Random Glucose Research Articles

The Relationship Between Polychlorinated and Polybrominated Biphenyls and Glycated Hemoglobin among Electronics Workers.

Polychlorinated biphenyls (PCBs) are persistent organic pollutants classified as endocrine disruptors related to prediabetes and diabetes. Polybrominated biphenyls are similar in structure to PCBs and are used as flame retardants. Due to the increased worldwide prevalence of diabetes, there is increased interest in understanding the role of environmental and occupational pollutants in its development. The study aims to assess the relation between PCBs and PBBs in the serum of electronic workers and glycated hemoglobin level as an early indicator of prediabetes and type 2 diabetes mellitus among occupationally exposed workers. Blood samples were collected from 152 workers to assess PCBs (by GCMS), random blood sugar (RBS), and glycated hemoglobin (HbA1c). Participants were classified into two groups according to the presence or absence of PCBs in their serum and were compared for RBS and HbA1c levels. Only two participants had detectable PCB derivate in their serum by GCMS, PCB 1 with methyl and benzole side chains. Regarding PBBs, 18 participants (12%) had detectable PBBs in their serum by GCMS. All participants had RBS and HbA1c levels within the normal range. No statistically significant difference was found between mean levels of RBS and HbA1c between participants with detected biphenyls and those without. The banning of PCB use in industry and modern automated techniques have prevented exposure to PCBs among electronics workers. However, exposure to PBBs continues in electronic industries, but it has no association with diabetes or prediabetes.

IJCM_385A: Establishment of a CKD Screening and treatment program at a secondary care hospital in rural Karnataka - A case study

Background: With the rapidly increasing incidence of kidney disease due to the rise in non- communicable diseases like diabetes and hypertension in India, a felt need for easily accessible Dialysis unit was found during the community assessment. Chronic Kidney Disease (CKD) education and screening program was also proposed to be established along with this to improve awareness and early detection. This would help in health system strengthening and prevent patients from travelling to far away locations for the dialysis sessions. Objective: 1. To conduct CKD education and screening camps in rural areas of Karkala taluk Methodology: The project was implemented for a duration of 12 months starting from July 2021. Camps were held along with help from local clubs & Rotary Club. The following blood tests were carried out: Glycosylated Hemoglobin, Random Blood Sugar (RBS) or Fasting Blood Sugar (FBS), Serum Creatinine and Lipid Profile. These tests were done free of cost for all camp attendees. If the parameters were found to be abnormal, they were referred to Dr TMA Pai Rotary Hospital, Karkala for confirmation of the diagnosis and further management. Along with screening, Health education sessions were also be carried out to create awareness regarding diabetes and Chronic Kidney Disease among the rural population. The Dialysis unit was set up with 3 dialysis machines with funding from Rotary International under the Global Grant scheme. Dialysis was provided at subsidized to Below Poverty Line (BPL) patients. Results: A total of 10 CKD screening & awareness camps were held during the project period. A total of 588 patients were screened. 132 were referred for further management. 8 patients were referred for Dialysis. Average of 170 dialysis sessions are carried out per months. 805 participants attended the training sessions. Conclusion: Similar set ups in rural areas will help in early detection of CKD and make dialysis more affordable and accessible.

IJCM_116A: Risk assessment of type II Diabetes mellitus using Indian Diabetic Risk Score among adults in a tertiary care hospital, Tamil Nadu - A cross sectional study

Background: Non-communicable diseases (NCD) kill 41 million people each year which accounts to 74% of all deaths globally. India ranks second with a diabetes population of 69.2 million and may rise to 123.5 million by 2040. Early detection of diabetes risk through periodic screening could be instrumental in controlling diabetes. Objectives: 1. To estimate the risk of type 2 diabetes mellitus among adults attending tertiary care hospital. 2. To assess correlation between INDIAN DIABETIC RISK SCORE(IDRS) and Random Capillary Blood Sugar (RBS). 1. To assess association between selected risk factors and risk of developing diabetes mellitus. Methodology: This study was done among 270 individuals aged 18 years and above attending NCD OPD in Madurai medical college, Tamil Nadu during November 2023. The sample size was calculated based on 40% global prevalence of moderate to high diabetic risk by Sarah Wild et al. Consecutive sampling was done. After obtaining informed consent, data was collected using semi structured questionnaire containing sociodemographic details, risk factors, and IDRS. Anthropometric measurements and RBS were done. The study excluded all known cases of Diabetes. Results: The mean age of the study participants was 42.25 years (SD 4.70). Majority (83.3%) were females. IDRS categorization showed 18.2%, 56.6% and 25.2% in the low, moderate and high-risk groups respectively. The study indicates moderate correlation (r=0.435) of IDRS and RBS values. Also, significant correlation (r=0.543) of IDRS with RBS in 18-30 age group. Age, waist circumference and body mass index (BMI) were significantly (P < 0.05) higher in the high-risk group. Conclusion: Screening of young adults by simple cost-effective tools like IDRS helps in further evaluation by blood investigations for early detection of diabetes, thereby preventing or delaying complications.

Diabetes, hypertension, and other cardiovascular disease risk factors among adults in an urban underprivileged community in Bangalore city, India.

Diabetes and hypertension are major risk factors of cardiovascular disease, which is known to be the leading cause of global mortality in the world today. Studies have shown that the prevalence of these risk factors is on the rise, with the burden of diabetes alone increasing by 80% in the last two decades. Complications of diabetes and hypertension result in huge public health challenges for the country and catastrophic medical expenditures for families among the urban poor. Our study aims to estimate the prevalence of diabetes, hypertension, and other cardiovascular risk factors among adults in an urban underprivileged community of Bengaluru city. A cross-sectional study was conducted over a period of 6 months where 2245 individuals aged 30 or older were interviewed using a structured interviewer-administered questionnaire used to capture sociodemographic details that assessed modifiable risk factors for diabetes and hypertension. Inclusion criteria for diabetes were considered if the random blood sugar reading was ≥200 mg/dL, whereas a diagnosis of hypertension was taken into consideration if the systolic blood pressure reading was ≥140 mmHg and/or diastolic blood pressure was ≥90 mmHg. Among the 2245 participants that took part in the study, 15.5% were diabetics and 17.2% were hypertensive. There was a strong association of diabetes among consumers of alcohol, with more than one-third having a high prevalence of the disease (odds ratio (OR): 2.09, 95% confidence interval (95% CI): 1.1-3.9). More than half the population were consumers of junk food; the prevalence of diabetes in this group was 1.35 times higher than that in their counterparts (OR: 1.35, 95% CI: 1.0-1.8). A significant association of diabetes was also seen among those identified with central obesity (OR: 1.83, 95% CI: 1.4-2.5). One-third of the population who consumed alcohol were found to be diagnosed with hypertension (OR: 3.08, 95% CI: 1.6-5.9), and one-fifth of individuals who were regular consumers of junk food had a higher prevalence of hypertension (OR: 1.41, 95% CI: 1.1-1.8). A higher prevalence of hypertension was also seen among individuals with central obesity or a body mass index (BMI) of >30 (OR: 1.59, 95% CI: 1.2-2.1; OR: 1.92, 95% CI: 1.4-2.6). The findings from our study conducted in an urban underprivileged area of Bengaluru city shed light on the significant associations between diabetes and hypertension and various demographic and lifestyle factors. Specifically, male gender and lower educational status were found to have a significant association with diabetes, whereas being unmarried and having a high BMI status were strongly linked to hypertension. In addition, the study revealed that elderly individuals, alcohol consumers, junk food eaters, and those with central obesity demonstrated an increased risk for both diabetes and hypertension. By identifying these risk factors, targeted interventions can be developed to address the unique challenges faced by this vulnerable section of society. Strategies can be designed to raise awareness, encourage healthier lifestyle choices, and improve access to healthcare services to effectively prevent and manage diabetes and hypertension in this community.

IJCM_279A: Evaluation of diabetes mellitus as a risk factor for urinary tract infection in women: A case control study

Background: Diabetes mellitus (DM) disrupts insulin production and function leads to hyperglycaemia and subsequently exacerbating the risk of complications. Studies highlight hyperglycaemia’s impact on neutrophil function, predisposing diabetic patients to severe infections like pneumonia, urinary tract infections (UTIs), and skin issues. Objectives: To quantify DM’s contribution to UTI development, and to assess the risk of contracting UTI conferred by diabetes mellitus in otherwise healthy women and to characterize the UTI in the cases. Methodology: The case control study was conducted among 200 participants (100 cases with UTI and 100 controls without UTI) from 3 hospitals affiliated to Kasturba Medical College, Mangalore. The data were collected using a structured proforma. Chi – square test and students ‘t’ test was used for comparison of the results across the groups. Results: Patients with urinary tract infections (UTI) showed a higher prevalence of diabetes mellitus (DM) (27.66%) compared to controls (7.45%). The UTI patients were 4.75 times more likely to have DM. Diabetic UTI cases exhibited elevated glycated haemoglobin (HbA1C) and random blood sugar levels than controls. Complicated UTIs were more prevalent in diabetic (77%) than non-diabetic (60%) UTI cases, with E. coli being the most common infecting organism. Conclusion: The uncontrolled diabetes mellitus confers an increased risk of developing UTI and the risk of developing UTI caused by organisms which are not known to cause infections in people with normal immunity (like Candida species). Additionally, diabetics show a higher proportion of complicated UTI cases as compared to non-diabetics.

Negative Air ions induced amelioration of biochemical parameters in Cerebral Palsy patients

Cerebral palsy (CP) is an umbrella term for a group of neurological abnormalities that impair a person's ability to stand, balance, walk, and maintain posture. It is caused by injury or anomalies in the developing brain, which tend to happen before or soon after birth or in early childhood. The study aimed to explore the influence of negative air ions (NAIs) on biochemical parameters in CP-inflicted patients and was conducted from February 1st to March 30th, 2021. Ethical permission from the Institutional Bioethics Committee (Ref: IBC-2017) and the Al-Umeed Rehabilitation Association (AURA) was obtained before the study. Thirty-one structured sessions of exposure to NAIs were conducted at AURA for six weeks after randomly allocating CP-inflicted participants into control (n=12; Median age: 14±5 years) and intervention groups (n=16; M age: Median age=14.5±7.1 years). Biochemical parameters included blood urea nitrogen, calcium, creatinine, electrolytes (bicarbonate, chloride, potassium, and sodium), liver function tests (alkaline phosphatase, alanine aminotransferase, aspartate transaminase, bilirubin total, direct bilirubin, and ?-glutamyl transpeptidase), protein tests (albumin, globulin, A/G ratio, and total proteins), and random blood sugar. For all tests, a trained phlebotomist collected blood samples from the premises of the rehabilitation center at baseline and sixth week. Paired t-tests were performed for within-group comparisons using SPSS v28. The biochemical parameters were normal in both groups at baseline and sustained normality in assessment at the sixth week. The NAI intervention showed no negative effects, indicating that it can be a progressive, non-pharmacological, cost-effective, and effective method to improve the quality of life of CP-inflicted patients.

Understanding the Dynamic Relationship of Diabetes Distress and Glycemic Indicators in Foot Ulcer Patients: A Correlative Study.

Diabetes-related distress and glycemic indicators are the most common concerns for patients with diabetes mellitus and have a major impact on diabetic patients' lifestyle, mental well-being, and healthcare access. The principal aim of research in this field is to ascertain the correlation between distress associated with diabetes and glycemic indicators. this helps in developing interventions that can enhance the overall physical and mental well-being of individuals with diabetes. The objective is to assess the diabetes distress and glycemic indicators among patients with foot ulcers and to find the correlation between diabetes distress and glycemic parameters. A descriptive correlational study was conducted among 159 patients with foot ulcers who were admitted to the hospital by using a non-probability purposive sampling method. The severity of diabetes distress was evaluated utilizing the four-subscale Diabetes Distress Scale (DDS-17). Glycemic indicators are calculated through the assessment of random blood sugar, fasting blood sugar (FBS), and glycosylated hemoglobin (HbA1c). The study revealed that most participants were above 60 years old and were male. Of the samples, 52% had moderate distress. All the subscales of diabetes distress are correlated to the overall DDS score. A negative correlation (r= -0.162, p < 0.041) was found between emotional burden and FBS which was statistically significant, whereas FBS is positively related to HbA1c (r=0.194, p=0.015). The significant correlation between DDS scores, the subscales of diabetes distress, and glycemic indicators highlights the criticality of incorporating diabetes distress management into comprehensive strategies for managing diabetes.Moreover, theresearch underscores the necessity of employing multidisciplinary strategies when attending to diabetic patients to prevent complications.

Sleep Pattern and Diabetes: Finding from a Cross-Sectional Study in Iraq

Aim: Diabetes is a seriously debilitating disease with deleterious complications associated with physical and psychological aspects of diabetic patients. Sleep quality in diabetics is affected by various factors such as the duration of the disease and its complications. The study aimed to investigate the prevalence of poor sleep quality among type 2 diabetic patients and it is relation to glycemic control. Methods: Comparative cross-sectional study to investigate the prevalence of sleep disturbances among type 2 diabetes mellitus patients was conducted. Face to face interview was used to obtain participant’s information by using a validated questionnaire. The value of fasting blood sugar or random blood sugar and HbA1c were also obtained. Results: Among 380 type 2 diabetes mellitus, 76.8% had poor sleep quality. No significant correlation was found between age, body-mass index, duration of diabetes, and duration of comorbid disease. Sleep showed a significant association with HbA1c, gender, educational level, employment and monthly income. Conclusion: Sleep disorder is a common problem among diabetic patients, in this study about two third of patients with type 2 diabetes mellitus had poor sleep quality. Bad sleep has a negative impaction on glycemic control so it is important to focus on sleep quality and try to improve it to maintain accepted glycemic control and reduce the risk of diabetic complications. Keywords: type 2 diabetes, sleep, glycemic control, sleep quality

THE INFLUENCE OF VARIOUS RISK FACTORS RELATED TO METABOLIC DISORDERS ON COGNITIVE FUNCTION IN THE ELDERLY GROUP

Dementia is a condition characterized by significant impairment in at least one domain of cognition, including executive function, complex attention, language, learning, memory, perceptual-motor, or social cognition. Risk factors for vascular dementia include smoking, hyperlipidemia, hypertension, diabetes, atrial fibrillation, obesity, and lack of exercise. This study aims to examine the relationship between metabolic disorders and dementia in the elderly. The design of this research was cross-sectional at the Hana Nursing Home in January 2024, with inclusion criteria in the form of an elderly group of at least 60 years. The independent variables in this study were blood pressure, hemoglobin, hematocrit, body mass index, cholesterol, uric acid, and random blood sugar. The dependent variable in this study includes the Mini-Mental State Examination (MMSE) score. This study included 61 respondents who met the inclusion criteria. The results of the multiple linear regression statistical test (Backward LR) with 6 stages stated that body mass index (p-value: 0.001; B: 0.281) and hematocrit (p-value: 0.011; B: 0.528) played a significant role in decreasing the value MMSE. The conclusion of this study is that body mass index, and hematocrit are related to dementia. This research opens up insight into the importance of controlling body weight and body composition, especially in the elderly group to prevent decline in cognitive function in old age.

Correlation of Blood Urea and Creatinine Levels With Thiamin Levels in Type 1 and Type 2 Diabetic Patients.

Introduction Serum urea and creatinine levels are the most commonly recognized parameters for evaluating renal impairment in patients with diabetes mellitus (DM). Therefore, this study evaluated the correlation between urea and creatinine levels and thiamin levels in patients with type 1 DM (T1DM) and type 2 DM (T2DM). Methods This multi-center, cross-sectional study was conducted at diabetic outpatient clinics in Karachi. The duration of the study was six months, from 1st January 2023 to 30th June 2023. A total of 60 patients were enrolled and divided into two groups, i.e., T1DM and T2DM, each containing 30 patients of both genders between the ages of 24 and 42 years. Demographic data and biochemical variables, such as urea, creatinine, random blood sugar, fasting blood sugar, hemoglobin A1c, and serum thiamin levels, were assessed. The Mann-Whitney U test and independent t-test were used to associate the means between the two study groups. The chi-square test and Spearman's correlation coefficient were used to determine the associations between the variables and T1DM and T2DM. Results The study results revealed that patients with T2DM had a significantly higher frequency of hypertension (p = 0.039), neuropathy (p = 0.038), and coronary artery disease (p = 0.010) than those with T1DM, in both genders. The level of serum thiamin was found to be significantly higher (p < 0.001) in T2DM (14.8 ± 4.82) than in T1DM patients (7.34 ± 1.90). Similarly, serum creatinine was higher in T2DM than in T1DM patients (0.83 ± 0.12 vs. 0.76 ± 0.17, p = 0.025). Moreover, the correlation of urea and creatinine with thiamin levels in T1DM and T2DM patients revealed that in T1DM and T2DM patients, urea and creatinine showed an insignificant positive correlation with thiamin levels. Conclusion We found a significantly higher level of serum creatinine and thiamin levels in T2DM patients than in T1DM; however, there was no significant correlation between urea and creatinine levels and thiamin status in T1DM and T2DM patients. Therefore, we conclude that although serum urea, creatinine, and serum thiamin are important disease biomarkers in diabetic patients, there is no correlation between them.

The Value of Admission Glycated Hemoglobin and Associated Factors in Non-Diabetic Patients with Heart Failure in Aden

Introduction: Heart failure (HF) is a multifactorial disorder characterized by impaired cardiac function, systemic inflammation and neurohormonal activation. It is a major cause of morbidity and mortality worldwide and has significant impacts on the quality of life, cost and longevity. This study was conducted to investigate the value of admission glycated hemoglobin (HbA1c) and associated factors among non-diabetic patients with heart failure. Methods: This is a descriptive prospective-hospital based study included 42 non-diabetic patients with HF on first occasion for admission at three major Aden hospitals for the period (January1st–December 31st, 2021). After thorough clinical history and examination, patients were investigated for random blood sugar, lipid profile, Pro Brain Natriuretic Peptide (Pro-BNP), HbA1c and followed till hospital discharge. Results: HF in non-diabetic patients predominates in males (81.0%) with a mean age of 56.0 ±11.5 years. The main associated factors were arterial hypertension (47.6%), coronary artery disease (9.5%), Khat chewing (57.1%), smoking (31.0%), obesity (28.6%), and family history of HF (21.4%). patients presented with New York Heart Association (NYHA) class III (47.6%) and low ejection fraction of ≤40.0% (76.2%). The median Pro-BNP was 2166.0 pg/mL, the mean admission HbA1c was 5.8% and the case fatality rate was 4.8%. The mean body mass index (BMI) was increasing with increasing level of admission HbA1c. HbA1c of 6.0-6.4% was associated with mortality cases and had significant positive association with BMI and significant negative association with total cholesterol. Conclusion: The admission HbA1c of 6.0-6.4% was associated with HF hospitalization and mortality in non-diabetic patients. This association is independent of age, gender, hypertension, hypercholesterolemia, glycemia, and clinical outcome suggesting direct effects of BMI on the development of high HbA1c level in non-diabetic patients with HF.

Type 1 Diabetes Mellitus And Its Complications In Children Aged ≤20 Years From Punjab, Pakistan

Background — Type 1 diabetes mellitus causes serious disease complication in children. Objectives- The main objective of this study was to assess the frequency and severity of diabetic complication in children ≤ 20 years of age from Punjab, Pakistan. Methods — The data of diabetic patients and their blood samples were collected from the diabetic registries at three districts of Punjab, Pakistan. Fasting plasma glucose, random plasma glucose, HbA1c, and GAD-65 autoantibodies were measured in sampled blood serum. The data on other clinical symptoms at the onset of disease were recorded as well. Results — Out of 310 patients, 54.2% were male, and their mean age at the onset of disease was 13.22 years. Among all patients, according to clinical indicators, high severity of the disease and serious complications were revealed. Conclusions — The diabetic complications were severe in all patients from three districts of Punjab, Pakistan, at and below the age of 20 years.

Nephroprotective effect of HZF by upregulating IκBα protein expression in DKD mice

HEZHIFNAG (HZF) is a traditional Chinese prescription used to treat diabetes. In this study, a mouse model of diabetic kidney disease (DKD) induced by alloxan was used, and the random blood glucose of diabetic mice decreased significantly after the intervention of HZF, and the morphological results showed that HZF improved the pathological damage of glomeruli, reduced the degree of fibrosis of kidney tissue, and increased the expression level of IKBα in the kidney of diabetic mice, suggesting that HZF has a protective effect on the DKD mice, and the mechanism of action may be related to the up-regulation of IKB-α expression.

Effects of electroacupuncture on the PI3K/Akt/CREB signaling pathway and hippocampal neuronal apoptosis in diabetic cognitive impairment rats.

To observe the effects of electroacupuncture (EA) on the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt)/cAMP response element binding protein (CREB) signaling pathway-related proteins and hippocampal neuron apoptosis in diabetic cognitive impairment (DCI) rats, and to explore the mechanisms of EA in treating DCI. Adult male SD rats were randomly divided into normal, model, and EA groups, with 12 rats in each group. The animal model of DCI was replicated using a high-fat, high-sugar diet combined with low-dose streptozotocin. The EA group received EA stimulation at "Yishu" (EX-B6), "Zusanli" (ST36), "Baihui" (GV20), and "Dazhui" (GV14). Blood glucose contents of the rats in each group were measured. The Morris water maze test was used to assess the learning and memory abilities of rats. Transmission electron microscopy was used to observe the ultrastructure of hippocampal CA1 neurons. Nissl staining was used to observe the pathological changes in hippocampal CA1 neurons. TUNEL staining was used to detect the apoptosis in hippocampal CA1 neurons. Western blot was used to detect the protein expression levels of p-PI3K/PI3K and p-Akt/Akt, as well as CREB, p-CREB, cysteine aspartate pro-tease (Caspase)-3, B-cell lymphoma-2 (Bcl-2), and Bcl-2 related X protein (Bax) in the hippocampal tissue of rats. Compared with the normal group, the rats' random blood glucose contents were significantly increased (P<0.01), the escape latency prolonged (P<0.01), and the original platform crossing counts reduced (P<0.01) in the model group. Significant damage to hippocampal CA1 neurons, a significantly increased neuronal apoptosis index (P<0.01), decreased ratio of p-PI3K/PI3K and p-Akt/Akt and expression of CREB, p-CREB and Bcl-2 proteins, increased expression of Caspase-3 and Bax proteins (P<0.01) were observed in the hippocampal tissue of rats in the model group. Compared with the model group, the rats in the EA group showed decreased random blood glucose content (P<0.01), shortened escape latency (P<0.01), increased original platform crossing counts (P<0.01), improved quantity and pathological morphology and ultrastructure of hippocampal CA1 neurons, reduced neuronal apoptosis index (P<0.01), increased ratio of p-PI3K/PI3K and p-Akt/Akt, and expression of CREB, p-CREB and Bcl-2 proteins (P<0.05, P<0.01) in the hippocampal tissue, and decreased expression of Caspase-3 and Bax proteins (P<0.01). EA can improve the learning and memory abilities of rats with DCI, and the mechanism may be related to the regulation of the expression of PI3K/Akt/CREB signaling pathway-related proteins, which attenuates the neuronal apoptosis in the hippocampus of rats, and improves the neural function.

Helicobacter Pylori Infection and Microalbuminuria in Diabetic Patients

Microalbuminuria is defined as an elevated urine albumin to creatinine ratio of 30-300 g/mg. It has been recognized as a strong indicator of the onset of diabetic nephropathy. Damage to vascular endothelium and systemic inflammation can result from H. Pylori infection. Thus, it stands to reason that the resulting glomerular damage might raise the excretion of albumin in the urine. Our goal was to find out if H. pylori and microalbuminuria are related in individuals with diabetes mellitus (DM). This is a case – control observational study conducted in 6 months. Random blood glucose, Urinary Albumin Creatinine Ratio (UACR) and H. Pylori Antigen (H. Pylori antigen) in stool were measured. To minimize possible confounding factors, selecting various matching variables was put consideration when choosing the control group. Therefore, most of the matching variables of the study were comparable in both groups makes the results of studying of H. pylori as a possible risk factor for microalbuminuria greatly accurate. we concluded that H. pylori infection is highly suggested to be an independent risk factor for the development of microalbuminuria in diabetic patients. As proven by the present work; a highly significant statistical relationship between H. pylori infection and the presence of microalbuminuria in patients with diabetes.

Current practice of pre-operative assessment at a public sector hospital in Pakistan - a clinical audit.

To assess the practice of ordering unnecessary laboratory investigations by primary surgical teams. The clinical audit was conducted from December 17, 2022, to January 15, 2023, at the Civil Hospital, Karachi, and comprised primary surgeons working in different surgical units who ordered laboratory investigations for patients as a part of preoperative assessment. Data was collected using a self-administered questionnaire. Data was analysed using SPSS 20. Of the 280 surgeons approached, 249(89%) responded. The units covered were General surgery 96(38.5%), Gynaecology 74(29.7%), Neurosurgery 5(2.0%), Ear, Nose and Throat 19(7.6%), Plastic surgery 15(6.02%), Paediatric surgery 13(5.2%), Vascular surgery 8(3.21%), Oromaxilofacial 9(3.61%), Opthalmology 6(2.4%), and Orthopaedics 4(1.60%).As part of baseline investigations, 244(98%) surgeons ordered complete blood count, 173(69.5%) ordered urea and creatinine, 229(92%) ordered viral markers, 197(78.7%) ordered fasting and random blood glucose, and 178(71.5%) focussed on cardiac fitness. A need was found to establish standard protocols for pre-surgery evaluation so that unnecessary investigations may be avoided.

Diabetes mellitus and associated risk factors among HIV infected patients on HAART

BackgroundUnderstanding the impact of disease associations is becoming a priority in Kenya and other countries bearing the load of infectious diseases. With the increased incidences of non-communicable diseases and the endemicity of infectious diseases in Sub-Saharan Africa, their co-existence poses significant challenges to patients, health workers and an overwhelmed health sector. Classical risk factors for diabetes such as physical inactivity and unhealthy diet may not solely explain the current trends, suggesting the role of novel risk factors including infections/inflammation. HIV and its treatment have been identified as potential contributors especially to patients with family history of confirmed diabetes cases. Co-infections frequently observed during HIV infection also significantly influence both the epidemiological and pathophysiological of the link between HIV and diabetes. Understanding the correlates of HIV and diabetes is crucial to inform management and prevention strategies of the twin infections. We therefore aimed to determine the prevalence of diabetes mellitus and risk factors in a population of HIV infected patients on HAART. This study determined the association of diabetes/impaired glucose regulation in the context of HIV-1. A cross-sectional study was conducted at a comprehensive care clinic in Nairobi (Kenya). Participants were screened for diabetes and impaired glucose regulation using random blood glucose and glycated haemoglobin (HbA1c) This paper describes the prevalence of diabetes mellitus in Human Immunodeficiency Virus positive individuals and the associated risk factors. We have demonstrated that family history is a risk factor for diabetes. While age and BMI are known risk factors, they were not associated with diabetes in this study.

Abstract P426: County-Level Structural Racism and Diabetes Prevalence Among White and Black US Adults

Background: Diabetes Mellitus affects 12.7% non-Hispanic Black adults as opposed to 7% non-Hispanic White Adults. We hypothesized that higher structural racism (SR) is associated with greater diabetes prevalence among Black and White adults. Methods: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study recruited 30,239 US Black and White adults from 48 contiguous US states in 2003-2007. We linked a novel county-level structural racism (CSR) metric reflecting domains of housing dissimilarity, school dissimilarity, high school graduation, incarceration, poverty, primary care access, and ambulatory care access. CSR was determined linked to REGARDS participants’ county location at time of recruitment. Diabetes was defined as fasting blood glucose ≥126 mg/dL or random blood glucose ≥200 mg/dL or use of diabetes medications. We excluded those missing CSR score and diabetes status. Poisson regression estimated relative risk (RR) of prevalent diabetes by higher (more adverse) CSR. Results: Among the 28,329 included participants (mean [SD] age 65 years, [9.43], 55% female participants, 42% Black participants). There was a greater proportion of Black adults in areas with higher CSR. As is shown in Table 1 , higher CSR was associated with higher RR of prevalent diabetes overall. However, higher CSR was associated with lower RR in race stratified models. Conclusions: Adverse levels of CSR were associated with lower diabetes prevalence in Black adults. It is unclear if this observation reflects operationalization of CSR, omitted variable bias, survival bias, or a true structural racism-diabetes association. Table 1 - Relative risk (RR) of Diabetes Prevalence age and sex adjusted per 1-point higher CSR*

Characteristics of Patients with Hypertension Admitted for COVID-19 Treatment in Khulna: Single-Centre Cross-Sectional Study

Background: The outbreak of coronavirus disease 2019 (COVID-19) has become a large threat to global health due to its high contagious nature and varied mortality. Arterial hypertension represents one of the most common comorbidities in patients with COVID-19. Close connections between inflammation and blood pressure (BP) have been described, and inflammation plays a key role in the outcome for patients with COVID-19. Objective: This study aims to investigate the clinical characteristics of patients with hypertension admitted for COVID-19 treatment in Gazi Medical College Hospital (GMCH), Khulna, Bangladesh. Methods: This was a cross-sectional type of observational study on patients with hypertension who were diagnosed with COVID-19 based on laboratory and/or radiological findings and admitted to Gazi Medical College Hospital, Khulna, Bangladesh, from July 1 to July 31, 2021. In that timeframe, overall, 215 patients with COVID-19 were admitted. Among them, 37 patients having hypertension fulfilled the inclusion criteria for the study. Demographic, clinical, laboratory and radiological data of those 37 patients were recorded and analyzed. Results: Among 37 study subjects, 54.1% were female. The mean age of the patients was 59.6±13.9 years. Among the study subjects, diabetes (56.8%) was the most common comorbidity. Regarding laboratory parameters, the mean Hb of the patients was 11.4±1.9 g/dl. In addition, the mean random blood sugar (RBS) level was 11.6±2.9 mmol/l. Neutrophilia and lymphocytopenia were observed in 86.5% and 83.8% cases, respectively. The mean D-dimer (2.4 mg/l) and CRP (72.5 mg/l) levels were well above their normal limits. In high resolution CT scan of the chest (HRCT chest), bilateral lung involvement was present in 89.2% cases. Ground-glass appearance was the most frequent (91.9%) radiologic pattern. Among antihypertensive drugs, losartan potassium was the most frequently used category (29.7%). Total 7 (18.9%) patients were severely affected with COVID-19 and admitted to the ICU, requiring mechanical ventilation. During our study, 2 patients (5.4%) died either due to multiple organ dysfunction syndrome or cardio-respiratory failure. Conclusion: The study provides key information to better understand the clinical characteristics of patients with hypertension admitted for COVID-19 treatment, which may help physicians to identify the factors associated with adverse outcomes in this disease. Mediscope 2024;11(1): 34-40

Compositional profiling and bioefficacy studies of pulses-supplemented isocaloric designer biscuits for recently diagnosed diabetic individuals

This study addresses global concerns about diabetes mellitus by exploring a novel approach to manage hyperglycemia through pulses-supplemented designer biscuits. Control and designer biscuits were prepared with varying proportions of wheat flour and pulses (chickpea, mungbean). The pulses-supplemented biscuits exhibited increased protein content and reduced readily available carbohydrates. Selected designer biscuits, with 12.5 % incorporation of chickpea and mungbean pulse flour, demonstrated significantly lower glycemic index (69.17 ± 5.01) and higher satiety index (122.19 ± 8.85) compared to control biscuits. These showed 13 % less glycemic index and 9 % higher satiety index as compared to control biscuits. A four-week bio-efficacy trial involving diabetic subjects consuming these biscuits as a routine snack resulted in an 11.45 % decrease in fasting blood glucose and a 19.15 % reduction in random blood glucose levels. Insulin and HDL levels also significantly improved. The study concludes that these designer biscuits possess a hypoglycemic effect, offering a potential dietary intervention for managing diabetes.