Browsing by Author "Ussher, F.A."
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Item First trimester zonulin levels and adiposity as predictive indices of gestational diabetes mellitus(Springer India, 2019-01-13) Amoah, B.Y.; Seini, M.M.; Yakubu, Y.A.; Ussher, F.A.; Alidu, H.BackgroundThis study was aimed at determining the levels of serum zonulin during the first trimester in pregnant women and to examine the relationship between zonulin and obesity in the development of gestational diabetes mellitus (GDM). Available evidence suggests that the permeability of the gut may be associated with obesity and insulin resistance both of which are characteristics of GDM.MethodsThis was a prospective longitudinal study in which a cohort of 314 pregnant women was monitored from first trimester at the Volta Regional Hospital, Ho, Ghana. Maternal serum zonulin and lipids were analyzed during the first trimester, and body mass index (BMI) was calculated for each participant. Glucose challenge tests (GCT) and oral glucose tolerance tests (OGTT) were done between 24 and 28 weeks of pregnancy, and diagnosis of GDM was made in accordance with the American Diabetes Association (ADA) criteria.ResultsWomen who developed GDM had elevated serum zonulin levels with sensitivity, specificity, and cutoff points of 80.95%, 80.41%, and > 47.5 ng/mL respectively in predicting GDM. With positive predictive value (PPV) and negative predictive value (NPV) of 0.708 and 0.986, respectively, zonulin has been shown by this study to be a good predictor of GDM. After adjusting for maternal age and BMI, obese pregnant women with elevated plasma zonulin were 109 times likelier to develop GDM as compared to those with normal BMIs.ConclusionsZonulin levels are increased significantly during the first trimester of pregnancy in women with GDM, and these increases precede the onset of GDM.Item Medication Adherence and Its Association with Glycaemic Control, Blood Pressure Control, Glycosuria and Proteinuria among People Living with Diabetes (PLWD) in the Ho Municipality, Ghana(Open Public Health Journal, 2018-12) Osei-Yeboah, J.; Lokpo, S.Y.; Owiredu, W.K.B.A.; Johnson, B.B.; Orish, V.N.; Botchway, F.; Ussher, F.A.; Avorkliyah, R.Background: Adherence is the active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of behaviour to produce a therapeutic result. The study is aimed at assessing adherence to medication and its relation to therapeutic outcomes among people living with diabetes in the Ho Municipality. Methodology: A cross-sectional study was conducted involving 150 diabetic patients attending the diabetic clinic at the Ho Municipal Hospital. Urine glucose and urine protein were measured using a two-parameter dipstick. The current fasting blood glucose and blood pressure, as well as the measurements of two previous visits, were documented. A semi-structured questionnaire including the Diabetes Complication Checklist and the Morisky, Green and Levine Adherence Scale were used to capture biodata, clinical information and medication adherence. Results: Optimal medication adherence was 60.67%. Glycaemic control and controlled blood pressure were 33.33% and 58.67%, respectively. The prevalence of glycosuria and proteinuria was 10.67% and 3.3%, respectively. Percentage glycaemic control and controlled blood pressure were found to be higher among the medication adherent group, while glycosuria and proteinuria were the highest among participants presenting with low medication adherence. Conclusion: In this group of patients living with diabetes in the Ho Municipality, high level of uncontrolled glycaemia and blood pressure exist. However, these two treatment outcomes may be modulated by optimal medication adherence.