Diabetes is a major public health problem. 285 million persons worldwide have diabetes, of these 51 million are in India. Diabetic peripheral neuropathy is a major microvascular complication of diabetes. Conventional methods used for the diagnosis of diabetic peripheral neuropathy in clinical practice have limited effectiveness. Since peripheral sensory neuropathy is a pivotal element in the causal pathway to both foot ulceration and amputation, screening and early identification of neuropathy offer a crucial opportunity for the patient with diabetes to actively modulate the course of suboptimal glycaemic control to currently recommended targets, and to implement improved foot care before the onset of significant morbidity. This study was carried out to evaluate the usefulness of simple bed side screening modalities for peripheral neuropathy like vibration perception threshold measurement with biothesiometer, 10g semmes-weinstein monofilament, diabetic neuropathy examination and symptom scores and ankle reflex testing in patients with diabetes mellitus and to seek an optimal screening method in diabetic clinic.
We report a rare case of a 50 year old Indian male patient with concomitant tophaceous gout and rheumatoid arthritis (RA) who presented with intradermal tophaceous deposits at some very rare sites. The presence of RA was confirmed by the presence of positive anti-CCP levels as compared to some other rare case reports where nonspecific rheumatoid factor substantiated the presence of RA. The presentation, diagnostic work up and management is discussed and the current literature pertaining to this interesting case is reviewed.
The chronic kidney disease (CKD) patients undergoing hemodialysis are predisposed to Hepatitis C virus (HCV) infection and serve as reservoir of infection to the hospital staff. The data on prevalence of HCV infection in patients receiving hemodialysis as renal replacement therapy is scarce and this highlights the significance of this study. 3 (7.1%) patients were anti-HCV ELISA positive whereas 39(92.9%) were anti-HCV negative.
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