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Comparison Between Seromarkers and Transient Elastography for Assessment of Significant Liver Fibrosis in NAFLD Patients
Md. Nuruzzaman,
Sanjoy Kumar Saha,
Mohammad Ashaduzzaman,
Mohammed Obayedur Rahman,
Amitav Saha,
Sajalendu Biswas,
Touhidul Karim Majumder,
Faruque Ahmed,
Nadia Farha,
Dr. Suparna Pramanik
Issue:
Volume 6, Issue 1, June 2022
Pages:
1-4
Received:
20 December 2021
Accepted:
19 January 2022
Published:
9 February 2022
DOI:
10.11648/j.ijg.20220601.11
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Abstract: Background: Transient elastography is very sensitive noninvasive tool to assess liver fibrosis in NAFLD patients. But it is costly and not widely available There are also seromarkers (APRI & FBI4) for ruling out significant liver fibrosis. This study intends to compare between seromakers & transient elastography result for assessment of significant liver fibrosis (SF) in NAFDL patients. Methods: This was an observational cross sectional study done in Sheikh Russel National Gastroliver Institute & Hospital from April 2019 to December 2019. A total 111 patients were selected by purposive sampling method. Demographic, clinical and biochemical data were collected. Liver fibrosis was assessed by transient elastography. Aspertate transaminase (ASI) to platelet ratio index (APRI) & FIB-4 score were compared among the non-significant fibrosis (F2-F4) patients. Result: The total number of study population was 111, among them 39 (35.3%) had significant liver fibrosis (Kpa>7.2; F0 to F1). There was significant difference in between SF & non SF groups in terms of mean serum ALT, AST, albumin and platelet count. APRT and FIB-4 were significantly higher in SF group. APRI had better accuracy (area under the receiver operating characteristics curve=0.925) than FIB-4) 0.885) in ruling out SF. Conclusion: Seromarkers are comparable to transient elastography in assessment of significant liver fibrosis in NAFLD patients. Among them APRI is more accurate in determining significant fibrosis.
Abstract: Background: Transient elastography is very sensitive noninvasive tool to assess liver fibrosis in NAFLD patients. But it is costly and not widely available There are also seromarkers (APRI & FBI4) for ruling out significant liver fibrosis. This study intends to compare between seromakers & transient elastography result for assessment of significant...
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A Novel J-Maneuver Withdrawal Method During Gastroscopy to Dilate the Benign Distal Esophageal Stenosis
Putut Bayupurnama,
Neneng Ratnasari,
Catharina Triwikatmani,
Fahmi Indrarti,
Sutanto Maduseno
Issue:
Volume 6, Issue 1, June 2022
Pages:
5-8
Received:
28 February 2022
Accepted:
24 March 2022
Published:
31 March 2022
DOI:
10.11648/j.ijg.20220601.12
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Abstract: Background: Bouginage and pneumatic dilation are the first treatments for benign esophageal stenosis or stricture. Aim of the study was to develop the simpler method to treat the benign distal esophageal stenosis. Methods: Five benign distal esophageal stenosis cases were included in the study. A standard videogastroscope was inserted into the gastric antrum of the patient and then the gastroscope tip was deflected 210° and rotated it until the gastroscope tip adhered to the gastric minor curvature in the mid of the corpus above the angular incisure. While retained that position, the gastroscope was withdrew slowly until the endoscopist felt the resistant of the minor curvature gastric wall and the scope could not be withdrew anymore, however the withdrawal process was continued for a few more milimeters and kept that position for a few seconds. This maneuver dilated the distal esophageal stenosis. Results: All benign distal esophageal stenosis patients (case 1: female, 49 years old; case 2: male, 75 years old; case 3: female, 72 years old; case 4: female, 32 years old; case 5: male 55 years old) were successfully dilated. Three patients (case 1, 2, and 3) have been 7 months after first dilation without further deglutition problem. Case 4 was relapsed after 6 months and redilated successfully. Case 5 has been 4 months observation period after first dilation and without any deglutition problem. Conclusion: J-maneuver withdrawal method during gastroscopy looked promising method to dilate benign distal esophageal stenosis, which can be performed by basic endoscopists. Further studies are needed to determine to what extent this method can treat distal esophageal stenosis.
Abstract: Background: Bouginage and pneumatic dilation are the first treatments for benign esophageal stenosis or stricture. Aim of the study was to develop the simpler method to treat the benign distal esophageal stenosis. Methods: Five benign distal esophageal stenosis cases were included in the study. A standard videogastroscope was inserted into the gast...
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DKK1 Promoter Methylation in Colorectal Cancer Is Associated with CIMP and Elevation of MYC Expression
Mie Yoshimura,
Kazuo Tamura,
Tomoki Yamano,
Nagahide Matsubara,
Akihito Babaya,
Michiko Yasuhara,
Aya Yano,
Miki Fukumoto,
Norihito Kawashita,
Junko Tatsumi-Miyajima,
Naohiro Tomita
Issue:
Volume 6, Issue 1, June 2022
Pages:
9-17
Received:
11 April 2022
Accepted:
3 May 2022
Published:
12 May 2022
DOI:
10.11648/j.ijg.20220601.13
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Abstract: Background: Carcinogenesis of colorectal cancer (CRC) is influenced greatly by the canonical WNT signaling pathway. Genetically, the secreted protein Dickkopf (Dkk) family is known as an antagonist to the WNT. To clarify the role of DKK1 in the WNT signaling pathway in the colorectal carcinogenesis, we examined the DKK1 promoter methylation in CRC and analyze the relationship of expression level of DKK1 and MYC in relation with APC gene abnormalities. Methods: We integrated clinico-pathological and molecular findings of 41 cases of CRC. We adopted methylation-specific PCR, DNA sequencing, allelic loss analysis, quantitative RT-PCR, and MSI testing for genetic analyses. Results: CRCs with DKK1 promotor methylation were found in 10 cases (24.4%), which were located predominantly in the proximal colon and frequently showed findings of poorly differentiated adenocarcinoma or mucinous adenocarcinoma. Furthermore, colorectal cancers with DKK1 promotor methylation showed characteristics of microsatellite instability (MSI)-high (70%) and a BRAF mutation (40%), which are known as the CpG island methylator phenotype (CIMP). In the DKK1 promotor methylation group, the relative expression level of DKK1 mRNA was significantly reduced in comparison to the DKK1 promotor un-methylation group (p < 0.05). When excluding the impact of APC abnormality, MYC expression in the DKK1 promotor methylation group was significantly elevated compared to that in the DKK1 promotor un-methylation group (p < 0.05). Conclusions: It is suggested that DKK1 is one of the regulators involved in MYC expression through the WNT signaling pathway and may have a negative effect on carcinogenesis of the colorectum without APC abnormalities.
Abstract: Background: Carcinogenesis of colorectal cancer (CRC) is influenced greatly by the canonical WNT signaling pathway. Genetically, the secreted protein Dickkopf (Dkk) family is known as an antagonist to the WNT. To clarify the role of DKK1 in the WNT signaling pathway in the colorectal carcinogenesis, we examined the DKK1 promoter methylation in CRC ...
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A Rare Case of Isolated Duodenal Crohn’s Disease
Mohammed Ali,
Hind Awad,
Maurice Murphy,
Ashraf Morcos
Issue:
Volume 6, Issue 1, June 2022
Pages:
18-21
Received:
30 March 2022
Accepted:
21 April 2022
Published:
24 May 2022
DOI:
10.11648/j.ijg.20220601.14
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Abstract: Crohn’s disease (CD) is an inflammatory bowel disease that is characterized by segmental and transmural involvement of any portion of the gastrointestinal tract from the mouth to the anus. However, isolated duodenal involvement is rather extremely rare and diagnosis requires comprehensive clinical evaluation. Herein we present the case of a 55 –year lady who was referred to the gastroenterology team with a working diagnosis of possible malignant gastric outlet obstruction. The lady had no background medical or surgical history apart from being investigated for iron deficiency anemia years back by having gastroscopy and colonoscopy which were not significant. Her son was known to have Crohn’s disease. She was originally admitted to hospital with a history of upper abdominal pain, early satiety and weight loss. There were no bowel symptoms. Apart from iron deficiency anemia, her blood investigations were normal. The CT abdomen and pelvis showed duodenal wall thickening with a stricture but otherwise normal, including normal bowels. She had repeated gastroscopy, dilatation and sampling of the stricture site. The first two samples showed non-specific duodenitis. The diagnosis of isolated duodenal Crohn’s disease was made based on the samples from the third gastroduodenoscopy procedure which showed non-caseating granuloma. She had normal ileocolonoscopy and biopsies. Her fecal calprotectin was 230 micrograms per milligram (50-200). Based on the above findings she was put on a course of steroids and started on a standard dose of Infliximab infusion following negative surveillance to rule out latent Tuberculosis and to exclude other viruses as per protocol. The patient made marked clinical, endoscopic and histological response thereafter. This case emphasizes the challenge of diagnosing duodenal Crohn’s disease which, as above, might require high index of clinical suspicion and repeated sampling. We expect that this case report adds to the existing literature on this subject.
Abstract: Crohn’s disease (CD) is an inflammatory bowel disease that is characterized by segmental and transmural involvement of any portion of the gastrointestinal tract from the mouth to the anus. However, isolated duodenal involvement is rather extremely rare and diagnosis requires comprehensive clinical evaluation. Herein we present the case of a 55 –yea...
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