Background: Diabetic foot ulcer is a very common condition encountered in surgical practise. Wound management pose a good challenge for a treating surgeon due to its physical, mental and social implications. The devitalised necrotic tissue present in ulcer does not favour the wound healing as it increases the chance of infection and delays appearance of granulation tissue. Hence debriding of devitalised tissue plays a key role in wound care. In present study ,we used papain urea based preparation in dressings which is a autolytic agent. This study was conducted to evaluate the effectiveness of use of papain urea based preparations compared with regular conventional dressing in diabetic foot ulcer management.Methods: This was a prospective study conducted in K. R. Hospital, Mysore, Karnataka, India. 60 eligible subjects with diabetic foot ulcers were selected and subjects were randomly allocated into two groups Group A and Group B with 30 subjects in each group. Subjects in Group A underwent dressing with papain urea based preparation and in Group B underwent regular conventional dressing. Results were assessed with respect to percentage decrease in necrotic tissue, incidence of infection, appearance of granulation and hospital stay.Results: Among Group A subjects percentage reduction of necrotic tissue was more, granulation appeared early and the hospital stay was less compared to Group B subjects which were statistically significant. However, there was no significant difference with respect to incidence of infection in both groups.Conclusions: Papain urea based preparation is effective in diabetic foot ulcer care.

Background:Mass in right iliac fossa is a very common condition a surgeon will come across in day to day practise. This study was aimed at assessing various symptoms with which subjects with mass in right iliac fossa present to clinician.Methods: 50 eligible subjects admitted in K. R. Hospital who were diagnosed to have mass in right iliac fossa clinically or radiologically were selected after informed valid consent. A proper history, thorough clinical examination and relevant investigations were done to diagnose the pathology. Various symptoms were assessed.Results:In our study, the various conditions which presented as mass in right iliac fossa were appendicular mass (42%), appendicular abscess (16%), ileocaecal tuberculosis (24%), carcinoma caecum (14%), ileopsoas abscess (4%). Various symptoms with which subjects presented were pain abdomen (88%), fever (78%), vomiting (30%), mass per abdomen (28%), weight loss (38%), bleeding per rectum (12%) and bowel disturbances (16%). Appendicular pathology was most common cause in younger age group and carcinoma caecum and ileocaecal TB was more prevalent in older age group.Conclusions:Various symptoms with which subjects presented were pain abdomen, fever, vomiting, mass per abdomen, weight loss, bleeding per rectum and bowel disturbances. Pain abdomen was the most common symptom in subjects with mass in right iliac fossa. Mass per abdomen as a symptom was found in 28% of the subjects.