Environmental exposure to cadmium (Cd) or lead (Pb) is independently associated with increased risks of type 2 diabetes, and chronic kidney disease. The aim of this study was to examine the effects of concurrent exposure to these toxic metals on the risks of diabetes and kidney functional impairment. The Cd and Pb exposure levels among study subjects were low to moderate, evident from the means for blood concentrations of Cd and Pb ([Cd]b and [Pb]b) of 0.59 µg/L and 4.67 µg/dL, respectively. Of 176 study subjects (mean age 60), 71 (40.3%) had abnormally high fasting plasma glucose levels. Based on their [Cd]b and [Pb]b, 53, 71, and 52 subjects were assigned to Cd and Pb exposure profiles 1, 2, and 3, respectively. The diagnosis of diabetes was increased by 4.2-fold in those with an exposure profile 3 (p = 0.002), and by 2.9-fold in those with the estimated glomerular filtration (eGFR) ≤ 60 mL/min/1.73 m2 (p = 0.029). The prevalence odds ratio (POR) for albuminuria was increased by 5-fold in those with plasma glucose levels above kidney threshold of 180 mg/dL (p = 0.014), and by 3.1-fold in those with low eGFR) (p = 0.050). Collectively, these findings suggest that the Cd and Pb exposure profiles equally impact kidney function and diabetes risk.

BACKGROUND: Type 2 diabetes, especially in the elderly, continues to plague the world. Thailand a developing country is not immune to these ravage effects and their distressing upsurge in health and economic societal burdens. Self-care management is an essential strategy to prevent complications and reduce type 2 diabetes complications. AIM: This study aimed to examine the treatment outcome and factors predicting diabetes self-care behaviors among elderly in Thailand. METHODS: A cross-sectional correlative predictive design using multiple linear regression models to evaluate data in elderly type 2 diabetics in Thailand (August through December 2017) to assess perceived behavioral control on diabetic self-care management. One hundred thirty-four participants data were collected via questionnaire along with individual health records becoming the foundation of this study. RESULTS: Most patients controlled glycemic outcome (77.9 %) through self-care behaviors at moderate rates (majority 55.9%). Subjective norms and perceived control strongly correlated with behavioral intention and self-care behaviors. Perceived behavioral control was the most important factor predicting intentions ( 4.025, p .01) and self-care management behavior (15.258, p .001). Patients responding to items regarding self-care behavior for diet, exercise and medication adherence showed favorable outcomes. CONCLUSION: More than half of the patients had moderate levels in self-care management and the majority had good glycemic outcomes. From the analysis, we find that perceived behavioral control is critical to predicting behavioral intention and diabetic self-care behavior among the elderly.

No abstract

No abstract

Background/Objective: Delays in diagnosing pulmonary tuberculosis (PTB) are linked to financial difficulties, employment limits, dependency, and symptomatic treatment, all of which have an impact on the patient's quality of life. Patients' psychological, economic, and social well-being are also harmed by delayed therapy. The goal of this research was to evaluate sociodemographic characteristics and quality of life in new pulmonary TB patients and determine the associated factors with delayed TB diagnosis. Methods: This was a cross-sectional study conducted in the Choke Chai Community Hospital, in Northeastern Thailand between 2016 and 2018. The information related to the patient’s medical history and laboratory tests were gathered from 332 newly diagnosed tuberculosis patients at the hospital's tuberculosis clinic; of those 15 died and were excluded from the final analysis. Data were analyzed using SPSS version 17.0. Results: The cases included new cases (94%) and those returning to receive treatment after discontinuation of treatment, relapse, or recurrence of the disease (6%). The sample consisted of 68.7% males and 31.3% females. The average age was 52.7 years (S.D = 15.64). The majority of patients were married (60.5%), employed (68.6%), received a low income (66.6%), had a history of chronic diseases (73%), drank alcohol (31.7%), and smoked (85.7%). Approximately half of PTB experienced treatment delay and had a low quality of life (QoL) (46.6%). The treatment delay was associated with age > 50 years (p <0.05), low self-care (p <0.05), long distance to facility (p <0.05), unavailable caretaker to treat (p <0.05), no caregiver in family (p <0.05), high expenses (p <0.01), and lack of information (p <0.001) Conclusion: It appeared that the patients' health-related quality of life could be deteriorated as a result of pulmonary tuberculosis. Treatment delays can be significantly reduced by changing the understanding of family caregivers, increasing awareness, providing adequate support for patients, and guaranteeing early diagnosis and treatment by implementing an efficient surveillance system.