ABSTRACT
Background: Management of the wound is a challenging process. Many conventional techniques have been used so far for wound management yet desired results are not achieved. A newer technique which is cost effective and safer has come into the play that gives better results. The aim of this study is the evaluate the efficacy of the negative pressureAim: wound therapy in wound management in low resource setting. To find out the effectiveness of vacuumObjective: assisted dressing on wound management by measuring graft uptake, wound healing time, need for re-grafting and hospital stay. In this prospective randomized comparative study, totally 52 cases were takenMaterials and Method: and divided into two groups randomly by lottery method as control group with 26 cases for conventional papain-urea ointment in combination with amorphous hydrogel colloidal silver gel dressing and as interventional group of 26 cases with modified vacuum assisted dressing. All wounds were initially subjected to thorough debridement. Wound bed preparation for SSG was achieved within 3-4 sets of vacuum dressing. Until regular conventional dressing done in control group. All the patients subsequently treated with SSG. Outcome was measured and results are compared. Results: Vacuum assisted dressing found to have sterile wound ,reduced hospital stay, earlier decrease in wound size, good graft uptake, deceased complication and cost effective. Vacuum assisted dressing proven to be effective thanConclusion: conventional method for wound bed preparation in SSG.
ABSTRACT
Introduction: Pulmonary Embolism is a major health problemwhich is associated with significant mortality and morbidity. Itis a common and lethal condition. This study was undertakento find the association between NT-Pro-BNP levels and thelocalisation of thrombus in acute Pulmonary Embolism and toprognosticate the patients.Material and methods: Prospective study conducted ata tertiary care hospital.Thirty patients with PulmonaryEmbolism of various etiologies, confirmed with clinicalfeatures, laboratory investigations and imaging and fulfillingthe inclusion and exclusion criteria were included. Aftergetting informed consent, Blood samples for assessmentof NT-Pro-BNP levels were collected within 24 hours ofadmission.Results: In 19 patients, the thrombus was located centrally(in main pulmonary artery) whereas in 11 patients, thethrombus was located in the peripherally (in segmental andsubsegmental pulmonary arteries). 22 participants of thestudy had normal clinical outcome. 5 patients were morbid(oxygen dependant/ heart failure) whereas 3 patients died.Patients with central pulmonary embolus had higher NT-ProBNP levels whereas patients with pulmonary embolus in thesegmental or subsegmental pulmonary arteries had relativelyless NTPro-BNP levels. Patients with high NT-Pro-BNPlevels had complicated in-hospital course/ mortality whereas,patients with relatively lower NT-Pro-BNP had uncomplicatedin-hospital course.Conclusion: This study shows that higher NT-Pro-BNPlevels indicate higher probability of a more central locationof thrombus in pulmonary embolism and also right ventricularoverload. Also patients with higher NT-Pro-BNP levels had acomplicated in hospital course.