ABSTRACT
PURPOSE: We aimed to evaluate and compare the efficacy of neem leaves extract with normal saline irrigation practice in wound dressing on healing outcome and clinic-physiological parameters among individuals with diabetic foot ulcer (DFU). METHODS: A quasiexperimental with repeated measures design was used on two study groups. One group received neem leaf extract wound irrigation and another group received normal saline wound irrigation. Study participants were randomly assigned to each group from 100 DFU individuals. Demographic and clinical data sheets were used to collect baseline information. Random blood sugar and HbA1C measurement was performed on the initial day of visit for all participants. We used the PUSH tool for wound assessment (wound surface area, exudate amount, and tissue type), and clinic physiological parameters (temperature, pulse rate, respiration, blood pressure, wound pain, wound infection, and local warmth) assessment was performed at baseline and then at the end of each week till four weeks were completed. Participants attended a foot clinic every 3rd or 4th day for wound care. RESULTS: Reduction of wound healing score (PUSH score) and other wound variables improved significantly in the neem leaves extract group (p < 0.001). There were no significant changes in the clinic-physiological parameters. CONCLUSION: Neem leaves extract irrigation for foot ulcers is considered to be very safe as it did not cause any complication systematically during the study. Neem leaf extract solution can be used as an alternative solution for normal saline. Managing DFU requires continuous foot care and early risk identification of ulcer.
ABSTRACT
BACKGROUND: Diabetic foot ulcer (DFU) is an important mortality factor among diabetes mellitus (DM) patients and has a massive impact on the quality of life (QoL) of patients. The non-heal foot ulcer needs extra care and need special attention in maintaining wound hygiene. Dressing on wound is done in four stages such as cleanse the wound, debridement of wound, fashioning of edges and final dressing. The important stage of cleanse the wound was done with solution extracted from neem leaves which has medicinal value and anti-biotic properties and was used instead of normal saline or water solution, which do not carry medicinal value. Other medicinal solutions are of high cost as well as not easily available such as octanedione dihydrochloride or hypochlorous acid etc. AIMS: This study was aimed to investigate the impact of DFU on QoL among patients suffering from chronic wounds. MATERIALS AND METHODS: A cross-sectional, descriptive study was conducted at foot care clinic in a private hospital situated at Guwahati, Assam. Data were collected using a pro forma consisting of sociodemographic variables, Wagner ulcer classification and Cardiff wound impact questionnaire. Analysis of data was done using the descriptive and inferential statistical methods. RESULTS: A total of 118 DFU patients of type 1 and 2 DM were studied. Out of which, 81.4% were male and 18.6% were female. About 66 participants (55.9%) were in grade 2 and 38 (32.2%) were in grade 3 of Wagner ulcer classification. Overall mean score for QoL was 6.27, whereas overall mean score for satisfaction on QoL was 7.01. Patients had the highest score in the well-being domain and lowest in the social life stress. Computation of correlation matrix and factor analysis showed a positive correlation between QoL and satisfaction and negative correlation between QoL and satisfaction with stressful experience of social life and physical symptoms experience (P < 0.05, 0.01). Multiple regression analysis reveals that satisfaction had a significant impact on QoL (P < 0.001) with r2 = 62.59%. Factor analysis of correlation matrix showed that physical symptoms and daily living experiences and social experiences as well as stress dominated factor 1 followed by satisfaction led QoL in factor 2 and social life stress was the leading force in factor 3. CONCLUSION: QoL of patients with DFUs can be improved by educating the diabetic patients on the prevention and early detection of foot ulcers, other diabetic complications, and availing benefits of prevailing health-care facility in early stages.
ABSTRACT
AIM: Some literatures revealed that the high performance liquid chromatography (HPLC) method for single component or multicomponent analysis of montelukast sodium with other drugs. However, these methods deals with time consuming, so it is necessary to develop a cost-effective and less time consuming method for the estimation of doxofylline and montelukast sodium in combined pharmaceutical formulation. MATERIALS AND METHODS: The separation was performed on an inertsil C8 (5 µm, 4.6 × 250 mm) column in isocratic mode with the mobile phase consisting a mixture of methanol and sodium phosphate buffer (75:25 v/v, pH 6.5 adjusted with orthophosphoric acid). The mobile phase was pumped at a flow rate of 1 mL min(-1) and eluents were monitored at 230 nm. RESULTS: The selected chromatographic conditions were found to separate doxofylline (retention time = 3.4 min) and montelukast sodium (retention time = 5.5 min) with a resolution of 5.47. The proposed HPLC method was validated with respect to linearity, accuracy, repeatability, specificity, robustness, and ruggedness as per International Conference on Harmonisation guidelines Q2(R1), November 2005 (Validation of Analytical Procedures: Text and Methodology). The percentage recoveries for doxofylline and montelukast sodium ranged from 98.1% to 101.7% and 98.2 to 101.9%, respectively, which indicated that the above method was enough accurate and precise. CONCLUSIONS: Hence, it was concluded that the developed method is suitable for routine analysis of these combination due to its less analysis time.
