Patients will be subjected to:
1-History taking including duration of diabetes and ulcer . 2 Clinical examination of ulcer , including diagnosis of osteomyelitis 3- Venous blood will be withdrawn to do the following laboratory tests :
HbA1c
erythrocyte sedimentation rate(ESR)
C reactive protein(CRP)
Complete blood culture
Serum urea and creatinine 4-culture and sensitivity test 5-Bone fragments and tissue biopsy from infected ulcers 6-Fundus examination

Diabetic Foot Osteomyelitis

swabs from ulcer tissue and bone biopsy for culture and sensitivity test and blood sampling

fungal osteomyelitis culture and sensitivity

Assuit University,71511

Fungal Infection in Patients With Diabetic Foot Osteomyelitis

The Effect of Fungal Infection on the Outcome Among Diabetic Patients With Foot Osteomyelitis

to evaluate the percentage of fungal infection among foot osteomyelitis and its effect on either healing or amputation.

to know the impact of adding antifungal treatment may accelerate healing and improve the prognosis.and know the percentage of patients with fungal osteomyelitis healed after antifungal therapy and evaluation of healing response through radiological and laboratory findings

Rowyda El-sayed Gooda Ali

assistant lecturer

Assiut University

Diabetic foot routine treatment without intervention

On the basis of routine treatment of diabetic foot, adipose stem cells will be added to treat diabetic foot

Diabetes Mellitus Foot Ulcer

intramuscular injection of adipose stem cells treat diabetic foot

MSCs treatment

Clinical Study of Adipose-derived Stem Cells in the Treatment of Diabetic Foot

Ulcer healing rate = number of cases of complete wound healing / total number of ulcers in this group

Amputation rate = number of amputations / total number of amputations in this group

Evaluate patients' limbs blood flow by ultrasound，We will record blood flow velocities, for example， 4ml/second.

The ratio of ankle artery pressure to brachial artery pressure was obtained by measuring the contractile pressure of the posterior tibial artery, anterior tibial artery and brachial artery of the ankle.ABI≥0.9 means normal,0.8≥ABI≥0.7means mild arterial obstruction,0.6≥ABI≥0.4means moderate arterial obstruction,ABI＜0.4means severe arterial obstruction.

Evaluate patients'oxygen level by TcPO2,TcPO2＜20mmHg means very severe lesion.

Evaluate patients' limbs blood flow by CTA,We will record blood flow velocities, for example， 4ml/second.

Evaluate patients' limbs blood flow by Rutherford classification，Grade 0: Normal Grade 1: Walking over 500 meters with lameness Grade 2: Walking 200-500 meters with lameness Grade 3: Walking within 200 meters with lameness Grade 4: Resting pain Grade 5: Small ulcer Grade 6: Large ulcer.

Evaluate patients' degree of pain by Wong-Baker Faces Pain Rating Scale.There are 6 faces in the Wong-Baker Pain Scale. The first face represents a pain score of 0, and indicates "no hurt". The second face represents a pain score of 2, and indicates "hurts a little bit." The third face represents a pain score of 4, and indicates "hurts a little more". The fourth face represents a pain score of 6, and indicates "hurts even more". The fifth face represents a pain score of 8, and indicates "hurts a whole lot"; the sixth face represents a pain score of 10, and indicates "hurts worst.

Maoquan Li

Prof. Dr. Li

Patients with diabetic foot ulcers treated with Heberprot P

Diabetic Foot

75 µg vials administered at the rate of a vial 3 times per week (Sunday Tuesday, Thursday) by intralesional and perilesional route.For this, the reconstitution and dilution of the vial will be carried out with 5 mL of water for injection. The administrations will be kept up to 8 weeks of treatment or until there is achieved granulation of the 100 % of the lesion.

Heberprot P

Efficacy and Safety of Heberprot-P® in Patients With Advanced Diabetic Foot Ulcer in Dasman Diabetes Institute.

Efficacy and Safety of Heberprot-P® in Patients With Advanced Diabetic Foot Ulcer in Dasman Diabetes Institute. Demonstrative Study

Lesion area granulation will be assessed as: Non response (0%-25%); Minimal (25%-50%); Partial (50%-75%); Total (75%-100%)

Dasman Diabetes Institute

Cuban Center for Genetic Engineering and Biotechnology

Multiple intra muscular injection of mesenchymal stem cells derived from human umbilical cord.

Any therapy for diabetic foot which is routinely practiced and accepted in China

Critical Limb Ischemia

Mesenchymal Stem Cells

Umbilical Cord

umbilical cord mesenchymal stem cells

Any thing directed to improve blood perfusion in the limb example.Heparin,Antiplatelet agents etc

diabetic foot/fever

Fungal Infection in Patients With Diabetic Foot Osteomyelitis

Clinical Study of Adipose-derived Stem Cells in the Treatment of Diabetic Foot

Efficacy and Safety of Heberprot-P® in Patients With Advanced Diabetic Foot Ulcer in Dasman Diabetes Institute.

Umbilical Cord Mesenchymal Stem Cells Injection for Diabetic Foot

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