scholarly journals Haemoglobin A1C Levels Constantly Below Lower Reference Limit in a Diabetic Patient With Microcytic Anaemia

2019 ◽  
Author(s):  
Frank Sheng Fan ◽  
Chih-Hao Chen ◽  
Hui-Chun Yang
Keyword(s):  
Glycaemic Control ◽  
Diabetic Patient ◽  
Daily Practice ◽  
Blue Staining ◽  
Haemoglobin A1c ◽  
Microcytic Anaemia ◽  
Laboratory Assessment ◽  
Reference Limit ◽  
Cresyl Blue ◽  
History Of

Introduction: Haemoglobin A1C (A1C), as a parameter of long-term glycaemic control, has been adopted to guide diabetic therapy all over the world. However, falsely high or low A1C could be troublesome in daily practice. Case description: A 75-year-old male diabetic patient affected by a reasonably inferred life-long history of microcytic anaemia was found to have abnormally low A1C values in the previous 5 months. Subsequent laboratory assessment with brilliant cresyl blue staining and haemoglobin electrophoresis detected haemoglobin H disease as the underlying cause of both the microcytic anaemia and the disturbed A1C measurement. Discussion: Enhanced erythrocyte destruction such as in haemoglobin H disease could explain a falsely decreased A1C level very well. Upon facing a questionable A1C value, physicians dealing with diabetes should consider the possibility of undiscovered underlying causes rather than too tightly glycaemic control.

scholarly journals Pott’s Disease with Psoas Abscess in a Diabetic Patient: A Conservative Approach

2014 ◽  
Vol 13 (2) ◽  
pp. 67-69 ◽  
Author(s):  
Mohammad Moin Uddin ◽  
Nusrat Sultana ◽  
Rezwan Rehan ◽  
Aminuddin A. Khan
Keyword(s):  
Developing Countries ◽  
Glycaemic Control ◽  
Physical Examination ◽  
Diabetic Patient ◽  
Psoas Abscess ◽  
Conservative Approach ◽  
Mri Imaging ◽  
Tuberculosis Case ◽  
Poor Glycaemic Control ◽  
History Of

Pott’s disease, also known as tubercular spondylitis, is a well known condition in developing countries. Here we report a case of Pott’s disease with bilateral psoas abscesses in a 51 years diabetic male with poor glycaemic control. Diagnosis is done on the basis of history, physical examination, plain radiology & MRI imaging and history of exposure to a tuberculosis case. He was treated conservatively and responded well to anti-tubercular chemotherapy.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21073

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

scholarly journals Limiting the executive power after the Second World War: the invention of administrative science

2021 ◽  
pp. 002085232098559
Author(s):  
Céline Mavrot
Keyword(s):  
Human Rights ◽  
World Order ◽  
Daily Practice ◽  
Second World War ◽  
Executive Power ◽  
World War ◽  
Administrative Power ◽  
History Of ◽  
Second World ◽  
Administrative Science

This article analyses the emergence of administrative science in France in the wake of the Second World War. The birth of this discipline is examined through the history of its founders, a group of comparatist aiming at developing universal administrative principles. The post-war context prompted the creation of checks and balances against administrative power (through oversight of the legality of administrative action) and against the powers of nation states (through human rights and international organizations). Administrative science and comparative law were meant to rebuild international relations. The history of this discipline highlights a legal project to redefine the role and limits of executive power at the dawn of the construction of a new world order. Points for practitioners Looking at long-term developments in the science of administration helps to inform administrative practice by providing a historical and reflective perspective. This article shows how a new understanding of the administrative reality emerged after the fall of the totalitarian regimes of the first half of the 20th century. It highlights the different ways in which administrative power was controlled after the Second World War through greater oversight over administrative legality, the establishment of universal administrative principles and the proclamation of human rights. Questions of administrative legitimacy and the limitation of administrative power are still very much part of the daily practice of executive power, and represent a central aspect of administrative thinking.

scholarly journals Sex differences and correlates of poor glycaemic control in type 2 diabetes: a cross-sectional study in Brazil and Venezuela

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023401 ◽  
Author(s):  
Fernanda G Duarte ◽  
Sandra da Silva Moreira ◽  
Maria da Conceição C Almeida ◽  
Carlos A de Souza Teles ◽  
Carine S Andrade ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Treatment Guidelines ◽  
Specific Treatment ◽  
Nationwide Survey ◽  
Haemoglobin A1c ◽  
Cross Sectional ◽  
Factors Associated ◽  
Adherence To Diet

ObjectiveExamine whether glycaemic control varies according to sex and whether the latter plays a role in modifying factors associated with inadequate glycaemic control in patients with type 2 diabetes (T2D) in Brazil and Venezuela.Design, setting and participantsThis was a cross-sectional, nationwide survey conducted in Brazil and Venezuela from February 2006 to June 2007 to obtain information about glycaemic control and its determinants in patients with diabetes mellitus attending outpatient clinics.Main outcome measuresHaemoglobin A1c (HbA1c) level was measured by liquid chromatography, and patients with HbA1c ≥7.0% (53 mmol/mol) were considered to have inadequate glycaemic control. The association of selected variables with glycaemic control was analysed by multivariate linear regression, using HbA1c as the dependent variable.ResultsA total of 9418 patients with T2D were enrolled in Brazil (n=5692) and in Venezuela (n=3726). They included 6214 (66%) women and 3204 (34%) men. On average, HbA1c levels in women were 0.13 (95% CI 0.03 to 0.24; p=0.015) higher than in men, after adjusting for age, marital status, education, race, country, body mass index, duration of disease, complications, type of healthcare, adherence to diet, adherence to treatment and previous measurement of HbA1c. Sex modified the effect of some factors associated with glycaemic control in patients with T2D in our study, but had no noteworthy effect in others.ConclusionsWomen with T2D had worse glycaemic control than men. Possible causes for poorer glycaemic control in women compared with men include differences in glucose homeostasis, treatment response and psychological factors. In addition, sex modified factors associated with glycaemic control, suggesting the need to develop specific treatment guidelines for men and women.

A Practical Approach to Pediatric Patients Referred With an Abnormal Coagulation Profile

2005 ◽  
Vol 129 (8) ◽  
pp. 1011-1016 ◽  
Author(s):  
Monica Acosta ◽  
Rachel Edwards ◽  
E. Ian Jaffe ◽  
Donald L. Yee ◽  
Donald H. Mahoney ◽  
...  
Keyword(s):  
Family History ◽  
Positive Family History ◽  
Laboratory Data ◽  
Bleeding Risk ◽  
Personal History ◽  
Retrospective Case ◽  
Laboratory Assessment ◽  
Repeat Testing ◽  
Effective Manner ◽  
History Of

Abstract Context.—Workup for prolonged prothrombin time (PT) and activated partial thromboplastin time (PTT) is a frequent referral to a Hematology and Coagulation Laboratory. Although the workup should be performed in a timely and cost-effective manner, the complete laboratory assessment of the coagulation state has not been standardized. Objective.—To determine which clinical and laboratory data are most predictive of a coagulopathy and to formulate the most efficient strategy to reach a diagnosis in patients referred for abnormal coagulation profiles. Design.—Retrospective case review. Medical records of 251 patients referred for prolonged PT and/or PTT to our Hematology Service between June 1995 and December 2002 were reviewed. Results.—The study included 135 males and 116 females with a mean age of 7.0 years. A personal history of bleeding was reported in 137 patients, and a family history of bleeding was reported in 116 patients. Fifty-one patients (20%) had a coagulopathy (ie, a bleeding risk). Factors predictive of a bleeding risk were a positive family history of bleeding (P < .001) and a positive personal history of bleeding (P = .001). Of 170 patients with findings of normal PT and PTT values on repeat testing, 14 were subsequently diagnosed with a coagulopathy. Two of these patients reported no positive personal or family history of bleeding. Conclusions.—Coagulopathy was identified in 20% of the children referred for abnormal PT and/or PTT. In the absence of a personal or family history of bleeding, a normal PT and/or PTT on repeat testing has a negative predictive value of more than 95%.

scholarly journals Evaluation and Transplantation of a SARS-CoV-2 Seropositive Kidney Candidate

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Maya C. Graves ◽  
Sapna A. Mehta ◽  
Bonnie E. Lonze ◽  
Nicole M. Ali
Keyword(s):  
New York ◽  
Kidney Transplant Recipient ◽  
Organ Transplant ◽  
Laboratory Assessment ◽  
Transplant Center ◽  
History Of ◽  
Center Activity ◽  
Transplant Candidates ◽  
Living Donor Kidney Transplant ◽  
Or History

The COVID-19 pandemic affected transplant center activity in areas with high number of cases such as New York City and prompted reevaluation of patients awaiting organ transplant diagnosed with SARS-CoV-2 infection. To resume safe transplantation at our center, we found it necessary to (1) identify transplant candidates with possible exposure to or history of COVID-19 infection, (2) outline a clinical and laboratory assessment to determine adequate clinical recovery from COVID-19 for transplantation, and (3) determine whether the possibility of perioperative COVID-19 transmission from the patient to staff would pose unacceptable risk. Here, we describe our center’s approach to proceeding with transplantation in a SARS-CoV-2 seropositive living donor kidney transplant recipient and describe early posttransplant outcomes.

scholarly journals TYPE 2 DIABETES MELLITUS;

2013 ◽  
Vol 20 (02) ◽  
pp. 237-243
Author(s):  
GHULAM HUSSAIN BALOCH ◽  
ABDUL QADIR DALL ◽  
ATIF SITWAT HAYAT ◽  
Syed Zulfiquar Ali Shah ◽  
Bikha Ram Devrajani
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
University Hospital ◽  
Diabetic Patients ◽  
Haemoglobin A1c ◽  
Type 2 Diabetic Patients ◽  
History Of ◽  
Upper Molar

Objective: To determine the frequency and pattern of dental carries in patients with type 2 diabetes mellitus. Design: Crosssectional descriptive study. Patients and methods: Patients with history of type 2 diabetes mellitus for ≥ 02 years duration with ≥ 35 years ofage and of either gender with dental pain visit at medical and dental outpatient department (OPD) of Liaquat University Hospital Hyderabad.The detail history was taken and the blood samples were taken for haemoglobin A1c (HbA1c) to assess the glycemic status. The existenceof dental carries and its pattern was diagnosed through dental examination by consultant dentist had clinical experience ≥05 years. The datawas collected on pre-designed proforma, entered and analyzed in SPSS version 11.00. Results: A total of 137 type 2 diabetic patients wereselected for this study, out of these 82 were males and 55 females. The dental carries was found in 98 (71.5%) patients. Out of these ninetyeight, 53 (54.08%) were males and 45 (45.92%) were female. Upper molar teeth involvement was present in 46 patients and lower molarteeth were involved in 52 patients. Dentine carries was seen in 35 patients, enamel carries in 19, white spot carries in 20 patients, pulpitis in16 patients, and pulp capping in 8 patients. Involvement of individual teeth was also assessed, the upper molar involvement was present in32 patients, premolar involvement was present in 11, incisor involvement in 03 patients. The lower molars were involved in 28 patients,lower pre molar in 21 and lower incisors in 03 patients. Dental carries was present in 43 (43.9%) patients in patients whose duration ofdiabetes was between 5-10 years, whereas those patients having duration >10 years had 31.6% frequency of dental carries, whileregarding duration of <5 years only 24 (24.5%) patients had dental carries. Conclusions: The diabetic patients are more prone to acquiredental caries.

scholarly journals Gestational diabetes mellitus with its maternal and foetal outcome: a clinical study

2017 ◽  
Vol 4 (4) ◽  
pp. 919 ◽  
Author(s):  
Mohan Makwana ◽  
Raj Kumar Bhimwal ◽  
Chaina Ram ◽  
S L. Mathur ◽  
Kanwar Lal ◽  
...  
Keyword(s):  
Glycaemic Control ◽  
Gestational Diabetes ◽  
Diabetic Mother ◽  
Vaginal Candidiasis ◽  
Low Socioeconomic ◽  
Infant Of Diabetic Mother ◽  
Medical College ◽  
History Of ◽  
Foetal Outcome ◽  
Sedentary Life Style

Background: Prevalence of the diabetes among pregnant women is increasing, attributable to advance maternal age, multi foetal gestation, increased body mass index, strong family history, sedentary life style, change in the diet, continued immigration. Gestational diabetes has few symptoms, commonly diagnosed by screening during pregnancy.Methods: The present study was conducted at Department of Medicine and Department of Obstetrics and Gynaecology, Dr. S.N. Medical College, Jodhpur. Rajasthan, India.Results: Out of 476 patients attending the antenatal outdoor at the Umaid Hospital, Jodhpur, Rajasthan, India. The prevalence of gestational diabetes in present study was 7.98%, Incidence of GDM found to increase with increasing age with maximum prevalence (10.71%) in more than 30 years age group, with increasing parity, low socioeconomic strata and in urban population. With maximum prevalence amongst higher parities (12.5%) in >G5 and higher). The incidence was higher with history of PIH (36.36%), family H/O DM (33.3%), GDM (12.12%), perinatal losses (15.15%), anomalous baby (9.09%), high BMI (67%). GDM complicate the normal course of pregnancy with increased incidence of PIH (36.4), Polyhydramnios (27.2%), infections like vaginal candidiasis (24.2%) and UTI (39.3%). The infant of diabetic mother had 12 (32.29%), 9 (26.47%), 11 (32.35%), 8 (23.53%) 5 (14.70%) and 3 (8.82%) of hypoglycemia, respiratory distress, macrosomia, congenital anomalies, birth injuries, polycythaemia, and hypocalcaemia respectively in diabetic mothers with suboptimal glycaemic control during pregnancy.Conclusions: GDM continues to be an important obstetrical condition with significant feto-maternal morbidity. Complications in infant of diabetic mother are more common with those mothers who had poor glycaemic control.

scholarly journals Effect of adding growth factors during in vitro maturation on the developmental potentials of ewe oocytes selected by brilliant cresyl blue staining

2021 ◽  
Vol 14 (2) ◽  
pp. 452-456
Author(s):  
Mohamed Fathi ◽  
Amr F. Elkarmoty
Keyword(s):  
Growth Factors ◽  
Growth Factor ◽  
Embryo Development ◽  
In Vitro Maturation ◽  
Blue Staining ◽  
Brilliant Cresyl Blue ◽  
Cresyl Blue ◽  
Nuclear Maturation ◽  
Maturation Medium

Aim: Several factors had been concerned with the developmental competence of the sheep oocyte. This study aims to investigate the effect of adding growth factors (insulin-like growth factor 1 [IGF-1] and epidermal growth factor [EGF]) in the maturation medium of ewe oocytes selected based on brilliant cresyl blue (BCB) screening on in vitro maturation (IVM), fertilization, and pre-implantation embryo development. Materials and Methods: Cumulus-oocyte complexes (COCs) were obtained from the ovaries of slaughtered ewes by either aspiration or slicing techniques. COCs were in vitro matured in a medium containing IGF-1 and EGF (control group). For BCB screening, oocytes were stained and divided into BCB+ oocytes that matured in the same maturation conditions without adding growth factors (Group 2) or in the presence of growth factors (Group 3), and BCB– oocytes that matured in medium without growth factors (Group 4) or with growth factors (Group 5). Results: The supplementation of the maturation medium with growth factors during IVM of (BCB+) oocytes resulted in a significant increase in nuclear maturation rate (90.9%), fertilization rate (75.6%), and embryo developmental rates (60.0%, 46.7%, and 33.3% for cleavage, morula, and blastocyst, respectively). Conclusion: Culturing BCB+ oocytes in a maturation medium containing both EGF and IGF-1 showed a significant improvement in nuclear maturation, fertilization, and pre-implantation embryo development in vitro.

scholarly journals Selection of Ovine Oocytes by Brilliant Cresyl Blue Staining

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Liqin Wang ◽  
Jiapeng Lin ◽  
Juncheng Huang ◽  
Jing Wang ◽  
Yuncheng Zhao ◽  
...  
Keyword(s):  
Embryonic Stem ◽  
Cumulus Cells ◽  
Oocyte Quality ◽  
G6pd Activity ◽  
Blue Staining ◽  
Animal Cloning ◽  
Cresyl Blue ◽  
Deep Blue ◽  
Glucose 6 Phosphate Dehydrogenase

Sheep oocytes derived from the ovaries collected from the slaughterhouse are often used for research onin vitroembryo production, animal cloning, transgenesis, embryonic stem cells, and other embryo biotechnology aspects. Improving thein vitroculture efficiency of oocytes can provide more materials for similar studies. Generally, determination of oocyte quality is mostly based on the layers of cumulus cells and cytoplasm or cytoplasm uniformity and colors. This requires considerable experience to better identify oocyte quality because of the intense subjectivity involved (Gordon (2003), Madison et al. (1992) and De Loos et al. (1992)). BCB staining is a function of glucose-6-phosphate dehydrogenase (G6PD) activity, an enzyme synthesized in developing oocytes, which decreases in activity with maturation. Therefore, unstained oocytes (BCB−) are high in G6PD activity, while the less mature oocytes stains are deep blue (BCB+) due to insuffcient G6PD activity to decolorize the BCB dye.

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