RESUMO
Diabetic foot ulcer is a chronic health issue leading to lower leg amputations in approximately 15% of patients with diabetics. There are many factors directly or indirectly involved in the physiology of wound healing but being a multisystem disorder, wound healing in diabetic patients retard or worsen with heavy exudates and severe microbial infections. Wound management is of prime importance and is an emerging area to incorporate wound regenerative materials in natural or synthetic dressing materials along with proper microbial control. The article aim to identify suitable dressing materials which exhibit inherent wound healing properties at the same time flexible to be used as drug carriers for slow, consistent and effective delivery of 'functional drugs' to the wound environment. The authors selected nine materials from the popular and well accepted dressings of patient choice, analyzed them using graph theoretic approach and ranked them on the basis of graph index values obtained. A critical review has also been done on the basis of their ranking, providing insights to the advantages, disadvantage and potential of top 5 ranked candidate materials. Alginate, Honey, Medifoam, Saline, and Hydrogel dressings were the top five candidate materials ranked respectively, even then, the authors suggests that 'modified hydrogels' can have the potential to be used as a future candidate in DFU treatment as it is the only material (among the top ranked ones) which can effectively used as regenerative drug carrier, while providing all other wound healing properties in relative proportions. The proposed framework can be modified and applied in the selection and ranking of materials for any kind of applications both in industry and medical fields by identifying factors influencing the final outcome of study and by listing the characteristics of the materials selected.
RESUMO
The global risks report of 2020 stated, climate-related issues dominate all of the top-five long-term critical global risks burning the planet and according to the report, "as existing health risks resurge and new ones emerge, humanity's past successes in overcoming health challenges are no guarantee of future results." Over the last few decades, the world has experienced several pandemic outbreaks of various pathogens and the frequency of the emergence of novel strains of infectious organisms has increased in recent decades. As per expert opinion, rapidly mutating viruses, emergence and re-emergence of epidemics with increasing frequencies, climate-sensitive vector-borne diseases are likely to be increasing over the years and the trends will continue and intensify. Susceptible disease hosts, anthropogenic activities and environmental changes contribute and trigger the 'adaptive evolution' of infectious agents to thrive and spread into different ecological niches and to adapt to new hosts. The overarching objective of this paper is to provide insight into the human actions which should be strictly regulated to help to sustain life on earth. To identify and categorize the triggering factors that contribute to disease ecology, especially repeated emergence of disease pandemics, a theory building approach, 'Total Interpretive Structural Modeling' (TISM) was used; also the tool, 'Impact Matrix Cross-Reference Multiplication Applied to a Classification' analysis (MICMAC) was applied to rank the risk factors based on their impacts on other factors and on the interdependence among them. This mathematical modeling tool clearly explains the strength, position and interconnectedness of each anthropogenic factor that contributes to the evolution of pathogens and to the frequent emergence of pandemics which needs to be addressed with immediate priority. As we are least prepared for another pandemic outbreak, significant policy attention must be focused on the causative factors to limit emerging outbreaks like COVID 19 in the future.
