Tropical Gastroenterology
Permanent URI for this collection
Browse
Recent Submissions
Item Multiple Hepatic Ectopics Over the Gall Bladder : A Rare Finding During Laparoscopic Cholecystectomy(All India Institute of Medical Sciences, 2022-03) Goyal, Lokesh; Vikas, BalwantItem Acute Hepatitis-A with COVID-19: Is it coinfection or Mere a Coincidence(All India Institute of Medical Sciences, 2021-03) Tambe, Anil; Nawghare, Pankaj; Biradar, Padmaja; Rathi, Pravin M.; Rathi, SurbhiItem Post-ERCP Hepatic Hematoma: Case Report and Review of Literature(All India Institute of Medical Sciences, 2022-03) Bhat, Ganesh; Shetty, Athish; Rodrigues, Gabriel; Kadavigere, Rajagopal; Pemmada, VikasItem Redo Laparoscopic Cholecystectomy in a Case of Heterotaxy Polysplenia Syndrome with Sealed GB Perforation(All India Institute of Medical Sciences, 2022-03) Ch, Naveen Kumar; Gupta, Sunita; Shahnawaz, Danish; Bhat, Vidya Sharada; Agarwal, AnilItem A Rare Presentation of Bleeding Colonic Angiodysplasia in Pregnancy(All India Institute of Medical Sciences, 2022-03) K, Sugumaran; Shahnawaz, Danish; Bhat, Vidhya Sharada; Derrick, B Kujur; Dahale, Amol; Saluja, Sundeep SinghItem Successful Management of Chylothorax in Cirrhosis of the Liver using Trans-jugular Intrahepatic Portosystemic Shunt (TIPS)(All India Institute of Medical Sciences, 2021-03) Jain, Ajay Kumar; Kaulavkar, Sandeep; Gupta, Shailesh; Jain, SuchitaItem Irreducible Rectal Prolapse in a Patient with Anorectal Malformation: Arduous to Reduce(All India Institute of Medical Sciences, 2021-03) Bhattacharjee, Hemanga Kumar; G Ezhilvanan; Buddha, MVVS Nukesh Naidu; Karthyarth, Mithun Nariampalli; Parshad, RajinderItem Recurrent Acute Pancreatitis Secondary to Lipoprotein Lipase Deficiency(All India Institute of Medical Sciences, 2021-03) Jain, Mayank; Jain, Kamna; Jain, VidyutItem Hepatolithiasis, A Rare Cause of Secondary Biliary Cirrhosis(All India Institute of Medical Sciences, 2022-03) Gupta, Ankur; Sonkar, DevendraItem Correlation of Gastric Scintigraphy and Clinical Symptoms in the Diagnosis of Gastroparesis and its Impact on Quality of Life: A Pan India Real World Study(All India Institute of Medical Sciences, 2021-03) Rai, Ramesh R; Choubal, Chittaranjan C; Agarwal, Mukesh; Khaliq, Abdul M; Farishta, Faraz J; Harwani, Yogesh P; Kumar, Sanjay YBackground: Gastroparesis with its varied etiology is one of the major health issues in India. Poor correlation between delayed gastric emptying and its symptoms is well-known. This study was planned to evaluate the proportion of confirmed gastroparesis by scintigraphy among patients with suggestive clinical features, their underlying aetiologies and clinical profiling in a real-world setting in India. Settings and Design: Patients clinically diagnosed with gastroparesis, presenting varyingdegreesofsymptoms for at least 12-weeks, were enrolled in this multic-entric,cross-sectional, clinico-epidemiological study. Results: Overall, 196/201 enrolled patients underwent gastric scintigraphy; 88 (45%) were found to be scintigraphically positive and 108 (55%) patients were only clinically positive. Underlying etiologies of gastroparesis were idiopathic (51.2%), type-2 diabetes (44.8%), type-1 diabetes (2.5%) and psychological conditions (1.5%). Most patients presented symptoms like postprandial fullness (75.6%), bloating (50.7%), abdominal pain (45.3%), nausea (41.3%), abdominal discomfort (40.3%), early satiety (37.8%) and vomiting (17.9%) of moderate severity. Common dietary risk factors were fatty diet (66.7%), fiber-rich food (57.7%) and carbonated drinks (18.9%). Weight loss (6.5%), esophagitis (5.5%) and electrolyte disturbances (0.5%) were the associated complications. About 89.8% were on proton-pump inhibitors, followed by prokinetics (51.8%) and antiemetics (8.4%). The mean PAGI-QoL score was 3.6 ± 0.94, suggesting a moderate effect of gastroparesis on QoL. Conclusion: Poor correlation exists between gastric scintigraphy and gastrointestinal symptoms, thus reiterating the significance of the clinical diagnosis of gastroparesis, especially in diabetes. Only about half of the patients were prescribed prokinetics, emphasizing the need for appropriate pharmacotherapy using prokinetics for holistic management of gastroparesis.Item Managing Clostridium Difficile Infection Induced Persistent Toxic Megacolon with Prucalopride(All India Institute of Medical Sciences, 2021-12) Jain, Ajay Kumar; Jain, Suchita; Bhagat, Priyanka; Joshi, Amit D; Sircar, ShohiniItem HNF1B Mutation: A Rare Cause of Syndromic Biliary Hypoplasia and Neonatal Cholestasis(All India Institute of Medical Sciences, 2021-12) Goyal, Ashok; Vinayagamoorthy, Vignesh; Sarma, Moinak Sen; Poddar, Ujjal; Srivastava, AnshuItem Human Intestinal Capillariasis: A Rare Cause of Chronic Diarrhoea In India(All India Institute of Medical Sciences, 2021-12) Usman, Sandhra Papparath; Kunnathuparambil, Sojan George; Ramakrishnan, Deepti; Augustine, Joy; Susheela, Kundoly VItem Vitamin D Toxicity Causing Acute Pancreatitis with Acute Kidney Injury: A COVID-19 Era Mishap?(All India Institute of Medical Sciences, 2022-03) Koduri, Krithi Krishna; Talukdar, Rupjyoti; Mallela, Ajay Raj; Rughwani, Hardik; Reddy, D.N.Item Clostridium Difficile is associated with High Mortality among Cirrhotics in India(All India Institute of Medical Sciences, 2022-03) Jayalakshmi, Vadivukkarasi Thangaraju; Anandan, Shalini; Zachariah, Uday George; Goel, Ashish; Veeraraghavan, Balaji; Kattiparambil, Sajith; Eapen, CEBackground: To assess the prevalence and impact of Clostridium difficile infection (CDI) in hospitalized patients with cirrhosis in India. Methods: In this prospective observational study from June 2015 to March 2016, all hospitalized patients with cirrhosis and acute diarrhea at the time of admission or during hospitalization were included. We studied hospitalized patients with cirrhosis without diarrhea during the same period to detect asymptomatic colonizers.Stool samples were tested for CDI, bacterial cultures, and parasite microscopy in patients with diarrhea.CDI was detected using a stool PCR test that detects the pathogenicity locus of toxigenic Clostridium difficile gene. We analysed the impact of CDI on hospital outcomes and also assessed the risk factors for acquiring CDI. Result: Among 92 hospitalized cirrhotic patients with acute diarrhea [male: 74; median age: 50 (range 19 to 80) years; Child’s class A: B: C: 8:41:43; median MELD score: 18 (range 6 to 44)], 6 (6.5%) had CDI by positive stool PCR. Use of antibiotics (100% CDI Vs 55.8% non-CDI, p= 0.04) and steroids (50% CDI vs 10.5% non-CDI, p =0.028) emerged as risk factors for CDI among cirrhosis patients. Two of the 6 patients (33.3%) with CDI as compared to 6/86 patients (7%) with no CDI died (p-value: 0.08).There were no asymptomatic colonizers amongst 35 hospitalized cirrhosis patients without diarrhea.Conclusions: C. difficile, although uncommon, was an important cause of mortality in cirrhosis patients hospitalized with diarrhea in India.Prior use of antibiotics or steroids were identified as risk factors for CDI.Item A Comparative Study on Outcome of Amoebic Liver Abscess in Patients With and Without Alcoholic Liver Disease(All India Institute of Medical Sciences, 2022-03) Sharma, Kartik; Kaur, NavneetBackground: Amoebic liver abscesses (ALA) in the presence of Alcoholic liver disease (ALD) constitutes a high-risk group of patients who are prone to complications and may need more aggressive treatment. This study was aimed at evaluating disease course and outcomes in patients of ALA with ALD, in comparison to those without ALD. Material & Methods: This prospective observational study was conducted on 60 consecutive patients of ALA without ALD (Group-I) and 60 consecutive patients of ALA with ALD (Group II). Result: The patients ALA with ALD were older (47.2 ±13.3 years) than those without ALD (34.1±14 years). Mean size of the abscess cavity was significantly larger in patients with ALD (391.2± 208.7 cc in Group I and 594.3 ± 297.9 cc in Group II). In Group I, conservative management was most common (43.3%); while in Group II pigtail catheter insertion was the most frequently used modality of treatment (45%). Complications like empyema (6.6%), acute on chronic liver failure (8.3%) and impending liver failure (23.3%) manifesting as ascites and oedema were seen only in patients in Group II and they also had longer hospital stay. (4.87 days in Group I vs 8.37 in Group II). Conclusion: Patients of ALA with ALD have a more aggressive course of disease and should be managed with a lower threshold for abscess drainage.Item Brunner Gland Adenoma: A Rare Cause for Upper Gastrointestinal Bleeding(All India Institute of Medical Sciences, 2021-12) Siva, Sangeetha; Shivaram, H V; Alur, Sunil Kumar; V, Shiva KumarItem Demographic, Clinical, Laboratory and Management Profile in Patients of Amoebic Liver Abscess from Northern India(All India Institute of Medical Sciences, 2022-03) Dhaked, GK; Agarwal, VK; Dhaked, S; Ahmad, T; Jhajharia, A; Ashdhir, P; Pokharna, RKBackground: Amoebic liver abscess (ALA) is a serious extra-intestinal manifestation of amoebiasis and a major problem in developing countries. Due to rapid urbanization, improved sanitation and hygiene in India, there has been a shift in disease epidemiology towards non-communicable disease, but recent changes in epidemiological and clinical pattern in ALA are not well studied. Aim: To evaluate recent demographic, clinical, laboratory and management profile in patient with ALA. Methods: It is a prospective observational study conducted in the Department of Gastroenterology, SMS medical college, Jaipur, Rajasthan from June 2018 to December 2020. A predesigned semi structured questionnaire consisting of socio-demographic factors, risk factors, clinical, laboratory and management profile was used to collect data. Result: A total 508 patients of amoebic liver abscess were analysed. Median age of presentation was 40 years, majority were males (90.4%) with chronic alcoholism (44.1%) and belonging to lower socio-economic class. Abdominal pain, fever and anorexia were the most common symptoms. A majority had right lobe involvement (77.6%) and solitary abscess in 67.5%. Most of the small liver abscesses (68%) were managed by medical treatment alone. Percutaneous needle aspiration was done in 62.6% patients, mostly for abscess size 5-10 cm (93%) with 90% success. A total of 24.6% patients underwent percutaneous catheter drainage, all successfully done. Intraperitoneal rupture was seen in 10% patient. Mortality was 1.5%. Conclusion: This is one of the largest cohorts of ALA which shows that a majority of cases are males from lower socioeconomic status with history of significant alcohol intake. Early initiation of a combined therapeutic approach leads to early symptomatic improvement, fewer complications and better outcomes.Item COVID-19 Infection and Splenic Infarct(All India Institute of Medical Sciences, 2021-12) Mathew, Joe Francis; Ramesh, G N; Siyad, Ismail; Mammayil, Geetha; George, Jeffey; Menon, Prashanth; Toke, Nilesh NamdeoItem Endovascular Management of Stent Fracture Causing Trans-jugular Intrahepatic Portosystemic Shunt Stent Malfunction(All India Institute of Medical Sciences, 2022-03) Malla, Sundeep; Razik, Abdul; Shalimar; Yadav, Richa; Gamanagatti, Shivanand