Medical Threat Research Articles

VITAMIN D AND SEMEN QUALITY IN URBAN, YOUNG, HEALTHY MEN (ANDROLS)

Background and Objective
 Our aim was to evaluate whether the blood concentration of 25(OH)D3 is associated with semen quality and sperm morphology parameters in young men.
 Material and methods
 Healthy, urban volunteers aged 20-35 were recruited from universities, clubs and societies in the macroregion of Lower Silesia (Poland). We evaluated medical history, lifestyle factors and environmental threats, collected semen samples, and evaluated vitamin D levels. We acquired data for 177 subjects.
 Results
 The mean concentration of 25(OH)D3was 13.7 ± 8.9 ng/ml. Only a minority of the included subjects (18%) had a serum 25(OH)D3 concentration above the lower limit (20 ng/ml). In total, 39% had severe vitamin D deficiency (<10 ng/ml). None of the studied semen parameters was correlated with the serum concentration of 25(OH)D3; we also found no correlations after adjusting for alcohol consumption, cigarette smoking, carrying a mobile phone in pant pockets, body mass index, caffeine consumption and physical activity.
 Conclusion
 Our data indicate that the serum concentration of 25(OH)D3 was not correlated with semen quality in a healthy, young urban population with prevalent vitamin D insufficiency.

An innovative robotic platform for magnetically-driven painless colonoscopy.

Colorectal cancer (CRC) represents a significant medical threat with a dramatic impact on the healthcare system with around 1.3 million patients worldwide, causing more than 700 thousand deaths annually. A key-aspect to successful and cost-effective disease management is represented by the early detection of CRC at asymptomatic stage. For this reason, population screening is highly recommended for patients older than 50 years or at high risk for familiarity. Currently, the standard endoscopic techniques do not meet this need. In recent years, innovative endoscopic robotic techniques and active locomotion devices have been developed as alternatives to conventional colonoscopy. The magnetically-driven robotic platform, presented by the authors, is conceived to perform less invasive and more comfortable colonoscopy with the aim to promote screening campaigns for detection of early colorectal neoplasm.

The medical threat of mamba envenoming in sub-Saharan Africa revealed by genus-wide analysis of venom composition, toxicity and antivenomics profiling of available antivenoms

Mambas (genus Dendroaspis) are among the most feared of the medically important elapid snakes found in sub-Saharan Africa, but many facets of their biology, including the diversity of venom composition, remain relatively understudied. Here, we present a reconstruction of mamba phylogeny, alongside genus-wide venom gland transcriptomic and high-resolution top-down venomic analyses. Whereas the green mambas, D. viridis, D. angusticeps, D. j. jamesoni and D. j. kaimosae, express 3FTx-predominant venoms, black mamba (D. polylepis) venom is dominated by dendrotoxins I and K. The divergent terrestrial ecology of D. polylepis compared to the arboreal niche occupied by all other mambas makes it plausible that this major difference in venom composition is due to dietary variation. The pattern of intrageneric venom variability across Dendroaspis represented a valuable opportunity to investigate, in a genus-wide context, the variant toxicity of the venom, and the degree of paraspecific cross-reactivity between antivenoms and mamba venoms. To this end, the immunological profiles of the five mamba venoms were assessed against a panel of commercial antivenoms generated for the sub-Saharan Africa market. This study provides a genus-wide overview of which available antivenoms may be more efficacious in neutralising human envenomings caused by mambas, irrespective of the species responsible. The information gathered in this study lays the foundations for rationalising the notably different potency and pharmacological profiles of Dendroaspis venoms at locus resolution. This understanding will allow selection and design of toxin immunogens with a view to generating a safer and more efficacious pan-specific antivenom against any mamba envenomation. Biological significanceThe mambas (genus Dendroaspis) comprise five especially notorious medically important venomous snakes endemic to sub-Saharan Africa. Their highly potent venoms comprise a high diversity of pharmacologically active peptides, including extremely rapid-acting neurotoxins. Previous studies on mamba venoms have focused on the biochemical and pharmacological characterisation of their most relevant toxins to rationalize the common neurological and neuromuscular symptoms of envenomings caused by these species, but there has been little work on overall venom composition or comparisons between them. Only very recently an overview of the composition of the venom of two Dendroaspis species, D. angusticeps and D. polylepis, has been unveiled through venomics approaches. Here we present the first genus-wide transcriptomic-proteomic analysis of mamba venom composition. The transcriptomic analyses described in this paper have contributed 29 (D. polylepis), 23 (D. angusticeps), 40 (D. viridis), 25 (D. j. jamesoni) and 21 (D. j. kaimosae), novel full-length toxin sequences to the non-redundant Dendroaspis sequence database. The mamba genus-wide venomic analysis demonstrated that major D. polylepis venom components are Kunitz-fold family toxins. This feature is unique in relation to the relatively conserved three-finger toxin (3FTx)-dominated venom compositions of the green mambas. Venom variation was interpreted in the context of dietary variation due to the divergent terrestrial ecology of D. polylepis compared to the arboreal niche occupied by all other mambas. Additionally, the degree of cross-reactivity conservation of mamba venoms was assessed by antivenomics against a panel of commercial antivenoms generated for the sub-Saharan Africa market. This study provides a genus-wide overview to infer which available antivenoms may be capable of neutralising human envenomings caused by mambas, irrespective of the species responsible. The information gathered in this study lays the foundations for rationalising the pharmacological profiles of mamba venoms at locus resolution. This understanding will contribute to the generation of a safer and more efficacious pan-Dendroaspis therapeutic antivenom against any mamba envenomation.

Frequency and characteristics of suicide attempts in dissociative identity disorders: A 12-month follow-up study in psychiatric outpatients in Switzerland

IntroductionDissociative identity disorder (DID) is often accompanied by suicidal behavior. However, systematic research regarding suicide attempts in DID is rare. ObjectiveAims of this study were to examine frequency, characteristics and risk factors for suicidal behavior in DID patients. MethodA sample of outpatients and day care patients with (n=17) and without DID (n=34) from psychiatric outpatient and day care units and a private practice located in Switzerland were assessed at baseline and at 12-month follow-up. At baseline, Axis I and Axis II disorders according to DSM-IV were ascertained with the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II), and the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D-R). Suicidal behavior during a 12-month period following the baseline assessment was assessed using the Longitudinal Interval Follow-Up Evaluation interview. ResultsWe found that 23.5% of subjects with DID and 0% of subjects without DID attempted at least one suicide during the 12-month period of observation (P=0.010). Medical threat of most suicide attempts was moderate to severe. Potential risk factors for suicidal behavior in DID subjects were a comorbid substance disorder or posttraumatic stress disorder, high number of any Axis I disorder, higher education, and foreign nationality. ConclusionOur results support previous evidence for a high risk of suicide attempts in patients with DID. The potential risk factors for suicidal behavior in DID subjects correspond largely to known risk factors for suicide in general population and mental disorders other than DID. The results emphasize the importance of assessing suicidal intentions when treating DID patients.

Improving ICU risk management and patient safety

PurposeThe purpose of this paper is to describe a study which aimed to develop and validate an assessment method for the International Electrotechnical Commission (IEC) 80001-1 (IEC, 2010) standard (the Standard); raise awareness; improve medical IT-network project risk management processes; and improve intensive care unit patient safety.Design/methodology/approachAn assessment method was developed and piloted. A healthcare IT-network project assessment was undertaken using a semi-structured group interview with risk management stakeholders. Participants provided feedback via a questionnaire. Descriptive statistics and thematic analysis was undertaken.FindingsThe assessment method was validated as fit for purpose. Participants agreed (63 per cent, n=7) that assessment questions were clear and easy to understand, and participants agreed (82 per cent, n=9) that the assessment method was appropriate. Participant’s knowledge of the Standard increased and non-compliance was identified. Medical IT-network project strengths, weaknesses, opportunities and threats in the risk management processes were identified.Practical implicationsThe study raised awareness of the Standard and enhanced risk management processes that led to improved patient safety. Study participants confirmed they would use the assessment method in future projects.Originality/valueFindings add to knowledge relating to IEC 80001-1 implementation.

Imipenem/cilastatin encapsulated polymeric nanoparticles for destroying carbapenem-resistant bacterial isolates

BackgroundCarbapenem-resistance is an extremely growing medical threat in antibacterial therapy as the incurable resistant strains easily develop a multi-resistance action to other potent antimicrobial agents. Nonetheless, the protective delivery of current antibiotics using nano-carriers opens a tremendous approach in the antimicrobial therapy, allowing the nano-formulated antibiotics to beat these health threat pathogens. Herein, we encapsulated imipenem into biodegradable polymeric nanoparticles to destroy the imipenem-resistant bacteria and overcome the microbial adhesion and dissemination. Imipenem loaded poly Ɛ-caprolactone (PCL) and polylactide-co-glycolide (PLGA) nanocapsules were formulated using double emulsion evaporation method. The obtained nanocapsules were characterized for mean particle diameter, morphology, loading efficiency, and in vitro release. The in vitro antimicrobial and anti adhesion activities were evaluated against selected imipenem-resistant Klebsiella pneumoniae and Pseudomonas aeruginosa clinical isolates.ResultsThe obtained results reveal that imipenem loaded PCL nano-formulation enhances the microbial susceptibility and antimicrobial activity of imipenem. The imipenem loaded PCL nanoparticles caused faster microbial killing within 2–3 h compared to the imipenem loaded PLGA and free drug. Successfully, PCL nanocapsules were able to protect imipenem from enzymatic degradation by resistant isolates and prevent the emergence of the resistant colonies, as it lowered the mutation prevention concentration of free imipenem by twofolds. Moreover, the imipenem loaded PCL eliminated bacterial attachment and the biofilm assembly of P. aeruginosa and K. pneumoniae planktonic bacteria by 74 and 78.4%, respectively.ConclusionsThese promising results indicate that polymeric nanoparticles recover the efficacy of imipenem and can be considered as a new paradigm shift against multidrug-resistant isolates in treating severe bacterial infections.

Gram-Positive Bacterial Infections: Research Priorities, Accomplishments, and Future Directions of the Antibacterial Resistance Leadership Group.

Antimicrobial resistance in gram-positive bacteria remains a challenge in infectious diseases. The mission of the Gram-Positive Committee of the Antibacterial Resistance Leadership Group (ARLG) is to advance knowledge in the prevention, management, and treatment of these challenging infections to improve patient outcomes. Our committee has prioritized projects involving methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) due to the scope of the medical threat posed by these pathogens. Approved ARLG projects involving gram-positive pathogens include (1) a pharmacokinetics/pharmacodynamics study to evaluate the impact of vancomycin dosing on patient outcome in MRSA bloodstream infection (BSI); (2) defining, testing, and validating innovative assessments of patient outcomes for clinical trials of MRSA-BSI; (3) testing new strategies for "step-down" antibiotic therapy for MRSA-BSI; (4) management of staphylococcal BSIs in neonatal intensive care units; and (5) defining the impact of VRE bacteremia and daptomycin susceptibility on patient outcomes. This article outlines accomplishments, priorities, and challenges for research of infections caused by gram-positive organisms.

Targeting biofilms and persisters of ESKAPE pathogens with P14KanS, a kanamycin peptide conjugate

BackgroundThe worldwide emergence of antibiotic resistance represents a serious medical threat. The ability of these resistant pathogens to form biofilms that are highly tolerant to antibiotics further aggravates the situation and leads to recurring infections. Thus, new therapeutic approaches that adopt novel mechanisms of action are urgently needed. To address this significant problem, we conjugated the antibiotic kanamycin with a novel antimicrobial peptide (P14LRR) to develop a kanamycin peptide conjugate (P14KanS). MethodsAntibacterial activities were evaluated in vitro and in vivo using a Caenorhabditis elegans model. Additionally, the mechanism of action, antibiofilm activity and anti-inflammatory effect of P14KanS were investigated. ResultsP14KanS exhibited potent antimicrobial activity against ESKAPE pathogens. P14KanS demonstrated a ≥128-fold improvement in MIC relative to kanamycin against kanamycin-resistant strains. Mechanistic studies confirmed that P14KanS exerts its antibacterial effect by selectively disrupting the bacterial cell membrane. Unlike many antibiotics, P14KanS demonstrated rapid bactericidal activity against stationary phases of both Gram-positive and Gram-negative pathogens. Moreover, P14KanS was superior in disrupting adherent bacterial biofilms and in killing intracellular pathogens as compared to conventional antibiotics. Furthermore, P14KanS demonstrated potent anti-inflammatory activity via the suppression of LPS-induced proinflammatory cytokines. Finally, P14KanS protected C. elegans from lethal infections of both Gram-positive and Gram-negative pathogens. ConclusionsThe potent in vitro and in vivo activity of P14KanS warrants further investigation as a potential therapeutic agent for bacterial infections. General significanceThis study demonstrates that equipping kanamycin with an antimicrobial peptide is a promising method to tackle bacterial biofilms and address bacterial resistance to aminoglycosides.

DOES BALANCE IMPROVE AFTER THE APPLICATION OF TAI CHI EXERCISE PROGRAM IN POST- MENOPAUSAL WOMEN WITH OSTEOPOROSIS?

Background. Osteoporosis is an emerging medical and socioeconomic threat characterized by a systemic impairment of bone mass, strength, and microarchitecture. Due to degenerative changes in morphology and structure, the amount of bone fragility and fractures increases affecting balance function. Tai Chi is a traditional Chinese mind- body exercise that has the potential to overcome the impairments associated with frailty. Methods. The study involved 13 post-menopausal women with osteoporosis. All subjects participated in Tai Chi exercise program which lasted for eight weeks. Two, one-hour group training sessions were taught per week. Balance assessment was performed three times: before Tai Chi exercise program, after four weeks and after eight weeks of the application of Tai Chi exercise program. Balance measurements were conducted using platform “Sigma Balance Pad” and BESS test. Results. Research findings of “Sigma Balance Pa” showed statistically significant changes ( p < .05) in eyes opened condition while in eyes closed condition no significant changes were observed (p ≥ .05). Results of BESS test revealed statistically significant improvement of static balance after Tai Chi exercise program (p = .033). Conclusions. Research results demonstrated balance improvement: body sway and center of pressure displacement speed decreased after Tai Chi exercise program. Further future research of reliability and validity of the BESS in subjects with osteoporosis should be considered.

The Sole Provider: Preparation for Deployment to a Medically Austere Theater.

The combat focus of the US Military over the past 15 years has primarily centered on the Iraq and Afghanistan areas of operation (AOs). Thus, much human and financial capital has been dedicated to the creation of a robust medical infrastructure to support those operations. However, Special Operation Forces (SOF) are often called upon to deploy in much more medically austere AOs. SOF medical providers operating in such environments face significant challenges due to the diversity of medical threats, extremely limited access to medical resupply, a material shortage of casualty evacuation platforms, lack of medical facilities, and limited access to higher-level care providers. This article highlights the challenges faced during a recent Special Forces deployment to such an austere environment. Many of these challenges can be mitigated with a specific approach to premission training and preparation.

Defining a Crisis: the Impact of Attention and Crisis Language on Diabetes in America

Public health crises are shaped by the nature of public discourse surrounding them. Attention and portrayal of disease in the media and advocacy from interest groups play a significant role in defining, labeling, and framing health threats in the United States. The frequency of coverage and the use of crisis language in the public discourse determine issue salience and creates a discursive epidemic that coincides with medical threats. Diabetes presents a growing challenge for public health in the U.S. due to its rising prevalence in the population; however, it also represents an important example of how health crisis are portrayed. This paper examines how media coverage and advocacy group portrayals of diabetes have evolved. Taking a longitudinal approach, media archives and advocacy group publications are examined, focusing on the period from 1985 to 2014. Finally, this paper seeks to use the coverage of diabetes as a reflection of public discourse and the nature of public health crises. This research falls at the intersection of several fields of study, including media effects, communication, psychology, and political behavior. The perception of a crisis and its surrounding discourse shape public perception and determine political and social response. Specifically, observing the frequency and content of language used to discuss diabetes in America can reveal the dynamics of communication in the public sphere and why some issues are salient while others are not.

Associations between physical activity and semen quality in young healthy men

To evaluate whether the level of everyday physical activity is associated with semen quality in young men. Cross-sectional study. Universities, clubs, and societies. Young healthy men (aged 18-35years) with unknown fertility (n = 177). Collection of data on medical history, lifestyle factors (physical activity, nutrition, addictions), and environmental threats (exposure of gonads to cellular phones, laptops). Collection of semen samples. Semen parameters. Men who were physically more active (3rd and 4th quartiles) had a higher percentage of immotile sperm than less active subjects (1st and 2nd quartiles). The mean (95% confidence interval) percentages were, respectively: 53% (38%-69%) and 51% (41%-61%) versus 38% (28%-49%) and 39% (29%-48%). Other semen parameters were unrelated to physical effort. Physical activity might be associated with an altered percentage of immotile sperm in young, lean, educated men who have not fathered children.

Recent government regulations in the United States seek to ensure the effectiveness of antibiotics by limiting their agricultural use

The development of bacteria resistant to antibiotics is viewed as a medical health threat. Because thousands of people die every year due to antibiotic-resistant bacteria, efforts are underway to reduce antibiotic usage which in turn will reduce the development of antibiotic-resistant bacteria. In the United States, the use of antibiotics in the production of food animals to enhance animal growth has been identified as contributing to resistance. In 2015, a veterinary feed directive was adopted by the U.S. federal government prohibiting nontherapeutic uses of antibiotics in food animals that should reduce usage. The continued usage of antibiotics by producers for preventing disease may mean the directive is insufficient to reduce nontherapeutic antibiotic administration. This may lead some consumers to seek meat products from animals raised without antibiotics. A governmentally-sponsored labeling program could encourage reduction in antibiotic usage.

English

The word "prescription", from "pre-" ("before") and "script" ("writing, written"), refers to the fact that the prescription is an order that must be written down before a drug can be dispensed. Prescription is a written order by the prescriber to the dispenser on how the drug should be dispensed. It serves as a means of communication among the prescriber, dispenser and drug consumer pertaining to treatment. That is why doctors are legally obliged to write prescription clearly. However, most of the time prescriptions are found to be unclear. Accordingly, the main objective of this survey study was to investigate the factors that affect proper prescription writing in Jimma University specialized hospital. In order to achieve the main objective, four specific objectives related to knowledge and perception on importance of good prescription and consequences of sloppy prescription writing, the practice of good prescription writing and other factors that affect the proper prescription writing were formulated. One hundred (25%) of the physicians and 50(100%) of the pharmacists were included in the survey. In order to select sample physicians, convenience sampling technique was employed. In order to collect data from the sample, two instruments namely questionnaire and document analysis were used. The collected data were analyzed using percentage and mean value. The result of the survey showed that most of the physicians have knowledge on the importance of clear prescription writing and they positively perceived that sloppy prescription writing has negative impact on both pharmacists and patients. Nevertheless, the magnitude of writing clear prescription was low because 54.8% of the sample prescriptions were proved to be illegible. Moreover, 70% of the pharmacists also reported that physicians write clear prescription only some times. The major factors that affect the proper prescription writing, according to the physicians, are shortage of time (69%), difficulty of some medicine names to spell (80%) and lack of feedback from pharmacists (52%) on their (physicians’) unclear prescription writing. Therefore, the university in collaboration with the hospital administrative bodies, ministry of health and other concerned bodies should work to make the physicians responsible and work cooperatively with pharmacists to alleviate the problem because illegible prescription may pose a medical threat to the treatment of a patient.   Key words: Prescription, writing, medical threat, illegible handwriting.

Faculty of Prehospital Care, Royal College of Surgeons Edinburgh guidance for medical provision for wilderness medicine.

To support leaders and those involved in providing medical care on expeditions in wilderness environments, the Faculty of Pre-Hospital Care (FPHC) of The Royal College of Surgeons of Edinburgh convened an expert panel of leading healthcare professionals and expedition providers. The aims of this panel were to: (1) provide guidance to ensure the best possible medical care for patients within the geographical, logistical and human factor constraints of an expedition environment. (2) Give aspiring and established expedition medics a ‘benchmark’ of skills they should meet. (3) Facilitate expedition organisers in selecting the most appropriate medical cover and provider for their planned activity. A system of medical planning is suggested to enable expedition leaders to identify the potential medical risks and their mitigation. It was recognised that the scope of practice for wilderness medicine covers elements of primary healthcare, pre-hospital emergency medicine and preventative medicine. Some unique competencies were also identified. Further to this, the panel recommends the use of a matrix and advisory expedition medic competencies relating to the remoteness and medical threat of the expedition. This advice is aimed at all levels of expedition medic, leader and organiser who may be responsible for delivering or managing the delivery of remote medical care for participants. The expedition medic should be someone equipped with the appropriate medical competencies, scope of practice and capabilities in the expedition environment and need not necessarily be a qualified doctor. In addition to providing guidance regarding the clinical competencies required of the expedition medic, the document provides generic guidance and signposting to the more pertinent aspects of the role of expedition medic.Electronic supplementary materialThe online version of this article (doi:10.1186/s13728-015-0041-x) contains supplementary material, which is available to authorized users.

Predictors of Physician Recommendation for Ethically Controversial Medical Procedures: Findings from an Exploratory National Survey of American Muslim Physicians.

Physician religiosity can influence their ethical attitude toward medical procedures and can thereby impact healthcare delivery. Using a national survey of American Muslim physicians, we explored the association between physician recommendation of three controversial medical procedures--tubal ligation, abortion, and porcine-based vaccine--and their (1) religiosity, (2) utilization of bioethics resources, and (3) perception of whether the procedure was a medical necessity and if the scenario represented a life threat. Generally, multivariate models found that physicians who read the Qur'an more often as well as those who perceived medical necessity and/or life threat had a higher odds recommending the procedures, whereas those who sought Islamic bioethical guidance from Islamic jurists (or juridical councils) more often had a lower odds. These associations suggest that the bioethical framework of Muslim physicians is influenced by their reading of scripture, and the opinions of Islamic jurists and that these influences may, paradoxically, be interpreted to be in opposition over some medical procedures.

Complete genome sequence of the siphoviral bacteriophage Βϕ-R3177, which lyses an OXA-66-producing carbapenem-resistant Acinetobacter baumannii isolate.

In recent years, antimicrobial resistance has become a major medical threat worldwide. Among these threats, the rapid increase in carbapenem-resistant Acinetobacter baumannii (CRAB) is a particularly challenging global issue in the health care setting. In this study, a novel lytic A. baumannii phage, Βϕ-R3177, infecting carbapenem-resistant A. baumannii strains was isolated from sewage samples at a hospital. The morphology of the phage as assessed by transmission electron microscopy (TEM) indicated that it belongs to the family Siphoviridae within the order Caudovirales. It has a linear double-stranded DNA genome of 47,575 bp with a G+C content of 39.83%. Eighty open reading frames (ORFs) were predicted; however, only 14 ORFs were annotated as encoding functional proteins, while most of the ORFs encoded hypothetical proteins. Among the total ORFs of the phage genome, no toxin-related genes were detected. A bioinformatics analysis showed that the whole genome sequence of phage Βϕ-R3177 exhibited 62% sequence similarity to that of Acinetobacter phage Βϕ-B1252, but there was no homology seen with other phages. Physiological characteristics, such as one-step growth properties, pH and temperature stability, and host cell lysis activity showed this phage has high stability and lytic activity against host bacteria and therefore has potential applicability as an antibacterial agent to control pathogens in the hospital environment.

NEW NON-MILITARY RISKS

NEW NON-MILITARY RISKS

Seroconversion to Japanese Encephalitis Virus Among U.S. Infantry Forces in Korea.

Japanese encephalitis virus (JEV) is endemic in the Republic of Korea (ROK), posing a medical threat to more than 29,000 U.S. Forces military personnel currently deployed in the ROK. The objective of this study was to provide data on the risk of JEV exposure among U.S. Forces in the ROK. One thousand U.S. Army Soldiers were randomly selected for the study from the cohort of infantry Soldiers deployed in the ROK for a period of at least 330 days from 2008 to 2011. Pre- and post-deployment serum specimens were tested for the presence of JEV antibodies by plaque reduction neutralization test. A total of 2/1,000 (0.2%) U.S. Army Soldiers post-deployment specimens tested positive for JEV antibody. Results from the pre-deployment specimens indicated one true seroconversion and one with titers suggestive of a JEV infection. These results indicate a low, but nonzero risk of JEV exposure among U.S. Army Soldiers in the ROK.

Diabetic foot complications and their risk factors from a large retrospective cohort study.

BackgroundFoot complications are considered to be a serious consequence of diabetes mellitus, posing a major medical and economical threat. Identifying the extent of this problem and its risk factors will enable health providers to set up better prevention programs. Saudi National Diabetes Registry (SNDR), being a large database source, would be the best tool to evaluate this problem.MethodsThis is a cross-sectional study of a cohort of 62,681 patients aged ≥25 years from SNDR database, selected for studying foot complications associated with diabetes and related risk factors.ResultsThe overall prevalence of diabetic foot complications was 3.3% with 95% confidence interval (95% CI) of (3.16%–3.44%), whilst the prevalences of foot ulcer, gangrene, and amputations were 2.05% (1.94%–2.16%), 0.19% (0.16%–0.22%), and 1.06% (0.98%–1.14%), respectively. The prevalence of foot complications increased with age and diabetes duration predominantly amongst the male patients. Diabetic foot is more commonly seen among type 2 patients, although it is more prevalent among type 1 diabetic patients. The Univariate analysis showed Charcot joints, peripheral vascular disease (PVD), neuropathy, diabetes duration ≥10 years, insulin use, retinopathy, nephropathy, age ≥45 years, cerebral vascular disease (CVD), poor glycemic control, coronary artery disease (CAD), male gender, smoking, and hypertension to be significant risk factors with odds ratio and 95% CI at 42.53 (18.16–99.62), 14.47 (8.99–23.31), 12.06 (10.54–13.80), 7.22 (6.10–8.55), 4.69 (4.28–5.14), 4.45 (4.05–4.89), 2.88 (2.43–3.40), 2.81 (2.31–3.43), 2.24 (1.98–2.45), 2.02 (1.84–2.22), 1.54 (1.29–1.83), and 1.51 (1.38–1.65), respectively.ConclusionsRisk factors for diabetic foot complications are highly prevalent; they have put these complications at a higher rate and warrant primary and secondary prevention programs to minimize morbidity and mortality in addition to economic impact of the complications. Other measurements, such as decompression of lower extremity nerves, should be considered among diabetic patients.