Seasonal Variations of Hyperglycemic Crises in Diabetic Patients at a National Hospital Center, Benin: a Cross Sectional Study

2021 ◽  
Vol 5 (6) ◽  
pp. 01-06
Author(s):  
Comlan Jules GNINKOUN ◽  
Finagnon Armand WANVOEGBE ◽  
Joseph Soglo FANOU ◽  
Calice Sèdodé TOFFOHOSSOU ◽  
François DJROLO
Keyword(s):  
Rainy Season ◽  
Meteorological Data ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Adherence To Treatment ◽  
Precipitating Factors ◽  
Cross Sectional ◽  
Seasonal Characteristics ◽  
Significant Difference ◽  
Hyperglycemic Hyperosmolar Syndrome

Aim : To study the seasonal characteristics of hyperglycemic decompensations in the endocrinology department of the CNHU-HKM of Cotonou. Materials and methods :It was a cross-sectional, descriptive, and study of diabetic patients hospitalized from January 1, 2010 to December 31, 2019. Diabetic patients hospitalized for ketosis decompensation and/or hyperglycemic hyperosmolar syndrome were included in this study. The meteorological data used were obtained from the climate observation network of the Direction de la Météorologie Nationale (DMN) du Bénin. We have considered the means of rainfall and temperature per month and per year. Results : A total of 613 patients were included during the study period. The mean age of the patients was 46.77±15.84 years. The frequency of hyperglycemic hyperosmolar syndrome and ketoacidosis was 14.7% and 69.5% respectively. Hyperglycemic crises were more frequent during the rainy season and periods of low temperature. The main precipitating factors were infections and non-adherence to treatment. The main infectious sites involved in hyperglycemic crises were pulmonary (19%), urogenital (21.3%) and malaria (26.8%). The frequency of these different infections was higher during the rainy season with a statistically significant difference (p=0.02) for malaria. Conclusion : The frequency of hyperglycemic crises was high and had a seasonal distribution. The most frequent precipitating factors were infections and non-adherence to treatment. Those factors were more frequent in the rainy season.

Myeloperoxidase as an Important Predictor of Cardiovascular Risk in Individuals with Rheumatoid Arthritis

2021 ◽  
Author(s):  
Elisangela Gueiber Montes ◽  
Fabiana Postiglioni Mansani ◽  
Alceu de Oliveira Toledo Júnior ◽  
Marcelo Derbli Schafranski ◽  
Bruno Queiroz Zardo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Risk ◽  
Cross Sectional Study ◽  
Important Predictor ◽  
Diabetic Patients ◽  
Glucocorticoid Treatment ◽  
Cross Sectional ◽  
Significance Level ◽  
Dose Time ◽  
Significant Difference

Abstract Background: Rheumatoid arthritis is an inflammatory disease with joint manifestations. In the presence of extra-articular manifestations, the morbidity and severity of the disease increases. Glucocorticoid is used as a treatment and may result in side effects related to cardiovascular risk. Methods: This was a cross-sectional study including 59 volunteers with rheumatoid arthritis receiving treatment at a Hospital of Campos Gerais, that aimed to establish the relation between cardiovascular risk, glucocorticoid treatment and myeloperoxidase in these patients. Subjects were divided into two groups: using (n = 39) and without glucocorticoids (n = 20). They underwent clinical evaluation, physical examination and blood samples were taken. Statistical analysis was performed using Student's t-test and Mann-Whitney test. Logistic regression was performed to assess cardiovascular risk. The significance level was 5% (α = 0.05). Calculations were performed using the Statistical Package for the Social Science version 21.0. Results: There has been a significant difference between groups in blood glucose values (p = 0.012), that can be explained by the different percentage of diabetic patients in the groups. When assessed cardiovascular risk using the predictors of glucocorticoid dose, time of glucocorticoid use, myeloperoxidase, and C-reactive protein together, these were responsible for significantly predicting cardiovascular risk (p = 0.015). Conclusions: A significant relation between the predictor myeloperoxidase alone was also demonstrated (p = 0.037), may it be an important predictor of cardiovascular risk among individuals with rheumatoid arthritis.

scholarly journals Comparison of ox-LDL Levels in Diabetic Patients with Normo-, Micro-, and Macroalbuminuria with Their First Degree Relatives and the Healthy Control Group

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Parisa Behzadi ◽  
Firouzeh Torabi ◽  
Massoud Amini ◽  
Ashraf Aminorroaya
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
First Degree Relatives ◽  
Significant Difference ◽  
Healthy Control ◽  
And Control

Oxidized low density lipoprotein (ox-LDL) is a product of oxidative stress. In this cross-sectional study, we compared the ox-LDL concentrations in diabetic patients with normoalbuminuria (n=28), microalbuminuria (n=28), and macroalbuminuria (n=28) with their first degree relatives (n=28) and healthy control people (n=31). They were selected by consecutive patient selection method. The ox-LDL level was assayed using ELISA. We measured blood pressure, lipid profile, fasting plasma glucose (FPG), and HbA1c in all groups. There was no significant difference in ox-LDL concentrations among normoalbuminuric, microalbuminuric, and macroalbuminuric diabetic groups. In diabetic patients with micro- and macroalbuminuria, ox-LDL concentration was higher than their first degree relatives (P=0.04andP=0.03) and control group (P=0.001andP=0.03, resp.). In normoalbuminuric diabetic persons, ox-LDL concentration was just higher than that of healthy people (P=0.02). There was no statistically significant difference in ox-LDL levels between normoalbuminuric diabetic patients and their first degree relatives. In conclusion, the presence and progression of albuminuria in diabetic patients are not related to ox-LDL concentration and genetic predisposition influences the plasma OX-LDL level. Larger sample size is needed to confirm this conclusion in future studies.

scholarly journals COVID-19 Severity and Comorbidities in Diabetic Patients

2021 ◽  
Vol 10 (3) ◽  
pp. 91-98
Author(s):  
Hamid Reza Samimagham ◽  
Mehdi Hassani Azad ◽  
Mohsen Arabi ◽  
Dariush Hooshyar ◽  
Abbas Sheikhtaheri ◽  
...  
Keyword(s):  
Disease Severity ◽  
Demographic Factors ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Severity Of Disease ◽  
Significant Difference ◽  
Laboratory Results ◽  
Patients With Diabetes ◽  
Severe Group

Background: This study aimed to investigate the demographic factors, comorbidities, and laboratory results of diabetic patients with coronavirus disease 2019 (COVID-19) severity. Materials and Methods: This cross-sectional study enrolled 171 diabetic patients with COVID-19 admitted based on chest CT scan findings to the COVID-19 ward of Shahid Mohammadi Hospital in Hormozgan, Iran from 1 March to 1 June, 2020. Reverse-transcriptase polymerase chain reaction (RT-PCR) test was performed, and the patients were divided into three groups (mild, moderate, and severe) based on the severity of disease. Then we investigated the demographic factors, comorbidities, and laboratory results of diabetic patients with severe COVID-19 severity. Results: Regarding comorbidities, there was no significant difference between the three groups. Moreover, there was a significantly lower lymphocyte count in the severe group compared to moderate and mild groups (P = 0.001). We showed the increase in blood urea nitrogen (BUN) and creatinine to be significantly associated with increased disease severity (P = 0.001 and P = 0.009, respectively). We also showed a significant difference in aspartate aminotransferase (AST) levels between different groups of patients (P = 0.002) with a higher level of AST in the severe group (P = 0.020). Lactate dehydrogenase (LDH) and troponin were also significantly associated with an increase in COVID-19 severity in patients with diabetes (P = 0.013 and P = 0.002, respectively). Conclusion: There was a significant association between disease severity and BUN, creatinine, AST, LDH, and troponin levels in diabetic patients with COVID-19. There was no significant association between different groups regarding severity of disease and comorbidities.

Multiple sclerosis patients and e-health system in Saudi Arabia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Foziah Alshamrani ◽  
Hind Alnajashi
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Adherence ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Adherence To Treatment ◽  
Related Factors ◽  
Cross Sectional ◽  
Content Type ◽  
Significant Difference ◽  
Multiple Sclerosis Patients

Purpose Multiple sclerosis (MS) is a chronic autoimmune neurological disease. Disease-modifying therapies (DMTs) are mainstay lifelong treatment with no immediate benefits observed. Adherence to treatment is necessary, however, non-adherence is common problem in MS patients. This paper aims to evaluate patient-related factors and satisfactions affecting medication adherence in Saudi MS patients and their rights to discontinue them against medical advice. Design/methodology/approach In total, 409 patients diagnosed with MS, using self-administered DMT (oral and injectable), were randomly enrolled in a cross-sectional study. Electronic questionnaire was used in data collection. Findings Most participants (71.1%) did not know about their MS type. Average age of participants when diagnosed with MS was 27.9 ± 8 years (range 7–69), mean disease duration was 8.1 ± 6.6. Most patients received injectable therapy 363 (88%). Overall adherence in our sample was 67%. Age of participants and duration of disease had no impact on treatment adherence. No significant differences found between genders, educational level, marital status, and smoking in relation to treatment adherence. Route of administration did not reach statistical significance despite a higher percentage of adherence reported in patients on oral DMT [33% (n = 15)] versus injectable therapy [29% (n = 104)]. Conversely, there was significant difference between adherent and non-adherent patients according to anxiety (p = 0.002) and family history of MS (p = 0.011). Originality/value The results revealed that the age of the participants and the duration of the disease had no impact on adherence to treatment.

Elderly Diabetic Patients: Depression and Adherence to Treatment

2017 ◽  
Vol 41 (S1) ◽  
pp. S657-S658
Author(s):  
R. Mendes ◽  
S. Martins ◽  
L. Fernandes
Keyword(s):  
Statistical Significance ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Depression Score ◽  
Anxiety And Depression ◽  
Diabetic Patients ◽  
Adherence To Treatment ◽  
Cross Sectional ◽  
Worldwide Population ◽  
Competing Interest

IntroductionDemographic changes with the aging of the worldwide population imply an increase in prevalence of chronic diseases, such as diabetes mellitus. Many studies have suggested that depression is higher in diabetic patients, and that this association often contributes to under-recognition of the illness, limiting adequate metabolic control.AimsTo study the association between depression and adherence to treatment in elderly diabetic patients.MethodsA cross-sectional study was conducted with elderly outpatients (≥65 years) from the Internal Medicine Department in São João Hospital (CHSJ, Porto). Patients unable to communicate were excluded. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale/HADS, and adherence to treatment with a clinical interview and from medical records.ResultsThe final sample included 78 patients, with an average of 75.3 (sd = 6.75) years. They were mostly female (80%), married (66.7%) and with low education level (62.8%). The mean number of comorbidities was 5.76 (sd = 1.6) and 98.7% took ≥5 drugs. In this sample, 23.1% had cognitive impairment, 16.7% depression and 24.4% anxiety. Patients not adhering to treatment presented a higher depression score, when compared with adherents (median 6vs3), even without statistical significance (P = 0.56).ConclusionsDiabetic patients not adhering to treatment tend to present more depression, in spite of the lack of statistical significance. These results suggest that depression can limit the adherence to treatment, which is in line with previous studies. In this context, the early diagnosis and treatment of depression seems to be an important target in the management of diabetes, particularly in elderly patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Triggering Factors for Breakthrough Seizures among Epileptic Patients. Cross Sectional Study in Epileptic Patients Attending Epilepsy Clinic Mansoura University Hospital, Egypt

2019 ◽  
pp. 1-10
Author(s):  
Mohammed Gomaa ◽  
Ahmed Esmael ◽  
Mohammed Saad
Keyword(s):  
Cross Sectional Study ◽  
Idiopathic Epilepsy ◽  
Sectional Study ◽  
Precipitating Factors ◽  
Cross Sectional ◽  
Epileptiform Discharges ◽  
Significant Difference ◽  
Epileptic Patients ◽  
Group 2 ◽  
Group 1

Background: The prevalence of breakthrough seizures in persons with epilepsy is very high in developing countries. Consequently, patients and physicians should be aware of the possible factors that may cause breakthrough seizures. Objective: The aim of our study is to determine the possible factors that may be a precipitating cause for breakthrough seizures in patients with epilepsy. Methods: This cross-sectional study included 100 persons with epilepsy with idiopathic epilepsy receiving antiepileptic drugs (AEDs). They were divided into two groups. Group 1 included 50 persons with epilepsy with a history of recent breakthrough seizures. Group 2 included 50 persons with epilepsy who had not experienced any recent breakthrough seizures. Patients were subjected to a thorough questionnaire addressing precipitating factors. All participants were subjected to an electroencephalogram (EEG) and the Morisky Medication Adherence Scale (MMAS). Results: There was no significant differences between group 1 and group 2 regarding age, sex, age of onset of epilepsy, occupation and marital status (P value range 0.5 – 0.2). The patients in group 1 were found to have longer durations of epilepsy, lower adherence to AEDs (P = 0.001), more missed doses of AEDs (P = 0.0001), more side effects of AEDs (P = 0.0005), more sleep deprivation, lower level of AEDs (P = 0.0006), more frequently on AED polytherapy (P = 0.0002), and more flickering lights (P = 0.04) than the participants in group 2. In terms of the EEG, group 1 showed a higher percentage of abnormal EEGs and more frequent focal epileptiform discharges (P = 0.003). Also, pathological findings in MRI brain were associated with higher breakthrough seizures (P = 0.005). No significant difference was found in both group1 and group 2 regarding emotional stress (P = 0.55), substitution of brand AEDs by generic one (P = 0.83), concurrent illness (P = 1), or the use of non AEDs (P = 0.79). Conclusion: The precipitating factors of breakthrough seizures are multifactorial and it is very important to educate patients about these precipitating factors to achieve better control of epilepsy.

scholarly journals Retinal Changes in Patients with Angina Pectoris and Anginal Equivalents: A Study of Patients with Normal Coronary Angiography

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Vahid Eslami ◽  
Simin Mojahedin ◽  
Ramin Nourinia ◽  
Mohammadreza Tabary ◽  
Isa Khaheshi
Keyword(s):  
Chest Pain ◽  
Angina Pectoris ◽  
Cross Sectional Study ◽  
Foveal Avascular Zone ◽  
Vascular Density ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Microvascular Changes ◽  
Significant Difference ◽  
Normal Coronary Angiography

AbstractBackground and aims: Approximately 10-30% of the patients with typical symptoms of angina pectoris have normal angiography showing normal macrovasculature. In these patients, however, the microvascular problems should be monitored. Hence, the main aim of this study is to evaluate retinal changes in normal angiographic patients.Methods: In this descriptive cross-sectional study, 60 normal angiographic patients with typical chest pain or anginal equivalents visiting Modarres Hospital Cardiology Research Center between 2018 and 2019 were enrolled and retinal changes were determined in Labbafinejad Hospital by Optical Coherence Tomography Angiography using Foveal Avascular Zone (FAZ), Superficial Vascular Density (SVD), and Deep Vascular Density (DVD).Results: The results of this study demonstrated that FAZ was normal in all subjects, but SVD and DVD were abnormal in 45% and 8.3%, respectively. Totally, 18.5% and 66.7% showed abnormal SVD among stable angina (SA) and unstable angina (UA) cases, respectively (P < 0.001). There was no statistically significant difference between abnormal DVD in SA and UA cases (P=0.058). Abnormal SVD was significantly more common among diabetic patients (P < 0.001), while DVD was not related to diabetes presence in the study population (P > 0.05). Moreover, abnormal SVD was more common among patients with chest pain (P=0.036), while there was no significant difference for DVD (P=0.371). Interestingly, abnormal ECG was associated with both abnormal DVD and SVD.Conclusions: The results of this study showed that nearly half of the patients with angina pectoris or anginal equivalents who revealed normal angiographic findings may suffer from retinal changes. Thus, retinal assessment is needed in these patients to evaluate microvascular changes.

Anaemia Management in Patients on Peritoneal Dialysis in Portugal: A Nationwide Multicenter Survey.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3753-3753
Author(s):  
Patrícia Q. Branco ◽  
Cristina P. Abreu ◽  
Pedro Pessegueiro ◽  
Manuel Amoedo ◽  
Anabela Rodrigues ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Best Practice ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Best Practice Guidelines ◽  
Multicenter Survey ◽  
Significant Difference ◽  
Anaemia Management ◽  
The Impact

Abstract Introduction: The European Best Practice Guidelines for the Anaemia Management (EBPG) recently published emerged as an international standard in the management of anemia in chronic kidney disease (CKD) patients. Objectives: To evaluate the impact of theses guidelines in the clinical practice in Portugal. Methods: This epidemiological, multicentric and cross-sectional study included patients on peritoneal dialysis that were under erythropoietin treatment in Portugal during 2004. Etiology of CKD, prevalence and anaemia treatment, comorbidity and side effects were evaluated. Results: 220 patients from 5 Units were evaluated. Mean haemoglobin was 12.34 g/dL and only 13,2% of patients had haemoglobin <11 g/dL. Ninety-nine percent of patients were treated with erythropoietin: 65% with beta erythropoietin (beta) and 35% with darbepoetin alfa (darbe). Subcutaneous route had been used in all cases: 5,4% with once-monthly administration (darbe), 19,55 % two times monthly (darbe and beta), 59% with once a week regimen (darbe and beta), 11,55% in two weekly doses (beta) and 4,5% in three weekly administrations (beta). Doses requirements were different according to administration frequency. More than 85% of patients had haemoglobin > 11 g/dl and no significant difference in haemoglobin levels was achieved in the two groups (beta and darbe). Erythropoietin doses were greater in the group treated with darbe (127 versus 113 UI/kg/week), but inflammation markers were significantly higher as well diabetic patients in this group. Conclusion: These results suggest that, according to the EBPG’s, mostly patients on PD in Portugal are already being well treated presenting heamoglobin levels in the therapeutic range.

Recommendation of Aspirin-Guide App and Physicians Clinical Decision of Aspirin Use to Prevent CVD Among Diabetic Patients, Is there any Differences?

2020 ◽  
pp. 107424842095897
Author(s):  
Mohammed Ali Batais ◽  
Khalid M. Almutairi ◽  
Turky H. Almigbal ◽  
Abdulaziz Alodhayani ◽  
Wadi B. Alonazi ◽  
...  
Keyword(s):  
Clinical Decision ◽  
Cross Sectional Study ◽  
Aspirin Therapy ◽  
Mobile App ◽  
University Hospital ◽  
Diabetic Patients ◽  
Patient Acceptability ◽  
Cross Sectional ◽  
Significant Difference

Objective: This study aims to identify the prevalence of aspirin use among type 2 diabetic (T2DM) patients and assess the concordance in aspirin use among these patients as prescribed by physicians and as recommended by the Aspirin-Guide app. Methods: A total of 301 T2DM patients from King Khalid University Hospital in Riyadh, Saudi Arabia participated in this cross-sectional study. Patient’s electronic medical records through eSihi system were reviewed and all data included in the free online and mobile app called Aspirin-Guide were collected in a specially designed data checklist. Result: The prevalence of aspirin use was more common in patients who were in the age group of 51 to 59 and male participants’ with T2DM. Males were nearly twice more likely to use aspirin compared to females (p = 0.001). Based on recommendations from the Aspirin-Guide app, 26% of the patients who were on aspirin (N = 51) were not eligible for aspirin therapy, while 37.7% (N = 40) of the patients eligible for aspirin therapy had not been put on aspirin by their physicians (p = 0.039). Male sex (P = 0.003), use of statins (P = 0.001), and being advised to use aspirin (P = 0.041), were significantly associated with aspirin use in T2DM patients. Conclusion: There was a significant difference in the proportion of patients currently on aspirin as prescribed by their physicians and those eligible for aspirin therapy as per the Aspirin-Guide app. The use of an app to uniformized aspirin use among eligible patients should be based on up-to-date guidelines and account for patient acceptability and willingness to commence treatment.

scholarly journals The Correlation between Hemoglobin A1c (HbA1c) and Hyperreflective Dots (HRD) in Diabetic Patients

2020 ◽  
Vol 17 (9) ◽  
pp. 3154
Author(s):  
Bing Seng Wong ◽  
Sharanjeet Sharanjeet-Kaur ◽  
Nor Fariza Ngah ◽  
Rajan Rajasudha Sawri
Keyword(s):  
Hemoglobin A1c ◽  
Normal Subjects ◽  
Cross Sectional Study ◽  
Microglial Cells ◽  
Receiver Operating Curve ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean ◽  
Hba1c Levels

Hyperreflective dots (HRD) are activated retinal microglial cells induced by retinal inflammation in diabetic patients. This study was conducted to compare the HRD count of normal and diabetic subjects; to determine the correlation between hemoglobin A1c (HbA1c) levels and HRD count; to determine HbA1c cut-off levels for the appearance of HRD in diabetic patients. A cross-sectional study was conducted among normal and diabetic patients. Fundus photos, SD-OCT images and HbA1c levels were taken. A total of 25 normal subjects, 32 diabetics without retinopathy and 26 mild-to-moderate nonproliferative diabetic retinopathy (NPDR) diabetics were recruited. There was a statistically significant difference between the mean count of HRD among the normal group, the diabetic without retinopathy group and the mild-to-moderate NPRD group. The mean HRD count in the inner retina layer was significantly higher compared to the outer retina layer. There was a significant linear relationship between the HbA1c levels and HRD count. Using the receiver operating curve, the HbA1c level of 5.4% was chosen as the cut-off point for the appearance of HRD. The positive linear correlation between the HbA1c levels and the appearance of HRD may indicate that hyperglycemia could activate retina microglial cells in diabetic patients.

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