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To Critically Assess the effect of oral vitamin D supplements on wound healing in a patient with diabetic foot ulcer and its impact on lipid metabolism. This is a single-Centre prospective randomised, control-controlled study was conducted in Department of Surgery Datta Meghe Medical College, Hingna, Nagpur, in collaboration with Datta Meghe Institute of Medical Sciences (DMIMS) Deemed to be University from June 2019 TO March 2020. A total of sixty patients were included in this study. A randomised grouping was done, group A vitamin d supplements and group B as an x-control group. In the group, A vitamin D levels were significantly increased after 12 weeks of intervention as compared to baseline while in group B, no change was seen after the intervention. There was a significant change in HbA1c level after intervention as group A vs group B. similar results were seen in total cholesterol levels after intervention in group A, and group B. Wound surface area was (29.83±15.02 vs 21.76±11.30, p=0.02) in group A and (25.06±14.02 vs 21.3±13.19, p=0.28) in group B respectively. The level of high-density lipoprotein in the group was significantly lower in level when compared to group A after 12 weeks of intervention. No significant changes were seen in the triglycerides level in group A and group B., A comparison of group A vs group B after 12 weeks of intervention, was done. It revealed that Vitamin D Glycosylated total haemoglobin cholesterol, High-density lipoprotein and Wound surface area, significantly improved. At the same time, there was no change seen in triglycerides levels in both the group.After intervention with vitamin D supplements for 12 weeks among patients with diabetic foot ulcer had a good result and beneficial effect on glucose metabolism, vitamin D levels, lipid profile and wound healing

Background: Lack of appropriate nutritional support during hospitalization may worsen patients' nutritional status and increases risk for infection, organ failure, decreased wound healing and suboptimal response to regular medical treatment. The prevalence and intensity of hospital malnutrition have been recognized as an important parameter in the outcome of disease. The study aimed at to determine incidence of malnutrition in hospitalized patients, the change in nutrition status during hospital stay and its effects on outcome of disease. Methods: It was a prospective study and conducted at a tertiary care hospital. Total 70 patients were studied. Each patient's nutritional status was determined from anthropometric data -body mass index, triceps skinfold thickness, mid-arm circumference, mid arm muscle circumference, MNA scoring, serum protein level changes during hospital stay. The next recording was done at 15 days and 30 days after discharge. Student's t is test used for statistical analysis. Results: The statistical difference for various parameters of nutritional status was found significant at admission and discharge. Conclusions: The change in various parameter of nutritional status was observed in hospitalized patients. The treatment should be aimed at treating specific disorders along with nutritional correction. It is recommended to have dietary plans at the time of admission in consultation with the dietician.

Dermoid cysts are developmental abnormal arrangement of tissues and are often evident soon after birth. Its occurrence in the orbit is relatively rare. We report a case of orbital floor dermoid in an 18-year-old female patient who presented with progressive, painless swelling in the lower eyelid associated with mild proptosis of three months duration. The lesion was excised completely, and histopathology confirmed the diagnosis of dermoid cyst.

Ergonomics is the science of best suiting the worker to his job, or to make the setting and surroundings favorable for the laparoscopic surgeon. The term was formally defi ned in 1949 and has brought benefi t and safety to many areas of human endeavor.1 The importance of ergonomics in the setting of laparoscopy cannot be overemphasized. Studies have shown that correct ergonomics can reduce suturing time.2 Pressurerelated chronic pain has been shown to be relieved by the use of ergonomically designed products.3 This article on ergonomics reviews the basic concepts and techniques, for example, triangulation, optimal coaxial alignment, drawbacks for the surgeon and the patient, and how to overcome these diffi culties by recent advances in technology.

Background: Laparoscopic cholecystectomy (LC) has become gold standard for the surgical treatment of gallbladder disease. 2% to 15% of patients require conversion to open surgery for various reasons. Pre-operative prediction of “difficult laparoscopic cholecystectomy” may not only improve patient safety but also be useful in reducing the overall cost of therapy. The aim of this study is to study the factors determining the preoperative predictability of difficult laparoscopic cholecystectomy.Method: 30 cases of laparoscopic cholecystectomy operated by a single experienced surgeon. There are total 15 score from history, clinical and sonological findings. They were evaluated and scored on the basis of scoring system of Randhawa and Pujahari. Score up to 5 is defined as easy, 6-10 as difficult and 11-15 as very difficult.Result: Previous history of hospitalization for cholecystitis and increased gall bladder wall thickness were found statistically significant in predicting difficult LC.Conclusion: The scoring system had a positive prediction value for easy prediction of 81.9% and for difficult prediction of 75%.

BackgroundGallbladder stones are more common in some regions of the world than others. Gallstones that are asymptomatic might be discovered as an afterthought during a regular ultrasound scan for another abdominal ailment. The changing incidence in India is mostly due to westernization and the availability of ultrasonography in both urban and rural areas, as well as increased affordability owing to changes in the socio-economic structure and the budget of investigations. This study aims to know the prevalence of gallstone disease as well as the risk factors that contribute to its development in central India. MethodA single-center, cross-sectional observational study was conducted. Seventy-two radiologically diagnosed cases of gallstone disease irrespective of age, gender, and comorbid condition were included in the study. ResultSeventy-two cases of gallstone were included in the research. The highest age-specific incidence of gallstone was in the fifth and sixth decades with the maximum incidence in the sixth decade. Females had a higher incidence of gallstone formation. The pain was the earliest symptom but we found that 41.67% patients had asymptomatic gallstones. A family history of gallstone disease is found positive in 69.44% of the patients who also had an increased risk of gallstone. 22.22% patient were only diabetic, 6.95% were only hypertensive and 20.83% were both diabetic + hypertensive. Comorbidity has a high prevalence of gallstone disease. Obesity has a significant link to gallstone disease, with BMI being one of the most important indicators of obesity. ConclusionThe prevalence of asymptomatic gallstones is relatively high in central India. We strongly recommend ultrasonography as a screening modality in patients with older age group, female gender, high cholesterol level, family history of gallstones, sickle cell disease, increased BMI and co-morbidities like diabetes or hypertension for early detection of gallstones formation.

Aim: This study was carried out on patients with diabetic foot ulcer (DFU) to assess the clinical characteristics, spectrum of microbial flora, antibiotic sensitivity, and devise an empiric antimicrobial therapy. Material Methods: Clinical data and tissue samples were collected from 105 diabetic foot ulcer patients between December 2018 and November 2019. The collected samples were processed as per Clinical and Laboratory Standards Institute guidelines and clinical and microbiological data was analyzed. Results: In this study of 105 patients, DFU was most common in males in 5 th and 6 th decade of life. Majority of patients had poor glycemic control and neuropathy. Of 110 bacterial isolates obtained from 97 samples, 73.7% were Gram-negative bacteria, and 27.3% were Gram-positive. Most of samples (48.6%) showed growth of single bacteria, growth of two bacteria and polymicrobial growth was seen in 28.6% and 15.2% of tissue samples respectively of which. Pseudomonas was predominant isolate (27.3%) sensitive to imipenem (90%), amikacin (86.6%), gentamicin (83.3%), and cefotaxime (80%) followed by Staphylococcus aureus (19.1%) sensitive to amikacin and gentamicin (100%), and ofloxacin (90%). Pseudomonas, E. coli, Proteus and Klebsiella were highly resistant to ampicillin and amoxicillin-clavulanic acid. Conclusion: This study showed DFU are common in 5 th and 6 th decades of life. Gram-negative bacteria are predominant infective organism. Most of both Gram-negative and Gram-positive bacteria are resistant to variable degrees to commonly used antibiotics and sensitive to aminoglycosides. Amikacin and gentamicin can be used as empiric antibiotics for treatment of DFU infections.