scholarly journals Is Ischemia-Modified Albumin a Biomarker in Wagner Classification in Diabetic Foot Ulcers?

2021 ◽  
Author(s):  
Sezai ÖZKAN ◽  
cihan ADANAS ◽  
hamit hakan alp
Keyword(s):  
Diabetic Foot ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional ◽  
Ischemia Modified Albumin ◽  
Reactive Protein ◽  
Similar Body

Background: We aimed to determine the relationship of ischemia-modified albumin (IMA) with diabetic foot ulcers and its predictive value in the Wagner classification. Methods: Our cross-sectional study was conducted in 120 diabetic foot patients and 60 healthy individuals with similar body mass index and age. Patients with a diabetic foot were classified according to the Wagner classification. Biochemical parameters, C-reactive protein (CRP) and IMA levels were measured in all patients and healthy volunteers. Screening performance characteristics of CRP and IMA were calculated according to Wagner classes and the presence of osteomyelitis. Results: CRP and IMA levels in the patient group were significantly higher than the control group. The highest IMA levels were detected in Wagner grade 5. CRP had higher sensitivity and specificity than IMA in the discrimination of other grades, except for grade 4-5 separation. For Wagner grade 4-5 distinction, IMA had 84.6% sensitivity and 94.7% specificity. Conclusion: IMA may play a role in the pathogenesis of diabetic foot ulcers and had a higher predictive value in discrimination of the Wagner grade 4 and 5. In the management of diabetic foot patients, it may be recommended that IMA is evaluated by clinicians.

scholarly journals Clinical and microbiological profile of diabetic foot ulcers in a tertiary care setup: a cross sectional analysis

2021 ◽  
Author(s):  
Siddharth Rai ◽  
Harleen Uppal ◽  
Arvind Kumar Sharma ◽  
Anil Kumar Gupta
Keyword(s):  
Diabetic Foot ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Cross Sectional ◽  
Microbiological Profile

Background: Diabetes associated neuropathy and vasculopathy leads to development of diabetic foot ulcers (DFU). They are responsible for considerable morbidity and a significant cost of health‐care worldwide. The magnitude of the problem becomes worse in regions where foot care is inadequate like in our country. The aim of the study to determine the microbiological profile and antimicrobial susceptibility pattern of organisms isolated from patients with diabetic foot ulcers.  Methods: The study was a cross sectional study done at King George’s Medical College, Lucknow from 2012-2014 in Lucknow, Uttar Pradesh. Based on the inclusion criteria sample were collected from 112 patients. The standard protocol for the identification of microorganisms was followed.  A descriptive analysis of the data was done.Results: Out of the 112 ulcers total 180 isolates were found. Of the 112 cases, 78 were monomicrobial, 32 were polymicrobial, and 2 cases were sterile on culture. The most common bacteria found was Staphylococcus aureus. Most of the staphylococcus isolated were sensitive to vancomycin, teicoplanin, cephalosporins, linezolid levofloxacin and pipercillin-tazobactum. Nearly 65% of S. aureus were methicillin‐resistant S. aureus.Conclusions: This study compiled clinical and microbiological profile of diabetic foot ulcers along with their antibiotic susceptibility patterns. Our study illuminates light on a high figure of neglected and poorly treated NHUs which could have been managed well and early treatment will prevent devastating consequences such as sepsis and amputation.  

scholarly journals A one year cross sectional study on role of Wagner’s classification in predicting the outcome in diabetic foot ulcer patients

2018 ◽  
Vol 5 (7) ◽  
pp. 2537
Author(s):  
Praveena D. L. ◽  
Shashi M. Uppin ◽  
S. S. Shimikore
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional ◽  
Grade Ii ◽  
One Year

Background: Diabetes mellitus-related foot ulceration is very common. Several classification systems for diabetic foot ulcers have been proposed. The present study was intended to assess the role of Wagner wound classification in predicting the outcome of diabetic foot ulcer and also know the grade of Wagner’s classification to which majority of diabetic foot ulcer patients.Methods: This present one year cross sectional study was carried out at the Department of General Surgery. A total of 100 patients with diabetic foot ulcer who presented during the study period were included. The diabetic foot ulcers were graded according to the Wagner’s classification. The relative risk of amputation in different grades of diabetic foot ulcer based on Wagner classification was determined.Results: In this study majority of the patients were males (79%) and the male to female ratio was 3.76:1. The mean age was noted as 55.8±10.45 years. Majority of the patients had duration of ulcer less than one month (88%). Surrounding skin was inflamed in 60% of the patients, necrosis was present in 40% and slough was noted in 98% while 44% of the patients had necrotic tissue. Based on Wagner’s Classification, most of the patients (48%) had Grade II diabetic foot ulcers. With regard to management, in 44% of the patients’ debridement was done and 36% of the patients had disarticulation or amputation in 36%. Of the 48 patients with grade II ulcer, 79% of the patients had healing without amputation. Of the 58 patients with grade I and II diabetic foot ulcers, 82.76% had healing without amputation compared to 17.24% of the patients who needed amputation. Patients with Grade III, IV and V had 3.59 times higher risk of amputation compared to patients with grade I and II. (p<0.001; 95% CI- 1.95 to 6.62).Conclusions: Grading of diabetic foot ulcer based on Wagner’s classification affects and predicts the outcome and the risk of amputation increases with increasing grade. Most of the patients admitted for diabetic foot ulcers in our hospital belonged to Wagner’s grade II (48%).

Evaluation of Ischemia-Modified Albumin and Fibrinogen in Relation with High-Sensitive C-reactive Protein in Diabetic Foot Ulcers

2020 ◽  
Vol 3 (2) ◽  
pp. 70
Author(s):  
MadanGopal Ramarajan ◽  
Haleemath Afrah ◽  
Reshma Sridhar ◽  
Sushith Sushith ◽  
PrathimaM Balakrishna ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
C Reactive Protein ◽  
Ischemia Modified Albumin ◽  
Reactive Protein

scholarly journals Validation of the SavvyCheckTM Vaginal Yeast Test for Screening Pregnant Women for Vulvovaginal Candidosis: A Prospective, Cross-Sectional Study

2021 ◽  
Vol 7 (3) ◽  
pp. 233
Author(s):  
Philipp Foessleitner ◽  
Herbert Kiss ◽  
Julia Deinsberger ◽  
Julia Ott ◽  
Lorenz Zierhut ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Predictive Value ◽  
Point Of Care ◽  
Cross Sectional Study ◽  
Control Group ◽  
Gram Stain ◽  
Cross Sectional ◽  
Point Of Care Test ◽  
Increased Risk ◽  
Vulvovaginal Candidosis

Pregnant women have an increased risk of vulvovaginal candidosis. Recurrent candidosis is under debate as a contributor to preterm birth, and vertical transmission may cause diaper dermatitis and oral thrush in the newborn. Apart from cultural methods, the gold standard for diagnosing candidosis is Gram staining, which is time-consuming and requires laboratory facilities. The objective of this prospective study was to validate a point-of-care vaginal yeast detection assay (SavvyCheckÔ Vaginal Yeast Test) and to evaluate it in asymptomatic pregnant women. We enrolled 200 participants, 100 of whom had vulvovaginal candidosis according to Gram stain (study group) and 100 were healthy pregnant controls (control group). Of these, 22 participants (11%) had invalid test results. The point-of-care test of the remaining 85 and 93 study participants in the study and control groups, respectively, showed a sensitivity of 94.1%, specificity of 98.9%, positive predictive value of 90.3%, and negative predictive value of 99.4% when compared with Gram stain. In conclusion, we found a high correlation between the SavvyCheckÔ Vaginal Yeast Test and Gram-stained smears during pregnancy. This suggests a potential role of this point-of-care test as a screening tool for asymptomatic pregnant women in early gestation.

scholarly journals THE IMPACT OF COMBINATION OF BREASTFEEDING AND EFFLEURAGE MASSAGE IN REDUCING PAIN RESPONSE IN INFANTS INDUCED BY BLOOD SAMPLING IN C-REACTIVE PROTEIN TEST: AN OBSERVATIONAL CROSS-SECTIONAL STUDY

2018 ◽  
Vol 4 (2) ◽  
pp. 242-248
Author(s):  
Alfi Maziyah ◽  
Diyah Fatmasari ◽  
Desak Made Wenten Parwati ◽  
Rr. Sri Endang Pujiastuti
Keyword(s):  
Intervention Group ◽  
Cross Sectional Study ◽  
Blood Sampling ◽  
Control Group ◽  
Pain Response ◽  
Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Massage Group

Background: C-reactive protein test is one of clinical assessments to minimize risks of infection in infants. However, its procedure may cause pain. Pain in the infant may result in negative metabolic behavior, physiology and metabolic response. Objective: This study was to describe the infant's pain response by administering a combination of breastfeeding and an effleurage massage on the blood sampling procedure of C-reactive protein examination.         Methods: This was a descriptive observational cross-sectional study. There were 30 infants selected using consecutive sampling technique, which 15 samples assigned in an intervention group (combination of breastfeeding and effleurage massage) and a control group. Premature Infant Pain Profile (PIPP) instrument was used to measure pain. Univariate analysis was performed with the aim to describe data in mean and median.Results: The average of pain response at 1-minute observation in the combination of breastfeeding and effleurage massage group was 7.47 ± 1.356, and the average of pain response in the control group was 10.80 ± 1.897. The average pain at 5-minutes in the intervention group was 3.53 ± 1.922 and control group was 6.00 ± 1.852. Conclusions: Pain responses in the combination of breastfeeding and effleurage massage group were lower than the pain response in the control group.

TLR2 and TLR4 expressions in late-onset neonatal sepsis: Is it a potential novel biomarker?

2020 ◽  
pp. 1-7
Author(s):  
R. Rohsiswatmo ◽  
M. Azharry ◽  
T.T. Sari ◽  
Y. Bahasoan ◽  
D. Wulandari
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Late Onset ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Tlr4 Expression ◽  
Cross Sectional ◽  
Reactive Protein

BACKGROUND: Late-onset neonatal sepsis (LONS) detection is problematic as no single examinations (blood culture, c-reactive protein (CRP), procalcitonin (PCT)) are reliable. Toll-like receptors (TLRs), which detect the presence of pathogen-associated molecular patterns is a promising novel biomarker, but less studied in LONS. This study aimed to determine neutrophils and monocytes TLR2 and TLR4 expression in LONS and their diagnostic value. METHODS: A cross-sectional study conducted in May and June 2017 involving 52 neonates with clinical late-onset (>72 hours of age) sepsis. We examine complete blood count, I/T ratio, CRP, PCT, as well as TLR2 and TLR4 expression to compared with blood culture as the gold standard. We classified cases into proven or unproven sepsis. RESULT: The incidence of LONS was 32.6% in the subjects. The expression of TLR2 was low in LONS, while TLR4 was high. TLR4 neutrophil expression has 88.2% sensitivity, 20% specificity, 34.9% positive predictive value (PPV), 77.8% negative predictive value (NPV), and an AUC of 0.541. TLR4 monocyte expression has 92.1% sensitivity, 11.4% specificity, 34% PPV, 80% NPV, and an AUC of 0.528. The AUC of CRP is increased from 0.608 to 0.843 after combination with TLR4, comparable with CRP + PCT (AUC 0.829). CONCLUSION: The increase in TLR4 expression has good sensitivity but low specificity. TLR4 expression, in combination with CRP, could become a reliable biomarker for the diagnosis of LONS.

scholarly journals Combination of Shengji ointment and bromelain in the treatment of exposed tendons in diabetic foot ulcers: Study protocol for a non-blind, randomized, positive control clinical trial

2021 ◽  
Author(s):  
yang zhao ◽  
rui gao ◽  
Xinyue Dai ◽  
Xu Sun ◽  
Zhaohui Zhang ◽  
...  
Keyword(s):  
Granulation Tissue ◽  
Diabetic Foot ◽  
Combined Treatment ◽  
Positive Control ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Foot Ulcers ◽  
Loss Of Function ◽  
Tendon Tissue ◽  
Factors Affecting

Abstract Background : Diabetic foot ulcers often affect tendon tissue. Consequently, the infection may spread proximally along the tendon, leading to amputation or even the death of patients. Exposed, degenerated, and necrotic tendons are key factors affecting the healing of diabetic foot ulcers. The effective treatment of the tendon involvement may positively affect the prognosis. In clinical practice, treatment with Shengji ointment and bromelain induces islands of granulation tissue on the denatured tendon surface, which gradually grows and merges. Ideally, the exposed tendon is covered entirely by granulation tissue. This trial aims to assess the effect of a combined treatment regime of Shengji ointment, which has been shown to regenerate muscle tissue and pineapple protease in preventing the loss of function and amputation caused by tendon necrosis. This trial will provide high-quality evidence for the effectiveness of this combination in healing diabetic ulcers with tendon necrosis. Methods: The sample size will be 180 patients who will be randomly assigned 1:1 to a treatment group (90 patients) using Shengji ointment combined with bromelain and a control group (90 patients) using hydrocolloid dressing. Both groups will continue their conventional treatments, such as blood glucose and blood pressure medication, lipid regulation, antiplatelets, and others. The primary outcome will be the wound coverage with granulation tissue. Secondary outcomes will be the wound healing rate, amputation extent (where needed), time to granulation, and the Maryland Foot Score. Other efficacy outcomes will be the time to debridement of necrotic tendon tissue and granulation tissue score. Discussion: This study will treat patients with diabetic foot ulcers with exposed, degenerated, and necrotic tendons with Shengji ointment and bromelain. The trial aims to promote regeneration and healing, to preserve the limb and its function, and to develop a comprehensive and effective protocol that can be applied to promote the healing of exposed tendons in diabetic foot wounds. Trial registration: ChiCTR2000039327; date of registration: 2020-10-23. http://www.chictr.org.cn/com/25/showproj.aspx?proj=62692

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