scholarly journals The therapeutic efficnecy of ranolazine in comparison with conventional therapy in diabetic individuals with ischemic heart disease; a randomized clinical trial

2019 ◽  
Vol 9 (1) ◽  
pp. 04-04
Author(s):  
Bahram Fariborz Farsad ◽  
Seyed Mostafa Alavi ◽  
Golshid Ghorbanian ◽  
Fanak Fahimi ◽  
Zahra Ghaemmaghami ◽  
...  

Introduction: Patients with diabetes mellitus (DM) have higher risk of coronary artery disease (CAD) and angina than the general population. Objectives: We sought to assess the impact of ranolazine as an antianginal agent to diminish hemoglobin A1c (Hb A1c) level in diabetic individuals under treatment with metformin and gliclazide. Patients and Methods: This study was a randomized parallel-group clinical trial to compare the therapeutic effects of ranolazine versus conventional treatment in patients with concomitant T2DM and stable angina. TERISA (type 2 diabetes mellitus evaluation of ranolazine in subjects with chronic stable angina) was employed to assess the efficiency of ranolazine in lowering the frequency of angina attacks. The study was performed on diabetic patients with symptomatic angina under treatment with either sublingual nitroglycerin or up to two types of antianginal agents. The patients in the intervention group received 1000 mg ranolazine twice a day while patients in the control group were administrated with conventional treatment. Reduction in baseline Hb A1c level was determined at 4 and 8 weeks after the interventions. Results: Ranolazine therapy resulted in up to 15% absolute reduction in Hb A1c level in diabetic patients who had baseline HbA1c level >7%. Ranolazine was more efficient in reducing Hb A1c in patients with poorly controlled disease (i.e. HbA1c>8%, P=0.017). Ranolazine did not affect the glycemic status of patients concomitantly treated with antidiabetic therapy (P=0.560). Conclusion: Concurrent administration of ranolazine along with anti-diabetic treatments (i.e. metformin and gliclazide) was safe to reduce the level of HbA1c in patients with poorly controlled diabetes and stable angina.

2021 ◽  
Vol 94 (3) ◽  
pp. 325-332
Author(s):  
Evelina Lesnic ◽  
Alina Malic ◽  
Ovidiu Tafuni

Background and aims. The Republic of Moldova ranks among the European Region countries with the highest global incidence of tuberculosis. Almost 5% of the cases with pulmonary TB had been diagnosed with DM in 2017. The aim of this study was to assess the impact of diabetes mellitus on the anti-tuberculosis treatment effectiveness for the improvement of the disease outcome. Methods. A retrospective, longitudinal and case-control study, which included a total number of 252 patients diagnosed with pulmonary tuberculosis and distributed into a study group of 93 patients diagnosed with diabetes mellitus and a control group of 159 patients without glycemic disorders was performed. The statistical analysis was performed using EpiInfo software. The statistical analysis of the differences between normally distributed continuous variables was tested with the Student T-test. Results. Based on the collected data we established that the majority of the patients with glycemic disorders were diagnosed with the type 2 diabetes, associated with hyperglycemia and in half of them complications of diabetes were revealed. The age older 55 years and the low economical state were common characteristics of the diabetic patients. Tuberculosis was detected in every second diabetic patient through the radiological screening compared with the passive detection of most of the non-diabetic patients. The anti-tuberculosis treatment outcome was endangered by a higher rate of the adverse drug events in patients with diabetes, which contributed to death in 15%, lost to follow-up 7%, and therapeutic failure in 6%. Conclusions. The anti-tuberculous treatment outcome in patients diagnosed with tuberculosis and diabetes mellitus was significantly diminished by glycemic disorders, history of the previous anti-tuberculous treatment and adverse drug reactions. Individualized therapeutic approach to tuberculosis could improve the treatment effectiveness.


2021 ◽  
Vol 64 (5) ◽  
pp. 16-20
Author(s):  
Alina Malic ◽  
◽  
Evelina Lesnic ◽  

Background: In the Republic of Moldova almost 5% of the cases with tuberculosis are diagnosed annually among diabetic patients. The aim of this study was to assess the impact of diabetes mellitus on the evolution and anti-tuberculosis treatment effectiveness in a prospective study. Material and methods: A prospective, longitudinal and case-control study, which included a total number of 252 patients diagnosed with pulmonary tuberculosis and distributed in a study group, consisting of 93 patients diagnosed with diabetes mellitus and a control group, consisting of 159 patients without glycemic disorders, was performed. Results: This study identified that one half of the group with diabetes was detected by active screening and one third received anti-tuberculous treatment before actual episode. A similar rate of diabetic and non-diabetic patients was microbiologically positive, as well confirmed with drug-resistance. The anti-tuberculous treatment effectiveness was lower in diabetic patients, the death rate and the low treatment outcome (lost to follow-up and failed) were higher than in non-diabetic patients. The main causes of unfavorable evolution were: glycemic disorders (hyperglycemia), diabetes complications and the history of the anti-tuberculous treatment in the anamnesis. Conclusions: The individualized approach and a tight follow-up should be performed regularly in all patients with glycemic disorders and tuberculosis for the improvement of the disease outcome.


Author(s):  
Dulcie Celia A. ◽  
Ezhil Ramya J. ◽  
Sriviruthi B.

Background: To evaluate the impact of type-II diabetes mellitus on cognitive function and to assess the factors associated with impaired function.Methods: This prospective study compared 100 type-II diabetic people attending the diabetic clinic of Tirunelveli Medical College Hospital with another 100 membered control group. The study group was selected randomly between the age group of 45-65 years. A neuro-cognitive assessment was done using Standardized Mini Mental State Examination (SMMSE), which is a simple and reliable screening test. This scale has 12 questions with time limits to assess orientation, memory, calculation, language, attention and construction. Magnitude and severity of cognitive decrement were analysed along with the possible factors affecting it.Results: Mean age of the study population was 54.6±7.24 years. Cognitive impairment was noted among 62 of cases and 48 of the control group, which means a 14% higher prevalence of cognitive impairment among the type 2 diabetics. The association of development of cognitive impairment and duration of diabetes mellitus was significant statistically (p value = 0.025443; p<0.05). Other demographic variables like gender, education and domicile were also seen to affect the results.Conclusions: Mild to moderate cognitive impairment was found significantly higher among the type-II diabetics than the non-diabetics. The cognitive impairment was found to be associated with the duration of diabetes. Hence the routine screening of cognition by SMMSE should be done in all type-II diabetic patients.


2021 ◽  
Vol 35 (2) ◽  
pp. 106-113
Author(s):  
Md Sadaqul Islam Sikdar ◽  
Md Mamunur Rashid ◽  
Md Khalekuzzaman ◽  
Iftekhar Alam ◽  
Mst Nazmun Nahar ◽  
...  

Background: Prevalence of coronary artery disease (CAD) among Bangladeshi population is higher in urban than rural population. Among the conventional risk factors diabetes mellitus is a major concern for Bangladeshi population. Fibrinogen (Fg) in plasma is associated with severity of CAD in some populations with acute coronary syndrome. Objective: The aim of the study was to find out the correlation between circulating fibrinogen level and severity of coronary artery disease in patients with type 2 diabetes mellitus with chronic stable angina (CSA). Methods: The study was carried out in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka from October 2015 to March 2016.Total 132 patients with chronic stable angina (CSA) and type 2 diabetes mellitus who got admitted for coronary angiogram were included in the study and they were divided into 2 groups according to the on admission level of fibrinogen. Coronary angiogram (CAG) was performed in all patients. The severity of the CAD was assessed by angiographic vessel score and Gensini score. Results: Mean Gensini score was 27.0±22.3 vs 22.2±16.4 and mean vessel score 1.6±0.9 vs 1.2±1.0 in group I and group II respectively (p=0.03 and 0.04, respectively). There was positive correlation between Fg and CAD severity in term of vessel score (r=0.19) and Gensini score (r=0.15). Univariate and multivariate analysis revealed that dyslipidemia, smoking and elevated fibrinogen were the independently significant predictors of severe CAD in type 2 diabetic patients with CSA. Conclusion: Elevated plasma fibrinogen positively correlates with the severity of CAD in patients with diabetes mellitus having chronic stable angina. Bangladesh Heart Journal 2020; 35(2) : 106-113


Author(s):  
Shah Namrata Vinubhai ◽  
Pardeep Agarwal ◽  
Bushra Fiza ◽  
Ramkishan Jat

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.


2019 ◽  
Author(s):  
Francisco Jesús Represas Carrera Sr ◽  
Ángel Alfredo Martínez Ques Sr ◽  
Ana Clavería Fontán Sr

BACKGROUND Diabetes mellitus is currently a major public health problem worldwide. It is traditionally approached in a clinical inpatient relationship between the patient and the healthcare professional. However, the rise of new technologies, particularly mobile applications, is revolutionizing the traditional healthcare model through the introduction of telehealthcare. OBJECTIVE (1) To assess the effects of mobile applications for improving healthy lifestyles on the quality of life and metabolic control of diabetes mellitus in adult patients. (2) To describe the characteristics of the mobile applications used, identify the healthy lifestyles they target, and describe any adverse effects their use may have. METHODS Review of systematic reviews and meta-analysis, following the guidelines of the Cochrane Collaboration and the Joanna Briggs Institute. We included studies that used any mobile application aimed at helping patients improve self-management of diabetes mellitus by focusing on healthy lifestyles. Studies needed to include a control group receiving regular care without the use of mobile devices. In May 2018, a search was conducted in Medline, Embase, Cochrane, LILACS, PsychINFO, Cinahl and Science Direct, updated in May 2019. The methodological quality of the studies was assessed using the Amstar-2 tool. RESULTS Seven systematic reviews of 798 articles were initially selected for analysis. The interventions had a duration of between 1 and 12 months. Mobile applications focused singly or simultaneously on different lifestyles aspects (diet, physical exercise, motivation, blood glucose levels, etc.). There are significant changes in HbA1c values, body weight and BMI, although in others, such as lipid profile, quality of life, or blood pressure, there is no clear improvement. CONCLUSIONS There is clear evidence that the use of mobile applications improves glycemic control in diabetic patients in the short term. There is a lack of evidence in its long-term benefits. It is thus necessary to carry out further studies to learn about the long-term effectiveness of mobile applications aimed at promoting the healthy lifestyles of diabetic patients. CLINICALTRIAL PROSPERO Register: CRD42019133685


Molecules ◽  
2021 ◽  
Vol 26 (5) ◽  
pp. 1332
Author(s):  
Gilda M. Iova ◽  
Horia Calniceanu ◽  
Adelina Popa ◽  
Camelia A. Szuhanek ◽  
Olivia Marcu ◽  
...  

Background: There is a growing interest in the correlation between antioxidants and periodontal disease. In this study, we aimed to investigate the effect of oxidative stress and the impact of two antioxidants, curcumin and rutin, respectively, in the etiopathology of experimentally induced periodontitis in diabetic rats. Methods: Fifty Wistar albino rats were randomly divided into five groups and were induced with diabetes mellitus and periodontitis: (1) (CONTROL)—control group, (2) (DPP)—experimentally induced diabetes mellitus and periodontitis, (3) (DPC)—experimentally induced diabetes mellitus and periodontitis treated with curcumin (C), (4) (DPR)—experimentally induced diabetes mellitus and periodontitis treated with rutin (R) and (5) (DPCR)—experimentally induced diabetes mellitus and periodontitis treated with C and R. We evaluated malondialdehyde (MDA) as a biomarker of oxidative stress and reduced glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG and catalase (CAT) as biomarkers of the antioxidant capacity in blood harvested from the animals we tested. The MDA levels and CAT activities were also evaluated in the gingival tissue. Results: The control group effect was statistically significantly different from any other groups, regardless of whether or not the treatment was applied. There was also a significant difference between the untreated group and the three treatment groups for variables MDA, GSH, GSSG, GSH/GSSG and CAT. There was no significant difference in the mean effect for the MDA, GSH, GSSG, GSH/GSSG and CAT variables in the treated groups of rats with curcumin, rutin and the combination of curcumin and rutin. Conclusions: The oral administration of curcumin and rutin, single or combined, could reduce the oxidative stress and enhance the antioxidant status in hyperglycemic periodontitis rats.


2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Freda Lalrohlui ◽  
Souvik Ghatak ◽  
John Zohmingthanga ◽  
Vanlal Hruaii ◽  
Nachimuthu Senthil Kumar

AbstractOver the last few decades, Mizoram has shown an increase in cases of type 2 diabetes mellitus; however, no in-depth scientific records are available to understand the occurrence of the disease. In this study, 500 patients and 500 healthy controls were recruited to understand the possible influence of their dietary and lifestyle habits in relation with type 2 diabetes mellitus. A multivariate analysis using Cox regression was carried out to find the influence of dietary and lifestyle factors, and an unpaired t test was performed to find the difference in the levels of biochemical tests. Out of 500 diabetic patients, 261 (52.3%) were males and 239 (47.7%) were females, and among the control group, 238 (47.7%) were males and 262 (52.3%) were females. Fermented pork fat, Sa-um (odds ratio (OR) 18.98), was observed to be a potential risk factor along with tuibur (OR 0.1243) for both males and females. Creatinine level was found to be differentially regulated between the male and female diabetic patients. This is the first report of fermented pork fat and tobacco (in a water form) to be the risk factors for diabetes. The unique traditional foods like Sa-um and local lifestyle habits like tuibur of the Mizo population may trigger the risk for the prevalence of the disease, and this may serve as a model to study other populations with similar traditional practices.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Arash Mohagheghi ◽  
Asghar Arfaie ◽  
Shahrokh Amiri ◽  
Masoud Nouri ◽  
Salman Abdi ◽  
...  

Introduction and Objective. Despite the effectiveness of electroconvulsive therapy (ECT) in treating major depressive disorder (MDD), its cognitive side effects make it less popular. This study investigated the impact of liothyronine on ECT-induced memory deficit in patients with MDD.Methodology. This is a double-blind clinical trial, in which 60 patients with MDD who were referred for ECT were selected. The diagnosis was based on the criteria of DSM-IV-TR. Patients were divided randomly into two groups to receive either liothyronine (50 mcg every morning) or placebo. After the assessment with Wechsler Memory Scale-Revised (WMS-R) before first session of ECT, posttests were repeated again, two months after the completion of ECT.Findings. By controlling the pretest scores, the mean scores of the experimental group were higher than the control group in delayed recall, verbal memory, visual memory, general memory, and attention/concentration scales (P<0.05).Conclusion. Liothyronine may prevent ECT-induced memory impairment in patients with MDD. This study has been registered in IRCT underIRCT201401122660N2.


2021 ◽  
pp. 004947552098474
Author(s):  
Arjuman Sharmin ◽  
Ali Hossain ◽  
Nazmul Islam ◽  
Zakir H Sarker ◽  
Sheikh S Hossain ◽  
...  

The outcome of lymph node tuberculosis (LNTB) management with conventional anti-tubercular treatment alone is unsatisfactory. We conducted a randomised open-label controlled clinical trial in the Department of Respiratory Medicine in Government Institute of Dhaka, Bangladesh from April 2017 to March 2019. Compared with controls, 54 patients of LNTB received category 1 anti-tubercular treatment with additional prednisolone after randomisation. Complete resolution in 21/54 (75%) and 7 (26.9%), symptomatic improvement in 26 (92.9%) and 22 (84.6%) and complications in 11 (39.28%) and 16 (61.53%) were observed in the treatment and control group, respectively. Thus, we recommend the use of steroids in this setting.


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