occurred in (29%) of patients. Diabetes was the second common risk factor for vascular failure as it occurred in (17%) of patients. Conclusion: Stenosis and infection are the most common complications of the vascular access. DM is an important risk factor for the incidence of infection. Other risk factors for dialysis CRBSI include older age, low serum albumin, high BUN and decreasing the duration of dialysis.
Online reporting is now widespread with 82% of the top 100 listed companies in Egypt providing a variety of financial data online. However, much of this information reflects the paper-based versions of annual reports with little attempt to enhance the usefulness of this data for decision makers. This online reporting provides the first generation (FG) of online reporting languages such as PDF, HTML, EXCEL and WORD formats. XBRL has been developed to provide a second generation (SG) of online reporting to enhance the data handling and usability of corporate reporting. The findings of a questionnaire survey in Egypt report that academics' and bankers' awareness of XBRL and SG reporting is very little compared to FG reporting formats. Additionally, the vast majority of respondents are aware of both the benefits and problems of adopting XBRL. This study has some recommendations for Egyptian regulators, standards' setters, accounting academics and professional accountants.
Background: Adipocyte fatty acid binding protein 4(A-FABP4) and retinol binding protein 4(RBP4) are recently discovered adipokines, which are members of lipocalin family. Both adipokines have been proposed to be important markers for metabolic syndrome and diabetes mellitus. Diabetic nephropathy is a leading cause of chronic kidney disease in patient starting renal replacement therapy and is associated with increased cardiovascular mortality. Objective: To study serum A-FABP4 and RBP4 levels in patients with type 2 DM with different stages of diabetic nephropathy and to investigate whether serum A-FABP4 and RBP4 could be used as biomarkers-in single or combination-for early detection of diabetic nephropathy. Subjects and methods: 60 subjects were included in this study ,they were divided into six groups according urinary albumin excretion(UAE) and glomerular filtration rate (GFR) Group 1 (Control group) consists of 10 patients who are normo-albuminuric with normal GFR. Group 2 consists of 10 patients who are normoalbuminuric with increased GFR>120 Group 3 consists of 10 patients who are microalbuminuric i.e. UAE 30-300 mg/day. Group 4 consists of 10 patients who are macroalbuminuric i.e. UAE ≥ 300 mg/day without renal impairment (normal creatinine and GFR > 90 ml/min/1.73m²). Group 5 consists of 10 patients who are macroalbuminuric with renal impairment and declining GFR <90 ml/min/1.73m². Group 6 consists of 10 patients who are end-stage renal disease (GFR <15 ml/min/1.73m²). Measurement of serum AFABP4 , serum RBP4 , UAE, GFR were done for every subject Results: There was significant increase in the serum level of AFABP4 and RBP4 among different stages of diabetic nephropathy and there was significant difference between microalbuminuric group and normoalbuminuric group so both biomarkers can be used for early detection of diabetic nephropathy. Both AFABP4 and RBP4 correlated positively with UAE and negatively with GFR. Conclusion: High circulating AFABP4 and RBP4 concentrations were demonstrated in early diabetic nephropathy in type 2 DM. AFABP4 and RBP4 increased significantly with the progression of diabetic nephropathy. Large scale multicenter and prospective studies are necessary to gather a definitive support that these adipokines might be directly involved in early detection of diabetic nephropathy and in impairment of kidney function in type 2 DM.
Background: HCV virus infection and type 2 diabetes mellitus are two major public health problems in Egypt. Egypt has the highest HCV virus prevalence in the world and is considered the ninth in rank of the highest prevalence of diabetes worldwide. The mutual relationship between diabetes and increased HCV infection may be due to the association of HCV with hepatic steatosis, insulin resistance and decrease of adiponectine synthesis as well as the nature of diabetes and its inherent complications and/or frequent parental exposure. Objective: determination of the prevalence of HCV infection in type-2 diabetics in Sharkia Governorate and to explore the predominant risk factors for HCV infection and its relation to some demographic parameters of this locality. Subjects and methods: A cross sectional randomized study was conducted to 642 patients, regardless of gender, body weight, educational level or socioeconomic levels, at multicentre managing diabetic patients at Sharkia governorate. All patients were subjected to detection of HCV-ab by third generation ELISA and HBA1C level Results:The prevalence of HCV infection among type 2 diabetic patients at Sharkia governorate approximates 38.7 %. Higher prevalence was detected among patients between 45 & 65 years old, low socioeconomic level, low educational level, and those who share personal utensils, have other family members infected with HCV. Patients who previously transfused, previous hospitalized, previously received parenteral anti-bilharzial therapy and those receiving insulin injections are also at high risk. Conclusion: As high as 39% of type-2 diabetics at Sharkia Governorate are HCV-infected. Apart from classic risk factors, The most significant independable factors associated with development of HCV infection in type 2 diabetics are low socioeconomic standard and low educational level. Previous blood transfusion, family members infected with HCV, parenteral antibilharzial treatment, sharing personal utensils and previous hospitalization may play also a role.
ContextDiabetic nephropathy in type 2 diabetes mellitus is one of the most serious microvascular complications. Immunoglobulin G (IgG), with molecular weight of 150 kDa, is excreted in urine of normoalbuminuric diabetic patients. AimsThe aim was to compare urinary IgG with microalbuminuria as an early indicator of diabetic nephropathy in patients with type 2 diabetes mellitus. Settings and designThe study was conducted in Zagazig University Hospital. Materials and methodsThis case-control study was conducted on 88 type 2 diabetic adult patients who were divided into four groups. Group I: 22 patients with normal albumin creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR), group II: 21 patients with normal ACR (<20 mg/g creatinine) and eGFR (>120 ml/min/1.73 m 2 ), group III: 24 patients with ACR from 20 to 200 mg/g creatinine and eGFR ranging from 60.74 to 102.48 ml/min/1.73 m 2 , and group IV: 21 patients with ACR more than 200 mg/g creatinine and eGFR ranging from 17.16 to 85.27 ml/min/1.73m 2 . Patients were subjected to complete blood count, kidney function tests (KFT), urinary albumin/ creatinine ratio, urinary IgG/creatinine ratio, random blood sugar, and estimation of GFR by modification of diet in renal disease equation. Statistical analysisThe data were analyzed using statistical package for the social science (SPSS), windows version 17. Description of qualitative variables was done by frequency and percentage. Description of quantitative variables was in the form of mean±SD. χ 2 -Test, Student's t-test, analysis of variance (F-test), and correlation analysis were used for analytical examination. ResultsHigh significant difference among the different groups was found regarding ACR (P<0.001) and immunoglobulin G creatinine ratio (IgGCR) (P<0.001). ACR and IgGCR are highly increased in groups III and IV in comparison with groups 1 and II. There was a significant positive correlation between IgGCR and age, diabetes mellitus (DM) duration, serum creatinine (P<0.001), blood urea nitrogen, ACR, and renal sonography, and negative correlation with eGFR (P<0.001), hemoglobin, and serum albumin. ConclusionIgG appears in urine in early stages of diabetic nephropathy even before microalbuminuria, so we recommend its use to define high-risk patients, allowing prompt interventions.
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