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  Citation statistics : Table of Contents
   2018| September-December  | Volume 9 | Issue 3  
    Online since August 22, 2018

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Diabetes in Asia: Special challenges and solutions
Akhtar Hussain
September-December 2018, 9(3):69-72
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A comparative study of clinical variables in tuberculosis patients with coexisting diabetes
Anil Kumar Agarwal, Nikhil Agarwal, Ramniwas Mahore
September-December 2018, 9(3):81-87
Background: Diabetes mellitus (DM) is recognised as an important risk factor for tuberculosis (TB). India has high-TB burden, along with rising DM prevalence. Aim: This study was conducted to document the co-existence of DM and TB in persons with established TB and difference in clinical presentation. Type of Study: This was a cross-sectional, descriptive observational study conducted at selected directly observed treatment (DOT) centre in Gwalior North-Central India. Materials and Methods: A total of 550 patients of confirmed diagnosis of TB and on treatment were recruited. The study participants were screened for DM and diagnoses were made on the basis of the World Health Organization criteria. Clinical parameters were compared between persons with DM and those without DM. Results: DM/TB comorbidity was noted in 85 persons, and these made up 15.4% of the study population. Mean age was higher in DM patients with TB (43.4 ± 15.4 vs. 33.1 ± 16.2 years, P = 0.000); the mean duration of symptoms of TB with DM was more (124 ± 16.4 vs. 107.49 ± 10.3 days). Majority of the patients (63.5% dysglycaemic and 43.6% normoglycaemic TB patients) were presented with a cough with or without expectoration and significantly found more in dysglycaemic TB patients (odds ratio = 2.2, P = 0.007). The frequency of reporting symptoms was higher among dysglycaemic TB patients as compared to normoglycaemic TB patients. This difference in both groups was found to be statistically significant (P < 0.05) for pleural effusion, fever, shortness of breath, chronic abdominal pain, fatigue/weakness and in other non-specific symptoms. Conclusions: Given the substantial burden of DM and TB co-morbidity, this study makes a contribution for re-echo the need to raise awareness on screening for DM in persons with TB.
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Impact of Christians fasting in type 2 diabetic patients among Egyptian coptic orthodox
Adel Abd El-Aziz El-Sayed, Amal Khalifa Noreldin, Mahmoud Kamal Elsamman, Diana Samy Zaky, Emad Sameh Kaldas
September-December 2018, 9(3):88-94
Context: Religious fasting has a variable metabolic impact health. Studies on Orthodox Christian fasting in diabetic patients are very scarce, and studies on health effects of Christian fasting in Egypt are lacking. Objective: The objective of the study is to evaluate the effect of fasting among Egyptian Coptic Orthodox Christians with and without Type 2 diabetes mellitus (DM). Settings and Design: A prospective study was conducted in Sohag San George Church and involved 49 Egyptian Coptic Orthodox Christians with Type 2 DM and 48 non-diabetic persons during the period of Great Lent 2013. Subjects and Methods: Both diabetic and non-diabetic groups were subjected to clinical evaluation, anthropometric measurements and laboratory investigations before and after fasting. Statistical Analysis Used: Statistical analysis was conducted using SPSS (11.0) for Windows and P < 0.05 considered as statistically significant. Results: Among the diabetic group, there was a significant reduction in systolic and diastolic blood pressure after fasting with P = 0.0001 and 0.047, respectively. Body mass index (BMI) and waist circumference were reduced significantly after fasting with P = 0.0005 and 0.001, respectively. Significant reduction in glycosylated haemoglobin after fasting was also detected. No significant change lipid profile was detected. Among non-diabetic group, significant decrease in BMI, waist circumference and high-density lipoprotein level was detected after fasting. There were no significant changes in blood pressure, triglycerides, cholesterol and low-density lipoprotein levels. Conclusion: Fasting among Egyptian Coptic Orthodox Christians has positive impacts on health among patients with Type 2 DM. It also showed some beneficial effects among fasting non-diabetic individuals.
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Diabetes risk score for identifying cardiometabolic risk factors in adult Bangladeshi population
Bishwajit Bhowmik, Tasnima Siddiquee, Anindita Mujumder, Tofail Ahmed, Hajera Mahtab, Abul Kalam Azad Khan, Akhtar Hussain, Gerd Holmboe-Ottesen, Tone Kristin Omsland
September-December 2018, 9(3):95-101
Context: Simple non-invasive tools to identify high-risk individuals would facilitate screening of cardiometabolic diseases as well as diabetes. Aims: (1) To estimate variations in Bangladesh diabetes risk score (BDRS) according to stages of glucose intolerance, (2) to examine the usefulness of BDRS for identifying metabolic syndrome (MS), dyslipidaemia and 10-year risk of coronary artery disease (CAD) in people with normal glucose tolerance (NGT). Subjects and Methods: Data were taken from a randomised cross-sectional study of 2293 patients in a rural community of Bangladesh in 2009, based on questionnaire interviews, anthropometric measurements, fasting blood samples and oral glucose tolerance test. The BDRS includes age, sex, body mass index, waist-hip ratio and hypertension (HTN). Spearman correlation and logistic regression were done to assess the relationship between BDRS and cardiometabolic risk factors. Results: The mean BDRS increased significantly with higher glucose intolerance (P for trend < 0.001). Among NGT group, the prevalence of cardiometabolic risk factors increased progressively from low-to-medium-to-high-risk score groups; HTN: 7.8%, 12.3% and 19.8% (P for trend: <0.001), dyslipidaemia: 16.3%, 25.3% and 27.4% (P for trend: <0.001), MS: 10.2%, 22.4% and 30.9% (P for trend: <0.001) and CAD risk: 3.6%, 9.0% and 13.8% (P for trend: <0.001), respectively. BDRS was significantly associated with MS (odds ratio [OR]: 1.92, P < 0.001); dyslipidaemia (OR: 1.30, P = 0.018); and CAD risk (OR: 1.93, P < 0.001). Conclusions: BDRS can be used for identifying MS, dyslipidaemia and CAD risk even among people with NGT.
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Systemic Factors Affecting Diabetic Retinopathy
Brijendra Kumar Srivastava, B Ramya, V Prathiba, V Mohan
September-December 2018, 9(3):73-77
Diabetic retinopathy (DR) is one of the leading causes of preventable blindness in the world. Apart from local pathophysiological changes happening at the level of retina, various systemic factors also play a role in pathogenesis and progression of DR. In this article, we will discuss systemic factors affecting DR such as hyperglycaemia, hypertension, hyperlipidaemia, nephropathy, pregnancy, anaemia and cardiovascular disease, with their association to progression of DR.
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Type 1 diabetes registry in developing countries: Perspective from India
Banshi Saboo, Anju Virmani, Sanjay Kalra, Dhruvi Hasnani, Ashok Kumar Das, Shaukat Sadikot, Jayprakash Sai, Tanya Rangwala, Karnik Patel
September-December 2018, 9(3):78-80
India has been a prey to rising tide of non-communicable diseases. It is becoming increasingly important to evolve strategies to ensure effective prevention, diagnosis and treatment of this rising burden. Available Indian data reveal different opinions regarding type 1 diabetes (T1D). Such variation in data leads to uncertainty in healthcare planning and management. This ununiformity in data and the absence of protocol make a task challenging. Many patients consult non-specialists and even doctors from different streams. On the part of the patients, the diagnostic and screening testing are a great burden. T1D registry is of great relevance to India. It helps in ensuring good clinical practice and errors. Endocrinologists and paediatricians can audit themselves using such a registry. The overall goal is to improve population health. The objective is to reduce morbidity and mortality while maximising the cost-effectiveness. Such a registry helps in fund allocation and healthcare planning and contributes to the formulation of pragmatic management guidelines. However, healthcare professionals are reluctant to share their data. This may be due to fear of being audited by peers or regulators and record maintenance. We must work towards creating a national registry of T1D. This should involve multiple centres across the country, as it will help enhance awareness about T1D and improve standard of care. The results of which can be used to advocate for greater allocation of resources to T1D care. An effective registry will help children claim their rightful place under the sun.
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