1. Impact of Bacterial Infection on Skin Graft Outcomes in Leg Ulcers
Digant Shikotara, Vijay Vasantlal Paria
Digant Shikotara, Vijay Vasantlal Paria
Abstract
Background: Chronic leg ulcers often present with bacterial colonization, which can interfere with the success of skin grafting procedures. The presence of comorbidities such as diabetes and advanced age further complicates wound healing and graft integration. Aim: To estimate the impact of bacterial colonization on the success rate of skin grafts in leg ulcers and to evaluate the modifying effects of diabetes and age on wound healing. Materials and Methods: This observational study included 60 patients undergoing split-thickness skin grafting for leg ulcers. Wound swabs were collected prior to grafting for aerobic bacterial culture. Participants were categorized based on colonization status, diabetes presence, and age groups. Graft uptake was clinically assessed on postoperative day 7 and 14. Data were analyzed using descriptive statistics and independent t-tests, with p < 0.05 considered statistically significant. Results: The most common isolate was Staphylococcus aureus (45%), followed by Klebsiella and Acinetobacter. Culture-negative wounds showed relatively better graft uptake. Diabetic patients exhibited lower mean graft take (76.4%) compared to non-diabetics (83.2%), though the difference was not statistically significant (p = 0.120). Infection was the leading cause of ulcers (48.3%), and males were predominantly affected (66.7%). Conclusion: Bacterial colonization, especially with S. aureus, negatively impacts graft success in chronic leg ulcers. Diabetes may further impair graft uptake. These findings highlight the importance of microbiological evaluation and glycemic control prior to surgical grafting to optimize wound healing outcomes.
2. Placental Pathology in Preeclampsia and Eclampsia and its Impact on Pregnancy Outcome-A Cross Sectional Study in a Tertiary Care Centre in Assam, India
Radha Rashmi Baruah, Usha Sarma, Akash Pradeep Bhuyan, Pitambar Baishya
Radha Rashmi Baruah, Usha Sarma, Akash Pradeep Bhuyan, Pitambar Baishya
Abstract
Background: Preeclampsia and eclampsia are significant hypertensive disorders during pregnancy, contributing notably to maternal and neonatal morbidity and mortality worldwide. In India, the incidence of preeclampsia is estimated to be 7 times higher as compared to global range. Knowledge of the placental pathology in these cases is of utmost significance in understanding its pathogenesis. However, no relevant studies were done in this north eastern region of India. Aims and Objectives: To study the spectrum of histopathological changes in the placenta in patients of Pre-eclampsia and Eclampsia. To see the outcome of pregnancies associated with Pre-eclampsia and Eclampsia. Materials and Methods: This cross-sectional analytical study was conducted in the Department of Obstetrics & Gynaecology and the Department of Pathology, Tezpur Medical College over a period of two years from January 2019 to December 2020. Detailed clinical and laboratory evaluation was done in each of the patient. After delivery their placentas were sent for histopathological examination and results were recorded. Results: A total of 120 pregnancies, comprising of 40 cases each of Pre-eclampsia, eclampsia and normal pregnancies were evaluated. Mean gestational age at delivery was found to be 36 weeks and 32 weeks in Pre-eclampsia and Eclampsia group respectively. 55% of newborns were found to be low birth weight in eclampsia as compared to 7.5% in normotensive control groups. The mean placental weight was statistically reduced (p<0.001) in pre-eclampsia and eclampsia groups as compared to control group. Placental necrosis was found to be the most common histopathological features in both preeclampsia (75%) and eclampsia (100%). Other changes include increased syncytitial knots, perivillous fibrin deposit, calcification, hypertrophy of spiral arterioles. Conclusion: Hypertensive disorders of pregnancies are associated with significant pathological changes in the placenta and has significant effect in the pregnancy outcome.
3. Comparison of Possum & P-Possum Scores in Predicting Mortality Among Patients Undergoing Emergency Abdominal Surgery
Himen Baidya, Damodar Chatterjee, Diptendu Chaudhuri
Himen Baidya, Damodar Chatterjee, Diptendu Chaudhuri
Abstract
Introduction: Laparotomies are among the most common surgical procedures. It is widely acknowledged that patients in these situations have bad outcomes. Although emergency laparotomies are among the most frequently performed urgent surgical operations, little is known about their results. The post-operative mortality rate for peritonitis is still high, currently estimated to be between 14.9 to 19.4%, despite countless advancements in surgical techniques, antimicrobial medications, and supportive care. Aims: To compare POSSUM and P-POSSUM scoring in predicting mortality in patients undergoing emergency abdominal surgery. Materials & Methods: Prospective study. Department of General Surgery, Agartala Government Medical College, Agartala, West Tripura from December 2019 to June 2022 and total sample size 150 patients. Result: The average Possum score (mean± s.d.) for patients who died was 92.7000± 5.8678. The mean Possum score (mean± s.d.) for patients who survived was 35.4343± 19.6384. The mean Possum score and outcome distribution was statistically significant (p<0.0001). Conclusion: We came to the conclusion that POSSUM and P-POSSUM scores are statistically significant predictors of death (p < 0.0001 for both) for patients undergoing emergency abdominal surgery at AGMC & GBP Hospital. The mean scores of patients who expired were substantially higher than those of survivors (POSSUM: 35.4, P-POSSUM: 18.9).
4. Study Comparing Quality of Life between Mitral Valve Repair and Mitral Valve Replacement
Suranjan Haldar, Haripada Das, Ashis Halder, Debabrata Biswas
Suranjan Haldar, Haripada Das, Ashis Halder, Debabrata Biswas
Abstract
Objectives: Among the Vulvular heart diseases, Mitral valve disease is the most frequent form of Vulvular heart diseases leading to cardiovascular morbidity and mortality globally. Mitral valve repair (MVr) has gained more attention since mitral valve replacement (MVR) is associated with some critical complications. The present study was conducted to evaluate and compare MV repair and replacement on recovery from surgery, with a focus on postoperative quality of life and health status over one year of follow up period. Methods: The present descriptive observational study with prospective design was conducted at a tertiary level healthcare institute in the city of Kolkata, West Bengal, over a period of one year. A total of 65 patients with mitral regurgitation admitted for mitral valve surgery in the department of Cardio-thoracic and Vascular surgery at the institute were interviewed using a pre-tested and pre-designed schedule and observing and recording the clinical variables after obtaining the ethical clearance from the institute and informed consent from each subject. Quality of life was evaluated with the Medical Outcomes Trust Short-Form 36-item Health Survey (SF-36) scale. Inferential statistics either by parametric or non-parametric tests according to the data distribution for continuous variables and Chi-square test categorical variables was performed to elicit association; p value of less than 0.05 was considered statistically significant. Results: The mean age (SD) of the study population among MV repair was 53.4 (±12.4) years and among MV replacement was 57.2 (±11.6) years. There was a gradual improvement in the NYHA functional class from baseline to 12 months follow-up time for both treatment groups. The mean value of various parameters of the SF-36 scores increased more among the patients of MV repair than replacement over one year of follow up period. Conclusion: There was marked and significant improvement in parameters like Physical function, Role limitation, Bodily Pain, General health and Social function among the patients with MV repair than replacement.