Displaying publications 101 - 120 of 140 in total

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  1. Kadir KH, Abdul Rashid AH, Das S, Ibrahim S
    J Foot Ankle Surg, 2011 Mar-Apr;50(2):252-6.
    PMID: 21354013 DOI: 10.1053/j.jfas.2010.10.017
    Diplopodia is a rare congenital disorder that has not been extensively discussed in textbooks, and case reports appear to be the main source of information. Although the exact cause of diplopodia remains unknown, the presence of extra digits as well as metatarsals and tarsals allows it to be differentiated from pedal polydactyly. Syndactyly refers to the congenital fusion of the digits. Concomitant bilateral syndactyly and diplopodia is extremely unusual, and in this report we describe a case of right diplopodia and left polydactyly combined with bilateral manual syndactyly in a 15-year-old girl who was ultimately treated with through-the-knee amputation. Radiological examination of the right leg revealed tibial hypoplasia and the right foot displayed 8 digits with corresponding metatarsals and tarsals, whereas the left leg revealed 2 extra digits on the medial aspect of the foot with corresponding metatarsal and tarsal bones. Anatomical dissection of the right foot revealed that it was divided into halves consisting of 8 toes with corresponding metatarsals and tarsals, as well as tibial hypoplasia and absence of the great toe. Diplopodia associated with tibial hypoplasia and syndactyly can be treated surgically, and the present case report details the clinical, radiological, and anatomical elements of this rare deformity.
    Matched MeSH terms: Amputation
  2. Eshraghi A, Abu Osman NA, Karimi MT, Gholizadeh H, Ali S, Wan Abas WA
    Am J Phys Med Rehabil, 2012 Dec;91(12):1028-38.
    PMID: 23168378 DOI: 10.1097/PHM.0b013e318269d82a
    The objectives of this study were to compare the effects of a newly designed magnetic suspension system with that of two existing suspension methods on pistoning inside the prosthetic socket and to compare satisfaction and perceived problems among transtibial amputees.
    Matched MeSH terms: Amputation Stumps
  3. Eshraghi A, Abu Osman NA, Gholizadeh H, Ali S, Sævarsson SK, Wan Abas WA
    Clin Biomech (Bristol, Avon), 2013 Jan;28(1):55-60.
    PMID: 23157843 DOI: 10.1016/j.clinbiomech.2012.10.002
    Different suspension systems that are used within prosthetic devices may alter the distribution of pressure inside the prosthetic socket in lower limb amputees. This study aimed to compare the interface pressure of a new magnetic suspension system with the pin/lock and Seal-In suspension systems.
    Matched MeSH terms: Amputation Stumps
  4. Gholizadeh H, Abu Osman NA, Eshraghi A, Ali S, Sævarsson SK, Wan Abas WA, et al.
    J Rehabil Res Dev, 2012;49(9):1321-30.
    PMID: 23408214
    Poor suspension increases slippage of the residual limb inside the socket during ambulation. The main purpose of this article is to evaluate the pistoning at the prosthetic liner-socket interface during gait and assess patients' satisfaction with two different liners. Two prostheses with seal-in and locking liners were fabricated for each of the 10 subjects with transtibial amputation. The Vicon motion system was used to measure the pistoning during gait. The subjects were also asked to complete a Prosthesis Evaluation Questionnaire. The results revealed higher pistoning inside the socket during gait with the locking liner than with the seal-in liner (p < 0.05). The overall satisfaction with the locking liner was higher (p < 0.05) because of the relative ease with which the patients could don and doff the device. As such, pistoning may not be the main factor that determines patients' overall satisfaction with the prosthesis and other factors may also contribute to comfort and satisfaction with prostheses. The article also verifies the feasibility of the Vicon motion system for measuring pistoning during gait.
    Matched MeSH terms: Amputation Stumps
  5. Zubaidah AW, Lim VKE
    Med J Malaysia, 1996 Mar;51(1):134-6.
    PMID: 10967993
    A 31-year-old Pakistani man was admitted to hospital after sustaining a Grade I compound fracture of the mid-shaft of the left tibia and fibula following a motor vehicle accident. He developed septicaemic shock, acute renal failure and Group A streptococcal necrotizing fasciitis of the left leg. The patient underwent an above knee amputation followed by disarticulation of the left hip with extensive debridement. He was treated with benzylpenicillin, vancomycin, inotropes and continuous haemodialysis and survived without further sequelae. Subsequently, skin grafting was done over the wound site. This case highlights the role of Group A streptococcus as a cause of this rare and life-threatening infection.
    Matched MeSH terms: Amputation
  6. Belgaid V, Courtin C, Desmarchelier R, Fessy M, Besse JL
    Malays Orthop J, 2020 Nov;14(3):82-89.
    PMID: 33403066 DOI: 10.5704/MOJ.2011.013
    Introduction: Diabetic foot ulcer is the main aetiology for non-traumatic amputation, which is a major public health care concern. A multidisciplinary approach in the management of this pathology has been shown to improve the surgical outcome. However, there are little data available on the tools we can use to pursue this multidisciplinary approach. The main goal of this cross-sectional study was to find out whether the implementation of a specific management pathway could improve the treatment outcome in the treatment of diabetic foot.

    Materials and Methods: From 2012 to 2014, we consecutively recruited patients with diabetic foot referred to Orthopaedic surgery department of our university for surgical opinion. A specific diabetic foot pathway was introduced in 2013. One group of patients who were treated with previous method were evaluated retrospectively. Another group of patients who were treated after implementation of the pathway were evaluated prospectively. We compared treatment outcome between the two groups.

    Results: We included 51 patients. Amputation rate was similar both the groups: 74% in the retrospective group not using the new pathway versus 73% in a prospective group that used the new pathway. Revision surgery was 39% in the retrospective group and 14% in the prospective group (p=0.05).

    Conclusion: We recommend the use of this simple and cost-effective pathway to guide the interdisciplinary management of diabetic foot. A prospective study with more subjects would provide a better overview of this management pathway.

    Matched MeSH terms: Amputation
  7. Vera-Cruz PN, Palmes PP, Tonogan L, Troncillo AH
    Malays Orthop J, 2020 Nov;14(3):114-123.
    PMID: 33403071 DOI: 10.5704/MOJ.2011.018
    Introduction: Classifications systems are powerful tools that could reduce the length of hospital stay and economic burden. The Would, Ischemia, and Foot Infection (WIFi) classification system was created as a comprehensive system for predicting major amputation but is yet to be compared with other systems. Thus, the objective of this study is to compare the predictive abilities for major lower limb amputation of WIFi, Wagner and the University of Texas Classification Systems among diabetic foot patients admitted in a tertiary hospital through a prospective cohort design.

    Materials and Methods: Sixty-three diabetic foot patients admitted from June 15, 2019 to February 15, 2020. Methods included one-on-one interview for clinico-demographic data, physical examination to determine the classification. Patients were followed-up and outcomes were determined. Pearson Chi-square or Fisher's Exact determined association between clinico-demographic data, the classifications, and outcomes. The receiver operating characteristic (ROC) curve determined predictive abilities of classification systems and paired analysis compared the curves. Area Under the Receiver Operating Characteristic Curve (AUC) values used to compare the prediction accuracy. Analysis was set at 95% CI.

    Results: Results showed hypertension, duration of diabetes, and ambulation status were significantly associated with major amputation. WIFi showed the highest AUC of 0.899 (p = 0.000). However, paired analysis showed AUC differences between WIFi, Wagner, and University of Texas classifications by grade were not significantly different from each other.

    Conclusion: The WIFi, Wagner, and University of Texas classification systems are good predictors of major amputation with WIFi as the most predictive.

    Matched MeSH terms: Amputation
  8. Bujang MA, Kuan PX, Sapri FE, Liu WJ, Musa R
    Indian J Nephrol, 2019 8 20;29(4):235-241.
    PMID: 31423056 DOI: 10.4103/ijn.IJN_152_18
    Introduction: Clinical parameters especially co-morbidities among end stage renal disease (ESRD) patients are associated with mortality. This study aims to determine the risk factors that are associated with mortality within three years among prevalent patients with ESRD.

    Methods: This is a cohort study where prevalent ESRD patients' details were recorded between May 2012 and October 2012. Their records were matched with national death record at the end of year 2015 to identify the deceased patients within three years. Four models were formulated with two models were based on logistic regression models but with different number of predictors and two models were developed based on risk scoring technique. The preferred models were validated by using sensitivity and specificity analysis.

    Results: A total of 1332 patients were included in the study. Majority succumbed due to cardiovascular disease (48.3%) and sepsis (41.3%). The identified risk factors were mode of dialysis (P < 0.001), diabetes mellitus (P < 0.001), chronic heart disease (P < 0.001) and leg amputation (P = 0.016). The accuracy of four models was almost similar with AUC between 0.680 and 0.711. The predictive models from logistic regression model and risk scoring model were selected as the preferred models based on both accuracy and simplicity. Besides the mode of dialysis, diabetes mellitus and its complications are the important predictors for early mortality among prevalent ESRD patients.

    Conclusions: The models either based on logistic regression or risk scoring model can be used to screen high risk prevalent ESRD patients.

    Matched MeSH terms: Amputation
  9. Hashim NA, Abd Razak NA, Gholizadeh H, Abu Osman NA
    JMIR Serious Games, 2021 Feb 04;9(1):e17017.
    PMID: 33538698 DOI: 10.2196/17017
    BACKGROUND: Brain plasticity is an important factor in prosthesis usage. This plasticity helps with brain adaptation to learn new movement and coordination patterns needed to control a prosthetic hand. It can be achieved through repetitive muscle training that is usually very exhausting and often results in considerable reduction in patient motivation. Previous studies have shown that a playful concept in rehabilitation can increase patient engagement and perseverance.

    OBJECTIVE: This study investigated whether the inclusion of video games in the upper limb amputee rehabilitation protocol could have a beneficial impact for muscle preparation, coordination, and patient motivation among individuals who have undergone transradial upper limb amputation.

    METHODS: Ten participants, including five amputee participants and five able-bodied participants, were enrolled in 10 1-hour sessions within a 4-week rehabilitation program. In order to investigate the effects of the rehabilitation protocol used in this study, virtual reality box and block tests and electromyography (EMG) assessments were performed. Maximum voluntary contraction was measured before, immediately after, and 2 days after interacting with four different EMG-controlled video games. Participant motivation was assessed with the Intrinsic Motivation Inventory (IMI) questionnaire and user evaluation survey.

    RESULTS: Survey analysis showed that muscle strength and coordination increased at the end of training for all the participants. The results of Pearson correlation analysis indicated that there was a significant positive association between the training period and the box and block test score (r8=0.95, P

    Matched MeSH terms: Amputation
  10. Loh, Li Loong, Raffael B. Ismail, Goh, Kian Liang, Kamarul Ariffin Khalid
    MyJurnal
    Giant cell tumour (GCT) of the metacarpal bone is rare, and it behaves more aggressively with a higher recurrence rate as compared to other long bones. Modalities such as bone curettage with or without bone grafting, ray amputation, or wide resection and reconstruction have been described as surgical management for this condition. Wide resection (en block) is often preferred as it has a lower recurrence rate among the rests. Reconstruction techniques options available include vascularised or non-vascularised fibular graft, iliac crest strut graft with loss of metacarpophalangeal joint function or with metatarsal substitution resulting in a more preserved function of the hand. This case report is about a 15-year-old teenager girl with a giant cell tumor of her left second metacarpal bone, which was confirmed with a plain radiograph and magnetic resonance imaging. This case report focuses the operative technique of the metacarpal reconstruction using the third metatarsal bone. The aim was to preserve hand function and cosmesis while achieving good local control of the disease without compromising the lower limb function. The transfer of osteoarticular ligamentous complex of the third metatarsal bone for the reconstruction of the second metacarpal bone defects is a possible operative procedure that provides good cosmetic and excellent functional outcomes while not compromising the donor’s foot function.
    Matched MeSH terms: Amputation
  11. Yusof MN, Ahmad-Alwi AA
    Malays Orthop J, 2019 Mar;13(1):25-29.
    PMID: 31001380 DOI: 10.5704/MOJ.1903.004
    Introduction: Large wounds in the leg require combination of local flaps or free flap for wound coverage. Gastrocnemius musculocutaneous flap (GMCF) allows a large wound to be covered by a single local flap. However, the conventional GMCF is often associated with donor site morbidity where the exposed soleus raphe causes poor uptake of the skin graft. Islanding the skin on the muscles allows the donor site to be closed primarily, thus avoiding the donor site morbidity. Materials and Methods: Medical records of twelve patients who underwent islanded GMCF surgery from 2004 till 2018 were reviewed retrospectively. Results: The mean age was 31 years old. Eight cases were with open fracture of the tibia, two degloving injury exposing the patella, one open fracture of patella and necrotising soft tissue infection. The wound size ranged from 12cm2 to 120cm2. All flaps survived. Three patients required skin grafting at the donor site while in the rest the donor sites were able to be closed primarily. Four patients developed deep infection, one healed after vacuum dressing, one after bone transport and one after split thickness skin graft. One patient ended up with below knee amputation after developing chronic osteomyelitis of the tibia. Conclusion: Islanded gastrocnemius musculocutaneous flap is an effective simple alternative for coverage of large soft tissue defects from the knee to half of the leg distally with minimal donor site morbidity. Aggressive debridement of unhealthy tissue is necessary to prevent infection following wound coverage with this flap.
    Matched MeSH terms: Amputation
  12. Abba Y, Abdullah FF, Daud NH, Shaari RB, Tijjani A, Sadiq MA, et al.
    Open Vet J, 2015;5(1):30-3.
    PMID: 26623360
    A Boer-Kajang cross male goat was presented to the Veterinary Hospital, University Malaysia Kelantan with a history of dysuria, hematuria and restlessness. The goat was intensively managed (confined to the pen) and fed with only palm kernel cake for the last three months. Physical examination revealed that the goat was dull, depressed, having an inflamed penis and prepuce with blood stained urine dripping from the penis. The differential diagnoses were obstructive urolithiasis, urinary tract infection and balanoposthitis. Based on the history, clinical signs, physical examination, urinalysis, ultrasonagraphy and feed analysis, the goat was diagnosed with obstructive urolithiasis and balanoposthitis. Treatment was instituted by amputation of the urethral process and retrograde urohydropulsion to relieve the blockade. Sulfadiazine-trimethoprim (Norodine(®)24) 15mg/kg, I.M; flunixin meglumine 2.2mg/kg, I.M; vitamin B complex 1ml/10kg, I.M and ammonium chloride 300mg/kg orally were administered. The goat responded well to treatment and was recovering well during a follow up visit.
    Matched MeSH terms: Amputation
  13. Asdren Zajmi, Nur Atikah Adam, Mohammed Abdelfatah Alhoot
    MyJurnal
    Introduction: Tropical phagedenic ulcer is a skin disease caused by a cocktail of bacteria. This painful ulcer forms over the lower limbs. It is also associated with necrotic slough and foul-smelling discharge that eventually lead to amputation and permanent disabilities. Tropical phagedenic ulcer in Malaysia has not been given much attention. In light of this situation, this research was conducted to assess the knowledge, attitude and practice regarding tropical phagedenic ulcer among the public in Shah Alam, Selangor. Methods: The total respondents were 384, consisting of 164 males and 220 females who were randomly selected. Data were obtained qualitatively through structured questionnaires and analysed using the chi-square test to study the association between the dependent variables and demographic factors. Results: The collected data showed that the respondents (67.2%) had poor knowledge of trop- ical phagedenic ulcer; merely 65.4% considered it to be a health problem, whereas 29.7% believed it is contagious. Also, the data revealed an association between age (χ2=13.587, p =0.004), marital status (χ2=15.435, p=0.001), time spent in community (χ2=6.438, p=0.04) and knowledge of the local name of tropical phagedenic ulcer. About 74.7% of the respondents did not know the cause of tropical phagedenic ulcer. Only 22.1% of the respondents had encoun- tered tropical phagedenic ulcer patients and an association was found between the variable with gender (χ2=4.672, p =0.031), age (χ2=24.134, p =0.000) and marital status (χ2=17.143, p =0.001). Conclusion: This study reveals mis- conceptions about the aetiology and transmission of tropical phagedenic ulcer which greatly influence the attitude of community members towards tropical phagedenic ulcer patients.
    Matched MeSH terms: Amputation
  14. NH Azmi, Azwanis Abdul Hadi, Mohd Aznan Md Aris, E Nasreen, Hashima
    MyJurnal
    INTRODUCTION: One of the most important and debilitating complication of diabetes mellitus is foot
    problem such as ulcers, infections and amputations. However, these complications are preventable by simple
    intervention such as regular foot care practice. This study aims to assess the foot care practice and its
    associated factors among type 2 diabetes mellitus patients attending primary health clinics in Kuantan.
    MATERIALS AND METHODS: This was a cross-sectional study conducted at four primary health clinics in
    Kuantan involving 450 study participants who were selected by using universal sampling method. Level of
    awareness and practice toward diabetic foot care was assessed using validated self-administered
    questionnaire. Multiple logistic regressions were performed to identify factors associated with poor foot care
    practice among the respondents. RESULTS: About 59.6% of respondents had poor foot care practice and
    50.9% had poor awareness level. Multivariate logistic regression analysis identified that, increasing age
    (OR 0.97, 95% CI: 0.955-0.993) and good awareness towards foot problem (OR 0.43, 95%CI: 0.289-0.643)
    were less likely to have poor foot care practice. However, Malay ethnicity (OR 1.81, 95% CI: 1.002-3.271) and
    obesity (OR 1.9, 95% CI: 1.225-2.976) were associated with poor foot care practice after controlling other
    variables. CONCLUSION: Majority of the respondents had poor foot care practice and poor awareness.
    Respondents who are older and have better awareness are less likely to have poor foot care practice.
    Diabetic patients who are Malays and/or obese are predicted to have poor diabetic foot practice and hence
    must be prioritized for a sustainable patient education and compliance towards foot care practice at primary
    care level.
    Matched MeSH terms: Amputation
  15. Pan, K.L., Zolqarnain A., Ong, G.B.
    Malays Orthop J, 2009;3(2):55-57.
    MyJurnal
    Osteosarcoma occurring in the humerus is often confined to the proximal part, in which case, reconstruction after excision is less daunting. When the tumour spreads down the medullary cavity distally, a total humeral replacement is often required. This is costly and beyond the means of the average patient in a developing country. An amputation is often the procedure of first resort. We report a 13-year-old boy with osteosarcoma originating from the left proximal humerus, with involvement of the marrow reaching down to the distal diaphyseal-metaphyseal junction, leaving only 6 cm of the distal humerus intact after wide resection. Reconstruction of the defect was done with a composite cement-autoclaved autograft fixed to the remaining humerus with a plate. At 40 months of follow-up, the patient is well with normal function of the elbow, wrist and hand. Salvaging the limb despite near total involvement of the humerus by high grade osteosarcoma is possible using material available in the average orthopaedic operating room.
    Matched MeSH terms: Amputation
  16. Faridah K, Azmi MT
    MyJurnal
    Background : Foot ulcers and its complications are an important cause of morbidity and mortality in diabetes. The aim of this retrospective study is to determine the ulcer-free survival in diabetic foot and its relevant predictors in a cohort of diabetic patients in the primary health care setting.
    Methods : Data of newly diagnosed diabetics (n=1121) who received treatment in five health centers in the district of Kuala Langat, Selangor between 1st January 1999 until the 30th June 2008 were studied. Information was gathered by reviewing patient’s medical records. All patients were followed until 31st December 2008. The duration of ulcer-free survival was measured from the date of being diagnosed as diabetic until the development of the ulcer.
    Results : The total incidence of diabetic foot ulcer was 9.9% (n=111), with an average annual incidence of 1%. The total incidence of amputation was 1.2%. Mean age of being diagnosed having diabetic was 52+10.7 year old and mean age of being diagnosed having diabetic foot ulcer was 54.68+10.16 year old. The mean for overall ulcer-free survival was 99 months (95%CI:96-102). Male gender (LR=6.56; p=0.01), smokers (LR=3.94; p=0.04), low body mass index (LR=4.45; p=0.03), impaired renal function (LR=5.17; p=0.02) and long duration between follow-up (LR=25.10; p
    Matched MeSH terms: Amputation
  17. Soliman A, Teoh SL, Ghafar N, Das S
    Mini Rev Med Chem, 2018 Oct 25.
    PMID: 30360709 DOI: 10.2174/1389557518666181025155204
    The incidence of diabetes mellitus (DM) is increasing worldwide. One of the main complications in DM is delayed wound healing which often requires amputation. Various drugs have been used to treat DM but they present with various complications and patients often do not comply with such treatment. This opens the door for complementary and alternative medicine. In the present review, we explore the molecular concept of wound healing occurring in different stages with special emphasis to DM. We also highlight potential herbal products such as NF3 (Chinese 2-Herb Formula), Zicao, Jing Wan Hong ointment, mixture of Adiantum capillus-veneris, Commiphora molmol, Aloe Vera, and henna, Aleo vera, Phenol-rich compound sweet gel, Jinchuang ointment, San-huang-sheng-fu (S) oil, Yi Bu A Jie extract, Astragali Radix (AR) and Rehmanniae Radix (RR), Yiqi Huayu, Tangzu yuyang ointment, Shengji Huayu recipe, Angelica sinensis, Lithospermun erythrorhison, Hippophae rhamnoides L., Curcuma longa, and Momordica charantia that could be effectively used to treat DM wounds. Future clinical trials are needed for designing potential drugs which may be effective in treating DM wounds.
    Matched MeSH terms: Amputation
  18. Natarajan, Satheesh Babu, Das, SreemoyKanti, Chandran, Suriyakala Perumal, Aung, Myo Oo, Kanneppady, Sowmya Shar, Entezarian, Maryam, et al.
    MyJurnal
    Diabetic wounds (DW) are a chronic, non-healing wound on the feet of diabetic patients that pose a serious challenge to world health. Around 84% of diabetic patients undergo lower leg amputations. Though numerous topical and systemic drugs have been used to heal the DW, these drugs have led to the emergence and subsequent rapid overgrowth of resistant bacterial strains, side effects and toxicity. Many herbal plants have very important role in wound healing because they promote the natural repair mechanisms. Moringa oleifera (MO) is an important medicinal plant which has an impressive range of medicinal uses including antimicrobial, anti-inflammatory, antidiabetic, antioxidant and anticancer activities.Recently few researchers reported that MO extracts have effective wound healing property due to the presence of rich flavonoids and vicenin-2. The objective of the present study was to develop hydrogel formulations loaded with Moringa oleifera leaves extract. The prepared hydrogels were evaluated for physical appearance, rheological behavior, skin irritation and wound-healing power in streptozotocin-induced diabetic male wistar albino rats. Results showed that all hydrogel formulations exhibited good and acceptable physical properties. All the animals tolerated the applied gels and no signs of irritations were noticed during the skin irritation study. The in-vivo wound healing studies showed a time dependent increase in percentage of wound, a contraction which is higher than that produced by the control groups. These contractions were statistically significant (P
    Matched MeSH terms: Amputation
  19. Leung AKC, Lam JM, Leong KF, Sergi CM
    Int J Dermatol, 2019 Nov;58(11):1239-1245.
    PMID: 31006857 DOI: 10.1111/ijd.14464
    Melanonychia striata is characterized by a tan, brown, or black longitudinal streak within the nail plate that runs from the proximal nail fold to the distal part of the nail plate. Melanonychia striata is due to increased activity of melanocytes or melanocytic hyperplasia in the nail matrix with subsequently increased melanin deposition in the nail plate. The most common cause of melanonychia striata associated with melanocytic activation is ethnic melanonychia which occurs in dark-skinned individuals. Other causes of melanonychia striata related to melanocytic activation include pregnancy, chronic local trauma, infections, medications, dermatological disorders, endocrine disorders, alkaptonuria, hemochromatosis, porphyria, graft-vs-host disease, Peutz-Jeghers syndrome, and Laugier-Hunziker syndrome. Causes of melanonychia striata associated with melanocytic hyperplasia include nail matrix melanocytic nevus, nail lentigo, and nail apparatus/subungual in situ and invasive melanoma. In most cases, melanonychia striata is a benign condition, especially in children. Consequently, most investigators advocate a wait-and-see approach. Nail apparatus/subungual melanoma should be suspected if there is an abrupt onset after middle age, personal or family history of melanoma, rapid growth, darkening of a melanonychia band, pigment variegation, blurry lateral borders, irregular elevation of the surface, a bandwidth >3 mm, proximal widening, associated nail plate dystrophy, single rather than multiple digit involvement, and periungual spread of pigmentation onto the adjacent cuticle and/or proximal and/or lateral nail folds (Hutchinson sign). Prolonged follow-up is mandatory for early detection of possible malignant changes.
    Matched MeSH terms: Amputation
  20. Kow RY, Low CL, Ruben JK, Zaharul Azri WMZ, Mor Japar Khan ESK
    Med J Malaysia, 2019 Oct;74(5):394-399.
    PMID: 31649215
    INTRODUCTION: Diabetic foot infection, a complication that is associated with lower-limb amputation, incurs a huge economic burden to the hospital and health care system of Malaysia. The bacteriological profile of pathogens in diabetic foot infections in Malaysia has been sparsely studied. We investigated the microbiology of diabetic foot infections in patients admitted to the district hospitals on the east coast of Malaysia.

    METHODS: A retrospective analysis was conducted in three district hospitals (Hospital Kuala Lipis, Hospital Bentong and Hospital Raub) in Malaysia from 1st of January 2016 to 31st December 2016. The clinical specimens were cultured using Clinical and Laboratory Standards Institute (CLSI) guidelines. Antibiotic sensitivity testing to different antibiotics was carried out using the disc diffusion method.

    RESULT: A total of 188 pathogens were isolated from 173 patients, with an average of 1.09 pathogens per lesion. Majority of the pathogens isolated were gram negative pathogens (73.4%). The most commonly isolated pathogens were Staphylococcus aureus (17.5%). This was followed by Klebsiella spp. (17%), Pseudomonas spp. (15.4%) and Proteus spp. (13.8%). Gram positive pathogens were sensitive to most of the antibiotics tested except penicillin and fusidic acid. Gram negative pathogens were sensitive to all antibiotics tested except ampicillin and amoxicillin/clavulanic acid. Amikacin provide coverage for all gram negative pathogens in DFI.

    CONCLUSION: For the management of patient with infection in diabetic foot, the choice of antibiotic therapy depends on the sensitivity of the pathogens, the severity of the infection, the patient's allergies history, toxicity and excretion of the antibiotics.
    Matched MeSH terms: Amputation
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