Aim Chronic radiation proctitis (CRP) develops in 5–15% of patients after pelvic radiation therapy, with rectal bleeding being the main symptom. Reports suggest that argon plasma coagulation (APC) can be an effective therapy for CRP following radiotherapy for prostate cancer, but there is less information about how useful it is after radiotherapy for gynaecological malignancy. The aim of this work therefore was to study the efficacy of APC for CRP after radiotherapy for gynaecological malignancy. Method This was a prospective study of consecutive patients with CRP following radiotherapy for gynaecological malignancy at IPGME&R, SDLD, Kolkata, India; symptoms included rectal bleeding grade (RBG) ≥ 2. APC was performed at monthly intervals to a maximum of four treatment sessions. Severity of disease at baseline was graded (endoscopically) by the total colonoscopic severity score (TCSS) and treatment response was assessed by reduction in RBG from ≥ 2 to ≤ 1 measured at > 6 months after cessation of APC. Results Seventy patients [90% with cervical cancer, 10% with endometrial cancer; mean age 51.93 ± 9.15 years; median RBG 3 (range 2–4)] received APC. Seven patients died due to underlying malignancy and seven patients were lost to follow‐up. Fifty‐six (85.7%) patients responded to therapy after a median of 2 (range 1–4) treatment sessions. Multivariate analysis demonstrated that a lower haemoglobin at the start of treatment predicted failure of therapy (P < 0.05). Conclusion APC is an effective management option for CRP in female patients with gynaecological malignancy. However, the more anaemic the patient the less likely it is to be successful.
Background: Clinical features and outcomes of liver abscess are ever changing, even in South Asia, where parasitic infections are common. It is important to devise management strategies to suit the changing needs. We wanted to capture this emerging spectrum in "real life" through assessment of clinical features, management strategies and outcomes of a cohort of treated liver abscess patients at a single center. Methods: A retrospective study of patients admitted to a referral institution between February 2010 and June 2014 was undertaken. Patients with liver abscess who have received prior treatment in another hospital, and have then been referred for a complicated disease course were studied; their demographics, clinical presentations, evolution and outcomes were analyzed. Results: A total of 154 patients [males 109, 70.78%), mean age 43.71 ±16.49 years] were included in this study. Alcohol use was the most common (23.38%) predisposing factor, followed by biliary obstruction (20.78%) and diabetes (11.04%). Most common presenting features were fever, pain abdomen and jaundice [92.9%, 86.4% and 20.8% patients respectively]. Majority of patients (58.4%) had a solitary liver abscess; right lobe being the commonest site(61%). Median abscess volume was 180 ml (Range 7-1524 mL); abscess rupture occurred in 21 (13.6%) cases, most commonlyin subdiaphragmatic location. Overall, abscess drainage was required in 97 (63%) patients [single time aspiration 15 (15.5%), percutaneous indwelling catheter 80 (82.8%), surgical drainage 2 (2.1%)]. Patients who required percutaneous drainage were mostly males, had higher abscess volumes and were more frequently alcohol users and diabetics. Six (3.9%) patients died in the study period. Conclusion: While large abscess, alcoholism and diabetes were associated with increased need for catheter drainage, 37% can be treated by drug therapy alone. Careful selection of subjects for drainage may help in decreasing the mortality rate in this benign condition.
Background – Intussusception is one of the most common abdominal emergencies dealt in early childhood by Paediatric Surgeons. We paediatric surgeon dealt various abdominal emergency in early childhood, Intussusception is the one of them. The decision to operate on patients of intussusception may sometimes be difcult, such as when the patients have transient intussusception without features of intestinal obstruction, like abdominal distension. Decision for surgery in patients of intussusception is very difcult in some circumstances like patient have complaint of abdominal pain only or transient intussusception. No other sign and symptoms of intestinal obstruction, abdominal distention. So, we did this study in such circumstances. to study the patients of recurrent intussusception, trans Aims and objectives - ient intussusception or newly diagnosed intussusception without intestinal obstruction, who had abdominal pain either off and on or continuous for long time. this is a Methods – retrospective study. It was conducted between January 2020 to December 2020 at Department of Paediatric surgery, Sir Padampat Mother and Child health institute, S.M.S. Medical College, Jaipur. Patient of persiste Conclusion - nt abdominal pain due to recurrent transient intussusception with or without classical triad is the matter of surgical intervention in paediatric patients.
Background: This study was done at SMS Medical College, Jaipur with an aim of emphasizing the need of having a high index of suspicion in newborn presenting with bilious vomiting for the diagnosis of malrotation. Methods: Cases of neonatal small intestinal obstruction due to malrotation presenting to the Department of Paediatric Surgery, SMS Medical College, Jaipur over a period of two years were evaluated. Results: A total of 48 newborns presented to our department with intestinal obstruction due to malrotation. Majority (82%) of the patients presented in the 2nd and 3rd week of life. 6 out of 48 patients presented with extensive gangrene of midgut. 9/48 patients died during the course of treatment and during follow-up. Conclusion: Malrotation is a relatively common cause of neonatal small bowel obstruction. A high index of suspicion is required in neonates presenting with bilious vomiting. Prompt diagnostic tools and early laparotomy prevents fatal complication of extensive midgut gangrene due to volvulus.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.