a b s t r a c tDiabetes is an important risk factor for atherosclerosis. The diabetic foot is characterized by the presence of arteriopathy and neuropathy. The vascular damage includes non-occlusive microangiopathy and macroangiopathy. Diabetic foot wounds are responsible for 5e10% of the cases of major or minor amputations. In fact, the risk of amputation of the lower limbs is 15e20% higher in diabetic populations than in the general population. The University of Texas classification is the reference classification for diabetic wounds. It distinguishes non-ischemic wounds from ischemic wounds which are associated with a higher rate of amputation. The first principles of treatment are the control of pain of an eventual infection. When ischemia is diagnosed, restoration of pulsatile blood flow by revascularization may be considered for salvaging the limb. The treatment options are angioplasty with or without stenting and surgical bypass or hybrid procedures combining the two. Distal reconstructions with anastomosis to the leg or pedal arteries have satisfactory limb-salvage rates. Subintimal angioplasty is a more recent endovascular technique. It could be suggested for elderly patients who are believed to be unsuitable candidates for a conventional bypass or angioplasty. The current article would focus on the various revascularization procedures.

Pheochromocytomas have been described in association with rare vascular abnormalities, most common of them being renal artery stenosis. A 45-year-old woman was admitted to our hospital with complaints of headache, sweating, anxiety, dizziness, nausea, vomiting and severe hypertension. For the last several days, she was having a dull aching abdominal pain with a palpable, pulsatile, expansile and non-tender mass in the epigastric region. Hypertension was confirmed biochemically to result from excess catecholamine production. Abdominal computed tomography revealed the presence of a right adrenal pheochromocytoma. Magnetic resonance imaging of the abdomen demonstrated an abdominal aortic aneurysm (AAA) of maximum transverse diameter of 4.5 cm with 3 cm lumen. Surgical removal of pheochromocytoma resulted in normalization of blood pressure to normal. Because of the asymptomatic 4.5 cm aneurysm, our patient was advised for periodic follow-up. To our belief, this is the first such case report emanating from India, citing this rare association between pheochromocytoma and AAA. It is concluded that when the two diseases occur simultaneously, both must be diagnosed accurately and treated adequately. Possible mechanisms of such an uncommon association are also discussed.

Background:The aim of the study was to study the sociodemographic factors in cases of pregnancy induced hypertension and its associated risk factors in a tertiary care hospital. Method: The present retrospective study was conducted in the Obstetrics and Gynaecology department of IMS & SUM Hospital, Bhubaneswar, Odisha from June 2017 to May 2018. A total of 120 cases of pregnant women with PIH were studied. The sociodemographic data like age, parity, gestational age of presentation, mode of delivery, maternal and perinatal complications were noted from the hospital records and studied. Results: The incidence of PIH was found to be 7.2% in pregnant women attending the IMS& SUM Hospital.52% cases were in the age group of 25-30 years and 27% were in the age group of 19-24 years. In the present study, incidence of PIH was found to be highest among primigravidas (65%) as copmpared to multigravidas (35%).Most cases were delivered by caesarean section (71%) and 29% were delivered vaginally. Out of 120 cases, 10 % of cases were complicated by eclampsia, Severe PIH in 6%, Abruptio placentae in 1.6% and HELLP Syndrome in 0.8% cases. Conclusion: PIH is a very common complication encountered in pregnancy associated with adverse maternal and fetal outcome. The risk ia higher among young primigravidas and in rural population. Better health care facilities and awareness among the pregnant women will help in reducing the incidence of PIH and its associated complications.

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Poor peristalsis and an inability to relax the lower esophageal sphincter are symptoms of achalasia cardia, a chronic neurodegenerative motility condition of the oesophagus. (LES). The primary problem with remedial operations for achalasia cardia is pulmonary aspiration of esophageal residual contents during induction of general anaesthesia. The timing of nil per oral or endoscopic clearance of esophageal contents prior to induction of anaesthesia is not governed by any universally accepted standards. We present the case of a 43-year-old man with a history of hypertension, diabetes, and myocardial infarction who underwent surgery to repair his sigmoid oesophagus. The patient was optimised before the anaesthesia was administered in accordance with the current standard of care. The patient's stay was uneventful, and there was no sign of aspiration during the operation. Aspiration during general anaesthesia was avoided by carefully optimizing the patient beforehand.