Medications included a proton-pump inhibitor (tablet Pantoprazole

Medications included a proton-pump inhibitor (tablet Pantoprazole 40mg twice a day) and a prokinetic agent (tablet Levosulpiride 75mg twice a day) given for a period of http://www.selleckchem.com/products/Dasatinib.html three months. Patients who improved symptomatically were continued on medical management. Those patients whose symptoms did not improve with conservative management and patients who required escalating doses of medications for symptom relief were subjected to laparoscopic Toupet’s fundoplication. Pneumoperitoneum was created by closed technique via a supraumbilical port. Dissection was carried out at hiatus, and fundus of stomach was mobilised and passed through a window created behind the gastroesophageal junction (shoe-shine technique). A 270�� posterior wrap was performed. Fundus was sutured to oesophagus by interrupted stitches.

Crural stitches were placed in case the crura were far apart and the opening was too wide. Nasogastric tube was removed on postoperative day one and sips begun. Soft diet was begun on the evening of the first postoperative day and the patient was discharged the next day in case of an uneventful recovery. Medications (proton pump inhibitors and prokinetic drugs) were continued for one month postoperatively. All patients were followed up for a period of 9 months after diagnosis (6 months after surgery for operated patients). Outcomes after treatment were evaluated by both subjective and objective criteria. Improvement in symptoms (assessed by visual analogue scale) at 3 and 9 months after diagnosis. Improvement in quality of life (assessed by SF-36 questionnaire) at 3 and 9 months after diagnosis.

A score was obtained for eight specific areas of functional health status��physical functioning, role limitation due to physical health, role limitation due to emotional problems, energy/fatigue, emotional well-being, social functioning, pain, and general health [2]. Changes in endoscopy findings at 9 months from diagnosis (6 months after surgery). Changes in manometry findings at 6 months after surgery. Patients managed surgically were also evaluated for complications: intraoperative bleeding requiring blood transfusion, diaphragmatic injury, pleural breach, splenic injury, esophageal perforation, gastric perforation, postoperative dysphagia, and wound infection. Results were analyzed using Student’s t-test, chi-square test, and Wilcoxon sign rank test. 3.

Batimastat Results and Discussion Fifty patients diagnosed to have gastroesophageal reflux disease (confirmed by endoscopy and esophageal manometry) were included in the study. 20 patients showed symptomatic improvement after three months and were thus managed conservatively, while 30 patients did not show any improvement in symptoms and were eventually operated. 88% of cases were in the age group of 20�C40 years while 12% cases were in the age group of 41�C50 years. Mean age of patients was 32.20 years.

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