ABSTRACT
Background: Diabetes mellitus is as old as mankind and perhaps humans know it from early ages. It is one of the most deeply studied diseases and is still un-understandable ailment that humans deal with. As we are digging deeper into the molecular basis of the disease, mind boggling results are coming out. It is not a single disease but a constellation of diseases that it gives birth to i.e. the complications. The main aim of this study was to evaluate the ultimate outcome of patients who present with lower limb complications related to diabetes mellitus type – 2 by early surgical intervention and to prevent infections to establish and become deep seated and involve deeper structures like muscles, bones or joints and to minimize the chances of amputation by early intervention. This study was carried out in Maharaja Agrasen Medical College, Agroha, Hisar, Haryana, India. Material and methods: The present prospective study was carried out on 150 patients who were suffering from foot ulcers in type – 2 diabetes mellitus and were randomly selected. The selected patients were evaluated for the presence of complications like peripheral vascular disease, and Umesh Kumar Chhabra, Sandeep Kumar Goyal, Satish Kumar Bansal, Gopal Singal. Diabetic foot – A clinical study: Early surgical intervention is a key to early cure and rehabilitation in accordance with the international consensus on the Diabetic foot. IAIM, 2016; 3(1): 110-115. Page 111 neuropathy. The ulcers were swabbed, cultured and early surgical intervention was done after which wounds were dressed with either of the following: Saline gauze, Povidone-iodine, Hydrogel, Hydrocolloid base, Human Recombinant Platelet derived Growth Factor. Results: 150 patients (100%) required early debridement, 83 patients (55.33%) required Split Skin Grafting, 5 patients (3.33%) required flap, 38 patients (25.33%) did not require any further surgical treatment and their wounds healed with dressing alone, 24 patients (16%) required amputation. Conclusions: Patient characteristics, such as sex, age, poor glycemic control, presence of peripheral vascular disease, peripheral neuropathy and delayed surgical intervention have a poor outcome in form of complete wound healing in patients with Diabetic foot.
ABSTRACT
Background: Since the introduction of male sterilization by surgery on deferens, several techniques have emerged to improve the results in terms of time, invasiveness, post operative infection, complications and success rate. Introduction: Vasectomy was introduced by Sharp in 1897. No scalpel vasectomy was introduced in China by Dr. Li Shun-Qiang in 1974. Intact fascial sheath helps in restoration of vas lumen and fascial sheath interposition prevents recanalization of vas by prevention of meeting of epithelialization from cut end of vas. Material and methods: The study was performed at PGIMS, Rohtak by performing surgery and follow-up up to one year of 326 subjects of no scalpel vasectomy. Clients were allocated in two groups. Group - A (155) with fascial sheath interposition and Group - B (171) without fascial sheath interposition. Surgeries were performed as a routine surgical procedure after full preparation of client including consent. Results: Majority of clients (56.1%) in Group - A were in age group 31-40 years followed by 22-30. years (28.4%), 41-50 years (14.8%) and 0.7% in age group more than 50 years. in Group - B, majority were also in age group 21-30 years (63.7%), followed by 31-40 years (29.8%), 41-50 years(5.9%) and 0.6% were of above 50 years. In Group - A, fascial sheath interposition was not possible in 17.2% clients due to non separation of sheath from vas. Sperm granuloma formation was observed in 8.6% in Group - A and 5.6% in Group-B. In comparison of 100% success rate in Group - A failure rate of 1.8% was observed in Group - B. Conclusion: The present study supports the existing literature that fascial sheath interposition adds a little more to the operating time of vasectomy, increases chances of wound infection and granuloma but has a less failure rate of vasectomy.