A population-based cohort study of symptomatic gallstone disease in diabetic patients

AIM:To investigate the prevalence of gallstone dis-ease(GSD) and to evaluate the risk of symptomatic GSD among diabetic patients.METHODS:The study was conducted by analyzing the National Health Research Institutes(NHRI) dataset of ambulatory care patients,inpatient claims,and the updated registry of beneficiaries from 2000 to 2008.A total of 615 532 diabetic patients without a prior history of hospital treatment or ambulatory care visits for symptomatic GSD were identified in the year 2000.Age-and gender-matched control individuals free from both GSD and diabetes from 1997 to 1999 were randomly selected from the NHIR database(n = 614 871).The incidence densities of symptomatic GSD were estimated according to the subjects' diabetic status.The distributions of age,gender,occupation,income,and residential area urbanization were compared between diabetic patients and control subjects using Cox proportion hazards models.Differences between the rates of selected comorbidities were also assessed in the two groups.RESULTS:Overall,60 734 diabetic patients and 48 116 control patients developed symptomatic GSD and underwent operations,resulting in cumulative operation rates of 9.87% and 7.83%,respectively.The age and gender distributions of both groups were similar,with a mean age of 60 years and a predominance of females.The diabetic group had a significantly higher prevalence of all comorbidities of interest.A higher incidence of symptomatic GSD was observed in females than in males in both groups.In the control group,females under the age of 64 had a significantly higher incidence of GSD than the corresponding males,but this difference was reduced with increasing age.The cumulative incidences of operations for symptomatic GSD in the diabetic and control groups were 13.06 and 9.52 cases per 1000 person-years,respectively.Diabetic men exhibited a higher incidence of operations for symptomatic GSD than did their counterparts in the control group(12.35 vs 8.75 cases per 1000 person-years).CONCLUSION:The association of diabetes with increased symptomatic GSD may provide insight to the treatment or management of diabetes in clinical settings.

Cost of Treatment of Chronic Spontaneous Urticaria in Turkey

Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system and society. The aim of this research is to estimate the cost of mild, moderate and severe CSU in Turkey and to forecast the cost of the disease from the payer (Social Security Institution—SSI) perspective. Expert opinions with Delphi technique were used in order to determine the cost items and their frequency. A questionnaire was designed to outline resources used in the out-patient, inpatient and emergency care episodes and was answered by dermatologists followed by a consensus meeting. Unit costs were calculated from the price list of the SSI. The annual total cost of treating the disease to the SSI was estimated as 262,111,978TL (94,417,870€) comprising 0.06% of the total healthcare budget in 2013. Since there is limited information about the cost of CSU in Turkey, the methodology and results of this study are unique and very important.

The phytochemical,proximate,pharmacological,GC-MS analysis of Cyperus esculentus(Tiger nut):A fully validated approach in health,food and nutrition

Cyperus esculentus(Tiger nut)has been grossly underutilized and unexploited despite its nutritional and medicinal potentials.This research aimed to evaluate the phytochemical,proximate,GC-MS and pharmacological properties such as antioxidant,anticancer,anti-elastase,anti-melanogenic and anti-tyrosinase activity in ethanol and n-hexane extracts of tiger nut.The pharmacological activities were measured using spectrophotometry,agar well diffusion,MCF-7 and HeLa cell methods.The tiger nut extracts(ethanol and n-hexane)in the phytochemical and proximate analysis showed the existence of bioactive compounds such as alkaloids,glycosides,flavonoids,crude fibres,tannins,proteins,carbohydrates,oxalates,phytates and fats content.The ethanol extract showed superior pharmacological(anticancer,antibacterial,anti-melanogenic and antioxidant)activities,especially against the MCF-7 cell line.The results for scavenging activity of ethanol extract(IC_(50)=535.57μg/mL)showed significant differences(p<0.05)when compared with n-hexane extract(IC_(50)=645.5μg/mL).The GC-MS assessment of both extracts showed the existence of bioactive compounds.Different concentrations(100,200 and 350 mg/mL)of tiger nut extracts against Shigella sp.,Salmonella sp.,Staphylococcus aureus and Escherichia coli demonstrated the highest level of inhibitions at 350 mg/mL.The findings of the current research showed that tiger nut has a high content of nutrients and bioactive phytochemicals.