Photodynamic therapy based on magnetic field stimulation: new directions in diverse medicine applications

Main Article Content

Ali Adil Turki Aldalawi
Nursakinah Binti Suardi
Naser Mahmoud Ahmed
Mahdi Ali S. Al-Farawn

Keywords

Photodynamic therapy; Electromagnetic and magnetic fields; Clinical application; Future studies; Combined therapeutic effect

Abstract

Despite the growing interest in photodynamic therapy (PDT) and the granting of regulatory approvals for many photosensitivity drugs and light applicators worldwide, there are many endeavors involving the search for a new physical mechanism that underpins PDT to influence various biological processes that are necessary for and contribute to In healing processes and in reducing pain, inflammation and other forms of damage. Electromagnetic and magnetic fields appear to be unique in their safety during clinical use. This review will focus on new clinical research advancements and will explore the value of incorporating external magnetic and electromagnetic fields for PDT technologies for the treatment of malignant and non-malignant disorders.

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References

1. J. F. Algorri, M. Ochoa, P. Roldán-Varona, L. Rodríguez-Cobo, and J. M. López-Higuera, “Photodynamic Therapy: A Compendium of Latest Reviews,” Cancers (Basel)., vol. 13, no. 17, p. 4447, 2021.
2. G. Tegos et al., “Concepts and principles of photodynamic therapy as an alternative antifungal discovery platform,” Front. Microbiol., vol. 3, p. 120, 2012.
3. C. H. Sibata, V. C. Colussi, N. L. Oleinick, and T. J. Kinsella, “Photodynamic therapy: a new concept in medical treatment,” Brazilian J. Med. Biol. Res., vol. 33, no. 8, pp. 869–880, 2000.
4. P. Agostinis et al., “Photodynamic therapy of cancer: an update,” CA. Cancer J. Clin., vol. 61, no. 4, pp. 250–281, 2011.
5. G. Gunaydin, M. E. Gedik, and S. Ayan, “Photodynamic therapy—current limitations and novel approaches,” Front. Chem., vol. 9, p. 691697, 2021.
6. J. Bhaumik, A. K. Mittal, A. Banerjee, Y. Chisti, and U. C. Banerjee, “Applications of phototheranostic nanoagents in photodynamic therapy,” Nano Res., vol. 8, no. 5, pp. 1373–1394, 2015.
7. D. Kessel, “Photodynamic therapy: a brief history,” J. Clin. Med., vol. 8, no. 10, p. 1581, 2019.
8. J. Zhang, C. Jiang, J. P. F. Longo, R. B. Azevedo, H. Zhang, and L. A. Muehlmann, “An updated overview on the development of new photosensitizers for anticancer photodynamic therapy,” Acta Pharm. Sin. B, vol. 8, no. 2, pp. 137–146, 2018.
9. M. M. Kim and A. Darafsheh, “Light sources and dosimetry techniques for photodynamic therapy,” Photochem. Photobiol., vol. 96, no. 2, pp. 280–294, 2020.
10. J. Zhang, C. Ding, L. Ren, Y. Zhou, and P. Shang, “The effects of static magnetic fields on bone,” Prog. Biophys. Mol. Biol., vol. 114, no. 3, pp. 146–152, 2014.
11. A. P. Colbert et al., “Static magnetic field therapy: a critical review of treatment parameters,” Evidence-based Complement. Altern. Med., vol. 6, no. 2, pp. 133–139, 2009.
12. J. C. Lin, Electromagnetic fields in biological
systems. Taylor & Francis, 2012.
13. I. Belyaev and M. S. Markov, Biophysical mechanisms for nonthermal microwave effects. Electromagnetic fields in biology and medicine. Boca Raton, London, New York …, 2015.
14. M. S. Markov and C. F. Hazlewood, “Electromagnetic field dosimetry for clinical application,” Environmentalist, vol. 29, no. 2, pp. 161–168, 2009.
15. M. S. Markov, “Benefit and hazard of electromagnetic fields,” Electromagn. fields Biol. Med., vol. 15, p. 28, 2015.
16. Y. J. Kim, J. S. Yoo, D. G. Hwang, and H. S. Lee, “Comparative analysis of photoplethysmography under pulsed magnetic field and low level laser stimulus: motivation for blood flow increase using stimulus on acupoint LI4 (Hegu),” J. Magn., vol. 19, no. 1, pp. 32–36, 2014.
17. A. A. Al-sharify, “The biological effects of low level laser therapy with static magnetic field on acute and chronic pain,” Eng. Tech, vol. 25, no. 10, pp. 1154–1161, 2007.
18. P. Zhang, G. Wu, C. Zhao, L. Zhou, X. Wang, and S. Wei, “Magnetic stomatocyte-like nanomotor as photosensitizer carrier for photodynamic therapy based cancer treatment,” Colloids Surfaces B Biointerfaces, vol. 194, p. 111204, 2020.
19. T. Dai et al., “Concepts and principles of photodynamic therapy as an alternative antifungal discovery platform,” Front. Microbiol., vol. 3, p. 120, 2012.
20. J. F. Algorri, M. Ochoa, P. Roldán-Varona, L. Rodríguez-Cobo, and J. M. López-Higuera, “Photodynamic Therapy: A Compendium of Latest Reviews. Cancers 2021, 13, 4447.” s Note: MDPI stays neutral with regard to jurisdictional claims in published …, 2021.
21. F. Hu, S. Xu, and B. Liu, “Photosensitizers with aggregation‐induced emission: materials and biomedical applications,” Adv. Mater., vol. 30, no. 45, p. 1801350, 2018.
22. K. Plaetzer, B. Krammer, J. Berlanda, F. Berr, and T. Kiesslich, “Photophysics and photochemistry of photodynamic therapy: fundamental aspects,” Lasers Med. Sci., vol. 24, no. 2, pp. 259–268, 2009.
23. J. Lieberman, “Granzyme A activates another way to die,” Immunol. Rev., vol. 235, no. 1, pp. 93–104, 2010.
24. Y. Choi, J. Chang, S. Jheon, S. Han, and J. Kim,“Enhanced production of reactive oxygen species in HeLa cells under concurrent low‑dose carboplatin and Photofrin® photodynamic therapy,” Oncol. Rep., vol. 40, no. 1, pp. 339–345, 2018.
25. Y. Su, H. Song, and Y. Lv, “Recent advances in chemiluminescence for reactive oxygen species sensing and imaging analysis,” Microchem. J., vol. 146, pp. 83–97, 2019.
26. T. C. Zhu and J. C. Finlay, “The role of photodynamic therapy (PDT) physics,” Med. Phys., vol. 35, no. 7Part1, pp. 3127–3136, 2008.
27. R. R. Allison and K. Moghissi, “Photodynamic therapy (PDT): PDT mechanisms,” Clin. Endosc., vol. 46, no. 1, pp. 24–29, 2013.
28. A.-G. Niculescu and A. M. Grumezescu, “Photodynamic therapy—an up-to-date review,” Appl. Sci., vol. 11, no. 8, p. 3626, 2021.
29. S. Kwiatkowski et al., “Photodynamic therapy–mechanisms, photosensitizers and combinations,” Biomed. Pharmacother., vol. 106, pp. 1098–1107, 2018.
30. Y. N. Konan, R. Gurny, and E. Allémann, “State of the art in the delivery of photosensitizers for photodynamic therapy,” J. Photochem. Photobiol. B Biol., vol. 66, no. 2, pp. 89–106, 2002.
31. J. H. Correia, J. A. Rodrigues, S. Pimenta, T. Dong, and Z. Yang, “Photodynamic therapy review: Principles, photosensitizers, applications, and future directions,” Pharmaceutics, vol. 13, no. 9, p. 1332, 2021, doi: 10.3390/pharmaceutics13091332.
32. A. K. Bhatta, U. Keyal, X. Wang, and E. Gellén, “A review of the mechanism of action of lasers and photodynamic therapy for onychomycosis,” Lasers Med. Sci., vol. 32, no. 2, pp. 469–474, 2017, doi: 10.1007/s10103-016-2110-9.
33. J. Dobson, G. F. de Queiroz, and J. P. Golding, “Photodynamic therapy and diagnosis: Principles and comparative aspects,” Vet. J., vol. 233, pp. 8–18, 2018, doi: 10.1016/j.tvjl.2017.11.012.
34. H. Abrahamse and M. R. Hamblin, “New photosensitizers for photodynamic therapy,” Biochem. J., vol. 473, no. 4, pp. 347–364, 2016.
35. M. Lan, S. Zhao, W. Liu, C. Lee, W. Zhang, and P. Wang, “Photosensitizers for photodynamic therapy,” Adv. Healthc. Mater., vol. 8, no. 13, p. 1900132, 2019.
36. T. Kiesslich, A. Gollmer, T. Maisch, M. Berneburg, and K. Plaetzer, “A comprehensive tutorial on in vitro characterization of new
photosensitizers for photodynamic antitumor therapy and photodynamic inactivation of microorganisms,” Biomed Res. Int., vol. 2013, 2013.
37. R. R. Allison and C. H. Sibata, “Oncologic photodynamic therapy photosensitizers: a clinical review,” Photodiagnosis Photodyn. Ther., vol. 7, no. 2, pp. 61–75, 2010.
38. J. Chhablani, “Disadvantages of photodynamic therapy for polypoidal choroidal vasculopathy,” Indian J. Ophthalmol., vol. 58, no. 6, p. 552, 2010.
39. F. R. Ochsendorf, “Use of antimalarials in dermatology,” JDDG J. der Dtsch. Dermatologischen Gesellschaft, vol. 8, no. 10, pp. 829–845, 2010.
40. O. Mermut et al., “The use of magnetic field effects on photosensitizer luminescence as a novel probe for optical monitoring of oxygen in photodynamic therapy,” Phys. Med. Biol., vol. 54, no. 1, p. 1, 2008.
41. R. Di Corato et al., “Combining magnetic hyperthermia and photodynamic therapy for tumor ablation with photoresponsive magnetic liposomes,” ACS Nano, vol. 9, no. 3, pp. 2904–2916, 2015.
42. B. W. Henderson, Photodynamic therapy: basic principles and clinical applications. CRC Press, 2020.
43. Á. Juarranz, P. Jaén, F. Sanz-Rodríguez, J. Cuevas, and S. González, “Photodynamic therapy of cancer. Basic principles and applications,” Clin. Transl. Oncol., vol. 10, no. 3, pp. 148–154, 2008.
44. H. Qiu et al., “A comparison of dose metrics to predict local tumor control for photofrin‐mediated photodynamic therapy,” Photochem. Photobiol., vol. 93, no. 4, pp. 1115–1122, 2017.
45. X. Wang et al., “Analysis of the in vivo and in vitro effects of photodynamic therapy on breast cancer by using a sensitizer, sinoporphyrin sodium,” Theranostics, vol. 5, no. 7, p. 772, 2015.
46. H. H. Jajarm, F. Falaki, M. Sanatkhani, M. Ahmadzadeh, F. Ahrari, and H. Shafaee, “A comparative study of toluidine blue-mediated photodynamic therapy versus topical corticosteroids in the treatment of erosive-atrophic oral lichen planus: a randomized clinical controlled trial,” Lasers Med. Sci., vol. 30, no. 5, pp. 1475–1480, 2015.
47. A. Petri, D. Yova, E. Alexandratou, M. Kyriazi,and M. Rallis, “Comparative characterization of the cellular uptake and photodynamic efficiency of Foscan® and Fospeg in a human prostate cancer cell line,” Photodiagnosis Photodyn. Ther., vol. 9, no. 4, pp. 344–354, 2012.
48. M. F. M. Ali, “Topical delivery and photodynamic evaluation of a multivesicular liposomal Rose Bengal,” Lasers Med. Sci., vol. 26, no. 2, pp. 267–275, 2011.
49. M. Wainwright and K. B. Crossley, “Methylene blue-a therapeutic dye for all seasons?,” J. Chemother., vol. 14, no. 5, pp. 431–443, 2002.
50. F. Cieplik et al., “Photodynamic biofilm inactivation by SAPYR—An exclusive singlet oxygen photosensitizer,” Free Radic. Biol. Med., vol. 65, pp. 477–487, 2013.
51. A. Didangelos, D. Simper, C. Monaco, and M. Mayr, “Proteomics of acute coronary syndromes,” Curr. Atheroscler. Rep., vol. 11, no. 3, pp. 188–195, 2009.
52. D. Zhenjun and J. W. Lown, “Hypocrellins and their use in photosensitization,” Photochem. Photobiol., vol. 52, no. 3, pp. 609–616, 1990.
53. A. Yamaguchi, K. W. Woodburn, M. Hayase, G. Hoyt, and R. C. Robbins, “Photodynamic therapy with motexafin lutetium (Lu-Tex) reduces experimental graft coronary artery disease,” Transplantation, vol. 71, no. 11, pp. 1526–1532, 2001.
54. E. Buytaert, M. Dewaele, and P. Agostinis, “Molecular effectors of multiple cell death pathways initiated by photodynamic therapy,” Biochim. Biophys. Acta (BBA)-Reviews Cancer, vol. 1776, no. 1, pp. 86–107, 2007.
55. R. Ankri, R. Lubart, and H. Taitelbaum, “Estimation of the optimal wavelengths for laser‐induced wound healing,” Lasers Surg. Med., vol. 42, no. 8, pp. 760–764, 2010.
56. P. Avci et al., “Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring,” in Seminars in cutaneous medicine and surgery, 2013, vol. 32, no. 1, p. 41.
57. M. R. Hamblin, T. Agrawal, and M. de Sousa, Handbook of low-level laser therapy. CRC Press, 2016.
58. D. E. Hudson, D. O. Hudson, J. M. Wininger, and B. D. Richardson, “Penetration of laser light at 808 and 980 nm in bovine tissue samples,” Photomed. Laser Surg., vol. 31, no. 4, pp. 163–168, 2013.
59. G. M. AFSARI, T. M. GHASEMI, M. A. Ansari, and A. Amjadi, “The propagation of
laser light in skin by Monte Carlo-diffusion method: A fast and accurate method to simulate photon migration in biological tissues,” 2011.
60. J. F. Algorri, M. Ochoa, P. Roldán-Varona, L. Rodríguez-Cobo, and J. M. López-Higuera, “Light technology for efficient and effective photodynamic therapy: a critical review,” Cancers (Basel)., vol. 13, no. 14, p. 3484, 2021.
61. J. Buch and B. Hammond, “Photobiomodulation of the Visual System and Human Health,” Int. J. Mol. Sci., vol. 21, no. 21, p. 8020, 2020.
62. S. Thomsen, “Pathologic analysis of photothermal and photomechanical effects of laser–tissue interactions,” Photochem. Photobiol., vol. 53, no. 6, pp. 825–835, 1991.
63. D. Nowis, M. Makowski, T. Stokłosa, M. Legat, T. Issat, and J. Gołab, “Direct tumor damage mechanisms of photodynamic therapy.,” Acta Biochim. Pol., vol. 52, no. 2, pp. 339–352, 2005.
64. B. W. Henderson, T. M. Busch, and J. W. Snyder, “Fluence rate as a modulator of PDT mechanisms,” Lasers Surg. Med. Off. J. Am. Soc. Laser Med. Surg., vol. 38, no. 5, pp. 489–493, 2006.
65. B. Novak, R. Schulten, T. Dirschka, R.-M. Szeimies, M. Foguet, and H. Lübbert, “Photodynamic Treatment of Actinic Keratosis Using Ameluz®: Recapitulation of Clinical Phase III Studies in the Light of Novel Preclinical Research”.
66. G. A. Wagnieres, W. M. Star, and B. C. Wilson, “In vivo fluorescence spectroscopy and imaging for oncological applications,” Photochem. Photobiol., vol. 68, no. 5, p. 603, 1998.
67. R. Richards-Kortum and E. Sevick-Muraca, “Quantitative optical spectroscopy for tissue diagnosis,” Annu. Rev. Phys. Chem., vol. 47, no. 1, pp. 555–606, 1996.
68. M. Kucinska, M. Murias, and P. Nowak-Sliwinska, “Beyond mouse cancer models: Three-dimensional human-relevant in vitro and non-mammalian in vivo models for photodynamic therapy,” Mutat. Res. Mutat. Res., vol. 773, pp. 242–262, 2017.
69. V. Monge-Fuentes, L. A. Muehlmann, and R. B. de Azevedo, “Perspectives on the application of nanotechnology in photodynamic therapy for the treatment of melanoma,” Nano Rev., vol. 5, no. 1, p. 24381, 2014.
70. S. Rajesh, E. Koshi, K. Philip, and A. Mohan, “Antimicrobial photodynamic therapy: An overview,” J. Indian Soc. Periodontol., vol. 15,no. 4, p. 323, 2011.
71. Z. Wang et al., “Application of photodynamic therapy in cancer: Challenges and advancements,” Biocell, vol. 45, no. 3, p. 489, 2021.
72. M. Alexiades-Armenakas, “Laser-mediated photodynamic therapy,” Clin. Dermatol., vol. 24, no. 1, pp. 16–25, 2006.
73. A. E. O’Connor, W. M. Gallagher, and A. T. Byrne, “Porphyrin and nonporphyrin photosensitizers in oncology: preclinical and clinical advances in photodynamic therapy,” Photochem. Photobiol., vol. 85, no. 5, pp. 1053–1074, 2009.
74. C. Gao, Z. Lin, D. Wang, Z. Wu, H. Xie, and Q. He, “Red blood cell-mimicking micromotor for active photodynamic cancer therapy,” ACS Appl. Mater. Interfaces, vol. 11, no. 26, pp. 23392–23400, 2019.
75. F. Ashrafi et al., “Effectiveness of Extremely Low Frequency Electromagnetic Field and Pulsed Low Level Laser Therapy in Acute Stroke Treatment,” Int. Clin. Neurosci. J., vol. 7, no. 3, pp. 127–131, 2020.
76. C. Ross and B. Harrison, “The use of magnetic field for the reduction of inflammation: a review of the history and therapeutic results,” Altern. Ther. Health Med., 2013.
77. Miyakoshi, “Effects of static magnetic fields at the cellular level,” Prog. Biophys. Mol. Biol., vol. 87, no. 2–3, pp. 213–223, 2005.
78. Saunders, “Static magnetic fields: animal studies,” Prog. Biophys. Mol. Biol., vol. 87, no. 2–3, pp. 225–239, 2005.
79. V. Zablotskii, T. Polyakova, O. Lunov, and A. Dejneka, “How a high-gradient magnetic field could affect cell life,” Sci. Rep., vol. 6, no. 1, pp. 1–13, 2016.
80. J. L. Kirschvink, A. Kobayashi‐Kirschvink, J. C. Diaz‐Ricci, and S. J. Kirschvink, “Magnetite in human tissues: a mechanism for the biological effects of weak ELF magnetic fields,” Bioelectromagnetics, vol. 13, no. S1, pp. 101–113, 1992.
81. D. Ni et al., “Magnetic targeting of nanotheranostics enhances cerenkov radiation-induced photodynamic therapy,” J. Am. Chem. Soc., vol. 140, no. 44, pp. 14971–14979, 2018.
82. O. Mermut et al., “Time-resolved luminescence measurements of the magnetic field effect on paramagnetic photosensitizers in photodynamic reactions,” in Optical Methods for Tumor
Treatment and Detection: Mechanisms and Techniques in Photodynamic Therapy XVII, 2008, vol. 6845, p. 68450T.
83. V. Y. Plavskii, “Principles of creating devices for magneto-laser therapy with a high magnetic field strength within the optical radiation coverage zone,” Mater. Sci. Res. J., vol. 7, no. 1, p. 1, 2013.
84. Y. Plavskii, “Correction of Magnetic Field Distribution within the Optical Radiation Coverage Zone of Magnetic Laser Therapy Apparatuses,” Biomed. Eng. (NY)., vol. 45, no. 1, pp. 9–11, 2011.
85. L. K. P. Suen, A. Molassiotis, S. K. W. Yueng, and C. H. Yeh, “Comparison of magnetic auriculotherapy, laser auriculotherapy and their combination for treatment of insomnia in the elderly: a double-blinded randomised trial,” Evidence-Based Complement. Altern. Med., vol. 2019, 2019.
86. Y. Chen, The magnetic confinement of electron and photon dose profiles and the possible effect of the magnetic field on relative biological effectiveness. University of Michigan, 2005.
87. A. Yadollahpour, M. Jalilifar, and S. Rashidi, “Antimicrobial effects of electromagnetic fields: A review of current techniques and mechanisms of action,” J Pure Appl Microbiol, vol. 8, no. 5, pp. 4031–4043, 2014.
88. O. Johansson, “Disturbance of the immune system by electromagnetic fields—A potentially underlying cause for cellular damage and tissue repair reduction which could lead to disease and impairment,” Pathophysiology, vol. 16, no. 2–3, pp. 157–177, 2009.
89. P. A. J. Kolarsick, M. A. Kolarsick, and C. Goodwin, “Anatomy and physiology of the skin,” J. Dermatol. Nurses. Assoc., vol. 3, no. 4, pp. 203–213, 2011.
90. Y. Katayama, T. Baba, M. Sekine, M. Fukuda, and K. Hiramatsu, “Beta-hemolysin promotes skin colonization by Staphylococcus aureus,” J. Bacteriol., vol. 195, no. 6, pp. 1194–1203, 2013.
91. S. Rashidi, A. Yadollahpour, and M. Mirzaiyan, “Low level laser therapy for the treatment of chronic wound: Clinical considerations,” Biomed. Pharmacol. J., vol. 8, no. 2, pp. 1121–1127, 2015.
92. N. B. Lipko, “Photobiomodulation: Evolution and Adaptation,” Photobiomodulation, Photomedicine, Laser Surg., vol. 40, no. 4, pp. 213–233, 2022.93. M. R. Hamblin and T. N. Demidova, “Mechanisms of low level light therapy,” Mech. low-light Ther., vol. 6140, p. 614001, 2006.
94. J. F. Schenck, “Physical interactions of static magnetic fields with living tissues,” Prog. Biophys. Mol. Biol., vol. 87, no. 2–3, pp. 185–204, 2005.
95. A. A. Pilla, “Mechanisms and therapeutic applications of time-varying and static magnetic fields,” Biol. Med. Asp. Electromagn. fields, vol. 3, 2007.
96. M. S. Markov, “Magnetic field therapy: a review,” Electromagn. Biol. Med., vol. 26, no. 1, pp. 1–23, 2007.
97. J. L. Wardlaw, T. J. Sullivan, C. N. Lux, and F. W. Austin, “Photodynamic therapy against common bacteria causing wound and skin infections,” Vet. J., vol. 192, no. 3, pp. 374–377, 2012.
98. G. B. Kharkwal, S. K. Sharma, Y. Huang, T. Dai, and M. R. Hamblin, “Photodynamic therapy for infections: clinical applications,” Lasers Surg. Med., vol. 43, no. 7, pp. 755–767, 2011.
99. E. E. Altunsoy, H. O. Tekin, A. Mesbahi, and I. Akkurt, “MCNPX simulation for radiation dose absorption of anatomical regions and some organs,” Acta Phys. Pol. A, vol. 137, no. 4, pp. 561–565, 2020.
100. A. Amendoeira, L. R. García, A. R. Fernandes, and P. V Baptista, “Light irradiation of gold nanoparticles toward advanced cancer therapeutics,” Adv. Ther., vol. 3, no. 1, p. 1900153, 2020.
101. A. M. El-Makakey, R. M. El-Sharaby, M. H. Hassan, and A. Balbaa, “Comparative study of the efficacy of pulsed electromagnetic field and low level laser therapy on mitogen-activated protein kinases,” Biochem. Biophys. Reports, vol. 9, pp. 316–321, 2017.
102. R. Zohre, Y. Ali, J. Mostafa, and R. Samaneh, “Nondrug antimicrobial techniques: electromagnetic fields and photodynamic therapy,” Biomed. Pharmacol. J., vol. 8, no. March Spl Edition, pp. 147–155, 2015.
103. Z. Li et al., “PEG-functionalized iron oxide nanoclusters loaded with chlorin e6 for targeted, NIR light induced, photodynamic therapy,” Biomaterials, vol. 34, no. 36, pp. 9160–9170, 2013.
104. J. Nurković et al., “Combined effects of electromagnetic field and low-level laser increase proliferation and alter the morphology of human adipose tissue-derived mesenchymal stem cells,” Lasers Med. Sci., vol. 32, no. 1, pp. 151–160, 2017.
105. N. Soroor and S. M. MD-Anesthesiologist, “Comparison between the effects of low level laser Therapy (LLLT) and Magnetic Low Level Laser Therapy (MLLLT) in treatment of knee Osteoarthritis (OA)”.
106. N. A. Abd El Rasheed, N. F. Mahmoud, H. A. Hamada, and A. El Khatib, “Pulsed electromagnetic fields versus laser therapy on enhancing recovery of diabetic foot ulcer: A single blind randomized controlled trial,” 2017.