Long Term Effects of Below-the-Knee Angioplasty in Diabetic Patients with Critical Ischemia of Lower Limbs Referred to Sina Hospital During 2010-2011

2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Mohammad-Reza Zafarghandi ◽  
Iraj Nazari ◽  
Morteza Taghavi ◽  
Abbas Rashidi ◽  
Sanaz Karimi Dardashti ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Lower Limbs ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Long Term Effects ◽  
Short Term ◽  
Critical Ischemia ◽  
Below The Knee ◽  
The Mean

AbstractDespite significant advances in the treatment of diabetic foot ulcers and below-the-knee critical ischemia, there are ongoing efforts to achieve a method with low complication, high success rate and persistence of long-term effects.was to examine the outcome of angioplasty in patients with below-the-knee critical ischemia referred to Hospital.. This semi-experimental study conducted on diabetics patients treated with PTA (Percutaneous transluminal angioplasty) with critical ischemia of lower limbs referred to Sina Hospital. After discharge, the patients were followed weekly for the first month and then monthly up to 12 months. The procedure short-term effects were examined through evaluation of wound healing as well as patients' recovery and pain relief, after one month. Given the distribution type, parametric and non-parametric test were used to compare the results before and after treatment. Pearson's correlation coefficient was used to determine the correlation between variables.. Twenty four patients participated in this study. The mean ankle-brachial index (ABI) at baseline was 0.55±0.17. A month after angioplasty, the index increased statistically significant to 0.93±0.16. The mean health score expressed by the patients at baseline was 5.48±1.39. A month after angioplasty, it was significantly increased (6.32±1.24). The mean pain score before enrollment was 6.68±2.52 (according to VAS scale). There was a significant decrease over time (3.45±1.13). The overall mean score of all patients at Rutherford Classification was 3.88±0.63 at baseline. During the 1st month and 6th month follow-up, it was changed to Class 0 that was statistically significant in the first month.. This study represents the mid-term outcomes of PTA. Although PTA treatment was associated with improved pain scores, satisfaction with health, classification of limb ischemia and diabetic foot ulcers, the effects only remain short-term and mid-term. However, long-term efficacy of PTA needs to be investigated further.

scholarly journals Clinical profiles of diabetic foot ulcer patients undergoing major limb amputation at a tertiary care center in North-eastern Tanzania

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Shabhay ◽  
Pius Horumpende ◽  
Zarina Shabhay ◽  
Andrew Mganga ◽  
Jeff Van Baal ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetic Foot ◽  
Care Center ◽  
Tertiary Care ◽  
Limb Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Random Blood Glucose ◽  
North Eastern ◽  
The Mean

Abstract Background Diabetic foot ulcers complications are the major cause of non-traumatic major limb amputation. We aimed at assessing the clinical profiles of diabetic foot ulcer patients undergoing major limb amputation in the Surgical Department at Kilimanjaro Christian Medical Centre (KCMC), a tertiary care hospital in North-eastern Tanzania. Methods A cross—sectional hospital-based study was conducted from September 2018 through March 2019. Demographic data were obtained from structured questionnaires. Diabetic foot ulcers were graded according to the Meggitt-Wagner classification system. Hemoglobin and random blood glucose levels data were retrieved from patients’ files. Results A total of 60 patients were recruited in the study. More than half (31/60; 51.67%) were amputated. Thirty-five (58.33%) were males. Fifty-nine (98.33%) had type II diabetes. Nearly two-thirds (34/60; 56.67%) had duration of diabetes for more than 5 years. The mean age was 60.06 ± 11.33 years (range 30–87). The mean haemoglobin level was 10.20 ± 2.73 g/dl and 9.84 ± 2.69 g/dl among amputees. Nearly two thirds (42/60; 70.00%) had a haemoglobin level below 12 g/dl, with more than a half (23/42; 54.76%) undergoing major limb amputation. Two thirds (23/31; 74.19%) of all patients who underwent major limb amputation had mean hemoglobin level below 12 g/dl. The mean Random Blood Glucose (MRBG) was 13.18 ± 6.17 mmol/L and 14.16 ± 6.10 mmol/L for amputees. Almost two thirds of the study population i.e., 42/60(70.00%) had poor glycemic control with random blood glucose level above 10.0 mmol/L. More than half 23/42 (54.76%) of the patients with poor glycemic control underwent some form of major limb amputation; which is nearly two thirds (23/31; 74.19%) of the total amputees. Twenty-eight (46.67%) had Meggitt-Wagner classification grade 3, of which nearly two thirds (17:60.71%) underwent major limb amputation. Conclusion In this study, the cohort of patients suffering from diabetic foot ulcers treated in a tertiary care center in north-eastern Tanzania, the likelihood of amputation significantly correlated with the initial grade of the Meggit-Wagner ulcer classification. High blood glucose levels and anaemia seem to be also important risk factors but correlation did not reveal statistical significance.

scholarly journals Characterization Of Phyto-Synthesized Silver Nanoparticles And Their Antimicrobial Activity Against Diabetic Foot Ulcer Bacterial Isolates

2021 ◽  
Vol 11 (6) ◽  
pp. 88-96
Author(s):  
Chhajed Shweta ◽  
Arora Asha
Keyword(s):  
Antimicrobial Activity ◽  
Silver Nanoparticles ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Limbs ◽  
Diffusion Method ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Bacterial Isolates

Diabetic Foot Ulcer (DFU) is one of the major complications of Diabetes. Patients with Diabetic Foot ulcers have a high susceptibility to microbial infections and are the leading cause of hospitalization and amputation of lower limbs. In the era of increased prevalence of bacterial resistance and outbreak of resistant infectious diseases, it is very essential to develop effective therapeutic strategies towards multi-drug resistant pathogens. The antimicrobial properties of silver nanoparticles have been well studied, therefore their use in biomedicine and pharmacology is a trend. Herein we present the use of Phyto-mediated synthesized AgNPs for the treatment of diabetic foot ulcers by topical administration. The nanoparticles were synthesized by reducing silver nitrate using Terminalia chebula fruit extract. The nanoparticles were analyzed and characterized using UV-Visible Spectrophotometer, FTIR, XRD, SEM with EDAX, TEM, and DLS. The synthesized silver nanoparticles were assayed for antimicrobial activity against five Diabetic Foot Ulcer bacterial isolates i.e. Escherichia coli, Klebsiella Pneumoniae, Pseudomonas aeruginosa, Streptococcus aureus, and Bacillus subtilis. The bactericidal property of synthesized nanoparticles was analyzed by the Agar well diffusion method, which revealed the remarkable antimicrobial effects against all the selective pathogenic bacterial isolates of Diabetic foot ulcers in the present study. These results constituted the basis for further studies on the use of plant-based silver nanoparticles for the treatment of Diabetic Foot ulcers from different origins

scholarly journals Long-Term Outcome and Disability of Diabetic Patients Hospitalized for Diabetic Foot Ulcers: A 6.5-year follow-up study

Diabetes Care ◽  
2008 ◽  
Vol 31 (7) ◽  
pp. 1288-1292 ◽  
Author(s):  
E. Ghanassia ◽  
L. Villon ◽  
J.-F. Thuan dit Dieudonne ◽  
C. Boegner ◽  
A. Avignon ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Follow Up Study

scholarly journals An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial)

2021 ◽  
pp. 153473462110536
Author(s):  
Tjun Yip Tang ◽  
Manfred Y. Q. Mak ◽  
C. J. Q. Yap ◽  
J. E. C. Boey ◽  
Sze Ling Chan ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Distribution System ◽  
Oxygen Therapy ◽  
Atmospheric Oxygen ◽  
Foot Ulcer ◽  
Glycated Haemoglobin ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Transcutaneous Oxygen ◽  
The Mean

Natrox™ topical oxygen therapy (TOT) ( Inotec AMD Ltd, Hertfordshire, UK) employs a small battery-powered “oxygen generator” to concentrate atmospheric oxygen and feeds pure, moist, oxygen through a fine, soft tube to a dressing-like “oxygen distribution system”, which is placed over the wound and is held in place by a conventional dressing. The aim was to determine the effectiveness of Natrox™ for non-healing diabetic foot ulcers (DFU) over a 3-month period.Longitudinal, single-arm, open prospective registry study using 12 weeks of TOT using a 4 week run-in period. 20 patients recruited to OTONAL had chronic DFU greater than 3 months duration or minor amputation sites with less than 50% healing in 4 weeks.There were 13 (65%) males and the mean age was 65.7 (±11.6) years. The mean glycated haemoglobin (HbA1c) was 6.9 (±1.3) mmol mol−1 and mean wound duration before TOT was 114 (±79.1) days. 18/20 (90.0%) patients had concomitant lower limb revascularization angioplasty for chronic limb threatening ischaemia. The mean size of the foot ulcer at baseline was 11.3 ± 14.8 cm2 and mean transcutaneous oxygen measurement value was 34.1 (±19.6) mm Hg. Wound closure of >75% was observed in 14/20 (70.0%) patients. There was a 91.3% (±14.9%) wound area reduction by 3 months (P = .001) and mean time for 100% closure was 77.6 ± 32.5 days. Mean pain scores reduced from 2.4 (±1.8) at baseline to .5 (±1.0) at 3 months (P = .008). All patients were very satisfied using the ambulatory device. Use of TOT in chronic diabetic foot wounds stimulates a healing state, underpinning the concept that oxygen plays a central role in wound healing. Our results are more compelling if you consider they started with relatively large-sized DFUs and majority of patients were frail with underlying peripheral artery disease. (NCT03863054)

scholarly journals Assessment of the outcomes of the treatment of patients with suppurative necrotic complications of diabetic foot syndrome with the use of programmed rehabilitation technologies

2018 ◽  
Vol 177 (6) ◽  
pp. 63-68 ◽  
Author(s):  
A. A. Glukhov ◽  
V. V. Sergeev ◽  
G. A. Semyonova
Keyword(s):  
Diabetic Foot ◽  
Reference Group ◽  
Postoperative Mortality ◽  
Diabetic Foot Syndrome ◽  
Study Group ◽  
Long Term Outcomes ◽  
Short Term ◽  
Critical Ischemia

Objective.To assess the outcomes of the treatment of patients with suppurative necrotic complications of diabetic foot syndrome (DFS) without critical ischemia with the use of programmed rehabilitation technologies (PRT).Materialand methods.The study included 82 patients. 40 patients (reference group) underwent conventional rehabilitation, while 42 patients (study group) were treated with PRT with the use of the original equipment AMP-01.Results.Use of PRT has been established to significantly improve the quality of rehabilitation, which helps to reduce the duration of inpatient treatment. The number of suppurative complications in the study group proved to be significantly less (p=0.014), and postoperative mortality was lower. The long-term outcomes of the treatment (number of late suppurative complications, ischemia progression, maintenance of foot support ability) in the study group was also found to be significantly better compared to the reference group.Conclusion.The use of PST promotes the improvement of short-term and long-term outcomes of the treatment of the patients with DFS suppurative necrotic complications.

scholarly journals Short Term Effects of Mild Severity COVID-19 on Left Ventricular Functions

2021 ◽  
Author(s):  
Osman Bektaş ◽  
Ahmet Karagöz ◽  
Feyza Nur Topçu Yenerçağ ◽  
Seçkin Dereli ◽  
Celali Kurt ◽  
...  
Keyword(s):  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Long Term Effects ◽  
C Reactive Protein ◽  
Short Term ◽  
Reactive Protein ◽  
The Mean ◽  
And Gender

Abstract Purpose: We aimed to evaluate long term effects of COVID-19 disease on left ventricular function using speckle tracking echocardiography. Methods: In our study, 96 non-hospitalized patients who were diagnosed with COVID-19 disease in our center between 15 August 2020 and 01 September 2020 and 96 age and gender matched control subjects were included.Results:The mean follow up duration was 137 ± 7 days. White blood cell, neutrophile and lymphocyte were significantly lower and C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) were significantly higher in the COVID-19 group. (6.6 ± 2.8 vs. 24.4 ± 21.8, p <0.001 and 4.1 ± 2.5 vs. 7.1 ± 4, p <0.001, respectively). LV-GLS and LV-GCS were significantly lower in the COVID-19 group. (-20.1 ± 3.1 vs -15.9 ± 2, p <0.001 and -29.3 ± 2.1 vs -26.3 ± 2.1, p <0.001, respectively). LV-GLS and LV-GCS were found to be negatively correlated with CRP (rs = -0.515, p <0.001 and rs = 0.-466, p <0.001, respectively) and NLR (rs = -0.494, p <0.001 and rs = -434, p <0.001, respectively). Conclusion: Deteriorating effects of COVID-19 disease on both LV-GCS and LV-GLS can be seen even in the short term. These detrimental effects seem to be associated with CRP levels and NLR measured in the course of active infection.

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