ABSTRACT
Introduction: Management of infected wounds is notalways simple and easy. Vacuum-assisted closure (VAC) isa wound healing therapy that utilizes a dressing system thatcontinuously or intermittently applies a negative pressure tothe wound surface. Our aim was to assess the Feasibility andadvantages of simplified version of otherwise costly VAC, orsimple suction drainage in selected cases.Material and methods: This prospective study was conductedin the unit 2nd of department of surgery at SMHS hospital, anassociated hospital GMC Srinagar, over a period of 3 yearsfrom January 2014 to December 2016. During this period, 32patients were subjected to vacuum suction treatment and wereincluded in this study.Results: Wall suction (VAC) was used in 26 patients. MiniVac drain (USG guided) was used in 5 cases. In one patient ofscalp infection conventional large size suction drain was used.The time taken for the wounds to become healthy was 3 to7(average 3.5) days of VAC dressing or suction drainage. Noantibiotics were given during suction drainage in 21 patients.Need for grafting by split skin grafting method was felt in only2 patients. Mild discomfort (abnormal sensation) was reportedin 21 patients. Hospital stay for patients managed by suctiontherapy ranged from12 hours (breast abcess) to 16 days withan average of 7 days. The total cost incurred in the patientsundergoing VAC for a period of 15 days per patient was Rs.800 ($ 12).Conclusion: VAC seems to have revolutionary potential inthe management of the difficult to treat infected wounds asfar as its safety, speed and cost-effectiveness are considered.
ABSTRACT
A 26 year old student reared as a female, presented with inability to menstruate and increased facial hair growth. On examination , patient had hyperandrogenic features including hirsutism, low pitched voice, microphallus with hypospadias. Investigations revealed a 46 XY karyotype with increased testosterone and imaging revealed both ovaries and testes with a hypoplastic uterus. The patient was managed with bilateral testicular gonadectomy, feminising genitoplasty and hormonal therapy.
ABSTRACT
Background: Patients with normal pulmonary function tolerate removal of an entire lung without respiratory problems. In patients witth impaired pulmonary function, post resectional function is of importance for the assessment of surgical risk. This necessitates the ability to measure the relative contribution of the parenchyma to be resected to the total lung function and the predicted postoperative lung functions. Objective: To determine preoperative lung functions as assessed with split lung functions and correlates with postsurgical lung functions and to determine the effect of lung resections on spirometric lung function. Material and methods: All those patients planned for lung resection surgery were included in the study. Predicted postoperative FEV1 and FVC were calculated. Preoperative spirometry was performed within a week before surgery. Predicted postoperative values were calculated. Postoperative spirometry was performed at the end of first month, third month, and sixth month for each patient. The relationship between potential predictors and postoperative complications were assessed. The predicted values were correlated with measured values (actual values) during the postoperative follow up. Results: Lobectomy was done in 64 persons. The predicted postoperative FEV1 and FVC correlated well with observed FEV1 and FVC in lobectomy (p<.05). The mean preoperative FEV1/L were 1.8 and the mean predicted postoperative (L) FEV1 were 1.4. The mean FEV1 at 1 month follow up were 1.6 and the mean FEV1 at 3 month follow up were 179.8.