Innovative health informatics as an effective modern strategy in diabetes management: a critical review.

OBJECTIVE: Diabetes mellitus is the most common metabolic disorder in developing countries. Mobile health applications are helpful in improving the diabetes management. However, the effectiveness of these techniques needs to be assessed rigorously. Therefore, the authors have systematically reviewed the recent clinical studies using mobile health applications for diabetes management. MATERIALS AND METHODS: Original articles that were published in ISI indexed journals listed in PubMed from the year 2007 till 2014 were searched using specific search key phrases. The intervention technology and study methodology were analysed to have a better understanding of the outcomes of each study. RESULTS: Twenty-one articles were selected for the review. Most studies (76%) reported positive outcomes after use of the mobile health applications. Smartphone apps significantly improved the clinical outcomes. User-friendliness of the systems often influence the patient compliance and the clinical outcomes. CONCLUSION: Smartphone/web applications offer significant benefits for patient care, education and behavioural modifications. Providing a continuous patient support using mobile may be a challenging task and would require adequate infrastructure and personnel.

Prevalence of urinary tract infection and risk factors among Saudi patients with diabetes.

PURPOSE: The aim of this study is to assess the prevalence of urinary tract infection (UTI) and its risk factors among Saudi diabetics. METHOD: A total of 1,000 diabetic patients were included. Patients were interviewed and examined at each visit every 6 months. RESULTS: The prevalence of UTI was 25.3 % in total diabetic population and 7.2 and 41.1 % in males and females, respectively. Females have highest risk of UTI (RR = 6.102; CI = 4.343-8.573; P < 0.001). Age, duration of diabetes and HbA1c did not influence the incidence of UTI, while BMI above 30 kg/m(2) increased the risk (RR = 1.722; CI = 1.532-1.935; P < 0.001). The incidence of UTI in both type 1 and 2 diabetics was similar (23.7 and 25.6 %). There was no significant risk in patients aged above 60 years (RR = 1.054; CI = 0.841-1.321; P = 0.651). The risk factors found to be associated with UTI were hypertension (RR = 1.202; CI = 1.061-1.361; P = 0.006), insulin therapy (RR = 1.411; CI = 1.262-1.578; P < 0.001) and nephropathy (microalbuminuria) (RR = 1.417; CI = 1.036-1.939; P = 0.031). CONCLUSION: The present study has shown that prevalence of UTI is more in diabetic females and diabetics with BMI above 30 kg/m(2). The other risk factors associated with UTI in general diabetic population were found to be microalbuminuria, hypertension and insulin therapy.

Clinico-laboratory characteristics of diabetic keto acidosis in adults in a tertiary hospital in Saudi Arabia.

OBJECTIVE: The present study is undertaken to evaluate the magnitude of DKA in Saudi population with specific emphasis on clinical laboratory characteristics over 20 years. MATERIAL AND METHODS: A prospective analysis of hospital records of 240 episodes of DKA requiring inpatient admission from December 1985 to December 2005 in adult patients in a tertiary hospital was performed. Besides the demographic data of the patients, the clinico-laboratory parameters relevant to the diabetes and DKA status were thoroughly reviewed. RESULTS: 150 males and 90 females were admitted with DKA with a mean age of 21.77 +/- 7.2 years. 16.6% (n=40) were diagnosed to have DM for the first time and others had a mean duration of DM of 5.02 +/- 4.88 years with an average daily insulin requirement being 45.09 +/- 23.9 units. 80.4% of the DKA episodes occurred in intermediate, secondary school and University level students. The commonest precipitating factors were missed insulin doses (51.2%) and respiratory tract infections (22.5%). The mean duration of stay in the hospital was 6.56 +/- 3.4 days and there were no deaths reported because of DKA. The mean blood sugar on presentation was 23.49 +/- 8.3 mmol/L whereas the mean pH and bicarbonate levels on presentation were 7.21 +/- 0.1 and 14.7 +/- 4.3 meq/L respectively. Blood pH was found to be significantly lower in female patients. Among patients below 20 years of age, females have significantly lower bicarbonate levels (11.7 +/- 6.2). Among patients above 20 years of age females had significantly longer duration of diabetes (8.86 +/- 8.36 years; p < 0.04). CONCLUSIONS: By providing intensive education and increasing the awareness of DKA, a major reduction in morbidity and hospitalizations due to DKA may be expected.

Simple and rapid method for the isolation of forskolin from Coleus forskohlii by charcoal column chromatography.

A simple, safe, rapid and economical method was developed for the isolation of high-purity forskolin from Coleus forskohlii roots using activated charcoal as an adsorbent in a column. The elution was carried out under reduced pressure to make the process rapid. Activated charcoal acted as a reversed phase adsorbent and allowed elution of forskolin without much impurities. The residue, obtained from the eluate was purified and crystallized using different solvent mixtures to obtain pure forskolin. The forskolin isolated was analyzed and characterized by UV, IR, RP-HPLC, electrospray ionization MS, 1H NMR and 13C NMR. The yield was 0.097% w/w (RSD 5.6%). The purity was 96.9% w/w (RSD 0.3%) as determined by RP-HPLC. The present method enables researchers to produce high-purity forskolin in their labs by using common chemicals.

A validated HPTLC method for determination of tea tree oil from cosmeceutical formulations.

A HPTLC method has been developed and validated for the determination of tea tree oil from cosmeceutical formulations. Tea tree oil concentration was estimated by analyzing the terpinen-4-ol content. The method employed TLC aluminium plates precoated with silica gel 60F-254. The solvent system consisted of toluene and ethyl acetate in the ratio 85:15. The calibration curve of terpinen-4-ol was linear in the range of 100-900 ng. The polynomial regression data for the calibration plots showed a good linear relationship with r(2)=0.9949. The Rf value of terpinen-4-ol was found to be 0.62+/-0.05. The method was validated for precision and accuracy. The minimum detectable amount was found to be 60 ng. The limit of quantitation was found to be 100 ng. The drug content was within the limits (+/-5% of the labeled content of the formulations). The recovery of tea tree oil was greater than 99%. The method was found to be simple, sensitive, precise, accurate and specific for estimation of tea tree oil from formulations.