Sherif Shalaby
Yale University, USA
Title: Evaluation of the effects and outcome of interventional radiological diagnosis and therapeutics approach in Budd-Chiari syndrome patients: A meta-analysis study
Biography
Biography: Sherif Shalaby
Abstract
Introduction: The middle East and Northern Africa have the highest prevalence of diabetes as a world region, with Egypt making the top 10 ranking. The number of patients with diabetes is on the rise. Also, healthcare expenditure and utilization of healthcare services are on the rise contributed to lower cases of diabetic lower limb amputation. However, the prevalence of complications in the Egyptian diabetic population characteristics is quite high. Prevalence of retinopathy is 20.5%, albuminuria 21%, nephropathy 6.7% neuropathy at 21.9%. However, diabetic foot complications are low with active diabetic foot ulcers relatively constant at 1%. How does this contrasting trend between diabetic foot complications and other diabetic complications compare to the United States to determine how pivotal large healthcare expenditure in preventing major diabetic foot amputations.
Methodology: Estimation of diabetic population at risk of lower limb amputation in Mansoura, Egypt (aged 25+ years old) in the year 2008-2013 was determined using percent (Straight-Line) growth rates equation of the general population of Mansoura. Prevalence of diabetic lower limb amputations in Mansoura, Egypt was estimated using recorded total (below and above the knee) diabetic lower limb amputations in Mansoura University hospital from 2009-2012. Based on the estimated number of patients with diabetes who are above the 25years of age and the number of amputations in each year, the prevalence of diabetic foot amputation in Mansoura is estimated. Egypt’s overall prevalence of diabetic foot amputation was estimated as a larger scale of Mansoura’s prevalence of diabetes taking into account the difference in the diabetic population. The results and other published trend in Egypt were compared to all Medicare parts A and B Fee-for-Service (FFS) cohort population.
Results: After calculating Egypt’s prevalence of major diabetic foot amputation, there is a consistent decrease in major diabetic foot amputations with an average of 0.3% of the diabetic population (0.5% average for all diabetic foot amputations in other large studies in Egypt). Comparing this phenomenon to the prevalence of diabetic foot amputations in the United States, the prevalence is much higher with 1.3% and 1.8% of diabetic patients undergo a major or lower extremity amputation. However, diabetic foot in Egypt has been documented at 6.9%, still lower than the United States.
Conclusion: Prevalence of diabetic foot amputation is decreasing both in Egypt and the United States but with a much larger prevalence rate in the United States. Considering the fact, Egypt diabetes-related healthcare expenditure is a fraction of the United States and lacks primary health care monitoring evidenced by high diabetic complications but yet has a lower prevalence of both foot ulcers and major lower extremity amputations. This may account for environmental or personal habits that may play a pivotal role in preventing diabetic foot amputations.