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Letters to the Editor

Pagets Disease, is it Common in the South India

Parthasarathy, S

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Indian Journal of Endocrinology and Metabolism: Nov–Dec 2020 - Volume 24 - Issue 6 - p 554
doi: 10.4103/ijem.IJEM_516_20
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I read with interest the article on Pagets disease by Aseervatham et al.[1] I have certain doubts regarding the article

  1. The authors have mentioned in the title that this is more common in South India, but in the methods, they have described the data from almost 10 outpatient clinics of various doctors (not from the institute)
  2. 66 patients from ten outpatient clinics in twelve years is described as common disease. May I know the method in which they describe it as common.
  3. The study has got no objectives. With a simple observational study, they have reasoned out that a drug intake has reversed many cases. In a year follow up is given in the data which includes patients from 2020. This incomplete year, how one year follow up can be done ?
  4. The authors have mentioned it as more common in South India, because there are only 27 reports from the west.[2] Is it true that the west report is from ten doctors of 12 years practice. If that is going to be the truth, then the conclusion is invalid. The western study is in 2006. Its exactly fourteen years now. is any epidemiological comparison valid after 14 years?
  5. In the last, they have mentioned as cohort study, do they mean to say, is it's a retrospective observational cohort ?
  6. Was FDG PET scan done in all cases even in 2008?
  7. There is no clear cut definition of remission in methodology. Hence percentage description in results seems vague. how a remission rate of 92.4% arrived at ?

I request the authors to clarify for the benefit of all readers.

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1. Asirvatham AR, Kannan S, Mahadevan S, Balachandran K, Sampathkumar G, Sadacharan D, et al Is Paget disease of bone more common in South India. Clinical characteristics, therapeutic outcome, and followup of 66 patients from Tamil Nadu? Indian J Endocr Metab. 2020;24:306–11
2. Joshi SR, Ambhore S, Butala N, Patwardhan M, Kulkarni M, Pai B, et al Paget's disease from Western India J Assoc Physicians India. 2006;54:5358
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