## 4 Discussion
Neutrophil secretions in diabetic conditions tend to be high compared to the normal conditions due to high ROS/RNS levels, resulting in increased inflammation and tissue damage [62]. This is evidence by the higher number of neutrophils on Day 3 up to Day 14 in the diabetic control group (133.0 \(\pm\) 8.2; 65.0 \(\pm\) 7.5; 42.0 \(\pm\) 4.7 cells/mm\({}^{2}\)) compared to normal control group (58.0 \(\pm\) 5.4; 32.0 \(\pm\) 0.9; 15.0 \(\pm\) 4.5 cells/mm\({}^{2}\)) (Table 4). Number of macrophages increase up to Day 7 and decreased on Day 14 for all groups, because on the Day 7 the wound condition undergoes inflammatory and proliferation processes. For example in the DAO group on Day 3 up to Day 7 number of macrophages increased (15.0 \(\pm\) 0.2; 21.0 \(\pm\) 1.4 cells/mm\({}^{2}\)) and decreased on Day 14 (6.0 \(\pm\) 0.5 cells/mm\({}^{2}\)) (Table 5). Neutrophils were secreting cytokines and granule proteins, which modulating monocyte or macrophage extravasation, phagocytosis and ROS production. In diabetics, the condition of hyperglycemia increases the activity of macrophages, thereby increasing the levels of ROS/RNS which causes a prolonged inflammatory phase [63] In addition, hyperglycemia and oxidative stress conditions can lead to polarization and modulating macrophage dysregulation, because change epigenetic code which is inhibit the wound-healing process [64]. This is evidence by the higher number of macrophages on Day 3 up to Day 14 in the diabetic control group (38.0 \(\pm\) 1.4; 47.0 \(\pm\) 0.7; 30.0 \(\pm\) 0.9 cells/mm\({}^{2}\)) compared to normal control group (15.0 \(\pm\) 1.4; 21.0 \(\pm\) 1.9; 6.0 \(\pm\) 0.2 cells/mm\({}^{2}\)). \begin{table}
\begin{tabular}{c c c c} \hline \hline \multirow{2}{*}{**Group Treatment**} & \multicolumn{3}{c}{**Neutrophils (cells/mm\({}^{2}\))**} \\ \cline{2-4}  & **Day 3** & **Day 7** & **Day 14** \\ \hline Normal (NC) & 58.0 \(\pm\) 5.4 & 32.0 \(\pm\) 0.9 & 15.0 \(\pm\) 4.5 \\ Diabetic (DC) & 133.0 \(\pm\) 8.2 & 65.0 \(\pm\) 7.5 & 42.0 \(\pm\) 4.7 \\ Alginate\(\,\)ointment (DA) & 74.0 \(\pm\) 8.5 * & 52.0 \(\pm\) 0.5 * & 29.0 \(\pm\) 2.1 \\ Alginate\(\,\)-okra ointment (DAO) & 58.0 \(\pm\) 1.9 ** & 33.0 \(\pm\) 1.2 ** & 14.0 \(\pm\) 2.6 ** \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Counts considering the mean and standard deviation of neutrophils. \begin{table}
\begin{tabular}{c c c c} \hline \hline \multirow{2}{*}{**Group Treatment**} & \multicolumn{3}{c}{**Meorphages (cells/mm\({}^{2}\))**} \\ \cline{2-4}  & **Day 3** & **Day 7** & **Day 14** \\ \hline Normal (NC) & 2548.0 \(\pm\) 187.2 & 894.0 \(\pm\) 87.6 & 0 \(\pm\) 0 \\ Diabetic (DC) & 3956.0 \(\pm\) 52.2 & 3631.0 \(\pm\) 74.8 & 424.0 \(\pm\) 5.2 \\ Alginate ointment (DA) & 3240.0 \(\pm\) 117.5 & 1229.0 \(\pm\) 49.9 & 0 \(\pm\) 0 \\ Alginate\(\,\)-okra ointment (DAO) & 2693.0 \(\pm\) 12.2 ** & 917.0 \(\pm\) 91.3 ** & 0 \(\pm\) 0 \\ \hline \hline \end{tabular}
\begin{tabular}{c} Letter notation on the table shows the result of the statistical test (\(\alpha<0.05\)). (**) notation shows insignificant differences with NC, but significant differences with DC. ** = \(\alpha\leq\) 0.01. \\ \end{tabular}
\end{table} 
Table 3: Counts considering the mean and standard deviation of wound width. \begin{table}
\begin{tabular}{c c c c} \hline \hline \multirow{2}{*}{**Group Treatment**} & \multicolumn{3}{c}{**Meorphages (cells/mm\({}^{2}\))**} \\ \cline{2-4}  & **Day 3** & **Day 7** & **Day 14** \\ \hline Normal (NC) & 15.0 \(\pm\) 1.4 & 21.0 \(\pm\) 1.9 & 6.0 \(\pm\) 0.2 \\ Diabetic (DC) & 38.0 \(\pm\) 1.4 & 47.0 \(\pm\) 0.7 & 30.0 \(\pm\) 0.9 \\ Alginate ointment (DA) & 21.0 \(\pm\) 0.5 & 29.0 \(\pm\) 3.8 & 11.0 \(\pm\) 0.7 \\ Alginate\(\,\)-okra ointment (DAO) & 15.0 \(\pm\) 0.2 ** & 21.0 \(\pm\) 1.4 ** & 6.0 \(\pm\) 0.5 ** \\ \hline \hline \end{tabular}
\end{table} 
Table 5: Counts considering the mean and standard deviation of macrophages.