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Abstract Background Oral thrush is the most common occurring fungal infection in the oral cavity in uncontrolled diabetic patients, it is treated by various antifungal drugs according to each case. This study aimed to evaluate the therapeutic effects of topical application of miconazole and miconazole-loaded chitosan nanoparticles in treatment of diabetic patients with oral candidiasis. Methods In this randomized controlled clinical trial. A total of 80 diabetic patients presenting with symptomatic oral candidiasis were randomly assigned into two treatment groups: miconazole and miconazole-loaded chitosan nanoparticles. The patients were treated for 28 days, and clinical assessments were conducted at baseline, 7, 14, 21 and 28 days. Clinical parameters, including signs and symptoms of oral candidiasis were evaluated and microbiological analysis was performed to determine the Candida species and assess their susceptibility to the antifungal agents. Statistical analysis was done to the categorical and numerical data using chi-square test and Kruskal Wallis test. Results The antifungal efficacy between the miconazole and miconazole-loaded chitosan nanoparticles (CS-MCZ) groups insignificant difference (P > 0.05) was observed. Both treatment modalities exhibited comparable effectiveness in controlling oral candidiasis symptoms and reducing Candida colonization as miconazole-loaded chitosan nanoparticles group showed a significant difference in the clinical improvement in respect of both signs and symptoms from baseline (70%) until the end of study at 28 days (5%) (P

Background: Oral thrush is the most common occurring fungal infection in the oral cavity in uncontrolled diabetic patients, it is treated by various antifungal drugs according to each case. This study aimed to evaluate the therapeutic effects of topical application of miconazole and miconazole-loaded chitosan nanoparticles in treatment of diabetic patients with oral candidiasis. Methods: In this randomized controlled clinical trial. A total of 80 diabetic patients presenting with symptomatic oral candidiasis were randomly assigned into two treatment groups: miconazole and miconazole-loaded chitosan nanoparticles. The patients were treated for 28 days, and clinical assessments were conducted at baseline, 7, 14, 21 and 28 days. Clinical parameters, including signs and symptoms of oral candidiasis were evaluated and microbiological analysis was performed to determine the Candida species and assess their susceptibility to the antifungal agents. Statistical analysis was done to the categorical and numerical data using chi-square test and Kruskal Wallis test. Results: The antifungal efficacy between the miconazole and miconazole-loaded chitosan nanoparticles (CS-MCZ) groups insignificant difference (P > 0.05) was observed. Both treatment modalities exhibited comparable effectiveness in controlling oral candidiasis symptoms and reducing Candida colonization as miconazole-loaded chitosan nanoparticles group showed a significant difference in the clinical improvement in respect of both signs and symptoms from baseline (70%) until the end of study at 28 days (5%) (P < 0.05) Moreover, miconazole-loaded chitosan nanoparticles, there was a significant reduction in the number of colonies forming units of Candida albicans from baseline until the end of the study at 28-day with P value < 0.000. Conclusions: This randomized controlled clinical trial and microbiological analysis demonstrate that both miconazole and miconazole-loaded chitosan nanoparticles are effective in the treatment of oral candidiasis in diabetic patients with no adverse reactions. Trial registration: NCT06072716 with first registration first registration in 10/10/2023. [ABSTRACT FROM AUTHOR]

BackgroundIn Ethiopia, the prevalence of chronic kidney disease (CKD) among the adult population ranges to 19.1%. The disease's impact has increased in low-resource settings due to a lack of knowledge about the condition and its risk factors. Diabetes is one of the numerous causes of CKD. Despite this, little was known in Ethiopia, particularly in the study area. This study aimed to identify the determinants of CKD among diabetic patients enrolled in care and follow up at pastoralist health facility of Jinka General Hospital (JGH), Southern Ethiopia, 2023.MethodsAn institutional-based cross-sectional study design was conducted among 626 diabetic patients recruited through a systematic random sampling. Data was collected using a structured interviewer-administered questionnaire and entered into Epi data version 7.2 and then exported to the Statistical Package for Social Sciences (SPSS) version 25 for further analysis. Bivariate and multivariate logistic regression analyses were conducted to find eligible variables for the later analysis. Variables with p < 0.25 at bivariate logistic regression were selected for multivariate logistic regression analysis. The variables with p < 0.05 at the multivariate analysis were taken as statically significant in the final model.ResultsThe prevalence of CKD was 2.7% (95% CI: 1.12–6.01%). Place of residence (AOR: 4.84; 95% CI: 1.51–15.40), presence of hypertension (AOR: 5.69; 95% CI: 1.58–20.51) and family history of CKD (AOR: 6.20; 95% CI: 1.40–15.49) were factors associated with CKD among diabetes patients.ConclusionThe prevalence found in this study was low when compared with the local studies. Provision of health education to diabetic patients on preventative measures such as physical exercise is cost-effective approach. Factors associated with CKD among diabetics can be significantly mitigated by strengthening the existing NCDs prevention packages in the study area particularly and in Ethiopia generally.

Introduction: People with uncontrolled diabetes are at significant risk of developing several oral health-related problems. Prevention and treatment of oral diseases in diabetic patients require persistent daily self-care at home and regular dental visits. Aim: The aim of this was to assess the level of knowledge and attitude of diabetic patients toward oral health in the Qassim region of Saudi Arabia. Materials and Methods: This cross-sectional, survey, and facility-based study was conducted at the Endocrine and Diabetic Center in Buraydah, Saudi Arabia. A simple random sampling technique was used and included male and female patients and excluding those with gestational diabetes. Each patient received a questionnaire containing four domains: sociodemographic data, oral health knowledge, general health knowledge, and oral health attitude. Results and Discussion: Statistical Package for the Social Sciences (SPSS) ran a detailed descriptive analysis. A sample size of 173 Saudi diabetic patients participated in this study (68 [39.3%] male and 105 [60.7%] female). Surprisingly, 75.7% did not know their diabetic type, 73.4% brush their teeth at least once daily, and 87.3% have never used interdental flossing. Just 38.2% knew diabetic patients were at a higher risk of developing oral disease. Furthermore, 19.7% have had their dentists educate them about the effect of diabetes on their oral health, and only 13.3% stated that their physicians had educated them about the relationship between diabetic status and oral health. It is paramount to ensure the role of dentists and physicians in educating patients, as most of the sample was unaware of the relationship between diabetes and oral health. Furthermore, interdental flossing is essential for dental home care and periodontium health. Most diabetic patients in this sample do not floss and must be educated about its importance. Conclusion: Integrated dental visits for diabetic patients, in coordination with their physician, may avoid further oral and general health complications. [ABSTRACT FROM AUTHOR]

Introduction: People with uncontrolled diabetes are at significant risk of developing several oral health-related problems. Prevention and treatment of oral diseases in diabetic patients require persistent daily self-care at home and regular dental visits. Aim: The aim of this was to assess the level of knowledge and attitude of diabetic patients toward oral health in the Qassim region of Saudi Arabia. Materials and Methods: This cross-sectional, survey, and facility-based study was conducted at the Endocrine and Diabetic Center in Buraydah, Saudi Arabia. A simple random sampling technique was used and included male and female patients and excluding those with gestational diabetes. Each patient received a questionnaire containing four domains: sociodemographic data, oral health knowledge, general health knowledge, and oral health attitude. Results and Discussion: Statistical Package for the Social Sciences (SPSS) ran a detailed descriptive analysis. A sample size of 173 Saudi diabetic patients participated in this study (68 [39.3%] male and 105 [60.7%] female). Surprisingly, 75.7% did not know their diabetic type, 73.4% brush their teeth at least once daily, and 87.3% have never used interdental flossing. Just 38.2% knew diabetic patients were at a higher risk of developing oral disease. Furthermore, 19.7% have had their dentists educate them about the effect of diabetes on their oral health, and only 13.3% stated that their physicians had educated them about the relationship between diabetic status and oral health. It is paramount to ensure the role of dentists and physicians in educating patients, as most of the sample was unaware of the relationship between diabetes and oral health. Furthermore, interdental flossing is essential for dental home care and periodontium health. Most diabetic patients in this sample do not floss and must be educated about its importance. Conclusion: Integrated dental visits for diabetic patients, in coordination with their physician, may avoid further oral and general health complications.

The first ray plays a vital role in the normal function of the foot and the gait cycle where in its absence can lead to abnormal changes in weight distribution to the residual first metatarsal stump and lesser metatarsals with predisposition to developing lesser toe deformities reulcerations and reamputations particularly in diabetic patients. This study aims to characterise the outcomes after first ray amputation and its associated risk factors with focus on the impact of residual first metatarsal length. All diabetic patients with first ray amputations from January 2012 to December 2016 were reviewed. Residual first metatarsal length was measured using postoperative radiographs. Risk factors for outcomes such as readmission, reulceration and/or reamputation, transfer ulceration and/or amputation of lesser toes, proximal amputations, ulcer-free duration (UFD) and mortality were analysed using bivariate logistic/linear regression followed by multiple logistic/linear regression models adjusting for confounding factors. Among 89 patients with first ray amputations, 65.3 % needed readmission for further treatment. Although only 10.1 % had reulceration at the first ray which all led to reamputation, there were 56.2 % with transfer ulceration and 40.4 % with transfer amputation of the lesser toes in this cohort. The prevalence of transmetatarsal amputation was 18 % and proximal amputations at 12.4 % while the average UFD was 27 months. Mortality rate was 31.5 % with an average of 3-year survival. Preservation of the first metatarsal length via metatarsophalangeal joint disarticulation independently reduced likelihood of readmissions and residual metatarsal length of > one third when compared to < one third after first ray amputations had lower likelihood of transfer amputation of lesser toes. First ray amputation in diabetic patients leads to significant morbidities and mortality. Preservation of the residual first metatarsal length independently reduced the likelihood of readmissions and transfer amputation to the lesser toes. [ABSTRACT FROM AUTHOR]

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Patient education is a crucial part of the efforts to improve the level of medication adherence. Successful diabetes self-management will be achieved if health practitioners (doctors, pharmacists, nurses, and other health-related professionals) provide education to their patients. One of the multimedia platforms that are now popular in patient education and health promotion is video. This study primarily aimed to review published research examining integration of video-based digital interventions into tech-based patient education methods to promote medication adherence in diabetic patients. All of the articles presented in this review were collected from the PubMed, Science Direct, and Sage Publication databases. This review compared study samples, intervention characteristics (length of intervention and learning media), and adherence outcomes, as well as additional outcomes across the studies. Of the 304 articles reviewed, seven studies that met the criteria were found and included in the review. Overall, 57.14% of the integrated video-based interventions demonstrated improved medication adherence and 42.86% demonstrated improvement in other related health outcomes. The interventions were 7 weeks to 6 months in length and were in the form of storytelling with videos, smartphone apps, educational programs, or web-based education. It can be concluded that video-based digital interventions aimed to improve medication adherence in diabetic patients are promising. For optimum outcomes, this study highly suggests that a combination of video (synchronous and asynchronous) and a good patient education program is an ideal form of intervention for patients with type 2 diabetes. Regarding the education platform, the intervention could be humanoid robots, storytelling, mobile health (mHealth) apps, websites, robot-enhanced diabetes care, and other related tech-based programs or even conventional models.

ObjectiveTo understand the situation and the influencing factors of life quality in diabetic patients in Shanghai， and to develop effective intervention measures.MethodsA total of 212 diabetic patients in Baoshan District， Shanghai were selected as the research objects. Diabetes specific quality of life scale （DSQL） was used to investigate the basic situation and quality of life of patients. Combined with biochemical detection indexes and questionnaire survey， data were analyzed by variance analysis and multiple linear stepwise regression analysis. Blood glucose level was assessed according to the 1999 WHO diagnostic criteria for type 2 diabetes.ResultsThe overall quality of life score in the patients was 4.31±7.82， which was higher than the domestic norm. The best quality of life was in the dimension of physiological function with the score of 1.84±6.00， which was lower than the domestic norm. The next was the dimension of social relationship， and the worst was the dimension of treatment. The single factor analysis and multivariate analysis identified the following influence factors of quality of life in the patients： family history， educational level， exercise habit， blood glucose control and diet control. There was a negative correlation with educational level and blood glucose control， and a positive correlation with diet control.ConclusionThe quality of life in the middle-aged diabetic patients was affected by the education level， blood glucose control and diet control. We suggest to strengthen the community management， health education， and improve the living habits.

Onychocryptosis presents unique challenges in diabetic populations, necessitating specialised interventions. Onychocryptosis, is a painful condition, often causing toe pain, discharge, and swelling of the nail fold. Treatments include nail wedge resection and matricectomy. Nail wedge resection is a surgical procedure that removes the affected portion of the nail plate following the natural strictures of the nail whilst a wedge-shaped section of the nail matrix is removed to correct deformities, relieve pain, or treat underlying nail pathologies. This minimally invasive procedure offers a short recovery time and is popular for treating conditions like ingrown nails, pincer nails, nail deformities, and chronic infections. Postoperative care is crucial for optimal healing and patient satisfaction. This case report explores the application of nail wedge resection in the South African context and highlights the crucial role of surgical techniques. [ABSTRACT FROM AUTHOR]

Diabetes is the disease which has become common in our life. Some expert also called it a lifestyle illness. Lifestyle is influenced by number of factors. Present study focused more on psychological aspects of an individual life. Therefore, the current study aimed to find the association among social support, locus of control & types of personality among diabetic patients. There were total of 319 diabetic patients that have been selected purposively from government hospital of Sawai Madopur District of Rajasthan, India. There was found highly significant relationship between different level of social support and different types of personality (χ2=53.29, p<0.01) and no significant relationship (χ2=0.67, p>0.05) between different levels of social support and locus of control. Another finding suggests no significant relationship (χ2=1.11, p>0.05) between different levels of locus of control and different types of personality. So, it may be said that type of personality is not independent from social support, but locus of control does. Another result indicated that locus of control is independent from the types of personality among diabetic patients. Therefore, it may be recommended the important role of personality and social support in diabetes. [ABSTRACT FROM AUTHOR]

Trichosporon colonizes the skin, vagina, gastrointestinal and respiratory tract of humans. Superficial infections are common, while disseminated trichosporonosis is rare, specifically seen among immunocompromised patients and often associated with high mortality. We report a rare case Trichosporon asahii infection in a 78-year-old diabetic, with associated acute interstitial glomerulonephritis. Molecular identification of the isolate was confirmed by sequencing IGS1 region of rDNA. Our study adds to a rather limited literature on renal complications of Trichosporonosis.

Objectives: The aim of study is to evaluate plasma glucose control in diabetic patient on hemodialysis by measure plasma glycated albumin and HbA1c and correlate them with parameters like serum electrolytes blood urea, serum creatinine, hemoglobin, serum albumin, total serum bilirubin, serum uric acid, parathyroid hormone, serum ferritin; to evaluate the effects of these parameters on the level of diabetic control. Methods: This is a cross sectional study which included type 2 diabetic patients on hemodialysis these patients are currently undergoing hemodialysis and are on hemodialysis for more than three months. Total 50 type 2 diabetic patients on hemodialysis; between ages of 47-62 years of either gender were selected randomly and comparison done between the effect of different factors on HbA1c and glycated albumin. Results: There were 50 patients enrolled in this study with a mean age of 54.5 ± 4.7 (range: 47-62) years. Males represented 58% (29 patients) while female represent 42% (21 patients) of the studied group with male to female ratio of 1.38 to one. The duration of diabetes (DM) ranged 4-20 years and two thirds of the cases had duration of 15 years or less. Regarding the treatment of DM, 35 patients (70%) were on soluble insulin while 15 patients neither receive insulin nor oral antidiabetic agent and their treatment was off. Poor glycemic control was significantly associated with younger age, patients aged <50 years were more frequent among the poor glycemic. Good glycemic control had significantly lower HbA1C% level. Conclusion: Most of our diabetic patient on HD has controlled diabetes reflected by the level of HbA1c and GA. Serum ferritin levels is positively correlate with HbA1c levels in diabetic patient on hemodialysis which suggests that serum ferritin levels can be a marker of glycemic control in type 2 DM. [ABSTRACT FROM AUTHOR]

Melaku Tadege Engidaw,1 Mahider Shimelis Feyisa2 1Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Melaku Tadege EngidawDepartment of Public Health, College of Health Sciences, Debre Tabor University, P.O. Box: 031, Debre Tabor, EthiopiaEmail meltad24@gmail.comBackground: Diabetes mellitus is a cluster of metabolic disorders which is characterized by hyperglycemia. The occurrence of anaemia is a significant public health problem among diabetic patients because of complication and dietary modifications. So, this study aimed to assess the magnitude of anaemia among adult diabetes mellitus patients in Debre Tabor General Hospital, Ethiopia.Methods: A cross-sectional study design was conducted. A simple random sampling technique was employed to collect data from 297 adult diabetic mellitus patients. After taking venous blood, the haemoglobin level was determined by using HemoCue 301 machine. Anaemia among diabetic patients was determined by using the haemoglobin level (< 13.0g/dL for male and < 12.0g/dL for female). Data were entered using EpiInfo version 7.2 and analyzed using SPSS version 21. The binary logistic regression model was used to explore the association of independent variables with anaemia. Finally, p-value < 0.05 was used to declare the level of statistical significance.Results: The prevalence of anemia among diabetic patient was 29.81% (95% CI: 24.27, 35.35). Diabetic patients unable to read and write (AOR = 3.51, 95% CI: 1.40, 8.75), able to read and write (AOR = 9.76, 95% CI: 3.15, 30.24), ≥ 4 family size (AOR = 0.53, 95% CI: 0.29, 0.99), intake of flesh meat (AOR=0.19, 95% CI: 0.05, 0.74), and parasitic infections (AOR = 0.26, 95% CI: 0.07, 0.95) were more likely to develop anemia.Conclusion: Anemia is a moderate public health problem among diabetic patients. Here, educational status, family size, intake of flesh meat, and intestinal parasite infections were the factors associated with the development of anaemia. So, working on these significant factors by health care providers during routine care is vital to prevent anaemia among diabetic patients.Keywords: prevalence, anemia, associated factors, diabetic patient, Ethiopia

ObjectiveTo investigate the effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients with diabetes with cardiovascular disease (CVD) or at high cardiovascular risk.DesignSystematic review and meta-analysis of randomized controlled trials (RCTs).Data sourcesPubmed, Embase, the Cochrane Library, and ClinicalTrial.gov from their inception to August 28, 2021.Review methodsRandomized control trials (RCTs) assess the effects of SGLT2i in patients with diabetes with cardiovascular disease or at high cardiovascular risk. Primary outcomes included the composite outcome of cardiovascular death (CV death) and hospitalization for heart failure (HHF), HHF, and renal composite outcomes. Secondary outcomes included major adverse cardiovascular events (MACE), CV death, all-cause mortality, and change from the baseline in HbA1c. Additionally, we assessed the effects of treatment in prespecified subgroups on the combined risk of primary and secondary outcomes. These subgroups were based on history of heart failure (HF), estimated glomerular filtration rate (eGFR) levels, and history of hypertension (HTN). A meta-analysis was carried out by using fixed effect models to calculate hazard ratio (HR) or mean difference (MD) between the SGLT2i administrated groups and the control groups.ResultsFour major studies (n = 42,568) were included. Primary outcomes showed that SGLT2i was associated with significantly lower risk of CV death/HHF (HR, 0.90; 95% confidence interval, 0.84 to 0.98; P for heterogeneity = 0.01), HHF (HR, 0.84; 95% CI, 0.73 to 0.98; p = 0.02), and renal composite outcomes (HR, 0.83; 95%CI, 0.74 to 0.92; p = 0.0007) in patients with diabetes with CVD or at high CV risk. Secondary outcome showed that the use of SGLT2i was associated with significant reduction of the HbA1c level (MD, −0.30; 95% CI, −0.36 to −0.23; p < 0.00001). In subgroup analyses, SGLT2i significantly reduced the risk of renal composite outcomes in patients without history of HF (HR, 0.75; 95% CI, 0.62 to 0.91; p = 0.003 < 0.025). No statistically significant differences were observed in other secondary outcomes and subgroup analyses.ConclusionsThe SGLT2i showed benefits on CV death/HHF, HHF, renal composite outcomes, and HbA1c reduction in patients with diabetes with CVD or at high CV risk. The benefits of improving renal composite outcomes were observed only in patients with diabetes without HF history.Systematic Review RegistrationPROSPERO CRD42021227400

Necrotizing fasciitis (NF) is a devastating soft tissue infection affecting fascias and subcutaneous soft tissues. While it is associated with several risk factors, including malignancy, alcoholism, liver disease, drug use, malnutrition, diabetes, male gender and old age, few case reports in the literature describe its rare connection with genital malignancy. Vulvar squamous cell carcinoma (SCC) is the fourth most common malignancy, representing 5% of all gynaecological tumours among women. NF due to vulvar SCC is a rare complication. In this article, we present the 1991 case of a 58-year-old diabetic female patient with NF due to vulvar SCC. While surgical intervention was successful, the prognosis for vulvar SCC was poor because of late detection.

Mohsen Meidani,1 Sayed Hamidreza Abtahi,2 Rasoul Mohammadi3 1Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran; 2Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran; 3Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranCorrespondence: Rasoul MohammadiMedical Mycology, Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranTel + 983137929175Fax + 983136688597Email Dr.rasoul_mohammadi@yahoo.comAbstract: Mucormycosis is an uncommon and acute fungal infection, with high morbidity and mortality. Traumatic mucormycosis mainly occurs in military conflicts, civilian trauma, and vehicle accidents. Hurricanes, tornadoes, floods, and tsunamis also play a major role in causing mucormycosis by inoculation. Herein, we presented a case of trauma-related mucormycosis in a 70-year-old diabetic male. He referred to a specialty clinic due to the auricular swelling after having fallen and having a major trauma in his ear. Pathologic examination of necrotic cartilage revealed broad ribbon like aseptate hyphae. Antifungal therapy with amphotericin B deoxycholate (1.5 mg/kg/day) was administered for 6 weeks as an initial therapy, and the patient was discharged with a regimen of posaconazole oral solution (400 mg PO bid with meals) for 8 weeks. He followed up for one year and there was no recurrence of the infection. In conclusion, traumatic mucormycosis is a rare but potentially life-threatening fungal infection. Early diagnosis and surgical excision are essential regarding the management of this critical condition. Knowing the underlying diseases is preferable to early diagnosis and timely initiation of antifungal therapy in order to improve survival rates.Keywords: traumatic implantation, mucormycosis, auricular cartilage, diabetic patient, Iran

IntroductionIt is extremely important for patients with diabetes undergoing maintenance hemodialysis (MHD) to receive regular ophthalmologic examinations. However, even in the field of MHD in Japan, where there are many hemodialysis patients and the survival rate is said to be one of the highest in the world, we often see patients with diabetes who do not receive regular ophthalmologic examinations. In this study, we surveyed the status of ophthalmology consultations and the use of diabetic eye notebook (DEN) among hemodialysis patients with diabetes at hemodialysis clinics to confirm the current situation, with the aim of confirming the effectiveness of education on consultation behavior by medical care staff.Materials and MethodsThis study included 38 diabetic hemodialysis patients attending one MHD clinic in Japan for one year from March 2018 to March 2019. In the first fact-finding survey in March 2018, hemodialysis care unit nurses (HCUNs) in the hemodialysis unit asked the diabetic hemodialysis patients whether they had consulted an ophthalmologist and used the DEN. Based on the results, the HCUNs recommended that hemodialysis patients with complications of diabetes be educated about the usefulness of regular ophthalmologic examinations, even during MHD, and that they use the DEN. This was followed by a second fact-finding survey in March 2019 to reconfirm ophthalmology consultations and DEN use.ResultsRegarding the presence of ophthalmology consultations, 22 of 38 (58%) patients had regular ophthalmology consultations in March 2018, and 27 of 38 (71%) patients had consultations in the following year after receiving information from an HCUN. Only 1 of 22 patients (5%) who consulted the ophthalmologist in March 2018 used a DEN, but 19 of 27 patients (70%) used it the following year.ConclusionIn the future, the development and utilization of a new DEN that includes more detailed patient information, and the spread of self-care guidance to patients by multidisciplinary health care professionals, will increase the consultation rate of MHD patients in Japan and reduce the incidence and progression of ocular diseases in MHD patients.

Tenofovir disoproxil fumarate is a nucleotide reverse transcriptase inhibitor and has been extensively used in the first-line treatment of viral infectious diseases such as chronic hepatitis B. Despite its good safety, the development of Fanconi syndrome is a rare adverse effect of long-term tenofovir therapy. Here, we report a case of a 62-year-old diabetic woman with a history of chronic hepatitis B who was exposed to tenofovir and developed drug-associated Fanconi syndrome. After discounting tenofovir, the patient's bone pain was markedly reduced. [ABSTRACT FROM AUTHOR]

Sarocladium kiliense is a soil saprophytic mold with worldwide distribution, which can infect humans and other mammals, sporadically. The clinical manifestations include mycetoma, onychomycosis, keratomycosis, pneumonia, and arthritis. Here, we present a disseminated infection due to S. kiliense in a diabetic patient infected to coronavirus disease 2019 (COVID‐19) from Isfahan, Iran. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes Mellitus is a one of the most challenging public health problem of 21stcentury. It currently affects over 463 million people worldwide and this figure is likely to 700 million by2045.Caregivers carry the responsibility for demanding daily care, support and supervision.This study was conducted among care givers of diabetic patients for assessment of knowledge of diabetes. Methodology: This study was institution based cross sectional study conducted on Adult (age>18Years) care givers of diabetic patient who attending OPD in SRG hospital a tertiary care teaching hospital of Jhalawar, Rajasthan. Simple Random Allocation sampling method was used followed by interview of 147 participants. Results: Knowledge of Diabetes among Care givers was average in >1/3rd (38.1%)followed by either good (31.3%) or poor (30.6%). In present study proportion of good knowledge was high among urban residents 35.7%compare to rural dwellers (4.8%). There was significant association found between education and occupation of caregiver knowledge about Diabetes. Statistically non-significant association was observed between Religion, type of family and marital status of caregivers and their knowledge of diabetes. Conclusion: Present study revealed only 31.3%study participants had good knowledge about diabetes. Knowledge about diabetes was significantly higher in urban area (35.7%), with more educated individuals and professionals by occupation.

Abstract Sarocladium kiliense is a soil saprophytic mold with worldwide distribution, which can infect humans and other mammals, sporadically. The clinical manifestations include mycetoma, onychomycosis, keratomycosis, pneumonia, and arthritis. Here, we present a disseminated infection due to S. kiliense in a diabetic patient infected to coronavirus disease 2019 (COVID‐19) from Isfahan, Iran.

The current study was aimed to ascertain the effect of blood lead level on brain tissues in patients with type 2 diabetes. A total of 300 human participants ages 27 to 60 years with type 2 diabetes (n = 150) and healthy individuals (n = 150) were included in this study. The serum samples were used for measuring HbA1c and fasting blood glucose. Blood lead level was measured using flame atomic absorption spectrophotometer. Magnetic resonance imaging sub-analysis was used to assess the brain hyperintensities. Brain hyperintensities were found in 55% of patients with diabetes and 6% of non-diabetic control group subjects. The deep white matter hyperintensities were observed in 45% of diabetic patients, while the subcortical hyperintensities were noted in 10% of cases. Entorhinal cortex changes (31%) and hippocampus changes (42%) were noted in diabetic patients with brain hyperintensities. Diabetic patients with brain hyperintensities showed higher blood lead levels, HbA1c, and fasting blood sugar (p < 0.0001) as compared with healthy volunteers. A higher correlation (R2 = 0.8922) was found between deep white matter hyperintensities' size and blood lead levels. In nutshell, persistence of high blood lead level in diabetic patients may progress to brain hyperintensities which may consequently lead to cognitive, behavioral changes and Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Objective: In Indonesia, the role of a hospital pharmacist in pharmaceutical care is still limited or even absent. This study aimed to determine whether counseling by a pharmacist could improve medication adherence, controlling the glycemic status, lipid profile, and blood pressure of type 2 diabetes mellitus (T2DM) outpatients. Methods: We conducted an interventional study at RSUD Kota Depok, a secondary public hospital, Indonesia, from April to October 2018. Counseling was given three times during the 4-month study. The study design was quasi-experimental with pretest-posttest group design on 77 respondents divided into intervention group (IGs) (n = 39 people) who received counseling and booklets from the hospital pharmacist and control group (CG) (n = 38 people) who were only given the booklets. We measured adherence with the Medication Adherence Questionnaire and conducted blood tests for fasting blood glucose (FBG), postprandial blood glucose (PPBG), glycosylated hemoglobin A1, lipid profiles (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and TG), and blood pressure measurements. Findings: In the IG, adherence parameters such as HbA1c and lipid profile improved, whereas in the CG, there were no statistically significant changes in clinical parameters and even nonadherence score increased (P = 0.008). IG showed statistically significant improvement in medication adherence, in parameters such as FBG, PPBG, and HbA1c, compared to CG. Based on the Chi-square test, IG also showed a statistically significant improvement in the number of controlled FBG (P = 0.05) and HbA1c (P < 0.001) compared to CG. In addition, a multivariate analysis showed that counseling by hospital pharmacist was 2.764 times (95% confidence interval [CI]: 1.096–6.794) and 9.964 times (95% CI: 3.434–28.917) better than no counseling in improvement of FBG and HbA1c, respectively. However, the significance disappeared after adjusted by type of medicine, duration of diabetes mellitus drug use, and medication adherence. Conclusion: Hospital pharmacist counseling is an important and significant factor in improving FBG and HbA1c levels of T2DM outpatients.

Trichosporon colonizes the skin, vagina, gastrointestinal and respiratory tract of humans. Superficial infections are common, while disseminated trichosporonosis is rare, specifically seen among immunocompromised patients and often associated with high mortality. We report a rare case Trichosporon asahii infection in a 78-year-old diabetic, with associated acute interstitial glomerulonephritis. Molecular identification of the isolate was confirmed by sequencing IGS1 region of rDNA. Our study adds to a rather limited literature on renal complications of Trichosporonosis. [ABSTRACT FROM AUTHOR]

In Diabetes Mellitus, the pancreas remains incapable of insulin administration that leads to hyperglycaemia, an escalated glycaemic concentration, which may stimulate many complications. To circumvent this situation, a closed‐loop control strategy is much needed for the exogenous insulin infusion in diabetic patients. This closed‐loop structure is often termed as an artificial pancreas that is generally established by the employment of different feedback control strategies. In this work, the authors have proposed an arbitrary‐order sliding mode control approach for development of the said mechanism. The term, arbitrary, is exercised in the sense of its applicability to any n ‐order controllable canonical system. The proposed control algorithm affirms the finite‐time effective stabilisation of the glucose–insulin regulatory system, at the desired level, with the alleviation of sharp fluctuations. The novelty of this work lies in the sliding manifold that incorporates indirect non‐linear terms. In addition, the necessary discontinuous terms are filtered‐out once before its employment to the plant, i.e. diabetic patient. The robustness, in the presence of external disturbances, i.e. meal intake is confirmed via rigorous mathematical stability analysis. In addition, the effectiveness of the proposed control strategy is ascertained by comparing the results with the standard literature. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) is one of the most important causes of mortality. Healthy diets can decrease CVDs and other chronic diseases especially in patients with type 2 diabetes. In this study, we investigate association between adherence to the modified Nordic diet and cardiovascular risk factors among patients with type 2 diabetes. Methods: This cross-sectional study was conducted among 339 type 2 diabetic patients. Anthropometric indices, blood pressure, and biochemical tests were evaluated. A validated and reliable semi-quantitative food frequency questionnaire (FFQ) was used to assess dietary intake. Nordic diet scores were calculated based on median intakes of six food groups. Results: Body mass index (BMI) was higher among participants who were in the lowest tertile of adherence to the Nordic diet (P=0.006). There was a significant association between socioeconomic status (SES) and adherence to the Nordic diet (P

Background: Generally, conservative interventions including physiotherapy modalities and manual therapy have been recommended in the management of carpal tunnel syndrome (CTS), but this subject has not been studied in diabetic patients with CTS. Therefore the aim of this study was to investigate the effects of manual therapy on diabetic patients with CTS. Methods: Thirty diabetic patients with CTS were randomly divided into two equal groups: modality group and manual therapy group. Participants in the modality group received transcutaneous electrical nerve stimulation (TENS) and therapeutic ultrasound (US) and patients in the manual therapy group received manual techniques for the median nerve and its surrounding structures. Interventions were applied 3 times weekly for 4 weeks in both groups. Visual analogue scale (VAS), symptom severity scale (SSS), functional status scale (FSS) and median neurodynamic test (MNT) were evaluated before and after the interventions in both groups. Paired t-test and independent t-test were used for statistical analysis. Results: Paired t-test revealed that all of the outcome measures had a significant change in the manual therapy group, whereas only the VAS and SSS changed significantly in the modality group at the end of 4 weeks. Independent t-test showed that the variables of SSS, FSS and MNT in the manual therapy group improved significantly greater than the modality group. Conclusions: Manual therapy techniques applied to mechanical interface of the median nerve and nerve mobilization possess more appropriate and valuable effects on hand difficulties than modalities in diabetic patients with CTS.

Aim We designed the study for determining if ankle peak systolic velocity (APSV) has value in prediction of healing in diabetic foot lesions in patients with critical lower limb ischemia. APSV is the mean of the peak systolic velocities estimated at the ankle level over the distal tibial arteries. Patient and Methods Patients were included if they had diabetes foot lesions. Such lesions were ulcers, gangrene, or tissue necrosis. In addition, they had nonpalpable pedal pulses. Endpoints were healed or healing foot lesions, revascularization, major amputation, or death. Fifty diabetic limbs were included. Results Twenty-five (50%) limbs with diabetic foot lesions reached the end of adequate healing or complete healing following revascularization (all had endovascular intervention). Twenty-one (42%) limbs had failed revascularization and had been amputated, and four (8%) patients died. After revascularization, the median APSV of the 25 limbs with healed or adequately healing lesions was signifi cantly higher than that of the 21 limbs with nonhealing lesions: 59.6 cm/s (30–90) versus 24.8 cm/s (10–60), P < 0.0001. At 37.5 cm/s as a cutoff value, it was found that the APSV showed a sensitivity of 90.5% (95% confi dence interval: 84.3–98.1%), a specifi city of 94.2% (95% confi dence interval: 77.3–96%), a positive predictive value of 90.5%, and a negative predictive value of 94.2% in predicting nonhealing lesions of diabetic foot.

The complete automated control and delivery of insulin and glucagon in type 1 diabetes is the developing technology for artificial pancreas. This improves the quality of life of a diabetic patient with the precise infusion. The amount of infusion of these hormones is controlled using a control algorithm, which has the prediction property. The control algorithm model predictive control (MPC) predicts one step ahead and infuses the hormones continuously according to the necessity for the regulation of blood glucose. In this research, the authors propose a MPC control algorithm, which is novel for a dual hormone infusion, for a mathematical model such as Sorenson model, and compare it with the insulin alone or single hormone infusion developed with MPC. Since they aim for complete automatic control and regulation, unmeasured disturbances at a random time are integrated and the performance evaluation is projected through statistical analysis. The blood glucose risk index (BGRI) and control variability grid analysis (CVGA) plot gives the additional evaluation for the comparative results of the two controllers claiming 88% performance by dual hormone evaluated through CVGA plot and 2.05 mg/dl average tracking error, 2.20 BGRI. The MPC developed for dual hormone significantly performs better and the time spent in normal glycaemia is longer while eliminating the risk of hyperglycaemia and hypoglycaemia. [ABSTRACT FROM AUTHOR]

Introduction Adherence to treatment regimen among diabetes patients is very crucial for good glycemic control. Poor adherence is a widely recognized problem causing great impact on poor health outcomes and healthcare costs. Hence, this study was conducted to identify the adherence to prescribed therapeutic regimen among diabetic patients. Methods A descriptive cross sectional research design was adopted. Data was collected purposively among 422 respondents attending at medical OPD in Tribhuvan University Teaching Hospital through interview using structured questionnaire. Analysis was done by descriptive and inferential statistics. Results The study findings revealed good follow up adherence (57.8%). Adherence to medicine, diet and exercise were (28.5%), (16.1%) and (8.8%) respectively. Dietary adherence was associated with sex (p=0.03), educational level (p<0.001), occupation (p=0.04), attending diabetic counseling (p<0.001) and knowledge level (p<0.001). Exercise adherence was associated with sex, educational level, attending diabetic counseling, history of hospitalization and knowledge level (p<0.05). Medication adherence was associated with attending diabetic counseling (p=0.03). Follow up adherence was associated with education, occupation, attending diabetic counseling, duration of diabetes mellitus, frequency of follow up visit, and knowledge level (p<0.05). Moreover, respondents with good adherence to exercise (75.7%), medicine (63.3%) and follow up adherence (66%) had controlled fasting blood sugar level (p=0.01, p=0.03 and p=0.01 respectively). Conclusion Adherence on diet and exercise was very low than other components among diabetes patients. So, it is recommended to focus on education especially on diet and exercise adherence which would be of great benefit in glycemic control. [ABSTRACT FROM AUTHOR]

The Diabetis is one of the most common chronic disorder across the world and the number of diabetic patients is on the rise .Majority of patients with type 2 diabetics fail to control glycaemia with diet and exercises .Lack of adherence to diabetic medication causes glycemic control and causes and can lead to treatment failure, development of complications and increases mortality. The objectives of the study were to assess the compliance to medications among type 2 diabetic patient and the demographic variables. A non-probability- purposive sampling technique is used to collect data from the samples. The sample size was 60 samples at selected rural community. The research design used in this study is Non experimental, Descriptive Research Design where Morisky Medication Adherence Scales is to determine the level of compliance of medication . The level was assessed by questionnaires. The result shows 1(2%) of sample had low adherence, 12(20%) of the sample had medium adherence, 47(78%) of sample had high adherence. There was significant association between the age, no significant association between other demographic variables. [ABSTRACT FROM AUTHOR]

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Background: In Ethiopia, the prevalence of chronic kidney disease (CKD) among the adult population ranges to 19.1%. The disease's impact has increased in low-resource settings due to a lack of knowledge about the condition and its risk factors. Diabetes is one of the numerous causes of CKD. Despite this, little was known in Ethiopia, particularly in the study area. This study aimed to identify the determinants of CKD among diabetic patients enrolled in care and follow up at pastoralist health facility of Jinka General Hospital (JGH), Southern Ethiopia, 2023., Methods: An institutional-based cross-sectional study design was conducted among 626 diabetic patients recruited through a systematic random sampling. Data was collected using a structured interviewer-administered questionnaire and entered into Epi data version 7.2 and then exported to the Statistical Package for Social Sciences (SPSS) version 25 for further analysis. Bivariate and multivariate logistic regression analyses were conducted to find eligible variables for the later analysis. Variables with p < 0.25 at bivariate logistic regression were selected for multivariate logistic regression analysis. The variables with p < 0.05 at the multivariate analysis were taken as statically significant in the final model., Results: The prevalence of CKD was 2.7% (95% CI: 1.12-6.01%). Place of residence (AOR: 4.84; 95% CI: 1.51-15.40), presence of hypertension (AOR: 5.69; 95% CI: 1.58-20.51) and family history of CKD (AOR: 6.20; 95% CI: 1.40-15.49) were factors associated with CKD among diabetes patients., Conclusion: The prevalence found in this study was low when compared with the local studies. Provision of health education to diabetic patients on preventative measures such as physical exercise is cost-effective approach. Factors associated with CKD among diabetics can be significantly mitigated by strengthening the existing NCDs prevention packages in the study area particularly and in Ethiopia generally., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Israel, Borko, Mota, Tesfaw, Feleke, Abraham, Akako, Samuel and Aynalem.)