Papers by International Journal of Contemporary Medical Research ijcmr
Background: Scalpel has been the gold standard tool for intraoral surgery. Since a few decades, l... more Background: Scalpel has been the gold standard tool for intraoral surgery. Since a few decades, lasers have also stepped up as operating instruments, be it cutting, ablation or photobiomodulation. In our research, we compared the efficacy of scalpel and diode laser in intraoral maxillofacial surgery. Setting and Design: In the durationof 3 years, a total of 100 patients were included in our study which were divided into two groups of 50 patients each; 50 in the test group for scalpel and 50 in the control group for laser. Materials and Methods: Inclusion criteria includes clinically diagnosed intraoral soft tissue lesions/growth indicative of tissue ablation, incision, excision, or biopsy. Exclusion criteria: Non consenting and/or non-cooperative patients. Presence of uncontrolled or advanced systemic diseases, immunocompromising diseases, porphyria or medications that cause photosensitivity (eg. Chloroquine, methotrexate etc) and serious eye defects. Results: While laser provided a clean surgical field by facilitating haemostasis during bleeding, its healing time was slower as compared to laser during the first postoperative week. 2% Lignocaine HCl with 1:80000 adrenaline was used as a local anaesthetic agent. Swelling and redness were both found to be pronounced in scalpel as opposed to laser which produced a coagulum ring of eschar formation during cutting. Discussion: Scalpel offers unmatched precision and speed during surgery. Its only drawback is bleeding which may be inconvenient for the surgeon. Laser not only clears the surgical field of the operator but also reduces the risk of bleeding from highly vascular areas like the tongue. The heat from the laser tip negates any additional measures required for cleaning. Conclusions: The 980 nm diode laser promises versatility and surgical efficacy during intraoral maxillofacial procedures and can be a good alternative to the conventional cold scalpel, offering equal patient satisfaction.
Background: This study compared intravenous ketorolac and
tramadol for post-operative discomfort ... more Background: This study compared intravenous ketorolac and
tramadol for post-operative discomfort prevention following
mandibular 3rd molar extractions. Preemptive analgesia may
reduce postoperative analgesic need by preventing pain.
Materials & methods: Forty patients who required surgical
extraction of mandibular third molars were divided randomly
into two groups. Group- I [Tramadol Group (n=20)] & Group-
II [Ketorolac Group (n=20)] patients were given preemptive
analgesia i.v. preoperatively. The parameters under evaluation
were hourly postoperative pain intensity measurement for 12
postoperative hours, mean time after which rescue analgesic
(acetaminophen) was taken within first 12 postoperative
hours, total analgesic (acetaminophen) consumption over 5
day recovery period, and patient’s assessment of the surgical
procedure.
Results: The study's findings indicated that there existed no
statistically significant disparity between each of the groups.
A significant proportion of those in the ketorolac group said
that the surgery was comparatively more favourable and
less painful, as evidenced by their higher scores and reduced
consumption of post-operative analgesics.
Conclusion: There is no statistically significant difference in
the two groups except global assessment. Clinically, we found
that, ketorolac has a slightly better preemptive analgesia
profile as the patients in ketorolac group experienced less
pain, required rescue analgesic late, required less analgesics
postoperatively and rated overall the procedure as relatively
better.
Introduction: Renal staghorn stones are challenging for urologists to ensure maximum stone cleara... more Introduction: Renal staghorn stones are challenging for urologists to ensure maximum stone clearance and minimal morbidity. Percutaneous nephrolithotomy (PCNL) has become the standard gold treatment for renal staghorn stones. To assess the safety and efficacy, percutaneous ureteroscopic manipulation to clear multiple calyceal stones in PCNL for renal staghorn stones. We present our initial experience with this new technique. Material and methods: We prospectively analysed 50 patients with staghorn stones admitted and underwent PCNL in our institute for over two years. Patients were evaluated clinically, radiologically and with laboratory investigations before subjecting to PCNL. Following standard PCNL, for inaccessible calyceal stones, a ureteroscope was introduced percutaneously through the secondary puncture. The calyceal stones were disintegrated into fragments by pneumatic lithotripsy and pushed into the pelvis; from there, fragments retrieved by a nephroscope. The operating time, stone-free rates (SFR), postoperative haemoglobin drop, complications, length of hospitalisation were recorded. Results: 0ut of 50 cases in 4 cases, we used this technique and attained complete stone clearance. Our procedural stone-free rate (SFR) improved to 90% from 82% using this technique. There were no complications in these 4 cases except for one patient who needed antibiotic change for fever. Conclusion: As the second puncture for ureteroscope manipulation was only dilated to 12F, the complications were lesser. This has its unique advantages by increasing procedural stone-free rate (SFR); hence there is less morbidity as it does not require additional staged ancillary procedures.
Introduction: Renal staghorn stones are challenging for urologists to ensure maximum stone cleara... more Introduction: Renal staghorn stones are challenging for urologists to ensure maximum stone clearance and minimal morbidity. Percutaneous nephrolithotomy (PCNL) has become the standard gold treatment for renal staghorn stones. To assess the safety and efficacy, percutaneous ureteroscopic manipulation to clear multiple calyceal stones in PCNL for renal staghorn stones. We present our initial experience with this new technique. Material and methods: We prospectively analysed 50 patients with staghorn stones admitted and underwent PCNL in our institute for over two years. Patients were evaluated clinically, radiologically and with laboratory investigations before subjecting to PCNL. Following standard PCNL, for inaccessible calyceal stones, a ureteroscope was introduced percutaneously through the secondary puncture. The calyceal stones were disintegrated into fragments by pneumatic lithotripsy and pushed into the pelvis; from there, fragments retrieved by a nephroscope. The operating time, stone-free rates (SFR), postoperative haemoglobin drop, complications, length of hospitalisation were recorded. Results: 0ut of 50 cases in 4 cases, we used this technique and attained complete stone clearance. Our procedural stone-free rate (SFR) improved to 90% from 82% using this technique. There were no complications in these 4 cases except for one patient who needed antibiotic change for fever. Conclusion: As the second puncture for ureteroscope manipulation was only dilated to 12F, the complications were lesser. This has its unique advantages by increasing procedural stone-free rate (SFR); hence there is less morbidity as it does not require additional staged ancillary procedures.
IJCMR
Introduction: Diabetes is the most prevalent disease worldwide, resulted from metabolic disorders... more Introduction: Diabetes is the most prevalent disease worldwide, resulted from metabolic disorders. The aim of the study was to investigate the effectiveness of health belief model (HBM) on promoting self care behavior in patients having type II diabetes mellitus in Lucknow city, India.
Introduction: Because the prevalence of antibiotic resistance
markedly increases with time worldw... more Introduction: Because the prevalence of antibiotic resistance
markedly increases with time worldwide, anti-H. pylori
treatment is continuing to be a great challenge for physicians
in clinical practice. Eradication of H. pylori infection markedly
changes the natural history of peptic ulcer in patients with
duodenal or gastric ulcer. Most peptic ulcers associated with
H. pylori infection are curable. Aim of present study was to
study the efficacies of 14 days ‘ Reverse Hybrid Therapy’ in
H.pylori positive G.I.patients.
Material and methods: 100 H.pylori positive patients with
upper G.I. complaints who underwent upper GI endoscopy
were included in the study. H.pylori infection was documented
by at least 2 positive results of Rapid Urease Test. Subjects
with any of the following criteria were excluded from the
study. 1. Previous eradication therapy 2. Allergy to any
antibiotic used in study. 3. Co- existence of any serious illness.
4. Pregnancy or lactating women 5. Previous gastrectomy
6. Use of antibiotics within last 4 week. Detailed medical
history and demographic details of the patients were recorded.
Routine haematogical tests and USG was done. Patients were
given 14 days dual therapy ie quadruple regimen (proton pump
inhibitor + amoxicillin + clarithromycin + metronidazole) for
first 7 days followed by dual regimen of PPI+ amoxicillin for
next 7 days. Patients were asked to report at 7, 14 days and at
6 weeks interval.
Results: Out of 97 patients 93 patients became negative for
H.pylori after 6 week of Reverse Hybrid eradication therapy.
It was observed that majority of patients enrolled in the study
were in the age group of 41–60 years (50%) followed by
below 40 yrs (27%), above 60 yrs (23%). Out of them, 74%
were male and 26% were female.
Conclusion: Out of 97 patients 93 patients became negative
for H.pylori after 6 week of Reverse Hybrid eradication
therapy. Hence, Reverse Hybrid Therapy is equally potent
therapy to Bismuth based therapy though the latter has a lot
of side effects.
Introduction: The role of exfoliative cytology as an adjunct
to endoscopic biopsy in the detectio... more Introduction: The role of exfoliative cytology as an adjunct
to endoscopic biopsy in the detection of upper gastrointestinal
malignancy is controversial insofar as some claim that its use
is of little clinical benefit. To evaluate the diagnostic accuracy
of upper gastrointestinal with brush cytology as compared to
conventional endoscopic biopsies.
Material and Methods: A prospective observational study
was conducted prospectively at Dhanalakshmi Srinivasan
medical college and hospital in perambalur. Total 45 Patients
with clinical signs and symptoms of benign and malignant
lesions of the upper gastrointestinal tract was included in the
study. The data was collected between April 2018 to March
2019.
Results: The brush cytology had a sensitivity of 72.73% in
predicting gastric malignancy of biopsy and Specificity was
75.00%, false positive rate was 25.00%, false-negative rate
was 27.27, positive predicting value was 88.89%, negative
predictive value was 50.00%, diagnostic accuracy was 73.33%,
positive likelihood ratio was 2.91 and negative likelihood
ratio was 0.36. In predicting esophageal malignancy in biopsy
Specificity was 83.33%, the false positive rate was 16.67%,
false-negative rate was 11.11%, the positive predicting value
was 88.89%, negative predictive value was 83.33%, diagnostic
accuracy was 86.67%, positive likelihood ratio was 5.33 and
negative likelihood ratio was 0.13 of brush cytology.
Conclusion: The study concluded that Prompt early
endoscopic examination with cytological and biopsy studies
in patients with early symptoms may help very much in the
early diagnosis and improves the survival rate.
ijcmr , 2019
Xenotransplantation is transplantation of living cells, tissues or organs from one species to ano... more Xenotransplantation is transplantation of living cells, tissues or organs from one species to another. There is a large number of patients who need to wait for allotrasplantation due to limited donors. This drives a need for the transplant of tissue from animals to humans. However, immune rejection and infections are major risks that may prevent a good outcome of xenotransplantation. Proper documentation and sterilisation of tissues is indispensable. This article highlights the present day prespectives of Xenotransplantation.
Introduction: Acute leukaemia is major group of haematological malignancies which need timely dia... more Introduction: Acute leukaemia is major group of haematological malignancies which need timely diagnosis and initiation of treatment at time because in initial stage of disease leukemic cell burden is low. Therefore the chances of achieving complete remission will be highest. Detection of immature leukemic cells in peripheral smear along with presence of clinical signs and symptoms are most important clue for timely diagnosis. The objectives of the present study were to determine the frequency of presenting clinical sign and symptoms and correlate them with laboratory data, morphological features of leukemia and prognostic factors in leukemia patients.
Introduction: White opacities have always been a major concern of esthetics for patients and can ... more Introduction: White opacities have always been a major concern of esthetics for patients and can have varying etiology such as dental fluorosis, early caries (white spot lesions), developmental defects etc. Resin infiltration is a novel microinvasive approach to treat smooth-surface white spot lesions has recently been developed.
Introduction: Pka of bupivacaine and ropivacaine are identical, but ropivacaine is less fat solub... more Introduction: Pka of bupivacaine and ropivacaine are identical, but ropivacaine is less fat soluble predicting that ropivacaine will block A-alpha fibers more slowly than bupivacaine. Intrathecal spread of local anaesthetic is not affected by patient position during and after injection is an added advantage of isobaric solution. Study aimed to see the anaesthetic efficacy of intrathecal isobaric ropivacaine 0.5%, with isobaric bupivacaine 0.5% in lower abdominal surgeries with respect to: 1. Onset and duration of sensory block, 2. Onset, quality and duration of motor block, 3. Hemodynamic changes.
Skin lesions or are valuable in approach towards common genodermatosis. Neurocutaneous markers ar... more Skin lesions or are valuable in approach towards common genodermatosis. Neurocutaneous markers are reflections of pathological process in the central nervous system. Case report: An 11 month old female child presented with convulsions, development delay, hyperpigmented macules in whorls, ocular lesions and MRI Brain suggestive of a multi-system genodermatosis affecting tissues of ectodermal origin like skin, nervous system, eye especially retinal, and dental abnormalities. A skilful history with complete clinical examination with due importance to skin lesion aids to diagnosis. Multidisciplinary follow-up is needed, particularly during the infancy to detect and manage possible neurological and ophthalmologic complications.
Introduction: An overdenture is a removable complete or partial denture that has one or more toot... more Introduction: An overdenture is a removable complete or partial denture that has one or more tooth roots or implants to provide support. In treatment planning of overdenture, variety of clinical alternatives must be considered to achieve good prognosis and to provide comfortable prosthesis to patient.
Introduction: Tooth loss leads to alveolar resorption specially in sagittal direction. Shortage o... more Introduction: Tooth loss leads to alveolar resorption specially in sagittal direction. Shortage of bone can prevent proper positioning of implants unless volume of bone is increased before implantation. This article demonstrates a procedure for widening the atrophic ridge using the lateral ridge expansion technique which is aimed at the creation of a new implant bed by longitudinal osteotomy of the alveolar bone. The buccal cortex is repositioned laterally using a greenstick fracture, and the space between the buccal and lingual cortical plates is left without any graft material. Case Report: Here we have presented an interesting case report of a split crest technique to expand narrow alveolar ridges for the placement of implants in a 35-year-old female patient. Conclusion: The modified approach for split crest technique to augment narrow alveolar ridges for placement of endosseous implants is devoid of foreign material usage and has a low rate cost, therefore, it can be employed more often
Introduction: Esthesioneuroblastoma is an extremely rare malignant tumour of the olfactory epithe... more Introduction: Esthesioneuroblastoma is an extremely rare malignant tumour of the olfactory epithelium. Originally described first by Berger et al in 1924.
A study was conducted to determine the interaction and interrelationship of BMI and steroids on b... more A study was conducted to determine the interaction and interrelationship of BMI and steroids on blood glucose levels in 110 cancer patients on chemotherapy. Patients with cancer are often treated with glucocorticoids as part of therapy, which may cause hyperglycemia. During the study we have seen that prediabetic patients and patients with higher Body Mass Index are more susceptible to develop diabetes mellitus which could be secondary to steroids. Study aimed to correlate that patients with higher BMI and prediabetes are prone to develop diabetes mellitus.
A study was conducted to determine the interaction and interrelationship of BMI and steroids on b... more A study was conducted to determine the interaction and interrelationship of BMI and steroids on blood glucose levels in 110 cancer patients on chemotherapy. Patients with cancer are often treated with glucocorticoids as part of therapy, which may cause hyperglycemia. During the study we have seen that prediabetic patients and patients with higher Body Mass Index are more susceptible to develop diabetes mellitus which could be secondary to steroids. Study aimed to correlate that patients with higher BMI and prediabetes are prone to develop diabetes mellitus.
Introduction: Lung cancer is the most common cause of cancer death worldwide. The World Health Or... more Introduction: Lung cancer is the most common cause of cancer death worldwide. The World Health Organisation reported the global incidence of lung cancer at approximately 1.8 million new cases in 2012. Study aimed to analyse the perfusion parameters measured by CT perfusion (CTP) with different histological subtypes, stage and location of tumour and tumour volume in cases of non-small cell lung cancer (NSCLC) prior to initiation of therapy.
One of the key factors of a successful endodontic treatment depends on the detection of all root ... more One of the key factors of a successful endodontic treatment depends on the detection of all root canals. To accomplish this, a thorough knowledge of root canals configuration is crucial. And invaluable information regarding the root canal systems is provided by Cone-beam computed tomography (CBCT). This research was aimed to analyse the number of roots and root canal variations in maxillary second molars in Western Indian population using CBCT.
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Papers by International Journal of Contemporary Medical Research ijcmr
tramadol for post-operative discomfort prevention following
mandibular 3rd molar extractions. Preemptive analgesia may
reduce postoperative analgesic need by preventing pain.
Materials & methods: Forty patients who required surgical
extraction of mandibular third molars were divided randomly
into two groups. Group- I [Tramadol Group (n=20)] & Group-
II [Ketorolac Group (n=20)] patients were given preemptive
analgesia i.v. preoperatively. The parameters under evaluation
were hourly postoperative pain intensity measurement for 12
postoperative hours, mean time after which rescue analgesic
(acetaminophen) was taken within first 12 postoperative
hours, total analgesic (acetaminophen) consumption over 5
day recovery period, and patient’s assessment of the surgical
procedure.
Results: The study's findings indicated that there existed no
statistically significant disparity between each of the groups.
A significant proportion of those in the ketorolac group said
that the surgery was comparatively more favourable and
less painful, as evidenced by their higher scores and reduced
consumption of post-operative analgesics.
Conclusion: There is no statistically significant difference in
the two groups except global assessment. Clinically, we found
that, ketorolac has a slightly better preemptive analgesia
profile as the patients in ketorolac group experienced less
pain, required rescue analgesic late, required less analgesics
postoperatively and rated overall the procedure as relatively
better.
markedly increases with time worldwide, anti-H. pylori
treatment is continuing to be a great challenge for physicians
in clinical practice. Eradication of H. pylori infection markedly
changes the natural history of peptic ulcer in patients with
duodenal or gastric ulcer. Most peptic ulcers associated with
H. pylori infection are curable. Aim of present study was to
study the efficacies of 14 days ‘ Reverse Hybrid Therapy’ in
H.pylori positive G.I.patients.
Material and methods: 100 H.pylori positive patients with
upper G.I. complaints who underwent upper GI endoscopy
were included in the study. H.pylori infection was documented
by at least 2 positive results of Rapid Urease Test. Subjects
with any of the following criteria were excluded from the
study. 1. Previous eradication therapy 2. Allergy to any
antibiotic used in study. 3. Co- existence of any serious illness.
4. Pregnancy or lactating women 5. Previous gastrectomy
6. Use of antibiotics within last 4 week. Detailed medical
history and demographic details of the patients were recorded.
Routine haematogical tests and USG was done. Patients were
given 14 days dual therapy ie quadruple regimen (proton pump
inhibitor + amoxicillin + clarithromycin + metronidazole) for
first 7 days followed by dual regimen of PPI+ amoxicillin for
next 7 days. Patients were asked to report at 7, 14 days and at
6 weeks interval.
Results: Out of 97 patients 93 patients became negative for
H.pylori after 6 week of Reverse Hybrid eradication therapy.
It was observed that majority of patients enrolled in the study
were in the age group of 41–60 years (50%) followed by
below 40 yrs (27%), above 60 yrs (23%). Out of them, 74%
were male and 26% were female.
Conclusion: Out of 97 patients 93 patients became negative
for H.pylori after 6 week of Reverse Hybrid eradication
therapy. Hence, Reverse Hybrid Therapy is equally potent
therapy to Bismuth based therapy though the latter has a lot
of side effects.
to endoscopic biopsy in the detection of upper gastrointestinal
malignancy is controversial insofar as some claim that its use
is of little clinical benefit. To evaluate the diagnostic accuracy
of upper gastrointestinal with brush cytology as compared to
conventional endoscopic biopsies.
Material and Methods: A prospective observational study
was conducted prospectively at Dhanalakshmi Srinivasan
medical college and hospital in perambalur. Total 45 Patients
with clinical signs and symptoms of benign and malignant
lesions of the upper gastrointestinal tract was included in the
study. The data was collected between April 2018 to March
2019.
Results: The brush cytology had a sensitivity of 72.73% in
predicting gastric malignancy of biopsy and Specificity was
75.00%, false positive rate was 25.00%, false-negative rate
was 27.27, positive predicting value was 88.89%, negative
predictive value was 50.00%, diagnostic accuracy was 73.33%,
positive likelihood ratio was 2.91 and negative likelihood
ratio was 0.36. In predicting esophageal malignancy in biopsy
Specificity was 83.33%, the false positive rate was 16.67%,
false-negative rate was 11.11%, the positive predicting value
was 88.89%, negative predictive value was 83.33%, diagnostic
accuracy was 86.67%, positive likelihood ratio was 5.33 and
negative likelihood ratio was 0.13 of brush cytology.
Conclusion: The study concluded that Prompt early
endoscopic examination with cytological and biopsy studies
in patients with early symptoms may help very much in the
early diagnosis and improves the survival rate.
tramadol for post-operative discomfort prevention following
mandibular 3rd molar extractions. Preemptive analgesia may
reduce postoperative analgesic need by preventing pain.
Materials & methods: Forty patients who required surgical
extraction of mandibular third molars were divided randomly
into two groups. Group- I [Tramadol Group (n=20)] & Group-
II [Ketorolac Group (n=20)] patients were given preemptive
analgesia i.v. preoperatively. The parameters under evaluation
were hourly postoperative pain intensity measurement for 12
postoperative hours, mean time after which rescue analgesic
(acetaminophen) was taken within first 12 postoperative
hours, total analgesic (acetaminophen) consumption over 5
day recovery period, and patient’s assessment of the surgical
procedure.
Results: The study's findings indicated that there existed no
statistically significant disparity between each of the groups.
A significant proportion of those in the ketorolac group said
that the surgery was comparatively more favourable and
less painful, as evidenced by their higher scores and reduced
consumption of post-operative analgesics.
Conclusion: There is no statistically significant difference in
the two groups except global assessment. Clinically, we found
that, ketorolac has a slightly better preemptive analgesia
profile as the patients in ketorolac group experienced less
pain, required rescue analgesic late, required less analgesics
postoperatively and rated overall the procedure as relatively
better.
markedly increases with time worldwide, anti-H. pylori
treatment is continuing to be a great challenge for physicians
in clinical practice. Eradication of H. pylori infection markedly
changes the natural history of peptic ulcer in patients with
duodenal or gastric ulcer. Most peptic ulcers associated with
H. pylori infection are curable. Aim of present study was to
study the efficacies of 14 days ‘ Reverse Hybrid Therapy’ in
H.pylori positive G.I.patients.
Material and methods: 100 H.pylori positive patients with
upper G.I. complaints who underwent upper GI endoscopy
were included in the study. H.pylori infection was documented
by at least 2 positive results of Rapid Urease Test. Subjects
with any of the following criteria were excluded from the
study. 1. Previous eradication therapy 2. Allergy to any
antibiotic used in study. 3. Co- existence of any serious illness.
4. Pregnancy or lactating women 5. Previous gastrectomy
6. Use of antibiotics within last 4 week. Detailed medical
history and demographic details of the patients were recorded.
Routine haematogical tests and USG was done. Patients were
given 14 days dual therapy ie quadruple regimen (proton pump
inhibitor + amoxicillin + clarithromycin + metronidazole) for
first 7 days followed by dual regimen of PPI+ amoxicillin for
next 7 days. Patients were asked to report at 7, 14 days and at
6 weeks interval.
Results: Out of 97 patients 93 patients became negative for
H.pylori after 6 week of Reverse Hybrid eradication therapy.
It was observed that majority of patients enrolled in the study
were in the age group of 41–60 years (50%) followed by
below 40 yrs (27%), above 60 yrs (23%). Out of them, 74%
were male and 26% were female.
Conclusion: Out of 97 patients 93 patients became negative
for H.pylori after 6 week of Reverse Hybrid eradication
therapy. Hence, Reverse Hybrid Therapy is equally potent
therapy to Bismuth based therapy though the latter has a lot
of side effects.
to endoscopic biopsy in the detection of upper gastrointestinal
malignancy is controversial insofar as some claim that its use
is of little clinical benefit. To evaluate the diagnostic accuracy
of upper gastrointestinal with brush cytology as compared to
conventional endoscopic biopsies.
Material and Methods: A prospective observational study
was conducted prospectively at Dhanalakshmi Srinivasan
medical college and hospital in perambalur. Total 45 Patients
with clinical signs and symptoms of benign and malignant
lesions of the upper gastrointestinal tract was included in the
study. The data was collected between April 2018 to March
2019.
Results: The brush cytology had a sensitivity of 72.73% in
predicting gastric malignancy of biopsy and Specificity was
75.00%, false positive rate was 25.00%, false-negative rate
was 27.27, positive predicting value was 88.89%, negative
predictive value was 50.00%, diagnostic accuracy was 73.33%,
positive likelihood ratio was 2.91 and negative likelihood
ratio was 0.36. In predicting esophageal malignancy in biopsy
Specificity was 83.33%, the false positive rate was 16.67%,
false-negative rate was 11.11%, the positive predicting value
was 88.89%, negative predictive value was 83.33%, diagnostic
accuracy was 86.67%, positive likelihood ratio was 5.33 and
negative likelihood ratio was 0.13 of brush cytology.
Conclusion: The study concluded that Prompt early
endoscopic examination with cytological and biopsy studies
in patients with early symptoms may help very much in the
early diagnosis and improves the survival rate.