The rise in lower extremity amputations due to nonhealing of foot ulcers in diabetic patients calls for rapid improvement in effective treatment regimens. Administration of growth factors (GFs) are thought to offer an off-the-shelf treatment; however, the dose- and time-dependent efficacy of the GFs together with the hostile environment of diabetic wound beds impose a major hindrance in the selection of an ideal route for GF delivery. As an alternative, the delivery of therapeutic genes using viral and nonviral vectors, capable of transiently expressing the genes until the recovery of the wounded tissue offers promise. The development of implantable biomaterial dressings capable of modulating the release of either single or combinatorial GFs/genes may offer solutions to this overgrowing problem. This article reviews the state of the art on gene and protein delivery and the strategic optimization of clinically adopted delivery strategies for the healing of diabetic wounds.

There is a strong association between cardiometabolic risk and adipose tissue dysfunction with great consequences on type 2 diabetic patients. Visceral Adiposity Index (VAI) is an indirect clinical marker of adipose tissue dysfunction. Gum Arabic (GA) is a safe dietary fiber, an exudate of Acacia Senegal. Gum Arabic had shown lipid lowering effect in both humans and animals. The aim of this trial was to determine the effect of GA supplementation on anthropometric obesity marker, Visceral Adiposity Index (VAI) and blood pressure in patients with type 2 diabetes mellitus. This randomized, double blinded, placebo controlled trial recruited a total of 91 type 2 diabetic patients (73 females, 18 males), age (mean ± SD) 50.09 ± 9.3 years on hypoglycemic agents and were randomly assigned into two groups, either to consume 30 g of GA or 5 g of placebo daily for 3 months. Anthropometric obesity markers were measured and indices were calculated. Blood pressure was measured and high density lipoprotein (HDL) and triglycerides (TG) were determined in fasting blood samples at the start and end of the study period. After intervention, Gum Arabic decreased BMI and VAI significantly (P < 0.05) in GA group by 2 and 23.7% respectively. Body adiposity index significantly decreased by 3.9% in GA group while there were no significant changes in waist circumference or waist-to-hip ratio (WHR). Systolic blood pressure significantly decreased by 7.6% in GA group and by 2.7% in placebo group from baseline with no significant changes in diastolic blood pressure in the two groups. Gum Arabic consumption at a dose of 30 g/d for 3 months may play an effective role in preventing weight gain and modulating adipose tissue dysfunction in type 2 diabetic patients, although no effect has been shown in waist-to-hip ratio. The trial had been registered as prospective interventional clinical trials in the Pan African Clinical Trial Registry (PACTR) PACTR201403000785219 , on 7th March 2014.

Peer-reviewedSolar Disinfection of water (SODIS) is a treatment method that traditionally exposes low turbidity water filled in\ud clear bottles to direct sunlight up to 6 h. Typically, water should have turbidity lower than 30 NTU before solar\ud exposure; however turbidities of water sources in communities vary and can reach higher than 200 NTU. In\ud order to reduce turbidity, flocculating agents like Moringa oleifera (Moringa) may be used. In this study we\ud assess the efficacy of Moringa to clear turbid water as a pretreatment for SODIS. We initially evaluate two\ud preparations– powdered seeds and an aqueous filtrate of the seeds, to determine if these can benefit SODIS in\ud turbid, E. coli contaminated water (Experiment 1). We show that powdered Moringa seeds reduce turbidity best\ud and that SODIS treatment of highly turbid water was effective regardless of reduced turbidity. Overnight,\ud however; a bio-active sludge layer formed. We then determined if 24 h Moringa pretreatment and decanting can\ud maintain water quality over an extended period (Experiment 2). After 24 h Moringa treatment showed a 2.1 log\ud reduction in E. coli, increasing following SODIS (6-log) E. coli without nightly recovery or sludge formation.\ud Untreated turbid controls showed SODIS disinfection after 6 h direct sunlight; however, nightly regrowth and\ud sludge layer formation occurred by 48 h. These results suggest that SODIS is capable of inactivating bacteria in\ud highly turbid water at 6 h; however, active biofilm sludge layers formed by 48 h. We conclude that, for longer\ud term water storage, we find a combination of Moringa seed powder pretreatment prior to SODIS to be optimal.PUBLISHEDpeer-reviewe