Introduction: Children with T1D experience behavioral difficulties and lower social competency compared with healthy children. Quality of life is considered to be a significant indicator of disease prognosis. Aim:To evaluate the health related quality of life of children with T1D, and how much it could be affected by their mood and family attitudes and to study the relationship between these variables and the metabolic control of the diabetic children.Methods: 72 children with T1D were included and subjected to; history taking, clinical examination, application of Peds QL (Diabetes Module, Version 3), Childhood Depression inventory Scale (CDI),Parent Stress Index(PSI) questionnaire and HbA1c%. Another 72 children apparently healthy, non-diabetic, age and sex matched and siblings of the diabetic patients were included as a control group. They were subjected to Childhood Depression inventory Scale (CDI), Parent Stress Index (PSI) questionnaire.Results: Diabetic patients had significant higher CDI Score and total PSI score than the control group. There were significant positive fair correlations between the age, weight and BMI of diabetic children with the child PedsQL, the parent PedsQL and CDI total scores. Concerning glycemic control, there were significant positive fair correlations between CDI total score with frequency of DKA attacks and HbA1c%. Using the PSI domains, poorly controlled diabetic patients had significant higher parental distress, parent/child dysfunctional interactions and higher PSI total score compared to good controlled patients. Using CDI domains, poorly controlled diabetic patients had significantly more negative self-esteem than good controlled patients. There was a significant positive moderate relationship between CDI total score and PSI score. Finally, there were significant negative weak correlations between PSI score and PedsQL (child and parental) i.e. the higher the parental stress, the lower the quality of life of the diabetic child (reported by both child and parent).Conclusion: diabetic children, especially the poorly controlled ones, are significantly suffering from symptoms of depression which causing stress for their parents and this has significant impact on their quality of life and glycemic control.

Vitamin D and its active form are potent immune-modulators and are known to play an important role in the glucose/insulin metabolism. Studies on type 2 diabetes mellitus (T2DM) have shown that vitamin D increases insulin efficacy; However, there are no studies that define a similar relationship in type 1 diabetes mellitus (T1DM). Aim of the work:To evaluate serum vitamin D status in children with type 1 diabetes mellitus with comparison to healthy subjects and to correlate its level with different clinical and laboratory parameters. Subjects and methods:This study included two groups; Group I: included 53 patients with T1D; 43 patients with poor glycemic control (group Ia ) and 10 patients with good glycemic control (group Ib). Another 15 apparently healthy children and adolescent's age and sex matched to the diseased group were taken as a control group and classified as group II. The studied groups were subjected to thorough history taking, clinical examination and laboratory investigations including: fasting blood glucose, glycated hemoglobin (HbA1c %), serum calcium level and 25-hydroxyvitD level. A serum 25OHD level of < 10 ng/mL was accepted as vitamin D deficiency, whereas < 20 ng/ mL was accepted as vitamin D insufficiency.Results: Serum 25-hydroxyvitD and serum calcium levels were significantly lower in T1D children than the control and in group Ia than group Ib. 25-hydroxyvitD had a significant strong positive correlation with serum calcium and significant strong negative correlations with fasting blood sugar and HbA1c %. Conclusion:T1D children had significantly lower serum 25-hydroxyl vit D and serum calcium levels than the control group. Vitamin D in diabetic persons is an important factor in glycemic control with subsequent prevention of further complications.

Introduction: An interaction between genetic susceptibility and environmental factors is assumed to be elaborate in the etiology of type 1 diabetes mellitus (T1DM). Autoimmunity may be induced in first years of life, suggesting that environmental agents encountered early in life could be triggers of the disease process.

Introduction: COVID-19 pandemic has affected HCPs in multiple way. It has caused psychological impact in form of anxiety, depression, and insomnia. In this study, we aim to study and compare the stress level, anxiety and depression among HCPs who are posted in special COVID-19 units with the HCPs who are not posted in COVID-19 units.Methods: This cross-sectional study was conducted in June 2020, at various hospitals of Karachi, Pakistan. All health care professionals (HCPs) were invited to participate. A total of 301 HCPs completed this study, who were divided into two groups; those who are posted in COVID-19 ward (Group A) and those who are not (Group B). Psychological Impact was English version of the Depression Anxiety Stress Scale - 21 (DASS-21).Results: In Group A, 70.5% had moderate, severe, or extremely severe depression compared to 49.2% in group B. In Group A, 75.4% had moderate, severe, or extremely severe anxiety compared to 44.7% in group B. In Group A, 80.3% had moderate, severe or extremely severe stress compared to 54.2% in group B. Anxiety, depression and stress were significantly higher in HCPs who were posted in COVID-19 ward compared to those who were not posted in COVID-19 wardConclusion: There was significantly higher anxiety, stress and depression in health care professionals posted in COVID-19 ward. Both the government and health care agencies should take responsibility for protecting the psychological well-being of health care communities all over the world and ensuring a healthy work environment.