Table of contents (Vol 5, No 6)

Prevention and Control of Diabetes in India

In view of the ever-increasing burden of diabetes mellitus, a health system approach is needed. The government of India has taken initiatives at a national level which is to be commended however an implementation plan is required at grass route level.

Picture by Jill A Brown


By Ramesh Verma, Pardeep Khanna, Bharti Mehta


Aloe Vera and Infected Leg Ulcers

This paper presents preliminary evidence that Aloe vera may promote wound healing. In the era of antibiotic resistance, this study offers cost-effective alternative therapy for chronic infected wounds resistant to conventional antibiotics.

Picture by leisimo


By Asima Banu, Sathyanarayana B C, Goura Chattannavar


Breast Cancer a Challenge in Primary Care

Women in Australia are reported to prefer to discuss their breast cancer-related problems with a specialist even though research suggests that patients generally prefer to consult with a general practitioner. The extent to which these patients will have maintained or return to their previous level of functioning will be a reflection on the quality of primary care, as some breast cancer-related health issues may persist beyond the time period when they are undergoing specialist review.

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By Moyez Jiwa, Arlene Chan, Jaco Lotriet, Shohreh Razmi

Infertility: Inability or Disability?

Medically, infertility, in most cases, is considered to be the result of a physical impairment or a genetic abnormality.  Couples who are unable to reproduce may be stigmatised. Infertility is assocaited with social and financial consequences. Without labelling infertility as a disability, it is difficult for the victims of this condition to access services and welfare benefits. Infertility treatments are expensive and seldom covered by insurance or government subsidy.There is a strong case to categorise infertility as disability.

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By Abha Khetarpal, Satendra Singh

The Business of Doctoring
Most patients who consult a generalist are unlikely to have life-limiting pathology. Therefore the doctors’ ability to communicate effectively is important not only to avoid litigation and complaint but crucially to make an accurate diagnosis and to be able to negotiate the most appropriate course of action. How doctors present and conduct themselves has an impact on their ability to assist their patients. A growing number of interruptions to the encounter when a doctor consults a patient are having an adverse impact on the business of doctoring.

Picture by Ambro


By Moyez Jiwa


Diabetic Mastopathy

Diabetic mastopathy is the occurrence of lymphocytic mastitis and stromal fibrosis in men as well as women having long-standing diabetes. Clinical and radiological appearance can raise a suspicion of malignancy and result in unnecessary biopsy. As these lesions are known to recur failure to recognise them can have devastating results. A case of diabetic mastopathy is presented so that unnecessary surgery can be avoided for future patients.

Picture by Patrick J Lynch


By Smite Balwant Sankaye, Sushil Ghanshyam Kachewar

Schmidt’s syndrome – case report

Very few cases of Schmidt’s syndrome have been reported because of its rare and atypical presentation. This case was diagnosed as chronic meningitis with initial presentation of headache, vomiting and altered sensorium.In cases with two or more endocrinopathies, the possibility of polyglandular syndrome should be considered and treated accordingly.

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By Amit Narayan Gupta, Shivashankara Kaniyoor Nagri

Ileal Volvulus and Carcinoid Tumours

Small bowel volvulus although rare should be a differential for any presentation of acute abdominal pain. There are no tests to exclude strangulated small bowel and laparotomy should not be delayed. Carcinoid tumours may also be associated with small bowel volvulus given its potential to cause fibrosis and the development of bands.

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By Chee Weng Leong


Breaking Bad News

A caring approach to disclosing bad news can reduce distress. In this letter the authors review strategies that can assist health professionals to deliver adverse news.

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By Sushil Ghanshyam Kachewar, Smita Balwantrao Sankaye


Children in an Urban World
UNICEF has been publishing its annual report on the State of the World’s Children (SOWC) since 1980. This year’s publication State of the World’s Children 2012 (SOWC 2012) appeared in February 2012, with the theme of “Putting Children First in an Urban World”. This edition is reviewed here.

Picture by Ian Wilson

By Ravi Ambey, Arjun Singh