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Background: The aim of this study was to examine the impact of education, coronavirus disease 2019 (COVID-19), and risk factors on the quality of life in patients with type 2 diabetes. Methods: A prospective study was conducted in three phases: before education, after education, and in the period of pandemic coronavirus disease 2019 (COVID-19). The subjects were diabetics on oral therapy. To determine the quality of life index, a standardized Ferrans and Powers survey questionnaire was used. Results: A total of 205 participants took part in the study, of which 111 (54.1%) were men and 94 (46%) women. Participants were enrolled in the study between January 2019 and September 2020. Glycated hemoglobin values were significantly higher before education compared to post-education and at the time of COVID-19 (Friedman test, p = 0.002), and body mass index was significantly lower after education compared to values before education (Friedman test, p = 0.008). The quality of life was significantly lower in all domains in the COVID-19 period (Friedman test, p < 0.001). Conclusions: A significant predictor of worse assessment of overall quality of life was male gender and rural place of residence. Disease duration of up to 5 years was a significant predictor of worse assessment in the psychological/spiritual domain, while being married was a predictor of better assessment of the quality of life in the family domain. The education of diabetics brought an increase in the health and quality of life while the coronavirus disease pandemic had negative consequences on the same parameters. We consider it necessary to systematically educate diabetics about the comorbidity of COVID-19.

A 37-year-old patient presented with severe but painless burn wounds on three fingers. These wounds were the consequence of his profession as a chestnut frier, where he had to handle hot chestnuts. For several weeks he had complained about paresthesias in his hands, but had been able to touch hot chestnuts without any pain sensation. Neuropathy was confined to the hands and carpal tunnel syndrome was suspected. Final diagnosis was confirmed by nerve conduction tests. After surgical decompression of the median nerve the patients regained his sensory ability in his hand after several weeks of recovery.The painless burn wounds as a consequence of neuropathy in this patient were the presenting symptom of a carpal tunnel syndrome, which is the most common upper limb compression neuropathy and accounts for approximately 90% of all entrapment neuropathies [1]. Several tests have been described for the diagnosis of carpal tunnel syndrome. Most of the tests are complementary to each other, and a combination of symptoms, signs and diagnostic tests should be employed when the diagnosis of carpal tunnel syndrome is made. The gold standard tests however are nerve conduction studies [2]. Surgery is the only effective therapeutic modality in moderate to severe cases [3].So the carpal tunnel syndrome gave our patient the ability to remove hot chestnuts from the stove without pain. However he had to pay for this unique advantage for his specific profession with severe burn wounds on his fingers.Goran Bajek, Hrvoje Šimić, Duje Vukas, Darko Ledić Conflict of InterestThe authors declare that there is no conflict of interest. ReferenceAtroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I (1999) Prevalence of carpal tunnel syndrome in a gen-1. eral population. JAMA 282: 153-158 Omer GE Jr (1992) Median nerve compression at the wrist. Hand Clin 2. 8: 317-324 Patterson JD, Simmons BP (2002) Outcomes assessment in carpal tunnel syndrome. Hand Clin 3. 18: 359-363

Backround: During the pandemic 2020 many hospitals became so-called Covid-19 Hospital. In Croatia our General County Hospital Nasice was the very first one with declared Covid-19 status. Our objective was to determine the clinical features of patients with severe COVID-19 disease considering of different cardiovascular risk factors and their health outcomes.Materials and Methods: A retrospective study was conducted by analysing the medical records of 541 hospitalized COVID-19 patients in Croatian General County Hospital Nasice during one year in the period from March 1st 2020 to March 1st 2021. We examined collected individual data as gender, age, presence or absence of comorbidity, type of comorbidity, laboratory data, number of days at hospital and outcomes (discharge home, transfer to another hospital and death).Results: Patients mean age was 72 years with range of 22 do 95 years. There were 408 (77%) discharged from the hospital, 23 (4%) transferred to another hospital, and 94 (18%) died. Hypertension had 325 (61%) of patients, coronary heart disease had 58 (11%) patients, cardiomyopathy had 98 (19%), arrhythmic disease had 88 (17%), valve disease had 24 (5%). Diabetes as risk factor had 151 patients (29%). Patients without any comorbidity were only 55 (10%). Total range of hospitalized days was 33 with 8 days mean. We found statistically significant differences in disease outcomes according to the gender and age of patients and whether patients suffer from cardiomyopathy and arrhythmic diseases. Age over 65, cardiomyopathy and valve disease were independent predictors of poor outcome for male. For female risk factors were cardiomyopathy, obesity and body mass index.Conclusions: The prevalence of cardio comorbidity in Croatian Covid-19 hospitalized patients was analyzed and genderdifferent predictors of health have been identified.

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