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Hypertension in patients with type 2 diabetes mellitus is a prevalent condition that leads to substantial morbidity and mortality. The aim of the study was to determine the prevalence of hypertension in type 2 diabetes attending endocrinology clinics at Hospital Universiti Sains Malaysia (HUSM), to describe antihypertensive treatment patterns, and to evaluate the target of blood pressure achieved by antihypertensive agents. The study was a prospective follow-up descriptive study. Study conducted at diabetic clinic outpatient at HUSM, Kelantan, Malaysia from January to December 2007. A total of 1077 diabetic patients involve in this study. The findings of our study showed that the majority patients type 2 diabetes mellitus 998 (92.7 %) had hypertension. For the patients who were on antihypertensive medications, 254 (23.6 %) of them were on monotherapy and 311 (28.9 %), 179 (16.6 %), and 198 (18.4 %) respectively received two, three and more than three antihypertensive agents. The majority of patients 872 (87.4 %) were on angiotensin converting enzyme inhibitors/angiotensin receptor blockers either alone or in combination with other antihypertensive drugs. A number of 601 (55.8 %) patients achieved blood pressure targets ≤ 130/80 mm Hg. Almost all patients with hypertension and diabetes will require a combination of antihypertensive medications. A number of patients was not achieved blood pressure goals ≤ 130/80 mm Hg. There is still need to educate both patients and health care providers of importance of achieving target of blood pressure in order to reduce morbidity and mortality in diabetes mellitus patients.

Some cellulose sulfates were prepared from linen pulp bleached by the H2O2 method. The infrared spectroscopy (IR) and the dielectric properties of the samples prepared under different conditions were studied. The results show that the mean hydrogen bond strength (MHBS) values increased by sulfonation while the asymmetric index decreased. The dielectric and the IR measurements gave more light on the structure and composition of the investigated samples. [ABSTRACT FROM AUTHOR]

Rice straw pulp has been bleached by a nonconventional fourstage method using organic solvents in the bleaching solutions. Methanol, ethanol, acetone, and dioxane, 10%, 30%, and 50% by volume were mixed with water as bleaching media in the first-stage process. Effects of kind and percentage of the organic solvent in the bleaching mixtures on the physical characterization of the bleached pulps and of the paper sheets were studied. Results are discussed on the basis of changing the physicochemical properties of the media by varying the solvent content in the bleaching mixture. [ABSTRACT FROM PUBLISHER]

Background: Botulinum toxin (BT) is a well-recognised treatment of chronic functional constipation (FC) and soiling refractory to medical treatment. The aims of this study were to assess the short and long-term outcomes of BT injection into the external anal sphincter muscles (EAS) for chronic FC treatment., Methods: We studied 196 children unresponsive to medical management of chronic FC, soiling, painful defecation and withholding behaviour (Rome III criteria) from April 2011 to January 2023. All patients underwent anorectal manometry (ARM) and endosonography-guided BT injection (Dysport® or Botox®) 10 units/kg body weight (maximum 200 units) into the EAS muscles at 3 and 9 o'clock positions and colonic transit study. Outcomes were measured using a validated symptom severity (SS) score questionnaire pre-operatively, at 3-6 months and 12-24 months follow up including: defecation frequency and pain, soiling, laxative(s), general health, behaviour, symptom improvement and faecaloma. Sum of scores ranged from 0 (best) to 65 (worst). We used Wilcoxon signed-rank test for matched-pairs related analysis and data presented as median (range) and p value < 0.05 was considered significant., Results: 196 patients (104 male) with a median age of 7 (1-16) years underwent anorectal investigations and BT injection into the external anal sphincters during 12 year study period. The median short and long term follow-up was 4 (1-27) months and 16 (5-60) months, respectively. 26 (13 %) patients had autism and 14 (7.1 %) had attention deficit hyperactivity disorder (ADHD). Median anal sphincter resting pressure was of 55 (20.5-113) mmHg. The pre-operative total SS score improved from median 31/65 (4-57) before BT treatment to median 15/65 (0-49) at 4-month after BT injection and median 16/65 (0-56) at 16-month follow-up, p < 0.001. 80 % (104/130) of patients showed significant short-term and 79 % (71/90) showed long-term improvement of their chronic FC symptoms following BT injections. 9 % (18/196) children required second BT injection for symptom recurrence and 18.3 % (36/196) required formation of an antegrade colonic enema (ACE) stoma., Conclusion: BT injection is an effective and safe new treatment of chronic FC unresponsive to conventional medical treatments. In our experience, 80 % of children have significant improvement of their symptoms and 9 % require repeat BT injection during a long term follow-up., (Copyright © 2024. Published by Elsevier Inc.)