Baseline Plasma Fibrinogen and Glycated Haemoglobin (HbA1c) Levels in Normoglycaemic Offspring of Adults with Type 2 Diabetes Mellitus

Background: Type 2 Diabetes mellitus (T2DM) is known to be preceded by a long pre-diabetic stage. Family studies have confirmed that the incidence of T2DM in the first-degree offspring of T2DM patients is higher than in the non-diabetic population. The levels of plasma fibrinogen and HbA1c in offspring of T2DM patients may be markers of the development of T2DM later in life. Objectives: To determine the plasma fibrinogen and HbA1c levels of normoglycaemic offspring of T2DM patients.  Methods: This study involved randomly selected 100 offspring of T2DM patients (ODP) and 100 offspring of non-diabetic parents (ONDP) aged between 16 and 40 years. Fasting Blood Glucose (FBG), plasma fibrinogen and HbA1c and height and body weight were measured using standard methods.  Results: The mean age of the ODP and ONDP were similar: 23.3±0.44 years and 23.44 ±0.40 years, respectively. The mean BMI was 23.83±0.42kg/m2 for ODP and 23.20±0.29kg/m2 for ONDP. The prevalence of overweight was 13.0% and 25.0% among the ODP and ONDP, respectively. The mean plasma fibrinogen was significantly higher in ODP (322.85 ± 5.15g/l vs 303.11 ±4.92 g/l; p = 0.006). The mean plasma HbA1c was also significantly higher among OND (5.13±0.03% vs 4.76±0.05; p = 0.000). Conclusions: The plasma fibrinogen and HbA1c levels are higher among ODP than ONDP. This pattern of variations may serve as a reason for instituting precautionary measures since it predates the development of T2DM

Bacterial migration through punctured surgical gloves under real surgical conditions

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions.</p> <p>Methods</p> <p>An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab.</p> <p>Results</p> <p>In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves) were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes). Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25%) punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98) of outer gloves and in 1% (1/96) of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers), the calculated migration was 50% (n = 5). The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes.</p> <p>Conclusions</p> <p>This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.</p

Evaluation of the Functions and Radiographic Severity of Osteonecrosis of the Head of Femur in South-west Nigeria

Background:&nbsp;Osteonecrosis of the femoral head is likely to be a complex of diseases rather than a single entity. In sub-Saharan Africa, epidemiological studies on the subject are uncommon. Objectives:&nbsp;To determine hip function, radiographic severity and other characteristics of patients with osteonecrosis of the femoral head (ONFH) at presentation in a sub-Saharan Africa population Methods:&nbsp;A combined prospective clinical survey and retrospective chart review of patients was done. Results:&nbsp;Fifty hips in 44 patients were studied (29 retrospectively and 15 prospectively). The prevalence of ONFH was 1.6%. The mean age was 24.8±13.2 years. The lesion was unilateral in 86.4% and bilateral in 13.6% of the hips. Sickle Cell Disease (SCD) occurred in 43.2%, sickle cell trait in 13.6%, and 20.5% of cases were idiopathic. Overall, 12% of affected hips were presented early, and all the hips were painful at presentation. Of the 18 hips studied prospectively, 72.2% had necrosis &gt;30% and &gt;30% subchondral collapse in 61.1%. The mean combined necrotic angle was moderate size, 197o±29.7o&nbsp;and 177.2o±69.4o&nbsp;for the right and left hips, respectively (p = 0.8). The mean WOMAC scores were 37.2 ±17.4 for function, 10.2±4.3 for pain and 4.2±2.7 for stiffness. Conclusion:&nbsp;Patients with osteonecrosis of the femoral head tended to be young adults and those with SCD. The majority present with large-sized osteonecrosis and subchondral collapse but moderate hip pain and stiffness

Pattern of limb amputation in a Kenyan rural hospital

Causes of limb amputations vary between and within countries. In Kenya, reports on prevalence of diabetic vascular amputations are conflicting. Kikuyu Hospital has a high incidence of diabetic foot complications whose relationship with amputation is unknown. This study aimed to describe causes of limb amputations in Kikuyu Hospital, Kenya. Records of all patients who underwent limb amputation between October 1998 and September 2008 were examined for cause, age and gender. Data were analysed using the statistical package for Social Sciences (SPSS) for Windows Version 11.50. One hundred and forty patients underwent amputation. Diabetic vasculopathy accounted for 11.4% of the amputations and 69.6% of the dysvascular cases. More prevalent causes were trauma (35.7%), congenital defects (20%), infection (14.3%) and tumours (12.8%). Diabetic vasculopathy, congenital defects and infection are major causes of amputation. Control of blood sugar, foot care education, vigilant infection control and audit of congenital defects are recommended