Background and Objectives: Patients with diabetes polyneuropathy are at a heightened risk for developing foot ulcers, often due to dynamic plantar foot pressure patterns that lead to increased pressure and shear forces in specific foot areas. This study aimed to evaluate the effects of foot insoles on peak pressure and the pressure–time integral in patients with polyneuropathy diabetic foot ulcers over a twelve-week period followed by an eight-week follow up. Materials and Methods: This was a prospective, randomized, double-blinded, controlled clinical trial involving 60 patients aged between 50 and 65 years of both genders. Inclusion criteria included midfoot ulcer grades II or III, a history of polyneuropathy diabetic foot ulcers lasting between six months and one year, diabetes duration of seven to ten years, glycated hemoglobin levels between 7% and 9%, and a body mass index (BMI) ranging from 25 to 30 kg/m². Participants were randomly assigned to either the study group, which received foot insoles along with medication and wound care, or the control group, which received only medication and wound care. Measurements of peak pressure and pressure–time integrals were taken at the start of this study, after twelve weeks, and again eight weeks post-study. Results: The results indicated significant differences in peak pressure and pressure–time integral measurements for the rearfoot, midfoot, hallux, and both medial and lateral forefoot areas after twelve weeks of using foot insoles compared to the control group. This suggests that the use of foot insoles effectively reduces peak pressure and the pressure–time integral in these critical areas. Conclusions: The findings of this study support the use of foot insoles as a beneficial intervention for decreasing peak pressure and the pressure–time integral on the hallux, medial, and lateral forefoot in patients with polyneuropathic diabetic foot ulcers, and they could play a crucial role in preventing further complications.

Introduction: Leptin is one of the new adipokines that reflects the pathological status of liver tissue in the chronic hepatitis C virus (HCV). This study aimed to investigate the leptin and liver enzymes responses to aerobic exercise (AE) in overweight nondiabetics with HCV. Material and methods: Forty nondiabetic non-cirrhotic HCV men aged 40–60 years old with a body mass index (BMI) varied from 25–29.9 kg/m2 were divided randomly to study and control groups. The study group (n = 20) received a 3-session continuous moderate-intensity AE per week for 12 weeks while the control group (n = 20) were advised to maintain their normal level of physical activity. Pre and post measurements of weight, BMI, waist circumference, fasting blood glucose (FBG), alanine transaminase (ALT), aspartate transaminase (AST), and leptin were measured for all forty patients. Results: Statistical ANOVA analysis revealed a post-treatment significant statistical decrease of all variables within the study group (p < 0.05) while the control group showed a non-significant difference of all measurements. Post-treatment between-group analysis showed a significant statistical difference in FBG, ALT, AST, and leptin in favor of the study group. Conclusions: To restore the normal hepatic cellular functions and to prevent HCV-induced hepatic fibrosis, AE is a strong therapeutic modality that lowers leptin levels via weight maintenance and/or loss, increased glucose uptake, and declined liver enzymes.

Background: Hemodialysis (HD) is the most common kidney replacement therapy for end-stage chronic kidney disease. Elderly HD patients, particularly, often struggle with low physical activity, leading to poor physical function, which makes exercise therapy a significant challenge. Objectives: This study aims to evaluate the effects of a combined intradialytic core stability and breathing exercise program on activities of daily living (ADLs), fatigue, balance, and cognitive function in patients on maintenance HD. Method: Sixty patients on maintenance HD were randomly assigned into two equal groups. All patients underwent an intradialytic exercise program. The study group received breathing exercises followed by core stability exercises for 30–45[ ]min, three times per week for 12 weeks, while the control group underwent only breathing exercises. Results: Baseline characteristics were comparable between groups ([ ]). Post 12-week intervention, [ ] mixed ANOVA revealed significant time and interaction effects across all outcomes. The study group showed greater post-intervention improvements than the control in functional independence (Δ [ ] vs. [ ]7.4; [ ]), fatigue (Δ [ ] vs. −6.4; [ ]), balance (Δ [ ] vs. −4.2[ ]s; [ ]), and cognition (Δ [ ]6.0 vs. [ ]2.4; [ ]) (all [ ]), demonstrating superior benefits of the combined exercise program. Conclusion: Integrating core stability with breathing exercises produces significantly greater improvements in ADLs, fatigue, balance, and cognition than breathing alone in haemodialysis patients. This superior, multifaceted approach should be adopted into routine clinical practice to optimise patient quality of life.