Isolated corrosive pyloric stenosis without oesophageal involvement: An experience of 21 years

Corrosive ingestion is common in Asia and it is a frequent cause of morbidity secondary to intense fibrotic reaction and stricture formation of the oesophagus. Isolated corrosive pyloric stenosis without oesophageal involvement is an uncommon phenomenon. All consecutive patients, with corrosive ingestion in the last two decades, were reviewed and analysed. Eleven out of 201 patients with corrosive ingestion had isolated gastric outlet obstruction. Patients' age ranged from 11 to 29 years with a male: female ratio of 1.75:1. All patients developed pyloric stenosis following ingestion of solution of acids. Barium study revealed complete/ near-complete gastric outlet obstruction in all patients. On laparotomy, there was gastric dilatation in 10 patients, who underwent posterior gastrojejunostomy, whereas the stomach was contracted in one patient, and hence anterior gastrojejunostomy was performed. Seven patients were completely relieved of their symptoms; persistent postprandial epigastric fullness and/or dyspepsia was observed in four patients whose gastrojejunostomy stoma was found adequate on barium study, suggestive of gastric motility disorder. We did not encounter gastrojejunostomy-related complication of stomal ulcer/stenosis in our patients. Isolated corrosive pyloric stenosis is not as rare as is commonly thought. Gastrojejunostomy is effective, although a fair percentage of patients appear to develop gastric motility disorder secondary to corrosive injury

Perception of acne patients regarding its pathogenesis and treatment

Background: acne vulgaris is the most common skin disease treated by dermatologists. Misconceptions about acne, regarding its causes, treatment options and their possible outcome are widespread

Objectives: the objective ofthis study was; to evaluate the knowledge and perception of acne patients regarding their understanding of acne pathogenesis, treatment options, and expectations

Patients and methods: this descriptive study was conducted in dermatology clinic, outpatient department of Sheikh Zayed Medical College /Hospital, from 1st January to 15th april,2010 and a total of 105 consecutive study subjects, who were diagnosed with acne were included. An informed verbal consent was ensured from every study subject

Results: the mean age of the patients was 18.8 +/- 2.7 years. Majority of the patients [87%] were females and unmarried [83 %]. 74% had education level matric and above. 48.6% belonged to urban areas, 30.4% to rural areas and 21% to urban slums. 67% of the patients of acne in our study reported that they felt frequently worried about their acne. 55 % of the study subjects had duration of acne less than three months, 41 % had duration between 3 to 12 months and 4% had duration more than one year. When asked about causes of acne, 35% related it with poor skin hygienic conditions, 19% to dietary factors, 13% to blocked skin pores, 10.5 % to inheritance factors, 7.6% to stress, 6.7% related to infection by germs. Regarding dietary aggravating factors; 38 % linked to oily food items, 14 % with tea, 13.3% with milk products. 17 % perceived that acne is not a curable disease. 41 % of the patients had no opinion about mode oftreatment. 67% ofthe patients expected the duration ofacne treatment may beup to 3 months

Conclusion: there is a need for accessible, accurate, community-based education on the natural history of acne, its pathogenesis, risk of sequelae, the effectiveness and expected duration of treatment, and the importance of prompt medical attention