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January-February 2016 Volume 29 | Issue 1
Page Nos. 1-59
Online since Monday, August 1, 2016
Accessed 585,831 times.
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EDITORIALS |
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The revised guidelines of the Medical Council of India for academic promotions: Need for a rethink |
p. 1 |
Rakesh Aggarwal, Nithya Gogtay, Rajeev Kumar, Peush Sahni PMID:27492027 |
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Sharing Clinical Trial Data: A Proposal from the International Committee of Medical Journal Editors |
p. 6 |
Darren B Taichman, Joyce Backus, Christopher Baethge, Howard Bauchner, Peter W de Leeuw, Jeffrey M Drazen, John Fletcher, Frank A Frizelle, Trish Groves, Abraham Haileamlak, Astrid James, Christine Laine, Larry Peiperl, Anja Pinborg, Peush Sahni, Sinan Wu PMID:27492028 |
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ORIGINAL ARTICLE |
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Diabetic retinopathy and its risk factors in patients with type 2 diabetes attending rural primary healthcare facilities in Tamil Nadu |
p. 9 |
Tony Fredrick, Prabhdeep Kaur, Manoj V Murhekar, Yuvaraj Jayaraman, K Kolandaswamy, Sudha Ramachandra Rao, Joseph K David PMID:27492029Background. India has a high burden of diabetic retinopathy ranging from 12.2% to 20.4% among patients with type 2 diabetes mellitus (T2DM). A T2DM management programme was initiated in the public sector in Tamil Nadu. We estimated the prevalence of diabetic retinopathy and its associated risk factors. Methods. We did a cross-sectional survey among patients with T2DM attending two primary health centres for treatment and follow-up in Kancheepuram, Tamil Nadu in January- March 2013. We did a questionnaire-based survey, and measured blood pressure and biochemical parameters (serum creatinine, plasma glucose, etc.) of the patients. We examined their eyes by direct and indirect ophthalmoscopy and defined diabetic retinopathy using a modified classification by Klein et al. We calculated the proportion and 95% CI for the prevalence and adjusted odds ratio (AOR) for risk factors associated with diabetic retinopathy. Results. Among the 270 patients, the mean (SD) age was 54.5 (10) years. The median duration of T2DM was 48 months. The prevalence of diabetic retinopathy was 29.6%. Overall, 65.9% of patients had hypertension, 14.4% had nephropathy (eGFR <60 mg/dl) and 67.4% had neuropathy. Among patients with comorbid conditions, 60%, 48%, 32%, and 3% were already diagnosed to have hypertension, neuropathy, retinopathy, and nephropathy, respectively. The risk factors for diabetic retinopathy were hypertension (AOR 3.2, 95% CI 1.7-6.3), duration of T2DM >5 years (AOR 6.5, 95% CI 3.6-11.7), poor glycaemic control (AOR 2.4, 95% CI 1.4-4.4), and nephropathy (AOR 2.3, 95% CI 1.1-4.6). Conclusions. There was a high burden of undetected retinopathy and other comorbid conditions among patients with T2DM. Early detection of comorbid conditions and glycaemic control can be improved by training care-providers and educating patients. |
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CLINICAL CASE REPORT |
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Guillain–Barré syndrome in a patient with neuropsychiatric systemic lupus erythematosus |
p. 14 |
GK Rajeshwari, CH Bangaru Rao, NV Sundarachary, SK Moula Ali, JS Kalyani, A Sridhar PMID:27492030Guillain-Barré syndrome is a rare manifestation of neuropsychiatric systemic lupus erythematosus (SLE). Clinical and electrophysiological features of Guillain-Barré syndrome in patients with SLE are different from those in patients without SLE. There is considerable variation in the management and prognosis. We present a patient with Guillain-Barrι syndrome and SLE and review the recent knowledge on the various manifestations of neuropsychiatric SLE.
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REVIEW ARTICLE |
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Routine health check-ups: A boon or a burden? |
p. 18 |
Bianca Honnekeri, Aniruddha Vyas, Disha Lokhandwala, Avani Vaishnav, Aditi Vaishnav, Mayank Singhal, Parag Barwad, Gopi Krishna Panicker, Yash Lokhandwala PMID:27492031Healthcare provider institutions in India now offer structured health check-up 'packages' for routine screening of common diseases. While some tests included within their ambit are in keeping with international and Indian recommendations, some are entirely unwarranted. Unnecessary and inappropriate screening tests may cause more harm than benefit. Besides financial and resource burden, there may be over-diagnosis and over-treatment, psychological distress due to false-positive test results, harm from invasive follow-up tests, and false reassurance due to false-negative test results. Clinicians must ensure a net benefit from tests and interventions in order to efficiently deliver preventive services. We reviewed current screening guidelines for cardiovascular disease and common cancers, and surveyed multiple 'packages' provided at 8 centres in Mumbai, India. We put forth our recommendations for routine health screening in asymptomatic adults in India. |
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SELECTED SUMMARIES |
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Control of scabies in endemic areas: Is mass drug administration the solution? |
p. 22 |
Riti Bhatia, M Ramam PMID:27492032 |
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Residents' working hours and patient safety: Have we finally laid the issue to rest! |
p. 23 |
N Ananthakrishnan PMID:27492033 |
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Total knee replacement or non-surgical therapy for osteoarthritis of the knee? |
p. 25 |
Rajesh Malhotra PMID:27492034 |
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LETTER FROM NEPAL |
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Post-earthquake Nepal: Acute-on-chronic problems |
p. 27 |
Buddha Basnyat PMID:27492035 |
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LETTER FROM MUMBAI |
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Then and now: Teaching medicine at the patient's bedside
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p. 28 |
Sunil Pandya PMID:27492036 |
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LETTER FROM GANIYARI |
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The art of letting go and the mandate of going further |
p. 30 |
Timothy S Laux PMID:27492037 |
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BOOK REVIEWS |
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Book Reviews |
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IMAGES IN MEDICINE |
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Cytomegaloviral retinitis
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p. 35 |
Koushik Tripathy, Pradeep Venkatesh, Rohan Chawla PMID:27492038 |
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Metachronous second primary of the oesophagus detected by FDG-PET/CT in a patient with follicular variant of papillary thyroid carcinoma |
p. 36 |
Sandip Basu, Rohit Ranade PMID:27492039 |
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CORRESPONDENCE |
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Elimination of lymphatic filariasis |
p. 37 |
SB Gogia, Sathi , Sangtin PMID:27492040 |
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CLASSICS IN INDIAN MEDICINE |
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Myelopathy complicating congenital atlanto-axial dislocation (A study of 28 cases) |
p. 38 |
NH Wadia PMID:27492041 |
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NEWS FROM HERE AND THERE |
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News from here and there |
p. 57 |
Sanjay A Pai PMID:27492042 |
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MASALA |
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Masala |
p. 59 |
Vivek Arya PMID:27492043 |
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