Diabetic foot resulting in amputation: our experience

Background: The aim of our study was to early diagnosis of diabetic foot so that the complications can be prevented, to control the systemic infection and prevent the complications, to study the effectiveness of regular dressing in diabetic foot so as to prevent the local spread of infection and the ulcer and to conclude that early diagnosis, care and proper meticulous treatment of diabetic foot can prevent amputation. Methods: The present study was prospective, observational and longitudinal. Protocol of the procedure was formed along with Performa, Patient Information Sheet, Informed Consent Form and approval from Ethical Committee. The present study was carried out in surgery department of C.U Shah medical college, Surendranagar; Gujarat state. The study was carried out from 1st August 2011 to 30th September 2013. A total of one hundred patients admitted in surgery ward with diabetes type 1 or 2 with ulcer on foot having grade 1 or 2 of Wagner’s classification without any other co morbid condition. These patients undergo daily dressing with various dressing solutions according to their ulcer characteristics. All the patients given diet/oral hypoglycaemic drug/insulin for control of diabetes. Antibiotics given according to the infective status of the patients. Patients were either completely treated, went under skin grafting or ended up with amputation were recorded.Results: Of 100 cases studied, youngest patient was 32 years and oldest was 80 years of age. Highest number of cases was found in the age group 61-70 years (30%). Of the 100 cases studied in this series 36 (36%) patient were having Wagner’s class 1 ulcer and 64 (64%) patient having class 2 ulcers. Of 100 cases, various surgical treatment given to the patients according to the ulcer. In that 65(65%) debridement, 20 (20%) Incision & drainage, 10 (10%) STG, 5 (5%) fasciotomy. Most of the patients were undergone basic surgical procedure which is debridement on the 7th day follow up, out of 100 cases 70 patients came for follow up. Out of 70, all patients having healing ulcer. Out of 70 patients, 15(21.43%) patients were underwent STG on 15th day and other 55 (71.57%) patients having healing ulcer advised daily dressing with follow up after 1 week. Out of 30 patients, 3 (10%) patients underwent amputation on 7th day of follow up. On the 15th day new 5 (16.67%) patients underwent amputations, so total number of amputation done till date was 8 (26.67%). On 21st day, new 7 (23.34%) patients were underwent amputations and total number of amputations till date were 15 (50%). On 30th day, new 15 (50%) patients underwent amputations.Conclusions: Foot ulceration in diabetic patients is a resource consuming, disabling morbidity that often is the first step towards lower extremity amputation. Prevention is the best treatment.

Histomorphological evaluation of colon lesions

Background: Both macroscopic and microscopic appearance helps in identification of the colon lesion which supports in the treatment of the patient in a better way. The authors were aimed at the prevalence of various colon lesions site wise distribution of various neoplastic and non-neoplastic lesions of the patients and to compare the distribution according to their age, sex and site.Methods: A retrospective study was designed to study of various intestinal biopsies sent for histopathological examination at Department of Pathology, N.H.L. Municipal Medical College and V.S. Hospital, Ahmedabad, from January 2015 to December 2016 for period of 2 years. The study was based on the histomorphological evaluation of colon lesions received during the study period.Results: A male preponderance was seen in the incidence of tumors irrespective of tumor type and site of tumor and M:F ratio was 1.64:1. In the large intestine, adenocarcinomas were the commonest malignant tumor. 46 cases (62.61%) were reported. The highest occurrence of appendicitis is in the 2nd and 3rd decade.Conclusions: The study revealed that various types of lesions in large intestine along with the age group and gender affected more. Male patients were majorly affected. Morphological identification helped to diagnose the type of lesion for early diagnosis. This study focuses the role of histopathological identification in early diagnosis of the disease so that the survival rates in such cases will be increased

Posterior wall repair by continues suturing in inguinal hernia meshplasty

Background: The conventional method of suturing mesh to posterior wall in inguinal meshplasty is by interrupted sutures. Technique of suturing mesh by continues sutures is a new concept and requires surveillance. Aims: To observe and scrutinize the technique in the form of simplicity, post-operative complication and anatomical reconstruction. Material & Methods: Patients having inguinal hernia were operated upon by present technique of posterior wall repair with continuous suturing in inguinal hernia meshplasty were selected for the study. Patients were observed in pre operative, intra operative and post-operative period & when they attend out-patient clinics. Data was collected in prescribed format& statistically analyzed to draw the conclusion. Result: Out of 20 patients, 19 patients are male and 1 patient is female. The highest incidence was in the 5th& 6th decade of life. No patients were found having major wound infection, seroma formation, or recurrence of hernia. 20 patients (100%) attended our follow up which ranged from 3 months to 6 months. 15 patients (75%) attended the OPD personally for follow up. Remaining 5 patients (25%) were questioned over the telephone and their response recorded. The average hospital stay recorded was 5-6 days. No recurrence was encountered in the follow up group. Conclusion: This technique of suturing of posterior wall repair with continuous suturing in inguinal hernia meshplasty was found to be technically simple, leading to least post op complications and attaining its goal of curing the inguinal hernia by good anatomical reconstruction

21 A RETROSPECTIVE STUDY OF CORRELATION BETWEEN DEPTH OF MALIGNANT TONGUE ULCER AND CERVICAL METASTASIS

<p>24A | 38 | JAN 2022 | IJABMS</p><p>Medical Journal Research Article</p><p>21 A RETROSPECTIVE STUDY OF CORRELATION BETWEEN DEPTH OF MALIGNANT TONGUE ULCER AND CERVICAL METASTASIS</p&gt

Prevalence of Depression amongst Higher Secondary School Adolescents in Bhopal Madhya Pradesh

Context: Depression in adolescents is an under recognized mental health problem. It can results into suicide, school drop-out, pregnancy, antisocial behavior, substance abuse, progress in to adult depression, functional disability and significant impairment. Objectives: To find out prevalence of depression and to study the associated risk factors. Settings and Design: A Cross-sectional study was carried out in a higher secondary school in Lady Bhore (Urban Health Centre) catchment area of Bhopal. Methods and Material: The study was started after taking permission from head of the department and from principle of the school. Students were briefed about the study and verbal consent was obtained from every student. Data was collected by standard tool- BDI and some self-generated questionnaire. Results: A total of 136 students were included in the study. 60 (44.1%) of study participants were found to have scores corresponding to mild degree of depression and 33(24.3%) were suffering from moderate depression whereas 3% were suffering from severe depression. Conclusions: This study highlights the common but ignored problem of depression in adolescence. We recommend that teachers and parents should be made aware of this problem with the help of school counsellors so that the depressed adolescent can be identified and helped rather than suffer silently

Targeting pannexin1 improves seizure outcome.

Imbalance of the excitatory neurotransmitter glutamate and of the inhibitory neurotransmitter GABA is one of several causes of seizures. ATP has also been implicated in epilepsy. However, little is known about the mechanisms involved in the release of ATP from cells and the consequences of the altered ATP signaling during seizures. Pannexin1 (Panx1) is found in astrocytes and in neurons at high levels in the embryonic and young postnatal brain, declining in adulthood. Panx1 forms large-conductance voltage sensitive plasma membrane channels permeable to ATP that are also activated by elevated extracellular K(+) and following P2 receptor stimulation. Based on these properties, we hypothesized that Panx1 channels may contribute to seizures by increasing the levels of extracellular ATP. Using pharmacological tools and two transgenic mice deficient for Panx1 we show here that interference with Panx1 ameliorates the outcome and shortens the duration of kainic acid-induced status epilepticus. These data thus indicate that the activation of Panx1 in juvenile mouse hippocampi contributes to neuronal hyperactivity in seizures

Promises and pitfalls of a Pannexin1 transgenic mouse line.

Gene targeting strategies have become a powerful technology for elucidating mammalian gene function. The recently generated knockout (KO)-first strategy produces a knockout at the RNA processing level and also allows for the generation of conditional KO alleles by combining FLP/FRT and Cre/loxP systems, thereby providing high flexibility in gene manipulation. However, this multipurpose KO-first cassette might produce hypomorphic rather than complete knockouts if the RNA processing module is bypassed. Moreover, the generation of a conditional phenotype is also dependent on specific activity of Cre recombinase. Here, we report the use of an efficient molecular biological approach to test pannexin1 (Panx1) mRNA expression in global and conditional Panx1 KO mice derived from the KO-first mouse line, Panx1tm1a(KOMP)Wtsi. Using qRT-PCR, we demonstrate that tissues from wild-type mice show a range of Panx1 mRNA expression levels, with highest expression in trigeminal ganglia, bladder and spleen. Unexpectedly, we found that in mice homozygous for the KO-first allele, Panx1 mRNA expression is not abolished but reduced by 70% compared to that of wild-type tissues. Thus, Panx1 KO-first mice present a hypomorphic phenotype. Crosses of Panx1 KO-first with FLP deleter mice generated Panx1f/f mice. Further crosses of the latter mice with mGFAP-Cre or NFH-Cre mice were used to generate astrocyte- and neuronal-specific Panx1 deletions, respectively. A high incidence of ectopic Cre expression was found in offspring of both types of conditional Panx1 KO mice. Our study demonstrates that Panx1 expression levels in the global and conditional Panx1 KO mice derived from KO-first mouse lines must be carefully characterized to ensure modulation of Panx1 gene expression. The precise quantitation of Panx1 expression and its relation to function is expected to provide a foundation for future efforts aimed at deciphering the role of Panx1 under physiological and pathological conditions