BackgroundChronic pancreatitis is a debilitating disease presenting with pain, diabetes and steatorrhoea. Surgery offers better long‐term pain relief than other interventions, but there is still uncertainty about the optimal surgical procedure and approach and a lack of long‐term follow‐up data in patients with chronic calcific pancreatitis selected for laparoscopic surgical treatment.MethodsThis was an observational cohort study of patients who underwent laparoscopic surgery for chronic calcific pancreatitis between January 2006 and April 2017, and had completed a minimum follow‐up of 1 year at a tertiary‐care teaching institute. Eligibility for the laparoscopic approach was main duct diameter greater than 7 mm, absence of extensive head calcification, size of head less than 3·5 cm, absence of local complications, and ASA grade I or II status. The primary outcome variable was a reduction in pain score by 1 year. Secondary outcomes were hospital stay, complications, pain score at 3 and 5 years, and the development or progression of exocrine and endocrine insufficiency.ResultsSome 57 patients were scheduled to undergo laparoscopic surgery for chronic pancreatitis: longitudinal pancreatojejunostomy (39), modified Frey's procedure (15) and pancreatoduodenectomy for suspicion of malignancy (3). The latter three patients were excluded from the analysis. Conversion to open surgery was needed in ten of the 57 patients (18 per cent). The mean(s.d.) age of the analysed cohort was 34·2(3·7) years and there was a predominance of men (34, 63 per cent). Adequate pain relief was achieved in 91, 89 and 88 per cent of patients at 1, 3 and 5 years of follow‐up respectively.ConclusionLaparoscopic surgical management of chronic calcific pancreatitis with longitudinal pancreatojejunostomy or modified Frey's procedure is feasible, safe and effective in selected patients for the relief of pain.

No abstract

BACKGROUND:Globally, there is a rising trend among women towards delaying pregnancy and childbirth. But in a developing country like India, the scenario is different where poor socio-economic status, lack of contraceptive knowledge, religious issues, desire for male child, dowry system, concept of large family predominate. OBJECTIVE OF THE STUDY: To study the maternal and fetal outcome of pregnancy in advanced maternal age. METHODOLOGY: A retrospective hospital based study was carried out in the department of obstetrics & gynecology; over a period of 3 years. Data was analyzed using Statistical Package for Social Sciences Version 16. RESULTS: 101 patients who met all the parameters in the inclusion and exclusion criteria were taken into consideration in this study. The mean age of the patients were 36.4 +/-2.24. Majority of them were under the group of multigravida (2-4), which is 63 (62.37%) in number. Grand multi was 34 (33.66%). There were increased incidence of congenital and chromosomal abnormalities with comparatively reduced incidence of maternal complications. CONCLUSION: Advanced maternal age is a vital time to screen for congenital and chromosomal abnormalities.

No abstract

No abstract