Serum leptin level and microvascular complications in type 2 diabetes

Background. Type 2 diabetes (T2DM) and its complications are highly prevalent in Egypt and are considered a major health problem. Insulin resistance arising from visceral obesity is the main pathological mechanism of T2DM. Leptin is an adipokine secreted from visceral adipose tissue and its level is proved to be higher in patients with T2DM, but its association with microvascular complications is not yet well-established, for this aim the present study was conducted. Methods. This cross-sectional study was conducted among 120 participants with T2DM recruited from the diabetes outpatient clinic of Alexandria Main Uni­versity Hospital, Alexandria, Egypt. Each participant was subjected to full history taking, complete physical examination and laboratory investigations. Results. Serum leptin level was significantly positively correlated with diabetes duration, BMI, WC, systolic and diastolic blood pressure, FPG, HbA1c, serum insu­lin level, HOMA-IR, total cholesterol, triglycerides and LDL-C. Regarding microvascular complications, serum leptin level was highly significantly positively correlated with UACR, peripheral neuropathy and retinopathy (P < 0.001) and significantly negatively correlated with e-GFR (P = 0.003). Conclusions. Serum leptin level is significantly correlated with microvascular complications in patients with T2DM in Alexandria, Egypt

Gender Differences in Presentation, Management, and In-Hospital Outcomes for Patients with AMI in a Lower-Middle Income Country: Evidence from Egypt

BACKGROUND: Many studies in high-income countries have investigated gender differences in the care and outcomes of patients hospitalized with acute myocardial infarction (AMI). However, little evidence exists on gender differences among patients with AMI in lower-middle-income countries, where the proportion deaths stemming from cardiovascular disease is projected to increase dramatically. This study examines gender differences in patients in the lower-middle-income country of Egypt to determine if female patients with AMI have a different presentation, management, or outcome compared with men. METHODS AND FINDINGS: Using registry data collected over 18 months from 5 Egyptian hospitals, we considered 1204 patients (253 females, 951 males) with a confirmed diagnosis of AMI. We examined gender differences in initial presentation, clinical management, and in-hospital outcomes using t-tests and χ(2) tests. Additionally, we explored gender differences in in-hospital death using multivariate logistic regression to adjust for age and other differences in initial presentation. We found that women were older than men, had higher BMI, and were more likely to have hypertension, diabetes mellitus, dyslipidemia, heart failure, and atrial fibrillation. Women were less likely to receive aspirin upon admission (p<0.01) or aspirin or statins at discharge (p = 0.001 and p<0.05, respectively), although the magnitude of these differences was small. While unadjusted in-hospital mortality was significantly higher for women (OR: 2.10; 95% CI: 1.54 to 2.87), this difference did not persist in the fully adjusted model (OR: 1.18; 95% CI: 0.55 to 2.55). CONCLUSIONS: We found that female patients had a different profile than men at the time of presentation. Clinical management of men and women with AMI was similar, though there are small but significant differences in some areas. These gender differences did not translate into differences in in-hospital outcome, but highlight differences in quality of care and represent important opportunities for improvement

Laboratory markers and radiological signs of mild versus severe COVID-19 patients

Background Coronavirus disease 2019 (COVID-19), a global pandemic that has spread worldwide in a dramatic manner since its first emergence in December 2019 from Wuhan, China. To date, there is still lack of an appropriate protocol that predicts cases who are impending to develop severe COVID-19. Hence, this work was an attempt to determine the potential association of the clinical, laboratory, and radiological parameters with the severity of COVID-19 and the ability of these parameters to predict the severe cases. Patients and methods This is a retrospective study that was based on recruiting the data from the files of patients who attended the chest outpatient clinic, or admitted to the chest department or the ICU of our institution. The study included adult patients who were diagnosed with COVID-19. Patients were categorized into two groups: severe/critical cases and mild/moderate disease cases. Data concerning the patient history, clinical picture, and radiological data were obtained and analyzed. Results Eighty adult patients with COVID-19 were included in this study. They were classified into severe/critical (40 patients) or mild/moderate disease (40 patients). Patients with severe/critical COVID-19 disease were significantly older in age and had higher comorbidities, prevalence, higher incidence of cough, dyspnea, gastrointestinal tract symptoms and fatigue, elevated total leukocyte count, lower relative lymphocytes, lower absolute lymphocytes and higher neutrophils, higher blood glucose levels, higher alanine transaminase, higher aspartate aminotransferase and lower serum albumin, reduced Ca levels, elevated lactate dehydrogenase, serum ferritin, D-dimer, and C-reactive protein levels. They had significantly higher computed tomographic (CT) scores and CT chest with greater than 50% lesions or progressive lesions. The mortality rate was 10%, all of which were from the severe disease group. Conclusion The current study is confirming an overall substantial association between severe COVID-19 and older age, chronic diseases, CT imaging pattern, and severity score, leukocyte count, lymphopenia, blood glucose, serum albumin, alanine transaminase, aspartate aminotransferase, calcium levels, C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin. These results highlighted the importance of using clinical, laboratory, and radiological features for monitoring of COVID-19 patients

Gender differences in in-hospital mortality.

a<p>p-values based on adjustment for clustering of data within hospital.</p>b<p>Risk factors adjusted for include smoking status, hypertension, diabetes mellitus.</p

Gender differences in initial presentation.

a<p>Mean (standard deviation) and p-values from t-test reported for continuous variables.</p

Gender differences in clinical management and in-hospital outcomes.

a<p>Recognized by Centers for Medicare & Medicaid Services (CMS) as “Core Measures” for AMI for inpatient hospital quality.</p>b<p>Mean(standard deviation) and p-value from t-test reported for continuous variables.</p