Hepatic cirrhosis; its etiology and complications

To determine etiology and complications in the patients suffering from cirrhosis of liver in Railway Hospital. Descriptive study. At Medical Unit II, IIMC-T, Pakistan Railway Hospital, Rawalpindi from March 2004 to July 2007. Patients suffering from cirrhosis of liver on the basis of clinical and ultrasonographic findings were included in the study. All other patients of liver disease without evidence of cirrhosis were excluded. Data of the patients regarding the etiological factors and complications of cirrhosis were recorded onaproforma. Out of 141 patients, 56% were males and 44% were females. The mean age was 48.67 years. Most of the patients had HCV infection [61%] followed by HBV infection [20.56%]. Co-infection with HBV and HCV was 3.54%. 3.54% had alcoholic cirrhosis while 5% had post-surgical biliary cirrhosis. Only 2.12% had Wilson's disease and 4.25% were cryptogenic. Most common presentation was simple ascites [33.33%], next was variceal bleeding [27.65%]. Spontaneous bacterial peritonitis was present in 7.8%, hepatic encepha-lopathy in 15.6%, hepatorenal syndrome in 2.12%, generalized bleeding tendency in 3.54% and 5% of cases developed hepatocelluar carcinoma. HCV infection was most common etiology while simple ascites was most common presentation. Emphasis should be on prevention of hepatitis B and C infections through public awareness programmes

Gastric carcinoma: 5 years survival after gastric surgery

To study the five years survival rate after resection for gastric carcinoma. Fifty six patients with gastric carcinoma in different stages were followed up for 5 years after gastric surgery to see recurrence, complications and survival rate. Of the 56 patients, 6 underwent total gastrectomy, 50 partial gastrectomy, 7 Billroth I and 43 modified Dl resection with Billroth II reconstruction. Six patients were alive at the end of 5th year, 3 with early gastric carcinoma and 3 with locally advanced carcinoma. Mortality was 17 patients in the first year, 10 in second year, 8 in third year, 3 in fourth year and 1 in the fifth year. Gastric carcinoma carries a bad prognosis. The 5-year survival rate in our series was 1.3%. Efforts should be made to diagnose and treat these patients at an early stage