Epicardial fat thickness obese patients an observational echocardiographic study

Obesity currently affects nearly one-third of the population in the industrialized world. Traditionally, anthropometric measures such as body mass index [BMI] or waist circumference have been used to quantify overall adiposity; however, regional fat depots may be of greater importance than overall adiposity. Several studies have highlighted pericardial fat and abdominal visceral adipose tissue [VAT] as unique, pathogenic fat depot. Recognize the relation of obesity to increase epicardial fat pad thickness in Iraqi patients. Epicardial fat thickness was measured in 62 consecutive subjects [28 women 45%, 34 men 55%] mean age of 47.77 years [SD 8.03], using routine transthoracic echocardiogram. Epicardial fat was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium, and its thickness was measured perpendicularly on the free wall of the right ventricle at end-systole. The results show progressive increase of epicardial fat with increasing BMI which was very significant statistically. High mean epicardial fat is significantly associate with increasing waist circumference. No difference in those below and above 45 years of age in mean epicardial fat and there is gender difference in epicardial fat, where males had more epicardial fat than females. There is increase in the epicardial fat pad thickness in overweight and obese [BMI >/= 25] patients if compared to normal persons epicardial fat increase with increasing waist circumference more likely in male obese and independent on age.

Compliance issue in type ii diabetes: does it reduce the prevalence of cardiovascular risk factors?

Type 2 diabetes, which is the most common form of diabetes, has an alarming increasing rate. It is a recognized risk factor for cardiovascular disease [CVD]. Non-compliance with healthy life styles, anti-diabetic drugs and diet are the central issues in patient's management as it might synergist other CVD risk factors. The aims of this study were to find out the compliance, prevalence of CVD risk factors, and any association between them in type 2 diabetic patients. A cross-sectional design and a convenient sample of 820 diabetic patients were used in conducting this study for the period from the 1st October, 2006 to 31st December, 2008. A Structured questionnaire was used to collect demographic information from the patients. 10 questions were used to determine the patient's compliance. The classic risk factors; obesity, hyperglycemia [HG], hypertension [HT], and hypercholesterolemia [HC], have been studied for each patient and compared with his/her compliance to find any association. The results of this study revealed that there were only 187 out of 820 [22.80%] with good compliance and 297 [36.22%], 336 [40.98%] patients with fair and poor compliance respectively. The prevalence of obesity, over weight, uncontrolled HG, HT [systolic, diastolic or both] and presence of HC in our diabetic patients were 27.32%, 36.83%, 51.95%, 40.73 and 30.37 respectively. Good compliance was associated significantly with normal body weight, controlled HG, absence of HT, and absence of HC. The study concluded that less than one third of our diabetic patients had good compliance. CVD risk factors are prevalent among them, and this prevalence is associated significantly with the level of compliance. Understanding the reasons behind these forms of non-compliance is an important key to the successful development of potential program to decrease the CVD risk factors and associated complications

Compliance behavior of type II diabetic patients attending the specialized center of endocrinology and diabetes in Baghdad

Diabetes mellitus [DM] is a chronic illness that requires continuous medical care to prevent acute and long-term complications. It is an emerging clinical and public health problem. It has been reported that 10.4% of the Iraqi population has been diagnosed as having diabetes. Non-compliance with anti-diabetic drugs and diet are the central issues in patient's management, as it reduces the efficacy of treatment. It also adds considerably to the long term complications of the disease. The aim of this study was to find out the compliance of diabetic patients attending the Specialized Center for Endocrinology and Diabetes [SCED] in Baghdad and assess any association between the compliance and different clinico-epidemiological variables of the patients. A cross-sectional design and a convenient sample was used in conducting this study for the period from the 1[st] October 2006 to the 31[st] July 2007. Three-hundred forty diabetic patients [type II DM] attended the SCED were studied [who had registered in the Center at least one year earlier]. A structured questionnaire was used to collect information from the patients and their files. Modified criteria and scale was used to determine the patient's compliance and its association with different variables. The results of this study revealed that there were only 22 out of 340 [6.47%] patients with excellent compliance, 62 [18.24%] patients with good compliance and 256 [75.29%] patients with fair and poor compliance. There was a statistically significant association of compliance with age, gender, marital status, number of children, level of education, body mass index, smoking, duration of the disease, and the presence of complications. There was no significant association of compliance with occupation and owning a house. The study concluded that most of the diabetic patients [75.29%] had fair and poor compliance which is a high and alarming proportion that may lead to more complications among our patients and hence more burdens on the health system