scholarly journals Metformin significantly lowers the mortality rate in diabetic COVID-19 patients

2021 ◽  
Author(s):  
Ramazan Korkusuz ◽  
Faruk Karandere ◽  
Fatih Okay ◽  
Hakan Koçoğlu
Keyword(s):  
Mortality Rate ◽  
Laboratory Tests ◽  
Viral Infections ◽  
Demographic Data ◽  
Diabetic Patients ◽  
Metformin Treatment ◽  
Advanced Stage ◽  
Protective Effects ◽  
Hospital Records ◽  
Significant Difference

Abstract Introduction: This study evaluates the effect of glycemic control and anti-diabetic agents on the prognosis of diabetic COVID-19 patients. Method: The study includes diabetic patients who were treated and followed up in our hospital because of COVID-19 between 1 June 2020 and 1 January 2021. Patients with any additional comorbidity were excluded from the study. The demographic data of the patients, physical examination findings, laboratory tests, and radiological examination results were obtained retrospectively from the hospital records system.Results: A total of 207 diabetic patients consisted of 125 (60.4%) males and 82 (39.6%) females were included to this study. The mortality rate in cases using metformin was found to be statistically significantly lower than in cases using other drugs (p=0.016; p<0.05). No statistically significant difference was found between the HbA1c and glucose measurements of the cases according to mortality (p>0.05).Discussion: Metformin treatment in diabetic patients diagnosed with COVID-19 should not be stopped, other than in cases with severely hypoxic advanced stage chronic renal failure. Metformin can be recommended as a preventative drug to increase survival in diabetic patients with COVID-19. Nevertheless, there is a need for more evidence and more extensive studies to investigate the protective effects of metformin in COVID-19 patients and in similar viral infections.

scholarly journals Fasting Hyperglycemia Increases In-Hospital Mortality Risk in Nondiabetic Female Patients with Acute Myocardial Infarction: A Retrospective Study

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Guojing Luo ◽  
Hong Liu ◽  
Shunkui Luo ◽  
Fang Li ◽  
Minhong Su ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Plasma Glucose ◽  
Independent Predictor ◽  
Diabetic Patients ◽  
Female Patients ◽  
Significant Difference

Previous studies had shown that elevated admission plasma glucose (APG) could increase mortality rate and serious complications of acute myocardial infarction (AMI), but whether fasting plasma glucose (FPG) had the same role remains controversial. In this retrospective study, 253 cases of AMI patients were divided into diabetic (n=87) and nondiabetic group (n=166). Our results showed that: compared with the nondiabetic patients, diabetic patients had higher APG, FPG, higher plasma triglyceride, higher rates of painless AMI (P<0.01), non-ST-segment elevation myocardial infarction (NSTEMI), and reinfraction (P<0.05). They also had lower high density lipoprotein cholesterol and rate of malignant arrhythmia, but in-hospital mortality rate did not differ significantly (P>0.05). While nondiabetic patients were subgrouped in terms of APG and FPG (cut points were 11.1 mmol/L and 7.0 mmol/L, resp.), the mortality rate had significant difference (P<0.01), whereas glucose level lost significance in diabetic group. Multivariate logistic regression analysis showed that FPG (OR: 2.014; 95% confidence interval: 1.296–3.131;p<0.01) but not APG was independent predictor of in-hospital mortality for nondiabetic patients. These results indicate that FPG can be an independent predictor for mortality in nondiabetic female patients with AMI.

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.

scholarly journals Effectiveness of Structured Teaching Programme on knowledge regarding diabetic complications among diabetes patients

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 143-147
Author(s):  
Muthulakshmi C ◽  
Joel Manoj S
Keyword(s):  
Diabetic Complications ◽  
Demographic Data ◽  
Diabetic Patients ◽  
Chronic Infections ◽  
Teaching Programme ◽  
Significant Difference ◽  
Structured Teaching ◽  
Post Test ◽  
Level Of Knowledge ◽  
Diabetes Patients

Uncontrolled diabetes over time leads to microvascular and macrovascular complications. Diabetes leads to a major impact on heart, eyes, kidneys, blood vessels and nerves. Diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, cardiovascular complications such as CAD, heart attack, stroke, chronic infections, skin problems, opportunistic systemic alterations cause lifetime disability as well as even death. Hence, the present study aimed at to assess the effectiveness of Structured Teaching Programme on knowledge regarding diabetic complications among diabetes patients at Saveetha Medical College and Hospital, Chennai. A quantitative quasi-experimental research design with one group pretest and post-test was obtained. Purposive sampling technique was followed among 60 diabetic patients and data were collected by using structured questionnaires. Pretest demographic data and knowledge were assessed, and then STP was implemented regarding diabetes complications. Posttest knowledge were assessed after 1 week and analyzed by using descriptive and inferential statistics. The study revealed that pretest mean score of knowledge was 11.62 + 4.60 whereas in the post-test mean score was 26.88 + 2.98. The mean difference is 15.27. The calculated paired 't' value of t = 30.0824 was found to statistically significant at p<0.0001 level. This clearly shows that the STP imparted to patients with diabetes mellitus had significant improvement in the post-test level of knowledge regarding diabetic complications. The studies concluded that there is a significant difference between the pre-test and posttest level of knowledge. Hence, the Structured Teaching Programme implemented in this study is effective to develop knowledge regarding diabetic complications among diabetic patients.

scholarly journals 174 SARS-Cov-2 Increases The 30-Day Mortality in Hip Fracture Patients. A UK District Hospital’s Experience

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
U Oduoza ◽  
G Mamarelis ◽  
R Chekuri ◽  
R Estfan ◽  
A Greer
Keyword(s):  
Hip Fracture ◽  
Mortality Rate ◽  
Demographic Data ◽  
University Hospital ◽  
Neck Of Femur ◽  
Exact Test ◽  
Fisher's Exact Test ◽  
Significant Difference ◽  
Fisher’S Exact Test ◽  
Mortality Ratio

Abstract Introduction Coronavirus disease 2019 (COVID-19) is a worldwide pandemic with a case mortality ratio of approximately 6.4%. Hip fracture patients are vulnerable if contracting COVID-19. Evidence is lacking regarding the mortality rate of hip fracture patients admitted during the COVID-19 pandemic. Method Retrospective review of all patients admitted to Southend University Hospital from March – April 2020. Demographic data (age, BMI, gender, co-morbidities) along with diagnosis of COVID-19 (clinical + (radiology +/- microbiology positive) and operative characteristics (time to operation, length of stay, ASA grading, Nottingham Hip Fracture Score), blood tests. Primary outcome was 30-day mortality rate in COVID-19 positive/negative patients who had hip fracture. Results 41 patients were included in the study of which 37 had a COVID-19 swab. Overall mortality in the group was 22%. Eleven patients tested positive for COVID-19. There was a statistically significant difference in mortality between those testing positive compared to those testing negative (54.5% versus 7,69% respectively, Fisher’s exact test, p = 0.004) and when comparing those who had an operation and tested positive for COVID-19 against those who had an operation and tested negative (37.5% versus 4,34% respectively, Fisher’s exact test, p = 0.043). Conclusions COVID-19 increases the 30-day mortality in neck of femur fracture patients.

scholarly journals Assessment of The Relationship of REMS and MEWS Scores with Prognosis in Patients Diagnosed with Covid-19 Admitted to the Emergency Department

2021 ◽  
Author(s):  
Behlul Bas ◽  
Mucahit Senturk ◽  
Tugce Nur Burnaz ◽  
Kubilay Timur ◽  
Asim Kalkan
Keyword(s):  
Emergency Department ◽  
Mortality Rate ◽  
Clinical Outcomes ◽  
Demographic Data ◽  
Scoring Systems ◽  
Roc Curves ◽  
Practical Method ◽  
Significant Difference ◽  
Discharged Patients ◽  
Global Increase

ABSTRACTAimWith the rapid and global increase in COVID-19 cases, it is becoming important to identify patients with a risk of mortality and patients that need hospitalization. The aim of this study is to try to predict the mortality rate of COVID patients admitted to the emergency department with rapid scoring systems such as REMS and MEWS and their clinical termination in the emergency department at the end of the first month.MethodWe have designed this study to be a single-centered, prospective and an observational study. A total of 392 patients diagnosed with COVID-19, who were admitted to the emergency department in a 1-month period, were included in the study. REMS and MEWS scores were calculated for each case. Demographic data of patients, clinical outcomes such as discharge, service hospitalization, ICU hospitalization, and first-month mortality were analysed based on these scores. ROC curves were analysed to determine the cut-off value with the help of which REMS and MEWS scores can predict 1-month mortality and hospitalization.ResultsOut of the 392 patients included in the study, the 43.4% (n=170) were female and 56.6% (n=222) were male. The average age of our patients was 48.98±19.49 years. The 1-month mortality rate of our patients was 4.3% (n=17). At the end of the first month, the mortality of patients with a comorbid disease was higher than those who did not (p<0.01). The average of the REMS score was higher in patients with an average mortality of (7.24±3.77) than in patients without it (2.87±3.09), and there was a statistically significant difference between them (p<0.01). Similarly, the average of the MEWS score was higher in patients with an average mortality of (2.76±1.86) than in patients without it (1.65±1.35), and there was a statistically significant difference (p<0.01). The REMS score of patients admitted to the service was higher than that of patients discharged (p<0.01). When the REMS score was determined as 3 cut-off value in ROC analysis, service hospitalization was 5 times higher in patients with a REMS score of 3 and above than in those who were discharged (OR: 1:5.022 95% CI: 3.088-8.168)). REMS and MEWS scores were also higher in ICU patients than in discharged patients (p<0.01).ConclusionIn predicting the 1-month mortality of ER patients diagnosed with COVID-19, REMS and MEWS scoring systems can be useful and guiding in determining the patients who need hospitalization for emergency physicians. The use of these scoring systems in emergency departments can help predict the clinical outcomes of patients at the time of the initial evaluation, and can also be a practical method of predicting the prognosis of the patients.

scholarly journals Respiratory Failure in Pneumonia with Diabetic Ketoacidosis (DKA)

2018 ◽  
Vol 38 (1) ◽  
pp. 57-63
Author(s):  
Novita Maulidiyah ◽  
Sri Indah Indriani ◽  
Prasenohadi Prasenohadi ◽  
Menaldi Rasmin
Keyword(s):  
Respiratory Failure ◽  
Mortality Rate ◽  
Viral Infections ◽  
Nasal Carriage ◽  
Sputum Smear ◽  
Diabetic Patients ◽  
Carriage Rate ◽  
Increased Risk ◽  
Staphylococcal Pneumonia ◽  
Tract Infections

The annual incidence rate of KAD is estimated to be between 4.6 and 8 per 1000 patients with diabetes. Based on the results of the physical examination, the patient was diagnosed as pneumonia with KAD. The mortality rate for community pneumonia on outpatients was 2%, inpatients was 5-20%, more so in patients in intensive care that was more than 50%. The problem in the patient is pneumonia. Resulting in pulmonary dysfunction which causes overload. Infections that can increase morbidity and mortality may be associated with Streptococcus infection (group B, S, pneumonia), Legionella and viral infections (influenza). The most common infections are pneumonia and urinary tract infections which account for between 30% and 50% of cases. Therefore, the choice of empiric antimicrobial therapy in diabetic patients with evidence of staphylococcal pneumonia (consistent with sputum smear results or associated soft tissue infection) should be guided by the prevalence of MRSA in the associated institutions. Respiratory failure is a complication of KAD and increases the mortality rate. and morbidity. Based on the high nasal carriage rate, there is an increased risk of staphylococcal pneumonia infection in diabetic patients. Community pneumonia is acute inflammation due to infection of the lung parenchyma acquired in the community. (J Respir Indo 2018; 38(1): 57-63)

scholarly journals Diabetic Patients with Comorbidities had Worse Outcomes When Suffered with COVID-19 and Acarbose might have Protective Effects

2020 ◽  
Author(s):  
Weihua Hu ◽  
Shunkui Luo ◽  
Zhanjin Lu ◽  
Chang Li ◽  
Qijian Chen ◽  
...  
Keyword(s):  
Cox Regression ◽  
Survival Curve ◽  
Hubei Province ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Diabetes Group ◽  
Risk Of Death ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
Diabetes Patients

Abstract Background: Previous studies showed that diabetes was a common comorbidity of COVID-19, but the effects of diabetes or anti-diabetic drugs on the mortality of COVID-19 have not been well described. To investigate the outcome of different status (with or without comorbidity) and anti-diabetic medication before admission of diabetic patients after SARS-CoV-2 infected, we collected clinical data of COVID-19 patients from Hubei Province and compared between diabetes and non-diabetes.Methods: In this multicenter and retrospective study, we enrolled 1,422 cases of consecutive hospitalized patients from January 21, 2020 to March 25, 2020 at six hospitals in Hubei Province, China. The primary endpoint was in-hospital mortality.Results: Diabetes patients were 10-years older than non-diabetes (p<0.001), had higher prevalence of comorbidities such as hypertension (p<0.001), coronary heart disease (p<0.001), cerebrovascular disease (CVD) (p<0.001), chronic kidney disease (CKD) (p=0.007). The incidence of mortality (p=0.003) were more prevalent among the diabetes group. Further analysis revealed that diabetes patients who took alpha-glucosidase inhibitor (AGI) had lower mortality rate(p<0.01). Multivariable Cox regression showed that male sex, hypertension, CKD, CVD, age were risk factors for the mortality of COVID-19. Survival curve revealed that, compared with diabetes only group, the mortality was increased in diabetes with comorbidities (p=0.009), but had no significant difference in the non-comorbidity group, p=0.59).Conclusions: Patients with diabetes had worse outcome when suffered with COVID-19, however, it was not associated with diabetes itself but the comorbidities. Furthermore, the administration of AGI could reduce the risk of death in patients with diabetes.

Left Ventricular Dysfunction and Blood Glycohemoglobin Levels in Young Diabetics

1991 ◽  
Vol 30 (05) ◽  
pp. 183-188
Author(s):  
A. Aydrner ◽  
A. Oto ◽  
E. Oram ◽  
O. Gedik ◽  
C. F. Bekdik ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Filling Fraction ◽  
Time To Peak ◽  
Significant Difference ◽  
The Mean ◽  
Hba1c Levels

Left ventricular function including regional wall motion (RWM) was evaluated by 99mTc first-pass and equilibrium gated blood pool ventriculography and glycohemoglobin (HbA1c) blood levels determined by a quantitative column technique in 25 young patients with insulin-dependent diabetes mellitus without clinical evidence of heart disease, and in healthy controls matched for age and sex. Phase analysis revealed abnormal RWM in 19 of 21 diabetic patients. The mean left ventricular global ejection fraction, the mean regional ejection fraction and the mean 1/3 filling fraction were lower and the time to peak ejection, the time to peak filling and the time to peak ejection /cardiac cycle were longer in diabetics than in controls. We found high HbA1c levels in all diabetics. There was no significant difference between patients with and without retinopathy and with and without peripheral neuropathy in terms of left ventricular function and HbA1c levels.

Parent’s Experiences from the Treatment of their Children at the Physic Children’s Surgery Clinic in Skopje.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
M. Trajchevska ◽  
A. Lleshi ◽  
S. Gjoshev ◽  
A. Trajchevski
Keyword(s):  
Health Care ◽  
Health Status ◽  
Independent Predictor ◽  
Demographic Data ◽  
Parental Satisfaction ◽  
Pediatric Care ◽  
Simple Random Sample ◽  
Significant Independent Predictor ◽  
Cross Sectional ◽  
Significant Difference

Background: The respect of the needs and wishes of the patients is in the focus of the human health system. The experience of the parents in terms of child’s health care may be used as an indicator of quality of the health care. Material and methods: The research is a quantitative analytical cross-sectional study. In accordance with the inclusion and exclusion criteria, simple random sample of 207 parents / guardians is covered, whose children in the period of three months, had been hospitalized in the hospital department JZUU Pediatric Surgery Clinic in Skopje.It was used a two parted questionnaire. The first part is a standardized questionnaire (Parent Experience of Pediatric Care - PECP), and the second part concerns the general socio-demographic data of the parent/guardian. Statistical evaluation was performed using appropriate statistical programs (Statistics for Windows 7,0 and SPSS 17.0). Results: In accordance with the age of the parents, the survey respondents were divided into two groups: a) age ≤ 33 years - 107 (51.69%) and b) age> 33 years - 100 (48.31%).Significant independent predictor of parental satisfaction from the receipt of their child to the clinic research confirms the age of the parent under / over 33 years due to 4.1% of the change in satisfaction (R2 = 0,041). Parents generally believe that their children's room of the clinic is "good", without significant difference between parental satisfaction from both age groups (Mann-Whitney U Test Z = -0,9613 p = 0,3364). Significant independent predictor of parental satisfaction from the room of their child improves the health status after treatment due to 6% of the change in satisfaction (R2 = 0,060). Parents generally believe that testing and treatment of their children in the clinic was "very good" and an independent significant predictor is to improve the health status after the treatment - 7,8% (R2 = 0,078). Conclusions: Regardless of the generally good parental satisfaction about health care for their children, it is necessary to continuously monitor the status of the clinic in order to consider the possible deficiencies and needs of intervention.

Treatment of ebola and other infectious diseases: melatonin “goes viral”

2020 ◽  
Vol 3 (1) ◽  
pp. 43-57 ◽  
Author(s):  
Russel J Reiter ◽  
Qiang Ma ◽  
Ramaswamy Sharma
Keyword(s):  
Mortality Rate ◽  
Infectious Diseases ◽  
Hemorrhagic Shock ◽  
Safety Profile ◽  
Ebola Virus ◽  
Viral Infections ◽  
Virus Disease ◽  
Attractive Potential ◽  
Potential Treatment

This review summarizes published reports on the utility of melatonin as a treatment for virus-mediated diseases. Of special note are the data related to the role of melatonin in influencing Ebola virus disease. This infection and deadly condition has no effective treatment and the published works documenting the ability of melatonin to attenuate the severity of viral infections generally and Ebola infection specifically are considered. The capacity of melatonin to prevent one of the major complications of an Ebola infection, i.e., the hemorrhagic shock syndrome, which often contributes to the high mortality rate, is noteworthy. Considering the high safety profile of melatonin, the fact that it is easily produced, inexpensive and can be self-administered makes it an attractive potential treatment for Ebola virus pathology.  

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