<p class="abstract"><strong>Background:</strong> The most common cause or source of infection in operating room is bacteria coming from inadequate cleaning of skin, surrounding environment, from the staff and from patient itself; especially geriatric with low immunity and diabetic patients. Surgical site skin infection complicates an estimated 5% of all surgeries performed in operation theater. Every measure must be taken to reduce the surgical site infection henceforth reducing the cost of treatment and morbidity of the patient. Povidone-iodine seems to be the best and cheap option.</p><p class="abstract"><strong>Methods:</strong> One hundred and forty two patients who underwent orthopaedic surgery has been studied for the postoperative outcome following pre-surgical skin preparation with 2 step use of povidone iodine (PVP-I). The area to be operated is scrubbed with PVP-I scrub 7.5% and then painted with 10% PVP-I solution on operative area and wide area above and below. The paint is kept for at least 10 min or till it dry and then washed with normal saline or cleaned with sterile gauze soaked in normal saline. All postoperative patients were given intravenous antibiotics for at least 3 days. Dressing was done with PVP-I as per protocol.<strong></strong></p><p class="abstract"><strong>Results:</strong> It has been found that out of one hundred and forty two patients studied, only 3.52% developed infection. Out of five infected patients, two were female and three with fracture were male patients.</p><p class="abstract"><strong>Conclusions:</strong> PVP-I is still one of the best anti-microbial preparation widely used in orthopaedic surgery till date. It has broad spectrum anti-microbial activity and do not have any history of developing any resistance to its content.</p>
Background & objective : Myocardial revascularization in diabetic patients is challenging. Off pump coronary artery bypass (OPCAB) surgery has been widely used for the treatment of coronary artery disease. The goal of this study was to compare outcomes of OPCAB in diabetic patients relative to non diabetic patients.
Methods:The present prospective study was conducted between January 2014 to June 2017. During the period a total of 193 patients (of whom 70 had diabetes and 123 patients were non-diabetics) were included in the study. All of them underwent coronary artery bypass grafting (CABG) without cardiopulmonary bypass surgery. The early clinical outcomes of OPCAB were evaluated during the postoperative hospital stay.
Result: Over three-quarters of the patients in both diabetic and non-diabetic groups were ≥ 50 years old with no significant intergroup difference (p = 0.825). Majority(90%) of the patients in either group was male (p = 0.786). Nearly half (48.5%) of the patients in diabetic and 45% in non-diabetic group were overweight or obese (p = 0.557). The smokers weremuch higher in non-diabetic group than that in the diabetics (p = 0.009). The average number of grafts needed was considerably higher in the diabetic group (p = 0.079). All the postoperative outcome variables like pneumonia, stroke, arrhythmia, renal failure requiring dialysis and postoperative mortality in both the groups were almost identical (p > 0.05).
Conclusion: Off-pump coronary artery bypassis the preferred choice of revascularization for multi-vessel coronary artery disease in diabetic patients. However, continuous, strict glycemic control is essential to have a good postoperative outcome.
Ibrahim Card Med J 2018; 8 (1&2): 10-16
Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).
To determine the efficiency of methods of quantitation of the volume density of components within kidney biopsies, techniques involving a semi-automatic digitizing tablet and stereological point counting were compared.Volume density (Vv) is a parameter reflecting the volume of a component to the volume that contains the component, e.g., the fraction of cell volume that is made up of mitochondrial volume. The units of Vv are μm3 /μm3.Kidney biopsies from 15 patients were used. Five were donor biopsies performed at the time of kidney transplantation (patients 1-5, TABLE 1) and were considered normal kidney tissue. The remaining biopsies were obtained from diabetic patients with a spectrum of diabetic kidney lesions. The biopsy specimens were fixed and embedded according to routine electron microscogy protocols. Three glomeruli from each patient were selected randomly for electron microscopy. An average of 12 unbiased and systematic micrographs were obtained from each glomerulus and printed at a final magnification of x18,000.
Diabetic Patients Develop Greater Intensity of Postoperative Pain than Non-Diabetics after Open Cholecystectomy: A Pilot Study
