Clinical Gastroenterology Journal

Objective: This study aims to evaluate the validation of the Rockall scoring system in predicting the outcomes of variceal bleeding among Sudanese patients.

Materials and methods: A cross-sectional hospital-based study involved 150 adult Sudanese patients presenting with Upper Gastrointestinal Bleeding (UGIB) of variceal origin. Patients with UGIB resulting from causes other than varices were excluded. Data were collected through a structured questionnaire complemented by upper gastrointestinal tract endoscopy findings, and patients were followed up until discharge.

Results: The study encompassed 150 patients, predominantly male (117, 78%), aged between 18 and 60 years (n=119, 79%), residing mainly in central regions (134, 89%). The leading presenting complaints included hematemesis (70, 46.7%) and melena (22, 14.6%). Notably, peri-portal fibrosis (101, 67.3%) and cirrhosis (24, 16%) were the primary etiological factors, with a significant prevalence of alcohol consumption (87, 58%). Concerning the grade of esophageal varices, grades III and IV were most prevalent (67, 44.7% and 47, 31.3%, respectively), and fundal varices were identified in 13 patients (8.7%). The mean Rockall score was 3.83±1.99, indicating moderate severity. Additionally, the Rockall score showed significant associations with the number of sessions, complications, bleeding recurrence, duration of hospital stay, and mortality (p<0.05).

Conclusion: Understanding the significance of the Rockall scoring system and its applicability to Sudanese patients with variceal bleeding has the potential to guide more effective strategies in the management of upper gastrointestinal tract bleeding, ultimately improving patient outcomes and reducing morbidity and mortality.

An acquired gastric Dieulafoy like lesion refers to a rare vascular abnormality found in the stomach that resembles Dieulafoy's lesion, a condition characterized by an abnormally dilated and fragile artery that causes sudden and potentially life-threatening gastrointestinal bleeding. In this case, the acquired lesion is caused by an unusual redirection of blood supply from the left phrenic artery to an enlarged splenule. This comprehensive approach not only enhances clinical practice but also informs health policy development for the betterment of public health.

An acquired gastric Dieulafoy like lesion refers to a rare vascular abnormality found in the stomach that resembles Dieulafoy's lesion, a condition characterized by an abnormally dilated and fragile artery that causes sudden and potentially life-threatening gastrointestinal bleeding. In this case, the acquired lesion is caused by an unusual redirection of blood supply from the left phrenic artery to an enlarged splenule. This comprehensive approach not only enhances clinical practice but also informs health policy development for the betterment of public health.

This case report discusses a chronic enteritis case which is a challenging disease marked by an inflammation in the small intestine. As well as, it may involve gastroenteritis and enterocolitis. Through the report, a clinical course of an adult 46-year-old male patient free past illness has showed multiple complicated GI issues after a series of checkups started on October, 2022. Such as, gastroscopy, colonoscopy and CT. Due to his complain of abdominal pain and diarrhea started 5 months ago before the diagnosis and receiving the proper treatment as a patient suffers from Crohn’s disease. Several lab tests have been taking in aim to identify the causative agent of signs and symptoms the patient showed. The clear result appears in the blood CX which indicated the presence of S. maltophilia sensitive on suprim. This type of obligate aerobic bacteria is classifying as gram negative bacillus which is opportunistic pathogen-uncommon cause of chronic enteritis disease found mostly as causative agent among hospitalized patients. This case shows importance in medical field due the presence of a rare pathogen as a dominant cause of chronic human gastrointestinal infection that should be treated urgently.

Background: Drug-induced liver injury (DILI) is caused due to various types of medications, herbs, or other xenobiotics, in the absence of other etiologies. DILI has been observed with different clinical features and biochemical abnormalities. Herbal products are responsible for DILI in many cases (10%). There exists no specialized gold standard method to diagnose or predict DILI, and the disease has been commonly diagnosed with the RUCAM score. Tinospora Cordifolia (Gulvel/Guduchi), which is readily available in the hilly area of western Maharashtra as a wild plant, has been used in Ayurveda for the treatment of hepatotoxicity. Furthermore, it is consumed as an immunemodulator during the COVID 19 pandemic.

Case presentations: During last year, there is a sudden increase in hepatitis cases. We observed 16 patients who consumed Tinospora Cordifolia (Gulvel/Guduchi) and depicted instability in liver function tests. This research found no other reason responsible for such complaints in these patients. All these patients had a RUCAM score greater than six. They had mild to severe level symptoms in which fourteen patients were recovered with supportive care. It was noted that elderly females were affected commonly, in which one mortality case happened secondary to ACLF. The study observed no cases in the family even after the consummation of similar products with similar doses.

Conclusion: Tinospora Cordifolia (Gulvel/Guduchi) can cause mild to severe grade hepatotoxicity with high doses, most probably in genetically susceptible elderly patients. Additionally, the study also states that mortality is rare. However, to confirm this observation and to provide prompt details, more research must be carried out.

Diets rich in fruits and vegetables, seeds and nuts play an important role in reducing inflammatory bowel disease. Consumption of dietary antioxidants reduces inflammatory bowel disease. In the present study, the relationship between Dietary Total Antioxidant Capacity (DTAC) and inflammatory bowel disease was studied in Golestan Hospital, Ahvaz, Iran. This study was performed on 86 individuals in the healthy group and 86 patients with inflammatory bowel disease. A 147-item food frequency questionnaire was used to collect data. Ferric ion Reducing Antioxidant Power (FRAP) values were used to calculate the DTAC. Data were analyzed using SPSS software version 23. The mean age was 33.4 ± 7.4 for the healthy group and 36.5 ± 10.7 for the patient group (P<0.05). The control group had a higher dietary antioxidant capacity compared to the patient group (the healthy group received higher antioxidant vitamins including alpha-carotene, lycopene, vitamin C, vitamin A) (P=0.001). In the original model and modified logistic regression models, individuals in the highest quartile of DTAC had a lower risk of IBD (OR: 1.78, 95% CI:(0/51-6.21); P: 0/001). High levels of DTAC were associated with reduced IBD risk. It seems that a diet with high antioxidant capacity can prevent IBD.