ABSTRACT
Objective: To evaluate the impact and effectiveness of 24-hour helpline service in providing information and educating patients about self-management of diabetes
Method: The study was conducted at Baqai Institute of Diabetology and Endocrinology [BIDE], a tertiary diabetes care center, Karachi, Pakistan. People with diabetes attending the outpatient department from November 2012 to October 2014 were included in this study. After providing diabetes education, a helpline number was provided for emergency situations. Calls of registered patients were received by diabetes educators stationed at the BIDE around the clock. Data was collected through specially designed interface of HMS [health management system] in which the current complaint of caller and the advice of educator was recorded
Result: A total of 4842 calls were received. Out of those, 4268 [88%] were made by Type-2 diabetics and 526 calls [10%] were made by Type-1 diabetics. The average age of patients was 47.6 years. Three seventy four calls [7.7%] were received with complaint of Hypoglycemia [72-80mg/dl]. Six hundred and ninety eight calls [14.4%] were received with complaint of hyperglycemia [>200mg/dl]. Insulin dose was adjusted on 935 calls [19.3%]. Calls regarding other special situations such as [insulin handling, technique, medicine information] 2014 [41.6%] were received
Conclusion: Station based 24-hour telephonic helpline service is an effective tool for providing continuous support to people with diabetes and their families, for the self-management of diabetes. It can help in the management of various acute complication of diabetes, thereby preventing unnecessary hospital visits and admission
ABSTRACT
Objective: To determine the frequency of depressive symptoms among young people with Type-I diabetes
Methods: This cross sectional study was conducted at Baqai Institute of Diabetology and Endocrinology, Karachi, Pakistan from February to December 2015. All People aged between 12-20 years with Type-I diabetes for at least 1 year attending the OPD were included in the study. Information about participants' demographic characteristics, co morbidities and Complications, current treatment and medications were obtained. Acylated hemoglobin [HbA1C] levels were checked in all People. The Center for Epidemiologic Studies Depression [CES-D] scale was used to assess the depressive symptoms in the study participants. A cut off value of >/= 16 was used to screen for depression. SPSS 19 was used to analyze the results
Results: Out of 104 people with Type-I diabetes, depressive symptoms were observed in 44 [42.3%] participants. Depressive symptoms were more frequent in females [28/55, 50.9%]. Depressed people had more episodes of DKA [11/44, 25%], hypoglycemia [12/44, 27.3%] or hospitalization [7/44, 15.9%] in the last six months which were not statistically significant
Conclusion: Depressive symptoms are quite common in people with Type-I diabetes. Health care professionals should consider screening youth with diabetes for depression regularly. Further large scale studies are needed to validate our findings
ABSTRACT
Objective: There is a strong positive association between increased low-density lipoprotein cholesterol [LDL-C] and coronary heart disease [CHD]
The accuracy of LDL-C estimation is essential and critically important. The aim of present study was to compare calculated LDL-C with direct homogeneous assay in patients with type 2 diabetes
Methods: This observational study was carried out at Baqai Institute of Diabetology and Endocrinology [BIDE] from January 2011 to December 2013. A total of 9620 patients with type 2 diabetes were included in the study
Fasting blood glucose, total Cholesterol, triglyceride, HDL cholesterol and LDL cholesterol were obtained using standard methods. Calculated LDL-C was obtained by Friedewald formula
Results: Mean difference of measured and calculated LDL-C was found to be -0.25, 6.63 and 46.55 mg/dl at triglyceride levels < 150 mg/dl, 150 - 400 mg/dl and > 400 mg/dl, respectively
The result shows that the difference between measured and calculated LDL-C increases as the triglyceride level increases
Conclusions: The findings of our study suggested that calculated LDL-C was lower, as compared to measured LDL-C, which may cause misclassifications that may have an impact on therapeutic decisions in patients with diabetes. Calculated LDL-C may depend on triglyceride levels so LDL-C should be measured by direct assay in routine clinical laboratories
ABSTRACT
To find out the various factors associated with non-adherence to diet, physical activity and insulin among patients with type 1 diabetes. [T1DM]. This cross sectional study was conducted among T1DM subjects attending the Baqai Institute of Diabetology and Endocrinology [BIDE] and Diabetic Association of Pakistan [DAP], from July 2011 to June 2012.Clinical characteristics, anthropometric measurements, knowledge regarding type 1 diabetes along with adherence to dietary advice, physical activity and insulin were noted on a predesigned questionnaire and score was assigned to each question. Patients were categorized as adherent or non-adherent on the basis of scores obtained. Statistical Package for Social Sciences [SPSS] for windows version 17.0 was used to analyze the data. A total of 194 patients [Male 94, Female 100], with mean age of 17.9 +/- 6.4 years, mean duration of diabetes 5.37 +/- 4.96 years [38.1% > 5 yrs, 61.9% < 5 yrs] were included in the study. One hundred and fourteen [58.5%] patients were non adherent to dietary advice, 82[42.3%] non adherent to physical activity while 88.1% respondents were non adherent to their prescribed insulin regimen. Factors associated with non-compliance were family type, occupation and educational level of respondent's parents, duration of T1DM, family history of diabetes, frequency of visits to diabetic clinic, knowledge regarding diabetes, lack of family support and fear of hypoglycemia. Non adherence to prescribed treatment regimen in patient with TIDM is quite high. There is need to design strategies to help patients and their family members understand their treatment regimen in order to improve their adherence
ABSTRACT
To determine the frequency and characteristics of dengue fever [DF] in patients of acute febrile illness presenting at a secondary care hospital. The observational cross sectional study was carried out from May to October 2010 in Remedial Centre Karachi and included patients above the age of 12 years who presented with acute febrile illness. The WHO classification and case definitions were used to classify the disease as Dengue Fever [DF], dengue hemorrhagic fever [DHF] and dengue shock syndrome [DSS]. Clinical, hematological and biochemical findings were recorded serially until discharge. During the study period, 90 [34.75%] presented with typical features of DF, 28 [31.11%] were dengue proven, seven [7.7%] proved to be of malaria in which malarial parasites were found positive in the peripheral blood, while the remaining 55 [61.11%] patients were dengue probable. Age of the patients ranged from 13 to 76 years. Fever was the most common clinical presentation [100%] followed by vomiting 50 [55.56%], body ache 31 [34.44%] abdominal pain 17 [18.89%] and headache 9 [10%]. Maculopapular rash was seen in 4[4.44%] patients. Laboratory findings included thrombocytopenia, leucopenia and raised alanine aminotransferase levels. Eighty one patients [90%] improved clinically and hematologically and were discharged in stable condition. Fever and thrombocytopenia were the most common presentation of dengue fever [DF]. The overall mortality of DF is low, if treated appropriately. Awareness of health care professionals and public regarding preventive strategies is essential to fight against this disease