Aim: Peripheral arterial disease (PAD) is chronic arterial occlusive disease of the lower extremities caused by atherosclerosis. Thepresent study was conducted for comparing the efficacy of minimally invasive procedure vs standard open approach for lumbarsympathectomy.Materials & methods: 100 patients were enrolled in the present study (who were scheduled to undergo lumbar sympathectomy) andwere divided broadly and randomly into two study groups: Group 1: Patients undergoing lumbar sympathectomy by minimal invasiveprocedure, and Group 2: Patients undergoing lumbar sympathectomy through standard open approach. Only those patients wereincluded who had Ischemic rest pain that requires continuous analgesia for more than 3 weeks and Ischemic foot ulcers that failed toheal for more than 6 weeks. All the patients underwent surgical procedures according to their respective study groups. All the resultswere recorded in Microsoft excel sheet and were analysed using SPSS software.Results: Mean duration of analgesic consumption for controlling pain postoperatively was 3.9 weeks in group 1 while it was 3.7weeks in group 2. Mean operative time among the patients of group 1 and group 2 was 51 minutes and 83 minutes respectively (pvalue < 0.05). Incidence of complications was significantly higher among the patients of group 2 in comparison to the patients ofgroup 1. Mean recovery time among the patients of group 1 and group 2 was 5.2 days and 7.3 days respectively (p- value < 0.05).Conclusion: Among patients undergoing lumbar sympathectomy, minimally invasive procedure is better in comparison to standardopen procedure.

Background: The concept of open laparoscopy is to eliminate the risks associated with blind insertion of the Veress needle and trocar. The present study was conducted to assess open versus closed method of pneumoperitoneum creation in laparoscopic surgery.Materials & Methods: 74 patients who underwent operative procedure for laparoscopysurgery of both genderswere divided into 2 groups based on method used. Group I patients were of open laparoscopy (Hasson technique) and group II were of Veress needle (closed method). Per operative findings like method of pneumoperitoneum creation and its duration, multiple attempts, incision size, extraperitoneal insufflation, port site bleeding, gas leak, total gas used were recorded. Results: out of 74 patients, males were 46 and females were 28. In group I and group II, the mean size of incision (mm) was 11.2 and 10.4, duration of pneumoperitonium creation (Sec) was 104.2 and 138.4, multiple attempts were seen in 9 and 4, gas leak at port site in 7and 3, port site bleeding in 5 and 2, pre peritoneal insufflation in 0 and 1 and wound infection in 1 and 2 respectively. The difference was significant (P< 0.05).Conclusion: Both methods were comparable interms of time taken to complete the operation and major and minor complications. Thus, open and closed methods of creating pneumoperitoneum in laparoscopic surgery are safe to perform.

Aim: The aim of this study to compare the topical sucralfate and ordinary saline for diabetic ulcer dressing.Materials and method: Of the 100 patients, 50 received traditional normal saline dressings and the other 50 received sucralfate dressings. Both groups used pressure relief from the affected area but no antibiotics. Both groups received once-daily dressings. The patients were followed up on a daily basis for 3 weeks in both groups. Results: Thirty percent of the patients had ulcers on the dorsal surface of the forefoot, and ten percent had ulcers on the medial malleoli. In conventional normal saline dressings, about 50% of the patients had ulcers on the plantar aspect and about 10% on the lateral malleoli, and 28% of the patients had ulcers on the dorsal surface of the forefoot and 20% had ulcers on the medial malleoli. In Sucralfate dressing, approximately 46% of the plantar aspect and approximately 6% of the lateral malleoli are affected. Dressing with sucralfate. In the Sucralfate dressing, 88% of patients had a negative culture. whereas 98% of patients receiving conventional normal saline dressings had a positive culture. Diabetic ulcers in the Sucralfate dressing had a better mean percentage reduction of area of 43.59±7.81 when compared to the Conventional normal saline dressings, which had a mean percentage reduction of area of 21.85±5.84 when the two groups were studied using an independent sample. The T-test was found to be statistically significant (P 0.0001). Conclusion: Sucralfate dressing is an efficient modality for facilitating wound area reduction in diabetic foot ulcer patients, and it can be used as an adjunct to conventional treatment (conventional dressings and debridement) for faster and better healing of diabetic ulcers. The wounds in the sucralfate dressing group contracted more than the wounds in the ordinary saline group