Comparison between role of honey dressing and oxoferin [tetrachlorodecaoxide] dressing in the management of infected wounds in diabetic amputated limbs

Introduction: Diabetic ulcer is a very common entity encountered in the general surgical practice. The problem needs keen interest and meticulous wound care for its management to prevent serious complications of these infected and gangrenous ulcers

Objective: The objective of the study was to compare the efficacy of honey dressing and oxoferin [tetrachlorodecaoxide] dressing in the management of infected wounds in diabetic amputated limbs

Study design: Randomized clinical trial

Setting: Surgical Unit-IV of Districted head quarter hospital Faisalabad

Subjects and Methods: The total sample size comprises of 98 patients were divided into two groups A and B. Group A was treated with honey dressing while group B was treated With oxoferin [tetrachlorodecaoxide] dressing. Area of the wounds to be dressed was measured in two largest dimensions and noted in cm. Sterile gauzes soaked in commercially available tube packed honey and oxoferin [tetrachlorodecaoxide] solution were applied over the wounds. Outcome of the both methods were assessed by measuring of the size of the wound at presentation and then after one week

Results: Significant decrease in wound size in oxoferin group was in 24 patients [49%] and in honey group was in 11 patients [22.4%]

Conclusion: Although the clinical experience detailed in this study showed better results to oxoferin as compare to honey dressing, more quality randomised controlled trials are needed to provide evidence to encourage the use of honey in wound care

Association between periodontal disease and cardiovascular disease

Studies have supported the notion that subjects with periodontitis and patients with multiple tooth extractions as a result of chronic advanced periodontal disease [PDD] have a greater risk of developing Cardiovascular disease [CVD] than those who had little or no periodontal infection. Periodontitis may predispose affected patients to CVD by elevating systemic C-reactive protein level and pro-inflammatory activity in atherosclerotic lesions and accelerate development of cardiovascular diseases. Oral health variables including loss of teeth, positive plaque Benzoyl-D-LArginine- Naphthyl Amide test [BANA] scores, and compliant of xerostomia may by considered as risk indicators for CVD. Exact mechanism which links PDD and CVD has not been firmly established. The link between PDD and CVD may be attributed to bacteria entering blood stream and attaching to the fatty plaque in coronary artery and contributing to clot formation which can lead to heart attack. Inflammation caused by PDD increases the plaque build up. The association between the two disease entities is cause for concern. However, dental and medical practitioners should be aware of these findings to move intelligently to interact with inquiring patients with periodontitis. They should be urged to maintain medical surveillance of their cardiovascular status, and work on controlling or reducing all known risk factors associated with CVD, including periodontal infection

Minimally invasive open heart surgery an experience at nicvd

Objective: This study was done to show that open heart surgical procedures can be done through a small sternal incision. Design: This was a single center prospective study. Place and Duration of study: Department of cardiac surgery, National Institute of Cardiovascular Diseases, Karachi. The study was completed in two years i-e Jan 1998 to Dec 1999

Subjects and Methods: A total of 40 patients underwent open heart surgery via minimally invasive approach through a lower median sternotomy. Of these 22 patients had ASD Closures, 8 underwent CABG Surgery and 10 patients had MVR procedure. The approach was via a small incision 8-1 0cm in length from xiphoid upwards and asymetrical lower median sternotomy upto the 2[nd] 1. C. S. deviated from midline on to the right side

Results: 22 patients had ASD Closure of these 21 patients had secundum defects while 1 had sinus venosus defect. In IHD group 2 patients had single vessel disease and 6 patients had 2 vessel disease [LAD and RCA]. 10 patient had MVR of these 5 patient had MR while 5 had mixed lesions. These patients had less postoperative pain. Early mobilization was achieved. No incidence of sternal dehiscence was noted. The scar was cosmetically much better than the conventional sternotomy scar and was completely hidden under the shirt

Conclusion: Open heart surgery is possible through a minimally invasive procedure. The advantages of the procedure are less trauma, less postoperative pain, reduced risk of infection. Patient recovery is quick and excellent cosmetic result

Coronary artery bypass grafting surgery: a 22 years experience

This study presents the results of 3011 patients who underwent coronary artery bypass grafting [CABG] surgery at National Institute of Cardiovascular Diseases [NICVD], Karachi, from 1977 to 1998. Of the 3011 patients, 81 percent had triple vessel disease. A total of 9964 grafts were done in these patients with an average of 3.3 grafts per patient Post-operatively, morbidity was comparable to the western data. However, the incidence of post-operative wound infection was much higher. Mortality was 9.4 percent daring the first 5 years of study. It has dropped down to 3.2 percent in recent years