ABSTRACT
@#Introduction: Chronic hyperglycemia can increase extracellular matrix (ECM) accumulation that leads to tendon fibrosis and subsequent contracture. Considering the reversibility of fibrosis, it is important to identify factors that are associated with it. The purpose of this study was to determine whether elevated HbA1c levels are associated with the development of Achilles tendon contracture in diabetes mellitus patients. Materials and methods: We reviewed 206 patients with diabetic foot problems between January 2015-December 2019. Demographic data, the presence of Achilles tendon contracture, and laboratory results were documented and statistically analysed between patients with contracture and without contracture. Results: Patients’ mean age was 58.46 ± 6.67 years old. Contracture was found in 84 out of 206 patients (40.78%) patients, with female predominance (45/84 patients; 53%). While contracture was found significantly associated with sex difference (0.035) and age groups (p=0.006), there was no meaningful association with HbA1c level groups (p=0.324). Conclusion: Findings do not support the use of HbA1c level as a sole determinant of Achilles tendon contracture. Seemingly, there are other confounding factors affecting the Achilles tendon contracture development in diabetes mellitus patients. It should be emphasised that albeit the association between chronic hyperglycemia and contracture development, the low HbA1c should not be overlooked as having no risk of Achilles tendon contracture and vice versa.
ABSTRACT
There have been many investigations on non-biodegradable materials acting as an antibiotic carrier for local drug delivery systems based on polymethyl methacrylate (PMMA) beads. However, the material is non-degradable and non-porous so that less than 5% of the encapsulated drug is released. In order to obtain better release of the antibiotics, greater porosity of the beads would be required. Adding fillers could increase the bead’s porosity, thus improving the antibiotic release from the beads. The purpose of the study is to optimize release kinetics of gentamicin from handmade beads by adding fillers such as glycine and sodium chloride in different concentrations. Terms of percolation theory will qualitatively be applied in interpreting the final results. Model beads were made by blending the antibiotics (gentamicin) with powdered PMMA, prepared with the inclusion of glycine and different concentration of sodium chloride in 100% monomer. To determine the gentamicin release, beads were placed in phosphate buffered saline (PBS) and aliquots were taken at designated times to measure the gentamicin concentration. Addition of glycine yielded 16 % release of the total amount of gentamicin incorporated in 24 hours. Subsequent addition of sodium chloride resulted in an increased gentamicin release, with little or no difference in gentamicin release once 16 g or more sodium chloride was added (gentamicin release 100% of the amount incorporated). In conclusion, addition of glycine and sodium chloride resulted in an increased release of gentamicin; however, the combination without sodium chloride seemed to have an inhibitory effect on the gentamicin release.