Effects of Social support and Self-efficacy of Glucose Control Among Malaysian Type 2 Diabetes Mellitus Patients in Primary Care

@#Diabetic control depends partially on self-management. Diabetes self-care is reported to be a strong predictor of glycemic control in Type 2 Diabetes Mellitus (T2DM) patients. Factors contributing to better self-care include self-efficacy and social support. We aim to determine effects of these factors on glucose control in T2DM patients in a primary care clinic. Methods: This study utilised data from a bigger study looking into factors affecting social support and self-efficacy and their correlation in T2DM patients. This study was done among 329 T2DM patients attending a primary care clinic in Selangor, Malaysia between November 2013- January 2014. Systematic random sampling was used. Instruments used were the MOS Social Support Survey and the Diabetic Management Self Efficacy Scale (DMSES). Patients’ socio-demographic data and glucose monitoring records were obtained. The association between social support and self-efficacy with blood glucose control was determined using logistic regression. Results: The mean age of the respondents is 54.6 (+11.2), mostly female (55.3%) and Malay ethnicity (63.5%). Being older and retired were predictors for good glucose control (OR=1.05,p=0.01 and OR=2.2,p=0.023) respectively. There is also significant correlations between number of close friends/relatives with social support and self-efficacy (r=0.162,p=0.030 and r=0.190,p=0.01) respectively. The correlation of social support and self-efficacy with HbA1c levels are r= -0.044(p=0.426) and r= -0.08(p= 0.744) respectively. Conclusion: There were no correlations between social support and self-efficacy with the level of HbA1c among patients with T2DM in this study. We found older aged and retired patients to have better HbA1c levels.

Gene therapy: An updated overview on the promising success stories

@#Gene therapy is a method of treatment of disease aimed at its molecular level. The progress of gene therapy, however, was as promising as it was tardy mainly due to the limitations in the resources and financial part of its development as well as owing to the rarity of most diseases it can offer its benefits to. The methods of gene therapy can vary depending on factors such as the physiology of tissue of interest, affinity of vectors to a certain type of cells, depth and accessibility of the tissue of interest, and size of the gene to be replaced or edited. The concept behind gene therapy has inspired scientists and clinicians alike leading to a rapid expansion of its clinical utility that has become so widespread to not only include diseases of monogenic origin, but also polygenic diseases, albeit not so commonly. This article delves into notable success stories of gene therapy which has been regarded as the beacon of medical novelty expected to blossom in the near future to provide a holistic, targeted, precise, and individualistic personalised-medicine as well as laying out the future hopes of gene therapy in the treatment of debilitating diseases such as solid tumours, AIDS, Tuberculosis, Diabetes Mellitus, psychiatric illnesses, which are still at a standstill, from a gene therapy point of view

Knowledge, attitude and practice towards dietary iron among patients with thalassemia and their caregivers in Peninsular Malaysia

@#Introduction: Thalassemias are the most common human monogenic disorders in the world. Regular blood transfusion and increased intestinal absorption of iron among thalassemia patients will lead to iron overload, which will not only markedly decrease their life expectancy but also pose a heavy burden to the healthcare system. The objective of this study was to evaluate the level of knowledge, attitude and practice towards dietary iron among thalassemia patients and their caregivers. Methods: An analytical cross-sectional study using purposive sampling method was conducted at eight thalassemia societies in Peninsular Malaysia. 260 respondents comprised of patients and caregivers were assessed with two separate sets of questionnaires. Results: Knowledge on dietary iron among the respondents was unsatisfactory, despite them having good knowledge on thalassemia disorder. Female patients were found to have better dietary knowledge, attitude and practice compared to males. The percentage of caregivers with good attitude and good practice were significantly higher compared to adult patients. Caregivers with children on iron chelators were noted to have better dietary attitude and practice. Thalassemia knowledge and children on vitamins were found to be the predictors of dietary knowledge among the patients and caregivers respectively. Conclusion: The level of knowledge on dietary iron among the patients and caregivers was unsatisfactory in spite of their attitude and practice towards dietary iron were good. Effective delivery of dietary information to the patients and caregivers is essential to enable them to choose a healthy diet for their condition.

The Rubber Stopper: A Simple and Inexpensive Technique to Prevent Pin Tract Infection following Kirschner Wiring of Supracondylar Fractures of Humerus in Children

Percutaneous pinning after closed reduction is commonly used to treat supracondylar fractures of the humerus in children. Minor pin tract infections frequently occur. The aim of this study was to prevent pin tract infections using a rubber stopper to reduce irritation of the skin against the Kirschner (K) wire following percutaneous pinning. Between July 2011 and June 2012, seventeen children with closed supracondylar fracture of the humerus of Gartland types 2 and 3 were treated with this technique. All patients were treated with closed reduction and percutaneous pinning and followed up prospectively. Only one patient, who was a hyperactive child, developed pin tract infection due to softening of the plaster slab. We found using the rubber stopper to be a simple and inexpensive method to reduce pin tract infections following percutaneous pinning.

Dehydration rates and rehydration efficacy of water and sports drink during one hour of moderate intensity exercise in well-trained flatwater kayakers

<p><b>INTRODUCTION</b>The aim of this study is to investigate the amount of water loss and percentage dehydration experienced during 1 hour of paddling on the kayak ergometer so as to help coaches and athletes tailor a suitable and adequate rehydration regime. Also, rehydration efficacy between water and a well established, commercially available sports drink (Gatorade, Quaker Oats company, USA) was investigated in this cross-over study.</p><p><b>MATERIALS AND METHODS</b>Ten national flatwater kayakers were monitored in a controlled setting while paddling the kayak ergometer for 1 hour at an intensity sustainable for long distance marathon. They rehydrated themselves ad libitum with provided beverage. Post-void towel-dried body mass was measured before and after the exercise with percentage dehydration calculated. Body core temperature (tympanic temperatures), ratings of perceived exertion and thirst index were monitored every 15 minutes. The amount of fluid consumed, urine output and urine specific gravity were obtained after exercise.</p><p><b>RESULTS</b>The results [mean +/- standard deviation (SD)] showed that kayakers underwent 1.10 +/- 0.52% dehydration while rehydrating with water as compared to 0.72 +/- 0.38% while rehydrating with Gatorade. Also, athletes on water rehydration had higher rating of perceived exertion (RPE) at the 30th and 60th minute mark of the exercise. Overall, athletes undergoing water rehydration lost significantly more body mass (0.70 +/- 0.39 kg) as compared to rehydrating with Gatorade (0.46 +/- 0.27).</p><p><b>CONCLUSION</b>Although the hydration efficacy of Gatorade proved superior to that of water, the athletes' hydration habits with either fluids did not provide adequate hydration. It is recommended that specific strategies be developed to address dehydration and rehydration issues of kayakers in Singapore.</p>

Modelling maximal oxygen uptake in athletes: allometric scaling versus ratio-scaling in relation to body mass

<p><b>INTRODUCTION</b>Maximal oxygen uptake, V&O2 peak, among athletes is an important foundation for all training programmes to enhance competition performance. In Singapore, the V& O2 peak of athletes is apparently not widely known. There is also controversy in the modelling or scaling of maximal oxygen uptake for differences in body size - the use of ratio-scaling remains common but allometric scaling is gaining acceptance as the method of choice.</p><p><b>MATERIALS AND METHODS</b>One hundred fifty-eight male (age, 21.7 +/- 4.9 years; body mass, 64.8 +/- 8.6 kg) and 28 female (age, 21.9 +/- 7.0 years; body mass, 53.0 +/- 7.0 kg) athletes completed a maximal treadmill run to volitional exhaustion, to determine VO2 peak.</p><p><b>RESULTS</b>V& O2 peak in L/min of female athletes was 67.8% that of male athletes (2.53 +/- 0.29 vs. 3.73 +/- 0.53 L/min), and V& O2 peak in mL/kg BM1.0/min of female athletes was 83.4% of male athletes (48.4 +/- 7.2 vs. 58.0 +/- 6.9 mL/kg BM1.0/min). Ratio-scaling of V& O2 peak did not create a size-free variable and was unsuitable as a scaling method. Instead, V& O2 peak, that was independent of the effect of body mass in male and female athletes, was best described using 2 separate and allometrically-derived sex-specific regression equations; these were V& O2 peak = 2.23 BM0.67 for male athletes and V& O2 peak = 2.23 BM0.24 for female athletes.</p>

Morbidity patterns among King Faisal University Students, Al Hassa, Kingdom of Saudi Arabia

To explore the prevalent morbidity problems among students at King Faisal University. To identify the nature of referred cases and assess the efficiency of the referral system. This was a retrospective, records-based descriptive study, involving the examination of the health records of students at King Faisal University, who attended the Medical Center for Primary Health Care services in a five-year period. A pre-tested compilation sheet was used for data collection. Out of 2472 consultations, about 58% of the diagnosed morbidity conditions were of infectious nature, mostly affecting the respiratory [62%], dental [14%], gastrointestinal [7%], and skin infections [5%], with more prevalence among males. The non-infectious morbidity conditions were recorded more among females and included muscle and joints problems [16%], allergic conditions [15%], gastrointestinal [8%], and trauma [5%]. Some of the encountered morbidity demonstrated seasonal variation. Case referrals were about 6%, more in the non-infectious conditions, with a deficient feedback system. Quality improvement of the medical records and the establishment of a proper referral system are necessary. Health education on preventable morbid conditions should be organized and implemented