“A STUDY ON FACTORS INFLUENCING THE CLINICAL OUTCOMES OF RAY AMPUTATION IN DIABETIC FOOT PATIENTS’’

The study was conducted on 50 diabetic foot patients who underwent Rays amputation in the Department of General Surgery, Chengalpattu Medical College Hospital from April 2021 to July 2021. The aim of our study was to “evaluate the factors for re-ulceration, re-amputation in diabetic foot patient following rays amputation”. The study was conducted after performing Rays amputation in diabetic patients after satisfying the inclusion and exclusion criteria In this study, Diabetic foot patients with Rays amputation was more common among the male population with mean age group being 60 – 69 years of age. Long duration of diabetes mellitus, diabetic ulcer patient with co morbidities had poor outcome. Early identication of diabetic ulcer patients with co- morbidities could assist clinicians in determining which patient mostly require reamputation. These patients should undergo aggressive and frequent preventative care including regular foot care visits, blood sugar control, regular treatment and follow up for comorbidities, diabetic foot education, specialized footwear, and evaluation for other complications

QUALITY OF LIFE OF THE PEPTIC ULCER PATIENT

New generation, which has been brought up in a world where geographical boundaries are no constraintis ready to try new recipes from across the world. The trend is catching up with the older generation also. But all such foods are not safe and can cause PUD. Various studies have shown detrimental effects of such so called junk foods on health of young adult males. Nowadays junk food has become the main attraction for the young generation as it also comes to western culture. The boys specially, who spend most of their time outside of their home, mainly eats unhygienic junk foods. For that reason, the attraction towards junk food increases and causes abnormalities to their digestion system, which ends in severe stages like ulcer. Most of the young people like to consume spicy and fatty foods, as spicy foods always look more colorful and more tasty than healthy foods which also causes extra attention to these foods. But they ignore the facts that spicy foods cause gas and acid formation and is very dangerous for health. Most of the young people are either engaged with study or engaged with jobs, and in both cases, they need to stay out of the house for maximum time which brings irregularity to their meal timing. The young adulthood is also sensitive because, at this age most people suffer from emotional stress which brings irregularity in sleeping, eating etc. These things affect their mental and physical health very badly as they can start smoking, drinking alcohol and can this lead to severe disorders like Gastrointestinal disorders, or ulcers. etc. Sometimes people take drugs as pain killers which can cause other severe disorders(ulcer). Therefore, this study is a reflection of the life style related issues which becomes the major factors of causing ulcer like severities.

A Novel Autologous Micrografts Technology in Combination with Negative Pressure Wound Therapy (NPWT) for Quick Granulation Tissue Formation in Chronic/Refractory Ulcer

Negative pressure wound therapy (NPWT) has been commonly used over the years for a wide range of chronic/refractory lesions. Alternatively, autologous micrografting technology is recently becoming a powerful modality for initiating wound healing. The case presented is of a patient with a lower leg ulcer that had responded poorly to NPWT alone for three weeks. Consequently, the patient was put on a combination therapy of NPWT and micrografting. After injection of a dermal tissue micrografts suspension into the entire wound bed, NPWT was performed successively for two weeks, resulting in fresh granulation tissue formation. Thereafter, the autologous skin graft was taken well. This case study indicates that for a chronic/refractory ulcer patient with poor NPWT outcome, combination therapy using micrografting treatment and NPWT could rapidly initiate and enhance granulation tissue formation, creating a favorable bedding for subsequent skin grafting.

Clinical characteristics of lower extremity ulcers

Common causes of lower-extremity ulcers are relatively easy to diagnose, but exact wound diagnosis needs always a holistic approach and a careful evaluation of the wound patient. Systematic assessment and the use of check-lists provides diagnostic tools. This review aims to provide clinicians with an overview of the different aetiologies of leg ulcer by describing the clinical characteristics of each aetiology. It also aims to provide tools for health-care providers when assessing a lower-extremity ulcer patient.

Penetrating Atheromatous Ulcer as a Precursor of Aortic Dissection: A Case Report

Background: Acute aortic syndromes include a range of life-threatening conditions with the most familiar entity being aortic dissection. However, variants of aortic dissection also include intimal tear without hematoma, aortic intramural hematoma, and lastly penetrating aortic ulcer (PAU), which will be the focus of this case report. Most PAUs are located in the descending thoracic aorta (85-95%), but they can also occur in the ascending aorta or arch as in the current case.Case Presentation: We report a case of a 77 year old male who presented with chief complaint of intermittent right-handed weakness associated with no numbness or mental status changes. Patient was admitted for stroke workup with unrevealing findings on CT (computed tomography) for acute abnormalities or any hemodynamically significant stenosis on carotid ultrasound. CT angiogram of head/neck revealed a penetrating aortic ulcer of the lateral aspect of the mid to distal ascending aorta. Patient was then transferred for further evaluation to a center of higher level care for further management.Conclusions: Patient was evaluated for surgical repair of penetrating ascending aortic ulcer. Patient underwent serial imaging throughout hospital course which showed grossly similar findings to prior examination and thus no surgical intervention was needed at that time. Patient was recommended to have follow up CT scan in one month to monitor progression of aortic ulcer. Penetrating aortic ulcers are rarely located in the ascending aorta and are considered precursors of life-threatening aortic dissections.

AN AYURVEDIC MANAGEMENT OF VARICOSE ULCER: A CASE STUDY

A male patient aged 37 yrs came to Salyatantra OPD of Sree Narayana Institute of Ayurvedic Studies & Research Hospital, Puthoor, Kollam with complaints of a non-healing wound on left medial malleolus since 6 months. Discharge and itching around wound since 10 days. Pain over inguinal region since 2 days and came here for better management. On examination there was a vertically oval shaped ulcer with slopping edge and the floor was covered with red granulation tissue and white margin on left medial malleolus. On palpation there was temperature rise and tenderness and inguinal lymph node enlargement. The diagnosis was confirmed as varicose ulcer. Patient was treated with Jalaukavacharana for 2 days, Yogavasthi and Avagaha and dressing with Jathyadi Ghrita and crepe bandaging for 9 days along with internal medication. The wound responded well with each treatment procedures. The wound was completely healed. Follow up was done on 7th day and 14th day of discharge. There was complete closure wound. No reappearance of disease since three months. Thus this patient was successfully treated with this Ayurvedic protocol without any recurrence and complications.

AN AYURVEDIC MANAGEMENT OF VARICOSE ULCER: A CASE STUDY.

A male patient aged 37 yrs came to Salyatantra OPD of Sree Narayana Institute of Ayurvedic Studies & Research Hospital, Puthoor, Kollam with complaints of a non-healing wound on left medial malleolus since 6 months. Discharge and itching around wound since 10 days. Pain over inguinal region since 2 days and came here for better management. On examination there was a vertically oval shaped ulcer with slopping edge and the floor was covered with red granulation tissue and white margin on left medial malleolus. On palpation there was temperature rise and tenderness and inguinal lymph node enlargement. The diagnosis was confirmed as varicose ulcer. Patient was treated with Jalaukavacharana for 2 days, Yogavasthi and Avagaha and dressing with Jathyadi Ghrita and crepe bandaging for 9 days along with internal medication. The wound responded well with each treatment procedures. The wound was completely healed. Follow up was done on 7th day and 14th day of discharge. There was complete closure wound. No reappearance of disease since three months. Thus this patient was successfully treated with this Ayurvedic protocol without any recurrence and complications.

Penetrating Atheromatous Ulcer As A Precursor Of Aortic Dissection: A Case Report

Background: Acute aortic syndromes include a range of life-threatening conditions with the most familiar entity being aortic dissection. However, variants of aortic dissection also include intimal tear without hematoma, aortic intramural hematoma, and lastly penetrating aortic ulcer (PAU), which will be the focus of this case report. Most PAUs are located in the descending thoracic aorta (85-95%), but they can also occur in the ascending aorta or arch as in the current case. Case Presentation: We report a case of a 77 year old male who presented with chief complaint of intermittent right-handed weakness associated with no numbness or mental status changes. Patient was admitted for stroke workup with unrevealing findings on CT (computed tomography) for acute abnormalities or any hemodynamically significant stenosis on carotid ultrasound. CT angiogram of head/neck revealed a penetrating aortic ulcer of the lateral aspect of the mid to distal ascending aorta. Patient was then transferred for further evaluation to a center of higher level care for further management. Conclusions: Patient was evaluated for surgical repair of penetrating ascending aortic ulcer. Patient underwent serial imaging throughout hospital course which showed grossly similar findings to prior examination and thus no surgical intervention was needed at that time. Patient was recommended to have follow up CT scan in one month to monitor progression of aortic ulcer, however patient lost to follow-up thereafter. Penetrating aortic ulcers are rarely located in the ascending aorta and are considered precursors of life-threatening aortic dissections.