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Article

Skin Manifestations of Diabetes Mellitus among Iraqi Patients

1Detroit Medical Center, Detroit, MI, USA

2Former Instructor, College of Medicine, University of Baghdad, Iraq

3Former Instructor, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq


American Journal of Medicine Studies. 2013, 1(3), 32-37
DOI: 10.12691/ajms-1-3-5
Copyright © 2013 Science and Education Publishing

Cite this paper:
Fady S. Yasso, Saba S. Yaso, Petra S. Yasso. Skin Manifestations of Diabetes Mellitus among Iraqi Patients. American Journal of Medicine Studies. 2013; 1(3):32-37. doi: 10.12691/ajms-1-3-5.

Correspondence to: Fady  S. Yasso, Detroit Medical Center, Detroit, MI, USA. Email: fadyyasso@yahoo.com.

Abstract

Diabetes mellitus (DM) is a clinical syndrome that is frequently associated by a variety of skin manifestations that commonly serve as ports of entry of different microorganisms. Although diabetes mellitus can be asymptomatic, many patients present with wide spectrum of manifestations. Skin manifestations can be associated with both type 1 & type 2 Diabetes and were seen in patients who use insulin as well as those who use oral hypoglycemic agents to control their glucose level. Early recognition of these skin manifestations assists in early diagnosis and helps to lead toward appropriate treatment for diabetes mellitus patients. Early diagnosis also share in preventing long-term complications. The present cross sectional study evaluates the frequency of skin manifestations in 110 diabetic Iraqi patients in Baghdad covering both males and females from different ethnicities and occupations. This study was conducted over the period of 2005 to 2006 including patients over 20 to 75 years age. A specific questionnaire was designed then distributed to all consenting patients. The skin manifestations observed were skin infections (19.4%), itching (12.1%), skin atrophy and inter-digital maceration (10.5%), waxy skin (9.7%), lipodystrophy (9.7%), skin thickening (7.2%), sweating disturbance (7.2%), DM dermopathy (6.5%), yellow nails (6.5%) and others. The different types of infections observed in diabetic patients involved in this study are discussed thoroughly. Infection, itching, skin atrophy and sweat disturbances are the most common three initial skin manifestations in Diabetes Mellitus patients of this work. A comparison is made between this study and other studies especially with the studies in Jordan and Pakistan and both agreement and disagreement are discussed. The present study reveals that it took more than 10 years for skin manifestations to appear in 60% of the patients. On the other hand, no patient reported manifestation at 30 or more years since they have been diagnosed with Diabetes mellitus. The maximum number of patients reported skin manifestations was at 17-18 year since the onset of Diabetes mellitus diagnosis. The paper concluded that the most cutaneous manifestations in DM Iraqi patients in Baghdad are bacterial and other skin infections.

Keywords

References

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Article

Structural Changes in Intervertebral Discs at Chronic Staphylococcus Aureus Osteomyelitis of the Tibia

1Central Research Laboratory, Novosibirsk State Medical University, Novosibirsk, Russia


American Journal of Medicine Studies. 2013, 1(3), 28-31
DOI: 10.12691/ajms-1-3-4
Copyright © 2013 Science and Education Publishing

Cite this paper:
Zhurakovsky I. P., Arkhypov S. A., Pustovetova M. G., Kunts T. A.. Structural Changes in Intervertebral Discs at Chronic Staphylococcus Aureus Osteomyelitis of the Tibia. American Journal of Medicine Studies. 2013; 1(3):28-31. doi: 10.12691/ajms-1-3-4.

Correspondence to: Kunts  T. A., Central Research Laboratory, Novosibirsk State Medical University, Novosibirsk, Russia. Email: tkunts3@ngs.rul

Abstract

Inflammatory process is not limited only local effects but could affect other organs and tissues. In the present study, we investigated the influence of tibial osteomyelitis caused by Staphylococcus aureus on extracellular matrix components of Wistar rat’s intervertebral discs. Histochemical assay was carried out on sulfated glycosaminoglycans, neutral glycoproteins and collagen fibers of nucleus pulposus. Immunochemical method was applied to I and II type collagen, fibronectin and fibulin-2. The role of persisting staphylococcal infection in the initiation and development of degenerative changes of the fibrous cartilage of intervertebral discs was demonstrated. Progressive disorders in sulfated glycosaminoglycans metabolism accompanied by changes of a fibrous component and collagen type predominance replacement suggest fibrous tranformation in intervertebral discs. Increase of neutral glycoproteins due to separate fractions, in particular, fibulin-2 could be considered as compensatory reaction on progressing overpatchings of fibrocartilage extracellular matrix components. Reorganizations mentioned are supposed to promote further dystrophic-degenerative changes in intervertebral discs.

Keywords

References

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Article

Recurrence Prevention of Childhood Primary Angiitis of Central Nervous System by Combination of Azathioprine and Aspirin

1Department of Paediatric Neurology, The Children’s Hospital, Lahore, Pakistan

2Department of Paediatric, Combined Military Hospital, Lahore, Pakistan


American Journal of Medicine Studies. 2013, 1(3), 22-27
DOI: 10.12691/ajms-1-3-3
Copyright © 2013 Science and Education Publishing

Cite this paper:
Muhammad Akbar Malik, Ghulam Rasul Choudry, Hamza Malik. Recurrence Prevention of Childhood Primary Angiitis of Central Nervous System by Combination of Azathioprine and Aspirin. American Journal of Medicine Studies. 2013; 1(3):22-27. doi: 10.12691/ajms-1-3-3.

Correspondence to: Muhammad  Akbar Malik, Department of Paediatric Neurology, The Children’s Hospital, Lahore, Pakistan. Email: docmalikpk2000@yahoo.co.in

Abstract

The objectives of the study were to determine the frequency of various presenting features and its effect on final outcome in childhood primary angiitis of central nervous system (cPACNS). The study also aimed to determine the frequency of complications with use of anticoagulants followed by long term Aspirin and Azathioprine in patients with ischemic infarcts. The study was conducted at the department of the Neurosciences and the Neuroradiology of the Children's Hospital from 1st Jan 2009 to 31st December 2010. Over the period of 2 years, 68 patients with acute ischemic strokes were admitted, who presented within 14 days of onset of the symptoms. Patients with ischaemic infarcts were treated with anticoagulants at least for 04 weeks and this was followed by long term use of Aspirin and Azathioprine. Patient were followed in Hospital based cohort study at single center and were systemically assessed for clinical presentation, classification of cPACNS, adverse effects of anticoagulants, aspirin, azathioprine and their hospital course. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 12.0 (Chicago, IL). 68 children with cAIS (boys 62%, girls 38%) with mean age of 8.5 years (median age 7.4 + 3.5 years), were enrolled in this study. Motor deficit (70%); headache (64%) and fever (20%) were the commonest symptoms, whereas, hemiparesis (60%); seizure 55 % (focal 35%, generalized 20%); and decreased conscious level (30%), were the commonest neurological findings. Neuroradiological findings of head revealed; ischemic strokes 50 (73.5%); hemorrhagic strokes 10 (14.7%) and ischaemic- haemorrhagic lesions 8(11.8%).Conventional angiography and/or MRA revealed that at the time of admission 51 (51/68, 75%) of the cohort had non-progressive (obliterative) and 17 (17/68,25%) had evidence of progressive arteriopathy. No secondary hemorrhagic was documented among infarcts strokes, which were treated with heparin and anticoagulants. Hospital outcome was as; survivors 56 (81.5%) and deaths 12 (18.5%). 40patints discharged on long term oral aspirin, and 14 children of these were commenced also on Azathioprine and are on follow-up. Male sex, deep conscious level and intra cerebral bleed causing severe raised intracranial pressure were the poor prognostic factor. The Neurological findings among 56 survivors were; normal 20%; minor disabilities 25%; moderate disabilities 20% and severe disabilities 35%.

Keywords

References

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Article

Submassive Pulmonary Embolism – A ‘Watch-And-Wait’ Strategy with Anticoagulation Alone or Advanced Therapy with Thrombolysis

1Department of Cardiology, “Pirogov” Emergency Hospital, Sofia, Bulgaria


American Journal of Medicine Studies. 2013, 1(3), 19-21
DOI: 10.12691/ajms-1-3-2
Copyright © 2013 Science and Education Publishing

Cite this paper:
Daniel Bogdanov Petrov, Svetlozar Ivanov Sardovski, Emilian Iliev Gagov, Maria Hristova Milanova. Submassive Pulmonary Embolism – A ‘Watch-And-Wait’ Strategy with Anticoagulation Alone or Advanced Therapy with Thrombolysis. American Journal of Medicine Studies. 2013; 1(3):19-21. doi: 10.12691/ajms-1-3-2.

Correspondence to: Daniel  Bogdanov Petrov, Department of Cardiology, “Pirogov” Emergency Hospital, Sofia, Bulgaria. Email: dpetrov@techno-link.com

Abstract

A 65-year old man, presented with syncope and dyspnea. On examination he was tachypneic, hypoxemic, normotensive, with elevated D-dimer and cardiac troponin. ECG showed sinus tachycardia S1Q3T3 syndrome and echocardiography revealed right ventricular dysfunction. Urgent computed tomograph angiograms showed bilateral pulmonary embolism. After treatment with intravenous tpA the patient's status improved and echocardiogram showed decreasing of the right ventricular systolic pressure. The most widely accepted indication for thrombolic therapy is proven pulmonary embolism with cardiogenic shock; therapy is also frequently considered when a patient presents with systemic hypotension without shock. The use of thrombolysis in submassive embolism – that is pulmonary embolism causing right ventricular (RV) dilatation and hypokinesis with systemic hypotension – is debated . The purpose of the study was to demonstrate a case of submassive pulmonary embolism who had an excellent clinical electrocardiographic and echocardiographic response to fibrinolysis.

Keywords

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Article

Depressive Symptoms among Community-Dwelling Older Adults with Mild to Moderate Knee Osteoarthritis: Extent, Interrelationships, and Predictors

1Department of Health and Behavior Studies, Columbia University Graduate School of Education, Teachers College, New York, USA


American Journal of Medicine Studies. 2013, 1(3), 11-18
DOI: 10.12691/ajms-1-3-1
Copyright © 2013 Science and Education Publishing

Cite this paper:
Ray Marks. Depressive Symptoms among Community-Dwelling Older Adults with Mild to Moderate Knee Osteoarthritis: Extent, Interrelationships, and Predictors. American Journal of Medicine Studies. 2013; 1(3):11-18. doi: 10.12691/ajms-1-3-1.

Correspondence to: Ray Marks, Department of Health and Behavior Studies, Columbia University Graduate School of Education, Teachers College, New York, USA. Email: rm226@columbia.edu

Abstract

The present cross sectional study strove to examine the prevalence and extent of comorbid depressive symptoms and its relationship with pain, function, disease impact, body mass index, medication history, and self-efficacy for managing pain, and other symptoms among a cohort of generally healthy older knee osteoarthritis (OA) patients with mild to moderate disease. Data previously collected on 71 generally healthy active women and 15 men with either unilateral or bilateral knee mild to moderate knee osteoarthritis, mean age, 72.47+7.15 years were analyzed with correlation analysis and descriptive statistics using the SPSS program. Analyses revealed: 1. More than 20% of the present cohort could be categorized as having severe clinical depression using a more stringent cut-off point than the standard, even though none were being treated for this condition; 2) Cases categorized as exhibiting depressive symptoms indicative of depressed mood tended to have more pain, worse mobility, and lower self-efficacy perceptions than those who were not exhibiting such symptoms; 3) Those with low self-management related self-efficacy were more likely to report depressive symptoms than not (p <.01). It is concluded that it is essential to routinely screen older adults with early stage osteoarthritis of the knee for depression, as well as their beliefs about their ability to manage their disease in efforts to reduce the immense disability burden of knee osteoarthritis.

Keywords

References

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