RESUMO
Objectives: In the UAE, the comparative prevalence of diabetes is reported as 18.98%, but there are very few studies evaluating glycemic control. Attaining the optimum glycemic control has been a global challenge over the years. However, there is a trend of global improvement with the availability of newer options of antidiabetic medications, increasing numbers of physicians, and patient awareness. Our primary aim was to assess the level of glycemic control across Dubai Health Authority points of care over the past five years. Additionally, we aimed to compare the differences in glycemic control between primary and tertiary centers, between nationalities, and type I and II diabetes
Methods: We conducted a retrospective analysis of the electronic medical records of all patients who attended primary and tertiary care centers within the Dubai Health Authority between 2012 and 2016. All patients with any type of diabetes were included in this assessment
Results: A total of 26 447 patients were included in the study; of these, 73.8% [n = 19 508] were UAE nationals while the other nationalities accounted for 26.2% [n = 6939] of patients. The overall mean glycated hemoglobin [HbA1c] levels from 2012 to 2016 was 7.76%. Patients attending primary care clinics had a mean HbA1c of 7.64% compared to 7.68% for the tertiary care cohort. Out of the total population, 37.7% achieved HbA1c < 7%. Over 40% of the patients attending primary care centers achieved HbA1c < 7% compared to 34.9% of those who attended tertiary care centers
Conclusions: Optimum glycemic target was achieved by less than 40% of patients. Glycemic control is still below the desired levels. However, there has been a trend of improvement in the last few years and we are achieving the international average targets. Further collaborative actions from clinical, educational, and strategic sectors are needed to improve our goals further
RESUMO
Dengue Fever is the most common arboviral disease in the world, and presents cyclically in tropical and subtropical regions of the world. In Pakistan there has been at least one confirmed outbreak in 1994. This is a series of 72 cases seen between September and December 2005 that were diagnosed as dengue fever, the case definition being acute fever with thrombocytopenia, leukopenia and high ALT, and with or without overt bleeding. There was no other explanation for the clinical and lab. investigations. Young adults were affected, males more often than females. Clinical presentation was fever, vomiting, abdominal pain, myalgia and minor to severe bleeding from the nose, gums, gastro intestinal tract or into the skin. Low platelets and TLC, and raised ALT were the salient laboratory features. Management consisted of judicious fluid replacement and fever reduction. Most patients recovered completely, except one young patient who presented with hypovolemic shock, and died of hemorrhage. Dengue viral infection must be regarded as a public health problem, and serious efforts undertaken for public awareness, surveillance and vector control