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   Table of Contents - Current issue
January-March 2021
Volume 1 | Issue 1
Page Nos. 1-44

Online since Friday, December 4, 2020

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GHEP: The launch of a new journal Highly accessed article p. 1
BS Ramakrishna, Velusamy Balasubramanian, J Ubaldhus
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Renal dysfunction in chronic liver disease: Current concepts, classification, and management Highly accessed article p. 2
Rohan Yewale, Balakrishnan S Ramakrishna
Renal dysfunction is not uncommon in patients with cirrhosis, particularly as disease advances and the liver function decompensates. This review discusses the various types of renal dysfunction that may occur, the current classification of these kinds of kidney injury, and the rational management of these disorders based on the pathophysiology of these conditions.
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Probiotics in gastroenterology p. 11
L Thayumanavan, M Tarakeswari, K Muthukumaran
Probiotic bacteria have become increasingly popular in the last two decades because of expanding scientific evidence pointing to their beneficial effects on human health. Currently it has become an attractive area of research in communicable and non communicable diseases. Their benefits are not only seen in GI diseases which are expected, but also seen in life style diseases like NAFLD and Cancer. This article provides a review of available information and summarizes the recent knowledge on the effects of prebiotics, probiotics and synbiotics on human health.
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Safe sedation practices in acute liver failure in resource-constrained settings: A viewpoint p. 17
T. J. Vadivukkarasi, S. Kandasamy, K. P. P. Abhilash, Uday Zachariah, Ashish Goel, C. E Eapen
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Toll-like receptor gene polymorphisms in Indian patients with inflammatory bowel disease p. 22
Kirankumar Baskaran, Srinivasan Pugazhendhi, Balakrishnan Ramakrishna
Background: Defective innate immune recognition of gut microbes may be one reason for the genesis of inflammatory bowel disease (IBD). Genetic defects in IBD show considerable variation between populations. This study evaluated three single-nucleotide polymorphisms (SNP) in the toll-like receptor (TLR) genes in patients with IBD and healthy controls. Methods: DNA isolated from peripheral blood of 200 IBD patients (100 Crohn’s disease and 100 ulcerative colitis) and 100 healthy controls were subjected to polymerase chain reaction and restriction enzyme digestion for three SNPs in TLR4 (D299G, rs4986790), TLR5 (392 stop codon, rs5744168) and TLR9 (-1486 T/C, rs187084) genes, and genotypes assigned according to the restriction fragment length polymorphism pattern. Results: Minor allele frequencies for the 3 polymorphisms were not significantly different between IBD patients and healthy controls. The TLR4 rs4986790 minor allele (G) frequency was 27/200 in controls compared to 48/400 in IBD (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.52–1.44, P = 0.6007). The TLR5 rs5744168 minor allele (T) frequency was 19/200 in controls compared to 45/400 in IBD (OR 1.20, 95% CI 0.63–2.12, P = 0.5132). The TLR9 rs187084 minor allele (C) frequency was 71/200 in controls compared to 129/400 in IBD (OR 0.88, 95% CI 0.61–1.26, P = 0.4261). Conclusion: These three polymorphisms in the TLR genes were not associated with IBD in the Indian population.
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Norovirus infection in renal transplant patients with chronic diarrhea: A report of four cases and review of the literature p. 28
Sarojini Ashok Parameswaran, B Subba Rao, S Balasubramaniam, Ashok Parameswaran, Anil Tarigopula
Diarrhea is not uncommon in immunocompromised patients We report here four renal transplant patients in whom a molecular testing panel for gastrointestinal pathogens revealed positive test for norovirus.
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Cap polyposis in a child: A rare cause of rectal bleeding p. 34
S Arulprakash, Tarun George, Malathi Sathiyasekaran
Inflammatory cap polyposis (CP) is a uncommon, non-malignant condition characterized by the presence of sessile and pedunculated polyps in the colon and rectum. The histology of these polyps reveals a “cap” of inflammatory granulation tissue with fibrinopurulent exudate that covers the polyps, hence the name “inflammatory cap polyposis”. The pathogenesis of this non-malignant condition is poorly understood and while several associations have been made, causality has yet to be elucidated. The mainstay of initial treatment is conservative, however complicated and refractory cases usually benefit from endoscopic or surgical intervention followed by close surveillance for disease recurrence and progression. We present a 12 yr old girl with a large cap polyposis which was resected successfully by EMR and literature review.
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Duodenal tuberculosis p. 37
S Palaniappan, Manoj Munirathinam, A Murali
Tuberculosis (TB) of the gastrointestinal tract is common in India. The most common site is the ileocecal region. TB involving the duodenum is rare. It can present as duodenal ulcer, gastric outlet obstruction, and rarely with periduodenal lymph nodal involvement and bile duct erosion. Here, we report a patient who presented with pain abdomen and significant weight loss. Evaluation revealed a duodenal ulcer with paraduodenal nodal mass with probable contained perforation. Endoscopic ultrasound with fine-needle aspiration cytology of the nodal mass revealed the diagnosis of TB. She was started on anti-TB therapy and responded well with complete resolution. This case report emphasizes the need for having TB as a differential diagnosis for duodenal ulcer in an endemic country like India.
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Metastatic adenoid cystic carcinoma – An unusual neoplastic lesion of the liver p. 40
Ashish Tapadia, Karattupalayam Sampath Mouleeswaran, Jacob Nikhil Thomas, Joy Varghese
Adenoid cystic carcinoma (ACC) is an uncommon tumor of the salivary glands and is known for its delayed presentation of distant metastasis. However, delayed presentation of metastatic ACC in the liver without primary recurrence is rare, and literature is limited. In this case report, we present a case of metastatic ACC involving the liver without primary recurrence 6 years after radical excision of submandibular ACC.
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Giant abdominoscrotal hydrocele in decompensated liver disease p. 43
Jacob Nikhil Thomas, Joy Varghese
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Stones and abdominal pain – Not the usual suspects p. 44
Rajeeb Jaleel, Girish Desai, Amit Kumar Dutta
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