Editorial

Editor: Abdulrazak Abyad

In this issue Dr Dadkhah A, looked at the service framework for older people in Japan. The author stressed that developed countries have thought and planned for population aging, but if the developing countries do not think about programming for health services of aged people, in the near future they will encounter socioeconomic and health crises. The author stressed that developing nations can learn a lot from the Japanese model of care.

A paper from Saudi Arabia looked at lessons from trials. The author stressed that a lot of trials have been published recently discussing the benefits of intensive glucose control versus conventional glucose control. One of these studies was the 10 - year follow - up of intensive glucose control in type 2 diabetes published in the New England Journal of Medicine in October 2008. Although this study reached interesting findings, the number of deaths during this study was too high (1,851 deaths out of 3,277 participants during 10 years). The contrast between the benefits and number of deaths force us to ask this question: Do we need all these deaths?

A paper from Jordan looked at the Value of HbA1c Testing in Diabetic Patients. The aim of the author was to investigate whether HbA1c testing can be used a predictor for the presence of diabetic retinopathy as an example of long term diabetic complications. A prospective study was conducted at Prince Ali Hospital in Southern Jordan. on 120 diabetic patients attending internal medicine clinic were investigated for their HbA1c level. The mean age of patients was 59.3 years. Forty patients were found to have diabetic retinopathy; thirty of them had non-proliferative changes and ten had proliferative retinopathy. HbA1c of more than 9% was associated with the most severe form of retinopathy. The author concluded that HbA1c measurement is a useful test for predicting and monitoring the risk of progression of diabetic retinopathy as an example of longterm diabetic complications

A paper from Bangladesh attempted to determine if I/A Methotrexate is effective in rheumatoid arthritis.
This study was conducted in medical B unit of Postgraduate Medical Institute, Lady Reading hospital and a private rheumatology clinic in Peshawar.
A total of 40 rheumatoid arthritis patients who were resistant to I/A steroids were included in the study. A total of 28 patients completed two follow ups, one for re-injection and the other for response analysis. The authors concluded that the response rate was 6/28 (21.42%), which is encouraging, besides the patients received only two injections of I/A MTX whuch was much better than reported in a few studies from abroad. It is the first ever study on I/A Methotrexate from NWFP and probably from Pakistan.

A paper from Iran looked at whether preoperative quality of life predicts adverse outcomes of coronary artery bypass graft surgery in the elderly? Seventy one patients ranging from 60 to 80 years old and who underwent pure CABG were consecutively studied. Patients' quality of life (QOL) was assessed before surgery by using SF-36 questionnaire. Postoperative early complications were also considered. The authors concluded that patients older than 60 years have poor physical role and appropriate social function before CABG, however different aspects of QOL before cardiac surgery may not influence postoperative early outcome.