RESUMO
Background: the occurrences of diabetes mellitus and diabetic nephropathy have increased quickly in the past few decades and have become an economic burden to the healthcare system in KSA. Diabetic nephropathy is a major complication of diabetes mellitus and is a primary cause of end-stage renal disease [ESRD]. The occurrence of non-diabetic renal disease [NDRD] in diabetic patients has been increasingly recognized in recent years. It is generally believed that it is difficult to reverse diabetic nephropathy, whereas some cases of non-diabetic renal disease are readily treatable and remittable. However, diabetic nephropathy is known to co-exist with non-diabetic renal disease in a poorly defined population of patients with type 2 diabetes mellitus. This study estimated the pervasiveness of co-existing diabetic nephropathy and non-diabetic renal disease in Saudi patients
Methods: data were retrospectively analyzed from 122 patients with type 2 diabetes mellitus who had experienced a renal biopsy between February 2014 and June 2017 at King Abdulaziz Hospital, region[s], KSA. Male patients numbered 75 [61.5%] of the study population. The biopsies were performed as urinary abnormalities or renal functions were atypical of a diagnosis of diabetic nephropathy. Biopsy samples were examined using light, immunofluorescence [IF] and electron microscopy [EM]. Clinical parameters were recorded for each patient at the time of biopsy
Results: nineteen of 122 diabetic patients [8%] had co-existing diabetic nephropathy and non-diabetic renal disease. These patients showed clinical features and pathologic characteristics of diabetic nephropathy, containing a high prevalence of diabetic retinopathy [88.8%], a long duration of diabetes, increased thickness of the glomerular basement membrane [GBM] and mesangial expansion. Nonetheless, they similarly presented with clinical findings which were inconsistent with diabetic nephropathy, such as hematuria, rapidly progressive renal failure and marked proteinuria. Immunoglobulin A [IgA] nephropathy was apparent in 5 out of the 10 patients [50%], tubulointerstitial lesions were found in two patients [20%], membrano-proliferative glomerulonephritis [MPGN] in two patients [20%] and membranous nephropathy [MN] in one patients [10%]
Conclusion: retrospective analysis of biopsy data suggests that approximately 8% of Saudi patients with type 2 diabetes mellitus may have co-existing diabetic nephropathy and non-diabetic renal disease. The most common histological diagnosis in our small series was IgA nephropathy
RESUMO
Background: Surgeons are regularly not involved in the post discharge care of patients after uncomplicated laparoscopic cholecystectomy. The purpose of the current study was to document the symptomatic recovery of patients following laparoscopic cholecystectomy, because this has a bearing on the planning of a postoperative care package
Methods: The study was designed as a postoperative telephone questionnaire survey and was carried out prospectively between June2016 and February2017 in King Abdulaziz Hospital, KSA
Results: The study cohort comprised 51 patients who all completed the study. Postoperatively, only 3% of the patients had postoperative nausea/vomiting lasting >/=2 days. Pain was symptomatic in 12% of patients. Port-site wounds were a source of significant symptoms in 69% of the patients. Postoperative reviews by a nurse and primary-care doctor were necessary in 76% and 34% patients, respectively, with a combined average of 3.1 reviews per patient. Less than 4% of patients believed that they would benefit from a surgeon's review 6 weeks after LC. Median time taken to return to routine preoperative activity after surgery was 21 days [IQR, 16 to 33], which was affected by the degree of activity undertaken, wound-related symptoms persisting for >/=3 weeks, planned follow-up clinic appointment, and discharge as an outpatient
Conclusion: Wound-related symptoms are common after LC, require substantial input from the community health service in their management, and may delay return to preoperative routine