Adequate and proper diabetes care in any practice is paramount and deems to be the fundamental requirement for good diabetes control. This is an audit of type 2 diabetes care process in a public Polyclinic, with the objectives of studying the quality of diabetic care provided in terms of clinical and managerial performance and also to give recommendations on improving its diabetes care delivery. The audit was done on patients' medical records selected via systematic random sampling. Patients who have been diagnosed with type 2 diabetes mellitus for more than 2 years, and those who have come for follow-up at least twice in between 1st October 2008 and 30th September 2009 by the medical officer and/or family medicine specialist. Patients with gestational diabetes mellitus and Type 1 diabetes mellitus were excluded. A total of 100 medical records were audited. 51% were female and 82% were in the 40-69 age group. Measurements of blood glucose and blood pressure were done at each follow-up at the polyclinic at 96% and 93% of the times, respectively. Within the past one year, HbA1c was performed in 46% of the patients, while renal profile was screened in 66% of the patients and urine protein was tested in 59% of the diabetics. Only 15% had their eyes screened by fundus camera. The diabetes care process at this public polyclinic was unsatisfactory, as many annual blood tests were not done and complications screening were also omitted. Thus, an urgent intervention is recommend in order to rectify these inadequacies.
The objectives of this study is to evaluate the efficacy of protein-free media in the preparation, holding and crypreservation of spermatazoa for use in ART. Normozoospermic semen samples (N=71) were used to compare the effects of media on the survival and quality of spermatozoa when washed and cultured with different media with and without added proteins at 4°C, 15°C, 22°C and 37°C for 0, 4-7 and 24h. Survival and quality of spermatozoa were assessed after freeze-thaw with synthetic cryoprotectant with and without proteins. Ethics/IRB approval was obtained (Ref. 1073.52). Spermatozoa parameters were similar in all media after washing and culture for 24h. Post-thaw survival and quality of spermatozoa was not significantly different 24h after thawing of samples frozen in all cryoprotectant medium. In conclusion synthetic protein-free culture and cryoprotectant media are equal in efficacy to protein-containing media in culture and cryopreservation of spermatozoa . Use of these synthetic media are anticipated to significantly reduce the risk, potentially associated with conventional protein-containing media, of transmission of disease and possibly harmful undeclared proteins to the patient, baby and the healtcare worker. Synthetic media also ensure consistency of quality between batches of media.