Objectives: Previous studies have shown that diabetic foot ulcers are principally associated with improper foot selfcare. Since appropriate foot self-care is essential to prevent diabetic foot-ulcers, any factors which can predict foot self-care behavior should be identified. However, until now, foot self-care behavior data and predictors of foot-care behavior in Indonesia remain unclear since such studies on Indonesian diabetic patients is very limited. Therefore, the purpose of this study was to investigate foot self-care behavior and to identify its predictors in Indonesia. The design of this study was cross-sectional. Cluster sampling was used, involving 546 type 2 diabetes mellitus patients registered in 22 primary healthcare centers. The questionnaires used in this study included the Diabetes Distress Scale, Beck Depression Inventory II, Family APGAR, Foot-Care Knowledge and Modified Diabetic Foot Care Behaviors. Results: Foot self-care behavior and knowledge about foot care were poor. The predictors of foot self-care behavior were age, educational level, diabetes distress, family support, and knowledge. It needs the program to improve foot self-care knowledge and the program to reduce the diabetes distress in Indonesian diabetic patients. In performing of these programs, families should be involved to improve the support toward foot self-care behavior in patients.

Diabetes mellitus (DM) is a chronic disease and a major health problem globally. Estimates suggest that in 2019, there were 63 million people in the world living with DM and that number is expected to rise to 578 million by 2030 and 700 million by 2045 (International Diabetes Federation, 2019). In Indonesia, there are approximately 10.7 million people living with DM in 2019 and that number is predicted to rise to 13.7 million in 2030, and 16.6 million by 2045 (International Diabetes Federation, 2019). An increasing number of people with DM will lead to increasing numbers of DM-related complications, such as retinopathy, nephropathy, and foot ulcers

Background: Diabetic foot ulcer will cause a reduction in quality of life (QOL), high care burden, and even mortality. An assessment of QOL and associated factors in patients with diabetic foot ulcer is important to provide evidence for establishing a care plan program for such patients. However, up to the present, there is no evidence of a published study that investigates the QOL and its associated factors in patients with diabetic foot ulcer in Indonesia. Purpose: The purpose of this study was to investigate the QOL in patients with diabetic foot ulcer in each domain and investigate the factors associated with this condition. Methods: The design of this study was a cross-sectional study. The total sample for this study was 55 patients. The QOL data were collected using a Diabetic Foot Ulcer Scale questionnaire. Statistical analyses were conducted using Mann-Whitney U-test and Kruskal-Wallis test. Results: The result showed that the QOL in the domains of emotions, positive compliance, family life, and friend were high, while the QOL in the domains of daily activities, physical health, leisure, finances, positive attitude, and treatment ranged from low to average. Significant differences were found between income (p=0.004), grade of the wound (p=0.047), number of wounds (p=0.029), and blood glucose (p=0.013) with QOL of patients. Other variables did not have a significant relationship with QOL, but marital status had a significant correlation with the domain of leisure (p=0.004) and duration of the ulcer had a significant correlation with the domain of emotions (p=0.001) Conclusion: There is a correlation between income, grade of the wound, the number of wounds, and blood glucose with QOL of patients with a diabetic foot ulcer. This study recommends to take into account economic status, grade and number of wound, and blood glucose level in order to improve the QOL of patients for an effective patient care plan.

Many toxic compounds in foods cause liver damage and disturbance of bodily function. Inflamma tion will precede liver damage as an initial response to poisoning. The inflammatory response depends heavily on the strength of the body's immune system. Many foods, drugs, and other compounds can decrease the immune system, but few serve as immunostimulants. This study aims to prove the decreasing of carbon tetra chloride toxicity using dateseed (Phoenix dactylifera L.) steeping to improve rat immunity. Methods: This was an experiment with pre and post test with a control group design. Wistar white rats were grouped into 6 groups, healthy control (HC), negative control (NC), positive control (PC), treatment dose 1 g/ kg (T1), treatment dose 3 g/kg (T3), and treatment dose 5 g/kg (T5). All of the groups were induced by CCL 4 before treatment except the HC group. The observed data were interleukin6 (IL6), lymphocyte count, and Creactive protein (CRP). Data from the groups were compared with an ANOVA test and followed by a post hoc test if a significant result was found. Results: The results showed that there were signifi cant differences between IL6, lymphocyte count, and CRP between HC and other groups that CCL 4 in duced. After the delivery of dateseed steeping, levels of IL6 and CRP decreased, and the lymphocyte count increased significantly. The group with the 5 g/ kg treatment dose was the most effective group for inhibiting the increase of IL6 and CRP, but a dose of 3 g/kg was the most effective to increase lymphocyte count. Conclusion: Dateseed steeping suppresses proin flammation mediators; it has a potency which improves cytokine proinflammation by inhibiting the inflamma tion process. Thus, date seed can be used as a cheap source of antiinflammation that can be considered as a health opportunity for developing countries.

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