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The aim of the present study was to evaluate the prevalence of subclinical and clinical systemic lymphedema in patients with lipedema and different body mass index (BMI) values.

A cross-sectional study was conducted to determine the prevalence of subclinical systemic lymphedemaand clinical lymphedema of the lower limbs detected by bioimpedance (InBody S10 device, Seoul, Korea) in 258 women with clinically diagnosed lipedema. The patients were divided into three groups based on BMI Group I - BMI below 30 kg/m

 ; Group II - BMI between 30 and 40 kg/m

 ; and Group III - BMI 40 to 50 kg/m

.

Fisher's exact test revealed a statistically significant difference between Group I and both Groups II and III (p = 0.0001) regarding the occurrence of lower limb lymphedema.

Patients with lipedema can develop edema even when their weight is within the standards of normality. However, obesity is an aggravating factor, as the prevalence of lipedema increases progressively with the increase in weight.

Patients with lipedema can develop edema even when their weight is within the standards of normality. However, obesity is an aggravating factor, as the prevalence of lipedema increases progressively with the increase in weight.Background Chronic diseases require long-term medication and adherence to medication is important for the control of disease as well as prevention of complications. Non-compliance may lead to worsening of the disease, which may affect patients' quality of life. This study aimed to assess the level of medication adherence and its association with quality of life (QOL) among hypertensive patients in Buraidah, Saudi Arabia. Methods A cross-sectional study was carried out in which 299 hypertensive patients were recruited from the randomly selected primary health care centers. Medication adherence was assessed by Hill-Bone Medication Adherence Scale, and quality of life was assessed by the World Health Organization's Quality of Life (WHOQOL)-BREF. Multivariate linear regression was used to assess the association of medication adherence with quality of life. Data was analyzed using SPSS version 21.0 (IBM Inc., Armonk, USA). Results The prevalence of poor adherence was found to be 38.8%. We did not find a significant association of medication adherence with any of the four (physical, psychological, social relationship, and environmental) domains of WHOQOL-BREF. However, poor medication adherence was associated with poor perceived overall QOL adjusted β=-0.012 (95% confidence interval [CI] -0.021 to -0.002; p=0.018) and health adjusted β=-0.013 (95% CI -0.025 to -0.002; p less then 0.018). Conclusion We found a high prevalence of non-adherence among hypertensive patients. This calls for developing interventions to improve compliance with medications to prevent complications of hypertension. Our study could not find a significant association of medication adherence with any of the domains of QOL, while poor adherence was associated with lower overall perceived QOL and health. Nonetheless, worsening of disease due to non-adherence may affect the QOL of patients. We recommend large scale prospective studies to explore the relationship between medication adherence and QOL.Background Surgical site infection (SSI) after cardiac surgery is a major concern. A limited number of studies have addressed the relationship of preoperative glycemic control on the risk of developing SSI after cardiac surgery. We aim to determine the incidence, microbiological pattern, and impact of preoperative hemoglobin A1C (Hgb A1C) on the development of SSI after cardiac surgery. Methods This is a single-center retrospective chart review that was performed on adult patients undergoing cardiac surgery from January 2017 to December 2018. Results Two hundred and twenty-nine patients underwent 233 procedures. The median age was 60 years; 71% males, 64% were diabetic, and 67% had a Hb A1C above 7% preoperatively. Around 7% of patients developed deep SSI. For patients that developed SSI, 63% had gram-negative bacteria. Hb A1C >7% was not found to be associated with an increased incidence of SSI. Conclusion Our results show that there is no apparent relationship between pre-operative Hgb A1C levels and SSI after cardiac surgery. Although we follow a comprehensive SSI perioperative bundle based on international guidelines that advocates using antibiotics to cover gram-positive organisms, it is interesting that the rate of gram-negative organisms in our patients' cohort is unexpectedly high. We believe that adjusting the perioperative antibiotic regimen based on local microbiological patterns seems to be a reasonable and easily achievable target to decrease the incidence of SSI.Background and Aims Fatty liver increases oxidative stress and may trigger antioxidant mechanisms. We aimed to compare the levels of vitamin D, which has antioxidant properties, as well as total oxidant status (TOS), total antioxidant status (TAS), and catalase between patients with nonalcoholic fatty liver (NAFL) and the control group. Methods We compared vitamin D, TOS, TAS, catalase levels, and other biochemical parameters between pediatric patients with ultrasonographically detected NAFL and an age-matched healthy control group. Results NAFL patients had a significantly lower vitamin D level (p less then 0.001). The patient group also had significantly greater height, weight, body mass index (BMI) Z score, parathyroid hormone, triglyceride, glucose, antioxidant (TAS and catalase), and TOS levels compared to the controls (p ≥ 0.001). There was no significant difference between the obese and non-obese NAFL patients with respect to TAS, TOS, catalase levels, and other biochemical parameters (p less then 0.05). There was a positive correlation between height, weight, BMI Z score, and hepatosteatosis grade, and TAS, TOS, and catalase levels, and a negative correlation with vitamin D level. We also found a negative correlation between vitamin D level and TOS and catalase level. selleckchem Conclusions Our study revealed lower levels of vitamin D and higher levels of oxidant-antioxidants including TOS, TAS, and catalase in patients with NAFL.

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