Background: Wound healing depends upon a balance between general factors which include nutritional status of the patient and local factors. Assessment of wound healing in relation to nutritional status of the patients in common surgical conditions.Methods: 46 surgical patients admitted in S.R.N. Hospital, Motilal Nehru Medical College, Allahabad during the period from July 2017 to July 2018, were included. Clinical, anthropometric examination, assessment of wound healing and factors affecting wound healing was done.Results: The mean age of the males patients were 38 years and that of female 33 years. Out of 46 patients included in our study 71.74% were male and 28.26% were females, and among these 15.15% of male and 38.46% female were malnourished. Percentage of wound contraction was 11.38% among the healthy and 2.30% in malnourished group, while the percentage of infection was 14% and 13% among healthy males and female and 20% each for malnourished males and females. Loss of weight was 9.4% and 10.1% among healthy male and female and 6.54% and 7.5% for malnourished male and females. The percentage of wound disruption in our study was 9% among malnourished group.Conclusions: Wound infection and disruption collectively increased the mortality and morbidity significantly in patients of malnourished group. Socio economic status has indirect correlation with wound healing. Malnourishment has a definite effect on wound healing.
A large majority of microcytic hypochromic anemia have defects in cellular hemoglobin synthesis due to either iron deficiency or thalassemia trait; both differing in management and prognosis. HPLC and serum iron profile as confirmatory tests are unavailable at health care centers. Blanket therapy of iron supplements is therefore given in all such cases which may cause iron overload in thalassemia cases. Easy to use and cost effective screening methods are desirable. The present study was undertaken to evaluate the diagnostic accuracy of twelve indices to effectively screen cases of thalassemia trait and differentiate them from iron deficiency anemia. Routine samples from the hematology lab with Hb \ 13 gm/dl, MCV \ 80 fl and MCH \ 27 pg were screened. Taking HPLC and serum ferritin as gold standard, out of total 1353 cases, 98 cases of thalassemia trait (HbA2 [ 3.5 on HPLC) and 1102 cases of iron deficiency anemia (serum ferritin \ 12 g/ml) were evaluated using discrimination indices. Diagnostic accuracy for each index was calculated. While few indices showed a sensitivity of 100%, their specificity was low which meant more number of false positive cases. Based on Youden's Index, which measures the diagnostic tests ability to balance sensitivity and specificity, the best three indices in the decreasing order of their efficacy in our study were Ricerca Index (RI), Green and King Index (GKI) and Mentzer Index (MI). MI is considered a reliable index by many clinicians since a long time, however RI and GKI were found to have a better diagnostic accuracy based on our study.
Most of the disease conditions whether benign or malignancypresents as lymphadenopathy. Therefore, first line evaluation of lymphadenopathy of unknown etiology, fine-needle aspiration cytology (FNC) act as an important diagnostic tool. Recently, an expert panel published the proposal of the Sydney system for reporting and classification of lymph node cytopathology. The aim of the present study was to evaluate the applicability of Sydney system of classification and reporting. Material and method: It is retrospective study done in tertiary health care center in which FNC diagnoses were correlated with histopathological and clinical follow-up, to assess the diagnostic accuracy and the risk of malignancy (ROM) for each diagnostic category. A total of 1204 lymph node FNCs that were performed between 1st of January 2021to 31st of August 2021 were reviewed. Results: Out of 1204 cases, n=127 cases (10.5%) were re-categorized as L1-inadequate/non-diagnostic n = 805 (66.8%) as benign (L2) n = 12 (0.99%) as atypical (L3) n = 15 (1.24%) as suspicious (L4), and n = 241 (20%) as malignant (L5). Statistical analysis: Sensitivity 99.37%, specificity 98.31%, positive predictive value 99.6%, negative predictive value 98.5%, and accuracy 98.12%. The ROM was 100% for L4 and L5category, 66.6% for L3, 1.51% and 0.66% for L1 and L2 categories, respectively. Conclusion:In lymph node FNC reporting, diagnostic accuracy can be improved by the implementation of Sydney system of classification and reporting. Moreover management recommendation specific for each categories with increased ROM that enables the clinician with better management of patient care.
Background: Doppler ultrasonic velocity detector which is least expensive and most versatile instrument. This technique is particularly helpful to establish the diagnosis of vascular insufficiency in clinically suspected cases of vascular disease and to predict the therapeutic results and follow up.Methods: The present study was conducted in MLN Medical College and SRN Hospital, Allahabad, Uttar Pradesh, India. Patients of either sex suffering from diabetes with or without ischemic symptoms, who presented themselves. Study consisted of 50 subjects, which were matched by age, sex and all physical characteristics. Among the 50 subjects, 20 were suffering from diabetes and had ischemic symptoms like intermittent or rest pain and gangrene. Another set of 20 patients in this study group were of diabetes without any ischemic symptoms. Remaining 10 patients were controls i.e., they were comparable in physical characteristics like age, sex, height and weight. They had never smoked neither had any vascular disease.Results: In this study, peak incidence of diabetic foot lesion was 6th decade and about 20% of female patient had foot lesion. In this study, the mean duration of disease in diabetic with ischemic symptoms was 9.6 years, while in asymptomatic group it was 6.9 years. It showed that as duration of disease increases, there is more probability for appearance of ischemic symptoms and foot involvement.Conclusions: In diabetics without ischemic symptoms, most of the doppler wave patterns are triphasic and biphasic, while in diabetics with ischemic symptoms biphasic and monophasic waves are predominantly seen.
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