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There are limited studies on the prevalence of diabetic peripheral neuropathy (DPN) and related foot deformities in patients with T2DM from India. To investigate the prevalence, characteristics, and risk factors for foot deformities in Asian-Indian individuals with T2DM and DPN. We analyzed 4290 patients (32.3% female, 67.7% male, mean age 51.1 ± 9.3 years) using a cross-sectional, retrospective observational method, focusing on signs and symptoms of foot complications and neuropathy. Dry Skin (44%), infection (19.7%), and ingrown toenails (16.6%) were the foremost prevalent foot health conditions. The most common neuropathic symptoms were burning (35.4%), muscle cramps (31.5%), and loss of sensation (26.6%). Multivariable logistic regression analysis identified nephropathy (OR 3.96 [95% CI: 3.02-5.20]), retinopathy (OR 3.85 [95% CI: 2.72-5.48]), coronary disease (OR 3.48 [95% CI: 2.42-5.04]), COVID-19 history (OR 2.37 [95% CI: 1.73-3.26]), smoking (OR 2.13 [95% CI: 1.56-2.91]), hypertension (OR 2.10 [95% CI: 1.63-2.73]), dyslipidemia (OR 2.09 [95% CI: 1.62-2.69]), alcohol use (OR 1.57 [95% CI: 1.14-2.15]), and high HbA1c (OR 1.29 [95% CI: 1.16-1.42]) as significant predictors (p < 0.001) of increased risk for multiple foot health complications. Diabetes duration showed no significant correlation with increased risk for multiple foot complications. This study revealed a significant incidence of foot deformities and neuropathic symptoms in Indian T2DM patients, influenced by various lifestyle and medical factors. The lack of correlation between diabetes duration and foot complications in the present study highlights the need for enhanced diabetes management and early detection strategies in India.…

PMID: 40233026

Most leg cramps are benign and self-limited. Idiopathic nocturnal leg cramp is the most common from of cramps. Occasionally, leg cramps may signify a significant systemic disorder. Investigations are usually not necessary unless indicated by the history or physical examination. Symptomatic treatment consists of stretching the affected calf muscle by forcible dorsiflexion of the foot.…

PMID: 9118592

<h4>Background</h4>Prolonged standing environments constitute an occupational risk factor for nurses, particularly for developing foot and ankle disorders. The definitions and potential relationship to hours spent walking or standing are poorly understood. This scoping review aimed to synthesize the main disorders found on nurses' ankles and feet, their prevalence, the influence of hours spent walking or standing, and gender differences.<h4>Methods</h4>This review followed a previously published protocol. Primary and secondary studies were retrieved from relevant databases from December 2020 to March 2021. Potential articles were collated to Mendeley, and two independent reviewers assessed the title and abstracts. Studies meeting inclusion criteria were included. Two researchers retrieved and reviewed the full text of these studies independently. A predetermined extraction tool was used to retrieve relevant data, summarized in a tabular and narrative format.<h4>Findings</h4>The most common disorder was pain, followed by numbness, burning feet, bunions, structural deformities, and calluses. Prevalence differed among studies, depending on settings and specific local policies. <i>Discussion:</i> Various foot and ankle disorders and related variables have been found, with clear gaps that may be addressed in the future.<h4>Conclusion/applications to practice:</h4>Few studies have focused on nurses' foot and ankle disorders. Mapping signs and symptoms may contribute to the future development of preventive interventions for nurses' workplaces.…

PMID: 36637114

Andersen-Tawil syndrome (ATS) is a multisystem channelopathy characterized by periodic paralysis, ventricular arrhythmias, prolonged QT interval, and facial dysmorphisms occurring in the first/second decade of life. High phenotypic variability and incomplete penetrance of the genes causing the disease make its diagnosis still a challenge. We describe a three-generation family with six living individuals affected by ATS. The proband is a 37-year-old woman presenting since age 16, with episodes of muscle weakness and cramps in the pre-menstrual period. The father, two brothers, one paternal uncle and one cousin also complained of cramps, muscle stiffness, and weakness. Despite normal serum potassium concentration, treatment with potassium, magnesium, and acetazolamide alleviated paralysis attacks suggesting a dyskalemic syndrome. Dysmorphic features were noted in the proband, only later. On the ECG, all but one had normal QT intervals. The affected males developed metabolic syndrome or obesity. The father had two myocardial infarctions and was implanted with an intracardiac cardioverter defibrillator (ICD). A genetic investigation by WES analysis detected the heterozygous pathogenic variant (NM_000891.2: c.652C>T, p. Arg218Trp) in the <i>KCNJ2</i> gene related to ATS, confirmed by segregation studies in all affected members. Furthermore, we performed a review of cases with the same mutation in the literature, looking for similarities and divergences with our family case.…

PMID: 38672523

Exercise-associated muscle cramps (EAMC) in the calf are common in rugby league. To date, the etiology and predictors of calf cramping are poorly understood. The aim of this study was to undertake a prospective investigation to identify predictors of calf cramping in rugby league players. Demographic and anthropometric data and calf cramp and injury history were collected in the preseason. Hydration status, number of games played, and calf cramps were recorded on game days. Male rugby league players (n = 103, mean age 18.8 ± 4.1 years) were classified as either EAMC (experienced at least 1 incident of calf cramps in the season) or no EAMC (no calf cramps). The following were investigated as possible predictors of EAMC using logistic regression modeling: competition level, age, ethnicity, playing position, history of cramping, precramping, low back pain, foot orthotic usage, foot posture, foot strike, muscle flexibility, calf girth, hydration status, and number of games played. Half the players, n = 52, experienced at least 1 incidence of calf cramping. Playing in a senior competition level (odds ratio: 0.21; 95% confidence interval: 0.06-0.75; p = 0.016), a history of calf cramping (10.85; 2.16-54.44; p = 0.004), and a history of low back pain resulting in missed field minutes (4.50, 1.37-14.79; p = 0.013) were found to predict EAMC. This study suggests that there is a high incidence of calf cramping in rugby league, especially at senior competition levels, and supports preseason screening in senior players to idetify those at risk of calf cramping and the development of possible preventative strategies.…

PMID: 23774284

Most leg cramps are benign and self-limited. Idiopathic nocturnal leg cramp is the most common from of cramps. Occasionally, leg cramps may signify a significant systemic disorder. Investigations are usually not necessary unless indicated by the history or physical examination. Symptomatic treatment consists of stretching the affected calf muscle by forcible dorsiflexion of the foot.…

PMID: 9118592

<h4>Background</h4>Muscle cramps are common among persons with cirrhosis and are associated with poor health-related quality of life (HRQOL). Treatment options are limited. We compared stretching or meditation in a randomized-controlled trial (RCT).<h4>Patients</h4>We enrolled 98 patients with a history of >4 muscle cramps in the prior month from 7/22-7/23. We randomized patients 1:1 to stretching versus meditation for 35 days. Our primary outcome was the change in cramp severity measured by the visual analogue scale for cramps (VAS-cramps, scaled 0-10). Secondary outcomes included a patient global impression of change (PGIC), change in sleep quality and global HRQOL measured using the EQ-5D and VAS-global HRQOL.<h4>Results</h4>Overall, 48% of patients had cirrhosis, 40% had diabetes, 16% the median age was 63, most were women (67%) and 81% were college educated. Both arms experienced a reduction in cramp severity-a median of 1.44 (.58-2.29) points for stretching and 1.97 (1.01-2.93) points for meditation. These changes were significant changes from baseline (p = .001 for stretching, p < .0001 for meditation) but these changes were equivalent between arms (p = .4). The PGIC was improved: 1.33 (1.02-1.65) for stretching, 1.05 (.70-1.41) for meditation, p-difference .2. Sleep was also improved for both. HRQOL did not change according to the Eq5D; according to the VAS, HRQOL rose for meditation by 6 (.1-11.8) points but not for stretching. More patients recommended stretching than meditation (79.2% vs. 55.3%, p = .02).<h4>Conclusion</h4>In a randomized trial, stretching and meditation both reduced cramp severity and improved sleep quality and global impression of change. While patients preferred stretching, there was no difference in effect between arms.…

PMID: 38860445