Role of oral health during COVID-19

Coronavirus disease 2019 (COVID-19) caused by novel coronavirus severe acute respiratory syndrome coronavirus 2 [SARS-Cov-2] has challenged the health care system worldwide. Currently, more than 43 million people are affected by this disease worldwide.1 The risk factors known to develop complications of COVID-19 are age along with comorbidities like diabetes, hypertension, obesity, cardiovascular diseases, COPD, CKD etc. This same population is also at risk for developing oral diseases. Other known risk factors for oral diseases are smoking, alcohol consumption. Preliminary reports suggest that there may be a connection between SARS-CoV-2 infections and the microbial load in the oral cavity.2 Yoon et al reported that SARS-CoV-2 viral load was consistently high in the saliva in the early stages of COVID-19.3 Few studies report that oral hygiene interventions in patients with pneumonia have drastically improved clinical outcome.4,5 Researchers also reported that improved oral care significantly reduces the incidence of ventilator-associated pneumonia in patients in an intensive care unit.6 Thus oral health is extremely important in the current pandemic of COVID-19

Prevalence of diabetic retinopathy in type 2 diabetes mellitus patients attending medicine out-patient department of a tertiary care hospital in Alappuzha, Kerala, India

Background: Diabetic retinopathy is a microvascular complication affecting the eyes of both Type 1 and Type 2 diabetes mellitus due to long-term hyperglycaemia. Diabetic retinopathy is the leading cause of blindness among working aged adults around the world. There are various factors leading to the development of diabetic retinopathy namely duration of diabetes, glycaemic control, age at onset of diabetes, uncontrolled hypertension. This is a hospital based cross-sectional study which aimed to study the prevalence of diabetic retinopathy in type 2 diabetes mellitus patients attending Medicine out-patient department of Government T. D. Medical College, Alappuzha, Kerala, India. The factors contributing to the development of retinopathy was also studied.Methods: 200 already diagnosed type 2 diabetic subjects were included in the study. Subjects were explained about the study and once the consent was received, data regarding age, gender, age at onset of diabetes, duration of diabetes, history of smoking, alcohol intake, and socio-economic status was documented. Height and weight was measured. Blood pressure was recorded with mercury sphygmomanometer. Then the subjects were evaluated for diabetic retinopathy by fundus examination after dilating the eyes. Findings were noted and subjects were categorized as no retinopathy, nonproliferative and proliferative diabetic retinopathy using the ETDRS classification.Results: In present study, out of 200 subjects, 63 subjects (31.5%) were affected with diabetic retinopathy (non-proliferative retinopathy=22.5%, proliferative retinopathy=9%). Prevalence of mild, moderate and severe non-proliferative retinopathy was 7.5% each. Significant association was found between diabetic retinopathy and duration of diabetes.Conclusions: Therefore, periodic screening of diabetic patients should be carried out for early detection and prevention of loss of vision

Hypoxia inducible factor stabilizers: a promising treatment for chronic kidney disease

Anemia in chronic kidney disease (CKD) is a very common complication. The two main factors contributing to the development of anemia in CKD is decreased erythropoietin production and iron deficiency. Other factors that might play a role in the pathogenesis of renal anemia are: chronic inflammation leading to increased hepcidin, uremic toxins, and shorter red blood cell life span. The mainstay of treatment is iron supplementation, blood transfusion and erythropoietin stimulating agents (ESA). The discovery of hypoxia inducible factor (HIF) pathway has opened a new chapter in the treatment of anemia in CKD. The oxygen-sensitive HIF pathway plays a prominent role in the control of erythropoiesis and iron metabolism. HIF stabilizers are a new set of drugs that inhibits prolyl hydroxylase domain (PHD) proteins which are key regulators of HIF activity. Several such compounds are being developed to revolutionize the treatment of renal anemia