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Background: Diabetic foot ulcer poses a serious threat to patients with Diabetes as the presence of an ulcer further significantly increases the risk of an amputation. Aim and Objectives: The present study was undertaken to assess: Correlation of transcutaneous oxygen tension (TcpO2) and ankle brachial pressure index (ABI) in outcome of diabetic foot and severity of neuropathy by grades. Materials and Methods: About 30 patients of Type 2 Diabetes Mellitus with foot lesions and 30 healthy controls were selected after obtaining informed consent and ethical committee clearance. Subjects were recruited taking into consideration various inclusion and exclusion criteria. The subjects were assessed for the following parameters: Vibration perception, hot, and cold perception along with TcpO2 and ankle brachial pressure index (ABI). The test results were compared within the two groups of cases, that is, Group I: Healed ulcer and Group II-Non-healed ulcer. The results of the two groups were compared with 30 healthy controls also. Results: Males were predominant (66.67%) compared to females (33.33%) in the diabetic foot patients. Severe derangements in the sensory modalities were found as observed by the bilaterally reduced values of vibration perception, hot perception and cold perception tests when diabetic foot patients were compared to controls. The values, however, were not significantly different between the two groups of patients of diabetic foot. The values of TcPO2 and ABI were bilaterally reduced in the cases as compared to controls and amongst the Group I and Group II comparison these values showed a significant difference. A highly significant positive correlation was observed between the TcPO2 and ABI test results in the diabetic foot patients that indicates both are complimentary tests for diabetic foot outcome prediction. Conclusion: Increased duration of diabetes, high value of Hba1c and presence of neuropathy were found to be important risk predictors for diabetic foot. Early and severe derangement of vibration perception indicated early involvement of large nerve fibers. Heat and cold perception is affected late and less severely, indicating late involvement of small nerve fibers in diabetic polyneuropathy. The positive correlation between TcPO2 and ABI indicates both are complementary tests for predicting the outcome of diabetic foot. However, TcPO2 being a better predictor maybe incorporated as a routine screening test for diabetic foot risk and outcome predictor in the diabetic foot clinic.
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BACKGROUND: Renal cell carcinoma (RCC) is the one of the dreadful urological carcinoma. In comparison to the West, it is very rarely seen in Asia as well in India. Very small number of studies is available in this geographical area. AIMS: We studied the demographic pattern, presentation, risk factors and survival of RCC in an Eastern Indian institution. We characterized and compared these data with available literature SETTINGS AND DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 81 patients of RCC from January 2008 to December 2012 were enrolled. Their pre‑operative data were reviewed. They were followed as per institutional follow‑up protocol. STATISTICAL ANALYSIS USED: Kaplan‑Meier plot was constructed for survival analysis. Comparison of survival curves was performed by Logrank test. P < 0.05 was considered to be significant. RESULTS: A total of 75 patients were analyzed with a mean follow‑up of 26.3 ± 17.7 months. The mean age of presentation in our study was 52.79 years with a peak at 5th decade. Nearly 73.33% patients having one or more risk factors. 9 out of 10 had presented with some symptoms. The survival for localized RCC was 100% and significantly greater than advanced RCC ( P < 0.0001). Similarly in the stage III, significant greater survival ( P < 0.0001) was noted compare to stage IV. CONCLUSIONS: The age of presentation of RCC in India has been found in 5th decade, which is a decade earlier than the western countries. Symptomatic RCC is still majority in India. Organ confined tumors have good prognosis. When it metastasizes to lymph node or distant organ, the outcome is poor. Our results may form the basis for further studies and it may be used as future reference.
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AIM: Bone metastasis in cervical cancer is rare. With the aim of defining the frequency of bony metastasis in patients of carcinoma cervix, with clinical suspicion of metastasis, we performed bone scan in 38 such patients. RESULTS: Twelve out of the 38 patients were confirmed as having metastasis. All the patients were also detected by bone scan (100% sensitivity). CONCLUSION: Bone scan should be investigation of choice for screening patients of carcinoma cervix with symptoms suggestive of metastasis in all stage of the disease. Bone scan is the most sensitive method for detection of bone metastasis. Bone scan offers the additional advantages of allowing a review of the kidney size to look for ureteric involvement and subsequent hydronephrosis.