Pub Date : 2017-07-08DOI: 10.4172/2161-1017.1000269
N. Gebara, C. Beaini, F. Karak, G. Hajje
Nicole Gebara1, Chadia Beaini2, Fadi El Karak3 and Georges Hajje4* 1Departments of Medicine, Bellevue Medical Center, Saint Joseph University, Beirut, Lebanon 2Department of Nephrology, Bellevue Medical Center, Saint Joseph University, Beirut, Lebanon 3Department of Oncology, Bellevue Medical Center, Saint Joseph University, Beirut, Lebanon 4Department of Endocrinology, Bellevue Medical Center, Saint Joseph University, Beirut, Lebanon
Nicole Gebara1, Chadia Beaini2, Fadi El Karak3和Georges Hajje4* 1黎巴嫩贝鲁特圣约瑟夫大学贝尔维尤医学中心医学系2黎巴嫩贝鲁特圣约瑟夫大学贝尔维尤医学中心肾内科3黎巴嫩贝鲁特圣约瑟夫大学贝尔维尤医学中心肿瘤科4黎巴嫩贝鲁特圣约瑟夫大学贝尔维尤医学中心内分泌科
{"title":"Refractory Hypocalcemia Effectively Treated with Steroids in Prostate Cancer Metastatic to Bone","authors":"N. Gebara, C. Beaini, F. Karak, G. Hajje","doi":"10.4172/2161-1017.1000269","DOIUrl":"https://doi.org/10.4172/2161-1017.1000269","url":null,"abstract":"Nicole Gebara1, Chadia Beaini2, Fadi El Karak3 and Georges Hajje4* 1Departments of Medicine, Bellevue Medical Center, Saint Joseph University, Beirut, Lebanon 2Department of Nephrology, Bellevue Medical Center, Saint Joseph University, Beirut, Lebanon 3Department of Oncology, Bellevue Medical Center, Saint Joseph University, Beirut, Lebanon 4Department of Endocrinology, Bellevue Medical Center, Saint Joseph University, Beirut, Lebanon","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84974185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-13DOI: 10.4172/2161-1017.1000268
Arindam Sur, G. Priya
Introduction: For development of Type 2 Diabetes mellitus, Vitamin D is thought to be a risk factor. Various studies have established the fact that Vitamin D replenishment improves glycemic status and insulin secretion in patients with Type 2 Diabetes mellitus with established hypovitaminosis D. This study was done to find out the degree of association between glycemic status and vitamin D levels in type 2 Diabetes Mellitus patients in a tertiary care center. Patient and methods: The study was done in the Department of Biochemistry, SCB Medical College, and Cuttack 48 patients of type 2 Diabetes Mellitus were taken as cases 42 healthy subjects were taken as controls. Biochemical parameters like FBS, PPBS, Urea, Creatinine, HbA1c, Lipid profile parameters were measured in both cases and controls. Results: The serum urea and creatinine levels were significantly elevated in complicated type 2 Diabetes mellitus patients as compared to healthy controls. Serum cholesterol, triglycerides, LDL Cholesterol levels also showed significant increase Vitamin D and FBS levels showed a significant negative correlation in cases and vitamin D levels were decreased in cases as compared to controls. Conclusion: As Vitamin D and FBS levels showed a significant negative correlation, and vitamin D levels were decreased in cases as compared to controls, so it can be proved that vitamin D can lead to good glycemic control and hypovitaminosis D can thereby lead to Type 2 Diabetes Mellitus.
{"title":"Association of serum Vitamin D level with Glycemic Status in Patients of Type 2Diabetes Mellitus","authors":"Arindam Sur, G. Priya","doi":"10.4172/2161-1017.1000268","DOIUrl":"https://doi.org/10.4172/2161-1017.1000268","url":null,"abstract":"Introduction: For development of Type 2 Diabetes mellitus, Vitamin D is thought to be a risk factor. Various studies have established the fact that Vitamin D replenishment improves glycemic status and insulin secretion in patients with Type 2 Diabetes mellitus with established hypovitaminosis D. This study was done to find out the degree of association between glycemic status and vitamin D levels in type 2 Diabetes Mellitus patients in a tertiary care center. \u0000Patient and methods: The study was done in the Department of Biochemistry, SCB Medical College, and Cuttack 48 patients of type 2 Diabetes Mellitus were taken as cases 42 healthy subjects were taken as controls. Biochemical parameters like FBS, PPBS, Urea, Creatinine, HbA1c, Lipid profile parameters were measured in both cases and controls. \u0000Results: The serum urea and creatinine levels were significantly elevated in complicated type 2 Diabetes mellitus patients as compared to healthy controls. Serum cholesterol, triglycerides, LDL Cholesterol levels also showed significant increase Vitamin D and FBS levels showed a significant negative correlation in cases and vitamin D levels were decreased in cases as compared to controls. \u0000Conclusion: As Vitamin D and FBS levels showed a significant negative correlation, and vitamin D levels were decreased in cases as compared to controls, so it can be proved that vitamin D can lead to good glycemic control and hypovitaminosis D can thereby lead to Type 2 Diabetes Mellitus.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"292 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79511479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-09DOI: 10.4172/2161-1017.1000E125
G. Maldonado, C. Rios
The capillary loop consists of an arterial or afferent branch and a venous or efferent branch. The main parameters to be evaluated are: length, diameter, density, venous plexus and morphological abnormalities. These elements should be evaluated in the distal row or near the nailfold. The normal number of capillaries per millimeter is from seven to twelve arranged in an inverted U-shape (Figure 1).
{"title":"Nailfold Capillaroscopy in Diabetes Mellitus: Potential Technique for the Microvasculature Evaluation","authors":"G. Maldonado, C. Rios","doi":"10.4172/2161-1017.1000E125","DOIUrl":"https://doi.org/10.4172/2161-1017.1000E125","url":null,"abstract":"The capillary loop consists of an arterial or afferent branch and a venous or efferent branch. The main parameters to be evaluated are: length, diameter, density, venous plexus and morphological abnormalities. These elements should be evaluated in the distal row or near the nailfold. The normal number of capillaries per millimeter is from seven to twelve arranged in an inverted U-shape (Figure 1).","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"143 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86629235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-31DOI: 10.4172/2161-1017.1000267
S. Tharwat, A. A. El-Megeid, A. Salam, L. Rashed, S. El-Hamid, S. Abdel-Shafy, D. Shaheen
Background and Aims: Flaxseed is a promising alternative reducing the risk of diseases associated with obesity. The purpose of this study is to determine the effect of supplemented bakery with flaxseed or flaxseed oil on type 2 diabetic patients Materials and Methods: Ninety type 2 diabetic on oral hypoglycemic (body weight, fasting, post prandial blood glucose, cholesterol, LDL, HDL, Triglycerides, VLDL and leptin) were recorded at base line, and after twelve weeks. Participants divided into 3 groups. Group 1 (control): Consists of 30 patients on regimen diet with type 2 diabetes who received regimen diet 1350 kcal. Group 2: Consists of 30 patients with type 2 diabetes and following regimen diet same as group (1) plus a dose of flaxseed oil bakery regimen diet for twelve weeks. Group (3): Consists of 30 subjects with type 2 diabetes on regimen diet the same as group (1) plus supplementation with flaxseed bakery product for twelve weeks. Results: After twelve weeks significant changes in group 2 and 3 Versus control in BMI (0.05, 0.03) fasting (p<0.001), post prandial glucose (0.03, 0.02, 0.001), HA1c (0.02, 0.01), cholesterol (0.024, <0.001, 0.01), triglycerides (<0.001), LDL (0.05, 0.001, 0.01), VLDL (<0.001) and leptin (<0.001). Conclusion: Regimen diet containing supplemented bakery with flaxseed or flaxseed oil for 12 weeks decrease BMI, blood glucose, lipid profile in type 2 diabetics, thus incorporating flaxseed in bakery is recommended.
{"title":"Effectiveness of Adding Flaxseed to Type 2 Diabetic PatientâÂÂs Regimen","authors":"S. Tharwat, A. A. El-Megeid, A. Salam, L. Rashed, S. El-Hamid, S. Abdel-Shafy, D. Shaheen","doi":"10.4172/2161-1017.1000267","DOIUrl":"https://doi.org/10.4172/2161-1017.1000267","url":null,"abstract":"Background and Aims: Flaxseed is a promising alternative reducing the risk of diseases associated with \u0000 obesity. The purpose of this study is to determine the effect of supplemented bakery with flaxseed or flaxseed oil on \u0000 type 2 diabetic patients \u0000Materials and Methods: Ninety type 2 diabetic on oral hypoglycemic (body weight, fasting, post prandial blood \u0000 glucose, cholesterol, LDL, HDL, Triglycerides, VLDL and leptin) were recorded at base line, and after twelve weeks. \u0000 Participants divided into 3 groups. Group 1 (control): Consists of 30 patients on regimen diet with type 2 diabetes \u0000 who received regimen diet 1350 kcal. Group 2: Consists of 30 patients with type 2 diabetes and following regimen \u0000 diet same as group (1) plus a dose of flaxseed oil bakery regimen diet for twelve weeks. Group (3): Consists of 30 \u0000 subjects with type 2 diabetes on regimen diet the same as group (1) plus supplementation with flaxseed bakery \u0000 product for twelve weeks. \u0000Results: After twelve weeks significant changes in group 2 and 3 Versus control in BMI (0.05, 0.03) fasting \u0000 (p<0.001), post prandial glucose (0.03, 0.02, 0.001), HA1c (0.02, 0.01), cholesterol (0.024, <0.001, 0.01), \u0000 triglycerides (<0.001), LDL (0.05, 0.001, 0.01), VLDL (<0.001) and leptin (<0.001). \u0000Conclusion: Regimen diet containing supplemented bakery with flaxseed or flaxseed oil for 12 weeks decrease \u0000 BMI, blood glucose, lipid profile in type 2 diabetics, thus incorporating flaxseed in bakery is recommended.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"6 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85460402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-26DOI: 10.4172/2161-1017.1000266
Av Sahasrabuddhe, Charru Singh, S. Pitale, Hs Patil
Introduction: The prevalence of OSA and its consequences are likely to increase in light of the current obesity epidemic. Studies have shown that the prevalence of OSA is significantly higher in the diabetes population. Recent studies have revealed that BMI and diabetes as significant independent predictors of OSA. Owing to little research in this field and lack of data from Central India, the present study aims at assessing the risk of development of obstructive sleep apnoea in obese and obese diabetic patients. Objectives: To find out the prevalence of OSA risk in obese patients with Diabetes mellitus using Berlin Questionnaire, to find out the prevalence of OSA risk in obese non diabetic patients, correlation of OSA risk with Body Mass Index, fasting blood sugar, HbA1c and Blood Pressure. Methodology: Twenty four obese diabetic patients (Group I) and thirty-five obese – non- diabetic patients (Group II) were selected from medicine OPD randomly. Results were matched with thirty-one healthy non-obese nondiabetic controls (Group III). Risk of OSA was assessed using pre designed, validated Berlin questionnaire. HbA1C and fasting blood sugars were done. Results: As per Berlin Questionnaire Category 1 showed 19 (79.17%), 21 (60%) and 7 (22.58%) cases as positive in ‘DM and Obese’, ‘No DM but Obese’ and ‘Control’ groups respectively, P-value<0.0001 using Chi-square test, Category 2 had 7 (29.17%), 6 (17.14%) and 0 cases as positive in ‘DM and Obese’, ‘No DM but Obese’ and Control groups respectively with P-value of 0.008 (P<0.05) using Chi-square test and Category 3 had 18 (75%), 25 (71.4%) and 1(3.23%) positive cases in ‘DM and Obese’, ‘No DM but Obese’ and ‘Control’ groups respectively, and the difference in the proportions was statistically significant with P-value<0.0001 using Chi-square test. Age above 40 years, female sex increased the risk of OSA. HbA1C was found out to be an independent risk factor for OSA risk. After adjusting for covariates for HbA1C, the OR obtained was 6.20 [95% CI: 1.37-28.07], with a P-value of 0.018 (P<0.05). Conclusion: Our study shows that the risk of OSA is significantly increases with increasing BMI, fasting blood glucose levels, mean arterial pressure and HbA1c levels. High risk of OSA was 58.9% in our study.
{"title":"Stratification of Obstructive Sleep Apnea Risk in Obese non-Diabetics and Obese Diabetics","authors":"Av Sahasrabuddhe, Charru Singh, S. Pitale, Hs Patil","doi":"10.4172/2161-1017.1000266","DOIUrl":"https://doi.org/10.4172/2161-1017.1000266","url":null,"abstract":"Introduction: The prevalence of OSA and its consequences are likely to increase in light of the current obesity \u0000 epidemic. Studies have shown that the prevalence of OSA is significantly higher in the diabetes population. Recent \u0000 studies have revealed that BMI and diabetes as significant independent predictors of OSA. Owing to little research \u0000 in this field and lack of data from Central India, the present study aims at assessing the risk of development of \u0000 obstructive sleep apnoea in obese and obese diabetic patients. \u0000Objectives: To find out the prevalence of OSA risk in obese patients with Diabetes mellitus using Berlin \u0000 Questionnaire, to find out the prevalence of OSA risk in obese non diabetic patients, correlation of OSA risk with Body Mass Index, fasting blood sugar, HbA1c and Blood Pressure. \u0000Methodology: Twenty four obese diabetic patients (Group I) and thirty-five obese – non- diabetic patients (Group \u0000 II) were selected from medicine OPD randomly. Results were matched with thirty-one healthy non-obese nondiabetic \u0000 controls (Group III). Risk of OSA was assessed using pre designed, validated Berlin questionnaire. HbA1C \u0000 and fasting blood sugars were done. \u0000Results: As per Berlin Questionnaire Category 1 showed 19 (79.17%), 21 (60%) and 7 (22.58%) cases as \u0000 positive in ‘DM and Obese’, ‘No DM but Obese’ and ‘Control’ groups respectively, P-value<0.0001 using Chi-square \u0000 test, Category 2 had 7 (29.17%), 6 (17.14%) and 0 cases as positive in ‘DM and Obese’, ‘No DM but Obese’ and \u0000 Control groups respectively with P-value of 0.008 (P<0.05) using Chi-square test and Category 3 had 18 (75%), 25 \u0000 (71.4%) and 1(3.23%) positive cases in ‘DM and Obese’, ‘No DM but Obese’ and ‘Control’ groups respectively, and \u0000 the difference in the proportions was statistically significant with P-value<0.0001 using Chi-square test. Age above \u0000 40 years, female sex increased the risk of OSA. HbA1C was found out to be an independent risk factor for OSA risk. \u0000 After adjusting for covariates for HbA1C, the OR obtained was 6.20 [95% CI: 1.37-28.07], with a P-value of 0.018 \u0000 (P<0.05). \u0000Conclusion: Our study shows that the risk of OSA is significantly increases with increasing BMI, fasting blood \u0000 glucose levels, mean arterial pressure and HbA1c levels. High risk of OSA was 58.9% in our study.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"6 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87200186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-10DOI: 10.4172/2161-1017.1000265
K. Baagar, A. Aboudi, H. Khaldi, B. Alowinati, A. Abou-Samra, S. Lindow
Objective: The incidence of diabetic ketoacidosis in pregnancy (DKP) varies from 0.5%, the lowest reported rate in western countries, to 8.9% in a study conducted in China. The associated fetal mortality is 9-36%. This study aimed to assess the current incidence, causes, and outcomes of diabetic ketoacidosis in pregnancy and identify factors associated with favorable outcomes. Methods: A retrospective chart review of 20 diabetic ketoacidosis hospital admissions of 19 pregnant women from 3,679 diabetic pregnancies delivered between June 2012 and May 2015 was conducted. Those with successful DKP management (group A) or with intrauterine fetal death or urgent delivery during diabetic ketoacidosis management (group B) were compared. Results: Thirteen cases had type 1 diabetes, and 6 cases had type 2 diabetes, including 2 new diagnoses. The most common precipitating factors were vomiting (55%) and insulin non-compliance (45%). Plasma glucose was <200 mg/dl in 50% of the patients. There was no maternal mortality, but there was one fetal death (5%). Only mean gestational age (21.8 ± 11.0 versus 33.7 ± 4.6 weeks, P=0.005) was significantly different between groups A (14 admissions) and B (6 admissions). Conclusion: The incidence of diabetic ketoacidosis was 0.5%, similar to the lowest incidence previously reported. Fetal mortality was 5%, lower than previously reported. The only factor associated with a favorable outcome was early gestational age at presentation. We recommend antenatal screening for diabetes, patient education, and compliance with insulin treatment as preventive measures against DKP.
目的:妊娠期糖尿病酮症酸中毒(DKP)的发生率从西方国家报道的最低的0.5%到中国进行的一项研究的8.9%不等。相关的胎儿死亡率为9-36%。本研究旨在评估妊娠期糖尿病酮症酸中毒的发生率、原因和结局,并确定与有利结局相关的因素。方法:回顾性分析2012年6月~ 2015年5月3679例糖尿病孕妇中19例入院20例糖尿病酮症酸中毒的资料。比较DKP管理成功(A组)或糖尿病酮症酸中毒管理期间宫内胎儿死亡或紧急分娩(B组)。结果:1型糖尿病13例,2型糖尿病6例,其中新诊断2例。最常见的诱发因素是呕吐(55%)和胰岛素不依从性(45%)。50%的患者血浆葡萄糖< 200mg /dl。没有产妇死亡,但有一例胎儿死亡(5%)。仅平均胎龄(21.8±11.0 vs 33.7±4.6周,P=0.005)在A组(14例)和B组(6例)之间有显著差异。结论:糖尿病酮症酸中毒发生率为0.5%,与既往报道的最低发生率相似。胎儿死亡率为5%,低于先前报道。与有利结果相关的唯一因素是分娩时的胎龄早。我们建议产前糖尿病筛查、患者教育和胰岛素治疗依从性作为预防糖尿病的措施。
{"title":"Retrospective Analysis of Diabetic Ketoacidosis in Pregnant Women over a Period of 3 Years","authors":"K. Baagar, A. Aboudi, H. Khaldi, B. Alowinati, A. Abou-Samra, S. Lindow","doi":"10.4172/2161-1017.1000265","DOIUrl":"https://doi.org/10.4172/2161-1017.1000265","url":null,"abstract":"Objective: The incidence of diabetic ketoacidosis in pregnancy (DKP) varies from 0.5%, the lowest reported rate in western countries, to 8.9% in a study conducted in China. The associated fetal mortality is 9-36%. This study aimed to assess the current incidence, causes, and outcomes of diabetic ketoacidosis in pregnancy and identify factors associated with favorable outcomes. \u0000Methods: A retrospective chart review of 20 diabetic ketoacidosis hospital admissions of 19 pregnant women from 3,679 diabetic pregnancies delivered between June 2012 and May 2015 was conducted. Those with successful DKP management (group A) or with intrauterine fetal death or urgent delivery during diabetic ketoacidosis management (group B) were compared. \u0000Results: Thirteen cases had type 1 diabetes, and 6 cases had type 2 diabetes, including 2 new diagnoses. The most common precipitating factors were vomiting (55%) and insulin non-compliance (45%). Plasma glucose was <200 mg/dl in 50% of the patients. There was no maternal mortality, but there was one fetal death (5%). Only mean gestational age (21.8 ± 11.0 versus 33.7 ± 4.6 weeks, P=0.005) was significantly different between groups A (14 admissions) and B (6 admissions). \u0000Conclusion: The incidence of diabetic ketoacidosis was 0.5%, similar to the lowest incidence previously reported. Fetal mortality was 5%, lower than previously reported. The only factor associated with a favorable outcome was early gestational age at presentation. We recommend antenatal screening for diabetes, patient education, and compliance with insulin treatment as preventive measures against DKP.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"42 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80049206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-24DOI: 10.4172/2161-1017.1000264
M. Godbole, M. Lotfy, L. McGowen
Aims of the study: To assess the prevalence of metabolic syndrome and implement a framework for screening and management of cardio metabolic risks in women on psychiatric in-patient wards. Background: An estimated 29-48% of psychiatric in-patients have metabolic syndrome. Severe mood disorders and psychotic illnesses are independent risk factors. 20-25% of the world’s adult population have metabolic syndrome and they are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. This study gives an overview of the application of Lester Tool on busy in-patient units and interventional approaches adapted by the team. Method: 46 admissions between April to July 2015 were included in Phase 1. Information on physical health medication and menopausal status was recorded in addition to metabolic syndrome parameters. Data on 47 admissions in Phase 2 between March to May 2016 was obtained. Advice on healthy lifestyle, diet, medication and smoking cessation was offered as routine. Results: Phase 1: Of the total 46 patients, 38 (82.60%) were on antipsychotics, 6 (13.04%) had metabolic syndrome and 14 (30.43%) did not and data was not available on 26 (56.52%). Most frequently missing criteria were waist circumference and triglyceride measurements. Phase 2: Of the total 45 patients, 14 (31.1%) had metabolic syndrome, 12 (26.6%) did not and data was unknown in 13 (28.8%). 2/3rd of admissions were compliant with investigations, as opposed to 1/3rd in Phase 1. 86.6% compliance was achieved in BMI checks. 20% were prescribed anti-hypertensive or anti-diabetic medication during admission and were referred to the dietician and diabetes clinic. Conclusion: Clinical identification and management of metabolic syndrome is essential and preventative measures by referral to specialist services or use of 3DFD model could be implemented. Lester Adaptation has been an effective tool for recording cardio metabolic risks; but in reality an effective interventional process could prove hard to achieve in mental health settings.
{"title":"Lester Adaptation of Cardio Metabolic Measurements: An Inpatient Interventional Framework for Women with Mental Illness","authors":"M. Godbole, M. Lotfy, L. McGowen","doi":"10.4172/2161-1017.1000264","DOIUrl":"https://doi.org/10.4172/2161-1017.1000264","url":null,"abstract":"Aims of the study: To assess the prevalence of metabolic syndrome and implement a framework for screening and management of cardio metabolic risks in women on psychiatric in-patient wards. Background: An estimated 29-48% of psychiatric in-patients have metabolic syndrome. Severe mood disorders and psychotic illnesses are independent risk factors. 20-25% of the world’s adult population have metabolic syndrome and they are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. This study gives an overview of the application of Lester Tool on busy in-patient units and interventional approaches adapted by the team. Method: 46 admissions between April to July 2015 were included in Phase 1. Information on physical health medication and menopausal status was recorded in addition to metabolic syndrome parameters. Data on 47 admissions in Phase 2 between March to May 2016 was obtained. Advice on healthy lifestyle, diet, medication and smoking cessation was offered as routine. Results: Phase 1: Of the total 46 patients, 38 (82.60%) were on antipsychotics, 6 (13.04%) had metabolic syndrome and 14 (30.43%) did not and data was not available on 26 (56.52%). Most frequently missing criteria were waist circumference and triglyceride measurements. Phase 2: Of the total 45 patients, 14 (31.1%) had metabolic syndrome, 12 (26.6%) did not and data was unknown in 13 (28.8%). 2/3rd of admissions were compliant with investigations, as opposed to 1/3rd in Phase 1. 86.6% compliance was achieved in BMI checks. 20% were prescribed anti-hypertensive or anti-diabetic medication during admission and were referred to the dietician and diabetes clinic. Conclusion: Clinical identification and management of metabolic syndrome is essential and preventative measures by referral to specialist services or use of 3DFD model could be implemented. Lester Adaptation has been an effective tool for recording cardio metabolic risks; but in reality an effective interventional process could prove hard to achieve in mental health settings.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"23 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86992373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-10DOI: 10.4172/2161-1017.1000262
S. Hammouda, E. Sultan, A. Mohamadin
Background: Glycosylated hemoglobin (HbA1c) was found to be a valuable predictor of the risk of congenital malformations. Other studies documented diabetic complications in subjects with HbA1c at the pre-diabetic levels. Objectives: This study was done to compare serum levels of zinc, magnesium and selenium between pregnant women with normal glycemic control, diabetes and pre-diabetes. Subjects/Methods: The data was part of a large prospective cohort study aimed at identifying some preventable risk factors that cause congenital malformations among Saudi women. 1103 healthy first trimester pregnant were randomly selected from antenatal clinics in twenty one health care centers and two hospitals at Al-Madinah Al- Monawarah, KSA. Clinical history, examination and lab analysis were done (serum levels of magnesium, zinc, selenium, and HbA1c). Subjects were classified by their HbA1c levels as normal (HbA1c<5.7%), pre-diabetic (HbA1c 5.7<6.5%), and undiagnosed type 2 diabetics (HbA1c≥6.5%), comparison in the lab results was done between the groups. Results: About 78. 9% (870 subjects) had normal HbA1c, 19.1% (211 subjects) had HbA1c in the range of prediabetes and 1.99% (22 subjects) had HbA1c>6.5% denoting undiagnosed type 2 diabetes Serum levels of nutrients were significantly lower among pre-diabetics compared to normal subjects, same results were obtained when comparing diabetics and pre-diabetics and diabetics and normal subjects. There was a significant negative correlation between the levels of HbA1c and zinc, magnesium and selenium. Conclusion and Recommendations: Changes in serum levels of zinc, magnesium and selenium occurs at the pre-diabetic stage and precedes the development of diabetes & may be responsible for medical complications that are recently reported at this stage. Studies should be done for re-establishment of safe target levels of HbA1c.
{"title":"Serum Levels of Zinc, Magnesium and Selenium among First Trimester Pregnant Saudi Women with Pre-Diabetes and Diabetes","authors":"S. Hammouda, E. Sultan, A. Mohamadin","doi":"10.4172/2161-1017.1000262","DOIUrl":"https://doi.org/10.4172/2161-1017.1000262","url":null,"abstract":"Background: Glycosylated hemoglobin (HbA1c) was found to be a valuable predictor of the risk of congenital malformations. Other studies documented diabetic complications in subjects with HbA1c at the pre-diabetic levels. \u0000Objectives: This study was done to compare serum levels of zinc, magnesium and selenium between pregnant women with normal glycemic control, diabetes and pre-diabetes. \u0000Subjects/Methods: The data was part of a large prospective cohort study aimed at identifying some preventable risk factors that cause congenital malformations among Saudi women. 1103 healthy first trimester pregnant were randomly selected from antenatal clinics in twenty one health care centers and two hospitals at Al-Madinah Al- Monawarah, KSA. Clinical history, examination and lab analysis were done (serum levels of magnesium, zinc, selenium, and HbA1c). Subjects were classified by their HbA1c levels as normal (HbA1c<5.7%), pre-diabetic (HbA1c 5.7<6.5%), and undiagnosed type 2 diabetics (HbA1c≥6.5%), comparison in the lab results was done between the groups. \u0000Results: About 78. 9% (870 subjects) had normal HbA1c, 19.1% (211 subjects) had HbA1c in the range of prediabetes and 1.99% (22 subjects) had HbA1c>6.5% denoting undiagnosed type 2 diabetes \u0000Serum levels of nutrients were significantly lower among pre-diabetics compared to normal subjects, same results were obtained when comparing diabetics and pre-diabetics and diabetics and normal subjects. There was a significant negative correlation between the levels of HbA1c and zinc, magnesium and selenium. \u0000Conclusion and Recommendations: Changes in serum levels of zinc, magnesium and selenium occurs at the pre-diabetic stage and precedes the development of diabetes & may be responsible for medical complications that are recently reported at this stage. Studies should be done for re-establishment of safe target levels of HbA1c.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"181 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77539164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-08DOI: 10.4172/2161-1017.1000263
Tiruneh Gg, Regasa Kd, Y. Feleke, T. Kebede, Yifru Ym
Background: Pituitary tumors are frequently encountered intracranial neoplasms. The prevalence of these tumors in autopsy series is reported to be significant in many studies. However, there are no adequate studies on magnitude, clinical presentation and outcome of pituitary lesions in our country. Patients and methods: A retrospective study, data collected using chart review was conducted at national endocrine referral clinics of the hospital. A five years data from June 2010 to June 2015 was collected. The patients’ clinico-demographic and radiologic features were documented using a prestructured data collection tool. Data was entered into SPSS version 20 and analyzed. Frequencies and means were computed for description of the various variables. Individuals aged 14 years and above from both sexes who started follow-up in the study years at Tikur Anbessa Specialized Hospital Endocrinology Clinics were included in the study. Results: Out of the total of 1124 patients seen at endocrine clinics 51 (4.54%) were diagnosed to have pituitary lesions. A total of 42 patients with confirmed pituitary lesions were included in the analysis out of which 30 (71.4%) were females and 12 (28.6%) were males. The age range was 14 to 60 years old (mean age was 32.5 years). Among the 42 patients 20 (47.6%) had prolactinoma, 9 (21.43%) Cushing’s disease, 7 (16.67%) acromegaly, 2 (4.76%) features of both prolactinoma and acromegaly, 2 (4.76%) panhypopituitarism, 1 (2.38%) hypogonadism and 1 (2.38%) nonfunctional pituitary adenoma. The most common presenting symptoms were headache in 33(78.6%) and visual disturbances in 20(47.6%) of patients. Among the 42 patients 26 (61.9%) had pituitary macroadenoma, 5 (11.9%) pituitary microadenoma, 7 (16.7%) normal Magnetic Resonance Imaging (MRI) and 4 (9.5%) of patients had no MRI. Of all patients included in the analysis 24 (57.1%) were treated medically only to control hormone secretion, 11(26.2%) patients were referred for surgical intervention and the rest were treated with both medical and surgical approaches or with regular follow-up only. Most of the patients with prolactinoma (80%) had improvement with medical treatment only. Conclusion: Pituitary lesions accounted 4.54% of endocrine patients and Prolactinomas were the most common followed by Cushing’s disease and Acromegaly. The patients with Prolactinomas had a good outcome with medical treatment only.
背景:垂体瘤是常见的颅内肿瘤。在许多研究中,这些肿瘤在尸检系列中的患病率是显著的。然而,我国对垂体病变的大小、临床表现和转归尚无充分的研究。患者与方法:回顾性研究,采用图表法收集我院全国内分泌转诊门诊资料。收集了2010年6月至2015年6月的5年数据。使用预先结构化的数据收集工具记录患者的临床人口学和放射学特征。数据输入SPSS version 20进行分析。计算频率和平均值来描述各种变量。在Tikur Anbessa专科医院内分泌科诊所开始随访的14岁及以上的男女个体被纳入研究。结果:内分泌门诊1124例患者中51例(4.54%)诊断为垂体病变。共纳入42例确诊垂体病变患者,其中女性30例(71.4%),男性12例(28.6%)。年龄14 ~ 60岁,平均年龄32.5岁。42例患者中有泌乳素瘤20例(47.6%),库欣病9例(21.43%),肢端肥大症7例(16.67%),同时伴有泌乳素瘤和肢端肥大症2例(4.76%),全垂体功能低下2例(4.76%),性腺功能低下1例(2.38%),无功能垂体腺瘤1例(2.38%)。最常见的症状为头痛33例(78.6%),视力障碍20例(47.6%)。42例患者中垂体大腺瘤26例(61.9%),垂体微腺瘤5例(11.9%),MRI正常7例(16.7%),无MRI检查4例(9.5%)。在纳入分析的所有患者中,24例(57.1%)患者仅接受药物治疗以控制激素分泌,11例(26.2%)患者转诊接受手术干预,其余患者采用内外科联合治疗或仅定期随访。大多数催乳素瘤患者(80%)仅经药物治疗后病情有所改善。结论:垂体病变占内分泌患者的4.54%,以泌乳素瘤最为常见,其次为库欣病和肢端肥大症。催乳素瘤患者仅经药物治疗效果良好。
{"title":"Magnitude, Clinical Presentation and Outcome of Patients with Pituitary Lesions:An Experience from Tikur Anbessa Specialized Hospital, Ethiopia","authors":"Tiruneh Gg, Regasa Kd, Y. Feleke, T. Kebede, Yifru Ym","doi":"10.4172/2161-1017.1000263","DOIUrl":"https://doi.org/10.4172/2161-1017.1000263","url":null,"abstract":"Background: Pituitary tumors are frequently encountered intracranial neoplasms. The prevalence of these tumors in autopsy series is reported to be significant in many studies. However, there are no adequate studies on magnitude, clinical presentation and outcome of pituitary lesions in our country. Patients and methods: A retrospective study, data collected using chart review was conducted at national endocrine referral clinics of the hospital. A five years data from June 2010 to June 2015 was collected. The patients’ clinico-demographic and radiologic features were documented using a prestructured data collection tool. Data was entered into SPSS version 20 and analyzed. Frequencies and means were computed for description of the various variables. Individuals aged 14 years and above from both sexes who started follow-up in the study years at Tikur Anbessa Specialized Hospital Endocrinology Clinics were included in the study. Results: Out of the total of 1124 patients seen at endocrine clinics 51 (4.54%) were diagnosed to have pituitary lesions. A total of 42 patients with confirmed pituitary lesions were included in the analysis out of which 30 (71.4%) were females and 12 (28.6%) were males. The age range was 14 to 60 years old (mean age was 32.5 years). Among the 42 patients 20 (47.6%) had prolactinoma, 9 (21.43%) Cushing’s disease, 7 (16.67%) acromegaly, 2 (4.76%) features of both prolactinoma and acromegaly, 2 (4.76%) panhypopituitarism, 1 (2.38%) hypogonadism and 1 (2.38%) nonfunctional pituitary adenoma. The most common presenting symptoms were headache in 33(78.6%) and visual disturbances in 20(47.6%) of patients. Among the 42 patients 26 (61.9%) had pituitary macroadenoma, 5 (11.9%) pituitary microadenoma, 7 (16.7%) normal Magnetic Resonance Imaging (MRI) and 4 (9.5%) of patients had no MRI. Of all patients included in the analysis 24 (57.1%) were treated medically only to control hormone secretion, 11(26.2%) patients were referred for surgical intervention and the rest were treated with both medical and surgical approaches or with regular follow-up only. Most of the patients with prolactinoma (80%) had improvement with medical treatment only. Conclusion: Pituitary lesions accounted 4.54% of endocrine patients and Prolactinomas were the most common followed by Cushing’s disease and Acromegaly. The patients with Prolactinomas had a good outcome with medical treatment only.","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"1 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89535198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.4172/2161-1017.1000280
Ahmed Rg
Thyroid hormones (THs) are involved in the programming of early prenatal period [1-37]. Moreover, adipokines [leptin (LEP), resistin (RETN), adiponectin (ADP), inflammatory cytokines [interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-α (TNF-α)], and chemokines [interleukin-8 (IL-8)] play an important role during the fetal development and early life [12,32,33]. THs also control the actions of LEP [8,9], interferon-γ [38], ADP [8,9,39], TNF-α [8,26], and growth factors [8,28,32,33,35,40,41] by non-genomic mechanisms. Alternatively, LEP, ADP, and TNF-ɑ modulate the functions of thyroid axis and insulin sensitivity [8]. Also, adipokines can regulate the hypothalamic-pituitary-thyroid axis (HPTA), thermogenesis, body weight, basal metabolic rate and appetite [42]. The nuclear receptors such as thyroid receptors (TRs), peroxisome proliferator-activated receptor-α (PPARα), and liver X receptor (LXR) are vital for the triiodothyronine (T3) regulation of cholesterol metabolism and transcription of lipogenic and lipolytic genes [42]. In white adipose tissue (WAT), the expression and secretion of ADP was decreased throughout the pregnancy [13,43]. Moreover, the expression of LEP and RETN was observed in the developing placenta [44] with reducing the insulin level [45]. Also, the coordination in the secretion these cytokines is involved in the availability of energy during the gestation [46].
{"title":"Synergistic Actions of Thyroid-Adipokines Axis during Development","authors":"Ahmed Rg","doi":"10.4172/2161-1017.1000280","DOIUrl":"https://doi.org/10.4172/2161-1017.1000280","url":null,"abstract":"Thyroid hormones (THs) are involved in the programming of early prenatal period [1-37]. Moreover, adipokines [leptin (LEP), resistin (RETN), adiponectin (ADP), inflammatory cytokines [interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-α (TNF-α)], and chemokines [interleukin-8 (IL-8)] play an important role during the fetal development and early life [12,32,33]. THs also control the actions of LEP [8,9], interferon-γ [38], ADP [8,9,39], TNF-α [8,26], and growth factors [8,28,32,33,35,40,41] by non-genomic mechanisms. Alternatively, LEP, ADP, and TNF-ɑ modulate the functions of thyroid axis and insulin sensitivity [8]. Also, adipokines can regulate the hypothalamic-pituitary-thyroid axis (HPTA), thermogenesis, body weight, basal metabolic rate and appetite [42]. The nuclear receptors such as thyroid receptors (TRs), peroxisome proliferator-activated receptor-α (PPARα), and liver X receptor (LXR) are vital for the triiodothyronine (T3) regulation of cholesterol metabolism and transcription of lipogenic and lipolytic genes [42]. In white adipose tissue (WAT), the expression and secretion of ADP was decreased throughout the pregnancy [13,43]. Moreover, the expression of LEP and RETN was observed in the developing placenta [44] with reducing the insulin level [45]. Also, the coordination in the secretion these cytokines is involved in the availability of energy during the gestation [46].","PeriodicalId":11670,"journal":{"name":"Endocrinology and Metabolic Syndrome","volume":"79 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90858861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}