Diabetic foot disorders are responsible for at least 50% of limb amputations in Jeddah, and usually associated with long hospital stay and low rehabilitation rate. To identify the percentage of lower limb amputations in patients admitted with diabetic foot disorders, a multicentre retrospective study was conducted over one year in Jeddah area in three major public hospitals. Two hundred and twenty-nine files were reviewed to identify the percentage of lower limb amputations among diabetic patients admitted with foot disorders. One hundred and twenty-eight records (the total number of patients who underwent amputations) were reviewed to obtain information about the presentation, associated factors, level of amputations, rates of postoperative complications, re-amputations, mortality, hospital stay and rehabilitation. Ulcer was the most common presentation (85.9%). Sixty percent of patients who were admitted with diabetic foot ended up with lower limb amputation. Toes amputation was the most common type followed by below knee then above knee amputation. Re-amputation, postoperative complications and mortality within 30 days were 3.9%, 4.7% and 7%, respectively. Only 12.5% of the amputees have been rehabilitated. Amputations on diabetics are a major health problem. Every effort should be made to avoid it particularly with limited resources for rehabilitation in developing countries.
Background This study aimed to investigate the impact of interactive lecture (IL) and team-based learning (TBL) on improving clinical reasoning skills (CRSs) and achieving learning outcomes (LO). Students’ feedback was obtained about the strategies. Methods This study was carried out at the Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia. Two modules, endocrinology, and emergency were selected. Students of each batch in both modules were divided into two arms. With a randomized crossover design, IL & TBL were used for two separate topics in each module. After each topic, a quiz in the form of well-structured MCQs was taken. A questionnaire was designed to obtain students’ feedback. SPSS version 23 was used to analyse results. The difference between the mean values was calculated by Student’s t-test. Feedback data is presented as frequency. P-value ≤ 0.05 was considered statistically significant. Results Learning outcomes were achieved by all groups in two modules, with both instructional strategies, IL and TBL. Students attempted >70% correct answers. However, in the emergency module, the groups with TBL as the instructional strategy performed better in quiz1 and quiz 2 (p = 0.026 and p = 0.016, respectively). Similarly, in the endocrinology module (3rd year), although the groups with TBL as the instructional strategy performed better in both quizzes, it was significant in quiz1 (p = 0.02). The difficulty indices of the clinical reasoning questions (CRQ) were used as the parameters for comparison. In the emergency module, group1, in quiz1, with TBL as an instructional strategy performed better in the CRQ (p = 0.017), while in quiz2, group2 with TBL as the instructional strategy performed better (p < 0.001). Group1 of the third-year students (endocrinology module) performed better in the CRQ in quiz 1 with TBL as an instructional strategy than group 2 with IL (p = 0.04). Mostly, students in both modules preferred TBL over IL, and especially they liked team application. Students perceived that TBL was a better strategy to learn CRS. Conclusions Students achieved LOs and CRS better with TBL as an instructional strategy. They preferred TBL over IL. It is suggested to include TBL, or increase its percentage, in the curriculum.
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