Background/objectives: Surgical managements which form the mainstay of these branchial apparatus anomalies are based on accurate understanding of the embryology and surgical anatomy. The conspicuous scarring in the young which becomes conspicuous as the age advances are reduced by newer approaches, the facelift approach, retroauricular approach and endoscope-assisted neck approach.Case report: A retrospective case series analysis of eight patients with complete fistula managed by the combined trans cervical approach. The recurrence was nil, with good surgical access and minimal scar at the incision site.
Conclusion:Combined transcervical approach is the conventional procedure of choice for branchial fistulas. While retroauricular hairline incision (RAHI) approach and endoscopic approaches need expertise and more instrumentation, meticulous cosmetic surgery techniques helps reduces scars of the transcervical approach.
Background: Diabetic foot ulcer is a serious and common complication of diabetes mellitus. 12%–25% have a risk of developing a foot ulcer during their lifetime. Diabetic neuropathy and micro- or macro-ischemia are the two main risk factors that cause diabetic foot ulcer.Methods: A cross sectional study was conducted in dept of general surgery, KVGMCH between 1st November 2019 and 30th August 2020 among 90 pts with diabetic foot ulcers, selected by systematic random sampling methods. Considering prevalence of DFU, among the diabetic pts as 8.8%, the sample size was estimated to be 90 using the formula 4pq/L2, with absolute error as 6%. Patients will be managed conservatively with antibiotics like aminoglycosides, cephalosporins, penicillin derivatives and dressings and if needed surgical interventions will be performed.Results: Maximum number of pts had HbA1c levels of >8% and they accounted for 35.55%. Almost 98% of the patients had neuropathy, 50% of them had signs of ischemia and 80% had infection. Maximum number of patients (58.88%) presented with diabetic ulcers belonging to Class 2 of Wagners classification. The most commonly isolated P. aeruginosa was sensitive to colistin, imipenem and amikacin. Most diabetics with HbA1C levels >8, had mean antibiotic duration of 19.04±4.65 days.Conclusions: Prevention is the best treatment. Wagner’s classification helps in correlating appropriate treatment to proper grade of lesion with better outcome. Effective glycemic control and education are of key importance for decreasing diabetic foot disease.
Background: Formic acid (FA) being pungent, odorless, easily available and consumed for suicidal purposes and the dilute form being colorless and odorless is consumed accidentally. Accidental ingestion is rare and deliberate self-harm is very painful and violent which has been a rare modality of committing suicide but for these areas where it is easily available.
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