Indian Journal of Gastroenterology最新文献

{"title":"Hepatitis B virus prevalence in India: A wake-up call for action.","authors":"Shekhar Swaroop, Shalimar, Subrat Kumar Acharya","doi":"10.1007/s12664-025-01804-5","DOIUrl":"https://doi.org/10.1007/s12664-025-01804-5","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325577","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":"Urinary lipoarabinomannan: A novel diagnostic tool for distinguishing gastrointestinal tuberculosis from Crohn's disease.","authors":"Mukesh Singh, Manjeet Kumar Goyal, Himanshu Narang, Malambo Mubbunu, Peeyush Kumar, Bhaskar Kante, Sudheer K Vuyyuru, Ashish Dutt Upadhyay, Prasenjit Das, Ankur Goyal, Raju Sharma, Urvashi B Singh, Govind Makharia, Saurabh Kedia, Vineet Ahuja","doi":"10.1007/s12664-025-01764-w","DOIUrl":"https://doi.org/10.1007/s12664-025-01764-w","url":null,"abstract":"<p><strong>Background: </strong>The differentiation between gastrointestinal tuberculosis (GITB) and Crohn's disease (CD) is challenging. Detection of urinary lipoarabinomannan (LAM), a glycolipid component of the Mycobacterium tuberculosis cell wall, has shown potential as a non-invasive diagnostic marker for tuberculosis.</p><p><strong>Objective: </strong>We evaluated the diagnostic accuracy of urinary LAM in distinguishing GITB from CD.</p><p><strong>Methods: </strong>This prospective study included patients diagnosed with GITB, CD or those with indeterminate conditions (January 2021 to April 2022). Comprehensive clinical evaluations, laboratory investigations, computed tomography (CT) enterography, colonoscopy and histopathological analyses were performed. First morning midstream urine samples were collected and analyzed using TB LAM antigen kit. The analytical team was blinded from the clinical data. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall diagnostic accuracy of urinary LAM were determined.</p><p><strong>Results: </strong>Of 98 patients, 36 were diagnosed with GITB and 62 with CD. Urinary LAM was positive in nine out of 36 GITB patients, yielding a sensitivity of 25% (95% C.I. 12.12-42.20%) and a PPV of 100% (95% C.I. 66.37-100.00%). None of the CD patients tested positive for urinary LAM, resulting in a specificity of 100% (95% C.I. 94.22-100.00%) and NPV of 69.66% (95% C.I. 65.54-73.50%). Overall diagnostic accuracy of urinary LAM in differentiating GITB from CD was 72.45% (95% C.I. 62.54-80.99%). Notably, the addition of urinary LAM testing to the existing diagnostic criteria improved the accurate identification of GITB from 44% to 55.6%.</p><p><strong>Conclusion: </strong>Urinary LAM testing exhibits high specificity and PPV, making it a significant adjunct in the diagnostic process for GITB.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325582","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":"Hepatitis A: A wake-up call!","authors":"Anil Chandra Anand, Akash Roy","doi":"10.1007/s12664-025-01803-6","DOIUrl":"https://doi.org/10.1007/s12664-025-01803-6","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325576","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":"Refining the role of ROTEM in ulcerative colitis: A critical perspective.","authors":"Sukrati Maheswari, Suprabhat Giri","doi":"10.1007/s12664-025-01819-y","DOIUrl":"https://doi.org/10.1007/s12664-025-01819-y","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325580","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":"Inflammation-related polymorphisms IFNG-AS1 rs1558744 and CCAT2 rs6983267: Potential risk factors for ulcerative colitis.","authors":"Dilek Sari-Tiric, Seda Orenay-Boyacioglu, Elmas Kasap","doi":"10.1007/s12664-025-01801-8","DOIUrl":"https://doi.org/10.1007/s12664-025-01801-8","url":null,"abstract":"<p><strong>Background: </strong>Recent research indicates that long non-coding RNAs (lncRNAs) may have a regulatory role in inflammatory processes, potentially influencing the development of inflammatory bowel diseases such as ulcerative colitis (UC). However, the relationship between UC and lncRNAs remains unclear, highlighting the need for further research in this area.</p><p><strong>Aim: </strong>This study aimed to define the possible roles of inflammation-related lncRNA polymorphisms in the pathogenesis of UC.</p><p><strong>Method: </strong>The study included adult patients over 18 years of age diagnosed with UC (n = 73) and a control group consisting of age-matched healthy individuals without any gastrointestinal complaints (n = 73). The inflammation-related ANRIL (rs10757278, rs1333048), IFNG-AS1 (rs1558744, rs7134599), LINC01430 (rs6017342), LOC101926945 (rs561722) and CCAT2 (rs6983267) polymorphisms were examined using the Fluidigm SNP Type method.</p><p><strong>Results: </strong>Of UC patients, 34.25% (n = 25) had proctitis, 28.77% (n = 21) had distal colon involvement and 36.98% (n = 27) had total colon involvement. Also, of the UC patients, 45.20% (n = 33) had suffered for 0-5 years, 41.10% (n = 30) for 5-10 years and 13.70% (n = 10) for 10-16 years. According to the pathology results of the most recent colonoscopy performed on UC patients, the disease was active in 60.27% (n = 44) and in remission in 39.73% (n = 29). The genotype distributions of the IFNG-AS1 rs1558744 and CCAT2 rs6983267 polymorphisms between the two groups revealed statistically significant results (p = 0.042 and p = 0.033, respectively). Allele frequency distributions of the IFNG-AS1 rs1558744 polymorphism between the UC and control groups were also statistically significant (p = 0.040). No statistically significant differences were observed when the examined polymorphisms were analyzed in relation to the location of involvement, disease activity state or disease duration in UC patients (p > 0.05).</p><p><strong>Conclusion: </strong>IFNG-AS1 rs1558744 and CCAT2 rs6983267 polymorphisms may be significant risk factors for the development of UC.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325578","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":"Aneurysmal dilatation of small intestine in a case of untreated celiac disease with enteropathy associated T-Cell lymphoma.","authors":"Jahnvi Dhar, Pankaj Gupta, Suvradeep Mitra, Jayanta Samanta","doi":"10.1007/s12664-025-01817-0","DOIUrl":"https://doi.org/10.1007/s12664-025-01817-0","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325575","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":"Perioperative versus adjuvant chemotherapy in carcinoma stomach-A retrospective propensity-matched analysis.","authors":"Archana Elangovan, Prasanth Penumadu, Biswajit Dubashi, N Sreekumaran Nair, Balasubramanian A","doi":"10.1007/s12664-025-01767-7","DOIUrl":"https://doi.org/10.1007/s12664-025-01767-7","url":null,"abstract":"<p><strong>Background: </strong>A uniform consensus on the optimal sequencing of treatment modalities in locally advanced gastric cancer is not reached due to conflicting results worldwide. We conducted a retrospective propensity-matched analysis to compare survival of locally advanced gastric cancer patients who were treated with peri-operative chemotherapy followed by surgery or upfront surgery followed by adjuvant chemotherapy.</p><p><strong>Methods: </strong>Deidentified records of prospectively maintained data of locally advanced gastric cancer patients treated from 2015 to 2020 were collected. A 1:1 propensity matching with a tolerance limit of 0.2 was performed. The outcome variables including recurrence-free and overall survival were compared among the matched groups using log-rank tests and Cox proportional hazards analysis was performed.</p><p><strong>Results: </strong>Two hundred patients (64 in peri-operative chemotherapy and 136 in the upfront surgery group) were included in the study. Variables including age group, sex, gastric outlet obstruction, tumor site, clinical T stage and node positivity were used for matching. The median overall survival and recurrence-free survival were found to be 21.90 months (95% CI = 13.30-30.49) and 15.08 months (95% CI = 8.17-21.98), respectively, in the peri-operative chemotherapy arm and 18.70 months (95% CI = 11.88-25.51) and 13.49 months (95% CI = 6.76-20.21), respectively, in upfront surgery arm with no significant difference (median follow-up 42 months). Patients who presented with pallor had Borrmann type 4 on endoscopy, received lesser number of chemotherapy cycles, lymph node ratio was > 0.13 and perineural invasion were associated with worse overall survival and recurrence-free survival.</p><p><strong>Conclusion: </strong>In this real-world scenario, retrospective propensity-matched study, no difference was noted in overall survival and recurrence-free survival between patients who received peri-operative chemotherapy or upfront surgery followed by adjuvant chemotherapy in locally advanced gastric cancer.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325579","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":"Intravenous iron in ulcerative colitis-Raising the (iron) bar.","authors":"Jimmy K Limdi","doi":"10.1007/s12664-025-01802-7","DOIUrl":"https://doi.org/10.1007/s12664-025-01802-7","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293689","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 retrograde cholangiopancreatography-related duodenal perforations: A systematic review and meta-analysis of management and outcomes.","authors":"Erfan Arabpour, Amir Sadeghi, Sajad Shojaee, Negin Tabatabaie, Sina Khoshdel, Amirreza Pouladi, Mohammad Abdehagh, Mohammad Reza Zali","doi":"10.1007/s12664-025-01788-2","DOIUrl":"https://doi.org/10.1007/s12664-025-01788-2","url":null,"abstract":"<p><strong>Background and objectives: </strong>Endoscopic retrograde cholangiopancreatography (ERCP)-related perforations (EPs) are rare but serious adverse events, with a reported frequency of 0.4% to 0.6% and mortality rates reaching 8%. The lack of a uniform classification system for injury patterns and evidence-based management guidelines poses significant challenges in clinical decision-making. This systematic review evaluates therapeutic approaches and outcomes of EPs using the Stapfer classification to address these gaps.</p><p><strong>Methods: </strong>We conducted a systematic review of studies that utilized the Stapfer classification to categorize EPs into four types, ranked by severity: type I (lateral/medial duodenal wall perforation), type II (periampullary injuries), type III (bile duct injuries) and type IV (retroperitoneal air alone). The study protocol was registered in PROSPERO (ID CRD42023473841).</p><p><strong>Results: </strong>Among 287 patients from 18 eligible studies, type-I perforations were associated with significantly higher mortality (adjusted OR = 3.17, 95% CI 1.45-6.99). Surgical management did not significantly increase mortality risk compared to non-operative treatment (adjusted OR = 1.99, 95% CI 0.66-6.00) but was linked to prolonged hospital stays (coefficient 8.58, 95% CI 2.71-14.46). In contrast, perforation type did not significantly influence hospitalization duration (coefficient - 0.64, 95% CI - 4.04 to 2.76).</p><p><strong>Conclusions: </strong>Our findings underscore the need for individualized treatment strategies based on perforation type and patient-specific factors. While the Stapfer classification aids in risk stratification, the heterogeneity of current evidence limits generalizability. Large-scale prospective studies are essential to establish standardized management protocols.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283798","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":"Effectiveness and safety of intravenous iron in ulcerative colitis: A real-world study of impact of disease activity and iron preparations.","authors":"Arman Reyaz Kochai, Uday Kiran Mangipudi, Prateek Bhatia, Aravind Sekar, Harshal S Mandavdhare, Vaneet Jearth, Vishal Sharma","doi":"10.1007/s12664-025-01775-7","DOIUrl":"https://doi.org/10.1007/s12664-025-01775-7","url":null,"abstract":"<p><strong>Background: </strong>There is lack of evidence on how disease activity in inflammatory bowel disease influences response to intravenous iron.</p><p><strong>Methods: </strong>A single-centre prospective study was conducted to study responses to intravenous iron in ulcerative colitis. Patients with iron deficiency anemia (hemoglobin < 8 g/dL OR < 12 g/dL with intolerance to oral iron or active disease) received protocolized intravenous iron dosing per European Crohn's and Colitis Organisation (ECCO) guidelines. Ferric carboxymaltose (FCM) or iron isomaltoside was used per patient preference. The outcomes were increase in Hb ≥ 2 g/dL, normalization of Hb at four weeks and normalization of iron indices (serum ferritin >100 ng/mL in active and > 30 ng/mL in inactive disease and transferrin saturation > 20%) assessed at four weeks.</p><p><strong>Results: </strong>Thirty-two patients (females = 21 [65.6%], mean age = 32.78 ± 12.65 years, active disease = 17 [53.1%]) received IV iron. Twenty-one received FCM, while 11 received iron isomaltoside. Complete normalization of Hb was seen in seven (41%) in active patients and nine (60%) in remission groups (p = 0.47). Normalization of iron profile was seen in 11 (64%) and 12 (80%) patients in two groups, respectively (p = 0.32). Secondary objectives of mean change in Hb and iron indices tended towards better response in inactive group, but were not statistically significant except change in transferrin saturation that was better in inactive group (20.8 ± 9.1% and 14.2 ± 8.1%, p = 0.04). FCM was associated with hypophosphatemia in 6/21 (28.5%) patients vs. none in isomaltoside group. The predictive performance for complete hematological response with the reticulocyte hemoglobin and percentage of hypochromic cells was low (area under the receiver operating characteristic [AUROC] of 0.67 and 0.685, respectively).</p><p><strong>Conclusion: </strong>Although there was a tendency towards better response to intravenous iron in those with remission, the findings were not statistically different. Larger studies are needed to provide conclusive evidence. Iron isomaltoside may be preferable over FCM due to risk of hypophosphatemia with the latter.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283797","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}