scholarly journals A Retrospective Study of Endoscopic Findings in Patients Presenting with Dyspepsia in a Rural Teaching Hospital

2018 ◽  
Vol 1 (2) ◽  
pp. 38-41
Author(s):  
Dhiraj Gurung ◽  
S. Khati
Keyword(s):  
Weight Loss ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Warning Signs ◽  
Rural Setting ◽  
Warning Sign ◽  
Upper Gastrointestinal Endoscopy ◽  
Gastrointestinal Pathology ◽  
Rural Teaching ◽  
Upper Gastrointestinal

Introduction: Dyspepsia is a common problem faced in our country and elsewhere. Benign causes predominate with occasional incidences of carcinoma of the stomach, esophagus. The presence of warning signs helps indicate the presence of such carcinomas though various studies differ as to its usefulness. Methods: Patients presenting with dyspepsia were investigated with a gastroscope to see the etiological pattern seen in the Karnali region and the usefulness of the warning signs. This study included the initial 100 patients undergoing upper gastrointestinal endoscopy for dyspepsia evaluation in our institution. Results: The majority of the patients (53%) showed normal findings on visual examination despite being symptomatic suggestive of functional dyspepsia. The most common warning sign was weight loss which had a positive predictive value of only 4%. Malena was present in 10% of the patients with a positive predictive value of 30%. Conclusions: Significant weight loss as a warning sign to screen patients for gastrointestinal pathology seems unsuitable in the rural setting.  

scholarly journals Warning sign as a predictor of dengue infection severity in children

2018 ◽  
Vol 27 (2) ◽  
Author(s):  
Abdullah S. Adam ◽  
Syahril Pasaribu ◽  
Hendri Wijaya ◽  
Ayodhia P. Pasaribu
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Dengue Infection ◽  
Public Health Problem ◽  
High Sensitivity ◽  
Warning Signs ◽  
Severe Dengue ◽  
Warning Sign ◽  
Diagnostic Study ◽  
Global Public Health

Background: Dengue has emerged as a global public health problem, about 500,000 affected patients of 50–100 million cases will develop severe dengue infection. Therefore, early identification of severe dengue infection symptoms can save a patient’s life. The 2009 WHO dengue infection classification proposed seven warning signs to identify the risk of severe dengue. This study was conducted to predict the severity of dengue infection based on the number of warning signs.Methods: This was a diagnostic study conducted with a retrospective analytic observation of patients admitted to Adam Malik hospital with a diagnosis of dengue infection from January 2014–May 2016. The association between warning signs and severe dengue infection was analyzed using logistic regression. We also analyzed the sensitivity, specificity, positive predictive value and negative predictive value.Results: Of 140 patients who fulfilled the research criteria were collected from the medical records. The patients were classified as severe dengue (n=28) and nonsevere dengue (n =112). The warning signs that were associated with severe dengue were persistent vomiting (p<0.05, OR 31.9, 95%CI), fluid accumulation (p<0.05, OR 22.4, 95%CI), mucosal bleeding (p<0.05, OR 9.1, 95%CI), lethargy (p<0.05, OR 43.1, 95%CI). After analyzing the diagnostic tests, the combination of three or more warning signs showed that sensitivity of 92.9%, specificity of 78.6%, positive predictive value of 52%, negative predictive value of 97.7% was found to be associated with a severe dengue infection.Conclusion: The combination of three or more warning signs showed a high sensitivity and specificity for predicting a severe dengue infection.

scholarly journals CandidaEsophagitis in an Immunocompetent Pregnant Woman

1993 ◽  
Vol 1 (3) ◽  
pp. 149-152 ◽  
Author(s):  
Jeffrey S. Greenspoon ◽  
Seth Kivnick
Keyword(s):  
Human Immunodeficiency Virus ◽  
Weight Loss ◽  
Candida Albicans ◽  
Gastrointestinal Endoscopy ◽  
Epigastric Pain ◽  
Upper Gastrointestinal Endoscopy ◽  
Second Trimester ◽  
Increased Risk ◽  
Immunodeficiency Virus ◽  
Upper Gastrointestinal

Background:Nausea and vomiting are common during the first half of pregnancy and usually require only supportive measures. When symptoms are progressive and weight loss occurs, treatable causes should be sought by means of upper gastrointestinal endoscopy. We report a case of an immunocompetent gravida with invasiveCandida albicansesophagitis.Case:The immunocompetent primigravida developed progressive nausea, vomiting, epigastric pain, and a 4.1 kg weight loss during the second trimester of pregnancy. Treatment with metoclopramide and cimetidine for presumed gastroesophageal reflux was not effective. The patient had normal T-cell CD4 and CD8 subsets and was human immunodeficiency virus (HIV) antibody negative. Upper gastrointestinal endoscopy revealedC. albicansesophagitis which was treated with oral nystatin. The esophagitis had resolved completely when reassessed postpartum. The use of histamine2blockers is associated with an increased risk for fungal esophagitis and may have been a contributing cause in this case.Conclusion:Pregnant patients with persistent nausea, vomiting, and weight loss should be evaluated by endoscopy for fungal esophagitis.

scholarly journals First Video Case Report of Chronic Retrograde Jejunojejunal Intussusception after Subtotal Gastrectomy with Braun’s Anastomosis

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Savaş Bayrak ◽  
Hasan Bektaş ◽  
Necdet Derici ◽  
Ekrem Çakar ◽  
Şükrü Çolak
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Case Report ◽  
Gastrointestinal Endoscopy ◽  
Subtotal Gastrectomy ◽  
Gastric Surgery ◽  
Upper Gastrointestinal Endoscopy ◽  
Video Presentation ◽  
Video Case Report ◽  
Upper Gastrointestinal

Intussusception, which is seen rarely in adults, is defined as the pulling or invagination of a part of the intestine into another segment of the intestine. In this case report we present chronic retrograde jejunojejunal intussusception following gastric surgery with Braun’s anastomosis in adult with video presentation. A 66-year-old woman, who had undergone gastric surgery 39 years ago and cholecystectomy 20 years ago, was admitted to our clinic with the complaints about weight loss, abdominal pain, nausea, and vomiting. Upper gastrointestinal endoscopy (UGISE) was applied, and patient was treated with surgery. This case report indicates that intussusception should be considered in the presence of clinical complaints following gastric surgery, as well as importance of endoscopy in diagnosis.

Accuracy of Radiologic and Endoscopic Diagnosis of Duodenal Ulcer

1988 ◽  
Vol 29 (6) ◽  
pp. 661-664
Author(s):  
T. Gjørup ◽  
E. Agner ◽  
L. Bording Jensen ◽  
K.-M. Møllmann
Keyword(s):  
Duodenal Ulcer ◽  
Diagnostic Criteria ◽  
Predictive Value ◽  
Gastrointestinal Endoscopy ◽  
Clinical Problem ◽  
Upper Gastrointestinal Endoscopy ◽  
Consecutive Series ◽  
Barium Examination ◽  
Upper Gastrointestinal ◽  
Selection Of

On the basis of results of barium examination and upper gastrointestinal endoscopy four diagnostic criteria of duodenal ulcer can be formed: 1) radiography reveals an ulcer, 2) endoscopy reveals an ulcer, 3) both radiography and endoscopy reveal an ulcer, and 4) radiography and/or endoscopy reveals an ulcer. In a consecutive series of 156 patients the accuracy of each of the four diagnostic criteria was determined using the findings of an experienced specialist in upper gastrointestinal endoscopy as a reference. The predictive value of a positive diagnosis (PVpos) for the four diagnostic criteria was 0.63, 0.88, 1, and 0.68, respectively, and the predictive value of a negative diagnosis (PVneg) for all four criteria was around 0.90. The selection of diagnostic criteria should therefore depend on the clinical problem.

Accuracy of Radiologic and Endoscopic Diagnosis of Gastric Ulcer

1987 ◽  
Vol 28 (4) ◽  
pp. 421-423 ◽  
Author(s):  
T. Gjørup ◽  
E. Agner ◽  
L. Bording Jensen ◽  
A. Mørup Jensen ◽  
K.-M. Møllmann
Keyword(s):  
Gastric Ulcer ◽  
Diagnostic Criteria ◽  
Predictive Value ◽  
Gastrointestinal Endoscopy ◽  
Point Of View ◽  
Upper Gastrointestinal Endoscopy ◽  
Contrast Study ◽  
Double Contrast ◽  
Upper Gastrointestinal ◽  
Test Result

Patients with upper abdominal pain are often examined with both double contrast study of the stomach and endoscopy. On the basis of the results of the two examinations four diagnostic criteria of an ulcer can be formed: 1) radiography reveals an ulcer, 2) endoscopy reveals an ulcer, 3) both radiography and endoscopy reveal an ulcer, and 4) radiography and/or endoscopy reveals an ulcer. In a prospective study the accuracy of each of the four diagnostic criteria was examined. Eighty-two randomly selected outpatients had a double contrast barium examination and an upper gastrointestinal endoscopy performed by staff personnel. The diagnosis of a specialist in upper gastrointestinal endoscopy was used as the standard. For the four diagnostic criteria the overall accuracy ranged from 0.80 to 0.88. The predictive value of a positive test result was around 0.70 and the predictive value of a negative test result ranged from 0.81 to 0.96. The specificity ranged from 0.87 to 0.95, and the sensitivity from 0.38 to 0.90. It is concluded that from a clinical point of view, the accuracy of the four diagnostic criteria does not differ to an extent that justifies recommendation of one diagnostic criterion of gastric ulcer rather than the other.

scholarly journals A Rare Cause of Weight Loss in Immunocompetent Subject

2019 ◽  
Vol 10 (02) ◽  
pp. 134-135
Author(s):  
Mukesh Nasa ◽  
Mahesh Gupta ◽  
Shashank Bhansali ◽  
Lipika Lipi ◽  
Rajesh Puri
Keyword(s):  
Weight Loss ◽  
Gastrointestinal Endoscopy ◽  
Indian Subcontinent ◽  
Strongyloides Stercoralis ◽  
Duodenal Biopsy ◽  
Upper Gastrointestinal Endoscopy ◽  
Unexplained Weight Loss ◽  
Upper Gastrointestinal ◽  
Routine Investigations

AbstractWe report a case of 61-year-old immunocompetent man with no comorbidity presenting with unexplained weight loss. All routine investigations could not point to the etiology of weight loss, but duodenal biopsy taken on upper gastrointestinal endoscopy revealed larvae of Strongyloides stercoralis, a nematode endemic to Indian subcontinent. The patient recovered after course of albendazole, and in the absence of other causality, weight loss was attributed to strongyloidiasis.

scholarly journals Performance of RoutineHelicobacter pyloriInvasive Tests in Patients with Dyspepsia

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Hsi-Chang Lee ◽  
Ting-Chang Huang ◽  
Chin-Lin Lin ◽  
Kuan-Yang Chen ◽  
Chung-Kwe Wang ◽  
...  
Keyword(s):  
Predictive Value ◽  
Gastrointestinal Endoscopy ◽  
Positive Culture ◽  
Upper Gastrointestinal Endoscopy ◽  
Rapid Urease Test ◽  
Urease Test ◽  
H Pylori ◽  
Sensitivity Specificity ◽  
Upper Gastrointestinal ◽  
Antral Biopsy

Background. This study was designed to compare the accuracy of three different invasive methods for the detection ofHelicobacter pylori (H. pylori)infection in patients with dyspepsia. These tests included culture, histology, and the rapid urease test (CLO test).Methods.H. pyloriinfection was diagnosed prospectively in 246 untreated dyspeptic patients who underwent upper gastrointestinal endoscopy. The gold standard forH. pyloriinfection was based on a positive culture or both a positive histological examination and a CLO test.Results.H. pyloriwas diagnosed in 33.3% of the patients. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were as follows: histology from the antrum (95.12; 95.12; 90.7; 97.5; 95.12%); histology from the antrum and corpus (95.12; 95.12; 90.7; 97.5; 95.12%); histology from the corpus (76.83; 96.95; 92.65; 89.33; 90.24%); culture (91.46; 100; 100; 95.91; 97.15%); a CLO test from the antrum and corpus (85.59; 100; 100; 93.71; 95.52%); a CLO test from the antrum (64.63; 100; 100; 84.97; 88.21%); a CLO test from the corpus (69.51; 100; 100; 96.77; 89.83%), respectively.Conclusions. Antral biopsy histology and culture are the best methods for the diagnosis ofH. pyloriinfection in our cohort of patients with dyspepsia.

scholarly journals Diet-Induced Alteration of Microbiota and Development of Obesity, Nonalcoholic Fatty Liver Disease, and Diabetes: Study Protocol of a Prospective Study (Preprint)

2018 ◽  
Author(s):  
Martine Uittenbogaart ◽  
Wouter KG Leclercq ◽  
Danielle Bonouvrie ◽  
Marleen M Romeijn ◽  
Arijan APM Luijten ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gut Microbiota ◽  
Fatty Liver Disease ◽  
Gastrointestinal Endoscopy ◽  
Paneth Cell ◽  
Upper Gastrointestinal Endoscopy ◽  
Microbiota Composition ◽  
Nonalcoholic Fatty Liver ◽  
Upper Gastrointestinal ◽  
Gut Microbiota Composition

BACKGROUND Development of obesity and obesity-related diseases, such as type 2 diabetes mellitus and nonalcoholic fatty liver disease (NAFLD), is associated with altered gut microbiota composition. The aim of this study is to investigate associations among dietary compounds, intestinal cell function, and gut microbiota composition. We hypothesize that dietary lipid intake is associated with Paneth cell and goblet cell properties that affect gut microbiota composition. OBJECTIVE The primary objective of this study is to determine whether a difference in dietary intake is associated with a difference in intestinal mucin-2 expression and gut microbiota composition. METHODS This is a single-center prospective study, including 1 obese group undergoing laparoscopic Roux-en-y gastric bypass and 2 lean control groups undergoing either laparoscopic cholecystectomy or upper gastrointestinal endoscopy (n=228). During laparoscopy, biopsies will be taken of visceral fat (omentum majus), liver, muscle tissue of the abdominal wall, and subcutaneous fat. In the obese group, a small segment of the jejunum will be collected for analysis, which will be compared with an endoscopically derived jejunal biopsy from the upper gastrointestinal endoscopy control group. Stool samples for microbiota profiling will be collected at baseline and 1 year after surgery. Primary outcomes are fecal microbiota composition and mucus characteristics. Secondary outcomes include Paneth cell phenotype, body weight, diet composition, glucose tolerance, resolution of comorbidities, and weight loss 1 year after surgery. RESULTS This trial is currently open for recruitment. The anticipated completion date is December 2019. CONCLUSIONS The Diet-Induced Alteration of Microbiota and Development of Obesity, NAFLD, and Diabetes study will improve insight into the pathophysiology of obesity and its associated metabolic disorders. Better understanding of weight loss failure and weight regain following bariatric surgery might also behold new therapeutic opportunities for obesity and obesity-related comorbidities. CLINICALTRIAL Netherlands Trial Register NTR5660; https://www.trialregister.nl/trial/5540 (Archived by WebCite at http://www.webcitation.org/78l7jOZre) INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11553

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