Comparison of carvedilol and propranolol for primary prophylaxis of esophageal variceal bleed in cirrhotic patients.

Cirrhosis continues to claim the lives of people worldwide every year. Esophageal variceal bleeding due to portal hypertension is one of the dreadful complications. We compared carvedilol with propranolol to find better drug that can prevent index variceal bleed in cirrhotic patients.

Gastric schwannoma.

Gastric Schwannomas are rare benign slow-growing tumors and warrant treatment/resection only when symptomatic. Watchful waiting is recommended for incidental or asymptomatic schwannomas.

Efficacy and tolerability of sofosbuvir and daclatasvir for treatment of hepatitis C genotype 1 & 3 in patients undergoing hemodialysis- a prospective interventional clinical trial.

Background: There is paucity of data using direct anti-viral agents (DAA) in patients on maintenance hemodialysis (MHD) infected with HCV-genotype 1 & 3. Aim of the study was to evaluate DAA therapy in patients infected with HCV-genotype 1 & 3 on MHD.

Methods: A prospective open label, parallel, non-randomized interventional trial was conducted in patients with Hepatitis-C on maintenance hemodialysis.

Effectiveness of multidisciplinary approach in patients undergoing therapy for chronic hepatitis C.

Objective: To assess the effect of a multidisciplinary approach on the outcome of treatment for hepatitis C virus infection.

Methods: This retrospective study was conducted at the gastroenterology division by primary care providers at Phoenix VA Healthcare system in Phoenix, Arizona, United States, and comprised clinical and laboratory data of all hepatitis C patients treated between November 2002 and December 2006. The patients were clinically evaluated to determine whether they were candidates for treatment with pegylated interferon a-2a or a-2b plus ribavirin.

Cortical venous infarcts and acute limb ischaemia in acute carbon monoxide poisoning: A rare case report.

A case of carbon monoxide poisoning is presented with unusual complications; some of which have not been reported previously. A 48-years-old Asian male presented to the emergency department with dyspnoea, altered state of consciousness and pale discolouration of skin after being locked inside a factory room with burning coal. Patient was in acute respiratory distress.

A rare case of Mirizzi syndrome due to pure calcium carbonate stones (Limy Bile).

We report the first case of Mirizzi syndrome in a patient who presented with biliary obstruction caused by pure calcium carbonate stones. A 61 years old male with history of portal vein thrombosis presented with rash, nausea and jaundice. An ultrasound of biliary tree showed gallstones with dilatation of hepatic duct and intrahepatic biliary tree.

Polyp detection rates using magnification with narrow band imaging and white light.

Aim: To compare the yield of adenomas between narrow band imaging and white light when using high definition/magnification.

Methods: This prospective, non-randomized comparative study was performed at the endoscopy unit of veteran affairs medical center in Phoenix, Arizona. Consecutive patients undergoing first average risk colorectal cancer screening colonoscopy were selected.

The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner.

Due to time constraints, fewer physicians are performing large volume paracentesis (LVP) resulting in a longer wait time and more emergency department (ED) and hospital admissions. At our institution, after initial supervision, a certified nurse practitioner (NP) has independently performed LVP in a dedicated cirrhosis clinic. The purpose of our study was to evaluate the feasibility and safety of LVP performed by a NP.

Hepatic hydrothorax: current concepts of pathophysiology and treatment options.

Pleural effusions develop in 6-10% of patients with end-stage liver disease. Although, commonly seen in conjunction with ascites, isolated hepatic hydrothorax can occur in a small number of patients with cirrhosis. Refractory hepatic hydrothorax particularly poses a challenging therapeutic dilemma as treatment options are limited at best in these patients.

Spontaneous regression of hepatocellular carcinoma is possible and might have implications for future therapies.

Hepatocellular carcinoma is a potentially challenging cancer with very high mortality. Medical therapies are generally ineffective in achieving complete remission, especially for aggressive types or for advanced stage cancers. Spontaneous regression of these tumors is a rare and fascinating phenomenon.

Prevalence of Barrett's esophagus in patients with moderate to severe erosive esophagitis.

Aim: To investigate the proportion of patients with moderate-severe erosive esophagitis (EE) who will have Barrett's esophagus (BE) after healing of inflammation.

Methods: Patients with EE of Los Angeles (LA) class B, C and D who underwent follow-up endoscopy documenting complete mucosal healing.

Results: A total of 86/169 patients were suspected of having BE (38 before healing and 48 after healing of EE) and, 46/86 eventually had the histological confirmation.

Intermittent obstruction of jejunostomy tube due to Ascaris lumbricoides infection.

A 45-year-old Costa Rican woman was seen for a jejunostomy tube malfunction. There was no evidence of tube malposition or intestinal obstruction. During endoscopy, a long worm was retrieved from the distal duodenum; it was later confirmed to be Ascaris lumbricoides.

The yield and safety of string capsule endoscopy in patients with dysphagia.

Background: Dysphagia is a contraindication for the use of conventional capsule endoscopy (CE). Because string CE (SCE) allows for the immediate retrieval of the device, it eliminates the risk of capsule retention.

Objective: To assess the yield and safety of SCE in patients with dysphagia.

Endoscopic resection of an ampullary carcinoid presenting with upper gastrointestinal bleeding: a case report and review of the literature.

Ampullary carcinoid is a rare tumor that can present with gastrointestinal bleeding, obstructive jaundice or pancreatitis. Some of these tumors are associated with Von Recklinghausen disease. The usual surgical options are a biliary-enteric anastomosis, Whipple procedure or rarely a local resection.