ABSTRACT
Varcial bleeding is a very serious complication with a reported mortality rate of 20-50%. Patients who have had a vatriceal hemorrhage are usually treated by endoscopic injection sclerotherapy or band ligation to eradicate the varices. Endoloop ligation is a new technique invented to achieve hemostatis and variceal eradiation. This work included fifty patients with acute esophageal ariceal bleeding, 25 patients were managed by band ligation and the other 25 patients were managed by endoloop ligation. The number of patients who rebelled during the follow-up was smaller in the endoloop group [12%] compared to the band group [28%], yet, this difference did not reach statistical significance. Also, no statistically significant difference was found between the two groups regarding the number of patients who showed complete varicea eradication, the number of active sessions needed to reach variceal eradiation or the incidence of variceal recurrence by the end of follow-up period of six months. It was found that the total cost of endoloop sessions' needed for variceal obliteration was 1163.9 l.e for erach patient, while it was 12.9.9 l.e for band ligaion. Also, the endoloop showed technical advanced over band application including better field of vision, more tight application, good results on junctional varices, and no strain exerted by the device on the endoscope. We can conclude that endoloop ligation is a new promising technique for managing bleeding esophageal varices
Subject(s)
Humans , Male , Female , Gastrointestinal Hemorrhage , Ligation , BandagesABSTRACT
Subclavian vein cannulation by double lumen catheters as a vascular access for hemodialysis was reported to be associated with several acute and delayed complications. Double lumen Maborker subclavian catheters has been fixed for 60 cases in the last six months. There was difficult introduction in 9 cases with initial cannulation of the internal jugular vein instead of the superior vena cava [SVC] in 4 of them. One case was resuscitated from cardiac arrest during introduction and 3 cases were treated for septicemia as a result of infection at the catheter site. The tip of the catheter: assessed by plain chest films was most in the right atrium in 34 cases, in the SVC in 24 cases and in the inferior vena cava in 2 cases. The mean dwelling time of the catheters was 4.68 +/- 1.8 weeks. Follow-up venography was done for 20 cases 3-6 months after removal of the catheter. It revealed the occurrence of subclavian vein thrombosis in 8 cases and stenosis in 2 of these 8 cases. Subclavian venography on the side of the fistula done for 20 patients on regular dialysis treatment for more than 3 years was normal. It was concluded that the subclavian vein as a route of vascular access for hemodialysis is a potential risk and should be approached only when obligatory
Subject(s)
Humans , BiomarkersABSTRACT
From this work, it was found that duodenal ulcer patients who heal and do not relapse tend to be nonsmokers; with lower basal [BAO], peak [PAO] and maximal [MAO] acid output; with higher nasal gastric bicarbonate [BS] secretion, higher gastric bicarbonate nonparietal concentration [B np] and with lower volume of parietal [Vp] and non parietal [Vnp] gastric secretion. Smoking increases the incidence of duodenal ulcer recurrence by increasing acid output, decreasing gastric bicarbonate and prostaglandin E secretion. Fasting serum gastrin and fasting serum prostaglandin E seem to be of less importance in identifying relapsing duodenal ulcer patients. Duodenal ulcer patients who do not relapse tend to have lower stimulated gastric H+, higher stimulated gastric bicarbonate secretion [BS], higher stimulated gastric bicarbonate non parietal concentrations [Bnp] and lower stimulated volume of parietal [Vp] and nonparietal [Vnp] gastric secretion especially 30 minutes after stimulation. There is statistically significant difference between healed and relapsing duodenal ulcer patients regarding H+, BS Bnp, Vp 30 minutes after stimulation with pentagastrin