The aim of this study was to prepare a profile of diabetic foot ulcer (DFU) complications and its management and to assess the outcome of the surgical interventions. A prospective study was carried out in 60 patients with DFU during the period of January 2009 to October 2010 to categorize them based on Meggit-Wagner system and to find out the complications, management, below knee amputation rate, and mortality rate. Majority of the patients (30 %, n = 18) presented with Wegner grade 3 DFU. Only three patients (5 %) presented with grade 0 DFU. Split skin grafting was the most frequently done intervention, comprising 29 % of the time. Below knee amputation was required in 10 % of cases and mortality rate was 12 %. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center are all factors which led to occurrence of DFU at an age earlier than that seen in other studies.
BACKGROUND Inguinal hernia is one of the most common surgical problem that presents to a surgeon in his outpatient department. The aim of this study is to compare the early and long-term health status and clinical outcomes of Stoppa and bilateral Lichtenstein hernia repair.
MATERIALS AND METHODSThe Stoppa group consisted of 24 patients and Lichtenstein's group consisted of 26 patients. Both groups were similar with respect to age, gender and post-operative followup. All the patients were followed up for a period of one year and compared the parameters like operating time, early complications, chronic groin pain and early recurrence.
RESULTSOperating time, early post-operative complications and chronic groin pain were comparable in both groups except for recurrent hernia, in which operative time taken for Lichtenstein repair is slightly more. Time for post-operative recovery to normal activities is less in Lichtenstein group and time taken for resumption of work is less in Stoppa group.
CONCLUSIONGiant prosthetic reinforcement of the visceral sac-Stoppa's repair is a good alternative to Lichtenstein repair for primary bilateral hernia and is superior for recurrent hernia.
Laparoscopic procedures to treat endometrial cancer are currently emerging. At present, we have evidence to do laparoscopic oncologic resections for endometrial cancer as proven by many prospective studies from abroad such as LAP2 by GOG. So, we have decided to assess the safety and feasibility of such a study in our population with the following as our primary objectives: (1) to study whether laparoscopy is better compared to open approach in terms of duration of hospital stay, perioperative morbidity and early recovery from surgical trauma and (2) to study whether the laparoscopic approach is noninferior to the open approach in terms of number of lymph nodes harvested in lymphadenectomy and rate of conversion to open surgery. We did a prospective nonrandomized comparative study of open versus laparoscopy approach for surgical staging of endometrial cancer from 16th May 2013 to 15th May 2015. To prove a significant difference in the hospital stay, we needed 29 patients in each arm. Thirty patients in each arm were enrolled for the study. The median duration of stay in the open arm was 7 days and in the laparoscopy arm it was 5 days. The advantage of 2 days in the laparoscopic arm was statistically significant ( value 0.006). Forty percent of patients in the open arm had to stay in the hospital for more than 7 days whereas only 3% of patients in the laparoscopy arm required to stay for more than 7 days ( value 0.001). This difference was statistically significant. There was no significant difference between the early complication rates between the two arms (20% in open vs. 13% in laparoscopy; value 0.730). There was a conversion rate of 10% in laparoscopy. The median number of nodes harvested in open arm was 16.50 and in the laparoscopy arm, it was 13.50. The difference was not statistically significant ( value 0.086). Laparoscopy approach for endometrial cancer staging is feasible in Indian patients and the short-term advantages are replicable with same oncologic safety as proved by randomized controlled trials.
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