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Wound healing refers to the replacement of destroyed or damaged tissue of a living organism by newly produced tissue, and the time taken is known as wound regeneration time. Wound care is a major challenging biomedical field due to the delayed healing process or delayed wound regeneration time. The factors responsible for delayed wound healing are poor oxygen flow, less exposure to moisture, diseases such as diabetes and cancer, etc., Wound dressings that are formulated from biopolymers such as chitosan, chitin, and cellulose have properties such as biocompatibility (compatible with living systems and does not cause any immunological rejection), biodegradable, nontoxic with minimal side effects, anti-microbial, anti-inflammatory properties. Chitosan is obtained from scales of fish and shrimp. It contains highly reactive amine groups and sodium alginate, which is a polysaccharide produced from seaweed and bacteria and is biocompatible with living systems and biodegradable polysaccharides. This study is based on the development of sodium alginate crosslinked hydrogel and testing the properties of hydrogel with amoxycillin drug and water release property of the drug.
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ABSTRACT: A 48-year-old male presented with proximal muscle weakness of the shoulder with difficulty in lifting objects above the shoulder in July 2012. Electromyogram was suggestive of chronic motor axonal loss with a myogenic pattern, and a deltoid muscle biopsy revealed groups of atrophic muscle fibers and hypertrophic fibers with pan fascicular atrophy suggestive of adult-onset spinal muscular atrophy. He was managed conservatively and developed bilateral pedal edema in August 2022. He had nephrotic range proteinuria, and renal biopsy revealed capillary wall thickening of glomeruli with serum PLA2R antibody positivity suggestive of primary membranous nephropathy. He was managed with telmisartan for 6 months, and there was a reduction in proteinuria. In January 2023, he was given Injection Rituximab due to worsening proteinuria. He failed to have a clinical resolution. This case report describes the management dilemma in membranous nephropathy with SMA due to the risk of toxic myopathies associated with tacrolimus and steroids.
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Background:Lumbar sympathectomy through radio ablation is a useful treatment of peripheral ischemia. However, clinical efficacy with respect to lower limb ulcers is not adequately established in the Indian population. The study was conducted to evaluate the role of radiofrequency ablation (RFA) of the lumbar sympathetic ganglia in healing of ischemic ulcers of the lower limb.Method:The prospective study with 63 patients registered in the General surgery department with lower limb ischemic ulcers between December 2017 July2019 were treated with RFA. Patients with cardiopulmonary disease, pregnant, congenital malformation, or skin infection at the site of intervention, or suffering from bleeding disorders, were excluded from the study. Clinical investigation of the wound was performed, and demographic data was collected. Comparative reduction in wound size was assessed through Friedman`s ANOVA (P<0.001). Difference in pain score, hospital stay, and walking distance were evaluated using Wilcoxon matched pair test (P<0.001), Unpaired t-test, and Paired t-test (P<0.05).Result:Majority of the patients were male (n=40) with a mean age of 60.93 SD14.34 years. Significant reduction in wound size, pain scores and hospital stay were observed post procedure(P<0.001). Number of RFA sessions was significantly associated with the size of the ulcer and Fontaine's classification 2 and 3 (P<0.0001).Conclusion:RFA of lumbar sympathetic ganglia is a potential treatment modality for lower limb ischemic ulcers.
Antecedentes: La simpatectomía lumbar a través de la ablación por radiofrecuencia es un tratamiento útil de la isquemia periférica. Sin embargo, la eficacia clínica con respecto a las úlceras en las extremidades inferiores no está adecuadamente establecida en la población india. El estudio se llevó a cabo para evaluar el papel de la ablación por radiofrecuencia (RFA) de los ganglios simpáticos lumbares en la curación de las úlceras isquémicas de la extremidad inferior. Método: El estudio prospectivo con 63 pacientes registrados en el departamento de cirugía general con úlceras isquémicas de las extremidades inferiores entre diciembre de 2017 y julio de 2019 fueron tratados con RFA. Los pacientes con enfermedad cardiopulmonar, malformación embarazada, congénita o infección de la piel en el lugar de la intervención, o que sufren de trastornos hemorrágicos, fueron excluidos del estudio. Se realizó una investigación clínica de la herida y se recopilaron datos demográficos. La reducción comparativa en el tamaño de la herida se evaluó a través del ANOVA de Friedman (P<0.001).Resultado: La diferencia en la puntuación del dolor, la estancia en el hospital y la distancia a pie se evaluaron mediante la prueba de par coincidente de Wilcoxon (P<0.001), la prueba t no emparejada y la prueba t emparejada (P<0.05). La mayoría de los pacientes eran varones (n-40) con una edad media de 60,93 SD14,34 años. Se observó una reducción significativa en el tamaño de la herida, las puntuaciones de dolor y la estancia hospitalaria (P<0.001). El número de sesiones de RFA se asoció significativamente con el tamaño de la úlcera y las clasificaciones 2 y 3 de Fontaine (P<0.0001).Conclusión: LA RFA de los ganglios simpáticos lumbares puede constituir una opción terapéutica para las úlceras isquémicas de las extremidades inferiores.