Introduction: Management of infected wounds is not always simple and easy. Vacuum-assisted closure (VAC) is a wound healing therapy that utilizes a dressing system that continuously or intermittently applies a negative pressure to the wound surface. Our aim was to assess the Feasibility and advantages of simplified version of otherwise costly VAC, or simple suction drainage in selected cases. Material and methods: This prospective study was conducted in the unit 2 nd of department of surgery at SMHS hospital, an associated hospital GMC Srinagar, over a period of 3 years from January 2014 to December 2016. During this period, 32 patients were subjected to vacuum suction treatment and were included in this study. Results: Wall suction (VAC) was used in 26 patients. Mini Vac drain (USG guided) was used in 5 cases. In one patient of scalp infection conventional large size suction drain was used. The time taken for the wounds to become healthy was 3 to 7(average 3.5) days of VAC dressing or suction drainage. No antibiotics were given during suction drainage in 21 patients. Need for grafting by split skin grafting method was felt in only 2 patients. Mild discomfort (abnormal sensation) was reported in 21 patients. Hospital stay for patients managed by suction therapy ranged from12 hours (breast abcess) to 16 days with an average of 7 days. The total cost incurred in the patients undergoing VAC for a period of 15 days per patient was Rs. 800 ($ 12). Conclusion: VAC seems to have revolutionary potential in the management of the difficult to treat infected wounds as far as its safety, speed and cost-effectiveness are considered.
Background Benign paroxysmal positional vertigo (BPPV) is considered to be the most common type of vertigo. There is strong evidence supporting the role of Dix Hallpike maneuver in diagnosing BPPV, and canalith repositioning maneuver CRM in managing it; but these maneuvers are underutilized. Material and methods: A prospective study was conducted in the Department of Neurology in a tertiary care center referral hospital in Kashmir, north India. All the patients of vertigo diagnosed as BPPV were included in study. History and examination was done and patients were followed to see the response of treatment. There referrals notes, previous records were checked for the diagnosis, treatment and investigations done for managing their complaints were studied and recorded. Results: Out of total of 101 patients diagnosed as BPPV, 77 were females and 24 were males with M:F ratio as 1: 3.2 . The frequency of various subtypes of BPPV were: posterior canal in 96 patients, horizontal canal in 4 and anterior canal in one. On reviewing records of patients only 10% of had been given diagnosis of BPPV .All patients had been treated with labyrinthine sedatives and other medications and none had been offered CRM.84% patients had undergone various unnecessary investigations . Conclusion. A vast majority of patients with BPPV don’t get an accurate diagnosis in their first contact with health care professionals. Most of the patients undergo unnecessary investigations .CRMs like Epley’s maneuver are not offered to BPPV patients even though they are the standard of care in this condition.
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