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Background and objectives: Hepatic abscess is a very common and significant health condition in developing countries including India. Alcohol consumption is one of the most important predisposing factors in causation of hepatic abscess followed by uncontrolled diabetes and immunosuppression. The aim of this study was to device a definitive protocol in the management of patients with liver abscess and to evaluate the different treatment option of liver abscess, amoebic or pyogenic in order to have some guidelines in our setting Material and methods: A hospital based prospective study was conducted between August 2014 to September 2016 in Bangalore medical and research institute (Victoria hospital and Bowring and Lady Curzon Hospital), Bangalore. The following study was done in a set of 50 patients diagnosed with liver abscess admitted in our hospital. After confirming the diagnosis, patients were exposed to different treatment modalities which consisted of medical management alone, USG guided Aspiration, Pigtail catheterization and exploratory laparotomy. Results: In our study majority of the patients (84%) were of amoebic liver abscess (ALA) and only 16% were of pyogenic liver abscess (PLA). Out of 50 patients 8 patients responded to drug therapy alone, 40 patients underwent ultrasound-guided aspiration and pigtail catheter placement and 2 patients were treated with CT guided aspiration. Open surgical method was excluded in our study. Conclusion: Image guided drainage is the best modality of treatment for liver abscess size >4cm in both pyogenic and amoebic liver abscess however in small size abscess medical management is equally good. Abscess cavity resolves better and has a lower recurrence rate in case of percutaneous catheter drainage than percutaneous needle aspiration.. Mortality was not observed in our series. Prompt diagnosis, aggressive medical treatment along with minimal intervention can keep the morbidity and mortality associated with this condition t

Background and objectives: Major limb amputation is reported to be a major but preventable public health problem that is associated with profound economic, social and psychological effects on the patient and family especially in developing countries where the prosthetic services are poor. Amputation has implications on both mobility and functionality. The purpose of this study was to outline the patterns, indications and short term complications of major limb amputations and to compare our experience with that of other published data. Material and methods: This was a cross-sectional descriptive study involving all patients who underwent major lower limb amputations at Bowring and Lady Curzon Hospital between March 2008 and February 2016. All patients who underwent major limb amputation were, after informed consent for the study, enrolled into the study Amputation was performed by the attending surgeon who also prescribed the postoperative care of the patient. Patients were followed up till discharge or death. Results: A total of 162 patients were entered into the study. Their ages ranged between 2180 years. The most common indication for major limb amputation was diabetic foot complications in 87.6% followed by chronic non healing ulcer and peripheral vascular disease. Above knee amputation was the most common procedure performed in 88.8%. Conclusion: Complications of diabetic foot ulcers and chronic non healing ulcer were the most common indications for major limb amputation in our environment. The majority of these amputations are preventable by provision of health education, early presentation and appropriate management of the common indications.

Background and objectives: Hepatic abscess is a very common and significant health condition in developing countries including India. Alcohol consumption is one of the most important predisposing factors in causation of hepatic abscess followed by uncontrolled diabetes and immunosuppression. The aim of this study was to device a definitive protocol in the management of patients with liver abscess and to evaluate the different treatment option of liver abscess, amoebic or pyogenic in order to have some guidelines in our setting Material and methods: A hospital based prospective study was conducted between August 2014 to September 2016 in Bangalore medical and research institute (Victoria hospital and Bowring and Lady Curzon Hospital), Bangalore. The following study was done in a set of 50 patients diagnosed with liver abscess admitted in our hospital. After confirming the diagnosis, patients were exposed to different treatment modalities which consisted of medical management alone, USG guided Aspiration, Pigtail catheterization and exploratory laparotomy. Results: In our study majority of the patients (84%) were of amoebic liver abscess (ALA) and only 16% were of pyogenic liver abscess (PLA). Out of 50 patients 8 patients responded to drug therapy alone, 40 patients underwent ultrasound-guided aspiration and pigtail catheter placement and 2 patients were treated with CT guided aspiration. Open surgical method was excluded in our study. Conclusion: Image guided drainage is the best modality of treatment for liver abscess size >4cm in both pyogenic and amoebic liver abscess however in small size abscess medical management is equally good. Abscess cavity resolves better and has a lower recurrence rate in case of percutaneous catheter drainage than percutaneous needle aspiration.. Mortality was not observed in our series. Prompt diagnosis, aggressive medical treatment along with minimal intervention can keep the morbidity and mortality associated with this condition t

Background and objectives: Major limb amputation is reported to be a major but preventable public health problem that is associated with profound economic, social and psychological effects on the patient and family especially in developing countries where the prosthetic services are poor. Amputation has implications on both mobility and functionality. The purpose of this study was to outline the patterns, indications and short term complications of major limb amputations and to compare our experience with that of other published data. Material and methods: This was a cross-sectional descriptive study involving all patients who underwent major lower limb amputations at Bowring and Lady Curzon Hospital between March 2008 and February 2016. All patients who underwent major limb amputation were, after informed consent for the study, enrolled into the study Amputation was performed by the attending surgeon who also prescribed the postoperative care of the patient. Patients were followed up till discharge or death. Results: A total of 162 patients were entered into the study. Their ages ranged between 2180 years. The most common indication for major limb amputation was diabetic foot complications in 87.6% followed by chronic non healing ulcer and peripheral vascular disease. Above knee amputation was the most common procedure performed in 88.8%. Conclusion: Complications of diabetic foot ulcers and chronic non healing ulcer were the most common indications for major limb amputation in our environment. The majority of these amputations are preventable by provision of health education, early presentation and appropriate management of the common indications.