Indian Journal Of Clinical Practice
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Gender Inequity in Neurological Health Care in India: Socio-Cultural Influences, Clinical Challenges, and Potential Pathways to Equity
Get PDFThe issue of gender-based inequity in health care, particularly in neuromedicine, is indeed a matter of serious concern in India.From birth, girls often face discrimination, which can manifest in malnutrition, unequal access to education, and inadequatehealth care, all of which impact their neurological health. Neurological conditions such as epilepsy, stroke, psychosomaticdisorders, and demyelinating disorders reveal stark disparities in diagnosis, treatment, and care based on gender. Keyfactors contributing to this gender-based inequity in neuromedicine are socio-cultural barriers (deep-rooted societal normsand cultural practices in India often prioritize the health of male family members over females. These norms can result inwomen delaying seeking medical attention or being denied care altogether. This contributes to late diagnoses and pooroutcomes for women with neurological conditions; myths misconceptions and misbeliefs (neurological disorders, particularlyepilepsy and psychosomatic disorders, carry significant stigma, especially for women). Misconceptions around conditionslike epilepsy can lead to social isolation, exclusion from marriage prospects, and neglect in care. Additionally, women’shealth issues are often dismissed as psychological or “hormonal”, leading to misdiagnoses; access to health care (womenoften face structural barriers, such as lack of autonomy in decision-making, lower financial independence, and restrictedmobility), which limit their access to neuromedical care. Health care resources in rural and underserved areas are limited,and gender biases in treatment mean that women are less likely to receive timely and adequate interventions for neurologicalconditions; malnutrition (poor nutrition among women), starting from childhood, is a significant contributor to neurologicalhealth problems. Malnutrition during pregnancy, which affects fetal development, can result in a higher prevalence ofdevelopmental neurological disorders in children, with gender-based neglect often continuing into adulthood. Potentialsolutions include awareness campaigns, policy changes, health care provider training, and community empowerment. Bydelving into these areas, we can begin to understand the complexities of gender inequity in neuromedicine and work towardmore equitable health care solutions
Unveiling the Eschar: A Mite’s Mark in Scrub Typhus
Get PDFScrub typhus is an acute febrile illness caused by Orientia tsutsugamushi, a Gram-negative intracellular organism transmittedby Leptotrombidium mites, with wild rats serving as natural reservoirs. The disease is more common in the TsutsugamushiTriangle, often afflicting travelers and creating diagnostic challenges in clinical practice. We present the case of a diabeticpatient who acquired the infection while visiting an agricultural farm. Our discussion covers clinical manifestations,diagnostic markers and treatment modalities, emphasizing the significance of early recognition and the benefits of prompttreatment. The importance of searching for an eschar, a key physical sign, is underscored and potential serious outcomesare discussed. Recent advances and preventive measures are also highlighted. This synthesis of research and clinical insightsaims to enhance global awareness, prompt diagnosis, and effective management of scrub typhus
Diabetes and Mental Health: A Review
Get PDFDiabetes is a staggering health concern globally. Its management prioritizes hyperglycemia and complications, and associatedmental health (MH) issues remain unidentified and unaddressed. People with diabetes mellitus (DM) experience emotionalchallenges due to the necessary lifestyle changes and the diagnosis itself. They may go through various stages similar toexperiencing grief, denial for diabetes diagnosis, anger as to why they have suffered this diagnosis despite a healthy lifestyle,bargaining that they can manage it by themselves, depression since it is an ongoing everyday struggle and finally acceptance,i.e., learning to live with diabetes with days where it is well managed and days where it flares out of control. There seems tobe a bidirectional relationship between diabetes and MH. People with diabetes have an increased risk of psychological andpsychiatric disorders like anxiety, depression, etc., and vice versa. Thus, addressing MH is important for effective diabetesmanagement
Euphrodasiac Patient Education: Therapy Through Thoughts, Wellness Through Words
Get PDFTherapeutic patient education (TPE) is the foundation of chronic disease management. TPE is a therapeutic intervention initself, and is also an adjuvant to pharmacological therapy and lifestyle modification. Backed by evidence and experience,TPE has been shown to improve glycemic control, quality of life, and overall health. This article highlights the need to focuson TPE as a major facet of overall therapy. “Euphrodasiac patient education” can offer treatment through thoughts, andwellness through words. If we are able to inculcate this in chronic care, we should be able to kick start a virtuous cycle ofeuphoria, or happiness, in the health care ecosystem
Prevalence of Sexual Dysfunction and Hypogonadism in Male Patients with Type 2 Diabetes Mellitus from a Tertiary Care Center in North India
Get PDFDiabetes is one of the most common chronic metabolic diseases resulting in sexual dysfunction (SD) in men.There is limited data regarding SD and testosterone deficiency (hypogonadism) in subjects with type 2 diabetes (T2D) fromIndia. This study aims to determine the prevalence of SD and hypogonadism, and the correlation of hypogonadism withcomplications of diabetes among adult males with T2D from North India. Methods: In this prospective observational study,people aged 18 to 70 years with T2D (diagnosed for at least 1 year) were evaluated for SD using the International Index ofErectile Function (IIEF) questionnaire. The demographic, anthropometry, biochemical parameters, and history of microvascularand macrovascular complications were recorded. In participants with low IIEF score (≤3), serum total testosterone (TT) wasmeasured twice 4 weeks apart and those with both values <280 ng/dL were defined to have hypogonadism. Results: Amongthe 253 patients (55.82 ± 8.42 years) enrolled, the prevalence of SD and hypogonadism was 27.7% and 18.6%, respectively.Patient on insulin treatment had more odds of hypogonadism likely because of more advanced diseases. Hypogonadismwas significantly associated with the presence of neuropathy and nephropathy (p < 0.0001 and p = 0.0013, respectively).There was also significant association of hypogonadism with cerebrovascular events and coronary artery disease (p < 0.0001).Conclusion: There is a high prevalence of SD and hypogonadism in adult males with T2D. Hypogonadism was significantlycorrelated with insulin treatment and associated diabetes complications
Pelvic Obesity: Clinical Aspects
Get PDFObesity is a multisystemic chronic disease, which is associated with various pelvic pathologies and abnormalities. Wesuggest a novel term: pelvic obesity, which is defined as a syndrome of morphological and functional abnormalities inthe pelvic cavity and its organs that are associated with obesity and result in genitourinary, reproductive, and systemicdysfunction. This communication enumerates the diverse aspects of pelvic obesity and elucidates the rationale for a unified,multidisciplinary approach
