RESUMO
Mesenteric ischemia (MI) is a reduction in blood flow of the mesenteric vessels resulting in ischemia or infarction if not treated properly. It is difficult to diagnose and it has a high rate of mortality. Moreover, it is managed either by open surgery or endovascular approach. We present a case of a 79-year-old male patient with MI managed initially by thrombolytic therapy with stent through inferior mesenteric artery which has failed. Few days later he presented with the same complaint. He was treated with heparin for five days and discharged in good condition. Six days later, the patient returned to the ED with MI and managed successfully with retrograde right common ilio-mesenteric artery bypass with no complication and made full recovery. Endovascular revascularization is a minimally invasive approach and it is the initial treatment of choice for mesenteric occlusive disease. However, this approach is not always feasible which explains the role for open approach.
RESUMO
The prevalence of type 2 diabetes mellitus (T2DM) is increasing every year, along with its health and economic burden/impact. Achieving glycemic control remains challenging, and only 9-15% of diabetic patients manage to reach the optimal level. A few strategies have been found to improve diabetic control, including self-management care (SMC). This study aimed to explore the relationship between patient characteristics, SMC, and glycated hemoglobin (HbA1c) levels, as an indicator of optimal glycemic control. This was a cross-sectional study of 200 participants conducted at the King Fahd University Hospital (KFUH) in Saudi Arabia. A pre-structured questionnaire including sociodemographic data and aspects of diabetes self-management was distributed among patients at KFUH and the Family and Community Medicine Center (FAMCO) of Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia. HbA1c data were extracted from patients' records. Unfortunately, the majority of the participants (65%) were found to have poor glycemic control. Glucose management was better in patients having T2DM for more than five years (mean: 4.01; p<0.05). In addition, an income of less than 5,000 Saudi Riyals (SR) was associated with lower physical activity (mean: 2.95; p<0.05). The level of blood sugar was uncontrolled among the majority of surveyed patients. Our study found variables associated with SMC and HbA1c levels, which might help to guide future initiatives aiming to enhance the care of patients with T2DM.
