbA1c) and fasting blood glucose(FBG) were collected by interview and hospital medical records. Statistically, independent t-test, an analysis of variance (ANOVA), chi-squared test and multiple regression analyses were used to assess the association between diabetes-related factors and periodontal health. Results Periodontal parameters including the number of missing teeth and papillary bleeding index were significantly influenced by duration of diabetes, FBG and compliance to self management of diabetes. CPI was significantly influenced by duration of diabetes, FBG and HbA1C. And Russell’s periodontal index was significantly influenced by duration of diabetes, FBG, HbA1C and compliance to self management of diabetes. Results of multiple linear regression analysis showed that the duration of diabetes showed significant positive correlation with all of the periodontal health parameters, except for missing teeth. HbA1c was correlated with Russell's periodontal and papillary bleeding index. FBG and compliance to self management of diabetes were correlated with missing teeth and papillary bleeding index respectively. Conclusions

  15. Association between diabetes-related factors and clinical periodontal parameters in type-2 diabetes mellitus.

    Science.gov (United States)

    Kim, Eun-Kyong; Lee, Sang Gyu; Choi, Youn-Hee; Won, Kyu-Chang; Moon, Jun Sung; Merchant, Anwar T; Lee, Hee-Kyung

    2013-11-07

    Evidence consistently shows that diabetes is a risk factor for increased prevalence of gingivitis and periodontitis. But there is a controversy about the relationship between diabetes related factors and periodontal health. The aim of the present study is to explore the relationship between diabetes related factors such as glycosylated hemoglobin, fasting blood glucose, duration of diabetes and compliance to diabetes self management and periodontal health status. Periodontal health of 125 participants with type-2 diabetes mellitus was measured by the number of missing teeth, community periodontal index (CPI), Russell's periodontal index and papillary bleeding index. Information on sociodemographic factors, oral hygiene behavior, duration and compliance to self management of diabetes, levels of glycosylated hemoglobin(HbA1c) and fasting blood glucose(FBG) were collected by interview and hospital medical records. Statistically, independent t-test, an analysis of variance (ANOVA), chi-squared test and multiple regression analyses were used to assess the association between diabetes-related factors and periodontal health. Periodontal parameters including the number of missing teeth and papillary bleeding index were significantly influenced by duration of diabetes, FBG and compliance to self management of diabetes. CPI was significantly influenced by duration of diabetes, FBG and HbA1C. And Russell's periodontal index was significantly influenced by duration of diabetes, FBG, HbA1C and compliance to self management of diabetes. Results of multiple linear regression analysis showed that the duration of diabetes showed significant positive correlation with all of the periodontal health parameters, except for missing teeth. HbA1c was correlated with Russell's periodontal and papillary bleeding index. FBG and compliance to self management of diabetes were correlated with missing teeth and papillary bleeding index respectively. Diabetes-related factors such as duration of

  16. MRI of the cuboid bone: Analysis of changes in diabetic versus non-diabetic patients and their clinical significance

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    Pierre-Jerome, Claude, E-mail: cpierr3@emory.edu [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Musculoskeletal Division, Orthopaedics and Spine Center, 59, Executive Park South, Atlanta, GA 30329 (United States); Reyes, Emmanuel J.; Moncayo, Valeria; Chen, Zhengjia Nelson; Terk, Michael R. [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Musculoskeletal Division, Orthopaedics and Spine Center, 59, Executive Park South, Atlanta, GA 30329 (United States)

    2012-10-15

    Objectives: (1) To investigate the association between diabetes and marrow changes in the cuboid; and (2) to evaluate the influence of age, gender, body mass index (BMI) and use of insulin in the occurrence of marrow changes in the cuboid. Research design and methods: MR and X-ray foot examinations of 237 patients [94 males, 143 females; mean age, 47.1 years (range 16–93 years)], five of whom underwent bilateral examinations, were reviewed. MR and radiographic studies were analyzed for the presence of marrow edema and fractures in the cuboid. Findings were correlated with demographic data (age, gender) and clinical information (BMI and use of insulin). Results: Two hundred and forty two feet – 69 diabetic and 173 non-diabetic – were retrospectively evaluated. There was a higher prevalence of marrow edema and fractures in the diabetic cuboid (n = 31, 45%) compared to non-diabetic cuboid (n = 25, 14%, p = 0.02). A fracture line was seen in fourteen (20%) diabetic cuboid bones compared to 4 (2%) in non-diabetic cuboid bones (p < 0.0001). Eleven (79%) cases of cuboid fractures in the diabetic population were radiographically occult. Multivariate data analysis revealed an adjusted odds ratio of 4.416 (95% CI; 2.307, 8.454) for the relationship between marrow changes (edema and fractures) in the cuboid and diabetes. For each year of age, the odds of changes in the cuboid increased by 2.2% (95% CI; 1.001, 1.044). Conclusion: Despite not bearing weight, the cuboid bone is more vulnerable to marrow edema and fractures in diabetic patients compared to non-diabetic patients. Age seems to be an influential factor.

  17. Blood glucose control and compliance of diabetic children

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    F. P. R. de Villiers

    1997-05-01

    Full Text Available Non-compliance is an important factor hindering good control in diabetics. The aim of this study was to identify areas of poor compliance with the diabetes management regimen in the children attending our clinic. A questionnaire was administered to 57 patients who attend the Paediatric Diabetes Clinic. It was designed to elicit socio-demographic data and information about the diabetic regimen. Prior to the administration of the questionnaire, patients were classified as being well, satisfactorily or poorly controlled, based on their average glycosylated Haemoglobin results over the past year.

  18. Contraception matters: indicators of poor usage of contraception in sexually active women attending family planning clinics in Victoria, Australia

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    Ong Jason

    2012-12-01

    Full Text Available Abstract Background Unintended pregnancy (mistimed or unwanted remains an important health issue for women. The purpose of this study was to determine the prevalence of and factors associated with risk of unintended pregnancy in a sample of Victorian women attending family planning clinics. Methods This cross-sectional survey of three Family Planning Victoria Clinics from April to July 2011 recruited women aged 16-50 years with a male sexual partner in the last 3 months, and not intending to conceive. The questionnaire asked about contraceptive behaviours and important factors that influence contraception use (identified from a systematic literature review. Univariate analysis was calculated for the variables of interest for associations with contraceptive use. An overall multivariate model for being at risk for unintended pregnancy (due to inconsistent or ineffective contraceptive use or non-use was calculated through backward elimination with statistical significance set at Results 1006 surveys were analyzed with 96% of women reporting contraception use in the last 3 months. 37% of women were at risk for unintended pregnancy due to imperfect use (61% inconsistent users; 31% ineffective methods or never using contraception (8%. On multivariate analysis, women at risk for unintended pregnancy compared with women not at risk were 1 partner in the last 3 months (OR 3.2, 95% CI 2.3-4.6. These women were dissatisfied with current contraception (OR 2.5, 95% 1.8-3.5; felt “vulnerable” to pregnancy (OR 2.1, 95% CI 1.6-3.0; were not confident in contraceptive knowledge (OR 2.6, 95% CI 1.5-4.8; were unable to stop to use contraception when aroused (OR 2.1, 95% CI 1.5-2.9 but were comfortable in speaking to a doctor about contraception (OR 2.3, 95% CI 1.1-4.1. Conclusion Despite reported high contraceptive usage, nearly 40% of women were at risk for unintended pregnancy primarily due to inconsistent contraceptive use and use of ineffective

  19. Neuropsychological screening of children of substance-abusing women attending a Special Child Welfare Clinic in Norway

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    Skogmo Idar

    2010-07-01

    Full Text Available Abstract Background Exposure to alcohol and illicit substances during pregnancy can have an impact on the child for the rest of his/her life. A Special Child Welfare Clinic (SCWC in Norway provides care for pregnant women with substance abuse problems. Treatment and support are provided without replacement therapy. Methods We performed a neuropsychological screening of 40 children aged four to 11 years whose mothers had attended the SCWC during pregnancy, and of a comparison group of 80 children of women without substance abuse problems. The children were presented with tests chosen from Wechsler Intelligence Scale for Children, third version (WISC-III, Nepsy, Halstead-Reitan and Raven's Progressive Matrices, Coloured Version. The tests were grouped into five main domains; (1 learning and memory, (2 visual scanning, planning and attention, (3 executive function, (4 visuo-motor speed and dexterity and (5 general intellectual ability Results No children in the study had test results in the clinical range in any domain. Bivariate analyses revealed that children of short-term substance-abusing mothers (who stopped substance abuse within the first trimester had significantly lower test scores than the comparison group in three out of five domains (domain 2,3,4. Children of long-term substance abusers (who maintained moderate substance abuse throughout pregnancy had significantly lower test results than the comparison group in one domain of the test results (domain 1. All but one child in the long-term group were or had been in foster homes. Most children in the short-term group stayed with their mothers. Multivariate regression analyses revealed that foster care minimum 50% of life time was associated with better scores on domains (1 learning and memory, (2 visual scanning, planning and attention, and (3 executive functions, while no significant associations with test scores was found for substance abuse and birth before 38 weeks of gestation

  20. Oral mucosal lesions in skin diseased patients attending a dermatologic clinic: a cross-sectional study in Sudan

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    Salman Hussein

    2011-09-01

    Full Text Available Abstract Background So far there have been no studies focusing on the prevalence of a wide spectrum of oral mucosal lesions (OML in patients with dermatologic diseases. This is noteworthy as skin lesions are strongly associated with oral lesions and could easily be neglected by dentists. This study aimed to estimate the frequency and socio-behavioural correlates of OML in skin diseased patients attending outpatient's facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. Methods A cross-sectional hospital-based study was conducted in Khartoum from October 2008 to January 2009. A total of 588 patients (mean age 37.2 ± 16 years, 50.3% females completed an oral examination and a personal interview of which 544 patients (mean age 37.1 ± 15.9 years, 50% females with confirmed skin disease diagnosis were included for further analyses. OML were recorded using the World Health Organization criteria (WHO. Biopsy and smear were used as adjuvant techniques for confirmation. Data were analysed using the Statistical Package for Social Science (Version 15.0.1. Cross tabulation and Chi-square with Fisher's exact test were used. Results A total of 438 OML were registered in 315 (57.9%, males: 54.6% versus females: 45.6%, p Tongue lesions were the most frequently diagnosed OML (23.3%, followed in descending order by white lesions (19.1%, red and blue lesions (11% and vesiculobullous diseases (6%. OML in various skin diseases were; vesiculobullous reaction pattern (72.2%, lichenoid reaction pattern (60.5%, infectious lesions (56.5%, psoriasiform reaction pattern (56.7%, and spongiotic reaction pattern (46.8%. Presence of OML in skin diseased patients was most frequent in older age groups (62.4% older versus 52.7% younger, p Conclusions OML were frequently diagnosed in skin diseased patients and varied systematically with age, gender, systemic condition and use of toombak. The high prevalence of OML emphasizes the importance of routine examination

  1. Knowledge of complications of diabetes mellitus among patients visiting the diabetes clinic at Sampa Government Hospital, Ghana: a descriptive study.

    Science.gov (United States)

    Obirikorang, Yaa; Obirikorang, Christian; Anto, Enoch Odame; Acheampong, Emmanuel; Batu, Emmanuella Nsenbah; Stella, Agyemang Duah; Constance, Omerige; Brenya, Peter Kojo

    2016-07-26

    Diabetes mellitus (DM) appears to be a global epidemic and an increasingly major non-communicable disease threatening both affluent and non-affluent society. The study aimed to determine the knowledge of diabetic complications among diabetes mellitus clients visiting the Diabetic Clinical at Sampa Government Hospital, Ghana. This questionnaire-based descriptive study recruited a total 630 patients visiting the Diabetes Clinic at the Sampa Government Hospital. Structured questionnaire was used to obtain information such as socio-demographic and knowledge on complications of diabetes. Out of a total of 630 participants, 325 (51.5 %) knew diabetic foot as the most common complication followed by hypertension 223(35.4 %), neuropathy 184 (29.2 %), hypoactive sexual arousal 160(25.4 %), arousal disorder 135(21.5 %), eye diseases 112(17.7 %), heart disease 58(9.2 %), and renal disease 34(5.4 %). Comprehensive assessment of level of knowledge on the complications showed that majority 378(60.0 %) of T2D patients did not have knowledge on diabetes complications, 169(26.9 %) had inadequate knowledge on diabetics complication while 82(13.1 %) had adequate knowledge. The risk factors associated with the level of knowledge of diabetic complications were female gender adjusted odd ratio (AOR) =2.31 (1.56-3.41) married participants AOR = 3.37 (1.44-7.93), widowed AOR = 2.98 (1.10-8.08), basic level of education AOR =0.18 (0.082-0.50), Junior High School (JHS) and above of education level AOR = 0.035(0.017-0.75), 5-9 years of T2D duration AOR = 0.31(0.018-0.57), ≥10 years T2D duration AOR = 0.042 (0.02-0.10) and urban dwellers AOR = 0.36 (0.22-0.68) respectively. Participants knew the individual complication of diabetic mellitus but lack an in-depth knowledge on the complications. Further expansion of diabetic educative programs like using mass media and involving national curriculum of education can improve self-regulatory awareness of

  2. The clinical effectiveness and cost-effectiveness of brief intervention for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial (SHEAR).

    Science.gov (United States)

    Crawford, Mike J; Sanatinia, Rahil; Barrett, Barbara; Byford, Sarah; Dean, Madeleine; Green, John; Jones, Rachael; Leurent, Baptiste; Lingford-Hughes, Anne; Sweeting, Michael; Touquet, Robin; Tyrer, Peter; Ward, Helen

    2014-01-01

    BACKGROUND Excessive use of alcohol is associated with poor sexual health, but the clinical effectiveness and cost-effectiveness of brief alcohol intervention in this setting has not been investigated. OBJECTIVE To examine the effects and cost-effectiveness of brief intervention for excessive alcohol consumption among people who attend sexual health clinics. DESIGN A two-arm, parallel-group, single-blind, pragmatic, randomised controlled trial. Participants were randomised via an independent and remote telephone randomisation service using permuted blocks, stratified by clinic. SETTING Study participants were recruited from three sexual health clinics in central and west London. PARTICIPANTS For inclusion, potential participants had to be aged ≥ 19 years, drink excessive alcohol according to the Modified-Single Alcohol Screening Question, and be willing to provide written informed consent. We excluded those who were unable to communicate in English sufficiently well to complete the baseline assessment and those who could not provide contact details for the follow-up assessment. INTERVENTIONS Brief advice was delivered by the treating clinician and comprised feedback on the possible health consequences of excessive drinking, a discussion of whether the participant's clinic attendance was linked to current alcohol use, written information on alcohol and health and an offer of an appointment with an alcohol health worker (AHW). Appointments with AHWs took place either in person or by telephone, lasted up to 30 minutes, and used the 'FRAMES' (Feedback about the adverse effects of alcohol, an emphasis on personal Responsibility for changing drinking behaviour, Advice about alcohol consumption, a Menu of options for further help and advice, an Empathic stance towards the patient and an emphasis on Self-efficacy) approach. Those in the control arm of the trial were offered a copy of a leaflet providing general information on health and lifestyle. MAIN OUTCOME MEASURES

  3. Comparison of the Adherence to the American Diabetes Association Guidelines of Diabetes Care in Primary Care and Subspecialty Clinics

    OpenAIRE

    2015-01-01

    Background Diabetes mellitus is a major public health problem with significant morbidity and mortality. Evidence based guidelines have been proposed to reduce the micro and macrovascular complications, but studies have shown that these goals are not being met. We sought to compare the adherence to the American Diabetes Association guidelines for measurement and control of glycohemoglobin (A1c), blood pressure (BP), lipids (LDL) and microalbuminuria (MA) by subspecialty and primary care clinic...

  4. Clinical and biochemical profile of lean type 2 diabetes mellitus

    OpenAIRE

    Punyakrit Deb Barma; Salam Ranabir; Lallan Prasad; Thangjam Premchand Singh

    2011-01-01

    Background: Type 2 diabetes mellitus is the most prevalent form of diabetes worldwide. In western countries majority of the cases are obese. The scenario may be different in certain parts of India. Various studies have reported a high prevalence of lean type 2 diabetes mellitus with a body mass index < 19 kg/m 2 . Materials and Methods: We evaluated 100 cases of lean type 2 diabetes mellitus (62 males and 38 females). Results and Conclusion: The mean duration of diabetes was 51.7 months (rang...

  5. Clinical management of concurrent diabetes and tuberculosis and the implications for patient services.

    Science.gov (United States)

    Riza, Anca Lelia; Pearson, Fiona; Ugarte-Gil, Cesar; Alisjahbana, Bachti; van de Vijver, Steven; Panduru, Nicolae M; Hill, Philip C; Ruslami, Rovina; Moore, David; Aarnoutse, Rob; Critchley, Julia A; van Crevel, Reinout

    2014-09-01

    Diabetes triples the risk for active tuberculosis, thus the increasing burden of type 2 diabetes will help to sustain the present tuberculosis epidemic. Recommendations have been made for bidirectional screening, but evidence is scarce about the performance of specific tuberculosis tests in individuals with diabetes, specific diabetes tests in patients with tuberculosis, and screening and preventive therapy for latent tuberculosis infections in individuals with diabetes. Clinical management of patients with both diseases can be difficult. Tuberculosis patients with diabetes have a lower concentration of tuberculosis drugs and a higher risk of drug toxicity than tuberculosis patients without diabetes. Good glycaemic control, which reduces long-term diabetes complications and could also improve tuberculosis treatment outcomes, is hampered by chronic inflammation, drug-drug interactions, suboptimum adherence to drug treatments, and other factors. Besides drug treatments for tuberculosis and diabetes, other interventions, such as education, intensive monitoring, and lifestyle interventions, might be needed, especially for patients with newly diagnosed diabetes or those who need insulin. From a health systems point of view, delivery of optimum care and integration of services for tuberculosis and diabetes is a huge challenge in many countries. Experience from the combined tuberculosis and HIV/AIDS epidemic could serve as an example, but more studies are needed that include economic assessments of recommended screening and systems to manage concurrent tuberculosis and diabetes.

  6. A CLINICAL STUDY OF MUCOCUTANEOUS MANIFESTATIONS OF DIABETES MELLITUS

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    Ramesh

    2015-06-01

    Full Text Available BACKGROUND AND OBJEC TIVES: It is a well - known fact that the skin is referred to as the mirror of the internal diseases. This study has undertaken with the objectives of knowing the spectrum of mucocutaneous manifestations in diabetes mellitus. METHODS: A total of 100 patients with dermatological manifestation were included in the study. Relevant investigation for the diagnosis of diabetes and dermatological disorders were done. RESULTS : Majority of the cases belonged to the age group 41 - 60 years. Various dermatoses observed in the patients were fungal, bacterial and viral infections, lichen planus, vitiligo, diabetic bullae and diabetic dermopathy, granuloma annulare, among the various cutaneous manifestations. Thirty four patients had associated systemic illness, hypertension being most commonly observed. INTERPRETATION AND CONCLUSION: A diabetic patient can present with both specific and non - specific dermatological manifestations. Thus a patient presenting with mucocutaneous manifestations in the absence of primary cutaneous disorders should be investigated for the underlying diabetic status . KEYWORDS : Diabetes; mucocutaneous Manifestations.

  7. Factors That Affect Quality of Life among People Living with HIV Attending an Urban Clinic in Uganda: A Cohort Study.

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    Doris Mutabazi-Mwesigire

    Full Text Available With the availability of antiretroviral therapy (ART and primary general care for people living with HIV (PLHIV in resource limited settings, PLHIV are living longer, and HIV has been transformed into a chronic illness. People are diagnosed and started on treatment when they are relatively well. Although ART results in clinical improvement, the ultimate goal of treatment is full physical functioning and general well-being, with a focus on quality of life rather than clinical outcomes. However, there has been little research on the relationship of specific factors to quality of life in PLHIV. The objective of this study was to investigate factors associated with quality of life among PLHIV in Uganda receiving basic care and those on ART.We enrolled 1274 patients attending an HIV outpatient clinic into a prospective cohort study. Of these, 640 received ART. All were followed up at 3 and 6 months. Health related quality of life was assessed with the MOS-HIV Health Survey and the Global Person Generated Index (GPGI. Multivariate linear regression and logistic regression with generalized estimating equations were used to examine the relationship of social behavioral and disease factors with Physical Health Summary (PHS score, Mental Health Summary (MHS score, and GPGI.Among PLHIV receiving basic care, PHS was associated with: sex (p=0.045 - females had lower PHS; age in years at enrollment (p=0.0001 - older patients had lower PHS; and depression (p<0.001 - depressed patients had lower PHS. MHS was only associated with opportunistic infection (p=0.01 - presence of an opportunistic infection was associated with lower MHS. For the GPG the associated variables were age (p=0.03 - older patients had lower GPGI; education (p=0.01 - higher education associated with higher GPGI; and depression - patients with depression had a lower GPGI (p<0.001. Among patients on ART, PHS was associated with: study visit (p=0.01, with increase in time there was better PHS

  8. Maintenance of improved lipid levels following attendance at a cardiovascular risk reduction clinic: a 10-year experience

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    Glen J Pearson

    2008-10-01

    Full Text Available Glen J Pearson1,5, Kari L Olson6, Nicole E Panich1, Sumit R Majumdar2,5, Ross T Tsuyuki1,4, Dawna M Gilchrist2,5, Ali Damani4, Gordon A Francis3,5The MILLARR Study (Maintenance of Improved Lipid Levels Following Attendance at a Cardiovascular Risk Reduction Clinic 1Department of Medicine, Divisions of Cardiology; 2General Internal Medicine; 3Endocrinology and Metabolism; Faculty of Pharmacy and Pharmaceutical Sciences; 4University of Alberta, Edmonton, Alberta, Canada; 5Cardiovascular Risk Reduction Clinic (CRRC, University of Alberta Hospital, Edmonton, Alberta, Canada; 6University of Colorado Health Sciences Center, Denver, Colorado, USA; 7Family Medicine (Private Practice, Calgary, Alberta, CanadaBackground: Specialty cardiovascular risk reduction clinics (CRRC increase the proportion of patients attaining recommended lipid targets; however, it is not known if the benefits are sustained after discharge. We evaluated the impact of a CRRC on lipid levels and assessed the long-term effect of a CRRC in maintaining improved lipid levels following discharge.Methods: The medical records of consecutive dyslipidemic patients discharged >6 months from a tertiary hospital CRRC from January 1991 to January 2001 were retrospectively reviewed. The primary outcome was the change in patients’ lipid levels between the final CRRC visit and the most recent primary care follow-up. A worst-case analysis was conducted to evaluate the potential impact of the patients in whom the follow-up lipid profiles post-discharge from the CRRC were not obtained.Results: Within the CRRC (median follow-up = 1.28 years in 1064 patients, we observed statistically significant improvements in all lipid parameters. In the 411 patients for whom post-discharge lipid profiles were available (median follow-up = 2.41 years, there were no significant differences observed in low-density lipoprotein-cholesterol, total cholesterol (TC, or triglycerides since CRRC discharge; however, there

  9. Liraglutide in Type 2 Diabetes Mellitus: Clinical Pharmacokinetics and Pharmacodynamics.

    Science.gov (United States)

    Jacobsen, Lisbeth V; Flint, Anne; Olsen, Anette K; Ingwersen, Steen H

    2016-06-01

    Liraglutide is an acylated glucagon-like peptide-1 analogue with 97 % amino acid homology with native glucagon-like peptide-1 and greatly protracted action. It is widely used for the treatment of type 2 diabetes mellitus, and administered by subcutaneous injection once daily. The pharmacokinetic properties of liraglutide enable 24-h exposure coverage, a requirement for 24-h glycaemic control with once-daily dosing. The mechanism of protraction relates to slowed release from the injection site, and a reduced elimination rate owing to metabolic stabilisation and reduced renal filtration. Drug exposure is largely independent of injection site, as well as age, race and ethnicity. Increasing body weight and male sex are associated with reduced concentrations, but there is substantial overlap between subgroups; therefore, dose escalation should be based on individual treatment outcome. Exposure is reduced with mild, moderate or severe renal or hepatic impairment. There are no clinically relevant changes in overall concentrations of various drugs (e.g. paracetamol, atorvastatin, griseofulvin, digoxin, lisinopril and oral combination contraceptives) when co-administered with liraglutide. Pharmacodynamic studies show multiple beneficial actions with liraglutide, including improved fasting and postprandial glycaemic control (mediated by increased insulin and reduced glucagon levels and minor delays in gastric emptying), reduced appetite and energy intake, and effects on postprandial lipid profiles. The counter-regulatory hormone response to hypoglycaemia is largely unaltered. The effects of liraglutide on insulin and glucagon secretion are glucose dependent, and hence the risk of hypoglycaemia is low. The pharmacokinetic and pharmacodynamic properties of liraglutide make it an important treatment option for many patients with type 2 diabetes.

  10. Text messaging to improve attendance at post-operative clinic visits after adult male circumcision for HIV prevention: a randomized controlled trial.

    Science.gov (United States)

    Odeny, Thomas A; Bailey, Robert C; Bukusi, Elizabeth A; Simoni, Jane M; Tapia, Kenneth A; Yuhas, Krista; Holmes, King K; McClelland, R Scott

    2012-01-01

    Following male circumcision for HIV prevention, a high proportion of men fail to return for their scheduled seven-day post-operative visit. We evaluated the effect of short message service (SMS) text messages on attendance at this important visit. We enrolled 1200 participants >18 years old in a two-arm, parallel, randomized controlled trial at 12 sites in Nyanza province, Kenya. Participants received daily SMS text messages for seven days (n = 600) or usual care (n = 600). The primary outcome was attendance at the scheduled seven-day post-operative visit. The primary analysis was by intention-to-treat. Of participants receiving SMS, 387/592 (65.4%) returned, compared to 356/596 (59.7%) in the control group (relative risk [RR] = 1.09, 95% confidence interval [CI] 1.00-1.20; p = 0.04). Men who paid more than US$1.25 to travel to clinic were at higher risk for failure to return compared to those who spent ≤ US$1.25 (adjusted relative risk [aRR] 1.35, 95% CI 1.15-1.58; pText messaging resulted in a modest improvement in attendance at the 7-day post-operative clinic visit following adult male circumcision. Factors associated with failure to return were mainly structural, and included transportation costs and low educational level. ClinicalTrials.govNCT01186575.

  11. A clinical study of the relationship between diabetes mellitus and periodontal disease.

    Science.gov (United States)

    Rajhans, Neelima S; Kohad, Ramesh M; Chaudhari, Viren G; Mhaske, Nilkanth H

    2011-10-01

    The relationship between diabetes mellitus and periodontal disease is not clear, even though studied intensively. From the available data, it seemed reasonable to believe that diabetics were more susceptible to periodontal disease than non.diabetics. The present study was to clinically evaluate the relationship of diabetes mellitus with periodontal disease along with various parameters. Fifteen hundred patients with diabetes mellitus were examined. A thorough oral examination was carried out and relevant history was recorded for all the patients. Results indicated that the prevalence of periodontal disease in diabetic patients was 86.8%. It can be concluded that poorer the glycemic control, and longer the duration of diabetes, the greater will be the prevalence and severity of periodontal disease.

  12. Dental anxiety reduction and dental attendance after treatment in a dental fear clinic: A follow-up study.

    NARCIS (Netherlands)

    Aartman, I.H.A.; de Jongh, A.; Makkes, P.C.; Hoogstraten, J.

    2000-01-01

    The aim of the present study was to assess treatment outcome in terms of dental anxiety reduction at a post-treatment assessment and dental anxiety reduction and dental attendance one year later. Furthermore, it was determined to what extent psychopathological characteristics were related to

  13. Risk stratification by endocrinologists of patients with type 2 diabetes in a Danish specialised outpatient clinic

    DEFF Research Database (Denmark)

    Munch, Lene; Arreskov, Anne B; Sperling, Michael;

    2016-01-01

    BACKGROUND: To target optimised medical care the Danish guidelines for diabetes recommend stratification of patients with type 2 diabetes (T2D) into three levels according to risk and complexity of treatment. The aim was to describe the T2D population in an outpatient clinic, measure the compliance......, the endocrinologists stratified less patients at level 3 compared to objective assessments (p diabetes patients, newly referred to or allocated for long-term follow-up in the out...

  14. Silent diabetic cardiomyopathy in everyday practice: a clinical and echocardiographic study

    OpenAIRE

    Loncarevic, Brane; Trifunovic, Danijela; Soldatovic, Ivan; Vujisic-Tesic, Bosiljka

    2016-01-01

    Background Whether type 2 diabetes mellitus (DM) in the absence of hypertension (HTA) and coronary artery disease (CAD) affects left ventricular (LV) phenotype and function among asymptomatic DM patients that can be easily discovered in everyday practice, what is the clinical risk profile for diabetic cardiomyopathy and how HTA and CAD modulate LV structure and function above diabetic cardiomyopathy, are still incompletely answered questions. Methods In 210 DM patients (group I: 70 asymptomat...

  15. Incretin-Based Therapies for Diabetic Complications: Basic Mechanisms and Clinical Evidence.

    Science.gov (United States)

    Kawanami, Daiji; Matoba, Keiichiro; Sango, Kazunori; Utsunomiya, Kazunori

    2016-07-29

    An increase in the rates of morbidity and mortality associated with diabetic complications is a global concern. Glycemic control is important to prevent the development and progression of diabetic complications. Various classes of anti-diabetic agents are currently available, and their pleiotropic effects on diabetic complications have been investigated. Incretin-based therapies such as dipeptidyl peptidase (DPP)-4 inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RA) are now widely used in the treatment of patients with type 2 diabetes. A series of experimental studies showed that incretin-based therapies have beneficial effects on diabetic complications, independent of their glucose-lowering abilities, which are mediated by anti-inflammatory and anti-oxidative stress properties. Based on these findings, clinical studies to assess the effects of DPP-4 inhibitors and GLP-1RA on diabetic microvascular and macrovascular complications have been performed. Several but not all studies have provided evidence to support the beneficial effects of incretin-based therapies on diabetic complications in patients with type 2 diabetes. We herein discuss the experimental and clinical evidence of incretin-based therapy for diabetic complications.

  16. Incretin-Based Therapies for Diabetic Complications: Basic Mechanisms and Clinical Evidence

    Directory of Open Access Journals (Sweden)

    Daiji Kawanami

    2016-07-01

    Full Text Available An increase in the rates of morbidity and mortality associated with diabetic complications is a global concern. Glycemic control is important to prevent the development and progression of diabetic complications. Various classes of anti-diabetic agents are currently available, and their pleiotropic effects on diabetic complications have been investigated. Incretin-based therapies such as dipeptidyl peptidase (DPP-4 inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RA are now widely used in the treatment of patients with type 2 diabetes. A series of experimental studies showed that incretin-based therapies have beneficial effects on diabetic complications, independent of their glucose-lowering abilities, which are mediated by anti-inflammatory and anti-oxidative stress properties. Based on these findings, clinical studies to assess the effects of DPP-4 inhibitors and GLP-1RA on diabetic microvascular and macrovascular complications have been performed. Several but not all studies have provided evidence to support the beneficial effects of incretin-based therapies on diabetic complications in patients with type 2 diabetes. We herein discuss the experimental and clinical evidence of incretin-based therapy for diabetic complications.

  17. Obstructive sleep apnoea is frequent in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Banghoej, Anne Margareta; Nerild, Henriette Holst; Kristensen, Peter Lommer;

    2017-01-01

    AIM: Obstructive Sleep Apnoea (OSA) is frequent in patients with type 2 diabetes. The aim of this study is to evaluate prevalence of OSA in patients with type 1 diabetes. METHODS: In a cross-sectional design, all patients with type 1 diabetes attending the outpatient clinic were offered screening...

  18. The quality of care of diabetic patients in rural Malawi: A case of ...

    African Journals Online (AJOL)

    Quality of diabetes care provided to diabetic patients attended to Mangochi hospital was ... surveillance measures to monitor progress and check for the development of ... The diabetes clinic was run by a nurse and a clinician at the time of our ...

  19. Endothelial dysfunction and low-grade inflammation and the progression of retinopathy in Type 2 diabetes

    NARCIS (Netherlands)

    Spijkerman, A.M.W.; Gall, M.A.; Tarnow, L.; Twisk, J.W.R.; Lauritzen, E.; Lund-Andersen, H.; Emeis, J.; Parving, H.H.; Stehouwer, C.D.A.

    2007-01-01

    Aims: To study whether microalbuminuria, endothelial dysfunction and low-grade inflammation are associated with the presence and progression of diabetic retinopathy. Methods: Patients with Type 2 diabetes (n = 328) attending a diabetes clinic were followed for 10 years and examined annually during t

  20. Endothelial dysfunction and low-grade inflammation and the progression of retinopathy in Type 2 diabetes

    DEFF Research Database (Denmark)

    Spijkerman, Annemieke M W; Gall, Mari-Anne; Tarnow, L

    2007-01-01

    AIMS: To study whether microalbuminuria, endothelial dysfunction and low-grade inflammation are associated with the presence and progression of diabetic retinopathy. METHODS: Patients with Type 2 diabetes (n = 328) attending a diabetes clinic were followed for 10 years and examined annually durin...

  1. A clinical study of dermatoses in diabetes to establish its markers

    Directory of Open Access Journals (Sweden)

    Dependra Kumar Timshina

    2012-01-01

    Full Text Available Background: Cutaneous manifestations of diabetes mellitus generally appear subsequent to the development of the disease, but they may be the first presenting signs and in some cases they may precede the primary disease manifestation by many years. Aims : T0 he aim of our study was to study the spectrum of dermatoses in diabetics, to know the frequency of dermatoses specific to diabetes mellitus (DM, and to establish the mucocutaneous markers of DM. Material and Methods: The study was conducted at a diabetic clinic and our department between September 2008 and June 2010. Two hundred and twenty-four diabetic patients were included in the study group and those with gestational diabetes were excluded. Healthy age- and sex-matched individuals were taken as controls. Results: The male to female ratio was 1 : 1.21. Type 2 DM was seen in 89.7% and type 1 DM in 10.3% of the patients. Dermatoses were seen in 88.3% of the diabetics compared to 36% in non-diabetic controls (P<0.05. Cutaneous infections were the most common dermatoses followed by acanthosis nigricans and xerosis in diabetics. Type 2 DM was found to have an increased risk of complications than type 1 DM. Complications of diabetes were seen in 43.7% of the diabetic cases. Diabetic dermopathy, loss of hair over the legs, diabetic foot ulcer, and so on, were found to be the cutaneous markers of DM in our group of cases. Conclusion: Dermatoses were more common in diabetics than non-diabetics. Cutaneous infections formed the largest group of dermatoses in DM.

  2. Prediction of preeclampsia in type 1 diabetes in early pregnancy by clinical predictors

    DEFF Research Database (Denmark)

    Vestgaard, Marianne; Sommer, Miriam Colstrup; Ringholm, Lene

    2017-01-01

    PURPOSE: The purpose of this study is to evaluate the prevalence and possible clinical predictors of preeclampsia present in early pregnancy among women with type 1 diabetes. METHODS: A systematic search of PubMed was conducted in April 2017. Inclusion criteria were largely unselected cohort......, including at least 100 women with type 1 diabetes, dealing with either the prevalence of preeclampsia or possible clinical predictors of preeclampsia identified in early pregnancy. RESULTS: Based on 11,518 pregnancies in 11 articles, the prevalence of preeclampsia in women with type 1 diabetes was 17%, five...... to six times more than in the background population. In early pregnancy, the following clinical predictors were associated with increased prevalence of preeclampsia: diabetic nephropathy (OR 3.7-23.5), microalbuminuria (OR 3.8-11.7), diabetic retinopathy (OR 1.9-2.9) and pre-existing hypertension (OR 3...

  3. Clinical Guidance on Screening Chronic Kidney Disease in Type 2 Diabetic Patients for Family Physicians

    Directory of Open Access Journals (Sweden)

    Seyed Esmaeil Managheb

    2015-10-01

    Full Text Available Incidence of diabetes is increasing in developing countries as well as Iran. Half of the patients are not aware of their disease so screening of diabetes is necessary. Lifestyle changes in society, high-saturated fat diet and decreased physical activity are the factors that influence the growing rate of diabetes in Iran.1 The need for addressing type 2 diabetes has been clarified for family physicians.2 Diabetes is a common disease that is associated with significant morbidity and mortality. It has an asymptomatic stage that may be present for up to several years before diagnosis.3 Diabetes is the leading cause of kidney disease.4 In a study among patients over 45 years with type 2 diabetes, these results were reported: 22% suffered from retinopathy, 7% had impaired vision, 6% had kidney diseases, 9% had clinical symptoms, and 19.1% were at risk for foot ulcers.5 Early treatment of type 2 diabetes can reduce or delay complications.6 Optimal glycemia and BP are important in the prevention of diabetic chronic kidney disease (CKD.4 Therapeutic goals in patients with complications, such as CKD, include maintaining renal function and stopping the trend of renal deterioration.5 Progression of diabetic nephropathy can be slowed through the use of some medications.4 How to screen and manage chronic kidney disease in patients with type 2 diabetes is shown in Figure 1.

  4. Nurse Practitioner Perceptions of a Diabetes Risk Assessment Tool in the Retail Clinic Setting.

    Science.gov (United States)

    Marjama, Kristen L; Oliver, JoAnn S; Hayes, Jennifer

    2016-10-01

    IN BRIEF This article describes a study to gain insight into the utility and perceived feasibility of the American Diabetes Association's Diabetes Risk Test (DRT) implemented by nurse practitioners (NPs) in the retail clinic setting. The DRT is intended for those without a known risk for diabetes. Researchers invited 1,097 NPs working in the retail clinics of a nationwide company to participate voluntarily in an online questionnaire. Of the 248 NPs who sent in complete responses, 114 (46%) indicated that they used the DRT in the clinic. Overall mean responses from these NPs indicated that they perceive the DRT as a feasible tool in the retail clinic setting. Use of the DRT or similar risk assessment tools in the retail clinic setting can aid in the identification of people at risk for type 2 diabetes.

  5. Biochemical and Clinical Variables of Normal Parathyroid and Hyperparathyroid Diabetic Chronic Kidney Disease Patients

    Directory of Open Access Journals (Sweden)

    Syed Abdul Kader

    2016-09-01

    Full Text Available Background: In chronic kidney disease (CKD intact parathyroid hormone (iPTH level is often increased before clinical hyperphosphatemia occurs. Despite its importance very few studies evaluated parathyroid status in CKD. Objective: The study was undertaken to estimate level of parathormone in diabetic CKD patients at a tertiary level hospital and assessing its relationship with different parameters like hemoglobin, calcium etc. and comparing biochemical and clinical variables between normal parathyroid and hyperparathyroid groups. Materials and Methods: It was a hospital based cross-sectional study involving purposively selected chronic kidney disease patients attending nephrology and endocrinology outdoor and indoor services of BIRDEM hospital, Dhaka, Bangladesh. Study was conducted during the period of April to October 2010. All the subjects were divided into two groups based on serum parathormone level and different parameters were compared between groups. Results: The mean duration of chronic kidney disease was significantly higher in hyperparathyroid group than that in the normal group (<0.001. Retinopathy and hypertension were more common in hyperparathyroid group than that in patients with normal serum parathormone (p<0.001 and p=0.012. Neuropathy was solely present in hyperparathyroid group (p<0.001. Mean fasting blood glucose, serum creatinine and serum phosphate were significantly higher in the hyperparathyroid group compared to normal group (p<0.001 in all cases while the mean serum calcium and haemoglobin were lower in hyperparathyroid group than those in the normal group (p<0.001 in both cases. Serum creatinine and serum parathormone bears a significantly linear relationship (r=0.986, p<0.001, while serum parathormone and serum calcium bears a significantly negative relationship (r=−0.892 and p<0.001. Conclusion: Earlier intervention on the basis of iPTH in addition to other biochemical parameters of chronic kidney disease is

  6. Prevalence of Antenatal Depression and Associated Risk Factors among Pregnant Women Attending Antenatal Clinics in Abeokuta North Local Government Area, Nigeria.

    Science.gov (United States)

    Thompson, Okechukwu; Ajayi, IkeOluwapo

    2016-01-01

    Objective. The prevalence of antenatal depression (AD) and associated risk factors among pregnant women attending antenatal clinics in Abeokuta North Local Government Area, Nigeria, was determined. Methods. A descriptive cross-sectional survey was conducted, interviewing 314 pregnant women selected by multistage sampling technique from among those attending antenatal clinics. Information was collected using structured questionnaire and a screening tool, Edinburgh Postnatal Depression Scale (EPDS), to assess probable depression. Results. The prevalence of antenatal depression was 24.5%. There were significant associations between antenatal depression and attending public health facility (P = 0.000), young maternal age (P = 0.012), single marital status (P = 0.010), not having formal education (P = 0.022), large family size (P = 0.029), planned pregnancy (P = 0.014), coexisting medical conditions (P = 0.034), history of previous caesarian section (P = 0.032), drinking alcohol during pregnancy (P = 0.004), and gender based abuse (P = 0.001). On health seeking behaviour for antenatal depression among depressed pregnant women, most, 68.9%, consulted their husbands about their symptoms; 57.3% took the decision to get treatment from doctors, and 52% sought prayer in the church. Conclusion. Antenatal depression is prevalent in this study population. Interventions to address its risk factors should be carried out and physicians should suspect depression in pregnant women reporting alcohol use and gender abuse.

  7. Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients

    NARCIS (Netherlands)

    Looijmans-Van den Akker, I.; Verheij, T.J.M.; Buskens, E.; Nichol, K.L.; Rutten, G.E.H.M.; Hak, E.

    2006-01-01

    OBJECTIVE: Influenza vaccine uptake remains low among the high-risk group of patients with diabetes, partly because of conflicting evidence regarding its potential benefits. We assessed the clinical effectiveness of influenza vaccination in adults with diabetes and specifically examined potential mo

  8. Clinical characteristics and heterogeneity in patients with ketosis-prone diabetes

    Institute of Scientific and Technical Information of China (English)

    谭惠文

    2014-01-01

    Objective To investigate the clinical characteristics,peripheral insulin sensitivity,andβ-cell function in patients with ketosis-prone diabetes(KPD).Methods Thirty-one patients with newly diagnosed ketosis-prone diabetes were admitted to West China Hospital from January2004 to December 2009.They were divided into 2 groups according to

  9. Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients

    NARCIS (Netherlands)

    Looijmans-Van den Akker, I.; Verheij, T.J.M.; Buskens, E.; Nichol, K.L.; Rutten, G.E.H.M.; Hak, E.

    OBJECTIVE: Influenza vaccine uptake remains low among the high-risk group of patients with diabetes, partly because of conflicting evidence regarding its potential benefits. We assessed the clinical effectiveness of influenza vaccination in adults with diabetes and specifically examined potential

  10. Clinical Observation of Opuntia Dillenii Tablet in Treating Type 2 Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    赵湘; 杨君超; 童钟杭; 周永列; 张文海; 戚世伟; 袁国荣

    2002-01-01

    @@ From June to September 1998, we selected Opuntia dillenii tablet (ODT) made from Opuntia dillenii Haw, to make a four-week clinical observation on thirty type 2 diabetes mellitus (DM) patients. The study proved that this medicine could improve the glycometabolism of DM patients effectively and avoid the early impairment of renal function of diabetic neuropathy, and it is reported as follows.

  11. Risk stratification by endocrinologists of patients with type 2 diabetes in a Danish specialised outpatient clinic

    DEFF Research Database (Denmark)

    Munch, Lene; Arreskov, Anne B; Sperling, Michael

    2016-01-01

    BACKGROUND: To target optimised medical care the Danish guidelines for diabetes recommend stratification of patients with type 2 diabetes (T2D) into three levels according to risk and complexity of treatment. The aim was to describe the T2D population in an outpatient clinic, measure the complian...

  12. Screening and management of risk factors for cardiovascular disease in HIV-positive patients attending an Australian urban sexual health clinic.

    Science.gov (United States)

    Kakar, Sheena; Drak, Douglas; Amin, Tahiya; Cheung, Jason; O'Connor, Catherine; Gracey, David

    2016-11-11

    Background: Few data exist regarding cardiovascular risk among HIV-infected patients attending sexual health clinics (SHC) in Australia. Methods: The medical records of 188 patients attending an inner-city SHC between August 2013 and July 2014 were retrospectively reviewed for cardiovascular risk factors and associated screening and management practices. Results: Cardiovascular risk factors were common among attendees of the SHC, including smoking (38%), hypertension (14%) and dyslipidaemia (11%). Of the 188 patients, 23% reported using potentially cardiotoxic recreational drugs, 25% of dyslipidaemic patients were not on therapy and 10% of patients were hypertensive; none were prescribed treatment. A smoking cessation program was offered to all patients. Conclusion: A high prevalence of risk factors for cardiovascular disease was demonstrated. Modification of risk factors could be improved.

  13. The clinical relevance of assessing advanced glycation endproducts accumulation in diabetes

    Directory of Open Access Journals (Sweden)

    Hillebrands Jan-Luuk

    2008-10-01

    Full Text Available Abstract Cardiovascular disease is the major cause of morbidity and mortality associated with diabetes. There is increasing evidence that advanced glycation endproducts (AGEs play a pivotal role in atherosclerosis, in particular in diabetes. AGE accumulation is a measure of cumulative metabolic and oxidative stress, and may so represent the "metabolic memory". Furthermore, increased AGE accumulation is closely related to the development of cardiovascular complications in diabetes. This review article will focus on the clinical relevance of measuring AGE accumulation in diabetic patients by focusing on AGE formation, AGEs as predictors of long-term complications, and interventions against AGEs.

  14. The clinical relevance of assessing advanced glycation endproducts accumulation in diabetes.

    Science.gov (United States)

    Meerwaldt, Robbert; Links, Thera; Zeebregts, Clark; Tio, Rene; Hillebrands, Jan-Luuk; Smit, Andries

    2008-10-07

    Cardiovascular disease is the major cause of morbidity and mortality associated with diabetes. There is increasing evidence that advanced glycation endproducts (AGEs) play a pivotal role in atherosclerosis, in particular in diabetes. AGE accumulation is a measure of cumulative metabolic and oxidative stress, and may so represent the "metabolic memory". Furthermore, increased AGE accumulation is closely related to the development of cardiovascular complications in diabetes. This review article will focus on the clinical relevance of measuring AGE accumulation in diabetic patients by focusing on AGE formation, AGEs as predictors of long-term complications, and interventions against AGEs.

  15. Zinc and diabetes--clinical links and molecular mechanisms.

    Science.gov (United States)

    Jansen, Judith; Karges, Wolfram; Rink, Lothar

    2009-06-01

    Zinc is an essential trace element crucial for the function of more than 300 enzymes and it is important for cellular processes like cell division and apoptosis. Hence, the concentration of zinc in the human body is tightly regulated and disturbances of zinc homeostasis have been associated with several diseases including diabetes mellitus, a disease characterized by high blood glucose concentrations as a consequence of decreased secretion or action of insulin. Zinc supplementation of animals and humans has been shown to ameliorate glycemic control in type 1 and 2 diabetes, the two major forms of diabetes mellitus, but the underlying molecular mechanisms have only slowly been elucidated. Zinc seems to exert insulin-like effects by supporting the signal transduction of insulin and by reducing the production of cytokines, which lead to beta-cell death during the inflammatory process in the pancreas in the course of the disease. Furthermore, zinc might play a role in the development of diabetes, since genetic polymorphisms in the gene of zinc transporter 8 and in metallothionein (MT)-encoding genes could be demonstrated to be associated with type 2 diabetes mellitus. The fact that antibodies against this zinc transporter have been detected in type 1 diabetic patients offers new diagnostic possibilities. This article reviews the influence of zinc on the diabetic state including the molecular mechanisms, the role of the zinc transporter 8 and MT for diabetes development and the resulting diagnostic and therapeutic options.

  16. Diabetes mellitus and dental implants: a clinical study.

    Science.gov (United States)

    Abdulwassie, Hassan; Dhanrajani, P J

    2002-01-01

    Diabetes mellitus is no longer considered to be a contraindication for implant-supported prostheses, provided that the patient's blood sugar is under control, and that there is motivation for oral hygiene procedures. This paper presents the experiences of treating diabetic patients using implants with good success rates.

  17. Clinical significance of intramammary arterial calcifications in diabetic women

    Directory of Open Access Journals (Sweden)

    Milošević Zorica

    2004-01-01

    Full Text Available Background. It is well known that intramammary arterial calcifications diagnosed by mammography as a part of generalized diabetic macroangiopathy may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient’s age when the calcifications occur, as well as to observe the influence of diabetic polineuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. Methods. Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2, as well as of 208 nondiabetic women (the control group were analyzed in the prospective study. The data about the type of diabetes, its duration, and polineuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. Results. Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001. Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001, while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age in relation to the control group (p=0.176. The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3% in comparison to the group without calcifications (26.1%, (p=0.005. The association between intramammary arterial calcifications and the duration of diabetes was not found. Conclusion. The obtained results supported the theory that intramammary arterial calcifications, detected by

  18. Fatores relacionados ao autocuidado de pessoas com diabetes mellitus atendidas em Serviço de Urgência no México Factores relacionados al autocuidado de personas con diabetes mellitus atendidas en Servicio de Urgencia en México Factors related to self-care in diabetes mellitus patients attended at Emergency Service in Mexico

    Directory of Open Access Journals (Sweden)

    Irasema Romero Baquedano

    2010-12-01

    Full Text Available Estudo transversal com os objetivos de determinar a capacidade de autocuidado de pessoas com diabetes mellitus tipo 2 e relacionar tal capacidade com variáveis sociodemográficas e clínicas. Participaram 251 pessoas que ingressaram no Serviço de Urgência do Hospital Regional Mérida, em Yucatán, México, em 2006. Os dados foram obtidos mediante entrevista domiciliar dirigida, utilizando-se formulário, questionário e a Escala de Capacidade Autocuidado. Para a análise, utilizou-se a estatística descritiva e correlacional. Os resultados mostraram que 83 (33,5% dos sujeitos apresentaram boa capacidade de autocuidado e 168 (66,5%, capacidade regular. Obteve-se correlação diretamente proporcional entre capacidade de autocuidado e anos de estudo (r=0,124; pEstudio transversal que tuvo como objetivos determinar la capacidad de autocuidado de personas con diabetes mellitus tipo 2 y relacionar tal capacidad con variables sociodemográficas y clínicas. Participaron 251 personas que ingresaron en el Servicio de Urgencia del Hospital Regional de Mérida, Yucatán, México, en 2006. Los datos fueron obtenidos a través de entrevistas domiciliarias dirigidas, utilizándose formulario, cuestionario y Escala de Capacidad de Auto-cuidado. Para el análisis se utilizó la estadística descriptiva y correlacional. Los resultados mostraron que 83 (33,5% de los sujetos exhibieron buena capacidad de autocuidado, y 168 (66,5% capacidad regular. Se obtuvo correlación directamente proporcional entre capacidad de autocuidado y años de estudio (r=0,124; pThis cross-sectional study aimed to determine the self-care ability of individuals with type 2 diabetes mellitus and to relate this capacity with some sociodemographic and clinical variables. Participants were 251 patients who attended the Emergency Service at the Mérida Regional Hospital in Yucatán, Mexico, in 2006. Data were obtained through directed home interviews, using a form, a questionnaire and the

  19. [Optimizing the managment of patients with diabetes mellitus: selected clinical trials from the 2004 Congress of the American Diabetes Association].

    Science.gov (United States)

    Scheen, A J; Radermecker, R P; Philips, J C

    2004-06-01

    The 64th scientific congress of the American Diabetes Association had a special session devoted to the presentation of the results from three clinical trials: 1) the first multicentre international trial of pancreatic islet transplantation according to the so-called Edmonton protocol with the primary endpoint of restoring insulin independence in type 1 diabetic patients; 2) three pivotal studies of 30 weeks testing both the efficacy and safety of exenatide (exendin-4), a new insulin secretagogue that is a long-acting analogue of glucagon-like peptide-1, in patients with type 2 diabetes treated with either metformin, or a sulfonylurea, or a metformin-sulfonylurea combination; and 3) the "Collaborative AtoRvastatin Diabetes Study" (CARDS), a placebo-controlled primary prevention trial of cardiovascular complications using atorvastatin 10 mg in 2 838 at risk patients with type 2 diabetes. The main results and conclusions of these trials are briefly presented as they open new perspectives in the management of patients with type 1 or type 2 diabetes mellitus.

  20. Study the Prevalence of Polycystic Ovarian Syndrome in Women with Type 2 Diabetes Referring to Kerman Diabetes Clinic

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    F. Mirzaie

    Full Text Available Introduction & Objective: Polycystic ovary syndrome (PCOS is a heterogeneous disorder that affects 5-10% of women of reproductive age patients with this syndrome one of the high risk groups for type 2 diabetes mellitus in future. This study was carried out to determine the prevalence of PCOS in patients with type 2 diabetes mellitus. Materials & Methods: One hundred women under 45 years with type 2 diabetes treating with diet or hypoglycemic drugs, referred to Kerman diabetic center in 2005 were identified. Women with galactorrhea or history of thyroid dysfunction were excluded from the study. Data were collected through interview and then data of 92 women were analyzed using t-test and x2. Results: Ninety two women enrolled in the study and 18 cases (19.5% had clinical symptoms of PCOS. The mean of age was 38 years (38.76±5.92 years. The mean age of women with PCOS was 34 and that of normal women was 39 years (P0.05. Conclusion: This study indicated women with type 2 diabetes mellitus had a higher prevalence of polycystic syndrome. Android obesity is associated with the increased risk of type 2 diabetes in women with PCOS.

  1. Study the Prevalence of Polycystic Ovarian Syndrome in Women with Type 2 Diabetes Referring to Kerman Diabetes Clinic

    Directory of Open Access Journals (Sweden)

    Fatemeh Mirzaie

    2008-03-01

    Full Text Available Introduction & Objective: Polycystic ovary syndrome (PCOS is a heterogeneous disorder that affects 5-10% of women of reproductive age patients with this syndrome one of the high risk groups for type 2 diabetes mellitus in future. This study was carried out to determine the prevalence of PCOS in patients with type 2 diabetes mellitus. Materials & Methods: One hundred women under 45 years with type 2 diabetes treating with diet or hypoglycemic drugs, referred to Kerman diabetic center in 2005 were identified. Women with galactorrhea or history of thyroid dysfunction were excluded from the study. Data were collected through interview and then data of 92 women were analyzed using t-test and x2. Results: Ninety two women enrolled in the study and 18 cases (19.5% had clinical symptoms of PCOS. The mean of age was 38 years (38.76±5.92 years. The mean age of women with PCOS was 34.89±3.96 and that of normal women was 39.7±5.96 years (P0.05. Conclusion: This study indicated women with type 2 diabetes mellitus had a higher prevalence of polycystic syndrome. Android obesity is associated with the increased risk of type 2 diabetes in women with PCOS.

  2. Insulinoterapia, controle glicêmico materno e prognóstico perinatal: diferença entre o diabetes gestacional e o clínico Insulinotherapy, maternal glycemic control and perinatal prognosis: difference between clinical and gestational diabetes

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    Neusa Aparecida de Sousa Basso

    2007-05-01

    Full Text Available OBJETIVO: avaliar protocolo de insulinoterapia e conseqüentes resultados maternos e perinatais, no diabetes gestacional e clínico, num serviço de referência para gravidez de alto risco. MÉTODOS: estudo prospectivo e descritivo, incluindo 103 gestantes portadoras de diabetes gestacional ou clínico, tratadas com insulina e acompanhadas no serviço, no período de outubro de 2003 a dezembro de 2005. Foram excluídos casos de gemelaridade, abortamento, abandono do pré-natal e parto fora do serviço. Compararam-se idade gestacional no início do tratamento; dose, aplicações/dia e incremento de insulina (UI/kg; média glicêmica e resultados perinatais. Utilizaram-se ANOVA e testes de Fisher e Goodman, considerando p25 kg/m² (88 versus 58,5%, o ganho de peso PURPOSE: to evaluate the insulin therapy protocol and its maternal and perinatal outcome in patients with clinical or gestational diabetes in a high risk reference service. METHODS: descriptive and prospective study including 103 pregnant women with gestational or clinical diabetes treated with insulin and attended by the reference service from October 2003 to December 2005. Gemellarity, miscarriages, unfinished prenatal care and deliveries not attended by the service were excluded. The gestational age at the beginning of the treatment, dosage, doses/day, increment of insulin (UI/kg, glycemic index (GI and perinatal outcomes were compared. ANOVA, Fisher’s exact test and Goodman’s test considering p25 kg/m² (88 versus 58.5%, weight gain (WG <8 kg (36 versus 17% and a high increment of insulin characterized the gestational diabetes. For the patients with clinical diabetes, despite the highest GI (120 mg/dL (39.2 versus 24% at the end of the gestational period, insulin therapy started earlier (47.2 versus 4%, lasted longer (56.6 versus 6% and higher doses of insulin (92 versus 43 UI/day were administered up to three times a day (54.7 versus 16%. Macrosomia was higher among newborns

  3. Pattern of cutaneous manifestations in diabetes mellitus

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    Goyal Abhishek

    2010-01-01

    Full Text Available Background: Diabetes mellitus affects individuals of all ages and socioeconomic status. Skin is affected by the acute metabolic derangements as well as by chronic degenerative complications of diabetes. Aims: To evaluate the prevalence of skin manifestations in patients with diabetes mellitus. To analyze the prevalence and pattern of skin disorders among diabetic patients from this region of Western Himalayas. Materials and Methods: One hundred consecutive patients with the diagnosis of diabetes mellitus and having skin lesions, either attending the diabetic clinic or admitted in medical wards were included in this study. Results: The common skin disorders were: x0 erosis (44%, diabetic dermopathy (36%, skin tags (32%, cutaneous infections (31%, and seborrheic keratosis (30%. Conclusion: Skin is involved in diabetes quite often and the manifestations are numerous. High prevalence of xerosis in our diabetic population is perhaps due to cold and dry climatic conditions in the region for most of the time in the year.

  4. Sex Disparities in Effects of Cystic Fibrosis-Related Diabetes on Clinical Outcomes: A Matched Study

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    Robert J Miller

    2008-01-01

    Full Text Available BACKGROUND: Cystic fibrosis-related diabetes (CFRD is an increasingly prevalent comorbidity factor for patients with cystic fibrosis (CF. CFRD has been associated with an accelerated decline in clinical parameters and an increased mortality rate.

  5. Regional differences in clinical care among patients with type 1 diabetes in Brazil: Brazilian Type 1 Diabetes Study Group

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    Gomes Marília B

    2012-10-01

    Full Text Available Abstract Background To determine the characteristics of clinical care offered to type 1 diabetic patients across the four distinct regions of Brazil, with geographic and contrasting socioeconomic differences. Glycemic control, prevalence of cardiovascular risk factors, screening for chronic complications and the frequency that the recommended treatment goals were met using the American Diabetes Association guidelines were evaluated. Methods This was a cross-sectional, multicenter study conducted from December 2008 to December 2010 in 28 secondary and tertiary care public clinics in 20 Brazilian cities in north/northeast, mid-west, southeast and south regions. The data were obtained from 3,591 patients (56.0% females and 57.1% Caucasians aged 21.2 ± 11.7 years with a disease duration of 9.6 ± 8.1 years ( Results Overall, 18.4% patients had HbA1c levels Conclusions A majority of patients, mainly in the north/northeast and mid-west regions, did not meet metabolic control goals and were not screened for diabetes-related chronic complications. These results should guide governmental health policy decisions, specific to each geographic region, to improve diabetes care and decrease the negative impact diabetes has on the public health system.

  6. Animal models for clinical and gestational diabetes: maternal and fetal outcomes

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    Kiss Ana CI

    2009-10-01

    Full Text Available Abstract Background Diabetes in pregnant women is associated with an increased risk of maternal and neonatal morbidity and remains a significant medical challenge. Diabetes during pregnancy may be divided into clinical diabetes and gestational diabetes. Experimental models are developed with the purpose of enhancing understanding of the pathophysiological mechanisms of diseases that affect humans. With regard to diabetes in pregnancy, experimental findings from models will lead to the development of treatment strategies to maintain a normal metabolic intrauterine milieu, improving perinatal development by preventing fetal growth restriction or macrosomia. Based on animal models of diabetes during pregnancy previously reported in the medical literature, the present study aimed to compare the impact of streptozotocin-induced severe (glycemia >300 mg/dl and mild diabetes (glycemia between 120 and 300 mg/dl on glycemia and maternal reproductive and fetal outcomes of Wistar rats to evaluate whether the animal model reproduces the maternal and perinatal results of clinical and gestational diabetes in humans. Methods On day 5 of life, 96 female Wistar rats were assigned to three experimental groups: control (n = 16, severe (n = 50 and mild diabetes (n = 30. At day 90 of life, rats were mated. On day 21 of pregnancy, rats were killed and their uterine horns were exposed to count implantation and fetus numbers to determine pre- and post-implantation loss rates. The fetuses were classified according to their birth weight. Results Severe and mild diabetic dams showed different glycemic responses during pregnancy, impairing fetal glycemia and weight, confirming that maternal glycemia is directly associated with fetal development. Newborns from severe diabetic mothers presented growth restriction, but mild diabetic mothers were not associated with an increased rate of macrosomic fetuses. Conclusion Experimental models of severe diabetes during pregnancy

  7. Diabetes and thalassaemia

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    Maria Barnard

    2013-03-01

    Full Text Available Diabetes is a significant complication of b-thalassaemia major. The aetiology includes iron overload causing b-cell destruction, autoimmunity, insulin resistance secondary to liver disease and development of type 1 or 2 diabetes. There are specific issues for patients with diabetes and thalassaemia which will be discussed here. Impaired carbohydrate metabolism must be detected early, to allow intensification of iron chelation. As life expectancy in thalassaemia rises, diabetic complications are seen. Optimising blood glucose and cardiovascular risk factor control is essential. Insulin remains critical for severely symptomatic patients. With milder hyperglycaemia, oral antidiabetic drugs are increasingly used. At Whittington Hospital, we wanted to address these issues. In 2005, we developed a unique Joint Diabetes Thalassaemia Clinic, where patients are reviewed jointly by specialist teams, including Consultant Diabetologist and Haematologist. The Joint Clinic aims to optimise diabetes, endocrine and thalassaemia care, while supporting patient self-management. A retrospective audit of the Joint Clinic (2005-09, showed improvement in glycaemic control, (Fructosamine falling from 344 umol/l to 319 umol/l. We compared our cohort to the National Diabetes Audit for England (2007-08. Patients attending the Joint Clinic achieved better glycaemic control (target reached: 73% Joint Clinic vs. 63% Nationally, blood pressure control (target reached: 58% Joint Clinic vs. 30% Nationally and cholesterol control (target reached: 81% Joint Clinic vs. 78% Nationally. 22.7% of our patients had ≥1 microvascular complication. A significant proportion had endocrinopathies (86% hypogonadism, 23% hypoparathyroidism, 18% hypothyroidism. Managing diabetes is one of the greatest challenges a person with thalassaemia can face. Training people to self-manage their diabetes and providing support from specialist teams working together are critical. The unique partnership

  8. Clinical status of a cohort of patients with type 1 diabetes diagnosed more than 2 decades before. Results of a specific clinical follow-up program.

    Science.gov (United States)

    Amor, Antonio J; Cabrer, Maria; Giménez, Marga; Vinagre, Irene; Ortega, Emilio; Conget, Ignacio

    2016-01-01

    The clinical course of type 1 diabetes mellitus (T1DM) has changed in recent decades. The aim of our study was to assess the long-term (> 20 years) clinical status of a patient cohort with T1DM under a specific treatment and follow-up program. A single center, observational, cross-sectional study was conducted of a patient cohort diagnosed with T1DM in the 1986-1994 period at our tertiary university hospital. Clinical characteristics, metabolic parameters, and occurrence of chronic complications and comorbidities after > 20 years of follow-up were collected. All subjects entered our specific program for patients with newly-diagnosed T1D and were followed up using the same clinical protocol. Data are shown as mean (standard deviation) or as number of patients and percentage. The appropriate test was used to compare quantitative and qualitative data. A P value <0.05 was considered statistically significant. A total of 279 patients were recorded, of whom 153 (53.6% women; mean age 46.6±8.6 years; age at onset 23.3±8.8 years; disease duration, 23.3±2.6 years) continued to attend our diabetes unit at the time of the analysis. Of these patients, 24.8% were administered continuous subcutaneous insulin infusion (CSII). Mean HbA1c in the past 5 years and in the last year were7.8±0.9% and 7.7±1.1% respectively (7.3±1.5% in those given CSII). Smoking was reported by 19.6% of patients, while 15.7% had high blood pressure and 37.9% dyslipidemia. Diabetic retinopathy was diagnosed in 20.4%, and 11.3% of the total cohort had nephropathy. Only 1.3% of our patients had a history of CVD. Data collected from a cohort of patients with T1DM for more than 2 decades regularly followed up with a specific program in a tertiary university hospital suggest a remarkably low prevalence of diabetic complications. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Survey of a Scottish diabetic clinic: a study of the etiology of diabetes mellitus.

    Science.gov (United States)

    Munro, H N; Eaton, J C; Glen, A

    1949-01-01

    Certain features of a group of 1309 diabetics were studied. The group was considered representative of Scottish diabetics since the sex distribution of cases corresponded to the sex distribution of deaths from diabetes recorded in the official mortality statistics for Scotland. Evidence is presented which justifies the use of Scottish mortality statistics for this purpose. A study of the incidence of diabetes in 413,110 Scottish recruits (male and female) suggested that in the general population the sex distribution of persons with undiagnosed diabetes might not be the same as that of persons known to have the disease. In both sexes, the disease began most frequently after age 40; sex incidence was equal up to age 40 and thereafter, female diabetics were more common than male diabetics. The high frequency of diabetes in women of middle age was confined to married women and appeared to be related, at least in part, to previous childbearing. The age at onset and the severity of the disease in this group of women were apparently uninfluenced by marriage and childbearing. Adult diabetics were no taller than the controls (hospital visitors). In the case of women diabetics, the maximum weight was significantly greater than that of the control from age 20 onwards, and in the case of male diabetics, from age 40 onwards. In both groups, married women were heavier than single women. The mean blood pressure was significantly higher in female diabetics after age 30 than in the corresponding control group. This hypertension could not be adequately explained on the grounds of obesity; it was not related to previous childbearing. Of 923 diabetics questioned, 23.2% had a family history of diabetes. As age at onset of the disease increased, positive family histories decreased. There was no relationship between presence of a positive family history and severity of the disease. The frequency of a positive family history in obese and hypertensive patients did not differ from that of a

  10. Determinants of first trimester attendance at antenatal care clinics in the Amazon region of Peru: A case-control study

    Science.gov (United States)

    Moore, Nora; Blouin, Brittany; Razuri, Hugo; Casapia, Martin; Gyorkos, Theresa W.

    2017-01-01

    Objective To identify determinants which influence the timing of the first antenatal care (ANC) visit in pregnant women. Design Retrospective matched nested case-control study. Setting Two health centres, Belén and 6 de Octubre, in the Peruvian Amazon. Population All pregnant women who had attended ANC during the years 2010, 2011, and 2012. Methods All cases (819 women initiating ANC in their first trimester) were selected from ANC registries from 2010 to 2012. A random sample of controls (819 women initiating ANC in their second or third trimester) was matched 1:1 to cases on health centre and date of first ANC visit. Data were obtained from ANC registries. Conditional logistic regression analyses were performed. Main outcome measure Case-control status of each woman determined by the gestational age at first ANC visit. Results Cases had higher odds of: 1) being married or cohabiting (aOR = 1.69; 95% CI: 1.19, 2.41); 2) completing secondary school or attending post-secondary school (aOR = 1.45; 95% CI: 1.02, 2.06); 3) living in an urban environment (aOR = 1.79; 95% CI: 1.04, 3.10) and 4) having had a previous miscarriage (aOR = 1.56; 95% CI: 1.13, 2.15), compared to controls. No statistically significant difference in odds was found for parity (aOR = 1.08; 95% CI: 0.85, 1.36). Conclusions This study provides empirical evidence of determinants of first ANC attendance. These findings are crucial to the planning and timing of local interventions, like deworming, aimed at pregnant women so that they can access and benefit fully from all government-provided ANC services. PMID:28207749

  11. Sensory manifestations of diabetic neuropathies: anatomical and clinical correlations.

    Science.gov (United States)

    Kazamel, Mohamed; Dyck, Peter J

    2015-02-01

    Diabetes mellitus is among the most common causes of peripheral neuropathy worldwide. Sensory impairment in diabetics is a major risk factor of plantar ulcers and neurogenic arthropathy (Charcot joints) causing severe morbidity and high health-care costs. To discuss the different patterns of sensory alterations in diabetic neuropathies and their anatomical basis. Literature review. Review of the literature discussing different patterns of sensory impairment in diabetic neuropathies. The different varieties of diabetic neuropathies include typical sensorimotor polyneuropathy (lower extremity predominant, length-dependent, symmetric, sensorimotor polyneuropathy presumably related to chronic hyperglycemic exposure, and related metabolic events), entrapment mononeuropathies, radiculoplexus neuropathies related to immune inflammatory ischemic events, cranial neuropathies, and treatment-related neuropathies (e.g. insulin neuritis). None of these patterns are unique for diabetes, and they can occur in nondiabetics. Sensory alterations are different among these prototypic varieties and are vital in diagnosis, following course, treatment options, and follow-up of treatment effects. Diabetic neuropathies can involve any segment of peripheral nerves from nerve roots to the nerve endings giving different patterns of abnormal sensation. It is the involvement of small fibers that causes positive sensory symptoms like pain early during the course of disease, bringing subjects to physician's care. This article emphasizes on the fact that diabetic neuropathies are not a single entity. They are rather different varieties of conditions with more or less separate pathophysiological mechanisms and anatomical localization. Clinicians should keep this in mind when assessing patients with diabetes on the first visit or follow-up. © The International Society for Prosthetics and Orthotics 2014.

  12. Tobacco and diabetes: clinical relevance and approach to smoking cessation in diabetic smokers.

    Science.gov (United States)

    López Zubizarreta, Marco; Hernández Mezquita, Miguel Ángel; Miralles García, José Manuel; Barrueco Ferrero, Miguel

    2017-04-01

    Smoking is, together with diabetes mellitus, one of the main risk factors for cardiovascular disease. Diabetic patients have unique features and characteristics, some of which are not well known, that cause smoking to aggravate the effects of diabetes and impose difficulties in the smoking cessation process, for which a specificand more intensive approach with stricter controls is required. This review details all aspects with a known influence on the interaction between smoking and diabetes, both as regards the increased risk of macrovascular and microvascular complications of diabetes and the factors with an impact on the results of smoking cessation programs. The treatment guidelines for these smokers, including the algorithms and drug treatment patterns which have proved most useful based on scientific evidence, are also discussed. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Missed Opportunities to Address Cardiovascular Disease Risk Factors amongst Adults Attending an Urban HIV Clinic in South Africa.

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    Miriam Rabkin

    Full Text Available We assessed cardiovascular disease (CVD risk factor prevalence and risk stratification amongst adults on antiretroviral therapy in South Africa. Of the 175 patients screened, 37.8% had high blood pressure (HBP, 15.4% were current smokers, 10.4% had elevated cholesterol, and 4.1% had diabetes, but very few (3.6% had a 10-year CVD risk >10%. One-third of those with HBP, 40% of those with diabetes, and two-thirds of those with high cholesterol had not previously been diagnosed. Although participants were adherent with chronic HIV care, screening for and management of CVDRF were suboptimal, representing a missed opportunity to reduce non-AIDS morbidity and mortality.

  14. Text messaging to improve attendance at post-operative clinic visits after adult male circumcision for HIV prevention: a randomized controlled trial.

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    Thomas A Odeny

    Full Text Available BACKGROUND: Following male circumcision for HIV prevention, a high proportion of men fail to return for their scheduled seven-day post-operative visit. We evaluated the effect of short message service (SMS text messages on attendance at this important visit. METHODOLOGY: We enrolled 1200 participants >18 years old in a two-arm, parallel, randomized controlled trial at 12 sites in Nyanza province, Kenya. Participants received daily SMS text messages for seven days (n = 600 or usual care (n = 600. The primary outcome was attendance at the scheduled seven-day post-operative visit. The primary analysis was by intention-to-treat. PRINCIPAL FINDINGS: Of participants receiving SMS, 387/592 (65.4% returned, compared to 356/596 (59.7% in the control group (relative risk [RR] = 1.09, 95% confidence interval [CI] 1.00-1.20; p = 0.04. Men who paid more than US$1.25 to travel to clinic were at higher risk for failure to return compared to those who spent ≤ US$1.25 (adjusted relative risk [aRR] 1.35, 95% CI 1.15-1.58; p<0.001. Men with secondary or higher education had a lower risk of failure to return compared to those with primary or less education (aRR 0.87, 95% CI 0.74-1.01; p = 0.07. CONCLUSIONS: Text messaging resulted in a modest improvement in attendance at the 7-day post-operative clinic visit following adult male circumcision. Factors associated with failure to return were mainly structural, and included transportation costs and low educational level. TRIAL REGISTRATION: ClinicalTrials.govNCT01186575.

  15. [Clinical practice recommendations for diabetes in pregnancy (Diabetes and Pregnancy Study Group of the Austrian Diabetes Association)].

    Science.gov (United States)

    Kautzky-Willer, Alexandra; Harreiter, Jürgen; Weitgasser, Raimund; Lechleitner, Monika

    2016-04-01

    Twenty-six years ago the St. Vincent Declaration aimed for an achievement of a comparable pregnancy outcome in diabetic and non-diabetic women. However, current surveys clearly show that women with pre-gestational diabetes still feature a much higher risk of perinatal morbidity and even increased mortality. This fact is mostly ascribed to a persistently low rate of pregnancy planning and pre-pregnancy care with optimization of metabolic control prior to conception. In addition, obesity increases worldwide, contributing to a growing number of women with type 2 diabetes at a childbearing age, and a further deterioration in outcome in diabetic women. Development of diabetic embryopathy and fetopathy are known to be related to maternal glycemic control (target: normoglycemia and normal HbA1c, if possible without hypoglycemia). The risk for hypoglycemia is at its greatest in early pregnancy and decreases with the progression of pregnancy due to the hormonal changes leading to a marked increase of insulin resistance. Intensified insulin therapy with multiple daily insulin injections and pump treatment are equally effective in reaching good metabolic control during pregnancy. All women should be experienced in the management of their therapy and on stable glycemic control prior to the conception. In addition, thyroid dysfunction, hypertension as well as the presence of diabetic complications should be excluded before pregnancy or treated adequately in order to decrease the risk for a progression of complications during pregnancy as well as for maternal and fetal morbidity.

  16. Factors Influencing the Choice of Child Delivery Location among Women Attending Antenatal Care Services and Immunization Clinic in Southeastern Nigeria.

    Science.gov (United States)

    Egharevba, Johnbull; Pharr, Jennifer; van Wyk, Brian; Ezeanolue, Echezona

    2017-01-01

    In Nigeria, most deliveries take place at home or with traditional birth attendants (TBAs). This study examined the factors that influenced or determined utilization of healthcare facility delivery services among women who attended antenatal care (ANC) services. A cross-sectional survey was conducted with 220 women who registered for ANC at a hospital and delivered within 18 months. Associations between independent variables and choice of healthcare facility delivery were analyzed. Multiple logistic regression was also used to identify the predictors of choice of delivery among women. Of the 220 women who registered for ANC, 75% delivered at a healthcare facility while 15% delivered with a TBA or at home. In the final model, number of children, having planned to deliver at a hospital, labor occurring at night, and labor allowing time for transportation were significant predictors of child delivery location among the women. Utilization of the health facilities for childbirth may increase if pregnant women are encouraged to book early for ANC and if during ANC, pregnant women were counseled to detect labor signs early. In addition to focused and intensified counseling for women with more children, support should be provided that includes financial provisions for transportation to the healthcare facility.

  17. Clinical diabetic nephropathy in a tropical African population

    African Journals Online (AJOL)

    failure, pregnancy, history suggestive of chronic glomerulone- phritis and absence of diabetic ... lrypoglycaemic agents were classified as type 1 and type 2 respectively. ... function, serum proteins, cholesterol, triglycerides, fasting and. 2 hours ...

  18. CASE REPORT Diabetic mastopathy: A clinical and radiological ...

    African Journals Online (AJOL)

    or axillary adenopathy. Ultrasound (US) demonstrated an ill-defined ... keeping with sclerosing lymphocytic mastitis, known also as diabetic mastopathy. ... mechanisms are: • exogenous insulin may result in an inflammatory or immunologic.

  19. Impact of diabets on clinical outcomes following multivessel percutaneous interventions

    Institute of Scientific and Technical Information of China (English)

    乔岩

    2013-01-01

    Objective To compare the rates of mortality,mycardial infarction (MI) ,repeat revascularization and stent thrombosis after percutaneous coronary intervention (PCI) with implantation of stents for diabetics versus nondiabetics with multivessel disease to evaluate the im-

  20. [Diabetes mellitus: from clinical knowledge to public health concern].

    Science.gov (United States)

    Scheen, André J

    2007-01-01

    Diabetes mellitus is a chronic disease whose prevalence is increasing worldwide. It remains associated with a high risk of severe complications, essentially micro- and macro-vascular complications. Type 1 diabetes is an auto-immune disease that leads to the destruction of insulin-secreting B cells and therefore requires an intensive optimised exogenous insulin therapy. Type 2 diabetes is a polygenic disease whose expression is favoured by inadequate lifestyle, leading to obesity. It combines a relative insulin secretory defect and insulin resistance, the latter being associated with various other cardiovascular risk factors. Treatment consists of lifestyle modifications first, then the prescription of various glucose-lowering oral drugs and finally, when requested, insulin therapy. A multi-risk intervention is mandatory to improve the cardiovascular prognosis. The prevention of diabetes and its complications is a major public health objective.

  1. Diabetes mellitus and spinal epidural abscess: clinical or surgical treatment?

    Science.gov (United States)

    Felício, João S; Martins, Carlliane Lins P; Liberman, Bernardo

    2011-12-01

    Spinal epidural abscess (SEA) is an uncommon condition and its most important predisposing factor is diabetes mellitus. Although the treatment of choice is prompt surgical abscess evacuation, followed by antibiotic therapy, successful conservative treatment of SEA has been reported in some cases. We describe a SEA case in a 23-year old white woman with diabetes for 14 years, who was successfully treated only with antibiotics, and achieved full recovery at the fourth month of follow-up.

  2. Mobile Phone-Based Education and Counseling to Reduce Stress Among Patients with Diabetes Mellitus Attending a Tertiary Care Hospital of India

    OpenAIRE

    Lipilekha Patnaik; Ashish Joshi; Trilochan Sahu

    2015-01-01

    Background: Stress among diabetic patients is much more as compared to normal individuals. A delayed recognition of stress undoubtedly worsens the prognosis for survival for many diabetic patients. Hence, this study was planned to develop an intervention model for the reduction of stress among diabetic patients and to evaluate the developed intervention model in the proposed group. Methods: This study was conducted in endocrinology outpatient department of a tertiary care hospital. Starti...

  3. Factors contributing to non-compliance to routine ante-natal haematinics among pregnant women attending ante-natal clinic in University of Maiduguri Teaching Hospital, Borno, Nigeria

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    Idris Umar Hambali

    2016-11-01

    Conclusions: In conclusion, this study provided information on the general response to factors contributing to non-compliance to routine ante natal haematinics among pregnant women attending ante natal clinic in UMTH which was about 62%. It is therefore recommended that the government should put in place relevant agencies to pro-actively inform pregnant women cut across all age groups, level of education, occupational classes, culture inclinations and financial status on the medical importance of haematinics intake during the gestation period. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3824-3831

  4. Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications.

    Science.gov (United States)

    Frier, Brian M

    2014-12-01

    Hypoglycaemia is a frequent adverse effect of treatment of diabetes mellitus with insulin and sulphonylureas. Fear of hypoglycaemia alters self-management of diabetes mellitus and prevents optimal glycaemic control. Mild (self-treated) and severe (requiring help) hypoglycaemia episodes are more common in type 1 diabetes mellitus but people with insulin-treated type 2 diabetes mellitus are also exposed to frequent hypoglycaemic events, many of which occur during sleep. Hypoglycaemia can disrupt many everyday activities such as driving, work performance and leisure pursuits. In addition to accidents and physical injury, the morbidity of hypoglycaemia involves the cardiovascular and central nervous systems. Whereas coma and seizures are well-recognized neurological sequelae of hypoglycaemia, much interest is currently focused on the potential for hypoglycaemia to cause dangerous and life-threatening cardiac complications, such as arrhythmias and myocardial ischaemia, and whether recurrent severe hypoglycaemia can cause permanent cognitive impairment or promote cognitive decline and accelerate the onset of dementia in middle-aged and elderly people with diabetes mellitus. Prevention of hypoglycaemia is an important part of diabetes mellitus management and strategies include patient education, glucose monitoring, appropriate adjustment of diet and medications in relation to everyday circumstances including physical exercise, and the application of new technologies such as real-time continuous glucose monitoring, modified insulin pumps and the artificial pancreas.

  5. CLINICAL ANALYSIS OF 50 CASES OF DIABETIC MACULOPATHY

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    Arvind Babu C

    2016-07-01

    Full Text Available To study age, incidence, sex incidence and relationship between Diabetic age and Maculopathy, Role of FFA and/or OCT in management. MATERIALS AND METHODS 96 eyes of 50 patients were screened in the OPD. Using slit lamp biomicroscopy, FFA and OCT the relationship between Diabetic age and type of maculopathy was analysed. RESULTS 32 patients were above 50 years of age and 18 less than 50. Ratio of males-to-females was 2.85:1. In our study 92% had bilateral involvement (Asymmetric, 14% with focal type of maculopathy had 6-10 years’ duration; 33% of diffuse had 11-15 years of duration; 30% of ischaemic type had 20-25 years’ duration. CONCLUSION Incidence of diabetic maculopathy was common after 50 years of age and with diabetes of longer duration. FFA is the most important diagnosing tool in classifying type of maculopathy and aids in management. Also focal maculopathy was common in early diabetics, diffuse type and ischaemic type were seen with longer duration of diabetes.

  6. Diabetic kidney disease: from epidemiology to clinical perspectives.

    Science.gov (United States)

    Park, Cheol Whee

    2014-08-01

    With worldwide epidemic of diabetes mellitus, diabetic nephropathy which is one of the major causes of microvascular complication has become a serious concern in Korea as well as the rest of the world. In view of its significance, there is an urgent and paramount need for proper managements that could either deter or slow the progression of diabetic nephropathy. Despite advances in care, ever increasing number of patients suffering from diabetic kidney disease and from end-stage renal disease implies that the current management is not adequate in many aspects. The reasons for these inadequacies compromise lack of early diagnosis, failure to intervene with timely and aggressive manner, and lack of understanding on the kind of interventions required. Another issue equally important for the adequate care of patients with diabetic nephropathy is an understanding of past, present and future epidemiology of diabetic nephropathy which serves, especially in Korea, as a material determining standard diagnosis and treatment and a national health-policy decision.

  7. Diabetic Kidney Disease: From Epidemiology to Clinical Perspectives

    Directory of Open Access Journals (Sweden)

    Cheol Whee Park

    2014-08-01

    Full Text Available With worldwide epidemic of diabetes mellitus, diabetic nephropathy which is one of the major causes of microvascular complication has become a serious concern in Korea as well as the rest of the world. In view of its significance, there is an urgent and paramount need for proper managements that could either deter or slow the progression of diabetic nephropathy. Despite advances in care, ever increasing number of patients suffering from diabetic kidney disease and from end-stage renal disease implies that the current management is not adequate in many aspects. The reasons for these inadequacies compromise lack of early diagnosis, failure to intervene with timely and aggressive manner, and lack of understanding on the kind of interventions required. Another issue equally important for the adequate care of patients with diabetic nephropathy is an understanding of past, present and future epidemiology of diabetic nephropathy which serves, especially in Korea, as a material determining standard diagnosis and treatment and a national health-policy decision.

  8. Clinical application analysis of continuing nursing in nursing service for diabetic patients.

    Science.gov (United States)

    Yang, Qiaohong; You, Liming; Huang, Jiewei; Chen, Qingling; Li, Miaona; Wong, Frances KamYuet

    2016-11-01

    The research is to establish a Continuing Nursing Project after discharge which conforming to the actual conditions of our country and explore whether such Continuing Nursing Project could effectively improve therapy compliance and blood glucose control of diabetic patients. mainly analyzing pathological mechanisms of diabetic patients and exploring the clinical effect and the complication after implementing Continuing Nursing to patients. after implementing Continuing Nursing, the diabetic patients could be better at controlling their diet, the drug usage rate and exercise rate have been improved significantly, complication rate have been decreased and the clinical effect is remarkable. the application of Continuing Nursing in the nursing service for diabetic patients, which could effectively improve living quality and clinical symptoms of patients, deserves to be popularized.

  9. Early management of type 2 diabetes based on a SMBG strategy: the way to diabetes regression--the St Carlos study : a 3-year, prospective, randomized, clinic-based, interventional study with parallel groups.

    Science.gov (United States)

    García de la Torre, Nuria; Durán, Alejandra; Del Valle, Laura; Fuentes, Manuel; Barca, Idoya; Martín, Patricia; Montañez, Carmen; Perez-Ferre, Natalia; Abad, Rosario; Sanz, Fuencisla; Galindo, Mercedes; Rubio, Miguel A; Calle-Pascual, Alfonso L

    2013-08-01

    The aims are to define the regression rate in newly diagnosed type 2 diabetes after lifestyle intervention and pharmacological therapy based on a SMBG (self-monitoring of blood glucose) strategy in routine practice as compared to standard HbA1c-based treatment and to assess whether a supervised exercise program has additional effects. St Carlos study is a 3-year, prospective, randomized, clinic-based, interventional study with three parallel groups. Hundred and ninety-five patients were randomized to the SMBG intervention group [I group; n = 130; Ia: SMBG (n = 65) and Ib: SMBG + supervised exercise (n = 65)] and to the HbA1c control group (C group) (n = 65). The primary outcome was to estimate the regression rate of type 2 diabetes (HbA1c 4 kg was 3.6 (1.8-7); p < 0.001. This study shows that the use of SMBG in an educational program effectively increases the regression rate in newly diagnosed type 2 diabetic patients after 3 years of follow-up. These data suggest that SMBG-based programs should be extended to primary care settings where diabetic patients are usually attended.

  10. Diabetic Ketoacidosis and Related Events in the Canagliflozin Type 2 Diabetes Clinical Program.

    Science.gov (United States)

    Erondu, Ngozi; Desai, Mehul; Ways, Kirk; Meininger, Gary

    2015-09-01

    This study assessed the incidence of serious adverse events of diabetic ketoacidosis (DKA) among patients with type 2 diabetes treated with canagliflozin. All serious adverse events of DKA and related events (ketoacidosis, metabolic acidosis, and acidosis) from 17,596 patients from randomized studies of canagliflozin through 11 May 2015 were analyzed. Serious adverse events of DKA and related events were reported in 12 patients (0.07%), including 4 (0.07%), 6 (0.11%), and 2 (0.03%) treated with canagliflozin 100 and 300 mg and comparator, respectively; corresponding incidence rates were 0.522, 0.763, and 0.238 per 1,000 patient-years, respectively. Most patients with DKA and related events had a blood glucose >300 mg/dL (16.7 mmol/L) at presentation of DKA, were on insulin, and had DKA-precipitating factors, including some with type 1 diabetes/latent autoimmune diabetes of adulthood. DKA and related events occurred at a low frequency in the canagliflozin type 2 diabetes program, with an incidence consistent with limited existing observational data in the general population with type 2 diabetes. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  11. A Study of Socio Demographic and Clinical Profile of Cases of Diabetic Foot

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    Jayesh B Gohel

    2012-06-01

    Full Text Available Introduction: Diabetic foot is a complication of Diabetes Mellitus, which is a group of metabolic disorders sharing the phenotype of hyperglycemia. The aim of the therapy is to avoid diabetic foot complications, salvage the limb with available modalities in hospital, preventing recurrences and rehabilitation. Methods: This article summarizes the profile of 200 patients with diabetic foot seen in General Surgery department of Civil Hospital at Ahmedabad. The diagnosis of diabetic foot was based on clinical, biochemical and radiological investigations. Clinical presentation can be divided into infective, vascular and neuropathic groups. Results: Average age of presentation was 55.02 year. There is a higher incidence in male patients, majority of patients (57% belongs to lower socioeconomic status. The average duration of diabetes is 9.78 years. Severity of lesion correlated with severity and duration of diabetes. Commonest presenting feature is an abscess followed by gangrene. Staph.aureus is the most common organism isolated from diabetic foot. X-Rays of feet were taken and majority presented with osteomyelitic changes. The average duration of hospital stay was 17.34 days. Conclusion: Foot ulceration in diabetic patients is a resource consuming, disabling morbidity that often is the first step towards lower extremity amputation. Prevention is the best treatment. Effective glycemic control and education are of key importance for decreasing diabetic foot disease, while early presentation and hospital admission, aggressive and appropriate medical and surgical treatment according to grade if disease can improve outcome and reduce the morbidity and mortality due to diabetes. [National J of Med Res 2012; 2(3.000: 279-281

  12. Relation of metformin treatment to clinical events in diabetic patients undergoing percutaneous intervention.

    Science.gov (United States)

    Kao, John; Tobis, Jonathan; McClelland, Robyn L; Heaton, Melissa R; Davis, Barry R; Holmes, David R; Currier, Jesse W

    2004-06-01

    Diabetic patients undergoing coronary interventions have worse clinical and angiographic outcomes than do patients without diabetes. Metformin, an insulin sensitizer, may decrease the occurrence of these outcomes. Diabetic patients in the Prevention of Restenosis with Tranilast and its Outcomes Trial were identified through their medical records (n = 2,772). In this trial, 1,110 diabetic patients received nonsensitizer therapy (insulin and/or sulfonylureas) and 887 received sensitizer therapy (metformin with or without additional therapy). Logistic regression was used to obtain odds ratios (ORs) (sensitizer vs nonsensitizer therapy) of any clinical event (death, myocardial infarction, or ischemia-driven target vessel revascularization) and adjusted for multiple risk factors. Multivariate analysis showed no effect of lesion characteristics on clinical outcomes. Compared with patients on nonsensitizer therapy, those on sensitizer therapy showed an adjusted OR of 0.72 (95% confidence interval [CI] 0.57 to 0.91, p = 0.005) for any clinical event. The differences between the nonsensitizer therapy group and the sensitizer group were attributable mainly to decreased rates of death (OR 0.39, 95% CI 0.19 to 0.77, p = 0.007) and myocardial infarction (OR 0.31, 95% CI 0.15 to 0.66, p = 0.002). In our retrospective analysis, use of metformin in diabetics undergoing coronary interventions appeared to decrease adverse clinical events, especially death and myocardial infarction, compared with diabetic patients treated with nonsensitizer therapy.

  13. Bone regeneration in cranioplasty and clinical complications in rabbits with alloxan-induced diabetes

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    Evanice Menezes Marçal Vieira

    2008-06-01

    Full Text Available This research evaluated the bone repair process in surgical defects created on the parietal bones of diabetic rabbits using the guided bone regeneration technique to observe the effects of alloxan in the induction of diabetes mellitus. Twenty-four adult rabbits were divided into three study groups: control (C, diabetic (D and diabetic associated to polytetrafluoroethylene (PTFE membrane (D-PTFE. For diabetes induction the animals received one dose of monohydrated alloxan (90 mg/kg by intravenous administration in the auricular or femoral vein. In group D-PTFE the membrane covered both the floor and the surface of the bone defect. In groups D and C, the bone defect was filled up with blood clot. The specimens were fixed in 10% formol and prepared for histomorphometric analysis. The results showed that the 90 mg/kg dose of monohydrate alloxan was sufficient to promote diabetes mellitus when administered in the auricular vein. Bone regeneration was slower in the diabetic group when compared with the control and diabetic-PTFE groups, but there was no significant statistical difference between the two experimental groups (D and D-PTFE. The oral and general clinical complications among the diabetics were weight loss, polyuria, polyphagia and severe chronic gingivitis.

  14. Brain alterations and clinical symptoms of dementia in diabetes: Abeta/tau-dependent and independent mechanisms

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    Naoyuki eSato

    2014-09-01

    Full Text Available Emerging evidence suggests that diabetes affects cognitive function and increases the incidence of dementia. However, the mechanisms by which diabetes modifies cognitive function still remains unclear. Morphologically, diabetes is associated with neuronal loss in the frontal and temporal lobes including the hippocampus, and aberrant functional connectivity of the posterior cingulate cortex and medial frontal/temporal gyrus. Clinically, diabetic patients show decreased executive function, information processing, planning, visuospatial construction, and visual memory. Therefore, in comparison with the characteristics of AD brain structure and cognition, diabetes seems to affect cognitive function through not only simple AD pathological feature-dependent mechanisms, but also independent mechanisms. As an Abeta/tau-independent mechanism, diabetes compromises cerebrovascular function, increases subcortical infarction and might alter the blood brain barrier (BBB. Diabetes also affects glucose metabolism, insulin signaling and mitochondrial function in the brain. Diabetes also modifies metabolism of Abeta and tau and causes Abeta/tau-dependent pathological changes. Moreover, there is evidence that suggests an interaction between Abeta/tau-dependent and independent mechanisms. Therefore, diabetes modifies cognitive function through Abeta/tau-dependent and independent mechanisms. Interaction between these two mechanisms forms a vicious cycle.

  15. The Prime Diabetes Model: Novel Methods for Estimating Long-Term Clinical and Cost Outcomes in Type 1 Diabetes Mellitus.

    Science.gov (United States)

    Valentine, William J; Pollock, Richard F; Saunders, Rhodri; Bae, Jay; Norrbacka, Kirsi; Boye, Kristina

    Recent publications describing long-term follow-up from landmark trials and diabetes registries represent an opportunity to revisit modeling options in type 1 diabetes mellitus (T1DM). To develop a new product-independent model capable of predicting long-term clinical and cost outcomes. After a systematic literature review to identify clinical trial and registry data, a model was developed (the PRIME Diabetes Model) to simulate T1DM progression and complication onset. The model runs as a patient-level simulation, making use of covariance matrices for cohort generation and risk factor progression, and simulating myocardial infarction, stroke, angina, heart failure, nephropathy, retinopathy, macular edema, neuropathy, amputation, hypoglycemia, ketoacidosis, mortality, and risk factor evolution. Several approaches novel to T1DM modeling were used, including patient characteristics and risk factor covariance, a glycated hemoglobin progression model derived from patient-level data, and model averaging approaches to evaluate complication risk. Validation analyses comparing modeled outcomes with published studies demonstrated that the PRIME Diabetes Model projects long-term patient outcomes consistent with those reported for a number of long-term studies. Macrovascular end points were reliably reproduced across five different populations and microvascular complication risk was accurately predicted on the basis of comparisons with landmark studies and published registry data. The PRIME Diabetes Model is product-independent, available online, and has been developed in line with good practice guidelines. Validation has indicated that outcomes from long-term studies can be reliably reproduced. The model offers new approaches to long-standing challenges in diabetes modeling and may become a valuable tool for informing health care policy. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  16. Parent Health Literacy and Communication With Diabetes Educators in a Pediatric Diabetes Clinic: A Mixed Methods Approach.

    Science.gov (United States)

    Howe, Carol J; Cipher, Daisha J; LeFlore, Judy; Lipman, Terri H

    2015-01-01

    Low health literacy is associated with poor communication between adults and providers, but little is known about how parents' health literacy influences communication in pediatric encounters. We examined how parent health literacy affected communication between parents and diabetes educators in a pediatric diabetes clinic. A mixed methods study was conducted including a cross-sectional survey of 162 parents and semi-structured interviews with a subsample of 24 parents of a child with Type 1 diabetes. Parent and child characteristics, parents' report of quality of communication, and parent health literacy were assessed. Logistic regression was performed to determine associations between health literacy and 4 subscales of the Interpersonal Processes of Care (IPC) survey; directed content analyses of interview data were completed. Although health literacy was not significantly associated with the IPC subscales, results from directed content analyses revealed different communication experiences for parents by health literacy classification. Low health literate parents were confused by diabetes jargon, preferred hands-on teaching, and wished for information to be communicated in simple language, broken down into key points, and repeated. Parents with adequate health literacy wanted comprehensive information communicated through ongoing dialogue. Findings indicate that learner-driven curricula may be most appropriate for diabetes education.

  17. Clinical questionnaire study of oral health care and symptoms in diabetic vs. non-diabetic predialysis chronic kidney disease patients.

    Science.gov (United States)

    Vesterinen, Maarit; Ruokonen, Hellevi; Furuholm, Jussi; Honkanen, Eero; Meurman, Jukka H

    2012-04-01

    This paper aims to study oral symptoms (burning mouth sensation, xerostomia, dysphagia, and dysgeusia) and background characteristics among chronic kidney disease (CKD) patients. The hypothesis was that patients experience oral discomfort and show interest towards dental care differently depending on the origin of their kidney disease. One hundred thirty-eight CKD patients at predialysis stage (94 men, 44 women, mean age 54 years) at the Helsinki University Central Hospital participated in the study. The patients were divided into a diabetic nephropathy group and a group of patients with other kidney diseases. The patients had a clinical oral examination and filled in a structured questionnaire. The data were analyzed and compared between the groups (SPSS for Windows version 15.0). T test was used for parameters normally distributed while binomial data were analyzed with cross-tabulations and chi-square test. Contrary to our study hypothesis, no statistically significant differences were seen in the questionnaire study between the diabetic vs. non-diabetic CKD patients in any other study parameter except in the use of medication (10 ± 2.3 vs. 8 ± 3.1 drugs daily, p diabetic, 48.2% in non-diabetic patients). No difference was seen in the frequency of oral discomfort among the different groups of predialysis patients investigated. Clinicians should be aware of nephropathy patients who frequently suffer from oral discomfort, particularly xerostomia.

  18. Improving diabetic foot screening at a primary care clinic: A quality improvement project

    Science.gov (United States)

    Allen, Michelle L.; Gunst, Colette

    2016-01-01

    Background Foot screening is an important part of diabetic care as it prevents significant morbidity, loss of function and mortality from diabetic foot complications. However, foot screening is often neglected. Aim This project was aimed at educating health care workers (HCWs) in a primary health care clinic to increase diabetic foot screening practices. Setting A primary health care clinic in the Western Cape province of South Africa Methods A quality improvement project was conducted. HCWs’ needs were assessed using a questionnaire. This was followed by focus group discussions with the HCWs, which were recorded, transcribed and assessed using a general inductive approach. An intervention was designed based on common themes. Staff members were trained on foot screening and patient information pamphlets and screening tools were made available to all clinic staff. Thirty-two consecutive diabetic patient folders were audited to compare screening in 2013 with that in 2014 after initiation of the quality improvement cycle. Results HCWs’ confidence in conducting foot screening using the diabetic foot assessment questionnaire improved markedly after training. Diabetic foot screening practices increased from 9% in 2013 to 69% in 2014 after the first quality improvement cycle. A strengths, opportunities, aspirations and results (SOAR) analysis showed promise for continuing quality improvement cycles. Conclusion The findings showed a significant improvement in the number of diabetic patients screened. Using strategic planning with appreciative intent based on SOAR, proved to be motivational and can be used in the planning of the next cycle. PMID:27608673

  19. Dietary beliefs and eating patterns influence metabolic health in type 2 diabetes: A clinic-based study in urban North India

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    Susan L Colles

    2013-01-01

    Full Text Available Background: Almost 15% of India′s urban adult populace now lives with type 2 diabetes. This study aimed to characterize the eating patterns, knowledge, beliefs, and determinants of food choice, and assess associations with the metabolic health among urban Asian Indians with type 2 diabetes. Materials and Methods: A cross-sectional study of 258 individuals (mean age 55.7 ± 10 years; body mass index 27.1 ± 4.8 kg/m 2 ; diabetes duration 10.1 ± 6.5 years attending two out-patient clinics in New Delhi, India. Food-related information was collected during a semi-structured interview. Clinical, anthropometric, and biochemical data were recorded. Results: Beliefs related to health and diabetes played a role determining food choice and dietary patterns; erroneous views were associated with the poor food choices and greater metabolic perturbations. Average consumption of fruits/vegetables was low. Intakes were positively associated with intentions to manage diabetes; inversely associated with the waist circumference and negatively correlated with one′s degree of personal responsibility for food choice. Household saturated fat usage was common. High fat intakes were positively associated with the taste preference, ratings of perceived "health-value;" waist circumference, glycosylated haemoglobin percentage (HbA1c% and lipids. Conclusions: Strategies to enhance diabetes control among Asian Indians are required and should encourage fruit/vegetable intake, personal accountability, and consider individual beliefs and preferences. Greater emphasis and resources directed to regular dietary and behavioral counseling may assist.`

  20. Indicators of adherence to physiotherapy attendance among Saudi female patients with mechanical low back pain: a clinical audit

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    Al-Eisa Einas

    2010-06-01

    Full Text Available Abstract Background Among current musculoskeletal interventions used to treat low back pain (LBP, physiotherapy exercise has the highest evidence of effectiveness in avoiding recurrence and chronic disability. However, effectiveness of physiotherapy is thought to be directly related to the patients' adherence to physiotherapy. Since adherence is reported to be directly influenced by socio-cultural factors, this study was conducted to investigate factors related to patients' adherence in a group of Saudi female patients with LBP. Methods A retrospective chart review was conducted on female LBP patients referred to the department of physiotherapy at a local tertiary hospital over a 12 month period. A total of 98 charts were reviewed. Two physiotherapists specialized in musculoskeletal rehabilitation collected information from the medical files. Data were classified in three categories: patients' personal demographics, patients' medical condition and history, and type of physiotherapy administered. Contingency tables and chi-square test were computed to test for differences in proportions. Spearman rank correlation coefficient was calculated to examine relationships among variables. Results Subjects who attended their scheduled appointments were classified as adherent (40%, and those who failed to attend 2 consecutive scheduled appointments and got discharged were classified as non-adherent (60%. Factors that significantly correlated with adherence included: age (r = 0.7, p Conclusion This study reveals an alarming level of non-adherence to physiotherapy among patients with LBP. It remains unclear as to what level of adherence is required to achieve beneficial effect of treatment. It is quite evident however, that early withdrawal from treatment would not allow the therapeutic benefits of the treatment to be realized. Future research should be directed toward developing strategies to improve adherence.

  1. Pulmonary tuberculosis among women with cough attending clinics for family planning and maternal and child health in Dar Es Salaam, Tanzania

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    Wandwalo Eliud R

    2009-08-01

    Full Text Available Abstract Background Tuberculosis (TB case detection in women has remained low in developing world. This study was conducted to determine the proportion of smear positive TB among women with cough regardless of the duration attending family Planning (FP and Maternal and child health (MCH clinics in Dar es Salaam. Methods We conducted a cross sectional study in all three municipal hospitals of Dar es Salaam, between October 2007 and June 2008. All women with cough attending FP and MCH clinics were screened for TB by smear microscopy. Pearson chi-square was used to compare group difference for categorical variables. Risk factors for smear positive were estimated by logistics regression with 95% confidence intervals (CI given for odds ratios indicating statistically significant relationship if the CI did not include one. Results We enrolled a total of 749 TB suspects. Five hundred and twenty nine patients (70.6% were from MCH clinics. Mean (SD age was 27.6 (5.2 years. A total of 616 (82.2% patients were coughing for less than two weeks as compared to 133 (17.8%, who coughed for two or more weeks. Among 616 TB suspects, 14 (2.3% were smear positive TB patients, and of the 133 who had coughed for two or more weeks, 13 (9.8% were smear positive TB patients. Risk factors associated with smear positive results were having attended more than one visit to any facility prior to diagnosis (OR = 6.8; 95%CI 2.57–18.0 and having HIV/AIDS (OR = 4.4; 95%CI 1.65–11.96. Long duration of cough was not a risk factor for being smear positive (OR = 1.6; 95%CI 0.59–4.49. Conclusion The proportion of smear positive TB patients among women with cough attending MCH and FP was 3.8%. Visits to any health facility prior to Diagnosis and HIV infection were risk for having a smear positive TB.

  2. Diabetes Prevention Program Outcomes Study (DPPOS) Phase 3 ? Research Project | Division of Cancer Prevention

    Science.gov (United States)

    DESCRIPTION (provided by applicant): Abnormal regulation of glycemia (dysglycemia) has a very long time course, from its earliest stage, labeled pre-diabetes, to the onset of Type 2 diabetes (T2D), to the development of clinically detectable microvascular changes and measurable atherosclerosis, to clinically manifest complications with attendant morbidity and mortality. |

  3. Clinical and biochemical profile of lean type 2 diabetes mellitus

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    Punyakrit Deb Barma

    2011-01-01

    Full Text Available Background: Type 2 diabetes mellitus is the most prevalent form of diabetes worldwide. In western countries majority of the cases are obese. The scenario may be different in certain parts of India. Various studies have reported a high prevalence of lean type 2 diabetes mellitus with a body mass index < 19 kg/m 2 . Materials and Methods: We evaluated 100 cases of lean type 2 diabetes mellitus (62 males and 38 females. Results and Conclusion: The mean duration of diabetes was 51.7 months (range 5-180 months. The glycemic control was poor according to standard guidelines. The majority of them showed response to oral hypoglycemic agents. Secondary failure to oral hypoglycemic agents was seen in 27 patients. The prevalence of microvascular complications was much higher than macrovascular complications. Neuropathy was the commonest complication seen in 70%, followed by retinopathy in 25%. Only 12 patients had hypertension, one had coronary artery disease and two had cerebrovascular accident. Lipid profile was not significantly deranged in our patients.

  4. Diabetic Ketoacidosis and Related Events in the Canagliflozin Type 2 Diabetes Clinical Program

    Science.gov (United States)

    Erondu, Ngozi; Desai, Mehul; Ways, Kirk

    2015-01-01

    OBJECTIVE This study assessed the incidence of serious adverse events of diabetic ketoacidosis (DKA) among patients with type 2 diabetes treated with canagliflozin. RESEARCH DESIGN AND METHODS All serious adverse events of DKA and related events (ketoacidosis, metabolic acidosis, and acidosis) from 17,596 patients from randomized studies of canagliflozin through 11 May 2015 were analyzed. RESULTS Serious adverse events of DKA and related events were reported in 12 patients (0.07%), including 4 (0.07%), 6 (0.11%), and 2 (0.03%) treated with canagliflozin 100 and 300 mg and comparator, respectively; corresponding incidence rates were 0.522, 0.763, and 0.238 per 1,000 patient-years, respectively. Most patients with DKA and related events had a blood glucose >300 mg/dL (16.7 mmol/L) at presentation of DKA, were on insulin, and had DKA-precipitating factors, including some with type 1 diabetes/latent autoimmune diabetes of adulthood. CONCLUSIONS DKA and related events occurred at a low frequency in the canagliflozin type 2 diabetes program, with an incidence consistent with limited existing observational data in the general population with type 2 diabetes. PMID:26203064

  5. A novel application of the Intent to Attend assessment to reduce bias due to missing data in a randomized controlled clinical trial

    Science.gov (United States)

    Rabideau, Dustin J; Nierenberg, Andrew A; Sylvia, Louisa G; Friedman, Edward S.; Bowden, Charles L.; Thase, Michael E.; Ketter, Terence; Ostacher, Michael J.; Reilly-Harrington, Noreen; Iosifescu, Dan V.; Calabrese, Joseph R.; Leon, Andrew C.; Schoenfeld, David A

    2014-01-01

    Background Missing data are unavoidable in most randomized controlled clinical trials, especially when measurements are taken repeatedly. If strong assumptions about the missing data are not accurate, crude statistical analyses are biased and can lead to false inferences. Furthermore, if we fail to measure all predictors of missing data, we may not be able to model the missing data process sufficiently. In longitudinal randomized trials, measuring a patient's intent to attend future study visits may help to address both of these problems. Leon et al. developed and included the Intent to Attend assessment in the Lithium Treatment—Moderate dose Use Study (LiTMUS), aiming to remove bias due to missing data from the primary study hypothesis [1]. Purpose The purpose of this study is to assess the performance of the Intent to Attend assessment with regard to its use in a sensitivity analysis of missing data. Methods We fit marginal models to assess whether a patient's self-rated intent predicted actual study adherence. We applied inverse probability of attrition weighting (IPAW) coupled with patient intent to assess whether there existed treatment group differences in response over time. We compared the IPAW results to those obtained using other methods. Results Patient-rated intent predicted missed study visits, even when adjusting for other predictors of missing data. On average, the hazard of retention increased by 19% for every one-point increase in intent. We also found that more severe mania, male gender, and a previously missed visit predicted subsequent absence. Although we found no difference in response between the randomized treatment groups, IPAW increased the estimated group difference over time. Limitations LiTMUS was designed to limit missed study visits, which may have attenuated the effects of adjusting for missing data. Additionally, IPAW can be less efficient and less powerful than maximum likelihood or Bayesian estimators, given that the parametric

  6. Theoretical perspectives to increase clinical effectiveness of lifestyle modification strategies in diabetes.

    Science.gov (United States)

    Peters, Rosalind M

    2004-01-01

    Diabetes affects more than 18 million people in the United States. The prevalence of type 2 diabetes has increased at an alarming rate in the past 20 years. Minorities are disproportionately affected, with the greatest increase in adult prevalence noted in African-American women. The increasing prevalence of type 2 diabetes in both children and adults is strongly associated with the increasing prevalence of obesity. Diabetes and its complications can be controlled with appropriate health care and patient self-management techniques. There is strong empirical evidence supporting the efficacy of dietary and physical activity interventions in the prevention and treatment of type 2 diabetes. The results of empirical studies have not translated well into clinical practice. Four key theoretical concepts are presented in an effort to increase the effectiveness of lifestyle intervention counseling by primary care providers. The four concepts include: perceptual congruence, mutual goal setting, readiness to change, and tailored interventions.

  7. Clinical and medication profiles stratified by household income in patients referred for diabetes care

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    Svenson Lawrence W

    2007-03-01

    Full Text Available Abstract Background Low income individuals with diabetes are at particularly high risk for poor health outcomes. While specialized diabetes care may help reduce this risk, it is not currently known whether there are significant clinical differences across income groups at the time of referral. The objective of this study is to determine if the clinical profiles and medication use of patients referred for diabetes care differ across income quintiles. Methods This cross-sectional study was conducted using a Canadian, urban, Diabetes Education Centre (DEC database. Clinical information on the 4687 patients referred to the DEC from May 2000 – January 2002 was examined. These data were merged with 2001 Canadian census data on income. Potential differences in continuous clinical parameters across income quintiles were examined using regression models. Differences in medication use were examined using Chi square analyses. Results Multivariate regression analysis indicated that income was negatively associated with BMI (p Conclusion Our findings demonstrate that low income patients present to diabetes clinic older, heavier and with a more atherogenic lipid profile than do high income patients. Overall medication use was higher among the lower income group suggesting that differences in clinical profiles are not the result of under-treatment, thus invoking lifestyle factors as potential contributors to these findings.

  8. Demographic and Clinical Characteristics of youth onset Diabetes Mellitus in Kashmir India

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    Riyaz Daga

    2015-07-01

    Full Text Available Diabetes mellitus (DM is a major public health problem. Objective of current study was to know the demography, clinical characteristics and etiology of youth Diabetes mellitus (DM in Kashmir, North India. METHODS: A prospective hospital based study, carried out in the Department of Endocrinology, SKIMS Srinagar, Kashmir India over the period from 2008 July - September 2010. Setting: A teaching, Research and tertiary care hospital at Srinagar Kashmir North India. PARTICIPANTS: All the new youth onset diabetes patients whose age were less than 25 years and were admitted in endocrinology ward for various reasons over the period from 2008 July - September 2010. PROCEDURE: All children with diabetes mellitus less than twenty five years of age were enrolled in this study. Variables recorded were demographics, clinical presentation, laboratory tests. RESULTS: A total of seventy two patients of youth onset diabetes mellitus were studied, Forty six were less than 20 years and twenty six more than 20 years of age. There were 33 males (45.8% and 39 females (54.2%. Family history of diabetes was present in nineteen (26.4%, fourteen were less than 20 yrs and five more than 20 yrs. Fifty nine (81.9% presented with osmotic symptoms, Thirteen (18.1% with DKA. Hypoglycemic episodes were present in forty one patients. Sixteen patients had nephropathy and nine had Retinopathy. CONCLUSION: Diabetes mellitus is a major public health problem. Type 2 diabetes mellitus is emerging as the form of diabetes in young diabetic patients, due to epidemic of childhood obesity.

  9. Amerlcan Diabetic Association Standards in an Air Force Medical Clinic

    Science.gov (United States)

    1996-05-01

    were overweight ; 30% were obese ; half of the patients were treated solely with oral hypoglycemics, 19% with diet alone, and almost one-third were...of Birth : Minot, North Dakota. Secondary Education: Des Lacs High School , Des Lacs, North Dakota, May 1969. Collegiate Institutions Attended: Minol...Slale College 1969 - 1973 BS Communication Arts 1973 Minol State College 1973 - 1974 BS Elementary Education 1974 Minol Slate College 1980 - 1984

  10. Prevalence and clinical characteristics of insulin-treated, anti-GAD-positive, type 2 diabetic subjects in an outpatient clinical department of a Dutch teaching hospital.

    NARCIS (Netherlands)

    Romkens, T.E.H.; Kusters, G.C.M.; Netea, M.G.; Netten, P.M.

    2006-01-01

    BACKGROUND: In clinical practice, type 1 and type 2 diabetic patients are sometimes difficult to distinguish. Type 1 diabetes has an immune-mediated pathogenesis, resulting in a loss of insulin-secreting beta-cells. Type 2 diabetes mellitus is characterised by a relative insulin insufficiency, witho

  11. Physical activity in type II Diabetes Mellitus, an effective therapeutic element: review of the clinical impact

    Directory of Open Access Journals (Sweden)

    Pedro Iván Arias-Vázquez

    2015-07-01

    Full Text Available A review was conducted in databases (PubMed, PEDro of type studies clinical trial, cohort study, systematic reviews, meta-analysis and clinical practice guidelines based on evidence they have studied the benefits of physical activity in the prevention , treatment and decreased risk of complications and death in patients with Type II Diabetes Mellitus. Realization regular physical activity is associated with a decreased risk of developing Diabetes Mellitus; likewise was associated with decrease in glycated hemoglobin percentage A1C values. Diabetic patients undergoing high levels of physical activity had decreased risk of complications and death from cardiovascular disease and all causes. At present the scientific evidence on the impact of physical activity in the prevention and treatment of Diabetes Mellitus is solid, so it must be emphasized promoting physical activity as a fundamental part of the therapeutic regimens for this disease.

  12. Clinical factors associated with the diagnosis and progression of diabetic nephropathy.

    Science.gov (United States)

    Liang, Shuang; Li, Qian; Zhu, Han-Yu; Zhou, Jian-Hui; Ding, Rui; Chen, Xiang-Mei; Cai, Guang-Yan

    2014-09-01

    As an important complication of diabetic mellitus, diabetic nephropathy (DN) has been the main cause of end-stage renal disease. It is of great importance to diagnose DN early, and to identify the risk factors of disease progression in order to carry out in-time and effective therapies. Previous literatures have reported the role of several clinical factors in the diagnosis and progression of DN, including age, longer diabetes duration, diabetic retinopathy, higher level of hypertension and HbA1c, and so on. However, the significance of these clinical factors is still controversial and limited. This review aimed to evaluate the values and limitations of these factors in diagnosing and predicting the renal outcome of DN.