Background: One of the most prevalent and serious consequences in people with diabetes mellitus is diabetic foot ulcer (DFU). High management complexity, morbidity, and mortality are its defining traits. More efficient treatment methods are required since DFU therapy is still seen as frustrating and unsatisfying, even though new treatment alternatives are being developed. Objective: To assess the efficacy of using of platelet-rich plasma (PRP) on healing of DFUs in comparison to conventional therapy. Method: A randomized controlled clinical trial was conducted on 92 diabetic patients with DFUs. Those patients were randomly divided into two equal groups either study group in which PRP was used and applied locally to the wound followed by Vaseline gauze and sterile dressing, and control group where patients received standard therapy in form of debridement and dressing. Patients were seen twice weekly throughout the treatment course and clinical evaluation was performed once weekly. Results: Both groups had insignificant differences as regard basic characteristics and laboratory data. Study group showed significant higher frequency of complete wound healing in comparison to the control group (73.8% vs. 30.4%; p<0.001). Percentage of wound reduction in the size of the ulcer at the end of the study in comparison to baseline size was significantly better in the study group. Mean time to complete healing was significantly lower among study group in comparison to the control group (8.15 ± 0.37 vs. 11.30 ± 0.17 (week); p<0.001). Conclusion: Autologous PRP significantly improved the complete ulcer healing in patients with DFUs. Well designed and adequately powered clinical trials are needed to confirm these findings.
The Mediterranean hemopathic syndromes (MHS) are the most prevalent hemoglobinopathies in the Mediterranean basin. Transfusion therapy is the main therapy for these disorders, particularly for severe forms of the disease. Currently, pre-transfusion serological typing of erythrocyte antigens is the standard tool for reducing complications of transfusion in those patients. This study compared genotyping with phenotyping of non-ABO erythrocyte antigens in patients with MHS and assessed the effect of transfusion therapy on their results. One-hundred ninety-eight MHS patients were recruited, screened, and proven negative for allo-antibodies. They were grouped into two groups: (1) 20 newly diagnosed patients with no transfusion history and (2) 178 previously diagnosed patients undergoing transfusion therapy. Patients were interviewed and clinically examined. Full blood count (FBC) and high performance liquid chromatography (HPLC) were done for group 1 only. Genotyping and phenotyping of non-ABO erythrocyte antigens were performed for group 1, and 25 patients out of group 2 were propensity score-matched (PSM) with group 1. Both groups were gender and age matched; 55% and 74% of groups 1 and 2 had major disease, respectively. Insignificant differences were observed between genotyping and phenotyping of non-ABO erythrocyte antigens in group 1, while significant discrepancies and mixed field results were noted in group 2 patients. Discrepancies were obvious with JKa, JKb, and little c antigens. Conclusively, molecular typing is a powerful tool for pre-transfusion testing in chronically transfused MHS patients. This testing reduces incidence of transfusion reactions. JKa, JKb and little c antigens are the most clinically significant non-ABO erythrocyte antigens.
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