Endoscopic sclero-therapy [ES] in the treatment of bleeding gastric varices

Of 154 patients with portal hypertension gastric varices was found in 24 [16S percent]. While the majority [87.5 percent] of patients had gastric varices in association with oesophageal varices, 3 [12.5 percent] patients had isolated gastric varices. Cyano-acrylate glue was used in a 3 week schedule. Variceal obliteration was achieved in 6 patients [25 percent] and reduction in size was noted in another 4 patients [16.6 percent]. No change was noted in 8 patients [33.3 percent]. There were 6 deaths [25 percent] 4 due to uncontrolled bleeding and 2 due to hepatic coma. It is concluded that Gastric Variceal sclerotherapy [GVS] should be attempted .for bleeding gastricc varices. The definitive treatment is surgical decompression

Esophageal motility in healthy smokers

The effect of smoking on oesophageal motility was studied on 30 active smokers, l0 passive smokers and 10 non smoker individuals. We used a solid state oesophageal catheter, which contained micro transducer and connected with computerized physiography and using station pull through technique, to record manometric findings at lower oesophageal sphincter [LES], oesophageal body and upper oesophageal sphincter [UES]. Results in this study showed highly significant reduction in LES pressure among heavy smokers and about 60% had low LES pressure below 20 mmHg while only 40% and 20% and 10% were affected in moderate, mild and passive smokers respectively. The response to wet swallow was 100% normal peristalsis and there is no significant changes in manometric record of UES. So, we can conclude that smoking mainly reduce LES pressure and is more marked in heavy smokers. therefore, smokers are more susceptible to incompetent cardia and more frequent reflux esophageal disea