Sri Lanka Journal of Diabetes Endocrinology and Metabolism最新文献

{"title":"Assessment of impact of comorbidities on quality of life scores among diabetics and non-diabetics: A hospital based case control study in Garhwal division of Uttarakhand, India","authors":"B. Nath, S. Gupta, R. Kumari","doi":"10.4038/sjdem.v14i1.7461","DOIUrl":"https://doi.org/10.4038/sjdem.v14i1.7461","url":null,"abstract":"Background: Health related quality of life (HRQoL) is an important patient reported outcome in any chronic disease, including diabetes and is the ultimate goal of health interventions. The objective of the study was to compare the Quality of Life (QoL) scores between patients with diabetes and those without diabetes. It also intended to compare QoL scores between the two with respect to comorbidities of various system, assess the association of increasing number of comorbidities on QoL scores in both the groups and find the determinants of QoL scores among diabetics using regression analysis.\u0000Methods: The present study was a hospital-based comparative study conducted in Garhwal division of Uttarakhand, India. The QoL scores were obtained using WHOQOLBREF questionnaire. Comparisons were made between 195 diabetics and an equal number of age and sex matched nondiabetics.\u0000Results: The total mean QoL score was significantly lower among diabetics in comparison to nondiabetics. Patients with diabetics with comorbidity of cardiovascular system reported highest mean QoL scores while those with respiratory comorbidities reported lowest mean scores. The mean QoL scores decreased with increasing number of co-morbities in both diabetics and nondiabetics, however the inter group differences were not found to be significant. Presence of three or more comorbidities (β= -9.5), income (β= 5.3), type of family (β= -5.9) and use of alcohol (β= 2.4) were significant determinants of QoL among patients of diabetes.\u0000Conclusion: The study illustrates the expanding horizons of the effect of diabetes on all the domains of life of an individual and therefore proposes and reinforces the role of interventions not just limited to control of blood sugar levels but also to enhance the quality of life of an individual with diabete","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49656052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical audit on in-patient diabetes care in a university medical unit","authors":"N. D. de Silva, R. Sirimanna, K. Ariyarathna, P. Jayasekara, D. Govindapala, A. Loku Prathapasinghe","doi":"10.4038/sjdem.v14i1.7481","DOIUrl":"https://doi.org/10.4038/sjdem.v14i1.7481","url":null,"abstract":"Introduction: Auditing is integral to recognising deficits in care and providing sustainable improvements. Auditing of in-patient diabetes care has not been practised in Sri Lanka despite its impact on patient outcomes. The objectives were to assess the quality of in-patient diabetes care at a University Medical Unit measured against the standards in 'National diabetes in-patient audit, UK' and American Diabetes Association. This was followed by implementing changes and re-auditing, completing the clinical audit cycle.\u0000Methods: Data were retrieved retrospectively from medical records of in-patients with diabetes at the medical ward, University Hospital - KDU. Documentation of outpatient medications, appropriateness of blood glucose monitoring, achieved glycaemic control and medication management errors were assessed. The first cycle was conducted in August 2021, followed by remedial measures, including educating medical and nursing staff and introducing hypoglycaemia and blood glucose monitoring algorithms and a structured insulin prescription form. The second cycle was conducted in July 2022.\u0000Results: Data were collected from 76 and 73 patient records in the first and second cycles, respectively. Outpatient medication regime was documented in 22 (28.9%) in the first cycle and 61 (83.6%) in the second cycle (p<0.001). Blood glucose monitoring was inadequate in 34.2% and 57.5% in the first and second cycles, respectively. Persistent hyperglycaemia was observed in 52.6% in the first cycle and 55.7% in the second. Ten patients had hypoglycaemia during the first cycle, while four incidences occurred during the second cycle. Medication adjustment for persistent hyperglycaemia was not performed in 50% and 43.6% of patients in the first and second cycles.\u0000Conclusions: Unprecedented scarcity of resources during the second cycle posed limitations in glycaemic monitoring. Observed deficiencies in in-patient diabetes care that remained resistant to the remedial measures necessitate strong consideration of more proactive care improvement initiative","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70134220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopause: A multidimensional approach to optimal Endocrine health","authors":"S. Pathmanathan, S. Abhayaratna","doi":"10.4038/sjdem.v14i1.7505","DOIUrl":"https://doi.org/10.4038/sjdem.v14i1.7505","url":null,"abstract":"No abstract available","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47639934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of Adrenal Endothelial Cyst in a young female","authors":"J. Prashanthan, N. Meegoda Widanege, C. Garusinghe","doi":"10.4038/sjdem.v14i1.7491","DOIUrl":"https://doi.org/10.4038/sjdem.v14i1.7491","url":null,"abstract":"Adrenal cysts are rare, often asymptomatic and non-functional. Here, we discuss the case of a 24-year-old young female who had been experiencing unexplained abdominal heaviness and pain for 6 months’ duration. An almost 5 cm anechoic lesion without a septum was detected by abdominal sonography across the left abdominal region. A 4.8x4.2x4.8cm suprarenal cyst was discovered on abdominal computed tomography (CT) scan displacing the left kidney inferiorly and anteriorly. There was no evidence of hormonal hypersecretion clinically or biochemically. She underwent successful laparoscopic left adrenalectomy, revealing a histopathological diagnosis of an endothelial cyst without any features of malignancy. The postoperative course was uneventful without recurrence during the period of follow-up. Current literature on the management of adrenal cysts is sparse although, personalized management with multidisciplinary team involvement is paramount importan","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47822011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical update on Primary Aldosteronism; Are we seeing only the tip of an iceberg?","authors":"N. Pathirana, P. Dissanayake, I. U. Jayawardana, S. Pathmanathan, M. Sumanatilleke","doi":"10.4038/sjdem.v14i1.7492","DOIUrl":"https://doi.org/10.4038/sjdem.v14i1.7492","url":null,"abstract":"Primary Aldosteronism (PA) is a common form of secondary hypertension, often undiagnosed, untreated, and overlooked leading to excess cardiovascular morbidity and mortality. Until recently it is being recognized as a binary disease. Recent evidence suggests PA is a disease spanning a continuum from subclinical stages to more florid disease manifesting as Conn’s syndrome. Timely diagnosis and appropriate surgical intervention can cure hypertension in PA whereas it can reduce hypertension-related target organ damage and excess mortality and morbidity associated with aldosterone excess. Unfortunately, most clinicians are still in the dark with regard to the pitfalls of diagnosing PA, thus detecting only the tip of the iceberg.","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43238237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exhaustive battle of salt: A challenging case of Adipsic Diabetes Insipidus following resection of Craniopharyngioma","authors":"P. Dissanayake, N. Pathirana, I. U. Jayawardana, S. Pathmanathan, M. Sumanatilleke","doi":"10.4038/sjdem.v14i1.7493","DOIUrl":"https://doi.org/10.4038/sjdem.v14i1.7493","url":null,"abstract":"Introduction: Even though rare, Adipsic Diabetes Insipidus (ADI) is a potentially life-threatening complication of craniopharyngioma: due to the mass effect of the tumor or perioperative consequences leading to severe hypernatremic dehydration. Even in expert hands, management of water balance, in the absence of thirst is extremely challenging.\u0000Case Description: A 25-year-old gentleman, an electrician presented to the neurosurgical casualty with worsening headaches, impaired vision, and features of raised intracranial pressure over 2 months. He was found to have a large cystic suprasellar mass with well-defined margins measuring 2.7cm x 2.7cm x 3cm with chiasmal compression, suggestive of craniopharyngioma, complicating with bitemporal hemianopia, hypogonadotropic hypogonadism (LH 0.78IU/L, FSH 1.2IU/L, Testosterone 33ng/dL), secondary hypothyroidism, cranial diabetes insipidus, prediabetes sparing the cortisol axis. He underwent transcranial resection of the tumor, revealing WHO grade1 adamantinomatous craniopharyngioma followed by radiotherapy. The post-operative period was complicated with severe hypernatremia despite escalating doses and changing dosage forms of desmopressin from parenteral to nasal spray to oral tablets. Two weeks following discharge, he presented with severe hypernatremia (176mEq/L), polyuria, weight loss, hypotension, and altered sensorium where his lack of thirst was appreciated.\u0000Conclusions: In those with ADI, for the management of water balance, a “personalized approach” with the involvement of both patient and family is of paramount importance. With appropriate dose titration of desmopressin, careful fluid prescription, and frequent monitoring of electrolytes even at best centers, it is a battle that is hard to win.","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42838604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutis Verticis Gyrata in Acromegaly an infrequent finding","authors":"S. Palle, C. Bhandiwad, S. Paidipally, V. Danda","doi":"10.4038/sjdem.v14i1.7490","DOIUrl":"https://doi.org/10.4038/sjdem.v14i1.7490","url":null,"abstract":"Cutis verticis gyrata is a rare clinical manifestation presenting with cerebral convolution like appearance of the scalp. It can be primary or secondary. We report a case of 41 year old male with acromegaly who had cutis verticis gyrata.","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47454020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in the management of resistant acromegaly: Experience of multi-modal therapy in Sri Lanka: A case report","authors":"M. Dilrukshi, H. Dissanayake, P. Dissanayake, M. Sumanatilleke, S. Pathmanathan, N. Somasundaram","doi":"10.4038/sjdem.v13i2.7482","DOIUrl":"https://doi.org/10.4038/sjdem.v13i2.7482","url":null,"abstract":"","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42950164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual dysfunction among men with diabetes: A review","authors":"N. D. de Silva, R. E. Wickramarachchi, M. Sumanatilleke, N. Somasundaram","doi":"10.4038/sjdem.v13i2.7479","DOIUrl":"https://doi.org/10.4038/sjdem.v13i2.7479","url":null,"abstract":"","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42984483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of cyanocobalamine responsive methylmalanoic acidemia presenting with metabolic stroke","authors":"M. W. A. Nimanthi, C. I. Kankananarachchi, H. Wackwella, K. D. Silva, U. D. S. Deshapriya, P. Gamage, M. S. Liyanarachchi, E. Jasinge, M. Fernando, S. Kodikara, N. Liyanarachchi, G. Hewawitharana","doi":"10.4038/sjdem.v13i2.7466","DOIUrl":"https://doi.org/10.4038/sjdem.v13i2.7466","url":null,"abstract":"","PeriodicalId":52577,"journal":{"name":"Sri Lanka Journal of Diabetes Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43056589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}