The Effect of Aloe Vera on the Healing of Diabetic Foot Ulcer: A Randomized, Double-blind Clinical Trial

BACKGROUND

Diabetic foot ulcer (DFU) is a prevalent complication of diabetes that can result in severe consequences. The cost of treating DFUs is high, and there is a lack of new therapies available in developing countries. This has created a demand for complementary and alternative treatments. The objective of this study was to assess the impact of aloe vera gel on the healing process of diabetic foot ulcers.

METHODS AND MATERIALS

The study was a double-blind, randomized, controlled clinical trial. The study samples were 66 patients with diabetic foot ulcers who were randomly assigned to two groups (intervention and control). All ulcers in both groups were washed with normal saline and dressed in sterile gauze. The ulcers in the intervention group were covered with a thin layer of Aloe Vera gel before the dressing. The Bates-Jensen Wound Assessment Tool (BWAT) was used on three occasions, including before the intervention period and at the end of each week. Data were analyzed using SPSS 16.

RESULTS

After three weeks, there was a notable contrast in the recovery pattern of the two groups. The patients who had aloe vera gel added to their dressing showed a more substantial decrease in the mean scores of their BWAT.

CONCLUSION

These findings are promising and suggest that Aloe vera may be a safe and effective adjunctive treatment for diabetic foot ulcers. However, further research is needed to confirm these results and to investigate the underlying mechanisms of aloe vera's therapeutic effect on diabetic foot ulcers.

Outcomes of Cochlear Implantation in Post-lingually Deaf Patients

INTRODUCTION

Cochlear implantation has been mentioned as the most effective therapeutic intervention in deaf patients and especially those with post-lingual deafness. We aimed to assess hearing improvement of post-lingually deaf patients after cochlear implantation.

MATERIALS AND METHODS

in this cross-sectional study all the post-lingually deaf patients who had undergone cochlear implantation (CI) surgery between December 2010 and February 2016 were assessed. Patients were recalled and after explaining the study process and signing an informed consent form, an audiometry was done by a single audiologist. In addition, demographic information, cause of hearing loss, age of onset, history of hearing aid use and surgical complications were recorded in a pre-designed checklist.

RESULTS

Twenty-nine male and 21 female with a mean age of 22.52±19.45 years underwent analysis. Most of patients (80%) had progressed condition since childhood. Sudden sensorineural hearing loss (SSNHL) was the most prevalent (10%) known etiology of deafness followed by meningitis (6%), Trauma (2%) and ototoxic drugs (2%) in the remaining 20% of the patients. Patients had the highest mean (37.1±12.61 dB) in 4000 Hz frequency and the lowest mean of hearing threshold level (32.6±8.37 dB) was for 1000 Hz frequency. Mean hearing threshold level was significantly lower in patients with lower ages of cochlear implantation (p=0.435). Patients with higher ages of deafness onset showed lower degree of hearing improvement (p=0.462).

CONCLUSION

The results of our study suggest that cochlear implantation significantly improves hearing function of post-lingual patients and can be considered as a certain cure for these patients in Iran.

Comparison of intelligence quotients of first- and second-generation deaf children with cochlear implants

Hearing impairment is a common type of sensory loss in children. Studies indicate that children with hearing impairment are deficient in social, cognitive and communication skills. This study compared the intelligence quotients of first- and second-generation deaf children with cochlear implants. This research is causal-comparative. All 15 deaf children investigated had deaf parents and were selected from Baqiyatallah Cochlear Implant Center. The 15 children with cochlear implants were paired with similar children with hearing parents using purposive sampling. The findings show that the Hotelling trace of multivariate analysis of variance (F = 6.78, p < 0.01, η_P² = 0.73) was significant. The tests of between-subjects effects for second-generation children was significantly higher than for first-generation children for all intelligence scales except knowledge. It can be assumed that second-generation children joined their family in the use of sign language as the primary experience before a cochlear implant. The use of sign language before cochlear implants is recommended.

Flap outcome using "c" shaped and "new" incisions in pediatric cochlear implantation

BACKGROUND

Skin flap failure is a significant, though relatively uncommon complication of cochlear implant surgery. To achieve a good surgical result, a proper plan to locate the prospective implant is required. Thus, a new design of flap was evaluated in this regard.

METHODS

Two hundred and eleven consecutive children undergoing cochlear implantation in Baqiyatallah Cochlear Implant Center were compared with 75 cases who were operated through the classic "C shaped" fashion from Jul/14/2007 to Feb/14/2009.

RESULTS

There was one case of flap necrosis in the classic approach but there were no major flap complications in "new" design, also keloid formation as a minor complication was rare in the "new" method.

CONCLUSION

The "new" design is easier to apply with fewer complications, so it can be recommended in children undergoing cochlear implantation.

Platelet count and neonatal sepsis: a high prevalence of Enterobacter spp

INTRODUCTION

Sepsis is a common complication in the neonatal intensive care unit. It is most common in the smallest and most premature infants in whom the clinical presentation can be subtle and nonspecific. The objectives of the present study were to identify the most common organisms causing sepsis and their associations with thrombocytopenia.

METHODS

This is a retrospective case analysis of blood culture positive patients between March 2003 and July 2007 in a single centre. We enrolled 53 eligible neonates whose blood culture yielded positively for any organism. Blood for the culture was obtained from a peripheral vessel. The data was analysed for differences in platelet and neutrophil count in terms of the microorganisms causing sepsis using chi-square and Fisher's exact tests, analysis of variance and Kruskal-Wallis, as appropriate.

RESULTS

The most common organism in the blood culture was Enterobacter spp. with 21 cases (39.6 percent) and the least common was coagulase-positive Staphylococcus spp. The most common organisms in infants with normal weight and early onset sepsis were coagulase-positive Staphylococcus spp. (50 percent and 36.7 percent, respectively), while in other neonates with low birth weight, very low birth weight and late onset sepsis, the most common organism was Enterobacter spp. (40.9 percent, 71.4 percent and 47.8 percent, respectively). The patients with Enterobacter spp. sepsis had a higher incidence of thrombocytopenia. The mortality rate was 15.1 percent (8/53 cases), which was significantly higher among those with the Enterobacter spp. sepsis (five cases, p-value is 0.033).

CONCLUSION

Our study shows the changes in the pattern of late onset neonatal infections in the neonatal intensive care unit. Enterobacter spp. is the most common organism causing neonatal sepsis accompanying thrombocytopenia.