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Background Diabetic nephropathy (DN) is one of the major causes of ESKD, and its complications are characterized by proteinuria, decreased glomerular filtration, and renal fibrosis resulting in the deterioration of renal functions, so early detection of nephropathy is essential to slow down and prevent the progression of the disease. Fatty acid-binding protein 4 (FABP4) is expressed in renal proximal tubule cells and released in response to hypoxia caused by decreased peritubular capillary blood flow, so serum FABP 4 is one of the promising biomarkers for early prediction of diabetic nephropathy in patients with type 2 diabetes. Methods This was a case–control study that included 120 patients with type-2 diabetes mellitus selected from Kasr Alainy Hospital, Cairo University Hospital, who were divided into 2 groups: the first group comprised 60 diabetic patients divided into 3 sub-groups according to their urinary albumin/creatinine ratio (normo-, micro-, and macroalbuminuria). The second group included 60 apparently healthy individuals. All patients were subjected to history, clinical examination, laboratory investigations, and serum FABP4 by ELISA. Results There was a significant increase in serum FABP4 in the macroalbuminuria group, followed by the microalbuminuria group, then the normoalbuminuria group, in comparison to the normal control group. There was a significant positive correlation between serum FABP 4 level and the duration of diabetes and HBA1c. There was a significantly negative correlation between serum FABP4 and serum albumin in the macroalbuminuria group. Receiver operating characteristic curve analysis found that serum FABP 4 discriminate micro- and macroalbuminuric patients with diabetes from controls with 96.6% and 98.3% diagnostic specificity and 100% diagnostic sensitivity respectively. Conclusion Serum FABP 4 can be used as a biomarker for the early detection of diabetic nephropathy.

BACKGROUND: Although it is well established that family medicine/primary care is the backbone of a successful healthcare system, family medicine clinics (FMC) services are still underutilized. Social marketing can be used as an effective approach to increase people’s awareness and change their attitude and behaviors related to primary care then promote service utilization. AIM: The objective of this study is to detect the causes of underutilization of FMC services and to study the role of a social marketing campaign on increasing the utilization of these services. METHODS: This is an experimental study where 1120 participants attending the primary health care center were interviewed pre- and post-campaign to assess the rates of FMC services utilization and the causes of underutilization. A 3 months social marketing campaign was held through internal and external marketing seminars then evaluating the campaign effect through service output indicators and comparing questionnaires’ results pre- and post-campaign. RESULTS: Underutilization of FMC services was caused mainly by the lake of knowledge about the presence of service (94.9%) and this decreased postcampaign to be (75.9%). The new patients attending the FMC increased from 61 to 2093, the frequency of weekly visits of the regular attenders increased by 32% and the number of new files opened post-campaign increased by 56%. CONCLUSION AND RECOMMENDATION: Social marketing is a successful technique to increase the utilization of the services provided by FMC. According to the results, it is recommended to promote social marketing activities to increase awareness of the FMC services and improve its utilization.