ABSTRACT
Diabetes mellitus [DM] is a serious health problem and remains an important cause of morbidity and mortality worldwide. Patients with uncontrolled diabetes develop complications; some of the most clinically important are foot ulcers, retinopathy, neuropathy and macrovascular complications. Foot complications such as foot ulcers constitute a major public health problem and impose a heavy burden in health service. The aim of the work was to isolate, identify the most common bacterial causes of diabetic foot lesions, and to assess the susceptabilty pattern of the isolated organisms to the commonly used antibiotics. Phagocytic index of neutrophils of diabetic foot patients was also evaluated and its change over a short treatment course. The study was carried out on 35 patients with diabetic foot wound admitted to the General Surgery Department in Benha University Hospital. Phagocytic index of neutrophils was determined for each case by the phagocytic test at the beginning of the study and 2 weeks later. Pus aspirates were collected from the foot wound and cultured to identify the causative bacteria and its antibiotic susceptibility pattern. The results of the bacteriologic study revealed that, pure culture was found in 12 patients [34.29%] and mixed infection was found in 23 patients [65.71%]. Gram negative isolates considered a high ratio [58.33%] than gram positive isolates [41.67%]. Most isolates were aerobes [90%], however anaerobes were [10%]. Staph aureus and Pseudomonas aeruginosa were the most commonly isolated bacterial species from diabetic foot wounds. The results of the immunologic study [phagocytic test] concluded that there is a statistically significant correlation between phagocytic index and the mean value of blood glucose
ABSTRACT
Serum levels of alpha-1-antitrypsin were determined in 37 infants and children and their parents. They were 20 cases of Down's syndrome, 7 cases of mosaic trisomy 21, 10 normal children and their consecutive parents. A significant decrease in mean serum alpha-1-anti-trypsin levels was found in mosaic Down syndrome cases in comparison to control group or to regular cases [P < 0.05]. No significant difference was found between alpha-1-antitrypsin levels in serum of parents of cases and that of parents of controls. Further, no correlation was found between cases or controls and their parents regarding serum alpha-1-antitrypsin levels. We conclude that alpha-1-antitrypsin might have a role in the development of trisomy 21 through its effect on mitotic cell division by unknown mechanism. Alpha-1-antitrypsin level in parents of cases might be defiicient only in the germ cell and mitotic non disjunction could happen upon an originally euploid zygote. As mosaic chromosomal abnormalities are of postzygotic origin, positive results observed in mosaic cases suggest that mitotic non disjunction could be the result of some unknwon influence of certain protease phenotypes upon a euploid zygote