Publications by authors named "Danujan Sriranganathan"
Article Synopsis
- This study aimed to investigate the prevalence of pouch fistulas in patients with ulcerative colitis who underwent restorative proctocolectomy with ileo-anal pouch anastomosis, as fistulas can lead to serious complications and pouch failure.
- After reviewing 33 qualifying studies, the research found the overall prevalence of developing at least one fistula to be 5%, with a 24% rate of pouch failure in those who experienced fistulas.
- The findings offer valuable insights that could help inform future medical guidelines, enhance the design of related research, and improve patient counseling.
Sensitivity and specificity of diagnostic modalities in pouchitis: a systematic review and meta-analysis.
Eur J Gastroenterol Hepatol
November 2023
Restorative proctocolectomy (RPC) is the most common surgical procedure to restore gastrointestinal continuity after surgical resection of the colon and rectum. Pouchitis is a common complication with several different modalities that can be used to aid diagnosis. This systematic review and meta-analysis aimed at exploring the sensitivity and specificity these diagnostic modalities.
View Article and Find Full Text PDFBackground And Aims: Nudix hydrolase 15 [NUDT15] genetic variants confer an increased risk of thiopurine-induced leukopenia [TIL]; however, their global prevalence in inflammatory bowel disease [IBD] patients is unknown. We aimed to evaluate the global prevalence of NUDT15 variants in IBD patients and incidence of TIL in these patients.
Methods: Six databases were searched from inception until July 2022.
Article Synopsis
- Fistulas are a serious complication of Crohn's disease, and current treatment options are limited, with little head-to-head comparison of their effectiveness.
- This study conducted a network meta-analysis of randomized controlled trials from 1978 to 2022 to evaluate various medical therapies for achieving and maintaining fistula remission.
- Results indicated that infliximab was most effective at 16-24 weeks, while ustekinumab showed the best results at 44 weeks, alongside promising outcomes from adalimumab and other biologics.
Background: Inflammatory bowel disease (IBD) is a multisystem disease impacting various body systems including musculoskeletal, ocular, skin, hepatobiliary, pulmonary, cardiac, and haematological systems. The extraintestinal manifestations of IBD are frequent, common in both ulcerative colitis (UC) and Crohn's disease (CD), and impact the morbidity and mortality of patients.
Methods: The Embase, Embase classic, and PubMed databases were searched between January 1979 and December 2021.
Introduction: Restorative proctocolectomy results in the formation of a pouch that adapts to a more colonic phenotype. The incidence of cancer of the pouch is thought to be low with most societal guidelines differing on their recommendations for surveillance.
Aims: We conducted a systematic review with meta-analysis to report the incidence of cancer in all pouch patients.
Aim: Ileal pouch-anal anastomosis is a restorative option for patients with ulcerative colitis (UC) requiring surgery. The primary outcome of this study was the relative risk of infertility in women with UC undergoing restorative proctocolectomy (RPC) compared to the same patients before undergoing RPC. Infertility was defined as the inability to conceive after 1 year of regular sexual intercourse without contraception.
View Article and Find Full Text PDFIn 2019, the European Crohn's and Colitis Organisation released guidelines for the medical management of Crohn's disease, concerning the induction of remission, the maintenance of remission and the treatment of fistulising perianal disease. This review summarises the key recommendations regarding the use of biologics in these settings.
View Article and Find Full Text PDFArticle Synopsis
- Pouchitis is a common complication after surgery and there hasn’t been much research directly comparing treatment options, prompting a network meta-analysis to evaluate various treatments.
- The search included 18 studies out of 4,291 abstracts, revealing that rifaximin is the most effective antibiotic for acute pouchitis, while metronidazole and probiotics are key for chronic pouchitis despite metronidazole having higher side effects.
- This analysis highlights the importance of antimicrobial therapy and suggests that rifaximin and probiotics could play bigger roles in treatment, while more extensive studies are needed to fully assess biologics.
Aim: Pouchitis is a clinically significant complication of ileal pouch-anal anastomosis with its prevalence varying in the literature. Pouchitis is thought to occur more commonly in patients with ulcerative colitis (UC) than in patients with familial adenomatous polyposis (FAP). We conducted a systematic review with meta-analysis of all published literature to report the prevalence of pouchitis in all pouch patients as well as specifically in UC and FAP.
View Article and Find Full Text PDFPorous bioactive glasses are attractive for use as bone scaffolds. There is increasing interest in strontium containing bone grafts, since strontium ions are known to up-regulate osteoblasts and down regulate osteoclasts. This paper investigates the influence of partial to full substitution of strontium for calcium on the dissolution and phase formation of a multicomponent high phosphate content bioactive glass.
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