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   2014| October-January  | Volume 5 | Issue 3  
    Online since January 12, 2017

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Factors screening the peripheral neuropathy in asymptomatic patients with type 2 diabetes by Neurothesiometer
AB Zafar, J Ahmed, A Basit, SFD Alvi, A Fawwad, M Riaz
October-January 2014, 5(3):3-3
To identify the feet at risk of developing foot ulceration in asymptomatic Type 2 diabetic patients using vibration perception thresholds. This study was conducted at Baqai Institute of Diabetology & Endocrinology (BIDE) over a period of 12 months from October 2009 to September 2010. A total of 99 patients were selected from the outpatient department after obtaining informed consent. Detailed history, physical examination including foot examination was carried out. All asymptomatic patients with Type 2 diabetes were considered eligible to participate in the study of Vibration Perception Threshold (VPT) obtained by Neurothesiometer. A cut off value of 25 V was used to identify feet at risk. Patients with Type 1 or Type 2 diabetes having present or previous history of foot ulcer, patients above 70 years of age, having painful neuropathy, chronic renal disease, chronic liver disease or congestive heart failure were excluded from the study. Out of 99 patients, 49 were males and 50 were females. More than half were above the age of 40 years, 33 subjects were between 40-50 years of age followed by 30 subjects in the age group of 51-60 years. Mean duration of diabetes was 7.65 ± 5.51 years. 10% of subjects showed VPT > 25. Among different variables, only duration of diabetes showed significant correlation with increased VPT. This study concludes that a significant number of asymptomatic Type 2 diabetic patients may have early stage of sensory neuropathy. VPT is an effective tool for identifying feet at risk of foot ulceration in asymptomatic patients.
[ABSTRACT]   Full text not available  [PDF]
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Rapidly increasing prevalence and associations of diabetes mellitus in a rural community of Pakistan
MS Qureshi, M Iqbal, AZ Nomani
October-January 2014, 5(3):4-4
The aim of the study was to assess the prevalence and association of risk factors for diabetes mellitus and impaired fasting glucose in a village with rural life style in Pakistan. Using a systematic random sampling approach, 354 households were selected. A total of 815 persons, representative of all socio-economic strata were tested to identify undiagnosed diabetes and impaired fasting glucose. Both were defined according to American Diabetes Association (ADA) guidelines. Prevalence of diabetes and baseline characteristics was analyzed using descriptive statistics. Odds ratio and confidence intervals were calculated. One way analysis of variance test and regression analysis were used to study the association of risk factors with diabetes and impaired fasting glucose. Prevalence of diabetes was 9.93% (81 out of 815 subjects) and that of impaired fasting glucose was 9.20% (75 out of 815 subjects). Prevalence of diabetes was seen to be higher in females (11.53%; 55 out of 477 subjects) as compared to males (7.69%; 26 out of 338 subjects). Maximum prevalence of diabetes was seen in the age group of 51-60 years i.e. 21.42% (24 out of 112 subjects). There was a gradual increase in prevalence from the age of 20 till the age of 40 years after which the prevalence increased sharply. High body mass index, increasing age and low socio-economic status were significantly associated with diabetes (p<0.05). The prevalence of diabetes mellitus is rapidly increasing even in people with rural life style in Pakistan with a current value of 9.93%. Increasing body mass index and low standard of living in the general population are significantly contributing to the increasing burden of diabetes and should be promptly addressed at national level.
[ABSTRACT]   Full text not available  [PDF]
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Association of high serum pro-BNP levels with severity of coronary artery disease and its limitations
AH Alhusseiny
October-January 2014, 5(3):5-5
Myocardial ischemia is the leading cause of mortality and morbidity all over the world. Previous studies demonstrated that myocardial ischemic patients subjected to coronary angiograph were more likely to have significant high serum proBNP. The study aims to assess the level of serum proBNP levels in myocardial ischemia patients who underwent coronary angiography and to relate the proBNP levels to the severity of coronary artery disease and the components of metabolic syndrome. A total number of 128 patients admitted to the coronary angiography unit at Diyala Teaching Hospital in Diyala, were recruited in the study. Indications of coronary angiography included; Acute coronary syndrome, positive treadmill test, Stable coronary artery disease and Percutaneous coronary intervention. The severity of coronary artery disease was assessed by detecting the significant occluded lesions in the number of occluded vessels. Serum proBNP levels were measured after angiography. The results show non-significant differences in the characteristics of patients and fasting serum lipids in different categories of vessels occluded. Significant high serum proBNP levels were observed with increasing number of vessels occluded and were not seen to be related to the components of metabolic syndrome. Serum proBNP levels were significantly and inversely correlated (r =0.5, p < 0.001) with ejection fraction of left ventricle.
[ABSTRACT]   Full text not available  [PDF]
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Osteomyelitis of the humerus as the initial presentation of Diabetes Mellitus
A.L.L Roshan, AT Matthias, J Indrakumar
October-January 2014, 5(3):1-1
Most cases of osteomyelitis occur in patient's foot with diabetes mellitus. Osteomyelitis occurs in the presence of vascular insufficiency. Here, a case of chronic osteomyelitis as the first presentation of diabetes is described, therefore it is concluded that all patients with osteomyelitis should be screened for diabetes.
[ABSTRACT]   Full text not available  [PDF]
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Factors associated with change in glycemic control in Japanese patients: Analyses of patients' misperception
T Suzuki-Saito, H Yokokawa, K Shimada, A Goto, S Yasumura
October-January 2014, 5(3):2-2
This study aimed at understanding the influence of misperception of glycemic control status on changes in glycemic control after 1 year of the baseline survey among patients with poorly controlled diabetes and examining the factors associated with improved glycemic control in patients with and without misperceptions. Data on 190 Japanese patients with poorly controlled diabetes were collected from a hospital-based prospective cohort study. Misperceptions of glycemic control and other medical information was collected from a self- administered questionnaire and medical records at the baseline. Data on glycemic control was also obtained from a 1-year follow-up survey. Patients with decreased HbA1c values were defined as improved and others as unchanged or worsened. There was no significant relationship between misperceptions of glycemic control at baseline and changes in glycemic control after 1 year. 41.1% of patients with improved glycemic control and 32.0 % with unchanged or worsened glycemic control had misperceptions at the baseline (p = 0.23). The factors significantly associated with improved glycemic control were a self-perceived high score for a lifestyle regimen adherence (odds ratio (OR) = 0.15, 95% confidence interval (CI) = 0.04-0.66) among patients with misperceptions, as well as the presence of diabetes retinopathy (OR = 0.27, 95% CI = 0.10-0.73) among patients without misperception. Although the misperception of glycemic control did not relate to the change in glycemic control after 1 year, but the associated factors differed between the two groups. Evaluating misperceptions could therefore assist health practitioners in providing suitable diabetes care.
[ABSTRACT]   Full text not available  [PDF]
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