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  1. Article ; Online: Long-term Outcome of Peroral Endoscopic Myotomy in Esophageal Motility Disorders: A Systematic Review and Meta-analysis.

    Nabi, Zaheer / Mandavdhare, Harshal / Akbar, Wahid / Talukdar, Rupjyoti / Reddy, Duvvur Nageshwar

    Journal of clinical gastroenterology

    2023  Volume 57, Issue 3, Page(s) 227–238

    Abstract: Background and aim: Peroral endoscopic myotomy (POEM) is an established treatment for achalasia. In this systematic review and meta-analysis, we aimed to analyze the mid and long-term outcomes of POEM in esophageal motility disorders.: Methods: ... ...

    Abstract Background and aim: Peroral endoscopic myotomy (POEM) is an established treatment for achalasia. In this systematic review and meta-analysis, we aimed to analyze the mid and long-term outcomes of POEM in esophageal motility disorders.
    Methods: Literature search was performed in databases including PubMed, Embase, Cochrane databases, and Google scholar from January 2010 to May 2021. The primary objective of the study was the clinical success (Eckardt score ≤3 or <4) at mid-term (30 to 60 mo) and long-term (>60 mo) follow-up after POEM. Secondary objectives included post-POEM gastroesophageal reflux (GER) as evaluated by symptoms, increased esophageal acid exposure, and reflux esophagitis.
    Results: Seventeen studies with 3591 patients were included in the review. Subtypes of motility disorders were type I (27%), type II (54.5%), type III (10.7%), distal esophageal spasm/Jackhammer esophagus (2%), and esophagogastric junction outflow obstruction (17.5%). Pooled mean follow-up duration was 48.9 months (95% CI, 40.02-57.75). Pooled rate of clinical success at mid-term follow-up was 87% (95% CI, 81-91; I2 , 86%) and long-term was 84% (95% CI, 76-89; I2 , 47%). In nonachalasia motility disorders (esophagogastric junction outflow obstruction, distal esophageal spasm, and Jackhammer esophagus), pooled rate of clinical success was 77% (95% CI, 65-85; I2 , 0%). GER as estimated by symptoms was 23% (95% CI, 19-27; I2 , 74%), erosive esophagitis was 27% (95% CI, 18-38%; I2 , 91%), and increased esophageal acid exposure was 41% (95% CI, 30-52; I2 , 88%).
    Conclusion: POEM is a durable treatment option in cases with achalasia. One-fourth of patients suffer from erosive GER in the long-term and success rates are lower in nonachalasia esophageal motility disorders.
    MeSH term(s) Humans ; Esophageal Achalasia/surgery ; Esophageal Achalasia/complications ; Esophageal Spasm, Diffuse/complications ; Treatment Outcome ; Esophageal Motility Disorders/surgery ; Esophageal Motility Disorders/complications ; Gastroesophageal Reflux/complications ; Esophagitis, Peptic/complications ; Myotomy ; Natural Orifice Endoscopic Surgery ; Esophageal Sphincter, Lower ; Esophagoscopy
    Language English
    Publishing date 2023-03-01
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 448460-5
    ISSN 1539-2031 ; 0192-0790
    ISSN (online) 1539-2031
    ISSN 0192-0790
    DOI 10.1097/MCG.0000000000001776
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1523: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: EUS-guided coil and glue injection versus endoscopic glue injection for gastric varices: International multicentre propensity-matched analysis.

    Samanta, Jayanta / Nabi, Zaheer / Facciorusso, Antonio / Dhar, Jahnvi / Akbar, Wahid / Das, Aritra / Birda, Chhagan Lal / Mangiavillano, Benedetto / Auriemma, Francesco / Crino, Stefano Francesco / Kochhar, Rakesh / Lakhtakia, Sundeep / Reddy, Duvvur Nageshwar

    Liver international : official journal of the International Association for the Study of the Liver

    2023  Volume 43, Issue 8, Page(s) 1783–1792

    Abstract: Background: Gastric varices (GVs) are conventionally managed with endoscopic cyanoacrylate (E-CYA) glue injection. Endoscopic ultrasound (EUS)-guided therapy using combination of coils and CYA glue (EUS-CG) is a relatively recent modality. There is ... ...

    Abstract Background: Gastric varices (GVs) are conventionally managed with endoscopic cyanoacrylate (E-CYA) glue injection. Endoscopic ultrasound (EUS)-guided therapy using combination of coils and CYA glue (EUS-CG) is a relatively recent modality. There is limited data comparing the two techniques.
    Methodology: This international multicentre study included patients with GV undergoing endotherapy from two Indian and two Italian tertiary care centres. Patients undergoing EUS-CG were compared with propensity-matched E-CYA cases from a cohort of 218 patients. Procedural details such as amount of glue, number of coils used, number of sessions required for obliteration, bleeding after index procedure rates and need for re-intervention were noted.
    Results: Of 276 patients, 58 (male 42, 72.4%; mean age-44.3 ± 12.1 years) underwent EUS-CG and were compared with 118 propensity-matched cases of E-CYA. In the EUS-CG arm, complete obliteration at 4 weeks was noted in 54 (93.1%) cases. Compared to the E-CYA cohort, EUS-CG arm showed significantly lower number of session (1.0 vs. 1.5; p < 0.0001) requirement, lower subsequent-bleeding episodes (13.8% vs. 39.1%; p < 0.0001) and lower re-intervention (12.1% vs. 50.4%; p < 0.001) rates. On multivariable regression analysis, size of the varix (aOR-1.17; CI 1.08-1.26) and technique of therapy (aOR-14.71; CI 4.32-50.0) were significant predictors of re-bleeding. A maximum GV size >17.5 mm had a 69% predictive accuracy for need for re-intervention.
    Conclusion: Endoscopic ultrasound-guided therapy of GV using coil and CYA glue is a safe technique with better efficacy and lower re-bleeding rates on follow-up compared to the conventional endoscopic CYA therapy.
    MeSH term(s) Humans ; Male ; Esophageal and Gastric Varices/diagnostic imaging ; Esophageal and Gastric Varices/therapy ; Gastrointestinal Hemorrhage/diagnostic imaging ; Gastrointestinal Hemorrhage/therapy ; Hemostasis, Endoscopic/methods ; Treatment Outcome ; Endosonography/methods ; Cyanoacrylates
    Chemical Substances Cyanoacrylates
    Language English
    Publishing date 2023-06-03
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2102783-3
    ISSN 1478-3231 ; 1478-3223
    ISSN (online) 1478-3231
    ISSN 1478-3223
    DOI 10.1111/liv.15630
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1632: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: New-onset prediabetes, diabetes after acute pancreatitis: A prospective cohort study with 12-month follow-up.

    Akbar, Wahid / Unnisa, Misbah / Tandan, Manu / Murthy, H V V / Nabi, Zaheer / Basha, Jahangeer / Chavan, Radhika / Lakhtakia, Sundeep / Ramchandani, Mohan / Kalapala, Rakesh / Koutarapu, Chandrakant / Gangdany, Zaid Mohd / Reddy, D Nageshwar / Talukdar, Rupjyoti

    Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology

    2022  Volume 41, Issue 6, Page(s) 558–566

    Abstract: Background: Acute pancreatitis (AP) is known to result in endocrine dysfunction (prediabetes, diabetes). The objective of this study was to determine the temporal incidence of endocrine dysfunction after onset of AP and determine the risk factors in ... ...

    Abstract Background: Acute pancreatitis (AP) is known to result in endocrine dysfunction (prediabetes, diabetes). The objective of this study was to determine the temporal incidence of endocrine dysfunction after onset of AP and determine the risk factors in Indian patients.
    Methods: In this prospective study, enrolled patients diagnosed with AP between February 2019 and May 2019 were followed at 3, 6, and 12 months until May 2020. Patients with recurrent AP, chronic pancreatitis, and pre-existing endocrine dysfunction were excluded. Demographic and disease severity (clinical, laboratory, and radiological) data were recorded. Mann-Whitney U and Chi-square tests were used to compare groups. Temporal trend for development of endocrine dysfunction was evaluated using the Extended Mantel Haenszel Chi-square test for trend. Logistic regression was used to identify independent risk factors.
    Results: Eighty-six patients (males 66, median [IQR] age 33.0 [26.0-44.2] years) who fulfilled enrolment criteria were finally analyzed. The most common etiology was alcohol (n=31 [36%]) followed by gallstones (n=17 [19.8%]). The proportion of patients with moderately severe acute pancreatitis and severe AP were 59.3% and 15.1%, respectively. Overall, the frequency of prediabetes and diabetes increased temporally across the follow-up period. These were 2 (2.33%) and 1 (1.16%) at 3 months, 11 (12.8%) and 5 (5.81%) at 6 months, and 20 (23.2%) and 9 (10.5%) at 1 year, respectively. On multivariable logistic regression, intervention for walled-off necrosis (WON) emerged as the single independent risk factor for endocrine dysfunction (odds ratio 9.01 [2.3-35.5]; p=0.002).
    Conclusions: Endocrine dysfunction is frequent after an episode of AP. Intervention for WON is an independent risk factor for endocrine dysfunction.
    MeSH term(s) Male ; Humans ; Adult ; Pancreatitis/epidemiology ; Pancreatitis/etiology ; Pancreatitis/diagnosis ; Prediabetic State/etiology ; Prediabetic State/complications ; Prospective Studies ; Acute Disease ; Follow-Up Studies ; Diabetes Mellitus/epidemiology ; Risk Factors
    Language English
    Publishing date 2022-12-29
    Publishing country India
    Document type Journal Article
    ZDB-ID 632595-6
    ISSN 0975-0711 ; 0254-8860
    ISSN (online) 0975-0711
    ISSN 0254-8860
    DOI 10.1007/s12664-022-01288-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2085: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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