scholarly journals Nano-Oxy: Diabetic ulcer treatment using oxygen nanoparticles concept as innovation in reducing amputation rates and antibiotics usage

2022 ◽  
Vol 13 (1) ◽  
pp. 309-316
Author(s):  
Shofiuddin Al Mufid ◽  
Naufal Achmad Tsany Daffa ◽  
Dedy Firmansyah ◽  
Octaviana Galuh Pratiwi ◽  
Innas Safira Putri ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
Activation Mechanism ◽  
Limb Amputation ◽  
Target Cells ◽  
Diabetic Patients ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Ulcer Therapy ◽  
Chronic Hyperglycemia ◽  
Ulcer Treatment

Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia caused by defects in insulin secretion, insulin reactions, or both. More than one third of diabetic patients have complications in the form of diabetic ulcers, and half are infected, and 15% of these infections require limb amputation. High cost expenditure and risks of microbial resistance to antibiotics also adds the complexity of the problem. The purpose of this literature review is to offer Nano-Oxy, using oxygen in nanoparticle size, as an alternative diabetic ulcer treatment. Literature searching was conducted through online search method. Oxygen therapy has been widely used to treat diabetic ulcers, including hyperbaric oxygen therapy (HOT) and topical oxygen therapy (TOT). Both of them have good results on diabetic ulcer therapy. Oxygen can act as an antimicrobial agent through the activation mechanism of neutrophils and macrophages which play a role in phagocytosis process and ROS regeneration. Nano-Oxy has advantages than the previous therapy, such as it does not cause barotrauma, oxygen poisoning, and low risk of burning. The mechanism of how Nano-Oxy works is similar with the Micro-nanobubbles (MNBs) concept. The negatively charged surface of MNBs can prevent them from aggregating, attracts particles, and help remove debris. MNBs also generate free radicals while shrinking in water, which contribute to its antibacterial effect. In addition, Nano-oxygen technology can be applied externally, but still have effect on the intended target cells. Therefore, Nano-oxygen can be used as a diabetic ulcer therapy to replace the role of antibiotics.

EFEKTIVITAS PERAWATAN ULKUS DIABETIKUM TERHADAP PENERIMAAN DIRI PASIEN DIABETES MELITUS TIPE II DI ASRI WOUND CARE CENTRE MEDAN

2019 ◽  
Vol 4 (2) ◽  
pp. 178
Author(s):  
Elis Anggeria ◽  
Patimah Sari Siregar
Keyword(s):  
Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
Wound Care ◽  
Type Ii Diabetes Mellitus ◽  
P Value ◽  
Type Ii ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Self Acceptance ◽  
Ulcer Treatment

<p><em>Diabetes mellitus (DM) is a group of metabolic diseases characterized by high levels of glucose in the blood (hyperglycemia) that occurs due to impaired insulin secretion, decreased insulin action, or a result of both. Self-acceptance is the ability and desire of individuals to live with all the characteristics themselves against diabetes mellitus. This study aims to determine the effectiveness of diabetic ulcer treatment on self-acceptance of Type II Diabetes Mellitus patients at Asri Wound Care Center Medan. This study uses quantitative research methods with a quasi-experimental design through the one-group pretest-posttest design approach. The population in the study as many as 20 people, with sampling techniques using saturated sampling, the research sample amounted to 20 people. This study uses a nonparametric statistical test that is paired t-test. The results of research on self-acceptance of patients with type II diabetes mellitus before treatment of diabetic ulcers showed that the majority of self-acceptance was not good, and the self-acceptance of patients after treatment of diabetic ulcers obtained the majority of good self-acceptance. The effectiveness of diabetic ulcer treatment on self-acceptance of type II diabetes mellitus patients obtained significance value p-value = 0.00 (p-value &lt;0.05) then H0 was rejected. This means that there are differences in self-acceptance of type II Diabetes mellitus patients before and after diabetic ulcer treatment at Asri Wound Care Center Medan. Future researchers are expected to discuss more deeply about the factors that affect the self-acceptance of diabetes mellitus patients who are undergoing treatment for diabetic ulcers.</em></p>

Relation Between Tissue Iron Content and Polarization of Macrophages in Diabetic Ulcer and the Transitional Zone of Diabetic Ulcers with Major Amputation

2021 ◽  
pp. 153473462110374
Author(s):  
Shirin Saberianpour ◽  
Mohamad H. Saeed Modaghegh ◽  
Mehdi Montazer ◽  
Mohammad M. Kamyar ◽  
Fatemeh Sadeghipour Kerman ◽  
...  
Keyword(s):  
Hypoxia Inducible Factor ◽  
Transitional Zone ◽  
Major Amputation ◽  
Blue Staining ◽  
Control Group ◽  
Diabetic Patients ◽  
Tissue Preparation ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Tissue Iron

Most diabetic lower-limb amputations probably result from combinations of contributing causes rather than from unitary causes. Iron-induced damage might modulate the development of chronic diabetes complications. In this study, the relationship between tissue iron levels and polarization of macrophages in induction of angiogenesis was investigated in diabetic ulcer samples and the transitional zone of diabetic ulcers. Patients with diabetic ulcers who underwent amputation were included. The transitional zone of diabetic ulcers, from the same diabetic patients, was used as a control group. After tissue preparation, Perls Prussian blue staining and immunohistochemistry for CD11c, CD163, and CD68 markers were done. Vascular endothelial growth factor (VEGF), hypoxia-inducible factor (HIF), Tie2, and protein kinase B (also known as AKT) transcription of genes were measured by real-time polymerase chain reaction. For statistical analysis, we used independent samples t-test or its nonparametric equivalents, Mann–Whitney U test was used for quantitative variables, and chi-square (or Fisher's exact test) for qualitative variables. According to the results, the ratio of M2 to M1 macrophages was decreased in ulcers tissue compared to the transitional zone of diabetic ulcers. The expression of angiogenesis-related genes was increased due to hypoxia induction such as HIF and VEGF in ulcer tissue ( P < .0001), but the expression of vascular stability-related genes such as Tie2 was decreased ( P < .0001).In amputated diabetic ulcers, the polarization of macrophages is toward the classic type, but no connection was found in terms of tissue iron and help in the polarization of macrophages.

scholarly journals Perbandingan efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Angelica M. J. Wagiu ◽  
Richard M. Sumangkut ◽  
Heber B. Sapan ◽  
Louise A. J. Waworuntu
Keyword(s):  
Peripheral Arterial Disease ◽  
Proteus Mirabilis ◽  
Peracetic Acid ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Citrobacter Diversus ◽  
Peripheral Arterial ◽  
Topical Antimicrobial

Abstract: Diabetic ulcer is a condition of infection, ulceration, and or destruction of inner skin tissue related to neurological disorders and degrees of peripheral arterial disease (PAD) in diabetic patients. Diabetic ulcer is prone to infection due to decreased immune response, therefore, opportunistic microbes can become pathogens. Infection is sttill a serious problem in diabetic ulcer since the high cost and long duration of treatment lead to complicated neclected ulcer. This study aimed to obtain the present profile of microbes in diabetic ulcers and the effectivitveness of peracetic acid dan feracrylum in the treatment of diabetic ulcers. This was a descriptive analytical study. The ulcer degree was determined by using PEDIS criteria. Pus specimen was taken with a sterile technique using a transport media, cultured in the Baxtec machine, and the microbes were identified and further tested for sensitivity to peracetic acid dan feracrylum 1%. The results showed that of the 57 patients there were 36 females with a mean age of 58.77+ 9.077 years. Most of the patients (30 patients) had diabetic ulcers of 4th degree. The result of pus culture showed Gram negative Proteus mirabilis as the most frequent microbe (17.5%). The sensitivity test showed that 100% of 12 types of microbes, 83.3% of Citrobacter diversus, and 60% of Proteus mirabilis samples were sensitive to peracetic acid, meanwhile, all microbes were resistant to feracrylum 1% dan NaCl as controls,. Conclusion: Peracetic acid was more effective than feracrylum 1% as topical antimicrobial for diabetic ulcer.Keywords: diabetic ulcer, microbe, topical antimicrobial agentAbstrak: Ulkus diabetik adalah suatu kondisi adanya infeksi, ulserasi dan atau kerusakan jaringan kulit yang lebih dalam yang berhubungan dengan kelainan neurologik serta berbagai tingkatan peripheral arterial disease (PAD) pada penderita diabetes melitus (DM). Ulkus diabetik lebih mudah terinfeksi karena respons kekebalan tubuh penderita DM biasanya menurun, bahkan kuman oportunistik juga dapat menjadi patogen. Infeksi masih menjadi masalah yang paling serius dialami penderita ulkus diabetik oleh karena biaya pengobatan yang besar dan waktu perawatan yang lama sehingga ulkus sering dibiarkan terinfeksi dengan komplikasi tanpa perawatan adekuat. Penelitian ini bertujuan untuk memperoleh data terkini pola kuman penderita ulkus diabetik dan untuk mengetahui efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik. Jenis penelitian ini ialah deskriptif analitik. Derajat ulkus dinilai dengan kriteria PEDIS. Spesimen pus diambil secara steril dengan media transpor, ditanam dalam mesin Baxtec, kemudian dilakukan identifikasi kuman dan uji sensitivitas terhadap asam perasetik dan feracrylum 1%. Hasil penelitian memperlihatkan dari 57 penderita ulkus diabetik terbanyak ialah perempuan (36 penderita) dengan rerata usia 58,77+9,077 tahun. Sebagian besar ulkus diabetik (30 penderita) termasuk derajat 4. Hasil kultur memperlihatkan Proteus mirabilis (Gram negatif) yang tersering (17,5%). Hasil uji sensitivitas pola kuman memperlihatkan 100% sampel dari 12 jenis kuman, 83,3% dari Citrobacter diversus, dan 60% dari Proteus mirabilis sensitif terhadap asam perasetik, sedangkan terhadap feracrylum 1% dan NaCl sebagai kontrol, seluruh kuman telah resisten. Simpulan: Asam perasetik lebih efektif dibandingkan feracrylum 1% sebagai antimikroba topikal pada ulkus diabetik.Kata kunci: ulkus diabetik, mikroba, antimikroba topikal

scholarly journals Effect of Health Education on Improving the Knowledge among Diabetes Mellitus Patients in the Prevention of Diabetic Ulcer in Regional Hospital of Tidore Island

2021 ◽  
Vol 4 (4) ◽  
pp. 379-384
Author(s):  
Haeril Amir ◽  
Nur Wahyuni Munir
Keyword(s):  
Diabetes Mellitus ◽  
Health Education ◽  
Diabetic Foot ◽  
Regional Hospital ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers

International  Diabetes  Federation  (IDF) reported that the number of diabetes mellitus patients worldwide increases every year. Diabetes mellitus is a chronic disease due to damage to the pancreas in producing enough insulin and characterized by impaired metabolism of fats, increased blood sugar, carbohydrates and protein both absolutely and relatively. Diabetic foot ulcers (DFU) are among the most common complications in diabetic patients and are associated with high mortality, morbidity, and health costs.   This study was to determine the effect of health education on knowledge improvement about diabetic ulcers in the regional hospital of Tidore Islands.  This research is a quasi-experimental type with a pretest-posttest without a control group design. The research sample consisted of 30 respondents who met the inclusion criteria. Data were analyzed using a paired test and processed with statistic version 21. Based on the research results, there was an improved knowledge in pre and post-health education counseling, where the average score before health education counseling was 11.6. After health counseling, the average value was 15.0. The results showed the effect of knowledge in the prevention of diabetic ulcers with a p-value =0,000.  Health education is an effort to improve patient's ability to prevent diabetic foot ulcers that have been proven in several scientific studies. Health education methods provide additional information so that patients who previously wondered about their disease can directly ask health workers. Health education affects the knowledge improvement of Diabetes Mellitus patients in the Regional hospital of Tidore Islands  

scholarly journals Transdermal deferoxamine prevents pressure-induced diabetic ulcers

2014 ◽  
Vol 112 (1) ◽  
pp. 94-99 ◽  
Author(s):  
Dominik Duscher ◽  
Evgenios Neofytou ◽  
Victor W. Wong ◽  
Zeshaan N. Maan ◽  
Robert C. Rennert ◽  
...  
Keyword(s):  
Wound Healing ◽  
Delivery System ◽  
Transdermal Delivery ◽  
Reactive Oxygen ◽  
Diabetic Patients ◽  
Ulcer Formation ◽  
Diabetic Wound ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Diabetic Wound Healing

There is a high mortality in patients with diabetes and severe pressure ulcers. For example, chronic pressure sores of the heels often lead to limb loss in diabetic patients. A major factor underlying this is reduced neovascularization caused by impaired activity of the transcription factor hypoxia inducible factor-1 alpha (HIF-1α). In diabetes, HIF-1α function is compromised by a high glucose-induced and reactive oxygen species-mediated modification of its coactivator p300, leading to impaired HIF-1α transactivation. We examined whether local enhancement of HIF-1α activity would improve diabetic wound healing and minimize the severity of diabetic ulcers. To improve HIF-1α activity we designed a transdermal drug delivery system (TDDS) containing the FDA-approved small molecule deferoxamine (DFO), an iron chelator that increases HIF-1α transactivation in diabetes by preventing iron-catalyzed reactive oxygen stress. Applying this TDDS to a pressure-induced ulcer model in diabetic mice, we found that transdermal delivery of DFO significantly improved wound healing. Unexpectedly, prophylactic application of this transdermal delivery system also prevented diabetic ulcer formation. DFO-treated wounds demonstrated increased collagen density, improved neovascularization, and reduction of free radical formation, leading to decreased cell death. These findings suggest that transdermal delivery of DFO provides a targeted means to both prevent ulcer formation and accelerate diabetic wound healing with the potential for rapid clinical translation.

Treating hard-to-heal ulcers: biocellulose with nanosilver compared with silver sulfadiazine

2020 ◽  
Vol 29 (Sup12) ◽  
pp. S33-S37
Author(s):  
Orawan Chansanti ◽  
Atthawit Mongkornwong
Keyword(s):  
Demographic Data ◽  
Good Choice ◽  
Silver Sulfadiazine ◽  
Randomised Control Trial ◽  
Control Group ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Group Control Group ◽  
Experimental Group ◽  
Ulcer Treatment

Objective: Controlling infection and promoting healing should be the aims of hard-to-heal diabetic ulcer treatment, along with improving a patient's general condition and their blood sugar control. Many hard-to-heal diabetic ulcers present with cavities, tracks or a combination of these. There is a new biocellulose (with a nanosilver dressing) which has the ability to contour around and conform to the irregular surface of a wound bed. The purpose of this study was to evaluate its efficacy compared with a silver sulfadiazine cream, for hard-to-heal diabetic ulcer treatment. Methods: In this randomised control trial, patients with hard-to-heal diabetic ulcers were divided into two equal-sized groups: treatment with the biocellulose with blue nanosilver (experimental group), and treatment with silver sulfadiazine cream group (control group). Cotton gauze was used as the secondary dressing for both groups. Demographic data, wound size, wound classification, wound photography and bacterial cultures were recorded at the beginning of the study. Wounds were debrided as necessary. Dressings were changed twice daily in the control group, and every three days in the experimental group. Results: A total of 20 patients took part in the study (10 patients in each group). The highest mean wound healing rates were 91.4% in the experimental group and 83.9% in the control group. No wound infections or adverse effects from the dressings were detected in either group. Conclusion: In this study, biocellulose with blue nanosilver adapted well to the wound bed. Wound reduction was greater in the experimental group than the control group. Biocellulose with blue nanosilver could therefore be a good choice for hard-to-heal diabetic ulcer treatment, due to its good healing rates and minimal care requirements.

scholarly journals Beneficial Effects of Combination Therapy of Sitagliptin and β-carotene Drugs on Streptozotocin-induced Diabetic Rats

2020 ◽  
Vol 23 (2) ◽  
pp. 87-95
Author(s):  
Pulye Roy ◽  
Monirul Islam ◽  
Mohammad Saiful Islam ◽  
Mamunur Rashid
Keyword(s):  
Combination Therapy ◽  
Density Lipoprotein ◽  
Diabetic Control ◽  
Diabetic Rats ◽  
Fixed Dose ◽  
Diabetic Patients ◽  
Control Groups ◽  
Chronic Hyperglycemia ◽  
Serum Glutamate ◽  
Β Carotene

Diabetes mellitus (DM), characterized by chronic hyperglycemia is one of the most common chronic diseases affecting millions of people worldwide. A significant component of the risk associated with DM is thought to be because of its abnormal lipid ‘triad’ profile. All the associated complications are mainly due to imbalance between generation of free radicals and the antioxidant systems like catalase (CAT) and super oxide dismutase (SOD) enzymes. Moreover, increased level of serum glutamate pyruvate transaminase (SGPT) and serum glutamate oxaloacetate transaminase (SGOT) are considered a consequence of hepatocyte damage. The current study was designed to investigate the antihyperglycemic and antidyslipidemic effects, oxidative stress and liver dysfunction indices of fixed dose combination therapy of sitagliptin [50 mg/70kg body weight (BW)] and β-carotene (5 mg/70kg BW) on streptozotocin (45 mg/kg BW) induced diabetic rats (SIDRs). The study showed that combination therapy induced a significant decrease in blood glucose level (BGL) from 19.09 ± 0.13 to 6.86 ± 0.11 mmol/l in comparison to the control group after daily treatment for three weeks. In case of dyslipidimic effect, combination therapy reduced total cholesterol (TC) (22.96%), triglycerides (TG) (17.54%) and low-density lipoprotein (LDL)-cholesterol (52.25%) levels significantly and increased high-density lipoprotein (HDL)-cholesterol level (55.98%) in comparison with respective diabetic control groups. We also observed that combination therapy lowered SGPT & SGOT level by 46.39% and 37.23%, respectively and increased SOD & CAT enzyme activity by 63.79% and 48.32%, respectively in comparison with diabetic control groups. These changes were significantly better than those of sitagliptin and β-carotene monotherapy. The suggestions of our findings of this research are that combination therapy is more potent than their individual monotherapy and may be beneficial for the treatment of diabetic patients with associated complications. Bangladesh Pharmaceutical Journal 23(2): 87-95, 2020

scholarly journals The Effects of Tocotrienol-Rich Vitamin E (Tocovid) on Diabetic Neuropathy: A Phase II Randomized Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1522
Author(s):  
Yeek Tat Ng ◽  
Sonia Chew Wen Phang ◽  
Gerald Chen Jie Tan ◽  
En Yng Ng ◽  
Nevein Philip Botross Henien ◽  
...  
Keyword(s):  
Vitamin E ◽  
Nerve Conduction ◽  
Controlled Trial ◽  
Intervention Group ◽  
Serum Biomarkers ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Diabetic Patients ◽  
Chronic Hyperglycemia ◽  
Conduction Velocities

Chronic hyperglycemia increases oxidative stress, activates inflammatory pathways and reduces nerve growth factor (NGF) among diabetic patients, which contribute to development of diabetic peripheral neuropathy (DPN). Tocotrienol-Rich Vitamin E (Tocovid) possesses potent antioxidant and anti-inflammatory properties which are postulated to target these pathogeneses in order to ameliorate DPN. This study aims to evaluate the effects of Tocovid on nerve conduction parameters and serum biomarkers among diabetic patients. This multicenter, prospective, randomized, double-blind, placebo-controlled clinical trial was conducted on 80 eligible participants. The intervention group (n = 39) was randomly allocated to receive 200 mg of Tocovid twice a day, and the control group (n = 41) received placebo twice a day. At the end of eight weeks, the nerve conduction parameters, as assessed by nerve conduction study, as well as serum biomarkers (NGF, malondialdehyde, vascular cell adhesion molecule 1, tumor necrosis factor receptor 1 and thromboxane B2) were compared between the two groups. Compared to placebo, Tocovid significantly improves the nerve conduction velocities of all nerves (+1.25 m/s, interquartile range [IQR] 3.35, p < 0.001, median nerve; +1.60 m/s, IQR 1.80, p < 0.001, sural nerve; +0.75 m/s, IQR 2.25, p < 0.001, tibial nerve). Meanwhile, the levels of serum NGF were significantly higher in the Tocovid group as compared to placebo at eight weeks post-intervention. Participants receiving Tocovid illustrated highly significant improvement in terms of nerve conduction velocities for all nerves tested after eight weeks of supplementation. In addition, Tocovid supplementation elevated the levels of serum NGF, in which its increase is postulated to reflect enhanced neuronal functions. This novel finding suggests that Tocovid could be a disease-modifying agent targeting serum NGF to improve nerve conduction velocities.

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