Background: An association between hiatus hernia and cholelithiasis has been suspected for a long time but has never been adequately documented. Cholelithiasis is an asymptomatic disease. The precise incidence of hiatus hernia is not known. In current era as the practise is getting result oriented not diagnosing Hiatus hernia and persistence of symptoms is considered as failure in case of surgery. Coexistence if diagnosed preoperatively is of great help in management of the patient. The purpose of the study is to study association of Hiatus hernia with cholelithiasis in patients with dyspepsia.Methods: This is a prospective study conducted in DR. D. Y. Patil Medical College, Pune, Maharashtra for a period of two years. 100 patients of dyspepsia were enrolled in the study. All patients of dyspepsia were subjected to USG- abdomen. Patients were divided into diagnosed cholelithiasis (A) and non-cholelithiasis (B) as per USG findings. Both groups were subjected to upper gastro intestinal scopy. Appropriate statistical method was applied to know the incidence of hiatus hernia in cholelithiasis and non -cholelithiasis patients. Comparison was done to know the association between hiatus hernia and cholelithiasis in the patients with dyspepsia.Results: Total 24% patients had both hiatus hernia and cholelithiasis. Whereas 23% patients had neither hiatus hernia nor cholelithiasis on applying chi-square, p-value is 0.58. This is statistically insignificant.Conclusions: There is no obvious association between hiatus hernia and cholelithiasis in patients with complains of dyspepsia.
Background: Acute fissure in ano, disease of young age is frequently associated with early hemorrhoids. The condition usually presents with severe pain, spasm and needs emergency Lateral internal sphincterotomy (LIS). Results of LIS are extremely rewarding. Additionally, effect of LIS on early hemorrhoids needs to be studied.Methods: Prospective observational study of 106 Patients of acute fissure in ano was conducted in Dr D.Y. Patil hospital and research center, Pune over 2 years. All the patients underwent emergency LIS and evaluated for symptomatic relief, complications and regression of the hemorrhoids diagnosed intraoperatively.Results: Acute fissure in ano is disease of young child bearing age group female (49%). Low fiber diet (75%) is associated with fissure. Lack of exercise and sedentary lifestyle are another factors. LIS is safe and effective tool to control pain and most of the other symptoms.86% patients get complete pain relief assessed by VAS score.98% patients are completely relieved after LIS. 95.2% patients got relief of anal spasm post-operatively.18% of the patients had early hemorrhoids and 70 to 80% of early hemorrhoids were completely reduced post LIS.Conclusions: Acute fissure in ano is the disease of young reproductive female with non-vegetarian diet, sedentary lifestyle, lack of exercise as risk factors. LIS is effective in reducing symptoms. VAS score is handy tool in assessing severity of pain and effectiveness of LIS. Complications with LIS are low making it safe procedure. Association of hemorrhoids with fissure appears insignificant. LIS appears to be effective in reducing the hemorrhoids with fissure.
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