Surgical services in Papua New Guinea (PNG) have seen an increase in admissions of patients with diabetic septic foot (DSF). Perception and beliefs about the causes of foot ulcer in PNG differ from medical evidence and may play a role in foot-related behaviours among DSF patients. This hospital-based prospective case series study examined the reasons for late presentation among 30 DSF patients in Nonga General Hospital from October 2013 to October 2014. Belief in sorcery was the most common cause of late presentation. Those who chose more than one home treatment were the most likely to present late, and those who presented late had a higher chance of getting a lower extremity amputation than those who presented early.

The rapid demographic changes occurring in the Pacific island countries, including Papua New Guinea, have led to a rapid increase in the prevalence of non-communicable diseases. Surgical services in Papua New Guinea are seeing a marked increase in admissions for diabetic septic foot (DSF). Lower extremity amputation is common, although specific criteria for this procedure are lacking. We report a prospective case series of 20 patients admitted to the Surgical Ward of Nonga General Hospital with DSF from October 2013 to July 2014. Patients who had lower extremity amputation were younger, had a higher level of HbA1c and a higher Wagner ulcer score than those managed conservatively.

Hirschsprung's disease (HD) is a disease entity synonymous with infants and newborns. We present a case of HD in a 21-year-old female that was never diagnosed in her infancy. This case highlights the diagnosis of HD in adults and enlightens us that this congenital disease may rarely be diagnosed in adults.