Background: Aim of study is to prospectively evaluate the ability of the Bedside Index for Severity in Acute Pancreatitis (BISAP) score to predict mortality as well as intermediate markers of severity.Methods: 50 patients admitted from December 2015 to November 2017 with acute pancreatitis were included in the study. BISAP score is calculated in all such patients based on data obtained within 24hrs of hospitalization. Patients were assessed for organ failure according to Marshall scoring system and followed throughout hospitalization for assessment of complications. Statistical analyses were made using Fischer’s exact probability test. The difference was assumed statistically significant when p<0.05.Results: There was a statistically highly significant trend for increasing mortality (p < 0.05) and intermediate markers of severity (p<0.05) that is transient organ failure, persistent organ failure and pancreatic necrosis with BISAP score ≥3.Conclusions: The BISAP score represents a simple way to identify patients at risk of increased mortality and the development of intermediate markers of severity within 24 hours of presentation.

Background: This study was undertaken to know whether clip usage or ultrasonic energy application, obtains better haemostasis of cystic artery during laparoscopic cholecystectomy.Methods: About 80 patients undergoing laparoscopic cholecystectomy were selected on a prospective basis and divided into two equal groups- A and B. a comparative study was done between the two group. Clips were used to control cystic artery in group A patients and ultrasonic energy device was used for the same in group B.Results: In group A, 2 patients had clip slippage intraoperatively which was dealt by reapplication of clips.in group B,1 patient had intraoperative bleeding from cystic artery few minutes after application of ultrasonic energy which was dealt by bipolar cauterization. In both the groups no, postoperative bleeding was encountered.Conclusions: During laparoscopic cholecystectomy, clip usage and ultrasonic energy application are equally competent in achieving haemostasis of cystic artery.

Chronic wounds are an economic burden to the patient as they put him out of work and consume quality working days. Local insulin therapy is an innovative method in wound care which accelerates wound healing by increasing angiogenesis and granulation tissue formation. This study aims to evaluate its efficacy. OBJECTIVES: To study the efficacy of topical use of insulin in terms of (1) Rate of wound healing (2) Hospital stay. MATERIALS AND METHODS: This is a prospective study carried out in a tertiary health care center in 46 patients after taking informed and written consent. All patients who were satisfying inclusion and exclusion criteria were randomised into two groups A and B. Local insulin therapy was given to group A and normal saline dressing were done to group B. Size and depth were recorded at the start of the treatment and every week thereafter during the period of study. Strict glycemic control was maintained. Results were compared at complete wound healing or at the end of 8 weeks which was earlier. RESULTS: Improvement of the wound in the form of diameter and depth is seen. Significantly increased proliferation of granulation tissue is noticed in most of the patients belonging to group A, that is who received local insulin therapy. CONCLUSION: Local insulin therapy appears to be an efficacious method in the treatment of chronic diabetic foot ulcers and is safe and effective without any systemic side effects. It significantly reduces the hospital stay.

Introduction: Bedsores contribute to the morbidity of bedridden patients and pose challenge for their rehabilitation. Newer methods are being practised and one among them is negative pressure wound therapy. This study was designed to evaluate its efficacy when compared to gauze dressings. Objectives: To study the effectiveness of negative pressure wound dressings over gauze dressings with respect to rate of wound healing. Materials and Methods: A prospective study was done on patients presenting with bedsores to surgery OPD at Narayana medical college. Patients were divided into two groups by random allocation wherein one group had gauze dressings and the other group underwent negative pressure wound therapy. From the time of initiation of treatment once in every week wound size and depth were measured for 6 consecutive weeks. Results were analysed. Results: There was significant improvement in patients treated with negative pressure wound therapy with respect to wound depth and area. Conclusion:Negative pressure wound therapy is an effective method in the management of bedsores.

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