Successful management of diabetic foot ulceration (DFU) is crucial for preventing long-term morbidity and lowering risk of amputations. This can be achieved with a multifaceted approach involving a multidisciplinary team, with the patient at the centre. However, not all healthcare setups enable this, and the rate of lower limb amputations continues to rise. It is therefore time to consider new approaches to diabetic foot care, capitalising on engagement from patients in self-management while supported by their informal caregivers (ICGs) to help improve outcome. The role of ICGs in DFU care has the potential to make a significant difference in outcome, yet this resource remains, in most cases, underutilised. Limited research has been conducted in this area to reveal the true impact on patient outcomes and the caregivers themselves. This narrative review aims to explore how ICGs can benefit DFU management with applicability to different healthcare setups while benefiting from established experience in the care of other chronic health conditions.

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This is a qualitative case study on adult users of continuous subcutaneous insulin infusion. • Developing psychosocial evaluation prior to the initiation of insulin infusion would set expectations of therapy and help clinicians decide the eligibility of patients for insulin infusion. • Regular education should be provided by nurse educators to maintain the psychosocial wellbeing of patients who suffer from fear of pump malfunction. AbstractObjectives: We aimed to determine the quality of life (QoL) of Kuwaiti adults with type 1 diabetes mellitus (T1DM) who used continuous subcutaneous insulin infusions (CSIIs) and to understand their perception of this treatment. Background: CSII is an effective and safe alternative to multiple daily injections for T1DM, with the potential to improve both glycemic control and QoL. Although CSII has been widely used in Kuwait, its effectiveness and benefits have not been properly evaluated. Healthcare providers and patients need more information on CSII before its initiation. Methods: In this qualitative case study, semi-structured individual interviews were performed using a topic guide. Interviews were

Background:Kuwait has a high prevalence and incidence of type 1 diabetes (T1D). At present there is a need for structured educational programs (SEP) specifically tailored for Arabian youth with T1D. This SEP was locally and culturally adapted from the Kids In Control of Food (KICk-OFF) course delivered at the Dasman Diabetes Institute, Kuwait. Aims:To explore the psychological and social impact of a pilot SEP for Arabian youth with T1D and their mothers through exploring their respective perspectives. Methods:All 20 participants were interviewed using semistructured interviews individually, with a duration of approximately 30-45 min. The interviews were recorded and then transcribed verbatim. Data were analyzed using an inductive thematic approach. Results:The adolescents gained more self-confidence in managing their diabetes and their mothers were more confident in allowing their children take the lead in their diabetes self-management. Participants were empowered with adequate knowledge about the underlying pathophysiology of glucose metabolism and the nutritional and pharmacological management which made them feel in control and helped them to better cope with diabetes. It reduced diabetes-related family stress and gave them more social freedom, supporting behavioral change for a better lifestyle. Conclusions:Attending the adapted SEP had a positive impact on adolescents with T1D and their mothers through enhancement of their knowledge and confidence, thus giving them a sense of disease control. This pilot study has proven effective in terms of enhancement of confidence in diabetes management and psychosocial factors. Therefore, there is a need for a wider implementation.

One nucleotide substitution in codon 39 of HLA‐DRB4*01:01:01:01 results in a novel allele, HLA‐DRB4*01:44.

One nucleotide substitution in codon 90 of HLA‐C*16:02:01 results in a novel allele, HLA‐C*16:46.

Introduction: Hepatitis C virus (HCV) infection is a principal cause of mortality globally. About 170 million people were infected with HCV worldwide. Egypt's Ministry of Health and Population has released a nationwide strategy to address this pandemic. Sofosbuvir is a new combination of direct-acting antiviral drugs that doesn't require addition of interferon and is an effective alternative to interferon. The systemic effects of Sofosbuvir are being investigated nowadays; however, there aren't enough studies on its impact on oral health yet. Aim of the study:To investigate the effect of Sofosbuvir on buccal mucosa in Albino rats.Materials and Methods: Twenty-eight Adult male albino rats were randomly divided into two main groups, fourteen rats each. Each group was furtherly subdivided into two subgroups A & B according to the time of sacrifice which was 45 and 60 days respectively. Control group (GroupI) was given distilled water daily by gastric tube, and experimental group (GroupII) was given Sofosbuvir (40 mg/kg/day) dissolved in distilled water by gastric tube. Specimens were examined histologically and immunohistochemically.Results: Group II showed vacuolization in the epithelium and signs of degeneration in both epithelium and connective tissue. Immunohistochemical results of GroupI showed strong positive nuclear immunoreactivity for Ki-67 in the epithelial cells and lamina propria, however GroupII showed weak nuclear immunoreactivity for Ki-67. Statistical results showed significant decrease in Ki-67 positive area percentage of SubgroupIIB when compared to SubgroupIIA. Conclusion:Sofosbuvir administration resulted in degenerative changes in buccal mucosa and affected its proliferation, which was time dependent.

Background: Kuwait is the second highest country in the incidence of T1D globally. Familial study of this disease may disclose certain causative agents responsible for passing the disease through families. The recruitment of T1D patients and their family members to participate in a Kuwaiti autoimmune diabetes (KADS) Study was challenging. It is a longitudinal study, it required taking blood samples every 6 months for 3 years duration for all family members of a person with diabetes. It is important to note that, in Kuwait, convincing families to participate in researches were an extremely difficult task which needs a highly skilled personal to persuade family participations. Aim: This abstract aimed to examine different recruitment approaches which were used and highlights the role of diabetes educators (DE) in the recruitment process. Method: Three recruitment approaches were examined.1-Physician-approach; recruitment took place through their physicians follow up visit.2-Research coordinator (RC) approach recruitment took place in the clinic area. While patient is waiting for his medical appointment the research coordinator offers participating in the research.3-DE approach Recruitment took place through their educator follow up visit. Results: Physicians were able to recruit 22 participants, but none of them completed the process of participation. While the RC could not recruit any participants. However, the DEs were able to recruit 274 participants. Conclusion: Although the Kuwaiti families are generally obedient to their doctors, the physician were not able to recruit only few participants for this study. In contrast, the prolonged pre-established good relationship between the patient, family and the DE resulted in mutual trust and facilitated the process of recruitment. Hence, more subjects were recruited compare to the physician and the RC approaches. Thus, the DE approach was proved to be a successful approach to recruit people for researches. Disclosure Z. Rahme: None. N.A. Taha: None. N. Mesbah: None.