Aim:The rheological properties of erythrocytes are impaired in diabetes mellitus, especially because of changes in their membrane lipid composition.The aim of this study was to determine and examine the relationship between red blood cell (RBC) membrane and serum lipid composition in type II diabetes subjects with and without nephropathy.Methods:Trinidadian subjects aged 18–65 years were recruited for the study regardless of gender and ethnicity. Fasting blood samples were collected from 60 subjects of whom 20 were healthy individuals, 20 had type II diabetes without complications, and 20 were type II diabetics with nephropathy. Weight, height, waist/hip ratio, and blood pressure were recorded. All the blood samples were analysed to determine the serum lipid concentration, membrane lipid composition and plasma glucose concentration.Results:The body mass index and the systolic blood pressure of the diabetics (28.17 ± 4.98 kg/m2, 153.21 ± 22.10 mmHg) and those with nephropathy (25.87 ± 4.68, 158.60 ± 22.49 mmHg) were higher when compared with controls (24.67 ± 5.18, 119.15 ± 13.03 mmHg). The diabetic (175.89 ± 102.73 μg/mgprotein) and diabetic nephropathy (358.80 ± 262.66) subjects showed significantly higher levels of RBC membrane cholesterol compared with controls (132.27 ± 66.47). The membrane phospholipids, protein and Na+/K+ATPase concentrations were altered in diabetics and diabetic nephropathy patients when compared with controls. The trends of increased serum cholesterol and decreased high-density lipoprotein in diabetics and diabetic nephropathy patients were noted as compared with controls but they are not significant as expected. The low-density lipoprotein cholesterol was significantly higher in diabetics when compared with diabetic nephropathy and control subjects.Conclusions:Our data suggest that there is a relationship between RBC membrane and serum lipid composition in subjects with type II diabetes with and without nephropathy. This relationship shows that diet and lifestyle plays a significant role in the alterations of the lipids both in serum and RBC membrane. The membrane and serum lipid composition may be used as possible indicators for type II diabetic patients with and without nephropathy to control their diet in the beginning stages to prevent them from further complications.

The COVID-19 pandemic led to huge changes to children’s daily lives including school closures, loss of contact with family and friends, and financial difficulties which impacted on the wellbeing of all children. The Social Determinants of Health model gives us a framework to consider the impact of lockdown directly on children, and indirectly through the impact on parents, families, community and government policy as children cannot be considered in isolation to families or society. Children have suffered directly with lack of access to healthcare, and a decline in their mental health. Infant bonding may have been affected due to maternal stress, anxiety or depression, compounded by limited Health Visitor support. Poverty, food insecurity and lack of exercise contributed to increased obesity. Many children will have been exposed to domestic violence, parental mental illness and child abuse without being able to tell teachers or other adults outside of the home, these Adverse Childhood Experiences (ACE) increase the risk for subsequent health and behaviour problems. Children have spent many hours online for school learning and socialising with friends but faced risks of criminal exploitation and grooming. The long-term financial implications of COVID-19 will continue to impact on society for many years to come and further increase social inequalities.

precise recurrence risk and prenatal diagnosis offered if indicated.32%(43/133) were referred to a specialist for the condition; 16%(23/133) informed re-orientation and palliative care. Current management and prognosis were supported in 16%(22/ 133) and specific treatment such as transplant or medication was provided in 13%(19/133). Specific screening was arranged in 5%(7/133). Conclusions This is the first NHS-based diagnostic service which provides rapid genetic diagnoses in acutely unwell children and the largest reported cohort of patients undergoing rapid exome sequencing. It demonstrates that this innovative and transformational national service has successfully provided rapid results while maintaining a high diagnostic rate. Most importantly, diagnoses have influenced both acute management in intensive care settings and long term management for children and their immediate and extended family members.

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