Study of Glycated Haemoglobin and Lipid Profile in Patients with Diabetic Foot Ulcer

Introduction: Diabetic foot ulcer is a major disablingcomplication of Diabetes Mellitus and often precedes lowerextremity amputation. This study aims to evaluate the level ofHbA1c and lipid profile in patients with diabetic foot ulcer asT2DM patients areprone to diabetic dyslipidemia,which puts them at risk ofdeveloping macrovascular and microvascular diseases.Material and methods: The study was accomplished at atertiary care hospital in Jammu & Kashmir. One hundred tensubjects with T2DM were enrolled for the present study, thisincluded 55 subjects with DFU and 55 subjects without DFU.The HbA1c and lipid profile of the subjects were measuredwith standard methods.Results: In our study HbA1c level was found higher indiabetic patients with diabetic foot ulcer when compared withpatients without. Also lipid profile was found deranged indiabetic foot ulcer patients in comparison to control group. Itwas found that approximately 78% DFU have HbA1c levels˃7%. Unlike the DFU-patients, 79% of patients without DFUhave HbA1c level controlled.Conclusion: As diabetic foot ulcer is a major disablingcomplication of Diabetes Mellitus and often precedes lowerextremity amputation, we conclude that HbA1c level shouldbe maintained in normal range and regulating it is imperativefor avoiding T2DM complications.

Small Incision Cataract Surgery with Trabeculectomy versus Phacotrabeculectomy in Eyes with Pseudoexfoliation - A Retrospective Study

Pseudoexfoliation (PXF) syndrome is very common in Kashmir Valley. Eyes with pseudoexfoliation have a higher incidence of both cataract and glaucoma. Eyes with pseudoexfoliation respond poorly to medical treatment hence the need for early surgical intervention. AIM: To evaluate the effectiveness of small incision cataract surgery (SICS) with trabeculectomy versus phacotrabeculectomy in patients with psuedoexfoliative glaucoma with coexistent cataract. Methods: Present retrospective study was done in the post graduate department of ophthalmology Sher-i-Kashmir institute of medical sciences (SKIMS) and hospital Bemina. A total of 50 eyes with pseudoexfoliative glaucoma were divided in to two groups, 25 underwent small incision cataract surgery with trabeculectomy and 25 had phacotrabeculectomy done by the same surgeon. Intra and postoperative complications were compared between the two groups, moreover best corrected visual acuity (BCVA) and intra ocular pressures (IOP) were compared at 8 weeks and 6 months. Results: In our study we found that there was a significant improvement in best corrected visual acuity as well as getting the desired IOP levels in both groups of patients. However the difference between the two groups in terms of intra and post-operative complications, BCVA and IOP was found to be statistically insignificant. Conclusion: Our study concludes that both SICS with trabeculectomy and phacotrabeculectomy are equally effective in management of patients with PXF associated with cataract and glaucoma.

Fine Needle Aspiration Cytology Of Palpable Breast Lumps With Their Histopathological Correlation

BACKGROUND: Fine-needle aspiration cytology (FNAC) is still an important first line diagnostic procedure in developing countries. FNAC of breast lesions is quite specific and sensitive investigation and the results are comparable to histopathology.Aim of study is to evaluate role of fine needle aspiration cytology in the diagnosis of breast lesions and to compare the cytological findings with the histopathology wherever possible. In addition the sensitivity, specificity and accuracy of FNAC in breast lesions are carried out. MATERIAL METHODS &RESULT: The present study was carried out on 100 patients who presented with palpable lump in the breast ;irrespective of age and sex were included in the study from the district hospital of North Karnataka, over a period of 15 months.In 69 cases ,cytological diagnosis was correlated with histological findings . RESULTS: There was preponderance of benign breast lesions: 55cases (79.71%) and malignant cases 14(20.29%) .In present study,sensitivity is 92.85%,specificity is 100% in diagnosisng malignant lesions,with accuracy of 98.48% .Positive predictive value is 100% and negative predictive value is 98.11%. CONCLUSION: With experienced hands, FNAC is safe, cost effective and a reliable technique for preoperative evaluation of palpable breast lumps. FNAC features are more informative when combined with physical and radiology findings (Triple test).

Knowledge and awareness about diabetes mellitus and diabetic retinopathy in suburban population of a South Indian state and its practice among the patients with diabetes mellitus: A population‑based study.

Context: Ocular complications due to diabetes mellitus (DM) were on the rise despite good literacy levels in South India. Aims: To assess the knowledge and attitude toward DM and diabetic retinopathy of the general population in a suburban town of South India. Settings and Design: Door‑to‑door population survey in suburban town of South India in May 2013. Materials and Methods: A 30‑point questionnaire was prepared and the data were collected and analyzed to determine statistically the knowledge, attitude, and practice (KAP) scores of the general and diabetic population and also to determine significant demographic associations. Results: In this study, 6211 people (3528 [56.8%] women and 2683 [43.2%] men) with a mean age of 55.6 ± 11.7 years (range 21–98 years) were included. Good knowledge and positive attitude were observed in 3457 (55.6%) and 3280 (52.8%) people. Among 1538 (25.4%) people known to have DM, only 619 (40.7%) had good knowledge, 828 (53.8%) had a positive attitude, and 886 (57.6%) had good practice patterns. Although half of them followed general diabetic care, only 9.6% had undergone screening for retinopathy. Literacy showed a significant association with good KAP (P < 0.001 each) in general population and those with DM. Overall, women had significantly better knowledge (P < 0.001). Conclusions: Better literacy, especially among women, is contributory to better public awareness; however, the trend for poor practice patterns needs to be radically changed with aggressive public motivation emphasizing on the necessity of retinopathy screening and periodic follow‑ups.

Tube thoracostomy in penetrating thoracic injuries

Objective: To determine the frequency of tube thoracostomy in penetrating thoracic injuries at a tertiary care hospital

Study design: Cross sectional study

Place and Duration of study: Department of Surgery Unit III, Civil Hospital / Dow University of Health Sciences Karachi, from March 2012 to March 2014

Methodology: All patients who presented with penetrating chest injuries due to firearm, stabs etc were treated according to ATLS protocol. Tube thoracostomy was performed when indicated. Chest tube was passed under local anesthesia

Results: A total of 100 patients included in this study. There were 92 males and 8 females. Mean age of the patients was 30+7.29 year. Mechanism of injuries included gunshot injury [n=62], stabs [n=24] and shrapnel injury [n=14]. Pneumothorax was diagnosed in 39 patients, haemothorax in 35, sucking wound of the chest in 20 patients and major vascular injury in 4 patients. Associated extra thoracic injuries were present in 26 patients. Tube thoracostomy was performed in 78 patients. Twenty-two patients underwent thoracotomy

Conclusions: Majority of patients with penetrating chest injuries were managed by tube thoracostomy. No mortality occurred in this series

Real-time in vivo micromorphology and histopathology of choroidal osteoma using enhanced depth imaging.

Choroidal osteoma is a usually unilateral benign tumor of the choroid composed of mature bone. Optical coherence tomography (OCT) has been used to image osteoma for several years. With the advent of enhanced depth imaging (EDI) feature of spectral‑domain OCT (SD‑OCT), better visualization of the morphology of choroidal lesions has been possible. Herein we present a case of choroidal osteoma in a 45‑year‑old woman, wherein in vivo morphology of the choroidal osteoma had been visualized using EDI technique of SD‑OCT before and after performing photodynamic therapy. EDI OCT has proven to be a valuable noninvasive imaging modality, almost comparable to histopathological examination, for diagnosing choroidal osteomas and for providing an insight into the in vivo micromorphological changes occurring during the course of the disease.

“Project Eklavya”: To Transform the Indian Health Education System.

Abstract: Over 6.3 lakh students have taken this year's pre medial test in India. The total number of MBBS seats in the country is around 52,300. The current doctor population ratio is 1: 1700. The country needs 1, 00,000 graduates yearly to achieve a ratio of 1:1000. Since graduates from public and private funded medical institutions are not motivated to serve in rural settings, increasing the number of places or establishing new medical institutions may not be an effective solution to the issue, as observed by Hazarika. The medical education model proposed in this article, which includes common entry and exist test with flexibility of learning medical education, will make medical education available to all deserving candidates irrespective of their caste, creed, financial status and, most importantly, geographical location. Any deserving candidate from even the remotest part of the country can access the best medical education using the powerful tool of information technology and the vast medical educators’ pool of talent and experience available in the country and abroad.

Impact of statins on risk and survival of ovarian cancer / 부인종양

No abstract available.

Complications of onlay and sublay mesh plasty in ventral abdominal hernia repair

Objective: To find out the frequency of seroma, wound infection and wound disruption in patients of ventral abdominal hernia operated with onlay and sublay mesh plasty

Study design: Cross sectional study

Place and Duration of study: Department of General Surgery Dow University of Health Sciences and Civil Hospital Karachi, from January 2010 - December 2014

Methodology: Ventral abdominal hernia patients were selected randomly for the procedure of onlay and sublay mesh plasty. Fifty patients each were operated with either of the techniques. Postoperatively patients were observed for the complications; seroma, wound infection and wound dehiscence. All patients were followed for a period of two weeks

Results: A total of one hundred patients were enrolled. Fifty of them had onlay and fifty underwent sublay mesh plasty for ventral abdominal hernia. There were 18 [18%] males and 82 [82%] females with male to female ratio of 1:4.5. Minimum age was 22 year and maximum 55 year. There were 55 [55%] para umbilical hernia, 14 [14%] umbilical, 14 [14%] epigastric and 17 [17%] incisional hernia. Maximum number of cases of wound infection were noted in onlay mesh plasty group [n=16, 16%] while in sublay group only six [6%] had this complication

Conclusion: Sublay mesh plasty technique for ventral abdominal hernia repair had less frequency of complications

study of Finger Prints Pattern in Relation to ABO, RH Blood Groups among Medical Students of AJK Medical College, Muzaffarabad [AJK]

Objective: to find out the relation of finger prints with blood groups among medical students. Study design: Cross sectional study. Place and Duration: This study wa conducted at Azad Jamrnu Kashmir Medical collqe Muzaffarabad [AJK] in the department of Forensic Medicine and Toxicology from Feb, 2013 to March, 2013. Materials and method: a total of 200 medical students of 1st year and 2nd year MBBS of AJK Mcdical College Irluzaffarabad with known blmd groups were included in tht srudy. Finger prinrs were taken by stamp pad mehod. Resullc: Lanps are rhc most commun while arches are the ltasr common occumng finger WnLs. Idoops arc predominant in bland group B and lowest in blood group AB and percentage of loops wrrc highest in Rh-positive individuals and Iower in Rh- ntgaive individuals. Contlusion: There is an association bcween disrributian af finger pint pattern and blad groups

Trend of Poisoning in Muzaffarabad [AJK]

Objective: The objective of this study is to determine the trend of poisoning in Muzaffarabad AJK. Study Design: Retrospective study. Place and Duration of Study: This study was conducted at combined Military Hospital [CMH] Muzaffarabad [AJK] during the period of 1'' January 2009 to 31" December 2010. Material and Methods: One hundred and forty cases of poisoning was brought in hospital. Information regarding Age, Gender, demography, manner, time of occurrence, and patient outcome was confirmed fiom hospital records and collected data was analyzed. Results: There were 98 female and 42 mate victims involved in this study and maximum cases belong to second and third decade of life [23.57% and 48.57% respectively. Most common manner of poisoning was suicidal 1 attempts. Most incidences of poisoning occur in month of June and an organophosphorous compounds was leading cause of poisoning followed by Benzodiazepines. Conclusion: Organophosphorous compounds are the major chemical agents which pose a health threat particularly to young people

Indications and outcome of small and large bowel stomas in emergency intestinal surgery

To evaluate the indications and outcome of small and large bowel stomas made during emergency intestinal surgery. Cross sectional study. Dow University of Health Sciences Civil Hospital Karachi, from January 2006 to December 2012. All emergency exploratory laparotomies performed for intestinal surgery, managed by stoma were included in this study. Decision for making stoma was based upon etiology, condition of the gut and judgment of the operating surgeon. Total numbers of patients were 200 [male 114, female 86] with mean age of 32.7 year. Trauma was the most common etiology. Firearm injury was the commonest mode [n=67, 33.5%] followed by stab wounds and blunt trauma [n= 12, 6.0%]. Patients also presented with perforation leading to peritonitis [n=65, 32.5%] and intestinal obstruction [n=52, 26%]. Tuberculosis was diagnosed in 5 [26.5%] patients, typhoid perforations in 35 [17.5%] and malignancy in 30 [15%] cases. The mortality in this series was 10%. Wound infection occurred in 42 [21%], burst abdomen in 10[5%] and enterocutaneous fistula and stoma retraction noticed in 6 [3%] patients. Stoma formation was a helpful adjunct surgical procedure performed in emergency intestinal surgery for various conditions with satisfactory outcome

Pattern of homicide in Muzaffarabad [AJK]

Homicide is the highest level of aggression found in all cultures and ages and is one of the oldest crimes in the human history. The pattern of Homicide has changed with the passage of time except for the motives which almost remain the same that is the lust of woman, money and land. The objective of this study is to determine the pattern of homicide in Muzaffarabad AJK. Prospective study. This study was conducted at combined Military Hospital [CMH] Muzaffarabd [AJK] during the period 1[st] Jan 2010 to 31[st] December 2011. Thirty cases of homicide presented for autopsy was selected on basis of police inquest and autopsy findings. These causes were examined regarding age, Sex, type of weapon used, part of body involved along with seasonal variations. The Homicide rate in Muzaffarabad during the years 2010 and 2011 is 2.748/100, 000 per year Males are the primary targets with 30% between 30-39 years of age. The most common weapons for this offence are the Blunt weapons. The Homicide rate is high with the use of Blunt weapons followed by firearms

Classification of suprascapular notch according to anatomical measurements in human scapulae

The objective of this study was to measure the maximum superior and inferior lengths of the suprascapular notch with the help of a Vernier caliper and to classify the notches accordingly into four types. This is an observational study, conducted from January to December 2009 at Islamic International Medical College, Rawalpindi. Two hundred and fifty dried human scapulae were procured and measured irrespective of age, gender, race and sidedness. The maximum superior length as compared to inferior length was the highest i.e. 68% [type -III]; percentage of notches with equal superior and inferior length was 14% [type-II] absence of notch was noted in 10% of scapulae [type-1] and notches with greater maximum superior length as compared to interior length was 8% [type-IV]. Suprascapular nerve entrapment may be associated with a specific type of suprascapular notch

Histological features of ligamentum venosum at different ages

To study the histological features of ligamentum venosum at different ages. An observational study. The study was conducted in Anatomy department at Islamic International Medical College Rawalpindi from June 2008 to June 2009. The study was based on 6 post- mortem specimens. The livers were dissected from cadavers at ages 5, 35, and 65 years. The ligamentum venosum was dissected and fixed in 10% formalin solution for 24 hours. After fixation and processing, the slides were stained with haematoxylin and Eosin stain. At the age of five years the lumen was completely obliterated towards the portal extremity whereas it was patent near the caval extremity. At the age of 35 years the lumen was patent; the ligamentum venosum had got an intima without an endothelium. At the age of 65 years the lumen was patent; the ligamentum venosum had gotanintima without an end othe lium. The study concludes that ligamentum venosum shows different histological features at different ages. The presence of internal elastic lamina at the age of sixty five years is a unique feature of this study