RESUMO
Background:Gastroesophageal reflux disease (GERD) is of the common disease affecting a significant proportion of the world population. GERD is a chronic disease that typically requires long term management in the form of lifestyle modification, medical therapy and, for a subset of patients, surgical therapy. Hence; we conducted the present study to assess and compare the outcome of medical and surgical treatment therapy in severely retarded subjects with GERD. Materials & Methods: The present study included comparison of efficacy of medical and surgical treatment in retarded patients with GERD. A total of 24 patients were included in the present study and were randomly divided into two study groups. Group A included patients that underwent medicinal treatment while group B included patients in which surgical treatment was planned. Nissen fundoplication and gastrostomy was performed in group B patients. Complete follow-up details of all the patients were maintained and compared. All the results were analyzed by SPSS software. Results A total of 24 patients were included in the present study which were broadly divided into two study groups. Mean age of the patients of group A and group B were 25.2 years and 24.2 years respectively. Respiratory symptoms were found to be present in 1 and 4 patients of group A and group B respectively. Significant results were obtained while comparing the respiratory symptoms in patients of group A and group B. Conclusion: Improvement in respiratory symptoms occurred significantly faster in patients undergoing medicinal treatment. However; no other significant changes were obtained in patients undergoing medicinal and surgical treatment.
RESUMO
Background: Peptic ulcer formation affects about 2-10% of world population every year with higher incidence in younger individuals. Being a surgical emergency, it has higher mortality and morbidity. Thus, the aim of our study was to evaluate the incidence of peptic ulcer perforation based on gender, age and also to study its associated risk factors, clinical presentations, site along with surgical management and complications. Materials & Methods: 75 patients diagnosed with perforated peptic ulcer were included and this study was conducted in the department of Surgery Government Bangur Hospital, Pali, Rajasthan, India. Structured performa was prepared to obtained details of patients and ethical clearance from the institute was also taken prior to the study. Results: 76% of patients in our study were males and 24% were females with male and female ratio 1:3.16. The prevalence of perforation was high in age group 20-30 years (30.7%). 62.7% of cases had positive family history and the incidence was in the patients who consumed non-vegetarian (84.8%), spicy (61.4%) and oily (69.5%) foods. Frequently observed clinical presentation were abdominal pain followed by tenderness and rigidity and gas under diaphragm. The common site of perforation was duodenum (62.7%) and most of the cases were treated by closure with omental patch (81.3%). The post-surgical complications frequently observed were wound infection (30.6%) and chest infection (28%). Conclusion: Peptic ulcer perforation is common disorder of gastrointestinal tract, now affecting younger adults with male preponderance. It is associated with unwanted health and economic issues. Therefore, earlier management is only the way to minimize complications and mortality.