Background and Objectives: Empyema thoracis is a condition in which pus collects in the pleural cavity. The optimal treatment of Empyema thoracis especially in the fibrinopurulent phase (Stage II) remains controversial. While the Inter Costal Drainage (ICD) is less invasive and cheap, it is not clearly proved that it is better than the Video Assisted Thoracoscopic Surgery (VATS) in terms of conversion into thoracotomy, morbidity and duration of hospital stay. No large randomized trial is available for comparing the two treatment strategies in the condition. Methodology:This study was a prospective comparative study of ICD insertion versus VATS as primary intervention in the fibrinopurulent stage of Empyema thoracis, which was conducted over a period of 2 years (Dec 2008 to Nov 2010), in a tertiarry care Medical College Hospital. With an incidence of around 5-10% and a considerable burden in our hospital, the study was taken up to compare the efficacy of ICD versus VATS, in terms of morbidity and cost effectiveness and to identify the optimal way of managing the condition. The study included a total of 40 patients with each group consisting of 20 patients. Sampling: Purposive sampling technique.The Statistical Methods Used: Descriptive statistics, Frequencies, Crosstabs, Independent sample t-test.Results: It was found that VATS was better than the conventional ICD insertion in terms of the variables like mean duration of hospital stay (p<0.05), mean duration of the chest tube in situ (p<0.05), mean cost of the treatment (p<0.05), complications (p<0.05) and failure rate (p<0.05) which were statistically significant. Conclusion:Our study concluded that Video Assisted Thoracoscopic Surgery is better than conventional ICD tube insertion as a primary mode of treatment in the fibrinopurulent stage of Empyema thoracis.
Background:Cancer constitutes an enormous burden on society in more and less economically developed countries alike. The incidence of gastric cancer is found to increase in the developing countries like India due to change in the life style like having smoked food containing nitrates, smoking , alcoholism and consumption of large amount of red chillies. The objective of this study was to measure the serum pepsinogen I and pepsinogen II levels and its ratio in gastric cancer patients admitted in JSS hospital and Bharath Cancer Centre during the period October 2012 to October 2014 and to compare with controls.Methods: 80 patients - 40 patients with gastric cancer and 40 patients control were studied. Serum pepsinogen I (PG I) and pepsinogen II (PG II) levels were measured using ELISA.Results:The mean PG I levels for cancer patients and controls were 93.98μg/dl and 82.156μg/dl respectively, the mean PG II levels were 42.67 μg/dl and 18.79 μg/dl respectively. The PG I/II ratio in cancer patients is 2.75 and 5.73 in controls, the ratio was significantly lower in cancer patients (P value significant).Conclusions:The ultimate aim in the management of carcinoma stomach is the early detection of the disease. At present endoscopy and biopsy is the gold standard of diagnosis. Different screening tools are under development for the diagnosis of the disease. Our study evaluates a test which can be recommended as an alternative to the diagnosis of gastric carcinoma at an early stage.
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