Background Diabetes group visits (GVs) are a promising way to deliver high quality care but have been understudied in community health centers (CHCs), across multiple sites, or with a focus on patient-centered outcomes. Methods We trained staff and healthcare providers from six CHCs across five Midwestern states to implement a 6-month GV program at their sites. We assessed the impact of diabetes GVs on patient clinical and self-reported outcomes and processes of care compared to patients receiving usual care at these sites during the same period using a prospective controlled study design. Results CHCs enrolled 51 adult patients with diabetes with glycosylated hemoglobin (A1C) ≥ 8% for the GV intervention and conducted chart review of 72 patients receiving usual care. We analyzed A1C at baseline, 6, and 12 months, low-density lipoproteins (LDL), blood pressure, and patient-reported outcomes. GV patients had a larger decrease in A1C from baseline to 6 months (-1.04%, 95% CI: -1.64, -0.44) and 12 months (-1.76, 95% CI: -2.44, -1.07) compared to usual care; there was no change in blood pressure or LDL. GV patients had higher odds of receiving a flu vaccination, foot exam, eye exam, and lipid panel in the past year compared to usual care but not a dental exam, urine microalbumin test, or blood pressure check. For GV patients, diabetes distress decreased, diabetes-related quality of life improved, and self-reported frequency of healthy eating and checking blood sugar increased from baseline to 6 months, but there was no change in exercise or medication adherence. Conclusions A diabetes GV intervention improved blood glucose levels, self-care behaviors, diabetes distress, and processes of care among adults with elevated A1Cs compared to patients receiving usual care. Future studies are needed to assess the sustainability of clinical improvements and costs of the GV model in CHCs.

PurposeThis study aims to explore the relationships between abnormal hysterosalpingography (HSG) findings and all types of infertility.Material and methodsThis retrospective study was carried out at a private radiodiagnostic centre in Lagos, Nigeria. The radiologist reports of all consecutive patients who had HSG evaluation from 2016 to 2018 were analysed. Biodemographic information and indications for HSG evaluation were also documented. Logistic regression was used to test correlations between the explanatory and outcome variables. P ≤ 0.05 represented a statistically significant result.ResultsA total of 450 patients were involved in this study, with ages ranging from 21 to 51 years and a mean age of 34.6 ± 5.56 years. The age group 31-35 years had the highest frequency of infertility. There were 299 patients referred for infertility. Secondary infertility was seen in 211 patients (46.9%), primary infertility was seen in 79 patients (17.6%), and subfertility was seen in nine patients (2%). There were 49 patients (10.9%) with cornual tubal blockage, while 57 patients (12.7%) had perifimbrial adhesion and/or blockage. There were 56 patients (12.4%) with hydrosalpinx and nine patients (2.0%) with tubal occlusion. Multivariate logistic regression analysis showed women with hydrosalpinx were 2.11 times more likely to be infertile than those without hydrosalpinx (95% CI: 1.02-4.36, p = 0.042).ConclusionsThe presence of hydrosalpinx was a significant risk factor in developing all types of infertility. Understanding the HSG patterns and their correlations with infertility will help physicians across the world when evaluating infertility in patients of similar background to our patient population.

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To evaluate the radiographic characteristics and prevalence of fabella and patella variants in an indigenous African population. This retrospective observational study of orthogonal knee radiographs of 377 consecutive subjects was conducted in Lagos, Nigeria, from February 2017 to November 2017. The presence of bipartite/multipartite patella, as well as the presence of fabella were noted. The craniocaudal diameter, anteroposterior diameter, fabello-femoral distance and fabello-tibial distance of the fabella were measured. P≤0.05 represented a statistically significant result. Three hundred and seventy-seven subjects were enrolled. The average age was 41.22±21.37 years with a range of 3-100 years old. There were 158 male (41.9%) and 219 female (58.1%) subjects. The prevalence of fabella was 11.94%. There was a positive correlation between age <47 and ≥47 and occurrence of fabella, P<0.015. There was no statistically significant difference between the mean male and female measured fabella diameters. The overall prevalence of bipartite and multipartite patella in this study was 2.12%. Among male and female subjects, the difference in prevalence of bi and multipartite patella was statistically significantly, P=0.03. The prevalence of fabella and patella variants was lower in this study compared to the findings in other populations and ethnicities. Sex and age were significantly correlated with fabella prevalence. The results reported in this study will facilitate future studies examining the correlations between fabella and patella variants and various knee pathologies in a population of Black African descent.

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