Clinical assessment of distal symmetric polyneuropathy (DPN) involves the evaluation of symptoms and signs. Although there are numerous tools to evaluate DPN, there is still a need to determine the most sensitive, specific, and accurate tests to detect DPN in a busy outpatient clinical setting. A total of 107 patients with type 2 diabetes were examined using Michigan Neuropathy Screening Instrument (MNSI). Total score of the instrument was used as a standard to calculate sensitivity, specificity and diagnostic accuracy of every single item of MNSI to find the most accurate and applicable test for evaluation of DPN. In patients' history, the most sensitive (99.4%) and accurate (78%) symptoms were muscle cramp and weakness. Numbness and prickling had lower sensitivity (72.6% and 67.9%, respectively) but greater specificity (65.2% and 47.8%). In physical assessment, the most accurate signs were appearance of feet (81.3%), ankle reflexes (67.2%), and vibration perception (63.5%). Monofilament test had a sensitivity of 16.7%, accuracy of 31.7% with specificity of 87%. Findings show that symptoms such as a muscle cramp, weakness, numbness, and prickling, as well as signs such as ankle reflexes, appearance of feet, and vibration could be used as the most accurate tests for rapid diagnosis of DPN. In addition, the results suggest that monofilament examination may not be the optimum test to detect high risk patients.
Introduction: Diabetes is a weakening wellbeing condition which is required to arrive at plague extents in the following 20 years. As per the World Health Organization, 108m individuals around the globe had diabetes in 1980; by 2014 that figure was 422m. After three years in 2017, 425m individuals overall were living with the ailment and this figure is relied upon to surpass a stunning 629m by 2045. There are two sorts of diabetes: individuals with type 1 can't create the hormone insulin (from the pancreas) which is engaged with controlling glucose levels. Individuals with type 2 diabetes don't deliver enough insulin or their bodies are impervious to it. Accordingly, the two kinds can prompt high glucose levels, which increment the danger of diabetes difficulties. One is retinal malady (retinopathy), the main source of visual impairment in individuals of working age in created nations. On the off chance that glucose levels are continually high in an individual, this can harm their veins. That implies the bloodstream can be obstructed or blocked and when that occurs in the veins serving the eye, the retina can't work appropriately, prompting vision issues. Be that as it may, our most recent exploration uncovers that malady, another condition that gets substantially less consideration, should cause worry for all individuals with diabetes – particularly those with type 2 – with regards to intensifying sight. Individuals with diabetes are bound to experience the ill effects of DED. Be that as it may, this condition is frequently neglected during diabetic ophthalmic appraisals which focus on retinal infection screening. Dry Eye Disease(DED) influences roughly 15% to 30% of those matured more than 50. Albeit dry eye seems like a generally harmless condition, indications can be upsetting, including obscured vision, torment, consuming, irritation, coarseness, dryness, corneal ulcers, and in extreme cases, visual impairment. What's more, since acceptable vision is so inherently identified with our everyday lives, DED can influence individuals' capacity to drive, read, stare at the TV and use cell phones and PCs. This can have repercussions on the general personal satisfaction, with DED harming passionate prosperity, work environment efficiency, and other everyday exercises. DED is known to have a comparable antagonistic impact on personal satisfaction as much as that for individuals living with angina, hip breaks, or those experiencing kidney dialysis. In spite of this, DED isn't routinely surveyed in those with diabetes since retinal illness checking is viewed as an all the more squeezing concern, thus regularly goes untreated. To intensify the issue, there has been little exploration researching the impacts of diabetes-related DED on the personal satisfaction of patients. There has likewise been little examination of DED in type 1 and 2 diabetes, which have totally different causes. This work is partly presented at Event on 12th Edition of Webinar Conference on Endocrinology & Diabetology July 20-21, 2020 Extended Abstract Vol. 4, Iss. 3 2020 Research and Reviews: The Neurosurgery Journal In the long haul, the extra screening cost could exceed the loss of profitability and produce monetary advantages as improved by and large prosperity and wellbeing. An ongoing report demonstrated a solid connection between sadness and indications. Assuaging DED could improve the personal satisfaction of type 2 patients – and with more extensive social, physical and mental advantages, it ought to be a need for eyecare experts and patients the same.
Aims and objectives: The purpose of the present work was to determine the diagnostic performance of tear osmolarity test; used to diagnose disease (DED) in type 2 diabetic participants using tear lab osmolarity system as the reference standard and to compare it with the other diagnostic tests (index tests) already in use, specifically Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, TFBUT, Rose Bengal and fluorescein staining.
Materials and methods: In this study 267 people with type 2 diabetes were recrutiated. Tear osmolarity as gold standard by 308 mOsm/L cutoff was used to diagnose disease. The other diagnostic tests were also performed: Ocular Surface Disease Index (OSDI) questionnaire, Tear Film Break up Time (TFBUT), Schirmer I test, Rose Bengal and Fluorescein staining. The results of these index tests were compared to the gold standard measurement.
Results: Dry disease prevalence by the tear osmolarity test was 27.9% with female prodominancy. This prevalence via the other common diagnostic tests were: OSDI (17.5%), Schirmer I test (32.5%), TFBUT (41.6%), Rose Bengal (10.8%), and Fluorescein staining (4.3%). TFBUT had the highest detection rate to diagnose DED. No significant correlation was detected between tear osmolarity and other diagnostic tests. By Fluorescein staining had the highest specificity (96.8%). With the cutoff score >12, the positive likelihood ratio for the OSDI questionnaire was the highest (1.78). The sensitivity was poor for all common diagnostic tests. ROC curve analysis could not determine optimal cut offs for the common diagnostic tests.
Conclusion: By comparison of the gold standard; other diagnostic tests underestimate the presence of disease in diabetic participants. Moreover, they could not differentiate tear hyperosmolarity from normal. Tear osmolarity could be considered as the best single test for detection of disease in daibetic patients.
Keywords: Diabetes Mellitus, Dry Eye Disease, Diagnostic Accuracy Study, STARD
Risk factors in gestational diabetes mellitus
Laily Najafi
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
Abstract
Aim:
To assess the power of risk factors to diagnose gestational diabetes mellitus.
Methods:
In this prospective study, approximately 500 women recruited in two departments that130 parturients with complete documents recruited in both groups (normal pregnancy and GDM). Gestational diabetes was confirmed at 24-28 weeks of gestation by one-step strategy.
Results:
Preexistene of risk factors; were more common in GDM group (94.4%; P-value = 0.001) due to ADA criteria. Diagnosis gestational age of the GDM group who have 1 risk factor (169) were as follows: 18 (14.6%) patients diagnosed in 24-28 weeks of gestation, 32 (26%) after 28 and the others (59.3%) before 24 weeks of gestation. In comparison between two groups, GDM have higher frequency of 2 risk factors and more; than the normal group (72% vs. 46%, p-value <0.001) (risk factors categorization: 0 or 1 instead of 2 risk factors and more). By determining final diagnosis as a dependent variable between maternal age, Pre-BMI, parity, abortion, family history of DM, history of GDM and education; we had found significant relationship between diagnosis and maternal age, education, family history of DM and history of GDM.
Conclusions:
We could suggest that the diagnosis gestational age of the GDM before 24 weeks of gestation may could reduce the maternal and fetal complications. Between the risk factors; maternal age, family history of DM and history of GDM were the more important to guide the GDM diagnosis.
Keywords:
Risk Factors, Gestational Diabetes Mellitus
Biography:
Dr. Laily Najafi has been Graduated from Shiraz university of medical sciences as Medical Doctor, with the specialties including PhD by research in clinical diabetes in Iran university of medical sciences. Later on she obtained her post-graduation from Iran university of medical sciences with subjects “types of diabetes” and then started working at Endocrine Research Center, Institute of Endocrinology and Metabolism, where she has continued her research. Presently she has been working at the mentioned center in Tehran, Iran.
SpeakerPublications:
American Diabetes Association. 2. Classification and diagnosis of diabetes. Diabetes care. 2015;38(Supplement 1):S8-S16.
Metzger BE, Buchanan TA, Coustan DR, De Leiva A, Dunger DB, Hadden DR, et al. Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus. Diabetes care. 2007;30(Supplement 2):S251-S60.
Center Joslin Diabetes. Guideline for Detection and Management of Diabetes in Pregnancy. Revised 6/15/11). Retrieved from https://www. joslin. org/Preg_guideline_5_10_11_ (2)-0615-11. pdf, 2011.
Bottom Note:
This abstract has been taken from the International Webinar on Endocrinology & Diabetology held as an online webinar on July 27, 2020
Neural tube defects (NTD) are one of the leading causes of infant mortality worldwide. This study was designed to determine the prevalence of NTDs among native Fars ethnic groups during 1998-2005, and to identify maternal and demographic factors associated with NTDs.We performed a descriptive cross-sectional hospital-based study in Dezyani Hospital, Gorgan, North of Iran, since January 1998 until December 2005. The design was based on a sample of 30,639 births of native Fars ethnic groups. Data were analyzed by using spss V13.5 software and were compared with the chi-square test.The prevalence of NTDs in Native Fars during the 8-year period was 25.4 per 10000 births (95% confidence interval: 20.1-31.8). The prevalence of NTDs was 20.6/10000 and 30.6/10000 in males and females respectively but this difference was not significant. The prevalence of spina bifida, anencephaly and encephalocele were 12.7, 11.4 and 1.3 per 10000 respectively. The rate of NTD was 48.9/10000 in newborns with mothers aged > 35 years. The highest rate of NTDs and spina bifida was in 2002. The highest and lowest rate of anencephaly was in 2005 and 2003 respectively. Twenty eight percent of the parents had consanguineous marriages. Degree relatedness 3, 4, 5 and 6 of consanguineous marriages were 12.8%, 9%, 3.8%, 2.5%, respectively. Also 47.5% of the parents resided in rural areas.This investigation showed that the rate of NTDs in Native Fars was higher in Iran. In addition, this rate is higher than the Canada and Ukraine and lower than Chinese people.
Eyebrow tattooing (ET) is a relatively common cosmetic procedure for middle-aged women which can hide age-related ptosis.We aimed to evaluate the periocular soft tissue changes following ET and its effects on upper eyelid blepharoplasty (UEBL).In this non-randomized prospective case-controlled study, 28 subjects recruited, 14 with ET for at least 5 years and 14 without ET. Eyebrows ultrasonography was performed to measure the periocular soft tissue thickness including skin and subcutaneous tissue on the medial and lateral side of the eyebrow. Then, UEBL was performed with extended eyelid skin incisions. So, the excised tissues being evaluated histopathologically.The mean age of patients was 50.6 ± 0.6 and 51.2 ± 5.59 years in non-eyebrow tattooing (NET) and ET groups, respectively (P = .78). In the ET group, soft tissue thickness was, respectively, equal to 5.90 ± 1.10 and 6.3 ± 0.95 mm on the lateral and medial side of the eyebrow, which were significantly thicker compared to the NET group (4.68 ± 0.69 and 4.78 ± 0.56 mm, respectively)(P = .001). Histopathological findings were ranging from edema-congestion to chronic inflammation and dermal fibrosis which were more frequently seen in ET group. However, this difference was statistically significant only for dermal fibrosis (P = .02). Surgical wound complications were observed in 3 patients who were in the ET group (P = .22).Subjects with eyebrow tattooing, as compared to a control group, showed a thicker eyebrow skin on ultrasonography and higher upper eyelid dermal fibrosis on histopathological examination.
Schwannomas or neurilemomas are rare, benign tumors that originate from the neural sheath. A 54-year-old man presented with left flank discomfort and lumbar pain for 6 months. A computed tomographic scan confirmed the existence of a 12 × 9 cm heterogeneous retroperitoneal mass adherent to the left psoas muscle that displaced the left kidney anteriorly. Total laparoscopic removal of the tumor was performed and pathologic examination revealed a benign schwannoma.
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