Type 2 diabetes care for patients in a tertiary care setting in UAE: a retrospective cohort study.

OBJECTIVE: We aimed to examine the quality of type 2 diabetes mellitus (T2DM) care in Al-Ain, in the United Arab Emirates (UAE). DESIGN: A retrospective cohort study from 2008 to 2010. SETTING: A diabetes centre located in a tertiary care hospital in Al-Ain, UAE. PARTICIPANTS: People with T2DM receiving care from the diabetes centre. RESULTS: 382 Emirates patients with T2DM were included in the analysis. Overall in 2010, proportions of people with T2DM reaching the following targets were: glycated haemoglobin (HbA1c) 41%, low-density lipoprotein (LDL) 72%, systolic and diastolic blood pressure (SBP/DBP) 47% and 73%, respectively. There was a significant improvement from 2008 to 2010, respectively, in the mean for the following: (1) HbA1c (8.5% [95% confidence interval, CI: 8.33-8.67] versus 7.5% [95% CI: 7.36-7.63]); (2) LDL (2.60 mmol/L [95% CI: 2.51-2.70] versus 2.27 mmol/L [95% CI: 2.21-2.33]); and (3) SBP (133.1 mmHg [95% CI: 131.7-134.4] versus 131.0 [95% CI: 130.1-131.9]). Glycaemic and lipid control were similar in men and women; however, HbA1c levels in men and women aged 60+ years were significantly lower by (0.7% [P = 0.01] versus 0.8% [P < 0.001], respectively) than for those aged between 18 and 39 years. CONCLUSION: This study demonstrates that there is encouraging progress in diabetes care in Al-Ain, UAE as reflected by the overall improvement in the mean of HbA1c, LDL and SBP, and the increase in the number of people reaching the target for the same indicators from 2008 to 2010. The results however show that there is scope for additional enhancement of care, especially for better glycaemic control among young patients and better SBP control among men

Views of patients about sickle cell disease management in primary care: a questionnaire-based pilot study.

OBJECTIVES: To determine how patients with sickle cell disease (SCD) perceive the quality of care that they receive from their primary healthcare providers. DESIGN: A questionnaire-based pilot study was used to elicit the views of patients about the quality of care they have been receiving from their primary healthcare providers and what they thought was the role of primary care in SCD management. SETTING: Sickle Cell Society and Sickle Cell and Thalassaemia Centre, in the London Borough of Brent. PARTICIPANTS: One hundred questionnaires were distributed to potential participants with SCD between November 2010 and July 2011 of which 40 participants responded. MAIN OUTCOME MEASURES: Analysis of 40 patient questionnaires collected over a nine-month period. RESULTS: Most patients are generally not satisfied with the quality of care that they are receiving from their primary healthcare providers for SCD. Most do not make use of general practitioner (GP) services for management of their SCD. Collecting prescriptions was the reason most cited for visiting the GP. CONCLUSION: GPs could help improve the day-to-day management of patients with SCD. This could be facilitated by local quality improvement schemes in areas with high disease prevalence. The results of the survey have been used to help develop a GP education intervention and a local enhanced service to support primary healthcare clinicians with SCDs ongoing management

Studies on ionics conduction properties of modification CMC-PVA based polymer blend electrolytes via impedance approach

In this study, the modification of cellulose derivative namely carboxymethyl cellulose (CMC) blended with polyvinyl alcohol (PVA) and doped with different content of NH4Br based solid polymer electrolytes (SPEs) prepared via solution casting method is investigated. The FTIR analysis demonstrated the interaction between CMC-PVA and NH4Br via COO−. The optimum ionic conductivity at ambient temperature is found to be 3.21 × 10−4 S/cm for the sample containing 20 wt% NH4Br with the lowest percentage of crystallinity and total weight loss. The conductivity-temperature relationship for the entire SPEs system obeys Arrhenius behaviour. Besides that, based on the Nyquist fitting analysis, it is shown that the ionic conductivity of the SPEs is primarily influenced by the ionic mobility as well as the ions diffusion coefficient. The H+ transference number obtained using non-blocking reversible electrode is 0.31, which further indicates that the conduction species is predominantly due to the cationic conduction

Toxic Effects of Low Concentration of Cyanotoxin (Microcystin¬-LR) on Mice and Study of Protective Efficacy of the Antioxidants Vitamins (C&E) and Capparis spinosa L. Root Extract

In this study the protective efficacy of vitamin C&amp;E and  ethanolic  extract roots of C.spinosa against toxic effects of algal toxin (Microcystin –LR) in mice  were done .Results showed significant decreasing p≤0.05 in values of hemoglobin (HB) and packed cell volume  (PCV) reach to 7.77 and 27.23 g/l in blood of mice treated  with  low  concentration of cyanotoxin (MC-LR = 0.15 ug/kg/day) compared with control group which reach to 12.21 and  40.22 respectively. Significant increasing were showed in some liver enzymes  ALT,AST and ALP when exposed to toxin only  which reach to 68.80 , 167.85 and 274 U/l respectively compared with control group , While groups treated with vitamins and extract showed non -significant differences with control group in values of blood parameters and enzymes. Histopathological  changes in liver  when group treated with toxin only represented by pyknotic hepatocyte , hypertrophy , binucleation  , infiltration of lymphocyte, karyolysis. While  kidney showed hypertrophy of cell glomerular arterioles , metaplasia of squamous epithelial tissue of bowman capsule wall in to cuboidal, hypertrophy of renal tubules cells , hyperplasia , also results showed the important role of vitamin C&amp;E and root extract of C. spinosa to keep the normal values of blood parameters and prevent histological changes as control group. Keywords: Algal toxin ( Microcystin-LR) ,  protective efficacy of  Vitamin C&amp;E  ,  C.spinos

Health and socio-demographic characteristics associated with uptake of seasonal influenza vaccination amongst pregnant women: retrospective cohort study

Pregnant women are at increased risk from influenza, yet maternal influenza vaccination levels remain suboptimal. This study aimed to estimate associations between socio-demographic and health characteristics and seasonal influenza vaccination uptake among pregnant women and understand trends over time to inform interventions to improve vaccine coverage. A retrospective cohort study using linked electronic health records of women in North West London with at least one pregnancy overlapping with an influenza season between September 2010 and February 2020. We used a multivariable mixed-effects logistic regression model to identify associations between characteristics of interest and primary outcome of influenza vaccination. 451,954 pregnancies, among 260,744 women, were included. In 85,376 (18.9%) pregnancies women were vaccinated against seasonal influenza. Uptake increased from 8.4% in 2010/11 to 26.3% in 2018/19, dropping again to 21.1% in 2019/20. Uptake was lowest among women: aged 15-19 years (12%) or over 40 years (15%; OR 1.17, 95% CI 1.10 to 1.24); of Black ethnicity (14.1%; OR 0.55, 95% CI 0.53 to 0.57), or unknown ethnicity (9.9%; OR 0.42, 95% CI 0.39 to 0.46), lived in more deprived areas (OR least vs most deprived 1.16, 95% CI 1.11 to 1.21), or with no known risk factors for severe influenza. Seasonal influenza vaccine uptake in pregnant women increased in the past decade, prior to the COVID-19 pandemic, but remained suboptimal. We recommend approaches to reducing health inequalities should focus on women of Black ethnicity, younger and older women, and women living in areas of greater socio-economic deprivation

Long-term effectiveness of a digital therapeutic intervention for smoking cessation: a randomized controlled trial

Introduction: The present study evaluated the long-term effectiveness of Quit Genius (QG), an extended digital smoking cessation intervention. Methods: Participants were adult smokers (N=556) recruited between January and November of 2019 via social media and referrals from primary care practices who were given nicotine replacement therapy and randomly assigned to Quit Genius (QG) (n=277), a cognitive behavioral therapy (CBT) based digital intervention or Very Brief Advice (VBA) (n=279), a face-to-face control intervention. Primary analyses (N=530), by intention-to-treat, compared QG and VBA on biochemically verified continuous 7-day abstinence at 4, 26, and 52 weeks post-quit date. Secondary outcomes included sustained abstinence, quit attempts, self-efficacy and mental well-being. Results: Seven-day point prevalence abstinence from weeks 4 through 52 ranged from 27% to nearly 45% among those who received QG, and from 13% to 29% for those in VBA. Continuous 7-day abstinence at 26 and 52 weeks occurred in 27.2% and 22.6% of QG participants, respectively, relative to 16.6% and 13.2% of VBA participants; QG participants were more likely to remain abstinent than those in VBA (Relative Risk [RR]= 1.71, 95% CI 1.17-2.50; p=0.005). Conclusions: This study provides evidence for the long-term effectiveness of an extended digital therapeutic intervention. Implications The long-term effectiveness of digital smoking cessation interventions has not been well-studied. This study established the long-term effectiveness of an extended CBT-based intervention; results may inform implementation of scalable, cost-effective approaches to smoking cessation in the health system