Compared benefits of educational programs dedicated to diabetic patients with or without community pharmacist involvement

Abstract Background: International guidelines on diabetes control strongly encourage the setting-up of therapeutic educational programs (TEP). However, more than half of the patients fail to control their diabetes a few months post-TEP because of a lack of regular follow-up by medical professionals. The DIAB-CH is a TEP associated with the follow-up of diabetic patients by the community pharmacist. Aim: To compare the glycated hemoglobin (HbA1c) and body mass index (BMI) in diabetic patients of Control (neither TEP-H nor community pharmacist intervention), TEP-H (TEP in hospital only) and DIAB-CH (TEP-H plus community pharmacist follow-up) groups. Methods: A comparative cohort study design was applied. Patients included in the TEP-H from July 2017 to December 2017 were enrolled in the DIAB-CH group. The TEP-H session was conducted by a multidisciplinary team composed of two diabetologists, two dieticians and seven nurses. The HbA1c level and the BMI (when over 30 kg/m2 at M0) of patients in Control (n = 20), TEP-H (n = 20) and DIAB-CH (n = 20) groups were collected at M0, M0 + 6 and M0 + 12 months. First, HbA1c and BMI were compared between M0, M6 and M12 in the three groups with the Friedman test, followed by the Benjamini-Hochberg post-test. Secondly, the HbA1c and BMI of the three groups were compared at M0, M6 and M12 using the Kruskal-Wallis test. Findings: While no difference in HbA1c was measured between M0, M6 and M12 in the Control group, Hb1Ac was significantly reduced in both TEP-H and DIAB-CH groups between M0 and M6 (P = 0.0072 and P = 0.0034, respectively), and between M0 and M12 only in the DIAB-CH group (P = 0.0027). In addition, a significant decrease in the difference between the measured HbA1c and the target assigned by diabetologists was observed between M0 and M6 in both TEP-H and DIAB-CH groups (P = 0.0072 and P = 0.0044, respectively) but only for the patients of the DIAB-CH group between M0 and M12 (P = 0.0044). No significant difference (P > 0.05) in BMI between the groups was observed. Conclusion: The long-lasting benefit on glycemic control of multidisciplinary group sessions associated with community pharmacist-led educational interventions on self-care for diabetic patients was demonstrated in the present study. There is thus evidence pointing to the effectiveness of a community/hospital care collaboration of professionals on diabetes control in primary care.

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Effect of manual reduction and indirect decompression on thoracolumbar burst fracture: a comparison study

10.21203/rs.3.rs-90414/v1 ◽

2020 ◽

Author(s):

Jian Huang ◽

Limin Zhou ◽

Zhaodong Yan ◽

Zongbo Zhou ◽

Xuejian Gou

Keyword(s):

Burst Fracture ◽

Wedge Angle ◽

Control Group ◽

Thoracolumbar Burst Fracture ◽

Manual Reduction ◽

Significant Difference ◽

Indirect Decompression ◽

The Difference ◽

Experimental Group

Abstract Study designRetrospective cohort study.ObjectiveTo evaluate the effect of manual reduction and indirect decompression on thoracolumbar burst fracture.Methods60 patients with thoracolumbar burst fracture who were hospitalized from January 2018 to October 2019 were selected and divided into experimental group (33 cases) and control group (27 cases) according to different treatment methods. The experimental group was treated with manual reduction and indirect decompression, while the control group was not treated with manual reduction. The operation time and intraoperative blood loss were recorded. VAS score was used to evaluate the improvement of pain. The anterior height of injured vertebra, wedge angle of injured vertebral body, encroachment ratio of injured vertebral canal were used to evaluate spinal canal decompression and fracture reduction. JOA score was used to evaluate the improvement of spinal function.ResultsThere was no significant difference in operation time and intraoperative blood loss between the two groups. Compared with the control group, the VAS score and the wedge angle of injured vertebral body of the experimental group on 3 days after operation and the last follow-up were significantly lower than that of the control group, and the difference was statistically significant. The ratio of anterior height of injured vertebra of the experimental group on 3 days after operation and the last follow-up were significantly higher than that of the control group, and the difference was statistically significant. The difference of the encroachment ratio of injured vertebral canal between preoperation and 3 days after operation was significantly higher than that of the control group, and the difference was statistically significant. The bladder function of JOA on 3 days after operation of the experimental group was significantly higher than that of the control group, and the difference was statistically significant. And the rest aspect of JOA on 3 days after operation and last follow-up of the experimental group were no significant difference Compared with the control group.ConclusionManipulative reduction and indirect decompression can obtain better clinical effect in the treatment of thoracolumbar burst fractures.

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Effect of manual reduction and indirect decompression on thoracolumbar burst fracture: a comparison study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02075-w ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Jian Huang ◽

Limin Zhou ◽

Zhaodong Yan ◽

Zongbo Zhou ◽

Xuejian Gou

Keyword(s):

Burst Fracture ◽

Wedge Angle ◽

Control Group ◽

Thoracolumbar Burst Fracture ◽

Manual Reduction ◽

Significant Difference ◽

Indirect Decompression ◽

The Difference ◽

Experimental Group

Abstract Objective To evaluate the effect of manual reduction and indirect decompression on thoracolumbar burst fracture. Methods Sixty patients with thoracolumbar burst fracture who were hospitalized from January 2018 to October 2019 were selected and divided into an experimental group (33 cases) and control group (27 cases) according to different treatment methods. The experimental group was treated with manual reduction and indirect decompression, while the control group was not treated with manual reduction. The operation time and intraoperative blood loss were recorded. VAS score was used to evaluate the improvement of pain. The anterior height of the injured vertebra, wedge angle of the injured vertebral body, and encroachment ratio of the injured vertebral canal were used to evaluate the spinal canal decompression and fracture reduction. JOA score was used to evaluate the improvement of spinal function. Results There was no significant difference in operation time and intraoperative blood loss between the two groups. Compared with the control group, the VAS score and the wedge angle of the injured vertebral body of the experimental group 3 days after the operation and the last follow-up were significantly lower than that of the control group, and the difference was statistically significant. The ratio of the anterior height of the injured vertebra of the experimental group 3 days after the operation and the last follow-up was significantly higher than that of the control group, and the difference was statistically significant. The difference of the encroachment ratio of the injured vertebral canal between preoperation and 3 days after operation was significantly higher than that of the control group, and the difference was statistically significant. The bladder function of JOA 3 days after the operation of the experimental group was significantly higher than that of the control group, and the difference was statistically significant. And the rest aspect of JOA on 3 days after the operation and last follow-up of the experimental group has no significant difference compared with the control group. Conclusion Manipulative reduction and indirect decompression can obtain a better clinical effect in the treatment of thoracolumbar burst fractures.

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The Efficacy of Follow-up Phone Calls for Capillary Blood Glucose Lowering in Diabetic Patients in Primary Care Unit

Siriraj Medical Journal ◽

10.33192/smj.2021.104 ◽

2021 ◽

Vol 73 (12) ◽

pp. 801-807

Author(s):

Possatorn Wongwutthiwet ◽

Tatree Bosittipichet ◽

Thanakamon Leesri

Keyword(s):

Primary Care ◽

Capillary Blood ◽

Mean Difference ◽

Control Group ◽

Diabetic Patients ◽

Capillary Blood Glucose ◽

Phone Calls ◽

Significant Difference ◽

Experimental Group

Objective: To study the effect of telephone call intervention on glycemic control in diabetic patients for 2 monthsMaterials and Methods: The quasi-experimental research included 130 Patients from January 2020 to March 2020 in primary care. The 115 patients were divided into 2 groups through a simple randomization process, 61 in experimental group and 54 in control group after exclusion. 115 Patients will be tested for Capillary blood glucose (CBG) level at a period of 0-month, 1-month and 2-months. CBG level were presented in mean ± SD, mean difference ± SD and analyzed by Independent t-test and Paired t-test.Results: The phone call intervention can lower CBG level compared to the control group. Mean difference of CBG between 0 month and 2 months follow-up in phone calls group vs control group (-6.80 ± 4.86 vs -2.96 ± 4.82 mg/dL) and mean difference CBG level between 1 month and 2 months follow-up in phone calls group vs control group (-5.77 ± 4.09 vs -4.22 ± 5.10 mg/dL) but had no significant difference (p >0.05)Conclusion: The follow-up phone calls can lower CBG level in the experimental group more than the control group, but there is no significant difference.

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Design and Implementation of Educational Interventions to Empower Female Students to Prevent Osteoporosis

Journal of Community Health Research ◽

10.18502/jchr.v7i4.266 ◽

2019 ◽

Author(s):

Nader Sharifi ◽

Farangis Sharifi

Keyword(s):

Controlled Trial ◽

Intervention Group ◽

Educational Interventions ◽

Female Students ◽

Control Group ◽

Significant Difference ◽

Prevention Of Osteoporosis ◽

The Mean ◽

The Difference ◽

Mean Variance

Introduction: Osteoporosis is a chronic disease which influences the life of people considerably, especially the women. Most women are not aware that osteoporosis is preventable. Although there is a higher risk of osteoporosis in postmenopausal women, but bone loss can begin at the age of 35. This research was conducted to design and implement educational interventions to empower female students to prevent osteoporosis. Methods: This interventional study was a controlled trial. This study was conducted on female students of Shahrekord Islamic Azad University. A two-stage stratified random sampling was used for recruiting samples. The sample size was set at 150 (75 interventions and 75 controls). A demographic questionnaire and a self-made questionnaire of self-empowerment for the prevention of osteoporosis were used to collect information. Data were collected before the intervention and three months after the intervention. The educational intervention was conducted in two months with eight education sessions. For statistical analyses, the SPSS software version 23 was used. Results: The mean age of the intervention group was 20.69 ± 2.24, and the control group was 20.29 ± 2.04, besides, there was no significant difference between the two groups (P= 0.26). The test indicates a significant difference in mean variance of the intervention group compared to mean variance of the control group in knowledge (P< 0.001), attitude (P< 0.001) and self-efficacy (P= 0.006). The difference in mean variance of the intervention group compared to the mean variance of the control group was not significant in life skills (P= 0.23). Conclusion: The results generally reflect the effect of educational interventions in improving the abilities of female students to prevent osteoporosis. It is suggested to design and implement educational programs to empower women to prevent osteoporosis. Keywords: Osteoporosis, Preventive, Knowledge, Attitude

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Subthreshold micropulse laser adjuvant to bevacizumab versus bevacizumab monotherapy in treating diabetic macular edema: one- year- follow-up

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211040887 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110408

Author(s):

Leila El Matri ◽

Ahmed Chebil ◽

Khaled El Matri ◽

Yousra Falfoul ◽

Zouheir Chebbi

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Intravitreal Injections ◽

Control Group ◽

Diabetic Patients ◽

Micropulse Laser ◽

Treatment Naïve ◽

The Difference ◽

Retrospective Comparative Study

Purpose: To compare the therapeutic impact of combining intravitreal injections of bevacizumab (IVB) with micropulse laser (MPL) in central diffuse diabetic macular edema (DME) versus IVB monotherapy during 12 months follow-up. Methods: We conducted a retrospective comparative study of 98 treatment-naive eyes (63 patients) with central diffuse DME. The first group of patients (IVB + MPL group, n = 49) was treated with 3 monthly IVB followed by MPL within 1 week after the third injection. Patients were then followed and treated on a pro re nata (PRN) basis, with MPL retreatment if necessary. The changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), number of IVB injections and MPL sessions were evaluated at 4, 8, and 12 months. A control group of diabetic patients with treatment-naive DME was treated with standard protocol of 3 monthly IVB as monotherapy then followed on a PRN basis (IVB group, n = 49). Statistic comparaison of BCVA, CMT, and IVB number variation was interpreted at 12 months between both groups. Results: In IVB + MPL group, baseline BCVA improvement was not significant at 4 and 8 months ( p = 0.90, p = 0.08), and was statistically significant ( p = 0.01) at 12 months. Mean CMT significantly decreased at 4, 8, and 12 months ( p < 0.01) in IVB + MPL group. The difference in BCVA (p = 0.091) and CMT (p = 0.082) variation at 12 months between both groups was not significant but the number of injections was significantly lower in IVB + MPL group (4.1 ± 1.5 injections) compared to IVB group (7.2 ± 1.3 injections) ( p < 0.005). Conclusion: Combining intravitreal injections of bevacizumab and MPL in the treatment of DME is effective and safe. This protocol may decrease the number of IVB and its frequency. It offers the advantage of lasting therapeutic response with fewer recurrences.

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Impact of a Pharmacy-Initiated Inpatient Diabetes Patient Education Program on 30-Day Readmission Rates

Journal of Pharmacy Practice ◽

10.1177/0897190019833217 ◽

2019 ◽

Vol 33 (6) ◽

pp. 754-759

Author(s):

Julie A. Murphy ◽

Michelle N. Schroeder ◽

Anita T. Ridner ◽

Megan E. Gregory ◽

Jangus B. Whitner ◽

...

Keyword(s):

Patient Education ◽

Medical Center ◽

Intervention Group ◽

Diabetes Patient ◽

Pharmacist Intervention ◽

Control Group ◽

Readmission Rates ◽

Inpatient Diabetes ◽

Significant Difference ◽

The Difference

Background: In October 2012, a pharmacy-driven Inpatient Diabetes Patient Education (IDPE) program was implemented at the University of Toledo Medical Center (UTMC). Objective: To determine the difference in 30-day hospital readmission rates for patients who receive IDPE compared to those who do not. Methods: This retrospective cohort was completed at UTMC. Patients admitted between October 1, 2012, and September 30, 2013, were included if they were ≥18 years and had one of the following: (1) diagnosis of diabetes mellitus, (2) blood glucose >200 mg/dL (>11.11 mmol/L) on admission, or (3) hemoglobin A1C of >6.5% (>48 mmol/mol). Patients who received IDPE from a pharmacist or student pharmacist (intervention group) were compared to patients who did not receive IDPE (control group). Results: The 30-day readmission rate was 13.2% for the intervention group (n = 364) and 21.5% for the control group (n = 149) ( P = .023). Average time to 30-day readmission was 13.1 (±8.3) days for the IDPE group and 11.9 (±7.9) days for the control group. There was no significant difference in diabetes-related readmission between the intervention and control groups (25.5% vs 21.9%). Conclusions: An IDPE program delivered primarily by pharmacists and student pharmacists significantly reduced 30-day readmission rates among patients with diabetes.

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Comparing the effectiveness of mobile social network-based mindfulness intervention with acceptance and commitment therapy and mindfulness therapy on self-management and glycated haemoglobin level among patients with type 2 diabetes

Journal of Shahrekord University of Medical Sciences ◽

10.34172/jsums.2019.39 ◽

2019 ◽

Vol 21 (5) ◽

pp. 221-228

Author(s):

Mohammad Mahdi Azadi ◽

Gholamreza Manshaee ◽

Mohsen Golparvar

Keyword(s):

Social Network ◽

Glycated Haemoglobin ◽

Self Management ◽

Control Group ◽

Diabetic Patients ◽

Acceptance And Commitment ◽

Significant Difference ◽

Mindfulness Therapy

Background and aims: The present study aimed to compare mobile social network-based mindfulness training, along with acceptance and commitment therapy (ACT) and mindfulness therapy on self-management and glycated haemoglobin (HbA1c) level in patients with type 2 diabetes. Materials and Methods: The research employed a pretest-posttest control group quasi-experimental design with a three-month follow-up. Among type 2 diabetic patients who referred to diabetes treatment centers in Isfahan in the spring of 2018, 80 of them were purposefully selected based on inclusion criteria and then randomly assigned to three groups of the social network-based mindfulness intervention, ACT, and mindfulness training, along with a control group. Then, the summaries of Diabetes Self-care Activities questionnaire and glycated haemoglobin test were used to measure the dependent variables. The mindfulness interventions were conducted in the form of attendance in the training sessions. In addition, virtual network-based training and ACT were presented during eight 45-minute and 120-minute sessions, respectively. Finally, the data were analyzed using repeated measures of ANOVA with Bonferroni post-hoc test by SPSS software. Results: The findings indicated that in the self-management variable, there was a significant difference between social network-based mindfulness (posttest mean=30.59, follow-up mean=30.88, P=0.004) and ACT (posttest mean=32.7, follow-up mean=32.29, P=0.001) with the control group. Further, a significant difference was observed between ACT and mindfulness therapy regarding self-management (P=0.04). In the HbA1c level, there was a significant difference only between social network-based mindfulness (mean in posttest and follow-up=7.44and 7.39, respectively, P=0.02) and the control group. Conclusion: According to the findings of the present study, mobile social networks-based mindfulness interventions, along with ACT, are considered as effective treatments for diabetic patients to increase self-management while reducingHbA1c.

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Surgical Site Occurrences of Simultaneous Panniculectomy and Incisional Hernia Repair

The American Surgeon ◽

10.1177/000313481508100813 ◽

2015 ◽

Vol 81 (8) ◽

pp. 764-769 ◽

Cited By ~ 13

Author(s):

Jeremy A. Warren ◽

Matthew Epps ◽

Cart Debrux ◽

James L. Fowler ◽

Joseph A. Ewing ◽

...

Keyword(s):

Hernia Repair ◽

Incisional Hernia Repair ◽

Control Group ◽

Excess Skin ◽

Significant Difference ◽

The Difference ◽

Prospective Database ◽

Flap Creation ◽

Repair Techniques

Horizontal panniculectomy (PAN) offers the advantage of wide exposure for hernia repair with elimination of excess skin and adiposity, at the expense of massive subcutaneous flap creation and its attendant risks. We report our experience with ventral hernia repair (VHR) with PAN compared with patients with hernia repair alone. A prospective database was reviewed retrospectively for all patients undergoing open VHR + PAN. A matched cohort of patients without PAN was used for comparison, resulting in 43 study and 43 control patients. Incidence of surgical site occurrences (SSO), surgical site infection (SSI), and recurrence were analyzed. A total of 43 patients underwent PAN + VHR with mesh. Mean body mass index was 34.3 kg/m2, with 35 per cent having undergone prior bariatric surgery. Repair techniques included retromuscular (74.4%), preperitoneal (11.6%), intraperitoneal (6.9%), onlay (4.6%), and suture (2.3%). Mesh used was polypropylene (76.7%), polyester (18.6%), bioabsorbable (2.3%), and polytetrafluoroethylene (ePTFE) (2.3%). Component separation was performed in 44.2 per cent of patients. There was a significant difference in total SSO between PAN + VHR and VHR alone (46.5% vs 27.9%; P < 0.001), though the difference for individual SSOs was not significant. There was no difference in SSI between groups (16.3% vs 20.9%; P = 0.776). Mean follow-up was 11.4 months, with recurrence rate of 11.6 per cent in the PAN group and 9.3 per cent in the control group ( P = 0.725). Panniculectomy at the time of VHR does not increase the incidence of SSI, though higher rates of skin necrosis and cellulitis were seen. There is no difference in recurrence. This approach is a valid option for patients with excessive abdominal panniculus requiring VHR.

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Association of Diabetes Mellitus with Acute Ischemic Stroke

Bangladesh Journal of Medical Biochemistry ◽

10.3329/bjmb.v9i2.36687 ◽

2018 ◽

Vol 9 (2) ◽

pp. 45-48

Author(s):

N Sharmin ◽

N Sultana ◽

H Rahman ◽

T Rahman ◽

SN Chowdhury

Keyword(s):

Diabetes Mellitus ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Risk Estimation ◽

Control Group ◽

Case Group ◽

Diabetic Patients ◽

Significant Difference ◽

The Difference ◽

Bangladeshi Population

Acute ischemic stroke occurs more frequently in diabetic patients. The purpose of the present study was to observe the association of diabetes mellitus with acute ischemic stroke in Bangladeshi population. This case-control study was carried out in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh during the period from January 2014 to December 2014. Patients presenting with acute ischemic stroke, age ranges from 18 to 65 years of both sexes, were taken as the case group. Age-and sex-matched healthy individuals were selected as control group. History of diabetes of both cases and controls were recorded and blood sample was collected from both cases and controls after overnight fasting for the estimation of blood sugar. A total number of 100 study subjects were taken of which 50 subjects presented with acute ischemic stroke were considered as cases and the rest 50 healthy subjects were taken as controls. In this study, the mean(±SD) of age of cases and controls were 56.54±12.18 and 53.34±7.98 years respectively. There was no statistically significant difference between mean age of the groups (p=0.124). Mean (±SD) of BMI was significantly higher in cases than that of controls (p=0.002) which were 27.25±3.25 and 25.38±2.57 respectively and the study subjects were sex matched, the difference between cases and controls was not statistically significant (p= 0.414). Diabetes mellitus was more commonly reported in case group (46.0%) than control group (6.0%) and the difference was found statistically significant (p=0.001). The risk estimation was calculated and was found a 13.34 OR (95% C.I. 3.66 to 48.62). From the findings of this study in may be concluded that diabetes mellitus is significantly associated with acute ischemic stroke.Bangladesh J Med Biochem 2016; 9(2): 45-48

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Assessment of Safety and Efficacy of Ultra-micro Transconjunctival Lower Eyelid Bags Removal Combined with Orbital Fat Transfer

10.21203/rs.3.rs-147432/v1 ◽

2021 ◽

Author(s):

Ke-xue Wang ◽

Xiong Xiang ◽

Jian-feng Zhang ◽

Man-cang Ma

Keyword(s):

Retrospective Chart Review ◽

Lower Eyelid ◽

Postoperative Recovery ◽

Control Group ◽

Observation Group ◽

Fat Transfer ◽

Orbital Fat ◽

Significant Difference ◽

The Difference

Abstract BackgroundThe elaboration of a precise operation is essential during lower eyelid blepharoplasty. The aim of this study was to investigate the clinical effect of ultra-micro transconjunctival lower eyelid bags removal combined with orbital fat transfer in the correction of lower eyelid bags. MethodsA total of 226 patients underwent lower eyelid blepharoplasty in our department during the past 3 years (2018-2020). Excluded were patients with previous eyelid surgery, diplopia, strabismus and associated procedures. A retrospective chart review of patients undergoing traditional transconjunctival blepharoplasty (n=104) and ultra-micro transconjunctival lower eyelid bags removal combined with orbital fat transfer (n=122) was performed. The length of follow-up ranged between 24 hours and 3 months after operation. ResultsThe control group (conventional conjunctival blepharoplasty) included 45 males and 59 females with an average age of (44.5±3.5) years, while the observation group (subconjunctival blepharoplasty with orbital fat transfer) included 49 males and 73 females with an average age of (43.1±4.2) years. There were no statistically significant differences between the two groups in gender (p = 0.27) and age (p = 0.44) (p > 0.05). The Clinical improvement of the observation group is significantly higher than the control group, after 5 days has significant statistical differences between two groups (P < 0.05). It was found that the clinical efficiency of the observation group was significantly higher than that of the control group (P < 0.05). Next, we compared the complications between the two groups and found that there was a significant difference between the two groups (P < 0.05). The satisfaction of the two groups at different follow-up times was compared: 1 day after the operation, the satisfaction of the observation group was 52.5%, and that of the control group was 32.5%, with no statistically significant difference (P > 0.05). The satisfaction of the observation group was higher than that of the control group at 3d and 1 month after surgery, and the difference was statistically significant (P < 0.05).ConclusionThe application of ultra-micro transconjunctival lower eyelid bags removal combined with orbital fat transfer can correct the lower eyelid bag safely and effectively with short postoperative recovery time, high patient satisfaction and low complication rate. This advanced technical skill may significantly improve the treatment of lower eyelid bags.

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