Your own country, the UAR, now has many good to excellent medical facilities -- might your cousin visit you at your location in Dubai to seek medical advice?
You could ask your doctor for a referral and whether he/she is confident that your country's doctors can readily handle your cousin's concerns.
I might add, there is excellent care available in other countries, such as Germany, however, if you have the means the United States is ther place to get immediate care. A circulatory evaluation is in order, and a vascular consult, because good tissue perfusion is essentiasl to healing. In the United States the drill pre-andpost amputatio0n is intravenous vancomyacin, howver ther Journal of Infectios Diseases, Jan 2011, suggests oral CIPRO is equally effective. There are two important cultures. Oner is that of the amputated toe, to determine what bacteria is present. The other is from the wound, to determine if there is any infection at the margins. If there are clear margins, and no osteomyelitis in the metatarsal, the infection is gone. Bear in mine re-infection is possible. Wear white socks that are cleaned every day with a mild bleach solution and see a physician if there is any siogn of injury to the toe or infection. These infections progress extremely rapidly in a diabetic, especially if there is poor peripheral circulation.
He should go to the United States for an evaluation from a podiatrist associated with a teaching hospital. First off, a color dopplar and vascular evaluation is required to determine the amount of blood flow in both legs. In general, amputation of a toe, foot, of limb is only necessary if there is osteomyelitis, which is determined in the United States by an MRI. Antibiotic treatment alone rarely resolves osteomyelitis, especially if there is vascular compromise. When the toe was amputated a culture should have been taken to determine the exact nature of the infectious organisms. This is a situation requiring immediate attention, as leg amputations often result from improper treatment. It goes without saying that he has to get his diabetes under close control with diet, exercise and medications,
If he has Buerger's That might have been helpful knowledge in the first post instead of leading us to beleave it was diabetic in nature.
The hyperbaric chamber may still be useful as both conditions result from decreased blood flow.
Thank you for your reply. My cousin is in Turkmenistan.
I haven't heard about hyperbaric chambers. I will definitely check.
I checked couple of doctors they said it is Buerger's symptoms. Not sure though.
Im sorry for your cousin, The best thing he can do is get control of his BG (blood sugars). he needs to keep is BG between 3.8 and 7.7 not just fasting but even 1 hour after eating.
Carbohydrates raise BG All carbs raise BG rice, wheat, sugar, most fruit will raise BG.
You dont say what country your in, many places have hyperbaric chambers for diabetic wounds.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2858204/