scholarly journals Diabetic polyneuropathy with/out neuropathic pain in Mali: A cross-sectional study in two reference diabetes treatment centers in Bamako (Mali), Western Africa

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241387
Author(s):  
Youssoufa Maiga ◽  
Salimata Diallo ◽  
Fatoumata dite Nènè Konipo ◽  
Oumar Sangho ◽  
Modibo Sangaré ◽  
...  

Introduction Diabetic polyneuropathy (DPN) with or without neuropathic pain is a frequent complication of diabetes. This work aimed to determine the prevalence of diabetic polyneuropathy, to describe its epidemiological aspects, and to analyze the therapeutic itinerary of patients with DPN. Methods This was a cross-sectional, descriptive study performed synchronously over six months at two major follow-up sites for patients with diabetes in Mali. DPN was diagnosed based on the Michigan Neuropathy Screening Instrument (MNSI). The neuropathic nature of the pain and the quality of life of patients were evaluated by the DN4 and the ED-5D scale, respectively. We used three (3) different questionnaires to collect data from patients (one at inclusion and another during the follow-up consultation) and from the caregivers of patients with DPN. Results We included 252 patients with diabetes, and DPN was found to have a healthcare facility-based prevalence of 69.8% (176/252). The sex ratio was approximately three females for every male patient. The patients were mostly 31 to 60 years of age, 83% had type 2 diabetes, and 86.9% had neuropathic pain Approximately half of the patients (48.3%) had autonomic neuropathy and they reported moderate to intense pain, which was mainly described as a burning sensation. The patients exhibited impaired exteroceptive and proprioceptive sensations in 51.7% of cases. The patients smoked tobacco in 3.4% of cases, while 36.6% of the patients were obese and had dyslipidemia. The caregivers clearly indicated that appropriate medications were not readily accessible or available for their patients with DPN. Conclusion The healthcare facility-based prevalence of DPN with or without neuropathic pain was high in our cohort. These inexpensive and easy-to-use tools (MNSI, DN4) can be used to adequately diagnose DPN in the African context. In Mali, screening and early treatment of patients at risk of DPN should allow for a reduction of the burden of the disease, while caregivers need to be adequately trained to manage DPN.

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036106
Author(s):  
Bikila Regassa Feyisa ◽  
Mekdes Tigistu Yilma ◽  
Belachew Etana Tolessa

ObjectiveTo assess health-related quality of life (HRQoL) and its predictors among patients with diabetes on follow-up at Nekemte Specialised Hospital in Western Ethiopia.Design, setting and participantsThis facility-based cross sectional study was conducted among 224 patients with diabetes mellitus (types I and II) on follow-up at one of the public hospitals in western Ethiopia. Respondents were selected by systematic random sampling and interviewed with the aid of a questionnaire.Main outcome measuredHRQoL was measured by using the Medical outcomes study 36-item Short Form (SF-36) Health Survey from 15 April to 5 June 2019. A structured questionnaire was used for data collection from participants selected by systematic random sampling. Multiple linear regression was used for the final model.ResultA total of 215 patients with diabetes consented and completed the study, giving a response rate of 96%. The mean score of the overall HRQoL of the study participants was 50.3±18.1. The highest mean score was obtained in the physical functioning domain and the lowest mean score in the general health domain. Age, education status, history of smoking, feeling of stigmatisation and body mass index were inversely associated with the overall HRQoL. Gender (male), marital status (currently married), absence of comorbidity and absence of chronic complications related to diabetes mellitus were positively associated with overall HRQoL.ConclusionThe overall HRQoL of patients with diabetes on follow-up at the study area was found to be moderate. General health, mental health, bodily pain and vitality were the most affected domains. Both the mental and physical components need to be considered when caring for the patients with diabetes on follow-up beyond provision of treatment.


2016 ◽  
Vol 50 (2) ◽  
pp. 255-262 ◽  
Author(s):  
Clarissa Cordeiro Alves Arrelias ◽  
Fernando Bellissimo-Rodrigues ◽  
Letícia Cristina Lourenço de Lima ◽  
Anderson Soares da Silva ◽  
Nereida Kilza da Costa Lima ◽  
...  

Abstract OBJECTIVE Analyze the factors associated with full hepatitis B vaccination (three doses) in patients with diabetes mellitus. METHOD Cross-sectional study, conducted in a health unit in a city in the state of São Paulo, with 255 patients on outpatient follow-up, in 2014. Data were obtained from the computerized system of the Municipal Health Department and via a structured questionnaire. A logistic regression model was used for analysis. RESULTS Full hepatitis B vaccination was noted in 13.7% of the patients and shown to be directly associated with their educational level (OR=1.30; CI: 1.07-1.57) and current or previous work as a health professional (OR=3.21; CI: 1.16-8.89). CONCLUSION Hepatitis B vaccination coverage was found to be low in patients with diabetes mellitus, indicating their vulnerability to this serious and potentially fatal disease. Higher educational level and working in the field of health were associated with better vaccination coverage.


Author(s):  
Mohammed I. M. Ahmed

Background: The level of awareness of diabetic retinopathy is considered an important factor for early diagnosis and management of diabetic retinopathy. This study aimed to assess the level of awareness of diabetic retinopathy among patients with diabetes mellitus in Khartoum, Sudan. Methods: This cross-sectional study was conducted among diabetic patients attending Zeenam and Abdullah Khalil Diabetic Centers between June and September 2018. A convenience sample of diabetic patients was used. Information on the sociodemographic characteristics of the patients, patients’ knowledge, compliance with available treatments, and routine eye examinations was collected using a semi-structured questionnaire. Patients were also asked about the barriers that may interfere with a regular eye examination. Results: A total of 200 patients were enrolled and 94 (47%) of them were female; 13% of the respondents were diagnosed with diabetic retinopathy, 31.5% were hypertensive, and 13.5% had hyperlipidemia. Additionally, 88.5% of the patients were aware that DM can affect their eyes and 87% had never been diagnosed with diabetic retinopathy. Although around 83% thought that diabetic retinopathy could lead to blindness, only 35.5% of them had undergone fundus examination by ophthalmologists. Moreover, 39% of the participants had irregular diabetes follow-up and 43% monthly follow-up. Only 31% went for regular eye check-up; however, their compliance with routine retinal assessment was poor, with a total of 72.5% of participants assuming that they have good vision and need not get their eyes checked up regularly. The chief factor that was related to increased awareness of diabetic retinopathy in the study was the level of education. Conclusion: Although a large proportion of diabetic patients in Khartoum are aware that diabetes mellitus can affect their eyes, regular retinal assessment of patients was poor, thus hindering early diagnosis and management.


2020 ◽  

Objectives: The COVID-19 pandemic has emerged as a significant threat to healthcare systems, and has resulted in treatment algorithms being changed in general surgery clinics, as is the case in all other medical disciplines. In the present study we analyze the outcomes of patients who have undergone elective colorectal surgery in our hospital since the COVID-19 outbreak, as well as the precautionary procedural changes that have been made. Methods: The present study evaluates the approaches applied for the treatment of elective colorectal cancer patients in a pandemic hospital. In this cross-sectional study, conducted in a tertiary-level public hospital in Istanbul, Turkey, a retrospective review is made of the files of patients who underwent elective colorectal surgeries between 11.03.2020, as the date on which first case of COVID-19 was officially identified in Turkey, and 01.05.2020, in the general surgery clinic of a tertiary healthcare facility that has been designated a pandemic hospital. Results: A total of 18 patients underwent a surgical resection in accordance with oncological principles between the defined dates, having been diagnosis with a colorectal malignancy. None of the operated patients were considered suspicious for COVID-19 preoperatively, nor did they have any contact history. Furthermore, there were no suspicions or signs of COVID-19 during the 14-day follow-up of the discharged patients. Conclusion: It was established in the present study that patients undergoing colorectal surgery and patients with COVID-19 infections in the same hospital can be treated successfully without cross-infection through the application of appropriate isolation principles. These successful findings were supported by a 14-day follow-up after discharge.


2020 ◽  
Vol 7 (12) ◽  
pp. 726-729
Author(s):  
Mirac Aysen Unsal ◽  
Suphi Bulgurcu

Objective:  To examine the relationship between the severity of polyneuropathy and nasal mucociliary clearance times in patients with polyneuropathy and investigate how the presence and severity of electrophysiological polyneuropathy might affect mucociliary clearance in patients with diabetes mellitus. Material and Methods: This prospective cross-sectional study was carried out in the Neurol-ogy and Ear, Nose and Throat (ENT) clinics in a tertiary hospital.  The study included three groups of patients with 20 participants in each group (Group 1, patients with diabetic poly-neuropathy; Group 2, patients with non-diabetic polyneuropathy; and Group 3, diabetes melli-tus patients with a normal nerve conduction study) Nasal saccharin test was performed on all patients. Results: There was a statistically significant difference in the duration of nasal mucociliary clearance among the groups (p= 0.001). There was a positive, statistically significant (p = 0.007) correlation between the nasal mucociliary clearance duration and the severity of poly-neuropathy. The nasal mucociliary clearance duration increased with the severity of polyneuropathy. Conclusion: Patients with diabetes mellitus are a special group, and preventable problems should be taken into consideration when examining nasal pathologies. It should be kept in mind that nasal mucociliary clearance dysfunction can be both a cause and a result in management of diabetes mellitus patients, and thus it should be evaluated carefully.


2020 ◽  
Vol 11 ◽  
pp. 215013272097191
Author(s):  
Maher R. Khdour ◽  
Heba B. Awadallah ◽  
Mustafa A. Alnadi ◽  
Doaa H. Al-Hamed

Introduction: To examine the mean differences between patient beliefs about medicine with reference to adherence and glycemic control. Methods: This study utilized a cross-sectional questionnaire-based approach. Adherence to medication was measured with the Morisky Green Levine Medication Adherence Scale (MGLS); glycemic control as the last HbA1c test value; and beliefs about medicine with the Beliefs about Medicines Questionnaire (BMQ). Results: According to MGLS scale, 220 (57.9%) of the diabetic patients were classified as high adherent to their medications and 160 (42.1%) were classified as low adherent. Patients had strong believes in their medication, the mean necessity score was significantly outweighed the mean concerns score (17.7 vs 14.4; P < .001). Low adherent patients had significantly more concerns about long term effect of medications (14.4 vs 13.8; P < .008). No significant mean differences were found between glycemic controlled and uncontrolled group regarding necessity or concern domains. Conclusion: Assessing beliefs about medicine is crucial for recognizing patients at risk of low adherence, which offers a way to help patients with diabetes to achieve a better glycemic control.


2021 ◽  
Vol 6 (1) ◽  
pp. e000616
Author(s):  
Elisabet Granstam ◽  
Anders Krifors ◽  
Elisabeth Freyhult ◽  
Hanna Åkerblom

BackgroundCOVID-19 is caused by SARS-CoV-2. Virus has been found in conjunctiva of hospitalised patients with COVID-19. Conjunctivitis has also been reported as a presenting symptom of disease.ObjectiveThe aims of the study were to investigate the prevalence of SARS-CoV-2 in the conjunctiva and throat among patients presenting at the emergency outpatient ophthalmological healthcare facility at a county hospital along with investigating the seroprevalence of SARS-CoV-2 among staff at the department.Methods and AnalysisSwabs from conjunctiva and throat of patients were analysed with real-time reverse transcriptase PCR (RT-PCR) for SARS-CoV-2. Blood samples for serological analysis were obtained from staff. A questionnaire was used to investigate symptoms associated with COVID-19 during the last 3 months as well as symptoms for which the patients were seeking ophthalmological healthcare.ResultsIn total, 68 patients and 70 individuals from the staff were included in the study. Conjunctivitis was observed in 7% of patients. One patient, presenting with reduced visual acuity due to preretinal haemorrhage in the macula, was positive for SARS-CoV-2 in throat swab. Contact tracing was negative. All other RT-PCR tests were negative. Seropositivity for SARS-CoV-2 was found in 4% of staff.ConclusionsOur study demonstrated low prevalence of SARS-CoV-2 among patients as well as low seroprevalence of SARS-CoV-2 IgG-antibodies among staff at the ophthalmological ward. The risk for contracting COVID-19 at the department was small. Follow-up investigation is planned.


2020 ◽  
Vol 26 (1) ◽  
pp. 31-36
Author(s):  
Md Zakaria Sarkar ◽  
AHM Ferdows Nur ◽  
Utpal Kumar Dutta ◽  
Muhammad Rafiqul Islam ◽  
Debabrota Roy ◽  
...  

Objective: The aim of this study was to evaluate hearing outcome after stapedotomy in patients with Otosclerosis. Methods: This cross sectional study was carried out from July 2017 to January 2019 in National Institute of ENT, Unit V. About 22 patients with Otosclerosis were included in this study. Diagnosis of Otosclerosis was based on the history, medical status with Otoscopy, Tuning fork tests and Audiometric tests. We compiled data on the pre and post operative air-bone gap (ABG) at 0.5, 1, 2 KHZ. The ABG was Calculated using AC and BC thresholds on the same audiogram. Post operative hearing gain was then Calculated from the ABG before the operation minus the ABG of the last follow up examination Results: In this study most of the cases were age group 14-30 years (72.7%), female (54.5%). Most common symptoms was progressive hearing loss, tinnitus (77.8%).The average preoperative hearing loss in this study was (AC) was 48.31±7.68. The average post opt. hearing (AC) at follow up was 28.95±10.30 with an average hearing gain of 15.40±8.53 dB which was significant. The average pre-operative ABG was 28.99 dB ± 8.10. The average post opt. ABG was analyzed at 1 follow up showed ABG 13.18±8.09 dB which was found to be significant. Conclusion: Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patient’s quality of life. A favorable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and appropriate surgical technique. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 31-36


2011 ◽  
pp. 122-129
Author(s):  
Quang Di Bui ◽  
Phuoc Lam Nguyen

Objectives: The aim of study is to evaluate the efficacy, tolerability and adverse effects of a standard triple therapy including Rabeprazole, Clarithromycin and Amoxicilline at Sai gon Hoan My hospital in order to consider treatment H.pylori for patients who have not yet eradicated before or need to be undertaked by alternative regimens. Methods: By descriptive cross-sectional study, the authors have examined 116 patients sufferring from peptic ulcer received 10-day therapy including Rabe (20mg b.d) plus Clari(500mg b.d) plus Amoxi(1g b.d). Eradication is confirmed with endoscopy after 4 weeks from completing of treatment. Results and Discussion: 100% of patients were initially included and noboby was dropped out of the follow-up satges. The mean age was 49 in which 62% was male, 73(62,9%) presented duodenal ulcer, 28(24,1%) gastric ulcer and 15(13%) simultaneous gastric and duodenal ulcers. All patients took medications correctly. Per-protocol and intention to treat eradication rates were both 75%(95% CI=73,4-78,3). Additionally, 62(53,4%) patients had at least one risky factor for peptic ulcer disease, smoking being the most common one 44(37,9%).The adverse effects were reported overall in 67% of the patients, mainly including changed taste, very bitter, tired 49%, trouble sleeping 12% and diarrhea 5%. Conclusion: this ten-day standard triple therapy used in this study is ineffective with high adverse effects.The first line eradication with new regimens should be alternative.


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