A 60-year-old woman was presented with an ulcer on the right foot. She was diabetic for 18 years. There is a black, bloody, discharge from the ulcer. The bleeding was profuse, and the smell was intolerable. There is some pain in the foot but no sense of touch. There was also numbness in both the legs. Appetite was poor, and she was sleepless. She complained of a chilly sensation in the body, and her extremities were cold to touch.

38/m presented with complaints of active bleeding while walking from both distal phalanges since 1 year k/c/o DM on Rx. please find Dx and Rx sir ?

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A 65 years old lady presented with a case of non healing ulcer over right fore foot 2nd toe plantar aspect since 2 years and left foot for foot over since 3 years associated with history of foul smelling pis discharge and cellulitis and fever since 15days for this they came. BP 160/90 Lab routine TC 16000 DC (N) 84% HB 13 gm RBS 317mg/dl ABI bilateral 0.9 TBI bilateral 0.8 Provisional diagnosis Grade2 B Neurotrophic ulcer bilateral A/ w cellulitis and osteomyelitis ? Over 2nd phalanx right foot Type 2 Diabetes MELLITUS Hypertension Diabetic peripheral Neuropathy Discussion open my dear colleagues and respected seniors

45yrs diabetic male.. with this tropic ulcer since 1 yrs.. Treated by various doctors .. The ulcer area heals and recurs again at the same spot.. Too much keratinization seen surrounding it .. No sensation of pain felt.. Debridement and dressing done (with megaheal) by me along with antibiotics (augmentin).. Tough diabetes is controlled and brought below 180 post lunch.. No other comorbidities present.. Kindly guide me with the management and m also worrisome regarding it reoccurring... Thank you...