Euroasian journal of hepato-gastroenterology最新文献

{"title":"Modified Heidelberg (Buchler's) Technique of Pancreaticojejunostomy after Pancreaticoduodenectomy and Its Implications on Postoperative Pancreatic Fistula.","authors":"Karthik Chalamalasetti, Sugaprakash Sankareswaran, Prabhakaran Raju, Sugumar Chidambaranathan","doi":"10.5005/jp-journals-10018-1460","DOIUrl":"10.5005/jp-journals-10018-1460","url":null,"abstract":"<p><strong>Introduction: </strong>With the advancement in surgical techniques, the mortality after pancreaticoduodenectomy (PD) has significantly decreased, but the morbidity remains the same. The occurrence of postoperative pancreatic fistula (POPF) directly affects morbidity, and many pancreatic reconstruction techniques have been developed to decrease the rates of clinically relevant postoperative pancreatic fistula (CR-POPF).</p><p><strong>Materials and methods: </strong>Our modified Heidelberg (Buchler's) technique differs from the original in the aspect that continuous sutures rather than intermittent sutures are used in all layers of the anastomosis. The outcomes of this technique were analyzed, and factors associated with POPF and CR-POPF were determined. A retrospective analysis was performed on data from 78 patients for whom the modified Heidelberg technique was used to perform pancreatojejunostomy (PJ) after PD at our institute between 2017 and 2023. In subgroup analysis, the incidence of POPF was compared between the initial phase when other PJ techniques were still practiced at our institute and the period after the technique was standardized.</p><p><strong>Results: </strong>The incidence of CR-POPF was 6.4%, and the overall incidence of POPF was 33.3%. Postpancreatectomy hemorrhage occurred in 7.6% of the patients, and the 30-day mortality rate was 5.1%. Following standardization, the incidence of CR-POPF was significantly reduced to 4%. Prior biliary stenting and soft pancreas were risk factors for the development of POPF (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The outcomes of PD tended to improve with the use of a single pancreatic anastomosis technique. Our modification of the Heidelberg technique of PJ is easy to perform and produces outcomes equivalent to the original Heidelberg technique. Our analysis showed that prior biliary stenting, soft pancreas, and intraoperative pancreatic duct stent placement increased the incidence of POPF, and CR-POPF was significantly associated with morbidity.</p><p><strong>How to cite this article: </strong>Chalamalasetti K, Sankareswaran S, Raju P, <i>et al.</i> Modified Heidelberg (Buchler's) Technique of Pancreaticojejunostomy after Pancreaticoduodenectomy and Its Implications on Postoperative Pancreatic Fistula. Euroasian J Hepato-Gastroenterol 2025;15(1):100-106.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"100-106"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Characterization of SIBO in NAFLD Patients.","authors":"Shamim Naizr, Zaigham Abbas, Darayus P Gazder, Aqsa Shahid, Manesh Kumar, Sania Maqbool","doi":"10.5005/jp-journals-10018-1468","DOIUrl":"10.5005/jp-journals-10018-1468","url":null,"abstract":"<p><strong>Background: </strong>The correlation between small intestinal bacterial overgrowth (SIBO) and nonalcoholic fatty liver disease (NAFLD) has gained heightened acknowledgment, especially in the late phases of liver disease. Despite this, studies focusing on the prevalence and specific characteristics of SIBO within the steatotic liver disease patient population in Pakistan remain sparse. This research seeks to investigate the prevalence and characteristics of SIBO in patients with fatty liver disease in a tertiary healthcare facility in Karachi.</p><p><strong>Materials and methods: </strong>Conducted from July 2023 to March 2024 at Ziauddin Medical University Hospital's Clifton Campus, this prospective cross-sectional study included 65 adults aged 18-80 diagnosed with NAFLD via FibroScan®. The evaluation of small bowel microbial overgrowth was established by a glucose hydrogen breath test (GHBT), where a rise in hydrogen concentration of ≥20 ppm from the initial measurement within two hours signifies a good outcome. Participant demographics, comorbid conditions, and clinical symptoms were documented.</p><p><strong>Results: </strong>Of the 65 individuals, 46 were male, with an average age of 44.88 ± 12.30 years, a mean index of body mass of 26.45 ± 6.45 kg/m², and an average waist measurement of 95.20 ± 15.17 cm. Lean NAFLD was observed in 40% of the participants. Frequent comorbidities included diabetes (40%), hypertension (38%), and dyslipidemia (38%). Small intestinal bacterial overgrowth was identified in 37% of the subjects, 28% of whom were asymptomatic. Symptoms prevalent in SIBO-positive individuals were bloating (41%), belching (26%), and abdominal pain (28%). Liver stiffness indicated that 23% had F2 fibrosis, 28% had F3, and 49% had F4. Controlled attenuation parameter (CAP) scores showed S1 steatosis in 37% of patients, S2 in 29%, and S3 in 34%. The presence of SIBO correlated with increasing fibrosis and steatosis levels. Small intestinal bacterial overgrowth (SIBO) positivity was more prevalent in the high Child-Pugh class and more severe liver dysfunction. With post-treatment giving <i>Lactobacillus reuteri</i> and rifaximin for two weeks, only 4% remained SIBO-positive. Significant associations of SIBO were also noted with dyslipidemia, hyperuricemia, and irritable bowel syndrome.</p><p><strong>Conclusion: </strong>This research highlights a significant incidence of SIBO in NAFLD individuals, particularly those with severe liver damage and comorbidities. It stresses the importance of regular screening for SIBO in such patients, suggesting that timely detection and intervention could enhance patient outcomes.</p><p><strong>How to cite this article: </strong>Naizr S, Abbas Z, Gazder DP, <i>et al.</i> Incidence and Characterization of SIBO in NAFLD Patients, Euroasian J Hepato-Gastroenterol 2025;15(1):38-43.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"38-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alpha-fetoprotein: A Multifaceted Player in Cancer Biology.","authors":"Mete Ucdal, Yigit Yazarkan, Gamze Sonmez, Basak Celtikci, Yasemin Balaban","doi":"10.5005/jp-journals-10018-1458","DOIUrl":"10.5005/jp-journals-10018-1458","url":null,"abstract":"<p><p>Alpha-fetoprotein (AFP), a major oncofetal protein, plays a pivotal role in cancer biology, extending beyond its initial identification in fetal development. Alpha-fetoprotein has multifaceted physiological functions mediated by its' complex structure interacting with specific receptors and ligands. The involvement of AFP in carcinogenesis encompasses a broad spectrum of pathophysiological mechanisms, including cell proliferation, apoptosis, metastasis, and immune modulation. Alpha-fetoprotein contributes to the pathological landscape of several cancers, especially hepatocellular carcinoma and germ cell tumors, through an intricate network of signaling pathways. Recent studies highlight the expanding clinical applications of AFP, suggesting its potential to improve the diagnosis and treatment of cancer as well as monitoring genetic diseases, such as neural tube defects and Down syndrome. This comprehensive overview of AFP aims to elucidate the complex biological interactions and clinical implications in cancer management.</p><p><strong>How to cite this article: </strong>Ucdal M, Yazarkan Y, Sonmez G, <i>et al.</i> Alpha-fetoprotein: A Multifaceted Player in Cancer Biology. Euroasian J Hepato-Gastroenterol 2025;15(1):72-82.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"72-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Octreotide with Placebo after Successful EVL to Prevent Rebleeding: A Randomized Controlled Trial.","authors":"Pradyush Kiran, Raj Kumar Nagarajan, Rajendran Theakarajan, Muhamed Tajudeen, Nandakishore Maroju","doi":"10.5005/jp-journals-10018-1474","DOIUrl":"10.5005/jp-journals-10018-1474","url":null,"abstract":"<p><strong>Background: </strong>The standard treatment for bleeding esophageal varices typically combines pharmacotherapy with endoscopic variceal ligation (EVL). As a general practice, vasoactive drugs are administered for 3-5 days, following banding to reduce the risk of rebleeding. However, the necessity of continuing these vasoactive drugs after definitive therapy remains uncertain, with no conclusive results available. This study aims to compare the efficacy of octreotide against a placebo after EVL in variceal bleeding.</p><p><strong>Materials and methods: </strong>This study was a prospective, double-blinded, randomized controlled trial conducted at a tertiary care institute in India. A total of 270 patients were recruited. All patients underwent EVL for variceal bleeding and were subsequently randomized into two groups. Patients in group A did not receive any drug, while patients in group B received octreotide for 3 days. They were monitored for 5 days to assess instances of very early rebleeding.</p><p><strong>Results: </strong>The baseline characteristics of patients in both groups were comparable. There was no significant difference observed between the two groups regarding very early rebleeding (within 5 days). One patient in each group (2/270) had very early rebleeding (<i>p</i> = 1.00). Although the cost-effectiveness of discontinuing octreotide immediately after EVL was not quantified, it was noted that the use of octreotide for 3 days resulted in increased demands on manpower, materials, finances, and prolonged hospital stays.</p><p><strong>Conclusion: </strong>Octreotide does not reduce the rates of very early rebleeding after EVL. Therefore, it can be safely discontinued after EVL, which could lead to shorter hospital stays and is more cost-effective.</p><p><strong>How to cite this article: </strong>Kiran P, Nagarajan RK, Theakarajan R, <i>et al.</i> Comparison of Octreotide with Placebo after Successful EVL to Prevent Rebleeding: A Randomized Controlled Trial. Euroasian J Hepato-Gastroenterol 2025;15(1):63-67.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"63-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early vs Conventional Oral Feeding after Pancreaticoduodenectomy: A Prospective Observational Study.","authors":"Ajay Sharma, Vinay Kumar Mahala, Anand Nagar, Shashwat Sarin, Harshil Shah, Milind Akhani, Hrishikesh Sinhasane, Rajendra Prasad Choubey, Peeyush Varshney","doi":"10.5005/jp-journals-10018-1465","DOIUrl":"10.5005/jp-journals-10018-1465","url":null,"abstract":"<p><strong>Background: </strong>Enhanced recovery after surgery (ERAS) protocols following pancreaticoduodenectomy (PD) have shown promising results. In all previous studies on ERAS following PD; the earliest oral feeding (liquids only) was started on the first postoperative day; our objective was to start oral (liquid and soft) feed at 6 hours of surgery and assess its effect on postoperative outcome.</p><p><strong>Materials and methods: </strong>All 26 patients (Group-I) undergoing PD from November 2021 to June 2022 were prospectively enrolled and subjected to early oral feeding (EOF), i.e., oral feed at 6 hours. They were compared with a retrospective cohort (Group-II) of 40 patients who received conventional oral feeding (COF) i.e., by feeding jejunostomy on day 1.</p><p><strong>Results: </strong>Age, intraoperative blood loss, and operative time were comparable. Time to start oral liquid (0 vs 1.5 ± 1.2 days, <i>p</i> = 0.00), soft diet (0 vs 3.8 ± 1.9 days, <i>p</i> = 0.00) and solid diet (3.1 ± 0.5 vs 7.2 ± 2.9 days, <i>p</i> = 0.00) was significantly shorter in EOF group. Nasogastric (NG) tube removal was earlier (1.6 ± 1.5 vs 3.9 ± 1.7 days, <i>p</i> 0.00) and required reinsertion less frequently in the EOF group. First stool passage time (3.7 ± 0.9 vs 5.9 ± 1.8 days, <i>p</i> 0.00) and stoppage of intravenous fluids (3.4 ± 0.8 vs 5.2 ± 1.8 days, <i>p</i> 0.00) were significantly earlier in EOF group. The length of postoperative hospital stay was less (5.9 ± 2.6 vs 8.8 ± 4.1 days, <i>p</i> 0.007) in the EOF group. There was no significant difference in postoperative complications, 90-day mortality, and readmission rates between the two groups.</p><p><strong>Conclusion: </strong>Early oral feeding after PD is feasible, safe, and reduces hospital stay.</p><p><strong>How to cite this article: </strong>Sharma A, Mahla VK, Nagar A, <i>et al.</i> Early vs Conventional Oral Feeding after Pancreaticoduodenectomy: A Prospective Observational Study. Euroasian J Hepato-Gastroenterol 2025;15(1):29-33.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Liver Failure and Hepatic Encephalopathy Secondary to Extensive Liver Metastases from Breast Cancer Successfully Treated Using Dose Modified Weekly Nab-paclitaxel and Trastuzumab.","authors":"Ajay Gupta","doi":"10.5005/jp-journals-10018-1461","DOIUrl":"10.5005/jp-journals-10018-1461","url":null,"abstract":"<p><p>Acute liver failure due to widespread carcinomatous infiltration of the liver by breast cancer carries a grave prognosis. The disease course is fulminant and deranged hepatic functions and poor performance status make chemotherapy difficult. Our patient was a 46-year-old lady with breast cancer who presented with acute liver failure and hepatic encephalopathy secondary to extensive liver metastases and who was successfully treated with chemotherapy (Nab-paclitaxel) and (immunotherapy) Trastuzumab. There is no such report of concomitant use of nab-paclitaxel and trastuzumab in acute liver failure in world literature. Usually, these patients are administered palliative care only, however, such nihilistic approaches prevent us from salvaging such patients. It is possible to salvage a proportion of this high-risk group of patients with immediate institution of suitable systemic therapy and appropriate supportive care. We present the report of such a case.</p><p><strong>How to cite this article: </strong>Gupta A. Acute Liver Failure and Hepatic Encephalopathy Secondary to Extensive Liver Metastases from Breast Cancer Successfully Treated Using Dose Modified Weekly Nab-paclitaxel and Trastuzumab. Euroasian J Hepato-Gastroenterol 2025;15(1):83-86.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"83-86"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Predictive Value of NLR and PLRs in Advanced Hepatocellular Carcinoma Patients Receiving First-line Systemic Therapy: Observations from a Tertiary Care Hospital in Pakistan.","authors":"Mohammad Ss Naviwala, Mahnoor Tariq, Warda Saleem, Faiza Ahmed, Armish Rehman, Waqas A Khan, Adeeba Zaki, Munira Moosajee, Yasmin A Rashid","doi":"10.5005/jp-journals-10018-1462","DOIUrl":"10.5005/jp-journals-10018-1462","url":null,"abstract":"<p><strong>Background and aim: </strong>Inflammatory biomarkers are commonly utilized and remain a topic of ongoing discussion regarding their role in predicting outcomes in advanced hepatocellular carcinoma (HCC). The overall survival (OS) of patients with advanced HCC who received first-line systemic therapy at a tertiary care hospital in Pakistan was examined in this study in relation to the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline and 1 month after treatment.</p><p><strong>Materials and methods: </strong>The study tracked 107 patients with advanced HCC from 2017 to 2024 who received atezolizumab/bevacizumab, lenvatinib, and sorafenib as therapy. Pretreatment and posttreatment (1 month) NLR and PLR values were analyzed. The most appropriate NLR and PLR cutoff thresholds were determined using receiver operating characteristic (ROC) analysis. Kaplan-Meier survival curves and log-rank tests were used to determine OS.</p><p><strong>Results: </strong>Nine months was the median OS, with a 95% confidence interval (CI) ranging from 5 to 13.7 months. Patients with a pretreatment NLR below 2.72 had a median survival of 13 months (95% CI: 9-32 months), whereas those with an NLR of 2.72 or higher had a median survival of 5 months (95% CI: 4-11). Similarly, patients with a pretreatment PLR under 102.86 achieved a median survival of 13 months (95% CI: 9-32), while those with a PLR equal to or above 102.86 experienced a median survival of 5 months (95% CI: 4-14). Treatment-related side effects, including deranged liver function tests, led to dose adjustments in 83.9% of patients and significantly influenced survival outcomes.</p><p><strong>Conclusions: </strong>Higher pretreatment NLR and PLR were related with lower survival outcomes in advanced HCC patients undergoing first-line systemic treatment. Although not statistically significant, these biomarkers show potential as predictive tools when integrated with established systems like Albumin-Bilirubin grading and Child-Pugh classification. Additional studies are required to validate their significance, particularly in the context of emerging therapies.</p><p><strong>Clinical significance: </strong>The NLR and PLR, combined with established tools, offer a cost-effective approach to refine patient selection and improve outcomes in advanced HCC, particularly in resource-limited settings.</p><p><strong>How to cite this article: </strong>Naviwala MSS, Tariq M, Saleem W, <i>et al.</i> Assessing the Predictive Value of NLR and PLRs in Advanced Hepatocellular Carcinoma Patients Receiving First-line Systemic Therapy: Observations from a Tertiary Care Hospital in Pakistan. Euroasian J Hepato-Gastroenterol 2025;15(1):107-112.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"107-112"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in Health-related Quality of Life and Patient Satisfaction after Pneumatic Dilatation in Achalasia Patients.","authors":"Sofia Hanif, Shahid Rasool, Umair Shafqat, Javeria Komal","doi":"10.5005/jp-journals-10018-1472","DOIUrl":"10.5005/jp-journals-10018-1472","url":null,"abstract":"<p><strong>Background: </strong>Achalasia, a rare motility disorder characterized by impaired lower esophageal sphincter relaxation, significantly impacts patients' quality of life. Pneumatic dilatation (PD) is a cost-effective and minimally invasive treatment, yet long-term prospective data from resource-limited settings remain scarce. This study aimed to evaluate the efficacy of PD in improving health-related quality of life (HRQoL) and patient satisfaction among achalasia patients in a peripheral Pakistani hospital.</p><p><strong>Materials and methods: </strong>A single-center, quasi-experimental study was conducted at Madina Teaching Hospital, Faisalabad, from 2017 to 2021. Eighty patients (mean age: 37.03 ± 10.49 years) diagnosed via high-resolution manometry or barium swallow were enrolled. Pneumatic dilatation was performed under fluoroscopic and endoscopic guidance using 35 and 40 mm balloons. Outcomes were assessed at baseline, 6 months, and 24 months using the Eckardt score and Short Form-8 Health Survey Questionnaire. Statistical analyses included repeated measures analysis of variance, Kaplan-Meier survival analysis, and Spearman's correlation.</p><p><strong>Results: </strong>Pneumatic dilatation resulted in a 75.1% reduction in Eckardt scores at 24 months (<i>p</i> < 0.001), with sustained symptom relief. Health-related quality of life scores improved significantly, from 18.05 ± 1.39 at baseline to 37.00 ± 1.08 at 24 months (<i>p</i> < 0.001). A strong negative correlation was observed between Eckardt scores and HRQoL (<i>r</i> = -0.40, <i>p</i> < 0.001). Minor complications occurred in 12.5% of patients, with no major adverse events. Symptom recurrence was observed in 8.75% of cases, successfully managed with repeat PD. Subgroup analyses revealed no significant differences in outcomes based on gender or age.</p><p><strong>Conclusion: </strong>Pneumatic dilatation is a safe, effective, and sustainable intervention for achalasia in resource-limited settings. It provides durable symptom relief, significantly improves HRQoL, and achieves high patient satisfaction over 24 months, with minimal complications. These findings highlight PD's viability as a first-line treatment in regions with limited access to advanced therapeutic options.</p><p><strong>How to cite this article: </strong>Hanif S, Rasool S, Shafqat U, <i>et al.</i> Improvement in Health-related Quality of Life and Patient Satisfaction after Pneumatic Dilatation in Achalasia Patients. Euroasian J Hepato-Gastroenterol 2025;15(1):54-57.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"54-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there any Association of Distal Biliary Strictures with Acute Pancreatitis?","authors":"Manesh Kumar, Zaigham Abbas, Darayus P Gazder, Shamim Nazir, Zeeshan Hyder, Aasia Yousuf, Shard K Bansari, Kajal Bai","doi":"10.5005/jp-journals-10018-1467","DOIUrl":"10.5005/jp-journals-10018-1467","url":null,"abstract":"<p><strong>Background and objective: </strong>This cross-sectional study aimed to determine the frequency of distal biliary strictures in biliary pancreatitis, their relation with clinical and biochemical characteristics, and possible associations as a precipitating factor.</p><p><strong>Materials and methods: </strong>A total of 51 patients with biliary pancreatitis were assessed for distal common bile duct (CBD) strictures and stones. Demographic data, biochemical parameters, and imaging findings were analyzed. Comparative analyses were conducted to evaluate differences between patients with and without strictures or stones.</p><p><strong>Results: </strong>The mean age of the cohort was 54.0 ± 16.72 years, with females comprising 58.8% of the population. Distal CBD strictures were detected in 54.9% of patients, more frequently in females (64.3%) compared with males (35.7%). Patients without strictures accounted for 45.1%, with an almost equal gender distribution (52.2% females and 47.8% males). The CBD stones were identified in 70.6% of cases, with a marginally higher frequency among females (52.8%). Comparative analyses between patients with and without strictures showed no statistically significant differences in amylase (<i>p</i> = 0.616), lipase (<i>p</i> = 0.531), total bilirubin (<i>p</i> = 0.674), alanine aminotransferase (<i>p</i> = 0.589), aspartate aminotransferase (<i>p</i> = 0.621), gamma-glutamyl transferase (<i>p</i> = 0.483), or alkaline phosphatase (<i>p</i> = 0.398). Similarly, no significant differences were observed between patients with and without CBD stones in amylase (<i>p</i> = 0.420), lipase (<i>p</i> = 0.471), total bilirubin (<i>p</i> = 0.545), or inflammatory markers such as C-reactive protein (<i>p</i> = 0.313). Among patients with strictures, 53.6% had concurrent CBD stones, compared with 91.3% of those without strictures (<i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>Distal CBD strictures were present in over half of the patients with acute biliary pancreatitis (ABP). The presence of CBD stones was less common in these patients. Strictures were more common in females. There is a possibility that the presence of stricture may itself lead to complete obstruction even without stone when plugged with sludge or microlithiasis, ending up in the building of back pressure and pancreatitis.</p><p><strong>How to cite this article: </strong>Kumar M, Abbas Z, Gazder DP, <i>et al.</i> Is there any Association of Distal Biliary Strictures with Acute Pancreatitis? Euroasian J Hepato-Gastroenterol 2025;15(1):34-37.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"34-37"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Characteristics at Admission Affecting Short-term Outcome in Hepatic Encephalopathy: A Cross-sectional Study.","authors":"Harshpreet Singh, Kamal Singh, Vivek Kumar, Rayidi Rajesh, Asheesh Gautam","doi":"10.5005/jp-journals-10018-1476","DOIUrl":"10.5005/jp-journals-10018-1476","url":null,"abstract":"<p><strong>Aim and background: </strong>To determine the factors that affect outcome in hospitalized patients of hepatic encephalopathy (HE).</p><p><strong>Materials and methods: </strong>This was a cross-sectional observational study aimed at correlating the presenting patient profile with outcome in patients of chronic liver disease (CLD) HE; with 131 participants over 18 months. The primary outcome was mortality, and the secondary outcome was duration of hospital stay in surviving patients.</p><p><strong>Results: </strong>Hypoglycemia, hypoxia, abnormal total leukocyte count (TLC), %Neutrophils, S. Sodium, S. Chloride, S. Urea, S. Creatinine and aspartate transaminase (AST) levels, MELD-Na score, and the number of precipitating factors were associated with higher mortality (at <i>p</i> ≤0.05). A prognostic index was calculated from seven parameters to predict mortality (area under curve AUC = 80.2%, sensitivity = 84.1%, specificity = 72.4% at cut-off 42). The mean duration of hospital stay was 4.3 (±4.5) days in patients who expired and 9.0 (±9.6) days in patients who recovered (<i>p</i> ≤ 0.05). Approximately 81.8 and 90.9% of deaths occurred within the first 3 and 10 days of admission, respectively.</p><p><strong>Conclusion: </strong>The study identified readily available lab parameters that can be used to detect patients at high risk of mortality during hospitalization for HE. A prognostic score calculable from these parameters has also been proposed. Most of the deaths were found to occur during the initial days of hospital stay.</p><p><strong>Clinical significance: </strong>The presentation and prognostic factors were different from those reported in Western literature. The identification of prognostic factors, and a high-risk early hospitalization period will help in the early detection and aggressive management of at-risk patients.</p><p><strong>How to cite this article: </strong>Singh H, Singh K, Kumar V, <i>et al.</i> Patient Characteristics at Admission Affecting Short-term Outcome in Hepatic Encephalopathy: A Cross-sectional Study. Euroasian J Hepato-Gastroenterol 2025;15(1):68-71.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"15 1","pages":"68-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}