Tag Archives: Diabetes

Incidences of Hepatitis B Surface Antigen and Hepatitis C Antibodies in Diabetics Patient at Oouth (Published)

In recent time, controversy have been stirred up over the aetiology of liver failure in diabetic patients. Hence, this study was carried out to determine the incidence of Hapatitis B surface antigen and Hapatitis C antibodies in diabetic patients at             OOUTH. 5ml venous blood samples was collected from the diabetic patients, centrifuged at 1500 rpm for 5minutes and screened for HBV and HCV using ELISA and Diaspot Kits respectively. Out of the 230 diabetic patients screened for Hepatitis Virus Infection, 49 (19.6%) of them were positive while 185 (80.4%) were negative. HBV infection was highest in frequency by 43 (95.6%), followed by HBV and HCV co-infection, with a frequency of 2 (4.4%). Gender and ages of diabetic patients were observed not to have significant relationship with the incidence of viral hepatitis infection (P>0.05). Incidence of viral hepatitis was significantly higher in uneducated and widowed diabetic patients (P<0.05). Higher incidence of viral hepatitis infection was found to be significantly associated with tattooing (P<0.05) while no significant association was observed between same infection and each of alcoholism, blood transfusion, previous surgery and number of sex partners (P>0.05). When the diagnostic test result of diaspot was compared with ELISA, sensitivity of 11.1% and 82.2% were respectively observed (P<0.05).In conclusion, this study has established that the incidence of viral hepatitis was higher among diabetic patients with no formal education, those who are widows, and tattoo. It was further discovered that diaspot is less sensitive compared to ELISA

Keywords: Aetiology, Diabetes, ELISA, HBV, HCV, Hepatitis, Liver

Precipitating Factors for Diabetes Foot Ulcer in a Nigerian Tertiary Hospital (Published)

The diabetic foot ulcer (DFU) continues to afflict patients with diabetes despite the knowledge of its precipitants. Given the high cost of managing DFU, we sought to determine whether the immediate precipitating factors for the development of foot ulcerations have changed, in order to suggest effective preventive strategies. Methods: This is a descriptive study. The case records of patients admitted for diabetic foot ulcer at Lagos University Teaching Hospital between 2003-2005 were retrospectively reviewed. Information extracted from the notes included age, sex, duration and type of diabetes, fasting and or random/casual plasma glucose at presentation, grade of foot ulcer, and the immediate precipitating factors. Results: Twenty seven case records of patients with DFU were available for analysis. There were 15 (55.6%) males. The age range was 43-83 years with a mean of 61.04years. Type 2 diabetes was present in 92.6% of the patients, while the mean duration of diabetes was 7.98 years (range, 0-27years). Diagnosis of DM was made for the first time in 2(7.4%) of the patients at presentation of the foot problem. The mean admitting fasting and random plasma glucose was 133.3mg% (7.4mmol/L) and 227.2 mg% (12.6mmol/L) respectively.  Of the 27 patients, 13 (48.1%) had the lesion on the right foot while 6(22.2%) had bilateral DMFS. Majority (85.2%) of the patients had grades 2-4 ulcers. Trauma was the most frequent precipitant occurring in 33.3% of cases followed by tight/ inappropriate shoe or ill-fitting foot wear (18.5%). Tinea pedis alone and burns precipitated DMFS in 7.4% and 3.7% cases respectively, while both tinea pedis and inappropriate foot ware further contributed to DMFS in 3.7% of patients. In 29.6% of cases, the ulcers developed spontaneously. Conclusions/Recommendations: The immediate precipitating factors for diabetic foot ulcer remain unchanged, and can be prevented through patients’ adherence with diabetes treatment, and health education on proper foot care and foot ware practices.

Keywords: Diabetes, Foot Ulcer, Precipitants, Prevention

A Web-Based Clinical Decision Support System for the Management of Diabetes Neuropathy Using Naïve Bayes Algorithm (Published)

Diabetes Neuropathy is a chronic health problem with devastating, yet preventable consequences. Due to this shortage of specialists, there is a need for a Clinical Decision Support System that will diagnose and manage diabetes neuropathy. This work therefore aimed at designing a web-based Clinical Decision Support System for the management of early diabetes neuropathy. Four pattern classification algorithms (K-nearest neighbor, Decision Tree, Decision Stump and Rule Induction) were adopted in this work and were evaluated to determine the most suitable algorithm for the clinical decision support system. Datasets were gathered from reliable sources; two teaching hospitals in Nigeria, these were used for the evaluation Benchmarks such as performance, accuracy level, precision, confusion matrices and the models building’s speed were used in comparing the generated models. The study showed that Naïve Bayes outperformed all other classifiers with accuracy being 60.50%. k-nearest neighbor, Decision Tree, Decision Stump and Rule induction perform well with the lowest accuracy for x- cross validation being 36.50%. Decision Tree falls behind in accuracy, while k-nearest neighbour and Decision Stump maintain accuracy at equilibrium 41.00%. Therefore, Naïve Bayes is adopted as optimal algorithm in the domain of this study. The rules generated from the optimal algorithm (Naïve Bayes) forms the back-end engine of the Clinical Decision Support System. The web-based clinical decision support system was then designed The automatic diagnosis of diabetes neuropathy is an important real-world medical problem. Detection of diabetes neuropathy in its early stages is a key for controlling and managing patients early before the disabling effect present. This system can be used to assist medical programs especially in geographically remote areas where expert human diagnosis not possible with an advantage of minimal expenses and faster results. For further studies, researchers can improve on the proposed clinical decision support system by employing more than one efficient algorithm to develop a hybrid system.

Keywords: Accuracy, Algorithm, Classification, Diabetes, Neuropathy, precision

Evaluation of The Program for Early Detection of Hypertension and Type 2 Diabetes Mellitus in Primary Health Care Centers in wassit Governorate. (Published)

Background: Over the past decade it has been clear that the prevalence of hypertension and type 2 diabetes is increasing rapidly. Only around one half are aware of their condition and other  of them have asymptomatic stage, presence of screening and diagnostic tools this make diseases suitable for early detection will improve the outcome of people with HTN and T2DM , aiming to control of both of them. Objective: To evaluate the program for early detection of HTN& T2DM in PHC centers, and compare between Primary Health Care Centers which applied the program? Subject and methods: This study was a descriptive, cross-sectional study which represents multistage sampling of 22 PHCCs in Wassit governorate, selected randomly from 44 primary health centers distributed in 6 primary health Care Sectors according to ballot technique. Results: The results showed that only (2794) clients represent 25.1% of study samples from 11140 target population within catchment areas of study centers were covered by program for early detection. Total number of +Ve patients (HTN+T2DM) in diagnostic test was (47) from total +Ve patients in screening test (542). 54.5% of study centers have a convenient place for early detection program. Good scores regarding to standard structural staff but shows that poor to acceptable scores regarding presence of doctor. The current study showed that there are clear deficiencies of all information were recording in the file of patient that have been detected by the program, Most of important poor scores for early detection program showed in current study at rural area of PHC centers. Conclusions and Recommendation: In spite of the presence of poor indicators, the early detection program services achievement in wassit governorate was acceptable according to the guideline of Iraqi MOH indicators. There is no application for referral and feedback system regarding program’s patients. The current study showed clear deficiency in total information required in early detection records and patients file and there is clear deficiency in different testing for patients that detection by program (laboratory test, ECG, X-ray). Through effective health education, patients can learn primary and secondary prevention strategies, decrease their risk status and make better lifestyle choices in order to optimize their health and wellbeing.

 

Keywords: Diabetes, Hypertension, Iraq

Electrolytes Induced Varied Glucose Levels Complicate Efficacy of Glibenclamide and Paw Paw Seeds Extract in Diabetes Treatment (Published)

The effects of aqueous extract of unripe and ripe paw paw seeds (Carica papaya) were investigated in twenty four (24) alloxan induced diabetes adult rats for 28 days. The results showed that in group 1 rats without diabetes, glucose correlated positively with potassium (r=0.59), but negatively with sodium chloride and calcium; (r – 0.94), (r = -0.84), and (r = -0.65) respectively. The weekly electrolytes levels were not significantly different, (p > 0.05). In group 2, diabetic rats without treatment had raised glucose levels correlated positively with potassium and sodium, (r = 0.32), (r = 0.6) , but negatively with chloride and calcium (r = -0.02), (r = -0.26). Also weekly electrolytes levels were not significantly different, (p>0.05). However, in group 3, diabetic rats treated with glibenclamide, potassium correlated positively with glucose (r = 0.79) but negatively with sodium, chloride and calcium, (r = -.022), (r = -0.1), (r = -0.4). But the weekly electrolyte levels were significantly different, (p<0.05). In group 4 diabetic rats treated with unripe seed extract only glucose levels reduced significantly weekly (p<0.05). The glucose levels correlated positively with potassium, sodium and chloride; (r = 0.84), (r = 0.25), (r = 0.26) but negatively with calcium, (r = -0.77). The weekly electrolytes were not significantly different, (p>0.05) In group 5, diabetic rats treated with unripe seed extract significantly reduced glucose levels weekly, (p<0.05). Potassium, Sodium and chloride correlated positively with glucose (r = 0.3) but negatively with calcium (r = -0.20). But the weekly electrolyte difference was not significant (p>0.05). In group 6 treated with both unripe and ripe seed extract, glucose levels were significantly reduced on day 28 (p<0.05). Potassium, sodium and chloride correlated positively (r = 0.3), but negatively with calcium, (r = -0.8), the weekly electrolyte were significantly different (p<0.05). it is concluded that ripe and unripe paw paw seed extracts are very potent as anti-diabetic therapy but seems to be masked by electrolyte induced raised glucose levels, a complication in the disease

Keywords: Diabetes, Electrolyte, Glucose levels, Paw Paw seeds

Electrolytes Induced Varied Glucose Levels Complicate Efficacy of Glibenclamide and Paw Paw Seeds Extract in Diabetes Treatment (Published)

The effects of aqueous extract of unripe and ripe paw paw seeds (Carica papaya) were investigated in twenty four (24) alloxan induced diabetes adult rats for 28 days. The results showed that in group 1 rats without diabetes, glucose correlated positively with potassium (r=0.59), but negatively with sodium chloride and calcium; (r – 0.94), (r = -0.84), and (r = -0.65) respectively. The weekly electrolytes levels were not significantly different, (p > 0.05). In group 2, diabetic rats without treatment had raised glucose levels correlated positively with potassium and sodium, (r = 0.32), (r = 0.6) , but negatively with chloride and calcium (r = -0.02), (r = -0.26). Also weekly electrolytes levels were not significantly different, (p>0.05). However, in group 3, diabetic rats treated with glibenclamide, potassium correlated positively with glucose (r = 0.79) but negatively with sodium, chloride and calcium, (r = -.022), (r = -0.1), (r = -0.4). But the weekly electrolyte levels were significantly different, (p<0.05). In group 4 diabetic rats treated with unripe seed extract only glucose levels reduced significantly weekly (p<0.05). The glucose levels correlated positively with potassium, sodium and chloride; (r = 0.84), (r = 0.25), (r = 0.26) but negatively with calcium, (r = -0.77). The weekly electrolytes were not significantly different, (p>0.05) In group 5, diabetic rats treated with unripe seed extract significantly reduced glucose levels weekly, (p<0.05). Potassium, Sodium and chloride correlated positively with glucose (r = 0.3) but negatively with calcium (r = -0.20). But the weekly electrolyte difference was not significant (p>0.05).In group 6 treated with both unripe and ripe seed extract, glucose levels were significantly reduced on day 28 (p<0.05). Potassium, sodium and chloride correlated positively (r = 0.3), but negatively with calcium, (r = -0.8), the weekly electrolyte were significantly different (p<0.05). it is concluded that ripe and unripe paw paw seed extracts are very potent as anti-diabetic therapy but seems to be masked by electrolyte induced raised glucose levels, a complication in the disease.

 

Keywords: Diabetes, Electrolyte, Glucose levels, Paw Paw seeds

Food Intake and Caffeine Determine Amyloid Beta Metabolism with Relevance to Mitophagy in Brain Aging and Chronic Disease (Published)

In the global world diabetes and mitochondrial disease is expected to cost the developing world in the next 30 years US $400 million. In diabetes an absent peripheral sink amyloid beta clearance pathway is now relevant to amyloid beta induced mitochondrial apoptosis. The quality of food consumed has raised major concerns with increased levels of plasma bacterial lipopolysaccharides (LPS) that induces amyloid beta aggregation and mitochondrial apoptosis with programmed cell death linked to non alcoholic fatty liver disease (NAFLD) and many organ diseases. The amount, nature and time of day of fat consumption in diabetes has become important with relevance to caffeine metabolism, brain toxic amyloid beta oligomer formation and neuron apoptosis. To prevent programmed cell death dietary fat and caffeine consumption need to be revised to allow rapid hepatic caffeine and amyloid beta metabolism with the prevention of global mitophagy associated with diabetes, NAFLD and neurodegenerative diseases.

Keywords: Diabetes, amyloid beta, caffeine, circadian rhythm, fat diet, mitochondria

MALE HYPERGLYCEMIC-INDUCED INFERTILITY: AN INTEGRATION OF SOME BIOCHEMICAL FACTORS (Published)

Concern for hyperglycemia due to diabetes mellitus and its complications in male diabetics prompted the need for this study. Making use of body fluids such as urine, seminal fluid, serum sample and excised tissues, we examined factors that can potentiate complications. Batteries of tests conducted includes insulin, glucose, glycated haemoglobin, urea, creatinine and some male sex hormones, FSH, LH and testosterone. Spectrophotometric, radioimmunoassay and histopathological approach were adopted for the analytical methods. A total of 100 subjects were studied out of which 50 were non diabetics as defined by their glucose concentration (3.5-5.6 mmol) and 50 diabetics with glucose concentration ranging from (15.5-35.5 mmol/l). Our findings portray a correlation among the factors and elicit a nexus that interrelate to cause complication in diabetes. Values of the analyte measured after a 24 hour fast showed a significant difference (p<0.05) between the diabetics and non diabetics while no statistical significant difference was observed among the normal subjects. We submit that variation in the values of biochemical parameters measured and their interactive interplay act in uncommon way to exercerbate diabetic complications and reduce fertility in males. Inhibiting these factors highlighted from rising will improve fertility among male diabetics.

Keywords: Biochemical Factors, Diabetes, Hyperglycemia, Infertility

Collaborative Identification of the Health Needs/Assets of Ikot Ishie Community, Calabar, Nigeria (Published)

Background: Identification of health needs within Nigeria has often been done with a top-down approach where policy and funding determines what health needs to focus on for interventions. Communicable diseases such as malaria have been studied extensively however; lack of cohesiveness and continuity often derails the gains achieved.

Objectives: To work collaboratively with stakeholders in Ikot Ishie Community in identifying their health needs/assets.

Methodology: A community organizing exercise using Key Informant Interviews, observation and Focus Group Discussions (FGD) was implemented.

Findings/Results: As a community embedded in a malaria endemic area, people are aware of malarial signs and symptoms and can easily identify its management/preventive measures. Persistent self-diagnoses/treatment of malaria, lack of information about the causes, signs/symptoms of other conditions and poor patronage of the primary health centre for preventive and early diagnoses of diseases were the identified needs. Collaborative identification of needs/assets builds trust and ownership of interventions, encouraging continuity.

Keywords: Collaboration, Community ownership, Continuity, Diabetes, Malaria, Self-diagnoses