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The association of metformin dose up-titration and treatment duration with adiposity, lipid profile indicators, and serum leptin levels in T2DM Iraqi patients
Get PDFIntroduction: Numerous factors, including age, gender, physical inactivity, insufficient dose, noncompliance, and drug-drug interactions, may contribute to significant intraindividual variation in metformin (MET) response. This study aims to determine the effect of Met dose and treatment duration on adiposity markers and serum leptin levels in Iraqi patients with type 2 diabetes.
Methods: Between October 2021 and March 2022, a cross-sectional study at the Diabetes and Endocrinology Center in Baghdad included 150 type 2 diabetes mellitus (T2DM) patients with a disease duration of more than 1 year. Clinical and physical examinations were conducted before enrollment. We measured anthropometric variables such as body mass index, waist-to-hip ratio, and visceral adiposity index. We evaluated glycated hemoglobin, leptin, C-reactive protein, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and triglycerides (TGs) in the serum.
Results: Only the TC/HDL-c and TG/HDL-c ratios were significantly different after the data were arranged according to glycemic control level. Arrangement for MET doses and treatment duration, none of the evaluated parameters were significantly different (p > 0.05) between groups receiving different doses of MET for different durations, except visceral adiposity index (VAI), which shows a very slight decrease (p = 0.046) after more than 10 years of treatment. Pearson’s correlation analysis revealed a weak and significant association between waist circumference (WC) and hip circumference and MET doses, and a weak and significant association between WC, VAI, and TG levels and treatment duration. The other markers lacked a significant relationship with MET doses or duration of treatment.
Conclusion: MET dose and duration of treatment were not significantly correlated with adiposity and lipid profiles in Iraqi patients with T2DM
The risk of hidden “hot spots” with high levels of air pollution in Madrid (Spain)
Get PDFAll urban areas at risk of breathing polluted air should be identified. In the outskirts of Madrid (Spain), there are roads with high traffic (highway A5) that are <5 meters away from nearby residential homes and schools with children and adolescents. The objective of this study is to ascertain the levels of NO2 in these populated areas. Several NO2 diffusion tubes were installed at a height of 3-m to measure NO2 concentrations in various locations of the A5 during the month of May 2022 (30 days). The four tubes located near the A5 measured a NO2 concentration of 49.7; 88.2; 56.8; and 60 μg/m³. The standard deviation and variation coefficient of the measurements were 0.5 and 2.7%, respectively. According to the WHO (2021), the admissible average annual limit is 10 μg/m³ and the daily limit is 25 μg/m³. This study aimed at measuring the concentration of NO2 near homes and primary and secondary schools located in a “toxic microenvironment” (close to the A5 in Madrid) found high and dangerous levels of NO2 impacting the health of the population. This is an area with a population of low socioeconomic level, which increases the impact on health
Plantar calcaneal spurs and their connection with lumbar herniating discs
No full textIntroduction: Calcaneal spurs are bony triangular projections of varying sizes that are found on the calcaneum. By analyzing the incidence of plantar spurs and lumbar herniated disks, the current research aims to provide a reliable baseline for determining the pathological significance of spurs with herniated disks.
Methods: Consecutive patients who had visited a local physiotherapy clinic for plantar calcaneal spurs between October 2022 and February 2023 with no self-reported comorbidities such as diabetes or vascular diseases were qualified for the study. Of the eligible subjects, a total of 84 patients were randomly selected from the clinic’s database. All 84 patients were subjected to weight-bearing lateral foot radiographs and magnetic resonance imaging scans. A Visual Analog Scale (VAS) was used to measure heel pain. Associations between the presence of spurs, herniated disks, sex, body mass index (BMI), and heel pain were then explored.
Results: Of the 84 patients, 40 were males (48%) and 44 females (52%), with a mean age of 64.2 ± 5.6 years. The mean BMI was 28.5 ± 5.2 kg/m2. From the analysis of the imaging examination results, of the 84 patients with calcaneal spurs, 40 (48%) had lumbar disk herniation at L5-S1, 38 (45%) at L4-L5, 1 (1%) high lumbar herniations, and 5 (6%) no hernia. Women accounted for 45% of L5-S1 herniations and 41% of L4-L5 herniations. Pearson correlation between the variables speaks for a positive weak (r = 0.33) and significant relationship between VAS and weight and between VAS and BMI (r = 0.436, p < 0.001).
Conclusion: Given the high percentage of patients suffering concomitantly from plantar calcaneal spurs and discal hernias (94%), we assume that there might be a probable link between the two disorders
The relationship between personality traits, dental anxiety, and self-reported bruxism among health professional students: A cross-sectional study
Get PDFIntroduction: Dental anxiety proves to be the hurdle for dental care, making self-awareness among the population more crucial. Similarly, bruxism has also been reported to be due to stress, but the pathophysiology has not been clearly understood. The current research aims to explore the association of personality traits with bruxism and dental anxiety among health professional students.
Methods: A total of 120 dental and medical students were included in our study. All the participants received three different questionnaires: The “modified dental anxiety scale” questionnaire to measure dental anxiety, the “modified bruxism assessment questionnaire” to assess the presence of bruxism, and “the big five inventory” to identify the personality trait. The collected data were statistically evaluated with significance at p < 0.05.
Results: Comparison of dental anxiety among professional students showed significantly (p < 0.001) higher anxiety among medical than dental students. Analyzing the prevalence of bruxism revealed awake bruxism to be significantly (p < 0.05) higher in males than females. On analyzing the relation between personality traits and dental anxiety, a positive correlation was seen between the neuroticism type of personality (r = 0.193, p < 0.05) and dental anxiety, especially in females.
Conclusion: The prevalence of self-reported awake bruxism was higher among male students, indicating the necessity for more investigation to ascertain the influence of various psychological factors. The correlation between dental anxiety and neuroticism type of personality trait points out the importance of identifying these individuals in a clinical setting and implementing strategies to reduce anxiety and enhance motivation for treatment
Thoracosurgical treatment of pleural complications in patients with coronavirus disease 2019 (COVID-19): A cross-sectional study
Get PDFIntroduction: Pleural complications in coronavirus disease 2019 (COVID-19) are relatively uncommon findings. Pleural involvement in these patients may directly correlate to disease severity and overall prognosis. We aimed to review clinical features and treatment approaches for pleural complications (accumulation of fluid/air inside the pleural cavity) in 45 patients with COVID-19, who were treated at our institution between April 2020 and October 2021.
Methods: Our study was designed as single-center, observational, cross-sectional study of 45 patients with COVID-19 and at least one radiologically verified pleural complication. Demographic data, radiological findings, as well as type and number of thoracosurgical intervention(s) were recorded for every patient. We included patients of both genders and various age groups, with positive RT-PCR assay for COVID-19 and radiologic features of pleural complications, which required single or multiple thoracosurgical interventions.
Results: Unilateral pleural complications were more common, right-sided pleural complications were found in 44.4% of patients. Right-sided pneumothorax was reported in 26.7% of patients. Almost one-fourth of our patients required invasive mechanical ventilation. Tube thoracostomy was performed in 84.4% of patients with unilateral pleural complications. A fatal outcome was most common in patients over 60 years old. More than half of patients with bilateral pleural complications died in our study.
Conclusions: Pleural complications are a rare finding in patients with COVID-19. Tube thoracostomy is the mainstay of treatment for most symptomatic patients with pleural complications. Future research should be directed toward investigation of long-term pulmonary consequences in patients with COVID-19
Influence of motion therapy on daily life activities of people with lumbar pain syndrome
Get PDFIntroduction: Lumbar pain syndrome (LPS) is defined as pain or discomfort localized between the edge of the twelfth rib and the lower gluteal region, with or without spread to the lower extremities, and, depending on the etiology and degree of symptomatology, can have negative consequences and be one of the main reasons for work disability and absenteeism worldwide. The aim of this study was to determine the impact of exercise therapy on the activities of daily living of a person with LPS.
Methods: This prospective, longitudinal, and randomized controlled trial was conducted from June 2014 to June 2016. It included 200 subjects with symptoms of LPS, both sexes, aged 30 to 50 years, sedentary and standing occupations, randomized and equally divided into two groups: Examined (n = 100) and the control group (n = 100). In this study, the Oswestry Low Back Pain Disability Questionnaire was used after clinical examination.
Results: The percentage of disability according to the Oswestry disability index at the first examination was 31.78 ± 14.11% in the participants of the test group and 38.74 ± 17.48% in the participants of the control group (p = 0.002). After the second examination, the percentage of disability was 6.64 ± 3.15% in the test group and 23.92 ± 14.84% in the control group (p = 0.001). At the end of the examination, the percentage of disability was 2.36 ± 0.78% in the subjects of the test group and 13.82 ± 11.25% in the subjects of the control group (p = 0.001). A statistically significant difference was found in all three examinations, and the reduction in the percentage of disability was greater in the study group, p < 0.05.
Conclusion: The research conducted showed that motion therapy procedures focused on achieving natural spinal mobility and improving trunk muscle strength are effective in reducin
Stigma and stigma-induced stress in filarial lymphoedema patients in Puducherry, India
Get PDFIntroduction: The morbidity management and disability prevention (MMDP) strategy for elimination of lymphatic filariasis (ELF) focuses on alleviating the sufferings of about 36 million filariasis patients living in 49 endemic countries. At present, available quality of life questionnaires are not adequate to address the stigma and stress of filarial lymphoedema (FLE) patients. Therefore, a comprehensive and a robust stigma and stress assessment tool needs to be developed.
Methods: We developed 49 item SARI-FLE-Version-2 questionnaire for stigma assessment and 20 item PSS-FLE-Version-2 questionnaire for stress assessment and tested it among different grades of FLE patients. We followed the Likert scale scoring system and conducted a statistical analysis using SPSS IBM version 25.0.
Results: Of the 80 lymphatic filariasis (LF) patients assessed, 35.0%, 42.5%, and 22.5% had grades 2, 3, and 4 LE of the lower extremity, respectively. The developed stigma tool had an excellent internal consistency, as indicated by high Cronbach alpha values for all six domains. There was a significant correlation (p < 0.05) between different stigma domains. In three domains (cognitive function, social stigma, and experienced stigma), the mean stigma scores were significantly higher for the grade 4 patients compared to grade 2 patients (p < 0.02).
Conclusion: Stigma and stress assessment tools in the form of 49 item SARI-FLE-Version-2 and 20 item PSS-FLE-Version-2 questionnaires are reliable in quantifying the stigma and stress of LF patients. There is a scope to incorporate these tools in the MM
Midwives’ descriptions of strategies and requirements when following up pregnant women at risk of developing perinatal depression - a qualitative study
Get PDFIntroduction: According to the guidelines, health-care personnel should have routines to identify depression and anxiety, but no screening tool is required. The aim of the study is to describe how midwives in antenatal care describe strategies and requirements when following up pregnant women at risk of developing perinatal depression.
Methods: Study is designed as qualitative descriptive study. It includes authorized midwives who work in prenatal care in Western Norway (n = 11) were interviewed between October 21 and November 02, 2021. Verbatim transcribed interviews were analyzed using manifest qualitative content analysis. The study was performed in accordance with the Consolidated Criteria for Reporting Qualitative Research.
Results: The manifest content analysis revealed three categories: (1) Midwife as haven, (2) Growing into the professional role as a midwife and (3) Organizational challenges in antenatal care. The midwives also expressed that they felt they were saddled with a great responsibility that could be a lot to bear. Clinical experience was highlighted as essential sources of self-confidence in work.
Conclusion: Identified categories confirm some crucial issues in midwifery-led maternity care, such as the need for continuous professional training, clear local guidelines, and sufficient time for consultation with women at risk of developing perinatal depression. The findings also reflect the importance of early detection of these women to offer support and assistance throughout pregnancy and after delivery
Quality of life of families with children with intellectual and developmental disabilities: Family health domain
Get PDFIntroduction: The most general definition of quality of life states that “quality of life is the degree of what makes life good.” Contemporary disability research increasingly relies on examining the quality of life of the whole family. Health and developmental outcomes are affected by the health of children and their environment. The objective of this study is to determine the difference in quality of life between families with children with disabilities and families with children without disabilities in the area of family health.
Methods: The Family Quality of Life Questionnaire was used to assess quality of life. The test group consisted of 41 families of children with intellectual disabilities and developmental disabilities who use day care centers. The control group consisted of 69 families of children without disabilities whose members are employed in day care centers.
Results: A statistically significant difference was found in the quality of life of families of children with disabilities and families of children without disabilities in the area of family health within the concept of satisfaction with family health (p = 0.0001), with respondents in the test group reporting a lower mean score of 3.1 ± 0.86 compared to subjects in the control group 3.94 ± 0.62. None of the respondents in the test group reported being very satisfied with family health, while for most respondents in both groups, 38 (92.8%) in the test group and 66 (95.7%) in the control group, family health was very important for quality of life.
Conclusion: A statistically significant difference was found in the quality of life of families of children with disabilities and families of children without disabilities within the concept of achievement, the concept of satisfaction with family health and the determination is a statistically significant difference in relation to the existence of health services in the place of residence
Comparative analysis of different physical therapy programs in the treatment of people with knee osteoarthritis
Get PDFIntroduction: Knee osteoarthritis (OA) develops gradually and causes pain, a decrease in range of motion, muscle mass, and strength and leads to a decrease in physical activity and a poor quality of life for the patient. The aim of this study was to investigate the effects of different physiotherapy programs on pain intensity, range of motion, and quality of life in people with knee OA.
Methods: The study was designed as a prospective, experimental, and randomized trial. Sixty subjects of both sexes and all ages with OA of the knee were enrolled in the study. In the studied Group I (n = 30), in addition to the standard protocol, high induction electromagnetic stimulation was applied using a Salus Talent device with a strength of 3 T and a frequency of up to 50 Hz for 10 min. In the test Group II (n = 30), in addition to the standard protocol, high-intensity laser therapy (HILT) with a power of 5 J was applied with the help of the Ilux Yag 1064 device for 7 min. The therapy protocol for both test groups lasted 8 weeks, with subjects treated once a week.
Results: Analysis of the mean scores on the VAS scale shows that in both groups, the lowest mean scores were recorded in the III measurement (4.35) and the highest in the I measurement (7.96). In all three measurements, there was a difference in the extent of mobility of internal rotation in the form of a higher average range of motion in the test group II, in which HILT was applied. Analysis of the mean scores on the knee injury and osteoarthritis outcome score quality of life scale showed that in both groups, the lowest mean scores were recorded at the first measurement (14.84), with the mean score increasing at the second (32.95) and third measurements (41.08).
Conclusion: Both methods showed significant results in reducing pain intensity, improving knee mobility, activities of daily living, and quality of life in people with knee OA. The obtained data do not give preference to any method but indicate them as adequate physiotherapy protocols to improve the function and quality of life of people with knee OA