ABSTRACT
Uropathogenic strains from inpatient and outpatient departments were studied from April 1997 to March 1999 for their susceptibility profiles. The various isolates were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Acinetobacter baumanii and Enterococcus faecalis. Antibiotic susceptibility pattern of these isolates revealed that for outpatients, first generation cephalosporins, nitrofurantoin, norfloxacin/ciprofloxacin were effective for treatment of urinary tract infection but for inpatients, parenteral therapy with newer aminoglycosides and third generation cephalosporins need to be advocated as the organisms for nosocomial UTI exhibit a high degree of drug resistance. Trimethoprim and sulphamethoxazole combination was not found to be effective for the treatment of urinary tract infections as all the uropathogens from inpatients and outpatients showed high degree of resistance to co-trimoxazole. Culture and sensitivity of the isolates from urine samples should be done as a routine before advocating the therapy.
ABSTRACT
Benefit of resection of metastatic lesions to the liver and lung from colonic cancer is well established. Resection of solitary metastasis or of locally recurrent malignancies in the periampullary region has now become the norm, as it increases survival. We present our experience with two patients with metastases in the periampullary region from previously treated colonic carcinoma who were treated with pancreaticoduodenectomy.
Subject(s)
Adenocarcinoma/secondary , Colonic Neoplasms/pathology , Duodenal Neoplasms/secondary , Female , Humans , Male , Middle Aged , Pancreatic Neoplasms/secondary , PancreaticoduodenectomyABSTRACT
OBJECTIVES: To assess the morbidity, mortality and 1- and 2-year survival rates, and safety of pancreaticoduodenectomy for periampullary (including pancreatic head) carcinomas in a non-oncology surgical set-up. METHODS: Records of 45 patients undergoing pancreaticoduodenectomies for periampullary cancers between July 1996 and April 2000 were reviewed. These included ampullary (n=23), pancreatic (14) and duodenal (2) adenocarcinomas, lower-end cholangiocarcinoma (5), and ampullary carcinoid (1). Thirty-seven patients underwent the Whipple procedure and 8 underwent the pylorus-preserving modification. RESULTS: The overall mortality rate was 11% and morbidity rate was 46%. Wound infection was the most common postoperative complication. The 1- and 2-year survival rates for periampullary cancers were 61% and 39% and those for pancreatic cancers were 57% and 36%, respectively. CONCLUSION: Pancreaticoduodenectomy for periampullary tumors remains a formidable procedure in our set-up. However, it can be performed safely with low mortality and morbidity rates.
Subject(s)
Adenocarcinoma/mortality , Adult , Aged , Ampulla of Vater/pathology , Bile Duct Neoplasms/mortality , Bile Ducts, Intrahepatic , Carcinoid Tumor/mortality , Cholangiocarcinoma/mortality , Duodenal Neoplasms/mortality , Female , Humans , Male , Middle Aged , Pancreatic Neoplasms/mortality , Pancreaticoduodenectomy , Survival Analysis , Treatment OutcomeABSTRACT
A prospective randomised trial was carried out to compare the efficacy of method of scrubbing the operative site for ten minutes with an antiseptic (GpA; n = 68) with a simplified method where the antiseptic was merely painted onto the operation site (GpB; n = 67). The median age, sex distribution and the types of procedures done in each group were similar as was the antibiotic policy. There were a total of 11 patients who got infected, 6 in the group A and 5 in the group B. No significant difference could be demonstrated in the infection rates between the two groups. It is concluded that the old method of prolonged scrubbing the operation site can safely be omitted to a more simplified version.