scholarly journals Effect of Health Education on Improving the Knowledge among Diabetes Mellitus Patients in the Prevention of Diabetic Ulcer in Regional Hospital of Tidore Island

2021 ◽  
Vol 4 (4) ◽  
pp. 379-384
Author(s):  
Haeril Amir ◽  
Nur Wahyuni Munir
Keyword(s):  
Diabetes Mellitus ◽  
Health Education ◽  
Diabetic Foot ◽  
Regional Hospital ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers

International  Diabetes  Federation  (IDF) reported that the number of diabetes mellitus patients worldwide increases every year. Diabetes mellitus is a chronic disease due to damage to the pancreas in producing enough insulin and characterized by impaired metabolism of fats, increased blood sugar, carbohydrates and protein both absolutely and relatively. Diabetic foot ulcers (DFU) are among the most common complications in diabetic patients and are associated with high mortality, morbidity, and health costs.   This study was to determine the effect of health education on knowledge improvement about diabetic ulcers in the regional hospital of Tidore Islands.  This research is a quasi-experimental type with a pretest-posttest without a control group design. The research sample consisted of 30 respondents who met the inclusion criteria. Data were analyzed using a paired test and processed with statistic version 21. Based on the research results, there was an improved knowledge in pre and post-health education counseling, where the average score before health education counseling was 11.6. After health counseling, the average value was 15.0. The results showed the effect of knowledge in the prevention of diabetic ulcers with a p-value =0,000.  Health education is an effort to improve patient's ability to prevent diabetic foot ulcers that have been proven in several scientific studies. Health education methods provide additional information so that patients who previously wondered about their disease can directly ask health workers. Health education affects the knowledge improvement of Diabetes Mellitus patients in the Regional hospital of Tidore Islands  

scholarly journals Assessment role of phagocytic neutrophil cells among different Wagner’s grades of diabetic foot ulcers infections

2020 ◽  
Author(s):  
Eidha Ali Bin-Hameed ◽  
Maryam Hamed Baras
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Gram Negative Bacteria ◽  
Diabetic Foot Ulcers ◽  
Bacterial Isolates ◽  
Gram Negative

Abstract Background: Foot ulcers complications in diabetes mellitus (DM) patients are one of the significant medical problems and an economic burden. The aim of this study is to assessment role of phagocytic neutrophil cells and its relationship with the incidence of diabetic foot ulcers (DFU) infection of diabetic patients. A total of 60 venipuncture blood samples collected from diabetes mellitus, diabetic foot ulcer patients and healthy persons as control group. 20 swabs from the DFU patients were collected and processed for culture and susceptibility test after the ulcers classified according to Wagner’s grades system. Phagocytic cells activity test was performed to determine the efficiency of phagocytic neutrophil cells in diabetic patients. Results: Gram positive bacteria were the most prevalent in the DFU patients 57.1% with statistical significant relationship between the type of bacteria and grades of Wagner’s classification followed by Gram negative bacteria in high grades of ulcers. Wagner’s ulcers grade 1 and 2 were the most prevalence in DFU patients 30%. There was a weak negative correlation between the efficiency of phagocytic neutrophil cells activity and grade ulcers classified (r = -0.323). Amikacin and ciprofloxacin were the most effective antibiotics against 90.5% and 81% of the bacterial isolates respectively, whereas ampicillin, cefepime and cefadroxil were less effective antibiotics against the bacterial isolates.Conclusion: When the grade of ulcer increased, the bacterial resistance to antibiotics increased, and this was emphasis the correlation with prevalent of Gram negative bacteria in the high grade of ulcers with high resistance of antibiotics. In contrast, the grade of ulcer increased, the efficiency of phagocytic neutrophil cells decreased.

scholarly journals Edukasi Kesehatan: Perawatan Kaki terhadap Pengetahuan, Sikap dan Tindakan Pencegahan Ulkus Kaki Diabetik

2019 ◽  
Vol 8 (1) ◽  
pp. 23
Author(s):  
Munali Munali ◽  
Kusnanto Kusnanto ◽  
Hanik Endang Nihayati ◽  
Hidayat Arifin ◽  
Rifky Octavia Pradipta
Keyword(s):  
Diabetes Mellitus ◽  
Health Education ◽  
Diabetic Foot ◽  
Sampling Technique ◽  
Foot Ulcers ◽  
Rank Test ◽  
Control Group ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Control Group Design

Introduction: People with diabetes mellitus were at 15% risk of developing diabetic foot ulcers. Diabetic foot ulcers can be prevented if people with DM have the knowledge, positive attitude and thus able to perform the diabetic foot care. The aim was to determine the effect of health education on knowledge, attitudes and preventionof diabetic foot ulcers of people with diabetes mellitus. Method: quasi-experiment research design pretest-posttest control group design. Sample was DM patients who visited the Bangkalan City Health Center, recruited by purposive sampling technique with sample size of 35 people in the treatment group and 35 people in the control group. Independent variable was the health education and the dependent variables were knowledge, attitudes and of diabetic foot ulcers. Data were collected with questionnaires andthen analyzed by Wilcoxon Sign Rank Test and Mann-Whitney Test.Result: The results showed that there was an effect of health education on knowledge (p=0.000), attitudes (p=0.000) and preventive actions (p=0.000) of diabetic foot ulcers.Conclussion: Health education was important as an effort to persuade DM patients to take charge on their knowledge and attitude foot care by firstly enhancing.

scholarly journals Staphylococcus aureus strains isolated from diabetic foot ulcers. Identification of the antibiotic resistant phenotypes

2013 ◽  
Vol 20 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Teodora Chiţă ◽  
Delia Muntean ◽  
Luminiţa Badiţoiu ◽  
Bogdan Timar ◽  
Roxana Moldovan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Resistance Pattern ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Bacterial Strains ◽  
Diabetes Clinic

Abstract Background and aims: Infected foot ulcer is one of the most feared complications of diabetes mellitus. Staphylococcus aureus is the most frequently isolated pathogen in diabetic foot infections. The aim of this study was to evaluate the prevalence of S. aureus strains involved in producing foot infections in diabetic patients and the antibiotic resistance pattern of these strains. Material and methods: The study included 33 S. aureus strains isolated from 55 diabetic foot ulcers. The subjects were selected from the 2465 patients with diabetes mellitus hospitalized in the Timişoara Diabetes Clinic, between 2011 and 2013. Germs’ identification relied on cultural and biochemical characteristics. Final identification and antimicrobial testing were performed using the Vitek 2 (Bio Merieux France) automatic analyzer. Results: All the 55 samples collected from diabetic foot ulcers were positive. We isolated 64 bacterial strains (some samples were positive for 2 microorganisms). The most frequently isolated germ was S. aureus, in 33 samples (51.56%). All these S. aureus strains showed resistance to benzylpenicillin, while only 33.33% were methicillin-resistant (MRSA). Conclusions: The most frequently isolated germ in the wound secretions from diabetic foot ulcers was S. aureus. The highest percentage of antimicrobial resistance was recorded to benzylpenicillin and erythromycin.

scholarly journals “ ASSESSMENT OF SEVERITY OF DIABETIC FOOT ULCERS USING DIABETIC ULCER SEVERITY SCORE.”

2020 ◽  
pp. 19-21
Author(s):  
Aarushi Mishra ◽  
Anilkumar P. Bellad ◽  
M.I. Uppin
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Severity Score ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
The Past

INTRODUCTION : Diabetes mellitus is a common metabolic disorder, prevalence steadily increasing over the past few decades. The complications associated with it , hence , has also increased. Diabetic foot ulcer is one of the most serious complications , utilizing resources, significantly contributing to the morbidity of the patient. There is hence, a need to correctly identify the severity of the diabetic foot ulcer so as to plan the appropriate management and to help in counselling of such patients. AIM : To assess severity in diabetic foot ulcer using diabetic ulcer severity score. MATERIAL AND METHODOLOGY : This is a hospital based longitudinal study , conducted on 93 study subjects admitted with diabetic foot ulcers. Diabetic ulcer severity score was calculated for each patient . The score was calculated by adding scores of the respective parameters constituting site of ulcer, number of ulcers, presence/absence of pedal pulsations, presence/ absence of bone involvement. Each patient was followed up for a period of 6 months , or earlier in case of patient undergoing minor/major amputation. After the study was conducted , analysis was done by calculating various percentages of healing /amputation with respect to the score. RESULTS : Out of the total 93 study subjects , 74.2% were males. The mean age was calculated to be 59.6 years with maximum number of subjects being in 55-60 years of age group range. Majority of them had diabetic ulcer severity score of 2 (42%). Out of the total study subjects , 58% had a complete healing , 28% underwent minor amputation whereas 14% underwent major amputation. 100% of the study participants with score 0 had healing of ulcer which decreased to 85% for score 1 , 53.8% for score 2 , 6.25% for score 3 and 0% for score 4. This was suggestive of poorer chances of healing as the diabetic ulcer severity score increases. CONCLUSION : With the increasing incidence of patients diagnosed with diabetes mellitus , the rate of complications of diabetes has also increased over the past few decades including the risk and occurence of diabetic foot ulcers There is an increasing need for diabetic foot ulcer prognostication systems and universal use of the same. Thus ,we recommend the use of diabetic ulcer severity score as a prognostic tool to assess the severity of the diabetic foot which will further enhance communication and counselling of the patient and will help in providing the appropriate treatment to such patients.

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 Randomized controlled clinical trial evaluating the efficacy of hyperbaric oxygen therapy in facilitating the healing of chronic foot ulcers in diabetic patients: the study protocol

2019 ◽  
Author(s):  
Jocefabia Reika Alves Lopes ◽  
Mariza D’Agostino Dias ◽  
João Antonio Correa ◽  
Maria Alice Bragagnolo Batalha ◽  
Luanda Karla Dantas Guerra
Keyword(s):  
Hyperbaric Oxygen ◽  
Diabetic Foot ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Standard Treatment ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers

Abstract Background: Diabetic limb ulcers are highly prevalent and contribute to a significant increase in cost for the treatment of these patients in health services. However, healing of these wounds is a major health problem and may even lead to amputation. The aim of the current study is to evaluate the efficacy of hyperbaric oxygen therapy (HBOT) in facilitating the healing of diabetic foot ulcers and reducing the number of amputations in these patients.Methods : The study will be conducted in the city of Imperatriz, Maranhão from 2019 to 2020, in diabetic patients with chronic foot ulcers (classified as Wagner grade 2, 3, and 4, persisting for more than one month). The outpatient follow-up for diabetic foot patients will be done at the SUS (Unified Health System), with a sample size of 120 patients (60 patients for each arm). Half of the patients will receive standard treatment, i.e. dressings, debridement, antibiotics, and load relief, along with HBOT (HBOT group), and the other half will receive only standard treatment (control group). The patients of the HBOT group will be evaluated upon admission, after 10, 20, 30 and 35 HBOT sessions, and after six months. The patients of the control group will also be evaluated at equivalent periods. The progression of the wounds and specific treatment, such as appropriate bandage, antibiotic therapy, or need of some surgical intervention will be evaluated on a weekly basis. The SF-36 quality of life questionnaire will be filled upon admission and after three months of follow-up in both groups. Upon admission, the patients of both groups will undergo arterial Doppler ultrasound, and laboratory tests–complete blood count, erythrocyte sedimentation rate, C-reactive protein, creatinine, fasting blood glucose, and glycosylated haemoglobin.Discussion : Diabetic foot ulcers are a highly prevalent complication of diabetes with serious consequences. A study to assess the efficacy of HBOT in healing the ulcers and reducing the rate of amputations in diabetic patients is justified, which will eventually aid in the development of guidelines for treating these ulcers.

scholarly journals Randomized controlled clinical trial evaluating the efficacy of hyperbaric oxygen therapy in facilitating the healing of chronic foot ulcers in diabetic patients: the study protocol

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Jocefábia Reika Alves Lopes ◽  
Mariza D’Agostino Dias ◽  
João Antonio Correa ◽  
Maria Alice Bragagnolo Batalha ◽  
Luanda Karla Dantas Guerra
Keyword(s):  
Quality Of Life ◽  
Diabetic Foot ◽  
Oxygen Therapy ◽  
Standard Treatment ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers

Abstract Background Diabetic limb ulcers are highly prevalent and contribute to a significant increase in cost for the treatment of these patients in health services. However, healing of these wounds is a major health problem and may even lead to amputation. The primary aim of the current study is to evaluate the efficacy of hyperbaric oxygen therapy (HBOT) in facilitating the healing of diabetic foot ulcers, in addition to secondarily evaluating whether it reduces the number of amputations and improves the quality of life in these patients. Methods A non-blind randomized clinical study will be conducted in the city of Imperatriz, Maranhão state, Brazil, from 2019 to 2020, in diabetic patients with chronic foot ulcers (classified as Wagner grades 2, 3 and 4, persisting for more than 1 month). The outpatient follow-up for diabetic foot patients will be done at the Unified Health System, with a sample size of 120 patients (the randomization allocation will be 1:1, being 60 patients for each arm). Half of the patients will receive standard treatment, i.e. dressings, debridement, antibiotics and load relief, along with HBOT (HBOT group), and the other half will receive only standard treatment (control group). The patients of the HBOT group will be evaluated upon admission, after 10, 20, 30 and 35 HBOT sessions, and after 6 months and 1 year. The patients of the control group will also be evaluated at equivalent periods (upon admission, after 2, 4, 6 and 7 weeks, 6 months and 1 year). The SF-36 quality of life questionnaire will be filled upon admission and after 3 months of follow-up in both groups. The primary and secondary endpoints will be assessed with 1 year of follow-up. Discussion Diabetic foot ulcers are a highly prevalent complication of diabetes with serious consequences. A study to assess the efficacy of HBOT in healing the ulcers and reducing the rate of amputations in diabetic patients is justified, which will eventually aid in the development of guidelines for treating these ulcers. Trial registration Registration number RBR-7bd3xy. Registered on 17 July 2019—Retrospectively registered.

scholarly journals Hubungan Profil Lipid dengan Kejadian Ulkus Kaki Diabetik pada Pasien Diabetes Melitus Tipe 2 RSUP dr. Mohammad Hoesin Palembang

2018 ◽  
Vol 1 (3) ◽  
pp. 182-191
Author(s):  
Sadakata Sinulingga ◽  
Evlin Kohar ◽  
Subandrate Subandrate
Keyword(s):  
Diabetes Mellitus ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Diabetic Foot ◽  
Lipid Lowering ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Fisher Exact Test ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional

Diabetic foot ulcersare long-term complications of diabetes mellitus that may increase morbidity and mortality, also reduce the quality of life of the patients. One of the causes of diabetic foot ulcers is peripheral arterial disease due to dyslipidemia. This study was conducted to determine the relationships of lipid profile with diabetic foot ulcers in patients with type 2 diabetes mellitus. Analytical observational study with cross-sectional design was conducted in 69 diabetic patients. Data was retrieved secondarily by observing the medical records. Total cholesterol, triglycerides, LDL, HDL, and consumption of lipid-lowering drugs of the patients were all recorded. Documented variables were analyzed using Fisher Exact test if Chi-square test criterias were not fulfilled. There was a significant association between diabetic foot ulcers with total cholesterol (p=0,001) and HDL (p=0,015), while triglycerides (p=0,393) and LDL (p=0,176) did not have a significant association with diabetic foot ulcers.Multivariable logistic regression identified HDL (B=2,221, S.E.=1,131, Wald=3,855, p=0,050, exp(B)=9,220 IK95% 1,004–84,691)as the most influential lipid profile fraction to the incident diabetic foot ulcers. Total cholesterol and HDL had a significant association with diabetic foot ulcers. The most influential lipid profile fraction to the incident diabetic foot ulcers is HDL.

scholarly journals Diabetic Foot Ulcers in a Kenyan Referral and Teaching Hospital: Risk Factors, Patient Characteristics and Clinical Outcomes

2019 ◽  
Vol 1 (2) ◽  
pp. 41-51
Author(s):  
Daniel Munyambu Mutonga ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Urban Areas ◽  
Hospital Admissions ◽  
Uncontrolled Hypertension ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Elevated Systolic Blood Pressure

Introduction: The burden of diabetes mellitus (DM) is increasing in resource-poor settings leading to a rise in diabetic complications. Foot complications result in almost half of all hospital admissions among diabetic patients and may result in amputations or death. Objective: To investigate the sociodemographic, clinic-laboratory characteristics and clinical outcomes of patients with diabetic foot ulcers (DFU) in a clinical setting. Materials and Methods: A cross-sectional study of 84 adult consecutive inpatients and outpatients at Kenyatta National Hospital (KNH) with any type of DM and having active DFU was conducted over 12 months. History and physical examinations findings were recorded through a structured questionnaire. Relevant data on the most recent blood tests and clinical outcomes for patients with foot ulcers were retrieved from the patients’ medical notes and analysed. Results: Majority (68%) were inpatients. The mean age was 60.30 years with 68% living in urban areas and 60% having minimal or no formal education. 8% were newly diagnosed with DM. The median duration of DM was 6.5 years. A majority (96%) had type 2 diabetes mellitus (T2DM). 45% were on insulin only, 18% on oral drugs only and 32% on a combination of both. The median random blood sugar was 9.60 mmol/L and glycated haemoglobin was 8.80%. Although 61% of patients had co-morbid hypertension, only about 40% had elevated systolic blood pressure (BP) while 23% had elevated diastolic pressures. A majority of the patients had good lipid profile, 85% with desirable total cholesterol and 70% having ideal low-density lipoproteins. The mortality rate among patients with DFU was 11%. Conclusion: There are poor outcomes for patients with DFU in this setting such as poor wound healing, high recurrence rates, increased amputations and mortality compared to previous studies. However, the prevalence of uncontrolled hypertension, dyslipidaemia and neuropathy was much lower than earlier local reports.

Macrophage Activation and M2 Polarization in Wound Bed of Diabetic Patients Treated by Dermal/Epidermal Substitute Nevelia

2020 ◽  
pp. 153473462094555 ◽  
Author(s):  
Manuela Montanaro ◽  
Marco Meloni ◽  
Lucia Anemona ◽  
Laura Giurato ◽  
Manuel Scimeca ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Macrophage Activation ◽  
Test Group ◽  
Inflammatory Cells ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
M2 Macrophage ◽  
Diabetic Foot Ulcers ◽  
M1 Macrophage

Clinical evidences have shown good results using dermal/epidermal substitutes (DESs) to treat diabetic foot ulcers. Recent studies suggest that, in addition to their scaffold action, DESs may favor wound healing by influencing wound bed inflammatory cells. This study aims to investigate whether DES may influence the inflammatory infiltrate and macrophages polarization toward a reparative phenotype. Fifteen diabetic patients with chronic foot ulcers have been randomly enrolled: 5 treated only by standard of care, served as control group (CG), and 10 treated with DES composed of type 1 bovin collagen (Nevelia, SYMATESE) considered as test group (TG). A biopsy was taken at baseline (T0) and after 30 days (T1). From bioptic paraffin specimen histological, immunohistochemical, and immunofluorescence analysis was performed. Immunohistochemistry reactions evaluated the number of M1 macrophage (CD38+) and M2 macrophage (CD163+). TG patients displayed general macrophage activation and their greater polarization toward M2 subpopulation 30 days after DES implant, compared with CG. From T0 to T1 there was a significant decrease of CD38+ (230 ± 42 and 135 ± 48 mm2, respectively; P < .001) and significant increase of CD163+ (102 ± 21 positive cells/mm2 and 366 ± 42 positive cells/mm2, respectively; P < .001). Confocal microscopy confirmed an increase of M2 cells as expressed by the reduced CD68+/CD163+ ratio. After 6 months of observation 6 patients (60%) of the TG completely healed, while only 1 patient (20%) healed in the CG ( P < .01). The tested DES makes possible to treat diabetic foot ulcers inducing tissue reparative processes through macrophage activation and M2 reparative polarization.

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