Incidence of Post-septoplasty Bleeding in patients without Nasal Packing

Objective: To evaluate the incidence of post-septoplasty hemorrhage and hematoma formation in patients without anterior nasal packs

Design: A Retrospective Study

Setting: ENT Department, Salmaniya Medical Complex, Kingdom of Bahrain

Method: Fifty-one patients with a symptomatic deviation of nasal septum who had septoplasty with/without inferior turbinoplasty were included in the study from August 2008 to April 2015. Patients who underwent septoplasty combined with endoscopic sinus surgery were excluded. Septoplasty was performed without postoperative anterior nasal packing, and the patients were assessed for postoperative bleeding and hematoma formation. All patients were followed-up for 4 weeks

Result: Two [3.9%] patients had postoperative bleeding on the day of operation. Forty-nine [96.1%] patients had no nasal bleeding during the hospital stay and no patient had hemorrhage after discharge. No patients had septal hematoma during the follow-up period

Conclusion: Incidence of bleeding following septoplasty without anterior nasal packing is very low and nasal packing should not be routinely used for this procedure

Impact of patient satisfaction with health care on glycaemic control among diabetic patients

Patient satisfaction with medical care is an important factor affecting treatment outcome in a chronic disease like diabetes mellitus. This study was formulated to detect the impact of patient satisfaction on glycaemic control among diabetic patients. The cross-sectional design was selected. A sample size of 526 diabetic patients was selected from a diabetes clinic to reveal the impact of patient satisfaction on fasting blood glucose and glycated haemoglobin A1c. The structured interview technique was adopted to collect both socio-demographic and clinical data of diabetic patients in addition to a fasting blood sample. The overall satisfaction and communication domains have the highest satisfaction mean scores [14.27 +/- 1.878 and 13.65 +/- 1.476], while accessibility and waiting time domains have the lowest satisfaction scores [8.97 +/- 2.059 and 8.99 +/- 1.387]. Diabetics with higher total satisfaction score were practicing regular periodic check up [82.37 +/- 7.027 compared with 78.63 +/- 7.538, P < 0.001], diet control [82.55 +/- 6.632 compared with 80.88 +/- 7.596, P = 0.0113] and were adherent to treatment regimen [81.96 +/- 7.072 compared with 77.92 +/- 8.068, P < 0.001]. Diabetic patients achieving the targeted level of either fasting blood glucose [83.35 +/- 6.777 compared with 80.72 +/- 7.418, P <0.001] or HbA1c [85.66 +/- 5.211 compared with 80.48 +/- 7.415, P < 0.001] had a significantly higher total satisfaction score than those not achieving the targeted levels. Satisfied diabetics with administered health services were more adherent to healthy practices and had a better control on HbA1c the long term component of glycaemic control

Effectiveness of self monitoring of blood glucose on glycaemic control among diabetic patients

Self monitoring of blood glucose [SMBG] is becoming of great importance for self management of diabetes mellitus. This study was formulated to detect the impact of decreased SMBG on glycaemic control among diabetic patients. The design of this study was a cross-sectional one. A sample size of 526 diabetic patients was selected from a diabetes clinic to reveal the impact of SMBG on fasting blood glucose and glycated haemoglobin A1c. The structured interview technique was adopted to collect both socio-demographic and clinical data of diabetic patients in addition to a fasting blood sample. Out of the total sample, 59.7% were performing SMBG, while only 18.6% were monitoring using this technique according to the recommended standard. Users of SMBG were more likely to have controlled fasting blood glucose [29.9% compared with 20.8%, P = 0.09] and controlled HbA1c [25.5% compared with 6.6%, P < 0.001] than non users. This impact was also evident after adjusting for the confounding factors. A decreasing trend in FBG was demonstrated with increased frequency of SMBG. Older age, higher level of education and positive family history proved to be significant predictors for using SMBG. SMBG can help diabetic patients to achieve a better glycaemic control especially if it is used in the recommended frequency. SMBG should be encouraged among all diabetic patients