scholarly journals Propolis as an Adjuvant in the Healing of Human Diabetic Foot Wounds Receiving Care in the Diagnostic and Treatment Centre from the Regional Hospital of Talca

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Verónica Mujica ◽  
Roxana Orrego ◽  
Roberto Fuentealba ◽  
Elba Leiva ◽  
Jessica Zúñiga-Hernández
Keyword(s):  
Diabetic Foot ◽  
Healing Process ◽  
Regional Hospital ◽  
Controlled Study ◽  
Serum Samples ◽  
Major Health Problem ◽  
Treatment Centre ◽  
Anti Inflammatory ◽  
Design And Methods

Objective. Diabetic foot wounds are a relevant diabetes complication and a major health problem. It has been described that propolis has health benefits due to its anti-inflammatory, antioxidant, and support in the healing process. The current study assessed the effect of propolis as an adjuvant in the healing of human diabetic foot ulcers. This was evaluated in a randomized placebo-controlled study of subjects receiving care in the Diagnostic and Treatment Centre from the Regional Hospital of Talca, Chile. Research Design and Methods. Randomized subjects received ambulatory healing treatment for diabetes foot wounds with propolis spray (3%), which was applied to cover the entire wound surface each time it was dressed from week 0 until cicatrization or 8 weeks as a maximum. Two serum samples were taken (day 0 and end of the study) for cytokine and oxidative stress analyses. Also, macro- and microscopy were analyzed in the process of wound healing. Results. The study comprised 31 subjects with type 2 diabetes in treatment for diabetic foot wounds in the Diagnostic and Treatment Centre from the Regional Hospital of Talca. Propolis promotes a reduction of the wound’s area by an average of 4 cm2, related to an increase in the connective tissue deposit compared to the control. Also, propolis increased the glutathione (GSH) and GSH/glutathione disulfide (GSSG) ratio (p<0.02), depleted tumor necrosis factor- (TNF-) α, and increased interleukin- (IL-) 10 levels. Topical propolis did not modify the biochemical parameters in the serum of the studied subjects. Conclusions. The topical use of propolis turned out to be an interesting therapeutic strategy as an adjuvant in the care of diabetes foot wounds due to its ability to improve and promote healing based on its anti-inflammatory and antioxidant profile. This trial is registered with NCT03649243.

scholarly journals EFFECTIVITY OF INDONESIAN HONEY ON DIABETIC FOOT ULCERS HEALING PROCESS: OBSERVATIONAL CASE STUDY

2019 ◽  
Vol 2 (2) ◽  
pp. 20-28
Author(s):  
Anita Sukarno ◽  
Nur Hidayah ◽  
Musdalifah Musdalifah
Keyword(s):  
Diabetic Foot ◽  
Healing Process ◽  
Cost Effective ◽  
Tissue Type ◽  
Foot Ulcers ◽  
Wound Healing Process ◽  
Diabetic Foot Ulcers ◽  
Necrotic Tissue

Background: Diabetic foot ulcers were common diabetes complication that progressively growth globally. The effectivity of Manuka honey in wound healing process was huge published currently. Modern dressing and Manuka honey may not affordable and cost effective since these dressings were not produced originally in Indonesia. In addition, the published study of Indonesian honey is still lack. Therefore, we conducted this study to investigate the effectivity of Indonesian honey in diabetic foot ulcers healing process. Method: This study design was observational case study. This study was conducted among type 2 diabetes with diabetic foot ulcers in Griya Afiat Homecare and ETN Center in Makassar City, Indonesia from March to June 2014. The Bates Wound Assessment Tool (BWAT) were used to collect the score of diabetic foot ulcer healing process regarding wound size, depth, edges, undermining, necrotic tissue type, necrotic amount, granulation, epithelization, exudate type and amount, surrounding skin color, edema and induration. Descriptive, Independent t-test, Analysis of Variance (ANOVA) and Wilcoxon signed rank test were conducted appropriately. Results: In total, 10 type 2 diabetes patients with diabetic foot ulcers were participated. The factors associated with wound healing process were diabetes treatment (t= 2.44, p= 0.041) and primary dressing (t= -2.76, p= 0.025). The effect of honey primary dressing was in reducing wound size (p= 0.043), improving necrotic tissue type (p= 0.041), reducing necrotic tissue amount (p= 0.042), increasing granulation (p= 0.038) and epithelization (p= 0.042). In the counterpart, the effect of modern dressing was in improving necrotic tissue type (p= 0.046) and increasing granulation (p= 0.042). Conclusion: Indonesian honey is beneficial on diabetic foot ulcers healing process. Recommendation: Therefore, findings suggest that honey should be considered as the alternative, cost effective and beneficial wound dressing on the diabetic foot ulcers.

scholarly journals Non-Targeted Metabolomic Analysis Reveals Serum Phospholipid Alterations in Patients with Early Stages of Diabetic Foot Ulcer

2020 ◽  
Vol 15 ◽  
pp. 117727192095482
Author(s):  
Ignacio I Álvarez-Rodríguez ◽  
Eduardo Castaño-Tostado ◽  
David G García-Gutiérrez ◽  
Rosalía Reynoso-Camacho ◽  
Juana E Elton-Puente ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Ulcer Formation ◽  
Metabolomic Analysis ◽  
Serum Phospholipid ◽  
Serum Samples ◽  
Cross Sectional

Diabetic foot ulcer (DFU) is a common complication of type 2 diabetes mellitus (T2DM) characterized by ulcer formation, which can lead to the amputation of lower extremities. However, the metabolic alterations related to this complication are not completely elucidated. Therefore, we carried out a metabolomic analysis of serum samples obtained from T2DM adult patients diagnosed with diabetic foot ulcer in a cross-sectional, observational, and comparative study. Eighty-four volunteers were classified into the following groups: without T2DM (control group, n = 30) and with T2DM and different stages of diabetic foot ulcer according to Wagner-Meggitt classification system: DFU G0 (n = 11), DFU G1 (n = 14), DFU G2 (n = 16), and DFU G3 (n = 13). The non-target metabolomic profile followed by chemometric analysis revealed that lysophosphatidylethanolamine (16:1) could be proposed as key metabolite related to the onset of diabetic foot ulcer; however, this phospholipid was not affected by diabetic foot ulcer progression. Therefore, further studies are necessary to validate these phospholipids as biomarker candidates for the early diagnosis of diabetic foot ulcer in T2DM patients.

scholarly journals Pentoxifylline improves the quality of life in type-2 diabetes foot syndrome

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Marwan S Al-Nimer ◽  
Rawa A Ratha ◽  
Taha O Mahwi
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Diabetic Foot ◽  
Short Form ◽  
Diabetic Foot Syndrome ◽  
Controlled Study ◽  
Disability Score ◽  
Group I

Objectives: To evaluate the effect of pentoxifylline on the quality of life (QoL) in diabetic foot syndrome (DFS) by using Short Form-36 questionnaire, and in reference to the revised neuropathy disability score (RNDS) and grading of diabetic foot. Methods: This randomized placebo-controlled study was carried in the Department of Pharmacology at University of the Sulaimani through 2018. A total number of 80 T2D patients were recruited from outpatients Department attended the Center of Diabetes and the Shar Teaching Hospital in the University of Sulaimani, Sulaimani-Iraq. Group I (non-DFS, n=40) were subgrouped into Group-IA treated with placebo (n=20), and Group-IB treated with 400 mg pentoxifylline thrice daily for 8 weeks. Group II (DFS, n=40) sub grouped into Group-IIA treated with placebo (n=20), and Group-IIB treated with pentoxifylline. The primary outcome measures including the data of SF-36, RNDS, and grading of diabetic foot. Results: Pentoxifylline therapy significantly reduced the RNDS, improved the clinical evidence of diabetic foot, improved the QoL particularly the domains that related to emotional problems and physical health. Pentoxifylline offered a better effect in DFS compared with non-DFS patients Conclusion: Pentoxifylline treatment improves the quality of life in diabetic foot syndrome and its effect is related to the scoring of revised neuropathy disability and grading of diabetic foot. doi: https://doi.org/10.12669/pjms.35.5.11 How to cite this:Al-Nimer M, Ratha R, Mahwi T. Pentoxifylline improves the quality of life in type-2 diabetes foot syndrome. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.11 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Thea T. Goie ◽  
Mergan Naidoo
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Foot ◽  
Regional Hospital ◽  
Foot Care ◽  
Diabetic Foot Disease ◽  
Foot Disease

Background: Diabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM).Methods: An observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa.Results: Two hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p < 0.05).Conclusion: The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.

scholarly journals Prognostic Significance of Circulating and Endothelial Progenitor Cell Markers in Type 2 Diabetic Foot

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Maria Sambataro ◽  
Elena Seganfreddo ◽  
Fabio Canal ◽  
Anna Furlan ◽  
Laura del Pup ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Healing Process ◽  
Prognostic Significance ◽  
Limb Ischemia ◽  
Precursor Cells ◽  
Peripheral Blood Cd34 ◽  
Calcitonin Gene ◽  
Foot Lesions ◽  
Neuropathic Foot

Objective. We studied circulating precursor cells (CPC) in type 2 diabetes mellitus (T2DM) with neuropathic foot lesions with or without critical limb ischemia and relationships between endothelial precursor cells (EPC) and peripheral neuropathy.Methods and Subjects. We measured peripheral blood CD34, CD133, and CD45 markers for CPC and KDR, CD31 markers for EPC by citofluorimetry and systemic neural nociceptor CGRP (calcitonin gene related protein) by ELISA in 8 healthy controls (C) and 62 T2DM patients: 14 with neuropathy (N), 20 with neuropathic foot lesions (N1), and 28 with neuroischemic recent revascularized (N2) foot lesions. Timing of lesions was: acute (until 6 weeks), healed, and not healed.Results. CD34+ and CD133+ were reduced in N, N1, and N2 versus C, and CD34+ were lower in N2 versus N1 (P=0.03). In N2 CD34+KDR+ remain elevated in healed versus chronic lesions and, in N1 CD133+31+ were elevated in acute lesions. CGRP was reduced in N2 and N1 versus C (P<0.04versus C26±2 pg/mL). CD34+KDR+ correlated in N2 with oximetry and negatively in N1 with CGRP.Conclusions. CD34+ CPC are reduced in diabetes with advanced complications and diabetic foot. CD34+KDR+ and CD31+133+ EPC differentiation could have a prognostic and therapeutic significance in the healing process of neuropathic and neuroischemic lesions.

scholarly journals Spontaneous and induced secretion of the pro-inflammatory and anti-inflammatory cytokines in patients with type 2 diabetes mellitus and diabetic foot syndrome

2020 ◽  
Vol 23 (3) ◽  
pp. 210-222
Author(s):  
E. V. Shikh ◽  
N. A. Petunina ◽  
L. V. Nedosugova ◽  
K. O. Galstyan ◽  
K. I. Kolmychkova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Foot ◽  
Diabetic Foot Syndrome ◽  
Control Group ◽  
Metabolic Drug ◽  
Anti Inflammatory

AIMS:Investigation of spontaneous and induced secretion of the pro-inflammatory cytokine tumor necrosis factor- (TNF-) and the anti-inflammatory chemokine C-C Motif Chemokine Ligand 18 (CCL18) by monocytes isolated from blood of patients with long-term type 2 diabetes mellitus (T2DM), both with or without foot ulcers and the effect of the course use of the combined metabolic drug Kokarnit as part of complex therapy on the dynamics of the severity of symptoms of DSPN and the cytokine phenotype in patients with long-term non-healing ulcers of the lower extremities MATERIALS AND METHODS:121 patients with T2DM, 79 without diabetic foot syndrome (DFS) and 42 patients with DFS were included. CD14+ monocytes were isolated from patients blood and stimulated by interferon- (IFN-) and interleukine-4 (IL-4) for induction of pro- and anti-inflammatory monocyte activation, respectively. The concentrations of TNF- and CCL18 in the culture medium were measured using ELISA on day 1 and day 6 after cell stimulation in all patients before taking the combined metabolic drug Kokarnit. Then they were randomly allocated either to the control group (57 people), to whom Kokarnit was added to standard treatment, or to the comparison group. After a 9-day course of application of Kokarnit, the dynamics of indicators was evaluated on a TSS scale. Assessment of cytokine status was carried out in 18 people with long-term non-healing ulcerative defects of the lower extremities, on the first and ninth day of treatment. RESULTS:A correlation was found between HbA1cand levels of stimulated secretion of TNF (r=0.726, p=0.027), CCL18 (r=-0.949, p=0.051) in patients with DSPN. In all patients with different duration of VDS, an increase in secretion of TNF- and CCL18 was observed (p0.05). However, stimulation of anti-inflammatory activation was not observed in patients with ulcerative defects lasting more than 6 months (p=0.033). The use of cocarnit in these patients had a decrease in stimulated secretion of TNF and an increase in CCL18. Throughout the entire observation period with the therapy, the score for the symptoms of polyneuropathy on the TSS scale in patients of the control group was statistically significantly higher. CONCLUSION:Against the background of therapy in patients of the main group, a statistically significant dynamics of indicators on the TSS scale was established. The cytokine modulating ability of Kokarnit to switch the cytokine status into the category of anti-inflammatory.

scholarly journals Use of propolis in difficult to heal diabetic wounds. Short review

2017 ◽  
Vol 127 (4) ◽  
pp. 173-175
Author(s):  
Patrycja Chylińska-Wrzos ◽  
Marta Lis-Sochocka ◽  
Barbara Jodłowska-Jędrych
Keyword(s):  
Diabetic Foot ◽  
Morphological Changes ◽  
Heart Diseases ◽  
Healing Process ◽  
Antioxidant Properties ◽  
Short Review ◽  
Laboratory Animals ◽  
Diabetic Patients ◽  
Anti Inflammatory ◽  
Diabetic Wounds

Abstract According to WHO, about 347 million of people worldwide suffer from diabetes. Diabetes has complex etiology, and the consequences of this illness are seen in the morphological changes of many tissues and organs i.e. neuropathy leading to the risk of diabetic foot. Due to the diabetic condition, injuries to blood vessels in diabetic foot can be classified as chronic. This is because such wounds remain unresponsive to treatment for months or even years. There are many therapeutic methods employed in treating such injuries. These involve the use of silver, iodine or multi-antibiotic preparations, but treatment is expensive and cumbersome for patients. In the natural environment, however, there are many anti-inflammatory preparations, among them propolis which was the subject of our focus. Due to its anti-inflammatory, antimicrobial, and antioxidant properties, propolis is widely used in the treatment of colds, caries, rheumatic diseases, heart diseases and treatment of burns, wounds and frostbites. Numerous studies also indicate the beneficial effects of propolis on the difficult to heal diabetic wounds in which the use of propolis can significantly accelerate the healing process. The treatment utilizing propolis is easy, inexpensive and does not seem to cause any side effects, therefore costs can be reduced to minimum. The few studies conducted in diabetic patients confirm the results obtained in laboratory animals.

scholarly journals Angiosome based revascularization for diabetic foot ulcer

2019 ◽  
Vol 6 (10) ◽  
pp. 3474
Author(s):  
Ahmed M. Hossny ◽  
Mahmoud S. Eldesouky ◽  
Mohamed A. Abdellatif
Keyword(s):  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Complete Healing ◽  
Controlled Study ◽  
University Hospitals ◽  
Acceptable Result ◽  
Group A ◽  
Group B

Background: The purpose of this study was to analyze the clinical benefit in wound healing and limb preservation after infrapopliteal endovascular revascularization guided by an angiosome model of perfusion in the healing process of diabetic foot ulcers.Methods: This is a prospective controlled study was conducted on 60 patients with critical lower limb ischemia in the form of diabetic foot ulcer and/or gangrene. The study period started from August 2017 until February 2019. Patients included in the study were essentially attending the Vascular Outpatient Clinic at Menoufia University Hospitals and Nasser Institute for Search and Treatment at Cairo treated by infra-popliteal angioplasty.Results: The 60 patients of our study who underwent successful infra-popliteal angioplasty we found that after six months 18 patients in the direct group A (85.71%), 9 patients in indirect group B (42.85%) and 17 patients in combined group C (94.44%) showed complete healing of their wounds and that 18 patients in group A (85.71%), 15 patients in group B (71.42%) and 17 patients in group C (94.44%) have their limbs salvaged total 50 patients (83.33%).Conclusions: We concluded that dilation of angiosome target artery plus any other significant tibial artery lesions should be considered and indirect revascularization should not be denied with acceptable result over time.

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