Impact of Diabetic Foot Ulcer on the Health-Related Quality of Life of Diabetic Patients in Khartoum State

Background This is a novel study from Sudan aimed at comparing health-related quality of life (HRQoL) between diabetic foot ulcer (DFU) patients and diabetes patients without DFU. Additionally, this study aimed to determine the factors correlating with lower HRQoL. Methodology A descriptive, cross-sectional study with a comparative group was conducted in three diabetes centers in Khartoum, Sudan, in 2020. A total of 120 Sudanese diabetic patients (mean age = 52 years) were divided into two groups, without DFU and with DFU, and interviewed in person. Demographic and clinical variables were recorded. HRQoL was evaluated using the standardized RAND-36 (36-Item Short Form Health Survey) survey for all participants. HRQoL domains and total scores were compared in the two groups using the t-test. Inference against sociodemographic data was determined using Pearson's test and analysis of variance. Results The DFU group (36 males, 24 females) scored significantly lower in five (yet higher in two out of the eight subscales) compared to the non-DFU diabetic group (31 males, 29 females). Energy/fatigue levels remained insignificant. Being a female (p = 0.03), painful ulcers (p = 0.001), insulin use (p = 0.04), and newly developed ulcers (p = 0.005) were associated with lower HRQoL total scores in the DFU group. However, educational levels had a positive correlation (p = 0.02). Conclusions DFU patients have lower HRQoL than diabetic patients without ulcers. They need more support, including disease-specific education, realistic expectations (regarding ulcer's impact, healing, and management), physical rehabilitation, and culturally sensitive assessment tools.

Targeting of Fumarate Hydratase from Mycobacterium tuberculosis Using Allosteric Inhibitors with a Dimeric-Binding Mode

With the growing worldwide prevalence of antibiotic-resistant strains of tuberculosis (TB), new targets are urgently required for the development of treatments with novel modes of action. Fumarate hydratase (fumarase), a vulnerable component of the citric acid cycle in Mycobacterium tuberculosis (Mtb), is a metabolic target that could satisfy this unmet demand. A key challenge in the targeting of Mtb fumarase is its similarity to the human homolog, which shares an identical active site. A potential solution to this selectivity problem was previously found in a high-throughput screening hit that binds in a nonconserved allosteric site. In this work, a structure-activity relationship study was carried out with the determination of further structural biology on the lead series, affording derivatives with sub-micromolar inhibition. Further, the screening of this series against Mtb in vitro identified compounds with potent minimum inhibitory concentrations.