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Gangrene is a serious and potentially life-threatening complication of diabetes mellitus, resulting from impaired blood circulation, neuropathy, and increased susceptibility to infection. Diabetic patients, particularly those with poorly controlled blood glucose levels, are at a significantly higher risk of developing foot ulcers and tissue necrosis that can progress to gangrene and ultimately lead to limb amputation if not managed promptly. This poster highlights the major types of gangrene encountered in diabetic patients, including dry, wet, gas, and Fournier’s gangrene, and outlines their characteristic features. It further discusses the primary causes and risk factors, such as peripheral arterial disease, diabetic neuropathy, foot trauma, infections, hypertension, smoking, obesity, and poor glycemic control. Common clinical manifestations include discoloration of the affected tissue, pain, swelling, ulceration, foul-smelling discharge, fever, and tissue necrosis. The poster also presents Wagner’s classification system for diabetic foot ulcers and gangrene, emphasizing the progression of disease severity. Effective management strategies include strict glycemic control, appropriate wound care, infection management, improvement of peripheral circulation, surgical intervention when necessary, lifestyle modification, and regular follow-up. Early detection, patient education, and routine foot care practices are essential in preventing complications, reducing the risk of amputation, and improving the quality of life among diabetic patients.
Copyright (c) 2026 Fatima Mirza, Ayesha Siddiqui, Nimra Edhi, Saba Ansari, Bisma Sheikh, Maryam Sohail (Author) https://creativecommons.org/licenses/by/4.0
Geriatric Foot Care Awareness: Walking into Old Age
Foot health is a fundamental yet frequently overlooked aspect of geriatric healthcare that directly influences mobility, independence, and overall quality of life in individuals aged 60 years and above. This study highlights the growing burden of geriatric foot disorders and emphasizes the importance of early prevention, awareness, and routine podiatric care. Age-related physiological changes, including skin thinning, reduced muscle mass, fat pad atrophy, impaired circulation, neuropathy, and decreased bone density, significantly increase susceptibility to foot complications in the elderly population. Common conditions identified include diabetic foot ulcers, bunions, arthritis, fungal infections, plantar fasciitis, nail disorders, and chronic skin fissures, all of which are further aggravated by risk factors such as diabetes mellitus, peripheral arterial disease, obesity, poor hygiene, reduced mobility, and inappropriate footwear. The study further demonstrates that neglected foot conditions can progress to severe complications including chronic ulcers, osteomyelitis, falls, fractures, septicemia, lower-limb amputations, and loss of independence. Evidence indicates that a large proportion of diabetes-related amputations are preventable through timely intervention and regular podiatric assessment. Preventive strategies such as daily foot inspection, proper nail and skin care, blood sugar control, supportive footwear, regular exercise, and scheduled podiatry checkups are therefore essential to preserving functional mobility and reducing healthcare burden. Overall, the study underscores the urgent need for improved geriatric footcare awareness, multidisciplinary management, and accessible podiatric services to promote healthy aging and enhance quality of life among older adults.
Copyright (c) 2026 Sawatry Nehal, Laiba Waqar, Rohina Arshad, Gul e Nimrah, Muneera Shoaib (Author) https://creativecommons.org/licenses/by/4.0
Decoding the Biomechanical Maturation and Clinical Nuances of Child Gait and Development
Child gait development is a dynamic and complex process that reflects the progressive maturation of the musculoskeletal and neuromuscular systems. This study highlights the importance of establishing standardized pediatric gait references to differentiate normal developmental variations from pathological abnormalities. A comprehensive diagnostic framework combining qualitative clinical assessment with advanced quantitative technologies, including 3D Motion Capture (3DMC), force plates, electronic walkways, surface electromyography (SEMG), wearable inertial measurement units (IMUs), and pressure mapping systems, was evaluated to analyze biomechanical changes during gait maturation. The study outlines five major phases of gait development, beginning with the “high guard” phase of initial independent walking between 11–15 months, characterized by increased stability and reduced efficiency, followed by early refinement, transitional alignment changes such as physiological genu varum and genu valgum, and progression toward mature adult-like gait patterns by approximately 7 years of age, with further improvements in metabolic efficiency during adolescence. Additionally, the framework facilitates early identification of atypical gait patterns associated with conditions such as cerebral palsy, equinus gait, crouch gait, scissoring gait, and structural torsional deformities including persistent femoral anteversion. Despite challenges such as pediatric compliance limitations, motion artifacts, and diagnostic variability, the integration of qualitative observations with quantitative gait metrics enables more accurate assessment and timely multidisciplinary intervention. Early detection within critical neuroplasticity periods can significantly improve long-term functional mobility, rehabilitation outcomes, and quality of life in children with gait abnormalities.
Copyright (c) 2026 Fareeha Nadeem Ur Rehman, Bisma Batool, Daniya Iqbal, Alina Javed, Zehra Riaz, Shehzadi Moattar Fatima (Author) https://creativecommons.org/licenses/by/4.0
Step Smart: The Hidden Impact of BMI on Foot Pain
Body Mass Index (BMI) is an important indicator of overall health and has a direct impact on musculoskeletal and foot health. Elevated BMI increases mechanical load on the feet, resulting in excessive plantar pressure, altered biomechanics, and structural deformities that negatively affect mobility and daily functioning. Individuals with obesity are more likely to develop foot-related conditions such as plantar fasciitis, pes planus (flat feet), heel pain, bunions, arthritis, joint stress, and gait abnormalities. Common symptoms associated with increased BMI include persistent foot pain, swelling, stiffness, numbness, fatigue during walking, and impaired balance. Several contributing factors, including sedentary lifestyle, poor footwear, prolonged standing, rapid weight gain, and genetic predisposition, further worsen these conditions. Preventive and management approaches such as maintaining a healthy BMI, engaging in regular physical activity, using supportive footwear and orthotic devices, and participating in physiotherapy and stretching exercises can significantly improve foot function and reduce pain. Maintaining an optimal BMI is therefore essential for preserving foot health, enhancing mobility, and improving overall quality of life.
Copyright (c) 2026 Wadiyah Waqar Rizvi, Syeda Rimsha Zehra Baqri, Yashal Sadaqat Sheikh, Abeera Athar Barry, Minhal Zahid, Umaima Fakhruddin (Author) https://creativecommons.org/licenses/by/4.0
*]:pointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id="request-WEB:da0373e5-5630-41c7-af8d-b7427d5d929b-0" data-turn-id-container="request-WEB:da0373e5-5630-41c7-af8d-b7427d5d929b-0" data-testid="conversation-turn-2" data-scroll-anchor="false" data-turn="assistant"> Vitamin D deficiency is a significant public health issue in Pakistan, affecting nearly 70–90% of the adult population despite adequate sunlight availability. This poster emphasizes the essential physiological functions of vitamin D in maintaining bone mineralization, calcium homeostasis, muscle strength, immune regulation, and cellular growth. Vitamin D is synthesized in the skin through ultraviolet-B (UV-B) radiation and subsequently activated in the liver and kidneys to perform its biological functions. Epidemiological evidence indicates a higher prevalence of deficiency among women, elderly individuals, children, dark-skinned populations, and indoor workers, with females being disproportionately affected. Contributing factors include limited sun exposure, sedentary indoor lifestyles, inadequate dietary intake, darker skin pigmentation, and chronic medical conditions such as malabsorption syndromes, liver disease, and kidney disorders. Clinical manifestations range from skeletal complications including rickets, osteomalacia, and osteoporosis to muscle weakness, recurrent infections, fatigue, depression, and cognitive disturbances. Diagnosis is primarily based on serum 25-hydroxyvitamin D levels, which classify deficiency, insufficiency, sufficiency, and toxicity. Management strategies highlighted in the poster include regular sunlight exposure, intake of vitamin D–rich foods, supplementation with vitamin D3, and routine monitoring through laboratory testing. The poster also addresses common misconceptions and promotes evidence-based awareness regarding vitamin D deficiency. Early identification, preventive interventions, and public health education are crucial to reducing the burden and long-term complications associated with vitamin D deficiency in Pakistan.
Copyright (c) 2026 Ammara Moghees, Noor Fatima, Samreen Khan, Elisha Maqbool, Qaiser Ali (Author) https://creativecommons.org/licenses/by/4.0
Awareness of Charcot Foot Among Diabetic Patients: A Podiatric Approach
Charcot Neuroarthropathy (Charcot Foot) is a severe and potentially disabling complication of diabetes mellitus that commonly develops in patients with peripheral neuropathy. Due to the loss of protective sensation, the condition is frequently painless in its early stages, leading to delayed diagnosis and progressive destruction of the bones, joints, and soft tissues of the foot and ankle. This study evaluates the level of awareness and knowledge regarding Charcot Neuroarthropathy among diabetic patients attending tertiary care hospitals in Karachi and examines its association with major risk factors, particularly body mass index (BMI) and glycemic control measured through HbA1c levels. The study emphasizes the importance of understanding the neurotraumatic and neurovascular mechanisms involved in disease progression, which contribute to inflammation, bone resorption, deformity, and instability, commonly resulting in a characteristic rocker-bottom foot deformity. Clinical manifestations such as swelling, redness, warmth, and deformity, along with diagnostic approaches including clinical examination, X-ray, MRI, and CT imaging, are highlighted for early detection. The research further identifies poor glycemic control, obesity, long duration of diabetes, foot trauma, and peripheral neuropathy as significant contributing factors. By promoting patient education, regular podiatric assessment, daily foot care, and timely diagnosis, the study underscores the importance of preventive strategies to reduce complications such as ulceration, infection, amputation, disability, and reduced quality of life among diabetic patients.
Copyright (c) 2026 Mateen Uddin, Mishlam Naveed, Jawariya Farhan, Faiza Iqbal, Fabiha Khan (Author) https://creativecommons.org/licenses/by/4.0
Diabetic foot ulcer (DFU) is a serious and common complication of diabetes mellitus that significantly affects patients’ quality of life and increases the risk of infection, hospitalization, and lower-limb amputation. It is characterized by an open sore or wound that usually develops on the feet as a result of peripheral neuropathy, poor blood circulation, and prolonged pressure or unnoticed injuries. Early identification and proper management of diabetic foot ulcers are essential to prevent severe complications. Risk factors such as uncontrolled blood glucose levels, inadequate foot care, smoking, obesity, and peripheral vascular disease further contribute to delayed wound healing. Effective prevention strategies include regular foot examination, patient education, glycemic control, appropriate footwear, and timely medical intervention. Multidisciplinary approaches involving wound care, infection management, and lifestyle modification play a vital role in improving healing outcomes and reducing morbidity. Raising awareness regarding diabetic foot care can help minimize complications and improve overall patient health and well-being.
Copyright (c) 2026 Zainab Amer, Hamza Ali, Mahnoor Anjum, Ramsha Zarmeen, Shahid Khan (Author) https://creativecommons.org/licenses/by/4.0
Plantar fasciitis is a leading cause of heel pain, primarily associated with repetitive stress, overuse, and biomechanical abnormalities of the foot. This case study highlights a patient presenting with persistent heel pain, most pronounced during the first steps in the morning and following prolonged periods of standing. Contributing risk factors included extended weight-bearing activities, possible improper footwear, and reduced flexibility of the lower limb structures. Clinical evaluation revealed localized tenderness at the medial calcaneal tubercle, tightness of the Achilles tendon, and pain exacerbated by weight-bearing movements. The diagnosis was established through a comprehensive assessment involving patient history, physical examination, and functional testing, emphasizing the importance of early identification and clinical evaluation in managing plantar fasciitis. This case underscores the role of mechanical stress and soft tissue
Copyright (c) 2026 Maryam Ashfaq, Muskan Zehra, Fatimah Siddiqui, Avisha (Author) https://creativecommons.org/licenses/by/4.0
Foot Health Status Among Academic and Clinical Workers: A Cross-Sectional Study
Foot health plays a vital role in mobility and occupational performance, particularly among individuals engaged in prolonged standing and physically demanding tasks. This study aims to compare foot health status between academic and clinical workers, who are exposed to distinct occupational stressors in different work environments. A cross-sectional study design will be employed, involving 196 participants aged 22–60 years with a minimum of six months of job experience. Foot health status will be assessed using the Foot Health Status Questionnaire (FHSQ), a validated tool for evaluating foot-related health outcomes. Data will be analyzed using SPSS version 26, and appropriate statistical tests, including the Chi-square test, will be applied to determine significant differences between groups. The findings of this study are expected to highlight occupational variations in foot health and contribute to improved workplace health strategies for both academic and clinical professionals.
Copyright (c) 2026 Muneeza Qasim , Javeria Zubair, Nehal Ismail, Sawera Shoukat, Syeda Rubasha Mir (Author) https://creativecommons.org/licenses/by/4.0
Prevalence of Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus using 10 g Semmes-Weinstein Monofilament Testing
Peripheral neuropathy is a common and significant complication of type 2 diabetes mellitus (T2DM), often leading to loss of protective sensation and an increased risk of foot ulceration and amputation. This study aimed to determine the prevalence of peripheral neuropathy among individuals with T2DM using the 10 g Semmes-Weinstein monofilament test, a simple and cost-effective screening tool. A cross-sectional design was employed, including participants with a confirmed diagnosis of T2DM. The monofilament was applied to specific plantar sites on both feet to assess sensory perception, with loss of protective sensation defined as the inability to perceive pressure at one or more sites. Findings indicate that the prevalence of diabetic peripheral neuropathy ranges approximately from 26% to 35%, with a considerable proportion of patients demonstrating sensory loss. These results highlight the importance of early screening and routine assessment in diabetic patients to prevent severe complications. The study supports the use of the monofilament test as an effective method for early detection and risk stratification in clinical and community settings.
Copyright (c) 2026 Maimoona Imam, Ameema Moiz, Zoya Hassan , Harmeen Arif , Ambreena Hussain (Author) https://creativecommons.org/licenses/by/4.0
PREVALENCE OF PES PLANUS IN GRADE 1 OBESITY
Pes Planus (flatfoot), characterized by the collapse of the medial longitudinal arch, is a frequently overlooked condition that can significantly affect gait, posture, and overall musculoskeletal health. With the rising prevalence of grade 1 obesity, increased mechanical stress on the foot arches has become a growing concern. Additional contributing factors such as age-related degeneration, gender-related ligament laxity, and occupational demands involving prolonged standing may further predispose individuals to this condition. This cross-sectional study aims to determine the prevalence of pes planus among individuals with grade 1 obesity and to evaluate its association with body mass index (BMI), age, gender, and prolonged standing occupations. A total of 378 participants aged 19–40 years with a BMI of 30.0–34.9 kg/m² will be recruited from hospitals, local markets, and primary schools. Individuals with a history of foot surgery or neurological disorders will be excluded. Pes planus will be assessed using the navicular drop test, and data will be collected through a structured proforma. Statistical analysis will be performed using SPSS version 25, with associations evaluated through the chi-square test. It is anticipated that pes planus will be highly prevalent in individuals with grade 1 obesity and significantly associated with both intrinsic factors (BMI, age, gender) and extrinsic factors (prolonged standing occupations). The findings are expected to emphasize the importance of early screening, preventive interventions, and ergonomic strategies to reduce long-term complications and improve quality of life.
Copyright (c) 2026 Mahanaim Shakeel, Maham Siddiqui, Muntaha Siddique, Fatima Javed, Muhammad Amir (Author) https://creativecommons.org/licenses/by/4.0
Prevalence of Onychocryptosis and Its Association with Occupational Footwear Practices Among Urban Workers in Karachi: A Cross-Sectional Study
Onychocryptosis, commonly known as ingrown toenail (IGTN), is a frequent podiatric condition characterized by pain, inflammation, and possible secondary infection, particularly among occupationally active individuals exposed to prolonged standing and inappropriate footwear practices. Despite its clinical importance, limited epidemiological data are available from urban populations in Pakistan. This cross-sectional study aimed to determine the prevalence of IGTN among workers in Karachi and evaluate its association with occupational footwear characteristics. A total of 200 male and female workers aged 18–60 years from multiple occupational sectors were recruited using a structured and pre-validated questionnaire that assessed demographic details, occupational variables, footwear habits, and symptomatology. Participants reporting two or more symptoms suggestive of IGTN underwent standardized clinical examination for confirmation. Data were analyzed using SPSS version 26, and Pearson’s chi-square test was applied to assess associations, with statistical significance set at p < 0.05. The prevalence of IGTN was found to be 24.0% (48/200). The most frequently reported symptoms among affected participants were pain during ambulation (79.2%) and discomfort while nail trimming (64.6%). Tight-fitting footwear was observed in 61.5% of IGTN cases, while 54.2% reported using shoes with a narrow toe-box design. Additionally, 68.8% of affected individuals wore footwear for more than eight hours daily. Statistical analysis demonstrated significant associations between IGTN and tight-fitting footwear (χ² = 9.74, p = 0.002) as well as narrow toe-box footwear design (χ² = 7.31, p = 0.007). In contrast, occupational sector and shift pattern showed no statistically significant relationship with IGTN occurrence. The study concludes that Onychocryptosis represents a substantial occupational foot health concern among urban workers in Karachi, with inappropriate footwear practices serving as major modifiable risk factors. Increased awareness regarding proper footwear selection and preventive foot care strategies is recommended to reduce disease burden and improve occupational health outcomes.
Copyright (c) 2026 Hina Mengal, Hifza Fatima , Haniya Rehman, Bisma Nadeem (Author) https://creativecommons.org/licenses/by/4.0
Prevalence of Medial Longitudinal Arch in Third Trimester of Pregnant Women
Pregnancy, particularly during the third trimester, is associated with substantial hormonal and biomechanical alterations that can affect foot structure and function. One notable change is the flattening of the medial longitudinal arch (MLA), which may contribute to pain, discomfort, and reduced postural stability. Despite its clinical relevance, limited local research has explored this phenomenon among pregnant women in Karachi. This cross-sectional observational study aims to evaluate changes in the MLA among 383 third-trimester pregnant women selected through non-probability convenience sampling. Assessment tools include the Navicular Drop Test, Foot Posture Index (FPI-6), footprint analysis, Visual Analog Scale (VAS), and Foot Function Index (FFI). Participants with congenital foot deformities, significant obstetric complications, or neurological and musculoskeletal conditions affecting gait are excluded. The findings indicate that MLA flattening is highly prevalent during the third trimester and is significantly associated with pain and functional limitations. Early identification and appropriate interventions, such as supportive footwear and foot care strategies, may improve comfort, mobility, and overall quality of life in pregnant women.
Copyright (c) 2026 Shiza Khan, Nida Khalil, Safa Fareed, Amtul Habib, Sakina Zehra (Author) https://creativecommons.org/licenses/by/4.0
Onychocryptosis, commonly known as an ingrown toenail, is a prevalent nail disorder characterized by pain, inflammation, and potential infection resulting from the penetration of the nail plate into surrounding soft tissue. This case report describes a 54-year-old male who presented with a 10-day history of pain, swelling, and erythema along the lateral border of the right great toe. Clinical examination revealed edema, tenderness, and purulent discharge, consistent with stage II (infection stage) Onychocryptosis. Although initial conservative management, including local care and patient education, was considered, persistent symptoms necessitated definitive intervention. The patient subsequently underwent partial nail avulsion combined with Phenol Matricectomy. Postoperative outcomes were favorable, with marked resolution of infection, alleviation of symptoms, and restoration of normal function. No recurrence was observed during follow-up. This case underscores the critical role of podiatrists in accurate diagnosis, appropriate staging, and timely selection of treatment strategies. It also highlights Phenol Matricectomy as a safe, minimally invasive, and highly effective procedure with low recurrence rates for managing moderate to severe Onychocryptosis.
Copyright (c) 2026 Shahzad Ali, Jerusha Gill, Maham Nadeem, Nimra Edhi, Sunaina Javed (Author) https://creativecommons.org/licenses/by/4.0
Plantar pressure mapping is an advanced technique used to assess how forces are distributed across the plantar surface of the foot during both standing and walking. It serves as an important diagnostic and monitoring tool in clinical and research settings by providing objective data on load distribution. This method utilizes sensor-based systems to capture variations in pressure, which are then represented visually through color-coded maps, making complex biomechanical data easier to interpret and analyze . The human foot plays a crucial role in supporting body weight and enabling movement. Any imbalance in pressure distribution can lead to discomfort, injury, or long-term musculoskeletal conditions. Through plantar pressure mapping, clinicians can evaluate how forces are transferred across different regions of the foot, identify abnormalities such as excessive loading, and assess gait patterns including pronation and supination. This information is essential for understanding foot function and improving overall biomechanical efficiency . The technique involves measuring the interaction between the foot and the ground using pressure-sensitive devices, such as mats or in-shoe sensors. These systems detect force variations and generate visual pressure maps, where high-pressure areas are typically indicated by warm colors (e.g., red and orange) and low-pressure areas by cooler tones (e.g., blue and green). Such graphical representations help clinicians quickly identify problematic regions and make informed decisions regarding diagnosis and treatment planning. Plantar pressure mapping is particularly valuable in managing conditions like diabetes, where patients are at a higher risk of developing foot ulcers due to reduced sensation and poor circulation. By identifying high-pressure zones early, healthcare providers can implement preventive strategies such as customized orthotics or specialized footwear. Additionally, this technique supports applications like gait analysis, orthotic design, and post-operative assessment, ultimately contributing to improved patient outcomes and reduced risk of complications.
Copyright (c) 2026 Zainab Farooq, Fatima Tuz Zahrah, Areeba Mansoor , Taha Malik, Fizza Anees, Ayesha Ayaz (Author) https://creativecommons.org/licenses/by/4.0
Limb Salvage: Predictors of Major Amputation and Limb Salvage Rates in Chronic Threatening Limb Ischemia (CTLI)
Chronic limb-threatening ischemia (CTLI) represents the most advanced and severe stage of peripheral arterial disease, with a significant clinical burden and an estimated 25% risk of major amputation within one year of diagnosis. Early identification of at-risk patients, followed by prompt and appropriate intervention, plays a crucial role in improving limb salvage outcomes. Given the high associated mortality, timely recognition and rapid revascularization remain the cornerstone strategies for preserving both limb and life. Current outcome data highlights the seriousness of this condition, with 1-year limb salvage rates ranging from 51% to 63% and overall survival rates between 66% and 83%, while major amputations still occur in nearly 18% of patients. Although surgical bypass offers durable results, endovascular therapy is often preferred in high-risk individuals to reduce perioperative complications. Notably, outcomes are closely linked to the timing of intervention, as both excessively early and delayed revascularization have been associated with poorer results, underscoring the importance of optimal clinical judgment. Successful management of CTLI depends on a combination of early diagnosis, aggressive risk factor modification, and a multidisciplinary treatment approach. Functional recovery after amputation is challenging, as above-knee amputees may require up to twice the normal energy expenditure for walking, making structured rehabilitation essential. Ultimately, restoring adequate vascular supply alongside comprehensive wound care is vital for achieving functional independence and improving the patient’s quality of life. This study further identifies key predictors of major amputation, including diabetes, chronic kidney disease, hemodialysis, smoking, tissue loss, infection, severity of ischemia, and timing of revascularization. The Wound, Ischemia, and foot Infection (WIfI) classification system is utilized to stratify patients into four risk categories, ranging from very low risk (<3%) to high risk (>25%), with stage 4 indicating the greatest likelihood of amputation. This risk-based stratification allows for more targeted, timely interventions aimed at maximizing limb salvage and reducing preventable amputations.
Copyright (c) 2026 Zymal Fatima Siddiqui, Fatima Rashid, Abiha Azfar, Anosha Kakar, Aroob Kakar, Haya Shoaib (Author) https://creativecommons.org/licenses/by/4.0
From Callus to Catastrophe: Identifying Early Warning Signs of Diabetic Foot Complications
Diabetic foot disease remains a major contributor to disability and lower-limb amputation, particularly among individuals with Type 2 diabetes. This project highlights the progression from early, seemingly minor pre-ulcerative lesions such as calluses, corns, and blisters to severe and potentially limb-threatening complications. A central challenge in prevention is the loss of protective sensation caused by peripheral neuropathy and impaired circulation. As a result, patients may not perceive pain from minor injuries, allowing unnoticed trauma to progress into infections and ulcers. This underscores the critical importance of early detection and proactive clinical vigilance before irreversible damage occurs. The study emphasizes the application of a standardized four-class risk stratification system to guide prevention and management. This framework categorizes patients based on the presence of neuropathy, peripheral arterial disease, deformities, or prior ulceration, enabling targeted screening and intervention strategies. Given that a significant majority of amputations are preceded by foot ulcers, recognizing early warning signs—such as persistent calluses, redness, swelling, discharge, or delayed wound healing is essential. Integrating patient self-care practices, including daily foot inspection and hygiene, with clinical management approaches like offloading, debridement, infection control, and appropriate pharmacological therapy, forms the cornerstone of effective care. Despite advances in management, diabetic foot ulcers have a high recurrence rate, placing patients at continued risk of complications. The findings highlight that early identification of pre-ulcerative changes, particularly calluses, combined with regular risk-based screening, is the most effective strategy to prevent disease progression. However, a notable gap persists between patient awareness and the implementation of clinical risk stratification. Bridging this gap through improved patient education, routine monitoring, and coordinated care is essential to reducing the burden of diabetic foot disease and improving long-term outcomes.
Copyright (c) 2026 Ayesha Anis, Zainab Inam, Rumaisa Uraizee , Yanabia Wajid, Nayab Qadir, Hafsa Khan (Author) https://creativecommons.org/licenses/by/4.0
Foot deformities in children are common orthopedic conditions that can adversely affect musculoskeletal development, gait, and overall functional outcomes if not identified and managed early. This poster provides an overview of three prevalent pediatric foot abnormalities: flat foot (pes planus), club foot (congenital talipes equinovarus), and idiopathic toe walking. Flat foot is characterized by the collapse of the medial longitudinal arch and is associated with genetic predisposition and environmental factors such as obesity, ligamentous laxity, and inappropriate footwear; it affects approximately 10–30% of children and adolescents and may lead to pain, abnormal gait, and long-term complications if untreated. Club foot is a congenital deformity involving inward and downward twisting of the foot, primarily managed using the Ponseti method of serial casting and bracing, with surgical intervention reserved for resistant cases; its etiology includes both genetic and prenatal environmental influences. Idiopathic toe walking is defined as persistent toe walking without a clear cause, though it may be associated with neurological or developmental conditions; if untreated, it can result in Achilles tendon shortening, ankle stiffness, and gait abnormalities. Management strategies across these conditions include conservative approaches such as physical therapy, orthotics, and casting, with surgery considered in severe cases. Early diagnosis and timely intervention are essential to prevent complications and improve long-term functional outcomes in affected children.
Copyright (c) 2026 Alizah Ali, Shazma Khan, Laiba Sammoo , Mahnoor Wistro , Mateen Malik (Author) https://creativecommons.org/licenses/by/4.0
Sex Differences in Foot Biomechanics: Implications for Podiatric Practice
Biological sex remains an under-recognized but critical determinant in podiatric medicine, significantly influencing foot biomechanics, Achilles tendon (AT) morphology, and plantar pressure distribution. This systematic review aimed to synthesize existing peer-reviewed literature to identify sex-specific differences in AT mechanics and morphology, compare gait patterns and plantar pressure distribution between sexes, and evaluate the clinical implications of these variations for injury prevention and podiatric practice. The findings indicate distinct sexual dimorphisms: males possess larger, stiffer ATs, yet paradoxically face a 2–8 times greater risk of tendon rupture compared to females, whose tendons exhibit lower stiffness and higher compliance driven by hormonal influences like estrogen and relaxin. Furthermore, the prevalence of hallux valgus is substantially higher in females (58%) than in males (25%), attributed to a complex interplay of footwear habits, osseous anatomy, and ligamentous laxity. Biomechanically, females demonstrate higher peak pressures in the hallux and forefoot alongside distinct gait patterns including greater knee valgus and hip abduction whereas males exhibit higher pressure in the lateral forefoot and heel. Ultimately, these results confirm that significant sex-based differences in foot biomechanics and pathology prevalence exist. Therefore, integrating sex as a fundamental biological variable is essential for advancing personalized podiatric assessments, optimizing orthotic prescriptions, and improving clinical rehabilitation outcomes.
Copyright (c) 2026 Syeda Fatima Zainab , Syeda Jasmin (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
GANGRENE: Its Impact and Modern Treatment Approaches
Gangrene is a severe pathological condition characterized by tissue necrosis resulting from compromised blood supply, infection, or trauma. It is commonly associated with chronic conditions such as Diabetes Mellitus and Peripheral Artery Disease, which significantly increase the risk of disease progression and complications, including limb amputation. Given its high morbidity, early recognition and timely management are critical in improving patient outcomes. This study aims to review the major causes, risk factors, clinical manifestations, and contemporary management strategies of gangrene, with a particular focus on prevention and early detection. The analysis is based on established medical literature and clinical guidelines, including those from the International Working Group on the Diabetic Foot, alongside other relevant resources on diabetic foot complications. Findings highlight that early identification of high-risk individuals especially patients with diabetes, vascular insufficiency, or sensory loss is essential in preventing disease progression. Routine foot assessments, patient education, and prompt clinical intervention play a pivotal role in reducing complications. Common clinical features such as pain, discoloration, swelling, and loss of sensation should be carefully monitored to enable early diagnosis. Current management strategies emphasize a multidisciplinary approach, including revascularization procedures (such as angioplasty or bypass surgery), surgical debridement of necrotic tissue, targeted antibiotic therapy, and advanced wound care techniques. These interventions have significantly improved healing rates and reduced the need for major amputations. Additionally, emerging therapies like hyperbaric oxygen therapy show promising results in selected cases by enhancing tissue oxygenation and promoting wound healing. In conclusion, effective prevention, early diagnosis, and comprehensive management are essential in reducing the burden of gangrene. Strengthening awareness, improving routine screening practices, and implementing evidence-based treatment strategies can substantially decrease morbidity and enhance overall patient outcomes.
Copyright (c) 2026 Areej Ahmed, Vaniza Khan, Irum Khan, Zainab Soomro, Hareem Younus, Naba Sheikh (Author) https://creativecommons.org/licenses/by/4.0
The Heat Map of Prevention: Utilizing Thermographic Imaging for Early Detection of Diabetic Foot Ulcers
Diabetic neuropathy often leads to a loss of protective sensation, creating a "pain gap" where patients are unable to feel early-stage injuries or inflammation. This lack of sensory feedback frequently results in severe ulceration and, in many cases, necessary amputation. This research utilizes infrared thermography to bridge this visual gap by identifying localized thermal "hot spots" where the temperature difference is greater than 2.2 degrees Celsius before skin breakdown occurs. The study aimed to evaluate the diagnostic precision of non-invasive infrared sensors in mapping pre-ulcerative thermal anomalies and to determine the correlation between plantar temperature asymmetry and the risk of localized tissue necrosis. Focusing on patients with confirmed diabetic neuropathy, the methodology required participants to undergo a 15-minute acclimatization period at 20 to 24 degrees Celsius to stabilize skin temperature before a plantar infrared scan protocol was executed. If a temperature differential of greater than 2.2 degrees Celsius was detected between corresponding sites on the feet, the area was flagged as a high-risk thermal anomaly, triggering immediate proactive offloading and intervention. The results demonstrated that infrared thermography functions effectively as a "visual pain sensor," detecting sub-clinical tissue stress and inflammation otherwise invisible to the naked eye. Ultimately, thermal scanning serves as a fast, low-cost, and radiation-free tool for routine diabetic foot assessments. By identifying "at-risk" feet in the pre-ulcerative stage, this technology can significantly reduce amputation rates and lower long-term healthcare costs, shifting the medical approach from reactive care to proactive thermal monitoring.
Copyright (c) 2026 Danish Perdeep kumar, Muhammad Ahmed Ather , Muhammad Haris Amin, Shehryar Khan, Haziq Suleiman, Musab bin Sajjad (Author) https://creativecommons.org/licenses/by/4.0
Microbial Dynamics of the Foot: Transition From Commensal Flora to Infection
The human foot hosts a diverse microbiome composed of commensal bacteria and fungi that play a crucial role in maintaining skin health and preventing colonization by pathogenic organisms. Common genera such as Staphylococcus and Corynebacterium coexist harmoniously with the host under normal conditions. However, environmental and physiological changes including increased moisture, poor hygiene, occlusive footwear, or skin damage can disrupt this balance, leading to microbial dysbiosis. This imbalance promotes the overgrowth of opportunistic pathogens, such as Staphylococcus aureus and various Gram-negative bacteria, as well as dermatophytic fungi, resulting in infections ranging from superficial conditions like tinea pedis to more severe tissue infections. Pathogenic progression involves mechanisms such as microbial adherence, keratin degradation, tissue invasion, and immune evasion. Understanding the transition from commensal flora to pathogenic states is essential for developing effective preventive and therapeutic strategies. This highlights the importance of maintaining proper foot hygiene and environmental control to preserve microbial balance and reduce the risk of infection, particularly in vulnerable populations such as individuals with diabetes.
Copyright (c) 2026 Sarah Salman, Insha Hassan, Tehreem Hafsa, Akasha Mukhtiar , Farheen Azeemi , Umaima Muhammad Naeem (Author) https://creativecommons.org/licenses/by/4.0
Deep Vein Thrombosis of the Lower Limb: Risk Factors, Clinical Manifestation, and Preventive Strategies
Deep Vein Thrombosis (DVT) is a critical medical condition characterized by the formation of blood clots within deep veins, most frequently occurring in the lower limbs. Globally, DVT affects approximately 1 to 2 individuals per 1,000 annually, with a significant burden observed in Pakistan; for instance, research in Karachi reported a 15.3% incidence rate among bedridden orthopedic patients who did not receive preventive treatment. The primary objective of this study is to evaluate major risk factors and clinical manifestations while emphasizing the necessity of early detection and public awareness. Analysis of clinical data reveals that the most prominent risk factors prolonged immobilization, aging, and hospitalization or ICU stays each account for 22% of cases, followed by hormonal therapy and orthopedic injuries at 11% each. While symptoms typically include unilateral leg swelling, pain, redness, and warmth, many cases remain asymptomatic, increasing the risk of the clot traveling to the lungs to cause a life-threatening pulmonary embolism. Ultimately, DVT is a highly preventable condition that remains underrecognized. These findings underscore the critical importance of implementing prophylactic measures, such as anticoagulant therapy and early mobilization, alongside robust patient education to reduce overall morbidity and mortality.
Copyright (c) 2026 Hina Mengal, Haniya Rehman , Hifza Fatima , Bisma Nadeem , Abeer Naeem (Author) https://creativecommons.org/licenses/by/4.0
Raising Awareness about Ingrown Toenails
Ingrown toenails represent a common yet preventable medical condition that can lead to significant pain, infection, and severe complications if ignored. This condition accounts for approximately 15% to 20% of all foot-related medical visits, highlighting its high prevalence among the general population. The pathological process typically advances through several distinct phases, beginning with the initial stage of nail ingrowth and progressing through stages of inflammation and suppuration before reaching a chronic stage process. Various risk factors contribute to this development, including improper nail trimming, toe injuries, fungal infections, sweaty feet, and the use of tight-fitting shoes. Clinical intervention is strongly advised when patients observe increasing pain, swelling, pus, drainage, or spreading redness, particularly for those with underlying health concerns like diabetes or poor circulation. Effective management and prevention strategies involve both medical and surgical approaches, ranging from antibiotic therapy to procedures such as partial nail avulsion, partial matrixectomy, and total nail avulsion.
Copyright (c) 2026 Ebad , Ibtehaj , Khalil , Noor , Aurangzeb (Author) https://creativecommons.org/licenses/by/4.0
Association between Traditional Footwear and Structural Foot Changes
Traditional footwear is essential for maintaining foot structure and function, yet its design often lacks critical arch support, cushioning, and stability. Biomechanical research shows that variations in foot arches and walking styles put different pressures on the feet, and wearing shoes that are too small in length or width significantly increases the risk for injuries. Studies indicate that 63–72% of individuals wear improperly sized shoes, leading to a high prevalence of conditions: 72% suffer from corns, 68% from calluses, 63% from foot pain, 45% from bunions, and 32% from hammertoes. Common complications include "pump bump" or Haglund's deformity caused by rigid straps on high heels, as well as an increased risk of ankle sprains due to impacted balance. Tight or narrow footwear causes deformities like hallux valgus and claw toes by squeezing the digits and restricting natural movement. Understanding this relationship is vital for balance, posture, and pain-free movement. Treatment involves rest and ice for pain relief, the use of orthotic insoles or toe spacers for alignment, physiotherapy to improve function, and surgery for severe cases.
Copyright (c) 2026 Areesha Fatima , Ayesha Begum, Tazmeen Lakhani, Aeman Habib , Alishba Saleem (Author) https://creativecommons.org/licenses/by/4.0
Percutaneous Nephrolithotomy in the managemant of urinary stones
CONFERENCE ABSTRACT Percutaneous Nephrolithotomy (PCNL) in the Management of Urinary Stones: Indications, Technique, and Outcomes Dr Sadaf Saadi Department of Urology, Sarhad University BACKGROUND Percutaneous Nephrolithotomy (PCNL) is the gold-standard minimally invasive surgical procedure for the management of large, complex, and refractory urinary calculi. First described by Fernström and Johansson in 1976, PCNL provides direct nephroscopic access to the renal collecting system, enabling efficient stone fragmentation and extraction. Urinary stone disease affects approximately 10–15% of the global population, with a lifetime recurrence risk of up to 50%. Current European Association of Urology (EAU) and American Urological Association (AUA) guidelines recommend PCNL as the first-line surgical treatment for renal calculi ≥20 mm and as salvage therapy following failed extracorporeal shockwave lithotripsy (ESWL) or ureteroscopy (URS). OBJECTIVE To comprehensively review the indications, patient selection criteria, operative technique, clinical outcomes, comparative efficacy against alternative modalities, and complication profile of PCNL in the contemporary management of urinary stone disease. INDICATIONS & PATIENT SELECTION PCNL is primarily indicated for renal stones ≥20 mm in the upper and mid pole, lower pole calculi ≥15 mm, and complex stone burdens including complete and partial staghorn calculi, struvite, and cystine stones. Additional indications include failed ESWL or URS with residual fragments >4 mm, stones in anatomically abnormal kidneys (horseshoe kidney, pelvi-ureteric junction obstruction), and morbidly obese patients. Absolute contraindications include uncorrected coagulopathy and untreated urinary tract infection, which must be resolved prior to surgery. SURGICAL TECHNIQUE PCNL is performed under general or spinal anaesthesia with the patient in the prone or modified supine (Valdivia) position. A ureteric catheter is placed cystoscopically to facilitate retrograde pyelography. Percutaneous access to the target calyx is achieved under fluoroscopic or ultrasound guidance using an 18-gauge needle. The access tract is sequentially dilated to 24–30 Fr using Amplatz serial dilators or a one-step balloon dilator, and an Amplatz sheath is secured. A rigid or flexible nephroscope is introduced, and stone fragmentation is performed using ultrasonic (Cyberwand), pneumatic, or laser (Ho:YAG or Thulium fibre) lithotripsy. Stone fragments are extracted with forceps or a retrieval basket. The procedure concludes with placement of a nephrostomy tube, or in selected cases a tubeless exit with an indwelling ureteric stent. OUTCOMES PCNL achieves stone-free rates of up to 95% for renal calculi ≥20 mm in experienced centres, representing the highest efficacy among available stone management modalities for this size category. Single-stage success is achieved in approximately 88% of cases, while stone-free rates for staghorn calculi range from 70–85% depending on stone burden and anatomical complexity. Mini-PCNL (≤14 Fr access sheath) achieves stone-free rates of approximately 83% with reduced blood loss and a smaller nephrostomy tract. Mean operative time ranges from 45–120 minutes depending on stone complexity, with a hospital stay of 2–3 days (1–2 days for tubeless cases) and return to normal activity within 10–14 days. Ultrasound-guided access has been shown to reduce radiation exposure by up to 60% without compromising stone-free outcomes. COMPARATIVE EFFICACY When compared to ESWL and URS/RIRS for stones ≥20 mm, PCNL demonstrates superior stone-free rates (95% vs 40–60% for ESWL and 70–80% for URS). ESWL and URS carry lower complication profiles and require no hospital admission; however, their efficacy is significantly diminished for larger, harder (cystine), and more complex stone burdens. PCNL remains the preferred modality for staghorn calculi, with ESWL achieving only 20–40% stone-free rates in this setting. The choice of modality must be individualised based on stone size, composition, location, renal anatomy, patient comorbidities, and institutional expertise. COMPLICATIONS The overall complication rate for PCNL is approximately 20–25%, with major complications (Clavien-Dindo Grade ≥III) occurring in ~5% of cases. Major complications include significant haemorrhage requiring blood transfusion (5–7%) or angioembolisation, urosepsis (2–3%), pleural injury with supracostal access, and colonic injury (<0.5%). Minor complications (Clavien I–II, ~20%) include post-operative fever and urinary tract infection, peri-nephric fluid collection, urinary extravasation, and residual stone fragments. Prophylactic antibiotics, appropriate patient selection, and meticulous operative technique are key measures in minimising complication rates. SPECIAL SITUATIONS & EMERGING TECHNIQUES Mini- and ultra-mini-PCNL (access sheaths 6–14 Fr) have expanded the application of percutaneous nephrolithotomy to paediatric patients and smaller stone burdens, with comparable efficacy and reduced morbidity. Tubeless and totally tubeless PCNL, avoiding nephrostomy tube placement in selected cases, further reduces post-operative pain and hospital stay. The supine (Valdivia) technique allows simultaneous ureteroscopic access and is preferred in obese or cardiopulmonary high-risk patients. Emerging technologies including Thulium fibre laser lithotripsy, artificial intelligence-guided fluoroscopy, and three-dimensional CT reconstruction for pre-operative planning are anticipated to further improve outcomes and reduce complication rates. CONCLUSIONS PCNL remains the most effective surgical intervention for large, complex, and staghorn renal calculi, achieving stone-free rates of up to 95% in experienced centres. Careful patient selection guided by current EAU/AUA guidelines, thorough pre-operative imaging, prophylactic antibiosis, and mastery of percutaneous access technique are essential to optimise outcomes. Continued technological innovation and the evolution toward smaller access tracts and improved energy sources promise to further enhance the efficacy and safety profile of this benchmark urological procedure. Keywords: Percutaneous Nephrolithotomy; PCNL; Urinary Stone Disease; Nephrolithiasis; Lithotripsy; Minimally Invasive Urology; Staghorn Calculi; Mini-PCNL; Urological Surgery References Türk C, et al. EAU Guidelines on Urolithiasis. Eur Urol. 2023;84(1):78–93. Assimos D, et al. AUA Surgical Management of Stones: Evidence-Based Guideline. J Urol. 2022;207(3):514–530. Desai M, et al. Mini versus Standard Percutaneous Nephrolithotomy: A Randomised Controlled Trial. BJU Int. 2021;128(2):231–240. Zanetti SP, et al. Outcomes in Supine Percutaneous Nephrolithotomy. Urology. 2022;168:75–81. Skolarikos A, et al. Metabolic Evaluation and Recurrence Prevention for Urinary Stone Patients. Eur Urol. 2023;84:96–114.
Copyright (c) 2026 Dr Sadaf Sadi (Author) https://creativecommons.org/licenses/by/4.0
HAMMER TOE: Risk Factor Recognition and Prevention Strategies for Foot Health
Hammer toe is a prevalent foot deformity characterized by an abnormal bend at the middle joint of one of the smaller toes, resulting in a distinct hammer-like appearance. This condition occurs when prolonged pressure or positioning forces the toes into a cramped state, causing the muscles and tendons to tighten and adjust to an unusual position. While often viewed as a structural issue, hammer toe can lead to significant pain, discomfort, and impaired mobility if left unmanaged. Hammer toe is a prevalent foot deformity characterized by an abnormal bend at the middle joint of one of the smaller toes, resulting in a distinct hammer like appearance. This condition occurs when prolonged pressure or positioning forces the toes into a cramped state, causing the muscles and tendons to tighten and adjust to an unusual position. While often viewed as a structural issue, hammer toe can lead to significant pain, discomfort, and impaired mobility if left unmanaged.
Copyright (c) 2026 Rameen Naeem, M. Hassan, Saira Khan , Eisha - tur - Raziya , Noor - ul - Ain (Author) https://creativecommons.org/licenses/by/4.0
Effects of Ibuprofen Duo on High-Grade Fever in Malaria Patients
Background Malaria is a major infectious disease characterized by recurrent high-grade fever, chills, and systemic inflammation. Fever management is important to reduce patient discomfort and prevent complications. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are commonly used as antipyretics. Studies have shown that ibuprofen significantly reduces febrile temperature in malaria patients compared with other antipyretics, making it a useful supportive therapy in malaria management. “Ibuprofen Duo” (a dual-action formulation or combined antipyretic therapy) may provide enhanced fever control in malaria patients with high-grade fever. Objective To evaluate the effectiveness of Ibuprofen Duo in reducing high-grade fever among malaria patients. Methods Study Design: Experimental study Participants: Patients diagnosed with malaria presenting with high-grade fever (>38.5°C). Intervention: Administration of Ibuprofen Duo 500mg twice per day for 5 days Data Collection: Body temperature recorded at baseline Temperature monitored at 1, 3, 6, and 12 hours after medication Clinical symptoms documented Outcome Measures: Reduction in body temperature Time to fever resolution Patient comfort and symptom improvement Results Significant reduction (p<0.005) in body temperature observed within the first few hours of ibuprofen administration. Ibuprofen demonstrated greater antipyretic effect compared with some standard treatments such as paracetamol in certain malaria studies. Fever duration and overall fever burden were reduced in patients receiving ibuprofen therapy. No major adverse effects were observed in most cases. Conclusion Ibuprofen Duo appears to be effective in reducing high-grade fever associated with malaria. It can serve as a useful supportive therapy alongside antimalarial treatment. Further randomized clinical trials with larger sample sizes are recommended to confirm its safety and effectiveness.
Copyright (c) 2025 Dr Arshad Bhatti (Author) https://creativecommons.org/licenses/by-sa/4.0
Achilles Tendinitis: clinical features, Risk factors, and Preventive strategies
Achilles tendinitis is a prevalent inflammatory condition affecting the tendon that anchors the calf muscles to the heel bone, serving as a critical component for human locomotion. This study explores the epidemiology and biomechanical triggers of the condition, noting significant prevalence rates among specific occupational groups in Pakistan, including nurses in Lahore (over 60%), physical therapists, and salespersons. Clinical manifestations typically include morning stiffness, swelling, and localized heel pain at the back of the ankle that intensifies during or after physical activity. The onset of tendinitis is largely driven by overuse, sudden increases in activity intensity, and improper footwear, such as high heels which place excessive stress on the tendon. Furthermore, physiological factors like tight calf muscles and inadequate stretching before exercise significantly elevate injury risk. To mitigate these risks, the study advocates for evidence-based preventive measures, including daily calf stretches, gradual progression of activity levels, and the use of supportive footwear. By integrating these postural and lifestyle adjustments, individuals can effectively protect tendon health and maintain long-term mobility.
Copyright (c) 2026 Almas, Syeda Ajjar, Maha, Marwa Barkat, Fiza Hamid (Author) https://creativecommons.org/licenses/by/4.0
Common Foot Myths vs Facts: Promoting Early Awareness for Better Foot Health
Foot health is frequently compromised by pervasive misconceptions that lead to improper self-care and long-term physiological complications. This study examines six common foot health issues barefoot walking, bunions, blisters, corns and calluses, toenail trimming, and flat feet to distinguish clinical facts from popular myths. While many believe conditions like bunions are merely cosmetic or that blisters should be drained, evidence suggests that these issues can significantly alter foot biomechanics or lead to secondary infections if managed incorrectly. The findings highlight that proper podiatric care involves evidence-based practices, such as cutting toenails straight across to prevent ingrown nails and utilizing padding for corns rather than dangerous at-home surgical scraping. Furthermore, the study clarifies that flat feet and barefoot walking are not inherently pathological but require situational caution based on comfort and surface safety. By promoting early awareness and differentiating between myths and facts, the public can adopt proactive care routines that mitigate the risk of infection and chronic discomfort.
Copyright (c) 2026 Unzila Javed, Alishba Rehan, Esha Alam, Roshni Gill, Abeera Abid (Author) https://creativecommons.org/licenses/by/4.0