Incidence of Type 2 Diabetes Mellitus among Emirati Residents in Ajman, United Arab Emirates / 가정의학회지

BACKGROUND: Diabetes mellitus (DM), particularly type-2 is a major public health concern worldwide. Not much information is available with regard to the incidence of DM in United Arab Emirates (UAE). This study aimed at determining the incidence rate of diabetes mellitus among Emirati population in Ajman, UAE. This is a retrospective cohort study. METHODS: This study was conducted in all primary health care centers and Shaikh Khalifa and GMC Hospitals, Ajman, UAE where the Emirati population primarily go for diagnosis and treatment. The incident cases of diabetes mellitus were collected during the period 2010 January to December. RESULTS: A total of 158 cases newly detected in 2010, 54 were among non-Emiratis and one was type-1 diabetes. Eliminating these, the remaining 101 were included in the analysis. The age of the patients ranged from 23 years to 78 years; 35 (34.7%) males and 66 (65.3%) were females. The overall incidence observed was 4.8/1,000 person-years (PY) with a female predominance of 6.3/1,000 PY against incidence among males of 3.3/1,000 PY. With regard to age specific incidence rate among males, it increases with age till 60 years and then showed a decreasing trend. Among females also the same trend was observed but not as similar to males. CONCLUSION: The highest incidence rate was observed in the 55-59 age group among males, 23.4/1,000 PY and females, 32.4/1,000 PY. Among males the incidence rate was much less compared to females in-the age groups older than 59 years.

Incidence of type-2 diabetes mellitus among Emirati population in Ajman, UAE

Diabetes Mellitus [DM], particularly type-2 is a major public health concern worldwide. Studies from UAE report that among the total cases of DM, 31% are type-2. Not much information is available with regard to the incidence of DM in UAE. This study aimed at determining the incidence rate of diabetes mellitus among Emirati population in Ajman, UAE. This study was conducted in all PHCs [Madinath, Hamidiya, Musherif, Muzeireh and Manama] and Khalifa and GMC hospitals, Ajman, UAE where the Emirati population primarily go for diagnosis and treatment. The incident cases of diabetes mellitus were collected during the period 2010 January to December. From the case files of 2010, data was abstracted / extracted retrospectively, for all those who were newly diagnosed to have diabetes mellitus. A total of 158 cases detected in 2010, 54 were among non-Emiratis and one was type-1 diabetes. Eliminating these, the remaining 101 were included in the analysis. The age of the patients ranged from 23 years to 78 years; 35 [34.7%] males and 66 [65.3%] were females. The overall incidence observed was 4.8/1000PY with a female predominance of 6.3/1000PY against incidence among males of 3.3/1000PY. With regard to age specific incidence rate among males, it increases with age till 60 years and then showed a decreasing trend. Among females also the same trend was observed but not as similar to males. The highest incidence rate was observed in the 55-59 aged groups among males, 23.4/1000PY and females, 32.4/1000PY. Among males the incidence rate was much less compared to females in - the age groups older than 59 years. Studies from other parts of the world report incidence rates, 4.3/1000PY [UK-2005], 5.3/1000PY [USA-2004] and 6.3/1000PY [Canada-2011]. This study also observed a similar incidence

Racial differences in left ventricular mass among hypertensive Egyptians: results from the Egyptian national hypertension project [NHP]

In this study, LV measurements were obtained from the records of 103 black [B] and 1108 non-black [NB] hypertensive [SBP >/140 and/or DBP >/90 mmHg] Egyptians who received no treatment and were age and gender matched. In B cases, the mean age was 56 years, 39% of them were males. In NB cases, age was 54 years, 43.4% were males. Left ventricular mass [LVM] was corrected for body surface area [BSA] and LVM index [LVMI]. The results of echocardiographic survey study of hypertensive Egyptians revealed that black hypertensive Egyptians have similar or even less LVMI as compared with NB in spite of the higher levels of SBP and urinary NA excretion. Data did not support the notion that black race is at especially higher risk of developing LVH

Future of research in hypertension in developing countries

Major changes in the health profile of many developing countries are taking place. Life expectancy in these countries is increasing, and people are more exposed to diseases of old age like hypertension and cardiovascular diseases. Scientific research in the developing world including this area-is lagging behind. However, high-quality research can still be carried out in spite of the limited resources. This paper identifies the different material and psychological barriers to scientific research. Epidemiological and clinical research represent high priorities in hypertension research in developing countries, and international cooperation is essential to improve the understanding of hypertension

Effect of acute volume loading on diastolic function in hypertrophic cardiomyopathy

To evaluate left ventricular [LV] diastolic function in hypertrophic cardiomyopathy [HCM], we studied pulsed Doppler parameters, isovolumic relaxation time index [IVRT interval from minimum LV dimension to mitral valve opening] and LV end-diastolic volume and mass [using the area-length method and apical 4-chamber 2D-echocardiography]. Doppler indices included: E/A ratio, deceleration [Dec] and peak filling rate [PFR]. Measurements [mean +/- SE] were obtained in 16 patients with HCM, age 47 +/- 3y, and 8 normal subjects [46 +/- 3y, p NS] at rest and after a rapid IV infusion of IL saline. IVRT [msec] was significantly longer in HCM 58 = 6 compared to normal 40 +/- 6, P. However, resting Doppler measurements were not significantly different in HCM and normal groups, respectively E/A 0.9 +/- 0.07 vs 1.2 +/- 0.16 Dec 284 +/- 31 vs 330 +/- 50 cm/sec2, PER 449 +/- 72 vs 366 +/- 46 ml/sec. We divided the patients into 2 groups: HCM-A, n = 6, type III [Maron et al. classification] hypertrophy involving 2 segments of LV by 2D-echocardiography; HCM-B, n = 10, types I, II or apical hypertrophy involving

Systolic time intervals and 24-hours free urinary catecholamines in normo-and hypertensives

QS2 interval was significantly greater in patients with FEH than in both normotensives [P <0.001] and patients with BLH [P <0.01]. No significant difference was found between QS2 interval in patients with BLH and normotensives. There was an insignificant difference between LVET in the three groups investigated. PEP in patients with FEH was significantly greater than both normotensives [P <0.001] and patients with BLH [P <0.001], while PEP in patients with BLH was significantly shorter than in normotensives and in patients with FEH [P <0.001]. PEP/LVET in patients with FEH was significantly greater than in both normotensives and patients with BLH [P <0.001]. In patients with BLH, PEP/LVET was significantly less than in both normotensives and patients with FEH [P <0.001]. 24-hours urinary catecholamines in patients with FEH was significantly greater [P <0.01] than in normotensives but insignificantly different from that in patients with BLH. 24-hours urinary catecholamines in patients with BLH was significantly higher than in normotensives [P <0.001]. The present study showed that myocardial contractility is diminished in patients with fixed essential hypertension, and increased in patients with border line hypertension than in the control subjects. Also, the study proved that the overall activity of the sympathoadrenal systems is increased in patients with both fixed essential and border line hypertension than in the control subjects

Systolic time intervals and 24-hours free urinary catecholamines in normo-and hypertensives

QS2 interval was significantly greater in patients with FEH than in both normotensives [P <0.001] and patients with BLH [P <0.01]. No significant difference was found between QS2 interval in patients with BLH and normotensives. There was an insignificant difference between LVET in the three groups investigated. PEP in patients with FEH was significantly greater than both normotensives [P <0.001] and patients with BLH [P <0.001], while PEP in patients with BLH was significantly shorter than in normotensives and in patients with FEH [P <0.001]. PEP/LVET in patients with FEH was significantly greater than in both normotensives and patients with BLH [P <0.001]. In patients with BLH, PEP/LVET was significantly less than in both normotensives and patients with FEH [P <0.001]. 24-hours urinary catecholamines in patients with FEH was significantly greater [P <0.01] than in normotensives but insignificantly different from that in patients with BLH. 24-hours urinary catecholamines in patients with BLH was significantly higher than in normotensives [P <0.001]. The present study showed that myocardial contractility is diminished in patients with fixed essential hypertension, and increased in patients with border line hypertension than in the control subjects. Also, the study proved that the overall activity of the sympathoadrenal systems is increased in patients with both fixed essential and border line hypertension than in the control subjects

Improvement of left ventricular filling after short term captopril therapy in hypertensive patients

Left ventricular [LV] filling abnormalities were reported in hypertensives. To study the effect of treatment on these abnormalities we studied 12 untreated pts before [b] and after [a] short-term captopril therapy using echo-Doppler techniques. Results were compared to an age matched control group [c] of 10 individuals and are summarized in the following table: -HR [B/M]; 79 [5]; 77 [5]; 79 [5] - SBP MMHG; 126[10]; 157 [15]; 136 [10] - DBP [MMHG]; 83 [5]; 108 [12]; 83 [4] - MBP [MMHG]; 97 [6]; 125 [9]; 97 [6] - A/R RATIO; .59 [.11]; 1.1 [.21]; .59 [.11] - ACC CM-SEC2; 740 [160]; 562 [181]; 740 [161] - DEC CM-SEC2; 506 [121]; 309 [103]; 506 [121] - PFR M/SEC; 530 [134]; 437 [150]; 531 [134] - LVM GM; 205 [40]; 249 [64]; 205 [40]. R: early peak velocity. A.' late peak velocity, [A CC and DCC] acceleration and deceleration of early velocity wave, PFR: peak early filling rate computed as RX mitral annulus diameter. LVM = LV mass. Compared to CB showed a higher blood pressure, and LVM. [P < 01]. LV filling showed a higher A/R and a lower ACC and /DCC [p < 01]. After therapy there was improvement in A/R ratio and a drop in blood pressure. Other parameters did not change significantly. Drop in A/R ratio showed a correlation to the drop in DBP [6 = 0.55]. We conclude that captopril short term therapy has a potential for improving LV filling in hypertensive patients and that this improvement is related to the drop in DBP

Doppler pressure half-time and catheter pressure gradient half-time in the calculation of mitral valve area

The use of Doppler derived measurements in the assessment of mitral stenosis [MS.] was evaluated in 45 patients [pts] with rheumatic heart disease and the data were compared with that obtained by cardiac catheterization and direct measurement of the valve orifice area [MVA] at surgery. Results showed that Doppler derived measurements of MVA by pressure half-time method were of particular value in 24 pts in whom technically adequate cross-sectional images and MVA measurements were difficult to obtain.Eighteen of these cases [40%] had heavily calcified and disorganized valves and six pts [13%] had a poor acoustic window. The Doppler data were more accurate than standard two-dimensional measurements in 30 pts.[66%] with atrial fibrillation. The comparison with Gorlin's formula for catheter-derived MVA was poor, especially in the presence of mitral regurgitation or irregular rhythm. Excellent comparisons were obtained with a catheter-derived pressure half-time and surgical assessment of MVA. Thus, The Doppler examination proved to be an invaluable adjunct to a complete assessment of MVA and replaces the need for haemodynamic assessment in most pts with MS

Angiotensin infusion test in normo-and hypertensive subjects

The reactivity of vascular smooth muscles in thirty patients with both fixed essential and border line hypertension was studied and compared with fourteen normotensive control subjects. Angiotensin II infusion was given in a concentration of 1 mcg of 5% glucose at a rate of 0.01, then 0.02 mcg/kg/m with frequent recording of BP and heart rate

Tyramine test in normo and hypertensive subjects

The effect of sympathomimetic amine tyramine was studied in 19 patients with fixed essential and border line hypertension compared with 11 normotensive control subjects. After obtaining control measurements, tyramine solution was injected IV in doses of 1, 2 and 3 mg separated by at least nine-ten minutes