Current Issue : April-June Volume : 2023 Issue Number : 2 Articles : 5 Articles
Introduction: We present a case of upper gastrointestinal bleeding in a woman aged 56 years with liver cirrhosis who was diagnosed with isolated duodenal variceal bleeding, which was successfully treated with histoacryl injection. Case Presentation: A 57-year female cirrhotic patient presented with melena. She had been diagnosed with duodenal variceal bleeding and treated successfully with 2.4 ml histoacryl using a normal gastroscope. The patient subsequently remained stable and free of any further GI bleeding. She was discharged 48 hours later. Her hemoglobin remained stable at 9 g/L. Conclusion: The histoacryl glue injection provides an effective treatment. Hence, this should ideally be performed by an experienced endoscopist who is aware of and vigilant for the serious complications of this treatment option....
Background: Due to the low mutational testing rate in patients with Gastrointestinal Stromal Tumors (GIST), The Life Raft Group (LRG), a non-profit organization that provides support, advocacy and conducts research for patients with GIST, analyzed various factors that may have an impact on patients’ ability to receive mutational testing. Methods: A survey about mutational testing for patients with GIST or their caregivers, was conducted in June 2020. The survey, sent to 1004 GIST patients and caregivers through email, was promoted through social media with instructions to contact the LRG to participate. The survey was designed by the LRG Patient Registry Department. Members of the LRG, regardless of Patient Registry status, were eligible to participate. Results: A total of 295 patients/caregivers participated in this study (response rate: 29.4%). The percentage of patients who indicated they had received mutational testing was much higher in this survey (80%) than in the general GIST community (26.7%). Several reasons were cited for having a test, including: “My doctor ordered/suggested that I have it done” (54%); “The Life Raft Group advised/suggested I have it done” (25%); “I asked my doctor to have it done” (22%); “I had it done as part of a clinical trial” (5%); “I am not sure” (3%) and “Other” (14%). Mutational testing resulted in a treatment change in 25% of cases. Patients were able to select more than one option when completing this question resulting in a percentage greater than 100. Conclusions: The LRG membership is voluntary and proactive; patients who join are more likely to participate in surveys and mutational testing, as well as more likely to have a GIST specialist. Mutational testing can influence understanding of a patient’s GIST and the treatment best suited to each case. These are extremely important findings, as it helps ensure that patients are on the proper treatment, which should lead to better outcomes....
Introduction: Liver cirrhosis is a global public health issue. Our aim was to determine the epidemiological, clinical, paraclinical and therapeutic aspects of liver cirrhosis in the hepato-gastroenterology department of the hospital Aristide Le Dantec in Dakar. Patients and Methods: We conducted a retrospective study with a descriptive focus covering the period from January 1st, 2010 to December 31, 2020. We included the medical records of patients which presented body of clinical and paraclinical arguments which supported the diagnosis of cirrhosis. The data collected were related to age, gender, clinical, paraclinical, therapeutic and prognosis aspects of cirrhosis and were analyzed with the software Sphinx Plus. Results: Prevalence of cirrhosis was 6.2%. Sex ratio was 2.1%. The average age was 38 years. Asthenia (60.9%), altered performance status (60.1%), abdominal pain (37.2%), gastrointestinal bleeding (29.6%) and abdominal swelling (27.8%) were the most common motives of consultation. Physical examination revealed primarily portal hypertension (74.9%), liver failure (2.4%), hepatomegaly (28.2%) and anemia (13.7%). Viral hepatitis B was the most common etiology (81.9%). Abdominal screening (ultrasound/ CT scan) showed hepatomegaly (80.6%), liver dysmorphia (87.7%), portal hypertension signs (85.3%) and portal vein thrombosis (18.2%). 55.1% Patients were classified as Child Pugh A, 33.8% were Child Pugh B and 11.1% were Child Pugh C. Tenofovir Disoproxil Fumarate (TDF) was prescribed to all patients affected by hepatitis B virus only. Evolution was characterized by clinical improvement and prognosis reclassification. Conclusion: Liver cirrhosis is a frequent pathology in the hepato-gastroenterology department of the hospital Aristide Le Dantec in Dakar. It affects young male adult. Hepatitis B virus is the leading cause. TDF is an effective treatment....
Background Crohn’s disease (CD), an inflammatory bowel disease (IBD), is a complex and heterogeneous disease characterized by nonspecific transmural inflammation of the gastrointestinal tract. CD has a variety of potential causes with no effective treatment available yet. Current clinical laboratory findings from patients do not provide direct indication of the status of mucosal inflammation in the intestine. Recently, it has been found that intestinal inflammation is generally associated with increased levels of 5-hydroxytryptamine (5-HT), which acts as an important gastrointestinal signaling molecule in intestinal homeostasis by stimulating specific receptors. Most previous researches were carried out in vitro or with animal models, and there was a lack of authentic clinical research. In this study, clinical specimens from patients with Crohn’s disease were used to investigate the expression of 5-hydroxytryptamine 7 receptor (5-HT7R) in the induction and development of chronic non-specific inflammatory bowel disease. Methods Patients with CD admitted to the Department of Gastroenterology in the First Affiliated Hospital of Anhui Medical University between June 2014 and January 2018 were recruited, among which 28 were in active disease and 32 were in remission. In addition, 20 patients who had no obvious abnormality by colonoscopy in the hospital during the same time period were recruited into the control group. Data of clinical disease activity (CDAI), CD endoscopic score (SES-CD) and magnetic resonance score (MaRIA) were collected from those two groups of patients. The expression and distribution of 5-HT7R were investigated and their correlations with clinical CDAI, MaRIA, and endoscopic SES-CD scores were analyzed. Results Our study demonstrated that 5-HT7R is expressed in intestinal neurons and CD11C-positive cells in human colon. In CD11c/CD86 double-positive cells in the bowel, 5-HT7R expression was significantly increased in the inflammatory area in the bowel of CD patients, and it was closely related to disease severity, MaRIA, and SES-CD scores. Conclusion The expression of 5-HT7R was significantly correlated with the degree of gut inflammation in CD patients and could be a potential biomarker for disease activity and the therapeutic efficacy in patients with Crohn’s Disease....
Background: Little evidence is available in terms of the role of dietary antioxidants in the management of irritable bowel syndrome (IBS) disease. This study aimed to examine the association between dietary total antioxidant capacity (dTAC) and odds of IBS and its severity. Methods: This cross-sectional study was conducted on 3,362 Iranian adults who were referred to health centers in Isfahan province, Iran. Participants’ dietary intakes were collected using a semi-quantitative validated food frequency questionnaire (DS-FFQ). The dTAC was measured by the ferric-reducing antioxidant power (FRAP) method. Multivariable binary or ordinal logistic regression analyses were performed to estimate any associations between dTAC and odds of IBS, IBS severity, and IBS subtypes. Results: The average age and BMI of the participants and dTAC score were 36.3 ± 7.87 year, 24.9 ± 3.82 kg/m2. The prevalence of IBS, IBS with constipation (IBS-C), IBS with diarrhoea (IBS-D), mixed IBS (IBS-M), and un-subtyped IBS (IBSU) were 22.2, 7.5, 4.6, 3.8, and 6.2%, respectively. In crude and adjusted models, the results did not show any significant association between dTAC and odds of IBS among whole and gender-age stratified populations. Being in the third compared with the first tertile of dTAC was not also significantly associated with odds of IBS severity. Besides, there were no significant associations between dTAC and odds of IBS-C, IBS-D, IBS-M, and IBS-U. Conclusion: This study indicates that dTAC may not be associated with the odds of IBS and its severity even after stratification for gender and body mass index....
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