Attitudes and self-care behavior of patients with type 2 diabetes attending the emergency department at Hamad general hospital

Diabetes is a public health problem and optimal glycemic control requires diligent daily self-management reduce morbidity and mortality associated with diabetes and its complications. By means of a carefully designed questionnaire, 215 patients with Type 2 diabetes who were admitted to the Emergency Department at Hamad General Hospital during the period from 1 May 2008 to 31 August 2008 were selected randomly and interviewed to determine their attitudes and behaviors influencing effective glycemic control and the extent to which they were helped by education and advice from care providers. The mean +/- SD of both the total diabetes attitudes with subscales, and the self-care behaviors were measured in addition to the mean +/- SD of both hemoglobin A1 c, and the number of admissions to the emergency department over the proceeding six months. Participants reported the highest performance following a specific diet which had the highest significant negative correlation [r=-0.1 81, p=0.009] with hemoglobin A1 c as compared with the other self-care behaviors. The study emphasized the importance of improving the attitude of Type-2 diabetics and their self-care behaviors because of the association with Emergency Department Admission and Glycemic Control. An appropriate educational approach and follow-up taking into account individual patient characteristics, needs to be implemented

Assessment of initiation time of thrombolytic therapy in patients with ST-segment elevation myocardial infarction in Hamad General Hospital

The elevation of reperfusion therapy for acute ST-segment elevation myocardial infarction are time-related and there are decreasing benefits with increasing delays to therapy. To determine whether the time interval between a patient's arrival at the emergency department of Hamad General Hospital, Qatar and initiation of thrombolytic therapy in the coronary care unit [door-to-needle time] is within the 30 minutes recommended by American College of Cardiology/American Heart Association guidelines, the medical records were reviewed of 213 patients with ST-segment elevation myocardial infarction who were admitted through the Emergency Department to receive thrombolysis in the Coronary Care Unit in the twelve months May 2006-April 2007. Medians were calculated for door-to-needle and pain-to-needle times and intermediate points. The median pain-to-needle and pain-to-door times were 211 and 143 minutes respectively, both increasing significantly with the age of the patient and were shorter in men than in women. The median door-to-needle time was 60 minutes with 11.7% of the sample having a door-to-needle time within the recommended 30 minutes. It is concluded that the need for transferring such patients from the emergency department to the coronary care unit of the hospital before the administration of thrombolysis incurs inevitable delays that can be minimized by administering thrombolysis in the emergency department