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Are Indications For Esophago Gastro Duodenoscopy Properly Followed?

Authors: Zuhair B Kamal زهير كمال --- Mohammed A Al-Atroshi محمد التروشي --- aad H Sultan سعد سلطان --- Wisam A Hussein وسام حسين
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 1 Pages: 56-60
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Symptoms related to the upper gastro-intestinal tract are very common. Attribution of these symptoms to upper G. I. T.diseases are usually done on clinical bases, which could be confirmed by Esophago Gastro Duodenoscopy (EGD). The use of such tools might increase the diagnosis accuracy for such complaints. The indications for upper G I endoscopy might decrease the negative results of endoscopies.Objective: To follow strict indications for Esophago Gastro Duodenoscopy in order to decrease the negative endoscopy results. Methods: One thousand eight hundred and ninety cases were subjected to EGD from Feb. 1999 to Feb 2009 at Alkindy Teaching Hospital and Abd-Al-Majeed private hospital in Baghdad, Iraq. A special endoscopy unit form was prepared containing data from patients, clinical complaint, indications for endoscopy request, and the endoscopic diagnosis, biopsies were taken when indicated and subjected to histopathological examination. All these data were studied and analyzed.Results: Out of the total 1890 patients there were 1114 males and 776 females with male to female ratio 3/2, the most common age group ranged from 21 to 50 years with a mean age of 32 years. Upper abdominal pain was the most common indication (30%), upper GI bleeding (27.94%), duodenal ulcer follow up (25.5%). The diagnosis of chronic DU was established in (40.21%) of cases, normal endoscopic results were found in (34.6%), duodenitis and gastritis in (15.2%).Conclusion: The high number of normal gastrointestinal endoscopies necessitates the need to follow strict indications before subjecting the patients for endoscopy.


Article
Is co2 laser Hemorrhoidectomy superior to conventional open Hemorrhoidectomy?

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Abstract

Background: Hemorrhoids are one of the mostcommon surgical conditions .Conventionalhaemorrhoidectomy was the traditional operation forthe treatment of hemorrhoids. Other modalities oftreatment had been used as an alternative operationsincluding CO2 laser haemorrhoidectomy.Objectives: To determine the outcome of treatmentof hemorrhoids by using CO2 laserhaemorrhoidectomy and its advantages overconventional surgeryMethods: This is a retrospective comparativeinterventional study of 1024 case of third degreehaemorhoids selected out of 1300 case ofhemorrhoids of different degrees, admitted toALKINDY, ALYERMOUK teaching hospitals andABD ALMAGEED private hospital, from May 1998to July 2002,they were treated by CO2 laserhaemorrhoidectomy and conventional surgery. Theyare divided into 2 groups randomly, 512 cases treatedby CO2 laser (group A), 512 cases treated byconventional surgery (group B). Both groups werestudied regarding operative time, hospital stay,healing time, post operative complications and costeffectiveness.Results: In GROUP A, the operative time rangedfrom 10 to 20 minutes with an average of 13 minutes.The hospital stay ranged from 4 to 12 hours with amean time of 10 hours as all cases were treated asday cases. Post operative pain was minimal in 50% ofpatients and required simple analgesia for treatmentwhile 50% had no pain. Bleeding occurred in lessthan 1% of cases, anal stenosis 3.3%, Infectionrecorded in 0.58% of patients.In GROUP B, Theoperative time ranged from 15 to 25 minutes with anaverage time of (19) minutes, hospital stay rangedfrom 24 to 48 hours with a mean time of 28 hours.Post operative pain recorded in all the patients(100%) and required narcotic analgesia for treatment,25 patients (4.8%) had varying degrees of bleeding,40 patients (7.8%) had infection, 25 patients (4.8%)had anal stenosis.In group A due to shorter hospitalstay, earlier healing of wounds, earlier return to workwhich was within 7 to 10 days, the surgical treatmentproved to be cost effective.Conclusion: CO2 laser Hemorrhoidectomy wasfound to be easy and safe procedure with lower rateof complications, shorter hospital stay and costeffective.

Keywords

Co2 --- Laser --- Hemorrhoids

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