Diabetic neuropathy: a focus on management

Diabetic neuropathy(DN) is a common troublesome ramification of diabetes mellitus impacting at least 50-60% patients of diabetes with multiple complication result in nerve damage, tingling, muscle wastage, sharp pains, burning and numbness in peripheral extremities more often experience pain in legs and feet. Hyperglycemia presents a central role in progression of DN that causes variations in the blood vessels providing blood to the peripheral nerves; metabolic diseases such as initiation of the polyol pathway, myo-inositol depletion, genetic deviations and elevated non-enzymatic glycation which causes the generation of free radicals or oxidative stress. Intense Glycemic control is vitalto the ultimate prevention of DN. Apart from allopathic treatments, there are various alternative treatments like herbal based therapies, acupuncture therapies and physiotherapies are used to improve pain and other symptoms of DN and its related complications. This review provides a summary of various therapies of DN for treatment and its management.

Treatment of Theophylline Poisoning

To the Editor.— We were interested in the report by Shannon and co-workers1 in which they described the use of multiple exchange transfusions for the treatment of an accidental toxic serum theophylline level in an infant in the postoperative phase of an arterial switch procedure. Although we have no problem with the rationale used for an invasive procedure that has multiple complication risks, we would like to emphasize the option for the use of activated charcoal products in infants who are able to tolerate orally administered medications.