Indian Journal of Gastroenterology最新文献

{"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":"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":"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}

{"title":"Outcomes of acute pancreatitis in elderly are comparable to those in adults in India: A propensity score-matched analysis.","authors":"Gauri Kumbhar, Sudipta Dhar Chowdhury, Ashish Goel, A J Joseph, Ebby George Simon, Amit Kumar Dutta, Reuben Thomas Kurien","doi":"10.1007/s12664-024-01734-8","DOIUrl":"https://doi.org/10.1007/s12664-024-01734-8","url":null,"abstract":"<p><strong>Background and objectives: </strong>The ageing population is increasing in India and there is hardly any information on outcomes of acute pancreatitis (AP) in the elderly in India. Hence we studied the comprehensive clinical characteristics and outcomes of AP in elderly patients.</p><p><strong>Methods: </strong>This study included patients admitted with AP to a tertiary care centre from October 2018 to October 2022. Patients with the first episode of AP presenting within 14 days of disease onset were eligible for inclusion. The elderly population was defined as age ≥ 60 years. Recurrent AP, chronic pancreatitis and AP presenting after 14 days of disease onset were excluded. Propensity score matching was performed based on etiology and severity to compare elderly and non-elderly groups. Primary outcome was serious adverse outcome (SAO: in-hospital mortality or discharge in critical state). Secondary outcomes included organ failures, local complications, necrosis, mesenteric vascular thrombosis (MVT), length of hospital stay, intensive care unit (ICU) admission and infections.</p><p><strong>Results: </strong>Of 630 eligible patients, 120 were > 60 years of age. Among the elderly, 72 (60%) were males. The median age was 68 (IQR 63-74) years. The most common etiology was biliary 76 (63.3%) followed by idiopathic 25 (20.8%) and alcohol eight (6.7%). Mild AP was seen in 72 (60%), while 21 (17.5%) had moderately severe and 27 (22.5%) had severe AP. Organ failures occurred in 27.5%, necrotizing pancreatitis in 15.2%, local complications in 27.6% and MVT in 3.3%. Infections affected 28.3%. Median hospital stay was four days (IQR 1-28), with 12.5% requiring ICU admission. SAO occurred in 8.3% of elderly patients, comparable to 11.4% in the non-elderly (p = 0.334). Bedside index for severity in acute pancreatitis (BISAP) score (adjusted OR 2.7, 95% CI 1.05-6.96, p = 0.04) and Charlson comorbidity index (without age) (adjusted OR 1.94, 95% CI 1.07-3.51, p = 0.03) independently predicted SAO in the elderly.</p><p><strong>Conclusion: </strong>The outcomes of AP in the elderly in India are similar to patients < 60 years. Charlson comorbidity index and BISAP score predicted serious adverse outcomes in the elderly.</p>","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":"143500791","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":"Reply to Khan et al., Critical Insights: ABC score is a better predictor for 30-day mortality in upper gastrointestinal bleeding: A prospective single-center study.","authors":"Vikas Pemmada, Athish Shetty, Ganesh Bhat","doi":"10.1007/s12664-025-01750-2","DOIUrl":"https://doi.org/10.1007/s12664-025-01750-2","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476495","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":"Short-term and long-term management of caustic-induced gastrointestinal injury: An evidence-based practice guidelines.","authors":"Anupam Kumar Singh, Deepak Gunjan, Nihar Ranjan Dash, Ujjal Poddar, Pankaj Gupta, Ajay Kumar Jain, Deepak Lahoti, Jamshed Nayer, Mahesh Goenka, Mathew Philip, Rakesh Chadda, Rajneesh Kumar Singh, Sreekanth Appasani, Showkat Ali Zargar, Sohan Lal Broor, Sandeep Nijhawan, Siddharth Shukla, Vikas Gupta, Vikram Kate, Govind Makharia, Rakesh Kochhar","doi":"10.1007/s12664-024-01692-1","DOIUrl":"https://doi.org/10.1007/s12664-024-01692-1","url":null,"abstract":"<p><p>The Indian Society of Gastroenterology has developed an evidence-based practice guideline for the management of caustic ingestion-related gastrointestinal (GI) injuries. A modified Delphi process was used to arrive at this consensus containing 41 statements. These statements were generated after two rounds of electronic voting, one round of physical meeting, and extensive review of the available literature. The exact prevalence of caustic injury and ingestion in developing countries is not known, though it appears to be of significant magnitude to pose a public health problem. The extent and severity of this preventable injury to the GI tract determine the short and long-term outcomes. Esophagogastroduodenoscopy is the preferred initial approach for the evaluation of injury and contrast-enhanced computed tomography is reserved only for specific situations. Low-grade injuries (Zargar grade ≤ 2a) have shown better outcomes with early oral feeding and discharge from hospital. However, patients with high-grade injury (Zargar grade ≥ 2b) require hospitalization as they are at a higher risk for both short and long-term complications, including luminal narrowing. These strictures can be managed endoscopically or surgically depending on the anatomy and extent of stricture, expertise available and patients' preferences. Nutritional support all along is crucial for all these patients until nutritional autonomy is established.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467135","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 cross-cultural study translating and validating the COMPAT-SF pain questionnaire in Telugu, Bengali and Hindi.","authors":"M Unnisa, A Agarwal, C Peddapulla, V Sharma, S Midha, S Jagannath, R Talukdar, A E Phillips, M Faghih, J Windsor, S S Olesen, P Garg, A M Drewes, L Kuhlmann","doi":"10.1007/s12664-025-01737-z","DOIUrl":"https://doi.org/10.1007/s12664-025-01737-z","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chronic pancreatitis (CP) is a fibroinflammatory disease causing functional injury. Abdominal pain is the predominant symptom negatively impacting the quality of life. The Comprehensive Pain Assessment Tool (COMPAT-SF) questionnaire, designed and validated to assess pain in CP, was previously only available in English and Danish. Given the high prevalence of CP in India, translating and validating COMPAT-SF into different languages becomes crucial.</p><p><strong>Methods: </strong>The COMPAT-SF underwent translation into three Indian languages (Hindi, Telugu and Bengali) and was back-translated to English to ensure cross-cultural equivalence. Validation was conducted at two tertiary care centers in India. As Hindi is the most widespread language, bilingual CP patients answered the COMPAT-SF in Hindi and English at a three-week interval. All sub-group answers were compared with patient data from the US. Structural equation modeling and confirmatory factor analysis were employed for validation.</p><p><strong>Results: </strong>Total 64 patients (19 Hindi-speaking,15 Telugu and 30 Bengali) were included and compared with 91 English-speaking patients. Translation adequacy was confirmed with > 85% concordance. Despite modest Cronbach alpha values in reliability analysis, structural equation modeling demonstrated high consistency with the original COMPAT-SF study. Some cultural differences in responses were observed, but the responses were comparable overall. Confirmatory factor analysis on the pooled data indicated an acceptable model fit and the Hindi version showed good accordance with the English version.</p><p><strong>Conclusion: </strong>The translated COMPAT-SF versions proved to be valid and reliable pain assessment tools for CP patients. The study underscores the importance of addressing pain comprehensively.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448931","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":"Effective prevention of hepatitis B transmission from pregnant women to babies in a real-life setting in India.","authors":"Surender Singh, Manjulata Verma, Abhishek Yadav, Ajay Kumar Mishra, Harshita Katiyar, Radha Krishan Dhiman, Amit Goel","doi":"10.1007/s12664-025-01748-w","DOIUrl":"https://doi.org/10.1007/s12664-025-01748-w","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440768","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}