Recurrent madura foot without draining sinuses: a case report

Madura foot or mycetoma is a chronic granulomatous disease characterized by localized infection of subcutaneous tissues by actinomycetes or fungi. The recurrence rate for the disease if treated inadequately is very high. Recurrence presents with swelling and multiple discharging sinuses. This is an unusual presentation of the disease without discharging sinuses which is probable the first report of this kind in the literature. A 34 year old, male, presented with the painless, progressive swellings over right foot since 4 years. No sinuses or discharge could be found on skin surface. The postoperative recurrence rate is very high, and this can be local or distant at the regional lymph nodes. This could be due to the disease biology and behavior or inadequate surgical excision. Usually it presents with multiple sinus tracts, and granule. We reported a case with classical absence of sinus tracts in recurrent actinomycosis

Pattern of diabetic foot - presentation and complications in rural Indian population

Background: Foot ulcer is one of the most common and deadest complications of diabetes mellitus. This is also a frequent cause of hospitalization and disability. Most of the patients with diabetic foot ulcers living in developing countries present to healthcare facilities fairly late with advanced foot ulcers because of poor economic status, inadequate knowledge of self-care, sociocultural reasons and poor and inadequate diabetes healthcare.Methods: A prospective study was conducted in the department of Surgery, JNMC Sawangi (Meghe), Wardha of DMIMS (DU) with the aim to evaluate the pattern of distribution of foot ulcers in diabetic foot patients and related complications. We enrolled 30 diabetic patients in the study, of these 21 (70%) were males and 9 (30%) were females with male to female ratio 2.33.  Results: The mean age of presentation was 52.93 ± 14.10 and the mean duration of diabetes was 8.20 ± 10.06. The maximum numbers of lesion was present in the region of second to fifth metatarsal (53.33%), followed by heel (26.66%) and great toe (10%). Maximum patients 9 (30%) had grade II lesions as per Wagner’s classification and 12 (40%) had II B as per University of Texas diabetic wound classification. Associated deformity was present in 36.66%, insensitivity to the 5.07 S-W monofilaments in 56.66%, impaired vibration in 43.33%, and abnor­mal Achilles tendon reflex in 40%. Ankle–brachial index <0.8 was present in 33.33%. Only 13.33% patients were using customized footwear whereas 46.66% were walking barefoot, the difference was statistically significant P = 0.0027.Conclusion: The health education to promote Knowledge, Attitude, Behavior and Practice (KABP) is essential to prevent diabetes associated foot complications.

Predictors of urinary retention in benign prostate hyperplasia

Background: Acute urinary retention (AUR) is one of the most significant complications or long-term outcomes of benign prostatic hyperplasia (BPH). Because of the high prevalence of BPH and its effect on the patient's quality of life, additional research is needed to better predict the risk factors of AUR. The study was aimed to find out the incidence and factors responsible for retention of urine in BPH.Methods: It was a prospective study, conducted at a medical college after the approval from IEC. The study included the patients admitted to the surgical wards admitted with the symptoms of lower urinary tract symptom and presented with acute urinary retention. Duration of the study was 2 months. A total 40 patients were studied over this duration. The outcome of the study was analyzed by these factors: Age in years, Symptom severity, Prostate Volume on DRE and USG Grade.Results: The mean age of presentation was 64.87±7.85 with median age of 65 years (range 45-82 years) with mean IPSS score of 17.45and the mean PVR was 110.80 ± 85.52 with median 110 (range 0-500). Maximum number of patients having Grade 3 and 4 enlargements had PSA level 9-12 ng/ml. The PSA levels and the grade of enlargement on USG were statistically significant (p-0.004).Conclusions: Out of the four factors considered to be the independent risk factors, all of them have positive correlation with the symptom of acute urinary retention. None of these four factors i.e. age in years, symptom severity, prostate Volume on DRE and USG grade could establish significant correlation.

Site selection for vascular access creation in hemodialysis in end stage renal disease

Background: Chronic kidney failure is characterized with progressive and irreversible diminishing of glomerular filtration rate. AVF has been unanimously considered the gold standard vascular access of choice for hemodialysis. Arterio-venous fistula (AVF) for hemodialysis should be created in patients with endogenous creatinine clearance < 20 mL/min/1,73m2. Aim of current study was to choose the proper site for arteriovenous fistula creation with minimal complications.Methods: It was a prospective study, carried out in the dept. of surgery from April 2008 to August 2013. A total of 140 patients were studied over the period. The fistulae were created using radial artery cephalic vein side to side and brachial artery cephalic vein side to side or end to side anastomosis. Statistical analysis used: Mean, Standard deviation, Standard error.Results: A total 140 patients were studied, out of them 104 were males and 36 were females. The radiocephalic site was used for 82 (58.57%) patients and 58 (41.43%) patients were operated on brachiocephalic site. The mean inner diameter of radial artery, brachial artery and cephalic vein (intima to intima) at elbow and wrist were 21.49001 ± 0.901 (SE - 0.28492), 3.72533 ± 1.06837 (SE - 0.30841) and 0.68079 ± 0.49551 (SE - 0.116790) respectively. The mean flows velocity of brachial and radial artery were 76.10526 ± 4.54477 (SE - 1.04264) and 52.64286 ± 5.5968 (SE - 1.495810) respectively. The success rate of AV fistula on table was 97.85% (137 out of 140). The incidence of complication was 18.57%.Conclusion: The site for fistula creation depends on the quality of the artery and vein. To achieve good success rates preoperative color Doppler is essential to evaluate the vessels. The complication rates can be minimised by following standard operating protocols.

Citation Context Sentiment Analysis for Structured Summarization of Research Papers

Abstract. Structured tabular summarization tremendously helps humans understand a topic, e.g. Wikipedia infoboxes. However, few methods exist to generate summary of research papers although it is time taking and painstaking to read a paper and even more difficult to infer its merits and limitations. We propose a method to generate structured summary of research papers. We turn to opinion of citing papers, because they are shown to be more focused than abstracts and contain additional information. This paper is a first step towards structured summarization of research papers using citing papers.

Hashimoto's encephalopathy versus catatonia: A diagnostic dilemma

Hashimoto's encephalopathy is a rare life-threatening disease entity with clinical presentation like psychiatric as well as neurological diseases, thus making it a challenging clinical scenario for physicians leading to delay in diagnosis and management of the patient. The incidence overall is under-estimated because of low overall awareness about the disease. Here, we report a 44-year-old female who was being treated for psychiatric disorders because of clinical presentation like catatonia but ultimately was diagnosed with Hashimoto's encephalopathy and responded very well to steroids

Relationship of Gallbladder Perforation and Bacteriobilia with Occurrence of Surgical Site Infections following Laparoscopic Cholecystectomy

Aim. To assess the occurrence of SSIs in patients with spillage of gallbladder contents and bacteriobilia during laparoscopic cholecystectomy. Methods. We evaluated 113 patients who underwent laparoscopic cholecystectomy between September 2013 and April 2015. The SSIs and their relationship with gallbladder rupture and bacteriobilia were assessed. Results. The mean age of patients developing SSIs was 45.57 ± 8.89 years. 18 patients (16%) had spillage of bile from the gallbladder. Percentage of SSIs overall was 6%, while percentage of SSIs in gallbladder content spillage was 5.5%. Organism profile of the culture from surgical site showed monomicrobial infection: 58% Staphylococcus aureus, 14% Pseudomonas, and 14% E. coli. The occurrence of SSIs in patients with bacteriobilia was 16% as compared to 2% in patients without bacteriobilia. Conclusions. Gallbladder content spillage is not a significant risk factor leading to increase in SSIs. The occurrence of SSIs is significantly higher in patients with bacteriobilia

Predictors of urinary retention in benign prostate hyperplasia

Background: Acute urinary retention (AUR) is one of the most significant complications or long-term outcomes of benign prostatic hyperplasia (BPH). Because of the high prevalence of BPH and its effect on the patient's quality of life, additional research is needed to better predict the risk factors of AUR. The study was aimed to find out the incidence and factors responsible for retention of urine in BPH.Methods: It was a prospective study, conducted at a medical college after the approval from IEC. The study included the patients admitted to the surgical wards admitted with the symptoms of lower urinary tract symptom and presented with acute urinary retention. Duration of the study was 2 months. A total 40 patients were studied over this duration. The outcome of the study was analyzed by these factors: Age in years, Symptom severity, Prostate Volume on DRE and USG Grade.Results: The mean age of presentation was 64.87±7.85 with median age of 65 years (range 45-82 years) with mean IPSS score of 17.45and the mean PVR was 110.80 ± 85.52 with median 110 (range 0-500). Maximum number of patients having Grade 3 and 4 enlargements had PSA level 9-12 ng/ml. The PSA levels and the grade of enlargement on USG were statistically significant (p-0.004).Conclusions: Out of the four factors considered to be the independent risk factors, all of them have positive correlation with the symptom of acute urinary retention. None of these four factors i.e. age in years, symptom severity, prostate Volume on DRE and USG grade could establish significant correlation.