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  1. Article: Size and Number of Gastric Varices Decide Amount of Glue Injected during Endoscopic Therapy.

    Patwa, Ajay Kumar / Yadav, Ambuj / Kumar, Satish / Anil, Navneet

    The Journal of the Association of Physicians of India

    2023  Volume 71, Issue 1, Page(s) 1

    Abstract: Introduction: Cyanoacrylate glue injection has become standard of care for acutely bleeding as well as for primary and secondary prophylaxis of high risk gastric varices. There is limited data on safe and effective amount of glue injected. Our study was ...

    Abstract Introduction: Cyanoacrylate glue injection has become standard of care for acutely bleeding as well as for primary and secondary prophylaxis of high risk gastric varices. There is limited data on safe and effective amount of glue injected. Our study was aimed to fulfill the gap.
    Materials: It was retrospective analysis of endoscopy laboratory chart, videos and corresponding case sheets of all consecutive endoscopies January to September 2022. Number, type and size of gastric varices, amount of glue injected and outcomes (technical success, intra procedural and post-procedural complications) were noted.
    Result: Among 337 upper gastrointestinal endoscopies performed during the study period, 12 patients had gastric varices. 3 had GOV1F1, 2 had GOV1F2, 8 had GOV2F2, 1 had GOV2F3 and one had isolated gastric varices, IGV2F1. 4 patients had history of upper GI bleed. 3 had one, 4 had two and 3 had three varices. 3 patients had <0.5 cm and 8 had >0.5 cm size varices. Cyanoacrylate glue was injected in 4 patients. Technical success was achieved in all (100%) patients. The amount of Cyanoacrylate glue injected was decided by the size and number of varices and varied between 1-4 ml depending on the above factors. Two patients had intra-procedural, self subsiding bleeding, one patient had severe abdominal pain needing intramuscular analgesic. None had fatal complication.
    Conclusion: Size and numbers of gastric varices are deciding factors for amount of glue injected during endotherapy. References Kumar A, Singh S, Madan K, et al. Undiluted N-butyl cyanoacrylate is safe and effective for gastric variceal bleeding. Gastrointest Endosc 2010;72(4):721-727. Saraswat VA, Verma A. Gluing gastric varices in 2012: lessons learnt over 25 years. J Clin Exp Hepatol 2012;2(1):55-69.
    MeSH term(s) Humans ; Esophageal and Gastric Varices/therapy ; Esophageal and Gastric Varices/complications ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/therapy ; Retrospective Studies ; Cyanoacrylates/therapeutic use ; Endoscopy, Gastrointestinal/adverse effects ; Varicose Veins/complications ; Treatment Outcome
    Chemical Substances Cyanoacrylates
    Language English
    Publishing date 2023-03-31
    Publishing country India
    Document type Journal Article
    ZDB-ID 800766-4
    ISSN 0004-5772
    ISSN 0004-5772
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Comparison of Objectively Assessed Versus Patient-Reported Clarity of Last Rectal Effluent for the Prediction of Quality of Bowel Preparation for Colonoscopy: A Prospective, Case-Control Study.

    Patwa, Ajay / Kumar, Satish / Bhagchandani, Deepak / Kumar, Amit / Atam, Virendra / Anil, Navneet / Mishra, Priya / Singh, Abhishek / Devi, Archana / Pal, Ajay K

    Cureus

    2024  Volume 16, Issue 2, Page(s) e53828

    Abstract: Introduction: Colonoscopy is a crucial procedure for various clinical purposes, including screening for colorectal cancer. Adequate bowel preparation is essential for its success. Poor bowel preparation can lead to bad outcomes. An objective assessment ... ...

    Abstract Introduction: Colonoscopy is a crucial procedure for various clinical purposes, including screening for colorectal cancer. Adequate bowel preparation is essential for its success. Poor bowel preparation can lead to bad outcomes. An objective assessment of bowel preparation quality is typically only possible after the colonoscope is inserted. This study aimed to objectively correlate the clarity of last rectal effluent, directly collected in a transparent container, with the quality of bowel preparation, and compare it with patient-reported descriptions.
    Methods: This prospective, single-centre, case-control study obtained ethical clearance and included patients aged >18 years undergoing colonoscopies. Cases included patients who collected the last rectal effluent and took photographs, while controls relied on verbal descriptions. Data collected included demographics, clinical information, bowel preparation quality, and lastly, stool clarity. A statistical analysis was performed to identify correlations and associations.
    Results: Of the 70 included patients, 45 were male. The mean age was 35.8 ± 14.3 years. Cases had a higher mean age (37.8 ± 14.6). A higher number of cases had comorbidities (11, 68.8%). Photographic recording of the last rectal effluent was not associated with the adequacy of bowel preparation. Thin yellow fluid was the most common last-rectal effluent clarity (33, 47.1%). Thin, clear fluid was significantly associated with adequate bowel preparation.
    Conclusion: Objective assessment of last rectal effluent clarity correlates with the quality of bowel preparation. This can improve the quality of bowel preparation for colonoscopies and potentially reduce the need for repeat procedures, contributing to better patient outcomes and cost savings in healthcare systems.
    Language English
    Publishing date 2024-02-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.53828
    Database MEDical Literature Analysis and Retrieval System OnLINE

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