54 results on '"Jayanta SAMANTA"'
Search Results
2. Impact of the Timing of Percutaneous Catheter Drainage following Endoscopic Drainage on Outcomes in Acute Necrotizing Pancreatitis
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Harsimran Bhatia, Sanya Vermani, Pankaj Gupta, Shameema Farook, Abhishek Kumar, Joseph Johnson, Jimil Shah, Anupam Singh, Vaneet Jearth, Jayanta Samanta, Harshal Mandavdhare, Vishal Sharma, Saroj K. Sinha, Usha Dutta, and Rakesh Kocchar
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acute pancreatitis ,collections ,drainage ,endoscopy ,catheter ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Background The role of dual-modality drainage of walled-off necrosis (WON) in patients with acute pancreatitis (AP) is established. However, there are no data on the association of clinical outcomes with the timing of percutaneous catheter drainage (PCD). We investigated the impact of the timing of PCD following endoscopic drainage of WON on clinical outcomes in AP.
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- 2024
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3. Correction: Outcomes of lumen apposing metal stent placement in patients with surgically altered anatomy: Multicenter international experience
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Benedetto Mangiavillano, Daryl Ramai, Michel Kahaleh, Amy Tyberg, Haroon Shahid, Avik Sarkar, Jayanta Samanta, Jahnvi Dhar, Michiel Bronswijk, Schalk Van der Merwe, Abdul Kouanda, Hyun Ji, Sun-Chuan Dai, Pierre Deprez, Jorge Vargas-Madrigal, Giuseppe Vanella, Roberto Leone, Paolo Giorgio Arcidiacono, Carlos Robles-Medranda, Juan Alcivar Vasquez, Martha Arevalo-Mora, Alessandro Fugazza, Christopher Ko, John Morris, Andrea Lisotti, Pietro Fusaroli, Amaninder Dhaliwal, Massimiliano Mutignani, Edoardo Forti, Irene Cottone, Alberto Larghi, Gianenrico Rizzatti, Domenico Galasso, Carmelo Barbera, Francesco Maria Di Matteo, Serena Stigliano, Cecilia Binda, Carlo Fabbri, Khanh Do-Cong Pham, Roberto Di Mitri, Michele Amata, Stefano Francesco Crinó, Andrew Ofosu, Luca De Luca, Abed Al-Lehibi, Francesco Auriemma, Danilo Paduano, Federica Calabrese, Carmine Gentile, Cesare Hassan, Alessandro Repici, and Antonio Facciorusso
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2024
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4. Synthesis and antibacterial potential of novel thymol derivatives against methicillin-resistant Staphylococcus aureus and P. aeruginosa pathogenic bacteria
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Ashutosh Shahi, Rakshit Manhas, Srija Bhattacharya, Arti Rathore, Puneet Kumar, Jayanta Samanta, Manish Kumar Sharma, Avisek Mahapa, Prasoon Gupta, and Jasha Momo H. Anal
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antibacterial ,thymol derivatives ,synergistic effect ,antibiotic resistance ,drug discovery ,Chemistry ,QD1-999 - Abstract
The increasing threat of antibiotic resistance has created an urgent need for new antibacterial agents, particularly plant-based natural compounds and their derivatives. Thymol, a natural monoterpenoid phenolic compound derived from Monarda citriodora, is known for its aromatic and therapeutic properties, including antibacterial activity. This study focuses on synthesizing dihydropyrimidinone and dihydropyridine derivatives of thymol and exploring their antibacterial properties. The synthesized compounds were tested for their in vitro antibacterial potential against pathogenic microorganisms, specifically Pseudomonas aeruginosa (Gram-negative) and methicillin-resistant Staphylococcus aureus (MRSA) (Gram-positive). Among the synthesized derivatives, compound 3i (ethyl 4-(4-hydroxy-5-isopropyl-2-methylphenyl)-2-imino-6-methyl-1,2,3,4-tetrahydropyrimidine-5-carboxylate) exhibited the most promising antibacterial activity, with minimum inhibitory concentration (MIC) values of 12.5 µM against P. aeruginosa and 50.0 µM against MRSA. Additionally, compound 3i demonstrated a synergistic effect when combined with vancomycin, enhancing its antibacterial efficacy. The optimum fractional inhibitory concentration index (FICI) observed was 0.10 and 0.5 for MRSA and P. aeruginosa, respectively, in combination with vancomycin. In silico analysis of the physiochemical properties of 3i indicated compliance with all drug-likeness rules. Furthermore, molecular docking studies revealed that compound 3i has a stronger binding affinity to the target protein than thymol, providing valuable insights into its potential mechanism of action.
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- 2024
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5. Outcomes of lumen apposing metal stent placement in patients with surgically altered anatomy: Multicenter international experience
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Benedetto Mangiavillano, Daryl Ramai, Michel Kahaleh, Amy Tyberg, Haroon Shahid, Avik Sarkar, Jayanta Samanta, Jahnvi Dhar, Michiel Bronswijk, Schalk Van der Merwe, Abdul Kouanda, Hyun Ji, Sun-Chuan Dai, Pierre Deprez, Jorge Vargas-Madrigal, Giuseppe Vanella, Roberto Leone, Paolo Giorgio Arcidiacono, Carlos Robles-Medranda, Juan Alcivar Vasquez, Martha Arevalo-Mora, Alessandro Fugazza, Christopher Ko, John Morris, Andrea Lisotti, Pietro Fusaroli, Amaninder Dhaliwal, Massimiliano Mutignani, Edoardo Forti, Irene Cottone, Alberto Larghi, Gianenrico Rizzatti, Domenico Galasso, Carmelo Barbera, Francesco Maria Di Matteo, Serena Stigliano, Cecilia Binda, Carlo Fabbri, Khanh Do-Cong Pham, Roberto Di Mitri, Michele Amata, Stefano Francesco Crinó, Andrew Ofosu, Luca De Luca, Abed Al-Lehibi, Francesco Auriemma, Danilo Paduano, Federica Calabrese, Carmine Gentile, Cesare Hassan, Alessandro Repici, and Antonio Facciorusso
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Endoscopy Lower GI Tract ,Stenting ,Endoscopy Small Bowel ,Endoscopic ultrasonography ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2024
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6. Semisynthesis of Novel Dispiro-pyrrolizidino/thiopyrrolizidino-oxindolo/indanedione Natural Product Hybrids of Parthenin Followed by Their Cytotoxicity Evaluation
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Chetan Paul Singh, Priyanka Sharma, Manzoor Ahmed, Diljeet Kumar, Yogesh Brijwashi Sharma, Jayanta Samanta, Zabeer Ahmed, Sanket Kumar Shukla, Abhijit Hazra, and Yogesh P. Bharitkar
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Chemistry ,QD1-999 - Published
- 2023
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7. Feasibility and Safety of Bedside Percutaneous Catheter Drainage of Necrotic Pancreatic Fluid Collections in the Intensive Care Unit
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Pankaj Gupta, Shreya Sehgal, Jyoti Gupta, Jayanta Samanta, Harshal Mandavdhare, Vishal Sharma, Usha Dutta, Rakesh Kochhar, and Manavjit Singh Sandhu
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drainage ,collections ,catheter ,acute necrotizing pancreatitis ,ultrasound ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Purpose Critically ill patients with acute pancreatitis (AP) require intensive care unit (ICU) admission. The management of pancreatic fluid collections (PFCs) in this group is challenging. We aimed to evaluate the feasibility and safety of bedside percutaneous ultrasound (USG)-guided interventions in necrotic PFC in ICU patients. Methods This retrospective study comprised consecutive patients with AP in the ICU who underwent bedside USG-guided interventions for necrotic PFC. Indications for intervention, technical success, clinical success, and complications were recorded. The site, number, and size of catheters were recorded. Clinical outcomes were assessed. Results Thirty-three patients (mean age, 38.1 years, 15 females) were included. All patients had nonresolving organ failure and were on mechanical ventilation. The mean pain to percutaneous catheter drainage (PCD interval was 42.2 days (range, 7–167 days). All the procedures were technically successful, and none of the patients required shifting to the interventional radiology suite for computed tomography guidance. PCD was clinically successful in 40% of the patients. There were no major complications. The mean length of hospital stay and ICU stay was 35 days (range, 6–69 days) and 13 days (range, 1–63 days), respectively. Six (17.1%) patients underwent necrosectomy. Sixteen (45.7%) patients died in the hospital. Conclusion USG-guided bedside PCD can be performed safely with high technical success in the ICU setting.
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- 2023
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8. Endoscopic Ultrasound-Guided Through-the-Needle Biopsy: A Narrative Review of the Technique and Its Emerging Role in Pancreatic Cyst Diagnosis
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Filipe Vilas-Boas, Tiago Ribeiro, Guilherme Macedo, Jahnvi Dhar, Jayanta Samanta, Sokol Sina, Erminia Manfrin, Antonio Facciorusso, Maria Cristina Conti Bellocchi, Nicolò De Pretis, Luca Frulloni, and Stefano Francesco Crinò
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mucinous cystic neoplasm ,EUS-FNA ,pancreatic cancer ,cystic fluid analysis ,intraductal papillary mucinous neoplasm (IPMN) ,neuroendocrine tumor ,Medicine (General) ,R5-920 - Abstract
Pancreatic cystic lesions (PCLs) pose a diagnostic challenge due to their increasing incidence and the limitations of cross-sectional imaging and endoscopic-ultrasound-guided fine-needle aspiration (EUS-FNA). EUS-guided through the needle biopsy (EUS-TTNB) has emerged as a promising tool for improving the accuracy of cyst type determination and neoplastic risk stratification. EUS-TTNB demonstrates superior diagnostic performance over EUS-FNA, providing critical preoperative information that can significantly influence patient management and reduce unnecessary surgeries. However, the procedure has risks, with an overall adverse event rate of approximately 9%. Preventive measures and further prospective studies are essential to optimize its safety and efficacy. This review highlights the potential of EUS-TTNB to enhance the diagnostic and management approaches for patients with PCLs. It examines the current state of EUS-TTNB, including available devices, indications, procedural techniques, specimen handling, diagnostic yield, clinical impact, and associated adverse events.
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- 2024
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9. Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Meta-Analysis of Randomized Controlled Trials and Trial Sequential Analysis
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Megha Bhandari, Jayanta Samanta, Marco Spadaccini, Alessandro Fugazza, Stefano Francesco Crinò, Paraskevas Gkolfakis, Konstantinos Triantafyllou, Jahnvi Dhar, Marcello Maida, Nicola Pugliese, Cesare Hassan, Alessandro Repici, Alessio Aghemo, Gaetano Serviddio, and Antonio Facciorusso
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EUS ,FNB ,FNA ,adequacy ,tissue ,cirrhosis ,Medicine (General) ,R5-920 - Abstract
Background: The efficacy of endoscopic ultrasound-guided liver biopsy (EUS-LB) compared to percutaneous liver biopsy (PC-LB) remains uncertain. Methods: Our data consist of randomized controlled trials (RCTs) comparing EUS-LB to PC-LB, found through a literature search via PubMed/Medline and Embase. The primary outcome was sample adequacy, whereas secondary outcomes were longest and total lengths of tissue specimens, diagnostic accuracy, and number of complete portal tracts (CPTs). Results: Sample adequacy did not significantly differ between EUS-LB and PC-LB (risk ratio [RR] 1.18; 95% confidence interval [CI] 0.58–2.38; p = 0.65), with very low evidence quality and inadequate sample size as per trial sequential analysis (TSA). The two techniques were equivalent with respect to diagnostic accuracy (RR: 1; CI: 0.95–1.05; p = 0.88), mean number of complete portal tracts (mean difference: 2.29, −4.08 to 8.66; p = 0.48), and total specimen length (mean difference: −0.51, −20.92 to 19.9; p = 0.96). The mean maximum specimen length was significantly longer in the PC-LB group (mean difference: −3.11, −5.51 to −0.71; p = 0.01), and TSA showed that the required information size was reached. Conclusion: EUS-LB and PC-LB are comparable in terms of diagnostic performance although PC-LB provides longer non-fragmented specimens.
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- 2024
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10. Society of Gastrointestinal Endoscopy of India Consensus Guidelines on Endoscopic Ultrasound-Guided Biliary Drainage: Part II (Technical Aspects)
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Jayanta Samanta, Priyanka Udawat, Sudipta Dhar Chowdhary, Deepak Gunjan, Praveer Rai, Vikram Bhatia, Vikas Singla, Saurabh Mukewar, Nilay Mehta, Chalapathi Rao Achanta, Ankit Dalal, Manoj Kumar Sahu, Avinash Balekuduru, Abhijit Bale, Jahangir Basha, Mathew Philip, Surinder Rana, Rajesh Puri, Sundeep Lakhtakia, Vinay Dhir, and India EUS Club
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biliary drainage ,endoscopic ultrasound ,obstructive jaundice ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Endoscopic management of bile duct obstruction is a key aspect in gastroenterology practice and has evolved since the first description of biliary cannulation by McCune et al in 1968. Over many decades, the techniques and accessories have been refined, and currently, the first-line management for extrahepatic biliary obstruction is endoscopic retrograde cholangiopancreatography (ERCP). However, even in expert hands, the success rate of ERCP reaches up to 95%. In almost 4 to 16% cases, failure to cannulate the bile duct may necessitate other alternatives such as surgical bypass or, more commonly, percutaneous transhepatic biliary drainage (PTBD). While surgery is associated with high morbidity and mortality, PTBD has a very high reintervention and complication rate (∼80%) and poor quality of life. Almost parallelly, endoscopic ultrasound (EUS) has come a long way from a mere diagnostic tool to a substantial therapeutic option in various pancreaticobiliary diseases. Biliary drainage using EUS-guidance (EUS-BD) has gained momentum since the first report published by Giovannini et al in 2001. The concept of accessing the bile duct through a different route than the papilla, circumventing the shortcomings of PTBD, and sometimes bypassing the actual obstruction have enthused a lot of interest in this novel strategy. The three key methods of EUS-BD entail transluminal, antegrade, and rendezvous approach. Over the past decade, with growing experience, EUS-BD has been found to be equivalent to ERCP or PTBD for malignant obstruction with better success rates. EUS-BD, however, is not devoid of adverse events and can carry fatal adverse events. However, neither the technique of EUS-BD nor the accessories and stents for EUS-BD have been standardized. Additionally, different countries and regions have different availability of the accessories, making generalizability a difficult task. Thus, technical aspects of this evolving therapy need to be outlined. For these reasons, Society of Gastrointestinal Endoscopy of India (SGEI) deemed it appropriate to develop technical consensus statements for performing safe and successful EUS-BD.
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- 2023
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11. Plastic versus metal stents for transmural drainage of walled-off necrosis with significant solid debris: a randomized controlled trial
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Rinkal Kakadiya, Gaurav Muktesh, Jayanta Samanta, Harshal S Mandavdhare, Pankaj Gupta, Jimil Shah, Phulen Sarma, Vikas Gupta, Thakur Deen Yadav, Anuraag Jena, Vishal Sharma, and Rakesh Kochhar
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Endoscopic ultrasonography ,Pancreas ,Intervention EUS ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2023
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12. Society of Gastrointestinal Endoscopy of India Consensus Guidelines on Endoscopic Ultrasound-Guided Biliary Drainage: Part I (Indications, Outcomes, Comparative Evaluations, Training)
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Praveer Rai, Priyanka Udawat, Sudipta Dhar Chowdhary, Deepak Gunjan, Jayanta Samanta, Vikram Bhatia, Vikas Singla, Saurabh Mukewar, Nilay Mehta, Chalapathi Rao Achanta, Ankit Dalal, Manoj Kumar Sahu, Avinash Balekuduru, Abhijit Bale, Jahangir Basha, Mathew Philip, Surinder Rana, Rajesh Puri, Sundeep Lakhtakia, and Vinay Dhir
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biliary drainage ,endoscopic ultrasound ,obstructive jaundice ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Endoscopic management of bile duct obstruction is a key aspect in gastroenterology practice and has evolved since the first description of biliary cannulation by McCune et al in 1968. Over many decades, the techniques and accessories have been refined and currently, the first-line management for extrahepatic biliary obstruction is endoscopic retrograde cholangiopancreaticography (ERCP). However, even in expert hands the success rate of ERCP reaches up to 95%. In almost 4 to 16% cases, failure to cannulate the bile duct may necessitate other alternatives such as surgical bypass or more commonly percutaneous transhepatic biliary drainage (PTBD). While surgery is associated with high morbidity and mortality, PTBD has a very high reintervention and complication rate (∼80%) and poor quality of life. Almost parallelly, endoscopic ultrasound (EUS) has come a long way from a mere diagnostic tool to a substantial therapeutic option in various pancreatico-biliary diseases. Biliary drainage using EUS-guidance (EUS-BD) has gained momentum since the first report published by Giovannini et al in 2001. The concept of accessing the bile duct through a different route than the papilla, circumventing the shortcomings of PTBD and sometimes bypassing the actual obstruction have enthused a lot of interest in this novel strategy. The three key methods of EUS-BD entail transluminal, antegrade, and rendezvous approach. Over the past decade, with growing experience, EUS-BD has been found to be equivalent to ERCP or PTBD for malignant obstruction with better success rates. EUS-BD, albeit, is not devoid of adverse events and can carry fatal adverse events. However, neither the technique of EUS-BD, nor the accessories and stents for EUS-BD have been standardized. Additionally, different countries and regions have different availability of the accessories making generalizability a difficult task. Thus, technical aspects of this evolving therapy need to be outlined. For these reasons, the Society of Gastrointestinal Endoscopy India deemed it appropriate to develop technical consensus statements for performing safe and successful EUS-BD.
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- 2023
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13. Association between the Distribution of Adipose Tissue and Outcomes in Acute Pancreatitis: A Comparison of Methods of Fat Estimation
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Saurabh Dawra, Pankaj Gupta, Neha Yadav, Anupam K Singh, Jayanta Samanta, Saroj K Sinha, Manavjit Singh Sandhu, and Rakesh Kochhar
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acute pancreatitis ,ct ,dual-energy x-ray absorptiometry ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Purpose To assess the correlation between abdominal fat measured at computed tomography (CT) and dual-energy X-ray absorptiometry (DXA) and association with clinical outcomes in patients with acute pancreatitis (AP). Methods This prospective study comprised consecutive patients with AP who underwent abdominal CT and DXA. Fat estimation was done on whole-body DXA and abdominal CT. Correlations among body mass index (BMI), waist circumference (WC), DXA, and CT fat measurements were determined. The association between fat measurements and clinical outcomes was assessed. Results Fifty-nine patients (mean age 38.2 years, 48 males) were included. There was a strong correlation (r = 0.691–0.799) between DXA and CT fat estimation. In addition, there was a significant association of the visceral adipose tissue (VAT) on DXA and CT with the severity of AP (p = 0.039 and 0.021, respectively) and the need for drainage of collections (p = 0.026 and 0.008, respectively). There was a weak correlation of the BMI and WC with the length of hospitalization (LOH) (r = 0.121, 0.190, respectively) and length of intensive care unit stay (LOICU) (r = 0.211, 0.197), while there was a moderate to strong correlation of the truncal fat and visceral fat on DXA and total adipose tissue and VAT on CT with LOH (r = 0.562, 0.532, 0.602 and 0.614, respectively) and LOICU (r = 0.591, 0.577, 0.636, and 0.676, respectively). Conclusion In conclusion, fat indices measured on DXA and CT are associated with the severity of AP. In addition, the fat measurements at DXA are strongly correlated with those obtained at CT.
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- 2023
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14. Endocuff Vision to Improve Adenoma Vision: A Brief Overview
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Jayendra Shukla and Jayanta Samanta
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colonoscopy ,polyp ,adenoma detection rate ,distal attachment cap ,colorectal cancer ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Colorectal cancer (CRC)-related mortality can be reduced through screening and early detection. The aim of any CRC screening program is to detect as many adenomas/polyps in the early stage as possible and hence, adenoma detection rate (ADR) is a key quality indicator of colonoscopy. Various methods and techniques have been studied and developed over the years to improve the quality of colonoscopy and thereby increase ADR. This ranges from use of various regimens to improve bowel preparation, defining an optimum colonoscope withdrawal time for the operator, distal attachment caps, use of different wavelength of light, colonoscope with increased degree of view to the use of modern-day artificial intelligence to improve ADR. Of all the various measures, use of distal attachment device seems an easy, cheap and readily usable technique to increase real-time ADR. A variety of such devices have been evaluated over time starting from simple transparent caps, EndoRings, Endocuff to Endocuff Vision for their effectiveness. In this review, we have provided a brief description of the various available distal attachment devices and a detailed technical overview of Endocuff and its modification the Endocuff Vision.
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- 2022
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15. Recurrence after Zenker’s peroral endoscopic myotomy despite complete septotomy: how far to go with myotomy on the esophageal side
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Harshal S. Mandavdhare, DM, Jayanta Samanta, DM, Anudeep Jafra, MD, Harjeet Singh, MCh, and Pankaj Gupta, MD
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2022
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16. The Use of a New Dedicated Electrocautery Lumen-Apposing Metal Stent for Gallbladder Drainage in Patients with Acute Cholecystitis
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Luca Brandaleone, Gianluca Franchellucci, Antonio Facciorusso, Jayanta Samanta, Jong Ho Moon, Jorge Vargas-Madrigal, Carlos Robles Medranda, Carmelo Barbera, Francesco Di Matteo, Milutin Bulajic, Francesco Auriemma, Danilo Paduano, Federica Calabrese, Carmine Gentile, Marco Massidda, Marco Bianchi, Luca De Luca, Davide Polverini, Benedetta Masoni, Valeria Poletti, Giacomo Marcozzi, Cesare Hassan, Alessandro Repici, and Benedetto Mangiavillano
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new dedicated lumen-apposing metal stent (LAMS) ,acute cholecystitis ,therapeutic endoscopic ultrasonography ,Medicine (General) ,R5-920 - Abstract
Aims: Lumen-apposing metal stents (LAMSs) in ultrasonography-guided gallbladder drainage (EUS-GBD) have become increasingly important for high-risk surgical patients. Our study aims to evaluate the technical and clinical success, safety, and feasibility of endoscopic ultrasonography-guided gallbladder drainage using a new dedicated LAMS. Methods: This is a retrospective multicenter study that included all consecutive patients not suitable for surgery who were referred to a tertiary center for EUS-GBD using a new dedicated electrocautery LAMS for acute cholecystitis at eight different centers. Results: Our study included 54 patients with a mean age of 76.48 years (standard deviation: 12.6 years). Out of the 54 endoscopic gallbladder drainages performed, 24 (44.4%) were cholecysto-gastrostomy, and 30 (55.4%) were cholecysto-duodenostomy. The technical success of LAMS placement was 100%, and clinical success was achieved in 23 out of 30 patients (76.67%). Adverse events were observed in two patients (5.6%). Patients were discharged after a median of 5 days post-stenting. Conclusions: EUS-GBD represents a valuable option for high-surgical-risk patients with acute cholecystitis. This new dedicated LAMS has demonstrated a high rate of technical and clinical success, along with a high level of safety.
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- 2023
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17. OUTCOME OF PER ORAL ENDOSCOPIC MYOTOMY (POEM) IN SIGMOID ACHALASIA AT A MEDIAN FOLLOW UP OF 17 MONTHS
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Harshal S MANDAVDHARE, Jayanta SAMANTA, Anudeep JAFRA, Harjeet SINGH, Pankaj GUPTA, and Usha DUTTA
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Achalasia cardia ,sigmoid esophagus ,POEM ,efficacy ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
ABSTRACT Background: Advanced achalasia cardia (AC) represents the end stage in the natural history of AC. Role of per oral endoscopic myotomy (POEM) in this technically difficult subset is emerging. Methods: Retrospective review of the patients who had undergone POEM for advanced AC with sigmoid esophagus. We assessed the technical success, clinical success and adverse event rate. Pre and post POEM Eckardt score (ES), integrated relaxation pressure-4sec (IRP-4), lower oesophageal sphincter pressure (LESP) and height and width of barium column at 5 minutes were noted. Results: Of the 85 patients who underwent POEM for AC, 10 patients had advanced AC with sigmoid esophagus of which eight were sigmoid and two were advanced sigmoid. The clinical and technical success was 100% with significant reduction of ES, IRP-4, LESP and height and width of barium column at 5 minutes. One patient had a minor adverse event in the form of mucosal injury that was closed with hemoclips. At a median follow up of 17 months there was no recurrence. Conclusion: Our study demonstrates POEM to be a safe and effective modality of treatment in this technically difficult subset of AC with sigmoid morphology.
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- 2022
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18. TPMT and NUDT15 polymorphisms in thiopurine induced leucopenia in inflammatory bowel disease: a prospective study from India
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Narinder Grover, Prateek Bhatia, Antriksh Kumar, Minu Singh, Deepesh Lad, Harshal S. Mandavdhare, Jayanta Samanta, Kaushal K. Prasad, Usha Dutta, and Vishal Sharma
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Inflammatory bowel disease ,Crohn’s disease ,Ulcerative colitis ,Cytopenia ,Bone marrow suppression ,6-mercaptopurine ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Polymorphisms in thiopurine methyltransferase (TPMT) and Nudix hydrolase-15 (NUDT15) have been implicated as the predominant cause of thiopurine induced leukopenia in the Western countries and East Asia respectively. Exact role of these polymorphisms in South Asian population with inflammatory bowel disease (IBD) is uncertain. Methods We included consecutive patients with IBD who were initiated on thiopurines at a center in North India. The dosage of thiopurines was titrated using regular monitoring of hemogram and liver function tests. Three TPMT polymorphisms (c.238 G > C, c.460 G > A, and c.719A > G) and one NUDT15 polymorphism (c.415 C > T) were assessed. Comparison regarding incidence of leukopenia and maximum tolerated thiopurine dosage was performed between those with wild polymorphism and those with TPMT and NUDT15 polymorphisms, respectively. Results Of the 119 patients (61 males, mean age 36.8 ± 13.5 years), 105 (88.2%) had ulcerative colitis and 14 (11.8%) had Crohn’s disease. Leukopenia was noted in 33 (27.7%), gastrointestinal intolerance in 5 (4.2%) and pancreatitis in 2 (1.6%). TPMT polymorphisms were detected amongst five patients of whom 1 developed leukopenia. NUDT15 polymorphism was noted in 13 patients of whom 7 had leukopenia. The odds of developing leukopenia in TPMT polymorphism were non-significant (0.77, 95% CI:0.0822 to 7.2134, P = 0.819) but were significantly higher in those with NUDT15 polymorphism (3.5933, 1.1041 to 11.6951, P value: = 0.0336). Conclusion NUDT15 polymorphism was more frequent than TPMT polymorphisms and was associated with thiopurine induced leukopenia. However, the tested polymorphisms account for only 24.2% of the risk of thiopurine induced leukopenia.
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- 2021
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19. New Perspectives in Endoscopic Treatment of Gastroesophageal Reflux Disease
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Federica Calabrese, Valeria Poletti, Francesco Auriemma, Danilo Paduano, Carmine Gentile, Antonio Facciorusso, Gianluca Franchellucci, Alessandro De Marco, Luca Brandaleone, Andrew Ofosu, Jayanta Samanta, Daryl Ramai, Luca De Luca, Abed Al-Lehibi, Walter Zuliani, Cesare Hassan, Alessandro Repici, and Benedetto Mangiavillano
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gastroesophageal reflux disease (GERD) ,transoral incisionless fundoplication (TIF) ,anti-reflux mucosal interventions (ARMI) ,anti-reflux mucosal resection (ARMS) ,anti-reflux mucosal ablation (ARMA) ,Medicine (General) ,R5-920 - Abstract
Gastroesophageal reflux disease has a high incidence and prevalence in the general population. Clinical manifestations are heterogenous, and so is the response to medical treatment. Proton pump inhibitors are still the most common agents used to control reflux symptoms and for healing esophagitis, but they are not a one-size-fits-all solution for the disease. Patients with persistent troublesome symptoms despite medical therapy, those experiencing some adverse drug reaction, or those unwilling to take lifelong medications deserve valid alternatives. Anti-reflux Nissen fundoplication is an effective option, but the risk of adverse events has limited its spread. In recent years, advancements in therapeutic endoscopy have been made, and three major endoluminal alternatives are now available, including (1) the delivery of radiofrequency energy to the esophago–gastric junction, (2) transoral incisionless fundoplication (TIF), and (3) anti-reflux mucosal interventions (ARMI) based on mucosal resection (ARMS) and mucosal ablation (ARMA) techniques to remodel the cardia. Endoscopic techniques have shown interesting results, but their diffusion is still limited to expert endoscopists in tertiary centers. This review discusses the state of the art in the endoscopic approach to gastroesophageal reflux disease.
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- 2023
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20. Cholangiocarcinoma in the Era of Immunotherapy
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Eleni Manthopoulou, Daryl Ramai, Jahnvi Dhar, Jayanta Samanta, Alexandros Ioannou, Ekaterina Lusina, Rodolfo Sacco, and Antonio Facciorusso
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cholangiocarcinoma ,immunotherapy ,adoptive cell therapy ,cancer vaccines ,checkpoint inhibitors ,Medicine - Abstract
Cholangiocarcinoma (CCA) is a rare malignancy of the gastrointestinal tract, with aggressive behavior, and portends a poor prognosis. Traditionally, it is classified according to its site of involvement as intrahepatic, perihilar, and distal cholangiocarcinoma. A host of genetic and epigenetic factors have been involved in its pathogenesis. Chemotherapy has remained the standard first-line treatment over the last decade, with a disappointing median overall survival of 11 months for locally advanced and metastatic CCA. The advent of immunotherapy has revolutionized the treatment of many pancreaticobiliary malignancies, offering durable responses with a safe therapeutic profile. To date, there have been no significant advances in the management of CCA. Novel immunotherapeutic methods, such as cancer vaccines, adoptive cell therapy, and combinations of immune checkpoint inhibitors with other agents, are currently under investigation and may improve prognosis with overall survival. Efforts to find robust biomarkers for response to treatment along with multiple clinical trials are also ongoing in this regard. In this review, we present an overview of the current advances and the future perspectives of immunotherapy in the management of CCA.
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- 2023
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21. Endotherapy for Nonvariceal Upper Gastrointestinal Hemorrhage
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Chhagan L. Birda, Antriksh Kumar, and Jayanta Samanta
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upper gastrointestinal bleed ,heat probe ,endoscopic hemostasis ,helicobacter pylori ,proton pump inhibitors ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Nonvariceal upper gastrointestinal hemorrhage (NVUGIH) is a common GI emergency with significant morbidity and mortality. Triaging cases on the basis of patient-related factors, restrictive blood transfusion strategy, and hemodynamic stabilization are key initial steps for the management of patients with NVUGIH. Endoscopy remains a vital step for both diagnosis and definitive management. Multiple studies and guidelines have now defined the optimum timing for performing the endoscopy after hospitalization, to better the outcome. Conventional methods for achieving endoscopic hemostasis, such as injection therapy, contact, and noncontact thermal therapy, and mechanical therapy, such as through-the-scope clips, have reported to have 76 to 90% efficacy for primary hemostasis. Newer modalities to enhance hemostasis rates have come in vogue. Many of these modalities, such as cap-mounted clips, coagulation forceps, and hemostatic powders have proved to be efficacious in multiple studies. Thus, the newer modalities are recommended not only for management of persistent bleed and recurrent bleed after failed initial hemostasis, using conventional modalities but also now being advocated for primary hemostasis. Failure of endotherapy would warrant radiological or surgical intervention. Some newer tools to optimize endotherapy, such as endoscopic Doppler probes, for determining flow in visible or underlying vessels in ulcer bleed are now being evaluated. This review is focused on the technical aspects and efficacy of various endoscopic modalities, both conventional and new. A synopsis of the various studies describing and comparing the modalities have been outlined. Postendoscopic management including Helicobacter pylori therapy and starting of anticoagulants and antiplatelets have also been outlined.
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- 2021
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22. Advances in Endoscopic Ultrasound (EUS)-Guided Liver Biopsy
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Daryl Ramai, Viraaj Pannu, Antonio Facciorusso, Banreet Dhindsa, Joseph Heaton, Andrew Ofosu, Saurabh Chandan, Marcello Maida, Barbara Lattanzi, Eduardo Rodriguez, Vicky H. Bhagat, Jayanta Samanta, and Monique T. Barakat
- Subjects
endoscopic ultrasound ,liver biopsy ,endoscopy ,percutaneous liver biopsy ,Medicine (General) ,R5-920 - Abstract
Recent years have seen the emergence of endoscopic-ultrasound-guided liver biopsy (EUS-LB) as an effective alternative to traditional (percutaneous or transjugular) liver biopsy techniques. Comparative studies have demonstrated that both endoscopic and non-endoscopic approaches are similar in terms of diagnostic adequacy, accuracy, and adverse events; however, EUS-LB offers the advantage of reduced recovery time. Additionally, EUS-LB enables the sampling of both lobes of the liver as well as the advantage of portal pressure measurements. However, EUS-LB may be argued to have a high cost, although this procedure can be cost-effective if bundled with other endoscopic procedures. Approaches utilizing EUS-guided liver therapy, such as the administration of chemotherapeutic agents and EUS elastography, are in development, and their optimal integration into clinical care is likely to emerge in the coming years. In the present review, we evaluate the available literature on EUS-LB indications, contraindications, variations in needle biopsy techniques, comparative outcomes, advantages and disadvantages, and future trends and perspectives.
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- 2023
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23. Percutaneous Endoscopic Gastrostomy Tube Gone Wrong: Endoscopic Closure to the Rescue
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Jahnvi Dhar, Naveen Kumar, Pankaj Gupta, Rakesh Kochhar, and Jayanta Samanta
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perforation ,over-the-scope clip ,pneumoperitoneum ,endotherapy ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Percutaneous endoscopic gastrostomy (PEG) is one of the most commonly performed endoscopic procedures and a first-line treatment for the establishment of enteral access in those with intolerance or contraindication to oral feedings. A small amount of pneumoperitoneum in the immediate postprocedure period is well reported after PEG tube placement. However, pneumoperitoneum resulting from displaced gastric bumper within 24 hours postprocedure is uncommon and rarely reported in the literature. Timely diagnosis and early endoscopic management can help tackle such an unusual complication.
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- 2021
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24. Computed Tomography Findings in Intraabdominal Hypertension in Patients with Acute Pancreatitis
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Pankaj Gupta, Rohan Kamat, Jayanta Samanta, Harshal Mandavdhare, Vishal Sharma, Saroj Kant Sinha, Usha Dutta, and Rakesh Kochhar
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acute pancreatitis ,abdominal compartment syndrome ,computed tomography ,intraabdominal hypertension ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Purpose Intraabdominal hypertension (IAH) in acute pancreatitis (AP) may reduce tissue perfusion and impair organ function and has been shown to portend poor prognosis. We investigated the computed tomography (CT) findings in patients with AP with IAH. Methods This retrospective study comprised of consecutive patients with AP from June 2016 to June 2018 in whom intraabdominal pressure (IAP) was measured. The patients who underwent a contrast-enhanced CT within 7 days of IAP measurement were included. Using a cutoff of 12 mm Hg for IAP, the patients were divided into IAH and non-IAH groups. Measures of severity and clinical outcome were evaluated. CT parameters were compared between the groups. Results The IAH group comprised of 41 patients, while there were 20 patients in the non-IAH group. The IAH group was characterized by severe disease, increased incidence of organ failure, increased requirement for drainage and surgery, prolonged hospital and intensive care unit stay. The mortality was not significantly different between the two groups. On univariate analysis, the CT features that were found to be significantly different between the two groups were the presence of collection (p = 0.036), the maximum dimension of collection (p = 0.004), volume of collection (p = 0.019), biliary dilatation (p = 0.011), and the presence of moderate-to-severe pleural effusion (p = 0.009). On multivariate analysis, all these parameters except biliary dilatation were found to be statistically significant. Conclusion CT findings in patients with AP may suggest IAH. This can be used as an additional marker for severity of AP.
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- 2021
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25. 2019 Novel Coronavirus Infection: Gastrointestinal Manifestations
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Jayanta Samanta, Jahnvi Dhar, Abdul Khaliq, and Rakesh Kochhar
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sars-cov-2 ,covid-19 ,gastrointestinal symptoms ,coronavirus ,fecal shedding ,digestive symptoms ,feco-oral transmission ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
The world is witnessing a major public health crisis in the wake of the third coronavirus strain pandemic, a novel coronavirus (severe acute respiratory syndrome coronavirus 2). Although initially thought to be a pure respiratory pathogen, recent reports have highlighted not only the extrapulmonary effects of the virus but also, importantly, the gastrointestinal tract (GIT) effects. Various studies have looked into the effects of this novel coronavirus infection (coronavirus-19 disease [COVID-19]) on GIT involvement with reports of more frequent involvement than previously expected. With feco-oral transmission, debate being conclusively proven with fecal samples testing positive for COVID-19 and longer shedding time, it only underlines the importance of GIT involvement. Moreover, the presence of other GI diseases, such as inflammatory bowel disease, with COVID-19 infection might wreak havoc leading to poor patient outcomes.
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- 2020
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26. Gastrointestinal complications in acute and chronic pancreatitis
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Akash Bansal, Pankaj Gupta, Harjeet Singh, Jayanta Samanta, Harshal Mandavdhare, Vishal Sharma, Saroj K Sinha, Usha Dutta, and Rakesh Kochhar
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acute pancreatitis ,bowel complications ,chronic pancreatitis ,gastrointestinal fistula ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Pancreatitis is one of the important medical conditions. Gastrointestinal (GI) complications of pancreatitis are important and lead to significant morbidity and mortality. Diagnosis of these complications is difficult and may require a strong clinical suspicion coupled with various imaging features. This review provides an extensive update of the whole spectrum of GI complication of pancreatitis, both acute and chronic, from inflammation, ischemia, and necrosis to obstruction, perforation, and GI fistulae. The focus is on the clinical and imaging features of this less commonly described aspect of pancreatitis.
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- 2019
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27. De novo double-hit B-cell precursor leukemia/lymphoma - an unusual presentation as peritoneal lymphomatosis
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Balamurugan Thirunavukkarasu, Jayanta Samanta, Prateek Bhatia, and Amanjit Bal
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Precursor B-Cell Lymphoblastic Lymphoma ,Peritoneal neoplasms ,c-myc ,Ascites ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Peritoneal lymphomatosis (PL) is a rare presentation of extranodal precursor leukemia/lymphoma. The presentation is often non-specific, leading to delayed diagnosis and treatment. In this case, though the preliminary diagnosis was established on ascitic fluid cytology, the disease progressed rapidly, leading to demise before initiating chemotherapy. Immunophenotyping and molecular studies, performed later, established a diagnosis of de novo B-cell precursor leukemia/ lymphoma with MYC, BCL2 rearrangements (Double-hit lymphoma). MYC, BCL2 rearrangements are rarely reported in precursor B-lymphoma/leukemia which carry dismal prognosis. In this report, we illustrate autopsy findings of PL in an elderly gentleman who presented with ascites for evaluation.
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- 2021
28. Does esophageal wall thickness on computed tomography predict response to endoscopic dilatation in patients with corrosive esophageal strictures?
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Pankaj Gupta, Ajay Gulati, Yalaka R Reddy, Jayanta Samanta, and Rakesh Kochhar
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computed tomography scan ,corrosive ,dilatation ,endoscopy ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and Aim To evaluate the role of esophageal wall thickness (EWT) on computed tomography (CT) in predicting response to endoscopic dilatation of corrosive esophageal strictures. Methods This was a retrospective study. A review of the records of patients who underwent endoscopic dilatation of esophageal strictures between January 2010 and December 2017 was performed. Patients who had a CT evaluation prior to dilatations were included. CT‐EWT was measured at the maximum visible point. Clinical details and endoscopic dilatation parameters were recorded. Technical success, clinical success, and recurrent and refractory strictures were recorded. CT‐EWT and the clinical parameters were evaluated regarding their role in predicting the number of dilatations required to achieve technical and clinical success. Results A total of 250 patients underwent endoscopic dilatations during the study period; 84 patients underwent thoracoabdominal CT. Complete clinical, endoscopic, CT data and follow up were available for 64 patients. There were 36 males. The median age was 30 years (range, 14–70 years). A total of 750 dilatations were performed. The median number of dilatations required to achieve technical success was 8.5 (range, 1–51). Dilatations were performed after a median period of 3 months (range, 1–40). Median CT‐EWT was 7 mm (range, 3–22). On univariate, as well as multivariate, analysis, CT‐EWT and the clinical parameters were found to be poor predictors of the number of dilatations required to achieve technical and clinical success. Conclusion CT‐EWT has no additional role in predicting response to the endoscopic dilatation of corrosive esophageal strictures.
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- 2019
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29. Change in serum levels of inflammatory markers reflects response of percutaneous catheter drainage in symptomatic fluid collections in patients with acute pancreatitis
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Bipadabhanjan Mallick, Shallu Tomer, Sunil K Arora, Anupam Lal, Narendra Dhaka, Jayanta Samanta, Saroj K Sinha, Vikas Gupta, Thakur Deen Yadav, and Rakesh Kochhar
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acute pancreatitis ,C‐reactive protein ,interleukin‐10 ,interleukin‐6 ,inflammatory markers ,interleukins ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background Percutaneous catheter drainage (PCD) is used as the first step in the management of symptomatic fluid collections in patients with acute pancreatitis (AP). There are limited data on the effect of PCD on inflammatory markers. Aim To study the effects of PCD on serum levels of C‐reactive protein (CRP), IL‐6, and IL‐10 and its correlation with the outcome. Methods Consecutive patients of AP with symptomatic fluid collections undergoing PCD were evaluated for serum levels of CRP, IL‐6, and IL‐10 before PCD and at 3 and 7 days after PCD. Resolution of organ failure (OF), sepsis, and pressure symptoms was considered to demonstrate the success of PCD. Changes in levels following PCD were correlated with outcome. Results Indications of PCD in 59 patients (age 38.9 ± 13.17 years, 49 male) were suspected/documented infected pancreatic necrosis (n = 45), persistent OF (n = 40), and pressure symptoms (n = 7). A total of 49 (83.1%) patients improved with PCD, five patients required surgery, and six died. A significant difference was noted between baseline levels of CRP (P = 0.026) and IL‐6 (P = 0.013) among patients who improved compared to those who worsened following PCD. Significant decrease (P
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- 2019
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30. Comparative study of the outcome between alcohol and gallstone pancreatitis in a high‐volume tertiary care center
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Jayanta Samanta, Narendra Dhaka, Pankaj Gupta, Anupam K Singh, Thakur D Yadav, Vikas Gupta, Saroj K Sinha, and Rakesh Kochhar
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acute pancreatitis ,alcohol ,biliary ,etiology ,gallstone ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and Aim The two most common etiologies of acute pancreatitis (AP) are alcohol and gallstone. Whether etiology contributes to the outcome in patients with AP is an unresolved issue, more so in the severe form of the disease. The aim is to study the effects of the etiological factors of alcohol and gallstone on the disease course and the role of etiology in the subgroup of severe AP. Methods Consecutive patients of AP with alcohol or gallstone etiology were included. Various severity parameters and various outcome measures, such as need for organ support, intensive care, surgical or radiological intervention, hospital stay, and mortality, were evaluated between the two groups. Results Of the 759 patients, alcoholic pancreatitis was seen in 368 (48.5%), while gallstone disease was observed in 246 (32.4%). Gallstone pancreatitis occurred in older age (P
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- 2019
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31. 'An Odyssey of Third Space Endoscopy'—from Entry into the Tunnel to Entry into the Peritoneal Cavity
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Harshal S. Mandavdhare, Shubhra Mishra, Jayanta Samanta, Jimil Shah, and Rakesh Kochhar
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third space ,per oral endoscopic myotomyfundoplication ,robotic ,endoscopy ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
The last decade has seen the growth of a completely new and exciting entity called the third space endoscopy (TSE) that has brought about a paradigm shift in the way we manage various disorders of the gastrointestinal tract. The journey started with per oral endoscopic myotomy (POEM) for achalasia cardia and within a decade the concept has been exploited to its best potential for disorders including submucosal tumor resection, pyloromyotomy for gastroparesis, complete division of septum without the risk of perforation in diverticular diseases of esophagus, restoration of esophageal lumen in long strictures, restoration of bowel movement in Hirschsprung’s disease, and then taking the concept to the next level of pure NOTES (natural orifice transluminal endoscopic surgery) by entering the peritoneal cavity and performing fundoplication. This review will discuss the history of TSE with brief discussion about the various applications and what has been achieved till present.
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- 2019
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32. Isolated Ascending Colon Varix: An Unusual Cause of Lower Gastrointestinal Bleed
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Jahnvi Dhar, Jayanta Samanta, Gaurav Muktesh, and Rakesh Kochhar
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portal hypertension ,cirrhosis ,ectopic varix ,lower gastrointestinal bleed ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Ectopic varices, defined as dilated portosystemic veins located at unusual sites other than the gastroesophageal junction and fundus, have been reported in cases of cirrhosis with underlying portal hypertension. The common sites usually are the rectum and duodenum. Isolated colon varix is therefore a rare phenomenon and such varix presenting with lower gastrointestinal bleed as the first manifestation is still uncommon. A high index of clinical suspicion, timely imaging with full-length colonoscopy, and subsequent endoscopic therapy can effectively manage this rare entity.
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- 2021
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33. Can high-frequency mini-probe endoscopic ultrasonography predict outcome of endoscopic dilation in patients with benign esophageal strictures?
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Philip Daniel, Jayanta Samanta, Ajay Gulati, Pankaj Gupta, Gaurav Muktesh, Saroj K. Sinha, and Rakesh Kochhar
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and study aims Endoscopic dilation is first-line management for benign esophageal strictures (ES). Depth of involvement of the esophageal wall on endosonography using high frequency mini-probe (EUS-M) may predict response to dilation. This study evaluated EUS-M characteristics to predict response of ES to endoscopic dilation. Patients and methods EUS-M was used to measure the total esophageal wall thickness (EWT), involved EWT, percentage of involved wall and layers of wall involved in consecutive patients of benign ES. After a maximum of five sessions of endoscopic dilation, the cohort was divided into responders and refractory strictures. EUS-M characteristics were compared for underlying etiology as also between responders and refractory strictures. Results Of the 30 strictures (17 females, age: 47.16 ± 15.86 yrs.) 13 were anastomotic, eight corrosive, seven peptic and 2 others. Corrosive strictures had the highest involved EWT and percentage of involved wall (3.51 ± 1.36 mm; 76.38 %) followed by anastomotic (2.73 ± 1.7 mm; 65.54 %) and peptic (1.39 ± 0.62 mm; 40.71 %) (P = 0.026 and 0.021 respectively). After five dilations, 22 were classified as responders and eight as refractory. Wall involvement > 70 % had a greater proportion of refractory strictures (P = 0.019). Strictures with involved EWT of ≥ 2.85 mm required more dilations (P = 0.011). Fewer dilations were required for stricture resolution with only mucosal involvement compared to deeper involvement such as submucosa and muscularis propria (2.14 vs. 5.80; P = 0.001). Conclusion EUS-M evaluation shows that corrosive and anastomotic strictures have greater depth of involvement compared to peptic strictures. Depth of esophageal wall involvement in a stricture predicts response to dilation.
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- 2020
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34. Cholangiocarcinoma: Challenges and Improving the Outcomes
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Suhang Verma, Jayanta Samanta, Anupam K. Singh, and Rakesh Kochhar
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2019
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35. The safety and efficacy of epidural anaesthesia in acute pancreatitis:a systematic review and meta-analysis
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Dhya Al-Leswas, Nesta Baxter, Wei B. Lim, Francis Robertson, Bathiya Ratnayake, Jayanta Samanta, Gabriele Capurso, Enrique de-Madaria, Asbjørn M. Drewes, John Windsor, and Sanjay Pandanaboyana
- Subjects
Hepatology ,Gastroenterology - Abstract
BACKGROUND: Acute pancreatitis (AP) has variable clinical courses. This systematic review and meta-analysis aimed to determine the safety, efficacy, and impact of epidural anaesthesia (EA) use in AP.METHODS: The PubMed, EMBASE, SCOPUS and Cochrane library databases were systematically searched between 1980 and 2022 using the PRISMA guidelines, to identify observational and comparative studies reporting on EA in AP. The meta-analysis was performed in R Foundation for Statistical Computing using the meta R Package for Meta-Analysis.RESULTS: A total of 9 studies with 2006 patients of which 726 (36%) patients had EA were included. All studies demonstrated high safety and feasibility of EA in AP with no reported major local or neurological complications. One randomised controlled trial demonstrated an improvement in pain severity using a 0-10 visual analogue scale (VAS) at the outset (1.6 in EA vs 3.5 in non-EA, P = 0.02) and on day 10 (0.2 in EA vs 2.33 in non-EA, P = 0.034). There was also improvement in pancreatic perfusion with EA measured with computerised tomography 13 (43%) in EA vs 2 (7%) in non-EA, P = 0.003. The need for ventilatory support and overall mortality was lower in EA patients 40 (19%) vs 285 (24%) P = 0.025 (OR: 0.49, 95% CI: 0.28-0.84) and 16 (7%) vs 214 (20%), P = 0.050 (OR: 0.39, 95% CI: 0.15-1.00), respectively.CONCLUSION: EA is infrequently used for pain management in AP and yet the available evidence suggests that it is safe and effective in reducing pain severity, improving pancreatic perfusion, and decreasing mortality.
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- 2023
36. Same-session double EUS-guided bypass versus surgical gastroenterostomy and hepaticojejunostomy:an international multicenter comparison
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Michiel Bronswijk, Giuseppe Vanella, Roy L.J. van Wanrooij, Jayanta Samanta, Jonas Lauwereys, Enrique Pérez-Cuadrado-Robles, Giuseppe Dell’Anna, Jahnvi Dhar, Vikas Gupta, Hannah van Malenstein, Wim Laleman, Joris Jaekers, Halit Topal, Baki Topal, Stefano Crippa, Massimo Falconi, Marc G. Besselink, Nouredin Messaoudi, Paolo Giorgio Arcidiacono, Rastislav Kunda, and Schalk Van der Merwe
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Gastroenterology ,Radiology, Nuclear Medicine and imaging - Abstract
Background and Aims: Gastric outlet and biliary obstruction are common manifestations of GI malignancies and some benign diseases for which standard treatment would be surgical gastroenterostomy and hepaticojejunostomy (ie, “double bypass”). Therapeutic EUS has allowed for the creation of an EUS-guided double bypass. However, same-session double EUS-guided bypass has only been described in small proof-of-concept series and lacks a comparison with surgical double bypass. Methods: A retrospective multicenter analysis was performed of all consecutive same-session double EUS-guided bypass procedures performed in 5 academic centers. Surgical comparators were extracted from these centers’ databases from the same time interval. Efficacy, safety, hospital stay, nutrition and chemotherapy resumption, long-term patency, and survival were compared. Results: Of 154 identified patients, 53 (34.4%) received treatment with EUS and 101 (65.6%) with surgery. At baseline, patients undergoing EUS exhibited higher American Society of Anesthesiologists scores and a higher median Charlson Comorbidity Index (9.0 [interquartile range {IQR}, 7.0-10.0] vs 7.0 [IQR, 5.0-9.0], P
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- 2023
37. Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement
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Ivo Boškoski, Valerio Pontecorvi, Mostafa Ibrahim, Vincent Huberty, Roberta Maselli, Stefan K. Gölder, Jan Kral, Jayanta Samanta, Árpád V. Patai, Rehan Haidry, Marcus Hollenbach, Enrique Pérez-Cuadrado-Robles, Marco Silva, Helmut Messmann, Tony C. Tham, and Raf Bisschops
- Subjects
N/A ,Settore MED/12 - GASTROENTEROLOGIA ,Gastroenterology - Abstract
Main recommendationsObesity is a chronic, relapsing, degenerative, multifactorial disease that is associated with many co-morbidities. The global increasing burden of obesity has led to calls for an urgent need for additional treatment options. Given the rapid expansion of bariatric endoscopy and bariatric surgery across Europe, the European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE and provides a framework to develop and maintain skills in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. This curriculum is set out in terms of the prerequisites prior to training, minimum number of procedures, the steps for training and quality of training, and how competence should be defined and evidenced before independent practice. 1 ESGE recommends that every endoscopist should have achieved competence in upper gastrointestinal endoscopy before commencing training in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse events. 2 Trainees in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery should have basic knowledge of the definition, classification, and social impact of obesity, its pathophysiology, and its related co-morbidities. The recognition and management of gastrointestinal diseases that are more common in patients with obesity, along with participation in multidisciplinary teams where obese patients are evaluated, are mandatory. 3 ESGE recommends that competency in bariatric endoscopy and the endoscopic treatment of the complications of bariatric surgery can be learned by attending validated training courses on simulators initially, structured training courses, and then hands-on training in tertiary referral centers.
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- 2023
38. Role of endoscopic ultrasound in the field of hepatology: Recent advances and future trends
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Jahnvi Dhar and Jayanta Samanta
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Endoscopic ultrasound ,medicine.medical_specialty ,Varices ,Hepatology ,Field (physics) ,medicine.diagnostic_test ,business.industry ,Liver biopsy ,digestive system diseases ,Frontier ,Internal medicine ,Medicine ,Medical physics ,Liver tumor ,business ,Elastography ,Liver disease - Abstract
The role of endoscopic ultrasound (EUS) as a diagnostic and therapeutic modality for the management of various gastrointestinal diseases has been expanding. The imaging or intervention for various liver diseases has primarily been the domain of radiologists. With the advances in EUS, the domain of endosonologists is rapidly expanding in the field of hepatology. The ability to combine endoscopy and sonography in one hybrid device is a unique property of EUS, together with the ability to bring its probe/transducer near the liver, the area of interest. Its excellent spatial resolution and ability to provide real-time images coupled with several enhancement techniques, such as contrast-enhanced (CE) EUS, have facilitated the growth of EUS. The concept of "Endo-hepatology" encompasses the wide range of diagnostic and therapeutic procedures that are now gradually becoming feasible for managing various liver diseases. Diagnostic advancements can enable a wide array of techniques from elastography and liver biopsy for liver parenchymal diseases, to CE-EUS for focal liver lesions to portal pressure measurements for managing various liver conditions. Similarly, therapeutic advancements range from EUS-guided eradication of varices, drainage of bilomas and abscesses to various EUS-guided modalities of liver tumor management. We provide a comprehensive review of all the different diagnostic and therapeutic EUS modalities available for the management of various liver diseases. A synopsis of all the technical details involving each procedure and the available data has been tabulated, and the future trends in this area have been highlighted.
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- 2021
39. Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?
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Harshal S Mandavdhare, Vishal Sharma, Manavjit Singh Sandhu, Jayanta Samanta, Naveen Kalra, Pankaj Gupta, Rakesh Kochhar, Usha Dutta, and Varun Bansal
- Subjects
Biliary drainage ,medicine.medical_specialty ,Original Paper ,Percutaneous ,Hepatology ,business.industry ,Retrospective cohort study ,medicine.disease ,Surgery ,biliary drainage ,gallbladder cancer ,cholangitis ,medicine ,PTBD ,Major complication ,Percutaneous transhepatic biliary drainage ,Gallbladder cancer ,Prospective cohort study ,business ,Unresectable gallbladder cancer - Abstract
Aim of the study This study aimed to evaluate the outcomes of patients with unresectable gallbladder cancer (GBC) with hilar involvement and cholangitis undergoing percutaneous transhepatic biliary drainage (PTBD). Material and methods This retrospective study comprised consecutive patients with unresectable GBC with cholangitis who underwent PTBD. The procedures were categorized as unilateral or bilateral. Bilateral PTBD was classified as simultaneous or sequential. The mean reduction in bilirubin at two weeks was recorded. Complications and mean overall survival were also recorded. Results Thirty-three patients (mean age 54.5 years, 12 males) were included. Thirty patients underwent unilateral drainage. Sequential drainage of the contralateral system was performed in 11 patients. Simultaneous bilateral PTBD was performed in 3 patients. PTBD was technically successful in all patients. Mean reduction in bilirubin was 41.5% in the unilateral group. The fall of bilirubin in the simultaneous bilateral PTBD group was 39%. The mean follow-up duration was 36.5 days. No major complications were encountered. At the last follow-up, 7 patients were alive. The mean overall survival was 34.6 days. Conclusions Patients with unresectable GBC and cholangitis frequently require bilateral drainage. However, prospective studies should be performed to evaluate whether a sequential or simultaneous PTBD should be performed.
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- 2021
40. Can high-frequency mini-probe endoscopic ultrasonography predict outcome of endoscopic dilation in patients with benign esophageal strictures?
- Author
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Jayanta Samanta, Ajay Gulati, Rakesh Kochhar, Philip Daniel, Gaurav Muktesh, Saroj K. Sinha, and Pankaj Gupta
- Subjects
medicine.medical_specialty ,Original article ,business.industry ,Esophageal wall ,Peptic ,Endoscopic ultrasonography ,Anastomosis ,medicine.anatomical_structure ,Submucosa ,Etiology ,Medicine ,lcsh:Diseases of the digestive system. Gastroenterology ,Pharmacology (medical) ,In patient ,Radiology ,lcsh:RC799-869 ,business ,Endoscopic dilation - Abstract
Background and study aims Endoscopic dilation is first-line management for benign esophageal strictures (ES). Depth of involvement of the esophageal wall on endosonography using high frequency mini-probe (EUS-M) may predict response to dilation. This study evaluated EUS-M characteristics to predict response of ES to endoscopic dilation. Patients and methods EUS-M was used to measure the total esophageal wall thickness (EWT), involved EWT, percentage of involved wall and layers of wall involved in consecutive patients of benign ES. After a maximum of five sessions of endoscopic dilation, the cohort was divided into responders and refractory strictures. EUS-M characteristics were compared for underlying etiology as also between responders and refractory strictures. Results Of the 30 strictures (17 females, age: 47.16 ± 15.86 yrs.) 13 were anastomotic, eight corrosive, seven peptic and 2 others. Corrosive strictures had the highest involved EWT and percentage of involved wall (3.51 ± 1.36 mm; 76.38 %) followed by anastomotic (2.73 ± 1.7 mm; 65.54 %) and peptic (1.39 ± 0.62 mm; 40.71 %) (P = 0.026 and 0.021 respectively). After five dilations, 22 were classified as responders and eight as refractory. Wall involvement > 70 % had a greater proportion of refractory strictures (P = 0.019). Strictures with involved EWT of ≥ 2.85 mm required more dilations (P = 0.011). Fewer dilations were required for stricture resolution with only mucosal involvement compared to deeper involvement such as submucosa and muscularis propria (2.14 vs. 5.80; P = 0.001). Conclusion EUS-M evaluation shows that corrosive and anastomotic strictures have greater depth of involvement compared to peptic strictures. Depth of esophageal wall involvement in a stricture predicts response to dilation.
- Published
- 2020
41. 2019 Novel Coronavirus Infection: Gastrointestinal Manifestations
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Abdul Khaliq, Jayanta Samanta, Jahnvi Dhar, and Rakesh Kochhar
- Subjects
coronavirus ,Disease ,Review Article ,medicine.disease_cause ,Inflammatory bowel disease ,Virus ,03 medical and health sciences ,0302 clinical medicine ,Pandemic ,medicine ,lcsh:RC799-869 ,General Environmental Science ,Coronavirus ,Gastrointestinal tract ,Transmission (medicine) ,business.industry ,SARS-CoV-2 ,feco-oral transmission ,Gastroenterology ,COVID-19 ,medicine.disease ,Review article ,digestive symptoms ,fecal shedding ,Radiology Nuclear Medicine and imaging ,gastrointestinal symptoms ,030220 oncology & carcinogenesis ,Immunology ,030211 gastroenterology & hepatology ,lcsh:Diseases of the digestive system. Gastroenterology ,business - Abstract
The world is witnessing a major public health crisis in the wake of the third coronavirus strain pandemic, a novel coronavirus (severe acute respiratory syndrome coronavirus 2). Although initially thought to be a pure respiratory pathogen, recent reports have highlighted not only the extrapulmonary effects of the virus but also, importantly, the gastrointestinal tract (GIT) effects. Various studies have looked into the effects of this novel coronavirus infection (coronavirus-19 disease [COVID-19]) on GIT involvement with reports of more frequent involvement than previously expected. With feco-oral transmission, debate being conclusively proven with fecal samples testing positive for COVID-19 and longer shedding time, it only underlines the importance of GIT involvement. Moreover, the presence of other GI diseases, such as inflammatory bowel disease, with COVID-19 infection might wreak havoc leading to poor patient outcomes.
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- 2020
42. Gastrointestinal complications in acute and chronic pancreatitis
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Usha Dutta, Akash Bansal, Jayanta Samanta, Saroj K. Sinha, Rakesh Kochhar, Vishal Sharma, Harjeet Singh, Pankaj Gupta, and Harshal S Mandavdhare
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gastrointestinal fistula ,medicine.medical_specialty ,Necrosis ,acute pancreatitis ,Perforation (oil well) ,Ischemia ,Review Article ,RC799-869 ,Gastroenterology ,chronic pancreatitis ,03 medical and health sciences ,Gastrointestinal complications ,0302 clinical medicine ,Internal medicine ,medicine ,Review Articles ,Hepatology ,business.industry ,bowel complications ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,030220 oncology & carcinogenesis ,Pancreatitis ,Acute pancreatitis ,030211 gastroenterology & hepatology ,medicine.symptom ,Complication ,business ,Gastrointestinal Fistula - Abstract
Pancreatitis is one of the important medical conditions. Gastrointestinal (GI) complications of pancreatitis are important and lead to significant morbidity and mortality. Diagnosis of these complications is difficult and may require a strong clinical suspicion coupled with various imaging features. This review provides an extensive update of the whole spectrum of GI complication of pancreatitis, both acute and chronic, from inflammation, ischemia, and necrosis to obstruction, perforation, and GI fistulae. The focus is on the clinical and imaging features of this less commonly described aspect of pancreatitis., Gastrointestinal complications of pancreatitis are important and lead to significant morbidity and mortality. Diagnosis of these complications is difficult and may require strong clinical suspicion coupled with various imaging features.
- Published
- 2019
43. Endoscopic Ultrasound Fine-Needle Biopsy versus Fine-Needle Aspiration for Tissue Sampling of Abdominal Lymph Nodes: A Propensity Score Matched Multicenter Comparative Study
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Antonio Facciorusso, Nicola Muscatiello, Christian Cotsoglou, Daryl Ramai, Stefano Francesco Crinò, Jayanta Samanta, Paraskevas Gkolfakis, and Juliana Londoño Castillo
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Endoscopic ultrasound ,Cancer Research ,medicine.medical_specialty ,pancreatic cancer ,colorectal cancer ,Article ,Metastasis ,Pancreatic cancer ,Biopsy ,medicine ,Sampling (medicine) ,fine-needle aspiration ,metastases ,Lymph node ,RC254-282 ,medicine.diagnostic_test ,business.industry ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,digestive system diseases ,Fine-needle aspiration ,medicine.anatomical_structure ,Oncology ,endoscopic ultrasound ,Propensity score matching ,fine-needle biopsy ,Radiology ,business - Abstract
There is a paucity of evidence on the comparison between endoscopic ultrasound (EUS) fine-needle biopsy (FNB) and fine-needle aspiration (FNA) for lymph node (LNs) sampling. The aim of this study was to compare these two approaches in a multicenter series of patients with abdominal tumors. Out of 502 patients undergoing EUS sampling, two groups following propensity score matching were compared: 105 undergoing EUS-FNB and 105 undergoing EUS-FNA. The primary outcome was diagnostic accuracy. Secondary outcomes were diagnostic sensitivity, specificity, sample adequacy, optimal histological core procurement, number of passes, and adverse events. Median age was 64.6 years, and most patients were male in both groups. Final diagnosis was LN metastasis (mainly from colorectal cancer) in 70.4% of patients in the EUS-FNB group and 66.6% in the EUS-FNA group (p = 0.22). Diagnostic accuracy was significantly higher in the EUS-FNB group as compared to the EUS-FNA group (87.62% versus 75.24%, p = 0.02). EUS-FNB outperformed EUS-FNA also in terms of diagnostic sensitivity (84.71% vs. 70.11%, p = 0.01), whereas specificity was 100% in both groups (p = 0.6). Sample adequacy analysis showed a non-significant trend in favor of EUS-FNB (96.1% versus 89.5%, p = 0.06) whereas the histological core procurement rate was significantly higher with EUS-FNB (94.2% versus 51.4%, p <, 0.001). No procedure-related adverse events were observed. These findings show that EUS-FNB is superior to EUS-FNA in tissue sampling of abdominal LNs.
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- 2021
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44. TPMT and NUDT15 polymorphisms in thiopurine induced leucopenia in inflammatory bowel disease: a prospective study from India
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Prateek Bhatia, Narinder Grover, Antriksh Kumar, Vishal Sharma, Kaushal K Prasad, Usha Dutta, Deepesh Lad, Jayanta Samanta, Minu Singh, and Harshal S Mandavdhare
- Subjects
Crohn’s disease ,Adult ,Male ,medicine.medical_specialty ,Bone marrow suppression ,India ,RC799-869 ,Gastroenterology ,Inflammatory bowel disease ,Young Adult ,Polymorphism (computer science) ,Internal medicine ,Medicine ,Humans ,6-mercaptopurine ,Prospective Studies ,Pyrophosphatases ,Crohn's disease ,Leukopenia ,medicine.diagnostic_test ,Thiopurine methyltransferase ,biology ,business.industry ,General Medicine ,Methyltransferases ,Diseases of the digestive system. Gastroenterology ,Hepatology ,Middle Aged ,medicine.disease ,Inflammatory Bowel Diseases ,Ulcerative colitis ,Cytopenia ,biology.protein ,medicine.symptom ,business ,Liver function tests ,Research Article - Abstract
Background Polymorphisms in thiopurine methyltransferase (TPMT) and Nudix hydrolase-15 (NUDT15) have been implicated as the predominant cause of thiopurine induced leukopenia in the Western countries and East Asia respectively. Exact role of these polymorphisms in South Asian population with inflammatory bowel disease (IBD) is uncertain. Methods We included consecutive patients with IBD who were initiated on thiopurines at a center in North India. The dosage of thiopurines was titrated using regular monitoring of hemogram and liver function tests. Three TPMT polymorphisms (c.238 G > C, c.460 G > A, and c.719A > G) and one NUDT15 polymorphism (c.415 C > T) were assessed. Comparison regarding incidence of leukopenia and maximum tolerated thiopurine dosage was performed between those with wild polymorphism and those with TPMT and NUDT15 polymorphisms, respectively. Results Of the 119 patients (61 males, mean age 36.8 ± 13.5 years), 105 (88.2%) had ulcerative colitis and 14 (11.8%) had Crohn’s disease. Leukopenia was noted in 33 (27.7%), gastrointestinal intolerance in 5 (4.2%) and pancreatitis in 2 (1.6%). TPMT polymorphisms were detected amongst five patients of whom 1 developed leukopenia. NUDT15 polymorphism was noted in 13 patients of whom 7 had leukopenia. The odds of developing leukopenia in TPMT polymorphism were non-significant (0.77, 95% CI:0.0822 to 7.2134, P = 0.819) but were significantly higher in those with NUDT15 polymorphism (3.5933, 1.1041 to 11.6951, P value: = 0.0336). Conclusion NUDT15 polymorphism was more frequent than TPMT polymorphisms and was associated with thiopurine induced leukopenia. However, the tested polymorphisms account for only 24.2% of the risk of thiopurine induced leukopenia.
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- 2021
45. Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study
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Ashok Kumar, Ritesh Agarwal, Goverdhan Dutt Puri, JS Thakur, Pranay Mahajan, Navin Pandey, Rashmi Ranjan Guru, Usha Dutta, Inderpaul Singh Sehgal, Arunaloke Chakrabarti, Rajesh Chhabra, Arnab Ghosh, P V M Lakshmi, Manisha Biswal, Sanjay Jain, Muralidharan Jayashree, Babita Ghai, Jagat Ram, Shweta Talati, Ranjitpal Singh Bhogal, Ritin Mohindra, Vikas Suri, Arun Kumar Aggarwal, Jayanta Samanta, Gurmeet Singh, Vipin Koushal, Madhumita Premkumar, Sunita Malhotra, Tulika Gupta, Anurag Sachan, Pankaj Malhotra, Swapnajeet Sahoo, Mini P Singh, Kapil Goel, Rakesh Kochhar, Pankaj Arora, Rakesh Sehgal, Bhavneet Bharti, Ashish Bhalla, Sandeep Grover, Narayana Yaddanapudi, and S. K. Sharma
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Adult ,Male ,medicine.medical_specialty ,Infectious Disease Transmission, Patient-to-Professional ,media_common.quotation_subject ,Developing country ,Risk Assessment ,organisation of health services ,health & safety ,Hospitals, University ,Tertiary Care Centers ,clinical governance ,03 medical and health sciences ,0302 clinical medicine ,human resource management ,Health care ,medicine ,Medical Staff, Hospital ,Humans ,030212 general & internal medicine ,Prospective Studies ,Personal protective equipment ,Developing Countries ,Personal Protective Equipment ,Health policy ,media_common ,international health services ,business.industry ,Health Policy ,COVID-19 ,General Medicine ,Organizational Policy ,Occupational Diseases ,Family medicine ,Models, Organizational ,Workforce ,Medicine ,Female ,Willingness to accept ,Risk assessment ,business ,Welfare ,030217 neurology & neurosurgery - Abstract
ObjectivesHealthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty.SettingOur tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless.ParticipantsWe recruited willing low-risk HCP, aged ResultsBetween 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (ConclusionA multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.
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- 2021
46. Corona Virus Disease-19 pandemic: The gastroenterologists’ perspective
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Rakesh Kochhar, Jahnvi Dhar, and Jayanta Samanta
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medicine.medical_specialty ,Pneumonia, Viral ,Disease ,Inflammatory bowel disease ,Virus ,Endoscopy, Gastrointestinal ,03 medical and health sciences ,Betacoronavirus ,Feces ,0302 clinical medicine ,Internal medicine ,Pandemic ,medicine ,Disease Transmission, Infectious ,Humans ,Disease management (health) ,Intensive care medicine ,Pandemics ,business.industry ,Transmission (medicine) ,SARS-CoV-2 ,Gastroenterology ,COVID-19 ,Disease Management ,Hepatology ,medicine.disease ,Inflammatory Bowel Diseases ,Gastrointestinal Tract ,030220 oncology & carcinogenesis ,Viral pneumonia ,030211 gastroenterology & hepatology ,business ,Coronavirus Infections - Abstract
The world is witnessing a serious public health threat in the wake of the third corona virus pandemic, a novel corona virus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]). The Corona Virus Disease-19 (COVID-19) is not limited to the respiratory system but has widespread involvement including the gastrointestinal (GI) tract and liver, with evidence of prolonged fecal shedding and feco-oral transmission. This finding has stirred up a hornet's nest of not only a newer modality of the spread of the virus but also a risk of the unpredictable duration of the infective potential of the shedders. We reviewed the literature on fecal shedding and possible implications on prevention and surveillance strategies. The pandemic is changing the management of underlying chronic diseases such as inflammatory bowel disease (IBD) and other diseases. Moreover, for the gastroenterologist, doing endoscopic procedures in this COVID-19 era poses a high risk of contamination, as it is an aerosol-generating procedure. There is a daily influx of data on this disease, and multiple societies are coming up with various recommendations. We provide a comprehensive review of all the reported GI manifestations of COVID-19 infection and the side effects of confounding drugs. We have summarized the management recommendations for diseases such as IBD with COVID-19 and nutritional recommendations and provided a concise review of the endoscopy guidelines by the various societies. This review provides a comprehensive account and a lucid guide covering various aspects of gastroenterology practice during this COVID-19 pandemic.
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- 2020
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47. Characterization of biofilms in biliary stents and potential factors involved in occlusion
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Rakesh Kochhar, Chetana Vaishnavi, and Jayanta Samanta
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0301 basic medicine ,Male ,Klebsiella ,Biofilm constituents ,Time Factors ,medicine.medical_treatment ,medicine.disease_cause ,Gastroenterology ,Ribotyping ,Biliary disease ,Predisposing factors ,Tertiary Care Centers ,Polybacterial profile ,0302 clinical medicine ,Cytology ,Medicine ,Prospective Studies ,Citrobacter ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Biliary stents ,Cholestasis ,biology ,Bile duct ,Streptococcus ,Polysaccharides, Bacterial ,General Medicine ,Enterobacter ,Middle Aged ,Prosthesis Failure ,medicine.anatomical_structure ,030211 gastroenterology & hepatology ,Female ,Stents ,Adult ,medicine.medical_specialty ,Prosthesis-Related Infections ,Underlying causes ,030106 microbiology ,Prosthesis Design ,03 medical and health sciences ,Young Adult ,Bacterial Proteins ,Internal medicine ,Humans ,Device Removal ,Aged ,Bacteria ,business.industry ,Stent ,medicine.disease ,biology.organism_classification ,Gastrointestinal Microbiome ,Biofilms ,Prospective Study ,business - Abstract
AIM To quantify the components in biofilms and analyze the predisposing factors involved in occlusion of biliary stents. METHODS In a prospective study conducted from April 2011 to March 2014 at a tertiary care hospital, all consecutive patients who required endoscopic biliary stent exchange/removal were included. Etiology of the biliary disease was diagnosed by imaging, cytology and on follow-up. Clinical details of patients with biliary stent retrieval were noted. All extracted stents were collected in sterile containers and immediately processed for quantification of biofilm proteins and polysaccharides. Molecular identification of commonly known and unknown bacteria was performed by polymerase chain reaction and density gradient gel electrophoresis methods. RESULTS Eighty one patients (41 males) with age range of 20-86 years were studied. The underlying causes for stent insertion were bile duct stones (n = 46; 56.8%) benign stricture (n = 29; 35.8%) and malignancy (n = 6; 7.4%) with cholangitis in 50 (61.7%) patients. The retrieved stent sizes were 7 Fr (n = 62; 76.5%) and 10 Fr (n = 19; 23.5%) with 65 days median insertion duration. Polybacterial consortia were detected in 90.1% of the stents. The most common bacteria identified by polymerase chain reaction alone and/or sequencing were Pseudomonas (n = 38), Citrobacter (n = 23), Klebsiella (n = 22), Staphylococcus (n = 20), Serratia (n = 16), Escherichia coli (n = 14), Streptococcus (n = 13), Enterococcus (n = 13), Aeromonas (n = 12), Proteus (n = 10) and Enterobacter (n = 9). Protein concentration according to gender (0.547 ± 0.242 mg/mL vs 0.458 ± 0.259 mg/mL; P = 0.115) as well as age > 60 years and < 60 years (0.468 ± 0.295 mg/mL vs 0.386 ± 0.238 mg/mL; P = 0.205) was non-significant. However, polysaccharide concentration was significant both according to gender (0.052 ± 0.021 mg/mL vs 0.049 ± 0.016 mg/mL; P < 0.0001) and age (0.051 ± 0.026 mg/mL vs 0.038 ± 0.016 mg/mL; P < 0.011). Protein concentration in the biofilm was significantly higher (0.555 ± 0.225 mg/mL vs 0.419 ± 0.276 mg/mL; P = 0.018) in patients with cholangitis, lower (0.356 ± 0.252 mg/mL vs 0.541 ± 0.238 mg/mL; P = 0.005) in the 10 Fr group than the 7 Fr group, and significantly higher (0.609 ± 0.240 mg/mL vs 0.476 ± 0.251 mg/mL; P = 0.060) in stents of ≥ 6 mo of indwelling time. However presence/absence of cholangitis, size of stent, indication of stent insertion and indwelling time did not affect the quantity of polysaccharide concentration. CONCLUSION Plastic stents retrieved from patients with biliary tract disease showed polymicrobial organisms with higher protein content among patients with cholangitis and those with smaller diameter stents. Longer indwelling duration had more biofilm formation.
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- 2018
48. Primary EUS-guided therapy of a giant visceral artery pseudoaneurysm: Expanding horizons (with video)
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K. Hemanth Kumar, Naveen Kumar, Pankaj Gupta, Jayanta Samanta, Jimil Shah, Gaurav Muktesh, and Rakesh Kochhar
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medicine.medical_specialty ,Pseudoaneurysm ,Text mining ,Visceral artery ,Hepatology ,business.industry ,Gastroenterology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,medicine.disease ,Images and Videos - Published
- 2021
49. TAXON: A Software Package for the Management of Plant Databases Developed using Visual Basic.
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Jayanta Samanta and Anil Kumar
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- 2001
50. The role of endoscopy in malignant hilar obstruction.
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Dhar J, Gupta P, and Samanta J
- Abstract
Malignant hilar biliary obstruction (MHO) is a medical challenge as regards both forming a correct diagnosis and its adequate management, in terms of treatment alternatives and palliative options. Surgical resection is the only curative treatment for the underlying disease, but the majority of patients are not suitable candidates because of an unresectable tumor or poor performance status. Biliary drainage (BD) can be achieved through the percutaneous transhepatic route or endoscopically, and the choice depends on a host of factors, including biliary anatomy and comorbidity of the patient. Though there is no consensus, the endoscopic approach is usually preferred over the former. Endoscopy can aid in both diagnosis (collection of histological as well as cytological samples, direct visualization of suspected malignant pathology, or use of endoscopic ultrasound [EUS] for evaluation and locoregional staging), and in achieving internal BD. Advances in the development of various stents, accessories and, more recently, the use of EUS have in fact further expanded its application in MHO management. The choice of stents to be used (type, make, and number), palliation methods, deployment techniques and the use of local ablative strategy are still evolving and require more data. The complexity of management of MHO mandates that each patient should receive a "personalized approach", all the way from establishing a diagnosis until final treatment, with the help of a multidisciplinary team effort. Herein, we provide a comprehensive literature review of the current role of endoscopy for MHO, according to its applications in various clinical settings., Competing Interests: Conflict of Interest: None, (Copyright: © Hellenic Society of Gastroenterology.)
- Published
- 2023
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