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Seth S.,Up Rural Institute Of Medical Science And Research Saifai | Nagrath A.,Up Rural Institute Of Medical Science And Research Saifai | Goel N.,Eras Medical College
African Journal of Primary Health Care and Family Medicine

Background: Abortion is the most common entity in the practice of obstetrics and gynaecology. Different methods and modes have been opted for until now to find an effective regimen with the least complications. We have tried the minimal dose (100mg) of Mifepristone (PO) instead of the presently recommended 200mg for medical abortion in early first trimester cases. Objectives: The objective of the study was to determine the efficacy of low dose (100mg) Mifepristone for medical termination of early pregnancy with oral Misoprostol 800μg, 24 hours later. Design: A prospective analytical study was conducted on a population of 82 early-pregnant patients who have requested medical abortions. Method: Pregnant women of less than 56 days gestation age from their last menstrual period, requesting medical abortion were selected over a period of 14 months from January 2007 to March 2008. They were given 100mg Mifepristone orally on Day-1, followed by 800μg Misoprostol orally 24 hours later on Day-2, keeping the patient in the ward for at least 6 hours. Abortion interval, success rate, post-abortion bleeding and side-effects were noted. Success was defined as complete uterine evacuation without the need for surgical intervention. Results: The total success rate of this minimal dose Mifepristone regimen was 96.25%. Pain and nausea were the predominant side-effects noted. In total 72 (90%) women had completely aborted within 5 hours of taking Misoprostol. Three (3.75%) women only required suction aspiration, hence termed as failed medical abortion. The abortion interval increased with the gestation age. All three failures were of the more-than-42-day gestational age group. The overall mean abortion interval was 4.68 ± 5.32 hours. © 2011. The Authors. Source

Gupta V.,Up Rural Institute Of Medical Science And Research Saifai | Singh S.P.,Up Rural Institute Of Medical Science And Research Saifai | Pandey A.,Up Rural Institute Of Medical Science And Research Saifai | Verma R.,Up Rural Institute Of Medical Science And Research Saifai
World Journal of Surgery

Background: The commonest surgical treatment used for peptic ulcer perforation is omental patching. If, however, the perforation leaks, it rarely heals by itself due to persistence of duodenal fistula (DF). We present our experience with a T-tube placed into the DF for better outcome of the patients. Methods: All patients in our hospital with DF following failure of surgery for duodenal perforation were included in this study. After identification of the perforation, a size 16 French T-tube was put in place. The patients were analyzed on basis of duration of hospital stay, complications related to the T-tube and overall complications, start of oral feeds, and follow-up. Results: In this 3-year study, ten patients with DF were admitted. The mean age was 50 years. The T-tube was kept in place within the fistula for 20.5 days. The mean duration to start oral feeds was 8.8 days. The mean duration of hospital stay was 23.2 days, and the mean follow-up period was 6.3 months. The complications observed in the postoperative period were fever in four patients, wound dehiscence in four patients, and peritoneal collection in two patients, all of which were managed easily. There was no peritubal leakage and no failure of surgery as regards placement of a T-tube. There were no deaths in this study. Conclusions: Placement of a T-tube into a DF appears to be very effective procedure for managing this complication of surgical repair of a perforated peptic ulcer with an omental patch. The technique appears to be simple and rewarding. Further use of this method by other workers will substantiate our efforts. © 2013 Société Internationale de Chirurgie. Source

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