Effect of limited access dressing on hydroxyproline and enzymatic antioxidant status in nonhealing chronic ulcers.

BACKGROUND: Healing ability of nonhealing chronic ulcers can be assessed by estimating hydroxyproline, total protein and enzymatic antioxidants such as glutathione peroxidase (GPx), glutathione S-transferase (GST) in the granulation tissue. MATERIALS AND METHOD: A total of 34 patients were analysed from two groups: Limited access dressing (LAD) group (n = 17) and conventional dressing group (n = 17). RESULTS: Patients treated with LAD that exerts combination of intermittent negative pressure and moist wound-healing had shown a significant increase in the hydroxyproline (P = 0.026), total protein (P = 0.004), GPx level (P = 0.030) and GST level (P = 0.045). CONCLUSION: Patients treated with LAD indicated significantly better anabolic effect on wound-healing compared to that of patients treated with conventional dressing.

Effect of exercise-based rehabilitation on functional capacity and renal function in type 2 diabetes mellitus with nephropathy: a randomized controlled trial.

INTRODUCTION: Diabetic nephropathy is a growing public health challenge with implications on health. Renal function decline impacts the functional ability and overall health and well-being of individuals with diabetic nephropathy due to development of several renal manifestations. The objective of the study was to determine the effect of an exercise-based rehabilitation program on functional capacity and renal function among individuals with type 2 diabetic nephropathy. METHODS: A total of 283 individuals were screened and 60 eligible participants aged 45-70 years with diabetic nephropathy were randomly allocated (n = 30 each) to the intervention group (IG) and control group (CG), respectively. The study outcome measures comprised of functional capacity (6-min walk test) and renal function assessed at baseline, 12th week and 24th week. Participants allocated to IG received 12 weeks of exercise based rehabilitation (comprising of supervised + home-based exercises) along with standard care and followed-up till 24th week. RESULTS: The repeated measures ANOVA with Greenhouse-Geisser correction indicated significant timepoint*group interaction effect for 6-min walk distance F (1.71, 90.59) = 619, p < 0.001, serum creatinine F (1.23, 65.14) = 174.8, p < 0.001, estimated glomerular filtration rate F (1.15, 60.88) = 105.2, p < 0.001, serum urea F (1.48, 78.45) = 261.4, p < 0.001 and urine protein F (1.13, 59.82) = 4.58, p < 0.328. CONCLUSION: The study found that exercise based rehabilitation improved both functional capacity and renal function among individuals with type 2 diabetic nephropathy.

Quality of life in patients with alcohol use disorders admitted to de-addiction centers using WHOQOL-BREF scale-A cross-sectional study.

BACKGROUND: Alcohol use disorders (AUDs) adversely affect a person's general health and the lives of their family and friends. These disorders are also the most undertreated mental illness with severe implications for public health. Hence, the present study aimed to employ the WHOQOL-BREF to assess the quality of life (QoL) of AUDs patients seeking treatment at de-addiction centers and identify the demographic variables associated with the QoL dimension scores. MATERIALS AND METHODS: A cross-sectional study was conducted among alcohol dependents taking treatment in de-addiction centers in Dakshina Kannada District, Karnataka. The WHOQOL-BREF questionnaire was administered to 124 subjects. Multiple regression analysis was carried out to identify the demographic variables associated with the QoL dimension scores. RESULTS: The domain mean scores were between 50 and 60 on the 0 to 100 scale. Age, social class, residential area, marital status, and years of drinking were the demographic variables found to be significantly associated with the dimension scores. CONCLUSIONS: Physicians should monitor the effect of alcoholism on QoL, and a multidisciplinary treatment plan with elements from the medical, social, and psychiatric fields should be used. The demographic variables should be considered while managing patients with AUDs.

Effect of novel Matrix Rhythm Therapy (MaRhyThe®) on neuropathic pain and maximum plantar pressure distribution among type 2 diabetes mellitus patients with peripheral neuropathy.

Background: There is a need for a non-pharmacological approach to reduce pain and plantar pressure in diabetic peripheral neuropathy (DPN). Matrix Rhythm Therapy (MaRhyThe®) is a therapeutic modality that works on the principle of physiologic rhythmic oscillations of the body cells. This study aimed to evaluate the effect of MaRhyThe® on neuropathic pain and maximum plantar pressure distribution among type 2 diabetes mellitus patients with peripheral neuropathy. Materials and methods: A total of 33 participants with DPN were recruited for the study based on inclusion criteria. Maximum plantar pressure was recorded using Win-Track 11K005, and the pain score was obtained using a visual analogue scale. Ten sessions of MaRhyThe® were given to all the participants. Outcome measures were evaluated at the baseline and after 10th session. Paired t-test was performed to analyze the changes in outcome measures. Results: Participants of DPN were recruited with the average age of 64 ± 9 years, and an average duration of diabetes was 14 ± 9 years were included. Results of the present study found significant improvement in neuropathic pain and plantar pressure in post intervention assessment. (p < 0.05). Conclusion: In the present study, we found that MaRhyThe® is effective in reducing neuropathic pain and maximum plantar pressure in type 2 diabetes mellitus with peripheral neuropathy.

Academic stress and associated sociodemographic variables: A study of pre-university students in Karnataka, India.

BACKGROUND: Academic stress is a predominant phenomenon among grade 11 and 12 students. The performance in Grade 12 is important for entry to higher education programs in India. The purpose of the study was to assess the magnitude of the perceived academic stress and identify the main stressors and the sociodemographic variables associated with the perceived academic stress among adolescents enrolled in the science stream in coastal Karnataka. MATERIALS AND METHODS: Upon Institutional Ethical Committee approval, a cross-sectional survey was carried out among pre-university students (science stream) of coastal Karnataka during February-April 2021. The study used Manipal Inventory of Academic Stress (MIAS) scale to collect data on perceived academic stress from 1859 students (response rate 68.3%). Stratified cluster sampling method was used to collect data from the study participants. IBM Statistical Package for the Social Sciences (SPSS) 26.0 was used to analyze the data. Descriptive statistics, unpaired t-test, one-way analysis of variance (ANOVA), and multiple linear regression analyses were used to study the association between academic stress and various demographic variables. RESULTS: The study revealed that 28% of the Grade 11 students and 26% of the Grade 12 students experienced high or extreme stress. The significant stressors were lack of time for revision, queries from neighbors or relatives, and parental expectations on academic performance. Gender, residence, and the medium of instruction until Grade 10 were associated with academic stress. CONCLUSION: Measures at the institutional and national levels are necessary to reduce the academic stress in higher secondary education. The integrated curriculum proposed in the National Educational Policy 2020 addresses a few stressors identified in this study.

Prevalence and Associated Risk Factors of Antenatal Depression among Pregnant Women Attending Tertiary Care Hospitals in South India.

Background: Antenatal depression (AND) is a common mood disorder that affects both the mother and the child. Objective: The current study is aimed at identifying the prevalence of antenatal depression and the risk factors associated with it in South Indian pregnant women. Materials and Methods: The current study was carried out in a tertiary care teaching hospital where pregnancy and postnatal care are offered. In the study, 314 pregnant women who visited the antenatal clinic for their prenatal checkups were included. To diagnose possible depression, Edinburgh Postnatal Depression Scale (EPDS) was used. The chi-square test was applied to determine the association between antenatal depression and various socioeconomic, obstetric, and medical factors. A logistic regression analysis was performed to identify significant confounding variables. Results: Of the total 314 women, 69 (21.98%) were suffering from possible depression with the mean EPDS score being 10.61 ± 7.48. Women of younger age had greater risks for depression than older women (AOR = 2.01; 95% CI: 0.56-7.20). Maternal age (χ 2 = 0.013, p = 0.009) and the presence of health issues during the current pregnancy (χ 2 = 5.18, p = 0.023) were the factors significantly associated with antenatal depression. Conclusions: Clinical efforts should focus on screening antenatal depression, early identification, and effective care, thus preventing progression to postpartum depression and its detrimental effects.

Effectiveness of a Disease Management Program (DMP) in controlling the progression of Chronic Kidney Disease among hypertensives and diabetics.

Background: The occurrence rate of stage 5 chronic kidney disease (CKD) will be 151 per million population in India in the coming years. Comorbidities like diabetes mellitus and hypertension are the usual triggers of CKD. Hence this study aimed to control the progression of CKD and to note the effectiveness of a structured education program that would help in the prevention of complications related to diabetes and hypertension. Methods: This quasi-experimental study was conducted among 88 participants who had hypertension, diabetes mellitus, or both for five or more years. The study objective was to find the effect of a Disease Management Program on delaying progression of CKD in patients with hypertension or diabetes mellitus.The baseline data were obtained from demographic proforma, and the clinical data collected were the blood pressure, serum creatinine, and random blood sugar (RBS) of the participants. The management of hypertension and diabetes mellitus was taught to them. In the fourth and the eighth month, blood pressure and blood sugar were reassessed. At one-year blood pressure, blood sugar, and serum creatinine were tested. Baseline and one-year follow-up blood pressure, blood sugar, and estimated Glomerular Filtration Rate were compared. Descriptive statistics and "Wilcoxon signed-rank test" were used to analyze the data. Results: In one year, the mean systolic blood pressure reduced by six mm of Hg and mean blood sugar by 24 mg/dl. The prevalence of CKD stage three and above (< 60 ml/min/m2) was nine (10.22%). The median decline in eGFR was 5 ml/min/m2 (Z= 5.925, P< 0.001). Conclusion: The Disease Management Program led to improvements in blood pressure and diabetes control and median progression of CKD was estimated at five ml/min/m2/year.

Effect of three indigenous food stains on resin-based, microhybrid-, and nanocomposites.

PURPOSE: This study investigated the effects of three indigenous food stains (tea, tobacco, turmeric) on a nanocomposite (Ceram-X-Mono, Dentsply DeTery, Konstanz, Germany), a microhybrid posterior (P60, 3M ESPE, St. Paul, MN, USA), and a universal microhybrid (Z100, 3M ESPE) resin-based composite (RBC). MATERIALS AND METHODS: Thirty-six disk-shaped specimens were fabricated (10 × 2 mm) for each type of RBC material, using a polytetraflouroethylene (PTFE) sheet. Specimens from each group were randomly distributed into three subgroups for each of the used stains. The baseline color values were measured using a spectrophotometer. The specimens were immersed in the staining solutions for a period of 3 hours per day for 15 days (3 hours/day × 15 days). Following this, the color change value (ΔE) was calculated. RESULTS AND CONCLUSION: All the tested groups showed a clinically perceptible color change (ΔE values = 3.3 or >3.3), except for tea-stained P60 (ΔE = 3.15) and Z100 (ΔE = 1.63) groups. Turmeric caused the most significant color change for all the tested RBCs. The least amount of color change was observed with the Z100 (tea, ΔE = 1.63; tobacco, ΔE = 13.59; turmeric, ΔE = 38.77) group that was statistically significant from P60 (tea, ΔE = 3.15; tobacco, ΔE = 18.83; turmeric, ΔE = 57.72), and Ceram-X-Mono (tea, ΔE = 3.32; tobacco, ΔE = 18.83; turmeric, ΔE = 53.95) groups.

Knowledge, Attitude, and Perception Among Endodontists Toward Regenerative Endodontics: A Cross-sectional Survey of Four Indian Universities.

BACKGROUND: Regenerative endodontics is a rapidly developing field in dentistry. However, the regenerative endodontic procedures are not familiar to many clinicians in India. AIM: This survey aimed at assessing the level of knowledge, attitude, and perception (KAP) among endodontists toward regenerative endodontics. MATERIALS AND METHODS: A cross-sectional survey was conducted in the year 2019 to collect data. A questionnaire to collect data on KAP toward regenerative endodontics was administered to 49 faculty and 69 postgraduate students of endodontics from four universities. The Chi-Square test and logistic regression were applied to study the association between KAP and demographic variables. Spearman's rho was computed to study the correlation between KAP scale scores of the participants. The data were analyzed by using Statistical Package for the Social Sciences software program (SPSS), version 15.0 (South Asia, Bangalore). RESULTS: The survey yielded an overall response rate of 81%. Less than 50% of the participants had sound knowledge, 65% had a positive attitude, and only 21% had a positive perception about Regenerative Endodontic Procedures (REPs). Most of the participants (86.5%) were of the opinion that regenerative therapies should be a part of dentistry. Majority of the participants (89.6%) were inclined to receive training in REPs. About 80% of the participants felt that the higher cost of treatment is a significant hurdle for patients to accept REPs. Less than half the participants (41.7%) were using REPs in their clinical practice, such as the use of membranes, scaffolds, and revascularization. CONCLUSION: Endodontists have a positive attitude toward the use of regenerative therapies. However, there is a deficiency of training in REPs in dental colleges.

Age Related Prevalence of Mild Cognitive Impairment in Type 2 Diabetes Mellitus Patients in the Indian Population and Association of Serum Lipids With Cognitive Dysfunction.

The magnitude of type 2 diabetes mellitus (T2DM) is ever-increasing in India, and at present, ~77 million people live with diabetes. Studies have established that T2DM increases the risk of neurodegenerative disorders. This study aimed to determine the age-related prevalence of mild cognitive impairment (MCI) in T2DM patients in the Indian population and to identify link between cognitive dysfunction in T2DM patients and serum lipid composition through untargeted and targeted lipidomic studies. Using a cross-sectional study, we evaluated 1278 T2DM patients with Montreal cognitive assessment test (MoCA) and digit symbol substitution test (DSST) for cognitive functions. As per MoCA, the prevalences of MCI in T2DM patients in age groups below 40, 41-50, 51-60, 61-70, 71-80 and 81-90 years were 13.7, 20.5, 33.5, 43.7, 57.1 and 75% with DSST scores of 45.8, 41.7, 34.4, 30.5, 24.2 and 18.8% respectively. Binomial logistic regression analysis revealed serum HbA1c ≥ 7.51, duration of T2DM over 20 years, age above 41 years, and females were independent contributors for cognitive dysfunction in T2DM patients. Preliminary studies with untargeted lipidomics of the serum from 20 T2DM patients, including MCI and normal cognition (NC) group, identified a total of 646 lipids. Among the identified lipids, 33 lipids were significantly different between MCI and NC group, which comprised of triglycerides (TGs, 14), sphingolipids (SL, 11), and phosphatidylcholines (PC, 5). Importantly, 10 TGs and 3 PCs containing long-chain polyunsaturated fatty acids (PUFA) were lower, while 8 sphingolipids were increased in the MCI group. Since brain-derived sphingolipids are known to get enriched in the serum, we further quantified sphingolipids from the same 20 serum samples through targeted lipidomic analysis, which identified a total of 173 lipids. Quantitation revealed elevation of 3 species of ceramides, namely Cer (d18:1_24:1), Hex1Cer (d16:0_22:6), and Hex2Cer (d28:1) in the MCI group compared to the NC group of T2DM patients. Overall, this study demonstrated an age-related prevalence of MCI in T2DM patients and highlighted reduced levels of several species of PUFA containing TGs and PCs and increased levels of specific ceramides in T2DM patients exhibiting MCI. Large-scale lipidomic studies in future could help understand the cognitive dysfunction domain in T2DM patients, while studies with preclinical models are required to understand the functional significance of the identified lipids.

Fracture Resistance of Endodontically Treated Maxillary Premolars with a Longer Single Post and Shorter Double Posts of Different Sizes: An In Vitro Study.

AIM: The aim of this study was to determine if there is any difference in fracture resistance between different post sizes and lengths when more than one post is involved. MATERIALS AND METHODS: Thirty extracted maxillary first premolars were endodontically treated and divided into three groups: In Group 1 (control group), no post space preparation was conducted and access cavities were restored with composite; in Group 2 (single post), post space preparation of 10 mm was carried out only in one of the canals; and in Group 3 (double post), post space preparation of 5 mm was conducted in both the canals. Appropriately sized glass fiber posts were cemented in Groups 2 and 3 followed by core buildup. The fracture resistance of the specimen was measured using a universal testing machine and the data analyzed. The mean fracture resistance values of the three groups were compared applying one-way analysis of variance (ANOVA) followed by post hoc Tukey's test. The data were analyzed using Statistical Package for the Social Sciences software program, version 15.0. South Asia, Bangalore. RESULTS: The control group had a significantly lower fracture resistance value as compared to Groups 2 and 3. No statistically significant difference was observed in the fracture resistance between Groups 2 and 3. CONCLUSIONS: No significant difference was observed between the fracture resistance of endodontically treated maxillary first premolars restored with size 3 single post of longer length and size 1 double posts of shorter lengths.

Dietary self-management practices among persons with T2DM: An exploratory qualitative study from western-coast of India.

BACKGROUND: Diabetes is a significant public health challenge for India. Self-management, including dietary management, physical activity, stress management, and adherence to medication, is critical in glycaemic control. Though data concerning self-management, in general, are available among persons with Type 2 Diabetes Mellitus (T2DM), exclusive research on dietary self-management was limited. AIMS: A qualitative study to explore the knowledge, current dietary practices, and the barriers and enablers for dietary self-care management in persons with T2DM. METHODS: In this qualitative study, in-depth interviews were conducted among 35 participants with T2DM who scored minimally and optimally in the Diabetes Self-Management Questionnaire (DSMQ). Interviews were conducted using a validated interview guide. In-depth interviews were audio-recorded, transcribed to verbatim and thematically analysed. RESULTS: The study included 20 males and 15 females. The three major themes derived in the study. Firstly, "Knowledge, Interpretation and Information" the majority of the participants have understood the influence of diet on control of blood glucose level includes food choices and quantum of food. Secondly, "Current Dietary Practices-Preferences, Availability of food and Convenience influence dietary practices': All participants had their own belief on the side effects and benefits of certain food items. Most of the participants followed a three-meal pattern: breakfast, lunch and dinner. Finally, Barriers and Enablers in dietary self-management practice. Knowledge, physical and emotional factors, behaviour, planning were the intrinsic factors. Elements of the research, social support, season and climate, food environment were the extrinsic factors and communication, and financial management was the intermediate influences observed. CONCLUSION: The themes generated by this research provide insight into self-management and patient expectations in dietary matters. It would be desirable for physicians and health care providers to be aware of these practices when advising people with T2DM on dietary self - management.

Caregiver Burden among Caregivers of Mentally Ill Individuals and Their Coping Mechanisms.

BACKGROUND: During a given year, almost 30% of the people around the world are affected by mentally ill health. In India, it accounts for about 20%. Caregivers face a lot of strain, ill health, and disrupted family life, with literature suggesting an increasing concern about their ability to cope up. The needs of caregivers of the mentally ill are given low priority in the current health-care setting in India. AIM: The aim of the study was to assess the burden of caregivers of mentally ill individuals and their coping mechanisms. METHODS: A cross-sectional study was employed with a quantitative approach. A convenient sample of 320 caregivers was taken from two private tertiary care centers and one public secondary care center in Udupi taluk. This study was conducted using the Burden Assessment Schedule (BAS) and Brief Cope Scale (BCS). Statistical analysis was done on categorical variables, and they were expressed as frequencies and percentages. Continuous variables were measured using mean and standard deviation. Univariate and multivariate analysis using binomial logistic regression was done. SPSS version 15 was used to analyze the data. RESULTS: According to BAS, severe burden accounted for 40.9% and moderate for 59.1%. The highest amount of burden was seen in the areas of physical and mental health, spouse related, and in areas of external support. The BCS showed that the most frequently used coping styles were practicing religion, active coping, and planning. CONCLUSION: This study concluded that caregivers of the mentally ill individuals do undergo a lot of burden. Hence, there is a need to develop strategies that can help them such as providing them with a support structure as well as counseling services.

Knowledge and awareness of dental implants as a treatment choice in adult population in South India: A hospital-based study.

CONTEXT: Implant-supported prosthesis improves the self-confidence and quality of life of the patient by giving them masticatory comfort and a high level of satisfaction. For any professional community, it is essential to know whether patients feel well informed and whether what they know reflects on the current advances in dental health care. The aim of this study was to assess the knowledge and awareness of dental implants as a treatment choice in patients visiting a dental college situated in Mangalore, Karnataka, India. MATERIALS AND METHODS: A questionnaire consisting of 13 close-ended questions was used to assess the level of knowledge and awareness among patients visiting prosthodontics outpatient department regarding dental implants as a treatment option for replacing missing teeth. A total of 242 participants were interviewed to collect the required data. Chi-square test was used to study the association between demographic variables and awareness about implantation. RESULTS: Only 17.8% of the population with missing teeth knew about dental implants as a treatment choice. For 69.8% of the population, the source of information regarding prosthetic options was through friends and relatives, and for 28.1%, it was from dentists. Awareness percentage was significantly higher among males (P = 0.024) and among those whose education level was graduation and above (P < 0.001). CONCLUSION: This study showed that knowledge and awareness regarding dental implants was disturbingly low. The patients had a very minimal and superficial knowledge regarding prosthetic options. Emphasis is placed on the need for conducting and implementing various public awareness campaigns and for establishing counseling centers.

Types of biological variables.

Identification and description of variables used in any study is a necessary component in biomedical research. Statistical analyses rely on the type of variables that are involved in the study. In this short article, we introduce the different types of biological variables. A researcher has to be familiar with the type of variable he/she is dealing with in his/her research to decide about appropriate graphs/diagrams, summary measures and statistical analysis.

Kinetics and kinematics of diabetic foot in type 2 diabetes mellitus with and without peripheral neuropathy: a systematic review and meta-analysis.

BACKGROUND: Diabetes mellitus patients are at increased risk of developing diabetic foot with peripheral neuropathy, vascular and musculoskeletal complications. Therefore they are prone to develop frequent and often foot problems with a relative high risk of infection, gangrene and amputation. In addition, altered plantar pressure distribution is an important etiopathogenic risk factor for the development of foot ulcers. Thus the review on study of foot kinematic and kinetic in type 2 diabetes mellitus to understand the biomechanical changes is important. METHODOLOGY: Scientific articles were obtained using electronic databases including Science Direct, CINAHL, Springer Link, Medline, Web of Science, and Pubmed. The selection was completed after reading the full texts. Studies using experimental design with focus on biomechanics of diabetic foot were selected. RESULTS: The meta-analysis report on gait velocity (neuropathy = 128 and non-diabetes = 131) showed that there was a significantly lower gait velocity in neuropathy participants compared to non-diabetes age matched participants at a high effect level (-0.09, 95 % CI -0.13 to 0.05; p < 0.0001). Regarding knee joint flexion range there was a significant difference between neuropathy and non-diabetes group (4.75, 95 % CI, -7.53 to 1.97, p = 0.0008). CONCLUSIONS: The systematic review with meta-analysis reported significant difference in kinematic and kinetic variables among diabetic with neuropathy, diabetic without neuropathy and non-diabetes individuals. The review also found that the sample size in some studies were not statistically significant to perform the meta-analysis and report a strong conclusion. Therefore a study with higher sample size should be done.

Ocular Morbidity among Students in Relation to Classroom Illumination Levels.

OBJECTIVE: This cross-sectional study was done to find the prevalence of eye strain and other ocular morbidities among students in Udupi, Karnataka. METHODS: The study protocol included interview, visual acuity examination using Snellen chart, and measuring classroom illumination through lux meter. RESULTS: 26% students had visual morbidity and the most prevalent symptoms of eyestrain were headache (38.6%), watering of eyes (25.7%), pain around eyes (15.6%) and blurred vision (11.9%). 55.5% classrooms and 88.4% blackboards did not have proper illumination. CONCLUSION: Low classroom illumination levels may be a possible factor for development of visual morbidity.

Relationship of Caffeine with Adiponectin and Blood Sugar Levels in Subjects with and without Diabetes.

INTRODUCTION: Coffee though not usually thought of as healthy food but can be treated as one of the beneficial drink. Many researchers have found strong evidence that coffee reduces the risk of several serious ailments, including diabetes, heart disease, cirrhosis of the liver, etc. The long term beneficial effect of coffee on diabetes is now understood to be more influential and obliging. MATERIALS AND METHODS: This study comprised 220 healthy subjects of which 143 consumed coffee and 77 did not. These were matched with 90 diabetic subjects. Among the 90 diabetics, 48 consumed coffee and 42 did not consume coffee. RESULTS: The mean adiponectin value was significantly higher in coffee consumed normal and diabetic subjects than the subjects who did not consume coffee. The decrease in fasting blood sugar and HbA1c values were also observed in normal and diabetic subjects who consumed coffee than the other groups who did not consume coffee. Significant difference (p<0.05) in mean FBG, PPBS, HbA1c and adiponectin were observed between coffee consumed and no coffee consumed groups. CONCLUSION: The long term use of caffeine is more efficient on blood sugar and adiponectin levels, which needed in the prevention of complications in diabetic subjects.

Quality of Life among Persons with Physical Disability in Udupi Taluk: A Cross Sectional Study.

BACKGROUND: Disability is not just a health problem or attribute of individuals, but it reflects the problems individuals experience in their interaction with society and physical movements. Disabled persons remain neglected part of society and they also experience various barriers due to restriction of participation. OBJECTIVES: The aim was to assess the quality of life (QOL) of physically disabled persons, the impact of physical disability on activities of daily living (ADL) and to study the awareness about laws and facilities available for disabled persons. MATERIALS AND METHODS: A cross-sectional community based study was conducted among 130 physical disabled persons who were selected using convenience sampling technique. The WHO BREF scale was used to assess QOL, while assessment of ADL was done using Barthel Index. Socio-demographic assessment was done using Udai Pareek scale. SPSS version 15.0 was used to analyze data. Categorical variables were expressed as frequencies and percentages. As per guidelines physical, psychological, social, and environmental domain scores for WHO BREF scale were calculated. RESULTS: Among the study participants, 36.2% had a disability from birth that is, congenital. The second common cause of disability was found to be postpolio residual paralysis as it was found among 26.2% respondents. Other causes found were stroke/paralysis and accidents, in 19.2% and 18.5% respondents, respectively. Activities such as transfer, mobility, and stair climbing showed greater impact of physical disability. It was found that 11.5% respondents required help in one of the ADL. QOL score was found to be low under the psychological domain reflecting on negative feelings, bodily image, appearance, spirituality, and self-esteem of respondents. CONCLUSION: Physical disability had affected social participation as well as marriage of the respondents. However, it was found that very few of them are aware about facilities provided under persons with disability act.

Intrinsic foot muscle and plantar tissue changes in type 2 diabetes mellitus.

BACKGROUND: Diabetes mellitus is a metabolic disorder with involvement of the neurovascular and muscular system. Peripheral neuropathy (PN) is thought to be the principal cause of foot complications in type 2 diabetes mellitus (T2DM). However, foot evaluation using ultrasonography early in the course of diabetes has not gained due importance. The aim of the present study was to evaluate the thickness of intrinsic foot muscles, plantar skin, plantar fascia, and plantar fat pad in T2DM subjects with and without PN using musculoskeletal ultrasonography. METHODS: This study was conducted in 30 T2DM subjects with and without PN and 30 age-matched non-diabetes mellitus (NDM) subjects. After detailed clinical evaluation, high-frequency musculoskeletal ultrasonography was used to measure the thickness of the intrinsic foot muscles and plantar tissue thickness under the metatarsals. Data were analyzed using independent t-tests to compare T2DM groups with NDM subjects, and one-way ANOVA followed by Tukey's honestly significant difference test for between- and within-group analyses. RESULTS: There was a significant reduction in the thickness of the intrinsic foot muscles and plantar tissue in T2DM compared with NDM subjects (P < 0.05). However, there were differences in intrinsic foot muscle and plantar tissue thickness between T2DM subjects with and without PN. CONCLUSION: There was a substantial decrease in intrinsic foot muscle and plantar tissue thickness in T2DM compared with NDM subjects, indicating that structural changes appear in the foot before PN develops. The techniques used in this study cannot exclude the possibility that neuropathic changes that are clinically undetectable may develop in parallel with changes in plantar tissues.