To Critically Assess the effect of oral vitamin D supplements on wound healing in a patient with diabetic foot ulcer and its impact on lipid metabolism. This is a single-Centre prospective randomised, control-controlled study was conducted in Department of Surgery Datta Meghe Medical College, Hingna, Nagpur, in collaboration with Datta Meghe Institute of Medical Sciences (DMIMS) Deemed to be University from June 2019 TO March 2020. A total of sixty patients were included in this study. A randomised grouping was done, group A vitamin d supplements and group B as an x-control group. In the group, A vitamin D levels were significantly increased after 12 weeks of intervention as compared to baseline while in group B, no change was seen after the intervention. There was a significant change in HbA1c level after intervention as group A vs group B. similar results were seen in total cholesterol levels after intervention in group A, and group B. Wound surface area was (29.83±15.02 vs 21.76±11.30, p=0.02) in group A and (25.06±14.02 vs 21.3±13.19, p=0.28) in group B respectively. The level of high-density lipoprotein in the group was significantly lower in level when compared to group A after 12 weeks of intervention. No significant changes were seen in the triglycerides level in group A and group B., A comparison of group A vs group B after 12 weeks of intervention, was done. It revealed that Vitamin D Glycosylated total haemoglobin cholesterol, High-density lipoprotein and Wound surface area, significantly improved. At the same time, there was no change seen in triglycerides levels in both the group.After intervention with vitamin D supplements for 12 weeks among patients with diabetic foot ulcer had a good result and beneficial effect on glucose metabolism, vitamin D levels, lipid profile and wound healing
Incisional hernia affects all age groups and involve both male and females. It can be defined as hernia which protrudes through surgical wound which was healed incompletely. Management of incisional hernia requires operative intervention most of the times it may laparoscopic repair with synthetic non-absorbable mesh or open anatomical repair.In partnership with Jawaharlal Nehru Medical College AVBR Hospital (Datta Meghe Institute of Medical Sciences) Sawangi (Meghe), Wardha, Maharashtra, this work was performed in the Department of General Surgery at Datta Meghe Medical College and Shalinitai Meghe Hospital and Research Centre ,Hingna , Nagpur. Over a period of 1 year 59 cases of diagnosed incisional hernia were included.33 males and 26 females were included. The mean age was years. Most common cause of Incisional Hernia (IH) post-operative wound infection(49.15%). In maximum cases history suggestive of emergency surgery(86.44%).Type of incision suggests maximum cases in midline incision (55.93%) followed by Pffanensteils incision (28.81%).Open mesh hernioplasty was the common procedure (57.62%) ,Lap mesh hernioplasty done in (25.42%)cases and (16.94%) cases were treated by suture repair. There was no evidence of recurrence in laparoscopic repair as open mesh hernioplasty has a recurrence rate of 03.57% and suture repair cases showed 33.33% recurrence.Incisional Hernia and its occurrence can be taken care of by implementing all standard aseptic precautions thereby avoiding chances of infection at the time of primary surgery wherein thorough peritoneal wash, proper techniques of wound closure and use of appropriate antibiotics is recommended. Management of IH with Laparoscopic mesh repair has its own advantage in terms of less hospital stay, negligible rate of recurrence though it is not cost effective at present scenario.
Background: The objective of this study is to evaluate the outcome of novel perioperative management involving prophylactic antibiotic, Intra Venous fluids and Intermittent Nasal Oxygen and avoidance of preoperative blood transfusion for Laparoscopic Cholecystectomy. Methods: A prospective study included all sickle cell disease (SCD) and trait patients who underwent Laparoscopic Cholecystectomy from January 2007 to August 2010 at Acharya Vinoba Bhave Rural Hospital, attached to Datta Meghe Institute of Medical sciences university, Sawangi, Wardha. India Result: A total of 26 patients underwent Laparoscopic Cholecystectomy. There were two recorded episodes of acute painful crises and three patients had postoperative fever. There were no recorded episodes of Acute Chest syndrome. Conclusion: Laparoscopic Cholecystectomy can be safely performed for sickle cell anemia (disease and trait) patients, without preoperative blood transfusion. A defined perioperative regimen including use of antibiotic, IV fluids and Intermittent Nasal Oxygenation for these patients helps to reduce SCD related complications. Keywords: Laparoscopy, Cholecystectomy, Sickle Cell, Nontransfusion, Haemoglobinopathy.
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