scholarly journals AYURVEDIC MANAGEMENT OF WAGNER’S GRADE II DIABETIC ULCER - A CASE STUDY

2021 ◽  
Vol 09 (3) ◽  
pp. 657-662
Author(s):  
Sreeja Pillai ◽  
Nitin Kamat ◽  
Hemant Paradkar ◽  
Anaya Pathrikar
Keyword(s):  
Diabetes Mellitus ◽  
Growth Factors ◽  
Foot Ulcer ◽  
Diabetic Ulcer ◽  
Uncontrolled Diabetes ◽  
Bowel Movements ◽  
History Of ◽  
Grade Ii ◽  
Wagner’S Grade

Diabetic ulcer has been a challenge to be tackled since there is deficiency of growth factors and impaired immunity, which can lead to amputation if timely intervention is not done. A 59-year-old male patient with a history of uncontrolled diabetes mellitus for 10 years presented with a non-healing foot ulcer since 1year. He was managed with Ayurvedic internal and external medications at OPD level. After 3 months, the outcome was encouraging with complete epithelialization along with improvement in his generalized complaints like lethargy, irregular bowel movements etc.

scholarly journals Effect of Ankle Pumping Exercise to Ankle Brachial Index in Type 2 Diabetes Mellitus Patients with Ulcer

1970 ◽  
Vol 1 (1) ◽  
pp. 11-17
Author(s):  
Tjie Haming Setiadi ◽  
Widjajalaksmi ◽  
Elida Ilyas ◽  
Em Yunir ◽  
Arini Setiawati
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Nutritional Status ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Smoking History ◽  
Diabetic Ulcer ◽  
History Of

Objectives: To analyze the effect of ankle pumping exercise and other factors such as gender, age, duration of Diabetic Mellitus, nutritional status, history of smoking, hypercholesterolemia, ulcer degreeand HbA1c to Ankle Brachial Index (ABI) in type 2 Diabetes Mellitus patients with diabetic ulcer.Methods: The quasi experimental design study with consecutive sampling and one-­week interval of intervention was conducted in this study. Analysis of changes in pre-­post test ABI used paired t-­testwhile other factors were measured with multiple regression.Results: Ankle pumping effect to right foot after exercise as 0.048 while ABI 0,017 on left foot and ABI 0.038 after exercise on both feet. It was not a statistically significant increase on both feet (p>0.05). The relations of multifactors to ABI : Gender 0.47(p 0.829), age 51.32 (p 0.743), duration of DM 83.16(p 0.490), BMI 21.82 (p 0.452), history of smoking 0.47 (p 0.769), hypercholesterolemia 0.11 (p 0.195), degree of ulcer 3.74 (p 0.635), HbA1c 0.89 (p 0.798).Conclusions: There is statistically no effect of ankle pumping exercise to ABI. We also did not find an effect of gender, age, and duration of DM, nutritional status, history of smoking, history of hypercholesterolemia, ulcer grade and HbA1c to increase of ABI in diabetic subjects with foot ulcer after ankle pumping exercise. Nevertheless, we found a sufficiently noted increase of systolic blood pressure of Dorsal Pedis Artery and Posterior Tibia Artery after ankle pumping exercise in type 2 DM subjects although this not statistically significant.Keywords : Diabetes Mellitus, diabetic ulcer ankle pumping, ankle-­brachial index.

scholarly journals Rhino-orbital COVID-19 associated mucormycosis- A case report

2021 ◽  
Vol 7 (4) ◽  
pp. 304-307
Author(s):  
Shanmuga Vadivoo Natarajan ◽  
B Usha
Keyword(s):  
Diabetes Mellitus ◽  
Infectious Disease ◽  
Case Report ◽  
Tertiary Care ◽  
Notifiable Disease ◽  
Health Ministry ◽  
First Case ◽  
Uncontrolled Diabetes ◽  
History Of ◽  
Second Wave

COVID-19 Associated Mucormycosis (CAM) is an emerging infectious disease that has caused increased mortality & morbidity in India during this second wave of the pandemic. The country has reported more than 30,000 cases and over 2,000 deaths by Mucormycosis so far, according to sources from Union Health Ministry. CAM is now a notifiable disease. At our Tertiary care teaching hospital, which caters for COVID 19 management, we are reporting the first case of Rhino orbital CAM, which was caused by Rhizopus spp. Our patient had a history of contact with a suspected COVID 19 patient and was recently diagnosed with uncontrolled diabetes mellitus. A direct KOH microscopic examination of purulent material aspirated from the sinonasal polyp of the patient revealed fungal elements, and Rhizopus spp was isolated. Due to a shortage of Amphotericin B, the patient was referred to a government higher speciality centre for further management. The patient was followed up & was noted that he was treated with antifungal and discharged following recovery.

Wound Assessment in Pedobarography Using Image Segmentation Techniques

2021 ◽  
Vol 11 (5) ◽  
pp. 1403-1409
Author(s):  
D. Sudarvizhi ◽  
M. Akila
Keyword(s):  
Diabetes Mellitus ◽  
Image Segmentation ◽  
Diabetic Foot ◽  
Execution Time ◽  
Musculoskeletal Diseases ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Primary Concern ◽  
Diabetic Ulcer ◽  
Fuzzy C Means

Pedobarography is elementary for kinetic gait analysis along with the analysis and exploration of multiple neurological and musculoskeletal diseases. One person among 11 adults suffer from Diabetes Mellitus. Also, Foot ulcers (FU) is a most harmful as well as associated chronic complications springing from diabetes mellitus (DM). Recently, there has been an evolving awareness that understanding the biomechanical factors beneath the diabetic ulcer in a better manner could result in improving the control activities over the disease, with considerable socio-economic effects. Diabetic Foot Ulcers (DFU) is a primary concern of this health issue, and if this is not addressed right can result in amputation. So in this research, the Image segmentation algorithms and Perimeter pixel comparison is carried out for wound classification depending on the simulation algorithm like Adaptive K-means, Clustering K means, Fuzzy C means, and Region growing approaches and among them, Fuzzy C means is found to achieve greatest accuracy of perimeter pixel values, which are 603, 462 and 356 pixel values in stages one, two and three. The time taken for execution among all the four simulation algorithms are observed and it can be revealed that Adaptive K means yields the least execution time for carrying out the simulation of foot ulcer. An evaluation on the self-assessment of wounds caused during diabetic foot ulcer employing image segmentation is developed. It is ultimately found that the objective of the image analysis pertaining to the ulcer in foot is the dynamic evaluation and definition of regions of high pressure in a diabetic patient’s foot depending on the estimations made on the perimeter pixel comparison and execution time.

scholarly journals Efek Pemberian Jamu Selama 45 Bulan terhadap Fungsi Ginjal pada Pasien Geriatri dengan Hipertensi dan Diabetes Mellitus di Rumah Riset Jamu Tawangmangu: Studi Kasus

2018 ◽  
Vol 1 (3) ◽  
pp. 061-066
Author(s):  
Fajar Novianto ◽  
Agus Triyono ◽  
Peristiwan R Widhi Astana
Keyword(s):  
Diabetes Mellitus ◽  
Filtration Rate ◽  
Geriatric Patients ◽  
Alternative Therapy ◽  
Vital Signs ◽  
Term Therapy ◽  
Kidney Glomerulus ◽  
History Of ◽  
Long Term Therapy

Pasien geriatri adalah pasien usia lanjut yang memiliki karakteristik multipatologi, daya faali menurun, dan dengan tanda penyakit yang tidak khas. Terapi pengobatan yang diterima pasien geriatri sangat kompleks sehingga sering menimbulkan Drug Related Problem terutama pada organ ginjal. Jamu menjadi terapi alternatif pada pasien geriatri yang memerlukan terapi jangka lama. Tujuan studi kasus ini adalah untuk melihat pengaruh pemberian jamu pada pasien geriatri yang sudah berobat dalam jangka waktu 45 bulan terhadap fungsi ginjal. Metode penelitian ini merupakan studi kasus berdasarkan data rekam medis di Rumah Riset Jamu Tawangmangu terhadap pasien geriatri yang secara rutin kontrol dan periksa ureum atau kreatinin selama 45 bulan dan masih mengkonsumsi jamu hingga bulan April 2018. Untuk melihat pengaruh jamu pada ginjal dilakukan pemeriksaan Glomerulus Filtration Rate (GFR). Hasil: Seorang laki-laki umur 61 tahun dengan keluhan tangan kanan merasa kesemutan. Pasien memiliki riwayat penyakit hipertensi dan diabetes mellitus lebih dari 15 tahun. Tekanan darah 140/90 mmHg dan tanda vital serta pemeriksaan fisik lainnya dalam batas normal. Pemeriksaan laboratorium Gula Darah Puasa (GDP) 227 mg/dL, ureum dan kreatinin diperiksa setelah bulan kelima pasien minum jamu yaitu ureum 35 mg/dL dan kreatinin 0,89 mg/dL. Selama minum jamu terjadi fluktuasi nilai GFR pasien tetapi tidak sampai menurun hingga kategori berat. Pada akhir bulan ke-45 meskipun terjadi penurunan GFR pasien dibanding pemeriksaan GFR yang pertama tetapi masih dalam kategori yang sama dengan nilai GFR pertama kali periksa (kategori ringan). Kesimpulan: Pemberian jamu dalam jangka waktu 45 bulan secara berturut-turut pada pasien geriatri tidak menyebabkan penurunan GFR signifikan.   Geriatric patients are elderly patients who have the characteristics of multi pathology, decreased physiology, and atypical symptom of a disease. Treatment received by geriatric patients is very complex so it often leads to Drug-Related Problems, especially in the kidney organs. Jamu is an alternative therapy for geriatric patients who need long-term therapy. The objective of this case study was to evaluate the effect of Jamu (herbs) on kidney function of geriatric patients who have been treated for 45 months. The research method was a case study based on the medical record of geriatric patients at Jamu Research Center in Tawangmangu who routinely control and examine for their urea or creatinine levels for 45 months and still consume herbs until April 2018. In order to evaluate the effect of jamu on the kidney, Glomerulus Filtration Rate (GFR) was examined. Results:  A 61-year-old male with a right hand feeling tingling. Patients have a medical history of hypertension and diabetes mellitus for more than 15 years. His blood pressure was 140/90 mmHg, meanwhile, the vital signs and other physical examinations were within normal levels. Laboratory tests of Fasting Blood Sugar (GDP) showed a level of 227 mg / dL, urea and creatinine levels were examined after the fifth month consumed jamu, the urea level was 35 mg / dL and creatinine level was 0.89 mg / dL. During jamu consumption there was a fluctuation in the patient's GFR but not until the severe category. At the end of the 45th month, despite a decrease in the patient's GFR compared to the first GFR examination but still in the same category as the first GFR score (mild category). Conclusion: Jamu consumption for 45 consecutive months in geriatric patients did not cause a significant reduction in GFR

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.

Management of Diabetic Foot Ulcer by Nishadi Yoga Avachoornana - A Case Study

2017 ◽  
Vol 2 (06) ◽  
Author(s):  
Chiranth Kumar R. ◽  
Syeda Ather Fathima
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Life Style ◽  
Genetic Factor ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Complications ◽  
Scientific Approach

Diabetes is considered as ‘ice burg’ of diseases as only 1/3rd of its manifestations can be made out clinically, though the exact cause is not known following are the theories put forth to explain diabetes mellitus - Genetic factor, Life style disorder, Autoimmune cause. Slight injury to glucose laden tissue will cause infection which is precipitated by an ulcer and it tends to a state of non - healing. Main stay of treatment includes antibiotics, debridement, local wound care. Inspite of these treatments there is less reduction in the statistics of diabetic foot complications and amputations. In Sushrutha Samhitha we get the most scientific approach for the management of Vrana, where Sushrutha has mentioned 60 Upakrama’s (modalities of treatment) of which Avachoornana (dusting) is one modality, seen to be effective in the management of diabetic non healing ulcers (Madhu Mehaja Dusta Vrana).

scholarly journals Consequences of misdiagnosis of diabetic charcot anthropathy of the ankle

1970 ◽  
Vol 4 (2) ◽  
pp. 83-86
Author(s):  
Chowdhury Iqbal Mahmud
Keyword(s):  
Diabetes Mellitus ◽  
Ankle Fracture ◽  
Ankle Arthrodesis ◽  
Fracture Dislocation ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Charcot Arthropathy ◽  
Uncontrolled Diabetes ◽  
History Of

Permanent deformity and disability can occur in diabetic Charcot arthropathy (neuropathic arthropathy) if not diagnosed and treated promptly. We report two patients with uncontrolled diabetes mellitus in whom the diagnosis of ankle neuro-arthropathy was delayed by up to six months, with misdiagnoses including ankle arthritis, osteomyelitis and cellulitis. The clinical scenario and appearances of the ankle and foot were typical of Charcot arthropathy. Unfortunately, both of them sustained ankle fracture-dislocation without a history of significant trauma. Both the patients were treated by ankle arthrodesis (fusion of joint). Prevention and early diagnosis of diabetic foot is the key to avoid the development of complications. In diabetic patients, a higher index of suspicion for the possibility of Charcot’s disease is needed. Key Words: Diabetes mellitus; Charcot arthropathy; ankle fracture-dislocation; arthrodesis. DOI: 10.3329/imcj.v4i2.6503Ibrahim Med. Coll. J. 2010; 4(2): 83-86

scholarly journals Risk factors associated with poor glycemic control in patients with type two Diabetes mellitus in Zakho city

2021 ◽  
Vol 7 (3) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Waist Circumference ◽  
Glycemic Control ◽  
High Performance ◽  
Poor Glycemic Control ◽  
Uncontrolled Diabetes ◽  
Two Factors ◽  
History Of ◽  
Diabetes Center

Diabetes Mellitus (DM) is a chronic condition caused by relative lack of insulin due to impaired insulin secretion or insulin resistance. The aim of this study was to investigate the prevalence of poor glycemic control in Zakho city and to explore the modifiable risk factors that may help controlling the disease. Materials and Methods We recruited patients with known history of diabetes receiving oral anti-diabetic medications. Those patients were registered in Zakho Diabetes center with regular visits. The measurement of anthropometric indices was conducted by trained personnel. Plasma glucose was determined using colorimetric enzymatic method with glucose oxidase. HbA1c concentrations were measured in whole blood samples using high performance liquid chromatography. Results In this study, 520 patients were recruited. The average age of the patients was 56.92±9.62. Among those, 190 were male. The blood sugar was controlled in 122 (23.4%) patients. We found a significant association between sex and HbA1C level (p=0.000; OR=0.4796; CI=0.3175-0.7243). In addition, waist circumference was significantly associated with HbA1C levels (p=0.018; OR=1.02; CI=1.0031-1.0373). Conclusions The vast majority of the patients had uncontrolled diabetes. We found that sex and waist circumference were risk factors for uncontrolled diabetes. Any diabetes controlling program should focus on those two factors.

scholarly journals WOUND HEALING PROPERTIES OF PURANA GHRITA WITH SPECIAL REFERENCE TO NON-HEALING DIABETIC ULCER- A case Study

2019 ◽  
Vol 7 (07) ◽  
Author(s):  
Kirti Mandar Deo
Keyword(s):  
Wound Healing ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Modern Medicine ◽  
Diabetic Ulcer ◽  
Inflammatory Phase ◽  
Ayurvedic Treatment

Diabetic foot ulcer (DFU) is one of the major complications found in 15% of diabetics. It significantly reduces the quality of life. In DFU there is a prolonged inflammatory phase, delayed mature granulation tissue formation and reduction in wound tensile strength. The recommended line of treatment as per modern medicine includes Blood sugar control, removal of dead tissue & Wound dressing.According to Charak Samhita, Prameha Pidaka are caused due to upeksha (neglect) of underlying Prameha. Prameha Pidaka are of darun type and have 7 subtypes. Purana Ghrita plays significant role in wound healing in non-healing diabetic ulcer.Objective: To study the effect of Purana Ghrita in non-healing diabetic ulcer.Methods: In the case presented here, a male patient aged 70 years with type 2 diabetes, was admitted in the hospital for 2 months for the treatment of Non- healing diabetic ulcer on the sole of left foot. Allopathy treatment did not give desired results. Hence after 2 months of admittance, Ayurvedic treatment was introduced for DFU. Dressing of wound was done by mixture of Purana Ghrita, honey, Triphala Churna and Haridra Churna along with the dressing, Rasapachak, Raktapachak, Mansapachak, Gudmaradi vati, Aarogyavardhini vati & Sanjivani guti were used internally at different times. Result and Conclusion: With above mentioned treatment the non-healing diabetic ulcer healed and the patient was discharged after 30 days.Purana Ghrita has Vrana nashak qualities. It cleanses as well as heals i.e. it has Shodhan and Ropan properties.

scholarly journals A Prospective Observational Study on Diabetic Induced Complications and their Prone towards Surgery

2021 ◽  
pp. 343-353
Author(s):  
C. Madhusudhana Chetty ◽  
K. Mabichan ◽  
H. Raga Sandhya ◽  
K. Mallikarjuna
Keyword(s):  
Diabetes Mellitus ◽  
Observational Study ◽  
Diabetic Complications ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Vascular Complications ◽  
Foot Ulcer ◽  
Patient Counselling ◽  
Diabetic Ulcer ◽  
Artery Disease

Background: This study was mainly aimed to find out the diabetic complications that had been lead to surgey. The Diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate,fat and protein metabolism resulting from defects in insulin secretion,insulin action, or both.The effects of diabetes mellitus include long-term damage,dysfunction and failure of various organs. Materials and Methods: A prospective observational study was conducted in the Santhiram college & general hospital for 6 months (December 2020 – May 2021)to assess the macro vascular and micro vascular complications of diabetes mellitus and prone to surgery of diabetic complications by using case sheets, prescriptions in tertiary care teaching hospital. Results: A total of 150 patients are included in this study.In patients with diabetic complications we have observed: Diabetic ulcer with cellulitis in 19, gangrene in 19, peripheral vascular disease in 6, gangrene with cellulitis in 11,Non healing diabetes foot ulcer in 35, Coronary artery disease 24, diabetic retinopathy 25, MI in 11 patients.Among all complications, non healing diabetic foot was observed to be more when compared to other diabetic complications.In the study performed in diabetic induced complications of patients, debridement was performed in 30% patients, Amputation were performed in 13%, skin grating was performed in 13% patients, Angioplasty were performed in 23% patients and lasix surgery performed in 13% patients. Conclusion: In our study we conclude that out of 150 cases, male patients are more prone to diabetic complications than females.The patient counselling should involve in minimizing the incidence and prevalence of diabetes by conducting the continuing health education and other health programms.

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