Mahmoud Moubark
Background: In the last decade, newly development of endovascular techniques gives good chance in the treatment of GIT vascular malformations. As the frequency of its use is increasing progressively, we in this study analyze the short- and mid-term radiological and clinical outcomes of a case with gastric arteriovenous malformation treated endovascular. Conclusion: Gastric AVM is rare, and its management depends on the size and extent of the lesion. We assume that the use of histoacryl in the treatment of AVM carries significant risk unlike dealing with direct AV fistula. It is safer to use coils to embolize the feeding artery
Florina Orwell
Gastroenteritis (stomach flu) is a common, worldwide disease and almost everyone suffers from it a few times in their life because it is almost impossible to avoid contact with some of the viral and bacterial causes. It is an illness triggered by the infection and inflammation of the digestive system. Typical symptoms include abdominal cramps, diarrhea and vomiting. In many cases, the condition heals itself within a few days. The main complication of gastroenteritis is dehydration, but this can be prevented if the fluid lost in vomit and diarrhea is replaced. A person suffering from severe gastroenteritis may need fluids administered intravenously (directly into the blood stream via a vein – the setup is often referred to as a ‘drip’). Some of the causes of gastroenteritis include viruses, bacteria, bacterial toxins, parasites, particular chemicals and some drugs.
Nizaj Akbul
Gastroesophageal Reflux Disease (GERD), commonly referred to as heartburn, is a condition resulting from stomach acid moving backward from the stomach into the esophagus (the tube that connects the mouth to the stomach). The acid causes burning, inflammation and pain on the lining of the esophagus and can eventually lead to permanent damage of the lining. Tightness in the chest may also be felt, and sometimes heartburn can be confused with symptoms of a heart attack. This backward flow of acid is also called reflux when symptoms are brief and intermittent and do not cause on-going symptoms. Many people experience acid reflux from time to time. GERD is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week. Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications or surgery to ease symptoms. The term “gastroesophageal” refers to the stomach and esophagus. Reflux means to flow back or return. Gastroesophageal reflux is when what’s in your stomach backs up into your esophagus. In normal digestion, your LES opens to allow food into your stomach. Then it closes to stop food and acidic stomach juices from flowing back into your esophagus.
Mohammad Asif Senawi
Gastric varices are an important Porto systemic collateral pathway, occurring in ~20% of patients with portal hypertension. They are considered distinct from oesophageal varices in that they have a propensity to haemorrhage at comparatively lower portal pressures, and are also associated with higher mortality rate with hemorrhage. The patients with cirrhosis or high portal blood pressure are highly prone to gastric variceal bleeding than the patients with splenic vein thrombosis (SVT). The bleeding leads to heavy loss of blood, which should be compensated by blood transfusion to regulate the blood circulation and to maintain the hemoglobin level 7-8 g/dL. This technique is a recovery approach to lower the risk of rebleeding and mortality. Gastric varices are treated by primary prophylaxis and secondary prophylaxis. The primary treatment includes drug therapy.
Augustine Turner
Expert Level (Scientific Service Achievement Award) The Scientific Service Achievement Award is the most esteemed award for the experts who have made exceptional and significant contributions at the field of Gastroenterology and Urology. These awards also provide a prospect to acknowledge those who play a major role in the progression to reach patients safety and requirements and nurses help in improving the life of people. Eligibility Criteria for this award.
Hany Eskarous* and Anuragh Gudur
Benign Recurrent Intrahepatic Cholestasis (BRIC) is a rare genetic disorder characterized by recurring episodes of jaundice. Two subtypes of BRIC have been well-characterized in the literature: BRIC I, caused by mutations in ATP8B1 gene, and BRIC II, triggered by mutations in ABCB11 gene. There are exceedingly rare cases of BRIC in which individuals do not have mutations in either of the associated genes, suggesting the possibility additional loci implicated in this disorder. Herein, we present a case of BRIC in a 21-year-old male who demonstrated clinical, biochemical and histological evidence of disease but lacked both of the associated mutations in ATP8B1 and ABCB11.
DOI: 10.37421/2952-8518.2024.9.230
DOI: 10.37421/2952-8518.2024.9.231
DOI: 10.37421/2952-8518.2024.9.232
Inflammatory Bowel Disease is a chronic inflammatory disorder of the gastrointestinal tract characterized by periods of relapse and remission. While the exact etiology of IBD remains elusive, it is increasingly recognized that the gut microbiota plays a crucial role in its pathogenesis. This review explores the current understanding of the intricate relationship between gut microbiota and IBD, focusing on microbial dysbiosis, mucosal immune response, and therapeutic implications. Furthermore, it discusses emerging research directions and potential future interventions targeting the gut microbiota for the management of IBD.
DOI: 10.37421/2952-8518.2024.9.233
DOI: 10.37421/2952-8518.2024.9.234
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DOI: 10.37421/2952-8518.2024.9.250
Trigeminal schwannomas are rare, benign tumors that arise from the schwann cells of the trigeminal nerve. Their location in the skull base presents significant surgical challenges due to the intricate anatomy and the proximity to critical neurovascular structures. Traditional approaches to their resection have included the subtemporal, retrosigmoid, and transpetrosal routes. However, the transorbital approach, an emerging minimally invasive technique, offers potential advantages in terms of reduced morbidity and improved cosmetic outcomes. This review systematically examines the literature on the efficacy and safety of the transorbital approach for trigeminal schwannoma resection.
DOI: 10.37421/2952-8518.2024.9.252
Pancreatic cancer presents significant diagnostic and therapeutic challenges, often diagnosed at advanced stages with limited treatment options and poor prognosis. Endoscopic Ultrasound (EUS) has emerged as a pivotal technology in the comprehensive management of pancreatic cancer, offering unparalleled capabilities in early detection, precise staging, and targeted therapeutic interventions. This abstract reviews the evolving role of EUS in pancreatic cancer care, emphasizing its diagnostic accuracy through high-resolution imaging and EUS-guided tissue sampling techniques like Fine-Needle Aspiration (FNA). EUS facilitates accurate staging by assessing tumor extent, vascular involvement, and lymph node status, crucial for treatment planning and determining surgical resectability. Moreover, EUS-guided therapies, including Fine-Needle Injection (FNI) and Celiac Plexus Neurolysis (CPN), provide minimally invasive options for localized treatment and palliative care, respectively. Technological advancements in EUS, such as contrast-enhanced imaging and elastography, continue to enhance diagnostic precision and therapeutic efficacy.
DOI: 10.37421/2952-8518.2024.9.255
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DOI: 10.37421/2952-8518.2024.9.258
DOI: 10.37421/2952-8518.2024.9.251
Mesiodens, a type of supernumerary tooth, typically occurs between the central incisors in the oral cavity. Its presence in the nasal cavity is an exceptionally rare anomaly, leading to symptoms such as nasal obstruction, recurrent infections, and epistaxis. Traditional surgical methods for removal can be invasive and complex.
DOI: 10.37421/2952-8518.2024.9.253
Endoscopic spine surgery has emerged as a transformative approach in spinal interventions, offering minimally invasive alternatives to traditional open procedures. This research article reviews the evolution, current trends, and recent developments in endoscopic spine surgery, highlighting technological advancements, clinical outcomes, and future directions in the field.
DOI: 10.37421/2952-8518.2024.9.254
Hany Eskarous*, Jared Hassler, Kimberly Forde and Mario Mekhail
Herbal medications have been used worldwide in place of conventional medical therapies as they are readily available over the counter and usually are lower cost. Currently, these are not tightly controlled by the Food and Drug Administration agency (FDA). However, herbal medications are always overlooked etiologic agents in hepatotoxicity. We present a case of hepatotoxicity with unique pathology findings from Red Bush Tea (Rooibos Tea) consumption in a 39-year-old patient evaluated for elevated liver enzymes. Biopsy showed a congestive hepatopathy pattern on histology. The patient elevated liver enzymes improved within few weeks after stopping bush tea.
Dilip Chaurasiya
There are very few studies have been done in India to study the clinical profile of chronic liver disease patients. This is a single-center crosssectional observational study. A total of 100 patients with chronic liver disease presented to the emergency, OPD, or admitted in the ward were studied. The study aimed to study the clinical profile of patients of chronic liver disease (CLD) who have features of portal hypertension, in terms of clinical presentation, the severity of disease (Child-Pugh classification), and laboratory parameters. The secondary objective was to find out that how many cases of chronic liver disease with portal hypertension have associated portal vein thrombosis presented to OPD or admitted to the wards of our hospital? Materials and method: It was a cross-sectional observational study. The place of the study was the Department of Medicine, Lady Hardinge Medical College and Associated Hospitals, New Delhi, and the duration of the study was November 2016 to March 2018. Inclusion criteria were all the patients of chronic liver disease with portal hypertension irrespective of the cause. Results and observations: In our study, the mean age of cases was 46.72 ± 11.04 years (expressed as Mean ± SD) and males (82) outnumbered females (18). The most common cause of chronic liver disease in our study population was alcohol. It was also the most common etiology of chronic liver disease among males and the 3rd most common etiology in females. Conclusion: Overall, when all etiologies were taken into consideration, the most common attributable reason for CLD in our study was alcohol followed by Hepatitis B, followed by Hepatitis C. Among other causes, Diabetes Mellitus was associated with 11% of our study group. There were no patients with Hypertension. Portal vein thrombosis affects the clinical profile of CLD. In our study, the incidence of PVT was 11% and was most common in CLD attributed to alcohol. In our study, most of the patients with PVT indicating and reiterating the association of PVT and the Stage of CLD.
DOI: 10.37421/2952-8518.2024.9.266
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.
DOI: 10.37421/2952-8518.2024.9.265
DOI: 10.37421/2952-8518.2024.9.263
DOI: 10.37421/2952-8518.2024.9.261
DOI: 10.37421/2952-8518.2024.9.262
DOI: 10.37421/2952-8518.2024.9.264
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.
Asala M Awaysa*, Areen E Ershaid, Arein AM Abufara, Jenan E Ershaid, Shereen Ershaid, Layth Al Karaja and Mosab Samamra
DOI: 10.37421/2952-8518.2024.9.267
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.
Widad A Sharfeldeen, Ahmed Rafei*, Hinda H Mohammed, Ola Emad Ahmed, Mohammad S Katta and Abdelmoneim Eltayeib Abdo
DOI: 10.37421/2952-8518.2024.9.260
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.
DOI: 10.37421/2952-8518.2024.9.269
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.
Soheila Shekari*, Asal Ataie Jafari, Mahmood Mahmoodi Majd Abadi, Shahryar Eghtesadi and Seyed Saeed Seyedian
DOI: 10.37421/2952-8518.2024.9.268
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.
Clinical Gastroenterology Journal received 33 citations as per Google Scholar report
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