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CORRESPONDENCES
Year : 2018  |  Volume : 66  |  Issue : 2  |  Page : 582

Establishing the natural history of disease


Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Tanda, Kangra, Himachal Pradesh, India

Date of Web Publication15-Mar-2018

Correspondence Address:
Dr. K R Sunil
Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Tanda, Kangra, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.227294

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How to cite this article:
Sunil K R. Establishing the natural history of disease. Neurol India 2018;66:582

How to cite this URL:
Sunil K R. Establishing the natural history of disease. Neurol India [serial online] 2018 [cited 2019 Oct 19];66:582. Available from: http://www.neurologyindia.com/text.asp?2018/66/2/582/227294




I read with interest the article entitled “Natural history of a cohort of Duchenne muscular dystrophy children seen between 1998 and 2014: An observational study from South India” published in Neurol India (2018;66:77-82).[1] The authors deserve credit for their efforts. The authors have used a mixed cohort (prospective and retrospective) design for establishing the natural history of Duchenne muscular dystrophy.

However, I have some concerns with the title of the study.

The authors, in the section under treatment and clinical improvement, state that around 54.5% of the children were on a regular oral prednisolone dose of 0.75 mg/kg/day whereas others did not agree to take steroids or chose to take alternate forms of therapy/medicines (ayurveda, homeopathy, yoga, etc.) or stopped their medication without medical consultation.

Diseases have a characteristic natural history, although the time frame and specific manifestations of the disease may vary from individual to individual. While dealing with a disease, natural history of that disease refers to the progression of a disease process in an individual over time, in the absence of treatment.[2] Therefore, the key to identifying natural history of diseases is to see the progress of the disease without intervention. However, the authors as already stated have intervened in form of treatment. Therefore, the current study is unable to describe the natural course of Duchenne muscular dystrophy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Singh RJ, Manjunath M, Preethish-Kumar V, Polavarapu K, Vengalil S, Thomas PT, et al. Natural history of a cohort of Duchenne muscular dystrophy children seen between 1998 and 2014: An observational study from South India. Neurol India 2018;66:77-82.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Principles of Epidemiology: Lesson 1, Section 9|Self-Study Course. Available from: http://www.cdc.gov ' Self-Study Course SS1978. [Last accessed on 2018 Jan 12].  Back to cited text no. 2
    




 

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