Mailed urine samples collected with preservative and received within 7 days if ambient temperature is ≤18°C, or within 2 days if the temperature is higher but does not exceed 30°C, are suitable for the measurement of urine albumin-to-creatinine ratio in randomized trials. Preserved samples frozen to -40°C or -80°C for 6 months before analysis also seem suitable.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia with increasing incidence worldwide. Much focus has been directed towards AF prevention, given the morbidity and mortality from stroke, heart failure, and dementia. There are a number of common conditions associated with the onset of AF including, but not limited to, increased alcohol consumption, body weight, exercise, and stress. To reduce the incidence of AF, public health campaigns and targeted patient interventions may be warranted to promote balanced alcohol intake, appropriate exercise, and stress management to prevent AF and associated comorbidity. In this narrative review, we consider the evidence linking these risk factors with AF, putative mechanisms underlying the association, and whether risk factor modification may reduce AF burden.

Hypertension On a population-wide basis, hypertension is the most common predisposing factor for AF. The relationship between AF and blood pressure (BP) was first convincingly demonstrated by the Framingham Heart Study (FHS), in which hypertensive patients (defined as a systolic BP [SBP] of 160 mm Hg or higher, diastolic BP [DBP] of 95 mm Hg or higher, or use of antihypertensive medications) were significantly more likely to develop AF (odds ratio, 1.5 for men and 1.4 for women) over a 38-year follow-up. Similarly, the Manitoba study demonstrated a 1.42-fold increased risk of AF in hypertensive individuals over a 44-year follow-up. 9 The association between higher SBP and AF has also been noted within a shorter follow-up time of 3 years. 9,10 The association between incremental SBP and DBP and risk of AF has been shown in a prospective, population-based study of 2014 Norwegian men who were nondiabetic and nonhypertensive at baseline. Over a 35-year follow-up, the risk of AF onset was increased 1.60-fold (95% CI, 1.15-2.21) with an SBP of 140 mm Hg or higher and 1.50-fold (95% CI, 1.10-2.03) with an SBP of 128 to 138 mm Hg, as compared with an SBP

No abstract

Background: Since the COVID-19 pandemic has started, glucocorticoids have been proved to be one of the most effective lifesaving treatments for respiratory complications associated with SARS CoV-2. Aim: To review the incidence of steroid induced diabetes and the associated risk factors in COVID-19 patients. Study Design: Retrospective cohort study Place and duration of the study: Bahria International Hospital Lahore from 15th April 2020 to 31st December 2020 Methodology: Two hundred and thirty patients of COVID-19 cases treated with glucocorticoids (Dexamethasone 4mg BID) were enrolled. All known cases of pre-existing diabetes mellitus and with initial (admission) random blood glucose levels of more than 200 mg/dl were excluded. Patients labelled as glucocorticoid induced diabetes mellitus (GI-DM)met the following criteria, fasting blood glucose level of more than 126 mg/dl or a random glucose level of more than200 mg/dlon two occasions after starting these patients on steroids. Results: The glucocorticoid induced diabetes mellitus was 36 (15.65%). Multivariate logistic regression analysis revealed that older age (odds ratio 1.19, 95% confidence interval (1.02-1.36) was found to be the most profound risk factor for GI-DM. Conclusion: Glucocorticoid induced diabetes mellitus found to be associated with glucocorticoid used among COVID-19 patients especially in older ages. So, it is recommended that the treating physicians should consider this side effect of steroids especially when dealing with geriatric cases. Keywords: Hyperglycaemia, COVID-19, Steroids, SARS-CoV-2, Diabetes mellitus, Steroids induced diabetes, Glucocorticoids