Waist Circumference, a Predictive Factor for Cardiovascular Disease; Our Experience

Background. Obesity worsens the prognosis of diabetic patients by increasing the cardiovascular risk and chronic complications. The aim of the study was to report the prevalence of waist circumference in individuals with diabetes and find out their association with other cardiovascular risk factors. Material and Methods We performed a transversal study, in which 100 patients with essential hypertension, and type 2 diabetes, were evaluated in comparison with 100 patients with only hypertension. We evaluate these patients for body mass index (BMI), waist circumference (WC); intimae media thickness (IMT); microalbuminuria; fundus oculi. Results. A total of 200 hypertensive patients were enrolled in the study. The diabetic hypertensive subjects significantly had higher BMI (p= 0.01) and WC statistically significant (103.6 cm vs 98.3 cm; P = 0.005). There was a significant positive association between WC and microalbuminuria (P = 0.009); WC and IMT (P= 0.028); 84% of patients with abdominal obesity have changes of diabetic retinopathy independently of the stage of changes. Conclusions. Prevalence of obesity in diabetic hypertensive patients was high. There was a positive relation of waist circumference and microalbuminuria, IMT, and diabetic retinopathy. This underlines the importance of measuring waist circumference when assessing cardiovascular risk factors in diabetic patients.Keywords: Abdominal obesity, organ damage, cardiovascular risk

Predictors, severity and associate factors of acute pancreatitis: A tertiary hospital’s experience

Aim: Acute pancreatitis is a common disorder that occurs following an acute response to a pancreatic injury. The aim of this study was to assess predictors of severity and associated factors, as well as the association of different classification systems of severity among pa-tients with acute pancreatitis (AP).Methods: A retrospective case series study was conducted in Albania including 150 patients with AP between March 2021 and March 2022. Variables such as baseline characteristics, la-boratory findings, and calculated scores of known severity classifications were analyzed. Pa-tients were graded as having mild, moderate, or severe acute pancreatitis based on the Revi-sion of the Atlanta Classification (RAC). Ordinal logistic regression was used to model the relationship between the ordinal variable (RAC categories) and the explanatory variables men-tioned above.Results: Women with AP had a higher average age than men with AP (62.5 vs. 57.5 years old, respectively, p<0.05). Additionally, the alcoholic etiology in males prevailed in 100% of cases, while the biliary etiology was more common in females (64.2% compared to 35.8% in males, p<0.001). Ordinal logistic regression showed that a one unit increase in the CT Severi-ty Index (CTSI) and Bedside Index for Severity in Acute Pancreatitis resulted in a 0.968 and 0.430 times increase, respectively, in the ordered log-odds of being in a higher RAC classifi-cation category. The presence of Systemic Inflammatory Response Syndrome (SIRS) (vs. non-present) resulted in a 2.98 higher ordered logit. Conversely, a one unit increase in satura-tion level decreased the ordered log-odds by approximately 0.4 times.Conclusion: The severity of acute pancreatitis is a medical event that requires accurate pre-diction, for which many classification systems have been compiled, with the RAC being the most recent consensus. CTSI, the presence of SIRS, and saturation levels are significantly as-sociated with RAC, without excluding the discussion on the predictive value of laboratory findings, such as glycemia, azotemia, and creatinine

Assessment of knowledge, attitudes and practices about public health nutrition among students of the University of Medicine in Tirana, Albania

Aim: the aim of this survey was twofold: (i): to assess medical students’ knowledge, attitudes and practices regarding nutrition in general, in order to identify their level of competences in the field of nutrition which will be useful in their future role of providers/health care professionals, and; (ii) to assess the knowledge, attitudes and practices regarding the discipline of public health nutrition in order to identify the needs for improving the curriculum of this subject in all the branches of the University of Medicine in Tirana.Methods: A cross-sectional study was conducted in June-July 2013 including a representative sample of 347 students at the University of Medicine in Tirana, Albania (61% females and 39% males; overall mean age: 23±2 years; response rate: 87%). A nutritional questionnaire, adopted according to the models used in previous international studies, was used to assess the level of knowledge, attitudes and practices among the university students.Results: Overall, about one third of the students was not satisfied with the quality and quantity of nutritional education and demanded a more scientifically rigorous curriculum. In general, students’ knowledge about infant feeding practices was adequate. However, there were gaps in the students’ knowledge regarding the commencement of breastfeeding, or the duration of exclusive breast-feeding. Furthermore, there was evidence of an insufficient level of knowledge among students regarding diet and nutrition in general and their health impact, especially on development and prevention of chronic diseases.Conclusion: This survey identified significant gaps in the current curriculum of public health nutrition at the University of Medicine in Tirana. Our findings suggest the need for intervention programs to improve both the quantitative and the qualitative aspects of nutrition curricula in all the branches of the University of Medicine Tirana, in accordance with the professional expectations of this teaching institution, as well as the urge for a movement towards a more integrated curriculum and problem-based learning approach