A Deadly Combination - HIV and Diabetes Mellitus: Where are we now?

BACKGROUND:The combination of HIV infection and diabetes mellitus (DM) represents a collision of two chronic conditions. Both HIV and DM increase the risk of developing tuberculosis (TB). Health resources in developing countries are already under strain as a result of the TB epidemic and poor diabetic control would further worsen this epidemic. Optimal diabetic control provides one avenue of curbing the TB epidemic in developing countries.OBJECTIVES:To establish if there is a difference in blood pressure; lipid and glycaemic control and complications between HIV-infected and uninfected diabetic patients; and to compare characteristics among HIV-infected diabetic patients between those with optimal and sub- optimal glycaemic control.METHODS:This was a retrospective chart review of all patients who visited the Edendale Hospital diabetic clinic; Pietermaritzburg; from 1 October 2012 to 30 September 2013.RESULTS:There were statistically significant differences noted in the following parameters between HIV-infected and uninfected diabetic patients: (i) mean HbA1c% (11.08% v. 10.14%; respectively); (ii) nephropathy defined by proteinuria (25.66% v. 15.43%); (iii) neuropathy (48.68% v. 42.10%); and (iv) Kidney Disease Outcomes Quality Initiative (KDOQI) stage =2 chronic kidney disease (30.87% v. 41.67%). There were no significant differences noted in the percentage of patients achieving the following target parameters between the two cohorts: (i) blood pressure (42.11% v. 35.62%); (ii) total cholesterol (36.84% v. 34.67%); and (iii) triglycerides (42.76% v. 40.19%). Within the HIV-infected diabetic cohort 85.23% displayed suboptimal glycaemic control. A significant percentage of HIV-infected diabetic patients on antiretroviral (ARV) therapy (89.36%) had suboptimal glycaemic control. HIV-infected female diabetic patients showed a significant increased waist circumference when compared with their HIV-uninfected counterparts.CONCLUSION:HIV-infected diabetic patients had significantly poorer blood sugar control and a higher incidence of neuropathy and nephropathy (when defined by overt proteinuria). There was a non-significant difference noted between the HIV-infected and uninfected diabetic patients with regard to blood pressure and lipid control. The majority of HIV-infected patients on ARVs failed to achieve target glycaemic control. Obesity remains a global challenge; as noted in both the HIV-infected and uninfected diabetic patients

Knowledge; Attitudes and Practices Regarding Iodine among Patients with Hyperthyroidism in the Free State; South Africa

Objectives: To gather baseline information on the knowledge; attitudes and practices regarding iodine and iodised salt among patients with hyperthyroidism in the Free State. Subjects and Setting: The study was part of a large cohort study that included the first 96 patients aged 13 years or older diagnosed withhyperthyroidism and referred to Universitas Academic Hospital in Bloemfontein; South Africa during 2005. Methods: The patients were interviewed in their language using a structured validated questionnaire. Descriptive statistics were used for data analysis. Results: The majority of the patients (86.9) did not know what iodine was. Similarly; a higher percentage of patients (76.7) were unaware of the most important or main source of iodine in the food of South Africans. Regarding knowledge of the most important harmful effect on the health of children if they did not get enough iodine; almost all of the patients (89.1) did not know what it was. Ninety-five per cent of salt was obtained from the local shops; and only 36.1of the patients read the labelling on the package during purchase. A very small proportion of patients (1.6) stored salt in closed containers and away from sunlight; while about half of them (49.2) stored salt in open containers without lids; 36.1stored it in rigid plastic containers with holes at the top; and 13.1stored it in the open plastic bags in which the salt was bought. Conclusions: Patients with hyperthyroidism lacked knowledge of iodine; as well as of the storage of iodised salt; and this could have contributed to the persisting endemic goitre reported in previous studies. An aggressive awareness programme; targeting policy makers and the public; is recommended to ensure sustainable elimination of iodine deficiency disorders in South Africa

TORCH agents in pregnant Saudi women

To determine the seroprevalence rates of IgG to common TORCH agents in pregnant Saudi women using indirect enzyme-linked immunosorbent assay. Subjects and A total of 926 samples of sera were tested for antibodies to TORCH agents known to cause serious congenital infections: Toxoplasma gondii, rubella, cytomegalovirus [CMV], herpes simplex viruses [HSV-1 and HSV-2], varicella zoster virus [VZV] and human immunodeficiency virus [HIV-1 and HIV-2]. Toxoplasma IgG antibodies were detected in 35.6%, CMV total IgG antibodies were found in 92.1%, rubella IgG antibodies in 93.3%, HSV-1 IgG antibodies in 90.9%, HSV-2 IgG in 27.1%, and VZV IgG antibodies in 74.4%. A 0% seroprevalence rate for HIV-1 and -2 was found. Pregnant Saudi women commonly have IgG antibodies to rubella, CMV, HSV-1 and -2, VZV, and T. gondii. Serological evidence of HIV infection was not observed