JMERC
Owner
Janbazan Medical and Engineering Research Center (JMERC) is the owner of IJWPH.
0.3
Cite Score
SJR: 0.114 / SNIP: 0.090
Volume 13, Issue 3 (2021)
Iran J War Public Health 2021, 13(3): 179-184 |
Back to browse issues page
Article Type:
Subject:
History
Received: 2021/08/18 | Accepted: 2021/08/25 | Published: 2021/11/8
Received: 2021/08/18 | Accepted: 2021/08/25 | Published: 2021/11/8
How to cite this article
Adnan Mohammed H, Qassim Mohammed H, Salman Omairi S. Phagocytic Activity of Patients with a Diabetic Foot in Wasit Province, Iraq. Iran J War Public Health 2021; 13 (3) :179-184
URL: http://ijwph.ir/article-1-994-en.html
URL: http://ijwph.ir/article-1-994-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rights and permissions
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
1- Department of Internal Medicine, College of Medicine, Wasit University, Kut, Iraq
2- Department of Microbiology, College of Medicine, Wasit University, Kut, Iraq
3- Department of Anatomy and Biology, College of Medicine, Wasit University, Kut, Iraq
2- Department of Microbiology, College of Medicine, Wasit University, Kut, Iraq
3- Department of Anatomy and Biology, College of Medicine, Wasit University, Kut, Iraq
Abstract (2017 Views)
Aims: Diabetes mellitus has been known as a common disease that leads to many comorbid conditions. One of these common conditions is the diabetic foot which increases infections risk. This study was aimed to investigate phagocytic activity in patients with a diabetic foot.
Materials & Methods: This study was carried out on 150 patients with a diabetic foot in al-Zahraa and al-Karama Teaching Hospitals, Iraq from January 2017 to January 2020. A total of 150 samples was collected for 3 groups (50 participants in each group). Blood samples were transferred into EDTA tubes, then 5ml of blood were pipetted in a plain tube. Thereafter, 0.5ml of working nitro blue tetrazolium solution was prepared by mixing an equal volume of 0.2% nitro blue tetrazolium solution with phosphate-buffered saline. Next, the plain tube was incubated at 37°C for 15 minutes in a water bath before being left for another 15 minutes at room temperature. A blood smear from the prepared mixture was then stained using Gemza stain. Finally, 100 neutrophils were randomly calculated, and the positive with formazan phenomena appear with blue-black granules were counted out of 100 cells. The statistical data analysis was performed with SPSS 22 using t-test.
Findings: The phagocytic activity was significantly higher in healthy control individuals (14.10±3.96) compared to DM1 (10.54±3.60) and DM2 (11.88±3.54) (p<0.05). There was a significant difference between the control group with DM1 (p=0.448, F=0.58), and DM2 (p=0.314. F=1.02) in term of phagocytes activity.
Conclusion: There is a clear reduction of phagocytic activity in patients with both types of diabetes mellitus with a diabetic foot comparing the healty group.
Materials & Methods: This study was carried out on 150 patients with a diabetic foot in al-Zahraa and al-Karama Teaching Hospitals, Iraq from January 2017 to January 2020. A total of 150 samples was collected for 3 groups (50 participants in each group). Blood samples were transferred into EDTA tubes, then 5ml of blood were pipetted in a plain tube. Thereafter, 0.5ml of working nitro blue tetrazolium solution was prepared by mixing an equal volume of 0.2% nitro blue tetrazolium solution with phosphate-buffered saline. Next, the plain tube was incubated at 37°C for 15 minutes in a water bath before being left for another 15 minutes at room temperature. A blood smear from the prepared mixture was then stained using Gemza stain. Finally, 100 neutrophils were randomly calculated, and the positive with formazan phenomena appear with blue-black granules were counted out of 100 cells. The statistical data analysis was performed with SPSS 22 using t-test.
Findings: The phagocytic activity was significantly higher in healthy control individuals (14.10±3.96) compared to DM1 (10.54±3.60) and DM2 (11.88±3.54) (p<0.05). There was a significant difference between the control group with DM1 (p=0.448, F=0.58), and DM2 (p=0.314. F=1.02) in term of phagocytes activity.
Conclusion: There is a clear reduction of phagocytic activity in patients with both types of diabetes mellitus with a diabetic foot comparing the healty group.
Keywords:
References
1. American diabetes association. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997;20(7):1183-97. [Link] [DOI:10.2337/diacare.20.7.1183] [PMID]
2. Genuth S, Alberti KGMM, Bennett P, Buse J, Defronzo R, Kahn R, et al. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care. 2003;26(11):3160-7. [Link] [DOI:10.2337/diacare.26.11.3160] [PMID]
3. American diabetes association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1:62-9. [Link] [DOI:10.2337/dc10-S062] [PMID] [PMCID]
4. Olatunbosun ST. What are the WHO diagnostic criteria for diabetes and impaired glucose tolerance?. Medscape. 2021, Sep 20. [Link]
5. Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomark Insights. 2016;11:95-104. [Link] [DOI:10.4137/BMI.S38440] [PMID] [PMCID]
6. Boulton AJM, Armstrong DG, Albert SF, Frykberg RG, Hellman R, Kirkman MS, et al. Comprehensive foot examination and risk assessment: A report of the task force of the foot care interest group of the american diabetes association, with endorsement by the american association of clinical endocrinologists. Diabetes Care. 2008;31(8):1679-85. [Link] [DOI:10.2337/dc08-9021] [PMID] [PMCID]
7. Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation: Basis for prevention. Diabetes Care. 1990;13(5):513-21. [Link] [DOI:10.2337/diacare.13.5.513] [PMID]
8. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217-28. [Link] [DOI:10.1001/jama.293.2.217] [PMID]
9. Cheer K, Shearman C, Jude EB. Managing complications of the diabetic foot. BMJ. 2009;339:4905. [Link] [DOI:10.1136/bmj.b4905] [PMID]
10. Davis WA, Norman PE, Bruce DG, Davis TM. Predictors, consequences and costs of diabetes-related lower extremity amputation complicating type 2 diabetes: The fremantle diabetes study. Diabetologia. 2006;49(11):2634-41. [Link] [DOI:10.1007/s00125-006-0431-0] [PMID]
11. Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Krivitz SR, et al. Diabetic foot disorders: A clinical practice guideline (2006 revision). J Foot Ankle Surg. 2006;45(5 Suppl):1-66. [Link] [DOI:10.1016/S1067-2516(07)60001-5]
12. Apelqvist J, Bakker K, Van Houtum WH, Nabuurs-Franssen MH, Schaper NC. International consensus and practical guidelines on the management and the prevention of the diabetic foot: International working group on the diabetic foot. Diabetes Metab Res Rev. 2000;16 Suppl 1:84-92.
https://doi.org/10.1002/1520-7560(200009/10)16:1+<::AID-DMRR113>3.0.CO;2-S [Link] [DOI:10.1002/1520-7560(200009/10)16:1+3.0.CO;2-S]
13. American diabetes association. Standards of medical care in diabetes-2013. Diabetes Care. 2013;36 Suppl 1:11-66. [Link] [DOI:10.2337/dc13-S011] [PMID] [PMCID]
14. Lipsky BA, Berendt AR, Deery HG, Embil JM, Joseph WS, Karchmer AW, et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2004;39(7):885-910. [Link] [DOI:10.1086/424846] [PMID]
15. Karchmer AW, Gibbons GW. Foot infections in diabetes: Evaluation and management. Curr Clin Top Infect Dis. 1994;14:1-22. [Link]
16. Embil JM, Trepman E. Microbiological evaluation of diabetic foot osteomyelitis. Clin Infect Dis. 2006;42(1):63-5. [Link] [DOI:10.1086/498121] [PMID]
17. Wheat LJ, Allen SD, Henry M, Kernek CB, Siders JA, Kuebler T, et al. Diabetic foot infections: Bacteriologic analysis. Arch Intern Med. 1986;146(10):1935-40.
https://doi.org/10.1001/archinte.146.10.1935 [Link] [DOI:10.1001/archinte.1986.00360220079017]
18. Sapico FL, Witte JL, Canawati HN, Montgomerie JZ, Bessman AN. The infected foot of the diabetic patient: Quantitative microbiology and analysis of clinical features. Rev Infect Dis. 1984;6 Suppl 1:171-6. [Link] [DOI:10.1093/clinids/6.Supplement_1.S171] [PMID]
19. Lipsky BA, Pecoraro RE, Larson SA, Hanley ME, Ahroni JH. Outpatient management of uncomplicated lower-extremity infections in diabetic patients. Arch Intern Med. 1990;150(4):790-7.
https://doi.org/10.1001/archinte.1990.00390160058013 [Link] [DOI:10.1001/archinte.150.4.790]
20. Joseph WS, Axler DA. Microbiology and antimicrobial therapy of diabetic foot infections. Clin Podiatr Med Surg. 1990;7(3):467-81. [Link]
21. Urbancic-Rovan V, Gubina M. Bacteria in superficial diabetic foot ulcers. Diabet Med. 2000;17(11):814-5. [Link] [DOI:10.1046/j.1464-5491.2000.00374-2.x] [PMID]
22. Sims D, Keating SE, DeVincentis AF. Bacteriology of diabetic foot ulcers. J Foot Surg. 1984;23(2):149-51. [Link]
23. Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJG, Armstrong DG, et al. 2012 infectious diseases society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012;54(12):132-73. [Link] [DOI:10.1093/cid/cis346] [PMID]
24. Jeffcoate WJ, Harding KG. Diabetic foot ulcers. Lancet. 2003;361(9368):1545-51. [Link] [DOI:10.1016/S0140-6736(03)13169-8]
25. Lipsky BA, Peters EJG, Senneville E, Berendt AR, Embile JM, Lavery LA, et al. Expert opinion on the management of infections in the diabetic foot. Diabetes Metab Res Rev. 2012;28 Suppl 1:163-78. [Link] [DOI:10.1002/dmrr.2248] [PMID]
26. Chantelau E, Tanudjaja T, Altenhofer F, Ersanli Z, Lacigova S, Metzger C. Antibiotic treatment for uncomplicated neuropathic forefoot ulcers in diabetes: A controlled trial. Diabet Med. 1996;13(2):156-9.
https://doi.org/10.1002/(SICI)1096-9136(199602)13:2<156::AID-DIA59>3.0.CO;2-U [Link] [DOI:10.1002/(SICI)1096-9136(199602)13:23.0.CO;2-U]
27. Hirschl M, Hirschl AM. Bacterial flora in mal perforant and antimicrobial treatment with ceftriaxone. Chemotherapy. 1992;38(4):275-80. [Link] [DOI:10.1159/000239012] [PMID]
28. Chang BB, Darling RC, Paty PS, Lioyd WE, Shah DM, Leather RP. Expeditious management of ischemic invasive foot infections. Cardiovasc Surg. 1996;4(6):792-5. [Link] [DOI:10.1016/S0967-2109(96)00045-2]
29. Lekstrom-Himes JA, Gallin JI. Immunodeficiency diseases caused by defects in phagocytes. N Engl J Med. 2000;343(23):1703-14. [Link] [DOI:10.1056/NEJM200012073432307] [PMID]
30. Notarangelo LD. Primary immunodeficiencies. J Allergy Clin Immunol. 2010;125(2 Suppl 2):182-94. [Link] [DOI:10.1016/j.jaci.2009.07.053] [PMID]
31. Dinauer MC. Primary immune deficiencies with defects in neutrophil function. Hematol Am Soc Hematol Educ Program. 2016;2016(1):43-50. [Link] [DOI:10.1182/asheducation-2016.1.43] [PMID] [PMCID]
32. Meerhof LJ, Roos D. Heterogeneity in chronic granulomatous disease detected with an improved nitroblue tetrazolium slide test. J Leukoc Biol. 1986;39:699-711. [Link] [DOI:10.1002/jlb.39.6.699] [PMID]
33. World health organization. The WHO global infobase [Internet]. Geneva: World Health Organization; 2006 [cited: unknown]. Available from: https://asksource.info/resources/who-global-infobase. [Link]
34. American diabetes association. Standards of medical care in diabetes-2010. Diabetes Care. 2010;33 Suppl 1:11-61. [Link] [DOI:10.2337/dc10-S011] [PMID] [PMCID]
35. Fox CS, Pencina MJ, Meigs JB, Vasan RS, Levitzky YS, Daqostino RB. Trends in the incidence of type 2 diabetes mellitus from the 1970s to the 1990s: The Framingham heart study. Circulation. 2006;113(25):2914-8. [Link] [DOI:10.1161/CIRCULATIONAHA.106.613828] [PMID]
36. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53. [Link] [DOI:10.2337/diacare.27.5.1047] [PMID]
37. Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010;362(12):1090-101. [Link] [DOI:10.1056/NEJMoa0908292] [PMID]
38. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011;378(9785):31-40. [Link] [DOI:10.1016/S0140-6736(11)60679-X]
39. Centers for disease control and prevention. National diabetes fact sheet, 2007 [Internet]. Atlanta: Centers for Disease Control and Prevention; 2010 [cited: Unknown]. Available from: https://stacks.cdc.gov/view/cdc/5613. [Link]
40. Lecube A, Pachon G, Petriz J, Hernandez C, Simo R. Phagocytic activity is impaired in type 2 diabetes mellitus and increases after metabolic improvement. Plos One. 2011;6(8):23366. [Link] [DOI:10.1371/journal.pone.0023366] [PMID] [PMCID]
41. Davidson NJ, Sowden JM, Fletcher J. Defective phagocytosis in insulin controlled diabetics: Evidence for a reaction between glucose and opsonising proteins. J Clin Pathol. 1984;37(7):783-6. [Link] [DOI:10.1136/jcp.37.7.783] [PMID] [PMCID]
42. Pavlou S, Lindsay J, Ingram R, Xu H, Chen M. Sustained high glucose exposure sensitizes macrophage responses to cytokine stimuli but reduces their phagocytic activity. BMC Immunol. 2018;19:24 [Link] [DOI:10.1186/s12865-018-0261-0] [PMID] [PMCID]
43. AL-Shaher MA, Al-Allaf RG. Estimation of phagocytic activity in diabetic patients (type 1,2) in Mosul city. Rafidain J Sci. 2012;23(8):31-40. [Link] [DOI:10.33899/rjs.2012.64520]
44. Liu BF, Miyata S, Kojima H, Uriuhara A, Kusunoki H, Suzuki K, et al. Low phagocytic activity of resident peritoneal macrophages in diabetic mice: Relevance to the formation of advanced glycation end products. Diabetes. 1999;48(10):2074-82. [Link] [DOI:10.2337/diabetes.48.10.2074] [PMID]
45. Martin S, Rothe H, Tschope D, Schwippert B, Kolb H. Decreased expression of adhesion molecules on monocytes in recent onset IDDM. Immunology. 1991;73(1):123-5. [Link]