Factors associated with non-adherence to insulin in Type 1 and Type 2 diabetes mellitus patients in Western region of Algeria, Tlemcen: a cross-sectional study.

Introduction: adherence to drugs is critical for achieving the best clinical results in the treatment of chronic diseases. Adherence to chronic drugs might be influenced by beliefs about medications and other variables. The goal of this study was to assess relevant determinants of medication adherence in Algerian population with insulin-dependent diabetes. Methods: from July 1st 2019 to February 29th 2020, a cross-sectional study was conducted. Participants who had been on insulin for at least 6 months were recruited from Tlemcen (Algeria) clinics in secondary care settings. Patients were invited to a face-to-face interview, in order to complete out the Morisky Medication Adherence Scale-8 (MMAS) tools to report their attitudes towards medication adherence and views about their insulin. The recruited patients' socio-demographic data was also collected. The related determinants of chronic drug non-adherence in the tested population were identified using a stepwise binary logistical regression model. Results: in this study, 147 patients out of 400 were not adhering to their insulin therapy (36.5%). Insulin non-adherence was linked to single status (AOR=2.088, CI=1.180-3.694), non-insurance (AOR=2.949, CI=1.323-6.572), number of daily insulin injections (AOR=1.269, CI=1.033-1.559), unawareness of the insulin regimen (AOR=3.528, CI=1.453-8.565), hypertension (AOR= 3.497, CI=1.98-6.154) and the non-practice of self-monitoring of blood glucose (SMBG) (AOR=2.635, CI=1.472-4.718). Conclusion: insulin adherence in Algerians is still well below international standards. This study improved the understanding of the factors affecting the non-adherence to insulin among diabetics and may be used as a baseline to target; throughout educational programs; the sub-populations identified as non-adherents.

A rare association between a dermoid cyst and arachnoid cyst of the cerebellopontine angle: a case report.

Supratentorial arachnoid cysts are usually asymptomatic and may be discovered by chance at autopsy; however, infratentorial arachnoid cysts, which correspond to liquid forms enclosed by an arachnoid sheet but whose pathogenesis is unknown, might cause symptoms. They don't need to be treated if they're asymptomatic and were discovered by chance. A variety of neurological symptoms can be present depending on their localization. Intracranial dermoid cysts are uncommon tumours that develop from ectopic epithelial cells in the brain. They are benign, slow-growing, and rarely rupture. The association between the two diseases is extremely rare and when it is present may suggest the existence of a common factor. We present a unique case of a young girl who developed headache and ataxia as a result of an intracranial infratentorial dermoid cyst and an arachnoid cyst of the cerebellopontine angle. Complete removal of the dermoid cyst and drainage of the cyst leads to a full recovery. Dermoid and arachnoid cyst are two pathologies with a possible common embryogenic factor, early surgery can give a better outcome in the long term.