Diabetic Retinopathy - Facts, Diagnosis and Treatment
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Diabetic Retinopathy – Facts, Diagnosis and Treatment

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8 months ago

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Diabetic retinopathy (DR) is a complication resulting from diabetes. It affects the retina, a delicate part of the eye. DR occurs due to uncontrolled blood sugar, which damages the retinal vessels and leads to loss of vision if left untreated. This condition is also a leading cause of blindness in people between 20 – 64 years.

Diabetics retinopathy affects about 80% of people living with diabetes for 20 years or more. However, receiving the right care and having regular eye check-ups can reduce about 90% of new diabetic retinopathy cases.

Stages of diabetic retinopathy

Diabetic retinopathy has two main stages. They include:

  • Non-proliferative diabetic retinopathy (NPDR)
  • Proliferative diabetic retinopathy (PDR)

Non-proliferative diabetic retinopathy

NDRP usually shows no symptoms, and the only way to get a correct diagnosis is by examining the fundus. The fundus can be found inside the eye, opposite the lens, and behind it. The fundus contains blood vessels, macula, optic disc, retina, and fovea.

During the fundus examination, the doctor will check for accumulation of lipoprotein, bleeding, microaneurysms, and retinal vessel changes.

Proliferative diabetic retinopathy (PDR)

PDR causes the development of abnormal new blood vessels (neovascularisation). These new blood vessels develop at the back of the eye and may erupt and bleed, leading to vitreous haemorrhage or traction retinal detachment.

In some cases, macular oedema occurs, which is a swelling resulting from the build-up of fluid. Macular oedema may cause the blood vessels to leak their content into the central vision, leading to blurry vision during any stage of the condition.

When the retina is diseased (ischemia), it causes thesecretion of vascular endothelial growth factor, a protein that stimulates new blood vessel formation – these new blood vessels lead to retinal swelling (oedema).

Diagnosis of diabetic retinopathy

Diagnosis of diabetic retinopathy occurs through clinical examination and examination of the dilated fundus. Your doctor may also use a fluorescein angiography to check the extent of ischemia in the retina. This diagnostic test uses a special camera to track the flow of blood in the retina.

Another means of diagnosing DR is using Ocular Coherence Tomography (OCT), an imaging test that determines the location and size of the swelling in the macula area.

Managing diabetic retinopathy

Managing diabetic retinopathy involves the systemic control of factors associated with a higher risk of the disease. These high-risk factors include:

  • Kidney problems
  • Blood sugar
  • Uncontrolled glucose
  • Smoking
  • High blood pressure (hypertension)
  • Dyslipidaemia (irregular lipid volumes)
  • Uncontrolled blood pressure levels

Studies from the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) and the UK Prospective Diabetes Study (UKDPS) found these conditions to be risk factors for diabetic retinopathy.

Treatment of diabetic retinopathy

Treatment for diabetic retinopathy may include the following;

  • Surgery in advanced cases
  • Injections inside the eye (IVT)
  • Laser treatment

Different studies from reputable organisations like the DRCR have shown that anti-VEGF (vascular endothelial growth factor) steroid injections cantreat central macular oedema, which occurs with diabetic retinopathy.

More extensive studies also showed that the anti-VEGF injection is not an inferior treatment to PRP laser, the gold standard treatment for proliferative diabetic retinopathy (PDR).

If you have diabetes, ensure you have regular check-ups to avoid other life-threatening conditions such as diabetic retinopathy.

If you are residing in London, book your private GP appointment today at Privatedoctor.london to see an experienced doctor if you have diabetes or diabetic retinopathy

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A Day Without Screens: Uncovering Me, Myself, & iPhone

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1 month ago

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May 2, 2023

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A vital journey for our generation.

It was a dark and stormy night, and I glanced at the time on my phone once more before laying it face down on the nightstand, never to be looked at again—well, for the next twenty-four hours at least.

A few weeks ago, I set off on a mission to see what life was like outside the confines of my tiny little screen. Although I’d like to say that this mission was born of my own conviction, I can’t claim that kind of self-driven will power. A day without screens was an assignment for my Media Studies course, and one that I was anxious to see unfold; I know my relationship with my phone is unhealthy, but I was eager to learn the extent of my reliance.

 

When the sacred day came, I expected mild boredom or withdrawal…

…what I got instead were intense feelings of detachment from the world around me (quite delectably coupled with the boredom and withdrawal of course).

I decided to let to morning wake me up naturally instead of going to buy some old fashioned alarm clock beforehand. When the sun peeked through my blinds, I immediately shrugged it off on account of it being a bit too early in my mind. This exchange between me and the sun happened two or three more times before I finally decided to crawl out of bed. With no concept of time and no idea what any of my friends were up to, I walked to the dining hall. The only things that greeted my arrival were my friends’ bewildered stares and the lone analog clock screaming two o’clock in the afternoon—they had just stopped serving lunch.

The rest of my day continued in a sluggish fashion. I avoided the screens of my friends as they crowded around them to laugh at some tweet or video. I crouched over my homework all day, not sure what else to do with my time. After my friends left, I sat in solitude just waiting for them to come back for me and tell me what the plan was for the night. My only companion was that taunting analog clock, the closest thing to modern technology I was going to get. Every tick of that clock was a lifetime as I itched for reunification with the other half of my heart.

And when that day was finally over, I jumped into bed like a kid on Christmas Eve. After I awoke the next morning to greet my phone in stark contrast to the way I had previously greeted the sun, that’s when my mind truly began to race. How did my reliance get so bad? Why did I feel like gravity had been ripped out from under me and I was floating through space and time? All the current events and tweets that I missed—do they really matter? Have I given inconsequential things meaning in my life that have no actual relevance to the actual wellbeing of my person?

 

All those thoughts and more tossed and turned in my head like a tumultuous storm at sea. But as the next days unraveled and I fell back into my usual routine, they passed as storms always do. I’m on my phone just as much as I always have been. I only think about that day every once in a while…but I think every once in a while might be a good enough place to start.

 

Phones aren’t going anywhere, so there is no use in trying to expel them from my life. However, my generation has so much of their identity tied up in their social media presence and the relationships and abilities that are heightened by technology. Phones were designed to complement daily lives, not conquer them; while I still may attempting to calm that constant clash for control in my life, at least I’m doing something.

My day without screens didn’t give me the solutions to the problems, but it did open my eyes to what some of the problems actually are. I can’t fix culture, but I can fix myself, and if I want to have a healthy relationship with me, myself, and I, then I’m going to need to have a healthy relationship with my iPhone as well.

 

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Ramen, Japan

Madison Franz

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1 month ago

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April 30, 2023

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Ramen is a popular Japanese dish that consists of Chinese-style wheat noodles served in a flavorful broth, typically topped with various ingredients such as sliced pork, green onions, seaweed, eggs, and bamboo shoots.  It has become a beloved and iconic part of Japanese cuisine.

Ramen originated in China and was introduced to Japan in the late 19th century. Over time, it underwent significant modifications and adaptations to suit Japanese tastes, leading to the development of various regional styles and flavors. Today, ramen is enjoyed throughout Japan and has gained international popularity as well.

Each region in Japan has its own distinct style of ramen, characterized by differences in the broth, noodles, and toppings. Some of the most well-known ramen styles include:

1. Tokyo Ramen (Shoyu Ramen): This style features a soy sauce-based broth that is typically clear and light. The noodles are thin and firm, and the toppings may include chashu (sliced pork), menma (fermented bamboo shoots), and nori (seaweed).

2. Sapporo Ramen (Miso Ramen): Originating from the northern city of Sapporo, this style features a rich and hearty miso-based broth. The noodles are usually thick and curly, and the toppings often include butter, corn, and bean sprouts.

3. Hakata Ramen (Tonkotsu Ramen): Hailing from the southern city of Fukuoka, Hakata Ramen is known for its creamy and milky tonkotsu (pork bone) broth. The noodles are thin and firm, and the toppings commonly include sliced pork belly, green onions, and pickled ginger.

4. Kitakata Ramen: This style comes from the city of Kitakata and is characterized by its soy sauce-based broth that has a slightly sweet and salty flavor. The noodles are thick, flat, and curly, and the toppings often include chashu, menma, and green onions.

These are just a few examples, and there are many more regional variations of ramen across Japan. Ramen shops, known as ramen-ya, can be found throughout the country, ranging from small local establishments to large chains. People often line up to enjoy a steaming bowl of ramen, especially during colder months.

Ramen has also gained global popularity, and you can find ramen restaurants in many major cities around the world. It has become a culinary symbol of Japanese cuisine, loved for its comforting and delicious flavors.

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5 Things I Need You To Know About My ADHD

Odyssey News

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2 months ago

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April 17, 2023

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There’s a lot of stigma around ADHD and it needs to go.

I must say, from an outsider’s perspective, I can see how some people may not believe that I have attention deficit hyperactivity disorder (ADHD). I am the last person to fit the stereotype of the little impulsive five-year-old boy that many people associate with ADHD. Nevertheless, I am affected by the same condition and would like to clarify how it affects me so that others may understand me better.

1. My ADHD doesn’t mean I don’t have a competent attention span

In fact, it isn’t a deficit of attention as much as I would describe it as a malfunction of attention. Attention can be defined as the brain’s ability to concentrate on a particular phenomenon and exclude all others. To say that I can’t keep attention, would be misleading, as many people who have ADHD also experience “hyperfocus” on certain topics. Typically, these topics are ones in which I am more engaged and interested in. With that being said, please understand I also did not choose to engage in these subjects much like how I did not choose to not engage in the others. The problem isn’t that I don’t have attention, but rather, I don’t get to regulate when I apply my attention and what I apply it on.

2. My ADHD is a ubiquitous part of my life

A commonly held notion is that ADHD only affects the ability to concentrate in a school setting. For me, however, it affects much more. It affects how I think, how I act, my daily conversations, what I worry about, how much I worry, the intensity of my emotions, my ability to plan, my awareness of how others perceive me, and it contributes to my feelings of exclusion. My ADHD is ultimately a part of me and plays a role in all that I do. With that being said, my ADHD comes with more positive traits as well: creativity, innovative thinking, empathy, sensitivity, compassion, and passion. Each of these play a role in how I interact and respond in various situations with all types of people on my daily life.

3. My ADHD is not a result of a lack of discipline

My ADHD is not a result of my not trying hard enough. It is not a result of my parents’ neglect to discipline me. In fact, I feel it makes me and many others with ADHD quite the opposite. Me personally, I find that I have to work three times as hard as the majority of my peers to get simple tasks done. One of the most frustrating assumptions is that the accommodations I get on tests gives me an unfair advantage. I think this is partly fueled by a misunderstanding of the seriousness of the condition and the abuse some people have taken of the accommodation system. It bothers me, as a person who genuinely struggles with the implications of ADHD, that there have been many people to fake the condition in order to illegally take and sell drugs or to take advantage of the accommodation system in order to perform better on tests.

Even with the extra time I have, I still have to work incredibly hard. Just because I have extra time, does not mean that suddenly all my problems go away. I spend time and a half longer than everyone else combatting my busy mind and rereading the questions several times until I can direct my attention to what they mean, to answer a multiple-choice exam. ADHD makes reading a lot more difficult for me. My difficulty being able to concentrate on the words I am reading contributes to anxiety and the feeling of being overwhelmed by large amounts of words on a page. As a result, it is very difficult, even with extra time, to perform to what I feel my potential should be on tests.

4. My ADHD does not define my success nor my intelligence

When I am having a conversation with someone, it may appear that I forget what I am talking about because I am mindless and get distracted by something completely unrelated. This is not true, however, as I frequently am distracted because I am reminded of a topic that is related in some way. The connection is typically small and the whole process happens so quickly in my mind. For this reason, I am quite creative and typically excel in tasks that require imaginative thinking. While ADHD affects my mind in some ways that make things a little more difficult, it does not affect my intelligence as a whole. Better put, it affects the means in which I learn. I have been able to succeed in magnet programs throughout my life, the International Baccalaureate program in high school, and balance various activities and clubs, some of which I took leadership roles in.

5. Judging my condition does NOT help anything

I feel like I can not talk about my ADHD without being heavily judged or misunderstood. This stereotype threat in itself has been shown, in many studies to impact performance, allowing the stereotype to live. In my personal experience, my own stress due to the feeling I can not communicate my ADHD comfortably heightens my social anxiety when talking to others, contributes to low self-esteem, and contributes to bouts of depression.

In short, we can do a lot better than this. We need to fight the stereotype and have empathy for individuals who have unique experiences, even if we do not share the same ones. Stop assuming everyone fits the statistic or is exactly like you. Celebrate diversity and make the effort to ask and listen to what individuals are feeling and experiencing.

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