JPMA. The Journal of the Pakistan Medical Association
-
Glycated haemoglobin is formed by simple chemical reaction between haemoglobin and blood glucose. It represents a reliable and moving average of blood glucose over preceding three months. In 2009 the International Expert Committee recommended the use of HbA1c to diagnose diabetes with a cut-off of 6.5%. ⋯ The DCCT reported significant reduction in retinopathy and nephropathy in T1DM, the follow up trial EDIC demonstrated 42% reduction in CVD with intensive reduction of HbAlc. This review is written to remind ourselves of the importance of this simple test which can predict early CV mortality in patients without prior CVD and poor prognosis in established cardiovascular disease. In a country like ours, Pakistan; where diabetes is prevalent with poor health awareness and limited resources, a test like HbA1c which costs Rs, 500.00 twice a year should be considered a cost effective way to avoid the long term diabetes complications, which once start unfolding put enormous burden on already stretched healthcare resources which could easily be avoided by intensive control of diabetes.
-
Review Case Reports
Pneumomediastinum and subcutaneous emphysema due to blunt neck injury: a case report and review of the literature.
Minor blunt neck injury from childhood trauma is a relatively common condition which can be potentially life-threatening in only rare circumstances. Pneumomediastinum may develop in up to 10% patients who have sustained blunt cervical or thoracic trauma and may be a significant cause of morbidity and mortality in affected individuals because of the associated damage to the oesophagus, larynx or trachea. ⋯ We present a paediatric blunt neck trauma accompanied by subcutaneous emphysema and pneumomediastinum secondary to a bicycle accident (neck striking the handlebar). Its radiologic appearance, clinical presentation, and the options for initial management in the emergency department (ED) are reviewed.