Etiology and management of leg ulcers - an Enigma

Chronic leg ulcer is defined as a defect in the skin below the level of knee persisting for more than six weeks and shows no tendency to heal after three or more months. Leg ulcers are debilitating and greatly reduce patients' quality of life. The common causes are venous disease, arterial disease and neuropathy. Management of patients with chronic ulcers has to be multidisciplinary and should include detailed history, physical examination, investigations, basic and newer treatment modalities, and educating patients on issues of correct foot care and the importance of seeking early medical advice

Anesthesia for dermatologic procedures and their complications

Local anesthesia [anesthesia] is the reversible loss of sensation in a defined area of the body and is achieved by the topical application or injection of agents that block the generation and/or journey of nerve impulses in tissue. No dermatological procedure is possible without a local anesthetic. Local anesthesia is used in many dermatological procedures and surgical operations. The aim is to minimize pain and suffering and maximize patient comfort. This article provides an insight into the various types of anesthesia for dermatologic procedures and their complications

study on the surgical treatment of ingrowing toenail with nail excision with chemical matricectomy versus nail excision alone

To compare the results of surgical treatment of ingrowing toenail with nail excision with chemical matricectomy versus nail excision alone. We selected 30 patients of ingrowing toenail for the study. The patients were divided into two groups of 15 patients each. In group I patients, nail avulsion with chemical matricectomy with 88% phenol was done. In group II only nail avulsion was done. In group I patients the surgical success rate was 98% and in group II, the surgical success rate was 86.6%. No patient complained about the cosmetic appearance of toenail after the operation. The technique is easy to perform and is associated with little morbidity and has a success rate of 98%

Effects of fatigue after sleep deprivation on cognitive functions in anaesthesia residents

Maintaining vigilance during an anaesthetic is hampered by a variety of factors relating to the patient, working environment and anaesthetist himself. Since fatigue is a common issue in the medical environment, there have been many studies of the effects of sleep deprivation and fatigue on human performance and well being. A review of the literature does not permit us to come to any specific conclusion due to the many flaws/shortcomings in most of the studies, including poor definition of the degree of acute sleep deprivation, lack of assessment of accumulated chronic fatigue, the effects of diurnal variation in performance, motivation and incentives etc. A need was felt to study the effects of fatigue associate with sleep deprivation in anaesthetists. We undertook this study in the anaesthesia residents to assess the effects of sleep deprivation on the mental performing abilities. Department of Anaesthesiology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab [India]. Residents of anaesthesia department. We excluded the variables known to affect the outcome. The residents who had used sedatives, alcohol or other similar CNS depressants; those with systemic illness/organic disorder or left handedness were excluded. In this study, fifty residents of anaesthesia were tested under two situations using a battery of cognitive function tests. Group I comprised of residents after their routine day duty [10 hrs, non sleep deprived]. Group II was formed by the same residents after their night duty with less than 4 hours of sleep in the previous 24 hours [sleep deprived]. The results lead us to the following. Fatigue following sleep deprivation adversely affects the psychomotor and cognitive functions of the anesthetist but not the short term