Background: One of the most common diabetes-related reasons for hospitalization is diabetic foot infections (DFIs), which are a significant cause of morbidity. Osteomyelitis (OM) is a regrettable side effect of a DFU infection that spreads via soft tissues into the underlying bone. Aim: to estimate the percentage of fungal infection in the pathogenesis of diabetic foot lesions and determine if adding antifungal drugs may affect the prognosis. Patients and methods: A prospective cohort study, including 100 diabetic patients with infected diabetic foot ulcers with underlying osteomyelitis. Two wound swabs and bone biopsies were taken from the depth of the ulcer consisting of necrotic slough and granulation tissue, and carried immediately to the microbiology laboratory, at Assiut University to be examined. Once the fungal culture study is positive, oral fluconazole 150 mg every other day for 2-3 weeks was started for the patient with a maximum duration of two months or when healing occurs. Results:The current study revealed that all the studied patients had positive bacterial growth. Out of them, 22 (22%) patients had mixed fungal and bacterial growth while the majority (78%) had only bacterial growth. Candida is the most common pathogen isolated in fungal OM. Conclusion:Regarding the treatment of OM caused by fungi, there is no clear consensus. In the current study, patients with a lengthy history of foot ulcers were more likely to develop fungal foot infections. Furthermore, it's critical to stop the spread of resistance because there aren't any other effective antifungal treatments for treating severe fungal infections.

Background: Red Blood Cell Distribution (RDW) is recognized as a global marker of chronic inflammation. Aim of Study:To study the relation between RDW and complications in patients with type 2 diabetes mellitus and its relation to CRP. Methods:The study included 70 patients with type 2 DM and 20 healthy controls with clinical and laboratory data including HbA1c, RDW and C Reactive Protein (CRP).Results: Patient group showed 65 (92.85%) of them had macrovascular and 64 (91.42%) patients had microvascular complications. When we compared patients with macrovascular and microvascular complications to control group we found high RDW in those with vascular complications than control group (p=0.001). There was a significant difference between RDW in patients with macrovascular complications in comparison to those without macrovascular complications ( p-value=0.02). There was a significant difference between RDW in patients with nephropathy compared to those with retinopathy. Conclusion:In our study, we confirmed a strong relation between diabetics with vascular complications and RDW.