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Background:Gastroesophageal reflux disease (GERD) is of the common disease affecting a significant proportion of the world population. GERD is a chronic disease that typically requires long term management in the form of lifestyle modification, medical therapy and, for a subset of patients, surgical therapy. Hence; we conducted the present study to assess and compare the outcome of medical and surgical treatment therapy in severely retarded subjects with GERD. Materials & Methods: The present study included comparison of efficacy of medical and surgical treatment in retarded patients with GERD. A total of 24 patients were included in the present study and were randomly divided into two study groups. Group A included patients that underwent medicinal treatment while group B included patients in which surgical treatment was planned. Nissen fundoplication and gastrostomy was performed in group B patients. Complete follow-up details of all the patients were maintained and compared. All the results were analyzed by SPSS software. Results A total of 24 patients were included in the present study which were broadly divided into two study groups. Mean age of the patients of group A and group B were 25.2 years and 24.2 years respectively. Respiratory symptoms were found to be present in 1 and 4 patients of group A and group B respectively. Significant results were obtained while comparing the respiratory symptoms in patients of group A and group B. Conclusion: Improvement in respiratory symptoms occurred significantly faster in patients undergoing medicinal treatment. However; no other significant changes were obtained in patients undergoing medicinal and surgical treatment.
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Background: Peptic ulcer formation affects about 2-10% of world population every year with higher incidence in younger individuals. Being a surgical emergency, it has higher mortality and morbidity. Thus, the aim of our study was to evaluate the incidence of peptic ulcer perforation based on gender, age and also to study its associated risk factors, clinical presentations, site along with surgical management and complications. Materials & Methods: 75 patients diagnosed with perforated peptic ulcer were included and this study was conducted in the department of Surgery Government Bangur Hospital, Pali, Rajasthan, India. Structured performa was prepared to obtained details of patients and ethical clearance from the institute was also taken prior to the study. Results: 76% of patients in our study were males and 24% were females with male and female ratio 1:3.16. The prevalence of perforation was high in age group 20-30 years (30.7%). 62.7% of cases had positive family history and the incidence was in the patients who consumed non-vegetarian (84.8%), spicy (61.4%) and oily (69.5%) foods. Frequently observed clinical presentation were abdominal pain followed by tenderness and rigidity and gas under diaphragm. The common site of perforation was duodenum (62.7%) and most of the cases were treated by closure with omental patch (81.3%). The post-surgical complications frequently observed were wound infection (30.6%) and chest infection (28%). Conclusion: Peptic ulcer perforation is common disorder of gastrointestinal tract, now affecting younger adults with male preponderance. It is associated with unwanted health and economic issues. Therefore, earlier management is only the way to minimize complications and mortality.
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Background: Obesity is generally classified as generalized obesity (GO) and abdominal obesity (AO). Individuals with obesity have higher rates of mortality and morbidity compared to non-obese individuals. Globally, the prevalence of childhood obesity has risen in recent years. The International Association for the Study of Obesity (IASO) and International Obesity Task Force (IOTF) estimate that 200 million school children are either overweight or obese. Aim of the study: To evaluate the prevalence of overweight and obesity in children of rural population. Materials & Methods: For the study we selected subjects from the local government schools in the rural area. A total of 180 subjects with age ranging from 5-17 years were included in the study. The body weight was measured without shoes using a measuring scale and height to the nearest centimeter was taken. Body Mass Index (BMI) was calculated as weight (in kilograms) divided by height (in meter squared). Results: In the study group, no. of obese patients was 12, no. of overweight subjects was 26 and no. of non-obese subjects was 142. We observed that maximum no. of obese children were seen in the age of 10 years (n=3) followed by age of 6, 14 and 15 years (n=2). No. of obese boys was 8 and no. of obese girls was 4. No. of overweight boys was 16 and no. of overweight girls was 10. Conclusion: The high frequency of obese and overweight children is observed in rural area. We found higher frequency of obesity in boys as compared to the girls. Obesity is a serious problem, which requires immediate attention, creating awareness program in the schools and parents encouraging their children to be involved in more physical exercises, sports and outdoor activities.
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Background: Ununited, femur neck fractures are a common problem in the developing countries like India where medical facilities are already deficient and ignorance, illiteracy and poverty further delay the patients in seeking proper treatment. The struggle to find the best treatment continues as relentlessly as it did half a century ago. The study was undertaken to evaluate the results of close reduction, cancellous screw fixation and fibular graft in ununited fractures of femoral neck in young adults with regards to achievement of fracture union, effect of this procedure on pre-existing AVN and establishment of relatively easy new surgical technique. Materials & Methods: This study was conducted in Government hospital, Pali, Rajasthan. It includes 25 cases treated by close reduction, cancellous screw fixation and fibular strut graft who have non-united fracture. The patients are systemically interrogated for personal details, mode of injury, time elapsed after injury, complaints, any other associated injury, any previous treatment taken and other systemic illness. Grading of fracture (Garden’s classification) resorption of neck and avascular necrosis changes are based on roentgen graphic findings. Results: Our study showed that the mean age of patients was 35.19 years and maximum patients were seen in 21-40 years of age (72%), male to female ratio was 2.57:1. Average union time in our series was 19 weeks. In present series good to excellent results found in 96% of cases; in only one case (4%) result was poor that was because of failure of procedure. Conclusion: We concluded that the cancellous screws fixed in closed reduced fracture and supplemented with fibular strut graft is one of the good methods as far as union and functional results are concerned in ununited fractures of femoral neck.
ABSTRACT
Prokinetics are commonly used for Functional Dyspepsia (FD) and GastroEsophageal Reflux Disease (GERD). Aims and Objectives: To evaluate the safety and efficacy of cinitapride Extended-Release (ER) tablets versus conventional cinitapride Immediate-Release (IR) tablets for the treatment of FD and GERD. Materials and Methods: Patients with FD and GERD received either cinitapride ER 3 mg tablets OD or cinitapride IR 1 mg tablets TID for 4 weeks in this randomized, multicentre study. Change in the mean intensity score of gastrointestinal (GI) symptoms (overall and individual) at the end of the study and at each weekly follow up visit as compared to baseline, patients with complete resolution of GI symptoms, patients with > 50% reduction from baseline in overall intensity score, rescue medication use and overall efficacy were recorded. The safety variables were reported adverse events (AEs), laboratory parameters, electrocardiogram, and overall tolerability. Unpaired t test, chi square test or Fisher’s exact test were used for analysis. p < 0.05 was considered significant. Results: Total 218 patients were enrolled Cinitapride ER tablets were non-inferior (non-inferiority margin -2.5) to cinitapride IR tablets for the change in the mean overall GI symptom intensity score at the end of the study as compared to the baseline (treatment difference - 0.2 (95% CI: -2.2, 1.7)); also, no significant difference was found for other efficacy variables (p > 0.05). Eight AEs of mild-to-moderate intensity were reported. There was also no difference in the overall tolerability between the study groups (p = 0.875). Conclusions : Both the study treatments were comparable in terms of safety and efficacy for the treatment of FD and GERD.