Indian Journal of Gastroenterology最新文献

{"title":"Primary caregiver burden and undiagnosed mental health illness in out-patients with inflammatory bowel disease-A multicentric prospective survey from the IBD Emerging Nations' Consortium.","authors":"Rupa Banerjee, Partha Pal, Ida Hilmi, Nalini Raghunathan, Masudur Rahman, Julajak Limsrivillai, Lubna Kamani, Uday C Ghoshal, Than Than Aye, Neeraj Joshi, Pezhman Alavinejad, Kiran Peddi, Rajendra Patel, Shubhankar Godbole, Duvurru Nageswhar Reddy","doi":"10.1007/s12664-024-01617-y","DOIUrl":"10.1007/s12664-024-01617-y","url":null,"abstract":"<p><strong>Background: </strong>Mental health is an overlooked aspect of inflammatory bowel disease (IBD) patient care with limited data from the developing world. The primary caregiver burden is expected to be high, but has not been evaluated.</p><p><strong>Methods: </strong>We conducted a questionnaire-based survey of consecutive out-patients with no diagnosed mental health illness (n = 289) and their primary caregivers (n = 247) from 10 centers across eight countries (Bangladesh, India, Iran, Malaysia, Myanmar, Nepal, Pakistan, Thailand) of IBD-Emerging Nations' Consortium (ENC). Patients were assessed for anxiety (PHQ-9), depression (GAD-7), quality of life (SIBDQ, IBDCOPE) and medication adherence (MMAS-8). Caregiver burden was assessed by Zarit-Burden Interview (ZBI), Ferrans and Power Quality of Life (QOL) scores and coping strategies (BRIEF-COPE). Multivariate logistic regression and correlation analyses were performed to identify risk factors and the impact on QOL in patients and caregivers.</p><p><strong>Results: </strong>Moderate to severe depression and anxiety were noted in 33% (severe 3.5%) and 24% (severe 3.8%) patients, respectively. The risk factor for depression was active disease (p < 0.001, OR6.3), while male gender (p = 0.01, OR0.45) and medication adherence (p = 0.003, OR0.75) were protective. Risk factors for anxiety were unmarried status (p = 0.015, OR2.3), female gender (p = 0.004, OR0.41), steroid use (p = 0.016, OR2.1) and active disease (p < 0.001, OR7.97). High GAD-7 and PHQ-9 scores positively correlated with high disease activity (r = 0.55, p < 0.001, Crohn's disease; r = 0.52, p < 0.001 ulcerative colitis) and negatively with SIBDQ (r =  - 0.63, p < 0.001; r =  - 0.64, p < 0.001 CD; r = 0.36, p = 0.001,UC). Sixty-five per cent (159/249) primary caregivers reported high burden (ZBI ≥ 21), which positively correlated with low educational status and low-income and negatively with QOL(r =  - 0.33, p < 0.001). The primary adaptive coping strategy among caregivers was religion, while maladaptive strategy was self-distraction.</p><p><strong>Conclusion: </strong>Nearly two-thirds of primary caregivers reported high burden of care. There was also high prevalence of undiagnosed depression and anxiety in IBD out-patients. This highlights the need for patient-caregiver integrated mental-health services in the developing world.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"1156-1167"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of endoscopic ultrasound-guided gallbladder drainage: A multicenter study from India (with video).","authors":"Radhika Chavan, Vikas Singla, Sridhar Sundaram, Shankar Zanwar, Chirag Shah, Sukrit Sud, Pankaj Singh, Chaiti Gandhi, Pratin Bhatt, Akash Goel, Sanjay Rajput","doi":"10.1007/s12664-024-01614-1","DOIUrl":"10.1007/s12664-024-01614-1","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) offers a safe and minimally invasive alternative for percutaneous cholecystostomy (PCC) in acute cholecystitis patients with high-surgical risk. Additionally, EUS-GBD serves as a rescue biliary drainage in malignant distal biliary obstruction. Despite its widespread application, data within the Indian context remains sparse. This study aims to report the outcomes of EUS-GBD through the first multi-center study from India.</p><p><strong>Methods: </strong>We retrospectively analyzed patients undergoing EUS-GBD at six tertiary care centers of India from March 2022 to November 2023. EUS-GBD was performed by free hand or over-the-guidewire technique with lumen-apposing metal stent (LAMS) or large caliber metal stent (LCMS). The primary outcome was technical success (defined as successful deployment of stent between gallbladder and stomach/duodenal lumen). The secondary outcomes were clinical success (defined as resolution of symptoms of acute cholecystitis and more than > 50% reduction in bilirubin level within two weeks in distal biliary obstruction), adverse event rate, 30-day mortality rate and 90-day reintervention rate.</p><p><strong>Results: </strong>Total 29 patients (mean age 65.86 ± 12.91, 11 female) underwent EUS-GBD. The indication for EUS-GBD were acute cholecystitis (79.31%) and rescue biliary drainage for malignant distal biliary obstruction (20.69%). LAMS was deployed in 92.86%, predominantly by free-hand technique (78.57%). Technical and clinical success rates were 96.55% and 82.75%, respectively. Adverse events occurred in 27.59% patients, with severe adverse events (bile leak and bleeding) being uncommon (10%). Both 30-day mortality rate and 90-day reintervention rate were 13.79% in patients. Cholecysto-duodenal fistula facilitated cholecystoscopic intervention and stone removal in one patient and transgastric EUS-GBD did not hamper bilio-enteric anastomosis during Whipple surgery in two patients.</p><p><strong>Conclusion: </strong>EUS-GBD is a safe and effective technique for managing acute cholecystitis in high-risk patients and for biliary drainage in cases with malignant distal biliary obstruction.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"1184-1193"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and survival of advanced untreated hepatocellular carcinoma of non-viral etiology.","authors":"Senarath Pathiranage Nimasha Ekanayaka, Nathasha Luke, Suchintha Bandara Thilakarathne, Anuradha Dassanayake, Mahiman Bhaagya Gunetilleke, Madunil A Niriella, Rohan Chaminda Siriwardana","doi":"10.1007/s12664-024-01636-9","DOIUrl":"10.1007/s12664-024-01636-9","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Hepatocellular carcinoma (HCC) is an aggressive tumor and presents late. The underlying etiology of HCC is changing rapidly. HCC in Sri Lanka is unique due to its predominant non-viral etiology (nvHCC) but lacks survival data.</p><p><strong>Method: </strong>Data was collected from patients who presented with HCC from 2011 to 2018. There were 560/568 (98.6%) nvHCC. The patients who were not candidates for tumor-specific treatment (149/560 [26.7%]) were selected. Population characteristics, demographic data, tumor characteristics, survival and factors affecting survival were analyzed.</p><p><strong>Results: </strong>The median age was 64 years (range 30-88) and 86% (n = 129) were males. As many as 124 (83%) were cirrhotic. The overall performance score was 80%. Nearly 21/124 tumors were detected in cirrhotic screening. Tumors were single nodular in 32 (21%), up to three nodules in 28 (18%), more than three nodules in 33 (22%) and diffusely infiltrating in 56 (37%). The major venous invasions were present in 78 (52.3%). Extra-hepatic tumor spread was seen in 19 (12.7%) (lungs 13 [72.2%], bones 2 [11.1%]). The median survival of patients receiving palliative care was three months (1-43 months). Tumor size and cirrhotic status were significant predictors in univariate analysis.</p><p><strong>Conclusion: </strong>A quarter of nvHCCs were not amenable to treatment at presentation as they had dismal survival.</p><p><strong>Clinical trial registry number: </strong>P/126/09/2021.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"1176-1183"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplifying the predictors of dyssynergic defecation.","authors":"Umang Arora, Govind K Makharia","doi":"10.1007/s12664-024-01711-1","DOIUrl":"https://doi.org/10.1007/s12664-024-01711-1","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous rupture of hepatic hydatid cyst into the right portal vein-A rare entity.","authors":"Archita Mahajan, Mansi Verma, Sumala Kapila","doi":"10.1007/s12664-024-01706-y","DOIUrl":"https://doi.org/10.1007/s12664-024-01706-y","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of spleen volume to body mass index ratio in Crohn's disease-A retrospective cohort study.","authors":"Mohammed Bilal Azam, Kuppusamy Senthamizhselvan, Pazhanivel Mohan, G Ramkumar","doi":"10.1007/s12664-024-01704-0","DOIUrl":"https://doi.org/10.1007/s12664-024-01704-0","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and causes for chronic nausea and vomiting in adult patients-A single-centre experience.","authors":"Mayank Jain","doi":"10.1007/s12664-024-01701-3","DOIUrl":"https://doi.org/10.1007/s12664-024-01701-3","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A simple four symptom-based BEDS score to predict dyssynergic defecation in patients with chronic constipation.","authors":"Mayank Jain, Vinodini Agrawal","doi":"10.1007/s12664-024-01697-w","DOIUrl":"https://doi.org/10.1007/s12664-024-01697-w","url":null,"abstract":"<p><strong>Background and aims: </strong>Dyssynergic defecation (DD) is a disorder of anorectal function characterized by impaired relaxation or inappropriate contraction of pelvic floor muscles on attempted defecation. Based on previous Indian studies, we devised a symptom score (bleeding per rectum, excessive straining for stools, digitation, sense of incomplete evacuation/blockage-BEDS) and tried to determine if it can identify which patients with chronic constipation are more likely to have DD.</p><p><strong>Methods: </strong>This is a prospective observational cohort study in which consecutive adult patients (> 18 years) with chronic constipation who were referred to our centre for anorectal manometry (ARM) between 2019 and 2023 were included. Prior to tests, patients were asked in detail regarding their symptoms and scoring was done. ARM was done by a single observer. Diagnosis of DD was based on standard criteria. Statistical tests used were median, range and percentages, Chi-square test and Mann-Whitney U-test. The data was analyzed for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Agreement of symptom-based scoring and DD diagnosis as per criteria was calculated using Cohen's κ coefficient. A p value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>As many as 244 patients (males 140, median age 42 years) formed the study cohort. Of these, 104 (42.6%) have DD. Sense of incomplete evacuation/sense of blockage (72.1% vs. 40%, p < 0.0001), excessive straining (73.1% vs. 22.1%, p < 0.0001) and digitation (28.8% vs. 13.5%, p 0.003) were more commonly reported in patients with DD. Taking a cut-off score of > / = 2, sensitivity of 69.2%, specificity 81.4% and positive likelihood ratio of 3.73 were noted. Similarly, if the score of > / = 3 was considered, the likelihood ratio increased to 4.71 with an increase in specificity (94.29%) and fall in sensitivity (26.92%).</p><p><strong>Conclusion: </strong>Symptom-based BEDS score of > / = 2 is useful in identifying patients with DD.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic enteropathy associated with SLCO2A1 gene (CEAS) in Indian adolescents: Apropos of two cases.","authors":"Aditi Kumar, Janvi Sirwani, Tara Prasad Tripathy, Susama Patra, Manas Kumar Panigrahi, Debasish Sahoo, Sonali Mohapatra, Amit Kumar Satapathy","doi":"10.1007/s12664-024-01698-9","DOIUrl":"https://doi.org/10.1007/s12664-024-01698-9","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic ultrasound elastography-guided fine needle aspiration for solid pancreatic lesions: Down but not out!","authors":"Praveer Rai","doi":"10.1007/s12664-024-01696-x","DOIUrl":"https://doi.org/10.1007/s12664-024-01696-x","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}