Aim:The objective of this study is to correlate microalbumin and sialic acid levels with anthropometric variables in type 2 diabetic patients with and without nephropathy. Methods: This study was a case control study and included 108 Trinidadian subjects (aged 15-60 years) of which 30 were healthy individuals, 38 had type 2 diabetes, and 40 were of type 2 diabetic patients with nephropathy. Blood pressure and waist to hip ratio were recorded. Fasting venous blood samples and urine samples were collected from all the subjects. Blood samples were analysed for the glucose, C-reactive protein, and sialic acid. Urine sample was analysed for microalbumin and sialic acid. Results: Urinary microalbumin was higher among diabetic subjects (28.9 ± 30.3 mg/L) compared with controls (8.4 ± 10.2 mg/L) and was signifi cantly higher in diabetic patients with nephropathy (792.3 ± 803.9 mg/L). Serum sialic acid was higher in subjects with diabetic nephropathy (71.5 ± 23.3 mg/dL) compared to diabetics (66.0 ± 11.7 mg/dL) and controls (55.2 ± 8.3 mg/dL). Increased microalbumin and sialic acid were correlated with other cardiovascular risk factors such as hypertension and waist to hip ratios (p Ͻ 0.05). Conclusions: From these results it can be concluded that the increased microalbumin and sialic acid were strongly correlated with hypertension and waist to hip ratios in Trinidadian type-2 diabetic patients. Measurement of sialic acid, microalbumin, and waist to hip ratio along with the blood pressure is recommended for all type 2 diabetic patients to reduce the cardiovascular risk.
Background There is limited data on access to radiotherapy services for CARICOM nations. Methods This was a descriptive mixed-methods observational study which used data collected via survey from staff working in Radiation Oncology in 14 CARICOM countries. Benchmark recommendations from the International Atomic Energy Agency were compared to existing numbers. The Directory of Radiotherapy Centers, World Bank, and Global Cancer Observatory databases were all accessed to provide information on radiotherapy machines in the region, population statistics, and cancer incidence data respectively. Both population and cancer incidence-based analyses were undertaken to facilitate an exhaustive review. Results Radiotherapy machines were present in only 50% of the countries. Brachytherapy services were performed in only six countries (42.9%). There were a total of 15 external beam machines, 22 radiation oncologists, 22 medical physicists, and 60 radiation therapists across all nations. Utilizing patient-based data, the requirement for machines, radiation oncologists, medical physicists, and radiation therapists was 40, 66, 44, and 106, respectively. Only four (28.6%) countries had sufficient radiation oncologists. Five (35.7%) countries had enough medical physicists and radiation therapists. Utilizing population-based data, the necessary number of machines, radiation oncologists, and medical physicists was 105, 186, and 96 respectively. Only one county (7.1%) had an adequate number of radiation oncologists. The number of medical physicists was sufficient in just three countries (21.4%). There were no International Atomic Energy Agency population guidelines for assessing radiation therapists. A lower economic index was associated with a larger patient/population to machine ratio. Consequentially, Haiti had the most significant challenge with staffing and equipment requirements, when compared to all other countries, regardless of the evaluative criteria. Depending on the mode of assessment, Haiti’s individual needs accounted for 37.5% (patient-based) to 59.0% (population-based) of required machines, 40.1% (patient-based) to 59.7% (population-based) of needed radiation oncologists, 38.6% (patient-based) to 58.3% (population-based) of medical physicists, and 42.5% (patient-based) of radiation therapists. Conclusion There are severe deficiencies in radiotherapy services among CARICOM nations. Regardless of the method of comparative analysis, the current allocation of equipment and staffing scarcely meets 50% of regional requirements.
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