Health Problems In People Research Articles

Sociodemographic profile of people with disabilities in rural areas in southern Brazil

Abstract Background People with disabilities (PWD) living in rural areas are subject to various vulnerabilities and inequalities that add to the barriers faced due to disabilities. The study aims to identify the sociodemographic profile of PWD living in rural areas of southern Brazil. Methods Quantitative study and a section of the ongoing research 'Work, Inclusion and Health Problems of People with Disabilities in Rural Scenario: an analysis in the southern region of Brazil', from the Health Studies and Research Group of the University of Santa Cruz do Sul (UNISC)/Brazil. Conducted in six municipalities in the state of Rio Grande do Sul with 37,333 inhabitants, 84.3% in the rural area and 32.7% are PWD. The first stage of data collection occurred through the survey of PWD older than 18 years and the second stage through a questionnaire. For statistical and descriptive analysis, the Software SPSS 22.0 was used. The research comply with the Resolution 466/2012 and the Ethics and Research Committee of UNISC approved it under nº. 341658. Results The subjects represent 1.33% of the total population and 1.57% of the rural population of the 6 municipalities. Data were compiled from 495 subjects and 22 of them answered the questionnaire. It was identified 271 subjects from three municipalities, 52.8% were male. The deficiencies were 39.1% intellectual, 25.5% physical, 18.1% auditory, 8.9% visual and 8.6% multiple. Of the 22: 12 were men; 12 were between 18 and 35 years old; 16 with white skin color; 11 did not complete elementary school; 13 with intellectual/mental disabilities; in 18 subjects the deficiencies are of congenital origin; 17 never worked; 5 have already worked and one still work. Conclusions The study shows that the PWD are mostly young men with low level of education, who did not perform work activity and with congenital mental disabilities. Such data are important for planning public policies that are more effective. Key messages Identifying data and the profile of PWD in rural contexts contributes to the development of public policies in the municipalities investigated and can contribute to other locations and regions. People with disabilities (PWD) living in rural areas are subject to various vulnerabilities and inequalities that add to the barriers faced due to disabilities.

Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis.

Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis.

Processing System and Evaluation Microbiological Quality of Drinking Water Fountain in Surabaya City

Introduction: Drinking water fountain (KASM) is one of the innovations of the Regional Drinking Water Company (PDAM) Surya Sembada Surabaya City to provide drinking where the location is in various public facilities. Health problems in people who consume KASM water can occur when the quality of water is not eligible. Unsafe drinking water can interfere with health and can cause waterborne disease. The purpose of writing this article is to identify the processing system and analyze the quality of water microbiology of KASM. Method: This type of research was a descriptive observational with case design report. Subject of study was drinking water fountain (KASM) was one of the innovations of the Regional Drinking Water Company (PDAM) Surya Sembadin the city of Surabaya. The data used was secondary data on 13 samples of KASM locations originating from the PDAM Surya Sembada Surabaya City and various literature. The method of data analysis used is qualitative. Result and Discussion: Water treatment in each KASM unit is an advanced process of water treatment plant (IPAM) PDAM Surya Sembada City of Surabaya. A series of water treatment processes through several equipments, consisting of: pressure tank, basin, low and high pressure switch, booster pump, radar, tank container, UV lamp, RO, Flow Reject, remineral, hexagonal, post-carbon, 1 micron catridge, GAC, 5 micron Catridge, and solenoid. Results of the evaluation of the microbiological quality of KASM based on the data quality Report water in January 2019-January 2020 indicates that the total parameters coliform at 13 point location 4.69% are not eligible, while for the parameter fecal coliform 100% qualified drinking water quality. Conclusion: monitoring of water quality, processing system, and sanitation need to be applied regularly to provide safe drinking water for the community

Impact of physiotherapeutic methods on urinary incontinence in the elderly

Purpose Urinary incontinence is one of the most important health problems for people over 65 years of age. It is defined as involuntary and uncontrolled loss of urine. This paper aims to present a contemporary view on the effects of physiotherapeutic procedures in combating urinary incontinence. Physiotherapeutic procedures were compared: pelvic floor muscle exercises, physical therapy and biofeedback (BF) to demonstrate their effectiveness in managing urinary incontinence in the elderly. Design/methodology/approach The databases Pubmed and GoogleScholar have been searched for articles on the impact of interventions – physiotherapeutic procedures on the effectiveness of the treatment of urinary incontinence in the elderly. Findings Pelvic floor muscle exercises are effective in the treatment of urinary incontinence, strengthen muscle strength and improve patients' quality of life. A long-lasting, systematic and individual training program with a physiotherapist is the most effective. BF helps to intensify the therapeutic effect of exercise but also allows you to achieve good results as an independent treatment method. Positive effects are also noticeable in physical therapy, electrostimulation and magnetotherapy are very effective. Physiotherapeutic procedures have a positive effect in the treatment of urinary incontinence in the elderly. However, further research is needed to clarify the most effective methods. Originality/value This paper offers many ways to deal with urinary incontinence in the elderly using physiotherapeutic procedures, thus helping to improve the quality of life of those affected by urinary incontinence.

Physical Activity, Ability to Walk, Weight Status, and Multimorbidity Levels in Older Spanish People: The National Health Survey (2009-2017).

Background. Many studies have shown a relationship between physical functioning and health status in older people. Aim. The purpose of this study was to analyze the temporal trends of physical activity (PA), ability to walk, weight status, self-perceived health, and disease or chronic health problems in people over 65 years from 2009 to 2017, using the European Health Survey in Spain and the National Health Survey in Spain. Methods. This study included 13,049 older people: 6026 (2330 men and 3696 women; age (mean, SD (Standard Deviation)) = 75.61 ± 7.11 years old) in 2009 and 7023 (2850 men and 4173 women; age (mean, SD) = 76.01 ± 7.57 years old) in 2017. Results. In 2017, older people exhibited lower values of moderate PA (p < 0.001), a lower number of hours of walking per week (p < 0.001), and worse self-perceived health status (p < 0.001) compared to 2009. These differences are maintained when comparing the sexes. Compliance with PA recommendations was 27.9% and 6.1% (chi-squared = 352.991, p < 0.001) in 2009 and 2017, respectively. There were no significant differences in weight status between older people in 2009 and 2017. In 2017, older people had significantly high percentages of disease or chronic health problems (p < 0.05), number of diseases (p < 0.001), severe difficulty walking 500 m without assistance (p < 0.05), and severe difficulty going up or down 12 stairs. Conclusions. From 2009 to 2017, Spanish older people worsened their PA levels and perception of their health status, and they increased their disease levels, which could be associated with the worsening of ability to walk in 2017.

A Cross-sectional Comparison of the Mental Health of People Trafficked to the UK for Domestic Servitude, for Sexual Exploitation and for Labor Exploitation

ABSTRACT The experiences and needs of trafficking victims have received increasing attention. However, variation in the experiences and needs of people trafficked for different types of labor have been poorly explored. People trafficked for domestic servitude may represent a particularly vulnerable group but are typically subsumed within labor exploitation. Our aim is to describe the characteristics, experiences, and mental health outcomes of a sample of trafficking victims, comparing across different types of exploitation. Using survey data, descriptive statistics and comparisons between groups were calculated using chi-squared tests and regressions. A sensitivity analysis was conducted to control for gender. Forty-four (29.3%) participants reported exploitation for domestic servitude, 43 (28.7%) for sexual exploitation, and 59 (39.3%) for other labor. Those exploited for domestic servitude reported higher levels of mental health problems, though this may be confounded by gender. Those exploited for domestic servitude also reported more experiences of violence and restriction than the other labor group, differences remaining after the sensitivity analysis. Researchers should disaggregate results by type of exploitation. Practitioners and policymakers should be aware of and responsive to the high prevalence of experiences of violence and restriction and mental health problems in people trafficked for domestic servitude to ensure their recovery.

Health risk assessment: heavy metals in fish from the southern Black Sea

Introduction. The coastal contamination of the Black Sea has been an important issue for several decades. Heavy metals are the most harmful contaminants which affect people health. The research objective of the present study was to determine the amounts of Cd, Hg, Pb, Cu, and Zn found in the whiting (M. merlangus L.) and the red mullet (M. barbatus L.). These Black Sea bottom fish species have the highest commercial value. The obtained data were used to assess the risk which the fish represents for human consumers.&#x0D; Study objects and methods. The elements were detected using an inductively coupled plasma mass spectrometer (ICP-MS). The amounts of the metals arranged in the following order: Zn &gt; Cu &gt; Pb &gt; Hg &gt; Cd. &#x0D; Results and discussion. The mean values of Cd, Hg, Pb, Cu, and Zn in the edible tissues were 0.013, 0.024, 0.07, 0.195, and 9.05 mg/kg wet wt. for whiting and 0.017, 0.036, 0.05, 0.29, and 6.4 mg/kg wet wt. for red mullet, respectively. These levels proved lower than the permitted values set by the Ministry of Agriculture, Forestry, and Fisheries of the UK (MAFF), Turkish Food Codex (TFC), and EU Commission Regulation. The target hazard quotient (THQ) for all the elements via consumption of whiting and red mullet were also low.&#x0D; Conclusion. Hazard index (HI) was ˂ 1, which means that the fish caused no health problems in people who consumed whiting and red mullet caught in the southern Black Sea during the fishing seasons of 2017–2018. The carcinogenic risk index (CRI) for whiting and red mullet was also considered insignificant.

US poised for action on PFAS

This year, both the US Congress and the US Environmental Protection Agency are likely to take action on per- and polyfluoroalkyl substances (PFAS) pollution. These synthetic chemicals, prized for their durability, don’t break down in the environment. Studies of some nonpolymeric PFAS show that they cause health problems in people and laboratory animals. Last week, the US House of Representatives was set to pass bipartisan PFAS legislation (H.R. 535) after C&EN’s deadline. The bill would speed the cleanup of the two PFAS—perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS)—that most frequently are detected in US drinking water. Epidemiology studies have linked PFOA and PFOS, chemicals found in the blood of most Americans, to adverse reproductive effects and other health harms. The bill contains a number of other provisions to control PFAS. At least some of them have sparked opposition to H.R. 535 from industry, including chemical makers, as well as

Management of Rehabilitation needs of "Unknown" Traumatic Brain Injury Survivors: A Medical and Psychiatric Social Work Perspective.

Traumatic brain injuries [TBI] caused by road traffic accidents [RTA] are a serious health problem for people of all countries across the globe. RTA will be a leading cause of mortality, morbidity, disabilities and creating many rehabilitation needs. Hence, this, article highlights the clinical concerns, burden, challenges, role of medical and psychiatric social worker, rehabilitation strategies and practical guidelines needed for successful rehabilitation of the unknown and abandoned TBI survivors.

Diagnostics of Environmental Risks and Mapping of Surface Water Sensitivity Due to Metal Contamination from Artisanal Gold Mining in C&amp;#244;te d’Ivoire: Case of Angovia, Kokumbo, Hireand Agbaou

The present study performed on the Angovia, Kokumbo, Hire and Agbaou sites consisted of mapping the environmental risks linked to artisanal gold mining activities in C?te d’Ivoire. An inventory was done by observing the different phases of gold extraction and identifying the risks associated with these phases. Using a Geographic Information System (GIS), the representation of the spatial distribution of the pollution risks has been realized from indicator descriptives of the environmental sensitivity (i.e. slope, proximity to the watercourse, soil cover) and the transfer indicator (i.e. rainfall). The analysis of this map showed low sensitivity of mercury (Hg), arsenic (As), copper (Cu) and zinc (Zn) measured in the waters of the Hire and Agbaou localities, while moderate sensitivity in Kokumbo surface waters and high sensitivity for those of Angovia locality were observed. Moreover, analysis of Hg, As, Cu and Zn content spatial distribution maps in surface waters revealed that Hg and As come mainly from the artisanal mining activities for most localities. Among these metallic trace elements observed, only the Hg content was above the WHO Limit Values, 1994 (>0.001 mg·L-1). The continuous spread of metallic trace elements in surface water can pose serious health problems for people living around artisanal gold mining sites, hence the need to put in place a protection plan against contamination.

Mental and physical health conditions in people with intellectual disabilities: Comparing local and national data

Accessible summaryPeople with intellectual disability have multiple health problems.People with intellectual disability have more physical and mental health conditions than people without intellectual disabilities.People with intellectual disability may need more health checks due to increased prevalence of physical and mental illnesses.More studies are needed to understand what interventions are effective to reduce health problems in people with intellectual disability.AbstractBackgroundStudies have reported increased prevalence of physical and mental health conditions in people with intellectual disabilities (ID) compared to people without intellectual disabilities. However, there are no studies looking into specific health conditions at a national level and comparing with areas that are socio‐economically disadvantaged (e.g. low income and low education attainment). This study examines and compares the prevalence of physical and mental health morbidity in people with and without intellectual disabilities at a local and national level in the UK.MethodThis study was an anecdotal analysis of physical and mental health data and annual health check‐up for England (national), London (regional) and Haringey (inner‐city borough of London) in 2016/17 using data from the NHS Digital database.ResultsPatterns of mental and physical conditions for people with and without intellectual disabilities were similar across Haringey, London and England data. Severe mental illness was more prevalent among people with intellectual disabilities compared to non‐intellectual disability peers. This further increased in the inner‐city London borough for the intellectual disability group. Certain physical health conditions were also more prevalent in people with intellectual disabilities. Certain activities such as monitoring blood pressure, recording body mass index and checking HbA1C were better in people with intellectual disabilities. Uptake of annual health checks for people with intellectual disabilities remained around 50%.DiscussionThis study further highlights the increased prevalence of mental and physical disorders in people with intellectual disabilities compared to people without intellectual disabilities. Further increased risk of mental disorders in an inner London borough compared to national data aligns with existing literature that highlights the negative impact of socio‐economic deprivation on mental and physical health. Further studies are needed to assess the health and social care measures that can reduce the physical and mental health morbidity in people with intellectual disabilities.

Sickling-suppressive effects of chrysin may be associated with sequestration of deoxy-haemoglobin, 2,3-bisphosphoglycerate mutase, alteration of redox homeostasis and functional chemistry of sickle erythrocytes.

Sickle cell disease (SCD) is a medical condition caused by mutation in a single nucleotide in the β-globin gene. It is a health problem for people in sub-Saharan Africa, the Middle East and India. Orthodox drugs developed so far for SCD focus largely on symptomatic respite of pain and crisis mitigation. We investigated the antisickling effects of chrysin via modulation of deoxy-haemoglobin, 2,3-bisphosphoglycerate mutase, redox homeostasis and alteration of functional chemistry in human sickle erythrocytes. In silico and in vitro methods were adopted for the studies. Chrysin was docked against deoxy-haemoglobin and 2,3-bisphosphoglycerate mutase, with binding energies (-24.064 and -18.171 kcal/mol) and inhibition constant (K i) of 0.990 µM and 0.993 µM at their active sites through strong hydrophobic and hydrogen bond interactions. Sickling was induced with 2% metabisulphite at 3 h. Chrysin was able to prevent sickling maximally at 2.5 µg/mL and reversed the same at 12.5 µg/mL, by 66.5% and 69.6%, respectively. Treatment with chrysin significantly (p < 0.05) re-established the integrity of erythrocytes membrane as evident from the observed percentage of haemolysis relative to induced erythrocytes. Chrysin also significantly (p < 0.05) prevented and reversed lipid peroxidation. Similarly, glutathione and catalase levels were observed to significantly (p < 0.05) increase with concomitant significant (p < 0.05) decrease in superoxide dismutase activity relative to untreated. From Fourier-transform infrared results, treatment with chrysin was able to favourably alter the functional chemistry, judging from the shifts and functional groups observed. Sickling-suppressive effects of chrysin may therefore be associated with sequestration of deoxy-haemoglobin, 2,3-bisphosphoglycerate mutase, alteration of redox homeostasis and functional chemistry of sickle erythrocytes.

State of mental health as a predictor for the outcome in patients with tuberculosis in health centers with high incidence. Lima, Peru. 2015-2017

Mental health problems in people with tuberculosis (TB) have been associated with negative outcomes. Some health care centers in Peru use an evaluation of mental health status proposed by the Dirección de Prevención y Control de Tuberculosis (DPCTB). To evaluate the association between the mental health evaluation indicators at the beginning of treatment and the outcome of people treated with TB. A retrospective cohort study in three health care centers from the district San Juan de Miraflores. The outcome was considered positive (cured) and negative (failure, dropout, death or change of treatment scheme). A significant association was found between the negative outcome and depressive symptoms (RR: 2.39, 95%CI: 1.19-4.78), substance abuse (RR: 2.58; 95%CI: 1.31-5.09) and unprotected sexual intercourse (p = 0.04). The multivariate analysis found association with depressive symptoms (RR: 2.19, 95%CI: 1.10-4.35) and substance abuse (RR: 2.19, 95%CI: 1.14-4.20). Depressive symptoms and drug consumption were associated with negative outcomes. Intervention studies focusing on these factors should be evaluated to improve treatment success.

Influence of tire crumbs on mechanical properties of sand-fine soil mixtures

ABSTRACT Population increases everyday which yields to usage of more vehicles for transportation of people and goods which causes increased amount of produced and scrap tires. Storage of scrap tires requires large areas which can be a problem. Scrap tires can also damage environmental, susceptible to fire and may cause health problems for people. Civil engineering applications such as construction of embankments and retaining walls can be a good option for using scrap tires in an environmental friendly way. Mixing some amount of scrap tire with soil to construct embankment and retaining wall can serve as a safe deposition of scrap tires and meet deformation requirements. Therefore, strength properties of scrap tires and soil mixtures should be investigated and determined. In this study, tire crumbs are mixed with sand, fine soil and sand-fine soil’s various mixtures. Mixtures are prepared by adding 10%, 20% and 30% tire crumbs by weight of mixtures. Maximum unit weight and optimum water content are determined. Direct shear test is conducted to determine shear strength properties, shear modulus and dilatancy behaviour of mixtures. Tire crumbs decreases unit weight of soil, increases angle of friction of soil. Optimum amount of tire crumb is found 20% of the soil.

"Constructing a health assessment questionnaire for people with intellectual disabilities: A cognitive interview study".

Health assessment instruments can help to raise awareness among general practitioners of specific health problems in people with intellectual disabilities (PID). The present authors developed a health assessment questionnaire using the cognitive interview technique (CI) to improve the comprehensibility. The utility of this approach to questionnaire development involving PID is assessed. A qualitative approach using the CI was employed. The study included PID and their caregivers. The present authors interviewed 14 participants in 5 subsequent rounds. After each round, the questionnaire was adjusted until saturation was reached. Three hundred and sixty three identified problems led to 316 changes to the questionnaire. Most problems (102) concerned the comprehension of the question, followed by problems in the "missing answer categories" and "inaccurate instruction" section. The comprehensible health assessment questionnaire can help PID to take an active role in communication with their GP. The use of CI helped to improve the questionnaire. CI is a usable and valuable procedure for PID.

Gambaran Pelaksanaan Deteksi Dini Inspeksi Visu L Asam Asetat (IVA) Terhadap Kejadian Kanker Serviks Pada Wanita Usia Subur Di Puskesmas Purwojati

Cancer is a health problem for people around the world, according to data from the World Health Organization (WHO), cervical cancer contributes 12% of all cancers affecting women and is the second leading cause of death for women in Indonesia after breast cancer. Every day, it is estimated that 41 new cases occur and 20 women die from the disease. Because of the high risk factors for this disease, women should do early detection, one of which is the Acetic Acid Visual Inspection (IVA) method. This method is relatively simple, comfortable and practical. IVA is a method for early detection of cervical cancer using 3-5% acetic acid, and has an accuracy of 90%. The purpose of this study was to determine the implementation of early detection of IVA on the incidence of cervical cancer in women of childbearing age in the Purwojati Health Center, Banyumas Regency. The research design used an analytic survey with a cross sectional approach. The sampling technique used accidental sampling. Data processing was carried out by using the Chi-Square (X2) test.&#x0D; The results showed that the incidence of cervical cancer was 15%, most women of childbearing age did not perform early detection of cervical cancer with the IVA method because of ignorance and shame.

The complexities of the borderline patient: how much more complex when considering physical health?

Borderline Personality Disorder is associated with a substantially reduced life expectancy, mostly due to physical health conditions that are life-shortening. This clinical review highlights pertinent risk issues for such conditions in Borderline Personality Disorder and suggests ways in which clinicians might address these. Selective literature review. People with Borderline Personality Disorder have a reduced life expectancy of some 20 years, attributable largely to physical health maladies, notably cardiovascular. Risk factors include obesity, sedentary lifestyle, poor diet and smoking. Added to these are other physical health problems, including poor sexual health, self-harm, substance use and blood-borne viruses. Chronic pain and opioid and benzodiazepine use are also common in people with Borderline Personality Disorder. Some psychiatric medications commonly used in people with Borderline Personality Disorder - notably certain antipsychotic agents - can add to the metabolic burden. Barriers to care include self-stigma and erratic adherence to medical care, as well as stigma on the part of clinicians, who often do not screen or provide adequate care for the physical health problems suffered by people with Borderline Personality Disorder. Clinicians need to be aware of the physical health problems in people with Borderline Personality Disorder and ensure appropriate screening and interventions, both preventative and therapeutic, are offered routinely.

Promoting physical activity through exergaming in young adults with intellectual disabilities: a pilot study

Various health problems of people with intellectual disabilities (ID) are associated with their physical inactivity. The present study aimed at the understanding of physiological and psychological responses toward exergaming in seven young adults with mild to moderate ID after a single-session and a multiple-session condition, respectively. Their heart rate (HR), the rating of perceived exertion (RPE), and physical activity enjoyment scale (PACES) were measured on control and exergaming sessions. The significant increased HR, which may represent the increased physical activity levels that led to energy expenditure, was observed after a single-session and a multiple-session condition. In addition, the significant increase in RPE and PACES were evident after a single-session condition but a multiple-session condition. The feeling of physical fatigue seems to be distracted by external motivators (e.g. music). However, the positive affectivity to exercise was not noted when exercise was scheduled as their daily routines. This phenomenon might explain the high prevalence of physical inactivity among this population.

STUDY OF SURGICAL MANAGEMENT AND COMPLICATIONS OF DIABETIC FOOT ULCER

Introduction: Diabetes is one of the most prevalent metabolic chronic diseases due to the imbalance production of insulin. One of the studies reported that in 2010 worldwide 285 million adults had diabetes and this figure may be increase to 439 million by the year 2030. Globally Diabetic foot ulcers (DFUs) constitute major health problem in people that significantly contribute to morbidity and mortality in diabetes patients. Approximate 1.0% to 4.1% of the annual population-based incidences of a diabetic foot ulcer (DFU) were reported. Due to this the lifetime may be as high as 25%. In Asian countries diabetic foot ulcer are major problems which are different from European countries or developing countries. From many studies reported diabetic foot problems in India are infectious and neuropathic in nature as compared to developed countries. According to World Health Organization (WHO) diabetic foot is defined as lower limb of a diabetic patient characterized by infection, potential risk of pathologic consequences ulceration or destruction of deep tissues associated with neurological abnormalities, various changes in peripheral neuropathy vasculopathy and superimposed infection that are mainly responsible foot ulceration. Ulcers are one kind of abscess which is difficult to treat because of poor wound healing that result from a combination of neuropathy, ischemia and hyperglycemia. &#x0D; Aim: The main objective was to study the outcome of treatment modalities and it’s relating factors to complication in diabetic foot ulcer. Material and method: Total 60 diabetic foot ulcer patients with the age range from 20 to 70 years were included. From all the patients’ detailed past and present history were recorded. For all the patients, general, physical and local and systemic examinations were also done. Detail laboratory examination like Fasting and Post Prandial Blood sugar levels, blood count, ECG, ESR, complete urine examination for the presence of ketone bodies and sugar, x-ray as well as culture and sensitivity of the discharge from ulcer were also done. Patients were treated with various treatment methods like conservative treatment, split skin grafting and amputation.&#x0D; Result: In this study male patients were more in proportion as compared to female. This study showed that maximum with the age group 14 -50 (43.3%) years old followed by 18.3% in 31-40 years old, 16.7% in 61-70 years old. 6.7% showed the least age group as 20 -30 years old. Out of total 60 patients, 38.3% of the patients showed diabetic ulcer foot which was more whereas 15% showed diabetic gangrene foot which was least. 25% showed diabetic cellulites foot and 21.7% showed as diabetic abscess foot. &#x0D; Conclusion: Globally as diabetes mellitus cases are increasing and it became rapidly the public health problem. This may be due to burden on economy, health system and on society to manage the diabetic foot problems. Diabetic foot management guidelines must be made into our practice protocols which may preventing limb loss, and decrease mortality and increase the quality of life of the patient. Hence for this it is only possible with the help of foot care education and health care workers. Hence, foot infection is to put first and care for it like hands.&#x0D; Keywords: Diabetes, foot ulcers, infections, amputations.

Human immunodeficiency virus and hepatotropic viruses co-morbidities as the inducers of liver injury progression.

Hepatotropic viruses induced hepatitis progresses much faster and causes more liver- related health problems in people co-infected with human immunodeficiency virus (HIV). Although treatment with antiretroviral therapy has extended the life expectancy of people with HIV, liver disease induced by hepatitis B virus (HBV) and hepatitis C virus (HCV) causes significant numbers of non-acquired immune deficiency syndrome (AIDS)-related deaths in co-infected patients. In recent years, new insights into the mechanisms of accelerated fibrosis and liver disease progression in HIV/HCV and HIV/HBV co-infections have been reported. In this paper, we review recent studies examining the natural history and pathogenesis of liver disease in HIV-HCV/HBV co-infection in the era of direct acting antivirals (DAA) and antiretroviral therapy (ART). We also review the novel therapeutics for management of HIV/HCV and HIV/HBV co-infected individuals.