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Mani R.,University of Southampton | Mani R.,Chiang Mia University | Mani R.,Shanghai JiaoTong University | Margolis D.J.,University of Pennsylvania | And 13 more authors.
International Journal of Lower Extremity Wounds | Year: 2016

Innovations in technology are used in managing chronic wounds. Despite the wide range of technologies available, healing of chronic wounds remains variable. In this paper, the authors offer an evidence based approach to the use of technology for diagnosis and management based on the concept of standardised care. © The Author(s) 2015.


Viswanathan V.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Kumpatla S.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Aravindalochanan V.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Rajan R.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | And 4 more authors.
PLoS ONE | Year: 2012

Background: Diabetes mellitus (DM) is recognised as an important risk factor to tuberculosis (TB). India has high TB burden, along with rising DM prevalence. There are inadequate data on prevalence of DM and pre-diabetes among TB cases in India. Aim was to determine diabetes prevalence among a cohort of TB cases registered under Revised National Tuberculosis Control Program in selected TB units in Tamil Nadu, India, and assess pattern of diabetes management amongst known cases. Methods: 827 among the eligible patients (n = 904) underwent HbA1c and anthropometric measurements. OGTT was done for patients without previous history of DM and diagnosis was based on WHO criteria. Details of current treatment regimen of TB and DM and DM complications, if any, were recorded. A pretested questionnaire was used to collect information on sociodemographics, habitual risk factors, and type of TB. Findings: DM prevalence was 25.3% (95% CI 22.6-28.5) and that of pre-diabetes 24.5% (95% CI 20.4-27.6). Risk factors associated with DM among TB patients were age (31-35, 36-40, 41-45, 46-50, >50 years vs <30 years) [OR (95% CI) 6.75 (2.36-19.3); 10.46 (3.95-27.7); 18.63 (6.58-52.7); 11.05 (4.31-28.4); 24.7 (9.73-62.7) (p<0.001)], positive family history of DM [3.08 (1.73-5.5) (p<0.001)], sedentary occupation [1.69 (1.10-2.59) (p = 0.016)], and BMI (18.5-22.9, 23-24.9 and ≥25 kg/m2 vs <18.5 kg/m2) [2.03 (1.32-3.12) (p = 0.001); 0.87 (0.31-2.43) (p = 0.78); 1.44 (0.54-3.8) (p = 0.47)]; for pre-diabetes, risk factors were age (36-40, 41-45, 46-50, >50 years vs <30 years) [2.24 (1.1-4.55) (p = 0.026); 6.96 (3.3-14.7); 3.44 (1.83-6.48); 4.3 (2.25-8.2) (p<0.001)], waist circumference [<90 vs. ≥90 cm (men), <80 vs. ≥80 cm (women)] [3.05 (1.35-6.9) (p = 0.007)], smoking [1.92 (1.12-3.28) (p = 0.017)] and monthly income (5000-10,000 INR vs <5000 INR) [0.59 (0.37-0.94) (p = 0.026)]. DM risk was higher among pulmonary TB [3.06 (1.69-5.52) (p<0.001)], especially sputum positive, than non-pulmonary TB. Interpretation: Nearly 50% of TB patients had either diabetes or pre-diabetes. © 2012 Viswanathan et al.


Kumpatla S.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Michael C.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Viswanathan V.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Viswanathan V.,Prof swanathan Diabetes Research Center
International Journal of Diabetes in Developing Countries | Year: 2015

This study was designed to evaluate the effect of yogasanas on glycaemic control, haemodynamic and lipid profile in newly diagnosed subjects with type 2 diabetes prescribed with oral hypoglycaemic agents (OHA). Three hundred and three (M:F 199:104) subjects were recruited in this prospective study and were divided into two groups. Group 1 (N = 149) were prescribed OHA alone, while group 2 subjects (N = 154) were prescribed OHA and received training individually once for regular yoga practice for 30 min daily. Baseline data on anthropometric, haemodynamic and biochemical details were collected, and subjects were asked to report for review after 3 months. All investigations were repeated after 3 months. A total of 241 subjects were available for follow-up. Diabetes treatment regimen was unchanged in both the groups during the study period. Both the groups were matched with respect to body mass index (BMI), glycaemic level, lipid profile and diet calorie consumption at baseline. BMI did not differ significantly at follow-up in both the groups. Glucose levels and HbA1c % showed greater reduction in group 2 practising yoga. Total and low-density lipoprotein (LDL) cholesterol alone improved in group 1, whereas improvement was seen in all lipid parameters in group 2. High-density lipoprotein (HDL) cholesterol was not statistically significant in both groups. Group 1 showed improvement in systolic blood pressure (P = 0.027), whereas group 2 subjects showed improvement in both systolic and diastolic blood pressures (P < 0.0001). In conclusion, regular practice of yoga along with conventional medicines could be beneficial for better control of diabetes. © 2015, Research Society for Study of Diabetes in India.


Viswanathan V.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Kumpatla S.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Narayan Rao V.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center
Journal of Association of Physicians of India | Year: 2014

Objective: People with diabetic neuropathy are frequently prone to several bone and joint abnormalities. Simple radiographic findings have been proven to be quite useful in the detection of such abnormalities, which might be helpful not only for early diagnosis but also in following the course of diabetes through stages of reconstruction of the ulcerated foot. The present study was designed to identify the common foot abnormalities in south Indian diabetic subjects with and without neuropathy using radiographic imaging.Methods: About 150 (M:F 94:56) subjects with type 2 diabetes were categorised into three groups: Group I (50 diabetic patients), Group II (50 patients with neuropathy), and Group III (50 diabetic patients with both neuropathy and foot ulceration). Demographic details, duration of diabetes and HbA1c values were recorded. Vibration perception threshold was measured for assessment of neuropathy. Bone and joint abnormalities in the feet and legs of the study subjects were identified using standardised dorsi-plantar and lateral weight-bearing radiographs.Results: Radiographic findings of the study subjects revealed that those with both neuropathy and foot ulceration and a longer duration of diabetes had more number of bone and joint abnormalities. Subjects with neuropathy alone also showed presence of several abnormalities, including periosteal reaction, osteopenia, and Charcot changes.Conclusions: The present findings highlight the impact of neuropathy and duration of diabetes on the development of foot abnormalities in subjects with diabetes. Using radiographic imaging can help in early identification of abnormalities and better management of the diabetic foot. © 2014, Journal of Association of Physicians of India. All rights reserved.


Satyavani K.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Archana S.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Kumar A.M.V.,International Union against Tuberculosis and Lung Disease The Union | Achanta S.,World Health Organization | Viswanathan V.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center
Journal of Association of Physicians of India | Year: 2015

Objective: To assess the sex differences in the prevalence of cardiovascular risk factors among patients with type 2 diabetes, visiting the hospital between March–December 2012. Methods: A cross-sectional study was performed among the type 2 diabetes patients attending M.V. Hospital for Diabetes, a tertiary centre specialized in diabetes care, Chennai, South India. We collected information on obesity (body mass index ≥25 kg/m2), hypertension, dyslipidemia, smoking, alcohol consumption and glycemic control (HbA1c >8% considered poor control). Results: Risk factors (prevalence) among 6113 (58% males; mean age 54 years) patients were obesity (68.4%), poor glycemic control (51.4%), hypertension (37.9%), dyslipidemia (34.7%), smoking (9.6%) and consumption of alcohol (10.3%), respectively. Women had a higher prevalence of obesity (75.7 vs 63.2%) and poor glycemic control while men had a higher prevalence of smoking and alcohol consumption. There were no sex differences in prevalence of hypertension and dyslipidemia. Cardiovascular risk factors were not associated with duration of diabetes. Conclusion: Cardiovascular risk factors were highly prevalent among patients with type 2 diabetes attending a tertiary care centre in South India, with different risk profiles among men and women. We recommend a gender-sensitive approach in planning interventions (counseling and treatment) to reduce the risk of cardiovascular disease. © 2015, Journal of Association of Physicians of India. All rights reserved.

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