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Short communication | DOI: https://doi.org/DOI:10.31579/2640-1045/108
1Chief Diabetologist- LK Diabetes Centre, Lucknow, India.
2Diabetologist and Podiatrist- LK Diabetes Centre,Lucknow, India.
3Junior Diabetologist- LK Diabetes Centre,Lucknow, India.
*Corresponding Author: LK Shankhdhar, Chief Diabetologist- LK Diabetes Centre, Lucknow, India.
Citation: LK Shankhdhar, K Shankhdhar, S Shankhdhar (2022). Common Problems Related to Podiatry. Endocrinology and Disorders. 6(1): DOI:10.31579/2640-1045/108
Copyright: © 2022 LK Shankhdhar, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 28 October 2021 | Accepted: 10 December 2021 | Published: 03 January 2022
Keywords: podiatry: diabetes; clinical examination
India is a developing country and lacks many things including Podiatry as subspecialty of Diabetes. There are no Podiatry Collegesnor provision for regular training of young physicians in podiatry. Missing job opportunity, kills interest of physicians in Podiatry. Most physicians have acquired some degree of skill by self-reading or doing observer ship abroad and by attending a few International conferences on Podiatry.
India is a developing country and lacks many things including Podiatry as subspecialty of Diabetes. There are no Podiatry Collegesnor provision for regular training of young physicians in podiatry. Missing job opportunity, kills interest of physicians in Podiatry. Most physicians have acquired some degree of skill by self-reading or doing observer ship abroad and by attending a few International conferences on Podiatry.
Under the circumstances, level of knowledge of an average patient can be expected to be poor. This article aims at emphasizing common errors by Indian patients pertaining to the field of podiatry. We are providing only qualitative account and have not gathered data for quantitative expression.
Neither physicians ask nor patientsinsist on regularfeet examination during their visit to physicians. Physicians ask to put off shoes only when some patient complains of some major foot problem such as a wound or an abscess.
Even during clinical examination, very few physicians have magnifying lenses toexamine foot problems closely.
Provision for podiatric investigations such as monofilament, Biothesiometer, Audio Doppler, foot mats and thermotip are available with only few physicinas in big towns. Ofcourse tuning fork is available with most but they use it rarely.
Interestingly fewer government hospitalshave provision for foot care compared to private clinics.
Therapeutic measures such as insoles, custom shoes, total contact casts etc are not available under one roof. Most measures are available with orthopedicians eitherat their clinicor they call the provider by phoning.
Even for surgical care for minor and major amputations, patient is referred to a general surgeon or orthopedic surgeon.
General rule is that shoe is discarded only when a cobbler refuses to repair.Thus shoes last lifelong.
Many patients get calluses, corns and even ulcers due to ill-fitting shoe or poorly repaired shoe.
No shoe shop has a horizontal scale for measuringfoot size, insteada vertical one is routinely used.
No patienthas information that shoes should be purchased in the evening.So most patientspurchase an ill-fitting shoe.
In many cases insole is torn or missingtotally.
Even holes can be found in insoles which might result into ulceration.
Fewer patientsuse shoes; most have poor sandles or chappals.
One variety is very popular among economically weaker persons. It is a chappal made of crude tyre. It is very tough and not fit for use even when new.
Bare foot walking is common in still poorer individuals. These individuals have very tough plantar soles with many cracks.
Taenia pedis is frequentwith itchy skin and cracks between toes, especially between 4th and 5th toes, due to barefoot walking coupled with frequent wettingof the feet.
Mycotic infections of nails (Taenia unguum) is frequent with hoof like nails, poorly trimmed or not trimmed at all for years. Many a times bathroom surgeries are performed on these nails with attended hazards.
Dermatitis is frequent mostly on ankle regions.
Neurodermatitis affectinglower parts of legs symmetrically is very frequent.
Many experimental therapies on patches of dermatitis by quacks make job of informed physicians more difficult. One patient came to me with a big ulcer over a dermatitis patch after applyingacid as per advice of a quack.
Many indigenous applications are applied ranging from diesel and cow dung to ash.
Fulminant infections follow poor therapies.
Dressing is done at surprising intervals; mostly when it is too stinking and dirty. To increase interval, patients often wrap a polythene around the dressings and change polytheneonly.
Physicians charge heavily for dressing since plight of dressings and wound is verybad.
Many individuals don’t wear any socks, as they are not requiredwith chappals and sandals.
No special socks are used. Socks of syntheticmaterial are frequently used since cotton socks are relatively costlier.
Torn socks with holes or poorlyrepaired socks are used for pretty long before being discarded.
Frequent washingis not seen so socks smell badly.
Annual foot checkup is not undertaken routinelydue to financial constraints.
Patients get foot checkup tests only when medical problemis far advanced.
Patients do not agree to minor surgeries such as corn and callus removal, whichare flood gatesfor ulceration and potential risk for amputation.
Even when amputation is imperative, patientsdon’t agree for it and waste timeand money for no avail.
All the authors declarethat they have no conflictof Interest.
We acknowledge this article to Late Dr. Uma Shankhdhar who became victim of Covid Pneumoniain May, 2021 She had contributed immenselyin preparing the draft of this article before her death.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
