Dataset Information

Integrated management of diabetic foot ulcers (DFU) using a smartphone - A case report.

ABSTRACT:

Introduction and importance

DFU care in India is expensive. Cost-effective integrated care approaches for diabetic wounds are a necessity.

Case presentation

A 54-year-old, type 2 diabetic male patient presented with bilateral Grade Four compound DFUs. He also had a peculiar pattern of progressive gangrenous lesions on both toes of his limbs. He was on medication for schizophrenia for 20 years. Doppler studies of both limbs revealed extensive atherosclerotic changes with no flow in the mid and very low flow in the distal left anterior tibial artery.

Clinical discussion

Along with Ayurvedic internal medication, in-home wound care was advised. Wound cleaning (shodhana) was done with Triphala decoction, gauze packing (ropana) with Gandhak druti, and application of Jatyadi oil (snehana) was done daily. The wound inspection was done using a smartphone. Out of six wounds, one infected wound measuring (8 cm-3 cm), one tunnelling wound measuring (9 cm-3 cm), one neuro-ischemic, Grade 4 planter wound, and other non-infected wounds healed within four to ten weeks. It has been observed that all the toes with progressive ischemic black spot on the proximal interphalangeal joint had deteriorated within 20-35 days.

Conclusion

Gandhak druti may be effective for progressive wounds. Jatyadi oil application to enhance microcirculation as a preventive therapy should be investigated. Wound dressing guidelines recommended in Ayurveda classics can be followed at diabetic wound in-home care using a smartphone. Correlative timeframe of pathophysiological signs and anatomical site of dermopathy patches can add value to the non-invasive microcirculation detection tests.

SUBMITTER: Jadhav SS

PROVIDER: S-EPMC11295545 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

Integrated management of diabetic foot ulcers (DFU) using a smartphone - A case report.

Jadhav Sangeeta Sanjay SS

International journal of surgery case reports 20240710

<h4>Introduction and importance</h4>DFU care in India is expensive. Cost-effective integrated care approaches for diabetic wounds are a necessity.<h4>Case presentation</h4>A 54-year-old, type 2 diabetic male patient presented with bilateral Grade Four compound DFUs. He also had a peculiar pattern of progressive gangrenous lesions on both toes of his limbs. He was on medication for schizophrenia for 20 years. Doppler studies of both limbs revealed extensive atherosclerotic changes with no flow in ...[more]

PMID: 39024993

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Project description:Background: Recent advances in high-throughput single-cell sequencing technologies have led to their increasingly widespread adoption for clinical applications. However, challenges associated with tissue viability, cell yield, and delayed time-to-capture have created unique obstacles for data processing. Chronic wounds, in particular, represent some of the most difficult target specimens, due to the significant amount of fibrinous debris, extracellular matrix components, and non-viable cells inherent in tissue routinely obtained from debridement. Methods: Here, we examined the feasibility of single cell RNA sequencing (scRNA-seq) analysis to evaluate human chronic wound samples acquired in the clinic, subjected to prolonged cold ischemia time, and processed without FACS sorting. Wound tissue from human diabetic and non-diabetic plantar foot ulcers were evaluated using an optimized 10X Genomics scRNA-seq platform and analyzed using a modified data pipeline designed for low-yield specimens. Cell subtypes were identified informatically and their distributions and transcriptional programs were compared between diabetic and non-diabetic tissue. Results: 139,000 diabetic and non-diabetic wound cells were delivered for 10X capture after either 90 or 180 min of cold ischemia time. cDNA library concentrations were 858.7 and 364.7 pg/µL, respectively, prior to sequencing. Among all barcoded fragments, we found that 83.5% successfully aligned to the human transcriptome and 68% met the minimum cell viability threshold. The average mitochondrial mRNA fraction was 8.5% for diabetic cells and 6.6% for non-diabetic cells, correlating with differences in cold ischemia time. A total of 384 individual cells were of sufficient quality for subsequent analyses; from this cell pool, we identified transcriptionally-distinct cell clusters whose gene expression profiles corresponded to fibroblasts, keratinocytes, neutrophils, monocytes, and endothelial cells. Fibroblast subpopulations with differing fibrotic potentials were identified, and their distributions were found to be altered in diabetic vs. non-diabetic cells. Conclusions: scRNA-seq of clinical wound samples can be achieved using minor modifications to standard processing protocols and data analysis methods. This simple approach can capture widespread transcriptional differences between diabetic and non-diabetic tissue obtained from matched wound locations.

Dataset Information

Integrated management of diabetic foot ulcers (DFU) using a smartphone - A case report.

Introduction and importance

Case presentation

Clinical discussion

Conclusion

Publications

Integrated management of diabetic foot ulcers (DFU) using a smartphone - A case report.

Similar Datasets

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