Burning Feet Research Articles

Relapsing-Remitting Immunotherapy Responsive Small-Fiber Neuropathy: Longitudinal Tracking Through 10 Years Including Pregnancies.

To expand understanding of the pathogenesis, presentations, and treatment of initially idiopathic small fiber polyneuropathy (SFN). We longitudinally readministered validated metrics to track disease course and treatment responses in a previously healthy woman with acute, postinfectious, skin biopsy-confirmed, idiopathic SFN. During 5 years, viral respiratory infections triggered 3 separated episodes of acute, disabling burning hand, foot, and face pain (erythromelalgia). The initial 2 resolved with high-dose prednisone, and the third responded to repeated immunoglobulin treatments. Pregnancy with miscarriage triggered a fourth exacerbation refractory to corticosteroids and cyclosporin. Immunoglobulins restored total remission for 2 months; then, 2 rituximab doses slightly improved later flaring. Subsequently, daratumumab initiated 100-day remission later maintained by belimumab, initiated to permit another pregnancy. Remission continued after gestational week 13 all-treatment withdrawal. A week 30 fifth flare responded to plasmapheresis, with healthy birth at week 40. At 11-week postpartum, as symptoms returned, restarting belimumab restored remission maintained during ≥19 months of breastfeeding. This decade of tracking characterizes a relapsing-remitting course of SFN with initially separated monophasic episodes becoming more confluent, as with multiple sclerosis. This tempo and responsiveness to 5 immunotherapies suggest dysimmune causality. Validated metrics helped define the course and track treatment efficacy, particularly during pregnancy and breastfeeding. This is a single observational study without controls. This provides Class IV evidence.

Foot and Ankle Disorders in Nurses Exposed to Prolonged Standing Environments: A Scoping Review.

Prolonged standing environments constitute an occupational risk factor for nurses, particularly for developing foot and ankle disorders. The definitions and potential relationship to hours spent walking or standing are poorly understood. This scoping review aimed to synthesize the main disorders found on nurses' ankles and feet, their prevalence, the influence of hours spent walking or standing, and gender differences. This review followed a previously published protocol. Primary and secondary studies were retrieved from relevant databases from December 2020 to March 2021. Potential articles were collated to Mendeley, and two independent reviewers assessed the title and abstracts. Studies meeting inclusion criteria were included. Two researchers retrieved and reviewed the full text of these studies independently. A predetermined extraction tool was used to retrieve relevant data, summarized in a tabular and narrative format. The most common disorder was pain, followed by numbness, burning feet, bunions, structural deformities, and calluses. Prevalence differed among studies, depending on settings and specific local policies. Discussion: Various foot and ankle disorders and related variables have been found, with clear gaps that may be addressed in the future. Few studies have focused on nurses' foot and ankle disorders. Mapping signs and symptoms may contribute to the future development of preventive interventions for nurses' workplaces.

Managing a case of hyperlipidaemia from the homoeopathic perspective: a case report

Hyperlipidaemia is a disorder characterised by elevated levels of lipid in blood and is frequently regarded as one of the main risk factors for atherosclerotic illnesses, including coronary heart disease. The associated risk factors include obesity, sedentary lifestyle, fatty food intake, excessive alcoholism and smoking. Since hyperlipidaemia has few or no significant clinical signs, a lipid panel or lipid profile analysis constitutes as the primary method of diagnosis. A case of 51-year-old male suffering from Hyperlipidaemia for few years, which was temporarily relieved with conventional treatment, has been presented here. Clinically patient reported with pain in calves, burning feet, dyspepsia and occasional arthritic pain. After a thorough clinical evaluation, Lycopodium Clavatum in increasing potency (up to Q5), was prescribed when needed. The outcome assessment was done by using the ‘Modified Naranjo Criteria’. This case report demonstrates improvement of symptoms as well as the reduction of serum cholesterol and triglycerides with individualised homoeopathic treatment.

A RETROSPECTIVE STUDY OF ADVERSE DRUG REACTION IN MULTIDRUG-RESISTANT TUBERCULOSIS PATIENTS AT TERTIARY CARE HOSPITAL

Objective: The objective of the study was to the analysis of different parameters including admission type, demographics, type of reaction, the seriousness of reaction, classification of organ system, drugs involved, action taken and outcome of reactions, causality assessment, severity assessment, and the preventability of ADRs for multidrug-resistant tuberculosis patients. Methods: This retrospective observational study was conducted during the period of September 2017 to June 2020 (34 months) at ADR Monitoring Centre, Department of Pharmacology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan. All spontaneously reported ADRs were evaluated using various parameters such as type of reaction, causality assessment, preventability, and severity. Results: In the present study, 92 (9.29%) ADRs were reported in relation to 68 MDR-TB patients. The majority of ADRs were considered probable (73.92%), moderate (41.30%), and definitely preventable (42.39%) in nature. In our study, most of the suspected drug names were included: 23 (25%) pyrazinamide, followed by 22 (23.91%) kanamycin, 12 (13.04%) cycloserine, and 11 (11.96%) linezolid. The majority of ADRs were non-serious (67.39%) in nature. ADRs were most commonly reported, with 17 (18.48%) reporting ototoxicity and 17 (18.48%) reporting joint pain, followed by 4 (4.35%) reporting burning feet syndrome, 4 (4.35%) reporting generalized itching, and 4 (4.35%) reporting psychosis. Conclusion: Our study included 36 different types of suspected ADRs that were reported with multiple frequencies due to 16 categories of drugs and combinations of drugs. The majority of patients were recovering and recovered from concerns associated with ADR after necessary medical intervention and management. Our purpose is to rationale the use of medicines for drug safety as well as patient safety.

Perbaikan Klinis Kaki Diabetik Menggunakan Terapi Akupunktur

This study aims to identify and analyze the effect of acupuncture therapy on diabetic foot disorders. The design of this study was a systematic review by searching five scientific databases to obtain relevant sources related to specific problems related to acupuncture therapy in reducing disorders of the diabetic foot, namely Pubmed, Scientidirect, Springer Journals, Scopus, and Sage Journals. The research results were 3103 articles, and five articles were relevant and met the criteria. The use of acupuncture therapy affects disorders of the diabetic foot, namely a significant reduction in symptoms such as a prickling sensation or burning feet, numbness, to pain, and as an alternative therapy option in diabetic neuropathy sufferers. In conclusion, acupuncture effectively treats diabetic foot disorders and can be applied to nursing care as a non-pharmacological therapy.
 
 Keywords: Acupuncture, Diabetic Foot, Neuropathy

TO STUDY EFFICACY OF JIVANTYADI GHRIT AS ADD-ON TREATMENT IN PTB TREATING WITH AKT (DOTS) REGIMEN

Background: Patients of Pulmonary Tuberculosis continued to be suffering from the adverse effects of the Anti-tubercular drugs even though they are used efficiently, the rate of infection of pulmonary tuberculosis is not satisfactory under control. Hence the present study was conducted, to study the efficacy and to minimize the side effects of present therapy (DOTs) by using along with Ayurveda formulation. Objectives: To Study the efficacy of Jivantyadi Ghrit as Add-on treatment in PTB treating with AKT (DOTs) regimen. Materials and Methods: It was an open labelled, controlled clinical study. It was conducted in 28 patients of PTB for six months. Results: There was significant reduction in group B patients regarding cough with expectoration, loss of appetite, loss of weight, evening rise of temperature, burning feet and hands. Significant reduction in side effects. There was significant reduction of score in lymphocyte count in group B patients. Conclusion: Study shows the scientific good evidences of add-on therapy of Jivantyadi Ghrit with AKT (DOTs) in the management of PTB.

Type-2 Diabetes Mellitus with Neuropathy: “Clinical Presentation and Nerve Conduction Study Findings”

Background: Diabetes mellitus (DM) is one of the chronic diseases all over the world. The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia with disturbance of carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, insulin action or both with an increased risk of neuropathy and other complications. Objective: To describe the clinical features and findings of nerve conduction study among the patients presented with diabetic neuropathy. Methods and Material: The study was conducted at the outpatient department of Uttara Crescent Hospital, Uttara, Dhaka, Bangladesh. Total 83 patients presented with a history of diabetes for 20 years and above and having features of neuropathy are included in this study. Patients who are suspected having neuropathy due to any other known cause were excluded from this study. Detail history regarding complaints of neuropathy was taken. History of symptoms like paraesthesia, tingling sensation, burning feet, hyperaesthesia, foot ulcer, history of weakness and gait abnormality was noted. Complete nervous system examination was performed and nerve conduction study was done. Results: Among the total 83 presented with neuropathy; the mean (±SD) age (Years) was 51.80 ((±10.24) with a range of 35-60 years (Fig-1). Out of total 83 patients, 60.24% (n=50) were male and 39.76% (32) were female. In our study we found that out of 83 patients 74 patients (89%) presented with tingling sensation at limbs, 52 patients (62.65%) had burning feet, 47 patients (56.63%) had diminished or loss of vibration sense, and 34 patients (41%) patients have diminished light touch. Above finding suggested that most patients presented with sensory symptoms. Out of 83 patients 42 patients (50.60%) had diminished ankle jerk and only 6 patients presented with foot ulcers. In this study out of 83 patients ...............

English

BACKGROUND Patients with diabetic peripheral neuropathy (DPN) suffer from numbness, burning feet, lightning pain, and pins-and-needles sensations. Recently, High resolution ultrasonography is commonly used for evaluation of peripheral nerve diseases because of its easy availability, time saving and non-invasiveness of the procedure. This study intended to compare the cross sectional area (CSA) of posterior tibial nerve (PTN) in type 2 diabetic patients with peripheral neuropathy with that of non-diabetic healthy adults using high resolution ultrasonography (HRU) and study the role of increase in HbA1c level and severity of DPN comparing with CSA of PTN. METHODS A cross sectional comparative descriptive study was conducted from November 2018 to May 2020 with 50 type 2 diabetic patients and 50 healthy adults. 50 type 2 diabetic patients, clinically diagnosed with DPN were analysed and using the Toronto Clinical Neuropathy Score (TCNS) System, the severity of neuropathy was determined. HbA1c level and other demographic data were collected. 50 healthy adults were taken as controls. The CSA of posterior tibial nerve was measured 3 cm proximal to the medial malleolus in both lower limbs using HRU. RESULTS The mean CSA of posterior tibial nerve in healthy subjects was 6.0 + / - 0.142 mm2 , and in diabetic patients with peripheral neuropathy was 11.77 + / - 0.291 mm2 . Upon comparing the mean CSA of posterior tibial nerve of diabetic subjects with peripheral neuropathy and control subjects were statistically significant (P < 0.001) in unpaired ‘t’ test. In our study, CSA of the posterior tibial nerve correlated significantly with TCNS and HbA1c levels, at P < 0.001. CONCLUSIONS This study showed that there is a significant difference between the cross sectional areas of posterior tibial nerve in diabetic subjects with peripheral neuropathy and healthy adult subjects. HRU can detect cross sectional area changes in the posterior tibial nerve early. Thus, ultrasonography can be used as a good screening tool in these patients. KEYWORDS Diabetic Peripheral Neuropathy, Posterior Tibial Nerve, High Resolution Ultrasonography

Spectrum of diabetic neuropathies.

The diabetic state results in neuropathy. The main causative mechanism is hyperglycemia, although microvascular involvement, hypertriglyceridemia, as well as genetic and immune mechanisms may be contributory. There is a growing spectrum of types of diabetic neuropathies that differ based on the type of fibers involved (e.g. myelinated, unmyelinated, autonomic, somatic), distribution of nerves involved, and mechanisms of neuropathy. The most common type is distal sensory neuropathy (DSN), which affects the distal ends of large myelinated fibers, more often sensory than motor, and is often asymptomatic. The next-most common is distal small fiber neuropathy (DSFN), which largely affects the unmyelinated fibers and carries the phenotype of burning feet syndrome. Diabetic autonomic neuropathy (DAN) occurs when widespread involvement of autonomic unmyelinated fibers occurs, and patients can be incapacitated with orthostatic hypotension as well as neurogenic bladder and bowel involvement. Radiculoplexus diabetic neuropathy causes proximal weakness and pain, usually in the lower extremity, and has a combination of immune, inflammatory, and vascular mechanisms. The nerve roots and plexus are involved. These patients present with proximal weakness of a subacute onset, often with severe pain and some autonomic failure. Finally, rapid and sustained reduction of blood glucose can result in treatment-induced diabetic neuropathy (TIND), which largely affects the sensory and autonomic fibers. This occurs if HbA1c is rapidly reduced within 3 months, and the likelihood is proportional to the original A1c and the size of the reduction.

Early onset of metronidazole-induced peripheral neuropathy in a patient with amoebic colitis:a case report

Peripheral neuropathy reportedly develops after a long period of metronidazole administration. Here, we report a case of amoebic colitis in which peripheral neuropathy occurred approximately 24 hours after administering metronidazole. A 76-year-old man presented with mucous and bloody stool. Initially, lower gastrointestinal endoscopy and stool analysis confirmed the occurrence of amoebic colitis, and metronidazole was then intravenously administered. The following day, however, the patient experienced a diminished sensation in a glove-and-stocking distribution in his extremities, followed by bilateral burning foot pain. After the withdrawal of metronidazole, the symptoms improved and finally disappeared 3 months later.

Development and Validation of RLS Diagnostic Questionnaire for Indian Population

Restless legs syndrome is a common condition affecting nearly 2% Indian population. Certain questionnaires for screening or diagnostic purpose have been developed in the West, and they were translated to Hindi. However, those questionnaires have been found to have limitations in Indian context considering the cultural effect on vocabulary for the description of symptoms. Based on the IRLSSG criteria, a 12-item questionnaire was developed. Most of the items had dichotomous responses. This questionnaire was tested in subjects having RLS. Control group consisted of subjects suffering from clinically significant anxiety, myalgia of legs, arthralgia in legs, burning feet syndrome, nocturnal leg cramps and somatic symptoms disorder persistent pain type; conditions that could mimic RLS. Face validity and content validity were examined. Internal consistency of the questionnaire was assessed. Diagnostic outcome from the new questionnaire was assessed against clinical diagnosis, which is considered as gold standard at present. This study included 49 cases of RLS and 44 subjects in control group. Female preponderance was noted in both groups (69.4% in RLS group and 63.6% in control group; P = 0.55). Mean age of subjects in both groups was comparable (38.1 ± 2.3 years in RLS and 40.1 ± 2.5 years in control group; P = 0.10). New diagnostic questionnaire had sensitivity of 73.4% (95% CI = 58.9–85.0) and specificity of 88.6% (95% CI = 75.4–96.2). Positive predictive value was 87.8% (95% CI = 75.6–94.3%) and negative predictive value was 75% (95% CI = 65–82.8) with the diagnostic accuracy of 80.6% (95% CI = 71.1–88.1). New questionnaire correlated well with clinical diagnosis (r = 0.62; P < 0.001). This questionnaire is a short and reliable method for diagnosis of RLS in Indian population.

“Burning Foot Syndrome” due to Acute Copper Deficiency Myeloneuropathy after Bariatric Surgery (P2.6-062)

“Burning Foot Syndrome” due to Acute Copper Deficiency Myeloneuropathy after Bariatric Surgery (P2.6-062)

Photodermatosis and Photo protection in Metropolitan Traffic Police in Kathmandu city

Background: Police officer serves a vital role in maintaining safety and serve are role model for discipline throughout the world, they are non–intentional type sun exposure(NISE).The objective of our present study was to evaluate photo protector practice, knowledge in response to Ultra violet Radiation ,Sunscreens and sun related photodermatosis.&#x0D; Methodology: A cross sectional study was conducted in traffic police officer at different locations at Kathmandu. Data was collected by using self-administered questionnaires and interviewed by Dermatologist to establish their knowledge and behaviour and practice in relation to ultra violet radiation and photo-protection.&#x0D; Result: Out of 265 participants, mean age was 27.1 years. Respondent with graduation and master degrees had knowledge and practice toward UVR, follow by higher secondary education. Regarding the practice for photo protection only 59.6% had knowledge about sunscreen, 39.6% knowledge about Ultraviolet Radiation and 24.9% had knowledge about Ultra Violet Index .Skin problem like melasma, premature wrinkles, and hardening of skin, polymorphic light eruption, burning foot syndrome, dermatophytes, and varicose vein.&#x0D; Conclusion: Traffic police officers showed good practices in term of wearing hat, clothes that cover most of the body parts but poor practice over sunscreen, UVR, UVI. Lectures &amp; seminar regarding the awareness and photo protection practice should be recommended.&#x0D; With lack of awareness among police officers and providing sunscreen for free should be considered by Police authorities. Similarly lectures &amp; seminar on sun protection should be provided in regularly.

Antimicrobial activity of Elytropappus rhinocerotis (Asteraceae) against micro-organisms associated with foot odour and skin ailments

Ethnopharmacological relevanceThe twigs of Elytropappus rhinocerotis are widely used in the Cape region of South Africa to treat foot odour, perspiration and also itchy, chilblained and burning feet. However, no antimicrobial studies have hitherto been published on this popular Cape herbal medicine, which is also used for a wide range of ailments. Aims of the studyTo determine the antimicrobial activity of the extracts, essential oil and two major labdane diterpenes isolated from E. rhinocerotis against micro-organisms associated with foot odour and other conditions associated with skin infections. Materials and methodsLeafy stems were harvested from three individual plants at three separate geographical localities, giving a total of nine plant samples. The samples were air-dried, powdered and extracted with a 1:1 mixture of methanol and dichloromethane, and also with sterile distilled water. A portion of each sample was also hydrodistilled to obtain nine samples of essential oil. Isolation of the major labdane diterpenes was performed using silica and ethyl acetate in hexane (3:7 v/v) as the mobile phase. Minimum inhibitory concentrations (MIC) were determined for nine crude extracts, as well as three essential oil samples and two labdane diterpenes obtained from a bulk sample. The test organisms used in this study were from Deutsche Sammlung von Mikrooganismen (DSM) and American type culture collection (ATCC) strains and included five bacterial species (Brevibacterium agri ATCC 51663, B. epidermidis DSM 20660, B. linens DSM 20425, Staphylococcus aureus ATCC 25923, S. epidermidis ATCC 12228) and one fungal species (Trichophyton mentagrophytes ATCC 9533) associated with the skin. ResultsThe presence of essential oil is reported for the first time. Organic extracts and essential oil samples showed moderate to noteworthy activity against selected test organisms. For the Brevibacteria, the lowest MIC values for phenolic extracts were several times lower than the corresponding values for the positive control zinc (shown in brackets): 0.0031 mg/mL against Brevibacterium agri (0.33 mg/mL), 0.17 mg/mL against B. epidermidis (3.91 mg/mL) – both for sample 2 of Vanwyksdorp; 0.13 mg/mL against B. linens (2.28 mg/mL) – for sample 3 of Vanwyksdorp. Two isolated labdane diterpenoids (one of which is here first reported) were also antimicrobially tested and showed moderate activity but had high abundance in the extracts. Two major monoterpenes and four sesquiterpenes in the essential oil were identified as 1,8-cineole (4.6–12.3%), terpinen-4-ol (9.2–24.3%), germacrene A (3.9–15.6%), (−)-spathulenol (1.7–37.8%), viridiflorol (0.3–100%), and silphiperfol-6-en-5-one (4.5–26.8%). ConclusionThe antimicrobial results particularly for the essential oils and against the Brevibacteria support the traditional topical use of Elytropappus rhinocerotis twigs to treat foot perspiration, foot odour and other related skin conditions.

Study of clinical and nerve conduction study correlation in patients of diabetic neuropathy in diabetes mellitus type 2

Background: Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia with disturbance of carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, insulin action or both with an increased risk of neuropathy. Early diagnosis and management of diabetic polyneuropathy (DPN) are crucial as failure to diagnose can lead to serious consequences, including disability and amputation. Present study aimed at investigating the demographic profile and correlation of clinical features with nerve conduction studies in patients with diabetic neuropathy in type 2 diabetes mellitus.Methods: The cross-sectional study design with total 66 patients of type 2 DM were selected in 30 to 60-year age groups, from Pt. Jawaharlal Nehru Memorial Medical College, Department of Medicine, Raipur (C.G.) (Pt. JNMMC) and associated hospital. Descriptive statistics and χ2 test were used for analysing the data.Results: Total 66 patients were selected, Most of the patients are presenting with tingling sensation (n=64, 97.0%) and burning feet (n=52, 78.8%), NCV is mostly absent in the tibial nerve (n=52, 78%), sural nerve (n=63, 95.5%) and planter nerve (n=41, 62.1%) while it is largely normal in median nerve (n=54, 81.8%) and ulner nerve (n=61, 92.4%). Tingling sensation, burning feet, diminished vibration sensation and diminished light touch are significantly associated (p=0.00) with NCV in different nerves.Conclusions: Limitations of study includes small sample size, lack of general population, and a control group. Diabetes mellitus is a chronic illness with an increased risk of neuropathy. NCS having high sensitivity and specificity for detection of DPN. Understanding the NCS and its correlates in patients with DPN is crucial for early detection and development of effective management and strategies to prevent its complications.

Comparison of Cross Sectional Areas of Median Nerve in Type 2 Diabetic Patients with Peripheral Neuropathy with Healthy Adult Subjects Measured by 2 D-B Mode High Resolution Ultrasonography

Background: Patients with diabetic peripheral neuropathy (DPN) have distal, symmetrical form of the disorder characterized by numbness, burning feet, pins-and-needles sensations and lightning pain. This study was designed to find out the difference between 2 Dimentional (D)-Brightness (B) mode high resolution ultrasonographically measured cross sectional areas of median nerve in type 2 diabetic patients with peripheral neuropathy and those of non-diabetic healthy adult subjects.Methods: This case-control study was done on 180 subjects aged 27-67 years in the department of Radiology and Imaging, BIRDEM from January 2012 to December 2013. Out of them 90 diabetic patients with peripheral neuropathy diagnosed electrophysiologically by nerve conduction study (NCS) were considered study group and age, sex and weight compatible 90 healthy subjects were considered as control group. Measurement of cross sectional areas of median nerve was performed first by the investigator himself purposefully, consecutively and subsequently confirmed by a radiologist in the department of Radiology and Imaging, BIRDEM, who did not know the subjects’ condition to eliminate bias. The major axis, minor axis and the cross sectional areas (CSA) of the median nerve were measured at the carpal tunnel.Results: In this study, the mean cross sectional areas (mm2) of median nerve healthy subjects was 7.78±1.00 mm2 and in diabetic patients with peripheral neuropathy was 13.67±2.97 mm2. The difference mean CSA of median nerve of diabetic subjects with peripheral neuropathy and control subjects were statistically significant (p&lt;0.05) in unpaired ‘t’ test.Conclusion: This study showed that there is a significant difference between the cross sectional areas of median nerve in diabetic subjects with peripheral neuropathy and healthy adult subjects. The mean cross sectional areas of median nerve were increased in diabetic patients with peripheral neuropathy compared to control group.Birdem Med J 2018; 8(1): 47-51

Small fiber neuropathy

Small fiber neuropathy (SFN) is still unknown. Characterised by neuropathic pain, it typically begins by burning feet, but could take many other expression. SFN affects the thinly myelinated Aδ and unmyelinated C-fibers, by an inherited or acquired mechanism, which could lead to paresthesia, thermoalgic disorder or autonomic dysfunction. Recent studies suggest the preponderant role of ion channels such as Nav1.7. Furthermore, erythromelalgia or burning mouth syndrome are now recognized as real SFN. Various aetiologies of SFN are described. It could be isolated or associated with diabetes, impaired glucose metabolism, vitamin deficiency, alcohol, auto-immune disease, sarcoidosis etc. Several mutations have recently been identified, like Nav1.7 channel leading to channelopathies. Diagnostic management is based primarily on clinical examination and demonstration of small fiber dysfunction. Laser evoked potentials, Sudoscan®, cutaneous biopsy are the main test, but had a difficult access. Treatment is based on multidisciplinary management, combining symptomatic treatment, psychological management and treatment of an associated etiology.

Gender differences in awareness of diabetes mellitus among the rural population

Background: Diabetes Mellitus is a chronic disorder, which is becoming rapidly epidemic in India.There are many complications occur due to uncontrolled diabetes mellitus.The outcome of diabetes depends mainly on the patient’s self-management like health-related behavior, which is based on his or her knowledge. Awareness on diabetes mellitus is still a lacunae among the Indian population.Aims and Objective: To determine the knowledge regarding awareness of diabetes like the risk factors, symptoms, complications and the management among the males and females in rural population.Materials and Methods: It is a cross sectional study conducted at the tertiary care center in rural Bangalore. A structured questionnaire was used and 300 adults were assessed on their knowledge regarding the awareness of diabetes.Result: Out of 300 adults, 159 adults (53%) had a history of diabetes. There was no gender difference observed regarding the awareness, nor the education played a role. There was significant difference observed in knowledge of diabetes Mellitus among the diabetics with respect to renal complications (p &lt;0.013), symptoms like blurring of vision (p &lt; 0.043) and burning feet (p &lt; 0.009).Conclusion: Both the diabetic and non-diabetic groups had very low awareness regarding diabetes and associated risk factors. Both Males and females awareness levels were poor. Proper Diabetic education programme will help in raising public awareness of the disease.Asian Journal of Medical Sciences Vol.8(2) 2017 44-49

To study clinical profile of peripheral neuropathy in type 2 diabetes mellitus using nerve conduction velocity

Introduction: Diabetes is one of the leading non communicable disease throughout the world. Due to its chronic nature it causes a number of complications. Diabetic peripheral neuropathy is one of the most dreaded complications of diabetes as it is associated with significant morbidity. Diagnosis of neuropathy is commonly done by NCV which is a gold standard test for it. Other simpler method to detect early loss of protective vibration sensation, to find out feet at risk of future complications is the need of the hour. Hence this study was done to study the symptoms of peripheral neuropathy in type 2 diabetic patients and to correlate these with patient's age, duration of diabetes, glycemic parameters and other microvascular complications. Methodology: This was a cross sectional study carried out in 40 patients with symptoms of peripheral neuropathy in the Department of General Medicine at Dhiraj General Hospital, Sumandeep Vidyapeeth, Piparia, Vadodara district, Gujarat. All patients were subjected to detailed clinical history, examination of their feet and neuropathy testing by NCV using the RMS NCV/EMG machine using a hand held biothesiometer. Results: Out of the total of 40 patients, 30 were males and 10 were females. Increasing age of the patients, increasing duration of diabetes, smoking and poor glycemic control were significant risk factors for the development of neuropathy. It was also consistently associated with other microvascular complications like retinopathy and nephropathy. The most frequently encountered symptom of neuropathy in our study was burning feet. Conclusion: The study concludes that increasing diabetes duration is an independent and strong risk factor and considering the dreaded complications of end stage diabetic foot disease, routine screening of all type 2 diabetic patients should be done in daily practice.

Flight Lieutenant Peach's observations on Burning Feet Syndrome in Far Eastern Prisoners of War 1942-45.

'Burning Feet Syndrome' affected up to one third of Far Eastern Prisoners of War in World War 2. Recently discovered medical records, produced by RAF Medical Officer Nowell Peach whilst in captivity, are the first to detail neurological examinations of patients with this condition. The 54 sets of case notes produced at the time were analysed using modern diagnostic criteria to determine if the syndrome can be retrospectively classed as neuropathic pain. With a history of severe malnutrition raising the possibility of a peripheral polyneuropathy, and a neuroanatomically plausible pain distribution, this analysis showed that Burning Feet Syndrome can now be described as a 'possible' neuropathic pain syndrome. After 70 years, the data painstakingly gathered under the worst of circumstances have proved to be of interest and value in modern diagnostics of neuropathic pain.