Dr. H. H. Alkaabi
Background: This study evaluates screening and management of renal impairment in adults with type 2 diabetes at the Royal Medical Services in Bahrain. Type 2 diabetes is a significant risk factor for chronic kidney disease, underscoring the importance of early identification and proper management in primary healthcare.
Methods: This retrospective study analyzed data from primary healthcare clinics' electronic medical records of 292 patients with type 2 diabetes. The study included 160 males (54.8%) and 132 females (45.2%), ranging from 32 to 94 years old. It focused on sociodemographic details, diabetic history, albuminuria screening, eGFR, and medication management for those with renal impairment.
Results:Among 292 patients, 57.9% had detectable albumin creatinine levels. In the albuminuria group, 31.5% were morbidly obese, while 27.3% were moderately obese. For patients with albuminuria, 39% had good HbA1c control (<7%), with a mean HbA1c of 7.5 ± 1.4. Both groups had a high prevalence of stage 2 hypertension cases. 9.4% of the albuminuria group were referred to nephrology for evaluation. Re-testing rates were 85.8% for albuminuria patients and 87.7% for non-albuminuria patients.
Discussion: Addressing compliance issues with regular urinary monitoring is crucial to improving diabetic kidney disease screening. The study underscores connections between albuminuria, obesity, and glycemic control, emphasizing the necessity for more research on renal risk factors for CKD progression. Results show good screening rates for T2DM complications in primary care, with a considerable number of patients having undetected renal issues. Implementing evidence-based strategies and guideline-driven assessments can enhance early T2DM detection and optimize diabetic kidney disorder management in this population.
Conclusion: The study on screening and managing diabetic kidney disease (DKD) in adults with type 2 diabetes. It focuses on early detection, high-risk populations, and intervention to prevent DKD progression. The study emphasizes the role of primary care physicians in identifying and managing DKD in type 2 diabetes patients to ensure effective care and prevent disease advancement.
Keywords: Chronic kidney disease, Type 2 diabetes mellitus, Albumin creatinine levels
Hasan Almajed1*, Yusuf Jalili2, Ahmad Noor3, Mahmood Alawainati4
Background: Surgical Site Infections (SSI) impose a critical complication following lower segment cesarean sections (LSCS), contributing significantly to maternal morbidity and mortality. Understanding the risk factors associated with SSI is essential for improving clinical outcomes and enhancing patient care. This study aimed to identify the rate and risk factors associated with SSI among women who underwent LSCS at Salmaniya Medical Complex (SMC) in Bahrain.
Methods: A retrospective observational study was conducted at SMC in the period between 2020 and 2023. All patients with SSI post-LSCS and a comparable sample of patients who underwent LSCS but had no SSI were included. Data including patient demographics, clinical characteristics, and specific risk factors related to SSI were collected from electronic medical records. Descriptive and inferential analyses were done.
Results: The rate of SSI was 2.1% among women who underwent LSCS in SMC. Predictors of higher rates of SSI post-LSCS included having an emergency LSCS (odds ratio [OR]=4.14), a longer hospital stay (OR 1.37), and pre-operative stage 1 hypertension (OR=2.66), while diabetes mellitus (OR=0.29) and post-operative elevated laying blood pressure were linked to a reduced risk (OR=0.42) of postLSCS SSI.
Conclusion: This study revealed a low rate of post-LSCS SSI. This study highlighted the implications of emergency procedures, hospital stay duration, and blood pressure management. The paradoxical protective effect of diabetes mellitus warrants further investigation. These insights are pivotal for developing targeted interventions aimed at minimizing SSI, thereby enhancing maternal health outcomes in clinical practice. Keywords: Pregnancy, Female, Surgical Wound Infection, Cesarean Section, Risk Factors
Abdulla Almusalam1*, Israa Sinan2
Background: Sleep is a crucial part of any stage of life to provide a resting period that is essential for decision-making matters, and mood, as well as to help the body reduce blood pressure and cardiovascular complications. Dealing with sleep deprivation is not uncommon for junior physicians working in healthcare, causing a decline in cognition which affects decision-making, and mood changes that cause irritability.
Aims: This study aims to measure the changes in visual working memory and mood within the junior physician population that faces sleep deprivation due to on-call shifts.
Methods: Following the recruitment of participants, they were asked to complete the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality and disturbances over 1 month. Following that, the participants were then requested to complete a Brief Mood Introspection Scale (BMIS) to measure their mood, as well as a visual working memory assessment (cognitive task) to assess cognitive functions. The BMIS and cognitive tasks were completed before and after their on-call shifts. Furthermore, the participants were requested to complete the BMIS and cognitive task on “normal shifts”, which was used as a control group.
Results: It has been observed that there are no statistically significant correlations between the cognition score and any of the BMIS sub-scales in the pre-call visit. However, within the post-call visit, positively associated moods in the BMIS sub-scales such as pleasantness (r = 0.414, p = 0.035) and overall positivity (r = 0.486, p = 0.012) had a statistically significant effect on cognitive scores. For the normal shift visit, all of the positively associated BMIS sub-scales had a statistically significant effect on cognitive scores: pleasantness (r= 0.640, p = 0.014), arousal (r = 0.570, p = 0.033) and overall positivity (r = 0.660, p = 0.011).
Conclusion: Sleep deprivation affects junior physicians immensely causing a decrease in positive mood and cognitive decline. Upon this reflection, medical institutions need to actively pay attention to the mental health and well-being of junior physicians to ensure that patient care is not halted or compromised.
Keywords: Sleep Deprivation, Visual Working Memory, Cognitive Impairment, Mood