Awareness and attitudes of people with diabetes regarding their disease in Hyderabad and Adjoining areas

Diabetes Mellitus [DM] is a chronic disease, associated with high degree of morbidity and mortality. Together with the advances in management of DM, and the widespread availability of treatment, patient's education and awareness about the disease is equally important for the optimum management of the disease. Hence, this study was designed to explore the prevailing attitudes and awareness of diabetic patients in and around Hyderabad - Sindh. A cross sectional survey. Interviews were made regarding attitude, awareness and education about the disease. Percentage scores were then compared separately among the gender [2 groups: male and female], age of the patients [3 groups; group 1, 18-30 years, group II, 31-50 years and group III 51-80 years], and time since the diagnosis of DM [3 groups; group A, less than 6 months, group B, 6.1 month to 3 years, and group C 3.1 years and more]. Total 127 patients were interviewed including 88[69.3%] men and 39[30.7%] women. Among these, 51.7% men and 51% women had a positive attitude while 55.4% of men and 38.8% women had adequate awareness. Also, 68.8% men and 62.8% women were adequately educated. A positive attitude was observed in 4.8%, 46.8% and 46.1% respectively in group I, II and III patients respectively. Corresponding figures for awareness were 49.6%, 55.1%, 44.4% and for education 63.2%, 69.4% and 65.1%. Regarding relationship to the chronicity of the disease, a positive attitude was observed in 53.8% of group A patients, 47.7% and 41.4% amongst group B and C patients respectively. Corresponding figures for awareness and education were 41.1%, 49.1% and 56.2% and 57.8%, 64.2% and 7.7% and 57.8% respectively. Adequate awareness and education about diabetes is lacking. Some aspects of diabetes education need more emphasis. Diabetes education should be tailored according to the individual patient understanding

audit of indications and complications of percutaneous endoscopic gastrostomy

To evaluate the indications and complication rate in fifty consecutive patients in whom percutaneous endoscopic gastrostomy [PEG] was attempted. A descriptive study. Fifty consecutive adults referred to our unit for consideration for primary percutaneous endoscopic gastrostomy feeding between November 1999 and October 2001 at The Aga Khan University Hospital, Karachi and Isra University Hospital, Hyderabad were evaluated prospectively. PEG insertions were successful in all fifty patients [29 Males, 21 Females]. The indications for PEG were neurogenic [80%], recurrent aspiration, not the gastric contents [8%], head and neck tumors [6%], esophageal tumor [4%] and dermatomyositis [2%]. Ninety six percent of the patients had the procedure as inpatients while 4% were outpatients when the procedure was performed. Eighty percent of the patients had at least one follow-up after the tube insertion. Major complications were peritonitis [2%] and aspiration of gastric contents [4%]. Minor complications were PEG site infection [16%], accidental tube removal [10%], PEG migration [6%] and PEG blockage [4%]. One patient died due to peritonitis. Oral feed was resumed in 12% of the patients and the tube was removed subsequently. PEG is a feasible and safe procedure in our set up. It provides adequate feeding support and has low mortality rate even in patients, debilitated secondary to their underlying disease