European Journal of Molecular & Clinical Medicine

The reconstruction of extensive traumatic lower limb defects need free flaps for covering the
defects when no local flaps are available for covering the defects. Free ALT flap is one of the
most commonly used flaps for reconstruction of extensive lower limb defects. This is a
prospective study of the thirty seven patients who had undergone Free ALT flap cover for the
extensive traumatic lower limb wound defects between January 2018 to April 2021 at our
Trauma care Hospital. One hundred and thirty patients had undergone reconstruction of
traumatic lower limb with one of the flap surgery. Thirty seven of this patients had underwent
a free ALT flap surgery for limb reconstruction. Only traumatic lower limb wound defects
were included in the study. Non traumatic wounds like diabetic limb wounds or cancer
wound defects were excluded. All the patient data including (age, sex and comorbidities),
mode of injury (Road traffic accident, Fall of heavy object, Crush injury), wound defect data
(site, size, underlying fracture and exposed structures), presence of any vascular injury in the
limb, the micro vascular flap data, postoperative complications and management data, follow
up data were recorded. Among patients who were managed with ALT flap, 62.6% of patients
presented with Post traumatic raw area, 25% of patients presented with Heel pad avulsion,
6.2% of patients presented with Post fasciotomy wound and 6.2% of patients presented with
Ankle contracture. Among patients who were managed with ALT flap, the success rate was
found to be 81.2%, 9.4% of patients had partial flap necrosis and 9.4% of patients had
complete flap necrosis.

Background: Nonalcoholic fatty liver disease (NAFLD) is a global epidemic that is often asymptomatic and silent, and progresses slowly and is one of the most common causes of chronic liver disease. NAFLD affects a third of the world population with very much high prevalence among patients with diabetes mellitus, obesity, hypertension, dyslipidemia, hypothyroidism etc. The natural history of NAFLD ranges from pure steatosis to steatohepatitis (NASH) to cirrhosis and in some patientsto hepatocellular carcinoma (HCC). NAFLD has been found to be the hepatic components of metabolic syndrome which is one of the leading causes of chronic liver disease. This study aimed to determine the biochemical hepatic markers and lipid profile among NAFLD patients and their possible relationship with degrees of fatty liver and other comorbidities to aid the clinician tointervene early in order to delay the occurrence of complications associated with NAFLD.
Materials and Methods: In this analytical cross sectional study, 145 individuals aged 20–69 years referred to the Govt Medical College/ GGH Hospital Suryapet during the period from June 2021 to May 2022, were included through sequential sampling method after meeting inclusion and exclusion criteria and after taking informed consent and ethical committee approval. Serum lipid profile and Serum liver enzymes was estimated on ERBA EM 360 auto analyzer.
Results: We found significant increase in lipid parameters (TC, LDL-C, VLDL-C, and TG), liver enzymes (AST, ALT, and GGT) and decrease in HDL-C and AST/ALT (Deritis ratio) in NAFLD with type 2 DM compared to controls.
Conclusion: We conclude from our study that in obesity, dyslipidemia, hypertension, hypothyroidism and Type 2 DM the elevated liver enzymes and lipid profile could be biomarkers for the early diagnosis of NAFLD with Type 2 DM and other comorbidities.

Physiological, immunogenetic, selection, technological, biotechnological, and other methods to increase the productivity of karakul sheep are used to increase their productivity, as well as biologically active substances that increase the productivity of karakul sheep.