Chronic diarrhea; diagnosis and management.

Chronic diarrhea is a very common disease which affects the quality of life of our patients. It is one of the major diseases for which patients are referred to gastrointestinal clinics. Irritable bowel syndrome, infectious diarrhea and abdominal tuberculosis due to unhygienic conditions in our part of the world and inflammatory bowel disease are the major causes of chronic diarrhea in young patients. We are reporting a young female patient who presented with chronic diarrhea, abdominal pain and bleeding per rectum mimicking ulcerative colitis for last many months but on colonoscopy examination an impacted foreign body was found in the sigmoid colon which was the culprit. Surgical retrieval of the foreign body resolved the symptoms.

Chronic Diarrhea Caused By an Impacted Foreign Body in the Sigmoid Colon: A Rare Scenario

Objectives: To identify the bacterial spectrum of SBP in patients with cirrhosis of liver. Study Design: Descriptive Cross-sectional study. Setting: Department of Gastroenterology and Hepatology, Madina Teaching Hospital, Faisalabad. Period: 1st November, 2018 – 30th June, 2019. Material & Methods: Two hundred and fifty cirrhotic patients having ascites and clinical symptoms and signs of SBP, consecutively admitted in the ward or presented to OPD were included in the study. Results: A total of 250 patients included in this study. SBP was diagnosed according to the predetermined criteria in 140 patients.  The culture-negative ascites was found in 77 (55%) and culture-positive ascites was found in 63 (45%) patients. The most common organism was E.Coli 28 (47.45%) followed by Enterococcus 10 (16.94%), Klebsiella Pneumoniae 6 (10.17%), Streptococcal Pneumoniae 5 (8.47%), S.aureus 5 (8.47%), Acinetobacter 3 (5.08%) and miscellaneous 2 (3.38%). Conclusion: The percentage of SBP is quite high among patients having cirrhosis and ascites and the Gram-negative bacterial spectrum is still much common in our region.

/pdf/the-bacterial-spectrum-of-spontaneous-bacterial-peritonitis-2zbt6tkhqg.pdf

The bacterial spectrum of spontaneous bacterial peritonitis in patients with cirrhosis of liver.

Abstract Background Chronic hepatitis C (CHC) management has changed tremendously after direct-acting antivirals (DAAs) availability. Sustained virological response (SVR) has improved significantly, but one of the major concerns is the chances of de novo hepatocellular carcinoma (HCC) development after DAAs. The objective of the study is to calculate the frequency of newly diagnosed cases of HCC after antiviral therapy for CHC in Pakistan. Materials and methods This prospective, interventional research was conducted from June 2017 to September 2020. All patients after antiviral therapy for CHC were followed with an ultrasound abdomen and α-fetoprotein, six monthly. Multiphasic computed tomography (CT) of the abdomen was performed in suspected cases. For quantitative variables, the mean and standard deviations were calculated, whereas the qualitative variables were analyzed by frequencies and percentages. Results Among 180 patients, 110 were men and 70 were women with a mean age of 45.52 ± 11.71 years. One hundred and twenty-six patients were noncirrhotic, 38 had compensated cirrhosis while 16 had decompensated cirrhosis. One hundred and sixty-four (91.11%) patients achieved SVR, of which 22 (12.22%) patients developed new HCC during follow-up. Compensated cirrhosis group had 10 patients, the decompensated group had 12 patients, and the noncirrhotic group had no new HCC cases. Among patients with the new HCC, 12 achieved SVR. Conclusion The risk of the development of HCC after antiviral treatment is highly significant among patients with liver cirrhosis. So, a strict surveillance strategy should be adopted in every cirrhotic patient following treatment with DAA agents even if they achieve SVR. Clinical significance Chances of developing HCC are still significantly high even after achieving SVR with DAAs in patients with liver cirrhosis. Patients with liver cirrhosis should be under surveillance for HCC even after achieving SVR after DAAs treatment. How to cite this article Rasool S, Hanif S, Ahmad A, et al. Frequency of De Novo Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up. Euroasian J Hepato-Gastroenterol 2022;12(2):73–76.

https://doi.org/10.5005/jp-journals-10018-1383

Frequency of De Novo Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up

Improvement in Health-related Quality of Life and Patient Satisfaction after Pneumatic Dilatation in Achalasia Patients

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Chronic Diarrhea Caused By an Impacted Foreign Body in the Sigmoid Colon: A Rare Scenario

The bacterial spectrum of spontaneous bacterial peritonitis in patients with cirrhosis of liver.

Frequency of De Novo Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up

Improvement in Health-related Quality of Life and Patient Satisfaction after Pneumatic Dilatation in Achalasia Patients