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Article: EUS guided drainage of intrahepatic pancreatic pseudocyst.

Gupta, Dhaval / Pipalia, Nirav / Pandav, Nilesh / Ingle, Meghraj / Sawant, Prabha

Tropical gastroenterology : official journal of the Digestive Diseases Foundation

2018 Volume 37, Issue 2, Page(s) 131–133

MeSH term(s)	Bile Ducts, Intrahepatic ; Child ; Cholangiopancreatography, Magnetic Resonance ; Diagnosis, Differential ; Drainage ; Endosonography ; Humans ; Male ; Middle Aged ; Pancreatic Pseudocyst/diagnostic imaging ; Pancreatic Pseudocyst/surgery ; Tomography, X-Ray Computed ; Ultrasonography, Interventional
Language	English
Publishing date	2018-09-19
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	605777-9
ISSN	0250-636X
ISSN	0250-636X
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Article ; Online: Gastric lipoma: an unusual cause of dyspeptic symptoms.

Nasa, Mukesh / Choksey, Ajay / Phadke, Aniruddha / Sawant, Prabha

BMJ case reports

2016 Volume 2016

Abstract: Gastric lipomas are rare tumours accounting for 2-3% of all benign gastric tumours. These are usually submucosal in origin but in rare cases may be subserosal in origin. Although a majority of gastric lipomas are asymptomatic and usually detected ... ...

Abstract	Gastric lipomas are rare tumours accounting for 2-3% of all benign gastric tumours. These are usually submucosal in origin but in rare cases may be subserosal in origin. Although a majority of gastric lipomas are asymptomatic and usually detected incidentally, occasionally these can cause abdominal pain, dyspeptic disorders, obstruction, invagination and haemorrhages. In the literature, only 200 cases of gastric lipomas have been reported so far. We report a case of a 56-year-old female with a submucosal symptomatic gastric lipoma presenting with disabling dyspeptic symptoms.
MeSH term(s)	Abdominal Pain/etiology ; Dyspepsia/diagnostic imaging ; Dyspepsia/etiology ; Dyspepsia/surgery ; Endoscopy, Gastrointestinal ; Female ; Gastrectomy ; Humans ; Laparotomy ; Lipoma/diagnosis ; Lipoma/surgery ; Middle Aged ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Vomiting/etiology
Language	English
Publishing date	2016-06-22
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2016-215297
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Article: Hematemesis: Unusual presentation of isolated gastric tuberculosis.

Nasa, Mukesh / Kumar, Arvind / Phadke, Aniruddha / Sawant, Prabha

The Indian journal of tuberculosis

2016 Volume 63, Issue 1, Page(s) 59–61

Abstract: A 25-year-old male presented with hematemesis, epigastric pain, and melena. He had dyspepsia with significant weight loss for 3 months period. On clinical examination, he was pale with no organomegaly or lymphadenopathy. The X-ray chest was normal, and ... ...

Abstract	A 25-year-old male presented with hematemesis, epigastric pain, and melena. He had dyspepsia with significant weight loss for 3 months period. On clinical examination, he was pale with no organomegaly or lymphadenopathy. The X-ray chest was normal, and ultrasound abdomen was normal. Upper GI endoscopy revealed nodularity and ulceration along proximal part of lesser curvature of the stomach. CT scan abdomen showed thickening of lesser curvature just below gastro-esophageal junction. The biopsies were negative for malignancy. Repeat upper GI endoscopy showed a nonhealing ulcer, on repeat well biopsies taken from the base of ulcer primary gastric tuberculosis was diagnosed. It showed many epithelioid cell granulomas and multinucleated giant cells with caseous necrosis on histology. Acid-fast bacilli on Zeil Neelsen staining and TB PCR were positive for Mycobacterium tuberculosis. He was put on four-drug anti-tuberculous treatment. On follow-up, the patient gradually improved and regained weight. Repeat upper GI endoscopy done after 8 weeks showed healing of the ulcer with decrease in nodularity.
MeSH term(s)	Adult ; Hematemesis/etiology ; Humans ; Male ; Stomach Diseases/diagnosis ; Stomach Diseases/microbiology ; Tuberculosis, Gastrointestinal/diagnosis
Language	English
Publishing date	2016
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2015.07.015
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Article: Megacystic microcolon intestinal hypoperistalsis syndrome with mydriasis in a male child.

Pandav, Nilesh / Gupta, Dhaval / Ingle, Meghraj / Sawant, Prabha

Tropical gastroenterology : official journal of the Digestive Diseases Foundation

2016 Volume 36, Issue 3, Page(s) 211–212

MeSH term(s)	Abnormalities, Multiple/diagnosis ; Biopsy ; Colon/abnormalities ; Diagnosis, Differential ; Diagnostic Imaging ; Humans ; Intestinal Pseudo-Obstruction/complications ; Intestinal Pseudo-Obstruction/diagnosis ; Male ; Mydriasis/complications ; Mydriasis/diagnosis ; Urinary Bladder/abnormalities
Language	English
Publishing date	2016-08-12
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	605777-9
ISSN	0250-636X
ISSN	0250-636X
DOI	10.7869/tg.292
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Article: Correlation of Computed Tomography of Colonic Wall Thickening with Colonoscopy.

Khairnar, Harshad / Ingle, Meghraj / Chauhan, Shamsher / Pipalia, Nirav / Sawant, Prabha / Pandey, Vikas / Shukla, Akash

The Journal of the Association of Physicians of India

2019 Volume 67, Issue 4, Page(s) 18–21

Abstract: Introduction: Computed Tomography of abdomen frequently shows bowel wall thickening with different grades and characteristic of thickening. The correlation of bowel wall thickening (BWT) with endoscopic findings is not well described in Indian ... ...

Abstract	Introduction: Computed Tomography of abdomen frequently shows bowel wall thickening with different grades and characteristic of thickening. The correlation of bowel wall thickening (BWT) with endoscopic findings is not well described in Indian population. Therefore we did this study to determine the correlation of BWT with endoscopic findings. Methods: Its Prospective single center study with 85 Consecutive patients with age group more than 12 years with CT scan abdomen showing bowel wall thickening were included in the study. Colonoscopy was done subsequently within a span of 15 days with appropriate bowel preparation. Colonoscopic correlation was done in relation to site, degree and characteristic of thickening. Biopsies were taken at the site of visible abnormalities on endoscopy and from normal appearing mucosa in case of strong suspicious of disease. Results: Total of 85 (37 men) consecutive symptomatic patients with colonic wall thickening on computed tomography underwent colonoscopy. The mean age group was 34.2 (SD±17.35) years. Endoscopy was normal in 20 patients (24%) and abnormal in 65 patients (76.5%). Patients with mild thickening were more likely to have normal endoscopy than those with moderate/severe thickening (19 versus 1 patient; p<0.001). The abnormality rate was similar across different bowel segments (left vs right side; 85.7% versus 76.5%, p< 0.57). Out of 65 patients with endoscopic abnormality, 41 (62.12%) had tuberculosis, 10 (15.16%) had malignancy. Most common cause of IC thickening was secondary to tuberculosis (n=40, 95.2%). Conclusion: A proportion of patients with thickening on CT scan, especially mild, may have normal colonoscopy. Patients should be counseled about the same prior to colonoscopy. However, colonoscopy should be done to rule out abnormality even when CT shows mild thickening.
MeSH term(s)	Adolescent ; Adult ; Colon ; Colonoscopy ; Humans ; Middle Aged ; Prospective Studies ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult
Language	English
Publishing date	2019-07-12
Publishing country	India
Document type	Journal Article
ZDB-ID	800766-4
ISSN	0004-5772
ISSN	0004-5772
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Article: Predictors of 1-month and 3-months Hospital Readmissions in Decompensated Cirrhosis: A Prospective Study in a Large Asian Cohort.

Patel, Ruchir / Poddar, Prateik / Choksi, Dhaval / Pandey, Vikas / Ingle, Meghraj / Khairnar, Harshad / Sawant, Prabha

Annals of hepatology

2019 Volume 18, Issue 1, Page(s) 30–39

Abstract: Introduction and aim: Considered as a healthcare quality indicator, hospital readmissions in decompensated cirrhosis predispose the patients and the society to physical, social and economic distresses. Few studies involving North American cohorts have ... ...

Abstract	Introduction and aim: Considered as a healthcare quality indicator, hospital readmissions in decompensated cirrhosis predispose the patients and the society to physical, social and economic distresses. Few studies involving North American cohorts have identified different predictors. The aim of this study was to determine and validate the predictors of 1-month and 3-months readmission in an Asian cohort. Material and methods: We prospectively studied 281 hospitalised patients with decompensated cirrhosis at a large tertiary care public hospital in India between August 2014 and August 2016 and followed them for 3 months. Data regarding demographic, laboratory and disease related risk factors were compiled. We used multivariate logistic regression to determine predictors of readmission at 1-month and 3-months and receiver operating curves (ROC) for significant predictors to obtain the best cut-offs. Results: 1-month and 3-months readmission rates in our study were 27.8% and 42.3%, respectively. Model for End stage Liver Disease (MELD) score at discharge (OR:1.24, p < 0.001) and serum sodium (OR:0.94, p-0.039) independently predicted 1-month and MELD score (OR:1.11, p-0.003), serum sodium (OR:0.94, p-0.027) and male gender (OR:2.19, p-0.008) independently predicted 3-months readmissions. Neither aetiology nor complications of cirrhosis emerged as risk factors. MELD score >14 at discharge and serum sodium < 133 mEq/L best predicted readmissions; MELD score being a better predictor than serum sodium (p - 0.0001). Conclusions: High rates of early and late readmissions were found in our study. Further, this study validated readmission predictors in Asian patients. Structured interventions targeting this risk factors may diminish readmissions in decompensated cirrhosis.
MeSH term(s)	Disease Progression ; Female ; Follow-Up Studies ; Humans ; Incidence ; India/epidemiology ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/epidemiology ; Liver Cirrhosis/therapy ; Male ; Middle Aged ; Patient Discharge/trends ; Patient Readmission/trends ; Prognosis ; Prospective Studies ; ROC Curve ; Risk Assessment/methods ; Risk Factors ; Severity of Illness Index ; Time Factors
Language	English
Publishing date	2019-05-21
Publishing country	Mexico
Document type	Journal Article
ZDB-ID	2188733-0
ISSN	1665-2681
ISSN	1665-2681
DOI	10.5604/01.3001.0012.7859
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Article ; Online: Serum ferritin levels predict histological severity in patients with nonalcoholic fatty liver disease in India.

Parikh, Pathik / Patel, Jatin / Ingle, Meghraj / Sawant, Prabha

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

2015 Volume 34, Issue 3, Page(s) 200–208

Abstract: Aim: The aims of the study were to determine the levels of serum ferritin which predict fibrosis in Indian patients with nonalcoholic fatty liver disease (NAFLD) and to establish correlation between Fibroscan values and serum ferritin levels.: Methods! ...

Abstract	Aim: The aims of the study were to determine the levels of serum ferritin which predict fibrosis in Indian patients with nonalcoholic fatty liver disease (NAFLD) and to establish correlation between Fibroscan values and serum ferritin levels. Methods: The clinical, biochemical, radiologic, and histological findings of consecutive adult NAFLD patients accessed at a tertiary care center over a 3-year period were analyzed. Those with concurrent liver diseases were excluded. Fifty-five of 250 NAFLD patients with fatty liver on ultrasound and raised enzymes (>40 IU/L) underwent liver biopsy. Patients were stratified into two groups based on their histological stage steatosis (with or without inflammation) but no fibrosis and nonalcoholic steatohepatitis (NASH) with fibrosis/cirrhosis. Serum ferritin levels were measured at the same time as getting liver biopsy. Fibroscan was carried out in each of these patients. These were compared with 50 age- and sex-matched controls with normal ultrasound, liver enzymes, and no history of alcohol. Student's t test was used as the test for significance. Results: Fifty-five NAFLD patients diagnosed on ultrasound and with raised enzymes underwent biopsy. Steatosis (with or without inflammation, but no fibrosis/ballooning) was seen in 35 patients, fibrosis/ballooning in 14 patients, and cirrhosis in 6 patients. Mean ferritin levels in groups with nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH) were 39.4 and 72.7 ng/mL, respectively (p < 0.001). The mean ferritin levels in NAFLD and controls were 51.2 and 35.2 ng/mL, respectively (p < 0.05). The area under the curve (AUC) of serum ferritin at value 48.0 ng/mL was 0.779. The coefficient of correlation between Fibroscan and serum ferritin levels was 0.9864 while that with alanine transaminase and aspartate aminotransferase was 0.69. Serum ferritin at the cutoff of 48 ng/mL differentiated significantly patients with fibrosis and higher Fibroscan levels. Conclusion: Serum ferritin was low in Indian individuals, and levels even within apparently normal range indicated fibrosis and cirrhosis. A cutoff level of 48.0 IU/mL distinguished fibrosis in NAFLD. Fibroscan correlated well with serum ferritin levels.
MeSH term(s)	Adult ; Biomarkers/blood ; Female ; Ferritins/blood ; Fibrosis ; Humans ; India ; Liver/pathology ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/pathology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/pathology ; Severity of Illness Index
Chemical Substances	Biomarkers ; Ferritins (9007-73-2)
Language	English
Publishing date	2015-06-25
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/s12664-015-0572-5
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Article ; Online: Prevalence of hypothyroidism in nonalcoholic fatty liver disease in patients attending a tertiary hospital in western India.

Parikh, Pathik / Phadke, Aniruddha / Sawant, Prabha

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

2015 Volume 34, Issue 2, Page(s) 169–173

Abstract: The aim of this study was to assess the prevalence of hypothyroidism in patients with nonalcoholic fatty liver disease (NAFLD). The patients visiting Gastroenterology outpatient clinic between September 2011 and September 2013 at our tertiary care center ...

Abstract	The aim of this study was to assess the prevalence of hypothyroidism in patients with nonalcoholic fatty liver disease (NAFLD). The patients visiting Gastroenterology outpatient clinic between September 2011 and September 2013 at our tertiary care center were investigated for NAFLD. Three hundred controls were selected on the basis of negative ultrasound examination. All patients above 18 years were included. All patients with alcohol intake greater than 20 g/day, HBsAg or anti-HCV positivity, and history of liver disease were excluded. Full thyroid profile was carried out in all patients and they were classified as follows: subclinical hypothyroidism (TSH >5.5 IU/mL but <10 IU/mL) and overt hypothyroidism (TSH >10 IU/mL). Eight hundred (500 NAFLD and 300 controls) patients were studied. The mean age of NAFLD patients was 44.3 years and of controls was 41.6 years, respectively. The female-to-male ratio of NAFLD patients was 1.8:1 and of controls was 1.94:1, respectively (p>0.05). Hypothyroidism was significantly more common in NAFLD patients compared to controls. Eighty-four patients were detected to have hypothyroidism in NAFLD group compared to only four patients in control group (p<0.001). Mean ALT (55 vs. 21 IU), AST (44 vs. 18 IU), and BMI (29.17 vs. 25.14 kg/m2) were significantly higher in NAFLD hypothyroid group compared to nonhypothyroid NAFLD. Multivariate regression analysis showed that NAFLD was statistically significantly associated with hypothyroidism [odds ratio (OR) 14.94, 95 % confidence interval (CI), 3.5 to 62.6]. Steatohepatitis was more common in hypothyroid as compared to nonhypothyroid group [OR 3.9, 1.2 to 11.1 (95 % CI)]. The prevalence of hypothyroidism in NAFLD was 16.8 %. Hypothyroidism was closely associated with NAFLD independently of known metabolic risk factors, confirming a significant clinical relationship between these two diseases.
MeSH term(s)	Adult ; Comorbidity ; Female ; Humans ; Hypothyroidism/epidemiology ; India/epidemiology ; Male ; Metabolic Syndrome ; Middle Aged ; Non-alcoholic Fatty Liver Disease/epidemiology ; Prevalence ; Regression Analysis ; Risk Factors ; Sex Factors ; Tertiary Care Centers/statistics & numerical data
Language	English
Publishing date	2015-04-16
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/s12664-015-0541-z
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Article: Accuracy of Leukocyte Esterase Reagent Strip (LERS) test for rapid bedside screening of spontaneous bacterial peritonitis: An observational study.

Khairnar, Harshad / Ingle, Meghraj / Pandey, Vikas / Kolhe, Kailash / Chauhan, Shamsher / Sawant, Prabha / Walke, Swapnil / Chaudhary, Vipul

Journal of family medicine and primary care

2020 Volume 9, Issue 11, Page(s) 5542–5546

Abstract: Introduction: Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication in cirrhotic patients with ascites. SBP is generally diagnosed based on an increased number of polymorphonuclear neutrophils in the ascitic fluid (>250/mm: ... ...

Abstract	Introduction: Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication in cirrhotic patients with ascites. SBP is generally diagnosed based on an increased number of polymorphonuclear neutrophils in the ascitic fluid (>250/mm Aims and objectives: Aim was to evaluate the diagnostic utility of leukocyte esterase reagent strip for rapid diagnosis of SBP in patients who underwent abdominal paracentesis and to calculate the sensitivity, specificity, positive, and negative predictive values. Methodology: The study was carried out on 64 patients with ascites. Cell count of AF as determined by colorimetric scale of Multistix 10 SG reagent strip was compared with counting chamber method (PMNL count ≥250 cells/mm Results: Of the 64 patients SBP was diagnosed in 17 patients, 47 patients were negative for SBP by manual cell count. At cut off of 2+; sensitivity to diagnose SBP was 100%; specificity of 94%; PPV being 57% and NPV of 94%. at the cut off level of 3+; sensitivity decreased down to 76%; specificity increased to 100%; PPV of 100% and NPV of 93.75%. Overall accuracy at 2 + and 3 + was respectively 94.5% and 93.75%. Conclusion: In this study we have found good sensitivity and specificity for the prompt detection of elevated polymorphonuclear neutrophil count. A negative test result excludes SBP with a high degree of certainty. Thus, it represents a convenient, inexpensive, simple bedside screening tool for SBP diagnosis.
Language	English
Publishing date	2020-11-30
Publishing country	India
Document type	Journal Article
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_1207_19
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Article: Difficult colonoscopy: air, carbon dioxide, or water insufflation?

Chaubal, Alisha / Pandey, Vikas / Patel, Ruchir / Poddar, Prateik / Phadke, Aniruddha / Ingle, Meghraj / Sawant, Prabha

Intestinal research

2018 Volume 16, Issue 2, Page(s) 299–305

Abstract: Background/aims: This study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation).: ... ...

Abstract	Background/aims: This study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation). Methods: Patients with body mass index (BMI) less than 18 kg/m Results: The primary end point was achieved in 32.7%, 43.8%, and 84.9% of cases with air, carbon dioxide and water insufflation ( Conclusions: Water insufflation was superior to air or carbon dioxide for pain tolerance. This was seen in the subgroups with BMI <18 kg/m
Language	English
Publishing date	2018-04-30
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3018469-1
ISSN	2288-1956 ; 1598-9100
ISSN (online)	2288-1956
ISSN	1598-9100
DOI	10.5217/ir.2018.16.2.299
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