HighlightsCholedocholithiasis can be treated by endoscopic extraction with or without stenting or by surgery.Stents cam form nidus for development of stones in CBD,may lead to cholangitis.Patients should be informed about ill effects of stent in-situ and advised to review for stent removal after 6 weeks.
Background: Circumcision has been the traditional treatment for phimosis, but with some controversies due to complications. The current study was undertaken to evaluate the effectiveness of topical steroid therapy as primary treatment for childhood phimosis. Methods: A prospective observational study was conducted and a total of 100 patients (age-3 to 12 years) of phimosis were enrolled. The management consisted of topical application of 0.05% betamethasone Ointment for 4 weeks. Those with partial response were advised additional 2 weeks of therapy. Failure to treatment cases were subsequently subjected to circumcision. Results: Total 100 patients were enrolled in the study. Out of 100 patients, 9 were excluded because of noncompliance and remaining 91 patients were studied and followed up. 85 cases out of 91 (93.4%) were declared a 'success'; while remaining 6 (6.6%) were declared 'failure' and were subjected to circumcision. Of the 85 successfully treated; majority (70, 82.3%) responded within 4 weeks of treatment and 15 (17.6%) responded in 6 weeks. The highest number of patients who responded to treatment within 4 weeks were < 5 years of age (54, 93.1%) (p<0.05). Conclusions: Topical steroid (0.05% betamethasone ointment) is an effective, safe, conservative and non-surgical method of primary treatment of childhood Phimosis, especially when combined with good hygiene practices of foreskin with daily retraction and cleansing.
Background: Peptic ulcer perforation is one the most common and catastrophic maladies that affect mankind. The aim of this study was to compare the surgical techniques of peptic ulcer perforation closure namely omentopexy and figure of 8 stitch with reference to recovery time and complications rate.Methods: Of 80 selected patients, figure of 8 method for closure of peptic perforation was used in 40 patients and 40 by using omentopexy method. Outcomes were compared in view of postoperative recovery time and postoperative complications such as wound complications, respiratory complications, burst abdomen, septicaemia, hospital stay, death.Results: In our study it was noted that age of presentation was in elderly males with risk factors like alcohol, smoking, tobacco chewing, and NSAIDS use in decreasing order. Late presentation was associated with higher complication including one death. In figure of 8 group it was found that RT Removal was early, early oral resumption loss hospital stay in figure of 8 group than in omentopexy group. Complications such as wound complication, burst abdomen , leak, and septicaemia were more in omentopexy group than figure of 8 group. Only one death occurred in study that was in omentopexy group.Conclusions: We came to conclusion that peptic perforation is more common in males around 50 years with risk factors of smoking and alcohol. Outcomes of surgery with figure of 8 stitch were better than omentopexy with respect to oral resumptions, early discharge, less complications such as wound complications, burst abdomen leak septicaemia and death.
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