Characteristics and Treatment Patterns of Patients with Type 2 Diabetes Mellitus in the Middle East and Africa Cohort of the DISCOVER Study Program: a Prospective Study.

Introduction: Despite the high prevalence of type 2 diabetes (T2D) and suboptimal glycemic control in the Middle East and Africa, comprehensive data on the management of T2D remain scarce. The main aim of this study is to describe the characteristics and treatment of patients with T2D initiating second-line glucose-lowering therapy in these regions.

Methods: DISCOVER is a global, 3-year, prospective observational study of patients with T2D enrolled at initiation of second-line glucose-lowering therapy.

Recommendations for management of diabetes and its complications during Hajj (Muslim pilgrimage).

Hajj is one of the five pillars of Islam and is a must-do for all adult Muslims once in their life provided they are able to do it. Considering the 8.8% global prevalence of diabetes, coupled with the number of Muslims performing Hajj (~2.

Diabetes and Ramadan: Practical guidelines.

Ramadan fasting is one of the five pillars of Islam and is compulsory for all healthy Muslims from puberty onwards. Exemptions exist for people with serious medical conditions, including many with diabetes, but a large number will participate, often against medical advice. Ensuring the optimal care of these patients during Ramadan is crucial.

Hepatitis C virus infection in a population with high incidence of type 2 diabetes: impact on diabetes complications.

A growing number of reports suggest a connection between hepatitis C virus (HCV) infection and type 2 diabetes (T2D). However, the association of HCV infection with diabetes-related complications has not yet been clarified. The aim of this study was to determine the prevalence of HCV infection in T2D-patients in Kuwait which has a high incidence of type 2 diabetes, and to investigate the association between HCV viremia and diabetes-related complications.

Abdominal cerebrospinal fluid pseudocyst due to infection with enterococcus faecalis. A case report.

Abdominal cerebrospinal fluid pseudocyst is a rare complication of ventriculo-peritoneal shunt occurring as a result of non-absorption of cerebrospinal fluid from the abdominal cavity due to inflammation. Usual presentations include abdominal symptoms; abdominal distention, pain, nausea, vomiting and symptoms of raised intracranial pressure like headache due to shunt dysfunction. The diagnosis may be delayed in severely handicapped patients due to poor communicability, multiple associated complications or co-morbidities.

Comparative analysis and interobserver variation of unenhanced computed tomography and intravenous urography in the diagnosis of acute flank pain.

Objectives: The purpose of this study was to compare unenhanced computed tomography (UECT) to intravenous urography (IVU) for detecting urinary tract calculi, signs of obstruction and non-renal causes in the assessment of acute flank pain, and in their interobserver agreement.

Patients And Methods: In this prospective study, carried out at a university hospital over a period of 1 year, 36 patients (27 males and 9 females) participated. Mean age was 44 +/- 15 years (range: 14-73 years).

The metabolic syndrome: useful concept or clinical tool? Report of a WHO Expert Consultation.

This article presents the conclusions of a WHO Expert Consultation that evaluated the utility of the 'metabolic syndrome' concept in relation to four key areas: pathophysiology, epidemiology, clinical work and public health. The metabolic syndrome is a concept that focuses attention on complex multifactorial health problems. While it may be considered useful as an educational concept, it has limited practical utility as a diagnostic or management tool.

Cerebral venous sinus thrombosis: unusual imaging appearance. A case report.

Cerebral venous sinus thrombosis (CVST) has widely varied clinical and radiological manifestations ranging from asymptomatic minimal brain oedema to severe haemorrhagic infarcts associated with focal deficits, coma and even death. Cerebral venous sinus thrombosis presenting with lobar or subdural hematomas are rare and the cause may easily be overlooked. We present a case of CVST with an atypical radiological picture of intra-arenchymal, subdural and subarachnoid haemorrhage.

Accuracy of 64-multidetector-row computed tomography in the diagnosis of coronary artery disease.

Objectives: The aim of this prospective study was to assess the accuracy of 64-multidetector-row computed tomography coronary angiography (CTA) in the diagnosis of coronary artery disease (CAD).

Patients And Methods: Ninety-two patients suspected of having CAD underwent CTA using a 64-slice CT scanner before a scheduled, conventional coronary angiogram (CCA). Blinded assessment of CTA to detect CAD was performed.

Isolated bilateral pyramidal tract lesions? An unusual case of demyelination following trauma. A case report.

This paper describes the case of a young woman who developed quadriparesis due to isolated bilateral pyramidal tract lesions suggestive of demyelination following trauma.

Pituitary apoplexy: a rare cause of cerebral infarction. A case report.

Pituitary apoplexy is usually the result of hemorrhagic infarction in pituitary adenoma. The clinical presentation of pituitary apoplexy varies widely and includes asymptomatic hemorrhage, classical pituitary apoplexy and even sudden death. Few cases of cerebral infarction associated with pituitary apoplexy have been reported in the literature.

Giant sigmoid diverticulum: a case report.

Objectives: To report an unusual presentation of a giant sigmoid diverticulum in the colon.

Clinical Presentation And Intervention: The patient presented with an abdominal mass, altered bowel habits, and increasing weight. The provisional diagnosis was made by barium enema and CT scan.

Risk factors for the development of diabetes mellitus in chronic hepatitis C virus genotype 4 infection.

Background And Aim: A high occurrence of type 2 diabetes (T2D) in patients with chronic hepatitis C virus (HCV) infection has been reported in Kuwait and other countries. However, HCV genotype 4 has been underrepresented in all previous studies. Our aim was to investigate the viral and host risk factors associated with the development of T2D in patients with chronic hepatitis C genotype 4 infection in the absence of liver fibrosis and steatosis.

Bilateral subdural hemorrhage following lumbar puncture in a case of suspected meningitis. A case report.

Intracranial subdural hemorrhage is a rare complication of lumbar puncture. Caudal traction and tear of the subdural veins due to negative pressure caused by leakage of cerebrospinal fluid (CSF) following lumbar puncture (LP) is the mechanism. Prolonged headache or neurological symptoms following LP should warrant cross-sectional imaging to rule out subdural hemorrhage as it can be fatal.

Magnetic Resonance Imaging in Balo's Concentric Sclerosis. A Case Report.

Concentric high signal intensity zones on T2-weighted magnetic resonance images of brain strongly suggest Balo's concentric sclerosis (BCS), a rare but recognized variant of multiple sclerosis. Differentiating BCS from multiple sclerosis or neoplasm can be difficult clinically. The pathognomonic MRI appearance can dramatically influence the course of the disease, allowing earlier diagnosis and therapy of the disease which was once considered to have an invariably fulminant and fatal course.

Perirolandic sparing and pituitary apoplexy in adult brain with global hypoxia. A case report.

Global hypoxia in adult brain usually manifests as ischemic lesions in watershed territories. Acute profound hypoxia involves the cortex especially the perirolandic area, white matter and deep grey matter. Perirolandic sparing in adult global hypoxia is not described in literature.

Cultural factors and patients' adherence to lifestyle measures.

Background: Non-adherence to preventive and therapeutic lifestyle recommendations among patients at high risk of cardiovascular disease is more prevalent and varied than previously thought. The problem needs to be addressed by those who are involved in the care of these patients.

Aim: To measure adherence and barriers of complying with lifestyle recommendations among patients with high cardiovascular risk factors.

Association of periodontal disease severity with diabetes duration and diabetic complications in patients with type 1 diabetes mellitus.

Objectives: The association between periodontal disease severity and diabetes complications and duration in patients with type 1 diabetes mellitus (DM) was investigated in this comparative cross-sectional study.

Materials And Methods: Twenty-nine patients with type 1 DM of < or = 5 years duration were compared with 43 patients with > 5 years duration of DM. Complete medical history and examination and assessments of retinopathy, neuropathy, and nephropathy were performed, followed by assessments of the plaque index (PI), pocket depth (PD), clinical attachment level (CAL), and the number of missing teeth by one examiner masked to the diabetic status of the patients.

Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes.

Background: Obesity and the metabolic syndrome have emerged as clinical and public health crises in many populations, but not all obese patients have the syndrome. As adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism, we postulate that estimation of adipokines may be useful addition to the criteria used to identify obese individuals with the metabolic syndrome.

Objective: To evaluate the determinants and associations of plasma adiponectin in relation to the metabolic syndrome in patients with Type 2 diabetes.

Spinal tuberculosis: CT and MRI feature.

Background: Spinal tuberculosis (TB) is perhaps the most clinically important extrapulmonary form of the disease. Early recognition is therefore necessary to minimize residual spinal deformity and/or permanent neurological deficit. We defined the CT and MRI image morphology of spinal TB and correlated the imaging features of these two modalities.

Prevalence of metabolic syndrome among hypertensive patients attending a primary care clinic in Kuwait.

Objective: To determine the prevalence of metabolic syndrome among hypertensive patients using the criteria of the National Cholesterol Education Program's Adult Treatment Panel III in a primary care health center in Kuwait.

Subjects And Methods: A population of 250 Kuwaiti hypertensive patients (129 males and 121 females) over the age of 40 were screened for metabolic syndrome by determining body mass index (BMI), waist circumference, levels of fasting plasma glucose and fasting plasma lipids (serum triglycerides, total cholesterol and high-density lipoprotein cholesterol). The study was carried out in the Mishref Family Practice Health Center, Kuwait, from January to July 2001.