Evaluation of HbA1c and tuberculin test in wound complications of surgical patients with diabetes.

Background: Diabetes is a global epidemic and India is regarded as the “diabetes capital of world”. Wound healing deficit are often seen in patients with diabetes mellitus. Aims & Objective: The present study was undertaken to correlate HbA1c level and plasma glucose level with wound complications in postoperative wounds in diabetic patients, to find out relationship of HbA1c and tuberculin test with wound complications, to correlate the role of HbA1c and tuberculin test in prediction of wound complications. Materials and Methods: The study is a prospective analysis of 100 patients from June 2006 to June 2008, in University Hospital in North India. All known diabetic and recently diagnosed diabetic patients with surgical illness were included in the study. All patients were investigated for HbA1c (by micromatTM Hemoglobin A1c test), Mantoux test (intradermally injecting 0.1 ml Tuberculin PPD with tuberculin syringe), blood sugar F/PP, serum albumin. Wound complications have been noted in postoperative period along with co-morbid condition of patients. Selected patients are divided in four group (i) clean wound; (ii) clean contaminated; (iii) contaminated and (iv) diabetic foot / dirty wound. Results: Out of 100 diabetic patients, male to female ratio was 3:2. Maximum number of patients are in age group of 51-60 years, 51 out of 100 patients were associated with comorbid condition. HbA1c level in diabetic patients were < 6 in 13%, 6-8 in 43%, 8-10 in 30% and >10 percent in 14% patients. Mantoux test was positive in 31 out of 92 patients. Wound complication was present in 54 patients, mostly in uncontrolled diabetes. Out of 99 patients, 41 have clean wound, 31 have clean contaminated, 6 contaminated and 21 patients having dirty / diabetic foot. Conclusion: Study show a fair correlation between HbA1c, Mantoux test and wound complication. There is decrease in cell mediated immunity leading to decrease in mantoux test positivity and increase in wound complication.

Abdomino-scrotal hydrocele in 35 years old: a case report.

Abdomino-scrotal hydrocele is a condition usually affecting children. It is unusual to find an abdomino-scrotal hydrocele in middle aged adult. Most of the patients are asymptomatic except cystic abdominal mass and discomfort occasionally. We hereby report an unusual presentation of abdomino-scrotal hydrocele at age of 35 years and presenting as large cystic abdominal mass extending into scrotum.

Leiomyosarcoma of stomach: a case report.

We report a rare case of leiomyosarcoma of stomach infiltrating into the spleen and tail of pancreas, which presented at the age of 28 years of age with haematemesis and was diagnosed after exploratory laparotomy. En block excision of tail of pancreas, spleen and part of the greater curvature of stomach containing the mass was done.

Penile fracture presenting as eggplant deformity.

Penile fracture is caused by sudden trauma to erect penis leading to tear of corpora cavernosa. Although penile fracture is a rare condition, it can lead to crippling penile deformity and erectile impotence, if intervention is delayed. We describe a case of penile fracture caused by masturbation and satisfactory outcome after early surgical intervention. Usually only clinical assessment is sufficient for diagnosis.

Isolated tuberculosis of testis.

Isolated epididymo-orchitis is an uncommon presentation of tuberculosis. We report a case of left sided epididymo-orchitis and scrotal involvement due to tuberculosis in a young male patient. The diagnosis was suspected on clinical examination of scrotum and confirmed by FNAC of scrotal and testis. Patient improved after taking antitubercular treatment. Key words: infection, scrotum, treatment.