Background: Gastric Cancer is the second most common cancer worldwide surpassed only by lung cancer as the leading cause of cancer deaths. Early disease has minimal, non-specific or no symptoms. Therefore prognosis for gastric cancer patients remain poor as most patients are diagnosed in advanced stages. Present study was thus undertaken to study various etiological risk factors, clinical presentations and associated complications in cases of Carcinoma stomach. Material and Methods: Present study was a hospital based prospective observational study conducted in diagnosed cases of gastric carcinoma underwent surgery at our tertiary hospital. Results: In present study total 25 patients were studied. Majority of the study participants were in the age group of 61-65 years (40 %), and male (64%) were more than female (36%), male: female ratio was 1.8:1. There was no statistical association between TNM staging and outcome (p=0.4401). 36 % of the study subjects were found to have tumour in the body of stomach and underwent subtotal gastrectomy. Whereas 64 % of the participant had tumour in the pylorus and underwent distal gastrectomy and palliative gastro jejunostomy. There is no statistical association between type of surgery and outcome. 16% of the total study participants developed ARDS. The most common complication encountered was pneumonia in 20% of the subjects. 44 % did not develop any complications after surgery. Significant statistical association between complications and outcome (p=0.003). 100% of the participants who underwent distal gastrectomy had ICU stay less than 10 days, 45.45% of the participants who underwent palliative gastro jejunostomy and 44.44% of the subjects who underwent sub-total gastrectomy had ICU stay less than 10 days. Conclusion: 36% had tumor in the body of stomach and underwent subtotal gastrectomy, 64% had tumor in the pylorus and underwent distal gastrectomy and palliative gastro jejunostomy. Highly significant statistical association was noted between ICU stay/ complications and outcome of surgery.
Background: One of the conservative management of ureteric caculi is by medical expulsive therapy by targeting common causes of obstruction such as edema, ureteral spasm and infection which will favour expulsion of calculi. The objective of this study was to assess comparative efficacy and safety of medical expulsive therapy of ureteric calculi.Methods: This was a randomized, prospective, open label, comparative study. Subjects satisfying inclusion and exclusion criteria were randomized into 4 groups tamsulosin, nifedipine, progesterone and control. Medical expulsion of calculi of 6mm to 15 mm size was carried out in 120 patients. Patients were followed up on OPD basis every third day. Calculi expulsion until day 28 as confirmed by abdominal ultrasonography was taken as the end point.Results: Expulsion rate in tamsulosin group was 90%, whereas nifedipine, progesterone group were 83.33% and 70% respectively which was significant compared to control group which was 36.6% (p < 0.005). Expulsion time was also reported to be significantly less in these groups as compared to control group. Therapy related adverse effects were minor and were seen in only 6 patients.Conclusions: Medical expulsive therapy of ureteric calculi of size 6 to 15mm with Tamsulosin, nifedipine and progesterone were safe and efficacious and could be implemented for initial management in selected patients.
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