Biochemical predictors of diabetic foot osteomyelitis: A potential diagnostic role for parathormone.

AIMS: The aims of this study were to evaluate parathormone (PTH) levels in people with diabetic foot ulcers (DFU) and investigate the relationship between PTH levels and osteomyelitis (OM) in this population. MATERIALS AND METHODS: Eighty-eight patients were admitted for DFU in a tertiary-care centre from October 2021 to May 2022. OM was diagnosed by clinical, laboratory, and radiological evaluations. Laboratory measurements and clinical parameters were collected from medical records. Participants in the study were divided into two groups according to the diagnosis of OM (patients with OM, group 1 [n = 54] and patients without OM, group 2 [n = 34]). RESULTS: Compared with group 2, patients in group 1 were younger and had a longer duration of diabetes. Erythrocyte sedimentation rate and fibrinogen were significantly higher in group 1 compared with group 2. PTH levels were significantly lower (group 1 vs. group 2, median [interquartile range] 16.2 (11.6, 31.0) vs. 23.7 (17.0, 38.1), p = 0.008) and alkaline phosphatase was significantly higher (97.0 (79.0, 112.0) vs. 88.0 (63.0, 107.0), p = 0.031) in group 1. In multiple linear regression analysis, the only independent predictors of PTH concentrations were alkaline phosphatase levels (ß-coefficient 0.441, p < 0.001) and the presence of OM (ß-coefficient -0.290, p = 0.038). CONCLUSIONS: In a population of patients with diabetes and OM admitted to a tertiary university centre, PTH levels were lower as compared with diabetic individuals without OM. The OM and alkaline phosphatase levels were independent predictors of PTH levels in this selected population.

Comparing outcomes of ILD patients managed in specialised versus non-specialised centres.

BACKGROUND: Early appropriate diagnosis and treatment of interstitial lung diseases (ILD) is crucial to slow disease progression and improve survival. Yet it is unknown whether initial management in an expert centre is associated with improved outcomes. Therefore, we assessed mortality, hospitalisations and health care costs of ILD patients initially diagnosed and managed in specialised ILD centres versus non-specialised centres and explored differences in pharmaceutical treatment patterns. METHODS: An epidemiological claims data analysis was performed, including patients with different ILD subtypes in Germany between 2013 and 2018. Classification of specialised centres was based on the number of ILD patients managed and procedures performed, as defined by the European Network on Rare Lung Diseases. Inverse probability of treatment weighting was used to adjust for covariates. Mortality and hospitalisations were examined via weighted Cox models, cost differences by weighted gamma regression models and differences in treatment patterns with weighted logistic regressions. RESULTS: We compared 2022 patients managed in seven specialised ILD centres with 28,771 patients managed in 1156 non-specialised centres. Specialised ILD centre management was associated with lower mortality (HR: 0.87, 95% CI 0.78; 0.96), lower all-cause hospitalisation (HR: 0.93, 95% CI 0.87; 0.98) and higher respiratory-related costs (€669, 95% CI €219; €1156). Although risk of respiratory-related hospitalisations (HR: 1.00, 95% CI 0.92; 1.10) and overall costs (€- 872, 95% CI €- 75; €1817) did not differ significantly, differences in treatment patterns were observed. CONCLUSION: Initial management in specialised ILD centres is associated with improved mortality and lower all-cause hospitalisations, potentially due to more differentiated diagnostic approaches linked with more appropriate ILD subtype-adjusted therapy.

Mixed methods quality evaluation of structured interprofessional medical ward rounds.

BACKGROUND: Standardised structure and content of interdisciplinary medical ward rounds can promote patient safety and patient-centred teamwork. AIMS: To evaluate interdisciplinary ward rounds using a Structured Interdisciplinary Bedside Rounding (SIBR) intervention. METHODS: The study involved multi-method, repeat measures with a non-equivalent control group. Non-participant observations were collected at: 1 and 6 months, on an intervention ward that introduced SIBR; and a control ward that continued traditional rounds. Focus group and survey data were also collected on the intervention ward. Participants were clinicians (medicine, nursing and allied health) working in two general medicine wards at a tertiary hospital in Melbourne, Australia. RESULTS: Seventy-eight patient rounds were observed at Time 1, and 239 at Time 2. The SIBR ward rounds had all clinician disciplines represented, whereas allied health and nurses were present for less than 20% of non-SIBR rounds. Interdisciplinary participation and frequency of desired clinician behaviours increased, and variability in duration of time per patient decreased, on the SIBR rounds. Longitudinal data reflected decreased performance of some SIBR behaviours in the intervention ward, while some desired behaviours increased in the control ward. Qualitative survey and focus group data indicated many positive views, but fit with broader ward routines impacted SIBR implementation. CONCLUSIONS: The overall recommendation by staff was that SIBR should continue. The results provide insights into the adoption of SIBR behaviours and illustrated diffusion of behaviours across wards. Highlighting successes and identifying barriers can help meet challenges for ongoing improvement.

Paediatric pre-operative anaesthetic clinic: A survey of consultant-led caseload and outcomes.

AIM: The role of pre-operative anaesthetic clinics (POAC) in adult practice is well-established and is developing in paediatric hospitals in the UK. METHODS: We carried out a retrospective survey of all patients assessed in our POAC by a consultant, determining the pre-operative problems and the perioperative anaesthetic interventions and outcomes. RESULTS: In 2016, 537 patients were seen by a consultant: the median age was 5.5 years (interquartile range 2.2-10.2) and median weight was 18.7 kg (interquartile range 12-28.7). 77% were ASA3 and 4% were ASA4. Seventy-five percent of patients referred for consultant assessment had a problem with at least one of the following four major body systems: cardiac (37%), respiratory (26%), airway (18%) and neurodevelopment (14%), Fifteen percent of these patients had two of these systems affected, and 3% had three or more. The rate of cancellation due to significant risk was 2.6% (n = 14): nine had significant cardiac risk and five had respiratory reasons. The rate of serious perioperative problems was 2.8% (n = 15): six were cardiac, six were respiratory, two neurological and one coagulation. Cardiac and airway problems occurred during anaesthesia, whereas problems relating to respiratory and neurological disease were post-operative. Of the 15 patients with three or more body system problems, 5 were cancelled or had a perioperative complication causing deterioration, 5 had a major complication but recovered fully and 5 proceeded to general anaesthesia (GA) without serious event. There were no deaths during GA or within 30 days. CONCLUSION: In the POAC, consultants identified a wide range of GA-related potential problems enabling patients to be investigated, informed and prepared (or cancelled because of excess risk), and for appropriate resources to be allocated to achieve efficient and safe perioperative care.

Impact of timing of presentation of acute pancreatitis to a tertiary care centre on the outcome.

BACKGROUND AND OBJECTIVES: Despite improvement in outcomes of acute pancreatitis (AP), some subgroups remain at increased risk. We studied the impact of onset-to-admission interval to a tertiary care centre on outcomes in AP. METHODS: Retrospective analysis of consecutive patients with first episode of AP admitted between 2009 and 2017 on the basis of onset-to-admission interval: ≤7 days, 8-21 days and >21 days was done. Patients were assessed for severity and managed using a step-up approach. Primary outcome measures were surgical necrosectomy and mortality. RESULTS: Of 745 patients (age 39.26 ±â€¯13.18 yrs, 69% male), 380 (51%) had presented ≤7 days, 229 (30.7%) between 8 and 21 days and 136 (18.3%) >21 days after pain onset. Severe pancreatitis was highest in 8-21 days group (129; 56.3%) followed by ≤ 7 days (166; 43.7%) and >21 days of illness (52; 38.2%).Surgical intervention rates were highest in the 8-21 days group(14%) followed by > 21 days (12.5%) and ≤7 days (6.6%) respectively (p = 0.007). Also, mortality was highest in patients with onset to admission interval of 8-21 days (24%) followed by > 21 days (15.4%) and ≤7 days (14.2%) (P = 0.007). On the multivariate analysis, age, late presentation, and the presence of organ failure were found to predict the mortality. CONCLUSION: Patients presenting between 8 and 21 days after onset perform poorly than those presenting earlier or later than them in terms of severity, organ failure, need for surgery and mortality although organ failure remains the most important determinant of outcome. This data can help in devising guidelines for referral of such patients.

Haematopoietic stem cell transplantation for primary immunodeficiency syndromes: A 5-year single-centre experience.

AIM: Haematopoietic stem cell transplantation (HSCT) is a central therapy in the treatment of primary immunodeficiency diseases (PIDs). Over the past 5 years, outcomes have been greatly improved due to earlier diagnosis, improved donor availability, advancements in graft manipulation and the use of less toxic preparative regimens. We present a 5-year audit of HSCT for PID at a single Australian tertiary hospital. METHODS: Retrospective case note review identified diagnosis, pre-transplant medical morbidity, transplant protocol, engraftment, adverse events, post-transplant immune reconstitution and general health. RESULTS: A total of 22 patients with PID underwent 24 HSCTs at our institution between 2012 and 2016. The most common indications were severe combined immunodeficiency, chronic granulomatous disease and familial haemophagocytic lymphohistiocytosis, with a genetic diagnosis in all but two patients. Reduced intensity or reduced toxicity conditioning was used in 91% of cases, and 75% of the donors were unrelated. Transplant-related mortality at day +100 was 9.5%, and cumulative overall survival was 86%. There were three mortalities, all secondary to viral infection, one of which occurred in the context of graft failure. Two patients remained on immune support, with the remainder achieving adequate immune reconstitution. CONCLUSIONS: The outcomes for HSCT for PIDs performed at Sydney Children's Hospital were in line with the world's best practice. HSCT should be considered a potential therapeutic option for all Australian PID patients with a valid disease indication.

Histo-pathological patterns in hysterectomy specimens at a tertiary care centre in India.

It is of interest to document histo-pathological patterns in hysterectomy specimens at tertiary care centre in India. This study included 442 cases. In this study, leiomyoma (9.17 %) was the most common preoperatively clinical diagnosis made in hysterectomy specimen. In this study, uterine fibroid showed a 90.47% correlation between pre-operative and histological findings. There was a 50 % correlation noted between adenomyosis and endocervical polyp.

A clinicopathological study on management of diabetic foot ulcer in tertiary care centre.

INTRODUCTION: Diabetes is a disease in which the body's ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood. India being the Diabetes Capital of the World has a Prevalence of 65.1 million suffering from DM of the Entire Indian Population being 1.33 billion of Worlds 6 billion people. This states that almost half of the Indian Population will sometime in their life be detected with Diabetes Almost 15-20 % of the population suffering from Diabetes are seen to have Diabetic Foot Ulcer at least once in their lifetime. It is also been noted that 10-15 % of patients suffering from Diabetic Foot Ulcer require Expert Management or Multi Disciplinary Approach. Diabetic foot ulcers have many pathogenic mechanisms, These risk factors are as follows: gender (male), duration of diabetes longer than 10 years, advanced age of patients, high Body Mass Index and other co-morbidities such as retinopathy, diabetic peripheral neuropathy, peripheral vascular disease, high glycated haemoglobin level (HbA1C), foot deformity, high plantar pressure, infections and inappropriate foot selfcare habits. Rough estimates are at about 1,00,000 lower limbs are amputated in India every year, of which at least seventy-five percent are neuropathic feet with secondary infections and are potentially preventable.

Acute Lower Respiratory Infection Profile in Children at Tertiary Hospital Bandung: Is There a Difference Before and During COVID-19 Pandemic?

This study aims to analyze differences of the prevalence and characteristics of acute lower respiratory infection (ALRI) in children at tertiary hospital before and during COVID-19 pandemic. This was an observational analytic study with cross-sectional design involving pediatric patients based on the time of the study which was in 1 year-prepandemic (A) and 1 year-pandemic period (B). For period A inpatient data were retrieved from medical records and period B used pediatric ALRI registry. The ALRI characteristics were analyzed with significance if P < .05. Prevalence in periods A and B were 5.8% (534/9252) and 4.9% (409/8283), respectively. The characteristics of ALRI for clinical, comorbidities, laboratory findings (NLR, TLC), and chest radiograph showed significant differences (P < .05). ALRI as manifestation of confirmed COVID-19 were identified in 16 (4.9%) cases. Prevalence of ALRI in children during COVID-19 pandemic is lower compared to before. There are differences in the characteristics of ALRI in pediatrics.

Status of Respectful Maternity Care Among Women Availing Delivery Services at a Tertiary Care Center in Central India: A Cross-Sectional Study.

Introduction There are numerous reports of disrespectful, abusive, or neglectful treatment during childbirth from health facilities worldwide. Although India has substantially increased the number of hospital deliveries and reduced the maternal mortality ratio, the quality of intrapartum and immediate postpartum care for delivering mothers has not been given much importance. Therefore, assessing mistreatment and quality of care during childbirth is vital for promoting respectful maternity care.  Methods A descriptive hospital-based cross-sectional study was carried out in a tertiary care center in central India. A convenience sampling method was used, and a total of 150 consecutive consenting women aged 18-49 years who delivered in the study setting were included. Data was collected using a predesigned and pretested questionnaire based on seven major categories per the Respectful Maternity Care (RMC) Charter. Results All the 150 women in the present study, i.e., 100%, experienced at least one form of disrespect during their labor, childbirth, or postnatal period at the hospital. The mean scores for domains of non-confidential care (0.59), non-consented care (0.95), abandonment or denial of care (1.21), and physical abuse (1.26) are low. Conclusion The findings of the present study shed important light on the current state of respectful maternity care in the study area. Though mothers are noticing and reporting positive changes in maternity care practices, respectful maternity care still has a long way to go.

Impact of covid-19 pandemic on characteristics of dental emergencies and treatment services at tertiary care centre.

To categorize and compare the dental emergencies along with status of health services received in the tertiary dental health care centre during the pre covid- 19 periods and period of the complete lockdown in COVID 19 pandemic. Methods: A retrospective cross-sectional observational survey was conducted. Four different groups period were studied on patients who visited for dental emergencies at tertiary care centre. April 14 to 13 May 2020 assigned and analyzed as a test period group or group IV. The control period group i.e. group III was 14 February 2020 to 17 March, pre lockdown COVID 19 month when there was no consideration of epidemic in India. Same as periods of group II and IV, group I and II from last year 2019 were also assigned and analyzed. The tertiary care centre provision of health services during this pandemic was also inquired and evaluated. The information was recorded regarding availability of health services like non-emergency dental treatments, emergency dental services, and online professional consultation. To compare four different time period of obtained data, Analysis of variance (ANOVA) and Chi square test were used. Results: The overall proportion and percentage of dental emergencies were raised. The reason for emergency visits to dental clinic were the main problem related with pulpal (46.0%) followed by abscess (16.6%), periapical lesions (15.0%), cellulitis (4.1%) or trauma (0.3%). In lockdown most of the dental emergencies 228(2 6 5) were endodontic related (86.1%) which managed mostly through '3A" approach (advise, analgesics and antibiotics) (60.1%) and remaining (26.0%) through extraction.

Epidemiology of Uveitis in a tertiary care centre in Portugal.

Purpose: Evaluate the prevalence and incidence, demographic characteristics, anatomical classification, concomitant complications and treatment of uveitis, as well as its association with systemic diseases in the northern Portuguese population referred to a tertiary care centre (São João Hospital, Porto).Methods: A retrospective observational study of 545 consecutive uveitis cases was performed between 12th April 2012 and the 26th October 2017. Uveitis was classified according to Standard Uveitis Nomenclature, while aetiology and complications were diagnosed by specific clinical and laboratory testing.Results: Prevalence was calculated to be 12,4 cases per 100,000 people while incidence was 3.9 cases per 100,000 people annual incidence. The ratio of females to males was 1.32:1 and the mean age at diagnosis was 47,86 years. Anterior uveitis was the most common classification making up 47.5%, followed by non-infectious posterior uveitis 18,0%, infectious posterior uveitis 8,4%, intermediate uveitis 5,5% and panuveitis 4,2%. Extra-uveal entities made up the rest of the causes (16.4%). In terms of aetiology, the majority of uveitis was idiopathic (32,1%) followed by axial spondylarthritis (12.1%), Behçet's disease (8,8%), sarcoidosis (6,1%), tuberculosis (5,5%), herpes (5,1%), toxoplasmosis (3,1%) among other less frequent causes.Conclusion: In our referral region, 72% of uveitis cases were correctly identified surpassing other studies. There was a higher rate of intermediate uveitis and lower number of panuveitis cases when compared to a previous Portuguese study. Extensive monitoring of the development of uveitis by international multicentre prospective studies could be useful for increasing practitioner awareness and diagnostic approach.

The adequacy of fluoroscopic upper gastrointestinal studies for suspected intestinal volvulus in a tertiary care centre vs. secondary centres: A regional multicentre study.

INTRODUCTION: Early diagnosis and treatment of intestinal volvulus are important to reduce morbidity. A fluoroscopic upper GI study is the gold standard for diagnosis and may be performed in a secondary or tertiary care centre prior to surgery. It is important the reporting radiologist is confident in the findings. We aim to assess whether there is any difference in confidence and study quality between paediatric and general radiologists who work in secondary or tertiary care centres. METHODS: Retrospective review of initial radiology reports and blinded review of the study images by paediatric radiologists. RESULTS: A total of 277 children underwent a fluoroscopic study for intestinal volvulus over a four-year period. The majority were performed at a tertiary care centre, by paediatric radiologists. The confidence of initial reporting was higher in paediatric than general radiologists despite whether they worked in a secondary or tertiary care centre (P-value < 0.001). On retrospective review, studies performed by paediatric radiologists were rated as having a higher confidence in identifying the location of the duodenojejunal flexure. General radiologists tended to have a slightly higher rate of repeat studies but still low at 2.2%. Despite this, there was no significant difference in the diagnosis rates and secondary centre general radiologists excluded malrotation in 62% of studies likely reducing transfer rates. CONCLUSION: Confidence in initial reporting and on review of the duodenojejunal flexure location in suspected intestinal volvulus is higher in paediatric radiologists compared with general radiologists, although diagnosis rates are no different.

A Composite Study of Coagulation Milieu in Covid-19: Experience from a Tertiary Care Centre from India.

BACKGROUND: The understanding of pathogenesis is necessary for the development of effective treatment for COVID-19. Various studies have postulated that there is a complex interplay of mediators of coagulation and inflammation responsible for the pathogenesis of COVID-19. We did this study on coagulation parameters and inflammatory markers and their effect on outcome in patients with COVID-19. METHODS: This was a single centre observational cross-sectional study. Procoagulants [Prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, lupus anticoagulant (LA), fibrinogen, factor-VIII (F-VIII)]; anticoagulants [protein-C (PC), protein-S (PS), antithrombin] and inflammatory markers [interleukin-6 (IL-6) and highly sensitive - C-reactive protein (hs-CRP)] were measured at the time of hospitalization and correlated with the severity of the disease. RESULTS: A total of 230 patients were enrolled, of which 61.3%, 20.0%, and 18.7% had asymptomatic/ mild, moderate, or severe disease, respectively. COVID-19 disease severity was associated with rising trends with coagulation parameters (PT, APTT, D-Dimer; p value 0.01, <0.0001, <0.0001, respectively). Falling trends of anticoagulant (PC, Antithrombin; p value <0.0001, 0.003 respectively) and rising trends of procoagulant (fibrinogen, F-VIII; p value 0.004, <0.0001 respectively) were observed with increasing COVID-19 disease severity. Multivariate logistic regression analysis found that advanced age, high D-Dimer, and high hs-CRP (p value 0.035, 0.018, <0.0001 respectively) were independent predictors of mortality in COVID-19. Procoagulant parameters (D-dimer, APTT, Factor VIII) were positively correlated with anticoagulant parameters (PC and PS) and inflammatory parameters (hs-CRP). CONCLUSION: This study revealed increased levels of coagulation and inflammatory parameters, which correlated with the severity of COVID-19. Age, D-dimer, IL-6, hs-CRP, APTT, fibrinogen, and Factor VIII were significantly higher in patients with moderate and severe disease as compared to asymptomatic/mild disease. Advanced age, high D-dimer, and high hs-CRP were significantly associated with poor outcomes.

Delayed referral increases the need for surgery and intervention in patients with acute pancreatitis.

BACKGROUND: The aim was to study the outcomes of acute pancreatitis (AP) patients who were referred from other facilities to a tertiary care centre. METHODS: Patients with AP were who were referred from other hospitals to a tertiary care centre between April 2013 and September 2019 were studied and their outcomes were analysed. Comparison was made between patients referred early (≤7 days) versus those referred late (>7 days). RESULTS: Of the 838 patients seen by us, 650 patients (77.6%) were referred from other centres. Median (interquartile range) onset to admission interval was 5 (4-7) days for those who were referred ≤7 days and was 16 (11-30) for those who were referred >7 days. Patients referred beyond 7 days of pain onset had higher rates of development of organ failure (P = 0.007), including acute lung injury (P = 0.008) and acute kidney injury (P = 0.026), infected necrosis (P < 0.0001), requirement of endoscopic/percutaneous drainage (P < 0.001) and need for surgery (P < 0.02) compared to patients who were referred ≤7 days of pain onset. Mortality was however similar in the two groups. CONCLUSION: Patients with AP referred to a specialized centre with AP early (≤7 days) have better outcomes than those referred late (>7 days) from other facilities.

Knowledge and Practice of Diabetic Foot Care in an In- Patient Setting at a Tertiary Medical Center.

Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients' knowledge and compliance of diabetic foot care. A cross sectional study performed on patients who were admitted to HSNZ from the 1st September 2013 to 30th April 2014 for diabetic foot infections. They were interviewed with a questionnaire of 15 'yes' or 'no' questions on foot care knowledge and practice. Score of 1 was given for each 'yes' answer. The level of knowledge and practice, whether good or poor, was determined based on the median score of each category. The result was tested using a chi-square test in SPSS version 17. A total of 157 patients were included in this study with a mean age of 56.33 years (31-77). There were 72 male (45.9%) and 85 female (54.1%) patients with the majority of them being Malays (154 patients, 98.1%). Majority of the patients (58%) had poor foot care knowledge while 97 patients (61.8%) had poor diabetic foot care practice as compared to the median score. Based on the chi square test of relatedness, there was no significant association between knowledge and practice with any of the variables. In conclusion, the majority of patients admitted for diabetic foot infections had poor knowledge and practice of diabetic foot care. Education regarding foot care strategies should be emphasized and empowered within the diabetic population.

A case series of kaposi's varicelliform eruption in dermatology in-patients in a tertiary care centre.

BACKGROUND: Recently, we noted increasing number of cases of Kaposi's varicelliform eruption (KVE) among dermatology in-patients who were being treated for various dermatoses, some of which have not been reported earlier to be associated with KVE, and hence, this report. AIMS: This study was designed to identify various dermatoses in which KVE occurred, to study the clinical features, course and response to specific antiviral treatment, to establish the risk factors, and course of the primary dermatoses during the episode of KVE. MATERIALS AND METHODS: We analyzed our data of dermatology in-patients in a tertiary care centre in South India from April 2008 to November 2009 (20 months). The data were tabulated and analyzed. RESULTS: Twenty cases (12 female and 8 male patients) of KVE were seen. The mean age of the patients was 46.4 years. There were seven cases of erythroderma, four of pemphigus vulgaris, three of toxic epidermal necrolysis, two of airborne contact dermatitis (ABCD), one each of lichenoid drug rash, and drug rash with eosinophilia and systemic symptoms (DRESS). Underlying dermatoses for erythroderma were: ABCD (3), psoriasis (3), and cutaneous T-cell lymphoma (1). Possible source of infection could be identified in five cases: exogenous sources in four cases and endogenous source in one case. The mean incubation period for cases with known source was 5 days (range, 2-9 days). Eighteen patients responded favorably to acyclovir. None of our patients had recurrent KVE during the study period. CONCLUSION: KVE may complicate any dermatosis where the integrity of the skin is compromised. Diagnosis and early treatment are important and possible in most cases if suspected.

Knowledge and Practice of Diabetic Foot Care in an In-Patient Setting at a Tertiary Medical Center

Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients’ knowledge and compliance of diabetic foot care. A cross sectional study performed on patients who were admitted to HSNZ from the 1st September 2013 to 30th April 2014 for diabetic foot infections. They were interviewed with a questionnaire of 15 ‘yes’ or ‘no’ questions on foot care knowledge and practice. Score of 1 was given for each ‘yes’ answer. The level of knowledge and practice, whether good or poor, was determined based on the median score of each category. The result was tested using a chi-square test in SPSS version 17. A total of 157 patients were included in this study with a mean age of 56.33 years (31-77). There were 72 male (45.9%) and 85 female (54.1%) patients with the majority of them being Malays (154 patients, 98.1%). Majority of the patients (58%) had poor foot care knowledge while 97 patients (61.8%) had poor diabetic foot care practice as compared to the median score. Based on the chi square test of relatedness, there was no significant association between knowledge and practice with any of the variables. In conclusion, the majority of patients admitted for diabetic foot infections had poor knowledge and practice of diabetic foot care. Education regarding foot care strategies should be emphasized and empowered within the diabetic population.