Background In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods and results CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure. Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest. Conclusion In patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes. ClinicalTrials identifier ISRCTN43070564

The Sumatra subduction zone, one of the most active plate tectonic margins in the world, is characterised by the Indo-Australia Plate subducting beneath the Sunda plate and Andaman micro plate, causing seismic activity along the plate boundary. There had been five major earthquakes of magnitude greater than 8.0 in this region from 2004 to 2014. Three of them are dip-slip and rest of the two is strike-slip type events. Regional earthquake activity after the occurrence of those five events was analyzed. Hypocentral data obtained from the Data Management Center at the Incorporated Research Institutions for Seismology for the period from January 2000 to December 2014 of magnitude 3.0 were used for the analysis. A statistical analysis was carried out to know whether earthquake activity has increased after the major five events and the analysis was carried out both qualitatively and quantitatively. The results of the analysis show that the number of earthquakes in the region has increased considerably after the occurrence of April, 2012 magnitude 8.6 and 8.2 strike-slip events. Further results show that there is no change in the regional earthquake activity after the occurrence of other three major dip-slip type events. Present study results reasonably agree with the results obtained by the other studies carried out with different methods. In the context of Sri Lanka, strike-slip type focal mechanism of the 2012 two major events may be the reason for increasing of activity in the region, especially in Eastern part of Sri Lanka near Maduruoya, Highland-Wijayan boundary and Wadinagala area of Ampara District.

Title of the article: Risk factors contributing to bacteraemia at a tertiary cancer center in South Asia Abstract:Context: Cancer patients are immunocompromised due to their medical condition resulting in neutropenia, increased exposure to intravascular devices (IVDs) and prolonged hospital stays.These conditions are established risk factors in causing bacteraemia. Bateraemia is a contributing factor towards increased rates of morbidity and mortality in several countries including Sri Lanka. Aims:The current study evaluates the risk factors such as demographic factors, neutrophil counts, presence of an IVD and length of hospitalization that would contribute to the development of bacteraemia among cancer patients at the Apeksha Hospital -Maharagama, Sri Lanka.Results: A higher prevalence of bacteraemia compared to other countries (13.7%) was reported with the highest frequency identified from oncology wards. Patients above 60 years with carcinomas were revealed to be more susceptible. A length of hospital stay exceeding three days was a statistically significant factor in causing bacteraemia. Gram-negative organisms accounted for majority of the infections while Acinetobacter species were more frequently isolated from IVDs.Conclusions: It could be suggested that additional care and sterility measures be taken when carrying out invasive procedures in such patients. Precautions could be taken in managing patients with a hospital stay exceeding 3 days as they have been identified as a risk group in acquiring nosocomial infections.Key-words: Cancer, immunocompromised, bacteraemia, neutropenia Abstract Page All rights reserved. No reuse allowed without permission.(which was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.

BackgroundSerum gamma glutamyltransferase (GGT) have shown a strong association with diabetes mellitus (DM) in many reported studies. Studies have proven the association of elevated body mass index (BMI) and deposition of fat causing insulin resistance leading to increased serum GGT levels. Evidence is less supportive in the Sri Lankan context.