Background: Diabetic foot ulcers is a major complication of diabetes mellitus, and precedes >80% of all diabetes related lower leg amputations. One of the risk factors in non-healing diabetic ulcer is low serum albumin level. The objectives of this study were to study the effect of low serum albumin level in patients with diabetic foot ulcer and to study the factors affecting wound healing in diabetic ulcer. Methods: Prospective cohort study in a tertiary hospital. Results: The mean age among study was 57.8 out of which 68.3% were males and 31.7% were females. 55% patients presented with slough over ulcer, 29.2% patients presented with healthy granulation and 15.8% patients presented with extensive wound infection. Among study group 50% patients had good glycaemic control and 50% patients had poor glycaemic control. Conclusions: Low serum albumin level is one of the attributable risk factor of non-healing ulcers in diabetic foot. Poor glycaemic status is also a risk factor for non-healing ulcer.

Background: This study was carried out with the objective to identify the tubercle of Zuckerkandl in patients undergoing thyroidectomy and to establish the relationship of TZN with the recurrent laryngeal nerve and superior parathyroid gland.Methods: 100 patients posted for thyroidectomy for various causes in Government medical college, Kozhikode for a period of 1 year between March 2014 and March 2015. 92 patients underwent total thyroidectomy, 4 patients underwent left hemithyroidectomy and 4 patients underwent right hemithyroidectomy. A total of 192 lobes i.e. 96 right lobes and 96 left lobes were studied.Results: Of the 100 patients studied TZN was identified in 63 (63%) patients. Of the 192 lobes studied, TZN was identified in 100 lobes (52.08%). This was 59 of 96 (61.40%) lobes on the right side and 41 of 96 (42.70%) lobes on the left side. Of the 92 Total Thyroidectomies, TZN was found bilaterally in 36 (39.10%) cases. RLN was identified ‘posteromedial’ in relation in 99 of the 100 (99%) TZNs studied and not visualized in relation to TZN in 1 (1%) case. The Superior Parathyroid was identified ‘superolateral’ in relation in 93 (93%), ‘lateral’ in 6 (6%) and ‘inferolateral’ in 1 (1%) of 100 TZNs studied.Conclusions: Zuckerkandl’s tubercle is a posterior extension of lateral lobes of the thyroid gland, maintains a constant relationship with the RLN and the superior parathyroid gland. It can be used as an anatomical landmark to assist in preservation of the RLN and the superior parathyroid gland during thyroid surgery.

BACKGROUNDSubtotal thyroidectomy is the preferred procedure currently done in our institution for multinodular goitre. However, many surgeons prefer near-total thyroidectomy for this condition as the recurrence of Multinodular goitre is less with this procedure. The main advantage of subtotal thyroidectomy is that the post-operative complications like hypothyroidism, hypocalcaemia and recurrent laryngeal nerve palsy are found to be less with this procedure. In this study, we assess the hypothesis that Subtotal thyroidectomy is not associated with increased risk of recurrence as compared to Near-total thyroidectomy and Total thyroidectomy in cases of benign thyroid disease, multinodular goitre. MATERIALS AND METHODSWe conducted a retrospective study among patients who underwent subtotal thyroidectomy in Govt. Medical College, Calicut during a 5-year period from 2008 to 2012. We collected data from the record library and contacted them through letter. A total of 108 patients were included. Then, detailed history taking, physical examination and relevant investigations were done. RESULTSPostoperative USG and FNAC showed 3 cases of recurrence, that is 2.8%. Postoperative functional status shows that 21% remained euthyroid and about 79% were hypothyroid. No cases of hypocalcaemia or recurrent laryngeal nerve palsy were reported. CONCLUSIONThere is no increased risk among these subjects considering recurrence, but had advantage of lesser complications. So it concludes that subtotal thyroidectomy is a better procedure for benign thyroid diseases compared to total thyroidectomy and is not with increased risk of recurrence.

Background: Saline dressings and povidone iodine dressings have been traditionally used for the management of chronic diabetic wounds Methods: Subjects attending diabetic wound clinic and surgery outpatient department/ casualty of Government Medical College and Hospital, Kozhikode, Kerala, India were divided into two groups by consecutive sampling i.e., Povidone iodine and Saline dressing group. Regular occlusive dressing was done for 6 weeks of follow-up period.Results: 3 out of 20 subjects in Saline treated group achieved complete healing by 6 weeks as compared to 1 out of 20 subjects in Povidone iodine treated group. There was a significant decrease in the wound surface area at 6th week in Saline dressing group in comparison to the povidone iodine group at P = 0.03 (<0.05) level of significance.Conclusions: Saline dressing is more effective in achieving healing in chronic diabetic wounds as compared to Povidone iodine dressing.