No abstract

Diabetic foot ulcer is the most devastating complication of diabetes that is still un-recognized. The treatment costs of these ulcers are very high to eventually save the leg/foot from amputation. To date, clinicians employ visual inspection of the wound site during its standard 4-week of healing process via monitoring of surface granulation. There is a need to develop on-site, low-cost imaging tools that can monitor the wound healing process periodically during the standard 4-week treatment process. A novel ultra-portable near-infrared optical scanner (NIROS) has been developed at the Optical Imaging Laboratory that can perform non-contact 2D area imaging of the wound site. Non-contact optical imaging studies were carried on diabetic subjects with foot ulcers (at Somesh Diabetic Foot Clinic, India) that were of healing and non-healing nature. A 710 nm LED source and a compact NIR sensitive camera were employed during non-contact imaging of the diabetic foot in order to obtain the near-infrared absorption images. From these preliminary studies it was observed that the non-healing wounds had a greater absorption contrast with respect to the normal site, unlike in the healing wounds. Demonstrating the ability of NIROS to differentiate healing vs. non-healing wounds in diabetic subjects can potentially impact early intervention in the treatment of diabetic foot ulcers.

Background: Patients receiving radiation therapy suffer from ill effects of cancer as well as the side effects of radiation therapy. In this study, we prepared a nutritional supplement therapy and ambulation plan for the patients and assessed the improvement in physical activity and decrease in fatigue.Methods: The patients who had completed at least 3 sittings of radiotherapy in the oncology ward were selected by non-probability purposive sampling method. 60 patients were divided equally into experimental and control group. In the experiment group patients were given porridge three times a day and made to walk after drinking the porridge every day for 25 days. In both groups, post test was conducted. The data obtained was analyzed using descriptive and inferential statistics.Results: All the patients in both the groups had fatigue before the intervention. After the intervention on 30th day, 7 (23.3%) patients had mild fatigue, 23 (76.70%) had moderate fatigue and there was none with severe fatigue in the experimental group. In the control group, fatigue level became severe in 3 (10.00%) patients and remained same in others. In the experimental group, significant improvement was shown in performing physical activities after the intervention. 9 (30%) showed good physical activity, 12 (40.00%) showed moderate activity after the intervention in the experimental group.Conclusions: As there was a significant reduction in the level of fatigue and improvement in the level of physical activity in the experimental group after the intervention which could be attributed to the effect of nutritional supplement therapy and ambulation.

Background: Foot infection is one of the commonest reasons for hospital admission of individuals with diabetes in India. Prescription footwear is an intricate aspect of a treatment program, not a therapy unto itself. Custom-made footwear can only be effective in preventing diabetic foot ulcers if worn by the patient as advised. This study was done in patients who are already prescribed customised footwear and evaluated the need for compliance based on the healing of these plantar foot ulcers.Methods: 85 diabetic patients with severe neuropathy and a non-healing callus ulcer or trophic ulcer (diameter 1-3 cm) for more than 3 months were included in the study. All these patients were followed up on weekly basis for 3 months and questioned about the use of customized footwear on regular basis. At the end of three months, the healing of these foot ulcers was compared based on whether they had been compliant with the customized footwear advice.Results: Of the 85 patients, 25 (29.4%) had shown improvement in wound healing with regular use of footwear. 60 (70.5%) patients who were not using the customized footwear had not shown any improvement in the plantar ulcers. The reasons for not using the recommended footwear were many commonest being wearing footwear only when going out and not inside the home.Conclusions: Non-compliance with customised footwear is emerging as an important cause of delay in wound healing of plantar foot ulcers.