Introduction: Though the role of inflammation is reputedly associated with contrast induced nephropathy (CIN), especially in the setting of Acute Coronary Syndrome (ACS), current risk scoring systems do not address inflammatory factors. Neutrophil lymphocyte ratio (NLR), a proportion of two inflammatory markers, is reflective of the balance between innate and adaptive immune responses, and therefore has a strong predictive value. Methods: A cross-sectional analytical study done among adult Filipinos diagnosed with ACS who underwent Percutaneous Coronary Intervention (PCI) from January to December 2018 at Makati Medical Center. Exposure of interest includes baseline NLR count and pre-procedural serum creatinine. Outcome was the incidence of CIN based on serum creatinine 24-48 hours post-procedure. Results and Analysis: A total of 166 ACS patients were analyzed, of which 11 (6.62%) has CIN. Patients with pre-procedural NLR > 4.71 were approximately five times as likely to develop CIN (aOR 1.51 to 17.55, p = 0.009), with sensitivity 63.64%, specificity 80.65%, accuracy 79.52%, Youden’s index 44.29%. On multivariate analysis, NLR and STEMI were associated with increased odds for CIN. STEMI patients had approximately four times the odds of developing CIN (aOR 3.893, 95% CI 1.07 to 14.13, p = 0.039). Conclusion NLR > 4.71 in Filipinos with ACS who underwent PCI is associated with increased risk to develop CIN.
Percutaneous Coronary Intervention

Objective: This study aims to determine the association of serum magnesium with distal symmetric peripheral neuropathy among persons with type 2 diabetes mellitus (DM). Methodology: A cross-sectional analytical study among adult Filipinos with Type 2 DM. Logistic regression was used to determine the association of serum magnesium with DSPN diagnosed by the Michigan Neuropathy Screening Instrument. The null hypothesis was rejected at 0.05α-level of significance. Results: The average serum magnesium levels were similar between those with versus without DSPN (2.06 ± 0.32 vs 2.05 ± 0.23, p = 0.873); the same was seen for corrected magnesium. There is insufficient evidence to demonstrate a significant statistical difference between those with and without DSPN in relation to glycemic control (HbA1c and FBS). Likewise, there is no significant statistical correlation between serum magnesium levels with HbA1c, FBS, BMI, or duration of diabetes. Conclusion This present study could not demonstrate any association between DSPN and serum magnesium, even after adjusting for age, sex, and comorbidity.
Magnesium ; Diabetic Neuropathies

Introduction: The coexistence of two global pandemics, COVID-19 and type 2 diabetes mellitus, has been implicated with worse prognosis. The association of diabetes and worse outcome in viral infections stems from the detrimental effect of hyperglycemia to the control of viremia and different components of the host response. This study aimed to describe the epidemiological and clinical characteristics of confirmed COVID-19 patients and establish the association of baseline glycemic status and COVID-19 outcomes among persons with type 2 diabetes. Methodology: A single center, retrospective study among adult persons with type 2 diabetes diagnosed with COVID-19 in Makati Medical Center from March 1 to August 31, 2020. A total of 156 medical records (26%) out of 584 confirmed cases were reviewed. Data were collected on diabetes status, comorbid conditions and laboratory findings. Both Cox proportional hazards models and logistic regression models were fitted. To assess the factors associated with mortality as a dichotomous endpoint (died/survived), binary logistic regression was performed. On the other hand, a time-to-mortality analysis was performed using Cox regression. For the effect estimate, we refer to hazard ratios in the Cox proportional hazards model and odds ratios in the logistic regression models. All analyses were adjusted for age and sex and two models were additionally adjusted for any presence of comorbidity. Results: A total of 156 COVID-19 patients with diabetes were analyzed. Upon admission, 13% were in diabetic ketosis, 4% were in a state of DKA, and 2% had hypoglycemia. About 5%, 33%, 26%, and 36% of patients had mild, moderate, severe, and critical COVID-19, respectively. Between non-survivors and survivors, the latter group were significantly younger in age (p<.003) and had less ICU admissions (p<.001). Although DKA status upon admission seemed to result in increased odds of non-survival (cOR 5.8 [95% CI 1.1-30.7]), no other feature in the glycemic history was significantly associated with mortality outcome after having adjusted for age and sex. Death in this study was limited to patients with severe or critical disease. Conclusion The risk of mortality is five times greater among patients admitted with diabetic ketoacidosis. The incidence of complications were also significantly greater and mortality was limited to patients with severe or critical disease.
Diabetes Mellitus ; Coronavirus