scholarly journals Clinical and endoscopic profile of patients with Mallory- Weiss tears

2017 ◽  
Vol 8 (6) ◽  
pp. 19-23
Author(s):  
Subash Bhattarai ◽  
Khus Raj Dewan ◽  
Gaurav Shrestha ◽  
Bhanumati Saikia Patowary
Keyword(s):  
Blood Transfusion ◽  
Clinical Presentation ◽  
Morbid Condition ◽  
Medical Sciences ◽  
Excessive Alcohol Consumption ◽  
Average Hospital ◽  
Endoscopic Findings ◽  
Haemodynamic Stability ◽  
History Of ◽  
Excessive Alcohol

Background: Mallory-Weiss tear is mainly located across the gastro-esophageal mucosal junction and presents with upper gastro-intestinal bleed of less severity. Haemorrhage frequently ceases spontaneously.Aims and Objective: This study was undertaken to establish the incidence, clinical and endoscopic profile of patients with Mallory- Weiss tear.Materials and Methods: Six hundred patients presenting with acute upper gastro-intestinal (UGI) bleed were included in the study. All patients underwent UGI endoscopy after achieving haemodynamic stability, usually within 24 hours. Cases with Mallory Weiss tear were identified and their clinical presentation, endoscopic findings, outcomes during hospitalization including rebleeding and mortality were studied.Results: Twenty eight (4.6%) patients out of six hundred acute upper gastro-intestinal bleed were diagnosed with Mallory-Weiss tear. Fourteen (50%) patients gave history of prior vomiting or preceeding retching. Only two patients (7.1%) presented with shock. The most common co-morbid condition was excessive alcohol consumption. Eighteen (64.3%) patients had no active bleeding during UGI endoscopy. All patients except four presented with a single tear with mean length of two cms. Blood transfusion was needed in eight (28.6%) patients only. Only one patient had re-bleeding. Average hospital admission was three days. No mortality was recorded in 7 days and 28 days of follow ups.Conclusions: Mallory-Weiss tear is not an uncommon cause of UGI bleeding nowadays and its incidence is rising every year. Hemorrhage frequently ceases spontaneously and conservative management is sufficient in many instances. When endoscopic findings reveal active haemorrhage, various endoscopic hemostatic techniques can be used.Asian Journal of Medical Sciences Vol.8(6) 2017 19-23

Characteristics, management and outcomes of patients with hepatocarcinoma in a low-income country.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16166-e16166
Author(s):  
Jennifer Dominguez ◽  
Bonnie Macario ◽  
Rixci Ramirez ◽  
Mario Daniel Castro
Keyword(s):  
Alcohol Consumption ◽  
Liver Cancer ◽  
Low Income ◽  
Cox Regression ◽  
Target Therapy ◽  
Income Country ◽  
Rank Test ◽  
Excessive Alcohol Consumption ◽  
History Of ◽  
Excessive Alcohol

e16166 Background: Worldwide, every year, there are nearly 905,000 patients diagnosed with liver cancer; it is the sixth most common malignancy and the third most lethal malignancy. Almost three quarters of new patients live in areas with low and medium-income country. Guatemala has the highest mortality and incidence of liver cancer. Objectives: Describe the clinical characteristics, main risk factors, treatment and outcomes of patients with hepatocarcinoma (HCC) in Guatemala. Methods: A retrospective review was performed among patients with HCC from January 2002 to December 2019 in the Instituto Guatemalteco de Seguridad Social (IGSS). Kaplan Meier curves, Cox regression and log-rank test were used to calculate overall survival (OS) and mortality. Results: 140 patients with HCC were analyzed, 114 women and 26 men with a median age of 60 years (20 - 99), 102 patients (73%) have history of excessive alcohol consumption and 11 (8%) has history of chronic hepatitis B or C virus infection. All of the patients have liver cirrhosis, Child-Pugh A 100 patients (71%), B 34 (24%) and C 6 (5%). 10 patients (7%) have HCC BCLC A, 0 (0%) BCLC B, 121 (81%) BCLC C and 9 (6%) BCLC D. All patients with HCC BCLC A received surgical treatment with a median OS of 123 months (95% CI 89 - 156 p < 0.001). 122 patients (89%) received target therapy with Sorafenib with a median OS of 17 months (95% CI 12 - 21 p < 0.001) and 8 patients (6%) underwent to chemoembolization with a median OS of 32 months (95% CI 12 - 52 p < 0.001). At this time, 111 patients (79%) died from the disease, 11 (8%) are alive with the disease and 8 (6%) are alive without disease. Conclusions: The most frequent risk factor for HCC is the excessive alcohol consumption, survival of patients with HCC are associated with treatment at the beginning of the disease.

scholarly journals Alcoholic Cirrhosis with Zinc and Copper Co-Deficiency

2019 ◽  
Vol 2 (1-3) ◽  
pp. 8-15
Author(s):  
Chanita Unhapipatpong ◽  
Daruneewan Warodomwichit ◽  
Kumutnart Chanprapaph
Keyword(s):  
Alcohol Consumption ◽  
Zinc Deficiency ◽  
Copper Deficiency ◽  
Zinc Supplementation ◽  
Alcoholic Cirrhosis ◽  
Oral Antibiotics ◽  
Excessive Alcohol Consumption ◽  
History Of ◽  
Excessive Alcohol

A 54-year-old Thai female with known alcoholic cirrhosis presented with chronic scaly eczematous patches and plaque for over 1 month. Initially, she was treated with oral antibiotics, but the lesions did not improve. The dermatologic examination and history of alcoholic cirrhosis were compatible with zinc deficiency. Moreover, copper deficiency was found together with zinc deficiency. Excessive alcohol consumption can cause zinc and copper co-deficiency. To avoid aggravated copper deficiency after zinc supplementation, copper and zinc were supplemented together in appropriate proportions. On the 2-week follow-up examination, her clinical outcome improved.

scholarly journals Murine Models of Nonalcoholic Fatty Liver Disease and Steatohepatitis

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Masashi Ninomiya ◽  
Yasuteru Kondo ◽  
Tooru Shimosegawa
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Fatty Liver Disease ◽  
Alcoholic Hepatitis ◽  
Murine Models ◽  
Excessive Alcohol Consumption ◽  
Nonalcoholic Fatty Liver ◽  
History Of ◽  
Excessive Alcohol ◽  
Multiple Hit

In 1980, Ludwig et al. first reported patients of steatohepatitis who lacked a history of excessive alcohol consumption but showed liver histology resembling alcoholic hepatitis and progression to cirrhosis of the liver accompanied by inflammation and fibrosis. The development of nonalcoholic steatohepatitis (NASH) is associated with obesity, diabetes mellitus, insulin resistance, and hyperlipidemia. However, the pathogenesis of NASH remains incomplete. A “multiple-hit” hypothesis for the pathogenesis of NASH based on an animal model has been proposed and remains a foundation for research in this field. We review the important dietary and genetic animal models and discuss the pathogenesis of NASH.

scholarly journals A Clinical Study of Ectopic Pregnancies in a Tertiary Care Hospital of Chittagong, Bangladesh

2014 ◽  
Vol 13 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Most. Sabina Yeasmin ◽  
M Jalal Uddin ◽  
Enamul Hasan
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
Clinical Presentation ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
History Of

Background: Motherhood, an eternal, universal and inherent dream which every woman has. This dream may not always be pleasant and it can involve nightmares. One of this is ectopic pregnancy: A pregnancy which can be life threatening. Aims : 1. To know the age group, parity, gestational age and the risk factors with re-spect to the ectopic pregnancy. 2. To know the clinical presentation of the ectopic pregnancy. 3. To know the treatment and morbidity and mortality associated with ectopic pregnancy.Materials & methods : A total of 47 admitted patients who were di-agnosed as ectopic pregnancy cases were retrospective analyzed between the periods from January 2013 to June 2014 at Chattagram Maa-O-Shishu Hospital Medical College, Agrabad, Chittagong. The following parameters: age, parity, gestational age, risk factors, clinical presentation, need for blood transfusion and findings on ultrasonogram and at surgery and morbidity associated with ectopic pregnancy were noted.Results: The incidence of the ectopic pregnancy in the pres-ent study was 7.4/1000 deliveries. A majority of the cases were multigravidas and majority of the cases gestational age were six to ten weeks. In most of the cases, there were no identifiable risk factors. The commonest risk factors present were history of MR (12.7 %)and abortion (10.6), history of tubal surgery (2.2%), infertility (2.2%) and pelvic inflammatory diseases (4.2%).The commonest symptoms were abdominal pain (89.3%), amenorrhea (78.7%) and abnormal vaginal bleeding (63.5%); and commonest signs were abdominal tenderness (70.5%), cervical excitation (52.6%) and adnexal tenderness (50.4%). Almost half (45%) were in a state of shock at admission. Ultrasound, a urine pregnancy test and serum B-hCG were the investigative modalities which were used. Surgery by open method in the form of salpingectomy (92.3%), salpingo-oophorectomy (5.5%) and salpingostomy (2.1%) were the mainstay of management. Morbidity included anemia (50.9%), blood transfusion (78%) and wound infection (2.1%). No maternal mortality noted.Conclusion: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.20993  

scholarly journals Collagenous Gastritis: An Unusual Presentation With Tubular Shaped Stomach

2020 ◽  
Vol 8 ◽  
pp. 232470962094469
Author(s):  
Nathaly Cortez ◽  
Manuel Berzosa ◽  
Adam Jacobs ◽  
Michael Bloom
Keyword(s):  
Weight Loss ◽  
Gastric Mucosa ◽  
Clinical Presentation ◽  
Case Reports ◽  
Collagen Deposition ◽  
Unique Case ◽  
Mucosal Atrophy ◽  
Endoscopic Findings ◽  
History Of ◽  
Collagenous Gastritis

Collagenous gastritis is a rare histopathologic entity that causes marked subepithelial collagen deposition in the gastric mucosa. Clinical presentation is diverse, considering only less than 100 cases have been reported. However, we report a unique case of isolated collagenous gastritis in a 71-year-old female who presented with a 6-month history of dyspepsia and 27 kg weight loss. Her endoscopic findings revealed a tubular shaped stomach with diffuse gastric mucosal atrophy, findings that differ with previous case reports of a cobblestone pattern. Treatment remains unclear.

scholarly journals Animals Models of Gastrointestinal and Liver Diseases. Animal models of alcohol-induced liver disease: pathophysiology, translational relevance, and challenges

2014 ◽  
Vol 306 (10) ◽  
pp. G819-G823 ◽  
Author(s):  
Stephanie Mathews ◽  
Mingjiang Xu ◽  
Hua Wang ◽  
Adeline Bertola ◽  
Bin Gao
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Neutrophil Infiltration ◽  
Alcoholic Liver Injury ◽  
Drinking Patterns ◽  
Excessive Alcohol Consumption ◽  
Ethanol Feeding ◽  
History Of ◽  
Excessive Alcohol ◽  
Binge Ethanol

Over the last four decades, chronic ethanol feeding studies in rodents using either ad libitum feeding or intragastric infusion models have significantly enhanced our understanding of the pathogenesis of alcoholic liver disease (ALD). Recently, we developed a chronic plus binge alcohol feeding model in mice that is similar to the drinking patterns of many alcoholic hepatitis patients: a history of chronic drinking and recent excessive alcohol consumption. Chronic+binge ethanol feeding synergistically induced steatosis, liver injury, and neutrophil infiltration in mice, which may be useful for the study of early alcoholic liver injury and inflammation. Using this chronic+binge model, researchers have begun to identify novel mechanisms that participate in the pathogenesis of alcoholic liver injury, thereby revealing novel therapeutic targets. In this review article, we briefly discuss several mouse models of ALD with a focus on the chronic+binge ethanol feeding model.

scholarly journals VIRAL MARKERS

2018 ◽  
Vol 25 (06) ◽  
pp. 903-907
Author(s):  
Mohammad Alam
Keyword(s):  
Risk Factors ◽  
Informed Consent ◽  
Blood Transfusion ◽  
Surgical Procedure ◽  
Descriptive Study ◽  
Medical Sciences ◽  
Ocular Surgery ◽  
History Of ◽  
Medical University ◽  
Barber Shops

Objectives: To know the prevalence and predisposing risk factors of HBVand HCV in patients undergoing ocular surgery. Study Design: Descriptive study. Setting:Department of Ophthalmology Khyber Medical University Institute of Medical Sciences / K.D.ATeaching Hospital Kohat. Period: January 2015 to December 2016. Materials and Methods: Alladmitted patients in eye ward for surgery. Informed consent was taken from patients. Detailedhistory including surgical, medical treatment, blood transfusion and other relevant was taken. Allthose patients who were not previously diagnosed as HBV and HCV positive were included in thestudy. ICT method was used for screening. Those who were positive with ICT were confirmed byEliza test. Eliza negative patients were excluded. During these two years total 2547 patients withmean age of 63.4 years were admitted in eye ward. Results: By ICT method 43(1.68%) patientswere HBC positive in which 24(55.81%) were male and19(44.18%) were female. 121(4.75%)patients were HCV positive, out of them 44(36.36%) were male and 77(63.63%) were female.All positive patients were confirmed by ELIZA test. Regarding predisposing risk factors. in HBVpositive, 13(30.23%) patients had history of major surgical procedure, 9(20.93%) patients haddental extraction, 6(13.95%) had blood transfusion, 6(13. 95%) had quackery injection with nondisposable syringes, 2(4.65%) patients had routine face and armpit shave in barber shops andno significant history in 7(16.27%) patients. In HCV positive, 29(23.96%) patients had history ofmajor surgical procedure, 22(18.18%) patients had blood transfusion, 18(14.87%) patients haddental extraction, 16 (13.22%) patients had history of injection by quack using non disposablesyringe, 13(10.74%)had routine face and armpit shave in barber shops and 23(19.00%) patientshad no significant history. Conclusion: HBV and HCV are common among community. HCV ismore prevalent as compared to HBV. Every patient should be screened before surgery.

scholarly journals Risk factors and clinical features of recurrent stroke in the Tyva Republic

2014 ◽  
Vol 95 (2) ◽  
pp. 199-202
Author(s):  
Kh D Mongush ◽  
A B Ondar ◽  
R Ch Chylbak-ool ◽  
M B Balchir ◽  
Ch O Mongush
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Alcohol Consumption ◽  
Arterial Hypertension ◽  
Recurrent Stroke ◽  
Excessive Alcohol Consumption ◽  
Stroke Group ◽  
History Of ◽  
Excessive Alcohol ◽  
Male Patients

Aim. To determine risk factors and clinical features of the recurrent stroke. Methods. A prospective 3-year cohort study was conducted including 120 patients with stroke admitted to the neurological department of the Republican Hospital №1 of Kyzyl at 2010-2012, 60 of whom had recurrent stroke (group 1), and 60 had primary stroke (group 2). Results. Recurrent stroke was by 16.66% more common in men. The mean age of males having recurrent stroke was younger compared to females (р 0.05). Patients with family history of arterial hypertension in closest relatives were significantly more prevalent among those with recurrent stroke (70 versus 35%, p 0.05). The rate of excessive alcohol consumption was also significantly higher in patients with recurrent stroke (18.33 versus 6.67%, p 0.05). Mortality associated with the recurrent stroke was higher in males of all age groups, difference was statistically significant in male patients over 70 years of age (p 0.05). Combined first 28-day mortality was 26.67% (32 cases), and was higher in patients with primary stroke (p 0.05). Only 21.67% of patients took antihypertensives regularly prior to the primary stroke, among patients with recurrent stroke this share reached 70%. Antiplatelet drugs were taken by 5% of patients prior to the primary stroke, in patients who suffered the stroke the share was higher and reached 53.33%. Conclusion. Family history of arterial hypertension was the most important risk factor for recurrent stroke. Male patients had higher risks of recurrent stroke and fatal outcome, which may be associated with lower drug compliance (including antiplatelet drugs and anticoagulants, antihypertensives) and higher exposure to other risk factors (smoking, excessive alcohol consumption).

scholarly journals Hirschsprung’s disease presenting as intractable anemia: a report of two cases and review of the literature

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaoang Sun ◽  
Jun Chu ◽  
Chenchen Li ◽  
Zhaohui Deng
Keyword(s):  
Blood Transfusion ◽  
Iron Supplementation ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Clinical Presentation ◽  
Poor Response ◽  
Hemoglobin Level ◽  
Oral Iron ◽  
History Of ◽  
Medical Histories

Abstract Background This report summarizes the clinical characteristics of intractable anemia as part of the clinical presentation of Hirschsprung’s disease (HD) and aims to strengthen clinicians’ ability to recognize early signs of HD. Case presentation An 11-year-old boy with a 6-year history of intractable anemia, low hemoglobin level (55 g/L), poor response to oral iron supplementation and blood transfusion, and difficulty with defecation was diagnosed with HD. A 19-month-old boy with a 3-month history of intractable anemia, low hemoglobin level (64 g/L), poor response to oral iron supplementation and blood transfusion, delayed meconium passage, and history of intestinal obstruction was also diagnosed with HD. Both patients underwent surgery, after which anemia was corrected effectively in both cases. Two more cases of intractable anemia as the chief complaint and diagnoses of HD over different durations since the onset of anemia (ranging from 1.7 years to 21 years) were identified in a literature search. Both patients underwent surgery, after which anemia was corrected. Conclusions Intractable anemia as part of the clinical presentation of HD is extremely rare. Detailed inquiries of medical histories and physical examinations are key to early diagnoses and preventing misdiagnoses. Anemia in HD patients may primarily be caused by impaired iron absorption due to HD.

scholarly journals An Autopsy Case of Edwardsiella tarda Meningoencephalitis

2018 ◽  
Vol 10 (2) ◽  
pp. 252-260
Author(s):  
Takahiro Makino ◽  
Isamu Sugano ◽  
Ikuo Kamitsukasa
Keyword(s):  
Treatment Initiation ◽  
Edwardsiella Tarda ◽  
Altered Consciousness ◽  
Rare Presentation ◽  
Excessive Alcohol Consumption ◽  
Alcoholic Fatty Liver ◽  
Prompt Treatment ◽  
History Of ◽  
Excessive Alcohol ◽  
Poor Outcomes

A 62-year-old male with a history of alcohol abuse was admitted with a headache and rapidly progressing altered consciousness that led to coma over several hours. Blood and cerebrospinal fluid cultures were positive for Edwardsiella tarda. Despite prompt treatment initiation, the patient died on the third hospital day. Autopsy showed meningitis of the entire cerebrum with ventriculitis, and alcoholic fatty liver was observed. Clinicians should be cognizant of E. tarda meningoencephalitis, a rare presentation which can be associated with poor outcomes in patients with excessive alcohol consumption and alcoholic liver disease.

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