Knowledge, Practice and Barriers of Diabetic Foot Ulcer among Diabetic Patients in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia, 2017

Background: In 2013, globally, there are an estimated 382 million people living with diabetes. In 2005 worldwide 3 %–10 % of people with diabetes have a diabetic foot ulcer. Ethiopian diabetic patient’s foot ulcer is main health problem. Diabetic Foot ulcer associated with sepsis results in 12% of death. Understanding of the important factors of diabetic foot ulcer in diabetics’ patients will enable high-risk patients to be recognized early.Objectives: To determine knowledge, practice and barriers of diabetic foot ulcer among diabetic patients in Hawassa University Comprehensive Specialized Hospital, Southern EthiopiaMethods: Hospital based cross sectional study was conducted among diabetic patients who have follow up in HCSH from April to May, 2017 GCA. A total of 139 diabetic patients were included in the study. The final study participants were selected using simple random sampling technique. The data was collected through interview method. Data was analyzed using SPSS version 20.00. Multivariate logistic regression was carried out to identify factors associated with diabetic patients. Adjusted odds ratios with 95% CI were computed to measure the associations between the outcome variable. A p-value of less than 0.05 was considered as significant result.Results: In this study 27.3% and 46.8% diabetic patients have good knowledge and practice of diabetic foot ulcer care respectively. The mean score knowledge and practice was 7.1±4.63 and 8.77± 2.27 respectively. Practice of diabetic foot ulcer was significantly associated with female diabetic patients [AOR=0.42; 95% CI: 0.21, 0.86], did not use moisturizer for diabetic foot ulcer care [AOR=0.41; 95% CI: 0.20, 0.85], heard about diabetic foot ulcer care [AOR=36.99; 95% CI: 4.58, 6.95], and age of diabetic patients >=61 years [AOR=3.94; 95% CI: .25, 2.38] were significant factors for knowledge of diabetic patients about diabetic foot ulcer care.Conclusion and recommendation: Significant proportion of diabetic patients has good knowledge about diabetic foot ulcer care. Just 46.8% diabetic patients have good practice of diabetic foot ulcer care. Gender and use moisturizer were significant factors with practice of diabetic foot ulcer care. So, more effort should be put into creating awareness about diabetic foot ulcer. Emphasis also needs to be given for diabetic patients in the age group between greater than or equal to 61 years. Keywords: diabetic patients, diabetic foot ulcer, knowledge, practice, and barrier Introduction

Knowledge, Practice and Barriers of Diabetic Foot Ulcer Among Diabetic Patients in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia, 2017

Background: In 2013, globally, there were an estimated 382 million people living with diabetes. In 2005 worldwide 3 %–10 % of people with diabetes have a diabetic foot ulcer. Ethiopian diabetic patient’s foot ulcer is main health problem. Diabetic Foot ulcer associated with sepsis results in 12% of death. Understanding of the important factors of diabetic foot ulcer in diabetics’ patients will enable high-risk patients to be recognized early.Objectives: To determine knowledge, practice and barriers of diabetic foot ulcer among diabetic patients in Hawassa University Comprehensive Specialized Hospital, Southern EthiopiaMethods: Researcher conducted a  hospital based cross sectional study among diabetic patients who were followed-up in HCSH  from April to May, 2017 GCA.A total of 139  diabetic patients were  included  in  the  study.  Study participants were selected using simple random sampling technique. The data was collected through interview method.  Data was analyzed using SPSS version 20.00.Multivariate logistic regression was carried out to identify factors associated with diabetic patients. Adjusted odds ratios with 95% CI were computed to measure the associations between the outcome variable. A p-value of less than 0.05 was considered as significant result.Results: Out of 139 diabetic patients, 27.3% and46.8% diabetic patients have good knowledge and practice of diabetic foot ulcer care respectively. The mean score knowledge and practice was 7.1±4.63 and 8.77± 2.27.  Practice of diabetic foot ulcer was significantly associated with being female  [AOR=0.42;  95%  CI:  0.21,  0.86],  not  using  moisturizer  for  diabetic  foot  ulcer  care [AOR=0.41; 95% CI: 0.20,  0.85], hearing  about diabetic foot ulcer care [AOR=36.99; 95% CI: 4.58, 6.95], and age of patients >=61 years [AOR=3.94; 95% CI: .25, 2.38] Conclusion and recommendation: Significant proportion of diabetic patients has good knowledge about diabetic foot ulcer care.  Nearly half of diabetic patients have good practice of diabetic foot ulcer care. Gender and use moisturizer were identified factors with practice of diabetic foot ulcer care. So, more effort should be put into creating awareness about diabetic foot ulcer. Emphasis also needs to be given for diabetic patients< 61 years old Keywords: diabetic patients, diabetic foot ulcer, knowledge, practice, and barrier

HUBUNGAN TINGKAT DEPRESI DENGAN DERAJAT DIABETIC FOOT ULCER PADA PASIEN RAWAT JALAN DI POLIKLINIK ENDOKRIN RSUD DR. ZAINOEL ABIDIN BANDA ACEH

ABSTRAKPasien diabetic foot ulcer umumnya mengalami hambatan dalam sosialisasi sehingga mengalami depresi. Depresi dapat menyebabkan supresi sistem imun yang berkaitan dengan derajat ulkus yang ditimbulkan. Tujuan penelitian ini adalah untuk menganalisis hubungan antara tingkat depresi dengan derajat diabetic foot ulcer. Penelitian ini merupakan penelitian analitik observasional dengan rancangan cross sectional. Penelitian ini menggunakan metode wawancara dengan kuesioner BDI dengan jumlah responden 38 orang. Hasil analisis korelatif dengan uji Spearman menunjukkan adanya hubungan kuat (r = 0,731) antara tingkat depresi dengan derajat diabetic foot ulcer p= 0,000 (

Correlation of HDL cholesterol serum and Wagner’s severity level of diabetic foot ulcers

Background: Diabetic foot ulcers are one of the leading causes of amputation in non-traumatic patients. This research aimed to investigate the correlation between the level of HDL cholesterol and the severity level of diabetic foot ulcer based on Wagner classification. The study conducted at Wahidin Sudirohusodo Hospital, Makassar, Indonesia.Methods: This is an observational study with the cross-sectional design. The data collected before and after the treatment. The change of the levels of HDL cholesterol and the severity level of the diabetic foot ulcer based on Wagner classification during the treatment were analyzed. Data analyzed using Spearman Correlation test, the paired t-test to assess the change in the levels of HDL cholesterol and the levels of severity of diabetic foot ulcer based on Wagner classification at the time admission and after the treatment.  ANOVA test was used to observe the reduction significance of the severity of diabetic foot ulcer based on Wagner classification, and it was categorized as significant if p<0.05.Results: The results indicated that there is a correlation between the level of HDL cholesterol and the severity level of diabetic foot ulcer based on Wagner classification either at the early treatment with p-value = 0.003 (r = - 0.448) and the end of the treatment with p-value = 0.001(r = - 0.477).  The lower of the level of cholesterol HDL, the higher was the severity level of the diabetic foot ulcer. Meanwhile, the correlation between the increase of the level of HDL cholesterol and the reduction of Wagner classification during the treatment was statistically insignificant with p-value = 0.100 (r = - 0.215).Conclusions: there was a correlation between elevated HDL cholesterol levels during treatment with Wagner classification decrease during treatment, the higher the HDL change, the higher the Wagner classification, but this was weak correlation and statistically insignificant

Pola Resistensi Bakteri Terhadap Antibiotik Pada Penderita Ulkus Diabetikum Di RSUP Dr. Soeradji Tirtonegoro Klaten Periode September 2014-Agustus 2015

Diabetic foot ulcer is characterized by open foot wounds in diabetic patients. If the infection is not properly treated the severity of infection will increase. A potent antibiotic against microorganism is needed for treating the infection. Increasing the use of antibiotics will have an impact on the development of bacterial resistance to antibiotics. The aim of this study was to determine the antibiotic resistance pattern of bacteria in patients with diabetic foot ulcer at X Hospital during September 2014-August 2015. This study was non experimental study with descriptive analytic method. This study with a retrospective design involved data collection from patient medical records, bacteria culture results, and antibiotic susceptibility testing results. The data were analyzed to determine the most bacteria to cause infection, the antibiotic resistance pattern of bacteria, and the appropriate use of antibiotic based on bacteria culture results and antibiotic susceptibility testing results. A total of 25 pathogens from 45 patients with diabetic foot ulcer were identified. Enterococcus sp. was the most bacteria found on infected foot wounds in diabetic patients 11 (13,4%), followed by Klebsiella sp. 9 (11,0%), and Staphylococcus aureus 8 (9,8%). Enterococcus sp. was resistant to meropenem (64%), amikacin (91%), ceftriaxon (82%), and cefixime (91%), then Klebsiella sp. and Staphylococcus aureus was resistant to ampicillin (100% and 67%). A total of 31,3% definitive antibiotics given to diabetic foot ulcer patients were appropriate with culture results and antibiotic susceptibility testing result. Keywords: Resistance pattern, diabetic foot ulcer, antibioti

A Single Case Study of Diabetic Foot Ulcer treated with Vrana Dhoopana and Kshara Picchu

In present scenario due to the sedentary lifestyle, diabetes mellitus has become common disease. Diabetic foot ulcer is a complication of diabetes mellitus which is the leading cause of lower limb amputations. It occurs in 15% of all patient with diabetes mellitus and precedes 84% of patients with diabetic foot ulcer which needs lower leg amputation. The management of diabetic foot ulcer requires blood sugar control, debridement, advanced dressing and offloading modalities. In Ayurvedic literature, Acharya Sushruta has described sixty treatment modalities, He has given more importance to Vranashodhana and Ropana. Acharya Vagbhatta has explained that Vranas which are caused by Madhumeha can be treated with Aragwadhadigana Dravyas, hence in the present study for Vrana Shodhanartha Prakshalana with Aragwadhadi Qwatha and Vrana Dhoopana by Guggulu, Nimba Choorna, Haridra, Jatyadi Ghrita were selected and for Vrana Ropanartha Jatyadi Taila was selected

Hubungan Spiritual Coping dengan Self Monitoring pada Pasien Diabetic Foot Ulcer

Spiritualitas yang dimiliki seorang penderita diabetes adalah sebuah kekuatan yang memberikan ketenangan dalam menghadapi penyakitnya. Individu dengan spiritual yang baik memungkinkan untuk melakukan perawatan diri yang positif. Perawatan yang baik tergantung pada bagaimana individu tersebut memanajemen dirinya atau self monitoring. Tujuan penelitian ini adalah untuk menganalisis hubungan Spiritual Coping dengan Self Monitoring pada Pasien Diabetic Foot Ulcer di RSUD Dr. H. Moch Ansari Saleh Banjarmasin. Penelitian kuantitatif ini menggunakan rancangan cross sectional. Teknik sampling menggunakan purposive sampling dan didapatkan 41 responden. Instrumen pengambilan data menggunakan kuesioner Brief RCope dan Self-Management Diabetes Melitus (SMDM).  Uji Analisa dengan korelasi spearman rank. Hasil Analisa dalam penelitian ini mayoritas responden berusia 45-59 tahun (51,2%) dengan jenis kelamin perempuan (61%) yang berpendidikan terakhir SD (39%). Mayoritas responden tidak bekerja dan semuanya berstatus menikah. Mayoritas menderita DM 1-5 tahun (51,2%) dan mayorita memiliki keluarga dengan Riwayat DM (61%). Hasil spiritual coping pada pasien diabetic foot ulcer dalam kategori negative (73,2%) denagn self monitoring yang buruk (75,6%). Hasil korelasi Spiritual Coping dengan Self Monitoring Pada Pasien Diabetic Foot Ulcer 0,000 dengan nilai r menunjukkan angka 0,811 yang mempunyai makna sangat kuat. Simpulan hasil penelitian ini adalah ada hubungan antara Spiritual Coping dengan Self Monitoring pada Pasien Diabetic Foot Ulcer di RSUD Dr. H. Moch Ansari Saleh Banjarmasin