Ayurvedic management of Ischemic Gangrene due to Diabetes Mellitus - A Case Report

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Vikram S. ◽  
Saraswathi Devi H.N.
Keyword(s):  
Diabetes Mellitus ◽  
Upper Limb ◽  
Medical Science ◽  
Limb Ischemia ◽  
Interesting Case ◽  
Therapeutic Interventions ◽  
Acute Ischemia ◽  
Arterial Circulation ◽  
Ct Angiogram ◽  
Choice Of Treatment

Medical science says that ischemia is a common complication in Diabetes, especially in the lower limb but this is a case presenting ischemic changes in upper limb which is unique and also in such type of acute ischemia amputation is the only choice of treatment to save the life of patient from septicaemia. Such a rare and interesting case was taken at Sri Sri Ayurveda Hospital and handled by proper Ayurvedic line of treatment by which circulation is re-established which saved both limb and life of patient. A patient by name Sundaramma, 62yr Female, visited Sri Sri Ayurveda Hospital on 29/2/2016 with a diagnosis of Right upper limb Ischemia with Diabetes Mellitus and Active TB. The main symptoms were severe pain and burning sensation in Right hand and forearm, discolouration of fingers with ulcers, Bluish black discolouration over right thumb, necrosis, pus dischargeand stiffness, associated with difficulty in movement of right arm, shoulder joint, elbow joint, palm and fingers. Diagnosed as Right Upper Limb Ischemia with Diabetes Mellitus and active TB. Therapeutic interventions like Right upper limb Doppler and CT angiogram were done. Such a complicated case was taken at Sri Sri Ayurveda Hospital, and carefully handled by Ayurvedic methods of management, which was ended up by preventing amputation of the limb and also achieving the re-establishment of arterial circulation.

The Predictors of Acute Lower Limb Ischemia on the Background of the Recommended Prophylaxis

2021 ◽  
Vol 20 (3) ◽  
pp. 637-641
Author(s):  
Vladimir Beloborodov ◽  
Vladimir Vorobev ◽  
Natalya Balabina ◽  
Vladimir Luchkevich ◽  
Olga Rizakhanova ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Retrospective Analysis ◽  
Lower Limb ◽  
Medical Science ◽  
Limb Ischemia ◽  
Acute Ischemia ◽  
Acute Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Anticoagulant Prophylaxis ◽  
Clinical Cases

Objective: Acute limb ischemia (ALI) manifests as sudden lower limb ischemia that, regardless of the underlying cause, can lead to amputation unless there is an appropriate treatment.The study aims to analyze predictors of the lower limb occlusive thrombosis with the acute ischemia development (ALLI), depending on the localization under specifically recommended prophylaxis. Materials and methods: The researchers performed a retrospective analysis of clinical cases with a confirmed diagnosis of acute lower limb ischemia (ALLI) for 2019. During this period, 20 patients met the study criteria. Results and Discussion: A multivariate analysis (predictors with a p<0.1) established hyperglycemia as a significant predictor of ALLI development under specific prophylaxis (RR 2.2; 95% CI -8.2; 8.4; p = 0.097). It indicates a double risk of ALLI for patients with hyperglycemia. Conclusion: The results indicate the need to correct glycemic parameters to reduce the risk of acute lower limb ischemia, even under antiplatelet or anticoagulant prophylaxis. It is also necessary to analyze the management protocols currently used for such patients to correct the recommended antiplatelet or anticoagulantschemes. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.637-641

Cardiac troponin I in patients with acute upper and lower limb ischemia

VASA ◽  
2008 ◽  
Vol 37 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Koutouzis ◽  
Sfyroeras ◽  
Moulakakis ◽  
Kontaras ◽  
Nikolaou ◽  
...  
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Cardiac Troponin ◽  
Cardiac Involvement ◽  
Troponin I ◽  
Limb Ischemia ◽  
Elevated Troponin ◽  
Troponin Elevation ◽  
Lower Limb Ischemia ◽  
Ischemia Group

Background: The aim of this study was to investigate the presence, etiology and clinical significance of elevated troponin I in patients with acute upper or lower limb ischemia. The high sensitivity and specificity of cardiac troponin for the diagnosis of myocardial cell damage suggested a significant role for troponin in the patients investigated for this condition. The initial enthusiasm for the diagnostic potential of troponin was limited by the discovery that elevated cardiac troponin levels are also observed in conditions other than acute myocardial infarction, even conditions without obvious cardiac involvement. Patients and Methods: 71 consecutive patients participated in this study. 31 (44%) of them were men and mean age was 75.4 ± 10.3 years (range 44–92 years). 60 (85%) patients had acute lower limb ischemia and the remaining (11; 15%) had acute upper limb ischemia. Serial creatine kinase (CK), isoenzyme MB (CK-MB) and troponin I measurements were performed in all patients. Results: 33 (46%) patients had elevated peak troponin I (> 0.2 ng/ml) levels, all from the lower limb ischemia group (33/60 vs. 0/11 from the acute upper limb ischemia group; p = 0.04). Patients with lower limb ischemia had higher peak troponin I values than patients with upper limb ischemia (0.97 ± 2.3 [range 0.01–12.1] ng/ml vs. 0.04 ± 0.04 [0.01–0.14] ng/ml respectively; p = 0.003), higher peak CK values (2504 ± 7409 [range 42–45 940] U/ml vs. 340 ± 775 [range 34–2403] U/ml, p = 0.002, respectively, in the two groups) and peak CK-MB values (59.4 ± 84.5 [range 12–480] U/ml vs. 21.2 ± 9.1 [range 12–39] U/ml, respectively, in the two groups; p = 0.04). Peak cardiac troponin I levels were correlated with peak CK and CK-MB values. Conclusions: Patients with lower limb ischemia often have elevated troponin I without a primary cardiac source; this was not observed in patients presenting with acute upper limb ischemia. It is very important for these critically ill patients to focus on the main problem of acute limb ischemia and to attempt to treat the patient rather than the troponin elevation per se. Cardiac troponin elevation should not prevent physicians from providing immediate treatment for limb ischaemia to these patients, espescially when signs, symptoms and electrocardiographic findings preclude acute cardiac involvement.

Acute Upper Limb Ischemia in a Patient with COVID-19 Pneumonia

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Alosaimi Roaa ◽  
Albajri Ahood A ◽  
Albalwi Roaa M
Keyword(s):  
Upper Limb ◽  
Limb Ischemia

Effects of Maternal Obesity and Gestational Diabetes Mellitus on the Placenta: Current Knowledge and Targets for Therapeutic Interventions

2020 ◽  
Vol 19 (2) ◽  
pp. 176-192
Author(s):  
Samantha Bedell ◽  
Janine Hutson ◽  
Barbra de Vrijer ◽  
Genevieve Eastabrook
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Maternal Obesity ◽  
Environmental Changes ◽  
Current Knowledge ◽  
Therapeutic Interventions ◽  
Placental Development ◽  
Exchange Site ◽  
And Function

: Obesity and gestational diabetes mellitus (GDM) are becoming more common among pregnant women worldwide and are individually associated with a number of placenta-mediated obstetric complications, including preeclampsia, macrosomia, intrauterine growth restriction and stillbirth. The placenta serves several functions throughout pregnancy and is the main exchange site for the transfer of nutrients and gas from mother to fetus. In pregnancies complicated by maternal obesity or GDM, the placenta is exposed to environmental changes, such as increased inflammation and oxidative stress, dyslipidemia, and altered hormone levels. These changes can affect placental development and function and lead to abnormal fetal growth and development as well as metabolic and cardiovascular abnormalities in the offspring. This review aims to summarize current knowledge on the effects of obesity and GDM on placental development and function. Understanding these processes is key in developing therapeutic interventions with the goal of mitigating these effects and preventing future cardiovascular and metabolic pathology in subsequent generations.

scholarly journals Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions

2021 ◽  
Vol 10 (4) ◽  
pp. 835
Author(s):  
Manoja P. Herath ◽  
Jeffrey M. Beckett ◽  
Andrew P. Hills ◽  
Nuala M. Byrne ◽  
Kiran D. K. Ahuja
Keyword(s):  
Diabetes Mellitus ◽  
Adipose Tissue ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fat Mass ◽  
Metabolic Disorders ◽  
Later Life ◽  
Therapeutic Interventions ◽  
Increased Risk ◽  
The Impact

Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.

Upper Limb Ischemia: 20 Years Experience from a Single Center

Vascular ◽  
2005 ◽  
Vol 13 (2) ◽  
pp. 84-91 ◽  
Author(s):  
Jean Deguara ◽  
Tahir Ali ◽  
Bijan Modarai ◽  
Kevin G. Burnand
Keyword(s):  
Upper Limb ◽  
Primary Repair ◽  
Limb Ischemia ◽  
Subclavian Steal Syndrome ◽  
Arm Amputation ◽  
Locoregional Anesthesia ◽  
Vein Bypass ◽  
Almost All ◽  
Revascularization Procedures ◽  
Steal Syndrome

The objective of this study was to review a single center's experience of upper limb revascularization over 20 years. All patients undergoing operative or endovascular upper limb revascularization between June 1983 and July 2003 were identified. One hundred eighty-four upper limb revascularization procedures were carried out on 172 patients. Sixty-one patients had a thromboembolic event (35%), 53 patients presented with a traumatic vascular injury (31%), and 29 patients had symptoms of chronic atherosclerotic upper limb ischemia (17%). Fifteen patients had subclavian steal syndrome, eight patients had thoracic outlet compression, and six patients had iatrogenic injuries of the upper limb arteries. Fifty-five thromboembolectomies were performed, 37 under locoregional anesthesia. Ten patients (18.2%) died from cardiopulmonary causes following embolectomy. Fifteen reversed saphenous vein bypass grafts were performed for traumatic damage. Twenty-seven patients had a primary repair, and five required a vein patch. One patient subsequently had an arm amputation, and two patients died. Twelve patients presenting with chronic arm ischemia had a subclavian angioplasty, 12 patients had a proximal bypass, and in 5 patients, stenoses were stented. The mortality in this group was 6.9% (2 of 29). The mortality for upper limb revascularization was 8.7%. Almost all deaths occurred after upper limb embolectomy, and the mortality of this procedure was similar to that of lower limb embolectomy. Deaths were the result of cardiac comorbidity, and this should be actively sought and treated if outcomes are to improve.

Bilateral Axillary Artery Aneurysms Presenting as Upper Limb Ischemia

2015 ◽  
Vol 29 (8) ◽  
pp. 1659.e9-1659.e12 ◽  
Author(s):  
Kimihiro Igari ◽  
Toshifumi Kudo ◽  
Takahiro Toyofuku ◽  
Yoshinori Inoue
Keyword(s):  
Upper Limb ◽  
Axillary Artery ◽  
Limb Ischemia

Double Diabetes: A Growing Problem Requiring Solutions

2021 ◽  
Author(s):  
Djordje S. Popovic ◽  
Nikolaos Papanas
Keyword(s):  
Diabetes Mellitus ◽  
Therapeutic Interventions ◽  
Metabolic Phenotype ◽  
Lipid Lowering ◽  
Glucose Disposal ◽  
Increased Risk ◽  
Glucagon Like Peptide 1 ◽  
Reliable Marker ◽  
Estimated Glucose Disposal Rate ◽  
Double Diabetes

AbstractThe growing proportion of type 1 diabetes mellitus (T1DM) patients with clinical features of insulin resistance (IR) has led to the description of a distinctive T1DM subgroup, still unrecognised by current guidelines, called double diabetes, assumingly associated with poorer metabolic phenotype and increased risk of micro- and macrovascular complications. The main goal of identifying double diabetes, estimated to be present in up to half of T1DM patients, is timely implementation of appropriate therapeutic interventions to reduce the increased risk of chronic complications and other adverse metabolic traits associated with this condition. Proposed diagnostic criteria are largely divided into three different groups: family history of type 2 diabetes mellitus (T2DM), obesity/metabolic syndrome, and IR. Estimated glucose disposal rate may prove the most reliable marker of double diabetes. In addition to general measures (diet, physical activity, antihypertensive, and lipid-lowering medications, etc.) and development of new insulin preparations with more hepatic action, double diabetes patients may derive more benefit from agents developed for T2DM. Indeed, such potentially promising agents include glucagon-like peptide-1 receptor agonists, sodium-glucose contrasporter-2 inhibitors, and their combination. We are now awaiting long-term trials assessing metabolic and vascular benefits of these medications in double diabetes.

scholarly journals TRADITIONAL MEDICINAL SYSTEMS FOR TREATMENT OF DIABETES MELLITUS: A REVIEW

2018 ◽  
Vol 10 (5) ◽  
pp. 7
Author(s):  
Dimple . ◽  
Ashwani Kumar ◽  
Vikas Kumar ◽  
Vidisha Tomer
Keyword(s):  
Diabetes Mellitus ◽  
Functional Foods ◽  
Medical Science ◽  
Herbal Medicines ◽  
Diabetes Treatment ◽  
Active Components ◽  
The World ◽  
Increasing Trend ◽  
Current Scenario ◽  
Treatment Of Diabetes

Diabetes mellitus (DM) is a chronic disease which has clinched the world. More than 300 million people of the world are suffering from this disease and the number is still increasing at a rapid rate as modern medical science has no permanent solution for the disease. Current scenario of the nutraceuticals has increased patient’s faith on the traditional medicinal system and world nutraceutical industry is estimated to reach $285.0 billion by 2021. The increasing trend of nutraceuticals in diabetes treatment makes it important to collect the traditional knowledge of medicines under one heading as it can help researchers to formulate new functional foods and nutraceuticals which can either lower down the risk or cure DM. In addition, the discussion of market available food products, their active components and possible health benefits can help the patients to understand the herbal medicines in a better way.

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