ஜர்னல் ஆஃப் நீரிழிவு சிக்கல்கள் & மருத்துவம்

Objective: Diabetes Mellitus (DM) is steadily increasing globally; whereas Cardiac Autonomic Neuropathy (CAN) is one of the well-established complications of diabetes mellitus that is long standing and poorly controlled. Alteration in cardiac sympathetic innervations may result in QTc interval prolongation and predispose to arrthymias and sudden death. QTc interval prolongation in ECG is rapid, non-invasive and specific method in detecting CAN among type two diabetic patients. This study aimed to determine the prevalence of prolonged QTc interval among Type 2 DM (T2DM) patients at Kilimanjaro Christian Medical Center, Moshi Tanzania. This cross-sectional hospital-based study was carried out from October 2016 to March 2017 among 310 type 2 diabetic patients.

Results: The prevalence of prolonged QTc interval among T2DM was found to be 32%. Poor glycaemic control (OR: 2.55, P=<0.0001), Being Hypertensive (OR: 1.73, P=0.037), High Total cholesterol (OR: 1.52, P=0.001), High LDL-c (OR: 1.28, P=0.005), High Triglycerides (OR: 1.64, P=0.001), Fasting plasma glucose (OR: 1.08, P=0.017), Diabetes duration (OR: 1.09, P=<0.0001), Insulin regimen (OR: 2.14, P=0.011), Combined regimen (Oral hypoglycemic and Insulin) (OR: 4.55, P=0.015), High BMI (P=0.008) were significant factors. Multivariate logistic regression showed that poor glycaemic control, fasting plasma glucose, insulin regimen and combined regimen (insulin and oral hypoglycemic) were determinants for QTc prolongation among T2DM patients in this study.

Conclusion: This study revealed a high prevalence of prolonged QTc interval. Modifiable factors such as poor glycaemic control, dyslipidemia, hypertension, fasting plasma glucose and treatment modalities were associated with the QTc prolongation. Furthermore, longer diabetes duration was also associated with QTc prolongation. Thus there is need of having a tightly glycaemic control, screening and management of dyslipidemia as well as regular ECG check up to high risk group.

Foot ulcer is mainly developing due to diabetic disease. It is an open sore on the foot. The aim of this research is to develop polyurethane memory foam insock in Ethiopia by replacing costly material silicon surfactant and distill water by locally available and affordable input materials castor oil as surfactant and tap water instead of distilled water for the diabetic foot ulcer patients. Under this research, it was able to prove the severity of foot ulcer in Ethiopia and enhance the high demand of orthotic appliance. Three memory foam insock with different surfactant ratios were manufactured at AMAGA P.L.C foam factory, Bahir Dar Ethiopia, using standard Polyols and diisocyanates. The in sock was prepared by using materials used in the factory to prepare PU memory foam mattress with 5 g, 9.5 g and 10.36 g of castor oil surfactant amount as a new replaced material instead of costly silicon surfactant from the three, the first castor oil (5 g) is not form a foam and hence no further investigation is conducted on it. Physical properties such as thickness, density, Hardness, Compression set, water absorption and abrasion resistance of developed in sock were tested. Further the new developed in sock was compared with that of existed commercial polyurethane in sock and the SATRA standards. The new developed insock has showed an equivalent mechanical property with the standard.

Gestational Diabetes Mellitus (GDM) is characterized as a kind of diabetes initially analyzed during pregnancy occurrence of GDM shifts from 2% to 14% around the world and it is expanding. Maternal glucose has been related with a danger of unfavorable pregnancy results in a direct way. High admission of soaked fat, low admission of polyunsaturated fat, and unnecessary gestational weight addition may build the danger of GDM. Actual movement is likewise connected with diminished danger of GDM. Way of life alterations have been demonstrated to be an important adjunctive treatment of GDM. Anticipation of gestational weight gain by dietary what's more, actual movement guiding have discovered positive outcomes and organized high-impact practice preparing has been appeared to diminish birth weight of the babies.