IMPACT : Issue 5

Content - Chairman\u27s Message - During 2014 Your Donations Helped Countless Patients - You Never Walk Alone - Hepatitis : The Silent Killer - First Successful Surgery To Separate Conjoined Twins - With Gratitude To Our Benefactors and Partnershttps://ecommons.aku.edu/impact/1004/thumbnail.jp

IMPACT : Issue 6

Content - Chairman\u27s Message - Light Upon Light - Mending Hearts - APPNA: “It is all about service and giving back.” - “The Aga Khan University is a blessing in this country - S.M. Pervezhttps://ecommons.aku.edu/impact/1005/thumbnail.jp

IMPACT : Issue 2

Content - Update From The Chairman’s Desk - The Difference We Made in 2012 - Assisting in a Miracle - By Helping Another, Our Own Burden Is Lightened : Mrs Talat Dehlavi - All I Want is to Go Back to School - We Give Zakat Purely to Please Allah : S.M. Muneerhttps://ecommons.aku.edu/impact/1001/thumbnail.jp

IMPACT : Issue 4

Content - Chairman’s Message - Distribution of Patients Assisted by PBS - Where There is Life There is Hope : Shaukat Qasim Agaria - Happenings - Dean, Medical College Comes on Board - Department of Oncology - Advancement, innovation and quality : Interview with Mr Moin Fuddahttps://ecommons.aku.edu/impact/1003/thumbnail.jp

Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence.

BackgroundWe hypothesize that depression in type 2 diabetes might be associated with poor glycemic control, in part due to suboptimal self-care. We tested this hypothesis by examining the associations of depression with clinical and laboratory findings in a multicenter survey of Chinese type 2 diabetic patients.Method2538 patients aged 18-75 years attending hospital-based clinics in four cities in China underwent detailed clinical-psychological-behavioral assessment during a 12-month period between 2011 and 2012. Depression was diagnosed if Patient Health Questionnaire-9 (PHQ-9) score ≥10. Diabetes self-care and medication adherence were assessed using the Summary of Diabetes Self-care Activities and the 4-item Morisky medication adherence scale respectively.ResultsIn this cross-sectional study (mean age: 56.4 ± 10.5[SD] years, 53% men), 6.1% (n = 155) had depression. After controlling for study sites, patients with depression had higher HbA(1c) (7.9 ± 2.0 vs. 7.7 ± 2.0%, P = 0.008) and were less likely to achieve HbA(1c) goal of <7.0% (36.2% vs 45.6%, P = 0.004) than those without depression. They were more likely to report hypoglycemia and to have fewer days of being adherent to their recommended diet, exercise, foot care and medication. In logistic regression, apart from young age, poor education, long disease duration, tobacco use, high body mass index, use of insulin, depression was independently associated with failure to attain HbA(1c) target (Odds Ratio [OR] = 1.56, 95%CI:1.05-2.32, P = 0.028). The association between depression and glycemic control became non-significant after inclusion of adherence to diet, exercise and medication (OR = 1.48, 95% CI 0.99-2.21, P = 0.058).ConclusionDepression in type 2 diabetes was closely associated with hyperglycemia and hypoglycemia, which might be partly mediated through poor treatment adherence

Extended thromboprophylaxis with betrixaban in acutely ill medical patients

BACKGROUND: Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. METHODS: Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding. RESULTS: A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55). CONCLUSIONS: Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218.)

Treating patients as persons : a capabilities approach to support delivery of person-centered care

Peer reviewedPublisher PD

IMPACT : Issue 12

Content: - From the Leadership - Hear his Plea - Hepatitis B and C : The Silent Killer - With Gratitude to our Partners and Supportershttps://ecommons.aku.edu/impact/1010/thumbnail.jp

IMPACT : Issue 13

Content: - I am a hero! - The hero - Enjoy the colors of life: a party for children with cancer - Events - Our Membershttps://ecommons.aku.edu/impact/1012/thumbnail.jp