ABSTRACT
Background:Lumbar sympathectomy through radio ablation is a useful treatment of peripheral ischemia. However, clinical efficacy with respect to lower limb ulcers is not adequately established in the Indian population. The study was conducted to evaluate the role of radiofrequency ablation (RFA) of the lumbar sympathetic ganglia in healing of ischemic ulcers of the lower limb.Method:The prospective study with 63 patients registered in the General surgery department with lower limb ischemic ulcers between December 2017 July2019 were treated with RFA. Patients with cardiopulmonary disease, pregnant, congenital malformation, or skin infection at the site of intervention, or suffering from bleeding disorders, were excluded from the study. Clinical investigation of the wound was performed, and demographic data was collected. Comparative reduction in wound size was assessed through Friedman`s ANOVA (P<0.001). Difference in pain score, hospital stay, and walking distance were evaluated using Wilcoxon matched pair test (P<0.001), Unpaired t-test, and Paired t-test (P<0.05).Result:Majority of the patients were male (n=40) with a mean age of 60.93 SD14.34 years. Significant reduction in wound size, pain scores and hospital stay were observed post procedure(P<0.001). Number of RFA sessions was significantly associated with the size of the ulcer and Fontaine's classification 2 and 3 (P<0.0001).Conclusion:RFA of lumbar sympathetic ganglia is a potential treatment modality for lower limb ischemic ulcers.
Antecedentes: La simpatectomía lumbar a través de la ablación por radiofrecuencia es un tratamiento útil de la isquemia periférica. Sin embargo, la eficacia clínica con respecto a las úlceras en las extremidades inferiores no está adecuadamente establecida en la población india. El estudio se llevó a cabo para evaluar el papel de la ablación por radiofrecuencia (RFA) de los ganglios simpáticos lumbares en la curación de las úlceras isquémicas de la extremidad inferior. Método: El estudio prospectivo con 63 pacientes registrados en el departamento de cirugía general con úlceras isquémicas de las extremidades inferiores entre diciembre de 2017 y julio de 2019 fueron tratados con RFA. Los pacientes con enfermedad cardiopulmonar, malformación embarazada, congénita o infección de la piel en el lugar de la intervención, o que sufren de trastornos hemorrágicos, fueron excluidos del estudio. Se realizó una investigación clínica de la herida y se recopilaron datos demográficos. La reducción comparativa en el tamaño de la herida se evaluó a través del ANOVA de Friedman (P<0.001).Resultado: La diferencia en la puntuación del dolor, la estancia en el hospital y la distancia a pie se evaluaron mediante la prueba de par coincidente de Wilcoxon (P<0.001), la prueba t no emparejada y la prueba t emparejada (P<0.05). La mayoría de los pacientes eran varones (n-40) con una edad media de 60,93 SD14,34 años. Se observó una reducción significativa en el tamaño de la herida, las puntuaciones de dolor y la estancia hospitalaria (P<0.001). El número de sesiones de RFA se asoció significativamente con el tamaño de la úlcera y las clasificaciones 2 y 3 de Fontaine (P<0.0001).Conclusión: LA RFA de los ganglios simpáticos lumbares puede constituir una opción terapéutica para las úlceras isquémicas de las extremidades inferiores.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Ulcer/therapy , Lower Extremity , Radiofrequency Ablation/methods , Ganglia, Sympathetic , Ischemia/therapy , Prospective Studies , Analysis of Variance , IndiaABSTRACT
Introduction: In India it has been estimated that roughly one-third of women and two thirds of men use tobacco in any form (smoke or smokeless form).Awareness of the hazards of smokeless tobacco consumption is very low in rural populations. On the other hand, many believe that tobacco use has medicinal value for curing or palliating common ailments such as toothache, headache, and abdominal pain. Aimand objectives: 1.To know the prevalence of smokeless tobacco consumption among females of more than 15 years of age 2.To study the factors responsible for smokeless tobacco consumption among them. Material and methods: Study design:Across sectional study. Study setting: Rural HealthTraining Centre (RHTC) Kaladagi, Bagalkot. Study participants:Women more than 15 years of age in slum area ofRHTCKaladagi.(255) Statistical analysis: Chi square test. Results: In present study 17.6% of women were chewing tobacco. 88.89% of women were chewing tobacco because of toothache. There is association between tooth ache and tobacco consumption and it is statistically highly significant also. Chi-square value=190.8 (P<0.0000001)
Subject(s)
Adolescent , Female , Humans , India , Rural Population , Tobacco, Smokeless/statistics & numerical dataABSTRACT
Introduction: Cervical cancer is both a preventable and a curable disease, preventable because the pre-invasive stage can be detected by screening and curable because the verily early stage can be cured. The incidence and mortality from this disease in developing countries is very high.Women of low socio-economic status and minority women are at particular risk for not adhering to recommended cancer screening guidelines. Objectives: 1.To study the cytological abnormalities of pap smear among married women in reproductive age group. 2.To study the risk factors of various stages of cervical dysplasia. Material and Methods: This study was conducted in the urban field practice area of S Nijalingappa Medical College, Bagalkot during 2009-2010. All married women in reproductive age group were included in the study. After obtaining a informed consent, they were interviewed with the predesigned, pre-structured proforma. Data were obtained on social and demographic factors, education, marital and reproductive history and tobacco chewing was obtained. Under aseptic precautions, pap smear was obtained. Results: In the present study, 211 married women participated, among them maximum (45%) were in the age group of 26-35 years. The pap smear report of these participants were inflammatory (57.8%). Severe dysplasia was reported in 9 women. Among the study participants, 66(31.3%) of the women had normal pap smear. Inflammatory smear was present more among 26-35 year age group (30.8%), Class II socio economic status (32.7%) and among Hindus(54.1%). Severe dysplasia was maximum reported among 46-55 years age group, class II socioeconomic status and among Hindus. Recommendation and conclusion: Cervical cancer is a problem with multiple causes and a multipronged approach is essential to combat it. It is essential to provide health education for women, particularly those from the lower socioeconomic strata regarding sexual and genital hygiene and appropriate treatment of sexually transmitted infection.