Background. Saudi Arabia is reported to have the highest number of children and adolescents with T1DM. However, data concerning glycemic control during adolescence are lacking. Objectives. To determine glycemic control at transition stage from pediatric to adult clinics, determine HBA1c patterns during follow-up, and identify any clinical or demographic variables that may predict a distinctive glycemic pattern. Design. Observational retrospective study. Setting. Dammam Medical Complex, secondary care hospital. Patients and Method. Adolescents aged ≥12 years, with HbA1c recorded at least once a year over 4 years of follow-up, were eligible for inclusion. A trajectory analysis from 2008 to 2019 was conducted, using latent class growth modelling (LCGM), and two-sample t-tests and Fisher’s exact tests were conducted to determine whether there was a statistically significant difference in demographic and clinical variables. Sample Size. 44 patients. Results. 61.36% were referred from pediatric clinics, and 84% were on multiple insulin daily injections. For the trajectory prediction, two groups were identified. Group 1 comprised 71.7%, had high HbA1c values at age 13 (HbA1c, 11.28%), and had a significant and stable decrease in HbA1c values with age (−0.32, <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="18.973pt" style="vertical-align:-3.42938pt" id="M1" height="11.7782pt" version="1.1" viewBox="-0.0498162 -8.34882 18.973 11.7782"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z"/></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><path id="g117-91" d="M512 -3V55L134 254V256L512 456V514L75 281V230L512 -3Z"/></g></svg><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.921pt" style="vertical-align:-3.42938pt" height="11.7782pt" version="1.1" viewBox="22.555183800000002 -8.34882 21.921 11.7782"><g transform="matrix(.013,0,0,-0.013,22.605,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><use xlink:href="#g113-49"/></g></svg>). Group 2 comprised 28.2%, showed poor HbA1c values at age 13 (HbA1c, 13.28%), and showed increase in HbA1c values slightly by age 15, which then steadily decreased with age (−0.27). Results indicated that the initial HBA1c value was a significant predictor for group trajectory <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="23.471pt" style="vertical-align:-3.42947pt" id="M2" height="12.7178pt" version="1.1" viewBox="-0.0498162 -9.28833 23.471 12.7178"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-41" d="M300 -147C201 -63 143 98 143 270S200 602 300 686L282 710C136 610 70 450 70 271V270C70 89 136 -72 282 -170L300 -147Z"/></g><g transform="matrix(.013,0,0,-0.013,4.498,0)"><use xlink:href="#g113-113"/></g><g transform="matrix(.013,0,0,-0.013,15.84,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z"/></g></svg><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="26.453pt" style="vertical-align:-3.42947pt" height="12.7178pt" version="1.1" viewBox="27.053183800000003 -9.28833 26.453 12.7178"><g transform="matrix(.013,0,0,-0.013,27.103,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,33.343,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,36.307,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.013,0,0,-0.013,42.547,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.013,0,0,-0.013,48.787,0)"><path id="g113-42" d="M275 270C275 450 212 609 64 710L45 686C145 604 203 442 203 270S147 -63 45 -147L64 -170C213 -68 275 89 275 270Z"/></g></svg>, while the remaining variables did not have any significance. Conclusion. Our study identified two groups with poorly controlled diabetes; however, the first group performed relatively better than the second group. Both groups almost doubled their targets, with a trend towards HbA1c reduction by the age of 19 in both groups. Limitations. Retrospective study with convenient, small sample size.

Sherifa A. Alsada

Ebtesam M. Ba-Essa

Alya A. Alsaffar

Trajectory Analysis of Glycemic Control in Adolescents with Type 1 Diabetes Mellitus at Dammam Medical Complex, Saudi Arabia

background inpatient data covid19 sarscov2 afflict inpati remain spars data need creat accur project resourc consumpt pandem continu publish report inpati data have come from china itali singapor both east west coast unite state objectiv the object present our inpati experi covid19 design set particip this retrospect studi 681 patient laboratoryconfirm covid19 from six hospit denver metropolitan area admit between februari 18 april 30 2020 clinic outcom patient discharg expir april 30 2020 were analyz main outcom compil patient demograph length stay number patient transfer admit icu icu length stay mechan ventil requir mortal rate result 890 patient laboratoryconfirm covid19 681 had discharg were includ analysi observ 100 surviv 018 age group 2 97 surviv 1930 age group 95 surviv 3164 age group 79 surviv 6584 age group 75 surviv 85 older age group our total inpati mortal 13 91 patient rise 29 59 patient those requir icu care conclus compar similar report from other metropolitan area our analysi discharg expir covid19 patient from six major hospit denver metropolitan area reveal lower mortal this includ subset patient admit icu regardless need intub lower icu length stay also observ

Paula J. Watts

Trevor Wojcik

Christina Baker-Sparr

Jason L. Kelly

Surit Sharma

Dmitriy Scherbak

How Do COVID-19 Inpatients in the Denver Metropolitan Area Measure Up?

Mohammad Nematshahi

Atefeh Asadi

Elham Behnamtalab

Mahbobeh Nematshahi

Corrigendum to &#x201c;The Impact of Saffron on Symptoms of Withdrawal Syndrome in Patients Undergoing Maintenance Treatment for Opioid Addiction in Sabzevar Parish in 2017&#x201d;

parathyroid gland secret parathyroid hormon play essenti role bone remodel excessiv product parathyroid hormon caus common metabol bone disord known hyperparathyroid classifi primari secondari tertiari hyperparathyroid late boni complic manifest giant cell osteolyt lesion call brown tumor primari hyperparathyroid usual sporad disord minor case occur inherit form one form hyperparathyroidismjaw tumor syndrom which character primari hyperparathyroid ossifi fibroma mandibl maxilla

Hazim Mahmoud Ibrahem

Gnathic Bones and Hyperparathyroidism: A Review on the Metabolic Bony Changes Affecting the Mandible and Maxilla in case of Hyperparathyroidism

background though effect intervent pain after surgic intervent undermanag worldwid systemat implement requir increas util avail evidencebas intervent manag inevit pain after surgeri the aim research project develop scalabl model manag pain after cesarean section implement world health organiz who pain manag guidelin through combin implement research qualiti improv method method implement world health organiz who pain manag guidelin use effect implement strategi first conduct format qualit explor identifi enabl obstacl addit took baselin assess pain manag implement process outcom use checklist prepar from guidelin adapt american pain outcom assess tool version 2010 respect then integr guidelin exist practic use collabor iter learn strategi analyz data statist packag social scienc spss version 21 compar befor after data use chisquar fischer exact test chang ani measur consid signific valu 005 result collect data from 106 mother befor 110 mother after intervent implement success integr pain fifth vital sign more than 87 valu 0001 patient fidel approxim 59 valu 0001 addit signific improv pain outcom measur after implement intervent conclus recommend systemat approach implement pain manag guidelin success recommend ward sustain gain hospit region nation replic success

Mengistu Hagazi Tequare

James John Huntzicker

Hagos Gidey Mhretu

Yibrah Berhe Zelelew

Hiluf Ebuy Abraha

Mehari Abrha Tsegay

Kesatea Gebrewahd Gebretensaye

Daniel Gebre Tesfay

Julio Gonzalez Sotomayor

Rahel Nardos

Mary Beth Yosses

Joshua Edwin Cobbs

Jennifer Pui Ling Schmidt

Wendy Weisman

Leslie K. Breitner

Pain Management and Its Possible Implementation Research in North Ethiopia: A before and after Study

introduct colonoscopi consid gold standard investig screen colorect cancer other lower gastrointestin patholog adequat bowel prepar absolut necessari fruit colonoscopi various bowel cleans agent be use his purpos the aim present studi compar two bowel cleans agent singl dose polyethylen glycol peg solut split dose sodium picosulf picosul tablet regard cleans efficaci toler among patient schedul colonoscopi method openlabel hospitalbas observ studi total sixtyfour patient were group random two group bowel cleans agent peg picosul dure studi period between 1 decemb 2015 30 novemb 2016 patient toler evalu use structur questionnair bowel cleans efficaci evalu use aronchick bowel prepar scale abps result the group receiv peg solut found have better efficaci than which receiv picosul tablet 633 versus 294 respect valu 0028 excel grade per abps the picosul group found better term toler than peg group nausea vomit encount signific higher peg group than picosul group 433 versus 118 respect valu 001 conclus colon prepar split dose picosul tablet better toler than even befor regimen peg solut howev peg solut found more efficaci bowel cleans procedur perform lesion detect were similar both agent

Amit Kumar Jaiswal

Shatdal Chaudhary

Effectiveness in Bowel Cleansing and Patient Tolerability of Polyethylene Glycol versus Sodium Picosulphate in Patients Undergoing Colonoscopy

objectiv hepatocellular carcinoma one most common diseas serious threaten human life health studi evalu inhibitori effect tanshinon iia tan iia combin adriamycin adm human hepatocellular carcinoma develop platform assess function chines herbal ingredi combin chemotherapi drug have synergist antitumor effect vivo method establish anim model human hepatocarcinoma hepg2 cell nude mice mice were divid model control group tan iia group adm group tan iia adm group the chang from general condit weight tumor volum inhibit rate were observ the data were gather from serum ast level histopatholog chang the content activ cytochrom p450 were determin spectrophotometr analysi cyp3a4 protein express analyz western blot the bind model crystal structur tan iia adm pregnan receptor pxr evalu discoveri studio 21 result combin tan iia adm could improv life qualiti reliev adm toxic decreas tumor volum declin serum ast level improv liner patholog section tumorbear mice the inhibitori rate tan iia adm cotreat were 3277 6096 7318 respect the tan iia group signific enhanc content cytochrom p450 erythromycin demethylas activ cyp3a4 protein express enhanc obvious tan iia adm group virtual molecular dock show both tan iia adm could stabli dock same bind site pxr differ interact conclus tan iia combin adm could improv life qualiti tumorbear mice enhanc antitumor effect the tan iia group increas concentr cytochrom p450 enzym activ combin tan iia adm could upregul cyp3a4 protein express make relev interact protein pxr virtual dock

Tao-Li Liu

Li-Na Zhang

Yue-Yu Gu

Mei-Gui Lin

Jun Xie

Yu-ling Chen

Jia-Hui Liu

Xin-Lin Wu

Sui-Lin Mo

The Synergistic Antitumor Effect of Tanshinone IIA Plus Adriamycin on Human Hepatocellular Carcinoma Xenograft in BALB/C Nude Mice and Their Influences on Cytochrome P450 CYP3A4 In Vivo

background osteoporosi hypertens frequent often coexist diseas among elder recent studi suggest both diseas may share same etiopatholog moreov treatment hypertens can affect bone miner densiti worsen osteoporosi the aim crosssect studi assess preval low bone mass osteoporosi postmenopaus syrian women investig relationship hypertens antihypertens drug method 813 postmenopaus women were involv crosssect studi age between 40 96 yrs their menopaus durat rang between 1 43 yrs bone miner densiti measur use dualenergi xray absorptiometri total lumbar spine l1l4 left hip tscore valu were use determin diagnosi osteoporosi the exist htn defin blood pressur 13085 mmhg histori hypertens medic result using world health organ criteria 24 had osteoporosi 452 had low bone mass the incid osteoporosi low bone mass signific increas age menopaus durat decreas bmi preval hypertens almost equal among women who had did have osteoporosi howev hypertens women who use thiazid beta blocker had higher valu total lumbar bmd compar women who did conclus hypertens postmenopaus syrian women age over 40 found associ osteoporosi howev mean total lumbar bmd hypertens women who took thiazid diuret beta blocker found increas signific compar women who did take either

Nermeen Hijazi

Zaynab Alourfi

Association between Hypertension, Antihypertensive Drugs, and Osteoporosis in Postmenopausal Syrian Women: A Cross-Sectional Study

objectiv the object proof concept studi were examin tempor chang fatigu divers gut microbiom over cours chemoradiotherapi crt adult rectal cancer investig whether differ divers gut microbiom between fatigu nonfatigu particip middl end crt investig whether differ relat abund fecal microbiota phylum genus level between fatigu nonfatigu particip middl end crt method stool sampl symptom rate were collect prior incept crt middl after 1216 treatment end after 2428 treatment crt descript statist mann whitney test were comput fatigu gut microbiom data were analyz use qiime2 softwar result particip 29 rang age from 37 80 year the median fatigu score signific chang end crt median 230 compar median score befor initi crt total sampl median 170 middl crt alpha divers abund operat taxonom unit lower fatigu particip 14930 531 than nonfatigu particip 18915 4418 23 208 similar trend observ shannon faith divers index middl crt howev end crt were signific differ ani alpha divers index between fatigu nonfatigu particip proteobacteria firmicut bacteroidet were domin phyla fatigu particip escherichia bacteroid faecalibacterium oscillospira were most abund genera fatigu particip conclus crtassoci perturb gut microbiom composit may contribut fatigu

Velda J. González-Mercado

Josué Pérez-Santiago

Debra Lyon

Israel Dilán-Pantojas

Wendy Henderson

Susan McMillan

Maureen Groer

Brad Kane

Sara Marrero

Elsa Pedro

Leorey N. Saligan

The Role of Gut Microbiome Perturbation in Fatigue Induced by Repeated Stress from Chemoradiotherapy: A Proof of Concept Study

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