A study on diabetes mellitus among diabetic foot ulcer patients in a tertiary care centre

Background: Diabetes mellitus is a chronic disease which occurs either when the pancreas does not reproduce enough insulin, the hormone that regulates blood sugar level or when the body cannot effectively use the insulin it produces. Hyperglycemia or raised blood sugar level is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the system of the body especially nerves and blood vessels. Diabetes mellitus has become the cause for growing public health concern in developing countries as it has been for a long time in most developed ones. The reason for increase in prevalence of diabetes mellitus in developing countries may include unhealthy life style, rapid westernization, poor knowledge, negative attitude and poor practice towards diabetes mellitus among general population. Objective of the study was to find out the knowledge, and awareness towards diabetes mellitus among diabetic foot ulcer patients attending in a tertiary care Centre.Methods: A cross sectional study was carried out in the surgical outpatient department of a tertiary care Centre. All diabetic foot ulcer patients attending surgical outpatient department for the period of two months was included. Juvenile diabetic patients, Type II diabetes mellitus patients with co morbidities are excluded.Results: Out of the 100-study participant’s majority are males (61%). 55% of the study participants are not aware of the major cause of diabetes mellitus. 92% of the population knew the accurate method of monitoring diabetes mellitus. 70.6% of people are aware of normal blood sugar level. 51% of people are aware of the complications of diabetes mellitus and 84.3% of people know the symptoms of diabetes mellitus. 68.6% of the population knew regular exercise can control diabetes mellitus yet only 50.8% of population exercise regularly.Conclusions: This study reflects that there is a need to improve diabetic knowledge among the patients which can be achieved through health education.

Download Full-text

The Effect of Topical Nano Silver Gel on Diabetic Foot Ulcer - A Randomised Control Study in Tertiary Care Centre

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v9i2.23 ◽

2021 ◽

Vol 09 (02) ◽

Author(s):

Ajay.P (MS General Surgery) ◽

Keyword(s):

Diabetic Foot ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Care Centre ◽

Tertiary Care Centre ◽

Nano Silver ◽

Control Study

Download Full-text

“Clinical Profile and Outcome of Diabetic Foot Ulcer in South Indian Tertiary Care Centre”

Surgical Update: International Journal of Surgery and Orthopedics ◽

10.17511/ijoso.2021.i02.01 ◽

2021 ◽

Vol 7 (2) ◽

pp. 01-05

Author(s):

Dr. K K Saravanan ◽

◽

Dr. Mohamed Mubarak Ali V A ◽

Keyword(s):

Diabetic Foot ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Clinical Profile ◽

Diabetic Patients ◽

Care Centre ◽

Tertiary Care Centre ◽

South Indian ◽

Doppler Study

Aim: To study the clinical profile and outcome of diabetic foot ulcer in a Tertiary Care Centre. Theclinical profile of 200 patients with diabetic foot ulcer was studied. Methods: Patients with diabeticfoot ulcer of both genders with age above 18 years willing to participate were included in the study.All patients were subjected to routine diabetic work up with Doppler study and X-ray foot to rule outbone involvement. Results & discussion: The majority of patients with diabetic foot ulcers were ofage group 51 to 60 years, male predominant, mostly with a duration of diabetes mellitus more than6 years had intermittent claudication and most population with a single ulcer. Conclusion: Ourstudy gives important information that diabetic foot ulcer is more common among middle-agedpeople with male predominance which gives the importance of screening diabetic patients forneuropathy and peripheral vascular disease.

Download Full-text

Prevalance and distribution of candidia species from diabetic foot ulcer in tertiary care centre, Jamnagar, Gujarat

Panacea Journal of Medical Sciences ◽

10.18231/j.pjms.2021.048 ◽

2021 ◽

Vol 11 (2) ◽

pp. 231-235

Author(s):

Binita J Aring ◽

Pushpa R Kateshiya ◽

Dipali Maganbhai Gavali

Keyword(s):

Diabetic Foot ◽

Fungal Pathogens ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Fungal Culture ◽

Care Centre ◽

Tertiary Care Centre ◽

Early Recovery ◽

Wound Discharge

Diabetes Mellitus is a chronic disease which may cause diabetic foot ulcer, which is a major cause of morbidity and mortality, it may also lead to foot amputation due to gangrene, and may cause cellulitis, abscess etc.To study prevalence of candidiasis in diabetic foot ulcer in a tertiary care centre, Jamnagar.32(10.66%) isolates that were recovered from wound discharge samples (300 samples tested) from November 2017 to September 2018. All isolates were visualized under direct microscopy, cultured, & sugar assimilation tests were performed.Amongst 300 samples 32(10.66%) were positive for fungal culture, in which major isolates was C. albicans (50%), C. tropicalis (18.75%), C. dubliniensis (9.37%), C.krusei (9.37%), C. glabrata (6.25%), C. parapsilosis (6.25%).This study shows that in Diabetic foot ulcer most common fungal pathogens were C. Albicans, C. tropicalis, C. dubliniensis, etc. Early identification of organism can help in early treatment and early recovery.

Download Full-text

Prevalence of diabetic complications and risk factors among diabetic foot ulcer patients: a retrospective hospital-based study

International Surgery Journal ◽

10.18203/2349-2902.isj20184631 ◽

2018 ◽

Vol 5 (11) ◽

pp. 3608

Author(s):

Shanmuga Raju P. ◽

Venkata Ramana N. ◽

Surya Narayana Reddy V. ◽

Bhagya Seela S. ◽

Sachin G.

Keyword(s):

Risk Factors ◽

Health Care ◽

Blood Sugar ◽

Diabetic Foot ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Diabetic Patients ◽

Care Hospital ◽

The Mean

Background: Diabetic foot ulcer is a painful, demands increased health care utilization, and increases healthcare costs for the patients as well as the health care system. The purpose of this study was to analysis the prevalence of diabetic foot complications and risk factors among diabetic patients at tertiary care Hospital, Karimnagar.Methods: Total 60 sample sizes were included in the study. The study was conducted at General Surgery ward, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar from July 2017 to June 2018. Demographic, complications and risk factors were recorded, and outcomes were analyzed using SPSS statistics version 21.0.Results: The Mean age of the study group is 50.31±14.26 years. The male to female distribution is 47 (78.3%) and 13 (21.7%) respectively. The mean duration of illness in days is 96.68±289.21, while mean HbA1C is 9.44±9.02. The mean fasting blood sugar and postprandial blood sugar is 159.78±70.01 and 157.78±86.28 which shown no significance difference (p = 0.87). Odds ratio with 95% confidence interval was computed to the level of significant.Conclusions: There was no significant outcome was found in diabetic foot ulcer. Patient with high risk complications need as early detection, foot care education, moderate physical, exercise, fitted foot wear and diabetic diet should be decrease the risk of diabetic foot ulcers.

Download Full-text

Management of Diabetic Foot Ulcer in a Tertiary Level Hospital-Faridpur

Bangladesh Heart Journal ◽

10.3329/bhj.v34i1.41908 ◽

2019 ◽

Vol 34 (1) ◽

pp. 52-57

Author(s):

AL Gaddafi ◽

DK Das ◽

G Faruque ◽

Z Islam ◽

MA Rahman ◽

...

Keyword(s):

Blood Sugar ◽

Diabetic Foot ◽

Care Center ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Diabetic Patients ◽

Cross Sectional ◽

Surgical Interventions ◽

Delay In Diagnosis

A descriptive type of cross sectional study among 210 diabetic patients with foot ulcer was carried out in Diabetic Association Medical College during the period of May 2016 to April 2017 and were categorized based on Meggitt-Wagner system to find out the complications, management, below knee amputation rate and mortality rate. The aim of this study was to practise a profile of diabetic foot ulcer (DFU), complications and its management to assess the outcome of the surgical interventions. Majority of the patients were male 112(53%), and most of them 116 patients (55.23%) presented within Wegner grade - 2 and grade-3 diabetic foot ulcers. The duration of diabetes more than 10 years was 116 (55%). 99 (47%) patients out of 210 patients developed diabetic neuropathy. 76 (36%) patients presented with CKD. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center, associated habit of smoking are all factors which lead to incidence of DFU at an earlier age than that seen in other studies. After admission of diabetic foot ulcer patients, diabetic foot ulcer is classified according to Wagner grading and treated the diabetic foot ulcer patients as the using protocol ’!1.Assesment whether it was conservative or surgical. 2. Optimal blood sugar control. 3. Systemic antibiotic. 4. Moist wound environment. 5. Offloading such as total contact casting. 6. Improves peripheral arterial circulation due to lack of vascularity. 7. Surgical debridement or minor amputation or major amputation. In case of G-4 or G-5 patients, ischemia was treated before debridement or amputation so that vascular circulation improved in the ulcer area and then healing potential was fastened. Bangladesh Heart Journal 2019; 34(1) : 52-57

Download Full-text

RISK FACTORS OF DIABETIC FOOT ULCER AT A TERTIARY CARE HOSPITAL AMONG DIABETIC PATIENTS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.480 ◽

2019 ◽

Vol 3 (8) ◽

Cited By ~ 1

Author(s):

Dr. Sanvar Mal Kantva ◽

Dr. Mahendra Kumar

Keyword(s):

Diabetes Mellitus ◽

Diabetic Foot ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Invasive Procedure ◽

Study Patient ◽

Diabetic Patients ◽

Care Hospital ◽

Cross Sectional

Introduction: Diabetes is a metabolic disorder which affects not only carbohydrate but also protein and fat metabolism. Diabetes is also associated with acute as well chronic complications. Almost most of the organs, tissues and systems are affected due to long standing diabetes mellitus. Thus, adult and elderly with long standing diabetes patients often present to the clinics with multiple complications. Among all these well-known complications, diabetic foot ulcer is the most common. It affects as many as 15% of patients with diabetes mellitus during their lifetime Material and Method: The study was a hospital based cross sectional study. Present study was carried out at outpatient department of General Surgery. After their verbal informed consent after explaining them the nature of the study. Patient confidentiality was maintained. The patients diagnosed with diabetic foot ulcer were given appropriate treatment, follow up and health education. The study patients were not subjected for any kind of invasive procedure for the present study purpose. Results: 64.0% patients were having peripheral neuropathy, 73% were having >10 years of diabetes, 49% were having peripheral arterial disease, 34% patients were having diabetic Charcot joint & 26% were having uncontrolled hyperglycemia. Conclusion: Diabetes Mellitus is a lifelong disease and diabetic foot complications can be life threatening, physically incapacitating, costly to treat and result in extensive morbidity. Keywords: Diabetes, foot ulcers, neuropathy

Download Full-text

A study on clinical grading and bacteriological profile of diabetic foot ulcers in tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20202847 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2342 ◽

Cited By ~ 1

Author(s):

Mohammed Hamza ◽

Thomas K. Thomas

Keyword(s):

Treatment Outcome ◽

Diabetic Foot ◽

Tertiary Care ◽

Foot Ulcer ◽

Antibiotic Sensitivity ◽

Diabetic Foot Ulcer ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Tertiary Care Centre ◽

Wagner’S Grade

Background: Diabetes is one of the commonest diseases worldwide and diabetic foot ulcer and its complications are associated with significant morbidity and even amputation. Early detection of colonizing agent of these ulcers help in reduced morbidity and hospital stay. We targeted this subgroup of patients to study Wagner’s grade, identify the bacterial agent and its antibiotic sensitivity and ankle-brachial pressure index (ABPI) assessment to detect PAD, for the best treatment outcome of diabetic foot ulcers.Methods: The present study was conducted in the Department of Surgery of SGMCRF, Venjaramoodu on 210 patients with diabetic foot ulcers between November 2017 and May 2019. Wagner’s grading of ulcer, culture and antibiotic sensitivity of microbe were done as well as ABPI was measured. Outcome of ulcers was compared to ABPI and ABPI was compared to time of healing.Results: Out of 210 patients 122 were males and 88 females, 62.9% had neuropathy and 66.7% had vasculopathy. Most patients presented with Wagner’s grade-II ulcers. Most common microbe isolated was pseudomonas aeruginosa which was most sensitive to piperacillin and tazobactam combination. Majority of lesions 62.9% had ABPI in range of 0.5-0.89.Conclusions: Wagner’s grading and presence of neuropathy are predictors of major amputation. Piperacillin and tazobactam should be empirical choice of antibiotic. ABPI was inversely related to time of healing and has got significant association with treatment outcome.

Download Full-text

ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer

Clinical & Investigative Medicine ◽

10.25011/cim.v44i4.37592 ◽

2021 ◽

Vol 44 (4) ◽

pp. E11-16

Author(s):

Muzammil H. Syed ◽

Mohammed Al-Omran ◽

Jean Jacob-Brassard ◽

Joel G. Ray ◽

Mohamad A. Hussain ◽

...

Keyword(s):

Lower Limb ◽

Diabetic Foot ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Care Hospital ◽

Reference Standard ◽

Diagnostic Coding ◽

Icd 10

Purpose: To estimate the positive predictive value (PPV) of Canadian ICD-10 diagnostic coding for the identification of hospitalization related to a diabetic foot ulcer (DFU). Methods: Hospitalizations related to a neuropathic and/or ischemic DFU were identified from the Discharge Abstract Database (DAD) records of a single Canadian tertiary care hospital between April 1, 2002 and March 31, 2019. The first coding approach required a most responsible diagnosis (MRDx) code for diabetes-specific foot ulceration or gangrene (DSFUG group). Three alternative coding approaches were also considered: MRDx code for lower-limb osteomyelitis (osteomyelitis group); lower-limb ulceration (LLU group); or lower-limb atherosclerotic gangrene (atherosclerosis group)—each in conjunction with a non-MRDx DSFUG code on the same DAD record. From all eligible DAD records, random samples were drawn for each coding group. DAD records were independently compared by a masked reviewer who manually abstracted data from the entire hospital record (reference standard). The PPV and 95% CI were generated. Results: Out of 1,460 hospitalizations, a total of 300, 50, 33 and seven records were included from the DSFUG, osteomyelitis, LLU and atherosclerosis samples, respectively. Compared to the reference standard, the PPV for all 390 records was 88.5% (95% CI 84.9 to 91.5). The DSFUG group had the highest PPV (90.0%, 95% CI 86.0 to 93.2), followed by the atherosclerosis (85.7%, 95% CI 42.1 to 99.6), LLU (84.9%, 95% CI 68.1 to 94.9) and osteomyelitis (82.0%, 95% CI 68.6 to 91.4) groups. Conclusion: Based on data from a Canadian tertiary care hospital, the specified coding algorithms can be used to identify and study the management and outcomes of people hospitalized with a DFU in Ontario.

Download Full-text