Indian Journal of Gastroenterology最新文献

{"title":"Plasma exchange to treat liver failure: The field expands.","authors":"Rohan Thomas, Chundamannil E Eapen","doi":"10.1007/s12664-025-01760-0","DOIUrl":"https://doi.org/10.1007/s12664-025-01760-0","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596982","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":"Age-stratified prevalence of anti-hepatitis A virus antibodies in four metropolitan Indian cities and recent changes in Pune city.","authors":"Sanjay Lalwani, Sonali Palkar, Balasubramanian S, Gurmeet Kaur, Monjori Mitra, Rupeshkumar Deshmukh, Ruta Kulkarni, Vidya Arankalle","doi":"10.1007/s12664-025-01746-y","DOIUrl":"https://doi.org/10.1007/s12664-025-01746-y","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pune, western India, was earlier identified as hyperendemic for hepatitis A. Subsequently, we noted age and socio-economic status-dependent reduction in hepatitis A virus (HAV) prevalence. To assess the situation in different parts of India, this multicentric, hospital-based, cross-sectional study was conducted in four metropolitan cities in the northern/southern/eastern/western regions.</p><p><strong>Methods: </strong>As per age group-anti-HAV-positivity-specific sample size calculations (1-40 years), 496 samples/centre were collected from Pune, Kolkata, Chennai and Ludhiana. All samples were tested for anti-HAV antibodies using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Overall, 44.9% of children up to five years of age were anti-HAV antibody-positive (ELISA), with a steady increase reaching 92.9% by the age of 26-40 years. Importantly, 782/1756 (44.5%) of the total population ≤ 15 years was anti-HAV negative and hence susceptible to HAV. The city-wise analysis documented similar patterns with a few differences. According to the World Health Organization (WHO) classification of HAV endemicity, Pune, Chennai and Ludhiana were classified as cities with intermediate endemicity, whereas Kolkata with lower seroprevalence had low endemicity. Compared to the 2011-2012 survey anti-HAV positivity remained unchanged in the other cities except for the rise in Chennai. Apart from age, other risk factors varied in different cities. A comparison of socio-economic-dependent, age-stratified serosurveys conducted during 1982, 1992, 1998, 2017 and 2022 in Pune documented the shift from high to intermediate endemicity in the population with high socio-economic status in 1998 and lower-middle socio-economic strata in 2017.</p><p><strong>Conclusion: </strong>The lowering of anti-HAV positivity reflects a definite improvement in sanitation and voluntary vaccination, but seems to have slowed down during recent years. Additional, well-defined efforts are necessary.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572319","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":"Comparison of DTPA camera-based Gates method versus plasma-clearance methods for assessment of GFR in cirrhosis: A pilot study.","authors":"Smita Divyaveer, Madhuri Kashyap, Kushal Kekan, Madhumita Premkumar, Kanchan Prajapati, Arka De, Anish Bhattacharya, Sarika Sharma Prashar, Komalpreet Kaur, Ashok Kumar Yadav, Jaskiran Kaur, Vaibhav Tiwari, Amol N Patil, Ajay Kumar Duseja, Nipun Verma, Malagouda R Patil, Raja Ramachandran, Vishnuvardhan Bagur, Harbir Singh Kohli","doi":"10.1007/s12664-025-01753-z","DOIUrl":"https://doi.org/10.1007/s12664-025-01753-z","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572819","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":"Comparison of direct intrahepatic portosystemic shunt and other major radiological interventions in patients with Budd-Chiari syndrome.","authors":"Sayan Malakar, Nishant Shah, Umair Shamsul Hoda, Avinash D Gautam, Rajanikant R Yadav, Srikanth Kothalkar, Rahul Jangra, Gaurav Pandey, Akash Roy, Praveer Rai, Samir Mohindra, Uday C Ghoshal","doi":"10.1007/s12664-024-01733-9","DOIUrl":"https://doi.org/10.1007/s12664-024-01733-9","url":null,"abstract":"<p><strong>Introduction: </strong>Radiological interventions in Budd-Chiari syndrome (BCS) include anatomical recanalization of the hepatic vein (HV), inferior vena cava (IVC) angioplasty and stenting. In case of technical difficulty and anatomical non-feasibility, an ultrasound-guided direct intrahepatic portosystemic shunt (DIPSS) is created. We aimed at evaluating the outcome of patients managed with DIPSS and comparing it with anatomical recanalization.</p><p><strong>Methods: </strong>We retrieved the data of patients with BCS managed at our institution between 2011 and 2021. Safety, efficacy and long-term outcomes were assessed and compared between radiological interventions.</p><p><strong>Results: </strong>Total 236 patients with BCS underwent radiological intervention in the study period. As many as 96 patients were excluded and 140 patients were included in the final analysis. The majority were males (F:M = 54:86). The median age at the time of diagnosis was 30 years (interquartile range: 25-37 years). The median follow-up period was 58 (14-72) months. On imaging, 53% (74) patients had combined HV and IVC block followed by isolated HV block in 54 patients (38.5%) and isolated IVC block in 12 patients (8.5%). As many as 32 patients were managed by DIPSS. Among others, 56 patients underwent IVC angioplasty with HV stenting and 30 required HV angioplasty and stenting. DIPSS had a comparable technical success rate (100% vs. 98.2% vs. 96%, respectively p > 0.5). However, the median stent patency was higher in the DIPSS group (72 [48-96] months) compared to IVC angioplasty and HV stenting (46 [36-60] months; p = 0.02) and HV angioplasty-stenting (42 [30-48] months; p = 0.04) groups. They had similar re-thrombosis rates (28%, 34% and 21%, respectively; p > 0.05). Overall complications were rare (3.5%) and no patient in the DIPSS group had adverse events.</p><p><strong>Conclusion: </strong>DIPSS is a safe and effective salvage procedure with an excellent long-term outcome in patients with BCS. It has a longer median stent patency compared to the anatomical recanalization group.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572818","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":"Comment on \"Eating behaviors and mental health among celiac patients, case-control study\".","authors":"Ahmed Faizan, Hubaib Iqbal Cheema","doi":"10.1007/s12664-025-01762-y","DOIUrl":"https://doi.org/10.1007/s12664-025-01762-y","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566987","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":"Spider telangiectasia in conjuctiva.","authors":"Radhika Chavan, Sanjay Rajput","doi":"10.1007/s12664-025-01758-8","DOIUrl":"https://doi.org/10.1007/s12664-025-01758-8","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566988","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":"Role of therapeutic plasma exchange on survival in pediatric acute liver failure and acute-on chronic liver failure: A systematic review and meta-analysis.","authors":"Kalpana Panda, Devi Prasad Dash, Prateek Kumar Panda, Mrutunjay Dash, Prasant Kumar Saboth, Girish Kumar Pati","doi":"10.1007/s12664-025-01742-2","DOIUrl":"https://doi.org/10.1007/s12664-025-01742-2","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic plasma exchange (TPE) has emerged as a promising treatment option for pediatric liver failure (PLF) either as a standalone therapy or as a bridge to liver transplant; however, its precise impact on survival outcomes has not been investigated systematically to date. This meta-analysis aims to evaluate the effect of TPE on survival of pediatric patients with liver failure.  METHODS: PubMed, Scopus and Embase databases were searched to include all studies till August 2024 reporting the effect of TPE on survival of acute and acute-on-chronic liver failure patients of age < 18 years. Primary outcome measures were overall survival (OS) and transplant-free survival (TFS) at Day ≥ 28 in pediatric acute liver failure (PALF) and pediatric acute-on-chronic liver failure (pACLF) patients undergoing TPE. The secondary outcome measure was to determine changes in biochemical parameters (international nrmalized ratio [INR], bilirubin and ammonia) pre and post-TPE in them.</p><p><strong>Results: </strong>Twelve studies (8 = exclusive PALF cohorts and 4 = combined PALF + pACLF cohorts) comprising 310 patients (273 = PALF and 37 = pACLF) who received TPE were included. Pooled OS at Day ≥ 28 for PLF after TPE is 61% (95% CI: 55-66%, p = 0.03, I² = 49%). The estimated pooled TFS in them was 35% (95% CI: 29-41%, p = < 0.01, I² = 84%). On sub-group analysis, the standard-volume TPE group had both higher OS and TFS in comparison to the high-volume sub-group. There was a significant improvement in all three biochemical parameters post-TPE compared to pre-TPE values. None of the included studies reported any TPE-related mortality or potentially fatal side effects.</p><p><strong>Conclusion: </strong>TPE shows the potential to improve overall survival in pediatric liver failure, mostly acting as a bridge to liver transplant or native liver recovery. Further, well-designed, adequately powered, randomized-controlled trials are needed to confirm TPE's survival benefit in PLF.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541900","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":"Tranexamic acid as treatment for acute gastrointestinal bleeding: A comprehensive systematic review and meta-analysis.","authors":"Ernesto Calderon Martinez, Gabriela D Briceño Silva, Camila Sanchez Cruz, Nathnael Abera Woldehana, Yash Shah, Dushyant Singh Dahiya, Manesh Kumar Gangwani, Saurabh Chandan, Fides Myles C Caliwag, Rodrigo Sebastian Maldonado, Rubeliz Bolivar-Barrios, Ada Motino, Rashmi Advani","doi":"10.1007/s12664-025-01749-9","DOIUrl":"https://doi.org/10.1007/s12664-025-01749-9","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal (GI) bleeding is a common and potentially life-threatening medical emergency. Despite advancements in therapy, mortality rates associated with GI bleeding remain high (2.4% to 11%). Tranexamic acid (TXA) has been proposed as a treatment. However, the HALT-IT trial questioned its efficacy and safety, showing no significant reduction in death and potential thrombotic complications. This meta-analysis aims to evaluate the effectiveness and safety of TXA in treating acute GI bleeding.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. In October 2024 a comprehensive literature search was conducted using relevant MeSh terms and keywords in 11 databases. We included patients with acute GI bleeding treated with TXA and compared it with either a placebo or standard treatment. Outcomes such as mortality, need for blood transfusion, surgery and thrombotic events were studied.</p><p><strong>Results: </strong>The search identified 6810 articles. After screening, 23 studies were included, encompassing 2,061,231 participants. Our meta-analysis demonstrated that TXA significantly reduced rebleeding rates overall (RR: 0.81, 95% CI: 0.87-0.97). This effect was even more pronounced in studies with a lower risk of bias. Additionally, TXA use was associated with a mortality reduction when administered through both oral and intravenous routes (RR: 0.56, 95% CI: 0.35-0.89) and in cases of upper GI bleeding (RR: 0.72, 95% CI: 0.59-0.87). However, TXA was linked to a significant increase in mortality in patients with lower GI bleeding (RR: 1.67, 95% CI: 1.44-1.93) and overall reduction when only randomized controlled trials (RCTs) were included (RR:0.83, 95% CI; 0.70 to 0,97, I2=0%). Other variables, such as the overall need for blood transfusions (RR: 1.03, 95% CI: 0.80-1.32), thrombotic events (RR: 1.30, 95% CI: 0.75-2.23) and the need for surgical intervention (RR: 0.78, 95% CI: 0.57-1.09), did not reach statistical significance. However, when considering only low risk of bias studies the need for surgical interventions was significantly reduced (RR: 0.85, 95% CI: 0.75 to 0.97, I2=0%).</p><p><strong>Conclusions: </strong>Our findings suggest that TXA significantly reduces rebleeding in patients, particularly in upper gastrointestinal bleeding (UGIB) and reduces need for surgical intervention when excluding high risk of bias studies. The findings also demonstrated a significant reduction in mortality, particularly in certain sub-groups. There was no definitive evidence that its use is associated with thromboembolictic events. These results highlight the potential benefit of TXA without dismissing the need for cautious interpretation and individualized patient management when considering TXA for GI bleeding.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541902","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":"Critical insights: ABC score is a better predictor for 30-day mortality in upper gastrointestinal bleeding-A prospective single-center study.","authors":"Alina Zaman Khan, Saad Khan, Hira Hameed, Safa Nasir, Zermeen Naveed","doi":"10.1007/s12664-025-01747-x","DOIUrl":"https://doi.org/10.1007/s12664-025-01747-x","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523315","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":"Desmoid fibromatosis.","authors":"Abhilash Gunasekaran, Divij Agarwal, Savita Agarwal, Amarinder Singh Malhi","doi":"10.1007/s12664-025-01751-1","DOIUrl":"https://doi.org/10.1007/s12664-025-01751-1","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500783","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}