Hepatic encephalopathy (HE), a morbid ordeal affecting chronic liver disease patients always insists for the search of a rational, superior & infallible agent beyond the time-proven standards i.e., ...Lactulose & Rifaximin. In this RCT, we compared the efficacy of intravenous (IV) L-ornithine-L-aspartate(LOLA) versus Oral LOLA in patients with chronic liver disease(CLD) enduring overt Hepatic Encephalopathy(OHE). 40 CLD patients with OHE were randomly assigned IV or oral LOLA in a 1:1 ratio. Patients were graded for HE and monitored for serum ammonia levels from day 1 to day 5. The aim was to compare IV versus oral LOLA efficacy in HE grades improvement and its correlation with ammonia levels. The study was registered with clinical trials registry-India, CTRI/2020/12/029943. Baseline characteristics of patients in both groups were similar. The mean difference in ammonia levels from day 1 to day 5 was 55.4 ± 32.58 µmol/L in the IV LOLA group and 60.75 ± 13.82 µmol/L in the oral LOLA group (p = 0.511). Significant reductions in ammonia levels were observed from day 1 to day 5 within each group (p < 0.001). HE grade & ammonia correlated positively in both groups. LOLA, regardless of administration route, has demonstrated efficacy in OHE.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background: Drotaverine and Mebeverine are used for alleviating the pain of IBS, but the evidence for their efficacy is scarce. In this randomised control study, we evaluated and compared their ...efficacy in improving severity, frequency of pain and its associated symptoms.
Methods: Patients fulfilling the ROME III criteria of IBS were evaluated in this randomised control trial during 4 weeks of treatment. Group A (n = 100) received 80 mg Drotaverine and Group B (n = 100) received 135 mg Mebeverine three times a day, 1 hour before meals. Primary outcome measure was, the reduction in severity of pain (>30% reduction) assessed by VAS (0 to 10 scale) & PSS (patient symptoms scores).
Results: The pain severity score fell from 6.02 to 4.8 on day 3 in Group A as compared to decrease from 6.72 to 6.62 in Group B (p < 0.01). This significant reduction in pain severity was observed till the end of the study, reducing from 6.02 to 1.78 (74% reduction) in Group A compared to 6.72 to 3.62 (46.1% reduction) in Group B (p < 0.05). There was a significant reduction in pain frequency, straining on stool, a change in one score in Bristol stool chart (BSC), achievement of complete spontaneous smooth bowel movement in Group A, compared to Group B patients. A significant improvement in Patient's evaluation of Global Assessment of Symptoms (p < 0.05) and Patient Assessment of Constipation - Quality Of Life (PAC-QOL) (p < 0.01) was observed in Group A compared to Group B.
Conclusion: Drotaverine was significantly superior in efficacy as compared to Mebeverine in alleviating pain severity (starting from day 3), frequency and stools-elated symptoms of IBS.
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Patients of end stage renal disease on maintenance hemodialysis were enrolled to study the prevalence of occult and dual hepatitis B virus （HBV） and hepatitis C virus （HCV） infection and non-occult ...hepatitis B and C virus infection. One hundred and two patients were enrolled. Thirty patients had HCV infection, three of them were positive in anti-HCV. So, 27 （90%） of HCV-positive patients had occult HCV infection. Eleven （11%） patients had HBV infection. Five patients were positive in anti-HBc or HBV-DNA, but negative in HBsAg （occult HBV infection）. Three （3%） patients had dual HBV and HCV infection. None of the patients showed changes in viral markers during the follow-up of 8 mo on average （1-12 mo）.
Aims: Skin disorders are a common health problem in pediatric age group, and a school-based survey seems to be a good screening tool for estimating the prevalence of cutaneous disorders among ...children. Subjects and Methods: A cross-sectional prospective study was conducted in three schools of semi-urban area of Jaipur. A total of 576 children including 218 boys and 358 girls of age group 4-18 years were examined for the study, and laboratory investigations were also done for all the children. Results: Out of 576 students, 349 students were found to have a skin disorder. Of all the affected children, 69.7% (370) had noninfectious dermatoses, 19.8% (105) had infectious dermatoses, and 10.5% (56) had nutritional dermatoses. Conclusions: In our study, the prevalence of skin infection was found to be associated with low socioeconomic status and poor personal hygiene. Hence, awareness regarding skin-related health problems in children as well as in their parents seems to be of utmost importance.
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Abstract
Background and study aims
Pseudoaneurysms are usually associated with high rates of morbidity and mortality. There are limited data in the literature on endoscopic ultrasound (EUS)-guided ...thrombin injection for pseudoaneurysms. The aim of this study is to assess the efficacy and safety of EUS-guided thrombin injection for pseudoaneurysms.
Patients and methods
This prospective study was conducted in our department between January and December 2018. All patients with symptomatic visceral artery pseudoaneurysms, who were unable to undergo angioembolization, were enrolled consecutively. Data related to demography, laboratory parameters, radiological imaging, pseudoaneurysms, and endotherapy were analyzed.
Results
Eight patients with median age 34 years (27–58 years), all men, were studied. The vessel involved was the splenic artery in 5 patients (62.5 %), the left hepatic artery in 2 (25 %), and the gastroduodenal artery in 1 patient (12.5%). The median size of the pseudoaneurysms was 2.9 cm × 2.6 cm (range, 1.8 × 1.9–4 × 5 cm). The median thrombin requirement was 400 IU (range, 200–500 IU) for loss of Doppler flow signals. EUS after 3 months showed obliterated pseudoaneurysms in 7 patients (87.5 %), while recurrence was observed in 1 patient (12.5 %) after 6 weeks.
Conclusions
EUS-guided thrombin injection may be a new option for the management of pseudoaneurysms.
Acute pancreatitis in acute viral hepatitis Jain, Pankaj; Nijhawan, Sandeep; Rai, Ramesh Roop ...
World journal of gastroenterology : WJG,
11/2007, Volume:
13, Issue:
43
Journal Article
Open access
AIM： To elucidate the frequency and characteristics of pancreatic involvement in the course of acute （nonfulminant） viral hepatitis. METHODS： We prospectively assessed the pancreatic involvement in ...patients with acute viral hepatitis who presented with severe abdomimanl pain. RESULTS： We studied 124 patients with acute viral hepatitis, of whom 24 presented with severe abdominal pain. Seven patients （5.65%） were diagnosed to have acute pancreatitis. All were young males. Five patients had pancreatitis in the first week and two in the fourth week after the onset of jaundice. The pancreatitis was mild and all had uneventful recovery from both pancreatitis and hepatitis on conservative treatment. The etiology of pancreatitis was hepatitis E virus in 4, hepatitis A virus in 2, and hepatitis B virus in 1 patient. One patient had biliary sludge along with HEV infection. The abdominal pain of remaining seventeen patients was attributed to stretching of Glisson＇s capsule. CONCLUSION： Acute pancreatitis occurs in 5.65% of patients with acute viral hepatitis, it is mild and recovers with conservative management.
Abstract
Capsule endoscopy (CE) is an advancing noninvasive technology primarily meant for small-bowel visualization, which has expanded its scope and has become a game changer in evaluation and ...management of various gastrointestinal (GI) diseases with special emphasis on obscure GI bleeding. The aim of this review is to know the basic aspects of CE and recent advances with clinical evidence.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The national registry for inflammatory bowel disease (IBD) was designed to study epidemiology and prescribing pattern of treatment of IBD in India.
A multicenter, cross-sectional, prospective ...registry was established across four geographical zones of India. Adult patients with ulcerative colitis (UC) or Crohn's disease (CD) were enrolled between January 2014 and December 2015. Information related to demographics; disease features; complications; and treatment history were collected and analyzed.
A total of 3,863 patients (mean age, 36.7 ± 13.6 years; 3,232 UC 83.7% and 631 CD 16.3%) were enrolled. The majority of patients with UC (n = 1,870, 57.9%) were from north, CD was more common in south (n = 348, 55.5%). The UC:CD ratio was 5.1:1. There was a male predominance (male:female = 1.6:1). The commonest presentation of UC was moderately severe (n = 1,939, 60%) and E2 disease (n = 1,895, 58.6%). Patients with CD most commonly presented with ileocolonic (n = 229, 36.3%) inflammatory (n = 504, 79.9%) disease. Extraintestinal manifestations were recorded among 13% and 20% of patients in UC and CD respectively. Less than 1% patients from both cohorts developed colon cancer (n = 26, 0.7%). The commonly used drugs were 5-aminosalicylates (99%) in both UC and CD followed by azathioprine (34.4%). Biologics were used in only 1.5% of patients; more commonly for UC in north and CD in south.
The national IBD registry brings out diversities in the 4 geographical zones of India. This will help in aiding research on IBD and improving quality of patient care.
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