Levels of Glycosylated Haemoglobin in newly discovered Sudanese Diabetics

Background: Diabetes mellitus (D.M) is one of the most known chronic illnesses in the world. The exposure of blood to variable concentrations of glucose gives rise to variable levels of Haemoglobin (Hb) glycation, a non-enzymatic reaction. This phenomenon had led to the concept of measurement of glycosylated Hb as an indicator of glycemic control of diabetic patients; furthermore, it could be a diagnostic tool for the disease.Objectives: The research aimed to measure the level of glycosylated Hb -designated HbA1c- in the newly discovered diabetics in Sudan.Material and Methods: This was a retrospective case-control study, done at the Police Hospital and Bahri Diabetic Centre during the period from June 2011- October 2011. The populations of the sample were newly discovered Sudanese diabetics, in two age groups. Forty patients and forty controls were assessed via questionnaire, and venous blood to perform the test of HbA1c using Nycocard© machine.Results: The mean of HbA1c in young diabetics was 10.0%, while that of old diabetics was 8.8%. There was no correlation between HbA1c and random blood glucose, body mass index, hypertension, or the duration of symptoms.Conclusion: HbA1c levels in newly discovered diabetics was found to be elevated, with significant difference between diabetics of less than forty, and above forty years of age.Key wards: Diabetes, HbA1c, Ketoacidosis, Hypertension

Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.

BACKGROUND: Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. METHODS: This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models. RESULTS: Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas. CONCLUSION: Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas