Prevalence and risk factors of albuminuria in Type 2 diabetes in Bahrain.

Microalbuminuria is the earliest sign of diabetic nephropathy, and is a marker of increased diabetic cardiovascular morbidity and mortality. We investigated the prevalence of albuminuria and associated risk factors among Type 2 diabetes (T2DM) patients, who were attending diabetes clinics at primary healthcare facilities in Bahrain. This was a cross-sectional study on 712 adult T2DM Bahraini patients screened for albuminuria using albumin:creatinine ratio test (ACR), in 9 selected primary healthcare centers in Bahrain in the period February-March 2006. Of the 702 participants, 196 (27.9%) were albuminuric. The prevalence of microalbuminuria (ACR>3.4 mg albumin/mmol creatinine) and macroalbuminuria (protein:creatinine ratio >22 mg protein/ mmol creatinine) were 22.0% (no.=155) and 5.8% (no.=41), respectively. Univariate analysis demonstrated significant associations between albuminuria and older age (>65 yr), longer duration of diabetes, high glycated hemoglobin (HbA1c), elevated triglycerides, total- and LDL-cholesterol, systolic (>160 mmHg) and diastolic (>90 mmHg) blood pressure (BP), and retinopathy. Multivariate regression analysis showed that high HbA1c, higher systolic BP, and long duration of diabetes, were significant predictors of albuminuria, while older age, male gender, and higher triglycerides were borderline predictors. Albuminuria in Bahraini T2DM patients was related to poor glycemic control, higher systolic BP, and longer duration of diabetes. Effective preventive and control strategies of those factors should be urgently implemented.

Oral manifestations of Beckwith-Wiedemann syndrome.

A report of case of a patient with Beckwith-Wiedemann syndrome is presented. The macroglossia associated with the syndrome necessitated long-term dental follow-up to prevent and treat problems with occlusion, speech, and esthetic appearance that might develop. Early intervention might be required if feeding or respiratory difficulties, resulting from the macroglossia, arise. The diagnosis of the syndrome should alert the dentist to the increased incidence of intra-abdominal malignancies and the need for periodic observation.

Splint therapy for electrical burns of the oral commissure in children.

Electrical burns of the oral cavity are relatively rare; a case is reported here. An acrylic splint fabricated for the patient helped prevent microstomia and the subsequent development of a deformity.

Thrombocytopenic purpura secondary to quinidine hypersensitivity.

A case of quinidine-induced thrombocytopenic purpura is reported. The patient had been previously sensitized and developed oral bleeding. On repeated ingestion of the drug, he developed classic oral manifestations of the hemorrhagic disease and sought dental treatment. Identification and withdrawal of the drug reversed the clinical and hematologic symptoms.

Submandibular space abscess due to Actinobacillus actinomycetemcomitans.

A submandibular space abscess is reported in which a pure culture of Actinobacillus actinomycetemcomitans was identified. The bacterium may often be overlooked as a pathogen due to its slow growth and its requirement for carbon dioxide for primary isolation. As A. actinomycetemcomitans is often resistant to commonly used antibiotics, proper management is based on careful utilization of microbiologic tests and clinical judgement. In this case prompt surgical drainage and appropriate antibiotic therapy resolved the abscess.

Adult benign granular cell tumor of the maxilla.

A granular cell tumor occurred in the right anterior maxilla of a 22-yr-old black man. It involved the right labial maxillary submucosa and the underlying bone. It also invaded the maxillary sinus and the nasal cavity on the same side. The ultrastructural features of the lesion confirmed the biopsy diagnosis of benign granular cell tumor. The treatment involved partial maxillectomy, split thickness skin graft and immediate dental prosthesis.