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 Jaundice is a frequent manifestation of biliary tract disorders and the evaluation and management of obstructive jaundice is a common problem faced by the general surgeon. During the last decade significant advances have been made in our understanding with regards to the pathogenesis, diagnosis, staging, and efficacy of surgical and nonsurgical management of obstructive jaundice. To diagnose the cause, site of obstruction, and management of a case of surgical jaundice is indeed a challenging task for the surgeon. Hence, a comprehensive study of the aetiology, clinical presentation, and management of obstructive jaundice is of paramount importance in the appropriate management of these patients. AIM This study evaluates the age and sex distribution, clinical presentation, aetiology, and the different modalities of treatment of obstructive jaundice. MATERIALS AND METHODS This prospective study was conducted in MKCG Medical College and Hospital, Berhampur, Odisha from September 2013-August 2015. Out of all surgical admissions from September 2013 to August 2015 in our hospital, 80 cases of surgical jaundice of different age group were selected randomly. A detailed history and clinical examination was done and appropriate investigations recorded. Patients were assessed preoperatively and later subjected to surgery or palliative procedure depending on the need. Postoperatively, patients' condition was assessed and complications were documented. Patients were followed up for mean period of 6 months where patients underwent surgical intervention/ERCP, any tissue removed was subjected for histopathological examination. RESULTS The occurrence of surgical jaundice was maximum in the 31-70 year age group. All patients presented with icterus and ultrasonogram was the most common investigation of choice. Most common cause of obstruction was choledocholithiasis followed by malignancy. CONCLUSION Commonest symptom of surgical jaundice in this study was pain abdomen and jaundice as per history. Commonest cause for surgical jaundice was found to be choledocholithiasis. Open exploration of common bile duct under experienced hands was found to be a good treatment modality in the management of obstructive jaundice.
Background: Acute pancreatitis presents as acute abdomen, is an inflammatory process of the pancreas associated with local and systemic complications requiring, in such cases, an intensive care. At present, there are lots of scores (such as Ranson’s, APACHE II, bedside index for severity in acute pancreatitis) that help us in predicting severity at the time of admission, but these are time consuming or require complex calculation and are costly. Our aim here is to analyse the simplified stratification system of the PANC 3 score, and its assessment in Predicting Severity of Acute Pancreatitis as decided by modified Marshals score.Methods: It is a prospective analytical observational study in which 74 patients were evaluated with PANC 3 scoring, who were diagnosed with acute pancreatitis and admitted to Dept. Of General Surgery, MKCG.Results: The results showed that PANC3 score had a 95.91% specificity, 68% sensitivity, 89.47% positive predictive value, and 85.45% negative predictive value, 86.48% diagnostic accuracy.Conclusions: PANC3 scoring system is one of the better systems because the three criteria used (haematocrit, body mass index, and pleural effusion) are simple, easy to assess, readily available, and economic Hence, the PANC3 score is a cost-effective, promising score that helps in predicting the severity of acute pancreatitis and triaging the patient, leading to prompt management.
Pancreatitis is one of the most frequent gastrointestinal tract disease for hospitalization all over the world, leading to tremendous emotional, physical and financial human burden. The spectrum of aetiological factors for pancreatitis varies according to continents. Hyperlipidaemia is a rare but known and established risk factor for pancreatitis and goes undetected in most of the clinical settings. Early diagnosis of hyperlipidaemia induced pancreatitis is important to prevent its recurrence and complications. METHODThis is a prospective study carried out on patients with pancreatitis over a period of two years in M.K.C.G. Medical College and Hospital, Berhampur, Odisha, India. Fifty cases of pancreatitis of different age group and both sexes were selected. Equal number of age and sex matched patients other than pancreatitis were taken as control from the indoor. The mean serum lipid profiles of cases were compared with the control group. RESULTIn this study it was observed that the Serum Total Cholesterol, Triglycerides, Low Density Lipoprotein and Very Low Density Lipoprotein were significantly higher in cases than controls, while HDL was found to be higher in controls. Young males were commonly affected and alcohol abuse is the most common risk factor followed by biliary stones. CONCLUSIONAll pancreatitis patients should be evaluated for any alteration in their serum lipid profile, if found to be treated with antilipidaemic drugs, dietary modulation, lifestyle change and physical exercise to limit the occurrence of this disease, pre vent its complications and to control the possibility of future recurrences.
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