Masters Degrees (Health Systems and Public Health)

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Browsing Masters Degrees (Health Systems and Public Health) by browse.metadata.advisor "Kondange, Chaitanya Shivshankar"

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    A retrospective review of diabetic foot ulcers treated with hyperbaric oxygen therapy in the Kingdom of Bahrain
    (Stellenbosch : Stellenbosch University, 2020-03) Alzaben, Ghadeer Salman; Meintjes, W. A. J.; Smart, Hiske; Kondange, Chaitanya Shivshankar; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Healthy Systems and Public Health.
    ENGLISH ABSTRACT : Background: Diabetic foot ulcer (DFU) is a common complication of uncontrolled diabetes mellitus (DM). Ulcers can be neuropathic, ischemic or neuro-ischemic. Its impact on the patient can be dramatic and can lead to amputation and loss of limb function. Hyperbaric oxygen therapy (HBOT) is used as an adjunct treatment to hasten the healing process or limit the extent of the damage caused by ischemia or necrotizing fasciitis. Since patients respond differently to HBOT, this study was carried out to identify factors that influence their response to the treatment after appropriate initial selection. Methods: We performed a case-control study of all patients with DFU treated in the hyperbaric and wound care unit at the King Hamad University Hospital between January 2013 and December 2018. Patients’ data were obtained upon patient hospital visit from clinical records. Various baseline factors were compared between patients with and without adequate HBOT treatment responses. Results: A total of 123 patients (cases n= 75 and controls n=48) were included in the study. There was no significant difference in age, gender, duration of DM, weight and body mass index between the groups (p>0.05). Cases group (11.9 ± 4.9 ) had higher white blood cell count than the control group (10.1 ± 3.7) (p=0.038). Haemoglobin level was significantly lower in the cases (11.4 ± 1.7 mg/dl) compared to control group (12.3 ± 1.7 mg/dl) (p=0.009). The number of patients who had new breakdown (19% cases and 4% control) and had smell wounds (45% cases and 21% control) were significantly higher in cases group compared to the control (p<0.03). Conclusion: Inflammation and haemoglobin status are major factors influencing wound healing in diabetic patients with ulcer subjected to HBOT.