ABSTRACT
Subcutaneous emphysema is defined as an escape of air in subcutaneous tissue. It is one of the most common complications after inter-costal chest tube drainage. Subcutaneous emphysema is usually benign requiring no specific treatment, but extensive subcutaneous emphysema can be uncomfortable and alarming for the patient. It can rarely lead to airway compromise, respiratory failure and death. Factors leading to its development, following chest tube insertion and methods of management, have not been extensively studied and published. This was an analytical study done over a period of two years, on indoor patients who developed subcutaneous emphysema. These cases were managed using four different modalities and were analyzed for various factors contributing to the development, severity, and resolution of subcutaneous emphysema. Results of this study highlight that the cases of hydropneumothorax and secondary pneumothorax were significantly more predisposed to the development of severe subcutaneous emphysema (following intercostal chest tube insertion) and large air leak as compared to others. Larger air leak develops higher grades of subcutaneous emphysema. The average time for resolution of subcutaneous emphysema was similar among the different modalities of management compared in the study.
ABSTRACT
Background: Calcaneal osteomyelitis is a complicated entity and much more challenging to treat. We present a case of calcaneal osteomyelitis treated with debridement, curettage and filling bone defect with antibiotic mixed calcium sulphate pellets. Case Report: A female patient presented with pain, swelling and purulent discharge from the left heel. Culture studies and magnetic resonance imaging findings were suggestive of osteomyelitis of the calcaneum. The patient was planned for definitive treatment, and remission was achieved with systemic antibiotics, debridement, curettage, and filling dead space with antibiotic mixed calcium sulphate pellets. Conclusion: Calcaneal osteomyelitis is very resistant to treatment and results in poor functional outcome. Management of calcaneal osteomyelitis with single-stage strategy using antibiotic mixed calcium sulphate effectively eradicates the disease to attain overall good functional outcome for the patient.
ABSTRACT
BACKGROUND: Over the past decades, various epidemiological data have shown that the pattern and profile of diabetes mellitus in India are different. The present study was carried out with an aim to study body mass composition in underweight type 2 diabetics and to compare with the normal population. MATERIALS AND METHODS: The cross-sectional comparative study was conducted between January 2015 and December 2016 and included 60 participants who were selected using the convenient sampling technique. Newly diagnosed patients with type 2 diabetes mellitus and BMI less than 18.5 kg/m2 were considered for the study. Chi square test and Independent student t test were used for finding the statistically significant difference in proportions and between means, respectively; Pearson correlation coefficient was estimated for finding the linear association between two continuous variables. RESULTS: No statistically significant difference was observed between the two groups in terms of age, waist-hip ratio, and BMI. Higher amount of fat mass and percentage were observed among the patients with diabetes as compared to that of the control group (P value < 0.05). However, there was no statistically significant difference between the underweight and the control group patients (P value > 0.05). A significant positive correlation was observed between HbA1c values and body fat mass values (P value < 0.05). CONCLUSION: Underweight type 2 diabetic patients were found to have high body fat mass as compared to healthy controls and the HbA1C values of the study participants were found to be positively correlated with fat mass.
ABSTRACT
BACKGROUND: Type III and IV jejunoileal atresias are associated with loss of significant length of the gut and can lead to short gut syndrome if further resection of proximal dilated gut is done. We modified the anastomotic technique so that proximal dilated segment of the gut is not resected as to prevent short gut syndrome. MATERIAL AND METHODS: Medical Record of patients of Type III and IV jejuno-ileal atresias managed with modified anastomotic technique in our center during 5-years was reviewed. RESULTS: Fifteen patients were managed with our modified technique. There were no anastomotic leak observed and there was 6% mortality seen in our modified technique. CONCLUSION: We found less mortality and morbidity in our technique compared to recommended techniques described in literature.
ABSTRACT
The hydroxyl radical generated by UV irradiation of hydrogen peroxide cause an extensive damage to guanine residues of ribohomopolymer, polyguanylic acid, poly (G) as investigated by spectrophotometric measurements, agarose gel electrophoresis, Sephadex G-200 gel filtration and DEAE Sephadex A-25 column chromatography. Native and ROS-poly (G) were highly immunogenic inducing high titre antibodies in rabbits. The antibodies showed wide range of cross reactivity with various synthetic polynucleotides exhibiting B-, A-, and allied conformations. The diverse antigen binding characteristics of the induced antibodies resembles to those of naturally occurring lupus anti-DNA autoantibodies. Sera from various SLE patients showed preferential binding to ROS-poly (G) than native poly (G), indicating that oxidatively modified guanine residues are better recognised. The significance of these findings in the induction of SLE anti-DNA autoantibodies by oxygen free radicals modified guanine residues in DNA has been discussed.
