JPMA. The Journal of the Pakistan Medical Association
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Review
Diabetic neuropathy and painful diabetic neuropathy: Cinderella complications in South East Asia.
The most common and debilitating microvascular complication of diabetes is diabetic peripheral neuropathy (DPN), affecting 50-90% of people with diabetes. The major manifestations of DPN are painful (pDPN) and painless diabetic peripheral neuropathy. Painful symptoms, occur in the feet and are worse at night and whilst they alert both the patient and physician, are often misdiagnosed and mismanaged. ⋯ PubMed, EMBASE, Medline and Google Scholar databases were searched between 1990 and 2017. This highlights the widely varying prevalence of DPN and pDPN in the World Health Organization (WHO) defined SEA countries and the dearth of published studies, especially in pDPN. We believe this will provide new direction for future research on DPN in the SEA region.
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Cardiovascular diseases possess a major cause for fatality and disability the world over. Since last several decades, the rates of cardiovascular diseases-related deaths have decreased in a number of high-income countries but increased in low- and middle-income countries with around 80% of the burden. ⋯ Practical efforts are required to enhance the understanding of cardiovascular diseases risk factors such as diet, physical activity, and tobacco-control policies to support prevention and control at the population level. This paper reviews the major modifiable risk factors in Pakistan, highlights available preventive services, and presents the most likely ways to promote risk-factor reduction.
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Case Reports
Pelvic abscess caused by a slow growing anaerobic bacterium, Eggerthella lenta: First case report from Pakistan.
We report a case of intrauterine contraceptive device (IUCD) related pelvic abscess caused by a challenging to grow anaerobic Gram positive rod named Eggerthella lenta. A middle aged lady presented with complaints of lower abdomen pain, intermittent vaginal bleeding since two weeks. ⋯ Histopathological examination disclosed adenomyosis and chronic non-specific endometritis. Microbiological evaluation of pus aspirate grew Eggerthella lenta.
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Carbohydrate counting or "carb counting" is a meal planning technique for persons with diabetes for managing blood glucose levels by tracking the grams of carbohydrate consumed at meals. With better patient education and awareness, carb counting has become an important step in diabetes management. ⋯ In the first part of this review basic principles of carbohydrate counting, its application in clinical practice and exchange lists pertaining primarily to South Asian populations have been discussed. Advanced carb counting involving equations which help in better understanding of insulin-to-carbohydrate ratio and insulin dose adjustment are also included in this review.