Assessment of diabetics' follow?up in a primary care setting, Riyadh, Saudi Arabia

Aim: The aim of this audit was to examine diabetic patients' follow?up at Aohoud Primary Care Clinic during the year 2013 and then compare the results with a recommended standard

Subjects and Methods: Chronic conditions' database at Aohoud Primary Care Clinic was accessed, diabetic patients were identified and inactive patients were excluded. Computerised and paper records were then reviewed. The number of follow?up investigations and visits [glycated haemoglobin [HbA1c], albumin?creatinine ratio [ACR], fasting lipids, retinal screening and podiatry visits] during 2013 were recorded. Annual follow?up criteria were set as follows: Having an HbA1c blood test at least twice and having ACR, fasting lipids, retinal screening and a podiatry visit at least once. A target of 75% of diabetics meeting the criteria was set up for this audit

Results: The total number of diabetics in Aohoud Clinic was 116 with the majority of them [96.5%] being type 2 diabetics. Sixty?nine percent of diabetics were above the age of 45 and 55.2% of them were females. In the year 2013, 58.6% diabetics had their HbA1c tested at least twice, 47.4% had their ACR measured once, 83.6% had their fasting lipids measured at least once, 29.3% had one retinal screening and only 4.3% had a formal podiatry visit

Conclusion: Deficiencies were observed regarding the diabetics' annual follow?up at our clinic during the year 2013. A more consistent approach is needed in requesting the lab investigations and referrals for diabetics in order to meet the clinic's target. Repeat auditing in a year's time is recommended to monitor improvement

Frequency of glomerular dysfunction in children with beta thalassaemia major

This study investigated the frequency of glomerular dysfunction in children with beta thalassaemia major [beta -TM] by using different markers and correlating them with serum ferritin and iron chelation therapy. The study, carried out between August 2011 and May 2012, included 100 patients with beta -TM, in two groups. Group Ia [n = 62] received chelation therapy [deferoxamine]. Group Ib [n = 38] received followup care at the Pediatric Hematology Outpatient Clinic, Minia University Children's Hospital, Egypt. Group II included 50 apparently healthy controls, age- and sex-matched to Group I. All patients underwent a thorough history-taking, clinical examination and laboratory investigations. Compared to Group II, Groups Ia and Ib had significantly higher levels of cystatin C, serum creatinine and serum ferritin, and a higher albumin/ creatinine ratio in their urine, and a significantly lower estimated glomerular filtration rate [eGFR] and creatinine clearance [P <0.05]. Moreover, Group ?a had a significantly lower eGFR and creatinine clearance than Group Ib. Cystatin C had a highly significant strong negative correlation with eGFR and creatinine clearance and a significantly strong positive correlation with serum ferritin, and a higher sensitivity and specificity than serum creatinine and creatinine clearance for small changes in GFR. beta -TM patients had a high frequency of glomerular dysfunction-possibly attributable to chronic anaemia, iron overload or chelation therapy. Periodic renal assessment is mandatory to detect renal complications. Cystatin C is a promising marker to monitor glomerular dysfunction, having a higher sensitivity and specificity than serum creatinine and creatinine clearance for small changes in GFR

Home environment and its relation to child health in a rural area, Assiut governorate

Children health is threatened from a variety of environmental agents, such as contaminated food and water, polluted indoor and outdoor air, traffic accidents, unsafe housing, environmental tobacco smoke, and exposure to more than 15000 synthetic chemicals. To assess the home environmental hazards and its health effects on children aged from 2-5 years in a rural area, Assiut Governorate, Egypt. This study was conducted using a hybrid design including field cross sectional part and interventional part by using a multistage random sample method, the following steps was conducted to select the study sample. All villages of Awlad-Elyas rural area affiliated to Assiut Governorate were included in the study [4 villages]. From each village 25% of rural families having children aged 2-5 years were systematic randomly selected. The total number was [415] families. Two tools used for data collection the first was structured personal interview and the second was home assessment checklist. Anthropometric measures: weight, height and body mass index was calculated for the children. Data analyzed using SPSS version 16. The mean age of mothers was 30.8 +/- 6.2 years, nearly half of them were at age group<30 years. One third of them were illiterate. The majority of mothers were housewives. [30.1%] of the children complained of pneumonia while 26.7% complained of asthma. For more than two thirds [69.4%] the cause of asthma was exposure to dust and fumes as reported by the mother. There is a strong relation between garbage disposal, animal's enclosure with respiratory complain, pneumonia and asthma of children were habitation with not separated animal's enclosure. Health classes for mothers should be held in MCH centers, well baby clinic and hospitals. It will include knowledge regarding home environmental hazards and its relation to children's health. Arranging a national day for environmental sanitation to increase the public awareness about that issue. And utilizing mass media is one the best methods to increase public awareness of mothers regarding home environmental hazards among their children and to correct the false concepts and habits

Serum levels of adhesion molecules in lichen planus and the effect of associated hepatitis C virus

The aim of this work was to measure the serum levels of intercellular adhesion molecule [ICAM-1], vascular adhesion molecule [VCAM-1] and E- selectin in lichen planus [LP] patients and to compare the levels of these adhesion molecules in LP patients associated with and without hepatitis C virus [HCV]. The serum levels of sICAM-1, sVCAM-1 and sE- selectin were measured by ELISA in 48 LP patients [38 classic and 10 actinic] and 24 healthy controls. Both patients and controls were screened for hepatitis C virus antibodies by ELISA technique. The serum levels of sICAM-1, sVCAM-1 and sE-selectin were significantly higher in LP patients compared with the controls. Only sE-selectin was significantly higher in actinic patients compared with patients with classical LP. There was no significant difference in the studied parameters between patients with and without mucus membrane affection. Hepatitis C associated LP patients had significantly higher levels of sICAM-1 and sVCAM-1 compared with hepatitis C negative patients. No significant difference in the levels of sE-selectin was found between the two groups

Oxidative stress in seminal plasma of subfertile men with varicocele

To compare the oxidative stress in the seminal plasma of subfertile patients with and without varicocele. The free radicals and antioxidants were measured in seminal plasma of subfertile men with [n= 48] and without varicocele [n=50]: lipid peroxidation [LPO], nitric oxide [NO], superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], glutathione reductase [GSH-R], total thiols [TT] and ceruloplasmin [CP]. Samples from patients with varicocele had significantly higher levels of LPO and NO in comparison with subfertile men without varicocele [P<0.001]. In addition, seminal plasma of patients with varicocele showed significantly lower activities of GSH-Px and GSH-R and lower levels of [TT] [P<0.001]. No significant differences in the activities of SOD enzyme and the levels of CP were found when the two groups were compared. Also, no significant differences in these biochemical variables were detected when varicocele was classified according to its grade or laterality. LPO levels correlated negatively with sperm motility [grade A] [r = -0.26, P<0.05], GSH-Px [r = -0.30, P< 0.05] and TT [r= -0.36, P<0.01] while correlated positively with the number of pus cells in semen [r= 0.35, P<0.01]. Furthermore, NO levels correlated positively with the percent of sperms with abnormal morphology [r= 0.34, P< 0.01] while correlated negatively with GSH-R [r=-0.38, P< 0.01]. Oxidative stress may be an important etiologic factor in the pathogenesis of infertility in patients with varicocele compared to other subfertile men. The therapeutic antioxidants and drugs that reduce NO levels may be implicated in the varicocele treatment

Isolation and concentration of microfilariae from peripheral blood of wuchereria bancrofti infected patients by density gradient centrifugation

A Ficoll-Hypaque gradient centrifugation technique was used for isolation and concentration of microfilaria from peripheral blood of 30 subjects with clinically and parasitologically diagnosed Wuchereria bancrofti infections. 86% of the microfilaria were found in the Ficoll-Hypaque layer. None were detected in the plasma, leucocyte layer or lower erythrocyte layer. 14% of microfilaria were identified on the top part of the erythrocyte layer. A 35-fold concentration and 88% quantitative recovery of parasites was achieved by conventional centrifugation of microfilaria-rich Ficoll-Hypaque layer. Following the centrifugation procedures, living motile microfilaria were separated. These results indicated that Ficoll- Hypaque centrifugation technique could be an effective method for the detection of low levels of microfilaremia, and for obtaining relatively pure suspensions of living microfilaria for metabolic studies, production of antigen-rich excretory-secretory products and antigen analysis