Diabetes mellitus is the most common metabolic problem all over the world. Over 150 million people worldwide, are affected with this problem.1, 2 In Pakistan, the prevalence of diabetic patients are between 7.6% to 11%.3. Objective and Methodology: The aim of this study is to compare the relative efficacy of hydrogel and papaya dressings for diabetic foot ulcers. Patients from the General Surgery Department at Mayo Hospital in Lahore were 114 in total. Patients were randomized into: group H, who received hydrogel dressings, and group P, who received papaya dressings. Both dressings were done in ward for 20 days, every 48 hours and if wound healing occurred earlier and slough decreased then dressings were stopped and patient was discharged. The wound was assessed by photographic wound assessment tool (PWAT). Results: In Group P, mean age of patients was 52.98±8.90 and in Group H, mean age of patients was 50.98±9.62. In Group P, 34(59.6%) patients were male and 23(40.4%) were female. While in Group H 29(50.9%) patients were male and 28(49.1%) were female patients. We used Wound Assessment tool “PWAT” to compare the efficacy of these two treatment regimes. As per final “PWAT” score hydrogel dressing is more effective as compared to Papaya dressing for diabetic wound healing. i.e. Group P (Papaya dressing): 5.09±1.65 vs. Group H (hydrogel Dressing): 6.02±1.78, p-value=0.005 Conclusion: Depending upon the outcomes of this research, it can be concluded that hydrogel dressing is more useful than papaya dressing for treating diabetic wound. Although papaya dressing also have a beneficial effect on diabetic wound but still its efficacy is less as compared to hydrogel dressing Keywords: Papaya, Hydrogel, Dressing, Diabetic Foot, Wounds, Ulcer.
Objective: This study was designed to determine whether or not "hypocalcemia following complete thyroidectomy in hyperthyroid patients was associated with preoperative vitamin D insufficiency." Methodology: This research was carried out in the West Surgical Ward of Mayo Hospital in Lahore, Pakistan. Total 60 patients were included in the study. Patients were divided in two groups i.e. Vit-D deficient group “with vitamin D deficiency” and Vit-D sufficient group “without vitamin D deficiency”. All the patients underwent total thyroidectomy preserving parathyroid glands performed by the same team of surgeons. Patients were assessed for signs and symptoms of hypocalcemia. Serum calcium was measured at day of surgery, post-operative day-1 and at the end of 2 weeks on follow up after surgery. Results: The mean of age in the Vit-D deficient group was 38.87±9.31 and in Vit-D sufficient group was 37.70±8.56. Majority of patients in the Vit-D deficient group were females (70.0%). In Vit-D deficient group, 13(43.3%) had hypocalcemia, while 5(16.7%) in Vit-D sufficient group (p-value 0.024). Conclusion: Pre-operative VDD “vitamin D deficiency” is linked with postoperative hypocalcemia increased occurrence after total thyroidectomy. There is a “positive correlation of preoperative vitamin D deficiency on postoperative hypocalcaemia after total thyroidectomy in patients of hyperthyroidism”. Keywords: Hyperthyroid, Total Thyroidectomy, Hypocalcemia, Vitamin D deficiency
In the field of General Surgery AA is the frequent clinical condition for which patients who need emergency surgery present with abdominal pain.1 Diagnosis of this pathology is made with the help of history, patient symptoms, and clinical exam and lab investigations. Ultrasonography (USG) and computed tomography (CT) images for acute appendicitis should be considered.2 Methodology: The purpose of the study is to compare the diagnostic accuracy of Modified Alvarado Score (MAS) and Ohmann Scores (OS) in diagnosing the pathology of Acute Appendicitis, while retaining histopathology as the basis for final diagnosis. A total of 411 patients were admitted via the Accidents & Emergency Department of Mayo Hospital Lahore, meeting the inclusion and exclusion requirements having the clinical diagnosis of acute appendicitis. For each patient, both Modified Alvarado and Ohmann scores were assessed prior to undergoing the procedure, i.e. open appendectomy. Abdominopelvic assessments and laboratory results were assessed and abdominal USG was performed in all patients. Biopsy of the removed appendix was sent for histopathology to Pathology Department of King Edward Medical University. Results: For the modified Alvarado and Ohmann score; sensitivity and specificity of was 89.74%, 90.48%, 85.13% and 80.95% respectively. The positive predictive value (PPV) and negative predictive value (NPV) for “modified Alvarado score” was 99.43% and 32.2% and for “Ohmann score” it was 98.81% and 22.67% respectively. Conclusion: Both scoring system are sensitive and specific enough for diagnosis of acute appendicitis. However, sensitivity and specificity of modified Alvarado score is higher as compared to Ohmann score. Keywords: Acute Appendicitis, Diagnostic Accuracy, Modified Alvarado Score, Ohmann Score, Histopathology.
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