Preventable Amputations Research Articles

Role of Dashanga Lepa in Prameha Pidika

Diabetes is a sickness recognized for its multifaceted headaches. Diabetic ulcer is one of the primary complications of diabetes. Diabetes impacts more than 8% of Indian person population. Up to 25% of diabetic sufferers develop foot ulcers. greater than 1/2 of foot ulcers come to be inflamed and require hospitalization and 20% of infections outcomes in amputation. Early powerful control can reduce the severity of complications along with preventable amputations and viable mortality and can also enhance universal pleasant of lifestyles. thousands of researches are being executed in this in which Ayurveda has a main role. distinctive numbers of Prameha Pidakas are cited in Ayurvedic Classics, according to Acharya Sushruta there are 10 distinctive styles of Prameha Pidakas. Dashanga Lepa is a poly herbal practice of Ayurveda, used to treat many skin ailments and Prameha Pidaka. In this article details description regarding Prameha Pidaka and Dashanga Lepa is explained.

Travmatik Diz Çıkıkları

Traumatic knee dislocations are a serious injury that threatens the entire extremity, requiring urgent evaluation and a multidisciplinary approach. The high frequency of limb-threatening vascular injury, misdiagnosis of knee injury, or failure to assess the limb's vascular status will result in a large number of potentially preventable amputations. We tried to demonstrate with case examples that this situation should be investigated carefully and aggressive treatment is mandatory in our study. 8 patients who applied to Pamukkale University Orthopedics and Traumatology Clinic and Alaşehir State Hospital Orthopedics and Traumatology Clinic in the last 3 years due to traumatic knee dislocation were evaluated. It was revealed that the group with multiple ligament injuries and neurovascular injuries, which is in the subgroup according to the Schenck classification, was the worst injury group according to the postoperative evaluation tests. It has been shown that postoperative Lysholm and Cincinnati scores of patients in the KD II group with isolated cruciate ligament injury without collateral ligament injury were better than other injuries.Among the patients in the KD I group, it was shown that the postoperative Lysholm and Cincinnati scores were relatively better in the group with anterior cruciate ligament (ACL) injury compared to the group with posterior cruciate ligament (PCL) injury.Management of these serious injuries, the importance of post-operative rehabilitation comes to the forefront with the early and appropriate intervention of experienced orthopedic surgeons with a multidisciplinary approach, as well as the high awareness in terms of neurovascular injuries.

A review of Wagner classification and current concepts in management of diabetic foot

Diabetic foot is a common complication of diabetes mellitus which affects 15% of diabetic patients in their lifetime. Effective management of diabetic foot can reduce severity of complications such as preventable amputations and possible mortality, and can also improve overall quality of life. The Wagner classification is most commonly used for grading diabetic foot ulcers. Wagner developed a classification system and a treatment algorithm for each grade of ulcer. He asserted that ischemic index derived from Doppler flow pressures is an essential baseline test to predict ulcer healing. The aim of this study was to evaluate and manage different lesions of diabetic foot according to Wagner classification. We propose a treatment-oriented assessment of diabetic foot ulcers based on a cross-examination of the medical, foot, and wound history; a systemized and detailed physical examination; and the results of complementary diagnostic procedures. The pathophysiology and treatment of diabetic foot ulcers are reviewed. While these guidelines cannot dictate the care of all affected patients, they provide evidence based guidance for general patters of practice.

Conceptual Study on Prameha Pidakas w.s.r. to Skin Lesions In Diabetes

Diabetes is a disease known for its multifaceted complications. Diabetic ulcer is one of the major complications of diabetes. Diabetes affects more than 8% of Indian adult population. Up to 25% of diabetic patients develop foot ulcers. More than half of foot ulcers become infected and require hospitalisation and 20% of infections results in amputation. Early effective management can reduce the severity of complications such as preventable amputations and possible mortality and can also improve overall quality of life. Thousands of researches are being carried out on this in which Ayurveda has a major role. Different numbers of Prameha Pidakas are mentioned in Ayurvedic Classics. According to Sushruta there are 10 different types of Prameha Pidakas. Diagnostic pictures of these 10 are presented here w.s.r. to diabetic skin lesions with the brief treatment aspect. This article gives the obvious view for the diagnosis and treatment modalities of Prameha Pidakas.

Amputation trends for patients with lower extremity ulcers due to diabetes and peripheral artery disease using statewide data

ObjectiveThis study reports all-payer amputation rates using state-based administrative claims data for high-risk patients with lower extremity (LE) ulcers and concomitant peripheral artery disease (PAD), diabetes mellitus (DM), or combination PAD/DM. In addition, we characterize patient factors that affect amputation-free survival. We also attempted to create a measure of a patient's ability to manage chronic diseases or to access appropriate outpatient care for ulcer management by accounting for hospital and emergency department (ED) visits in the preceding 60 days to determine how this also affects amputation-free survival. MethodsPatients admitted to nonfederal hospitals, seen in an ED, or treated in an eligible ambulatory surgery center within California from 2005 through 2013 with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for a disease-specific LE ulcer were identified in the California Office of Statewide Health Planning and Development database. All subsequent hospital, ED, and ambulatory surgery center visits and procedures are captured to identify whether a patient underwent major amputation. Yearly amputation rates were determined to analyze trends. Amputation-free survival for the PAD, DM, and PAD/DM groups was determined. Cox modeling was used to evaluate the effect of patient characteristics. ResultsThere were 219,547 patients identified with an incident LE ulcer throughout the state. Of these, 131,731 were DM associated, 36,193 were PAD associated, and 51,623 were associated with both PAD and DM. From 2005 to 2013, the number of patients with LE ulcers who required inpatient admission, presented to the ED, or had outpatient procedures was stable. However, there was a statistically significant increase in overall disease-associated amputation rates from 5.1 in 2005 to 13.5 in 2013 (P < .001). Patients with PAD/DM had the greatest increase in amputation rates from 10 per 100 patients with LE ulcers in 2005 to 28 per 100 patients in 2013 (P < .001). Despite that patients with PAD/DM were 8 years younger than patients with PAD only, they had similar amputation-free survival. Within all age groups, men had worse amputation-free survival than women did. Race did not predict amputation-free survival, but having multiple prior ED or hospital admissions was a significant predictor of worse amputation-free survival. ConclusionsPotentially preventable amputations associated with high-risk diseases are increasing among patients who require inpatient hospital admission, present to the ED, or require outpatient interventional treatment. This trend is most notable among patients with a combination of PAD and DM. Patients with repeated hospitalizations before admission for the LE ulcer had the highest risk of amputation.

Preventing foot complications in diabetes: the St Vincent Declaration 26 years on

Preventing foot complications in diabetes: the St Vincent Declaration 26 years on

Amputation Risk in Patients with Diabetes Mellitus and Peripheral Artery Disease Using Statewide Data

Conflicting data exist regarding changes in amputation rates in patients with ulcers because of diabetes mellitus (DM) and peripheral artery disease (PAD). This study focuses on how population-based amputation rates are changing in the current treatment era. Using the California Office of Statewide Health Planning and Development Patient Discharge database, all patients who underwent major nontraumatic lower extremity (LE) amputation in 2005 through 2011 were identified. Age-adjusted population-based amputation risk was determined by year. Gender and age trends in amputation risk were estimated separately for diabetes-related amputations and PAD-related amputations, treating all California residents as the population at risk. From 2005 to 2011, 32,025 qualifying amputations were performed in California. Of these, 11,896 were DM-associated (n = 1,095), PAD-associated (n = 4,335), or associated with both conditions (n = 6,466). PAD-associated amputation rates and combined PAD/DM-associated amputation rates have changed little since 2009 after decreasing substantially over the prior 5 years, but DM-associated amputation rates have continuously increased since 2005. California residents older than the age of 80 years had the most dramatic decrease in PAD-associated amputation rates from 2005 to 2011 (i.e., from 317 to 175 per million Californians). Men with PAD/DM had amputation rate 1.5 times higher than those of patients with PAD alone and 5 times higher than rates of DM patients. In women the difference between patient with PAD and PAD/DM was not seen; however, these rates were 2.5 times higher than patients with DM alone. Preventable amputations associated with high-risk diseases are no longer decreasing despite continuing advances in care and education. Octogenarians with PAD represent the highest risk group for amputation, but DM-associated amputations have increased since 2005. Further research to understand treatment pathways for patient with LE wounds may shed light on pathways for amputation prevention in the future.

Literature review on the management of diabetic foot ulcer.

Diabetic foot ulcer (DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime. Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it's suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications.

Characteristics of patients with psoriasis and Type 2 diabetes in a central China case-control study

ejd.2012.1680 Auteur(s) : Xue-Chao Xu, Ai-Ping Feng feng-aiping@medmail.com.cn Department of Dermatology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Psoriasis is considered as a systemic disease due to the increase in incidence of cardiovascular events and prevalent cases of T2DM, which is the leading cause of end-stage renal disease, preventable amputations, blindness and cardiovascular disease [1, 2]. The etiology of psoriasis [...]