Objectives: To study the effect of providing tertiary (specialized) health care for type 2 diabetic patients to meet the WHO and ADA standards and glycemic targets.
Method: Six months, Jan. – Jun. 2010, cohort study was conducted on 600 adult diabetics who registered in the National Diabetes Center (NDC) / Al-Mustansiriya University, Baghdad – Iraq. They were followed for 3- 6 months; each time patients were examined physically and their blood pressure, height, weight and BMI were measured. Fasting blood samples were taken from all patients to test the FPG, HbA1c, T.Chol, TG, HDL and LDL.
Results: Patients’ age was 52.85±15.56 year and the male/female ratio was 1.01, the median duration of disease was 7 years and their BMI was 28.80 ± 13.02 kg/m2. Patients’ achievement during study period, of glycemic and cardiovascular risk factors, meet the targets of ADA, NHANES and NCEP/ATP III Guidelines of FPG, PPG, HbA1c, T.Chol, TG, LDL, HDL, systolic and diastolic blood pressure by 26.74%, 29.09%, 32.78%, 61.0%, 60.86%, 76.19%, 74.35%, 52.54% and 62.50% respectively.
Conclusions: We concluded that tertiary health service can help to meet the international guidelines and recommended targets for type 2 diabetes. Improving quality and coverage of tertiary health services may help in achieve and sustain targets; and afterward close adhering to the WHO and ADA standards and glycemic targets.
Abbreviations: BMI=Body Mass Index, FPG= Fasting Plasma Glucose, PPG = post prandial plasma glucose, HbA1c =glycated hemoglobin, T.Chol. = total cholesterol, TG = Triglyceride, LDL = low-density lipoprotein, HDL = high-density lipoprotein, ADA= American Diabetes Association, NHANES = National Health and Nutrition Examination Survey, NCEP/ATP III = National Cholesterol Education Program/Adult Treatment Panel
Diabetic foot ulcer (DFU) or Lower limb ulcers are one of the major complications caused by diabetes mellitus especially when patients fail to maintain tight glycemic control. DFU is linked to multiple risk factors along with the genetic factors and ethnicity which play a significant role in the development of DFUs through their effects on multiple aspects of the pathophysiological process. This narrative review aimed to summarize all the previous studies within the last ten years associating gene polymorphism and DFU. Polymorphism associated with vascular endothelial growth factor (rs699947), the G894T polymorphism of the endothelial nitric oxide synthase gene, interleukin-6–174 G>C gene polymorphism, heat shock protein 70 gene polymorph
... Show MoreGestational Diabetes Mellitus (GDM) is the most common metabolic disorder that found during gestation and is define as hyperglycemia of variable severity with onset or first recognition during gestation that does not clearly characterize any form of the preexisting diabetes (American Diabetes Association [1]). It affects approximately 16.5% of pregnancies worldwide (Plows, et al.[2]). The placenta is an organ that connects the mother and her fetus during pregnancy (Gul, et al.[3]). In the placenta, glucose can be transformed into glycogen for storage by either glycogen synthase or using glycogenin as a prime. However, the function of glycogen deposition stays a matter of debate, it may be the source of fuel for placenta itself or the storag
... Show MoreThe present work involved two steps: the first step include Mannich reaction was carried out on 2- mercaptobenzimidazole using formaldehyde and different secondary amine or amide to gives the compounds(2-16). The secnd step include preparation of (Ethylbenzimidazoly-2-mercaptoacetate)(17) from the reaction of 2- mercaptobenzimidazole with ethylchloroacetate than prepared hydrazide derivative[18]from reaction of compound(17) with hydrazinehydrate. Followed Preparation of shiff bases(19-24) and there reaction with mercaptoacetic acid to give a new compounds containing thiazolidinderivetives(25-30).Structure confirmation of all prepared compound were proved using FTIR and element analysis (C.H.N.S) and mesurmentedmelting poi
... Show MoreThe poly(ethylene oxide) polymer (PEO) is doped with fine powder of MnCl2 salt and thin films of thickness (50–150 mm) with salt content (0, 5, 10, 15, and 20 wt%) are obtained. The AC electrical conductivity and dielectric constants are studied as a function of temperature through an impedance technique. It is found that AC conductivity increases and the calculated activation energy decreases with increasing temperature due to enhancement of the ionic conduction in the film bulk. The dielectric constants of the doped membranes increase with temperature. It is found that the peak value of the tanloss is shifted to a higher frequency at higher temperatures. The dielectric behavior is explained on the basis of
... Show MoreBackground: Drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules to achieve sustained seizure freedom. Up to 30% of patients referred to clinics with a diagnosis of pharmaco-resistant epilepsy may have been misdiagnosed, and many can be helped by optimizing their treatment.Pseudoresistance, in which seizures persist because the underlying disorder has not been adequately or appropriately treated, must be ruled out or corrected before drug treatment can be considered to have failed.
Objectives: The objectives of this study were to determine the causes of drug failure in patients with epilepsy and to differenti
... Show MoreVitiligo is an acquired idiopathic skin disorder characterized by depigmented macules due to loss of cutaneous melanocytes. A potential role of the immune dysfunction has been suggested in vitiligo, so to test this hypothesis, certain cytokines (IL-17A and TNF-?) and immunoglobulins (IgM, IgG, IgA and total IgE) were investigated in all participants. The study included: 60 patients with age range between (6-55) year; 30(11 males and 19 females) were untreated and 30(12 males and 18 females) were treated with Narrow Band Ultraviolet-B (NB-UVB) and 30 (14 males and 16 females) apparently healthy control. Serum was separated and cytokines (IL-17A and TNF-?) and total immunoglobulin E (IgE) were detected by using Enzyme Linked Immunosorbent Ass
... Show MoreBackground: Insulin resistance is present in 50% or more of patients with primary hypothyroidism. Metformin can decrease TSH levels in these patients by a complex matter, this can be of great help in clinical practice.
Objective: This study was designed to evaluate the effect of metformin in reducing TSH levels in patients with primary hypothyroidism.
Methods: Hundred patients with primary hypothyroidism, 82 females, 18 males were included in this study, everyone was followed up for two months after adding metformin 850 mg twice daily in addition to thyroxin.
Results: 36 patients (36%) have a normal baseline TSH and no change after 2 months, 64 pa
... Show MoreA new Schiff bases ligand 4- ((2-hyolroxy phenylimino) methyl) -2, 6-dimethoxyphenol derived from condensation of 2- amino phenol with 4-hydroxy -3, 5-dimethoxy benzaldehyde have been synthesized and characterized by spectroscopy, spectra, Mass spectrum and elemental microanalysis (C.H.N). Metal Complexes with ions have been also synthesized and characterized spectroscopic methods spectroscopy, flame atomic absorption, molar conductivity measurements and magnetic susceptibility. These studies indicate that the moler ratio for the complexes. The complexes showed characteristics octahedral geometry with the (O,N) ligand coordinated in bidentate mode while with showed square planer. The enzyme activity of the ligand and i
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