Background: Duodenal fistula is severe complication and complicated in management. Morbidity and mortality were high. The aims of study were to determine the clinical characteristic of duodenal fistula after surgical treatment of duodenal blunt and penetrating trauma, and attitude of treatment. Methodology: Retrospective study was done. Data of the patients with post-operative duodenal fistula after surgical procedure who were admitted in Cho Ray Hospital from 6-1996 to 6-2000 were analyzed. Results: There were 15 posttraumatic duodenal fistulas. Locations of fistula were often in D2 and D3 (80% of cases). Time of appearance of fistula was 10,257,25 days (2-29 days) after operative management of duodenal trauma. Mean of fistula output was 573626ml/24 hours. Total of energy of parenteral nutrition was 800130,23 Kcalo. Post-operative mortality was 26%. Only one case or 6.7% was spontaneous closure with medical treatment. 67.3% of cases was healed by surgical treatment. Conclusion: Main treatment for post-operative fistula of duodenal trauma is surgical procedure. Need of selection of appropriate time for operation is proposed. Pre- and post-operative management such as withholding oral taking, replacing fluid and electrolytes, and administering total parenteral should be paid attention
Duodenal Diseases ; Wounds and Injuries ; surgery

Study on 58 patients with circumferential hemorrhoids which were treated by self-control group. The results: there were 53.4% males and 46.6% females. The mean age 45 ± 9 years. 33 patients had third degree and 25 patients had fourth degree hemorrhoids. The mean time of procedure was 40 ± 9.6 (20 – 60 minutes). 90% of patients had minor or mild post-operative pain. The immediate complications included anal spasm in 2 cases, perianal edema in 3 cases, dysuria in 3 cases and external hemorrhoids in 2 cases
Hemorrhoids ; Therapeutics ; epidemiology ; surgery

Globally, providing evidence on the economic burden of chronic obstructive pulmonary disease (COPD) is becoming essential as it assists the health authorities to efficiently allocate resources. This study aimed to summarize the literature on economic burden evidence for COPD from 1990 to 2019. This study examined the economic burden of COPD through a systematic review of studies from 1990 to 2019. A search was done in online databases, including Web of Science, PubMed/Medline, Scopus, and the Cochrane Library. After screening 12,734 studies, 43 articles that met the inclusion criteria were identified. General study information and data on direct, indirect, and intangible costs were extracted and converted to 2018 international dollars (Int$). Findings revealed that the total direct costs ranged from Int$ 52.08 (India) to Int$ 13,776.33 (Canada) across 16 studies, with drug costs rannging from Int$ 70.07 (Vietnam) to Int$ 8,706.9 (China) in 11 studies. Eight studies explored indirect costs, while one highlighted caregivers’ direct costs at approximately Int$ 1,207.8 (Greece). This study underscores the limited research on COPD caregivers’ economic burdens, particularly in developing countries, emphasizing the importance of increased research support, particularly in high-resource settings. This study provides information about the demographics and economic burden of COPD from 1990 to 2019. More strategies to reduce the frequency of hospital admissions and acute care services should be implemented to improve the quality of COPD patients’ lives and reduce the disease’s rising economic burden.

Background: Periostin (PN) concentration increases in the blood of patients after acute myocardial infarction (AMI) and affects the process of cardiac remodelling leading to myocardial fibrosis. This study aimed to evaluate the correlation between serum PN levels with cardiac function and short-term prognosis (after 3 months of AMI) in patients with non-ST-elevation AMI. Methods: Case-control study, 3-month follow-up. 35 patients with AMI and 37 healthy people were chosen as the control group. In the group of patients, serum PN was obtained from day 5 - 7 of the disease. The correlation between PN and TIMI, GRACE scores, body mass index (BMI), laboratory findings, and 3-month post-MI data including pro B-type natriuretic peptide (pro-BNP) and echocardiographic parameters. Results: Serum PN levels increased significantly when patients had AMI, negatively correlated with ejection fraction (EF) (r = - 0.462, p = 0.005), positively correlated with left ventricular end-diastolic diameter (LVDd) (r = 0.413, p = 0.014). Conclusions: AMI increases serum PN levels, and PN can be used to predict cardiac function 3 months after MI in patients with non-ST elevation AMI.