Volume 9

Comparable Outcomes of Uncovered Metallic Stents and Partially Covered Metallic Stents in Malignant Distal Duodenal Obstruction

Research Article

1. Abstract
1.1. Background/Purpose: Endoscopic management with self-expandable metallic stents (SEMSs) for advanced malignant gastroduodenal obstruction is widely used, however stenting in patients with malignant distal duodenal obstruction (MDDO) is challenging because of the length and flexibility of the endoscope, the curved configuration of the duodenal C-loop, and the angle of the duodenojejunal flexure. Studies focusing on the outcomes of stenting in patients with MDDO are lacking. Therefore, the aim of this study was to investigate the clinical outcomes of uncovered SEMS (UC-SEMS) and partially covered SEMS (PC-SEMS) placement in patients with MDDO.

Long-Term Follow-Up of Overdose of Iron Tablets in Adult Successfully Managed Without Liver Transplant: A Case Report

Case Report

1. Abstract
Iron toxicity is common in children because of accidental ingestion. However, there are very less reports of adults with suicidal attempts. We report a case of 19 years old who developed acute liver injury 48 hrs after the deliberate consumption of a large dose of iron tablets. Laboratory tests for other hepatotoxins were negative. Although the peak iron level was lower 197 μg/dl than the hepatotoxic level, there was significant acute liver injury reflected by rise in Total bilirubin (10 mg %), Serum glutamic pyruvic transaminase (3014 U/L), and International normalization ratio (4.5). Treatment with deferoxamine was given along with other symptomatic treatments. This case was managed conservatively without a liver transplant. We also report the longest follow-up period showing clinical, biochemical and radiological changes in this case report.

Can combination of SGLT2 inhibitors and DPP-4 inhibitors be combination of choice for T2DM associated MAFLD?

Review Article

1. Abstract
Globally, metabolic associated fatty liver disease (MAFLD) is the leading cause of liver disease and the most common cause for liver transplantation. Type 2 Diabetes mellitus (T2DM) is major risk factor for development of MAFLD with Indian prevalence of 56.5% T2DM patients suffering from MAFLD. MAFLD and T2DM are pathophysiological linked with IR, T2DM, and obesity significantly contributing to MAFLD. Treatment with anti-diabetic agents in T2DM patients at risk of MAFLD may reduce the risk of MAFLD progression. Sodium glucose cotransporter 2 (SGLT2) inhibitors are reported efficacious in early preliminary non-clinical and clinical studies. SGLT- 2 inhibitors contribute to MAFLD alleviation by reduction of hyperglycaemia, enhancement of systemic insulin resistance, increased caloric loss and body weight reduction substantially due to glycosuria. Gliptins or dipeptidyl peptidase 4 (DPP-4) inhibitors prevent inactivation of incretins, such as glucose-dependent insulinotropic polypeptide (GIP) and glucagon like peptide (GLP)-1 by DPP-4 enzyme. SGLT2 inhibitors (dapagliflozin) are also shown to lower the blood level of soluble dipeptidyl peptidase-4, which is strongly correlated with liver enzymes.

Split-dose Lactulose with Adjunctive Oral Bisacodyl and Oral Sodium Phosphate: A Pilot Study of a Novel Bowel Preparation

Clinical Paper

1. Abstract
1.1. Background: Various colonoscopic bowel preparations are in use clinically. Split-dose preparations are generally recommended for morning colonoscopies. We herein present a novel form of bowel preparation with split-dose lactulose as the backbone with oral bisacodyl and sodium phosphate, in a pilot study assessing its safety and efficacy.

Clinical Predictive Value of CD-DST for the Efficacy of Postoperative XELOX Adjuvant Chemotherapy in Advanced Gastric Adenocarcinoma

Research Article

1. Abstract
1.1. Introduction: Anticancer drug insensitivity/resistance is a bottleneck in the treatment of gastric cancer. To overcome this challenge, we evaluated the clinical utility of an in-vitro collagen gel droplet embedded culture drug sensitivity test (CD-DST) using patient-derived gastric cancer tissues for personalized treatment guidance.
1.2. Methods: We collected the surgically removed fresh tumor tissue samples from 72 patients with advanced gastric adenocarcinoma who underwent surgical resection between March and December 2018. Overall survival (OS) and disease-free survival (DFS) were analyzed using the Kaplan-Meier method.

Appendicular Tuberculosis- A Rare Entity

Case Report

1. Abstract
1.1. Background: Tubercular appendicitis is a rarely encountered entity, even in developing country like India where tuberculosis (TB) is highly prevalent.
1.2. Case Report: A 26-year-old female patient presented initially with short duration epigastric pain associated with intermittent vomiting and mimicked non ulcer dyspepsia (NUD). The pain later became more intense, generalized and finally localized to right iliac fossa. The initial ultrasonogram done by junior radiologist was normal but a repeat done after a gap of three days revealed lump in right iliac fossa , surrounded with dilated gut loops but this lump was not appreciated on clinically. The laparoscopic appendicectomy was done which on histopathological examination showed tubercular appendicitis.

Tele Counseling -Effective Strategy for Blood Donors with Chronic Hepatitis B and C

Research Article

1. Abstract
1.1. Background: The blood is a life saving component which cannot be produced but has to donated by healthy donors. In view of high Seroprevalence of transfusion-transmitted infectious diseases such as HIV, hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis in India which affects the safety of blood for recipients, mandatory screening is done for above infections in every donated unit of blood. This maneuver leads to detection of these infections in healthy volunteer donors who were unaware of the same. The main thrust is to bring all these donors to bring on board for further diagnostic tests and treatment. In this Tele counseling is playing an important role and giving good results.

Application of Teach-back Health Education Model in Nutritional Support Manage- ment During Radiotherapy for Patients with Locally Advanced Esophageal Cancer

Clinical Paper

1. Abstract
1.1. Aim: To explore whether the teach-back health education model can reduce the incidence of malnutrition during radiotherapy in pa- tients with locally advanced esophageal cancer.
1.2. Methods: A historical study design was used to compare the in- cidence of malnutrition during radiotherapy between the traditional education model and the teach-back health education model inter- ventions in patients with locally advanced esophageal cancer who received radiotherapy. Patients who were admitted from May 2013 to June 2018 were traditional education group, and patients who were admitted from July 2018 to October 2020 were teach-back educa- tion group.

Expression Mechanism of Immunogenic Cell Death-Related Molecules in Colorectal Cancer

Review Article

1. Abstract
Immunogenic Cell Death (ICD) plays an important role in the treatment of colorectal cancer, and the relevant molecular mechanisms of its role in colorectal cancer are closely related to a variety of Damage-Associated Molecular Patterns (DAMPs), such as calreticulin (CRT), Heat Shock Protein (HSP), Adenosine Triphosphate (ATP), high mobility group protein B1 (HMGB1) signaling molecules, Type I interferon (IFN-1) and so on. DAMPs attract natural killer cells, macrophages, dendritic cells and other innate immune cells through various pattern recognition receptors, and promote their maturation and activation to kill tumor cells and produce memory effects. ICD and its DAMPs provide a new therapeutic basis and means for the treatment of colorectal cancer. Monitoring the changes in the immunogenicity of tumor cells before and after non-surgical treatment of colorectal cancer, and organically combining chemotherapy and/or targeted therapy with immunotherapy can improve the therapeutic effect of tumors. This article reviews the expression mechanism of ICD-related molecules in colorectal cancer.

Metadoxine Prevents Endoplasmic Reticulum Stress and Apoptosis in Mice and Patients with Non-Alcoholic Steatohepatitis

Research Article

1. Abstract
Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disorder. Although metadoxine successfully affects alcohol-associated steatohepatitis, its impact on non-alcoholic steatohepatitis (NASH) is mostly unknown. This study aims to explore the underlying mechanism of metadoxine and determine its impact and healing potential in NASH. We used and randomly divided male C57BL/6J mice into three groups of six animals: 1) a control group fed with standard diet; 2) a NASH group that received a high-fat diet (HFD); 3) a metadoxine group that received HFD and metadoxine (200 mg/kg).