A clinical profile of diabetic polyneuropathy in Mandalay General Hospital

A cross-sectional study of risk factors, associated complications and nerve conduction studies on diabetic polyneuropathy was conducted on 68 diabetics with and without clinical evidence of polyneuropathy in Mandalay General Hospital over a 9-month study period. Diabetic polyneuropathy was seen in older age groups. the duration of diabetes is a significant risk fator for diabetic polyneuropathy. there was no association with fasting blood sugar levels, smoking, hypertension and hypercholestrolaemia in our study. Diabetic polyneuropathy has increased association with retinopathy, though ischaemic heart disease and nephropathy have no association in our study. On performing nerve conduction studies, diabetic polyneuropathy patients have significantly lower nerve conduction velocity than those without polyneuropathy. Subclinical polyneuropathy was detected in 15 per cent of diabetic cases, without clinical evidence of polyneuropathy. It is concluded that early detection of diabetic subclinical polyneuropathy is possible with electrophysiologic studies. Early detection of subclinical polyneuropathy and early detection and alleviation of risk factors and intensive therapy to control blood glucose may prevent irreversible nerve damage and associated complications.

A study of HbA1c in diabetics of Mandalay General Hospital

The Diabetes Control and Complications Trial (DCCT) demonstrated that in insulin dependent diabetes mellitus, the incidence of retinopathy, nephropathy and neuropathy could be reduced by intensive treatment and reduction of blood glucose concentration and glycosylated haemoglobin values to normal. the present methods of assessing diabetic control ed. urine glucose measurements or random blood glucose estimations tend to be unreliable. They only relate to blood glucose control over the preceding few hours, or minutes respectively. The newly avail-able measurement of the degree of glycosylation of haemoglobin provides an index of integrated plasma glucose levels over a longer period of time, and a completely new tool to aid clinicians. Ninety-six diabetic cases from Medical Unit II and diabetic clinic, Mandalay General Hospital were studied over a 10-month study period from October 1994. Fasting blood sugar and HbA1c levels of patients with and without diabetic complications and risk factors were compared. There is a positive correlation between fasting blood sugar and HbA1c levels in this study. However, there is no significant difference in fasting blood sugar and HbA1c levels of diabetic patients with and without complications as patients were taking regular treatment and follow-up at the diabetic clinic. The mean duration of diabetes in diabetics with and without complications was 6.58 years and 2.69 years respectively. Patients with complications had a significantly longer duration of diabetes although their fasting blood sugar and HbA1c levels are level with those of patients without diabetic complications. This supports the evidence that long-term complications of diabetes are not solely dependent on glycaemic control and duration of diabetes plays an important role. Statistical analysis was done by correlation coefficient and Student's 't' test.

Knowledge, attitudes and behaviours on HIV infection/AIDS among clinical students and house surgeons in Mandalay

Data were collected to assess the current level of knowledge, attitude towards prevention and actual practices among clinical students and house surgeons in Mandalay in 1994. It was found that there were class related differences in KAP scores of medical students. In addition, they could correctly answer the difference between AIDS and HIV infection as their education advanced (Chi=45.55, p < 0.005), but there was no difference with regard to knowledge of AIDS counselling (p > 0.1) and the use of condom (p > 0.1). Only 49.5 percent would like to take care of AIDS patients in their wards. To avoid treating AIDS patients is the main reason in 38.6 percent of them. At the same time, 23 percent of students believed that AIDS should be prevented by isolating HIV infected cases. Percentage of presence of risk behaviour are nearly the same for the three different clases. 27.2 percent of students had heterosex and among them, 51.1 percent reported always using condom while 10.2 percent reported never using condom at all. It may be due to the misperception about the transmission or inability to break down the lod socio-cultural constraints or just due to the fact that information increases knowledge but does not change behaviour. An integrated and comprehensive educational programme and periodic feedback is recommended.