Assessment of Lactate Dehydrogenase Levels Among Diabetic Patients Treated in the Outpatient Clinics at King Hussein Medical Center, Royal Medical Services, Jordan

The aim of the present study was to study the association of metformin dose with peripheral neuropathy in diabetic patients at Jordanian Royal Medical Services. A retrospective study was conducted to collect data from files of 392 diabetic patients at Jordanian Royal Medical Services. A working sheet was created for each patient that included the following information: gender, age, peripheral neuropathy, vitamin B12 status, metformin use, and metformin dose. Data were analyzed using SPSS version 20. Data were represented as frequencies and percentages for categorical variables such as gender, and vitamin B12 status; means and standard deviations for continuous variables such as age. The relationships between variables were examined using Chi-Square, and One Way Anova. Significance was considered at alpha level <0.05. Study findings showed that the prevalence of diabetic peripheral neuropathy among participants was about 43%. Vitamin B12 deficiency was about 7%. Diabetic peripheral neuropathy was significantly associated with gender (p=0.018). No significant associations were observed between peripheral neuropathy and vitamin B12 or metformin dose. Taken together, the results of the present study showed that treatment with metformin did not lead to vitamin B12 deficiency, although the prevalence of diabetic peripheral neuropathy was relatively high (about 43%).

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Studying The Prevalence Of Achieving Therapeutic Goals Of Diabetes Treatment Among Diabetic Patients In Royal Medical Services

European Scientific Journal ESJ ◽

10.19044/esj.2016.v12n3p9 ◽

2016 ◽

Vol 12 (3) ◽

pp. 9

Author(s):

Abdulelah Meqbel Almala ◽

Toleen Issam Bisharat ◽

Rawan Abid Alkareem Ababneh ◽

Ola Issa Alkaradsheh ◽

Kholoud Husban ◽

...

Keyword(s):

Heart Disease ◽

Diabetic Neuropathy ◽

Diabetic Complications ◽

Foot Ulcer ◽

Medical Services ◽

Diabetic Patients ◽

Global Level ◽

Therapeutic Goals ◽

And Gender ◽

Royal Medical

Diabetic complications are considered a public concern on global level and have their negative impacts on patients. The main objectives of the present study were to determine the prevalence of diabetic complications among a sample of diabetics in Royal Medical Services and to conclude the appropriate recommendations to reduce the effects of diabetic complications. The method of choice involved a retrospective design and 392 files of diabetic patients were reviewed. Study findings showed that the prevalence of diabetic neuropathy was 43%, hypertension 42%, diabetic foot ulcer 9%, glaucoma 48%, and heart disease 25%. Predictors for diabetic neuropathy were the level of HbA1C (p=0.015), and gender (p=0.018), while the predictors for hypertension were duration of DM (p=0.000) and age (p=0.000). The predictors of foot ulcer included the level of HbA1C (p=0.013), and the use of metformin (p=0.026). Glaucoma was predicted by duration of DM (p=0.002), and gender (p=0.017). Heart disease was predicted by duration of DM (p=0.003), gender (p=0.041), and age (p=0.000). Taken together, diabetic complications are prevalent on global level and in our settings which implies that the therapeutic options of DM are still far from their ultimate goals. we recommend adopting of more effective monitoring systems for screening diabetics, particularly those who are expected to develop diabetes. We also recommend to activate the roles of clinical pharmacist to raise the awareness level about diabetic complications among the public.

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THE IMPACT OF TREATMENT WITH METFORMIN ON DIABETIC FOOT ULCER AMONG DIABETIC PATIENTS VISITING JORDANIAN ROYAL MEDICAL SERVICES

Indian Research Journal of Pharmacy and Science ◽

10.21276/irjps.2017.4.2.9 ◽

2017 ◽

Vol 4 (2) ◽

pp. 1021-1026

Author(s):

Reem Ibrahim Mahadeen ◽

◽

Maysoon Hwaidi ◽

ManalEdiab Al-Harasis ◽

Ayman Ragheb Jaarah ◽

...

Keyword(s):

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Medical Services ◽

Diabetic Patients ◽

The Impact ◽

Royal Medical

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Evaluation of Optimal Treatment for Urinary Tract Infections in Outpatient Clinics at an Academic Medical Center: Opportunities for Antimicrobial Stewardship

American Journal of Infection Control ◽

10.1016/j.ajic.2021.07.005 ◽

2021 ◽

Author(s):

Jennifer H. Walters ◽

Michael P. Stevens ◽

Jihye Kim

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Antimicrobial Stewardship ◽

Medical Center ◽

Academic Medical Center ◽

Optimal Treatment ◽

Outpatient Clinics ◽

Academic Medical ◽

Tract Infections

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Abstract 657: Increased Urinary Angiotensin Converting Enzyme 2 (ACE2) In Type 2 Diabetic Patients

Hypertension ◽

10.1161/hyp.64.suppl_1.657 ◽

2014 ◽

Vol 64 (suppl_1) ◽

Author(s):

Sridevi Gutta ◽

Nadja Grobe ◽

Hassan Osman ◽

Mohammad Saklayen ◽

Khalid M Elased

Keyword(s):

Mass Spectrometry ◽

Medical Center ◽

Diabetic Patients ◽

Enzyme Assays ◽

Renal Tubules ◽

Type 2 Diabetic Patients ◽

Major Health ◽

Angiotensin Converting Enzyme 2 ◽

Noninvasive Biomarker

Diabetes and its associated chronic kidney disease (CKD) is a major health burden and there is an urgent need for new sensitive biomarkers to detect and monitor the progression of CKD. Albuminuria is still the gold standard for the evaluation of kidney function. However, its sensitivity and reliability have recently been questioned. ACE2 is highly expressed in renal tubules and has been shown to be shed in the urine of diabetic patients with CKD. The aim of the study was to investigate whether urinary ACE2 is increased in diabetic patients with CKD before the onset of microalbuminuria. Participants were recruited from Dayton VA Medical Center (Dayton, OH, USA). Baseline urinary albumin creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were determined three months before initiation of the study in non-diabetic patients (UACR <30 mg/g, eGFR=97.40±16 ml/min/1.73 m 2 ), and in diabetic patients with normoalbuminuria (UACR <30 mg/g, eGFR=83.08±17 ml/min/1.73 m 2 ), microalbuminuria (UACR = 30-300 mg/g, eGFR=47.13±23 ml/min/1.73 m 2 ), and macroalbuminuria (UACR >300 mg/g, eGFR=39.68±20 ml/min/1.73 m 2 ). Using fluorogenic and mass spectrometry-based enzyme assays, we measured urinary and plasma ACE2 activity in patients. Urinary ACE2 activity was significantly increased in diabetic patients with normoalbuminuria (0.58±0.2 nmol/hr/mg creatinine), microalbuminuria (1.19 ±0.5 nmol/hr/mg creatinine), and macroalbuminuria (2.265±0.4 nmol/hr/mg creatinine) compared with non-diabetic controls (0.06 ± 0.02 nmols/hr/mg creatinine) (p<0.0001). These results were confirmed by detecting the ACE2 product Ang-(1-7) ( m/z 899) in incubations of urine samples with the natural substrate Ang II ( m/z 1046) using mass spectrometry-based enzyme assays. In addition, urinary ACE2 expression was significantly increased in diabetic patients as determined by western blot analysis (p<0.05). Plasma ACE2 activity was not detectable in control and diabetic patients. In conclusion, urinary ACE2 is increased in diabetic patients with CKD which suggests that urinary ACE2 could be used as an early, noninvasive biomarker for diabetic nephropathy before the onset of microalbuminuria.

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THE ROAD AHEAD TO BETTER MEDICAL CARE FOR CHILDREN

PEDIATRICS ◽

10.1542/peds.6.3.553 ◽

1950 ◽

Vol 6 (3) ◽

pp. 553-556

Keyword(s):

Child Health ◽

Medical Care ◽

Medical Center ◽

Point Of View ◽

Medical Services ◽

High Quality ◽

The Road ◽

Provide Child Care ◽

Ultimate Objective ◽

The Many

THE road to better child health has been discussed in relation to the doctor and his training, health services and their distribution. We have dealt with the unavoidable question of costs. Particular attention has been given to some of the advantages and dangers of decentralization of pediatric education and services. Each of the various subjects has been discussed from the point of view of its bearing on the ultimate objective of better health for all children and the steps necessary to attain this goal. Now, we may stand back from the many details of the picture, view the whole objectively and note its most outstanding features. First is the fact that the improvement of child health depends primarily upon better training for all doctors who provide child care, general practitioners as well as specialists. This is the foundation without which the rest of the structure cannot stand. The second dominant fact is the need for extending to outlying and isolated areas the high quality medical care of the medical centers, without at the same time diluting the service or training at the center. The road to better medical care, therefore, begins at the medical center and extends outward through a network of integrated community hospitals and health centers, finally reaching the remote and heretofore isolated areas. Inherent in all medical schools is a unique potential for rendering medical services as well as actually training physicians. The very nature of medical education—whereby doctors in training work under the tutelage of able specialists in the clinic, hospital ward, and out-patient department—provides medical services of high quality to people in the neighboring communities.

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