RESUMO
Background and Aims: Diabetic foot ulcers, a major cause of amputations in diabetics, could benefit from natural products as adjuncts to standard care, given the costs and adverse effects of typical therapies. This study aims to evaluate the short-term effects of dressing with Dermaheal ointment in the treatment of DFUs through a double-blinded randomized controlled clinical trial. Methods: This double-blinded, placebo-controlled trial included 50 patients with Wagner's ulcer grade I or II, randomly assigned to Dermaheal and placebo groups (received standard treatment and placebo ointment). The ulcer site was dressed daily for four consecutive weeks with either Dermaheal or placebo ointment. Ulcer healing score (using DFU healing checklist), ulcer size with transparent ruler and largest dimension of ulcer, and pain severity using numerical pain rating score (were recorded at five-time points, including baseline, and on weeks 1, 2, 3, and 4). Also, ulcer healing status was investigated at the trial ended in November 2021. Results: Both groups showed significant improvement in ulcer healing over 4 weeks (p time < 0.001), with more remarkable progress in the Dermaheal group (p group = 0.03). At the trial end, complete ulcer healing was also significantly higher in the Dermaheal group compared to the placebo group (56% vs. 12%, p = 0.002). Both groups exhibited a decrease in ulcer size (p time < 0.001). Considering the baseline ulcer size as a covariate, substantial changes in mean ulcer size were noted in the initial (p = 0.01), second (p = 0.001), third (p = 0.002), and fourth (p = 0.002) weeks of the intervention, showing a preference for the Dermaheal group. However, no significant between-group difference was observed in pain severity levels. Conclusion: Dressing with Dermaheal as a topical treatment shows promise in improving healing and reducing the size of diabetic foot ulcers. Further research is needed to confirm these findings' long-term efficacy.
RESUMO
Background and Objective: Many biological activities and pharmacological usages have been revealed for the Cuscuta species. The present study aimed to assess the beneficial effects of Cuscuta on removing skin dark spots in healthy individuals, which is an important cosmetic concern, especially in women. Materials and Methods: This prospective, interventional before-after trial was conducted in 70 healthy individuals without any evidence of skin or systemic disorders who presented for consultation on removing skin darkening. The Cuscuta extract was prepared and then assessed for plant quality control and lack of microbial contamination. The content of melanin at baseline and at 1 and 3 months after intervention was assessed using Dermacatch, an accurate skin colorimetric measurement tool. Results: Comparison of the melanin content of the lesions and treated area to the surrounding normal area at baseline and at 1 month after treatment showed a significant reduction in melanin content from 519.61 ± 45.09 to 498.50 ± 39.35 (P < 0.001). This reducing trend remained significant from the first month to the third month after treatment (from 498.50 ± 39.35 to 483.53 ± 40.99, P < 0.001). This decreasing trend was persistent even after adjusting baseline characteristics including gender, age, and duration of skin lesions. Both patients and investigators had high satisfaction level with the anti-melanogenesis effect of Cuscuta extract. Conclusion: Cuscuta extract is useful for removing hyperpigmented lesions and for skin lightening in healthy individuals.