scholarly journals Early and complete vitrectomy versus tap and inject in acute post cataract surgery endophthalmitis presenting with hand motion vision; a quasi-experimental study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Seyed Ali Tabatabaei ◽  
Soran Aminzade ◽  
Aliasghar Ahmadraji ◽  
Mohammad Soleimani ◽  
Bahram Bohrani Sefidan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cataract Surgery ◽  
Medical History ◽  
Demographic Data ◽  
Diabetic Patients ◽  
Past Medical History ◽  
Motion Vision ◽  
Initial Management ◽  
Significant Difference ◽  
History Of

Abstract Background Based on endophthalmitis vitrectomy study, intravitreal injection of antibiotics is preferred for initial management of cases of acute post cataract surgery endophthalmitis (APCE) with presenting vision of hand motions (HM). This study aimed to compare outcomes of early and complete vitrectomy (VIT) and vitreous tap and antibiotic injection (T&I) in cases of APCE presented with vision of HM. Methods In this prospective study, cases of APCE with vision of HM between 2018 and 2020 were enrolled. According to the time of presentation, the patients were arranged into two groups (VIT vs. T&I). Demographic data, elapsed time to developing endophthalmitis, past medical history, microbiology results, complications, and final visual acuity were recorded and analyzed. Results Seventy-six eyes of 76 patients were enrolled. Fifty-three eyes underwent T&I and twenty-three were arranged into the VIT group. Past medical history of 34.2% of patients was significant for diabetes mellitus. There was a statistically significant lower logMAR in VIT group compared to T&I group (diff = 0.14, 95% CI: 0.04 to 0.24, P-value = 0.007). The comparison of the diabetic and non-diabetic patients in both groups showed that the visual outcome was better in non-diabetic cases compared to the diabetic subjects. There was no statistically significant difference between the diabetic and non-diabetic groups regarding the superiority of procedure. Conclusion Based on our results, we could recommend that it’s maybe better to do early and complete vitrectomy as the initial management of APCE with the vision of HM. Past medical history of diabetes mellitus is not a determining factor for choosing initial management between vitrectomy and antibiotic injection.

Carbohydrate Sources Preferences of Women With Past Medical History of Gestational Diabetes Mellitus in Puncak Alam, Malaysia

2019 ◽  
Vol 18 (11) ◽  
pp. 1028-1035
Author(s):  
Farhanah Ahmad Shuhaimi ◽  
Norazmir Md Nor ◽  
Siti Sabariah Buhari ◽  
Emmy Hainida Khairul Ikram ◽  
Ummy Syalshabella Mu Zamri
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Medical History ◽  
Past Medical History ◽  
History Of

122 In Patients with Lower Extremity Burns and Osteomyelitis, Diabetes Mellitus Increases Amputation Rate

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S81-S82
Author(s):  
Kathleen A Iles ◽  
Lori Chrisco ◽  
Stephen Heisler ◽  
Booker King ◽  
Felicia N Williams ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Lower Extremity ◽  
Burn Injury ◽  
Healing Process ◽  
Common Mechanism ◽  
P Value ◽  
Diabetic Patients ◽  
Significant Difference ◽  
History Of ◽  
The Impact

Abstract Introduction Diabetes mellitus (DM) is a critical comorbidity with burn injury due to the disrupted healing process. Previous reports have confirmed the increased rate of osteomyelitis (OM) and subsequent amputation in this cohort, however this has yet to be studied in comparison to non-diabetic patients. In this retrospective analysis, we investigate OM and amputation in both the diabetic and non-diabetic lower extremity burn populations to determine the impact of DM on these outcomes. Methods The burn registry was used to identify all patients admitted to our tertiary burn center from January 1, 2014 to December 31, 2018. Only patients with lower extremity burns (foot and/or ankle) were included. Patients with burns to additional body areas were excluded. Amputations were categorized by time from injury. Statistical analysis was performed using Student’s t test, chi-squared test, and Fischer’s exact test. Results Of the 315 patients identified, 103 had a known diagnosis of DM and 212 did not. Scald injury was the most common mechanism and average TBSA was similar. Differences were observed in average length of stay (LOS) and admission cost, with diabetics demonstrating both a higher LOS (13.7 days vs 9.2 days, p-value= 0.0016) and cost ($72,883 vs $50,500, p-value= 0.0058) (Table 1). In total, 17 patients were found to have radiologically confirmed OM within three months of the burn injury. Fifteen of these patients had a history of DM and two had no history of DM (p-value= < 0.001) (Table 2). The DM OM patients were found to have a higher blood glucose level on admission (219 mg/dL vs 110 mg/dL, p-value= 0.0452). No significant difference was seen in Hgb A1c in diabetics with or without OM (9.26% vs 8.81%, p= 0.2743). Notably, when non-diabetics were diagnosed with OM, significant differences were observed in both LOS and cost in comparison to their counterparts without OM (36 days vs 9 days; p= 0.0003; $226,289 vs $48,818, p=0.0001). Of the 11 patients who required an amputation, 10 (90.9%) of these patients had comorbid DM. Conclusions DM patients with lower extremity burns are more likely to develop OM than their non-diabetic counterparts. When radiologically confirmed OM is present, DM patients have an increased rate of amputation. OM incurs significant healthcare utilization and cost in both the diabetic and non-diabetic populations.

scholarly journals Diabetic Muscle Infarction

2020 ◽  
Vol 4 (1) ◽  
pp. 99-100
Author(s):  
Sophia Ahmed ◽  
Romeo Fairley
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diabetes Mellitus ◽  
Magnetic Resonance ◽  
Medical History ◽  
Lower Extremities ◽  
Past Medical History ◽  
Resonance Imaging ◽  
Muscle Infarction ◽  
History Of

A 58-year-old male with past medical history of diabetes mellitus presented with pain to the bilateral groin for six weeks. Magnetic resonance imaging of the patient’s lower extremities revealed acute myoedema, and he was diagnosed with myositis secondary to diabetic muscle infarction.

scholarly journals A Case of Obstructing Candida Glabrata Bladder Mucus Treated with Intravesicular Amphotericin - B

2021 ◽  
Vol 6 (10) ◽  
pp. 720-724
Author(s):  
Dr. Nicholas Gaeto, PGY 2, ◽  
Dr. Glenn Goodwin, PGY 2, D.O. ◽  
Mara Seat, OMS III
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Medical History ◽  
Amphotericin B ◽  
Enterococcus Faecalis ◽  
Candida Glabrata ◽  
Past Medical History ◽  
Emphysematous Cystitis ◽  
History Of ◽  
Repeat Imaging

A 51-year-old female with a past medical history of poorly controlled diabetes mellitus presented to the emergency department with signs of emphysematous cystitis and pyelonephritis with associated Enterococcus faecalis bacteremia and Candida Glabrata (C.Glabrata) fungemia. She was treated with micafungin and amoxicillin with improvement in her symptoms. During her course she underwent repeat imaging which showed improvement in her cystitis and no obstruction in her bladder. She was discharged on home IV micafungin. She returned to the emergency department the next day with acute urinary obstruction and was found to have a completely obstructing mucus ball in her bladder. This was removed cystoscopically and surgical cultures grew C. glabrata. She was successfully treated with intra-vesicular amphotericin B and was discharged.

scholarly journals Clinical Features of Bipolar Disorder with and without Comorbid Diabetes Mellitus

2003 ◽  
Vol 48 (7) ◽  
pp. 458-461 ◽  
Author(s):  
Martina Ruzickova ◽  
Claire Slaney ◽  
Julie Garnham ◽  
Martin Alda
Keyword(s):  
Diabetes Mellitus ◽  
Bipolar Disorder ◽  
Demographic Data ◽  
Outcome Variable ◽  
Diabetic Patients ◽  
Global Assessment Of Functioning ◽  
Not Otherwise Specified ◽  
Frequent Use ◽  
History Of ◽  
Dm Type 2

Objective: Several papers have reported higher prevalence of diabetes mellitus (DM) type 2 in patients suffering from bipolar disorder (BD). The possible links between these 2 disorders include treatment, lifestyle, alterations in signal transduction, and possibly, a genetic link. To study this relation more closely, we investigated whether there are any differences in the clinical characteristics of BD patients with and without DM. Method: We compared the clinical data of 26 diabetic and 196 nondiabetic subjects from The Maritime Bipolar Registry. Subjects were aged 15 to 82 years, with psychiatric diagnoses of BD I ( n = 151), BD II ( n = 65), and BD not otherwise specified ( n = 6). The registry included basic demographic data and details on the clinical course of bipolar illness, its treatment, and physical comorbidity. In a subsequent analysis using logistic regression, we examined the variables showing differences between groups, with diabetes as an outcome variable. Results: The prevalence of DM in our sample was 11.7% ( n = 26). Diabetic patients were significantly older than nondiabetic patients ( P < 0.001), had higher rates of rapid cycling ( P = 0.02) and chronic course of BD ( P = 0.006), scored lower on the Global Assessment of Functioning Scale ( P = 0.01), were more often on disability for BD ( P < 0.001), and had higher body mass index ( P < 0.001) and increased frequency of hypertension ( P = 0.003). Lifetime history of treatment with antipsychotics was not significantly associated with an elevated risk of diabetes ( P = 0.16); however, the data showed a trend toward more frequent use of antipsychotic medication among diabetic subjects. Conclusions: Our findings suggest that the diagnosis of DM in BD patients is relevant for their prognosis and outcome.

scholarly journals Study of TSH level at the time of diagnosis of Hypothyroidism in patients with Diabetes Mellitus- A Retrospective Study

2020 ◽  
Vol 4 (2) ◽  
pp. 24-28
Author(s):  
Indu K.C. ◽  
S Ghimire ◽  
R Deo
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Kidney Disease ◽  
P Value ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Other Information ◽  
Patients With Diabetes ◽  
History Of ◽  
The Mean ◽  
The Difference

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.

scholarly journals Prevalence of arterial hypertension and diabetes mellitus among cataract patients

2019 ◽  
Vol 17 (3) ◽  
pp. 208-211
Author(s):  
V. Haykin ◽  
Y. Zdravkov ◽  
A. Isaeva ◽  
S. Kostova ◽  
Iv. Tanev
Keyword(s):  
Diabetes Mellitus ◽  
Arterial Hypertension ◽  
Insulin Treatment ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Age Related ◽  
Significant Difference ◽  
History Of ◽  
Cataract Patients

Cataract is a leading cause for avoidable blindness. Age-related cataract is a multifactorial disease, affecting patients over 60 years old. Diabetes mellitus (DM), arterial hypertension (AH) or a combination of both are risk factors for developing a cataract. The aim of the study is to evaluate the prevalence of DM and AH among cataract patients. After an informed consent, cataract patients were randomly chosen to participate in the study. Diagnostic criteria for AH were defined as: systolic blood pressure higher than 140 mmHg, diastolic higher than 90 mmHg and the usage of antihypertensive therapy. Diabetic patients (medical history of DM or reported usage of antidiabetic drugs) were divided in two groups: Type I DM if the patient is on insulin treatment before the age of 30 years, and Type II DM if the patient is on antidiabetic or insulin treatment after the age of 30 years. A total of 126 cataract patients on average age of 66, 2 years participated the study. The youngest patient was a 29 years old female with type I DM and the oldest - 88 years old AH female. There were 63 AH patients (50%) , 2 with type I DM (1.6%), 6 with type II DM (4.8%), 6 patients with AH and type I DM (4.8%), and 11 patients with AH and type II DM (8.7%). 38 patients had no DM or AH (30.2%), among them 20 had no comorbidities. Systemic AH and DM are non-infectious epidemic diseases. According to our study cataract formation in type I DM patients occurs earlier than in diabetes type II DM and hypertensive patients. Type II DM patients develop cataract earlier. We found no significant difference between the average ages of cataract surgery in AH patients and otherwise healthy patients (without comorbidities). Hypertension was found in the majority of cataract patients (50%) and prevalence of diabetes mellitus was 19.9%. We can speculate that many cataract patients in Bulgaria do not undergo surgery due to their socioeconomic status. Hypertension and diabetes mellitus should be better controlled in order to decrease the incidence of visual loss caused by cataract.

scholarly journals 651. Comparative Analysis Between Bacterial And Fungal Malignant Otitis Externa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S384
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Fatma Smaoui ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Otitis Externa ◽  
Clinical Presentation ◽  
The Elderly ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Duration Of Treatment ◽  
Evolutionary Features ◽  
Significant Difference ◽  
Malignant Otitis Externa ◽  
History Of

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p&lt; 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p&lt; 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures

scholarly journals Past medical history of tumors other than meningioma is a negative prognostic factor for tumor recurrence in meningiomas WHO grade I

2021 ◽  
Author(s):  
Annamaria Biczok ◽  
Philipp Karschnia ◽  
Raffaela Vitalini ◽  
Markus Lenski ◽  
Tobias Greve ◽  
...  
Keyword(s):  
Medical History ◽  
Tumor Recurrence ◽  
Clinical History ◽  
Study Endpoint ◽  
Past Medical History ◽  
Who Grade ◽  
Increased Risk ◽  
History Of ◽  
Meningioma Recurrence ◽  
The Impact

Abstract Background Prognostic markers for meningioma recurrence are needed to guide patient management. Apart from rare hereditary syndromes, the impact of a previous unrelated tumor disease on meningioma recurrence has not been described before. Methods We retrospectively searched our database for patients with meningioma WHO grade I and complete resection provided between 2002 and 2016. Demographical, clinical, pathological, and outcome data were recorded. The following covariates were included in the statistical model: age, sex, clinical history of unrelated tumor disease, and localization (skull base vs. convexity). Particular interest was paid to the patients’ past medical history. The study endpoint was date of tumor recurrence on imaging. Prognostic factors were obtained from multivariate proportional hazards models. Results Out of 976 meningioma patients diagnosed with a meningioma WHO grade I, 416 patients fulfilled our inclusion criteria. We encountered 305 women and 111 men with a median age of 57 years (range: 21–89 years). Forty-six patients suffered from a tumor other than meningioma, and no TERT mutation was detected in these patients. There were no differences between patients with and without a positive oncological history in terms of age, tumor localization, or mitotic cell count. Clinical history of prior tumors other than meningioma showed the strongest association with meningioma recurrence (p = 0.004, HR = 3.113, CI = 1.431–6.771) both on uni- and multivariate analysis. Conclusion Past medical history of tumors other than meningioma might be associated with an increased risk of meningioma recurrence. A detailed pre-surgical history might help to identify patients at risk for early recurrence.

Abstract 1122‐000214: Clinical Factors Associated rTPA Administration in Acute Ischemic Stroke Patients with History of Atrial Fibrillation

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Chase A Rathfoot ◽  
Camron Edressi ◽  
Carolyn B Sanders ◽  
Krista Knisely ◽  
Nicolas Poupore ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Medical History ◽  
Clinical Decision Making ◽  
Past Medical History ◽  
Clinical Factors ◽  
Stroke Patients ◽  
Factors Associated ◽  
History Of

Introduction : Previous research into the administration of rTPA therapy in acute ischemic stroke patients has largely focused on the general population, however the comorbid clinical factors held by stroke patients are important factors in clinical decision making. One such comorbid condition is Atrial Fibrillation. The purpose of this study is to determine the clinical factors associated with the administration of rtPA in Acute Ischemic Stroke (AIS) patients specifically with a past medical history of Atrial Fibrillation (AFib). Methods : The data for this analysis was collected at a regional stroke center from January 2010 to June 2016 in Greenville, SC. It was then analyzed retrospectively using a multivariate logistic regression to identify factors significantly associated with the inclusion or exclusion receiving rtPA therapy in the AIS/AFib patient population. This inclusion or exclusion is presented as an Odds Ratio and all data was analyzed using IBM SPSS. Results : A total of 158 patients with Atrial Fibrillation who had Acute Ischemic Strokes were identified. For the 158 patients, the clinical factors associated with receiving rtPA therapy were a Previous TIA event (OR = 12.155, 95% CI, 1.125‐131.294, P < 0.040), the administration of Antihypertensive medication before admission (OR = 7.157, 95% CI, 1.071‐47.837, P < 0.042), the administration of Diabetic medication before admission (OR = 13.058, 95% CI, 2.004‐85.105, P < 0.007), and serum LDL level (OR = 1.023, 95% CI, 1.004‐1.042, P < 0.16). Factors associated with not receiving rtPA therapy included a past medical history of Depression (OR = 0.012, 95% CI, 0.000‐0.401, P < 0.013) or Obesity (OR = 0.131, 95% CI, 0.034‐0.507, P < 0.003), Direct Admission to the Neurology Floor (OR = 0.179, 95% CI, 0.050‐0.639, P < 0.008), serum Lipid level (OR = 0.544, 95% CI, 0.381‐0.984, P < 0.044), and Diastolic Blood Pressure (OR = 0.896, 95% CI, 0.848‐0.946, P < 0.001). Conclusions : The results of this study demonstrate that there are significant associations between several clinical risk factors, patient lab values, and hospital admission factors in the administration of rTPA therapy to AIS patients with a past medical history of Atrial Fibrillation. Further research is recommended to determine the extent and reasoning behind of these associations as well as their impact on the clinical course for AIS/AFib patients.

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