Publications by authors named "Ali Nawras"
Debridement of infected walled-off pancreatic necrosis is indicated to treat and prevent sepsis-related multiorgan failure. The aim of this study was to evaluate the efficacy and safety of the EndoRotor-powered endoscopic debridement system to remove solid debris under direct endoscopic visualization. Search strategies were developed for PubMed, EMBASE, and Cochrane Library databases from inception to June 2022, in accordance with Preferred Reporting items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines.
View Article and Find Full Text PDFThe altered anatomy in Roux-en-Y gastric bypass (RYGB) makes conventional endoscopic retrograde cholangiopancreatography (ERCP) a technically challenging procedure. EUS-directed transgastric ERCP (EDGE) and laparoscopic-assisted ERCP (LA-ERCP) are alternative modalities used with comparable efficacy and adverse events in such patients. We conducted a meta-analysis comparing EDGE and LA-ERCP to assess the efficacy and safety in patients with RYGB.
View Article and Find Full Text PDFIntroduction: Multiple pharmacological interventions have been studied for managing eosinophilic esophagitis (EoE). We performed a comprehensive systematic review and network meta-analysis of all available randomized controlled trials (RCT) to assess the efficacy and safety of these interventions in EoE in adults and children.
Methods: We performed a comprehensive review of Embase, PubMed, MEDLINE OVID, Cochrane CENTRAL, and Web of Science through May 10, 2023.
Background/aims: Transjugular intrahepatic portosystemic shunt (TIPS) is a commonly performed procedure in patients with liver cirrhosis to treat portal hypertension-related conditions, including variceal bleeding and refractory ascites. However, while the increased risk of hepatic encephalopathy (HE) after TIPS is important to consider when determining whether a patient is a good candidate for TIPS, currently there is no widely used method to predict the development of post-TIPS HE, although the model for end-stage liver disease (MELD) score is used to predict post-TIPS mortality. We conducted a systematic review and meta-analysis to evaluate sarcopenia as a risk factor for HE and mortality in patients undergoing TIPS.
View Article and Find Full Text PDFBackground: Endoscopic mucosal resection is a frequently employed method for removing colonic polyps. Nonetheless, the recurrence of these polyps over a healed submucosal base can complicate the extraction of leftover lesions through standard procedures. EndoRotor, a non-thermal device specifically designed for endoscopic mucosal resection, has recently been assessed for its utility in removing colonic polyps, non-dysplastic Barrett's esophagus, and pancreatic necrosis.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the trend of upper gastrointestinal bleeding (UGIB) mortality rates in the U.S. before and during the COVID-19 pandemic.
- Researchers analyzed deidentified data from the CDC to estimate age-standardized mortality rates and used linear regression to project mortality rates for 2021 based on trends from 2012 to 2019.
- Findings indicate that UGIB mortality rates significantly increased from 3.3 to 4.3 per 100,000 between 2012 and 2021, suggesting that the COVID-19 pandemic may have influenced UGIB-related deaths.
Background: Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiological gastrostomy (PRG) are commonly utilized to establish access to enteral nutrition. However, data comparing the outcomes of PEG vs. PRG are conflicting.
View Article and Find Full Text PDFBackground And Aims: Transjugular intrahepatic portosystemic shunt (TIPS) is often used in patients with cirrhosis to manage portal hypertension-related complications. Unfortunately, 35-50% of patients develop overt hepatic encephalopathy (HE) after TIPS. However, data on lactulose and rifaximin to prevent post-TIPS HE is limited.
View Article and Find Full Text PDFBackground/objective: Gastrostomy tube (G tube) is a commonly performed procedure for nutritional support. Current guidelines recommend discontinuation of dual antiplatelet therapy (DAPT) prior to G tube placement to reduce bleeding risk.
Aims: We aim to compare bleeding risk in single, dual and no antiplatelet therapy during G tube placement.
Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure typically utilized to treat refractory ascites and variceal bleeding. However, TIPS can lead to significant complications, most commonly hepatic encephalopathy (HE). Advanced age has been described as a risk factor for HE, as the elderly population tends to have decreased cognitive reserve and increased sarcopenia.
View Article and Find Full Text PDFIntroduction: Clostridium difficile Infection is a significant source of morbidity and mortality, which is on the rise. Fecal Microbiota Transplantation (FMT) is an alternative therapy to antibiotics with a high success rate and low relapse rate. Current data regarding the efficacy of the types of FMT used, namely fresh, frozen, and lyophilized is conflicting.
View Article and Find Full Text PDFThe optimal technique for removal of large common bile duct (CBD) stones (≥ 10 mm) during endoscopic retrograde cholangiopancreatography (ERCP) remains unclear. We aimed to perform a comparative analysis between different endoscopic techniques. Adhering to PRISMA guidelines, a stringent search of the following databases through January 12, 2021, were undertaken: PubMed/Medline, Embase, Web of Science, and Cochrane.
View Article and Find Full Text PDFIntroduction: Recent randomized controlled trials (RCTs) and meta-analysis have demonstrated improved adenoma detection rate (ADR) for colonoscopy with artificial intelligence (AI) compared with high-definition (HD) colonoscopy without AI. We aimed to perform a systematic review and network meta-analysis of all RCTs to assess the impact of AI compared with other endoscopic interventions aimed at increasing ADR such as distal attachment devices, dye-based/virtual chromoendoscopy, water-based techniques, and balloon-assisted devices.
Methods: A comprehensive literature search of PubMed/Medline, Embase, and Cochrane was performed through May 6, 2022, to include RCTs comparing ADR for any endoscopic intervention mentioned above.
Article Synopsis
- Esophageal foreign body impaction (FBI) is a gastrointestinal emergency that often requires urgent treatment, and this study compares cap-assisted endoscopic techniques to conventional methods for removal.
- A total of seven studies involving 1,407 patients showed that the cap-assisted technique has a significantly higher technical success and en bloc retrieval rates, along with fewer adverse events compared to conventional methods.
- The findings suggest that the cap-assisted technique is both more effective and safer, but further research with larger randomized trials is necessary to validate these results.
Our study aims to provide a more holistic understanding of the available data and predictive risk factors for gastrointestinal bleed (GIB). We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Web of Science Core Collection and calculated relative risk and meta-regression was utilized to evaluate for risk factors in order to assess the effect of covariates. Our meta-analysis reported a pooled prevalence rate of GIB of 24.
View Article and Find Full Text PDFGas embolisms are a rare complication of endoscopic retrograde cholangiopancreatography (ERCP). While there have been multiple reports of ERCP-associated air embolisms, only 2 case reports using oral cholangioscopy and CO insufflation have been reported in the literature. We present a unique case of a fatal CO venous air embolism during ERCP without using cholangioscopy and with no intentional CO insufflation of the biliary tree.
View Article and Find Full Text PDFBackground/aim: Upper gastrointestinal bleeding (UGIB) usually requires esophagogastroduodenoscopy (EGD) for diagnostic and-potentially-therapeutic purposes. However, blood within the gastric lumen may hinder the procedure. Administration of prokinetics like erythromycin has shown efficacy.
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- The study investigated the effects of two different guidewire sizes (0.035-inch vs. 0.025-inch) on the outcomes of endoscopic retrograde pancreatography (ERCP) through a systematic review and meta-analysis of randomized controlled trials (RCTs).
- A total of three RCTs involving 1079 patients were analyzed, finding no significant differences in primary biliary cannulation rates or the incidence of pancreatitis among the two guidewire sizes.
- The conclusion suggests that the choice of guidewire should be based on the endoscopist's skill and preference, rather than on differences in outcomes between the two sizes.
Recent studies evaluated the impact of i-scan in improving the adenoma detection rate (ADR) compared to high-definition (HD) colonoscopy. We aimed to systematically review and analyze the impact of this technique. A thorough search of the following databases was undertaken: PubMed/Medline, EMBASE, Cochrane and Web of Science.
View Article and Find Full Text PDFBackground: Hemorrhagic ascites is characterized as red blood cell count greater than 10,000/mm. In cirrhosis, ascites is an event of decompensation, and associated with poor prognosis. However, significance of hemorrhagic ascites is unclear.
View Article and Find Full Text PDFAn esophageal fistula is a pathological connection between the esophagus and another structure. The most common treatment for an esophageal fistula is airway stenting. However, several case series have demonstrated the superiority of the over-the-scope clip (OTSC) system for fistula closure.
View Article and Find Full Text PDFEosinophilic esophagitis (EoE) is an immune-mediated disorder that may be related to exposure to additive chemicals in crops, air pollutants, or supplements found within livestock. Co-occurring allergic or atopic diseases including atopic dermatitis, food allergies, and asthma are also commonly seen in 70% of cases and help guide diagnosis. Diagnosis of EoE requires eosinophilic infiltration greater than 15 eosinophils per high power field (HPF) with endoscopic evidence of abnormal esophageal changes.
View Article and Find Full Text PDFBackground: Peroral endoscopic myotomy (POEM) is increasingly used to treat esophageal achalasia, but is associated with a high rate of gastroesophageal reflux disease (GERD). The aim of our meta-analysis was to compare short and standard POEM in terms of clinical success and postoperative GERD.
Methods: We conducted a systematic review and meta-analysis of studies that compared POEM using short myotomy with standard myotomy.