Abstract TMP36: Diabetes Mellitus Prevents The Complete Recanalization In Patients With Middle Cerebral Artery Occlusion

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Junya Aoki ◽  
Kazumi Kimura ◽  
Naomi Morita ◽  
Masafumi Harada ◽  
Norifumi Metoki ◽  
...  

Introduction: The mechanism of the unfavorable outcome in diabetic patients treated with intravenous thrombolysis (tPA therapy) is still uncertain. We investigated the relationship of diabetes mellitus with early and delayed recanalization after tPA therapy. Methods: Data on 165 patients from the prospective randomized control study, evaluated the efficacy of combined tPA and Edaravone therapy, were retrospectively analyzed. All patients had the middle cerebral occlusion before t-PA therapy. Based on a history of diabetes mellitus or hemoglobin A1c level of ≥6.5% on admission, all patients were classified into diabetes (D) or non-diabetes (ND) groups. The presence of arterial recanalization was assessed at 2 points: 1) early recanalization, defined as at least partial recanalization <50% within 2 h after tPA therapy; and 2) delayed complete recanalization at 24 h. Results: Among the 165 (96 men; median age, 78 [69-85] years) patients, 33 (20%) patients were classified into the D group. Age, initial NIHSS score, DWI-ASPECTS, proximal occlusion, and the onset to needle time were not different between the 2 groups (p=0.118, 0.607, 0.586, 0.258, 0.238). Early recanalization was similarly observed in the D and ND groups (61% vs. 51%, p=0.435). However, complete recanalization at 24 h was significantly infrequent in the D group (13% vs. 44%, p=0.002). This tendency was consistent in patients with as well as without early recanalization. Regarding patients with early recanalization, 4 (22%) of the 18 patients in the D group and 34 (58%) of the 59 patients in the ND group had complete recanalization at 24 h (p=0.014). Among those without early recanalization, none (0%) of the 13 patients with the D group had complete recanalization at 24 h, while 18 (30%) of the 60 patients achieved it (p=0.029). By the multivariate regression analysis, diabetes mellitus was the independent negative factor for complete recanalization at 24 h (OR 0.17, 95%CI: 0.05-0.54, p=0.002). At 3 months, there is an increased mortality rate in the D group (19% vs. 6%, p=0.038). Conclusion: Diabetes mellitus was an indicator of no complete recanalization at 24 h regardless of the early recanalization. This may explain the mechanism of the unfavorable outcome in patients with diabetes mellitus.

Author(s):  
P. Amulya Reddy ◽  
K. Saravanan ◽  
A. Madhukar

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.


2020 ◽  
Author(s):  
Abel Sinshaw Assem ◽  
Mebratu Muusew Tegegne ◽  
Destaye Shiferaw Alemu ◽  
Asamere Tsegaw Woredekal ◽  
Tsehay Kassa Tefera

Abstract Background: Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients’ knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps for timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia. The aim of this study was to assess knowledge about diabetic retinopathy, eye check-up practice and associated factors of diabetic retinopathy among adult diabetic patients at Debark hospital, Northwest Ethiopia. Methods: Institution based cross-sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant. Result: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR= 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR=4.54;(1.31-15.7)], type II diabetes mellitus [AOR=3.9;(1.6-9.6)], duration of diabetes (6-12 years[AOR=4.4;(1.4-13.5)]), history of eye disease [AOR=5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR=3.77; (1.05-13.5)]) and history of eye disease [AOR=2.47; (1.09-5.62)] were associated with good eye check-up practice. Conclusion: The proportion of good knowledge about diabetic retinopathy among diabetic patients at Debark hospital was fair (47.4%) and good eye check-up practice (eye examination at least once in the past year) was low (39.6%). Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.


2019 ◽  
Author(s):  
Mebratu Muusew Tegegne ◽  
Abel Sinshaw Assem ◽  
Destaye Shiferaw Alemu ◽  
Asamere Tsegaw Woredekal ◽  
Tsehay Kassa Alemu

Abstract Background: Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients’ knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps in timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia in general and the study area in particular. Purpose: The aim of this study was to assess knowledge, eye check-up practice and associated factors of diabetic retinopathy among diabetic patients at Debark hospital, Northwest Ethiopia. Materials and Methods: Institution based cross – sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant. Result: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR= 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR=4.54;(1.31-15.7)], type II diabetes mellitus [AOR=3.9;(1.6-9.6)], duration of diabetes (6-12 years[AOR=4.4;(1.4-13.5)]), history of eye disease [AOR=5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR=3.77; (1.05-13.5)]) and history of eye disease [AOR=2.47;(1.09-5.62)] were associated with good eye check-up practice. Conclusion: The proportion of good knowledge about diabetic retinopathy among diabetic patients was fair (47.4%) in the study setting and good eye check-up practice was low (39.6%) Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.


2020 ◽  
Author(s):  
Mebratu Muusew Tegegne ◽  
Abel Sinshaw Assem ◽  
Destaye Shiferaw Alemu ◽  
Asamere Tsegaw Woredekal ◽  
Tsehay Kassa Tefera

Abstract Background:Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients’ knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps in timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia.The aim of this study was to assess knowledge, eye check-up practice and associated factors of diabetic retinopathy among adult diabetic patients at Debark hospital, Northwest Ethiopia.Methods: Institution based cross – sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant.Result: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR= 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR=4.54;(1.31-15.7)], type II diabetes mellitus [AOR=3.9;(1.6-9.6)], duration of diabetes (6-12 years[AOR=4.4;(1.4-13.5)]), history of eye disease [AOR=5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR=3.77; (1.05-13.5)]) and history of eye disease [AOR=2.47; (1.09-5.62)] were associated with good eye check-up practice. Conclusion: The proportion of good knowledge about diabetic retinopathy among diabetic patients at Debark hospital was fair (47.4%) and good eye check-up practice (eye examination at least once in the past year) was low (39.6%). Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.


2018 ◽  
Vol 108 (5) ◽  
pp. 370-374
Author(s):  
Nélia Cunha ◽  
Célia Galhardas ◽  
Margarida Apetato ◽  
André Lencastre

Background: Diabetes mellitus is a predisposing factor for onychomycosis (OM). A high frequency of nonfungal onychodystrophy (OD) is also alleged, although information on the prevalence of specific nail changes is scant. We evaluated the prevalence and types of nail changes in a cohort of diabetic patients with fungal and nonfungal OD. Methods: During a 6-month period, inpatients with diabetes mellitus were screened for foot and toenail changes. Demographic, social, and clinical data were recorded, as was information concerning foot and toenail care. Fungal infection was confirmed by mycologic examination and by histologic analysis of nail clippings. Results: Of the 82 patients included, 65 (79.3%) had nail changes, and 34 of these 65 patients (52.3%) were diagnosed as having OM. The most frequently observed nail signs were subungual hyperkeratosis, onycholysis, yellow discoloration, and splinter hemorrhages, each seen in more than 25% of the patients. Tinea pedis and superficial pseudoleukonychia were observed more frequently in the OM group (P &lt; .05). Conversely, prominent metatarsal heads and history of nail trauma were more frequent in patients with nonfungal OD (P &lt; .05). Conclusions: Physicians who care for diabetic patients should not ignore nail changes. Fungal and nonfungal OD are common and should be addressed in the global evaluation of the feet to help prevent breaks in the skin barrier and subsequent bacterial infections and ulcers.


Author(s):  
Gunay Adalat Valiyeva

Liver damage in diabetes mellitus is of particular interest, since this factor significantly affects the course of the disease, the level of compensation and prognosis of the underlying disease. The aim. To study the effect of complex treatment using ursosan on the functional state of the hepatobiliary system in patients with diabetes mellitus. Materials and methods. The study included 30 patients with type 1 diabetes mellitus and 48 patients with type 2 diabetes. According to the duration of diabetes, patients were divided into three subgroups: a) up to five years; b) 5–10 years; c) more than 10 years. The number of patients was: 1a group – 13, 1b group – 10, 1c group – 7 people; Group 2a – 23, 2b group – 13, 2c group – 10 people. The control group consisted of 23 apparently healthy people. Ursosan was prescribed at a dose of 10-12 mg per 1 kg of body per day for 6 months. Clinical laboratory and instrumental research methods were used to study the functional state of the liver and gallbladder. Research results. After the course of treatment with Ursosan, patients with diabetes mellitus showed normalization of protein, pigment, enzymatic metabolism and, to a lesser extent, lipid metabolism in the liver, which led to an improvement in cellular metabolism and redox processes, providing a stable course of diabetes. Conclusions. A 6-month course of treatment with Ursosan in diabetic patients promotes long-term diabetes compensation. Patients during treatment have a decrease in cytolysis syndrome indicators (alanine aminotransferase (AlAT), aspartate aminotransferase (AsAT), lactate dehydrogenesis (LDH)) by about 1.5 times in all 3 indicators compared to the indicators before treatment. The same trend was observed in terms of gamma-glutamine transferase (GGT) and alkaline phosphatase (ALP)


2020 ◽  
Author(s):  
Abel Sinshaw Assem ◽  
Mebratu Muusew Tegegne ◽  
Destaye Shiferaw Alemu ◽  
Asamere Tsegaw Woredekal ◽  
Tsehay Kassa Tefera

Abstract Background: Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients’ knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps for timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia. The aim of this study was to assess knowledge about diabetic retinopathy, eye check-up practice and associated factors of diabetic retinopathy among adult diabetic patients at Debark hospital, Northwest Ethiopia. Methods: Institution based cross-sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant. Result: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR= 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR=4.54;(1.31-15.7)], type II diabetes mellitus [AOR=3.9;(1.6-9.6)], duration of diabetes (6-12 years[AOR=4.4;(1.4-13.5)]), history of eye disease [AOR=5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR=3.77; (1.05-13.5)]) and history of eye disease [AOR=2.47; (1.09-5.62)] were associated with good eye check-up practice. Conclusion: The proportion of good knowledge about diabetic retinopathy among diabetic patients at Debark hospital was fair (47.4%) and good eye check-up practice (eye examination at least once in the past year) was low (39.6%). Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.


2020 ◽  
Author(s):  
Mebratu Muusew Tegegne ◽  
Abel Sinshaw Assem ◽  
Destaye Shiferaw Alemu ◽  
Asamere Tsegaw Woredekal ◽  
Tsehay Kassa Tefera

Abstract Background:Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients’ knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps in timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia.The aim of this study was to assess knowledge, eye check-up practice and associated factors of diabetic retinopathy among adult diabetic patients at Debark hospital, Northwest Ethiopia.Methods: Institution based cross – sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant.Result: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR= 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR=4.54;(1.31-15.7)], type II diabetes mellitus [AOR=3.9;(1.6-9.6)], duration of diabetes (6-12 years[AOR=4.4;(1.4-13.5)]), history of eye disease [AOR=5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR=3.77; (1.05-13.5)]) and history of eye disease [AOR=2.47; (1.09-5.62)] were associated with good eye check-up practice. Conclusion: The proportion of good knowledge about diabetic retinopathy among diabetic patients at Debark hospital was fair (47.4%) and good eye check-up practice (eye examination at least once in the past year) was low (39.6%). Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.


2020 ◽  
Vol 4 (2) ◽  
pp. 24-28
Author(s):  
Indu K.C. ◽  
S Ghimire ◽  
R Deo

Background: To evaluate the difference in the level of TSH in diabetic and non diabetic patients at the time of the diagnosis of hypothyroidism. Methods: 100 diagnosed cases of hypothyroidism, 50 with diabetes and 50 without diabetes were studied. The level of TSH at the time of diagnosis and other information were obtained from the medical records. Results: The mean TSH in patients with the history of diabetes at the diagnosis of hypothyroidism was 19.9616±26.990 and in those without the history of the diabetes was 10.4797±6.503 (p value 0.018). The females with diabetes had higher level of TSH level at the time of diagnosis of hypothyroidism than females without diabetes (p value 0.045). There was no statistically significant difference in the level of TSH in males with and without diabetes at the time of diagnosis of hypothyroidism. Conclusion: Patients with diabetes mellitus had higher level of TSH at the time of diagnosis of hypothyroidism in comparison to those without diabetes. Early identification of the raised TSH levels in diabetic patients and timely intervention will help to reduce the chances of adverse cardiovascular outcomes and diabetic kidney disease in this group of patients.


2020 ◽  
Vol 2 (1) ◽  
pp. 14-18
Author(s):  
Adnan Khan ◽  
Tajamul Ahmad ◽  
Nadia Afridi ◽  
Madiha Anees ◽  
Bilal Khan

Introduction: A fall may be defined as a loss of balance, resulting in coming to rest on the ground or on another object below knee level. Fear of all or Basophobia is a condition of concern towards falls and natural fear of unable to stand or walk. Since the identification of the post-fall syndrome, fear of fall is considered the major health issue among elderly population. Therefore, this study was conducted to measure the level of fear of fall and factors which might contribute to it. Material & Methods: It was a cross sectional study conducted to measure the level of fear of fall among the diabetic patients of Hayatabad Medical Complex Peshawar. According to the inclusion criteria, participants who had age more than 40 years and diabetic history of more than 2 years were included in the study. We measured the fear of fall with age, gender and duration of diabetes mellitus. Convenient sampling technique was used for the recruitment of the participants. Data was collected by self-repored questionnaires and was analyzed by SPSS 20.0 version. Results: A total of 306 participants, 164 (53.59%) males and 142 (46.40%) female with a mean age 56.02 ± 9.68 years (mean ± sd) were recruited. The level of fear of all was high in diabetic patients in which 222 (72.5%) participants showed high, 48 (15.7%) moderate and 36 (11.8%) low concerns. Conclusion: Fear of fall is a common problem in both male and female population having diabetes mellitus. It is one of the major concerns among patients with diabetes. It has a positive relation with age, duration of DM, and insulin intake.


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