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Education Material for Health Care Professionals: Newsletter Version


Sometimes the arteries in the ankles are calcified due to diabetes.

This makes measurement of blood pressure at the ankle unreliable. In this situation, more information is obtained by measuring pressure at the toe. As a guide, a toe brachial index less than 0.5 indicates the presence of peripheral vascular disease

If necessary, the following tests should be considered :

A) Doppler studies for blood flow.
B) Arteriography.

All these investigations may not be necessary in every patient and the range of investigations should be individualised.

In so far as foot complications are concerned, prevention is still the best policy.  It is absolutely essential that the feet of all the patients be examined for the presence of any problems which may predispose the patient to foot infections.

“The germ is nothing. It is the terrain in which it is found that is everything.”  Louis Pasteur, 1860

If present, these MUST be treated before, rather than after, a foot infection develops.

and calluses are thick layers of skin caused by too much rubbing or pressure on the same spot. Corns and calluses can become infected.

can form if shoes always rub the same spot. Wearing shoes that do not fit or wearing shoes without socks can cause blisters. Blisters can become infected.

Ingrown toenails happen when an edge of the nail grows into the skin. The skin can get red and infected. Ingrown toenails can happen if one cuts into the corners of ones’ toenails when they are trimmed. One can also get an ingrown toenail if your shoes are too tight.

A bunion forms when the big toe slants toward the small toes and the place between the bones near the base of  the big toe grows big. This spot can get red, sore, and infected. Bunions can form on one or both feet. Pointy shoes may cause bunions. Bunions often run in the family. Surgery can remove bunions.

Plantar warts are caused by a virus. The warts usually form on the bottoms of the feet and tend to go away without treatment.


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