clinicaltrials.gov Identifier: NCT01082874.

Background: Hydatid disease or Echinococcosis is a zoonotic disease caused by the larva of Echinococcus species and is one of the oldest known diseases to man. The disease has a worldwide distribution and is also well recognized and documented in India. Aims: This study was carried out with the aim of describing the epidemiology (demography, clinical presentation, imaging characteristics, and in-hospital course) of Cystic Echinococcosis (CE) in central India. Materials and Methods: The clinical study of hydatid disease was conducted as a single case series including both historical and current cases at the Mahatma Gandhi Institute of Medical Sciences, Central India. The study investigator screened all the histopathology records from 1997 to 2004 for historical case group. The current case group extended from 2005 to 2007. The historical case group included 91 patients and the current case group had 26 surgically treated patients. Results: Females were the dominant sex affected by the disease. Hydatid of the liver was more common, especially in the right lobe. Pain in the abdomen was the most common presenting complaint. Lump in the abdomen was the most common clinical finding. Patients with pulmonary hydatid presented to the hospital earlier than the patients with abdominal hydatid (P=0.03). Partial pericystectomy and external drainage was the most commonly performed surgery. The most common postoperative complication was wound infection. Conclusions: This study highlights the epidemiology of CE in the rural region of Indian subcontinent. The population in rural areas are more exposed to zoonotic diseases. Proper education, creating awareness, and implementing strict rules regarding the disposal of remains of slaughtered animals can help eradicate this disease.

Introduction Diabetes is the most common metabolic disease encountered by a surgeon. A sound knowledge of symptomatology, clinical signs and etiology can prevent most of the disease burden and complications and thus reduce social burden. The study tells about common foot problems among diabetes and correlates it with the awareness among people. Aim and objectivesThe study aims to obtain an initial and representative data sample to identify the common pedal complications of diabetes mellitus and to provide an initial projection for the development of a podiatric foot health education program within the Hospital-Medical Centre Complex.Materials and methods 500 diabetic patients were examined of whom 52 had diabetic foot lesions. The symptoms, signs and grade of foot lesion were cross studied with duration, type and occupation of patient. Chi square test was performed and a probability value of p <0.05 was considered signifi cant. ConclusionThe prevalence of diabetic foot in a hospital based rural diabetic population was observed to be 10.4%. Foot lesion were common in the age group 41-60 years. The most common symptom was numbness in foot ( 40.6%) and was more common in long duration diabetes, Type II diabetes and outdoor workers. Common foot deformity observed were callosities (54.6%) and Hallux valgus/ varus ( 28%). The least common was Charcot's deformity (3.6% ). Ulceration (23%) and amputation (5.7%) were higher in outdoor workers. Wagner's grade 2 lesions were the most common foot lesion with diabetic foot. The questionare regarding knowledge, awareness and foot care showed. 99.8% did not inspect the feet properly and 74% washed their feet properly.

Persistent efforts are being made to reduce operative trauma and morbidity and to improve cosmesis following laparoscopic cholecystectomy. The trend is to reduce the number of incisions, and thus single-incision laparoscopic cholecystectomy (SILC) and natural orifice endoscopic surgery (NOTES) are becoming popular. There is a paucity of studies pertaining to cosmetic outcome after SILC and conventional laparoscopic cholecystectomy in rural Indian population. In the present study, the cosmetic outcome of SILC versus conventional laparoscopic cholecystectomy (CLC) in rural Indian population was evaluated. Sixty patients with gallstone disease were randomly assigned to two groups. In group A (n=30), CLC was performed, while group B (n=30) was subjected to SILC. The cosmetic outcome was evaluated using a body image questionnaire on the 7th and 30th postoperative days. On the 7th postoperative day, the body image score for SILC was 6.23±0.89 and for CLC, 8.26±1.08 (p<0.0001), while the cosmetic score for SILC was 19.56±1.07 and for CLC, 15±1.20 (p<0.0001). On the 30th postoperative day, the body image score for SILC was 5.50±0.68 and for CLC, 8±1.31 (p<0.0001), while the cosmetic score for SILC was 21.13±0.57 and for CLC, 15.63±1.06 (p<0.0001), which favored SILC over CLC. The patient perception and acceptance of SILC was better than that of CLC in terms of cosmetic outcome.

IntroductionPerioperative Ischaemic Evaluation-2 (POISE-2) is an international 2×2 factorial randomised controlled trial of low-dose aspirin versus placebo and low-dose clonidine versus placebo in patients who undergo non-cardiac surgery. Perioperative aspirin (and possibly clonidine) may reduce the risk of postoperative acute kidney injury (AKI).Methods and analysisAfter receipt of grant funding, serial postoperative serum creatinine measurements began to be recorded in consecutive patients enrolled at substudy participating centres. With respect to the study schedule, the last of over 6500 substudy patients from 82 centres in 21 countries were randomised in December 2013. The authors will use logistic regression to estimate the adjusted OR of AKI following surgery (compared with the preoperative serum creatinine value, a postoperative increase ≥26.5 μmol/L in the 2 days following surgery or an increase of ≥50% in the 7 days following surgery) comparing each intervention to placebo, and will report the adjusted relative risk reduction. Alternate definitions of AKI will also be considered, as will the outcome of AKI in subgroups defined by the presence of preoperative chronic kidney disease and preoperative chronic aspirin use. At the time of randomisation, a subpopulation agreed to a single measurement of serum creatinine between 3 and 12 months after surgery, and the authors will examine intervention effects on this outcome.Ethics and disseminationThe authors were competitively awarded a grant from the Canadian Institutes of Health Research for this POISE-2 AKI substudy. Ethics approval was obtained for additional kidney data collection in consecutive patients enrolled at participating centres, which first began for patients enrolled after January 2011. In patients who provided consent, the remaining longer term serum creatinine data will be collected throughout 2014. The results of this study will be reported no later than 2015.Clinical Trial Registration NumberNCT01082874.

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This study suggests that the overall POISE-2 results apply to vascular surgery. Perioperative withdrawal of chronic aspirin therapy did not increase cardiovascular or vascular occlusive complications. Registration number: NCT01082874 ( http://www.clinicaltrials.gov).

There was no distinct advantage to SILC with regard to immediate postoperative pain. Pain was significantly less (P < 0.01) in the SILC group on postoperative day 7.