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   2015| October-January  | Volume 6 | Issue 3  
    Online since January 16, 2017

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Study of Self Medication In Patients With Diabetes Using Path Analysis
M Rezaei, A.R.A Safavi, NM Alavi, H Kashefi
October-January 2015, 6(3):2-2
Self-medication is a behavior in which one tries to solve his/her health condition or problem without professional help. With regard to mortality and severe complications of diabetes, inappropriate self- medication can have severe consequences but proper planning can control this behavior to improve the patient's health. In this study, the effect of each factor on self-medication in patients with diabetes is determined using path analysis technique. This cross-sectional study was conducted in the Kermanshah diabetes center. The number of patients with diabetes interviewed were 500. Each patient's score of self-medication were determined according to a questionnaire, with a higher score showing greater self-medication. Demographic information and scores of trust to doctors, medical expenses, others' recommendations and busy work environment as predictor variables were measured and analyzed using SPSS 16.0. Based on the questionnaire scores, two patients (0.4%) largely, 191 (38.7%) moderately and 300 (60.9%) slightly were on self-medication. The variable; mistrust of doctors only directly, variables; age, the duration of diabetes and family history of heart disease only indirectly and variables; busy work environment, medical expenses, others' recommendations and family history of hypertension directly and indirectly were related to self-medication. The results of this study showed that more than 60% of patients with diabetes had low self-medication, which represents the success of education principles and methods. Extracting causal relationships among the complexity of factors influencing a disease requires powerful statistical tools such as path analysis.
[ABSTRACT]   Full text not available  [PDF]
  2,094 448 -
Role of HbA1C level as a diagnostic tool of diabetes and pre-diabetes in middle-aged Bangladeshi population
A Begum, MA Muttalib, TA Sultana, S Choudhury
October-January 2015, 6(3):3-3
Diabetes Mellitus is one of the leading non -communicable diseases all over the w orld including Bangladesh. Diabetes is often preceded by a prodromal condition termed pre -diabetes. Oral glucose tolerance test (OGTT) still is regarded as gold standard in diagnosis of blood glucose abnormality. Although less number of bodies are considering measurement of HbA1C as an alternate tool to identify risk group. The present study w as undertaken to evaluate the role of measurement of HbA1C in t he diagnosis of diabetes and pre-diabetes in middle-aged Bangladeshi subjects. A total 177 subjects of age w ithin the range of 30-45 years w ere selected for the purpose and classified into healthy control (n=62) pre-diabetes (n= 69) and diabetes (n=46) groups based on the values of OGTT. Middle aged Bangladeshi subjects attending Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) hospital, the HbA1C values w ere 5.0 -5.6% in control group, 5.6-6.2% in pre-diabetes and 8.1-9.7% in diabetes group (95% CI). The optimal cut -off value of HbA1C related to pre-diabetes diagnosed by OGTT w as 5.6%, w hich show ed the sensitivity 47.8%, specificity 74.2%, positive predictive value 67.3% and negative predictive value 58.5%. Variants of hemoglobin especially Hemoglobin E (HbE) is prevalent in South East Asia including Bangladesh. The presence of genetic variants of hemoglobin can profoundly affect the accuracy of HbA1C measurements. So measurement of HbA1C may not correlate adequately w ith actual blood glucose level.
[ABSTRACT]   Full text not available  [PDF]
  2,019 371 -
Assessment of factors relating to screening of diabetes complications in patients with Type 2 Diabetes Mellitus during follow up: A descriptive study in Sri Lanka
G.N.D Perera, V Navarathnarajah, W.G.C Pradeep, W.D.D Priyankara, A Kulatunga
October-January 2015, 6(3):1-1
Diabetes is a growing epidemic disease in the world and the associated micro and macrovascular complications cause significant morbidity and mortality. We conducted a descriptive cross sectional study to evaluate the adequacy of screening and to identify the factors relating to poor diabetes complication screening in type 2 Diabetes Mellitus (DM) patients during follow ups. We have included patients with type 2 DM, admitted to a medical unit in a tertiary care center. Study was conducted from September 1 to October 31, 2012. The study participants were interviewed using an interviewer administered questionnaire. Patients were examined to assess microvascular complications, macro vascular complications, BMI and blood pressure. All patients had FBS, lipid profile, Urine albumin estimation and renal function testing. Screening performed during their follow up was assessed during the interview. There were 147 patients (81 males and 66 females) with an average age of 58.5 ± 9yrs. There were 97 (65.9%) patients who followed up at National Hospital of Sri Lanka (NHSL). Majority (n=133, 90.5%) were given disease education during follow up. Out of the total, 23(15.6%) were using SMBG while only 69(46.9%) had at least one HbA1c performed in the preceding year. Patients following up at NHSL had lower BMI, better glycaemic control, better lipid values and had received better microvascular complication screening. Follow up at a hospital other than NHSL was associated with poor microvascular complication screening. Female gender and increasing age was associated with poor retinopathy screening. Microvascular complication screening is suboptimal and the adherence to guidelines depends on the healthcare facility of follow up, sex and age of the patient. There is an urgent need to educate medical practitioners and patients on proper diabetes care.
[ABSTRACT]   Full text not available  [PDF]
  1,961 413 -
Study of hearing function in type-2 diabetes with reference to common risk factors
AK Pandey
October-January 2015, 6(3):4-4
Type 2 diabetes mellitus is the most prevalent non-communicable disease having progressive irreversible sensorineural hearing loss as sequela. Contemporary diabetes management needs to pay attention to timely detect and check or mitigate hearing loss which may seriously compromise safety, efficiency and quality of life. Magnitude of the problem was assessed among 51 type 2 diabetes patients by pure tone audiometry, in comparison with 51 age-matched non-diabetic controls. Glycaemic control, blood pressure, lipid profile and retinopathy were examined for any association to presence and extent of hearing loss. Glycaemic control in managed type 2 diabetics was not tight and all patients suffered hearing loss of some degree. Less than third of control suffered hearing loss in higher age and often with pre diabetic profile of blood sugar. Hyperglycaemia showed singularly strongest correlation to extent of hearing loss, while rising tendency in blood pressure came as close second risk factor. Retinopathy was strongly associated with extensive hearing loss. Triglycerides and VLDL profiles did and LDL or HDL profiles did not correlate to the extent of hearing losses. Duration of the diagnosed disease also showed no correlation. Mitochondrial dysfunction due to hyperglycaemia either directly or indirectly through free radical excess is appealing as basis for damage to high energy sensitive cochlear and neural cells. Hyper-coagulability may but atherosclerosis may not be a mode of contribution by altered lipid profile to hearing loss. Lose control of blood sugar, blood pressure, presence of microangiopathy, raised triglyceride signal a bad omen for hearing function.
[ABSTRACT]   Full text not available  [PDF]
  1,846 338 -