Introduction: Diabetic foot may be defined as a group of syndromes in which neuropathy, ischemia and infection lead to tissue breakdown, resulting in morbidity and possible amputation. Foot problem remains very common in people with diabetes throughout the world, affecting up to 15% of diabetic patients during their life time. The aim of this study is to assess the various presentations of diabetic foot ulcers and surgical management. Materials and Methods:This is a hospital based prospective observational study conducted in 50patients of diabetic foot ulcers admitted in the department of General Surgery at Zoram Medical College (ZMC), Falkawn, Mizoram during the period of November 2017 to December 2021. All patients with diabetes mellitus suffering from foot ulcers of all age groups, incidental diagnosis of diabetes with foot ulcers, patients with gangrenous foot complicated by diabetes are included.Patients with foot infections or gangrene foot without diabetes mellitus or incomplete treatment are excluded. Results: The commonest presentation in this study is ulcer followed by gangrene and abscess. The most common site of lesion is toes (42%) followed by dorsum of foot (30%) and planter of foot (16%). 72% of patients (36) had neuropathy, 14% had vasculopathy and 10% had both. 30 (60%) patients are healed by debridement and dressing alone, 11 (22%) patients need amputation or disarticulation to heal. Skin grafting is done in 9 patients. No patient dies of the ulcer. Conclusion: Diabetic foot ulcer is a complication of prolonged diabetes mellitus which increases with age and duration of the disease. The surgical management of diabetic foot ulcers should be based on the knowledge of pathophysiology of diabetes and practice of new treatment modalities.
Introduction: Acute appendicitis is the most common general surgical emergency. Appendicectomy is the treatment of choice for acute appendicitis and the most commonly performed emergency abdominal operation. Open appendectomy is found safe and effective operation with low morbidity but found to be associated with post operative pain, wound infection and complications like intestinal obstruction which may delay recovery. Laparoscopic appendectomy emerged as a good option for treatment of appendicitis. The purpose of this study was to compare the laparoscopic versus open approach among patients with appendicitis in our centre. Materials And Methods: This study was a prospective study of 100 patients with clinically diagnosed as appendicitis admitted in the department of General Surgery, Unit II, Zoram Medical College for a period of two years during November 2019 to October 2021. They were divided into two groups - Open Appendectomy (OA) group and Laparoscopic Appendectomy (LA) group of 50 patients each. Age ranges from 10yrs to 75yrs. Exclusion criteria were pregnant female, chronic medical problems, haemodynamically unstable or psychiatric illness, cirrhosis, coagulation disorders, patients on steroid, immuno-compromised patients, patients on chemotherapy for malignancy and those who are not willing to participate. OA was performed through standard Mc Burney incision. LA was performed through a standard 3 ports technique. Results: The most common presentation of appendicitis is abdominal pain followed by nausea/vomiting and common in younger age group of 10-20 years. Laparoscopic Appendectomy was found as safe and effective as Open Appendectomy. LA has more acceptable cosmetic result, shorter hospital stay and less postoperative pain. The pain score was significantly reduced in LA group (3.2+-1.4) and in OA (4.1+-1.8). Conclusion: LA was found as safe and effective as OA. LA has more acceptable cosmetic result, shorter hospital stay and less postoperative pain.
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