Comparative evaluation of Super-oxidized Solution and Povidone Iodine solution in Management of Infected Diabetic Ulcers

  Background: Diabetic foot ulcer is a moving issue to each clinician in everyday practice. Super-oxidized Solution is a more up to date idea in the wound management.  Aim: The current investigation was attempted to compare the effectiveness of  super-oxidized preparations and povidone iodine in the management of infected diabetic ulcers. Materials and methods: This prospective study was conducted on a total of 60 patients presenting with infected diabetic ulcers. Patients were divided into two groups of 30 each based on computer generated randomization that is, group A (Topical super-oxidized solution dressing) and group B (Topical povidone iodine dressing). Wound was observed for decrease in size of the ulcer, granulation, tissue quality and discharge from the wound at the end of each week for two weeks. Results: In the present study, 76.67% of patients in group A and B were males and the male to female ratio was 3.2:1. The mean group A was 55.90 ± 14.27 years compared to 51.50 ± 13.18 years in group B. Type 2 diabetes was present in 96.67% and 93.33% of patients in group A and B. The mean initial ulcer area in group A was 3882 ± 1890 mm2 compared to 3992 ± 2000 mm2 in group B. The mean final area in group A was significantly low (1607 ± 862 mm2) compared to group B (2351 ± 1240 mm2; p=0.009) and the comparison of mean change in ulcer area was significantly high in group A compared to group B (2215 ± 1060 mm2 vs 1641 ± 856 mm2; p=0.024). The mean percentage reduction in  ulcer among patients with group A was significantly high (58.90±5.21percent vs.40.90±8.76 percent; p=0.024).The commonest organism isolated in group A was Escherichia coli (26.67%) and in group B, it was staphylococcus. The culture was positive in 26% of the patients in group A compared to 50% in group B (p=0.063).Conclusion : Overall, topical super-oxidized solution dressings accelerated the healing process resulting in faster recovery through reduction in ulcer area in patients infected with diabetic ulcers compared to topical povidone iodine dressing

A Comparative Study to Evaluate thePeri-Operative and Post-Operative Complications of Vaginal and Abdominal Hysterectomy

Background: Abdominal and vaginal hysterectomies are the two predominant operative modalities for various uterine conditions; however the indications for selecting a particular procedure in any setting may not be optimally defined. Aim: This study was undertaken to evaluate the appropriate route of hysterectomy (abdominal or vaginal) in a hospital population for women with benign disease by comparing peri-operative and post-operative complications. Materials and Method:Eighty subjects were equally divided into vaginal and abdominal hysterectomy groups by convenience (non-probability) sampling. The primary outcome measures were operative time, primary haemorrhage, wound infection, post-operative analgesia, febrile morbidity, hospital stay and secondary haemorrhage; secondary outcome measure were re-admission and reopening.Results: There were no differences in the patients’ mean age, parity, body mass index, and preoperative haemoglobin levels between groups. Vaginal hysterectomy was associated with less febrile morbidity, wound infection operative time, bleeding requiring transfusion and re-admission than abdominal hysterectomy. Main indication for women having abdominal operation was leiomyomas, whereas more women having uterovaginal prolapse had vaginal hysterectomy. Conclusion: Patients requiring a hysterectomy for benign lesions having a moderate-sized uterus can be offered vaginal route for surgery

Evaluation of the efficacy of Ormeloxifene in DUB

Background: Dysfunctional uterine bleeding (DUB) is a common gynaecological disorder that usually ends up in hysterectomy and causes psychological and physiological stress. Medical management with hormones and NSAIDS has inherited side effects. Ormeloxifene, a selective estrogen receptor modulator, is emerging as a safe and effective agent for dysfunctional uterine bleeding. The objective of the study was to evaluate the role of ormeloxifene in medical management of dysfunctional uterine bleeding.Methods: 60 patients, on whom diagnosis of dysfunctional uterine bleeding was made, were included in the study. Patients were given ormeloxifene 60mg. The primary outcome measures were menstrual blood loss (assessed by pictorial blood assessment chart score), hemoglobin concentration and endometrial thickness. The secondary outcome measures were acceptability and side effects of ormeloxifene.Results: There was a significant reduction in mean PBAC after treatment. The mean hemoglobin concentration increased significantly. The mean pretreatment endometrial thickness decreased significantly after treatment with ormeloxifene (p < 0.05). 76.7% of the women showed marked subjective improvement in symptoms. The most common side effect reported was amenorrhea (13.3%).Conclusion: Ormeloxifene can be considered as an effective and safe therapeutic option for the medical management of dysfunctional uterine bleeding

A Prospective Study to Evaluate the Prevalence of Bacterial Profile and its Antibiogram

Background: The bacterial profile and the antibiotic pattern of the wound infections may change from time to time and place to place. Emergence of antimicrobial drug resistance has made the treatment of these wound infections very difficult. Aim: The aim of the study was to identify the prevalent bacterial profile and its antibiogram in our area. Materials and Methods: Pus samples from various sites were collected aseptically from 828 patients and were subjected to isolation and identification of aerobic bacteria by standard technique and subsequently antibiogram was carried out by Kirby-Bauer method. Results: Of the 828 clinical samples, 458 showed growth. Staphylococcus aureus was the most common organism isolated (37%), followed by Escherichia coli (21%), Klebsiella (17%), Pseudomonas (8%) among others. S. aureus was found to be highly resistant to penicillin, ampicillin, and erythromycin, while being sensitive to linezolid and vancomycin. On the other hand, of the gram-negative bacilli isolated, E. coli was found to be more common, followed by Klebsiella, Pseudomonas, Proteus, and Acinetobacter. They were all found to be highly resistant to cephalosporins and fairly sensitive to aminoglycosides and carbapenems. Conclusion: This study shows that in spite of the topographical diversity, the infecting bacterial isolates and their antibiogram from this area are found to be similar to those found in any other part of India