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Archives of Disease in Childhood ; 107(Supplement 2):A272-A273, 2022.
Article in English | EMBASE | ID: covidwho-2064034


Aims Our aim is to assess whether Covid-19 had an overall impact on diabetic control within the paediatric type 1 diabetic population who attend Causeway Hospital. We retrospectively compared baseline HbA1cs of patients between the years 2019 - 2021 to assess for change in the mean HbA1c throughout all paediatric T1DM patients as well as to compare patients with and without an insulin pump. We planned to retrospectively assess the percentage of newly diagnosed diabetic patients who were in DKA on initial presentation. Finally, we wanted to assess HbA1c control of patients with a libre 2 sensor to assess whether patients who scanned more frequently have better overall HbA1c and/or time in target glucose range. Methods NIECR, TWINKLE and LIBREVIEW systems were used to collect data from all Causeway diabetic patients from 2019-2021 to compare HbA1c, number of libre scans and data including whether patients presented in DKA. For data collected on patients with a libre sensor - this was analysed using an unpaired t-test and a p-value subsequently calculated to assess statistical significance. Results In total data was collected from 92 patients throughout the years 2019 - 2021. The median HbA1c of all T1DM patients increased from 65.2 in 2019 to 65.7 in 2020 then improved in 2021 to 64.07mmol/mol. In 2020, there were fewer overall patients with a new diagnosis of T1DM (n=8) compared with 2019 (n=11) and 2021 (n=11). In 2020 37.5% of newly diagnosed patients were in DKA on initial presentation compared with 18% in 2019 and 27% in 2021. Total number of T1DM patients with an HbA1c <48 was 5.6% in 2019, 3.8% in 2020 and 11.8% in 2021. Mean HbA1c from all T1DM patients increased from 65.24mmol/mol in 2019 to 65.72mmol/mol in 2020 and improved to 64.08mmol/mol in 2021. Mean HbA1c in T1DM patients with an insulin pump also increased from 57.76mmol/ mol in 2019 to 59.63mmol/mol in 2020 and improved to 57.56mmol/mol in 2021. In patients with a libre 2 sensor, percentage time within target glucose range (3.9-10mmol/L) increased from 31.25% in those who scanned <4 times/day(n=12) to 59.44% in those who scanned >12 times/day(n=18) resulting in a pvalue of 0.0001. In patients with a libre 2 sensor, mean HbA1c values in those who scanned <4 times per day was 76.5 compared to 55mmol/mol for patients who scanned >12/day resulting in a p-value of 0.0003. Conclusion Throughout all T1DM paediatric patients, we noted an increased HbA1c in 2020 and an improvement in 2021. There was also an increase in incidence of DKA at presentation in newly diagnosed patients who presented in 2020 compared to 2019/2021. Our patients with an insulin pump had better overall HbA1c control than those who self-inject. Patients with a libre 2 sensor who scan more frequently are more likely to have an increased amount of time within the target glucose range of 3.9-10mmol/L and are more likely to have a lower HbA1c.

medrxiv; 2020.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2020.08.02.20166504


Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In Myanmar, first COVID-19 reported cases were identified on 23rd March 2020. There were 336 reported confirmed cases, 261 recovered and 6 deaths through 13th July 2020. The study was a retrospective case series and all COVID-19 confirmed cases from 23rd March to 13th July 2020 were included. The data series of COVID-19 cases were extracted from the daily official reports of the Ministry of Health and Sports (MOHS), Myanmar and Centers for Disease Control and Prevention (CDC), Myanmar. Among 336 confirmed cases, there were 169 cases with reported transmission events. The median serial interval was 4 days (IQR 3, 2-5) with the range of 0 - 26 days. The mean of the reproduction number was 1.44 with (95% CI = 1.30-1.60) by exponential growth method and 1.32 with (95% CI = 0.98-1.73) confident interval by maximum likelihood method. This study outlined the epidemiological characteristics and epidemic parameters of COVID-19 in Myanmar. The estimation parameters in this study can be comparable with other studies and variability of these parameters can be considered when implementing disease control strategy in Myanmar.

COVID-19 , Communicable Diseases
Cureus ; 12(6): e8809, 2020 Jun 24.
Article in English | MEDLINE | ID: covidwho-623209


Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, there has been a growing and justifiable fear of catching the virus from the emergency rooms, thus decreasing the hospital visits. With Virginia State slowly reopening and HCA local hospitals resuming elective procedures, the number of emergency room visits, are recovering and increasing. We report a sad and unfortunate case of an 87-year-old female who was experiencing pressure-like chest pain but presented to the emergency room five days later out of fear of catching COVID-19 from the hospital. On presentation to the ED, she was found to have an non-ST-elevation myocardial infarction, which required urgent stenting of the left anterior descending artery. Unfortunately, several hours later, she developed fatal cardiogenic shock due to ventricular septal rupture. We are reporting this case to highlight one of the many potential bad outcomes as a result of a delay in seeking necessary medical attention due to the fear of contracting the virus.