Prevalence of DFU among diabetic patients and its management

: To study the prevalence of DFU among diabetic patients and the management of DFU among diabetic patients.: Prospective observational study. : The study was conducted in inpatients with diabetes of all departments and inpatients with diabetic foot ulcer (DFU) of surgical department of age 20 to 80 of both genders with sample size 150 were included from September 2019 to march 2020. The prevalence of DFU among diabetic patients was 16%. Among them more diabetic cases were seen in age group of 50-59 and DFU in 40-49 and More diabetic cases are observed in male compared to female. DFU observed equally and the most common causative organism for DFU was staphylococcus aureus followed by proteus species, klebsiella and pseudomonas aeruginosa and more cases of DFU were noticed in diabetic patients with duration of 6-10 years. As the main cause of DFU is infection the primary treatment is anti microbial therapy and the most prescribed class of antibiotics is cephalosporins followed by nitroimidazoles, penicillins, oxazolidinones, lincosamides etc. surgical procedures like debridement, amputation and sometimes both were done in 9,14,1 patients respectively. : Our study revealed the information regarding the prevalence of DFU among diabetic patients is due to lack of knowledge and uncontrolled diabetes may develop poor circulation which leads to wound that may heal slowly which leads to DFU.

Post COVID 19- mucormycosis and osteomyelitis of the mandible- A rare case report

Corona virus disease was declared as pandemic in 2020. The second wave of covid 19 in India was completely influenced by the fatal complication of covid 19 called Mucormycosis. It was declared as an epidemic in India after 2 wave. The use of Corticosteroids in the management of covid 19 and uncontrolled diabetes mellitus with other systemic illness has shown tremendous immunosuppression which has ultimately caused Mucormycosis. Mucormycosis is rare in mandible. We are presenting a case report with brief discussion of 9 patients having post covid Mucormycosis along with osteomyelitis of the mandible, the rarest form of the post covid infection, which was managed surgically as well as with adjuvant antibacterial and antifungal drugs followed by post-operative prosthetic rehabilitation. This fatal infection has to be kept in mind in covid 19 active cases as well as in recovered patients, especially in those having comorbidities and judicious use of cortico-steroids should be recommended.

Case of Mycotic Pseudoaneurysm of the Common Carotid Artery due to Salmonella typhi Bacteremia

Aneurysm of the extracranial carotid artery is a rare disease, mycotic pseudoaneurysms being even less common. They are a life-threatening complication of systemic infection and atherosclerosis. Immunocompromised people, including patients with HIV, uncontrolled diabetes melltus, those on immunosuppressants like high-dose steroids, and chemotherapy, are at a higher risk for development of mycotic pseudoaneurysms. Due to the high risk of potential complications like rupture and thromboembolic events, mycotic aneurysms always require surgical management. Early detection followed by restoration of blood flow is critical to minimize a fatal outcome. Here we report the case of a 52-year-old man with a past history of hypertension and dyslipidemia who presented with a pulsatile painful neck swelling. On evaluation, the patient was diagnosed to have Salmonella typhi bacteremia, HIV infection, and a mycotic aneurysm of the left common carotid artery.

Time from diagnosis does not improve diabetes care knowledge for older adults with type 2 diabetes

Uncontrolled diabetes is a risk factor for Alzheimer’s disease development. Knowledge of diabetes management is one tool in helping individuals with diabetes to control their blood glucose levels. The goal of this study was to determine whether there was a relationship between self-rated understanding of diabetes management and time since diagnosis, and whether there were differences in self-rated understanding based on time since diagnosis. This study used an observational, cross-sectional, self-report design with two delivery options. Participants were adults over 50 years of age participating either online or at a senior apartment. A survey was developed to include self-rated diabetes management knowledge, relatives with diabetes, and Alzheimer’s disease symptoms, as well as lifestyle behaviors. The data were filtered to include only those with a self-reported diabetes diagnosis, and analyzed using non-parametric statistics, the Mann-Whitney test and Spearman’s rho. There was no relationship or difference between time since diagnosis and self-rated understanding of diabetes management. Continuing education is needed to help people with diabetes to manage their condition, even years after diagnosis. Failure to understand diabetes management is likely to lead to uncontrolled diabetes, which is associated with increased risk of Alzheimer’s disease.

Evaluation of Tear Evaporation Rate in Patients with Diabetes Using a Hand-Held Evaporimeter

Diabetes is a very common disease and is considered a risk factor for many diseases such as dry eye. The aim of the current work was to evaluate the tear evaporation rate (TER) in patients with diabetes using a hand-held evaporimeter. This observational, case–control and non-randomized study included 30 male patients with diabetes (17 controlled and 13 uncontrolled) with a mean ± standard deviation (SD) of 33.1 ± 7.9 years. An age-matched (18–43 years; 32.2 ± 6.5 years) control group consisting of 30 male subjects was also enrolled for comparison. Subjects with thyroid gland disorder, a high body mass index, high blood cholesterol, or thalassemia, contact lens wearers, and smokers were excluded. The TER was measured after the completion of the ocular surface disease index (OSDI) by each participant. The OSDI and TER median scores were significantly (Wilcoxon test, p < 0.05) higher in patients with diabetes (median (interquartile range; IQR) = 12.0 (8.3) and 46.4 (36.7) g/m2h, respectively) compared to the subjects within the control group (5.6 (7.0) and 15.1 (11.9) g/m2h, respectively). The median scores for the OSDI and TER measurements were significantly (Wilcoxon test, p < 0.05) higher among uncontrolled diabetes patients (13.0 (11.5) and 53.4 (14.2) g/m2h, respectively) compared to those obtained for patients with controlled diabetes (11.0 (8.0) and 27.3 (32.6) g/m2h, respectively). The tear evaporation rate in patients with diabetes was significantly higher compared to those obtained in subjects without diabetes. Uncontrolled diabetes patients have a higher tear evaporation rate compared to controlled diabetes patients. Therefore, diabetes can lead to eye dryness, since these patients possibly suffer excessive tear evaporation.

COVID-19 Associated Rhino-Orbital-Cerebral Mucormycosis - An Institutional Series

Invasive fungal infection or mucormycosis is almost always confined to the patients with altered host defenses such as in transplant recipients, diabetics or patients with malignancies. Hypergycemia or uncontrolled diabetes, particularly diabetes acidosis is considered as the strongest and very well known risk factor for mucormycosis. It has spread like fire amongst the active COVID-19 and post COVID-19 diabetic patients. Many studies across the world have established the definitive severity of SARS-CoV-2 infection amongst diabetic patients.

Predictive Modeling Of Diabetic Retinopathy Disease By Use Of Machine Learning

According to a report by the World Health Organization (WHO), one of the leading causes of death by the end of 2030 will be diabetes, which is a serious disease. Timely treatment of this disease can prevent serious complications, including death. The number of people getting infected with diabetes is millions. The risk of getting this infection is common now a days and is more prevalent in women than men. Diagnosis process for diabetes is quite tedious. Diabetes retinopathy is a disorder that is caused by uncontrolled diabetes and can cause complete blindness if left untreated. Therefore, if detected early its treatment can prevent the unfavourable effects of diabetic retinopathy. The actual diagnosis of diabetes retinopathy by eye doctors takes a lot of time and patients need to suffer more during this time. Thus the latest achievements in science and technology makes it easier to predict the disease. The aim is to diagnose whether a person is diabetic or not using a phase-based machine learning method. This paper reviews, classifies and compares algorithms with previously suggested strategies to develop better and more efficient algorithms.

The second wave of COVID-19 results in outbreak of mucormycosis: diabetes and immunological perspective

Objectives To evaluate the potential relationship between COVID-19 pandemic and mucormycosis outbreak. Methods PubMed, Embase, Cochrane Library and Google Scholar were searched for the term “COVID-19 and mucormycosis” up to May 31, 2021. Results After the second wave of COVID-19, the mucormycosis outbreak complicates the natural course of COVID-19. COVID-19 patients with uncontrolled diabetes mellitus with diabetic ketoacidosis, excessive glucocorticoid use, prolonged neutropenia, malnutrition and any underlying immunocompromised conditions are at risk of developing mucormycosis. Conclusions Hyperglycaemia impairs the motility of phagocytes and also decreases the oxidative and non-oxidative mechanism of killing the causative pathogen. Chronic hyperglycemia also leads to the formation of advanced glycation end-products (AGE), which leads to cross-linking between key proteins of inflammation and connective tissue such as collagen which makes tissue susceptible to immunological dysregulation. The receptor for AGE (RAGE) is expressed on various inflammatory cells including neutrophils and its activation by AGEs leads to activation of many down signaling pathways which ultimately leads to impairment of the inflammatory response. Hyperglycemia also increases serum Nitric Oxide (NO), which decreases neutrophil motility and reduces the synthesis and release of various inflammatory mediators such as TNF-α and IL-1β, IL-6. It also decreases the expression of adhesion molecules such as LFA-1 and ICAM-2, on neutrophils. Steroids cause immunosuppression majorly by inhibiting the NF-κB pathway which is a transcription factor involved in the synthesis of many immunological mediators such as Interleukins, cytokines, chemokines, etc., and various adhesion molecules.