scholarly journals MON-620 Ademolus Hypoglycemic Index

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Adegbenga Bolanle Ademolu

Abstract This article proposes ADEMOLUS HYPOGLYCEMIC INDEX (AHI) which is a mathematical representation of hypoglycemic episode (HE) in a patient with recurrent hypoglycemia over a consecutive three months period. It also apply it to clinical practice using diabetic patients in order to demonstrate and emphasize its relevance in present day medical practice worldwide. This is a retrospective study of 65 HE occurring in 6 randomly selected diabetes mellitus patients from 86 case files studied who had attended the endocrinology unit. The data was analyzed by using Ademolus Classification of hypoglycemia (ACH) and the 2018 ADA/EASD Classification of hypoglycemia to define hypoglycemia. AHI was calculated from the HE using the proposed mathematical formula. SPSS version 23 was used for data analysis. All six patients had a series of hypoglycemic episodes occurring in three consecutive months. Patient 1 had an AHI of 0.53 using both ACH and 2018 ADA/EASD classification.By using the Pearson correlation statistics, AHI using ACH correlated well with AHI using 2018 ADA/EASD classification of hypoglycemia with a value of 0.993.Similarly the findings of AHI derived using ACH is significant with values derived using ADA/EASD 2018 classification of hypoglycemia with a p-value of 0.000 (correlation is significant at values of 0.01). One of the clinical implication of AHI is that the risk of developing reversible or irreversible neurological damage can be reduced clinically as patient with mild to moderate form of chronic hypoglycemia yet to develop irreversible neurological damage or neurological sequelae can be prevented early enough from progressing since a reduced AHI value out of a series will be a pointer towards progression to neurological damage if it has not occurred! In patient 1 her AHI was not in the severe range. In patient 3, in the last quarter of 2016, her AHI was 0.60, in the first quarter of 2017, her AHI was zero, then between June, July and August 2017 her AHI was 0.64. At this juncture in this patient management, it will be good to evaluate the etiological factors in this chronic kidney disease diabetic patient who once again has started having recurrent hypoglycemia as it was some 6 months earlier. Patient 6 had two consecutive reading of AHI for two consecutive quarters of a year.The result reveals that she is chronically deteriorating gradually and tending towards more severity in her development of HE as her AHI fell from 0.52 in the preceding quarter to 0.46., this connotes worsening chronic hypoglycemic state over time and a poorer prognosis. The lower the AHI, the poorer the prognosis.AHI is relevant for monitoring of chronic or long term recurrent HE in susceptible individuals whether diabetic or not. References: 1. Fonseca VA, Kirkman MS, Darsow T, Ratner RE (2012) The American Diabetes Association Diabetes Research Perspective. Diabetes Care 35(6): 1380–1387.

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Shahnaz Tofangchiha ◽  
Atoosa Moetaghedi Larijani ◽  
Iraj Mirzaii-Dizgah ◽  
Mahdi Isazadeh ◽  
Shima Rahimi ◽  
...  

Background: Type 2 diabetes and thyroid disorders cause extensive changes in insulin resistance. An increase in serum resistin level is associated with insulin resistance. Objectives: The current study aimed to investigate the cumulative effect of diabetes and hypothyroidism on the serum resistin levels of type 2 diabetic patients. Methods: Participants were divided into four groups using the convenience sampling method. Each group contained 30 diabetic patients, 32 hypothyroid patients, 30 diabetics + hypothyroid patients, and 29 healthy individuals. Serum samples were taken from participants and their serum resistin levels were measured. Data were collected and analyzed using SPSS version 23. Pearson correlation test, ANOVA statistical analysis, and Tukey post hoc test were used to analyze the data. A P-value of < 0.05 was used as statistically significant. Results: Among patients with hypothyroidism, resistin, and thyroid-stimulating hormone were moderately correlated (P = 0.001, r = 0.580). ANOVA revealed a statistically significant difference between the resistin levels in the studied groups (P = 0.000, F = 6.813). Conclusions: Serum resistin levels are significantly lower in people with diabetes + hypothyroidism than in people with only one of these two conditions. Therefore, the cumulative effect of diabetes and hypothyroidism on resistin levels cannot be deduced from the findings of the present study.


Author(s):  
Mohammad Afkhami-Ardekani ◽  
Mahmoo Emami-Meibodi ◽  
Naimeh Mostafae ◽  
Arezoo Afkhami-Ardekani ◽  
Boshra Najafi

Objective: The risk of cardiovascular disease increased in diabetic patients due to lipoprotein metabolism disorder and insulin resistance. There is different type of dyslipidemia in diabetic patient. The nicotinic acid (niacin) is categorized as vitamin B family and decreases low-density lipoproteins (LDL) and triglyceride (TG) level and increases high-density lipoproteins (HDL). The aim of this study was to compare the effect of niacin treatment with and without atorvastatin on lipid profile on diabetic patient. Materials and Methods: This study is cross over clinical trial on 30 diabetic patients (9 men, 21women) referred to diabetes research center of Yazd (IRAN). At initiation of study administered atorvastatin alone (20 mg/day) for 6 weeks (protocol A), and after 3 weeks washout period, started atorvastatin (20 mg/day) with niacin (50 mg/day) for 6 weeks (protocol B). Statistical analysis was accomplished by using SPSS for windows, version 11.50 and kappa and paired T-test. Results: Patients on protocol B had statistically significant more increase of HDL-C (P-value= 0.08) and decrease of TG than profile A (P-value= 0.024). Also, 2 hours post prandial blood sugar and HbA1c changes in two groups were not significant A (P-value= 0.226), B (P-value= 0.918). Patient in group B had statistically significant decrease in systolic blood pressure and diastolic blood pressure than group A (P-value= 0.010, P-value= 0.015). Conclusion: This study showed decrease of TG, LDL-C and total cholesterol and increase of HDL in both groups. There are significant changes in HDL-C and TG in group B that used niacin with atorvastatin than group A.


2019 ◽  
Vol 9 (02) ◽  
Author(s):  
Haider S Al-Hadad ◽  
Aqeel Abbas Matrood ◽  
Maha Abdalrasool Almukhtar ◽  
Haider Jabur Kehiosh ◽  
Riyadh Muhi Al-Saegh

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease. Few biomarkers for SLE have been validated and widely accepted for the laboratory follow-up of inflammatory activity. In SLE patients, with lupus nephritis (LN), complement activation leads to fluctuation of serum C3 and C4 that are frequently used as clinicalm biomarker of disease activity in SLE. Patients and Methods: In this study the number of patients were 37, seven patients were excluded for incomplete data collection, 28 were females ,2 were males. The duration of the study is two years from 2015 to 2017. Patients were considered to have SLE and LN according to American College of Rheumatology (ACR) criteria, and International Society of Nephrology/ Renal Pathology Society (ISN/RPS). All patients were evaluated withm clinical presentation, laboratory investigations. Our patients underwent kidney biopsy according to standard procedure by Kerstin Amann, and their tissue specimens were studied in the laboratory with light microscope (LM) and immunofluorescence microscope reagents. The relationship between the serological markers and immunofluorescence deposits in kidney biopsy of all patients were studied using the statistical analysis of Pearson correlation and single table student's T test. A P value 0.05 was considered statistically significant. Results: The granular pattern of IF deposits was present in all LN patients, and in more than two third of patients these IF deposits presented in glomerular, tubular, and mesangium sites. While less than one third of patients had IF deposits in the mesangium only. There was no statistically significant correlation between serum ANA, anti-dsDNA, and IF deposits of different types. There was significant correlation between serum C3 and C4 hypocomplementemia and IgG immune deposits in kidney biopsy, and there was significant relationship between serum C3 hypocomplementemia and full house immunofluorescence (FHIF) deposits inm kidney biopsy.Conclusions:Immunofluorescence deposits is mainly granular pattern in LN patients. There was no significant association between serum ANA, anti-dsDNA, and immune deposits in kidney tissue. Immunofluorescence deposits of IgG type correlates significantly with serum C3 and C4 hypocomplemetemia, and these immune deposits in association with low complement levels correlates with LN flare. There was significant correlation between C3 hypocomplementemia and FHIF.


2016 ◽  
Vol 4 (1) ◽  
pp. 3-7
Author(s):  
Tanka Prasad Bohara ◽  
Dimindra Karki ◽  
Anuj Parajuli ◽  
Shail Rupakheti ◽  
Mukund Raj Joshi

Background: Acute pancreatitis is usually a mild and self-limiting disease. About 25 % of patients have severe episode with mortality up to 30%. Early identification of these patients has potential advantages of aggressive treatment at intensive care unit or transfer to higher centre. Several scoring systems are available to predict severity of acute pancreatitis but are cumbersome, take 24 to 48 hours and are dependent on tests that are not universally available. Haematocrit has been used as a predictor of severity of acute pancreatitis but some have doubted its role.Objectives: To study the significance of haematocrit in prediction of severity of acute pancreatitis.Methods: Patients admitted with first episode of acute pancreatitis from February 2014 to July 2014 were included. Haematocrit at admission and 24 hours of admission were compared with severity of acute pancreatitis. Mean, analysis of variance, chi square, pearson correlation and receiver operator characteristic curve were used for statistical analysis.Results: Thirty one patients were included in the study with 16 (51.61%) male and 15 (48.4%) female. Haematocrit at 24 hours of admission was higher in severe acute pancreatitis (P value 0.003). Both haematocrit at admission and at 24 hours had positive correlation with severity of acute pancreatitis (r: 0.387; P value 0.031 and r: 0.584; P value 0.001) respectively.Area under receiver operator characteristic curve for haematocrit at admission and 24 hours were 0.713 (P value 0.175, 95% CI 0.536 - 0.889) and 0.917 (P value 0.008, 95% CI 0.813 – 1.00) respectively.Conclusion: Haematocrit is a simple, cost effective and widely available test and can predict severity of acute pancreatitis.Journal of Kathmandu Medical College, Vol. 4(1) 2015, 3-7


2013 ◽  
Vol 01 (01) ◽  
pp. 001-003
Author(s):  
Aruna Singh ◽  
Nymphea Pandit ◽  
Monica Sharma

Abstract Aim- 1. The aim of this study was to investigate the average maximum range of inter-incisal mouth opening in a representative sample of the adult subjects of Haryana. 2. To see any correlation between maximal inter-incisal opening with age. Methods- Maximum mouth opening was studied in 756 adult subjects with age range of 20-50 years in Yamunanagar, Haryana. Age limit was further divided into three groups (20-30, 31-40, 41-50). Those with clinical history of TMJ involvement, OSMF, any trauma, odontogenic and non-odontogenic infections, dental prosthesis on the anterior teeth, congenital anomalies in the maxillofacial region were excluded from this study. The measurements were recorded twice and mean of the two values were taken. Statistical Analysis- Independent sample t-test was calculated to compare age and mouth opening in both male and females respectively. Bivariate pearson correlation was used to see any relationship between age and mouth opening. P-value ≤ 0.05 and CI (confidence interval) at 95% were considered statistically significant. The Results- The average mouth opening of males (45.36±6.70 mm) subjects was higher as compared to female (41.27 ± 6.75 mm) with significant, p-value 0.000. The mean mouth opening ± SD for both sexes combined was 43.39 ± 7.02 mm. The corresponding values for mean inter-incisal opening in male population aged 20-30, 31-40, 41-50 were 45.52 ± 7.15, 46.16 ± 5.47, 42.96 ± 6.82 mm and in female population aged 20-30, 31-40, 41-50 were 41.40 ± 7.08, 41.60 ± 6.29 and 40.03 ± 6.38 mm respectively. Conclusion- Maximal mouth opening differ significantly with gender. There is a decrease in MMO with older age group.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1848.2-1849
Author(s):  
M. A. Mortada ◽  
H. Eitta ◽  
R. Elmallah ◽  
A. Radwan ◽  
A. Elsaman

Background:Musculoskeletal Ultrasonography (MSUS) is now a widely used tool for monitoring of rheumatoid arthritis (RA). Although there are many proposed sets of composite scores, a fixed set of joints may not be an ideal tool to assess a disease like RA, which affects many joints and tendons in different presentations. In previous study (1) U9 score was proven to be correlated with disease activity parameters.Objectives:To determine whether US assessment using U9 score is useful for monitoring response to treatment for RA or not?Methods:A prospective, multicenter study were conducted in period from July 2019 to December 2019. All recruited RA patients were subjected to: Disease activity assessment by clinical disease activity indices (CDAI and DAS28 ESR). Functional status assessment by (HAQ) and ultrasonographic assessment using U9 score which include 8 joints (bilateral wrists,2ndMCP,3RDMCP and knees) plus most clinically affected joint or tendon (one joint or one tendon). Most clinically affected joints from 48 joints. Any affected tendons could be choosing. All targeted joints were evaluated according to EULAR guidlines and by EULAR/ OMERACT combined score (0-3). Targeted tendons were scored (0-3).All patients received their treatment (biologic and non biologic DMARDs) according to the decision of the treating physicians. No specific therapy is needed. CDAI and DAS28 ESR, HAQ and U9 score were repeated after 3 months to detect the response to change after receiving the therapy.Results:One hundred and forty patients (23.6% were male) with mean age 39.26±11.30 were recruited from 4 tertiary referral university hospitals.There was a significant difference (<0.001) between the first and second visits as regards clinical, laboratory and ultrasonographic parameters. DAS 28 decreased form (5.29±1.21) to (3.95±0.99), ESR decreased from (42.12±15.24) to (26.84±12.32), HAQ2 improved from (0.652±0.350) to (0.510±0.237) and U9 total US score decreased from (13.56±5.18) to (8.02±4.28).There was significant correlation between U9 ultrasonographic score and clinical parameters at both visits (table 1).Table 1.correlation between U9 ultrasonographic score and clinical parameters.U9 at 1stvisitU9 at 2ndvisitDAS-28Pearson Correlation(P value)0.806<0.0010.790<0.001CDAIPearson Correlation(P value)0.787<0.0010.773<0.001HAQPearson Correlation(P value)0.431<0.0010.317<0.001We found that the most suitable cut-off value of U9 score to predict high disease activity was 11.5 (sensitivity 85.7% and specificity 80.6%), cut off value for moderate disease activity was 5.5(sensitivity 83.2% and specificity 88%) and cut off value for low disease activity was 3.5 (sensitivity of 83.3% and specificity 57.1%). These results are summarized in the following table:Conclusion:U9 ultrasonographic score is very useful method for evaluating the monitoring the response of treatment.References:[1]Mortada, et al. Annals of the Rheumatic Diseases 2019;78:1009.Disclosure of Interests:None declared


2019 ◽  
Vol 7 ◽  
pp. 205031211983209 ◽  
Author(s):  
Seung-Joo Nam ◽  
Sung Chul Park ◽  
Sang Hoon Lee ◽  
Dong Wook Choi ◽  
Sung Joon Lee ◽  
...  

Objective: To compare Helicobacter pylori ( H. pylori) eradication rate of type 2 diabetic patients with non-diabetic subjects. Methods: In this multicenter prospective observational study, H. pylori-infected subjects were enrolled from three university-affiliated hospitals. Eradication regimen was triple therapy with standard dose of proton pump inhibitors (b.i.d), amoxicillin (1.0 g b.i.d), and clarithromycin (500 mg b.i.d) for 7 days. Urea breath test was performed 4 weeks after treatment. Various clinical and laboratory data were collected for identification of factors associated with successful eradication. Results: Totally, 144 subjects were enrolled and 119 (85 non-diabetic and 34 diabetic patients) were finally analyzed. Eradication rate was 75.6% and there was no difference between diabetic patients and non-diabetic subjects (73.5% vs 76.5%, p value: 0.814). Adverse drug reactions were reported in 44.5% of patients. In multivariate analysis for predicting H. pylori eradication in diabetic patients, HbA1c (⩾7.5%) was a significant factor affecting eradication rate (adjusted odds ratio: 0.100, 95% confidence interval: 0.011–0.909, p value: 0.041). Conclusion: Diabetes itself is not a major factor affecting H. pylori eradication. However, poor glucose control may harmfully affect H. pylori eradication.


2014 ◽  
Vol 2014 ◽  
pp. 1-19
Author(s):  
Liliana Ibeth Barbosa-Santillán ◽  
Inmaculada Álvarez-de-Mon y-Rego

This paper presents an approach to create what we have called a Unified Sentiment Lexicon (USL). This approach aims at aligning, unifying, and expanding the set of sentiment lexicons which are available on the web in order to increase their robustness of coverage. One problem related to the task of the automatic unification of different scores of sentiment lexicons is that there are multiple lexical entries for which the classification of positive, negative, or neutral{P,N,Z}depends on the unit of measurement used in the annotation methodology of the source sentiment lexicon. Our USL approach computes the unified strength of polarity of each lexical entry based on the Pearson correlation coefficient which measures how correlated lexical entries are with a value between 1 and −1, where 1 indicates that the lexical entries are perfectly correlated, 0 indicates no correlation, and −1 means they are perfectly inversely correlated and so is the UnifiedMetrics procedure for CPU and GPU, respectively. Another problem is the high processing time required for computing all the lexical entries in the unification task. Thus, the USL approach computes a subset of lexical entries in each of the 1344 GPU cores and uses parallel processing in order to unify 155802 lexical entries. The results of the analysis conducted using the USL approach show that the USL has 95.430 lexical entries, out of which there are 35.201 considered to be positive, 22.029 negative, and 38.200 neutral. Finally, the runtime was 10 minutes for 95.430 lexical entries; this allows a reduction of the time computing for the UnifiedMetrics by 3 times.


Author(s):  
Siew Bee Aw ◽  
Bor Tsong Teh ◽  
Gabriel Hoh Teck Ling ◽  
Pau Chung Leng ◽  
Weng Howe Chan ◽  
...  

This paper attempts to ascertain the impacts of population density on the spread and severity of COVID-19 in Malaysia. Besides describing the spatio-temporal contagion risk of the virus, ultimately, it seeks to test the hypothesis that higher population density results in exacerbated COVID-19 virulence in the community. The population density of 143 districts in Malaysia, as per data from Malaysia’s 2010 population census, was plotted against cumulative COVID-19 cases and infection rates of COVID-19 cases, which were obtained from Malaysia’s Ministry of Health official website. The data of these three variables were collected between 19 January 2020 and 31 December 2020. Based on the observations, districts that have high population densities and are highly inter-connected with neighbouring districts, whether geographically, socio-economically, or infrastructurally, tend to experience spikes in COVID-19 cases within weeks of each other. Using a parametric approach of the Pearson correlation, population density was found to have a moderately strong relationship to cumulative COVID-19 cases (p-value of 0.000 and R2 of 0.415) and a weak relationship to COVID-19 infection rates (p-value of 0.005 and R2 of 0.047). Consequently, we provide several non-pharmaceutical lessons, including urban planning strategies, as passive containment measures that may better support disease interventions against future contagious diseases.


2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
Benoit J Arsenault ◽  
Mathieu R Brodeur ◽  
David Rhainds ◽  
Anne-Elen Kernaleguen ◽  
Véronique Lavoie ◽  
...  

Background: Studies have shown that low HDL-cholesterol levels may be associated with the progression of aortic valvular calcium and aortic valvular stenosis (AVS), but whether patients with AVS have impaired cholesterol efflux capacities is unknown. Methods and results: We have measured four parameters of cholesterol efflux capacity in apolipoprotein B-depleted serum samples from 48 patients with (aortic jet velocity ≥2.5 m/s, mean age = 72 ± 7 years and 72.7% men) and 51 patients without AVS (aortic jet velocity ≤ 1.7 m/s, mean age 71 ± 7 years and 70.6% men). Cholesterol efflux capacity was measured using J774 macrophages with and without stimulation of ABCA1 expression by cAMP (non-stimulated efflux, total efflux and ABCA1-mediated efflux), and HepG2 hepatocytes to measure SR-BI-mediated efflux. Mean HDL-cholesterol and apolipoprotein A-I levels as well as efflux are shown in the table for patients with vs. without AVS. The Pearson correlation coefficient between HDL-cholesterol levels and SR-B1-dependent efflux was 0.39 (p=0.007) in patients with AVS and 0.68 (<0.0001) in controls (P-value for the difference between the correlation coefficients obtained with Fisher’s test = 0.04). Conclusions: This study provides evidence that serum from patients with AVS may have impaired cholesterol efflux capacities, especially through the SR-B1 pathway. Table. Mean HDL-cholesterol and apolipoprotein A-I levels as well as non-stimulated-, total-, ABCA1-, and SR-B1-dependent cholesterol efflux obtained from patients’ serum with vs. without AVS. Data is shown as mean ± SD. Differences between categories were assessed using a Student unpaired t-test.


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