Choudhry Abid Nazir, Shahid Mahmood, Rizwana Nawaz, Tehmina Naz, Zeshan Talib, Ahmad Shahzad.
Severity and outcome of patients presenting with diabetic foot at tertiary care center at Gujrat.
Pak J Med Health Sci Jan ;13(4):1024-6.

Aim: To detect the Severity and outcome of patients presenting with Diabetic Foot at tertiary care center at Gujrat. Study design : cross sectional study. Place and Duration of Study : Study w as conducted for a period of two years from 1st January 2016 to 31st December 2017 in Aziz Bhatti Shaheed Teaching Hospital Gujrat . Methods : Total 274 adult patients diagnosed as diabetes mellitus with complication of diabetic foot were included in the study. The patients were enrolled from surgical out-patient department, emergency and from other wards of the hospital. Known diabetic females from gynecology and obstetrics were also included due to problem of diabetic foot. A detailed history was obtained regarding the duration of the diabetes and its type. They were asked about compliance and control of diabetes. A detailed history was obtained about the foot ulcer regarding onset duration and progression. Results: The data revealed that diabetic foot problem affected females more frequently 159 (58%) than males 115 (42%) . The most common age group of diabetic patients with foot involvement were the 5th and 6th decades. Out of 274 patients, 214 (78%) were known diabetics and 60 (22%) were diagnosed incidentally after admission in the surgery department. Out of 214 known diabetic patients, 77 (36%) were on insulin therapy, 98 (46%) were on oral hypoglycemic and 39 (18%) were not taking any drug. The grading of diabetic foot was done according to Wagner classification. The commonest presentation was grade IV of diabetic foot in Wagner classification, with 96(35%) patients followed by Grade III in 77(28%) patients and followed by Grade II in 56(20%) patients. Thirty (10%) patients were enrolled in grade I and in grade V of Wagner classification only 15(5.4%) patients were admitted. These patients were managed according to Wagner classification. Only conservative management with good diabetic control, antibiotic cover and foot care was carried out in 25(9.12%) patients. Surgical intervention was carried out in rest of 249 (90.88%) patients. Out of 249 patients who were provided surgical treatment, the commonest procedure was major debridement that was performed in 105 (42.16%) patients; minor debridement was performed in 70(28.11%) patients. Conclusions: Diabetic foot ulcers are very common among diabetic population. Early detection and treatment may help to decrease the chances of amputation. Proper hygiene and foot care education in diabetic patients may be an important way of dealing with this major problem .

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