Effect of socks structures on plantar dynamic pressure distribution Soltanzadeh, Zeynab; Shaikhzadeh Najar, Saeed; Haghpanahi, M ...
Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine,
11/2016, Volume:
230, Issue:
11
Journal Article
Peer reviewed
A major purpose of investigating the plantar pressure in patients with pain or those at risk for skin injury is to reduce the pressure below metatarsal heads, specially first and second metatarsal ...heads. The aim of this article is to evaluate the effects of the socks structures on the changes in plantar dynamic pressure. In this study, seven socks types with different structures for the sole area were produced. The Gaitview
AFA-50 system, a force plate, was used to measure the plantar dynamic pressure of 10 participants. The barefoot plantar dynamic pressure distribution was compared with the plantar dynamic pressure distribution with socks by two independent samples test on various zones of the foot and on different genders using SPSS software. Mann-Whitney tests were used to determine specific significant differences. The obtained results showed that the main trend was to redistribute the plantar dynamic pressure from the higher plantar pressure zones (toe and first through forth metatarsal bone regions) were decreased and as a result the plantar pressure toward the relatively lower pressure zones (fifth metatarsal bone and midfoot regions). In comparison with the barefoot condition, the cross miss structure reduced the mean pressure in the critical region of the foot (first metatarsal) for male and female subjects ( p < 0.05) and also the mock rib structure reduced the mean pressure for female subjects ( p < 0.05). In general, the results suggested wearing the socks because the socks make the plantar pressure redistributed from high to low plantar pressure zones. The results of this research indicated that wearing socks with cross miss and mock rib structures will reduce the mean plantar pressure values in forefoot area in comparison with the barefoot condition.
Diabetes as one of Non-communicable diseases has allocated a large proportion of cost, time and human resources of health systems. Now, due to changes in lifestyle and industrial process, incidence ...of diabetes and its complications have been increased. Accordingly diabetic foot considered as a common complication of diabetes.
Nurses are health care providers who actively involved in prevention and early detection of diabetes and its complications. The nurses’ role could be in health care, health, community education, health systems management, patient care and improving the quality of life.
Diabetes Nurses play their educating role in the field of prevention of diabetic foot, foot care and preventing from foot injury. In care dimension, nurses responsible for early detection of any changes in skin and foot sensation, foot care, dressing and apply novel technology.
In the area of rehabilitation, help patient sufferings from diabetic foot ulcer or amputation, to have movement are diabetes nurse’s duties.
Consequently, nurses need to attend in special training to use the latest instructions of diabetic foot care in order that provides the effective services to facilitate promote diabetic patients health.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Introduction
Providing health care to patients at home could be causing the mortality and readmission rates reduction in addition to satisfaction of both patients and health care providers increase. ...The aim of this study was to assess the cost-effectiveness of home care service compared to hospital based care in patients with diabetic foot ulcer.
Methods
An economic evaluation study and a trial study were simultaneously conducted in Iran. In trial phase, patients with diabetic foot ulcer were randomly assigned to the home care or hospital care. The Cost and Quality of life data were determined as measures of the study. Incremental cost-effectiveness ratio was calculated for comparative purposes. The model consisted of five stages of the disease. The Tree Age Pro 2009 and R software’s were used for data analysis.
Results
120 patients were enrolled in our trial; among which 30 patients were in home care service group and 90 patients in hospital based care group. The rate of ulcer size reduction in hospital based care was significant (
P
value = 0.003) in comparison with home care service. The total cost of the home care and hospital strategies were 1720.4 US$, 3940.3 US$ and the total effectiveness were 0.31 and 0.29, respectively. The incremental cost-effectiveness ratio (ICER) was 117,300 US$ per
quality-adjusted life year
for home care intervention compared to hospital based care. Based on ICER plane home care treatment will be placed on the southeastern quadrant of the Cost-Effectiveness Plane, and is suggested as a more dominant treatment alternative.
Conclusions
Regarding current evidence, home care strategy for patients suffering diabetic foot ulcer enjoys more cost effectiveness compared to hospital care. It is suggested that healthcare policy makers determine the tariff for health care services for disease groups according to the activity based costing approach.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Diabetic peripheral neuropathy (DPN) accounts for 80% of diabetic foot ulceration; therefore neurologic examination plays a critical role in screening at risk patients. Our objective was assessment ...the prevalence of DPN and related factors based on clinical findings.
This cross-sectional study was conducted on 124 diabetics who were randomly recruited from Diabetes Clinic of Dr. Shariati University Hospital (Tehran/Iran) in 2004. After gathering demographic data and blood sampling for fasting blood sugar (FBS), the questionnaires United Kingdom (UK), Michigan, Diabetic Neuropathy Score (DNS), and 10-g monofilament testing were administered. Analysis tests were chi-square, pearson correlation and logistic regression.
The patient's age ranged 17-75 years; with 44% male. Ninety one percent suffered from type two diabetes and the mean duration of diabetes was 10 years. The mean FBS level was 181.5 mg/dl. While the prevalence of DPN based on Michigan, DNS, and monofilament testing was about 32-38%, some 54% were diagnosed by UK test. Tingling in the lower extremity was the most frequent complaint (42%). The strongest linear correlation was reported between Michigan and DNS (r= 0.7), and then between monofilament test and DNS (r= 0.6). The age > 50 years, length of diabetes > 10 years, and FBS >200 mg/dl were the main risk factors for DPN based on DNS.
It seems that the combination of Michigan and monofilament test can provide an accurate screening tool for detecting DPN. In addition, tight glucose control, regular assessment of the lower extremity, and to educate diabetics is urged in elderly diabetics, longer duration of diabetes, and those with high FBS.
BACKGROUND AND OBJECTIVE:Diabetic foot ulcer is a major complication caused by diabetes. Electrical stimulation is considered as an efficient modality of diabetic wound healing. This study aimed to ...investigate the effects of direct-current stimulation of cathodal on skin temperature and acceleration of ischemic diabetic foot ulcer closing. METHODS:This randomized, single-blinded, clinical trial was conducted from November 2013 to September 2014 on 20 patients with type II diabetes suffering from ischemic diabetic foot ulcers. Subjects were randomly divided into two groups of electrical stimulation and placebo. The electrical stimulation group received direct-current cathodal stimulation to the wound for one hour a day, repeating three days a week (4 weeks, 12 sessions), and the placebo group underwent the same procedure with zero-intensity electrical stimulation. Skin surface temperature was measured in the plantar and dorsal areas of the diabetic foot before and after the intervention at sessions one, six and twelve. In addition, the surface of ulcer area was measured at the same intervals (IRCT: 2014110819854 N1). FINDINGS:Comparison of the study groups indicated the mean of skin temperature changes to be significantly higher in the stimulation group compared to the placebo group at sessions one (p=0.01, 0.41±0.2 and 0.75±0.26), six (p=0.01, 0.25±0.27 and 0.6±0.21) and twelve (P=0.007, 0.25±0.27 and 0.66±0.23), respectively. In addition, reduction of the wounded area was considerably higher in the electrical stimulation group (52.68%) compared to the placebo group (38.39%) at session 12 (p=0.02). CONCLUSION:According to the results of this study, direct-current cathodal stimulation could improve skin temperature and accelerate wound closing in ischemic diabetic ulcers.
Obesity is an important and life-threatening disease, associated with different chronic conditions such as cardiovascular disease, diabetes, and dyslipidemia. We sought to address the paucity of ...information on the trends of anthropometric indices such as weight, waist circumference, and body mass index in the adult population of Iran.
We drew upon data from the First Non-communicable Disease Survey in Iran in 2005. In total, 79,611 participants between 20 and 64 years old were selected via the random multistage cluster sampling. The Lambda Median Scale method was applied to construct normal curves for anthropometric indices.
The mean of waist circumference in both genders increased with age and in all the age groups except those between 20 and 24 years old was higher in the women. The mean of body mass index was higher in all the age brackets in the women, but the means of weight and height were higher in the men. The association of theses indices with diabetes, hypertension, and dyslipidemia was stronger in men.
The ranges of waist circumference and body mass index in Iranian population are different from those of other countries. The higher body mass index and waist circumference in females and the direct association between obesity and chronic diseases, is advisable that the effects of this phenomenon be fully investigated and due heed be paid to the importance of lifestyle modification.
According to WHO reports, the prevalence of diabetes is 10.3% in Iran with an approximate male to female ratio of 1:1 (1). ...the result of the recent multicenter study to assess the characteristics ...of patients with DF, suggested that amputation rate in hospital employing a multidisciplinary approach compared with another center was lower (23.7% compared to 30.1%).
Background and Objective: Respecting the patient's rights is one of the most important components of providing humanistic care and a priority in the field of medical ethics in Iran. Therefore, the ...charter of patients' rights in Iran was announced in 2009 as a practice guide in this field. This study was conducted with the aim of investigating the realization of patient rights from the viewpoint of doctors, nurses and patients hospitalized in selected departments of Shariati Hospital affiliated to Tehran University of Medical Sciences. Methods: This cross-sectional study was conducted in Tehran in 2016-2017 on 487 participants who were selected by convenience sampling method. The data collection tool was the questionnaire of patients' rights awareness. The scores obtained were based on the individual's point of view regarding the observance of the right in question and ranged from 1 (not observed at all) to 5 (completely observed). Findings: Based on the results of this study, doctors and nurses have reported less realization of patients' rights compared to patients. Patients, nurses and doctors, respectively, agree with the greater realization of patient rights in the areas of observance of justice (4.54±0.96), being polite to the patient (4.17±0.90), and quality of service in a scientific sense (3.37±0.85). In addition, patients reported less realization of patients' right in the areas of responsibility and accountability (3.03±1.59) (p=0.000), and nurses and doctors reported less realization of patients' rights in the areas of attention to the patient's well-being and comfort (3.45±0.99) and (2.48±0.84) (p=0.000). Conclusion: The findings of the study showed that, in general, the attitude of the patients indicated that the patient's rights were better fulfilled compared to the doctors and nurses. of course, the views of service receivers and service providers were different regarding the degree of compliance with different dimensions of patient rights in the hospital, and it is necessary to prioritize the views of patients as service receivers and main beneficiaries in the interventions, and the service providers should be informed about it and the solutions to solve the existing shortcomings should be identified and appropriate action should be taken to solve them.
Background: Diabetic peripheral neuropathy (DPN) accounts for 80% of diabetic foot ulceration; therefore neurologic examination plays a critical role in screening at risk patients. Our objective was ...assessment the prevalence of DPN and related factors based on clinical findings.Methods: This cross-sectional study was conducted on 124 diabetics who were randomly recruited from Diabetes Clinic of Dr. Shariati University Hospital (Tehran/Iran) in 2004. After gathering demographic data and blood sampling for fasting blood sugar (FBS), the questionnaires United Kingdom (UK), Michigan, Diabetic Neuropathy Score (DNS), and 10-g monofilament testing were administered. Analysis tests were chi-square, pearson correlation and logistic regression.Results: The patient's age ranged 17 -75 years; with 44% male. Ninety one percent suffered from type two diabetes and the mean duration of diabetes was 10 years. The mean FBS level was 181.5 mg/dl. While the prevalence of DPN based on Michigan, DNS, and monofilament testing was about 32-38%, some 54% were diagnosed by UK test. Tingling in the lower extremity was the most frequent complaint (42%). The strongest linear correlation was reported between Michigan and DNS (r= 0.7), and then between monofilament test and DNS (r= 0.6). The age > 50 years, length of diabetes > 10 years, and FBS >200 mg/dl were the main risk factors for DPN based on DNS.Conclusion: It seems that the combination of Michigan and monofilament test can provide an accurate screening tool for detecting DPN. In addition, tight glucose control, regular assessment of the lower extremity, and to educate diabetics is urged in elderly diabetics, longer duration of diabetes, and those with high FBS.
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