ABSTRACT
CONTEXT: Lifestyle modifications play a major role in controlling blood glucose levels among diabetes mellitus for the prevention of its complications. Mobile phones can be used as an efficient tool for improving the healthy lifestyle through health education. AIMS: The aim of the study is to measure the efficacy of behavior change communication using mobile calls in controlling blood sugar levels, increasing medication adherence, healthy diet, and physical activity among diabetic patients. SETTINGS AND DESIGN: A randomized controlled trial was conducted in an urban area of Pondicherry between 50 (25 per arm) type 2 diabetes patients. SUBJECTS AND METHODS: All participants were interviewed using a structured questionnaire. Fasting blood glucose (FBG) was measured. Single-time health education was given to both groups. The intervention group received a mobile phone calls reminders thrice weekly for 2 months. Changes in FBG, diet, physical activities, and adherence to medications were assessed after 2 months. STATISTICAL ANALYSIS USED: Means and proportions were calculated. Chi-square test and paired t-test were used to calculate the P value. RESULTS: FBG increased significantly in the control group by 25.6 mg/dl (P = 0.03), whereas it was only 6.5 mg/dl in the intervention group (P = 0.56). Adherence to medications was increased significantly in both interventions (+21%) and control (+19%) groups. Number of fruits intake days per week (+1, P = 0.01) and fruits serving per day (+0.5, P = 0.00) have increased significantly in the intervention group. Recreational physical activity was increased in the intervention group but not statistically significant. CONCLUSION: Our study findings suggest that mobile phone calls might help to improve glycemic control. It also suggests that it could improve the adherence to medications and intake of fruits. In the future, studies with large sample size and longer intervention need to be conducted.
ABSTRACT
BACKGROUND: Indications for surgery in Hashimoto's thyroiditis (HT) patients are compressive symptoms and suspicion of malignancy. A high incidence of thyroid malignancy has been reported in patients with HT. The effect of surgery on discomfort in swallowing and tightness in the neck has not been properly evaluated. AIMS: The aim of our study is to compare the indications, complications, and associated cancers in patients operated for HT with those surgically treated for other benign goitres. The effect of surgery on minor symptoms like tightness in the neck and discomfort in swallowing is included. SETTING AND DESIGN: This was a retrospective case-control study at a tertiary care centre. PATIENTS AND METHODS: A total of 271 patients who had undergone surgery for benign thyroid diseases were included. Group A consisted of 35 patients who had HT and Group B consisted of patients operated for other benign thyroid diseases (236 patients). STATISTICAL ANALYSIS: Data were analyzed using SPSS 12 software. Independent group's t-test was used to compare the means and Fisher's exact test was used for categorical data. RESULTS: In Group A, the common indications for surgery were discomfort associated with swelling (45.7%), cosmesis (34.3%), and pain with swelling (11.4%) whereas in Group B, the indication was predominantly cosmetic (80%). A total of 22.9% patients of Group A and 6% of Group B were hyperthyroid. The sensitivity of FNAC for diagnosing thyroiditis was 62.8% (n = 22). Postoperative complication rates were similar in both the groups. The mean operating time was higher in Group A even though the gland was smaller. Incidental malignancy was 3.4% in Group B whereas there was none in Group A. Discomfort in swallowing and tightness in the neck were relieved at 3 months after surgery. CONCLUSIONS: Large, euthyroid and apparently asymptomatic HT occasionally need surgical intervention. Discomfort in swallowing and tightness in the neck are relieved after surgery. Thyroidectomy is safe to perform and has a low incidence of permanent complications. There was no associated malignancy in our series of HT.