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Diabetic foot: A prospective study of clinical
presentation, management and outcome. Background: Diabetic foot is the cause of amputation in 85% of all non-trauma amputations, and 25% diabetic foot patients end up with an amputation. The disease pattern in Southern Africa is not well documented. Aims: To evaluate the clinical presentation, risk factors and outcome of management diabetic foot. Patients and methods: A prospective study of 107 adult patients admitted into hospital with foot ulcers or gangrene was done. Forty-two had diabetic foot. Human immunodeficiency virus (HIV) infection, full blood count, T-cell profile, and fasting blood sugar were tested. Limb radiographs were taken. The ankle-brachial index (ABI) was measured. Neuropathy was tested for by nylon monofilament. Epi Info 2002 was used for statistical analysis. Results: Main symptoms were pain, swelling, disability, and parasthaesia. Neuropathy, ischaemia and foot deformities were present. A third of patients tested positive for HIV. The mean CD4 cell count was reduced. Two thirds of the patients had their limbs healed. A fifth had limb amputation. Conclusions: Diabetic foot is a disabling condition. Diabetic foot patients are immunosuppressed. |
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