CIRRHOTIC PATIENTS; PREVALENCE OF PORTAL HYPERTENSIVE GASTROPATHY UNDERGOING UPPER GASTROINTESTINAL ENDOSCOPY AT A TERTIARY CARE HOSPITAL IN SHAHEED BENAZEERABAD

Objectives: The aim behind this study was to determine the prevalence of portalhypertensive gastropathy in cirrhotic patients undergoing upper gastrointestinal endoscopy at atertiary care hospital in Shaheed Benazeerabad. Study Design: Hospital based cross sectionalstudy. Setting: Medicine Department of People’s Medical University, Shaheed Benazeerabad.Period: Six months from 20th August 2014 to 21st February 2015. Material and Methods: Atotal of 115 patients presenting with variceal bleeding (having history of liver cirrhosis since>2 years) and who further was undergoing diagnostic Endoscopic gastrodudenoscopy wereenrolled in the study. All endoscopies were performed by the endoscopists using a GIFQ 160Gastroscope (Olympus, Tokyo, Japan) in the left lateral position. The presence or absenceof PH gastropathy (outcome variable) was noted at each endoscopy. SPSS version 17.0 wasused to analyze the collected data. Results: The average age of the patients was 39.98±11.02years and mean duration of liver cirrhosis was 4.62±1.5 years. There were 70 (60.87%) maleand 45 (39.13%) were female. Regarding socioeconomic status, most of the cases were inlower and middle class. Frequency of portal hypertensive gastropathy (PHG) in patients of livercirrhosis undergoing upper gastrointestinal endoscopy was observed in 60% (69/115) cases.Conclusion: The frequency of PHG was 60% in the studied group of cirrhotic patients. Thisconcludes that if in the liver cirrhosis patients early identification and appropriate therapeuticmeasures of PHG is taken the morbidity in these patients can be decreased.

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Correlation of serology with morphological changes in gastric biopsy of H. pylori infection

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171599 ◽

2017 ◽

Vol 5 (5) ◽

pp. 1851

Author(s):

Amit Rajan ◽

Prosenjit Ganguli ◽

Niloy Pathak ◽

Amar Ranjan ◽

Ragini Thapa ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Gastrointestinal Endoscopy ◽

Morphological Changes ◽

Tertiary Care ◽

Upper Gastrointestinal Endoscopy ◽

Care Hospital ◽

Tissue Sections ◽

Hematoxylin And Eosin ◽

H Pylori ◽

Upper Gastrointestinal

Background: Helicobacter pylori is involved in many gastrodeudonal complications and many diagnostic tests are available for its identification. The present study was done with the objective to evaluate the morphological changes induced by H. pylori in the gastric mucosa and to correlate them with the severity of the infection.Methods: This study was conducted in a tertiary care hospital from July 2013 to June 2014. 60 patients with symptoms of dyspepsia and requiring an upper gastrointestinal endoscopy were included in the study. Upper gastrointestinal endoscopy was performed on all patients. Hematoxylin and Eosin staining (H and E), modified Giemsa staining were performed on tissue sections and examined microscopically for gastritis and presence and absence of H. pylori.Results: Out of 60 patients, 33 were male and 27 were females. Serology by immunochromatography technique was positive in 41 patients. Serology was found to have a sensitivity and specificity of 90.90% and 59.25% respectively. H. pylori was positive in 28 cases on H and E. With a sensitivity and specificity of 84.84% and 100% respectively. H. pylori was positive in 33 cases on modified Giemsa with a sensitivity and specificity of 100%.Conclusions: Simultaneous morphologic and serological detection of H. pylori helps in its complete distribution and identification of its precancerous morphological nature.

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Appropriateness of Referral for Upper Gastrointestinal Endoscopy in a Tertiary Care Hospital

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v14i2.45897 ◽

2020 ◽

Vol 14 (2) ◽

pp. 152-155

Author(s):

Md Mizanur Rahman Khan ◽

Md Abdul Wahab ◽

Md Muaz Yasin ◽

Farzana Zafreen

Keyword(s):

Open Access ◽

Gastrointestinal Endoscopy ◽

Tertiary Care ◽

Armed Forces ◽

Upper Gastrointestinal Endoscopy ◽

Care Hospital ◽

College Hospital ◽

Endoscopic Procedures ◽

Medical College ◽

Upper Gastrointestinal

Introduction: Upper gastrointestinal endoscopy (UGE) allows physicians to directly schedule endoscopic procedures for their patients without prior consultation. Evaluation of appropriateness of endoscopic procedures is associated with costs and beneﬁts. Objectives: To assess the appropriateness of the use of UGE in an open-access setting in Bangladesh. Materials and Methods: This cross-sectional multicenter study was conducted among 300 patients referred for UGE at Dhaka Medical College Hospital and Shaheed Suhrawardi Medical College and Hospital from January 2016 to June 2016. The American Society for Gastrointestinal Endoscopy (ASGE) guidelines was used to assess the appropriateness of referral. The participants were selected by purposive nonprobability sampling and a pre-tested questionnaire was used for data collection. Results: Out of 300 respondents 62.3% was male. History of smoking was more in male and taking NSAIDs were more in the female. In UGE 46.7% revealed normal findings but majority 53.3% had some pathology. About 86% cases, UGE was found appropriate according to ASGE guideline and majority appropriate cases 37.3% were referred by internal medicine specialist. Appropriateness of referral among different physicians was not statistically significant. Conclusion: Appropriateness of referral for UGE performed in tertiary care level hospitals in an open-access setting like Bangladesh was satisfactory. Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 152-155

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Pattern of upper gastrointestinal diseases: an audit of 1000 cases based on endoscopic findings from a tertiary care hospital in Mysore

International Surgery Journal ◽

10.18203/2349-2902.isj20182395 ◽

2018 ◽

Vol 5 (7) ◽

pp. 2412

Author(s):

Shashikumar H. B. ◽

Madhu B. S. ◽

Motati Harshini

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Gastrointestinal Symptoms ◽

Gastrointestinal Diseases ◽

Cross Sectional Study ◽

Common Finding ◽

Care Hospital ◽

Cross Sectional ◽

Endoscopic Findings ◽

Upper Gastrointestinal

Background: Fibreoptic endoscopy is a highly efficient diagnostic tool, which is now increasingly being used in the diagnosis of upper gastrointestinal diseases. This study has been carried out to evaluate the distribution of various upper gastrointestinal diseases based on endoscopic findings in a tertiary care hospital in Mysore.Methods: A cross-sectional study was conducted based on data from endoscopic register of 1000 subjects who underwent endoscopy for various upper gastrointestinal symptoms from 1st January 2017 to 31st December 2017(one year).Results: Mean age of the study population was 50.23 years (SD-15.46). Minimum age was 12 years and maximum was 88 years. About 44.7% of the study subjects belonged to 40-60 age group.61.6% of the study subjects were males. Most common indication was pain abdomen (32.1%) followed by dysphagia (22.2%). Of the 1000 study subjects 18.6% had normal findings. Most common finding was Gastritis / Duodenitis /Gastric erosions (28%). Malignant lesions were noted among 11.1%, of which esophagus and stomach are 5.4% and 4.9% respectively.Conclusions: Endoscopic diagnosis is useful for early detection of UGI diseases and helpful for their management.

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Outcome of Esophageal Variceal Ligation in Cirrhotic Patients: Experience in a Tertiary Care Hospital in Dhaka

BIRDEM Medical Journal ◽

10.3329/birdem.v9i1.39727 ◽

2019 ◽

Vol 9 (1) ◽

pp. 63-69

Author(s):

Shireen Ahmed ◽

Md Nazmul Hoque ◽

Tareq Mahmud Bhuiyan

Keyword(s):

Adverse Events ◽

Esophageal Varices ◽

Gastrointestinal Endoscopy ◽

Upper Gastrointestinal Endoscopy ◽

Care Hospital ◽

Esophageal Variceal ◽

Band Ligation ◽

Esophageal Variceal Ligation ◽

Upper Gastrointestinal

Background: Bleeding from esophageal varices in cirrhosis is an emergency condition. Esophageal varices band ligation has shown better results in terms of variceal obliteration as well as having fewer side effects like ulceration, perforation and stricture formation. Methods: This observational study was conducted at the gastroenterology department of BIRDEM general hospital, from September 2014 to March 2015. Subjects were eligible if they had a diagnosis of cirrhosis based on history, physical examination, biochemical parameters and presence of esophageal varices in upper gastrointestinal endoscopy. All patients were tested to determine the cause of liver cirrhosis. All patients under-went upper gastrointestinal endoscopy after consent. Esophageal variceal ligation was done at appropriate situation and patients were followed up later on. SPSS 23 was used for statistical analysis. Results: The sample size was 69. The cumulative mean age was 55.58±14.462 years (range: 20-90), with gender-based mean age of 54.76±15.704 years for males and 57.22±11.739 years for female. Mild portal hypertensive gastropathy (PHG) was found 31 (44.9%) patient and severe PHG 36 (52.2%). Patients were followed up for mean period of 8.52±3.6 months. Variceal obliteration was achieved in 25 (36.2%) patients, while 06 (8.7%) cases developed re-bleeding during the study period and this type of patients were managed by other modalities or combination therapies. Recurrence of varices occurred in 13 (18.8%). 25 (36.2%) patients reduction of varix size occured after esophageal variceal ligation (EVL), 32 (46.4%) required second session and 12 (17.4%) required more than second session (Table-2). Thirty nine (56.5%) patients experienced minor adverse events like GI discomfort (retrosternal pain or dysphagia), while severe adverse events were noticed in 13 (18.8%) patients. Fundal varix was found among 8 (11.6%) patient on follow up endoscopy and GAVE found in 6 (8.69%) patients. All patient developed PHG during follow up endoscopy. Conclusion: Band ligation eradicates esophageal varices with less complications and a lower re-bleeding rate, but at the same time eradication is associated with more frequent development of PHG and fundal varices. Birdem Med J 2019; 9(1): 63-69

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Spontaneous Bacterial Peritonitis in Cirrhotic Patients Hospitalized in the Tertiary Care Hospital

Gastroenterology ◽

10.1016/s0016-5085(11)63949-8 ◽

2011 ◽

Vol 140 (5) ◽

pp. S-953

Author(s):

Arslan Kahloon ◽

Rodjawan Supakul ◽

Paul Y. Kwo ◽

Raj Vuppalanchi ◽

Marwan Ghabril ◽

...

Keyword(s):

Spontaneous Bacterial Peritonitis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Bacterial Peritonitis ◽

Cirrhotic Patients

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Safety of balanced propofol and midazolam in upper gastrointestinal endoscopy for sedation in cirrhotic patients

Journal of the Pakistan Medical Association ◽

10.47391/jpma.526 ◽

2020 ◽

pp. 1-13

Author(s):

Laima Alam ◽

Mohammad Asif Khattak ◽

Mafaza Alam

Keyword(s):

Gastrointestinal Endoscopy ◽

Recovery Period ◽

Hepatic Clearance ◽

Upper Gastrointestinal Endoscopy ◽

Patient’S Satisfaction ◽

Dose Time ◽

Group I ◽

Significant Difference ◽

Cirrhotic Patients ◽

Upper Gastrointestinal

Abstract Objective: Sedation for upper gastrointestinal endoscopy (UGIE) in patients with cirrhosis is theoretically associated with high incidence of adverse events due to low levels of binding proteins and decreased hepatic clearance of drugs. The objective of the study was to assess the safety of combined propofol and midazolam sedation in cirrhotic patients undergoing UGIE. Methods: A total of 500 patients undergoing UGIE were divided in to two groups in a prospective observational study from Jan 1st 2018 to June 30th 2018. Group (I) consisted of cirrhotic patients who underwent the procedure with sedation and Group (II) consisted of non-cirrhotic patients who opted for sedation. The main outcome measurements included vitals monitoring before, during and after procedure, total sedation dose, time to initial and deep sedation, recovery time and complications. Results: There was no significant difference between sedation safety and rate of complications for the cirrhotic and non-cirrhotic patients except for the recovery period during initial 10 minutes. The Modified Aldrete score for the cirrhotic patients was 9.5±0.5 min as compared to 9.8±0.4 min for non-cirrhotic patients (p<0.001) at 10 minutes. Grade 2 hepatic encephalopathy was seen in 0.8% of the cirrhotic patients who required hospitalization for 24 hours. Also balanced sedation was acceptable by the patients and the endoscopists equally with statistically significant scores on endoscopist’s assessment of co-operation and assessment of patient’s satisfaction scores. Continuous...

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Acute upper gastrointestinal bleeding in a tertiary care hospital in South India - Have we Improved the outcomes?

Tropical gastrology ◽

10.7869/tg.350 ◽

2016 ◽

Vol 37 (3) ◽

Author(s):

Vishnu Prasad NR

Keyword(s):

Gastrointestinal Bleeding ◽

South India ◽

Upper Gastrointestinal Bleeding ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Acute Upper Gastrointestinal Bleeding ◽

Upper Gastrointestinal

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SPECTRUM OF FINDINGS IN PATIENTS PRESENTING FOR UPPER GASTROINTESTINAL ENDOSCOPY AT A TERTIARY CARE HOSPITAL AND THE INFLUENCE OF AGE AND GENDER

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i3.2940 ◽

2021 ◽

Vol 71 (3) ◽

pp. 744-48

Author(s):

Fayyaz Hassan ◽

Khalil Ahmad ◽

Saeed Bin Ayaz ◽

Heyyan Bin Khalil

Keyword(s):

Esophageal Varices ◽

Gastrointestinal Endoscopy ◽

Age Groups ◽

Military Hospital ◽

Upper Gastrointestinal Endoscopy ◽

Care Hospital ◽

Age And Gender ◽

Number Of Patients ◽

And Gender ◽

Upper Gastrointestinal

Objective: To determine the spectrum of findings in patients presenting for upper gastrointestinal (UGI) endoscopy and investigate role of age and gender. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology & Internal Medicine, Combined Military Hospital Kharian, from Jul 2017 to Mar 2019. Methodology: The data regarding 638 consecutive patients who underwent upper gastrointestinal endoscopy in the department were collected from the computer-based database and patients were stratified into two groups according to their age: ≤50 and >50 years. Results: The mean age was 50.2 ± 17.4 (range: 7-100) years. There were 431 males and 207 females. The commonest presenting complaint was decompensated chronic liver disease (CLD) 162 (25.4%). The upper gastrointestinal endoscopy was normal in 306 (48%) and abnormal in 332 (52%) patients. The commonest abnormality seen on upper gastrointestinal endoscopy was esophageal varices seen in 167 (26.2%) followed by non-specific gastropathy, and hiatal hernia seen in 28 (4.4%) and 21 (3.3%) patients respectively. No significant differences were observed among males and females for a positive upper gastrointestinal endoscopy. Significantly large number of patients of age >50 years had an abnormal upper gastrointestinal endoscopy (p<0.001). The commonest upper gastrointestinal endoscopic abnormalities were similar in both genders and age-groups. Conclusion: The commonest finding on upper gastrointestinal endoscopy were esophageal varices and non-specific gastropathies. Females and patients ≤50 years had a higher prevalence of a normal upper gastrointestinal endoscopy. The commonly observed upper gastrointestinal endoscopy findings were generally similar among the genders and the age-groups.

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