Risks To Feet In The Eastern Nepal: Outcomes Of Foot Complications Among HIV Patients | 17913
Epidemiology: Open Access
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Approximately 30% of patients affected with immunodeficiency viruses suffer from foot complications. It is
invariably a peripheral neuropathy which manifests in the form a mild to severe symptomatology. It is costly, disabling and
have a prolonged hospitalization or morbidity. An understanding of the pathogenesis, disease spectrum, reporting to a health
care provider early on, and the treatment efficiency is primarily poor. The disease prototype has been observed in this study:
Reasons for good and negative outcomes have been identified and the specific management strategy useful for our setup has
All patients presented to the surgical clinics with AIDS and foot complications in the past one year were included
in the present study conducted at a community based center. The details regarding their feet status, the demographics, their
medical surgical treatment and their outcomes were documented on a prospective basis. Logistic regression analysis was
undertaken to determine the association between factors of interest and outcomes of healing in the form of major or minor
amputation has been done.
Forty-three patients were recorded and the male to female ratio was 5:1 where 25% had neuropathic ulcers and 55%
had severe disease at presentation. Associated Insulin Dependent Diabetes Mellitus was found in 20% of them. Two types of
AIDS foot pathology were recognized that are not usually classified: Acute injury without neuropathy and deep soft tissue
infections; 41% required major and 34% required minor amputations respectively and 25% did improve with dressings and
debridement. The total number of hospital stay was 764 days. Major amputation was associated with ischemia, severe disease
at presentation and aging.
Patterns of feet complication observed in patients with AIDS are described through text and pictorial
representation. The magnitude of disease and factors, which lead to poor outcome, are identified. Attention should be waged
through a multidisciplinary team approach to timely referral from a primary care facility are patient education, early diagnosis
and appropriate definitive management.
Shailesh Adhikary qualified as a Surgeon from Post Graduate Institute in Chandigarh, India in 1994 and currently working as a clinical teacher and a Surgeon at the
Community Based Medical College in Eastern Nepal for 12 years. He has published 34 papers at national and international journals and is serving as an Editorial
Board Member for
Asian Journal of Surgery
. He is also the Governor of Endoscopic Laparoscopic Surgeons of Asia working to promote the Minimal Access Surgery
development across Nepal and in Asia.
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