Skip to main content

Diabetic Retinopathy– An Overview | Book Publisher International

Diabetic retinopathy is the leading cause of blindness world over. Neurovascular degeneration of the retina is considered presently as the cause as against the vascular changes which are believed to be causative previously. In fact the neuronal changes are shown to ante-date the vascular changes. There is complex interaction of many cells like pericytes, mullers cells, astrocytes, vascular endothelial cells as well as factors like advanced glycation products, Oxidative and metabolic stress, inflammatory cytokines, leukotrienes, various growth factors and glycoproteins etc. in the pathogenesis of DR. Various biochemical pathways like Polyol pathway, glucosamine pathway, AGE pathway and PKC pathways interacting with one another is also recognised as having a role in the pathogenesis of DR. But the common link responsible for all these factors involvement linking to DM2 is still not clear. The mechanism explaining Benfotiamine, a thiamine analogue found to be useful in treating DR , though attractive in integrating the various biochemical pathways cited above, is not comprehensive. The concept of reactive oxygen species (ROS) is a better alternative explanations linking up all pathogenic factors concerned to chronic hyperglycaemia of DzM2. But antioxidants proved futile in treating DR. It may be useful to remember that extensive ROS production in DM2 is consequent to shift of energy metabolism from glycolysis to B-oxidation of fats. Unless this is reversed, ROS production continues. The Diabetes Control and Complications Trial (DCCT) and UKPDS are the two landmark clinical trials that clearly showed the relationship between chronic hyperglycaemia and genesis of DR. Progression in T1DM and T2DM patients, respectively. Randomized controlled trials have shown that early treatment of DM2 can reduce an individual’s risk of severe visual loss by 57%. Intensive glycaemic control appeared long lasting because of the metabolic memory, also known as ‘legacy effect’. A term which explains the beneficial effects of immediate intensive treatment of hyperglycaemia with a sustained benefit with respect to the outcomes for many years, regardless of glycaemia in the later course of diabetes. Hence the current emphasis is prevention of DR with strict glycaemic control in DM2 ab initio.

Biography of author(s)

A. S. V. Prasad
Department of Internal Medicine, GITAM Dental College, Rishikonda, Visakhapatnam, Andhra Pradesh, India.


Comments

Popular posts from this blog

A Brief Study of Middleware Technologies: Programming Applications and Management Systems | Chapter 15 | Novel Research Aspects in Mathematical and Computer Science Vol. 1

  Many platforms, services, applications, hardware, and operating systems are connected through the middleware layer. Because the middleware layer abstracts much low-level complexity and makes applications and software systems portable, it allows disparate systems to interface and function together in harmony. Middleware technologies enable software engineers to swiftly construct software systems and applications, allowing developers to focus on more important tasks. This chapter examines several types of middleware systems and discusses middleware capabilities, middleware operation, middleware's function in cloud-based systems, and the best middleware platforms to use. Middleware systems are widely utilised and can be found in practically any software system or application. Middleware programmes provide as a link between many sorts of systems and protocols. They serve as a mechanism for various systems. To successfully exchange information, it runs on a variety of operating system

A Prospective Study about Safety and Efficacy of Perioperative Lidocaine Infusion | Chapter 09 | New Horizons in Medicine and Medical Research Vol. 8

 Opioids cause clinically significant side effects such as respiratory depression, immunosuppression, muscle rigidity, negative inotropism, nausea, vomiting, hyperalgesia, urine retention, postoperative ileus, and drowsiness. Perioperative opioids are a major contributor to the United States' and other countries' opioid epidemics. Non-opioid analgesics, particularly lidocaine, are becoming more common for perioperative use as a result of this. A total of 185 adult patients were randomly assigned to one of two groups: control group I (105 patients) [fentanyl group] or group ii (80 patients) [opioid-free anaesthesia group]. Lidocaine 1.5 mg/kg bolus followed by 1.5 mg/kg/h infusion intraoperatively, and 1.5-2 mg/kg/h infusion for 2-8 hours postoperatively were given to patients in both groups at anaesthetic induction. Intraoperatively, both groups received analgesic adjuvants such as diclofenac 75 mg, paracetamol 1 gm, and mgso4 30-50 mg/kg. If the mean arterial pressure (map)

Ethnopharmacological Survey among Traditional Medicine Practitioners in Abidjan (Côte d'Ivoire) for the Management of Pathologies such as Malaria, ENT Diseases, Diarrhea, Typhoid Fever and Anemia | Chapter 05 | New Horizons in Medicine and Medical Research Vol. 8

 Traditional Medicine Practitioners (TMPs) of Côte d'Ivoire are familiar with the therapeutic herbs. Medicinal plants have been shown to be useful in the treatment of common diseases such as malaria (KROA, 2004) and diabetes (N'GUESSAN et al, 2013) in several studies and scientific study. In the Abidjan District, the current policy is to integrate traditional medicine and pharmacopoeia into the national health system in order to improve population health coverage, particularly in the management of commonly encountered diseases such as malaria, ENT diseases, diarrhoea, typhoid fever, and anaemia. This research aims to increase the use of traditional medicine and pharmacopoeia in the national health system. Over the course of three months, fifty (50) PMTs in the District of Abidjan participated in this study. Plant therapists accounted for 30 of the 50 PMTs polled at the end of the study, or 60%. Traditional medicine centres use 61 types of medicinal plants from 36 famili