Journal of Advance Medical Sciences

Parents’ education and dental health in children with type 1 diabetes mellitus

2026-04-27T11:24:25+00:00

Aim: To assess influence of parents’ education levels on the dental health among their children with type 1 diabetes mellitus (T1DM).

Methods: A cross-sectional study was conducted in Benghazi-Libya included diabetic children aged 4-15 years. Data were collected via a clinical dental examination and questionnaire survey completed by parents. The study targeted diabetic children, with a minimum sample size of 151 participants determined at a 95% confidence level. Clinical examination was performed using the DMFT/dmft index according to WHO criteria. The data were logged and analyzed using IBM-SPSS for Windows version 29.0 (SPSS Inc., Chicago, IL). Frequencies and percentages were measured to assess the influence of parental education on the dental health of their children.

Results: Clinical examination revealed a high prevalence of dental caries in both primary (56.5%, mean dmft 2.31) and permanent dentitions (54.5%, mean DMFT1.63). The mean dmft is decreased among children of university educated mothers than of non-university educated mothers. These differences were statistically significant. However, the mean dmft was higher among children of university educated fathers than of non-university educated fathers. These differences were not statistically significant.

Conclusion: This study displayed a high prevalence of dental caries among children with type 1 diabetes mellitus in Benghazi. The present study showed that a high parents’ educational level does not directly subscribe to good oral health care for their children. The parents need further attention by presenting more programs dealing with dental health which will be useful in improving their children’s oral health.

Exercise-induced ischemia in newly diagnosed asymptomatic type 2 diabetes mellitus patients: a prospective observational study

2026-04-30T13:19:22+00:00

Background: Cardiovascular disease remains the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Coronary artery disease in diabetes may remain clinically silent until advanced stages because of autonomic dysfunction, altered pain perception, and diffuse atherosclerosis. Early recognition of occult ischemia may permit timely preventive intervention.

Objective: To determine the prevalence of exercise-induced ischemia using treadmill exercise testing in newly diagnosed asymptomatic T2DM patients and to identify associated clinical predictors.

Methods: This prospective observational study enrolled 200 newly diagnosed asymptomatic T2DM patients with normal resting electrocardiograms and no known coronary artery disease. All patients underwent detailed clinical evaluation, biochemical investigations, lipid profile assessment, and treadmill stress testing using the Bruce protocol.

Results: Of the 100 participants, 63% were male and 37% were female. The majority belonged to the 41–50 year age group. Mean body mass index was 24.71 ± 3.42 kg/m². Mean fasting blood glucose was 181.74 ± 33.80 mg/dL, postprandial blood glucose 229.35 ± 57.92 mg/dL, and HbA1c 8.63 ± 1.22%. Positive treadmill stress testing suggestive of exercise-induced ischemia was observed in 2% patients. HbA1c was significantly higher in treadmill-positive patients compared with treadmill-negative patients.

Conclusion: Exercise-induced ischemia was uncommon in newly diagnosed asymptomatic T2DM patients. Poor glycemic control was significantly associated with positive stress testing. Selective rather than universal screening may be more appropriate in this population.

Utility of NT-proBNP in predicting short-term outcomes in acute exacerbation of COPD without overt cardiac involvement

2026-06-21T12:28:29+00:00

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with substantial morbidity, mortality, prolonged hospitalization, and increased healthcare burden. Early identification of high-risk patients remains a clinical challenge because the severity of exacerbations often varies widely between individuals. Biomarkers capable of predicting disease severity and adverse outcomes may help optimize triage and management strategies. N-terminal pro–B-type natriuretic peptide (NT-proBNP), a marker released in response to myocardial wall stress, has been shown to rise in AECOPD even in the absence of overt cardiac disease due to hypoxia, pulmonary hypertension, and right ventricular strain^[1-4].

Objectives: To evaluate the association between NT-proBNP levels and short-term adverse clinical outcomes in patients admitted with AECOPD without overt cardiac involvement, and to determine its predictive utility for ICU admission and ventilatory support.

Methods: This cross-sectional observational study included 90 consecutive patients admitted with AECOPD between July 2024 and June 2025. Patients with known heart failure, ischemic heart disease, significant valvular heart disease, cardiomyopathy, severe renal dysfunction, or echocardiographic evidence of cardiac dysfunction were excluded. NT-proBNP levels were measured at admission along with arterial blood gas (ABG) parameters and inflammatory markers. Outcomes assessed included ICU admission, need for ventilatory support, duration of ICU stay, and total hospital stay. Statistical analysis included Chi-square test, Mann–Whitney U test, Spearman correlation analysis, and receiver operating characteristic (ROC) curve analysis.

Results: The mean age of the study population was 65 years, with males comprising 69% of participants. ICU admission was required in 50% of patients, while 47.8% required ventilatory support. Median NT-proBNP level was 306.5 pg/mL. Higher NT-proBNP levels were significantly associated with ICU admission, ventilatory support, prolonged ICU stay, and longer hospital stay (p < 0.0001). NT-proBNP also showed significant correlations with worsening ABG parameters, including lower pH, higher PaCO₂, and lower PaO₂. ROC analysis demonstrated strong predictive performance, with an AUC of 0.87 for ICU admission at a cutoff of 452 pg/mL and an AUC of 0.84 for ventilatory support at a cutoff of 274 pg/mL.

Conclusion: NT-proBNP is a strong independent predictor of short-term adverse outcomes in AECOPD patients even in the absence of overt cardiac disease. Elevated NT-proBNP levels reflect physiological severity and may serve as a valuable biomarker for early risk stratification, clinical decision-making, and resource allocation in patients presenting with AECOPD.