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Serum Homocysteine Level Might Be a Predictor for Persistence of Abnormal Glucose Tolerance in Gestational Diabetes
Shradha Shrestha,
Sharmin Jahan,
Nusrat Sultana,
Mohammad Fakhrul Alam,
Yasmin Akter,
Mohammad Farid Uddin,
Muhammad Abul Hasanat
Issue:
Volume 6, Issue 2, June 2021
Pages:
58-63
Received:
19 March 2021
Accepted:
12 April 2021
Published:
26 April 2021
Abstract: Background: Increased plasma homocysteine levels are recognized to exert oxidative damage resulting into risk factors for insulin resistance (IR) and vascular disease. Present study was conducted to observe post-partum persistence of abnormal glucose tolerance (AGT) and level of homocysteine after delivery in patient with GDM. Methods: This observational cross-sectional study encompassed 100 subjects (age: 28.58±4.26 years, BMI: 26.7±2.80 Kg/m2; mean±SD) who were diagnosed as GDM during their index pregnancy by any of the internationally acceptable standard criteria. At 6-12 weeks post-partum, each of them underwent anthropometric measurements, 75 gram 2 sample OGTT and measurement of plasma homocysteine level by utilizing the chemiluminescent Immunoassay method. Results: Of the 100 subjects, 32% converted to having AGT during 6 – 12 week of post-partum follow up. Statistically significant difference was found in between the AGT and normal glucose tolerance (NGT) groups in circulating concentration of homocysteine (AGT vs NGT: 9.19±1.15 vs. 6.29±1.31 mmol/L; p=<0.001). Mean age and BMI were significantly higher in the AGT group (p<0.05 for both). Independent association was found between each of the variables age, history of macrosomia and higher homocysteine level with AGT in multiple regression analysis. Conclusion: Our study identified persistence of AGT and elevation of homocysteine levels are more prominent in women with GDM in post-partum period.
Abstract: Background: Increased plasma homocysteine levels are recognized to exert oxidative damage resulting into risk factors for insulin resistance (IR) and vascular disease. Present study was conducted to observe post-partum persistence of abnormal glucose tolerance (AGT) and level of homocysteine after delivery in patient with GDM. Methods: This observa...
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Smartphone App to Deliver Virtual Follow-up Care for Children with Type 1 Diabetes During the COVID-19 Pandemic: Experience in a Resource-Limited Setup
Latika Rohilla,
Priyanka Walia,
Gurpreet Kaur,
Saniya Gupta,
Atul Gupta,
Arti Yadav,
Pamali Nanda,
Jaivinder Yadav,
Rakesh Kumar,
Nancy Sahni,
Devi Dayal
Issue:
Volume 6, Issue 2, June 2021
Pages:
64-68
Received:
5 April 2021
Accepted:
14 April 2021
Published:
26 April 2021
Abstract: COVID-19 pandemic has forced the medical fraternity to quickly adopt telemedicine for patient care. However, the feasibility and utility of smartphone app-based telecare for children with type 1 diabetes (T1D) in resource-limited settings is scarcely reported. A web-based survey, developed with “Google forms”, was sent to parents via the smartphone app WhatsApp, and the responses to the 12 coded questionnaire items were analyzed. The multiple-choice questions were related to the experiences, satisfaction, and expectations regarding the follow-up care delivered to children with T1D between April and November 2020. A total of 578 queries were resolved through WhatsApp during the study period. These were mostly related to reviewing reports, insulin titration, or other minor ailments. From 332 participants in the two WhatsApp groups, 183 responses (55.1%) were collected. The majority of respondents found the WhatsApp telecare model as easy to learn (69.4), simple to use (68.3%) and were overall satisfied (64.5%). None of the families reported that they would recommend against the use of telecare through WhatsApp. Most of them (45.9%) felt that this model could be used in addition to their physical follow-up visits. However, only 15.3% felt that this model could replace all clinic visits in the future. Only 12% of the respondents reported technical difficulties. In conclusion, virtual follow-up care delivered through WhatsApp is feasible and acceptable to families of children with T1D. The minor challenges related to internet access and low literacy levels were easily overcome. WhatsApp-based virtual visits may complement physical visits to the clinic, especially for patients from remote areas.
Abstract: COVID-19 pandemic has forced the medical fraternity to quickly adopt telemedicine for patient care. However, the feasibility and utility of smartphone app-based telecare for children with type 1 diabetes (T1D) in resource-limited settings is scarcely reported. A web-based survey, developed with “Google forms”, was sent to parents via the smartphone...
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Hyperglycemia During Pregnancy Depends on Numerous Factors (Hypertension During Pregnancy, Previous Birth of a Fetus over 4 kg, Hirsutism - Bulgarian Screening, 2019)
Anna-Maria Borissovа,
Boyana Trifonova,
Lilia Dakovska,
Eugenia Michaylova,
Mircho Vukov
Issue:
Volume 6, Issue 2, June 2021
Pages:
69-75
Received:
3 April 2021
Accepted:
19 April 2021
Published:
29 April 2021
Abstract: Gestational diabetes mellitus (GDM) starts during pregnancy and can increase the risk of adverse pregnancy outcomes, as well as be the cause of a number of diseases in the years after birth in both the mother and the fetus. The aim is to study in the Bulgarian population of pregnant women the relationship between hyperglycemia during pregnancy and some factors – arterial hypertension (AH), previous macrosomic baby weighing 4.5 kg or above, hirsutism. Material: A cross-sectional multicenter population-based study which included 547 pregnant women, with average age 30.49±5,12 years was conducted in 84 settlements in Bulgaria. Methods: A questionnaire was completed, blood pressure was measured (Guideline of ESC/ESH, 2018), BMI was calculated. A two-hour, 75 g oral glucose tolerance test (OGTT) was performed. Glucose was quantitatively determined using enzymatic reference method with hexokinase (Roche reagent) on Cobas e501 analyzer. The statistical analysis was performed using standard SPSS 13.0 for Windows. Results: The incidence of Hyperglycemia for the whole group of pregnant women was 14.4% (79/547), up to 24 gestational week (g.w.) it was 5.3% (29/547) and after 24 g.w. - 9.1% (50/547), P < 0.01. Of all screened pregnant women, 2.4% (13/547) developed AH during the current pregnancy. Hyperglycemia was found in 38.5% (5/13) of the women with AH and in 13.9% (74/534) of the women without AH, P < 0.028. In 3.29% of the pregnant women (18/547) a macrosomic baby weighing 4.5 kg or above was found in a previous pregnancy. Hyperglycemia was present in 38.9% (7/18) of women who gave birth to a large fetus against 13.6% (72/529) of women who gave birth to a fetus under 4 kg, P < 0.008. Hirsutism was reported in 7.9% (43/547) of the studied pregnant women. Hirsutism is twice as common in pregnant women with Hyperglycemia - 13.9% (11/79) versus hirsutism in those with Normoglycemia - 6.8% (32/468), P < 0.049. There was a significant correlation between Hyperglycemia and gestational age (P < 0.006), previous fetal birth over 4 kg (P < 0.03), AH during the current pregnancy (P < 0.01), presence of hirsutism (P < 0.03). Conclusion: A good knowledge of all risk factors associated with the development of glucose intolerance and GDM could play an important role in the early diagnosis of this common disorder during pregnancy.
Abstract: Gestational diabetes mellitus (GDM) starts during pregnancy and can increase the risk of adverse pregnancy outcomes, as well as be the cause of a number of diseases in the years after birth in both the mother and the fetus. The aim is to study in the Bulgarian population of pregnant women the relationship between hyperglycemia during pregnancy and ...
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A Retrospective Study of the Microbiology of Diabetic Foot Infections at a Community Hospital in Bermuda
Donna Kaye Bennett,
Tamar Nasqidashvili,
Joseph Saunders,
Lavern Swaby,
Clyde Wilson
Issue:
Volume 6, Issue 2, June 2021
Pages:
76-79
Received:
29 March 2021
Accepted:
22 April 2021
Published:
30 April 2021
Abstract: There is a high prevalence of type 2 diabetes mellitus in Bermuda. It has been well established that a significant number of patients with diabetes mellitus will develop a diabetic foot infection (DFI), which is associated with increased morbidity and mortality. The objectives of this study were to determine the microbiological and antimicrobial susceptibility profile in DFIs and to investigate whether methicillin resistant Staphylococcus aureus (MRSA) is a common pathogen as well as playing a pivotal role in amputations. A retrospective study was carried out on 96 patients diagnosed with DFI. Demographic data, types of cultures, antimicrobial susceptibility profile and antimicrobial management were collected from medical records. Ninety six patients were investigated and Staphylococcus aureus was the most common organism isolated, followed by Pseudomonas aeruginosa, Group B Streptococcus and Proteus mirabilis. In addition, MRSA organisms were isolated at a low frequency. The organisms isolated showed susceptibility to commonly used antimicrobial agents such as amoxicillin/clavulante, clindamycin, cefazolin, ampicillin/sulbactam, tetracycline, ceftriaxone, trimethoprim-sulfamethoxazole and piperacillin-tazobactam. There was an association between peripheral vascular disease (PVD) and diabetes related amputations. In conclusion, Staphylococcus aureus is a common organism in DFI and the findings of the study does not support empirical MRSA antimicrobial therapy for the management of DFI. There was no evidence to suggest that there is an association between MRSA and diabetes related amputations.
Abstract: There is a high prevalence of type 2 diabetes mellitus in Bermuda. It has been well established that a significant number of patients with diabetes mellitus will develop a diabetic foot infection (DFI), which is associated with increased morbidity and mortality. The objectives of this study were to determine the microbiological and antimicrobial su...
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Patterns of Thyroid Function in Metabolic Syndrome Patients and Its Relationship with Components of Metabolic Syndrome
Nazma Akter,
Zafar Ahmed Latif
Issue:
Volume 6, Issue 2, June 2021
Pages:
80-87
Received:
10 May 2021
Accepted:
4 June 2021
Published:
16 June 2021
Abstract: Background: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities characterized by central obesity, hyperglycemia plus insulin resistance, hypertriglyceridaemia plus low high density lipoprotein (HDL) cholesterol and hypertension. This cluster of metabolic syndrome is associated with some of the endocrine disorders prominently thyroid dysfunction. Thyroid dysfunction and metabolic syndrome are both associated with cardiovascular disease risk conversely increasing both morbidity and mortality. Objectives: This study was carried out to evaluate thyroid function in patients with metabolic syndrome and to assess its relationship with the components of metabolic syndrome in a tertiary care hospital. Methods: A cross sectional study was carried out among metabolic syndrome patients attending Hormone and Diabetes clinic in a tertiary care hospital, Dhaka, Bangladesh during June 2019 to March 2020. We included 346 patients who fulfilled National Cholesterol Education Program-Adult Treatment Panel (NCEP ATP) III criteria. Anthropometric parameters include; height, weight and waist circumference were measured and blood pressure were taken in standard conditions. Fasting blood samples were analyzed to measure glucose, triglyceride (TG), high density lipoprotein (HDL) cholesterol and thyroid hormones [Thyroid stimulating hormone (TSH) and Free Thyroxine (FT4)]. Patients categorized as euthyroid if all thyroid hormone levels fell within normal reference range [TSH: 0.47-5.0mIU/L; FT4: 0.71-1.85 ng/dL]. Subclinical hypothyroidism (SCH) was considered if TSH >5.0mIU/L and free T4 is within normal reference value (0.71-1.85 ng/dL). Conversely, overt hypothyroidism was diagnosed if TSH >5.0 mIU/L and freeT4<0.71 ng/dL. Results: Among study population 22.8% were males and 77.2% were females, with mean age of 42.61±9.13 years. Average body mass index (BMI) of the study subjects was 26.37±3.78 kg/m2. Thyroid dysfunction was seen in 47.1% of metabolic syndrome patients. The prime thyroid dysfunction was subclinical hypothyroidism (34.4%) followed by overt hypothyroidism (12.7%). Thyroid dysfunction was much common in females (37.3%) than males (9.9%) but was not statistically significant; [p=0.19]. Triglyceride showed significant positive correlation with TSH level (r=0.168, p<0.05) but negative correlation with free T4 (r=-0.200, p=<0.001). However, HDL cholesterol showed significant negative correlation with TSH level (r=-0.150, p<0.05). Conclusions: Our study recognizes thyroid dysfunction in metabolic syndrome patients; subclinical hypothyroidism was the commonest followed by overt hypothyroidism. The current study also correlates thyroid function with some components of metabolic syndrome (high density lipoprotein cholesterol and triglycerides).
Abstract: Background: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities characterized by central obesity, hyperglycemia plus insulin resistance, hypertriglyceridaemia plus low high density lipoprotein (HDL) cholesterol and hypertension. This cluster of metabolic syndrome is associated with some of the endocrine disorders prominently thyroid d...
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