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Introducción: La diabetes mellitus tipo 2 (DM2) es un problema de salud pública creciente, frecuentemente asociada con sobrepeso y obesidad. El índice de masa corporal (IMC) y la hemoglobina glicosilada (HbA1c) son indicadores clave en el manejo de la DM2. Objetivo: Correlacionar el IMC y la HbA1c en pacientes con DM2 atendidos en el Hospital Distrital de Capiatá, Paraguay, en diciembre de 2022. Materiales y métodos: Estudio correlacional con datos secundarios de 38 pacientes DM2. Se recolectaron datos demográficos, clínicos, antropométricos y bioquímicos. Se utilizó la correlación de Pearson para determinar la correlación entre IMC y HbA1c, con un nivel de significancia de p<0,05. El protocolo de investigación fue aprobado por el Comité de Ética en Investigaciones de la FCQ-UNA (CEI913/2022). Resultados: El 65,8% fueron mujeres, con edad promedio de 55,8±5,2 años. El 86,8% presentó exceso de peso. La glucemia en ayunas promedio fue 245,0±57,0mg/dL y la HbA1c 8,8±3,4%. Se observó una tendencia al aumento de los niveles de HbA1c con el incremento del IMC. Los pacientes con peso normal presentaron una HbA1c promedio de 6,8±1,5% (buen control), mientras que aquellos con sobrepeso y obesidad mostraron valores de 8,6±2,7% (mal control) y 11,2±3,0% (control crítico), respectivamente. Estas diferencias resultaron estadísticamente significativas (p<0,01). Se observó una correlación fuerte y significativa entre IMC y HbA1c (r=0,681, p<0,01). Conclusión: Existe una correlación directamente proporcional entre el IMC y el control glucémico en pacientes con DM2. Estos hallazgos resaltan la importancia del control del peso en el manejo de la DM2.
Introduction: Type 2 diabetes mellitus (T2DM) is a growing public health problem, frequently associated with overweight and obesity. Body mass index (BMI) and glycated hemoglobin (HbA1c) are key indicators in the management of T2DM. Objective: To correlate BMI and HbA1c in patients with DM2 treated at the Capiatá District Hospital, Paraguay, in December 2022. Materials and methods: Correlational study with secondary data from 38 DM2 patients. Demographic, clinical, anthropometric and biochemical data were collected. Pearson's correlation was used to determine the correlation between BMI and HbA1c, with a significance level of p<0.05. The research protocol was approved by the Research Ethics Committee of the FCQ-UNA (CEI913/2022). Results: 65.8% were women, with an average age of 55.8±5.2 years. 86.8% were overweight. The average fasting blood glucose was 245.0±57.0mg/dL and the HbA1c was 8.8±3.4%. A tendency to increase HbA1c levels with increasing BMI was observed. Patients with normal weight had an average HbA1c of 6.8±1.5% (good control), while those with overweight and obesity showed values of 8.6±2.7% (poor control) and 11.2± 3.0% (critical control), respectively. These differences were statistically significant (p<0.01). A strong and significant correlation was observed between BMI and HbA1c (r=0.681, p<0.01). Conclusion: There is a directly proportional correlation between BMI and glycemic control in patients with DM2. These findings highlight the importance of weight control in the management of T2DM.
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Background: Diabetic autonomic neuropathy can affect the autonomic nervous system (ANS) as a whole and result in a detrimental impact on cardiovascular, gastrointestinal, and genitourinary systems. However, urinary bladder dysfunction is one of the most important complications of long-standing and poorly controlled diabetes mellitus (DM) and often impairs the quality of life presenting as an under-recognized complication of diabetes. Cardiac autonomic functions are also severely affected in DM, leading to cardiac autonomic neuropathy (CAN). Hence, the present study aimed at correlating the urinary bladder functions with cardiac autonomic functions in Type 2 diabetic patients. Aims and Objectives: The aim of the study was to assess the cardiac autonomic functions using a cardiac ANS study (CANS study) and correlate it with the urinary bladder functions using uroflowmetry studies in Type 2 DM patients. Materials and Methods: This is an analytical cross-sectional study, with a sample size of 31 Type 2 DM patients recruited from the diabetology ward of Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai. The patients were clinically examined and the history was collected. The Uroflowmetry test was done in the Department of Urology and the CANS study was done in the Department of Diabetology and the parameters were recorded in Microsoft Excel and analyzed using Statistical Package for the Social Sciences software. Results: A majority of subjects had significant severe and definite sympathetic involvement and early and definite cardiac autonomic neuropathy in the CANS study. Subjects with cardiac autonomic neuropathy had a negative correlation with voided volume, maximum flow rate, and average flow rate and a positive correlation with voiding time, and post-voided residual urine volume. Conclusion: According to this study, subjects with uncontrolled diabetes had predominant sympathetic nervous system dysfunction and also early, definite cardiac autonomic neuropathy. Subjects with early cardiac autonomic neuropathy had significant alterations in the uroflowmetry parameters indicating bladder voiding dysfunction in them. Hence, CANS study and uroflowmetry can be used to determine early ANS dysfunction in DM.
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Background: To effectively manage diabetes, it is crucial to achieve optimal glycemic control by ensuring that A1C levels remain below 7.0%. This study aimed to investigate the impact of Nigella sativa oil (black seed oil, BSO) on glycemic control in alloxan-induced diabetic Wistar rats. Methods: Forty (40) male Wistar rats weighing 200-250 gm were randomly allocated into eight (8) groups of five (5) animals per group. Group 1 received normal saline as the normoglycemic control, while groups 2 to 8 were given alloxan monohydrate to induce hyperglycemia, following the method of Osikwe et al. Following the induction of hyperglycemia, group 2 received normal saline, group 3 received 200 mg/kg of metformin, group 4 received 2 mg/kg of glimepiride, group 5 received 2.5 ml/kg of BSO, group 6 received glimepiride and BSO, group 7 received metformin and BSO, and group 8 received BSO, glimepiride, and metformin. Results: The results showed that BSO significantly reduced fast blood glucose levels compared to the diabetic control group (p<0.05), lowered glycosylated hemoglobin to <7%, and improved pancreatic beta cell function. Conclusions: Black seed oil reduces fasting blood glucose, exhibits synergism with glimepiride, and improves pancreatic beta-cell function in alloxan-induced diabetic Wistar rats.
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Background: Diabetes mellitus is a rapidly increasing global health concern, having a substantial impact on morbidity and mortality. Glycated hemoglobin (HbA1c) is the primary measure of diabetes control, reflecting glycemic levels over the past 3 months. However, hemoglobin (Hb) abnormalities, such as those seen in iron deficiency anemia (IDA), can theoretically affect HbA1c levels. IDA, affecting over 30% of the global population, results from inadequate iron intake, hemorrhage, or poor iron absorption, leading to reduced Hb production. This study aims to evaluate the impact of IDA on HbA1c levels in non-diabetic patients, providing insights into accurate HbA1c interpretation in anemic patients. Aims and Objectives: The study aimed to determine the impact of IDA on HbA1c levels in non-diabetic individuals. Materials and Methods: This cross-sectional study was conducted over 6 months at Trichy SRM Medical College Hospital and Research Center. There were a total of 100 IDA patients and 100 age- and sex-matched healthy controls. Hb levels below 10 g/dL with a microcytic image suggestive of iron deficiency, postprandial blood sugar (PPBS) levels below 140 mg/dL following an oral glucose tolerance test (OGTT), and fasting blood sugar (FBS) levels below 100 mg/dL were the inclusion criteria. Exclusion criteria included Hb levels above 10 g/dL, altered FBS or PPBS values post-OGTT, diagnosed Type 2 diabetes mellitus, individuals younger than 18 years, and those with conditions such as hemoglobinopathies, hemolytic anemia, hypothyroidism, pregnancy, or abnormal renal function tests. Ethical approval and informed consent were obtained. Data collection included demographics, medical history, and laboratory investigations. Statistical analysis was performed using SPSS version 26, with t-tests, mean, and standard deviation (SD) for association analysis, and Chi-square tests for sex comparisons. Correlations were assessed through t-test. The significance level was kept at 0.05. Results: The study confirmed that both groups met the inclusion criteria for non- diabetic status. The control group exhibited normal Hb levels, whereas the study group had Hb levels indicative of IDA. General and systemic examination findings were normal in both groups. Significant differences were observed across all measured parameters, with Hb levels, serum ferritin, mean corpuscular volume, mean corpuscular Hb, mean corpuscular Hb concentration, and red cell distribution width significantly lower in the study group. HbA1c levels were significantly elevated in the study group compared to the control group (5.87 ± 1.25 vs. 4.97 ± 1.59, P < 0.001),supporting the hypothesis that IDA is associated with elevated HbA1c levels in non-diabetic patients. Conclusion: The study’s findings align with previous research indicating that IDA leads to elevated HbA1c levels. The prolonged erythrocyte survival and altered Hb glycation processes in IDA are likely contributors to this elevation. These results emphasize the need to consider anemia status when interpreting HbA1c valuesto avoid misdiagnosis and inappropriate management of diabetes. Clinicians should ensure comprehensive evaluations, including iron status assessments when encountering unexpectedly high HbA1c levels in non-diabetic individuals.
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La diabetes mellitus es una enfermedad metabólica que se caracteriza por tener un aumento en los niveles de glucemia, causando un estado inflamatorio sistémico que puede afectar la cicatrización de las lesiones periapicales presentes en la periodontitis apical, una enfermedad inflamatoria crónica causada por una infección endodóntica cuyo desarrollo está regulado por la respuesta inmunitaria del huésped. La diabetes podría interactuar con la periodontitis apical al desencadenar la modulación inmunitaria, pudiendo afectar la respuesta clínica de las lesiones periapicales e interferir con la cicatrización después del tratamiento endodóntico. El objetivo de esta revisión de la literatura es analizar la evidencia respecto a la relación entre la diabetes mellitus y la presencia y severidad de la periodontitis apical de origen endodóntico. Se recopilaron artículos de las bases de datos PubMed, Scopus y Web of Science entre los años 2016 y 2021. Se eligieron 31 artículos pertinentes para el estudio. En el 41,6% de los estudios se encontró una mayor presencia de periodontitis apical en pacientes con diabetes asociada a una lesión apical más compleja y comprometida. Un 25% de los estudios encontró que los pacientes diabéticos mal controlados presentan mayor presencia de periodontitis apical. Un 25% de los estudios encontró que niveles altos de HbA1c se asocian a la presencia de periodontitis apical. Se encontró una relación entre la diabetes y la periodontitis apical, por lo que la diabetes debe ser considerada como un factor preoperatorio importante en el desarrollo y severidad de la periodontitis apical, sin embargo, se deben realizar estudios experimentales más estandarizados para poder determinar con mayor exactitud esta relación, además de poder indagar la bidireccionalidad entre ambos.(AU)
Diabetes mellitus is a metabolic disease that is characterized by an increase in blood glucose levels, causing a systemic inflammatory state that can affect the healing of periapical lesions present in apical periodontitis, a chronic inflammatory disease caused by an endodontic infection whose development is regulated by the host's immune response. Diabetes could interact with apical periodontitis by triggering immune modulation, being able to affect the clinical outcome of periapical lesions and interfering with healing after endodontic treatment. The objective of this literature review is to analyze the evidence regarding the relationship between diabetes mellitus and the presence and severity of apical periodontitis of endodontic origin. Articles were collected from the PubMed, Scopus and Web of Science databases between the years 2016 and 2021. 31 relevant articles were included for this study. In 41.6% of the studies a greater presence of apical periodontitis was found in patients with diabetes associated with a more complex and compromised apical lesion. 25% of the studies reported that poorly controlled diabetic patients had a greater presence of apical periodontitis. 25% of the studies reported high levels of HbA1c in association with apical periodontitis. A relationship was found between diabetes and apical periodontitis, which means diabetes should be considered as an important preoperative factor in the development and severity of apical periodontitis; however, more standardized experimental studies should be carried out to determine this relationship more accurately, in addition to being able to investigate a bidirectionality between the two.(AU)
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Resumen Objetivo: Determinar las Estrategias de Afrontamiento en pacientes con Neuropatía Periférica con Diabetes Tipo 2 de una Unidad de Medicina Familiar de la Seguridad Social en Tabasco, México. Material y métodos: Estudio observacional, transversal y analítico. Muestra n=118 pacientes con Diabetes Tipo 2, que cumplieron los criterios de inclusión y aceptaron participar previo consentimiento informado. Se aplicó cuestionario de datos sociodemográficos-clínicos, el inventario de estrategias de afrontamiento (CSI) y evaluación de Neuropatía Periférica Diabética con instrumento modificado del Sistema de Información Médica Familiar (SIMF), IMSS. La información se obtuvo de pacientes y expedientes clínicos. El análisis de la información incluyó estadística descriptiva e inferencial con chi cuadrada de Pearson y valor p≤0.05 El proceso de datos se realizó con programa SPSS 26. Resultados: Pacientes con edad Ⱦ=59 años, mujeres 73.7% (87), casadas 55.1% (65), labores del hogar 52.5% (62), secundaria 32.2% (38). Con HbA1C ≥7%: 83.1% (98), IMC Ⱦ≥30 Kg/m2. Se observó Neuropatía Periférica estadio II y III con HbA1C ≥7%, sin afrontamiento 62.2% (61), con X 2 =11.508, gl=3 y p=0.003 estadísticamente significativo. Conclusiones: Los pacientes con hemoglobina glucosilada HbA1C≥7%, presentaron estrategias de afrontamiento inadecuadas desadaptativas centradas en la emoción, predominando las subescalas primarias retirada social y autocrítica. La neuropatía periférica estadio II con HbA1C igual o mayor a 7% presentó mayor prevalencia en mujeres cuyas estrategias de afrontamiento fueron inadecuadas, desadaptativas centradas en la emoción.
Abstract Objective: Determine Coping Strategies in patients with Peripheral Neuropathy with Type 2 Diabetes in a Social Security Family Medicine Unit in Tabasco, Mexico. Material and methods: Observational, cross-sectional and analytical study. Sample n=118 patients with Type 2 Diabetes, who met the inclusion criteria and agreed to participate with prior informed consent. A sociodemographic-clinical data questionnaire was applied, the coping strategies inventory (CSI) and evaluation of Diabetic Peripheral Neuropathy with a modified instrument from the Family Medical Information System (SIMF), IMSS. The information was obtained from patients and clinical records. The analysis of the information included descriptive and inferential statistics with Pearson's chi square and p value≤0.05. The data processing was carried out with SPSS 26 program. Results: Patients aged Ⱦ=59 years, women 73.7% (87), married 55.1% (65), housework 52.5% (62), secondary school 32.2% (38). With HbA1C ≥7%: 83.1% (98), BMI Ⱦ≥30 Kg/m2. Peripheral Neuropathy stage II and III was observed with HbA1C ≥7%, without coping 62.2% (61), with X 2 =11.508, gf=3 and p=0.003 statistically significant. Conclusions: Patients with glycated hemoglobin HbA1C≥7% presented inadequate maladaptive coping strategies focused on emotion, with the primary subscales social withdrawal and self-criticism predominating. Stage II peripheral neuropathy with HbA1C equal to or greater than 7% presented a higher prevalence in women whose coping strategies were inadequate, maladaptive focused on emotion.
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Background & Objectives: The importance of this study lies in the ever-increasing prevalence of diabetes and the fact that serum GGT (Gamma Glutamyl Transferase) levels re?ect a diverse metabolic process [9]. This aim of this study is to unravel the potential association between serum GGT levels and serum glycated hemoglobin (HbA1c). In this observational studyMethods: outpatients above 18 years of age were selected. Individuals meeting the inclusion criteria were selected from all the three metabolic spectrums i.e. non diabetic, pre diabetic and diabetic and the relationship between HbA1c and GGT was measured in all of them. In this study, a totalResults: of 122 patients were included, comprising 40 non-diabetic, 41 prediabetic, and 41 diabetic individuals. The mean serum GGT level across all participants was 23.63, with a standard deviation of 11.82 (p value = 0.000079). Mean of GGT in non-diabetic, prediabetic, diabetic patients were 16.6 (SD = 8.59), 24.64 (SD = 11.6) and 29.5 (SD = 11.6) respectively. It was observed that in the higher quartiles of GGT more prediabetic and diabetic individuals were present as compared to lower quartiles. In our study a strong link is found betweenInterpretation & Conclusions: serum GGT levels and serum HbA1c levels. This suggests a signi?cant relationship between glucose metabolism and serum GGT levels in the body [11]. This opens the doors for future research into the relevance of serum GGT levels as a marker for glucose intolerance.
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Background: Pulmonary tuberculosis (PTB) mortality remains high despite current availability of effective anti-TB drugs. This could be due to pathophysiological derangements that are not fully understood and managed during anti-TB therapy. The objective of this study was to evaluate the hematological changes in newly diagnosed PTB patients. Methods: 55 newly diagnosed PTB patients and 55 healthy controls were included in this cross-sectional non-randomized study. Complete hematological profiles were determined using an automatic analyzer. Peripheral blood films were used to evaluate cellular morphology. Data was analyzed using chi-square and Mann-Whitney tests (SPSS version 29.0). Results: Males constituted 80% (44) of the newly diagnosed PTB patients and 81.8% of the blood donor controls. Compared with the control group, the PTB patients group exhibited significantly lower median red blood cell (RBC) count (4.79×106 µl vs 5.2×106 µl, p=0.001), hemoglobin levels (12.8 g/dl vs 14.3 g/dl, p=0.0001), hematocrit (37.9% vs 42.05%, p=0.0001), mean platelet volume (8.9 fl vs 10.5 fl, p=0.0001) and platelet distribution width (10.4 fl vs 13.0 fl, p=0.0001). The median platelet count for the PTB group was significantly higher relative to controls (314.0×103/µl vs 237.0×103/µl, p=0.0001). Similarly, the PTB group had a significantly higher PCT% compared to controls (0.27% vs 0.25%, p=0.002). Morphological analysis of peripheral blood films revealed normocytic normochromic anemia and microcytic hypochromic anemia in 54.5% (n=30) and 34.6% (n=19) of PTB patients, respectively. Conclusions: Newly diagnosed PTB patients in Western Kenya present with leukocytosis, elevated platelet count and anemia, suggesting the need for appropriate management and routine monitoring of hematological profiles.
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Backgrounds: Iron nutritional anemia is anemia that arises due to empty iron reserves in the body so that the formation of hemoglobin is disrupted. Hemoglobin is part of red blood cells used to determine anemia status. Decreased iron intake can reduce hemoglobin levels in the body. Aim: The purpose of the study was to determine food intake and consumption of blood supplement tablets (Iron) on the incidence of anemia among adolescent girls in Urban and Rural areas. Study Design: This type of research is Experimental Research using Quasi Experimental design. Place and Duration of Study: This research was carried out at SMP Negeri 3 Manado and SMP Kristen Koha after obtaining approval from the ethics commission in August � September 2023 Methods: The population in this study were adolescent girls in SMP Negeri 3 Manado and SMP Kristen Koha. The sample in this study was obtained from the Estimating the difference between two population proportions with absolute precision formula totaling 88 students divided into 44 adolescent girls in urban areas and 44 adolescent girls in rural areas. Results: This study indicates that there is a difference in the average hemoglobin levels of adolescent girls in State Junior High School 3 Manado and Kristen Koha with a value of p<0.005, there is a difference in the average food intake (energy) of adolescent girls State Junior High School 3 Manado and Kristen Koha with a value of p<0.005, there is a difference in the average consumption of Iron tablets of adolescent girls in State Junior High School 3 Manado and Kristen Koha with a value of p<0.005. Conclusion: The conclusion of this study is that there is a difference in the average hemoglobin levels of urban and rural adolescent girls with p<0.005, there is a difference in the average food intake (energy) of urban and rural adolescent girls p<0.001, and there is a difference in the average consumption of Iron tablets of urban and rural adolescent girls with p<0.004.
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La fisiopatología de la diabetes incluye la persistencia de un estado inflamatorio de bajo grado caracterizado por el incremento de citocinas proinflamatorias, proteínas de fase aguda y alteraciones en la respuesta inmunitaria que conllevan al desarrollo de complicaciones macrovasculares y microvasculares. Los mecanismos involucrados en la activación del estado inflamatorio no están totalmente esclarecidos, pero se sabe que la hiperglucemia juega un rol determinante. La hemoglobina glicada es en la actualidad el marcador biológico por excelencia utilizado para evaluar la evolución de los niveles de glucemia en los pacientes diabéticos debido a su formación irreversible y acumulativa, proporcionando información retrospectiva sobre el equilibrio glucémico durante dos a tres meses anteriores a su medición. Sin embargo, poco se conoce sobre su asociación con la respuesta inflamatoria en estos pacientes. El objetivo de esta investigación es recopilar evidencias que permitan establecer una asociación entre los niveles de HbA1c y el estado inflamatorio en pacientes con diabetes mellitus, lo que permitiría considerar a la HbA1c no sólo como una medida fiable para evaluar el control glucémico retrospectivo. Sino además, como un biomarcador asociado al estado inflamatorio y por consiguiente al riesgo de desarrollar complicaciones propias de esta enfermedad.
The pathophysiology of diabetes includes the persistence of a low-grade inflammatory state characterized by an increase in proinflammatory cytokines, acute phase proteins and alterations in the immune response that lead to the development of macrovascular and microvascular complications. The mechanisms involved in the activation of the inflammatory state are not fully elucidated, but it is known that hyperglycemia plays a determinant role. Glycated hemoglobin is currently the biological marker par excellence used to evaluate the evolution of blood glucose levels in diabetic patients due to its irreversible and cumulative formation, providing retrospective information on the glycemic balance during two to three months prior to its measurement. However, little is known about its association with the inflammatory response in these patients. The aim of this research is to gather evidence to establish an association between HbA1c levels and inflammatory status in patients with diabetes mellitus, which would allow HbA1c to be considered not only as a reliable measure to assess retrospective glycemic control. But also as a biomarker associated with the inflammatory state and, consequently, with the risk of developing complications of this disease.
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Humans , Diabetes Mellitus/diagnosis , Diabetes Mellitus/blood , Glycated Hemoglobin/analysis , Glycated Hemoglobin/adverse effects , Biomarkers , Diabetes Mellitus/pathology , Hyperglycemia , InflammationABSTRACT
Background: Sickle cell disease (SCD) is a monogenic disorder characterized by aberrant hemoglobin S (Hb S) due to an A-to-T mutation in the ?-globin gene. This leads to erythrocytes deforming or sickling, causing sickle cell crises, growth retardation, increased infection susceptibility, chronic hemolysis, multi-system organ damage, disability, and death. Anemia in SCD patients is primarily due to reduced red cell lifespan and hypersplenism in infants. Methods: Patients from the VIMSAR Burla general medicine ward OPD/IPD were randomly assigned to a control group and a study group. Clinical examinations and histories were recorded, including hospital stay frequency, volatile organic compounds, blood transfusion history, and medication use. Patients on hydroxyurea continued their treatment. Conventional blood investigations (CBC, random blood sugar, liver function tests, serum urea, creatinine levels, and urine analysis) were conducted. Results: The study showed that SCD patients in the study group taking 4 mg/day of aspartame had a significant increase in mean hemoglobin percentage starting from the first month and continuing until the third month, compared to the control group. The most substantial therapeutic benefit was observed in the third month. Conclusion: Currently, hydroxyurea is the only FDA-approved effective treatment for SCD, but it it has several side effects. Aspartame, a safer over-the-counter medication, demonstrated greater efficacy than hydroxyurea in raising Hb% and reducing VOC, hospitalisations, and blood transfusions without adverse effects over a six-month trial. Aspartame is suggested as a potential first-line treatment for SCD, warranting a large-scale double-blind randomised controlled study to confirm its therapeutic benefits.
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Introducción. La diabetes mellitus de tipo 1 se considera una de las enfermedades crónicas más frecuentes de la infancia. Es un factor de gran riesgo de desarrollar enfermedad cardiovascular temprana y afecta también la salud ósea. Objetivo. Describir las características demográficas y los parámetros bioquímicos de una población de niños con diabetes de tipo 1, supervisados en la unidad pediátrica de diabetes de un hospital español de tercer nivel. Materiales y métodos. En este estudio retrospectivo, se determinaron los parámetros de control metabólico, lipídico y óseo en 124 niños con diabetes de tipo 1, a los que se hizo seguimiento en la Unidad Pediátrica de Diabetes del Hospital Universitario Miguel Servet de Zaragoza, desde mayo del 2020 hasta julio del 2021. Resultados. Los niños con diabetes de tipo 1 presentan peor control metabólico de la enfermedad en la pubertad, pero su control lipídico se puede considerar aceptable. Existe una correlación inversa de los marcadores de formación ósea con el tiempo de evolución de la enfermedad, así como con el control metabólico. Conclusión. Los marcadores de formación ósea se encuentran correlacionados de forma inversa con el porcentaje de hemoglobina glicosilada y con el tiempo de evolución de la diabetes. En estos pacientes, el perfil lipídico y el óseo son más favorables cuando existe un buen control metabólico de la enfermedad.
Introduction. Type 1 diabetes mellitus is considered one of the most common chronic diseases of childhood. It is a high-risk factor for developing early cardiovascular disease and it also affects bone health. Objective. To describe demographic characteristics and biochemical parameters of a population of children with type 1 diabetes, evaluated in the pediatric diabetes unit of a tertiary Spanish hospital. Materials and methods. In this retrospective study, we determined metabolic, lipid, and bone parameters in 124 children with type 1 diabetes who were monitored in the pediatric diabetes unit of the Hospital Universitario Miguel Servet in Zaragoza (Spain) from May 2020 to July 2021. Results. Children with type 1 diabetes have worse metabolic control of the disease at puberty, but their lipid control is considered acceptable. We found an inverse correlation between bone formation markers and disease duration, as well as with metabolic control. Conclusion. Bone formation markers are inversely correlated with the percentage of glycated hemoglobin and diabetes evolution time. Patients' lipid and bone profiles are more favorable when metabolic control of the disease is achieved.
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Humans , Child , Diabetes Mellitus, Type 1 , Glycated Hemoglobin , Osteocalcin , LipidsABSTRACT
Background: Several studies have reported the effectiveness and safety of liposomal iron in increasing hemoglobin levels and correcting anemia. However, there was a dearth of information regarding the prescription pattern of physicians regarding its use and advantages in the actual practice. The present survey-based study aims at gathering clinicians' perspectives regarding the clinical use and benefits of liposomal iron in the treatment of anemia in Indian settings. Methods: This cross-sectional study used a 19-item questionnaire to gather insights from specialists across different Indian settings regarding their perspectives on anemia and liposomal iron. Results: Out of 124 participants, 77% opined that liposomal iron was highly bioavailable, achieves much higher plasma iron concentration, and bypasses the extremely restrictive, normal intestinal barriers. Oral liposomal iron was preferred by 77% of clinicians for the rapid increase in hemoglobin level and 99% of clinicians reported improved patient compliance with liposomal iron therapy for anemia. According to 50% of clinicians, oral liposomal iron was effective in non-hemodialysis dependent chronic kidney diseases and 87% of clinicians reported that patients without CKD needed oral liposomal iron. Half of the respondents reported a significant increase in Hb with liposomal iron in both dialysis and non-dialysis patients. Conclusions: The survey participants reported that liposomal iron treatment for anemia was beneficial in treating both CKD and non-CKD patients. The survey findings have corroborated the advantages of liposomal iron for treating anemia such as increased bioavailability, rapid and effective increase in Hb level, better patient compliance and tolerability, decreased side effects, cost-effectiveness, and flexible dosing.
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Background: Blood transfusion is a life-saving intervention. Blood should be accepted from non-remunerated and healthy donors. Proper donor screening procedure minimizes the risk of transfusion transmitted Infections and also wastage of blood and blood products and thus screening of donors is a prerequisite for blood donation. Methods: This is a retrospective study conducted in blood bank center in the Department of Pathology in a Government teaching hospital, Shivamogga from January 2022 to June 2022. All the voluntary and replacement donors were evaluated by the standard questionnaire and medical examination including demographic profile, anthropometry, blood group, vital signs and hemoglobin estimated by cyanmethemoglobin method were collected from the donation requisition forms and online deferred list. The data were represented in the form of percentage, descriptive statistics and analysed. Results: Out of 3,449 blood donors, 252 were deferred. The deferral rate was 7.31%. Among the ineligible donors, males 245 (97.22%) outnumbered females 7 (2.8%). 242 donors (96.03%) were temporarily rejected among which high blood pressure constituted to 23.02% followed by alcohol consumption (11.11%) whereas 10 donors (3.96%) were deferred permanently. 9 donors (3.57%) had low haemoglobin level. Conclusions: Temporary deferrals are more than permanent deferrals thus temporarily deferred donors should be instructed to return for blood donation after their period of deferral days to retain the pool of blood donors.
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Background: Anemia is worldwide health problem. Medical students come from different geographical regions, socio-economic status and cultural backgrounds. Pernicious anemia occurred more frequently in A blood group males and females. This study was undertaken to find out correlation of hemoglobin with blood group in medical students. Methods: A total of 150 healthy students were finally recruited for the study consisted of 79 males and 71 females. In this study, blood group was determined using glass slide method while hemoglobin concentration was estimated using Sahli抯 method. Results: Blood group O+ was the most common, followed by B+ blood group in our study. In this study 132 healthy students tested Rh+, whereas the remaining 18 tested Rh-. In this study, students with hemoglobin concentration less than 10 gm/dl were taken as anemic. Total 40 students are anemic, out of 40, 28 females were anemic whereas only 12 males were found to be anemic. 36 students with Hb less than 10 gm/dl were Rh positive and 4 students Rh negative. Conclusions: In this study, students with blood group B are more prone to anemia followed by blood group O; A and least is with blood group AB.
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Background: Diabetes Mellitus Type 2 (DMT2) is one of the commonest disorders of endocrinology which is characterized by the raised blood glucose level due to insulin resistance in body cells. This study was aimed to determine the correlation between the glycated hemoglobin (HbA1c) and serum uric acid (SUA) in patients with DMT2. Methods: This cross-sectional study was conducted in a tertiary care hospital of Lahore. 73 Patients’ recruitment was made via convenient sampling technique and a developed inclusion and exclusion criteria. Self-structured proforma was used for data collection. Data analysis was done in SPSS version 25.0. Results: From total patients, 40 (54.79%) were women while 33 (45.21%) were men. Means of different variables like age, HbA1c, and serum uric acid level were 54.98 years with standard deviation (SD) of ±11.67 years, 7.90 with SD of ±1.85%, and 7.51 with SD of ±0.81 respectively. 32 (43.83%) patients had good glycemic control whereas 41 (56.17%) patients had poor glycemic control. The frequencies of hyperuricemia and normal SUA in study population were 35 (47.94%) and 38 (52.06%) respectively. The means of the HbA1c across gender had statistically significant difference. Difference in the means of the SUA level, across gender and between patients with hyperuricemia and normal SUA level, was also statistically significant. Moreover, correlation between the HbA1c and SUA was positive and statistically significant. Conclusions: In a nutshell, this study suggests that increase in SUA level, worsen the glycemic control by raising glycated hemoglobin level among patients with DMT2.
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Background: Anemia is a recognized risk element for numerous adverse outcomes during pregnancy and childbirth. However, limited comprehensive data is available regarding its influence on specific maternal health issues. Additionally, there is inadequate research on the connections between anemia during pregnancy and the resulting impacts on both the mother and the fetus outcome. Methods: In this observational study, a total of 414 pregnant female participants were recruited according to their hemoglobin levels (Hb). The subjects were divided into mild, moderate, and severe anemia according to their hemoglobin level, Results: The study consisted of 414 women with varying degrees of anemia: mild (228,55.1%), moderate (128,30.9%), and severe (58,14%). The morphological analysis indicated that the majority of cases exhibited normocytic normochromic anemia, as opposed to microcytic hypochromic anemia, in both mild (60.5% vs 39.5%) and moderate anemic pregnant women (55.5% vs 44.5%). However, this proportion was reversed in severe cases, with a prevalence of 84.5% for microcytic hypochromic anemia. The results indicated that pregnant women with anemia were more likely to experience adverse outcomes, except for placental complications (p-value=0.05), delivery method (p-value=0.02), and fatal consequences such as low birth weight and miscarriage (p<0.05, respectively). Conclusion: The prevalence of mild-moderate and severe anemia was found to be associated with maternal complications and adverse outcomes such as low birth weight and miscarriage. Adopting a comprehensive approach to prevent anemia in women of reproductive age is crucial to improving their hematological status and enhancing maternal and child health outcomes.
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Background: Cardiovascular diseases (CVD) continue to be the leading cause of mortality in patients with diabetes. Uncontrolled blood glucose levels are thought to increase the likelihood of CVD in individuals with diabetes. Therefore, stratification of cardiovascular risk in people with diabetes is crucial. Objective: To assess the relationship between cardiovascular risk, as measured by the Jakarta Cardiovascular Score (JCS), and blood glucose control, as shown by hemoglobin A1c (HbA1c) levels, in individuals with diabetes. Materials and Methods: A cross-sectional analytic analysis was undertaken in a private clinic between April and June 2022. This study examined 110 diabetes patients who had not experienced any cardiovascular complications. Correlation analysis was employed to investigate the association between the risk of CVD and levels of HbA1c. Results: According to JCS, a significant proportion of patients (86.4%) were classified as high risk for CVD. The recorded HbA1c values varied from 5% to 16.20%. Around 90% of the study participants exhibited uncontrolled blood glucose levels, as evidenced by an HbA1c value exceeding 7%. Nevertheless, individuals with HbA1c levels below 7% exhibited a more excellent average total risk score. The JCS and HbA1c levels showed a weak negative connection, with a correlation coefficient (r) of -0.198 and a P value of 0.038. Conclusion: There is a weak negative correlation between the cardiovascular risk score of diabetic patients and their blood glucose control.
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Introducción: la diabetes mellitus es una enfermedad crónica que, al no ser controlada, puede desencadenar en complicaciones macro y microvasculares. Uno de los indicadores de un adecuado control glucémico es la hemoglobina glicosilada. Objetivos: determinar la frecuencia de complicaciones macro y microvasculares en pacientes diabéticos tipo 2 con hemoglobina glicosilada alterada internados en el Hospital Nacional de Itauguá periodo 2022 - 2023 Metodología: estudio observacional, descriptivo de corte transversal que incluyó a 170 pacientes adultos internados en el servicio de clínica médica del Hospital Nacional (Itauguá, Paraguay) durante los años 2022 y 2023. Resultados: la edad media fue de 58 ± 12 años, con predominio del sexo femenino (51 %). La complicación más frecuentemente diagnosticada fue la enfermedad del pie relacionada a la diabetes con 83 pacientes (49 %), seguido por retinopatía diabética 23 (14 %). El valor promedio de hemoglobina glicosilada fue de 10 ± 2 %. Solamente 6 (4 %) del total de pacientes presentó un valor de HbA1C≥ 7,1 %. La comorbilidad asociada más frecuente fue la hipertensión arterial 87 (51 %). El 91 % de los pacientes conocía ser portador de la enfermedad, el 80 % recibía algún tipo de tratamiento. Conclusiones: el pie diabético fue la complicación vascular diagnosticada con mayor ,frecuencia, especialmente en pacientes con HbA1C≥ 7,1 %.
Introduction: diabetes mellitus is a chronic disease that, if not controlled, can lead to macro- and microvascular complications. One of the indicators of adequate glycemic control is glycosylated hemoglobin. Objectives: to determine the frequency of macro and microvascular complications in type 2 diabetic patients with altered glycosylated hemoglobin admitted to the Hospital Nacional from 2022 to 2023 Methodology: this was an observational, descriptive, cross-sectional study that included 170 adult patients admitted to the Internal Medicine service of the Hospital Nacional (Itauguá, Paraguay) during the years 2022 and 2023. Results: the mean age was 58 ± 12 years, with a predominance of the female sex (51 %). The most frequently diagnosed complication was foot disease related to diabetes with 83 patients (49 %), followed by diabetic retinopathy 23 (14 %). The average value of glycosylated hemoglobin was 10 ± 2 %. Only 6 (4 %) of the total patients had an HbA1C value ≤7 %. The most frequent associated comorbidity was arterial hypertension 87 (51 %). 91 % of the patients knew they were carriers of the disease, 80 % received some type of treatment. Conclusions: diabetic foot was the most frequently diagnosed vascular complication, especially in patients with HbA1C ≥7.1 %.
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Resumo Fundamento: A triagem do câncer é absolutamente necessária em pacientes com derrame pericárdico, pois o câncer é uma das doenças mais graves em sua etiologia. Estudos anteriores indicaram que o índice de inflamação imunológica sistêmica (IIS), o índice prognóstico nutricional (PNI) e o escore de hemoglobina, albumina, linfócitos e plaquetas (HALP) podem ser escores relacionados ao câncer. Objetivos: Este estudo foi iniciado considerando que esses sistemas de pontuação poderiam prever o câncer na etiologia de pacientes com derrame pericárdico. Métodos: Os pacientes submetidos à pericardiocentese entre 2006 e 2022 foram analisados retrospectivamente. A pericardiocentese foi realizada em um total de 283 pacientes com derrame pericárdico ou tamponamento cardíaco de moderado a grande no período especificado. Os índices de HALP, PNI e IIS foram calculados do sangue venoso periférico retirado antes do procedimento de pericardiocentese. O nível de significância estatística foi aceito em p<0,05. Resultados: O escore HALP foi de 0,173 (0,125-0,175) em pacientes com câncer. Detectou-se que em pacientes não oncológicos o escore foi de 0,32 (0,20-0,49; p<0,001). O escore de PNI foi de 33,1±5,6 em pacientes com câncer. Detectou-se que em pacientes não oncológicos o escore foi 39,8±4,8 (p<0,001). Conclusão: Os escores HALP e PNI são testes de triagem de câncer fáceis e rápidos que podem prever metástases de câncer na etiologia de pacientes com derrame pericárdico.
Abstract Background: Cancer screening is absolutely necessary in patients with pericardial effusion, given that cancer is one of the most serious diseases in the etiology of pericardial effusion. In previous studies, it was stated that the systemic immune-inflammation index (SII); the prognostic nutrition index (PNI); and the hemoglobin, albumin, lymphocyte, platelet (HALP) score can produce scores related to cancer. Objectives: This study began considering that these scoring systems could predict cancer in the etiology of patients with pericardial effusion. Methods: This study produced a retrospective analysis of patients who underwent pericardiocentesis between 2006 and 2022. Pericardiocentesis was performed in a total of 283 patients with moderate-to-large pericardial effusion or pericardial tamponade within the specified period. HALP, PNI, and SII scores were calculated according to the peripheral venous blood taken before the pericardiocentesis procedure. The statistical significance level was set at p<0.05. Results: The HALP score proved to be 0.173 (0.125-0.175) in cancer patients and 0.32 (0.20-0.49) in non-cancer patients (p<0.001). The PNI score proved to be 33.1±5.6 in cancer patients and 39.8±4.8 in non-cancer patients (p<0.001). Conclusion: The HALP score and PNI proved to be easy and fast cancer screening tests that can predict cancer metastasis in the etiology of patients with pericardial effusion.