scholarly journals Study on drug profile used in diabetic foot ulcer

2020 ◽  
Vol 9 (7) ◽  
pp. 1095
Author(s):  
Rajalakshmi Ramesh ◽  
Kowsalya Moorthi ◽  
Saravanan Kunchithapatham ◽  
Prema Mariappan
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Base Line ◽  
Age Group ◽  
College Hospital ◽  
Medical College ◽  
The Common ◽  
Using Data ◽  
Collection Form

Background: The objective was to study about the drugs used in management of diabetic foot ulcer (DFU) and to grade the wounds using Wagner’s scale.Methods: An observational study was conducted at Department of Pharmacy, Rajah Muthiah Medical College Hospital over a period of six months from November 2018 to April 2019. The data was collected from 85 patients using data collection form. The patients were selected based on inclusion and exclusion criteria.Results: Overall 85 patients were enrolled in this study. The prevalence of DFU found to be 36% more in males 58 (68%) than in females 27 (32%). Considering the age group, higher prevalence was reported in patients among the age group of 60-70. This study shows, patients were found commonly to have habits of alcohol 18 (21%), smoking 11 (13%) and both 22 (26%). Overall, 23 classes of drugs were used in this study. Among these, mostly were antibiotics 12 (52%) then hypoglycemic drugs 5 (21%) and others are analgesics (9%), anti-ulcerant and vitamins. This study shows that the common antibiotics prescribed are metronidazole 39 (24%), cefotaxime 36 (22.7%), ciprofloxacin 25 (15.8%) and piperacillin 21 (13.2%). The common hypoglycemic drug used were of insulin 63 (74%), metformin 43 (77%), glimepiride 12 (14%) and metformin and glimepiride 12 (14%). By using Wagner’s scale, out of 85 patients, most of the ulcer were predominantly between grade IV and V.Conclusions: Targeting range of glycaemic levels and proper antibiotics is the best way of treating DFU. This study has provided the base line data regarding management of DFU which helps to improve therapeutic outcome.

STUDY OF SURGICAL MANAGEMENT AND COMPLICATIONS OF DIABETIC FOOT ULCER

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr. Devi Das Verma ◽  
Dr. Anil Kumar Saxena
Keyword(s):  
Health Problem ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
World Health ◽  
Foot Ulcers ◽  
Age Group ◽  
Major Health Problem ◽  
Split Skin Grafting ◽  
Foot Problems

Introduction:  Diabetes is one of the most prevalent metabolic chronic diseases due to the imbalance production of insulin. One of the studies reported that in 2010 worldwide 285 million adults had diabetes and this figure may be increase to 439 million by the year 2030. Globally Diabetic foot ulcers (DFUs) constitute major health problem in people that significantly contribute to morbidity and mortality in diabetes patients. Approximate 1.0% to 4.1% of the annual population-based incidences of a diabetic foot ulcer (DFU) were reported. Due to this the lifetime may be as high as 25%. In Asian countries diabetic foot ulcer are major problems which are different from European countries or developing countries.  From many studies reported diabetic foot problems in India are infectious and neuropathic in nature as compared to developed countries. According to World Health Organization (WHO) diabetic foot is defined as lower limb of a diabetic patient characterized by infection, potential risk of pathologic consequences ulceration or destruction of deep tissues associated with neurological abnormalities, various changes in peripheral neuropathy vasculopathy and superimposed infection that are mainly responsible foot ulceration. Ulcers are one kind of abscess which is difficult to treat because of poor wound healing that result from a combination of neuropathy, ischemia and hyperglycemia.  Aim: The main objective was to study the outcome of treatment modalities and it’s relating factors to complication in diabetic foot ulcer.  Material and method:  Total 60 diabetic foot ulcer patients with the age range from 20 to 70 years were included.  From all the patients’ detailed past and present history were recorded.  For all the patients, general, physical and local and systemic examinations were also done. Detail   laboratory examination like Fasting and Post Prandial Blood sugar levels, blood count, ECG, ESR, complete urine examination for the presence of ketone bodies and sugar, x-ray as well as culture and sensitivity of the discharge from ulcer were also done. Patients were treated with various treatment methods like conservative treatment, split skin grafting and amputation. Result: In this study male patients were more in proportion as compared to female. This study showed that maximum with the age group 14 -50 (43.3%) years old followed by 18.3% in 31-40 years old, 16.7% in 61-70 years old.  6.7% showed the least age group as 20 -30 years old.  Out of total 60 patients, 38.3% of the patients showed diabetic ulcer foot which was more whereas 15% showed diabetic gangrene foot which was least. 25% showed diabetic cellulites foot and 21.7% showed as diabetic abscess foot.  Conclusion: Globally as diabetes mellitus cases are increasing and it became rapidly the public health problem. This may be due to burden on economy, health system and on society to manage the diabetic foot problems. Diabetic foot management guidelines must be made into our practice protocols which may preventing limb loss, and decrease mortality and increase the quality of life of the patient. Hence for this it is only possible with the help of foot care education and health care workers.  Hence, foot infection is to put first and care for it like hands. Keywords: Diabetes, foot ulcers, infections, amputations.

scholarly journals A prospective observation study on diabetic foot ulcer using diabetic ulcer severity score at tertiary care hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 3553
Author(s):  
Bharti Saraswat ◽  
Kapil Kumar Gill ◽  
Ashok Yadav ◽  
Krishan Kumar
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Scoring Systems ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer

Background: A number of scoring systems and classifications are available for diabetic foot ulcers with intention to compare the treatment modalities and future outcomes. Many of them are complex and don’t predict future outcome within the patients. Aim and objectives of current study were to establish a wound-based clinical scoring systems (DUSS) as daily clinical practice by assessing the efficacy of diabetic ulcer severity score.Methods: A total of 73 diabetic patients with foot ulcers were included in this prospective observational study conducted at Dr. S.N. Medical college, Jodhpur and attached hospitals from July 2018 to August 2020. Ulcers were assessed and DUSS score created. Patients were followed up for six months or until healing or amputation if either.Results: In this prospective study of 73 patients with diabetic foot ulcers, most common age group affected was between 51-70 years. Mean age group was 58.57±12.66 years. Mean duration of diabetes was 7.61±5.72 years. Most commonly ulcers were of DUSS score 2. Mean DUSS score was 1.97±1.15. Majority of diabetic foot ulcer patients (37 out of 51) with DUSS score 0, 1 and 2 healed by primary intention after wound debridement. Those with score 3 & 4 majority of them (20 out of 22) had amputation.Conclusions: This is a very simple scoring system that provides an easily accessible and a streamlined approach in the clinical setting without need of any advanced investigative equipment. Hence this can be applied in any set up.

scholarly journals Increased Mortality in Diabetic Foot Ulcer Patients: The Significance of Ulcer Type

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
N. K. Chammas ◽  
R. L. R. Hill ◽  
M. E. Edmonds
Keyword(s):  
Cause Of Death ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Premature Mortality ◽  
Control Group ◽  
Diabetic Patients ◽  
Age At Death ◽  
College Hospital ◽  
Neuropathic Foot

Diabetic foot ulcer (DFU) patients have a greater than twofold increase in mortality compared with nonulcerated diabetic patients. We investigated (a) cause of death in DFU patients, (b) age at death, and (c) relationship between cause of death and ulcer type. This was an eleven-year retrospective study on DFU patients who attended King’s College Hospital Foot Clinic and subsequently died. A control group of nonulcerated diabetic patients was matched for age and type of diabetes mellitus. The cause of death was identified from death certificates (DC) and postmortem (PM) examinations. There were 243 DFU patient deaths during this period. Ischaemic heart disease (IHD) was the major cause of death in 62.5% on PM compared to 45.7% on DC. Mean age at death from IHD on PM was 5 years lower in DFU patients compared to controls (68.2 ± 8.7 years versus 73.1 ± 8.0 years,P=0.015). IHD as a cause of death at PM was significantly linked to neuropathic foot ulcers (OR 3.064, 95% CI 1.003–9.366, andP=0.049).Conclusions.IHD is the major cause of premature mortality in DFU patients with the neuropathic foot ulcer patients being at a greater risk.

scholarly journals A clinical study of commonly isolated organism and its antibiotic sensitivity in diabetic foot ulcers in Sri Manakula Vinayagar Medical College and Hospital, Pondicherry

2020 ◽  
Vol 7 (8) ◽  
pp. 2512
Author(s):  
Anand Shanmugaiah ◽  
Saravanan Pandian ◽  
Sudha Selvam
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Sugar ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Empirical Therapy ◽  
Gram Negative ◽  
Medical College ◽  
Diabetic Foot Infections

Background: Diabetic foot ulcer is one of the major surgical problem leading to hospital admission. Diabetic foot ulcer patients with uncontrolled diabetes may end up in forefoot amputation. Early aggressive debridement, control of blood sugar and empirical antibiotic therapy would reduce the morbidities in patients with diabetic foot ulcer. Further the knowledge of commonly isolated microbes and their antibiotic sensitivity pattern would be helpful to start empirical therapy. The purpose of this study was to determine the microbiological profile of diabetic foot infections (DFIs) and assess the antibiotic susceptibility of the causative agents.Methods: This cross-sectional study was conducted in 115 patients admitted with diabetic foot ulcer over a period of 9 months from October 2015 to June 2016 at the department of general surgery, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Tissue scrapping samples were collected and processed as per standard guidelines.Results: 167 organisms were isolated from 115 patients. 52% of culture showed polymicrobial growth. There was increased prevalence of gram-negative organisms 53% compared to gram positive organisms 47%. When comes to individual isolate, Staphylococcus aureus was the most common organism isolated 24.6% followed by Pseudomonas aeruginosa 21%. All gram-positive aerobes were sensitive to vancomycin and gram-negative isolates were sensitive to amikacin, piperacillin-tazobactum, gentamycin and cefotaxime.Conclusions: Staphylococcus aureus and Pseudomonas were the common pathogens isolated. This study recommends use of vancomycin along with piperacillin-tazobactum as an empirical therapy along with adequate blood sugar control and early debridement of devitalized tissues in patients with diabetic foot infections.

scholarly journals Abruptio placenta and its maternal and fetal outcome

2019 ◽  
Vol 8 (8) ◽  
pp. 3323
Author(s):  
Ritu Mishra ◽  
Aditya Prakash Misra
Keyword(s):  
Neonatal Morbidity ◽  
Fetal Outcome ◽  
Age Group ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Maternal Mortality And Morbidity ◽  
Life Threatening ◽  
Abruptio Placenta ◽  
The Common

Background: Abruptio placenta is one of the common cause of antepartum haemorrhage and is defined as premature separation of normally implanted placenta. It is more common in second half of pregnancy. Abruptio placenta is serious complication of pregnancy and causes high maternal and neonatal morbidity and mortality.Methods: This retrospective study of abruptio and its maternal and perinatal outcome was carried out between July 2016 and October 2017 at Rama Medical College Hospital and research centre.Results: Incidence of Abruptio placenta is 1.6%. It is most common in the women of age group 30-35 years. 75% of cases were associated with severe pre-eclampsia. Live births were 75% while stillbirths were 25%. PPH occurred in 30% of cases. DIC accounts for 25% of the complication.Conclusions: Abruptio placenta is life threatening complication of pregnancy and it is associated with poor maternal and fetal outcome if not managed appropriately. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.

scholarly journals A prospective observational study of drug prescription pattern of antibiotics in diabetic foot ulcer in tertiary care teaching hospital

2020 ◽  
Vol 9 (7) ◽  
pp. 1020
Author(s):  
Kamalavarshini Paramasivamsasanger ◽  
Prema Mariappan ◽  
Dhivya Govindasamy ◽  
Padmavathi Karunakaran ◽  
Rajalakshmi Ramesh
Keyword(s):  
Observational Study ◽  
Diabetic Foot ◽  
Prospective Observational Study ◽  
Drug Prescription ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Prescribing Pattern ◽  
College Hospital ◽  
First Choice

Background: Our aim was to study a prescribing pattern of antibiotics used in diabetic foot ulcer (DFU).Methods: 50 patients were selected by inclusion and exclusion criteria basis. It was a prospective observational study conducted in Department of Surgery, Rajah Muthiah Medical College Hospital (RMMCH), Annamalai University.Results: This study reveals that male patients 60% are more prone to develop diabetic foot ulcer than the female patients 40%. Patients of 50 to 60 age group 32% has higher prevalence of DFU. The most commonly prescribed antibiotics are metronidazole 48% and cefotaxime 48% followed by piperacillin and tazobactam combination 30%, ciprofloxacin 20%, linezolid 18%, amoxicillin and clavulanic acid combination 12%, cefixime 6%, clindamycin 4%, amikacin 4%, faropenam 4%, ceftriaxone 2%, amoxicillin 2%, gentamicin 2%, cefoperazone sodium and sulbactam combination 2%.Conclusions: Lack of antibiotic sensitivity test leads to growth of organism, wrong antibiotic selection and irrational use of antibiotics. And also observed patient developed resistance to linezolid antibiotic when used as a first choice of drug to treat diabetic foot infection including methicillin-resistant Staphylococcus aureus (MRSA) infected patients.

Management and Outcome of Diabetic Foot-A Study of Hundred Case

2020 ◽  
Vol 23 (1) ◽  
pp. 25-28
Author(s):  
Mohammad Ali ◽  
Md Jamal E Rabby ◽  
Md Masud Zaman ◽  
Md Abdus Salam ◽  
Md Kabirul Hassan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Treatment Modalities ◽  
Diabetic Patients ◽  
Minor Trauma ◽  
College Hospital ◽  
Medical College ◽  
Foot Complications ◽  
Foot Problems

Background: Diabetes mellitus is a complex metabolic disorder that affect 1-2 percent of the population. It can give rise to many tissue complications among which foot is particularly vulnerable to circulatory and neurological disorder, so that even minor trauma can lead to ulceration and infection. Methods: Between September 2008 and August 2009, 100 patients were undergone treatment for diabetic foot at department of Surgery, Shaheed Ziaur Rahman Medical College Hospital, Bogra. This study included all the cases of diabetic foot irrespective of age, sex and diabetic status. Results: After 12 weeks treatment 84% of patient were completely recovered, 2% developed abscess, 8% developed ulceration and 6% developed gangrene. Mean age of diabetic patients with foot ulcer is 50-60 years. Out of 100 cases 64% male and 36% female. Maximum number of patient (64%) had foot problems after suffering from diabetes mellitus for a period of 6-10 years. Conclusion: The modalities of treatment of diabetic foot should be selected for each type of pathology depending on the pattern of presentations of diabetic foot. Careful selection of treatment modalities can reduce the rate of diabetic foot complications and improve the quality of life of diabetic patients. Journal of Surgical Sciences (2019) Vol. 23 (1) : 25-28

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