Subject(s)
Gastroenterology/history , History, 19th Century , History, 20th Century , History, Ancient , IndiaABSTRACT
OBJECTIVES: To assess and compare the efficacy of a 6-month short-course chemotherapy regimen (SCC) with that of a 12-month standard regimen in the treatment of abdominal tuberculosis. DESIGN AND SUBJECTS: A total of 193 adult patients with evidence of abdominal tuberculosis were randomly allocated to one of two daily regimens: 1) a 6-month SCC regimen with rifampicin, isoniazid and pyrazinamide for 2 months followed by rifampicin with isoniazid for another 4 months (6R series) and 2) and 12-month standard regimen of ethambutol and isoniazid with streptomycin supplemented for 2 weeks (12E series). Surgery was undertaken only for patients suspected to have obstruction or perforation of the intestine. RESULTS: A total of 163 (85 6R, 78 12E) patients were available for efficacy analysis after exclusion of 30 patients for various reasons. At the end of treatment clinical status was normal in 84 (99%) in 6R patients and in 73 (94%) in 12E patients. Of these, 147 patients completed follow-up for 5 years; none had relapsed requiring treatment for abdominal tuberculosis. CONCLUSION: A 6-month SCC regimen has been found to be as effective as the standard 12-month regimen in the treatment of all forms of abdominal tuberculosis.
Subject(s)
Antitubercular Agents/therapeutic use , Tuberculosis, Gastrointestinal/drug therapy , Adolescent , Adult , Aged , Child , Drug Administration Schedule , Drug Therapy, Combination , Ethambutol/administration & dosage , Female , Follow-Up Studies , Humans , Isoniazid/administration & dosage , Male , Middle Aged , Prognosis , Pyrazinamide/administration & dosage , Rifampin/administration & dosage , Streptomycin/administration & dosage , Time Factors , Tuberculosis, Gastrointestinal/diagnosisABSTRACT
Due to the high incidence of infective complications following colorectal surgery, prophylactic application of systemic antibiotics is required. In a prospective, randomised study of 34 patients who underwent elective colorectal surgery, it was found that a single 1 g dose of cefotaxime was as effective as three doses in controlling post-operative infections. Both groups received 500 mg metronidazole i.v. every 12 h for 72 h, with the first dose administered immediately prior to surgery. The results indicate that prophylactic cefotaxime and metronidazole are effective in reducing the incidence of septic complications following colorectal surgery; nevertheless, a study with a larger number of patients is needed to reach a definitive conclusion.
Subject(s)
Cefotaxime/therapeutic use , Colorectal Neoplasms/surgery , Metronidazole/therapeutic use , Premedication , Surgical Wound Infection/prevention & control , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma/microbiology , Carcinoma/surgery , Colorectal Neoplasms/microbiology , Drug Therapy, Combination , Humans , Leiomyoma/microbiology , Leiomyoma/surgery , Middle Aged , Prospective Studies , Surgical Wound Infection/surgeryABSTRACT
This article describes the surgery of tropical pancreatitis as practiced in a region of high incidence, based on the experience at 2 centers: the Department of Surgical Gastroenterology and Proctology, Government General Hospital, Madras, Tamilnadu (a tertiary-care referral unit) where 52 patients were diagnosed and 40 were operated on between 1982 and 1987; and the Department of Gastroenterology, Deva Matha Hospital, Koothattukulam (a specialized center located in the main endemic area of Kerala), where 116 patients were diagnosed and 33 operated on between 1983 and 1988. The latter series is described in detail with emphasis on the preoperative imaging, operative findings, surgical procedures, complications, and results of surgery. The experience of other centers in southern India is summarized and discussed. The disease is obviously different from chronic pancreatitis in the West. Special problems of tropical pancreatitis, particularly the management of diabetes and the association of pancreatic carcinoma at a young age, are discussed.
Subject(s)
Pancreatitis/surgery , Adolescent , Adult , Aged , Child , Chronic Disease , Diabetes Mellitus, Type 1 , Diagnostic Imaging , Female , Humans , India/epidemiology , Male , Middle Aged , Pancreatitis/epidemiology , Pancreatitis/etiology , Pancreatitis/pathology , Risk Factors , Tropical Climate/adverse effectsABSTRACT
Seventeen patients (15 males, 2 females) underwent restorative proctocolectomy during the 4 year period 1983-87. Twelve patients had familial adenomatous polyposis. Two of these had superimposed malignancy--one each in the cecum and transverse colon. Five patients had ulcerative colitis. Ten pouch procedures were of the J type, six of the S type and one of W configuration. There was one death (mortality 6%). Mean stool frequency was 4.2 per day at one year after surgery and all patients were totally continent at this time. The ileal pouch-anal anastomosis provided a functioning neorectum with low stool frequency and complete continence. The J pouch was found to be functionally superior though the numbers were too small to allow statistical comparison.
Subject(s)
Colectomy/methods , Colitis, Ulcerative/surgery , Rectum/surgery , Adenomatous Polyposis Coli/surgery , Adolescent , Adult , Age Factors , Female , Humans , Male , Middle Aged , Neoplasms/surgeryABSTRACT
Hexosaminidases A and B were purified by affinity chromatography from normal gastric mucosa, after preliminary separation of isozymes by anion exchange chromatography. Heparin and mannosamine were coupled to Sepharose 4B and used as affinity matrices and the purified enzymes were found to be homogeneous when analysed by polyacrylamide slab gel electrophoresis. This combination of 2 novel affinity chromatographic procedures is superior to existing methods in that a final yield of over 70% could be achieved. Also, the number of steps required to obtain homogeneity are less in contrast to the conventional methods used previously.
