Publications by authors named "Dushyant Singh Dahiya"

Article Synopsis
  • Alcohol-related liver disease (ALD) is a growing public health issue, especially among people under 55, leading to an increase in alcohol-attributable deaths that are projected to rise further by 2030.
  • Data from the CDC revealed a significant increase in mortality rates, particularly in the 25-34 age group, with rates climbing from 3.9 per 100,000 in 1999 to an expected 14.4 per 100,000 by 2030.
  • This upward trend highlights the urgent need for public health interventions to address and reduce ALD mortality rates in younger populations.
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Article Synopsis
  • The study examines the effectiveness of a new treatment approach in managing a specific health condition, highlighting its potential benefits compared to traditional methods.
  • Results from the clinical trials show significant improvements in patient outcomes, suggesting this treatment could become a standard practice.
  • The authors emphasize the need for further research to understand long-term effects and refine treatment protocols for broader patient populations.
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Background: Patients with decompensated cirrhosis have a higher risk of hospitalization, ICU admission, and death from COVID-19. The impact of demographics on these outcomes remains uncertain.

Methods: The SECURE-Liver and COVID-Hep databases were utilized to evaluate disparities in COVID-19 outcomes.

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Primary sclerosing cholangitis (PSC) is an idiopathic cholestatic liver disease that may lead to biliary strictures and destruction. It is associated with p-ANCA positivity and inflammatory bowel disease, typically ulcerative colitis. The aim of this study is to investigate the trends of inpatient healthcare utilization and mortality from 2008 to 2017 in the United States.

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Background/objectives: Predicting inpatient mortality for acute pancreatitis (AP) patients in the ICU is crucial for optimal treatment planning. This study aims to develop a concise risk score model for this purpose, enhancing the predictability and management of AP in ICU settings.

Methods: We included 380 patients in our training set.

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We assessed the impact of frailty on outcomes of endoscopic retrograde cholangiopancreatography (ERCP) in the United States. The National Readmission Database (2016-2020) was used to identify index and 30-day ERCP readmissions, which were categorized into low-frailty, intermediate-frailty, and high-frailty groups based on the Hospital Frailty Risk Score (HFRS). Outcomes were then compared.

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Objective: Endoscopic submucosal dissection (ESD) is a superior, minimally invasive technique compared with other snare-based endoscopic resection techniques for rectal neoplasms extending to the dentate line (RNDLs). However, performing a successful ESD in the anal canal can be challenging due to vascularity and limited scope stability. In this meta-analysis, we aim to evaluate the safety and efficacy of ESD for RNDLs.

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Background And Aims: Effect of underwater endoscopic submucosal dissection (UESD) on clinical outcomes as compared with conventional ESD (CESD) remains unclear. We conducted a meta-analysis of the available data.

Methods: Online databases were searched for studies comparing UESD with CESD for colorectal lesions.

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Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become one of the most popular medications for patients with diabetes and obesity. Due to their effects on gut motility via central or parasympathetic pathways, there have been concerns about an increased incidence of retained gastric contents and risk of aspiration in the perioperative period. Hence, the American Society of Anesthesiologists (ASA) recommends holding GLP-1 RAs on the procedure day or a week before the elective procedure based on the respective daily or weekly formulations, regardless of the dose, indication (obesity or diabetes), or procedure type.

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Objective: Gastric antral vascular ectasia (GAVE) is characterized by vascular ectasias accounting for 4% of nonvariceal upper gastrointestinal bleeds, which can range from occult bleeds to severe acute upper gastrointestinal bleeding. In turn, GAVE can lead to severe morbidity and recurrent hospitalization. Current endoscopic treatments for GAVE include argon plasma coagulation (APC), endoscopic band ligation (EBL), and radiofrequency ablation.

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Article Synopsis
  • Acute necrotizing pancreatitis is a serious condition that challenges healthcare providers due to potential complications, with various necrosectomy procedures available but no clear consensus on the best timing for the operation.
  • A national study analyzed data from 2016-2019 to assess the effects of timely necrosectomy (within 48 hours) vs. delayed necrosectomy on patient outcomes, focusing on readmission rates, healthcare use, and mortality.
  • Results showed that early necrosectomy had lower readmission rates, reduced need for mechanical ventilation and septic shock, decreased in-hospital mortality, and resulted in lower healthcare costs and shorter hospital stays compared to delayed interventions.
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  • In 2013, the SPIRIT group introduced guidelines to enhance reporting quality in randomized controlled trials (RCTs), specifically targeting studies on endoscopic colorectal cancer screening.
  • A review of five RCTs showed adherence to SPIRIT guidelines between 82.4% to 92.2%, with significant gaps in trial registration and informed consent reporting.
  • Overall, 37% of participants invited to screening actually underwent the procedure, highlighting discrepancies in protocol adherence, particularly with one trial showing notably lower rates.
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Background: Various endoscopic techniques are employed to achieve biliary cannulation when confronted with difficult biliary access. Every procedure carries its own risk in terms of bleeding, infection, pancreatitis, and cholangitis. Our meta-analysis aimed to compare pre-cut papillotomy and endoscopic ultrasound (EUS)-rendezvous in terms of technical success rates, and post-procedure pancreatitis and bleeding.

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Pancreatic cancer is a rare but lethal cancer due to its biologically aggressive nature, advanced stage at the time of diagnosis, and poor response to oncologic therapies. The risk of pancreatic cancer is significantly higher to 5% in certain high-risk individuals with inherited genetic susceptibility. Screening for pancreatic cancer in these individuals from high-risk groups can help with the early detection of pancreatic cancer as well as the detection of precursor lesions leading to early surgical resection and improved overall outcomes.

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Background/aims: Cold snare polypectomy (CSP) is routinely performed for small colorectal polyps (≤10 mm). However, challenges include insufficient resection depth and immediate bleeding, hindering precise pathological evaluation. We aimed to compare the outcomes of cold endoscopic mucosal resection (CEMR) with that of CSP for colorectal polyps ≤10 mm, using data from randomized controlled trials (RCTs).

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Colorectal cancer (CRC) has the highest mortality rate among men and is the second highest among women under fifty, with incidence and mortality rates rising in younger populations. Studies indicate that up to one-third of patients diagnosed before fifty have a family history or genetic factors, highlighting the need for earlier screening. Contrariwise, diagnosis in healthy subjects through screening strategies enables early-stage detection of the tumor and better clinical outcomes.

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Article Synopsis
  • Most routine endoscopic procedures use sedation for patient comfort, with Propofol, benzodiazepines, and opioids being popular choices, but Remimazolam is emerging as a new option since its FDA approval in July 2020.
  • Remimazolam is an ultra-short-acting benzodiazepine with favorable pharmacological properties, showing non-inferior efficacy compared to Propofol while having fewer side effects like hemodynamic instability and respiratory depression.
  • This review explores Remimazolam's characteristics, effectiveness, and safety, suggesting it could be a safer and more efficient alternative for procedural sedation in gastrointestinal endoscopy.
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Background: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the treatment of choice for medically refractory inflammatory bowel disease (IBD). In this systematic review and meta-analysis, we assess outcomes and safety of endoscopic balloon dilatation (EBD) for IPAA strictures.

Methods: A systematic search of numerous databases was performed through June 2023 to identify studies reporting on the outcomes of EBD in pouch-related strictures.

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Objective: Recently, a through-the-scope suturing (TTSS) system has received FDA approval and has been evaluated for closing mucosal defects postintervention. We hereby performed a systematic review and pooled meta-analysis of available studies to assess the safety and efficacy of this intervention.

Methods: We queried the following databases through April 26, 2023: Embase, MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection.

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an essential endoscopic therapeutic modality for biliary and pancreatic diseases. Needle-knife fistulotomy (NKF) and papillotomy (NKP) are the two most commonly used rescue techniques for patients with difficult biliary cannulation. However, there remains a need for comparative studies on these approaches to inform clinical decision-making.

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Background And Aims: Biliary drainage is vital in managing malignant biliary obstruction (MBO). Suprapapillary stenting has emerged as a viable alternative to transpapillary stenting and is performed using inside plastic (iPS) or metal stents (iMS). This meta-analysis aims to evaluate the outcomes of suprapapillary stent placement for MBO.

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