Introduction: Foot ulcers are serious complication of Diabetes Mellitus and are known to be resistant to conventional treatments. They may end in severe complications like amputations if not treated wisely at the earliest. Foot ulcers affect 10-25% of Diabetic patients. Management of a Diabetic Foot Ulcer (DFU) is often a challenging problem. Healing of these ulcers often takes a long time and may need one or more methods of treatment. In particular Vacuum assisted wound closure (VAC) therapy has gained popularity for treatment of chronic and complex wounds in patients with Diabetes. Aims and Objectives: To evaluate the efficacy of vacuum assisted wound closure (VAC) therapy for the treatment of diabetic foot ulcers.

Behçet disease is a systemic vasculitis characterized by recurrent oral and genital ulcers and uveitis. We describe a rare case of a 43-year-old woman with Behçet disease who was admitted for pyrexia of unknown origin, cough, dyspnea, and chest pain. Her computerized tomography scan revealed pulmonary embolism and right ventricular thrombus. She was treated with anticoagulation for pulmonary embolism and right ventricular thrombus. She was well during her last follow-up.

Aim of the study is to analyse the accuracy and speed of ultrasound guided transversus abdominis plane block with two different monitor positions. Materials and Methods: Prospective observational study was conducted after institutional hospital ethics committee. Twenty four male patients posted for open inguinal hernia repair posted under spinal anaesthesia were selected and divided randomly into two groups and at the end of surgery USG TAP block was given. Group I -USG monitor was kept in line, whereas in Group II -USG monitor was kept in perpendicular to the participant. Twelve anaesthetists who had performed more than 20 procedure were selected and they performed one procedure in each group. History of back pain and neck pain was elicited and any discomfort during procedure was recorded. Accuracy of USG image was recorded. Time taken for the procedure was recorded for both groups. Result: Twelve anaesthetists were selected for this prospective study. Time taken to perform USG TAP in Group I vs Group II was (69.08 ± 8.19 s vs 80.16 ± 4.84s). Difference was statistically significant (p<0.001). Needle placement was significantly more accurate when anaesthetists had the monitor in front of them than to the side (Score was 15 vs 24). Out of 12 anaesthetists, 4 had history of neck pain previously and one was taking treatment for the same. When performed in Group I they had no discomfort but when performed in Group II, anaesthetists with positive history had discomfort during the procedure. Conclusion: It was concluded that the performance of USG TAP block was comfortable and more accurate and the procedure time was shorter, if the monitor was kept in line of the sight of the operator.

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The aim of the study is to evaluate the effect of transversus abdominis plane block on chronic postoperative pain after inguinal hernia repair. Methods: Prospective randomized double blinded study is conducted on 40 male patients posted for inguinal hernia repair under spinal anaesthesia. Divided into 2 equal groups. Group I received USG TAP block with 20 ml of 0.25% bupivacaine whereas Group II received 20 ml of normal saline (Placebo) at the end of surgery. Postoperative VAS scores, analgesic consumption, DN4 scoring at 3 and 6 months to evaluate chronic pain were studied. Results: Forty male patients were enrolled. Postoperative VAS scores of Group I had improved scores than Group II. Analgesic consumption is also reduced in Group I compared to Group II (156.6  48.3 vs 282.1  43.2) which was statistically significant. Incidence of neuropathic pain in Group II was 5% at 3 months and 10% at 6 months; whereas in Group I one patient scored '3' at 3 months which reduced to '2' at 6 months. No restriction of daily activities present in Group I patient. Conclusion: USG TAP block provided better postoperative VAS scores and analgesic consumption, along with the reduction in incidence of chronic pain than placebo.