Comparative study of vacuum-assisted closure therapy versus vacuum-assisted closure therapy supplemented with vitamin C in compound wound healing

Background: It is imperative for early and precise management of the compound wound for preventing further complication and delaying definitive management. As we all know superiority of vacuum assisted closure (VAC) therapy in wound management over any other method, but adding vitamin C has been shown to accelerate wound healing, reducing hospital stay, and cost of management and prevention of delaying definitive management of wound due to some conspicuous property of vitamin C that serve as superior adjuvant in wound healing. Methods: A case series of 40 patients who have been inflicted with compound wounds with most following road traffic accidents. We then categorised patients and tried to observe any difference in rate of satisfactorily healing of wound with 20 patients put on VAC therapy alone and other 20 patients put on VAC therapy supplemented with vit C. Results: Patients who were undergoing VAC dressing and supplemented with vitamin C, not only portrayed a better result of wound healing but also reduced the amount of vacuum dressing sittings. Conclusions: It was observed that, in general, patients who were undergoing VAC dressing and supplemented with vitamin C, not only portrayed a better result of wound healing but also reduced amount of vacuum dressing sittings, improved rate of granulation tissue, reduced hospital stay, early definitive fixation of associated fracture and skin grafting and showed superior outcomes in terms of better tissue recovery

A prospective study of the functional outcome of 3 stitch technique in a compound humerus shaft fracture

Background: Intramedullary nailing of compound shaft humerus fractures has been an innovative and surgically friendly technique to deal with extensive soft tissue injury that impedes open reduction and internal fixation. The purpose of this article is to highlight the minimally invasive technique of intramedullary humerus nailing to prevent the perioperative and postoperative complications encountered. A 1 year follow up of all the patients have shown functionally excellent results and good surgical outcome. Methods: We have conducted this prospective study from Jan 2020 to Jan 2022 at DR. D.Y. Patil medical college and hospital. Informed consent from each patient was taken explaining the methods of study and probable complications.  By this 3-stitch technique we have treated 25 adult patients sustaining post traumatic compound humerus shaft fractures by Antegrade humerus nailing. We have included compound injury upto type 3A (Gustilo-Anderson classification). Results: Out of the 25 patients, 23 patients showed functionally excellent outcomes with good compliance to rehabilitation protocol but 2 patients had delayed wound healing of which 1 patient had undergone VAC therapy, which later healed well after a period of 2-3 weeks with sequential dry dressings. None have gone into nonunion. Conclusions: Our study suggests that the 3-stitch technique is a good alternative method compared to external fixators and other various surgical techniques and yields good results with lesser complications and better cosmetic outcomes in compound injuries

Prospective study of radiological and functional outcomes of humeral mid-shaft fractures by anterior bridge plating technique

Background: The humerus can be considered the most versatile bone in the human body. Can be successfully approached by a variety of methods for fracture fixation including functional bracing, plating (posterior, lateral, and anterior), and intramedullary nailing (antegrade and retrograde). Notably, many humeral fractures can be successfully managed conservatively due to the wide range of acceptability for reduction. Anterior bridge plating (ABP) which utilizes the minimally invasive approach popularly known as the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique can be said to be the latest entrant in this list. The present study was undertaken to evaluate the efficacy of ABP. Methods: The study was carried out from July 2020 to July 2022 in DR. D. Y. Patil medical college and hospital, Nerul, Navi Mumbai, involving 32 patients who met the selection criteria and were operated at the tertiary care centre. Informed consent was obtained from all the patients for use of their clinical and imaging data. Ethical committee approval was taken. The assessment of the patients was done based on functional and radiological outcomes periodically. Results: Majority of patients belongs to age group 18-25 years (46.87%). Majority of side of injury were found right side (65.62%). In most of the cases, the extent of the displacement of fractures were 2-5 cm (71.87). Conclusions: In conclusion ABP is a very good technique in treating mid-shaft humeral fractures with minimal soft tissue dissection, smaller scars, and early return to overhead activities

Epidemiology and risk factors of chronic kidney disease in India – results from the SEEK (Screening and Early Evaluation of Kidney Disease) study

Background: There is a rising incidence of chronic kidney disease that is likely to pose major problems for both healthcare and the economy in future years. In India, it has been recently estimated that the age-adjusted incidence rate of ESRD to be 229 per million population (pmp), and >100,000 new patients enter renal replacement programs annually. Methods: We cross-sectionally screened 6120 Indian subjects from 13 academic and private medical centers all over India. We obtained personal and medical history data through a specifically designed questionnaire. Blood and urine samples were collected. Results: The total cohort included in this analysis is 5588 subjects. The mean ± SD age of all participants was 45.22 ± 15.2 years (range 18–98 years) and 55.1% of them were males and 44.9% were females. The overall prevalence of CKD in the SEEK-India cohort was 17.2% with a mean eGFR of 84.27 ± 76.46 versus 116.94 ± 44.65 mL/min/1.73 m2 in non-CKD group while 79.5% in the CKD group had proteinuria. Prevalence of CKD stages 1, 2, 3, 4 and 5 was 7%, 4.3%, 4.3%, 0.8% and 0.8%, respectively. Conclusion: The prevalence of CKD was observed to be 17.2% with ~6% have CKD stage 3 or worse. CKD risk factors were similar to those reported in earlier studies. It should be stressed to all primary care physicians taking care of hypertensive and diabetic patients to screen for early kidney damage. Early intervention may retard the progression of kidney disease. Planning for the preventive health policies and allocation of more resources for the treatment of CKD/ESRD patients are imperative in India