IMPACT FACTOR: 1.8
The factors responsible for Hepatocellular Carcinoma (HCC) growth are not precisely known. `To study the clinical parameters associated with increases in Maximum Tumor Diameter (MTD).
lpha-Fetoprotein (AFP) is an oncofetal-protein that is an important prognostic biomarker in Hepato Cellular Carcinoma (HCC) patients, yet the reasons for this importance are unclear. We aimed to evaluate the relationships between AFP and Maximum Tumor Diameter (MTD), multifocality, Portal Vein Thrombosis (PVT) and survival.
Background: Foodborne diseases or foodborne diarrhea are important reasons affecting the global population. Diarrheagenic E. coli is the most important pathogens, which causes diarrhea in humans. On May 27, 2022, Anji County Hospital of Chinese Medicine treated several patients with acute onset of gastroenteritis. It was found that this was an outbreak caused by two different EPECs.
Duodenal Pseudomelanosis (DP) also known as pseudomelanosis duodeni is an uncommon entity characterized by upper endoscopic evidence of specks of black- brownish pigmentation of the mucosal layer in the duodenum. Pseudo-melanosis duodeni is commonly seen in females and mostly middle-aged to elderly populations. Pigment (ferrous sulfide) laden macrophages collect in the normal villi of the duodenum.
The connection between Pyloric Stenosis of Infancy (PS) with Duodenal Ulcer (DU) in adults is undeniable. Both occur predominantly in males and in the same ratio-5/1. Both have a familial basis [1] and both have hyperacidity [2,3,4] which is fundamental to pathogenesis. In both conditions blood group O-the blood group associated with hyperacidity -predominates [5,6] and presumably reflects a parietal mass at the top of the normal range.
Although Coronavirus disease 2019 (COVID-19) primarily involves the respiratory system, it can also progress to a multisystem illness frequently involving the gastrointestinal tract. It is commonly observed that COVID elevates Liver Function Tests (LFTs) during an acute infection, but not much has been published about the effects once the infection clears. We investigated outcomes of elevated LFTs during a COVID infection as well as long-term LFTs.
A 28-year-old male patient presented to us with chief complaints of mild intermittent non radiating pain abdomen, in right lower abdomen for 2 months, along with significant weight loss. Routine investigations were done which was suggestive of Anaemia (Hb 10gm/dl), lower serum albumin 3.4mg/dl, increased ESR.
Colorectal cancer is one of the leading causes of cancer worldwide, accounting for over 25% of cancers and 35% of cancer-related deaths across the globe [1,2]. Liver metastases present in more than half of colorectal cancer cases [3]. Therefore, personalized therapy and evaluation of changes in tumor size are pivotal for treatment success.
Acute-on-Chronic Liver Failure (ACLF) is a necessary step between decompensated cirrhosis and death. It is generally thought of as a multi-organ failure associated with decompensated cirrhosis, with a high chance of death. Herb-induced Liver Injury (HILI) is the term used for acute liver injury caused by herbal and dietary supplements, and this might disarrange a previously compensated cirrhotic patient, precipitating ACLF.
Cirrhosis, a prevalent manifestation of chronic liver disease, is associated with a high risk of morbidity and mortality. Previous research has examined the function of oxidative stress and the therapeutic effects of various herbs, albeit with ambiguous results. E. Angustifolia L.’s influence on malondialdehyde (MDA) and tumour necrosis factor- (TNF-) in cirrhosis was evaluated for the first time in the present investigation.
To evaluate the Centers for Disease Control and Prevention hepatitis C care cascade, that assesses hepatitis C follow-up testing and laboratory evidence of likely clearance/cure and recurrent viremia, among Californian incarcerated or detained persons (IDP) and general populations.
Purpose: Esophageal Squamous Cell Carcinoma (ESCC) and Adenocarcinoma (EAC) are common and deadly diseases. The gut microbiome has been implicated in cancer development, yet its role in esophageal cancer (EC) pathogenesis remains unclear.
Methods: We performed a systematic review to summarize the literature on the microbiome and EC. Three databases were queried for studies performing microbial analysis in Barrett’s Esophagus, EAC and ESCC.
Faecal calprotectin (FC) is a marker to diagnose Inflammatory bowel disease (IBD), that is Ulcerative Colitis & Crohn’s Disease. Identifying IBD from other gut related disorder is of prime importance in managing the condition. Faecal calprotectin is cheap and non-invasive, it also helps in assessing the further need of any possible invasive procedure such as colonoscopy or imaging studies. The main objective of this observational study was to diagnose new IBD in mildly raised faecal calprotectin value(60ug/g-300ug/g). This study was done in a district-level hospital in the UK...
Celiac Disease (CD) represents an immune-mediated disorder that involves the body’s inability to digest gluten properly. After contact with gluten, patients of all ages might experience symptoms such as bloating, diarrhea, gas, growth issues, and anemia. In the past two decades, its prevalence has drastically increased worldwide, so the need for a better understanding of this disease and novel potential treatment options has never been greater. Today, patients are still advised to follow a completely gluten-free traditional gold standard CD diet...
Aim: Our aim in this study; It is aimed to accurately evaluate the pain in our patients with abdominal pain and general pain in the body with different measurement and scoring methods and to determine an effective treatment regimen.
Material and method: Our patients with acute symptoms diagnosed with COVID-19 were hospitalized, followed up and treated in our COVID Services in our Medical Faculty Health Research and Application Center hospital between November and December 2020...
Background: Hydrogen peroxide (H2O2) ingestion is associated with caustic injury and gaseous oxygen production that may cause Hepatic Portal Venous Gas (HPVG) and air embolism leading to mesenteric ischemia and CNS infarction with ensuing encephalopathy, seizures, and even death...
Diarrhoea is usually a symptom of a bowel infection and the etiology of infectious diarrhea is generally mixed. Development of resistance to anti-microbial agents and increased risk of developing clostridium difficile-associated diarrhoea pose a new threat. In combination with metronidazole, rifaximin with its unique properties and broad spectrum activity can be a rational approach for infectious diarrhoea as co-infection is the norm in majority of the patients...
Esophageal Cancer (EC) has the sixth-worst prognosis because of its aggressiveness and poor survival. Patients with EC are malnourished due to anorexia, dysphagia, pain, and hypercatabolic state, which results in cancer cachexia and high mortality rates. Oral feeding usually remains inadequate to cover nutritional needs, while Enteral Nutrition (EN) remains the recommended solution...
Transjugular Intrahepatic Portosystemic Shunt (TIPS) is an established treatment for complications of decompensated liver cirrhosis causing portal hypertension. Hepatic encephalopathy is a frequent complication of TIPS; however, cerebral edema, which is more commonly seen in acute liver failure, has rarely been reported in chronic liver failure or post-TIPS. There are multiple proposed mechanisms that may contribute to cerebral edema after TIPS placement, but few established risk factors or treatment options exist...
Primary Biliary Cholangitis (PBC) is a chronic cholestatic disease of the liver. Due to the permanent cholestasis, fibrosis and cirrhosis eventually occur. It is said to be a rare disease in black Africans. We reported a case of Anti-Mitochondrial Antibody (AMA) negative PBC in a forty-one-year-old woman who fulfilled two out of the three diagnostic criteria...
We proposed human intestine as the gate for the delivery of the therapeutic recombinant proteins expressed inside of the human body. The normal intestinal microflora was used to express the selected genes of the pathogenic organism Yersinia pestis the causative agent for plug in humans and animals. We have confirmed the production of the selected proteins by the PCR to their DNAs expressed in intestinal bifidobacteria chosen...
Gastrointestinal disorders are a very common problem sometimes in a variety of people. We herein offer our methodology to cure such disorders in any condition, including home environment, by the two simple and reproducible methods, which anyone could reproduce and use.
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic began almost 2 years ago but new and rare complications are still being reported. It is well known that COVID-19 infection is commonly accompanied by Gastrointestinal (GI) symptoms, including dysgeusia, nausea, vomiting, diarrhea, and abdominal discomfort...
Background: There are several serious side effects associated with the use of clozapine, an atypical antipsychotic medication. Constipation, however, is an increasingly overlooked side effect that has resulted in fatal complications. We present the case of a patient with severe constipation due to long-term use of clozapine.
Colon and rectal cancer is the third most common cancer accounting for 1.93 million new cases in the year 2020. It is the second most common cause of cancer deaths in recent years. Newest guidelines suggest screening for colorectal cancer starting at the age of 45 for average-risk individuals of 40 years old or 10 years prior to youngest affected first-degree relative under the age of 60 or two or more first-degree relatives at any age with colorectal cancer or advanced polyp...
The burden of Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH) are increasing worldwide. Growing evidences showed its ability to prog- ress to Hepatocellular Carcinoma (HCC). In the transplant field, NAFLD is the most common cause of discarding the livers and, to further complicates matters, the high preva- lence of NAFLD-associated HCC in the absence of cirrhosis could be a factor jeopardizing the complex transplant chain...
Objectives: Data on lower Gastrointestinal (GI) disease are generally sparse. In addition, the pattern of GI disease is changing over time.
The objectives of this study were to identify the main indications and associated endoscopic findings in patients presenting for elective lower GI endoscopy at a major teaching hospital, thus provide database and identify the current pattern of lower GI disease in our community.
Background and aim: Malondialdehyde (MDA) results from lipid peroxidation of polyunsaturated fatty acids and it is a marker for oxidative stress. Its level is higher in cirrhotic patients with viral etiology than in matched healthy controls. So, it may strongly correlate with Portal Hypertension (PH) in cirrhotic patients. This work aims at evaluation of the relevance between plasma MDA level and portal hypertension in cirrhotic patients.
For years, we have conducted telepathology consultation for cancer patients from China. Major discrepancies in diagnosis were identified in all cases. Herein, we focus on one unique case of esophageal large cell neuroendocrine carcinoma to illustrate differences in pathology practice patterns between American and Chinese pathologists.
We report a 69-year-old man with a medical history of Myasthenia Gravis diagnosed 10 years before and treated with pyridostigmine who was admitted to the hospital due to microcytic anemia and hyponatremia in a routine blood test. The laboratory values revealed microcytic anemia (Hct: 20, 40%, Hb: 6.30 g/dl, MCV: 75 ,30 fl, MCH: 23, 20 pg, MCHC: 30.90 g/dl) and hyponatremia (Na: 121 mmol/l)...
Introduction: Gastrointestinal endoscopy is one of the most important diagnostic and therapeutic methods that is being performed in children day by day. Nausea vomiting, delirium, bronchospasm, and laryngospasm after anesthesia are the most common complications after endoscopy in children. These complications may cause anxiety and fear to both the patient and their companions...
Objective: To compare the rate of uncomplicated and complicated acute appendicitis, and their management strategies between the COVID-19 pandemic period and the control group.
Summary background data: Literature shows significant reduction in the emergency department visit due to patients’ fear of contracting the COVID-19. Healthcare professionals are concerned that this may lead to delayed presentations of high acuity illnesses...
Objectives: Data on GastroIntestinal (GI) disease from developing countries are lacking. In addition, the pattern of GI disease is changing over time.
The objectives of this study were to identify the main indications and associated endoscopic findings in patients presenting for elective upper GI endoscopy at a major teaching hospital, thus identifying the current pattern of GI disease and the changes that occurred over the past decades.
Metastatic prostate cancer seldomly affects the liver. Moreover, hemoperitoneum is an un-common manifestation of metastatic liver cancer and it has never been reported to be caused by rupture of hepatic metastatic lesions secondary to prostate adenocarcinoma. We describe a case of advanced prostate cancer with liver metastases, presenting with hemoperitoneum, which was successfully treated. Treatment included transarterial embolization, blood transfusions and hormonal therapy...
Hemobilia or bleeding from the hepatobiliary tract and is an uncommon cause of upper gastrointestinal bleeding that it may be caused by iatrogenic biliary injury, malignancy or vascular malformations [1]. The management of significant hemobilia is focused on arterial embolization, however biliary stents have become accepted as alternative therapies [2].
A 30-year old man presented to the Gastroenterology Department with diffuse abdominal pain, distention and constipation. He was born with an imperforate anus, treated by posterior sagittal anorectoplasty and construction of a neo-anus. He developed an anal stenosis for which he had numerous dilations during childhood. During recent years he defecated by means of active straining and manual abdominal pressure...
Video Capsule Endoscopy (VCE) allows examination of the entire length of the small bowel not visualized by standard Esophagogastroduodenoscopy (EGD) and colonoscopy. The main indications are for suspected small bowel bleeding and diagnosis and management of small bowel Crohn’s disease (CD). It is a safe procedure to perform in adults and children with the greatest risk being capsule retention. Contraindications to VCE include patients with gastrointestinal obstructions, strictures or fistulas and patients with implanted electromedical devices.
Background: Primary Sclerosing Cholangitis (PSC) is a chronic cholestatic liver and is highly associated with Inflammatory Bowel Disease (IBD).
Objective: Our aim was to evaluate the prevalence of PSC, phenotypic characteristics, outcomes in a cohort of IBD patients from a single-center in Northeastern of Brazil.
Methods: Data were analyzed retrospectively; risk factors of Ulcerative Colitis (UC)-PSC were compared with UC alone.
Background: Gastro-intestinal disease account for significant proportion of patient load not only on Gastroenterology specialists but also on General physician and surgeons. These patients can have varied manifestations and mimic disease pertaining to many different organs leading to multiple myths associated with them.
Discussion: Gastro-intestinal disease can have different clinical presentation, most common being the dyspepsia and other presentations are alteration in bowel habits, early satiety, gastro-esophageal reflux, distension or fullness of abdomen and epigastric pain.
Nobel Prize, 2020 in Physiology or medicine were jointly given to two American scientists Harvey J. Alter and Charles M. Rice and one British Scientist Michael Houghton for the discovery of Hepatitis C virus. The Nobel committee considered four decades of research on discovery and study of this virus. Prof Alter first identified the causative agent of transfusion associated unknown hepatitis, Prof. Houghton discovered and named this causative agent Hepatitis C virus and Prof...
Aim: Arachidonic acid metabolism plays a role in the development and progression of many neoplasms through Cyclo Oxygenase (COX) and Lip Oxygenase (LOX) enzyme pathways. Over-expression of 5- Lipoxygenase (5-LOX) enzyme has been demonstrated in different human cancers. A few studies have investigated the relationship between colon neoplasms and 5-LOX enzymes. The aim of this study was to examine and compare 5-LOX expression in normal colonic tissue and polyp tissue in patients with colonic polyps.
Objective: Malnutrition is common in patients with esophageal cancer. A Feeding Jejunostomy (FJ) for enteral feeding is an effective method to improve nutritional status.
The objective of this study was to evaluate the surgical technique and advantages of Robot-Assisted Minimally Invasive Esophagectomy (RAMIE) during surgical placement of the FJ and compare it to the open procedure. Secondly the use of barbed sutures to fix the FJ to the abdominal wall was also assessed.
Purpose: Vascular disease is believed to be a risk factor for radiation injury in normal tissues, including the intestine. Clinical studies evaluating the relationship between hypertension and radiation enteropathy have been inconclusive, possibly because most hypertensive subjects were receiving blood pressure reducing treatment. This study assessed the association between uncontrolled hypertension and intestinal radiation injury in a clinically relevant rat model.
Background: Bacillus clausii is a gram-positive spore forming bacterium, used as a probiotic. Despite its wide use in acute diarrhea, little is known about its ability to modify the intestinal microbiota.
Aims: Aim of this study is to investigate the effect of B.clausii on a mild DSS induced acute colitis in mice evaluating gut microbiota modulation.
70 yr old male presented with history of throat pain of 1-month duration, sudden onset severe pain. Pain was severe with feeling of blocking sensation of throat and difficulty in swallowing movements. Pain is radiating to neck, evaluated by ENT for pharyngeal pathology and was referred for upper GI scopy to rule out esopahgeal problems. He is a diabetic and on treatment. Upper GI scopy was normal and suggested high-resolution oesophageal manometry to rule out motility disorder.
Background: Hepatitis B Virus (HBV) causes severe liver disease, such as Hepatocellular Carcinoma (HCC) and life-threatening liver disease. Hepatitis B virus infection is one of the most dominant public health problems these days. Therefore, this study aimed to determine the seroprevalence of HBV infection among patients attending Addis Alem Hospital, Bahir Dar, Northwest Ethiopia.
Objective: To investigate the diagnosis and treatment of mesh-related infection after tension-free repair of inguinal hernia.
Methods: The clinical data of 12 patients with patch infection after tension-free repair admitted to our hospital from May 2016 to June 2019 were retrospectively analyzed. Among the patients, there were 7 cases.
Background: Liver exposed to toxic injury have exhibited to regenerate through a compensatory growth process. The aim of this study was to establish the hepatoprotective properties of Elephantopus scaber L. in cirrhotic rat regeneration partial hepatectomy.
Methods: Cirrhosis was induced by Thioacetamide (TAA, 200 mg/kg) administration for 6, 24, 72 to 168 h, then received surgical 70% cirrhotic PHx was examined. Rats were sacrificed after 6, 24, 72 and 168 h regeneration.
The human liver usually receives blood supply from hepatic artery arising from the common hepatic artery (Figure1). One or two aberrant hepatic arteries (S,D) appear in 30% of fetal livers and 28.6 % of adult livers (Table 1), [1,2,3]. The aberrant arteries (S or D) occupy an entire lobe of the liver in high frequency. The human liver receives any of three arterial supplies; triple (MSD), double (MS, MD, SD), or single (M,S,D; Figure1, Table 1). The arterial supply of the liver has been classified into seven patterns: MSD, MS, MD, SD, M, S, D (Table 1) [4,2,3]...
Objective: According to recent ESGE guideline adequate polypectomy technique should be used in >80% of polypectomies. Despite recommendations of snare polypectomy for small polyps (6-9mm) almost half of them are resected by forceps. The aim of this study was to analyse if the publication of clinical data or guideline have more impact on the reduction of the forceps resection rate of polyps ≥5mm.
Gastric Cancer, is a frequent cancer in Italy, the mortality associated with it is still high. It is essential to detect more new prognostic factors that allow to identify patients at higher risk, to guide the new possibilities with adjuvant and neoadjuvant chemotherapies. Various prognostic factors have been identified; tumor diameter, degree and type of pathological differentiation, lymph node status, surgical resection, margins status.
SARS-CoV-2, the virus that causes COVID-19, has led to an ongoing worldwide pandemic that has afflicted nearly 46 million lives world. Current clinical evidence indicates that gastrointestinal symptoms may be more prevalent across COVID-19 infections than clinicians previously realized. Furthermore, these symptoms are common among patients who present with no other COVID-19 symptoms, suggesting that these individuals may be unknowingly spreading the disease to others.
The Mirizzi syndrome is a set of symptoms related to the obstruction of the common hepatic duct by an impacted stone in the cystic duct or gallbladder infundibulum. The objective of article is to describe a case of a woman with obstructive jaundice and cholangitis diagnosed by Endoscopic Retrograde Cholangiopancreatography (ERCP), and the subsequent surgical management of the patient.
Two month old male child presented at pediatric gastroenterology clinic of a tertiary care hospital in Delhi, India with persistent cough with choking during feeding. He also had vomiting after feed. On upper gastrointestinal endoscopy, esophageal stricture was seen at 13 cm from incisor with evidence of Tracheo-esophageal fistula adjacent to stricture. He was referred to Pediatric surgery for surgical closure of fistula.
Introduction: Inflammatory bowel disease includes ulcerative colitis and Crohn Disease (CD). About 25-30% of diagnosed patients correspond to pediatric age, with an increasing prevalence. Objective: To characterize children with ulcerative colitis and Crohn disease. Material and Method: A descriptive cross-sectional study was carried out that included 31 children with confirmed diagnoses of both entities according to the Lennard-Jones criteria, attended in the pediatric consultation of the Institute of Gastroenterology between 2017 and 2019.
Non-Alcoholic Fatty Liver Disease (NAFLD) has currently emerged as common liver disorder compared to alcoholic liver disease. The prevalence of NAFLD in India varies from 9% in rural areas to 32% in urban populations. This incidence is reported to be the lowest in western India (44.1%) compared to the highest prevalence in northern states (72.4%). Available treatments are associated with certain side-effects.
We report the case of a 75-year-old female patient with a big tumor in the lower rectum with intestinal obstruction and lower gastrointestinal bleeding history who underwent to laparotomy with tumor biopsy and terminal colostomy at another hospital in Peru. She came to our institution for clinical evaluation with pathology result of rectal gastrointestinal stromal tumor.
Since the initial description of laparoscopic fundoplication in 1991 for the treatment of gastroesophageal reflux disease, different minimally invasive procedures have been developed until nowadays, when esophagectomy is performed using combined thoracoscopy and laparoscopy. The aim of our study is to analyse the intraoperative complications of minimally invasive esophagectomy in prone position.
Achalasia is a rare chronic autoimmune motility disorder of the esophagus. A curative treatment restoring the motility does not exist, however there are good options for symptom control by laparoscopic Heller myotomy (LHM). The aim of this study was to evaluate the effect of LHM in patients with achalasia and to evaluate achalasia-disease specific quality of life (achalasia-DSQoL) and health related quality of life (HRQoL).
Inflammatory Bowel Disease (IBD) is defined as chronic idiopathic inflammation of the intestines which includes two gastrointestinal disorders of unknown etiology: Ulcerative Colitis (UC) and Crohn’s Disease (CD). The nature of clinical symptoms persistence is connected with different factors, among others angiogenesis plays an important role in development of changes within bowel wall. Both macro- and microscopically examined bowels from patients suffering from acute phase of IBD revealed sometimes dramatically congested vessels with hemorrhagic foci.
The recent pandemic disease coronaviruses which spread universally are extremely pathogens for humans. It involved critical respiratory syndrome cause, extra-pulmonary manifestations, and in some times cause death as a result of massive alveolar damage and progressive respiratory failure.
The syndromic ductopenia or also known Alagille syndrome constitutes one of the causes of cholestasis in pediatrics. A genetic disorder characterized mainly by chronic cholestasis secondary to hypoplasia of the intrahepatic biliary ducts. Histological lesion is characterized by a decrease in the number of biliary ducts in the portal spaces. It is a disease with a mortality close to 20% and patients may need hepatic transplantation.
Nodular Gastritis in a frequent diagnosis in upper digestive endoscopies in children and much more common in those infected with Helicobacter pylori. Recent research suggests that this diagnosis in childhood may increase the risk of cancer in adulthood. With this study we aim to provide an approach to the theme at the Institute of Gastroenterology.
Infection is the second most common cause of esophagitis, second only to gastroesophageal reflux, and represents a clinically important disorder. Immunosuppressed patients are at highest risk for infectious esophagitis, with candida, herpes simplex virus, and cytomegalovirus being the most common causative microorganisms.
Antony van Leeuwenhoek, the Dutch tradesman who first identified Giardia in 1681, has become a legend in Parasitology. Last November 4th marked the 338th anniversary of the submission of his letter, addressed to Sir Robert Hook, the then Secretary of the Royal Society of London, in which he described his observations in his own faecal sample...
Peutz Jeghers Syndrome is a rare hereditary polyposis, characterized by the presence of polyps in most cases in the gastrointestinal tract and the presence of very characteristic melanic macules, which lead to periodic monitoring of the entire tract. Gastrointestinal due to the high risk of complications such as bleeding, anemia and intussuspection with concomitant risk of intestinal infarction and subsequent intestinal reception and an increased risk of presenting gastrointestinal and extraintestinal cancer.
Objective: To develop a validated comfort score for gastroscopy
Design: The Bath Gastroscopy Toleration Score (GTS) was developed during routine a gastroscopy list. The score was used by the endoscopist and two nurses to grade the comfort of the patient. During the list the wording of the score was amended and subsequently a consensus between endoscopists and nurses produced the Bath GTS, a five-point scale from 0 – 4 which ascends in terms of patient discomfort....
Objective: Giardiasis is an intestinal infection and inflammatory mediators take place in host defense mechanisms. The aim of this study was to examine the consistency and usefulness of c-kit in diagnosis, to establish the roles of iNOS, COX-2 and ICAM-3 in the pathogenesis of Giardia Lamblia infection...
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