The Indian Practitioner

A. G. Unnikrishnan ¹, Vedavati Purandare ¹

Affiliations
1 Division of Endocrinology and Diabetes Chellaram Diabetes Institute, Pune-411021, IN

Abstract

Hypothyroidism is common in India. With the increased availability of TSH testing, diagnosis of hypothyroidism has become more frequent. Subclinical hypothyroidism, characterised by normal thyroid hormones and a high TSH, poses a challenge to clinicians. TSH measurement is the single most important test for diagnosis and follow up. The treatment of choice is levothyroxine and the dose must be titrated to achieve normal TSH level. In addition to a discussion on the management of hypothyroidism, this article will also focus on the management of subclinical hypothyroidism and myxoedema coma.

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K. V. Kavitha ¹, A. G. Unnikrishnan ²

Affiliations
1 Department of Podiatry, Chellaram Diabetes Institute, Pune, IN
2 Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, IN

Abstract

Diabetic foot problems are a major complication of diabetes, and have a significant impact on morbidity and mortality. Foot ulcer remains a major health concern in people with diabetes. Diabetic foot problems require good clinical care which includes effective bedside screening for neuropathy and vascular problems, both of which are contributing factors for the foot problems. Early, aggressive treatment including glycaemic control, right intervention, antibiotic therapy along with good foot care practices such as good foot hygiene and daily inspection, proper footwear which minimises pressure, offloading and wound care management are all crucial in preventing and managing major foot related problems.

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