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Participants attended a foot clinic every 3rd or 4th day for wound care. Reduction of wound healing score (PUSH score) and other wound variables improved significantly in the neem leaves extract group ( 0.001). There were no significant changes in the clinic-physiological parameters. Neem leaves extract irrigation for foot ulcers is considered to be very safe as it did not cause any complication systematically during the study. Neem leaf extract solution can be used as an alternative solution for normal saline. Managing DFU requir
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