The potential impact and diagnostic value of inflammatory markers on diabetic foot progression in type II diabetes mellitus: A case-control study.

BACKGROUND: The wound-healing process in diabetic foot is affected by pro and anti-inflammatory markers, and any disruption in the inflammatory reaction interferes with tissue homeostasis, leading to chronic non-wound healing. AIM: This study aimed to determine the diagnostic value and effect of CRP, IL-6, TNF, and HbA1c on initiation the and progression of diabetic foot ulcers. METHOD: ELISA was used to quantify IL-6, TNF, CRP, and HbA1c in 205 patients with diabetes, and 105 were diabetic foot free. The prevalence and progression of diabetic foot were also evaluated. The area under the curve (AUC) was calculated using the receiver operating characteristic (ROC) curve to analyze the predictive values. Forward stepwise logistic regression analysis was used to compute the odds ratio (OR) and the corresponding 95% confidence intervals (CIs). RESULTS: CRP, IL-6, and FBS were found to be significant predictors of diabetic foot (OR=1.717, 95% CI=1.250-2.358, P=0.001; OR=1.434, 95% CI=1.142-1.802, P=0.002; and OR=1.040, 95% CI=1.002-1.080, P=0.037), respectively. The AUCs for CRP, IL-6, and HbA1c in predicting diabetic foot were 0.839, 0.728, and 0.834, respectively, demonstrating a good predictive value for each diagnostic marker. CONCLUSION: The current study demonstrated that IL-6, CRP, and HbA1c may be useful biomarkers to indicate diabetic foot progression. Furthermore, our findings showed a substantial relationship between CRP and HbA1c in individuals with diabetic foot conditions.

Assessment of Knowledge, Attitudes, and Perception of Health Care Workers Regarding COVID-19, A Cross-Sectional Study from Egypt.

Healthcare workers (HCWs) are at the frontline defense against the coronavirus disease 2019 (COVID-19) pandemic. Inadequate knowledge and incorrect attitudes among HCWs can directly influence practices and lead to delayed diagnosis, poor infection control practice, and spread of disease. This study aimed to assess the knowledge, perception, and attitude of the Egyptian HCWs towards the COVID-19 disease. A descriptive cross-sectional study was conducted in Egypt, among 407 HCWs using a self-administered questionnaire. The mean correct answer rate was 80.4% with a mean knowledge score of 18.5 ± 2.7 out of 24. A positive correlation between knowledge and attitude scores was detected (r = 0.215, p < 0.001). About 83.1% of our participants reported that they were afraid of being infected with COVID-19, and 89.2% stated that they were more susceptible to COVID-19 infection as compared to others. Unavailability of personal protective equipment (PPE), fear of transmitting the disease to their families, and social stigma were the most frequently reported reasons for increased risk perception. The overall knowledge level of HCWs was generally good especially among physicians. A positive attitude was detected among allied health professionals more than physicians. Risk perception was high among HCWs. Causes of increased risk perception need to considered by the government and the Egyptian Ministry of Health.