scholarly journals EVALUATION OF CLINICAL AWARENESS OF DIABETIC MELLITUS AMONG RAKMHSU MEDICAL STUDENTS- A QUESTIONNAIRE SURVEY

2022 ◽  
Vol 5 (12) ◽  
Author(s):  
Samiha Anjum Hossain ◽  
Reshme Rafi ◽  
Batul Abdeali Saherawala ◽  
B K Manjunatha Goud ◽  
Joan Bryant Kumar
Keyword(s):  
Medical Students ◽  
Questionnaire Survey ◽  
Good Knowledge ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
General Physician ◽  
Rapid Phase ◽  
Validated Questionnaire ◽  
Number Of Patients ◽  
Clinical Awareness

Introduction: The number of patients with diabetes are increasing in rapid phase and the present medical students will encounter with such patients in the future very often. It was essential to understand and update their knowledge through education and awareness programs. Materials and methods: The cross-sectional questionnaire survey has been conducted in RAK Medical and Health Sciences University (RAKMHSU) with due approval from research ethics committee. After going through various indexed articles related to our topic, a pre designed pre validated questionnaire was prepared. The questionnaire assessed the knowledge about symptoms, investigations, treatment and complications. This was applied after validation to second, third, fourth and fifth year medical students. Results: The study showed the majority in both groups 93.5% and 89.2% agreed that they will be involved in taking care of diabetic patients in their future practice. The study also found that 65.2% group A agreed that excessive thirst and urination is a indicative of low blood sugar when compared with 31.7% from group B. With regard to symptoms majority in both groups agreed itchy skin is not a symptom of DM.  When asked about insulin misuse, only 36.8% and 55.4% students agreed that blood glucose will go below 50mg/dl. Discussion and conclusion: Our study correlated with various studies which showed many students had problems in treatment aspects. But we also had positive results which correlated with other study showing they have good knowledge about symptoms. We also found our students had good knowledge about diabetic ketoacidosis. In conclusion, there is a need for conducting regular workshops, seminars, conferences in medical colleges to upgrade the knowledge of students and make them a competent general physician. Key words: Diabetes, Keto acidosis, Education, Knowledge, Risk factors

Identifying the Predictors of Self-Management Behaviors in Patients with Diabetes Based on Ecological Approach: A Systematic Review

2020 ◽  
Vol 16 ◽  
Author(s):  
Mahnaz Davari ◽  
Hamed Rezakhani Moghaddam ◽  
Aghil Habibi Soola
Keyword(s):  
Scientific Information ◽  
The Self ◽  
Self Management ◽  
Ecological Approach ◽  
Selection Strategy ◽  
Diabetic Patients ◽  
Personal Factors ◽  
Management Interventions ◽  
Number Of Patients ◽  
Management Behaviors

Background: Recognizing and promoting the factors that affect the self-management behaviors of diabetes leads to a reduction in the number of patients and an improvement in the quality of care. The ecological approach focuses on the nature of people's interactions with their physical and socio-cultural environments. Objective: The purpose of this study was to identify the predictors of self-management behaviors with a comprehensive approach in these patients. Methods: The Keywords were investigated in the relevant national and international databases, including PubMed, Google Scholar, Science Direct, Scopus, and Scientific Information Database, Magiran, and Iran Medex to obtain the articles published from 2009 to 2019. The search and article selection strategy was developed based on the Prisma checklist and was carried out in three steps. Results: Most studies have shown that personal factors had the highest prediction power for the self-management of diabetes. Then, the interpersonal factors, society and policy-making factors, and group and organization factors were most frequently reported predictors of self-management behaviors in diabetic patients. Conclusion: Self-management of diabetes is necessary for controlling it because 95% of care is done by the patient. When designing self-management interventions, factors based on the individual level that increasing self-management behaviors should be taken into account.

Proportion of type 2 diabetic patients achieving treatment goals and the survey of patient’s attitude towards insulin initiation in patients with inadequate glycaemic control with oral anti-diabetic drugs

2020 ◽  
Vol 16 ◽  
Author(s):  
Shivashankara Bhat ◽  
Mukta Chowta ◽  
Nithyananda Chowta ◽  
Rajeshwari Shastry ◽  
Priyanka Kamath
Keyword(s):  
Glycaemic Control ◽  
Diabetic Patients ◽  
Treatment Goals ◽  
Insulin Initiation ◽  
Type 2 Diabetic Patients ◽  
Number Of Patients ◽  
Patient’S Perception ◽  
Hba1c Target ◽  
Type 2 Diabetic

Background: Type 2 diabetic patients often require insulin therapy for better glycaemic control. However, many of these patients do not receive insulin or do not receive it in a timely manner. Objective: The study was planned to assess the proportion of type 2 diabetic patients attaining treatment goals as per the ADA 2018 guidelines. In addition, patient’s perception on insulin therapy assessed and compared between insulin naïve and insulin initiated type 2 diabetic patients. Methods: The study was conducted in type 2 diabetic patients. Data on their demographics, medical history, duration of diabetes, history of diabetes related complications, the current antidiabetic medication received, most recent glycaemic parameters were noted. Patient’s perception on insulin initiation was recorded through structured interview. Results: A total of 129 patients were included in the study. Around 76.7% patients achieved HbA1c target (<7%). Duration of the disease is much higher in patients who did not meet the HBA1c target. A good number of patients felt that insulin injection would be physically painful (56.5%). Majority of the patients also felt that insulin will make their life less flexible (64.8%). Many patients are having the opinion that insulin is required for life long (73.2%). More number of patients on insulin agreed with the statement ‘Leads to good short-term outcomes as well as long-term benefits’ compared to insulin naïve patients. Conclusion: The results highlight that the proportion of patients achieving recommended glycaemic target is not satisfactory. Many patients who are inadequately controlled with oral antidiabetic drugs were reluctant to initiate insulin.

"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

2020 ◽  
Author(s):  
Swati Anand ◽  
Amardeep Kalsi ◽  
Jonathan Figueroa ◽  
Parag Mehta
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Positive Impact ◽  
The United States ◽  
Phone Call ◽  
Diabetic Patients ◽  
Dietary Compliance ◽  
Glucose Levels ◽  
Uncontrolled Diabetes ◽  
Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

scholarly journals Knowledge, attitude, and practices (KAPs) of Community pharmacists regarding COVID-19: A cross-sectional survey in two provinces of Pakistan

2021 ◽  
pp. 1-23
Author(s):  
Khayal Muhammad ◽  
Muhammad Saqlain ◽  
Gul Muhammad ◽  
Ataullah Hamdard ◽  
Muhammad Naveed ◽  
...  
Keyword(s):  
Online Survey ◽  
Good Practice ◽  
Community Pharmacists ◽  
Vital Role ◽  
Good Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Knowledge Age ◽  
Good Attitude

Abstract The coronavirus disease 2019 (COVID-19) is a global pandemic having no therapy and pharmacists being a part of the healthcare system had a vital role in the management of COVID-19. The purpose of this study is to assess the knowledge, attitude, and practices (KAPs) of community pharmacists (CPs) regarding COVID-19. An online survey was conducted among 393 CPs in two provinces of Pakistan during the lockdown period. A validated questionnaire (Cronbach alpha, 0.745) was used for data collection. All statistical analysis was analyzed by using SPSS version 21. Among 393 participants, 71.5% (n=281) had good knowledge, 44% (n=175) positive attitude and 57.3% (n=225) had good practice regarding COVID-19. Social media (45.29%, n=178) was reported as the main source to seek information of COVID-19. Good knowledge, age ≥ 26 years and Ph.D. degree level were the substantial determinants (p= <0.05) of a good attitude. Similarly, community pharmacist who had an experience of >5 years, hold a Ph.D. degree, good knowledge and good attitude had higher odds of good practice as compared to reference categories (p= <0.05). In short, majority of CPs had good knowledge, but had a poor attitude and practice towards the COVID-19. Standard-structured educational and counselling programs for CPs regarding COVID-19 are needed for effective management.

scholarly journals Medical students' choice of specialty and factors determining their choice: A cross-sectional questionnaire survey in Melaka-Manipal Medical College, Malaysia

2011 ◽  
Vol 5 (2) ◽  
pp. 69-76 ◽  
Author(s):  
Yu Wei Chew ◽  
Sudeash Rajakrishnan ◽  
Chin Aun Low ◽  
Prakash Kumar Jayapalan ◽  
Chandrashekhar T. Sreeramareddy
Keyword(s):  
Medical Students ◽  
Questionnaire Survey ◽  
Cross Sectional ◽  
Medical College

scholarly journals Randomized Prospective Controlled Trial of Recombinant Granulocyte Colony-Stimulating Factor as Adjunctive Therapy for Limb-Threatening Diabetic Foot Infection

2001 ◽  
Vol 45 (4) ◽  
pp. 1094-1098 ◽  
Author(s):  
Fausto de Lalla ◽  
Giampietro Pellizzer ◽  
Marco Strazzabosco ◽  
Zeno Martini ◽  
Giovanni Du Jardin ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Adjunctive Therapy ◽  
Standard Treatment ◽  
Diabetic Patients ◽  
Cumulative Number ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Diabetic Foot Infection ◽  
Number Of Patients ◽  
Stimulating Factor

ABSTRACT Adult diabetic patients admitted to our Diabetes Center from September 1996 to January 1998 for severe, limb-threatening foot infection were consecutively enrolled in a prospective, randomized, controlled clinical study aimed at assessing the safety and efficacy of recombinant human granulocyte colony-stimulating factor (G-CSF) (lenograstim) as an adjunctive therapy for the standard treatment of diabetic foot infection. Forty patients, all of whom displayed evidence of osteomyelitis and long-standing ulcer infection, were randomized 1:1 to receive either conventional treatment (i.e., antimicrobial therapy plus local treatment) or conventional therapy plus 263 μg of G-CSF subcutaneously daily for 21 days. The empiric antibiotic treatment (a combination of ciprofloxacin plus clindamycin) was further adjusted, when necessary, according to the results of cultures and sensitivity testing. Microbiologic assessment of foot ulcers was performed by both deep-tissue biopsy and swab cultures, performed at enrollment and on days 7 and 21 thereafter. Patients were monitored for 6 months; the major endpoints (i.e., cure, improvement, failure, and amputation) were blindly assessed at weeks 3 and 9. At enrollment, both patient groups were comparable in terms of both demographic and clinical data. None of the G-CSF-treated patients experienced either local or systemic adverse effects. At the 3- and 9-week assessments, no significant differences between the two groups could be observed concerning the number of patients either cured or improved, the number of patients displaying therapeutic failure, or the species and number of microorganisms previously yielded from cultures at day 7 and day 21. Conversely, among this small series of patients the cumulative number of amputations observed after 9 weeks of treatment appeared to be lower in the G-CSF arm; in fact, only three patients (15%) in this group had required amputation, whereas nine patients (45%) in the other group had required amputation (P = 0.038). In conclusion, the administration of G-CSF for 3 weeks as an adjunctive therapy for limb-threatening diabetic foot infection was associated with a lower rate of amputation within 9 weeks after the commencement of standard treatment. Further clinical studies aimed at precisely defining the role of this approach to this serious complication of diabetes mellitus appear to be justified.

Basic life support awareness level among medical students in Jordan: a cross-sectional study

2021 ◽  
Author(s):  
Ebraheem Albazee ◽  
Mohammad Alnifise ◽  
Lina Almahmoud ◽  
Ahmed Alsaeedi ◽  
Mohammed Al-balawi ◽  
...  
Keyword(s):  
Medical Students ◽  
Basic Life Support ◽  
Life Support ◽  
Cardiopulmonary Arrest ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade Point ◽  
Validated Questionnaire ◽  
Awareness Level

Objective: Performing basic life support (BLS) in patients with cardiopulmonary arrest decreases mortality and morbidity. In addition, BLS knowledge is a prerequisite for medical graduation. The present study was conducted to determine the awareness level of undergraduate medical students in Jordan regarding BLS and background knowledge. Methods: This cross-sectional study was conducted between 17 April 2021 and 12 May 2021. A validated questionnaire was used as an online Google form and was posted in all medical student groups and Jordanian universities through various social medias. We categorized level of awareness into two groups: adequate awareness for those who got 60% or more, and inadequate awareness for those who got less than 60% in BLS test. Chi-square test was used to compare different variables. Results: A total of 886 students with a mean age of 21.5 (± 2.2) years completed the survey, including 552 females (62.3%). Among participated students, only 281 (31.7%) had adequate awareness, whereas 605 (68.3%) had inadequate awareness, with a mean score of 10 (± 3.8) out of 20. Surprisingly, there was no statistically significant correlation (P=0.210) between grade point average (GPA) and awareness level among participated students. On the contrary, we detected statistically significant relationships (P<0.001) between various variables and awareness level. Conclusion: Overall, we found that awareness of BLS among medical students in Jordan is not adequate. We can improve the awareness of medical students in this regard through obligating them to educate the general population, especially school students, as a volunteer campaign.

scholarly journals DOES INSULIN LIKE GROWTH FACTOR-1 (IGF-1) DEFICIENCY HAVE A “PROTECTIVE” ROLE IN THE DEVELOPMENT OF DIABETIC RETINOPATHY IN THALASSEMIA MAJOR PATIENTS?

2015 ◽  
Vol 7 ◽  
pp. e2015038 ◽  
Author(s):  
Vincenzo De Sanctis
Keyword(s):  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Cross Sectional Study ◽  
Protective Role ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Patients ◽  
Italian Population ◽  
Sectional Study ◽  
Cross Sectional ◽  
Number Of Patients

Objective: This cross-sectional study was designed to give insights into relationship between Insulin-Growth-Factor 1 (IGF-1) levels and diabetic retinopathy (DR) in a sample of  thalassaemia major(TM) patients with insulin dependent diabetes mellitus (IDDM). Τhis relation was not previously evaluated, despite the fact that both diseases co-exist  in the same patient. The  study   also  describes the clinical and biochemical profile of the associated complications in TM patients with and without IDDM.   Design: A population-based cross-sectional study.  Participants:The study  includes 19 consecutive TM patients with IDDM and 31 age- and sex-matched TM patients without  IDDM who visited our out-patient clinics for an endocrine assessment Methods: An extensive medical history, with data on associated complications and current medications, was obtained. Blood samples were drawn in the morning after an overnight fast to measure the serum concentrations of IGF-1, glucose, fructosamine , free thyroxine (FT4), thyrotropin (TSH) and biochemical analysis . Serologic screening assays for hepatitis C virus seropositivity (HCVab and HCV-RNA) were also evaluated,  applying routine laboratory methods.Plasma total IGF-1 was measured by a chemiluminescent immunometric assay (CLIA) method. Ophthalmology evaluation was done by the same researcher using stereoscopic fundus biomicroscopy through dilated pupils. DR was graded using the scale developed by the Global Diabetic Retinopathy Group. Iron stores were assessed by direct and indirect methods. Results:Eighteen TM patients with IDDM (94.7 %) and 10 non-diabetic patients (32.2 %) had IGF-1 levels below the 2.5th percentile of the normal values for the Italian population. The mean serum IGF-1 concentrations were significantly lower in the diabetic versus the non-diabetic TM groups (p < 0.001). DR was present in in 4 (21 %) of 19 TM patients with IDDM and was associated with the main classical risk factors, namely inefficient glycemic control  and duration of disease but not  hypertension. Using the scale developed by the Global Diabetic Retinopathy Group, the DR in our patients was classified as non proliferative diabetic retinopathy (NPDR). Only few numbers of microaneurysms [1-3] were detected. Our data also confirm the strong association of IDDM in TM patients with other endocrine and non-endocrine complications.Conclusions: These results , although on a small number of patients, suggest a possible ‘protective’ role of low IGF-1 in the development of DR in TM patients 

scholarly journals Surgical and medical morbidity following failed non-traumatic partial foot amputation in diabetic patients

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Cole Cheney ◽  
John Femino
Keyword(s):  
Hospital Admissions ◽  
Demographic Data ◽  
Time Frame ◽  
Diabetic Patients ◽  
Index Procedure ◽  
Limb Preservation ◽  
Initial Surgery ◽  
Number Of Patients ◽  
Partial Foot Amputation

Category: Ankle, Diabetes, Lesser Toes, Midfoot/Forefoot Introduction/Purpose: Maximal limb preservation is often the goal in choosing partial foot amputation (PFA) as a treat-ment for diabetic foot infections. Some of these patients will go on to experience multiple hospital admissions, IV antibiotic courses, surgical debridements, re-amputations and other medical compli-cations. This study describes the treatment course of these patients starting at second partial foot amputation and ending at 5 year follow-up. Methods: A retrospective cohort was built from a database of all amputation procedures performed on diabet-ic patients at the University of Iowa Department of Orthopedics from 2000 – 2015. The cohort was evaluated over time frame starting at second PFA (index procedure) and ending at 5 years after in-dex procedure. Of 264 patients who underwent partial foot amputation, 49 experienced two lower extremities PFA between January 2000 and December 2011 (cut-off used to allow minimum of 5 years post-PFA). Demographic data was recorded at index PFA and included surgical dates, laterali-ty, surgery type, diagnoses at time of initial surgery, and death date. A chart review collected in-formation on 5 year post-index PFA incidence of: non-surgical hospitalizations, antibiotic admin-istrations, total contact cast applications, and complications (such as osteomyelitis and acute renal failure). Results: Thirty-two (65%) of the second partial foot amputations (index) were ipsilateral and 17 were con-tralateral to first partial foot amputation (pre-index procedure). Eighteen (37%) of the partial foot amputation patients eventually experienced transtibial / transfemoral amputations in the 5 years fol-lowing index PFA. Eleven (22%) had at least a third partial foot amputation (and as many as 7) dur-ing study period. Sixteen (32%) patients had 17 transtibial / transfemoral amputations within 5 year time frame. 11 of the 17 (65%) TT / TF procedures were ipsilateral to index (second) PFA. Seven (17%) of the patients died. Conclusion: Maximal limb preservation may not be beneficial in all cases, particularly in the case of repeat PFAs. This cohort of repeat PFA patients demonstrated a complicated medical course with long pe-riods of hospitalization, leg immobilization in cast, and home-going antibiotics (requiring PICC). This study suggested that over a 5 year period following second PFA, patients on average experi-enced at least 31 days in TCC, 17 days hospitalized and underwent one additional amputation pro-cedure. These are likely underestimates due to follow-up or outside hospital cares. A large number of patients (18 or 37%) ultimately required higher-level amputation. There is a potential morbidity with PFA that may not be communicated to patients when making these decisions. In this cohort, the average days to second PFA was 360 days. 18 of 49 repeat PFA patients underwent tran-stibial or transfemoral amputation within 5 years of their initial PFA. The morbidity of the interim medical course over 5 years added to the poor quality of life after PFA.

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