INTRODUCTION: Foot infections are the most common problems in patients with diabetes. These individuals are predisposed to foot infections because of a compromised vascular supply secondary to diabetes. Local trauma and/or pressure (often in association with lack of sensation because of neuropathy), in addition to microvascular disease, may result in various diabetic foot infections that run the spectrum from simple, superficial cellulitis to chronic osteomyelitis. Globally, diabetic foot infections are the most common skeletal and soft-tissue infections in patients with diabetes. The incidence of diabetic foot infections is similar to that of diabetes in various ethnic groups and most frequently affect elderly patients. There are no significant differences between the sexes. The mortality risk is highest in patients with chronic osteomyelitis and in those with acute necrotizing soft-tissue infections. PRECIPITATING CAUSES OF FOOT ULCERATION AND INFECTION:  Friction in ill-fitting or new shoes.  Untreated callus.  Self-treated callus.  Foot injuries (unnoticed trauma in shoes or when walking barefoot).  Burns (for example, excessively hot bath, hot water bottle, hot radiators, hot sand on holiday).  Corn plaster.  Paronychia.  Artefactual (self-inflicted foot lesions are rare; occasionally failure to heal is due to this cause).  Heel friction in patients confined to bed.  Foot deformities (callus, clawed toes, bunions, pes cavus, hallux rigidus, hammer toe, Charcot's foot, deformities from previous trauma or surgery, nail deformities, edema) NEUROPATHY: More than 60% of diabetic foot ulcers are the result of underlying neuropathy. 1,2 The development of neuropathy in affected patients has been shown in animal and in vitro models to be a result of hyperglycemia-induced metabolic abnormalities .3,4,5 One of the more commonly described mechanisms of action is the polyol pathway. 4 The hyperglycemic state leads to an increase in action of the enzymes aldose reductase and sorbitol dehydrogenase. This results in the conversion of intracellular glucose to sorbitol and fructose. The accumulation of these sugar products results in a decrease in the synthesis of nerve cell myoinositol, required for normal neuron conduction. Chemical conversion of glucose results in

Objective: To evaluate and compare the safety and efficacy of Solifenacin, Tamsulosin, and Tadalafil in treating ureteral stent related symptoms (SRS) in patients with indwelling Double-J ureteral stents. Materials and Methods: A prospective randomized controlled study was conducted on 146 consecutive patients in the department of urology, Government Stanley Medical College & Hospital, Chennai, Tamilnadu, India between Sept 2017-March 2019, with SRS after taking informed consent and confirming DJ Stent position by X-ray KUB post-operatively. Patients were randomized into 4 groups: Group A (Placebo), Group B (Solifenacin 5 mg), and Group B (Tamsulosin 0.4 mg) and group D (Tadalafil 5 mg) at end of 1st week till the removal of DJ stent at end of 3 weeks. All patients were assessed for bothersome lower urinary tract symptoms (LUTS) using the validated Ureteral Stent Symptom Questionnaire (USSQ) at 1st week and 3 weeks after the starting of medications. Appropriate statistical analysis as carried out and the level of significance was set at P < 0.05. Results: LUTS, general health, and work performance improved with Solifenacin, Tamsulosin and Tadalafil and all the three were comparable in relieving urinary symptoms. Tadalafil was better at relieving body pain, additional problems and sexual problems better than Tamsulosin. Tadalafil showed comparable improvement in LUTS, better sexual health and decreased body pain compared to solifenacin, whereas the latter had better general health, additional problems & work performance scores. Conclusion: Solifenacin is more effective than Tamsulosin in alleviating LUTS associated with SRS and both show a distinctive advantage over placebo. PDE inhibitor Tadalafil can also be tried for SRS and is as effective as antimuscarinics and α-blockers in relieving urinary symptoms and is more efficacious in relieving sexual symptoms and body pain.

This was a prospective clinical study performed in the surgical department of MKCG Medical College and Hospital, Berhampur, Odisha, during the period from September 2013 to August 2015. Six hundred and forty eight patients who underwent surgical procedures >1 hour were included in this study to find the incidence of deep vein thrombosis (DVT) development postoperatively. AIMS AND OBJECTIVESIdentifying the possible risk factors and to identify the subgroup of patients needing prophylaxis routinely after a surgical procedure. METHOD OF COLLECTION OF DATAPatients aged >15 years who underwent surgeries (APR, colostomies, abdominal surgeries, hernia repairs, MRM, thyroidectomies, perforation closure etc.) lasting for more than one hour under spinal, epidural and general anaesthesia. Patients unwilling to take part in the study, patients on anticoagulant therapy and patients previously diagnosed with DVT or VTE were excluded from the study. PROCEDUREClinical examination was carried out in the postoperative period to look for limb pain and swelling. D-dimer levels and Doppler USG were used for diagnosis. RESULTS AND CONCLUSIONThe incidence of DVT was 1.23% and the mean age group of the patients affected was 50.5 years. Male-to-female ratio was 1.28:1. OCP intake, smoking, higher BMI, major surgeries under GA and greater and postoperative immobilisation were important risk factors. Colonic surgeries had a greater chance of post-op DVT development. Duplex USG had a high sensitivity and specificity and thus can be considered the gold standard test for diagnosis of DVT, whereas D-dimer has low specificity and specificity thus not reliable for DVT diagnosis post-operatively.