scholarly journals Factors associated with diabetic foot among type 2 diabetes in the region of Monastir (Tunisia)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Abroug ◽  
M Ben Fredj ◽  
M Kacem ◽  
C Bennasrallah ◽  
W Dhouib ◽  
...  
Keyword(s):  
Risk Factors ◽  
Glycemic Control ◽  
Diabetic Foot ◽  
Disease Duration ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Poor Glycemic Control ◽  
P Value ◽  
Validated Questionnaire ◽  
The Relationship

Abstract Background The diabetic foot (DF) has actually a high rate of disability leading to impaired quality of life and even mortality. Glycemic control among Tunisian adults with diabetes mellitus remains poor. However the relationship between glycemic control and foot complication have not been clearly established. The aim of the present study was to assess the relationship between diabetic foot lesions and glycemic control and the diabetic duration in the people with DT2. Methods A cross-sectional survey was conducted in five Primary Health care Centers (PHC) in the region of Monastir (Tunisia) from March 2016 to April 2017. Data were collected using interviewer administered structured questionnaire. Validated questionnaire was used to assess diabetic foot diseases.nA multivariate logistic regression analysis was conducted to assess the relationship between glycemic control, diabetic duration and the DF lesions. A p-value of < 0.05 was considered statistically significant. Results In total 383 patients were recruited, of whom 258 (67.9%) were men. The mean age of participants was 60.7±11.3. Poor glycemic control (HbA1c ≥ 7.0%) increased the risk of abnormal patellar reflex (aOR=7.07; CI95% 1.65-30.1; p = 0.03) and calf claudication (aOR=7.07; CI95% 1.65-30.1). The long duration of diabetes (10 years and more) was a significant factor associated with an abnormal Achill reflex (aOR=2.31; CI95% 1.12-4.76; p = 0.02), a needle-stick perceptual disorder(aOR=2.08; CI95% 1.14-3.78; p = 0.01), a vibration sensibility perceptual disorder (aOR=2.02; CI95% 1.01-4.08; p = 0.04), a negative monofilament test (aOR=2.69; CI95% 1.04-5.16; p = 0.003), an absent dorsalis pedis artery pulsation(aOR=2.35; CI95% 1.09-5.05;p=0.02) and an absent posterior tibial artery pulsation (aOR=3.06; CI95% 1.28-7.28; p = 0.01). Conclusions This study identified that disease duration and poor glycemic control are significant risk factors related to DF development in the current T2DM population. Key messages Disease duration and poor glycemic control are significant risk factors related to DF development in the T2DM population in the region of Monastir. Prevention programs should be focused on patient education about modifiable risk factors in particular glycemic control and adequate and regular foot care.

scholarly journals Incidence and Risk Factors of Post-Operative Delirium in Elderly Patients Who Underwent Spinal Anesthesia in Orotta, Halibet and Sembel Hospitals: A Cross Sectional Study in Eritrea

2021 ◽  
pp. 1-8
Author(s):  
Michael Beraki Mengistu ◽  
◽  
Yonatan Mehari Andemeske ◽  
AriamTsegay Emhatsion ◽  
HabtomTareke Wrieta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of

Background: Delirium is a common but often underdiagnosed set of transient symptoms often seen in elderly patients following surgeries under spinal anesthesia. With early recognition and diagnosis based on the established standard criteria delirium can be improved. Early identification of the possible contributingfactors and the magnitude of the burden will help in the management of the fragile elderly patients. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who have done surgery under spinal anesthesia. Method: This cross sectional study was conducted in the National Referral Hospitals and Sembel PrivateHospital, in Asmara, Eritrea from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no known history of dementia or delirium or no mental disorder, no history of acute cerebrovascular disease. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, data was analyzed with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value <0.05 was considered as statistically significant. Results: The mean age of the participants was 74 ±6.62 and 102 (79.1%) of the participants were males. POD occurred in 14 (10.9%) of the patients. Adjusting all the potential factors, age was identified as arisk factor for developing POD. Conclusion: Age was determined to be a significant risk factor of delirium. Elderly patients require more attention and care and the findings might help to develop preventive strategies to the occurrence of POD

scholarly journals Factors Associated with Spontaneous Preterm Delivery in a Nigerian Teaching Hospital

2016 ◽  
Vol 29 (1) ◽  
pp. 9-14
Author(s):  
Omole Ohonsi Abiodun ◽  
Belga Francis
Keyword(s):  
Risk Factors ◽  
Preterm Delivery ◽  
Teaching Hospital ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
P Value ◽  
Chi Square ◽  
Low Socioeconomic ◽  
Spontaneous Preterm Delivery ◽  
Chi Square Test

Objective (s): To determine the aetiological factors of preterm deliveries at Aminu Kano Teaching Hospital, Kano, Nigeria..Materials and methods: This case-control study was conducted between 1st June 2006 and 31st May 2007.One hundred and forty eight women with preterm deliveries (cases) were compared with seven hundred and forty women who delivered at term (control). Data analysis was done using Epi- Info software (6.0 CDC Atlanta Georgia, USA). Univariate and multivariate logistic regression analysis were performed and the results were expressed as odds ratio (OR) with 95% confidence interval (CI). The contribution of the risk factors were estimated using chi square test and a p-value of < 0.05 was taken as significant.Results: The period incidence of preterm deliveries was 69 per 1000 births. Unbooked and low socioeconomic statuses, primigravidity, previous preterm deliveries, multiple pregnancies, pre-eclampsia, and malaria in pregnancy were significant risk factors that were associated with preterm delivery. These associations were still demonstrable after adjusting for confounding variables.Conclusion: Early girl marriage and childbearing and spontaneous pre-labour rupture of membranes not to be independent risk factors in this study. Women with risk factors should be managed in specialist hospitals.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 9-14

scholarly journals Prevalence of Complications of Diabetes and Risk Factors Among Patients with Diabetes in the Diabetes Clinic in Southeast of Iran

2021 ◽  
Author(s):  
Hamed Taheri ◽  
Roya Rafaiee ◽  
Raheleh Rafaiee
Keyword(s):  
Risk Factors ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Clinical Information ◽  
Cross Sectional Study ◽  
Poor Glycemic Control ◽  
P Value ◽  
Diabetes Clinic ◽  
Cross Sectional ◽  
The Mean

Objective: Academic health services play an important role in the prevention and control of diabetes mellitus (DM) in Iran. This study aimed at determining the prevalence of DM-related complications and the associated risk factors among patients with DM in a university-affiliated outpatient diabetes clinic of a referral hospital in Southeast of Iran, Zahedan. Materials and Methods: This cross-sectional study was conducted from January to April 2019 in an academic diabetes clinic. A total of 334 patients with DM, whose characteristics (age, sex, family history of DM, and substance abuse), as well as laboratory and clinical information, were recorded in the baseline forms, were included. The relationship between variables were assessed by Pearson’s correlation coefficient at P-value< 0.05 and using SPSS version 20.0. Results: The mean age of the participants was 54.27 (±11.57) years. In these patients, DM type 2 was estimated at 99.1%, and the mean duration of the disease was 8.98 (±6.93) years. The findings showed that 77.2% of the patients had poor glycemic control. Also, 85.4% of the patients had fasting blood sugar (FBS) level >126 mg/dL. There was a significant relationship between insulin-dependent therapy and drug abuse (P-value <0.001). The prevalence of hyperlipidemia (68.9%), hypertension (50.6%), retinopathy (29.6%), nephropathy (11.7%), and neuropathy (12.3%) was also determined. Conclusion: The majority of the patients (77.2%) in this study had poor glycemic control, and 69.9% of them suffered from microvascular complications, macrovascular complications, or both. Therefore, frequent visits accompanied by patient education could help to better diabetes control

scholarly journals Risk factors of amputation in diabetic foot infections

2018 ◽  
Vol 5 (4) ◽  
pp. 1399 ◽  
Author(s):  
Quraysh Shabbir Sadriwala ◽  
Bapuji S. Gedam ◽  
Murtaza A. Akhtar
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Glycemic Control ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Factors Associated ◽  
Diabetic Foot Infections

Background: Diabetes is the most common underlying cause of foot ulcers, infection, and ischemia, leading to hospitalization and the most frequent cause of non-traumatic lower extremity amputation. Despite well-defined risk factors for diabetic foot ulcer development, limited data are available as to which factors predict amputation in a diabetic foot ulcer episode. Therefore, to predict lower limb amputation occurrence and to determine the factors associated with the risk of amputation in diabetic patients, we conducted this study.Methods: A hospital based longitudinal study was carried out to assess the risk factors associated with amputation in diabetic foot infection. Patients with foot infections, who were either a diagnosed case of diabetes mellitus or were diagnosed at the institute were included in the study. We excluded patients receiving immunosuppressive therapy or radiotherapy, and infections at or above the ankle joint. Study factors were demographic details, biochemical parameters, Wagner grading, peripheral neuropathy as evaluated by nerve conduction test and vasculopathy as assessed by Ankle brachial index. The primary outcome factor was amputation. The data was presented as descriptive statistics and analyzed by dividing the patients into amputation and non-amputation group, and univariate and multivariate analysis was done.Results: A total of 64 patients were included in the study, out of which the amputation rate was 39.1%. Poor glycemic control, osteomyelitis, vasculopathy, peripheral neuropathy and Wagner grading were statistically significant.Conclusions: In the present study, poor glycemic control, vasculopathy, peripheral neuropathy and higher Wagner grade are significant risk factors for amputation in diabetic foot infections.

scholarly journals Occupational Determinants of Leptospirosis among Urban Service Workers

2020 ◽  
Vol 17 (2) ◽  
pp. 427 ◽  
Author(s):  
Azman Atil ◽  
Mohammad Saffree Jeffree ◽  
Syed Sharizman Syed Abdul Rahim ◽  
Mohd Rohaizat Hassan ◽  
Khamisah Awang Lukman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Occupational Exposures ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Service Workers ◽  
Validated Questionnaire ◽  
Urban Service ◽  
Polymerase Chain

This study was carried out to determine the risk factors of leptospirosis infection among local urban service workers in Sabah. This is a cross-sectional study involving 394 workers in Kota Kinabalu City, Sabah, conducted from February to March 2017. Information on demography, occupational exposures and environmental factors was obtained by a modified validated questionnaire. Polymerase Chain Reaction (PCR) was used to determine the prevalence of positive leptospirae. The overall figure for positive leptospirae was 9.4% (95% CI: 6.8–12.8). Urban sweepers and lorry drivers made up the highest proportion of positive leptospirae respondents, contributing 15.5% and 9.4%, respectively. The significant risk factors for positive leptospirae were older age (p-value = 0.001), higher monthly salary (p-value = 0.039), longer duration of employment (p-value = 0.011) and working as an urban sweeper (p-value = 0.021). Leptospirae was prevalent among healthy urban service workers and relates to their working activities.

scholarly journals Risk factors for tissue expander infection in scar reconstruction: a retrospective cohort study of 2374 consecutive cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Chen Dong ◽  
Minhui Zhu ◽  
Luguang Huang ◽  
Wei Liu ◽  
Hengxin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Failure ◽  
Logistic Regression Analysis ◽  
Disease Duration ◽  
Multivariate Logistic Regression Analysis ◽  
Tissue Expansion ◽  
Multivariate Logistic Regression ◽  
Hematoma Evacuation

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p &lt; 0.001), larger volume of expander (200–400 ml vs &lt;200 ml; OR, 1.74; p = 0.032; &gt;400 ml vs &lt;200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of &lt;1 year, expander volume of &gt;200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

scholarly journals Effect of Regular Khat Chewing on Serum Fasting Sugar Level in Diabetic patients versus Healthy Individuals; A comparative study

2021 ◽  
Vol 14 ◽  
pp. 117863882110352
Author(s):  
Yordanos Mengistu ◽  
Gobena Dedefo ◽  
Mesay Arkew ◽  
Gebeyehu Asefa ◽  
Gutema Jebessa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Glucose Oxidase ◽  
Blood Sugar ◽  
Poor Glycemic Control ◽  
Fasting Blood Sugar ◽  
Healthy Individuals ◽  
Cross Sectional ◽  
Khat Chewer

Background: Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat’s effect on blood glucose especially in our setting, Harar estern Ethiopia. Objective: Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects. Method: A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement. Result: (Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control. Conclusion: There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects. Recommendation: Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.

scholarly journals POS1465-HPR THE RELATIONSHIP BETWEEN SEDENTARY BEHAVIOR AND SLEEP IN RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1017.2-1018
Author(s):  
N. Kelly ◽  
E. Hawkins ◽  
H. O’leary ◽  
K. Quinn ◽  
G. Murphy ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Sleep Quality ◽  
Sedentary Behavior ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
P Value ◽  
Poor Sleep ◽  
Cross Sectional ◽  
The Relationship

Background:Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory condition that affects 0.5% of the adult population worldwide (1). Sedentary behavior (SB) is any waking behavior characterized by an energy expenditure of ≤1.5 METs (metabolic equivalent) and a sitting or reclining posture, e.g. computer use (2) and has a negative impact on health in the RA population (3). Sleep is an important health behavior, but sleep quality is an issue for people living with RA (4, 5). Poor sleep quality is associated with low levels of physical activity in RA (4) however the association between SB and sleep in people who have RA has not been examined previously.Objectives:The aim of this study was to investigate the relationship between SB and sleep in people who have RA.Methods:A cross-sectional study was conducted. Patients were recruited from rheumatology clinics in a large acute public hospital serving a mix of urban and rural populations. Inclusion criteria were diagnosis of RA by a rheumatologist according to the American College of Rheumatology criteria age ≥ 18 and ≤ 80 years; ability to mobilize independently or aided by a stick; and to understand written and spoken English. Demographic data on age, gender, disease duration and medication were recorded. Pain and fatigue were measured by the Visual Analogue Scale (VAS), anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), and sleep quality was assessed using the Pittsburgh Sleep Quality Index. SB was measured using the ActivPAL4™ activity monitor, over a 7-day wear period. Descriptive statistics were calculated to describe participant characteristics. Relationships between clinical characteristics and SB were examined using Pearson’s correlation coefficients and regression analyses.Results:N=76 participants enrolled in the study with valid data provided by N=72 participants. Mean age of participants was 61.5years (SD10.6) and the majority 63% (n = 47) were female. Participant mean disease duration was 17.8years (SD10.9). Mean SB time was 533.7 (SD100.1) minutes (8.9 hours per day/59.9% of waking hours). Mean sleep quality score was 7.2 (SD5.0) (Table 1). Correlation analysis and regression analysis found no significant correlation between sleep quality and SB variables. Regression analysis demonstrated positive statistical associations for SB time and body mass index (p-value=0.03846, R2 = 0.05143), SB time and pain VAS (p-value=0.009261, R2 = 0.07987), SB time and HADS (p-value = 0.009721, R2 = 0.08097) and SB time and HADSD (p-value = 0.01932, R2 = 0.0643).Conclusion:We found high levels of sedentary behavior and poor sleep quality in people who have RA, however no statistically significant relationship was found in this study. Future research should further explore the complex associations between sedentary behavior and sleep quality in people who have RA.References:[1]Carmona L, et al. Rheumatoid arthritis. Best Pract Res Clin Rheumatol 2010;24:733–745.[2]Anon. Letter to the editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab = Physiol Appl Nutr Metab 2012;37:540–542.[3]Fenton, S.A.M. et al. Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity. BMC Musculoskelet Disord 18, 131 (2017).[4]McKenna S, et al. Sleep and physical activity: a cross-sectional objective profile of people with rheumatoid arthritis. Rheumatol Int. 2018 May;38(5):845-853.[5]Grabovac, I., et al. 2018. Sleep quality in patients with rheumatoid arthritis and associations with pain, disability, disease duration, and activity. Journal of clinical medicine, 7(10)336.Table 1.Sleep quality in people who have RASleep variableBed Time N(%) before 10pm13(18%) 10pm-12pm43 (60%) after 12pm16 (22%)Hours Sleep mean(SD)6.56 (1.54)Fall Asleep minutes mean(SD)33.3(27.7)Night Waking N(%)45(63%)Self-Rate Sleep mean(SD)2.74 (0.90)Hours Sleep mean(SD)6.56 (1.54)Disclosure of Interests:None declared

Clinical and radiological risk factors for rupture of vertebral artery dissecting aneurysm: significance of the stagnation sign

2021 ◽  
pp. 1-6
Keyword(s):  
Risk Factors ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Significant Risk Factor ◽  
Tertiary Hospital ◽  
Dissecting Aneurysm ◽  
Irregular Surface ◽  
Vertebral Artery Dissecting Aneurysm

OBJECTIVE The aim of this study was to investigate the clinical and radiological factors associated with the rupture of a vertebral artery dissecting aneurysm (VADA) and to evaluate whether the stagnation sign is a significant risk factor for rupture of VADA. METHODS Clinical and radiological variables of 117 VADAs treated in a tertiary hospital from September 2008 to December 2020 were retrospectively reviewed. The stagnation sign is defined as the finding of contrast agent remaining in the lesion until the venous phase of angiography. Univariate and multivariate analyses were executed to reveal the associations between rupture status and VADA characteristics. RESULTS The rate of ruptured VADAs was 29.1% (34 of 117) and the stagnation sign was observed in 39.3% (46 of 117). Fusiform shape (OR 5.105, 95% CI 1.591–16.383, p = 0.006), irregular surface (OR 4.200, 95% CI 1.412–12.495, p = 0.010), posterior inferior cerebellar artery (PICA) involvement (OR 3.788, 95% CI 1.288–11.136, p = 0.016), and the stagnation sign (OR = 3.317, 95% CI 1.131–9.732, p = 0.029) were significantly related to rupture of VADA in multivariate logistic regression analysis. CONCLUSIONS This study showed that fusiform shape, irregular surface, PICA involvement, and the stagnation sign may be independent risk factors for the rupture of VADA. Therefore, when the potential risk factors are observed in unruptured VADA, more aggressive treatment rather than follow-up or medical therapy may be considered.

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