We examined whether the COVID-19 pandemic has affected the incidence of tuberculosis (TB) and influenza in Serbia, a Southeast European country with a low TB incidence rate and a mandatory BCG vaccination at birth. The first case of COVID-19 was registered on March 6, 2020. Despite the need for a sudden adaptation of the health care system, routines of mycobacterial laboratories have never stopped. In 2020, the number of newly diagnosed TB patients was significantly lower than expected (p = 0.04), but the number of patients with influenza increased when compared to 2019. Although many patients with influenza A H1N1 were observed before the beginning of the COVID-19 pandemic, the increment of cases could also be a consequence of cases of influenza with COVID-like symptoms detected thereafter. It may also be attributed to misclassification of clinical cases that were negative for SARS-CoV-2 and reported as influenza. Difficulties to seek medical attention because of the COVID-19 pandemic and possible underreporting are considered as reasons for the decline in the incidence rate of TB. On the other hand, individual and social measures to prevent the spread of SARS-CoV-2 such as wearing face masks, social distancing, lockdown, which were strictly applied to COVID-19 patients, health care staffs and most of the population, could have hindered TB infections more than the two viral diseases, which appear to be more contagious. The increased motivation of the population to protect their health during the COVID-19 pandemic provided an opportunity for their effective education. This is crucial in further combating TB as a preventable disease.
This study examines the influence of diabetes mellitus type 2 (DM type 2) on morbidity and mortality in patients after acute myocardial infarction (AMI). The study included 261 patients with acute myocardial infarction, treated at the General Hospital in Leskovac during the period from January to December 2007. The incidence of diabetes mellitus in patients with AMI was 28.4% (74 patients). The group of patients with both diabetes mellitus and AMI had an equal number of men and women (37), whereas the group of patients without DM type 2 had significantly more males (118, 63.1%) than females (69, 36.9%) (p<0.05). The average age in diabetics with acute myocardial infarction was 66.34±9.34 years, and in non-diabetics 64.29±11.48 years. The youngest diabetic with DM type 2 and acute myocardial infarction was 42, while the youngest nondiabetic was 37 years old. The oldest subject with diabetes and acute myocardial infarction was 82, whereas the oldest subject without DM type 2 was 88 years old. The majority of diabetics with acute myocardial infarction (40.5%) were in the group ranging from 70-79 years of age, while 30.5% of non-diabetics were in the group ranging from 60-69 years of age. Diabetes duration was usually 1-5 years (25.7% of patients). It is characteristic that in 13.5% of patients with acute myocardial infarction, DM type 2 was diagnosed at the time of infarction. The majority of subjects (58.10%) were treated with oral hypoglycemics. The incidence of positive anamnesis for the existence of early cardiovascular disease was much higher in diabetics (68.9%), whereas the proportion of active smokers was considerably lower in diabetics (31.0%). Hypertension was more frequent in diabetics (71.6%). Heart failure was statistically more frequent in patients with both acute myocardial infarction and DM type 2. Fatal outcome was registered more often in the group of subjects with DM type 2 (21.6%), with regard to the group of patients without diabetes mellitus (7.0%).
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