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Volume 13 Issue 9 (September) 2024

Original Articles

Comparison of USG Color Doppler Scan and Conventional Methods (Fundoscopy and Urine ACR) in Assessing Limb Salvation in Diabetic Foot Patients With ABPI<0.5
Dr. Aman Pankaj, Dr. Sandeep Kansal, Dr. Sunidhi Mishra, Dr. Shashank Mishra, Dr. Swarnima Agarwal, Dr.Anurag Tomer, Dr. Sachin Agrawal

Introduction: To compare USG Color Doppler scan and conventional methods (fundoscopy and urine ACR) in assessing limb salvation in diabetic foot patients with ABPI<0.5. Materials & Methods: The present observational analytical study was conducted during February 2023 to August 2024 at Chhatrapati Shivaji Subharti Hospital among 50 patients with type 2 diabetes mellitus and age above 18 years, having one or the other forms of diabetic foot lesions and foot lesions like gangrene of foot chronic indolent ulcers, cellulitis and abscess with diabetes. Microvascular assessment was done by fundoscopy and urine test for albumin and creatinine ratio. Following standard treatment, patients were followed-up after 2 weeks, 4 weeks and 3 months. By comparing the outcomes of clinical evaluation, microvascular assessment and USG color doppler imaging, correlation was established between the clinical outcome of the patient and three modalities (USG color Doppler, Urine ACR and Fundoscopy). Results: Subjects with major amputations also had higher grade of Urine ACR (83.33%) and also had some grade of diabetic retinopathy on fundoscopy. HBA1C of patients with PDR came significantly higher than patients with No evidence of DR (P- value 0.0001) and with grade 1 (mild NPDR) P- value 0.0047. It was observed that urine ACR was raised in subjects along with duration of T2DM and poor glycaemic control.Conclusion: It can be concluded that diabetics with higher level of block had higher grade of urine ACR and some grade of retinopathy. Such subjects had poor outcome, so urine ACR and grade of retinopathy can be used as an alternative to USG color doppler in low resource settings where doppler is unavailable or doppler cannot be used due to wound factors as prognostic markers and preventive measures should be taken to reduce these in further follow-ups.

 
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