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The therapeutic approach established for diabetes control varies according to its classification. Understanding the differences between each type is possible a complete and distinct treatment for the individual. This chapter will address the classification of diabetes types as well as their main differences.

Importance: As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic spreads, increasing cases of dermatologic manifestations of the disease continue to be reported. Observations: In this general review of the case reports, case series, and other systematic reviews on this subject, several patterns of cutaneous lesions have been compiled. These include viral exanthems, papulovesicular, pernio-like, vasculopathy-related, and other miscellaneous rashes. Conclusions and Relevance: While clinical observations and subjective cases of rashes associated with SARS-CoV-2 are important to furthering our research and study of this viral disease, we as clinicians must be cautious in attributing causation with correlation. Continued research and study are needed before we can attribute a source for these dermatologic manifestations. Funding: This research was partially support by IMPACT funds to NY from the School of Medicine, University of Alabama at Birmingham.

Background: Non-alcoholic fatty liver disease (NAFLD) has been increasingly identified in patients with inflammatory bowel disease (IBD), though metabolic risk factors for NAFLD are less frequent in IBD patients. Qatar is among countries characterized by the high prevalence of fatty liver. We aimed to characterize NAFLD in IBD patients and to determine factors associated with its severity. Methods: A retrospective observational study was conducted to estimate the prevalence of NAFLD in all IBD patients followed at Hamad hospital, Doha, Qatar between January 2008 to December 2017. The associations between two or more qualitative variables were assessed using χ2-test and quantitative data between two independent groups were analyzed using the unpaired t-test. Multivariate logistic regression analysis was applied to determine the predictive values of each predictor for NAFLD among IBD patients. Results: Among 913 IBD patients with a mean age of 36.9±13.2 years and BMI 26.9±6.1; 550 were males (60.2%), 383(41.9%) with Crohn’s disease and 530 (58.1%) with Ulcerative colitis. 24 (22.2%) patients had severe steatosis. The overall prevalence of NAFLD was 11.8% (95% CI 9.9, 14.1) and does not differ significantly between CD and UC patients (11.7% vs 11.9%; P=0.949).Patients who developed NAFLD were older at baseline (42.6±12.5 vs 36.2±13.1 years; P 30 kg/m2 (adjusted OR 2.24; 95% CI 1.28, 3.91; P=0.01) and diabetes mellitus (adjusted OR 1.98; 95% CI 1.15, 3.4; P=0.02) significantly associated with an increased risk of NAFLD. Females were less likely having the risk of NAFLD (adjusted OR 0.58; 95% CI 0.36, 0.93; P = 0.02) in comparison to males. The treatment with biologic does not increase the risk of steatosis. The predicted cutoff NAFLD score ≥ -1.67 had good predictive ability for significant steatosis in IBD cases. Conclusion: The prevalence of NAFLD is not uncommon among IBD patients in Qatar. Older age, high BMI and…

Universal acquired melanosis or “Carbon Baby Syndrome” is a progressive condition without any definitive evidence of etiology, long-term prognosis and treatment1. We describe case of a four year old female child presented with blackish discolouration of skin all over body giving a picture similar to “Carbon Baby”.

Cultural competence is more than speaking the language or recognizing the cultural icons of a given group of individuals. Treating the individual is treating their culture. A culturally competent treatment professional must acknowledge an individual’s cultural strengths, values, and experiences while encouraging behavioral and attitudinal change. A significant variable in the change process is the relationship between racial or ethnic matching of clients and counselors. Successful treatment reveals a group of cultural dynamics on how this therapeutic alliance might affect treatment outcomes. To meet these complex cultural challenges, the movement towards a pluralistic cultural framework of helping with its bilingual and bicultural sensitivity appears to be a significant variable to engage the community and the individual in the healing process. Environmental exposures, such as pollution, high-crime areas, and lack of parks or playgrounds, social services, such as transportation, housing, and childcare, mental health care, significantly impact on lifestyle choices. Building strong, grassroots recovery community organizations (RCOs) and linking RCOs into a national movement to develop recovery leaders, offer many opportunities for the recovery community. It helps people in recovery, family members, friends, and allies to express their collective individual and neighborhood voices on issues of common concern by providing a forum for recovery-focused community services that support individual growth.

With the COVID pandemic sweeping across the globe [1], over 1240,000 people have been infected in India (as of July 23,2020 ) in India. With approximately 30,000 deaths, the nation has been reeling under the ravages of COVID 19, and the economic fallout that followed in its wake. Tamil Nadu has over 1,80,000 cases with approximately 3144 deaths (23/07/2020). In this unfavourable milieu, surgical postgraduates joined the course through the process of NEET selection and counselling. Given that social distancing was essential, meet and greet, introduction and case based discussions are held on online platforms such as Google Meet and ZOOM.

Higher rates of anger and aggression have been observed in problem gamblers. In this cross-sectional study the relationship between anger, aggression and a community sample of problem gamblers was examined within two subtypes of gambling: Perceived Skill Gambling (sports, cards, track) and Chance Gambling (bingo, lotteries, slot machines) gambling. Aggression and anger were assessed by the Aggression Questionnaire (AQ) and the Trait Anger Scale (TAS), respectively. Results indicated that Perceived Skill Gamblers (i.e., sports, card, track) scored higher on expressing anger on the AQ as well as on the hostility, physical and verbal and aggression subscales of the TAS. There were no sex differences on any AQ subscale except for the Physical Aggression Subscale. We did not find gender differences on the TAS. The study shows evidence that Perceived Skill Gamblers experience more anger, hostility, physical and verbal aggression as measured by the AQ. The current findings contribute to an improved understanding of the complexity of the factors that are implicated in gambling disorder, and suggests that anger and aggression should be routinely assessed among disordered gamblers seeking treatment.

Leisure sports events are increasingly popular in China and have an important economic and cultural impact on urban Chinese society. Taking the 100-kilometer Hike Through Shenzhen as an example, the purpose of the study was to investigate the relationship between the dimensions of service quality, leisure involvement, satisfaction and subjective well-being by using a structural equation modelling (SEM). Results show that environment, interaction and outcomes each has a significant positive impact on service quality. It was also found that service quality of the event has a significant impact on participants’ happiness by positively affecting their leisure involvement and satisfaction. Results suggest that marketing campaigns with an emotional component can deepen participants’ sense of identity in regard to events, enhance individuals’ physical well-being and promote a ‘healthy China’.

The purpose of the present study was to introduce stochastic search variable selection (SSVS) as a procedure to identify a subset of important predictors of gambling harm. The target set of predictors were dimensions of trait impulsivity, gambling cognitions, and gambling motivations. Five types of gambling harm (feeling one has a personal problem; social criticism; feeling guilt; health; and, financial) were measured by the Problem Gambling Severity Index. Casino patrons completed the measures. As a first step, we identified the significant predictors that would be included in modelling an aggregate harm score. The most important predictors, the cognition that one is not able to stop gambling, and the motivation to escape or avoid life stressors, were positively associated with overall harm. Two weaker, but statistically significant, predictors were negatively associated with harm: sensation-seeking and illusion of control. Although a perceived inability to stop gambling was the most important predictor of each individual harm, the pattern of predictors varied across harms. For example, sensation-seeking was an important predictor only for the belief that one has a gambling problem, and escape/avoidance motivation was strongly predictive of financial harm. The results suggest that primary interventions designed to mitigate harm should address the belief that the gambler is unable to stop gambling, and motivations related to escape/avoid life stressors. Other interventions would be tailored to the specific harms experience by the gambler.

Background.The endoscopic outcome of gastric ulcers is not well described in sub-Saharan Africa. This study was therefore conducted in order to track the endoscopic outcome of non complicated gastric ulcers following standard medical treatment in sub-Saharan African population. Methods.This was a prospective cohort study conducted from January to July 2018 in three tertiary healthcare centers in Yaounde (Cameroon).Gastric ulcers and gastric H. pylori infection were diagnosed and monitored by upper digestive endoscopy performed before and at least four weeks following treatment with proton pump inhibitors alone or combined with antibiotics depending on H. pylori status. A complete case analysis was done using the SPSS software, version 21.0. p-values ≤0.05 were considered as significant. Results. Ninety-six patients (54.2% males) with a mean age of 55.3 ± 14.9 years were initially enrolled. In most patients, the ulcer frequently was unique (76%) and the antrum was the commonest localization 76 (79.2%). Among patients with H. pylori infection, the quadruple therapy was the most prescribed treatment 41 (87.2%) patients. There were 60 (62.5%) subjects lost to follow-up. Of the 36 (37.5%) patients who underwent repeat endoscopy, 26 (72.2%) had ulcer healing and 8/13 patients had successful H. pylori eradication. A delay of repeat endoscopy >8 weeks was the only predictor of non-healing of the ulcer: relative risk 0.6[95% CI: 0.3-1.08], p = 0.05. Conclusion.Ulcer healing was found in nearly 2/3 of patients and H. pylori eradication in almost ¾ of patients. This study should be repeated in a large sample.