Clinical Study of Chronic Lower Limb Ischemia and its Management

Background: The aim of the study was to study the modes of presentation of chronic lower limb ischemia, to study the effectof comorbid conditions such as smoking, diabetes, and hypertension on the presentation, progression of lower limb ischemia,and to correlate the above study finding with management and outcome.Materials and Methods: This is a study of 77 cases of chronic lower limb ischemia admitted in Mahatma Gandhi MemorialHospital, attached to Kakatiya Medical College, Warangal, Telangana state, during the period of October 2011–October 2013.All the patients with a history of chronic lower limb ischemia requiring admission during the study period are included in thisstudy. Results were analyzed.Results: In our hospital, 125,263 patients were admitted between the study period, i.e., October 2011 and October 2013. Amongthem, the number of cases of chronic lower limb ischemia was 77. Thus, the incidence of chronic lower limb ischemia amongthe total number of hospital admissions was found to be 0.06%. The total number of surgical admissions in our institute duringthe period from October 2011 to October 2013 was 12,877, of which the number of cases of chronic lower limb ischemia was77 (incidence – 0.597%). The highest incidence of chronic lower limb ischemia is seen to occur in the age group of 50 yearsand above. The main features at the time of presentation were with gangrenous changes in the lower limb, ischemic ulceration,claudication, and rest pain.Conclusion: Atherosclerosis (77.92%) is the major etiological factor causing chronic lower limb ischemia. Thromboangiitisobliterans is the second cause and it exclusively affects males. Smoking plays a major role in the etiology of chronic lower limbischemia and smokers get affected at a younger age, 12.1 years, than non-smokers. Diabetes has a major role in the etiologyof chronic lower limb ischemia. It also has a crucial role in the outcome of the patients. Most of the cases in the present studywith diabetes had surgical intervention (92.59%) with very few cases managed by conservative approach alone (7.41%).

Measure of liability in Medical Negligence A hospital based study

Background: Negligence is the breach of a legal duty of care. Liability is the responsibility of a person for his acts of commission and omissions. Aim: This study aimed to determine the role of liability in medical negligence in teaching hospital. Materials and methods: A total 36 medical negligence cases reported during the period of 3 years i.e. from July 2011 to June 2014 were gathered from Hospital Case Records, Inquest Reports, Post Mortem Examination Reports, and Forensic Science Laboratory Reports. Results: Among these 36 cases of medical negligence doctors were liable for their negligence in 15 cases i.e. 41.7% and vicariously liable in 3 cases i.e. 8.3%. There was no liability for doctors in 18 cases i.e. 50%. Conclusion: It this study, male and female was equally suffered for medical negligence. Among the females pregnant cases were more common. Most of the medical negligence cases had come to the hospital with major health problem. Health care professionals are increasingly facing complaints Naveen Kumar E, Ramesh K, Alugonda Y, Kothapalli J, Goud AK. Measure of liability in Medical Negligence – A hospital based study. IAIM, 2016; 3(3): 123-127. Page 124 regarding the facilities, standards of professional competence and the appropriateness of their therapeutic and diagnostic methods.