Significant ketoacidosis at autopsy: a single-centre systematic review

AimTo examine the value of vitreous beta-hydroxybutyrate and serum acetone in the investigation of sudden unexpected death.MethodsCoroners’ autopsy reports from a provincial UK city, with a population of approximately 900 000, over a 24-month period with significant ketoacidosis were studied. Demographic features, medical history, anatomical and histological findings, and biochemical parameters, including renal function, vitreous glucose, serum and vitreous alcohol, were analysed.ResultsForty-two cases (28 males and 14 females) were identified; 55% had a history of alcohol and/or substance misuse, and mental health problems, particularly depression and anxiety, and 16% were diabetic. In all, 50% of subjects had alcoholic ketoacidosis (AKA), 19% had diabetic ketoacidosis (DKA) and 12% had a history of both diabetes and alcohol abuse. In 19% of cases, an exact cause of ketoacidosis was established. In AKA, the subjects typically had low vitreous glucose and low or undetected blood alcohol levels. All of the subjects with raised vitreous glucose levels had DKA.ConclusionKetoacidosis is relatively common and should be considered as a cause of sudden death, especially in alcoholic patients and patients with diabetes with no clear cause of death at autopsy.

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Depression and Anxiety among Patients with Type II Diabetes Mellitus in Chitwan Medical College Teaching Hospital, Nepal

Nursing Research and Practice ◽

10.1155/2021/8846915 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Kalpana Sharma ◽

Govinda Dhungana ◽

Shailendra Adhikari ◽

Archana Bista Pandey ◽

Muna Sharma

Keyword(s):

Diabetes Mellitus ◽

College Teaching ◽

Educational Status ◽

Current Treatment ◽

Depression And Anxiety ◽

Medical College ◽

Prevalence Of Depression ◽

Patients With Diabetes ◽

History Of ◽

Diabetes Patients

The prevalence of depression and anxiety disorders is common among people with diabetes mellitus. Coexistence of diabetes and depression/anxiety increases the risk of diabetes complications and reduces the overall quality of life. Hence, this study aimed to assess the depression and anxiety among patients with type 2 diabetes mellitus in Chitwan. Descriptive survey was carried out among 296 purposively selected clinically diagnosed type 2 diabetes patients admitted in the Chitwan Medical College Teaching Hospital from 15th June 2018 to 17th September 2019. Patients were interviewed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7). Data were analyzed using descriptive and inferential statistics. Of 296 diabetic patients, 48.6% were 60 years and above, 59.5% female and 61.5% literate; their common occupation was agriculture (38.2%) followed by household work (26.4%). Nearly two-thirds (62.8%) of diabetes patients had other chronic comorbid conditions. Depression and anxiety were observed among 57.8% and 49.7% of diabetes patients, respectively. While observing the severity, 27.4%, 19.6%, 8.4%, and 2.4% of patients had mild, moderate, moderately severe, and severe depression, respectively. Likewise, 24.7%, 20.3%, and 4.7% of patients had mild, moderate, and severe anxiety, respectively. Current living status, educational status, medicine adherence, satisfaction toward current treatment, and history of mental illness in the family were found to be significant factors associated with the anxiety of patients with diabetes. Further, educational status, smoking habit, satisfaction towards current treatment, and history of diabetes in family were the factors associated with depression. Prevalence of depression and anxiety is high among admitted patients with diabetes mellitus, and many factors are associated with it. Hence, regular screening services are essential along with diabetes management plan for timely identification and treatment of the vulnerable groups in the healthcare centers.

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A Study to Evaluate the Quality of Life of Patients with Diabetes Mellitus

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i47b33157 ◽

2021 ◽

pp. 575-585

Author(s):

P. Amulya Reddy ◽

K. Saravanan ◽

A. Madhukar

Keyword(s):

Diabetes Mellitus ◽

Diabetes Management ◽

Study Data ◽

Categorical Variables ◽

P Value ◽

Diabetic Patients ◽

Physical Endurance ◽

Glucose Levels ◽

Patients With Diabetes ◽

History Of

Aim: The aim of the study was to evaluate the QOL of patients with Diabetes Mellitus. Study Design: This was a prospective, observational study. Duration of Study: The study was conducted from August 2019 to January 2021 in Yashoda Hospital, Hyderabad. Methodology: Patients of either sex with ≥1year history of diabetes willing to give the consent were included in the study. Patients of either sex with <1year history of DM, Pregnant/lactating women and patients not willing to give the consent were excluded from the study. Data on Blood glucose levels (FBS, PPBS) and HbA1C was also obtained and assessed. QOLID questionnaire was administered to the patients and assessed which consisted of a set of 34 items representing 8 domains such as Role limitation due to the physical health, Physical endurance, General health, Treatment satisfaction, Symptom botherness, Financial worries, Mental health, and Diet satisfaction). Results: A total of 200 patients were analysed in the study,108(54%) were males and 92(46%) were females. The average age of the patients was 58.5 years with majority being 51-70years (73.5%) of age. Patients with higher age and females had poor QOL compared to others. The correlation between various categorical variables with that of scores of QOL in various domains was assessed, Age of the patients influenced QOL score in various domains like RLPH (p value-0.038), PE (p value-0.0183), and SB (p value-0.0002), Gender has influenced QOL score in domains like RLPH (p value-0.0008), PE (p value-0.0106), TS (p value-0.0005) and Educational Qualification has influenced QOL score in RLPH (p value-0.0008), GH (p value-<0.0001), TS (p value-<0.0001), E/MH (p value-<0.0001). Conclusion: The results concluded that overall QOL was noticeably low in Diabetic patients especially in Women and elderly thus indicating that Diabetes management is not restricted to treatment but also requires attention on QOL of patients.

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Qualitative analysis of serious case reviews into unexpected infant deaths

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-315156 ◽

2018 ◽

Vol 104 (1) ◽

pp. 30-36 ◽

Cited By ~ 1

Author(s):

Joanna J Garstang ◽

Peter Sidebotham

Keyword(s):

Child Protection ◽

Substance Misuse ◽

Social Care ◽

Mental Health Problems ◽

Case Review ◽

Parental Mental Health ◽

Criminal Records ◽

Unexpected Death ◽

Infant Deaths ◽

Vulnerable Families

ObjectiveTo develop a detailed understanding of the circumstances of sudden unexpected death in infancy (SUDI) cases subject to serious case review (SCR).DesignThis was a thematic analysis of SCRs relating to cases of SUDI in England. SCRs were obtained for SUDI cases dying between 1 April 2011 and 31 March 2014. These were cases (aged 0–2 years) that presented as a SUDI and for which no clear medical or forensic cause of death was found.ResultsSCRs were held for 30 SUDI cases, published reports were available for 27/30. The median (range) age at death was 2 (0–19) months. Background risk factors in families included: alcohol or drug dependency in 18/27, parental mental health problems in 14/27, domestic abuse in 9/27 and parental criminal records in 13/27. Nineteen infants had received support from social care, 10/19 were subject to child protection plans. Neglect was a feature in 15/27 cases. Parents did not engage with professionals in 18/27 cases, involving social care in 14/18, health care in 13/18 and drug and substance misuse services in 5/18. Eighteen of 27 deaths occurred in highly hazardous sleep environments, 16/18 involved cosleeping and 13/16 cosleeping deaths occurred with parents who were intoxicated with alcohol or impaired by drugs.ConclusionMost SUDI cases occurred in hazardous sleep environments and are potentially preventable. They occurred in families well known to services with concerns about neglect, substance misuse and poor engagement. More consideration is needed on how best to support such vulnerable families.

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Comparison of algorithms for the prediction of glucose levels in patients with diabetes

Nova Scientia ◽

10.21640/ns.v13i26.2752 ◽

2021 ◽

Vol 13 (26) ◽

Author(s):

Daniel Arturo Olivares Vera ◽

David Asael Gutiérrez Hernández ◽

Marco Antonio Escobar Acevedo ◽

Claudia Margarita Lara Rendón ◽

Dulce Aurora Velázquez Velázquez

Keyword(s):

Neural Networks ◽

Moving Average ◽

Arima Model ◽

Percentage Error ◽

Diabetic Patients ◽

Autoregressive Integrated Moving Average ◽

Glucose Levels ◽

Univariate Time Series ◽

Patients With Diabetes ◽

History Of

This work presents a comparison between two algorithms for the prediction of glucose levels in diabetic patients by using a univariate time series. The algorithms are applied to the history of fasting glucose levels to predict the five following values. The comparison is performed between 1) The Autoregressive Neural Networks (ARNN) and 2) The autoregressive integrated moving average (ARIMA) models. A total of 70 series are analyzed, and we show that the results obtained for the ARIMA model have error percentages higher than 25% of the predicted value to the expected value. In contrast, in 73% of the cases, the percentage error was less than 25% for the Autoregressive Neural Networks.

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Study of Diabetic Mellitus and Knowledge of Lotion Foot Care on the Community

International Journal of Pharmaceutical Quality Assurance ◽

10.25258/ijpqa.v9i3.13659 ◽

2018 ◽

Vol 9 (3) ◽

Author(s):

Hariyadi DM ◽

Athiyah U ◽

Hendradi E ◽

Rosita N ◽

Erawati T ◽

...

Keyword(s):

Blood Glucose ◽

T Test ◽

Small Scale ◽

Scale Production ◽

Foot Care ◽

Diabetic Mellitus ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Before And After ◽

History Of

The prevention of Diabetic Mellitus (DM) and its complications is the main aim of this study, in addition to the training of lotion foot care application and the development of small scale industry. The research team delivered knowledge in the form of training on Diabetic Mellitus, healthy food, treatment and prevention of complications, and small-scale production of cosmetic products. The aim of this study was to determine the correlation between training on diabetic and lotion foot care application as preventive measures against diabetic complications on the patient's blood glucose levels in the community of residents in Banyuurip Jaya, Surabaya. It was expected from this training that the knowledge of the residents increases and people living with diabetic undergo lifestyle changes and therefore blood sugar levels can be controlled. The parameters measured in this research were blood glucose levels, the anti diabetic drug types consumed, and compliance on diabetics. This study used the data taken from 60 patients with DM over a period of one month. Questionnaires and log books was used to retrieve data and changes in blood glucose levels in diabetic patients. The results showed the demographic data of patients with type 2 diabetic of 85% female and 15% male, with the range of patients aged of 61-70 years of 46.67% and had history of diabetic (90%). The history of drugs consumed by respondents was anti diabetic drugs such as metformin (40%), glimepiride (33.37%) and insulin (6.67%). In addition, the increased knowledge of DM patients after being given the training compared to before training was shown in several questions in the questionnaire. A statistical analysis using t-test analyzed a correlation between training provided in order to enhance understanding of the patient, as well as correlation with blood glucose levels. A paired T-test showed that there was a relationship between the knowledge of trainees before and after training (p less than 0.05). An interesting result was that there was no relationship between blood glucose levels before and after training provided (p> 0.05).

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Ten Percent of SIDS Cases are Murder — or are They?

Academic Forensic Pathology ◽

10.23907/2017.018 ◽

2017 ◽

Vol 7 (2) ◽

pp. 163-170 ◽

Cited By ~ 2

Author(s):

Christopher M. Milroy ◽

Charis Kepron

Keyword(s):

Sudden Infant Death ◽

Current Data ◽

Metabolic Changes and Oxidative Stress in Diabetic Kidney Disease

Antioxidants ◽

10.3390/antiox10071143 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1143

Author(s):

Midori Sakashita ◽

Tetsuhiro Tanaka ◽

Reiko Inagi

Keyword(s):

Oxidative Stress ◽

Kidney Disease ◽

Stress Responses ◽

Diabetic Kidney Disease ◽

Renin Angiotensin System ◽

Therapeutic Agents ◽

Metabolic Changes ◽

Diabetic Kidney ◽

Glucose Levels ◽

Patients With Diabetes

Diabetic kidney disease (DKD) is a major cause of end-stage kidney disease, and it is crucial to understand the pathophysiology of DKD. The control of blood glucose levels by various glucose-lowering drugs, the common use of inhibitors of the renin–angiotensin system, and the aging of patients with diabetes can alter the disease course of DKD. Moreover, metabolic changes and associated atherosclerosis play a major role in the etiology of DKD. The pathophysiology of DKD is largely attributed to the disruption of various cellular stress responses due to metabolic changes, especially an increase in oxidative stress. Therefore, many antioxidants have been studied as therapeutic agents. Recently, it has been found that NRF2, a master regulator of oxidative stress, plays a major role in the pathogenesis of DKD and bardoxolone methyl, an activator of NRF2, has attracted attention as a drug that increases the estimated glomerular filtration rate in patients with DKD. This review outlines the altered stress responses of cellular organelles in DKD, their involvement in the pathogenesis of DKD, and discusses strategies for developing therapeutic agents, especially bardoxolone methyl.

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Thymoma in an aged backyard Leghorn chicken, with reviews of a database and literature

Journal of Veterinary Diagnostic Investigation ◽

10.1177/1040638721990896 ◽

2021 ◽

Vol 33 (2) ◽

pp. 336-339

Author(s):

Julia Blakey ◽

Carmen Jerry ◽

Ana da Silva ◽

Simone Stoute

Keyword(s):

Soft Tissue Mass ◽

Animal Health ◽

Postmortem Examination ◽

Cervical Region ◽

Laboratory System ◽

Unexpected Death ◽

Tissue Mass ◽

Microscopic Features ◽

History Of ◽

Backyard Chickens

A 7-y-old backyard Leghorn chicken ( Gallus domesticus) was submitted to the California Animal Health and Food Safety Laboratory System (CAHFS)–Turlock branch for postmortem examination, with a history of unexpected death. At postmortem examination, a hemorrhagic soft tissue mass was observed in the cervical region. Microscopically, a densely cellular neoplasm of polygonal epithelial cells and small lymphocytes was observed. The microscopic features of the neoplasm in combination with positive immunohistochemistry for pancytokeratin and CD3 were used to classify the lesion as a thymoma. Thymoma was diagnosed in only 5 birds submitted to CAHFS from 1990 to 2019. Thymoma has been described only rarely in birds, and is an unusual diagnosis in backyard chickens.

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Predicting Risk of Antenatal Depression and Anxiety Using Multi-Layer Perceptrons and Support Vector Machines

Journal of Personalized Medicine ◽

10.3390/jpm11030199 ◽

2021 ◽

Vol 11 (3) ◽

pp. 199

Author(s):

Fajar Javed ◽

Syed Omer Gilani ◽

Seemab Latif ◽

Asim Waris ◽

Mohsin Jamil ◽

...

Keyword(s):

Low Income ◽

Operating Characteristic ◽

Mental Health Problems ◽

Characteristic Curve ◽

Antenatal Depression ◽

Low Income Countries ◽

Support Vector ◽

Depression And Anxiety ◽

Gynecology And Obstetrics ◽

Operating Characteristic Curve

Perinatal depression and anxiety are defined to be the mental health problems a woman faces during pregnancy, around childbirth, and after child delivery. While this often occurs in women and affects all family members including the infant, it can easily go undetected and underdiagnosed. The prevalence rates of antenatal depression and anxiety worldwide, especially in low-income countries, are extremely high. The wide majority suffers from mild to moderate depression with the risk of leading to impaired child–mother relationship and infant health, few women end up taking their own lives. Owing to high costs and non-availability of resources, it is almost impossible to diagnose every pregnant woman for depression/anxiety whereas under-detection can have a lasting impact on mother and child’s health. This work proposes a multi-layer perceptron based neural network (MLP-NN) classifier to predict the risk of depression and anxiety in pregnant women. We trained and evaluated our proposed system on a Pakistani dataset of 500 women in their antenatal period. ReliefF was used for feature selection before classifier training. Evaluation metrics such as accuracy, sensitivity, specificity, precision, F1 score, and area under the receiver operating characteristic curve were used to evaluate the performance of the trained model. Multilayer perceptron and support vector classifier achieved an area under the receiving operating characteristic curve of 88% and 80% for antenatal depression and 85% and 77% for antenatal anxiety, respectively. The system can be used as a facilitator for screening women during their routine visits in the hospital’s gynecology and obstetrics departments.

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Trauma, Sleep and Mental Health Problems in Low-Income Young Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031145 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1145

Author(s):

Rachel A. Fusco ◽

Yan Yuan ◽

Hyunji Lee ◽

Christina E. Newhill

Keyword(s):

Mental Health ◽

Young Adults ◽

Low Income ◽

Mental Health Problems ◽

Trauma Exposure ◽

Health Problems ◽

Equation Modeling ◽

Poor Sleep ◽

Depression And Anxiety ◽

The Relationship

Low-income young adults are more likely to have exposure to trauma, which increases risk for mental health problems. Although adequate sleep promotes good health, people with histories of trauma are more likely to have sleep problems. The current study explored whether poor sleep mediated the relationship between trauma exposure and mental health. A sample of 143 low-income 18–24-year-old young adults completed depression, anxiety, and trauma exposure measures and wore sleep monitors for four nights. Structural equation modeling (SEM) was used to examine both direct and indirect effects of variables. Results showed that higher trauma exposure was associated with depression and anxiety. Mean sleep hours per night was fewer than six, far below recommended guidelines for optimal health and functioning. Fewer sleep hours partially mediated the relationship between both trauma exposure and depression and anxiety, and the direct effect from trauma remained significant after adjusting for the partial mediation from sleep.

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