Background: Diabetes is the most common underlying cause of foot ulcers, infection, and ischemia, leading to hospitalization and the most frequent cause of non-traumatic lower extremity amputation. Despite well-defined risk factors for diabetic foot ulcer development, limited data are available as to which factors predict amputation in a diabetic foot ulcer episode. Therefore, to predict lower limb amputation occurrence and to determine the factors associated with the risk of amputation in diabetic patients, we conducted this study.Methods: A hospital based longitudinal study was carried out to assess the risk factors associated with amputation in diabetic foot infection. Patients with foot infections, who were either a diagnosed case of diabetes mellitus or were diagnosed at the institute were included in the study. We excluded patients receiving immunosuppressive therapy or radiotherapy, and infections at or above the ankle joint. Study factors were demographic details, biochemical parameters, Wagner grading, peripheral neuropathy as evaluated by nerve conduction test and vasculopathy as assessed by Ankle brachial index. The primary outcome factor was amputation. The data was presented as descriptive statistics and analyzed by dividing the patients into amputation and non-amputation group, and univariate and multivariate analysis was done.Results: A total of 64 patients were included in the study, out of which the amputation rate was 39.1%. Poor glycemic control, osteomyelitis, vasculopathy, peripheral neuropathy and Wagner grading were statistically significant.Conclusions: In the present study, poor glycemic control, vasculopathy, peripheral neuropathy and higher Wagner grade are significant risk factors for amputation in diabetic foot infections.

Acute obstructive suppurative pancreatic ductitis (AOSPD) is a rare complication of chronic pancreatitis that has been described in only seven previous case reports since 1995. We report a case of a 33-year-old female a known case of chronic pancreatitis with computed tomography suggestive of dilated main pancreatic duct with multiple calcifications. On exploration, pancreatic duct aspiration revealed frank pus. Pus was drained after opening the pancreatic duct and longitudinal pancreaticojejunostomy was done. Patient was relieved of her symptoms after surgery. In conclusion, AOSPD should be considered in long standing cases of chronic pancreatitis. AOSPD appears to respond quickly after drainage procedure like longitudinal pancreaticojejunostomy and should be considered the treatment of choice.

Background: A bezoar is persistent, ingested material that collects within the gastrointestinal tract. The most common type of bezoar, a gastric trichobezoar, is made up of human hair and found in the stomach. Patients with trichobezoar often remain asymptomatic for many years. The aim of treatment of trichobezoar is removal of the bezoar and to prevent recurrence. Case Report: A 12 year old girl presented with abdominal pain and vomiting. suffering from trichophagia developing trichobezoar. Ultrasonography was suggestive of partial gastric outlet obstruction and barium swallow was suggestive of bezoar in gastric lumen. Conclusion: Trichobezoar should be considered in young females presenting with non-specific abdominal complaints.

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