BACKGROUND: Individuals with diabetes may develop diabetic foot ulcers due to diabetic peripheral neuropathy. Multiple factors influence the ulcer healing process; oxygen helps in facilitating the different stages of wound healing. OBJECTIVE: The objective of this systematic review was to analyze the different levels of evidence available in the application of topical oxygen therapy, warm oxygen therapy, or other modes of topical oxygen delivery in the healing dynamics of diabetic foot ulcers. METHODS: Databases searched included Pubmed/Medline, Science Direct, Web of Science, Scopus, Cochrane, and CINAHL. The eligibility criteria of studies included participants ≥18 years with chronic non-healing diabetic foot ulcer (duration ≥3 months) receiving warm oxygen or topical oxygen therapy (TOT), and other modes of topical oxygen administration, which were compared with standard care group. Randomized and non-randomized studies were included. The primary outcome measure assessed was the rate of wound healing or wound closure. RESULTS: The review included 5 studies which used different modes of topical oxygen administration. The healing trajectory of the wounds was completely achieved in low-grade ulcers (grade 1), whereas all highgrade ulcers (grades 2, 3, and above) showed either 100% or 50% healing with a reduction in ulcer size and ulcer tissue depth. CONCLUSION: Topical oxygen therapy facilitates wound healing dynamics among individuals with chronic diabetic foot ulcers.

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This letter to the editor’s article highlights the role of incorporating physical activity as a critical component in addressing fear among type 2 diabetes mellitus individuals during the COVID-19 pandemic.

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Purpose Diabetic foot ulcer (DFU) is a significant healthcare burden demanding prompt attention. In the past decade, newer technologies such as topical oxygen therapy have grown increasingly popular. The purpose of the study was to determine effect of KADAM-a topical warm oxygen therapy (TWOT) medical device in healing of DFU. Methods The KADAM medical device developed by Yostra Labs Pvt Ltd, delivered pure oxygen between 93 ± 3% concentration at an optimal temperature range of 39-42º Celsius to DFU wound site. Results A total of 40 diabetic foot ulcer individuals, aged over 18 years were included in the study. Individuals with the Grade 1 DFU were 34 (85%), grade 2 were 5 (12.5%) and grade 3 were 1 (2.5%). The changes in initial area and final area for the various diabetic foot ulcer grades were as follows: 0.32 [0.12, 0.96] (< 0.001) for grade 1 ulcer, 0.76 [0.54, 1.17] (P = 0.013) for grade 2 ulcer and 1.26 for grade 3 ulcer. The percentage reduction in wound size achieved for the grade 1 & 2 DFU were 100%, and grade 3 was 75%. Conclusion Topical warm oxygen therapy serves as an adjunctive modality to facilitate diabetic foot ulcer healing in the clinical practice.

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Background: Microalbuminuria among obesity cases reflects specific glomerular damage or is the marker of generalized endothelial cell dysfunction is still debatable. Thus, this study aimed to assess the presence of microalbuminuria among obese persons and non-obese individuals, who were euglycemic and normotensive.Methods: A case control study was conducted among patients attending outpatient department of general medicine in Govt Thiruvarur Medical College, Thiruvarur, for their illnesses from June 2017 to December 2017. A total of hundred participants with fifty obese cases and fifty non obese controls were included in this study. Detailed history and examination were done by the principal investigator and the same was documented in a proforma. Data entry was done using Microsoft excel and the statistical analysis includes odds ratio were calculated using Statistical Package for Social Sciences (SPSS) software version 17.Results: Among the study participants, 32% and 4% had microalbuminuria in obese and non-obese group, respectively. Also, obese participants were 11.29 times at higher chances of having microalbuminuria when compared to the non-obese patients with significant p value (p=0.002).Conclusions: Microalbuminuria can be used to predict the risk of complications in obese subjects in order to bring down the overall morbidity and mortality related to renal function.

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