Role of Negative Pressure Wound Therapy in Healing of Diabetic Foot Ulcers

Introduction: Foot disorders such as ulceration, infection and gangrene are the most common, complex and costly sequelae of diabetes mellitus.[1-3] Even for the most superficial wounds, treatment is often difficult with poor healing responses and high rates of complications. The purpose of this study is to compare the rate of ulcer healing with the negative pressure dressing technique to conventional moist dressings in the treatment of diabetic foot ulcers. Materials and Methods: The study was conducted on 30 patients, which were divided into two groups. One group received negative pressure dressing while other group received conventional saline moistened gauze dressing. Results were compared for rate of wound healing. Results: There was a statistically significant difference in the rate of appearance of granulation tissue between the two groups; with granulation tissue appearing earlier in the study group. The study group promised a better outcome (80% complete responders) as compared to the control group (60% complete responders). Conclusions: Negative pressure wound therapy has a definitive role in healing of diabetic foot ulcers

Case Report - Long-standing extrusion of calculus: A rare complication of urolithiasis

There have been reports of extrusion of ureteric or vesical calculi causing various complications. Extrusion of a urinary calculus is an uncommon complication of urolithiasis. It may occur in cases of ureteral obstruction with spontaneous rupture of proximal dilated ureter and subsequent extrusion of the calculus leading to urinoma formation and sepsis. Here, we are presenting a case with long-standing spontaneous extrusion of a urinary calculus which was lying in the left pararectal region in the hollow of the sacrum

Simplified criteria for predicting the severity of gallstone pancreatitis

BACKGROUND: There was a need for a simple method of predicting the severity of gallstone pancreatitis soon after admission, to guide the clinician for intensive monitoring, or for transfer to a specialist center. AIM: To validate the role of simplified criteria [white blood cell count (WBC) 65 14.5 x 103/dl; blood urea nitrogen (BUN) 65 12 mg/dl; random blood sugar (RBS) 65 150 mg/dl; pulse 65 100/min] in predicting the severity of gallstone pancreatitis at admission. SETTING AND DESIGN: This prospective study was performed on 54 patients with gallstone pancreatitis admitted in the Department of Surgery of a tertiary hospital. MATERIAL AND METHODS: Fifty-four patients with gallstone pancreatitis were followed for development of complications. Sensitivity analysis of Biliary Ranson 65 3, modified Imrie 65 3, acute physiology and chronic health evaluation II (APACHE-II) score of 65 5, WBC 65 14.5 x 103/dl, BUN 65 12 mg/dl, RBS 65 150 mg/dl, pulse 65 100/min and combinations of the four simplified criteria were compared using the Z -test. P < 0.05 was considered statistically significant. RESULTS: Both Biliary Ranson 65 3 and modified Imrie 65 3 had sensitivity of 96.15% and specificity of 96.43%. Both APACHE-II 65 5 and RBS 65 150 mg/dl had sensitivity of 88.46%, which is comparable to Biliary Ranson 65 3 and modified Imrie 65 3. CONCLUSION: RBS > 150 mg/dl can be used as a simplified prognostic indicator at admission in patients with gall stone pancreatitis and is comparable to Biliary Ranson 65 3, modified Imrie 65 3, and APACHE-II of 65 5