Point-of-Care Ultrasound (POCUS) in the Field of DiabetologyRead the full article
International Journal of Chronic Diseases publishes original research articles, review articles, and clinical studies in all areas of chronic diseases.
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Assessment of Prevalence, Associations ,Knowledge, and Practices about Diabetic Foot Disease in a Tertiary Care Hospital in Colombo, Sri Lanka
Background. One in five adults in Sri Lanka has either diabetes or prediabetes, and one-third of those with diabetes are undiagnosed. Diabetic foot is a debilitating condition affecting up to 50% of patients with both type 1 and type 2 diabetes. The risk of nontraumatic lower limb amputations is 15 times higher in diabetic patients when compared with nondiabetics. Patient education about correct foot care practices is the cornerstone of prevention of diabetic foot disease. Objective. To assess the prevalence of diabetic foot disease, knowledge, and practices about diabetic foot care among diabetic patients. Methods. 334 patients attending the diabetic clinic in Colombo South Teaching Hospital were recruited according to the inclusion and exclusion criteria. Data were collected using 3 questionnaires, and they were filled using the foot examination findings, patients’ medical records, and direct interviewing of the patients. Results. The mean age of the patients included in the study was years while the median duration of diabetes was years. 34.1% patients had peripheral neuropathy, and 29.5% had peripheral vascular disease. Diabetic foot disease according to the WHO definition was present only in 23 (6.9%) patients. There was a significant association between peripheral neuropathy and current or past foot ulcer which took more than 2 weeks to heal (). Knowledge about foot care was less among the studied population, and it was associated with poor foot care practices. Presence of diabetic foot and current or past foot ulcer which took more than 2 weeks to heal were significantly associated with the foot care knowledge and practices () Conclusion. Improvement of patients’ knowledge about foot care and their practices have a significant impact on the reduction of diabetic foot disease.
The Contributive Role of IGFBP-3 and Mitochondria in Synoviocyte-Induced Osteoarthritis through Hypoxia/Reoxygenation Injury: A Pathogenesis-Focused Literature Review
Osteoarthritis (OA), one of the most common joint disorders, is characterized by chronic progressive cartilage degradation, osteophyte formation, and synovial inflammation. OA lesions are not only located in articular cartilage but also in the entire synovial joint. Nevertheless, most of the early studies done mostly focused on the important role of chondrocyte apoptosis and cartilage degeneration in the pathogenesis and progress of OA. The increased expression of hypoxia-inducible factors (HIF-1α and HIF-2α) is known to be the cellular and biochemical signal that mediates the response of chondrocytes to hypoxia. The role of the synovium in OA pathogenesis had been poorly evaluated. Being sensitive to hypoxia/reoxygeneration (H/R) injury, fibroblast-like synoviocytes (FLS) play an essential role in cartilage degradation during the course of this pathology. Insulin-like growth factor binding protein 3 (IGFBP-3) acts as the main carrier of insulin-like growth factor I (IGF-I) in the circulation and remains the most abundant among the six IGFBPs. Synovial fluids of OA patients have markedly increased levels of IGFBP-3. We aim to discuss the interconnected behavior of IGFBP-3 and synoviocytes during the course of osteoarthritis pathogenesis, especially under the influence of hypoxia-inducible factors. In this review, we present information related to the essential role that is played by IGFBP-3 and mitochondria in synoviocyte-induced osteoarthritis through H/R injury. Little research has been done in this area. However, strong evidences show that the level of IGFBP-3 in synovial fluid significantly increased in OA, inhibiting the binding of IGF-1 to IGFR 1 (IGF receptor-1) and therefore the inhibition of cell proliferation. To the best of our knowledge, this is the first paper providing a comprehensive explanatory contribution of IGFBP-3 and mitochondria in synovial cell-induced osteoarthritis through hypoxia/reoxygenation mechanism.
Association of ABO and Rh Blood Group Phenotypes with Type 2 Diabetes Mellitus at Felege Hiwot Comprehensive Referral Hospital Bahir Dar, Northwest Ethiopia
Background. ABO and Rh blood group antigens are thought to be among genetic determinants of type 2 diabetes mellitus. Identification of blood group phenotypes are more associated with type 2 diabetes mellitus. It will be helpful for individuals who are susceptible blood groups to take care of themselves by avoiding other predisposing factors and taking preventive measures. Methods. Hospital-based comparative cross-sectional study was carried out from February to April 2019 at Felege Hiwot Comprehensive Referral Hospital. Sociodemographic and clinical data were collected with a semistructured pretested questionnaire. ABO and Rh Blood group were determined by slide and test tube methods. Biochemical parameters were determined with Mindray BS-200E fully automated clinical chemistry analyzer. Data were analyzed by IBM SPSS version 20 statistical software. Chi-square test and logistic regression analysis were employed for data analysis. A value of < 0.05 was considered statistically significant. Results. From a total of 424 participants included for this study, blood group O was found higher in frequency with 74 (34.9%) and 97 (45.75%) for cases and healthy controls, respectively. ABO blood groups showed significant association with T2DM, a chi-square value of 12.163 and value of 0.007. However, the Rh blood group was not associated with T2DM. Binary logistic regression analysis revealed that blood group B had a higher risk (OR: 2.12, 95% CI: 1.33-3.32) and blood group O had decreased risk (OR: 0.636, 95% CI: 0.43-0.94) of T2DM as compared to other blood groups. Conclusion. ABO blood group antigens showed significant association with type 2 diabetes mellitus. Blood group B was associated with an increased risk and O blood group with decreased risk of type 2 diabetes mellitus.
Sustaining, Forming, and Letting Go of Friendships for Young People with Inflammatory Bowel Disease (IBD): A Qualitative Interview-Based Study
Inflammatory bowel disease (IBD) is an incurable, chronic, gastrointestinal condition that can constrain young people’s social relationships. Few studies have specifically explored friendships of people with IBD. This qualitative, participatory study used interviews, photographs, and friendship maps to explore friendships and friendship networks of young people with IBD. An online Young Person’s Advisory Group was actively engaged throughout the study. Thirty-one young people participated ( males, female; Crohn’s disease, ulcerative colitis, IBD-unclassified; the mean age at study was 18.7 years; range 14-25 years). Findings present a metatheme “The importance and meaning of friendships” and three interwoven subthemes of “Sustaining friendships,” “Forming new friendships,” and “Letting go of friendships.” Friendship was important to the young people with IBD, providing support, but associated with challenges such as disclosure. Such challenges could be mitigated by clearer conversations with clinicians about friendships and more extensive conversations about friendships and long-term conditions in education settings.
Self-Care Experiences of Adults with Chronic Disease in Indonesia: An Integrative Review
We conducted a literature review to document what is known regarding the self-care experiences and various influencing factors among adults living with chronic disease in Indonesia, from the perspective of those living with the illness. We searched CINAHL and Google Scholar to identify peer-reviewed research focused on men and/or women living with a chronic disease (the most prevalent) in urban or rural settings in Indonesia. Using a “Self-Care of Chronic Illness” framework as a guide, information on self-care experiences and how various factors influence these experiences, was extracted and synthesized. Nine studies were included (3 quantitative; 6 qualitative). Self-care involves maintaining well-being through different strategies (e.g., foot hygiene, seeking information/care, praying, diet, resting, and simplifying life), following prescribed treatments, and using traditional remedies. Religion sometimes serves as a means for taking care of one’s health (e.g., prayer), or as a source of motivation to self-care, while in other instances, it results in a fatalistic attitude. Which treatments (conventional versus traditional) are sought, it is affected by an understanding of the disease and treatments, which is shaped by beliefs, values, emotions, health literacy, and SES. The literature shows that family, especially women, has a key role in providing support. Community organizations also play an important supportive role, particularly for patients in rural areas. Significant barriers to healthcare include costs and care not being well-adapted to the psychosocial needs and contexts of patients. The literature highlights a disconnection between the self-care experiences and how healthcare and support are delivered. To better support self-care, healthcare professionals should use a personalized approach; however, more research is needed to gain a better understanding of what patients want and expect regarding how religion, beliefs, life circumstances, and the use of alternative therapies should be addressed within the patient-professional dynamic.
Psychosocial Adjustment to Illness and Its Relationship with Spiritual Wellbeing in Iranian Cancer Patients
Background. The aim of this study was to investigate the psychosocial adjustment to illness and its relation with spiritual health in cancer patients. Methods. This study was conducted in 2019 in Iran. It was a descriptive study with a sample of 124 cancer patients. Data were collected using two questionnaires of the psychosocial adjustment to illness scale (PAIS) with 46 questions and the Paloutzian and Ellison spiritual health scale with 20 questions. Results. The mean age of the participants in this study was (range 18 to 87 years). The mean months of life with cancer were 16.5 months. The mean score of psychosocial adjustment to illness was . The mean score of spiritual wellbeing in the studied patients was . The results of the Pearson correlation test showed a significant inverse relationship between the mean score of psychosocial adjustment to illness and the mean score of spiritual wellbeing (, ). Conclusion. Cancer patients in this study had relatively good psychosocial adjustment with their illness. Spiritual wellbeing can increase psychosocial adjustment to illness in this group of patients.