RESUMO
Background: Gastro-duodenal perforation is a common surgical emergency that remains a formidable health burden worldwide with significant morbidity and mortality. Ulcer disease remains the most common cause of gastro-duodenal perforation. Diagnosing the presence of H. pylori can help eradicate the infection from the community at large and thereby reduce the chances of gastro-duodenal perforation. Aims: To assess the clinical presentation of gastro-duodenal perforation patients and to evaluate the detection of Helicobacter pylori infection by available investigations. Materials and Methods: A descriptive observational study was conducted among 80 patients presenting with clinical features suggestive of gastro-duodenal perforation and confirmed by clinical, radiological basis and operative findings admitted at a rural tertiary care hospital during 2019-2020. Detailed history was taken from the patient/party, clinically examined, and blood/tissue samples were investigated. The patients were managed with standard treatment modality in the studied institute. Data were collected, compiled, and entered MS Excel and analyzed using appropriate software. Descriptive analysis was done in the form of proportion for categorical variables, mean or median for continuous variables. Result: Cases of gastro-duodenal perforations were more among middle to later age of life, mostly affecting married male patients hailed from rural area and unskilled workers. History of intake of spicy food, prolonged starvation, history of NSAID use were common among them. Majority of the patients had history of pain abdomen in the past suggesting of PUD and history of taking variety group of acid reducing agents. Most of them presented with epigastric pain, vomiting, abdominal distension along with other signs of peritonitis. Obliteration of liver dullness and free gas under right dome of diaphragm was also noted in large proportion among them. Majority of cases were found positive for H. pylori on Histology (85%), followed by rapid urease test (RUT) (80%) and a positivity of 72.5% and 68.8% on serum IgG and IgA antibody respectively. Rapid Urease Test was more sensitive as well as specific in diagnosing of H. pylori than antibody detection test. Conclusion: Early detection of H. pylori infection and treatment with potent anti H. pylori therapy postoperatively has been found to be adequate.
RESUMO
BACKGROUND: Lung cancer is one of the major causes of morbidity and mortality both in developed and developing countries. Adverse drug reactions (ADRs) are inevitable, albeit unwanted aspects of cancer chemotherapeutic agents used in lung cancer. AIM AND OBJECTIVES: To determine common ADRs and the severity of ADRs of different chemotherapeutic agents used in non-small cell lung cancer (NSCLC) patients. MATERIALS AND METHODS: The study was conducted among purposively selected 160 patients who had undergone chemotherapy for lung carcinoma. Clinical records of NSCLC patients were reviewed and data related to the socio-demographic and clinic-therapeutic profiles of patients were collected. ADRs were graded according to the Common toxicity criteria (CTC) grading. Data analysis was done using the IBM-SPSS software and presented using the principle of descriptive statistics. Relationships between ADRs and drug regimens were determined using Chi-square tests considering a 95% confidence interval and P value ≤ 0.05 as significant. RESULT: Among 160 patients, 78.8% were males and 21.3% were females. The mean age was 59.15 ± 10.6 years, illness duration was 7.5 ± 10.6 months, and treatment duration was 4.4 ± 0.91 months. The overall mortality rate and systemic toxicity of the paclitaxel-carboplatin combination were the lowest. Almost an equal proportion of moderate to severe changes in parameters such as myelosuppression, anemia, thrombocytopenia, alopecia, skin changes, allergic reaction, and peripheral neuropathy, were observed with all chemotherapeutic regimens. Gemcitabine-carboplatin regimen was associated with a higher proportion of altered liver enzymes, electrolyte imbalance, diarrhea, pleural effusion, and renal toxicities. CONCLUSION: There was a high prevalence of ADRs with different chemotherapeutic agents. Early detection of these ADRs may help in minimizing the damage by either modifying the dose or changing the offending agent.