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2016| January-February | Volume 29 | Issue 1
Online since
August 1, 2016
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ORIGINAL ARTICLE
Diabetic retinopathy and its risk factors in patients with type 2 diabetes attending rural primary healthcare facilities in Tamil Nadu
Tony Fredrick, Prabhdeep Kaur, Manoj V Murhekar, Yuvaraj Jayaraman, K Kolandaswamy, Sudha Ramachandra Rao, Joseph K David
January-February 2016, 29(1):9-13
PMID
:27492029
Background.
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.
[ABSTRACT]
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REVIEW ARTICLE
Routine health check-ups: A boon or a burden?
Bianca Honnekeri, Aniruddha Vyas, Disha Lokhandwala, Avani Vaishnav, Aditi Vaishnav, Mayank Singhal, Parag Barwad, Gopi Krishna Panicker, Yash Lokhandwala
January-February 2016, 29(1):18-21
PMID
:27492031
Healthcare 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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CLINICAL CASE REPORT
Guillain–Barré syndrome in a patient with neuropsychiatric systemic lupus erythematosus
GK Rajeshwari, CH Bangaru Rao, NV Sundarachary, SK Moula Ali, JS Kalyani, A Sridhar
January-February 2016, 29(1):14-17
PMID
:27492030
Guillain-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.
[ABSTRACT]
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CORRESPONDENCE
Elimination of lymphatic filariasis
SB Gogia, Sathi , Sangtin
January-February 2016, 29(1):37-37
PMID
:27492040
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EDITORIALS
The revised guidelines of the Medical Council of India for academic promotions: Need for a rethink
Rakesh Aggarwal, Nithya Gogtay, Rajeev Kumar, Peush Sahni
January-February 2016, 29(1):1-5
PMID
:27492027
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1,496
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LETTER FROM NEPAL
Post-earthquake Nepal: Acute-on-chronic problems
Buddha Basnyat
January-February 2016, 29(1):27-27
PMID
:27492035
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[PubMed]
1,299
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LETTER FROM MUMBAI
Then and now: Teaching medicine at the patient's bedside
Sunil Pandya
January-February 2016, 29(1):28-29
PMID
:27492036
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[PubMed]
1,254
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EDITORIALS
Sharing Clinical Trial Data: A Proposal from the International Committee of Medical Journal Editors
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
January-February 2016, 29(1):6-8
PMID
:27492028
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1,089
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LETTER FROM GANIYARI
The art of letting go and the mandate of going further
Timothy S Laux
January-February 2016, 29(1):30-31
PMID
:27492037
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1,057
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NEWS FROM HERE AND THERE
News from here and there
Sanjay A Pai
January-February 2016, 29(1):57-58
PMID
:27492042
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IMAGES IN MEDICINE
Cytomegaloviral retinitis
Koushik Tripathy, Pradeep Venkatesh, Rohan Chawla
January-February 2016, 29(1):35-35
PMID
:27492038
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998
40,406
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CLASSICS IN INDIAN MEDICINE
Myelopathy complicating congenital atlanto-axial dislocation (A study of 28 cases)
NH Wadia
January-February 2016, 29(1):38-56
PMID
:27492041
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1,205
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IMAGES IN MEDICINE
Metachronous second primary of the oesophagus detected by FDG-PET/CT in a patient with follicular variant of papillary thyroid carcinoma
Sandip Basu, Rohit Ranade
January-February 2016, 29(1):36-36
PMID
:27492039
Full text not available
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[PubMed]
708
40,392
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MASALA
Masala
Vivek Arya
January-February 2016, 29(1):59-59
PMID
:27492043
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294
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SELECTED SUMMARIES
Total knee replacement or non-surgical therapy for osteoarthritis of the knee?
Rajesh Malhotra
January-February 2016, 29(1):25-26
PMID
:27492034
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319
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Control of scabies in endemic areas: Is mass drug administration the solution?
Riti Bhatia, M Ramam
January-February 2016, 29(1):22-23
PMID
:27492032
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1,138
253
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Residents' working hours and patient safety: Have we finally laid the issue to rest!
N Ananthakrishnan
January-February 2016, 29(1):23-25
PMID
:27492033
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BOOK REVIEWS
Book Reviews
January-February 2016, 29(1):32-34
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