Diabetic foot ulcers (DFU) is a lesion of all layers of skin, necrosis or gangrene that occurs in the soles of the feet in diabetes mellitus (DM) patients, caused by: (1) causative factor (peripheral neuropathy, high foot plantar pressure and trauma); (2) contributive factors (atherosclerosis and diabetes). The treatments of diabetic ulcers consist of determining and repairing the underlying cause of ulcer, good wound care and prevention of ulcer recurrence. The cause of diabetic ulcers can be determined by deep anamnesis and physical examination. DFU therapy includes necrotomy/debridement, reducing the load/pressure on the offensive area, manage the infection by diagnosing the type of bacteria, providing adequate antibiotics and ulcer treatment using wound dressing clean and moist.

Diabetic foot ulcer (DFU) is among the many complications of diabetes and it takes a very long period of time to heal. It can lead to the amputation of the lower limb, thereby resulting to death or in most cases, a bad quality of life. The aim and objective of this study is to assess the effect of bitter melon leaves extracts on serum TNF-α levels and improvement of diabetic foot ulcers. The study technique used here is the randomized, double-blinded, placebo-controlled trial. Thirty patients suffering from DFU participated in the trial and according to PEDIS scores were divided into two groups, of which 15 patients were in the treatment group and administered with bitter melon leaves extract at a dose of 6 g/day and the remaining 15 patients were in the control group and were given placebo. This intervention was done for 4 weeks and the examination of serum TNF-α levels was carried out at baseline and at the end of treatment. The readings of the healing process for diabetic foot ulcers with PEDIS scores were also taken at baseline, weeks 2, 3 and 4. Data were analyzed using the paired t-test and the independent t test. After 4 weeks of treatment, there was a decrease in baseline serum TNF-α levels in the treatment and control groups (29.5 ± 8.6 pg/ml, P = 0.0001 and 202.5 ± 610.2 pg/ml, P = 0.001). There was no effect on serum TNF-α levels (P = 0.28). There was a decrease in PEDIS degrees from baseline, week 2, 3 and 4 in the treatment and control groups (2.7±0.5; 2.7±0.5; 2.7±0.6; 1.9±0.6 and 2.6±0.5; 2.6±0.5; 2.5±0.6; 2.2±0.8). However there was no effect on diabetic foot ulcer improvement both groups in week 2 (P = 0.46), week 3 (P = 0.57) and week 4 (P = 0.29). Bitter melon leaves extracts is proven to have no effect on the serum TNF-α levels and improvement of diabetic foot ulcers.

Masalah kesehatan yang terjadi pada lansia umumnya adalah penurunan fungsi organ yang memicu terjadinya berbagai penyakit degeneratif termasuk hipertensi. Penyakit degeneratif pada lansia jika tidak ditangani dengan baik maka menurunkan kualitas hidup lansia. Hipertensi merupakan suatu gejala penyakit degeneratif kardiovaskuler yang paling banyak di alami oleh lansia dan belum dapat diketahui dengan pasti penyebabnya. Penatalaksanaan hipertensi pada lansia selain dengan farmakologi dapat pula dilakukan dengan non farmakologi seperti senam hipertensi. Penelitian ini bertujuan untuk mengetahui pengaruh senam hipertensi lansia terhadap penurunan tekanan darah lansia dengan hipertensi di Panti Wredha Darma Bhakti Kelurahan Pajang Surakarta. Penelitian ini adalah penelitian kuantitatif dengan rancangan preexperiment design One Group Pre test-post test. Pengumpulan data menggunakan Sphygmomanometer air raksa, sedangkan analisis data menggunakan uji Wilcoxon Signed Rank Test. Hasil dari penelitian ini adalah tekanan darah sebelum pemberian intervensi sebagian besar adalah prehypertension (39%), tekanan darah setelah pemberian intervensi senam hipertensi sebagian besar adalah normal (56%), danterdapat pengaruh senam hipertensi terhadap tekanan darah lansia di Panti Wredha Dharma Bhakti Pajang Surakarta (p-value = 0,001).

Masalah kesehatan yang terjadi pada lansia umumnya adalah penurunan fungsi organ yang memicu terjadinya berbagai penyakit degeneratif termasuk hipertensi. Penyakit degeneratif pada lansia jika tidak ditangani dengan baik maka menurunkan kualitas hidup lansia. Hipertensi merupakan suatu gejala penyakit degeneratif kardiovaskuler yang paling banyak di alami oleh lansia dan belum dapat diketahui dengan pasti penyebabnya. Penatalaksanaan hipertensi pada lansia selain dengan farmakologi dapat pula dilakukan dengan non farmakologi seperti senam hipertensi. Penelitian ini bertujuan untuk mengetahui pengaruh senam hipertensi lansia terhadap penurunan tekanan darah lansia dengan hipertensi di Panti Wredha Darma Bhakti Kelurahan Pajang Surakarta. Penelitian ini adalah penelitian kuantitatif dengan rancangan preexperiment design One Group Pre test-post test. Pengumpulan data menggunakan Sphygmomanometer air raksa, sedangkan analisis data menggunakan uji Wilcoxon Signed Rank Test. Hasil dari penelitian ini adalah tekanan darah sebelum pemberian intervensi sebagian besar adalah prehypertension (39%), tekanan darah setelah pemberian intervensi senam hipertensi sebagian besar adalah normal (56%), danterdapat pengaruh senam hipertensi terhadap tekanan darah lansia di Panti Wredha Dharma Bhakti Pajang Surakarta (p-value = 0,001).

Objective: This study aims to prove the effect of supplementation of bitter melon leaves extract on glycemic status in diabetic foot ulcer (DFU). Materials and Methods: This study used a randomized, double-blinded, and placebo-controlled trial. Thirty DFU patients based on PEDIS 1-8 scores who met the criteria were divided into 2 groups consisting of 15 patients as a treatment group with the administration of bitter melon leaves extract at a dose of 6 g/day and 15 patients as a control group of with placebo. This intervention was conducted in 4 weeks. Glycemic status was measured by the value of glycated albumin and examined at baseline and at the end of treatment. Data were analyzed using paired t-test and independent t-test. Results: After 4 weeks of treatment, there was an increase in the baseline value of glycated albumin in the treatment group from 24.5 ± 11.7% to 25.8 ± 12.7% or an increase of 1.3 ± 6.3% and a decrease in the control group from 27.5 ± 13.1% to 25.8 ± 8.5% or a decrease of 1.7 ± 12.4%. The results of the analysis of the effect of supplementation of bitter melon leaves extract on the value of glycated albumin were not significant (p = 0.99). Conclusion: The supplementation of bitter melon leaf extract with a dose of 6 g / day did not significantly affect the value of glycated albumin. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.281-287