A questionnaire based survey on awareness of diabetic foot care in Indian population with diabetes: A cross-sectional multicentre study.

Objective: To find awareness regarding foot care in Indian population with diabetes in various parts of India. Materials and Method: A cross-sectional study design was used to perform a multicenter, national level survey from August, 2011 to February, 2012 in various parts of India. Descriptive analysis was done using Statistical Package for Social Sciences (SPSS) 16. Awareness levels for diabetic foot care were calculated as absolute frequencies and were reported as overall percentages. Spearman test was used to find the correlation for foot problems and diabetic foot care with socioeconomic status. Results: A total of 323 peoples were screened (there were 222 men and 101 women in the study with a mean age of 58.2 ± 8.6 years). 8.7% of men reported ulcer during the 1 st year of onset of diabetes, where as 8.3% of women were prone for ulcers in 16-20 years of diabetes, 56.4% of the population in urban area and 46.6% of the population in the rural area had been educated regarding foot care in diabetes. However, only 30.5% of population in urban areas and 9.7% of population in the rural areas knew about the importance of shoe selection in diabetes. Spearman's correlation was significant for foot problems with family income and educational status, P = 0.03 and P = 0.02 respectively. Conclusion: There is a need to bridge the disparity in awareness regarding diabetic foot management in Indian masses. More aggressive measures are required to implement current preventive foot care strategies in India.

Aspirin resistance.

Aspirin reduces the odds of serious atherothrombotic vascular events and death in a broad category of high risk patients by about one quarter. The term 'aspirin resistance' has been used to describe not only an absence of the expected pharmacologic effects of aspirin on platelets but also poor clinical outcomes, such as recurrent vascular events, in patients treated with aspirin. Various factors such as genetic, nonadherence, variable response to different doses, co-morbid conditions and drug interactions are responsible for aspirin resistance. Many methods, with their limitations, are available to measure the effects on platelets. Despite treatment failures, aspirin remains the single most cost-effective drug for the secondary prevention of atherothrombotic disease. To optimize its clinical effectiveness, clinicians should be aware of the potential causes of aspirin treatment failure, prescribe aspirin in appropriate doses, and encourage patients to take aspirin, stop smoking, and avoid regular use of NSAIDs.

Efficacy and tolerability of trandolapril in mild to moderate hypertension--a double blind comparative clinical trial with enalapril in Indian population.

Several large scale clinical trials have demonstrated that angiotensin converting enzyme inhibitors offer cardiovascular and renal protection independent of their effects on systolic BP. Trandolapril is a new angiotensin converting enzyme inhibitor approved for the treatment of hypertension. The potential advantages of this drug are long duration of action and better tolerability. The objective of the study was to compare the efficacy and tolerability of trandolapril with that of enalapril in mild to moderate hypertension in Indian population. In this double blind, multicentric, parallel comparative clinical study, 120 patients with mild to moderate hypertension were randomly assigned to receive trandolapril 2 mg or enalapril 5 mg once daily for 8 weeks. The attainment of sitting diastolic blood pressure <90 mmHg at the end of 8th week was considered as primary outcome measure and attainment of diastolic blood pressure <90 mmHg or reduction of at least 10 mmHg diastolic blood pressure compared to baseline at any visit was considered as secondary outcome measures. 98.4% patients treated with trandolapril and 92.6% patients treated with enalapril fulfilled the primary outcome measure. 54, 72 and 62% patients on trandolapril and 52, 61 & 64% patients on enalapril fulfilled secondary outcome measure at the end of 2nd, 4th and 8th week respectively. Also trandolapril was better tolerated than enalapril with no significant abnormality in lab parameters.