Association between diabetes-related distress and glycemic control in primary care patients with Type 2 diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Egypt.

BACKGROUND: Diabetes-related distress and glycemic control are of a particular concern to primary care physicians because of the impact of the coronavirus disease 2019 pandemic on diabetic patients' lifestyle, psychological well-being and healthcare access. Our aim was to evaluate the relationship between diabetes-related distress and glycemic control in diabetic patients with Type 2 diabetes mellitus (T2DM) in primary care settings during the pandemic. MATERIALS AND METHODS: This cross-sectional study was conducted at primary healthcare clinics in a rural area in Egypt among 430 patients with T2DM during the period from September 2020 to June 2021. All patients were interviewed for their sociodemographic, lifestyle, and clinical characteristics. Diabetes-related distress was measured by the problem areas in the diabetes scale (PAID), where a total score of ≥40 indicated a severe diabetes-related distress. The most recent glycosylated hemoglobin (HbA1c) measurements were used to indicate the glycemic control. Quantile regression model (0.50 quantile) was used to perform the multivariate analysis to identify significant factors associated with HbA1c level. RESULTS: Most of the participants had a suboptimal glycemic control (92.3%), while 13.3% had severe diabetes-related distress. HbA1c level was significantly and positively correlated with the total PAID score and all its sub-domains. Multivariate quantile regression revealed that obesity, multi-morbidity, and severe diabetes-related distress were the only significant determinants of the HbA1c median level. Obese patients had significantly higher median HbA1c compared to patients who were not obese (coefficient = 0.25, P < 0.001). Patients with two or more comorbidities (i.e., multimorbidity) had a significantly higher median HbA1c than patients with single or no chronic comorbidities (coefficient = 0.41, P < 0.001). Severe diabetes-related distress was significantly associated with higher median HbA1c compared to nonsevere diabetes-related distress (coefficient = 0.20, P = 0.018). CONCLUSION: Diabetes-related distress had a significant association with HbA1c level. Family physicians should implement multifaceted programs to optimize diabetes control and reduce any associated distress.

Mental Health of LGBTQ Individuals Who are Arab or of an Arab Descent: A Systematic Review.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at a higher risk of mental illness when compared to their heterosexual and cisgender counterparts. Most research emanates from Western countries, with a paucity of studies in the Arab world. We systematically reviewed studies assessing the mental health of LGBTQ individuals who live in the Arab world or are of Arab descent. Of 261 articles, seven were eligible for analysis. Depression was the most common psychiatric disorder. Suicidal ideations and attempts were frequent in trans women. Post-traumatic stress disorder was also common, with the majority of precipitating traumatic events being related to sexual orientation and/or gender identity. Societal and familial stressors in the Arab culture are major contributors to the increased vulnerability of the LGBTQ community to mental health challenges. Further research is of utmost need while taking into consideration the Arab socio-cultural context.

Association between Cannabis Use Disorder and Self- and Other-Directed Aggression.

Cannabis is the most widely used drug worldwide. Data about the association of cannabis use with aggression is heterogeneous. The objective of the current study was to assess the nature of the association between cannabis use disorder (CUD) and self-directed, other-directed, and combined aggression. We used data from the National Survey on Drug Use and Health across 2008 to -2014, with a pooled sample of 270,227 adult respondents. We used regression models to estimate the odds ratios (ORs) for those having CUD perpetrating each form of aggression compared with no aggression and other-directed compared with self-directed aggression. CUD was associated with significantly increased odds of committing other-directed (adjusted OR [aOR] = 1.42, 95 percent CI = 1.26-1.60) and combined aggression (aOR = 2.11, 95 percent CI = 1.36-3.26) compared with no aggression. CUD was associated with a nonstatistically significant risk of other-directed compared with self-directed aggression (aOR = 1.29, 95 percent CI = .97-1.69). In those 18 to 25 years old, CUD was significantly associated with an increased differential risk of other-directed versus self-directed aggression (aOR = 1.29, 95 percent CI = 1.03-1.62). Cannabis use disorder seems to increase the risk of other-directed aggression compared with self-directed aggression, especially among youths.

Psychological distress experienced by physicians and nurses at a tertiary care center in Lebanon during the COVID-19 outbreak.

The COVID-19 outbreak has had a significant mental health toll on healthcare workers in Lebanon. We examined pandemic-related psychological distress among healthcare workers in a tertiary care medical center. One hundred and fifty participants completed an online questionnaire. About half showed a high risk of acute distress (58.7%) on the GHQ-28, while most (89.3%) scored low/moderate stress on the PSS-10. The IES-R revealed concern for post-traumatic stress in one-third of participants, significantly in nurses (p = 0.008) and those living with vulnerable individuals (p = 0.030). Mental health history did not increase the risk. Our findings highlight the need for early targeted interventions during the pandemic.

Elevation of Pro-inflammatory and Anti-inflammatory Cytokines in Rat Serum after Acute Methamphetamine Treatment and Traumatic Brain Injury.

The use of methamphetamine (METH) is a growing worldwide epidemic that bears grave societal implications. METH is known to exert its neurotoxic effects on the dopaminergic and serotonergic systems of the brain. In addition to this classical studied mechanism of damage, findings from our laboratory and others have shown that acute METH treatment and mechanical injury, i.e. traumatic brain injury (TBI), share common cell injury mechanism(s). Since neuro-inflammation is a signature event in TBI, we hypothesize that certain cytokine levels might also be altered in rat brain exposed to an acute METH insult. In this study, using a cytokine antibody array chip, we evaluated the serum levels of 19 cytokines in rats 24 h after exposure to a 40 mg/kg acute regimen of METH. Data were compared to rats subjected to experimental TBI using the controlled cortical impact (CCI) injury model and saline controls. Sandwich ELISA method was used to further validate some of the findings obtained from the antibody cytokine array. We confirmed that three major inflammatory-linked cytokines (IL-1ß, IL-6, and IL-10) were elevated in the METH and TBI groups compared to the saline group. Such finding suggests the involvement of an inflammatory process in these brain insults, indicating that METH use is, in fact, a stressor to the immune system where systemic involvement of an altered cytokine profile may play a major role in mediating chemical brain injury after METH use.