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Frequency of Metabolic Syndrome in Type 2 Diabetes Mellitus in a Tertiary Care Hospital of Bangladesh
Get PDFBackground: Metabolic syndrome has long been recognized as a risk factor for coronary heart disease. However, the relationship between metabolic syndrome and type 2 diabetes mellitus and the independent contribution of metabolic syndrome remain unclear. This study was planned to evaluate the status of metabolic syndrome in type 2 diabetic population and the ability to predict type 2 diabetes mellitus in parallel with conventional stroke risk factors. Methods: A hospital-based descriptive observational study was conducted on 100 patients with type 2 diabetes mellitus who were selected using consecutive random sampling techniques. Patients were diagnosed through proper history taking, clinical examination, and necessary investigations. The outcome values were measured in anthropometric measurements, blood pressure, dyslipidemia, and blood glucose. Results: Among 100 patients with type 2 diabetes mellitus, 64% were females who were housewives (41%) with a significant difference (p < 0.001), and mean ± SD was 58 ± 12.24 yrs ranging 32–85 years. About 30% had a positive family history of type 2 diabetes mellitus and 28% tobacco abuse. Of the total, 31% of the patients had high blood pressure, and 28% had low HDL with a significant difference (p < 0.001), but 46% had high triglyceride levels, which was not significant. More than half (53.12%) of females showed central obesity, while only 16.67% had central obesity among males, with a significant difference (p = 0.04) in both sexes. There was a high frequency of metabolic syndrome in patients with type 2 diabetes mellitus (68%) with a significant difference; 48% were female and 20 % were male. In patients with metabolic syndrome, central obesity was found in 36 (52.94%) patients where females were predominantly affected (32, 88.89%); hypertension found in 28 (4118%) patients where males were the predominantly affected (16, 57.14%) patients’ hypertriglyceridemia found in 44 (64.70%) patients, where females were the predominantly affected (26, 59.09%) patients; low HDL was found in 22 (32.35%) patients where females were the predominantly affected patients (16, 72.73%). Conclusion: The frequency of metabolic syndrome was more than double in women (48%). Central obesity and low HDL were significantly more prevalent in women than men, whereas hypertension was significant in men. Thus, it would be reasonable to conclude that women are more likely to suffer from metabolic syndrome from cardiovascular morbidity and mortality
Responses of Patients with T3-4N0-2M0 Rectal Cancer to Preoperative Chemoradiotherapy: A Review of Current Literature
Get PDFObjective: The study investigates the efficacy and safety of chemoradiotherapy and radiotherapy followed by surgery in patients with locally advanced unresectable rectal cancer.Materials and Methods: We reviewed records for 65 patients with locally advanced unresectable rectal cancer treated by preoperative chemoradiotherapy or radiotherapy followed by surgery between 2013 and 2016. Of these, 23 patients were treated with preoperative chemoradiotherapy (40–45 Gy) plus concomitant chemotherapy (5-Fluorouracil + Calcium Folinate). For comparison, 42 similar patients treated by preoperative radiotherapy (45–50Gy) plus surgery served as controls. The primary endpoint of the study was overall survival and local control rate.Results: No treatment plan was delayed because of toxicities in both groups. The radical resectability rate was 69.9% in the chemoradiotherapy group and 33.3% in the radiotherapy plus surgery group (p = 0. 024). The anal sphincter preservation rates were 26.6% and 3.7%, respectively (p = 0. 028). The anal sphincter preservation rates of lower rectal cancer were 27.3% and 0.0%, respectively (p = 0. 014). Response rates of chemoradiotherapy and radiotherapy plus surgery groups were 82.6% and 61.9% (p = 0. 053). The tumor downstage rates were 16 (69.6%) and 24 (57.1%) in these groups (p = 0. 206). The 3-year overall survival rates were 66.7% and 55.6% (p = 0. 485), and the tumor-free survival rates were 40. 3% and 33. 1% (p = 0. 663). The 3-year local recurrent rates were 26.9% and 48.1% (p = 0. 174). No obvious late effects were found in either group.Conclusion: The results of this study suggested at least that acute side effects of preoperative chemoradiotherapy can be tolerated, and a higher surgical resection rate can be achieved. However, chemoradiotherapy did not improve the survival rate, whereas it increased local recurrence due to the high rate of anal sphincter preservation. It is safe and effective to use 5-Fluorouracil + Calcium Folinate and 5-DFUR as a radiosensitizer during the whole course of radiotherapy
Attitudes and Beliefs of Physical Therapists in Saudi Arabia Regarding Direct Access and Scope of Practice
Get PDFPurpose: This study aimed to understand better what practicing physical therapists know and believe about direct access (DA) and scope of practice (SOP) for physical therapy in Saudi Arabia (SA). Methods: A pilot study was first performed to ensure the clarity of the questions. Then, a cross-sectional survey was sent through emails, and social media platforms included three main sections: demographics, opinions, and beliefs questions. Results: A total of 150 respondents met the inclusion criteria. About 55.3% of the participants reported never or rarely using an SOP document as a reference for knowing their practice. Moreover, nearly 48% learned about the SOP through an informal discussion. Only 24.7% of the participants correctly identified which practice setting DA is permitted. Most participants felt confident or strongly confident of their abilities to assess (67.3%) and treat (72%) patients without physicians’ referral. Around 84% of the participants agreed or strongly agreed that DA should be expanded to include all healthcare settings. Conclusion: We found that physical therapists are confident about their ability to treat and assess patients without physicians’ referrals. There is uncertainty about where DA is permitted in SA
The Effect of Educated Platelets on the Healing Process of Burn Wounds in Rats: Educated Platelets in Rat Burn Wound Healing
No full textBurns are serious life-threatening health problems. This study was performed to determine the effect of educated platelets on burn wound healing process. 28 female wistar albino 200-220 gr rats were randomly divided into four groups. Group A1 rats(n:7) were the first-line burnt group from which blood samples are extracted to develop platelet-rich plasma(PRP) with the educated platelets that have a response to burn injury. Group B1 rats(n:7) were the unburnt group with ordinary platelets. Group A2 rats(n:8) were the second-line burnt group which was given PRP with educated platelets. Group B2 rats(n:6), as control group, were the second-line burnt group which was given PRP with ordinary platelets. Photos of rats' dorsum were taken by digital camera on the first day and 21st day of the study. Wound healing was determined by scar surface area. In the study group (Group A2) mean wound area was 53±37 mm², in the control group (Group B2) mean wound area was 114±55 mm² on the last day of the experiment. The sizes of the wounded areas were significantly lower in the study group compared with the control group (p: 0.039). Educated platelets seem to facilitate the recovery period of burn wound healing in rats
A Clinical Guide for the Management of Double Teeth
No full textIntroduction: A double tooth can be a consequence of fusion or gemination and is characterized by a size increasing of the tooth and a morphological modification. This anomaly concerns the anterior teeth and occurs in temporary and permanent dentition. Double teeth causes various problems (aesthetic, occlusal, endodontic, orthodontic, periodontal…). The management of clinical situations involving such abnormalities is often complex. Our aim is to present a reasoned analysis based on a systematic review of therapeutic attitudes used in different clinical situations when the abnormal tooth is located at the anterior maxillary region. Material and Methods: We carried out electronic research via Pubmed and Sciencedirect to collect case reports published during the 20 recent years (1999-2020). We included 46 articles corresponding to 57 relevant case report that we classified based on Aguilo and coll. Classification (1999). Results: Partial crown and root section is indicated for type I. Stipping is indicated for type II. The management of type III is compromised by the canal morphology. Extraoral and entraoral hemisection are only indicated for type IV. Coronoplasty is usually unavoidable. Endodontic, orthodontic, or periodontal treatment can be indicated depending on the situation. The extraction is considered as a last resort, the space is restored by autotransplantation of a supernumerary tooth, a prosthetic restoration, or an implant by the end of the craniofacial growth. Conclusion: The management of double teeth is a therapeutic challenge, every case is different, a multidisciplinary approach is recommended
Digital Models and Orthodontic Diagnosis: What Degree of Reliability?
Get PDFBackground: Our study aims to evaluate, through a systematic review, the reliability of numerical models compared to conventional models on the main parameters of orthodontic diagnosis Method: four databases were consulted: PubMed; Google Scholar, Cochrane Library, and Ebscohost. The research included published studies since 2010, meta-analysis studies, randomized and non-randomized controlled trials, and prospective and retrospective studies.Results: Among 3811 selected references, only five studies met our inclusion criteria. In the systematic review, there were statistical differences between the digital models and the plaster models. However, this difference is clinically acceptable. On the other hand, there are some limitations, relative to the types of the severity of the congestion, the elapsed time to digitize, and the numerical means.Conclusion: The results of our systematic review have shown that there is no clinically significant difference between the numerical and physical models for the majority of diagnostic parameters
Transcription Factor NF-κβ and Molecules Derived from its Activation in Age-Related Macular Degeneration
Get PDFActivation of the nuclear factor kappa β (NF-κβ) is related to many inflammatory diseases, including age-related macular degeneration (AMD). The imbalance in the redox state, which happens mainly in senescence, associated with several peculiar characteristics of the macular region, has led to studies of this molecule for AMD therapeutic interventions. Findings report the involvement of NF-κβ both in the triggering as well as in the worsening condition of AMD. The present article correlates AMD oxidant and inflammatory genesis with the action of the nuclear factor kappa β. Besides its mechanism of action, this study also analyzes the main inflammatory cytokines and adhesion molecules that may be activated by NF-κβ and are closely related to AMD
Lifestyles and Cognition
Get PDFCognitive decline is a growing medical concern. It includes age-related cognitive decline, mild cognitive impairment, and dementia. Dementia results in considerable dysfunction in life and is associated with an increase in mortality. Since there is no cure at this time, attention is being increasingly directed towards prevention. Lifestyle factors, such as smoking, alcoholism, physical inactivity, poor diet, improper sleep, and loneliness are repeatedly being recognized as modifiable factors that can reduce cognitive decline. This manuscript briefly reviews the lifestyle-cognition relationship.
 
An Exceptional Case of Simultaneous Double Ileoileal Intussusception Secondary to Burkitt’s Lymphoma
No full textThe telescoping or the invagination of a segment of the intestine in its adjacent part is called intussusception. This incident is highly prevalent in children, while it is uncommonly observed in adults. Among those, only about 5% of cases occur. On the other hand, about 5% of intestinal obstructions in adults are caused by intussusceptions, and in these cases, more than 50% are secondary to a neoplasm. Burkitt's lymphoma is a rare cause of intussusception. In fact, less than 20 cases have been reported in the literature in adults. In addition, Double intussusceptions due to Burkitt's lymphoma are extremely infrequent. We present the case of a 20-year-old woman who exhibited symptoms of intestinal obstruction and was diagnosed with ileal double invagination during exploration by abdominal tomography and laparotomy. The lead point pathology was found to be Burkitt's lymphoma. This case represents a rare cause of intussusception secondary to Burkitt's lymphoma. In infants, intussusception is often treated with air enema reduction, but in adults, intussusception is normally associated with a point of contact, and surgical management is required. The aim of this work is to present a case of double intussusception in adults due to Burkitt's lymphoma. This case is the second reported in the literature. This report contains interesting diagnostic images, surgical details, and sample photographs
Oral Manifestations of the Immune Thrombocytopenic Purpura
Get PDFIntroduction: Hemorrhagic oral mucosa lesions are the most common clinical manifestations of immune thrombocytopenic purpura (ITP). Case Report: A 41-year-old female patient consulted the Oral Surgery Department of the Dental Consultation and Treatment Center in Rabat for spontaneous gingivorrhagia. Clinical examination and further examination showed severe thrombocytopenia associated with an anemic syndrome. The diagnosis of ITP was made. Treatment was based on oral corticosteroids and immunoglobulin in the hospital. Conclusion: These manifestations sometimes lead the patient to consult their dental surgeon in the first intention, hence the need to make the diagnosis based on a thorough global examination and refer the patient to an adapted structure