Waist Circumference in recently diagnosed type 2 diabetics

Body mass index [BMI] is often used to reflect total body fat amount [general obesity] whereas waist circumference [WC], waist-to-hip ratio or waist-to height ratio is used as a surrogate of body fat centralization [central obesity]. The clustering of cardiovascular risk factors in association with disturbance of glucose and lipid metabolism is referred to as metabolic syndrome. Men and women who have waist circumference > 94cm and 80 cm respectively, are considered to be at increased risk for cardio metabolic disease.The relation between waist circumference and clinical outcome is consistently strong for diabetes risk, and waist circumference is a stronger predictor of diabetes than BMI. Our study is the first study to measure waist circumference in newly diagnosed Egyptian diabetic patients. We found that, 56% of newly diagnosed Egyptians diabetic patients have metabolic syndrome. At the same time we found a statistically significant difference as regard metabolic syndrome components between low waist and high waist groups but the difference was statistically insignificant when we compared low BMI with high BMI groups in newly diagnosed diabetics. This means that waist circumference is a simple tool to predict diabetes and metabolic syndrome better than other measures

Follow up of diabetic complications

Some research found that certain diabetic complications occur more frequently in some racial minority groups. Rate of diabetic complications in real-world practice is higher than expected from the clinical trial setting, especially among patients with complications at diagnosis. This suggests that in diabetic patients racial differences may exist in macro vascular and micro vascular disease frequency. 340 diabetic patients were chosen randomly from out patients' clinic of the national institute of diabetes and endocrinology. They received conventional treatment.by different doctors with no special protocol for treatment and was examined twice once at 2004 and another at 2006. Our result showed that during three year there are significant deterioration in weight, BMI. ECG, retinopathy, FBS, AST, ALT, cholesterol, triglyceride, urea, uric acid, GFR, HBlAC.And there were significant improve as regard BP, ACR, LDL. The major complications develop by Egyptian diabetic patients within 3 years follow up was increase percent of retinopathy [27%], followed by teeth loss [23%] then IHD [5%] with no patient develop ESRD. also there are deterioration of GFR.. As regard risk factors there is deterioration in cholesterol followed by waist circumference, BMI, triglyceride then HDL.but significant improve in BP control In Egyptian diabetic patient nudus examination and lipid profile must checked regularly every three moth

Diabetic nephropathy in type 2 diabetic patients attending the outpatient clinic of N.I.D.E: prevalence and risk factors

Diabetic nephropathy is the leading cause of end-stage renal disease [ESRD] worldwide, and it is estimated that 20% of type 2 diabetic patients reach ESRD during their lifetime [2]. Incidence of diabetes in Egypt was estimated to be 9-11% [5]. Our study is the first large study which try to evaluate the prevalence of diabetic nephropathy and its risk factors in Egyptian diabetic patients. The study included 2651 type 2 Egyptian diabetic patients attending the outpatient clinics of N.I.D.E. Our results show that 74.2% of our patients [1968 patients] have chronic kidney disease. Stage 1 [normal GFR and urine abnormality] and stage2 [mild decrease of GFR] represent more than 88% of them. This is the stage where we can do our best to prevent renal failure. CKD patients have older age, longer duration of diabetes, higher systolic and diastolic BP, higher FBS, glycated Hb, triglycerides LDL, uric acid, waist circumference and low HDL compared with non CKD diabetic patients. As regard GFR, 8.9% [236 patients] of our patients have hypofiltration and 26% [689 patients] have hyperfiltration. There is an urgent need to launch a national diabetes control program to tackle the potential economic burden due to diabetic nephropathy in Egypt

Diagnosis of urinary tract infection in infants and children with protein energy malnutrition

This study was carried out to assess the prevalence of urinary tract infection [UTI] in infants and children with protein energy malnutrition [PEM], to evaluate the reliability of dipstick tests for its diagnosis and to show the most common causative organisms and their sensitivity to antibiotics. Urine samples were aseptically obtained from 60 patients of both sexes who were suffering from different types of PEM and from 40 healthy age- and sex- matched infants and children as controls. Patients were selected from the pediatric outpatient clinic, Faculty of Medicine, Menoufia University. Urine samples were examined for: 1]Dipstick [nitrite and leukocyte esterase] tests; 2] microscopic urine examination for leukocytes; 3] bacterial colony count and identification of the causative bacterial species; and 4] their antibiotic sensitivity were performed. Results showed increased prevalence of UTI among PEM patients [33.33%] than controls [7.5%]. Nitrite and leukocyte esterase tests had low sensitivity [35% and 55% respectively] and high specificity compared to urine analysis and culture. Enterobacteriaceae [E. coli, Klebsiella and Proteus] constituted 95% of the total isolates and they were highly sensitive to amikacin, tobramycin, gentamycin, and cefotaxime. In conclusion, it is important to look for UTI in PEM patients by demonstration of bacteriuria using culture which can not be replaced by screening dipstick tests

Meningococcal carrier state in primary school children, in a rural area: factors affecting and antibiotics for eradication

A survey of meningococcal carrier rate was conducted in El-Batanoon village, Monoufia Governorate, on 269 primary school children [183 males and 96 females], aged between 8 and 12 years. Those children were classroom contacts to five cases of N. meningitidis. Carrier rate among home contacts of these cases was claimed to be zero by MOH. The carrier rate among school contacts was found to be 15.15%. The highest percentage of carrier rate was from the age of 8-10 years [68.6% in males and 67.27% in females]; 63.64% of the carriers suffered from upper respiratory tract infection. The bad aeration and overcrowding of the classrooms were found to be factors related to the high carrier rate. The predominant serogroup was A [51.75%]. The most effective antibiotic used in eradicating nasopharyngeal carrier was rifampin [92%] followed by chloramphenicol [68%]