60 results on '"Jimil Shah"'
Search Results
2. Sarcopenia is common in ulcerative colitis and correlates with disease activity
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Pardhu B Neelam, Rimesh Pal, Pankaj Gupta, Anupam K Singh, Jimil Shah, Harshal S Mandavdhare, Harjeet Singh, Aravind Sekar, Sanjay K Bhadada, Usha Dutta, and Vishal Sharma
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inflammatory bowel diseases ,ulcerative colitis ,sarcopenia ,absorptiometry, photon ,grip strength ,Medicine ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background/Aims Association of sarcopenia with disease severity in ulcerative colitis (UC) is not clearly defined. We planned to estimate the prevalence of sarcopenia in patients with UC as per the revised definition and its relation with the disease severity. Methods A cross-sectional assessment of sarcopenia in patients with UC was performed. Disease activity was graded according to complete Mayo score. Hand grip strength was assessed with Jamar hand dynamometer, muscle mass using a dual energy X-ray absorptiometry scan, and physical performance with 4-m walk test. Sarcopenia was defined as a reduction of both muscle mass and strength. Severe sarcopenia was defined as reduced gait speed in presence of sarcopenia. Results Of 114 patients (62 males, mean age: 36.49±12.41 years), 32 (28%) were in remission, 46 (40.4%) had mild-moderate activity, and 36 (31.6%) had severe UC. Forty-three patients (37.7%) had probable sarcopenia, 25 (21.9%) had sarcopenia, and 14 (12.2%) had severe sarcopenia. Prevalence of sarcopenia was higher in active disease (2 in remission, 6 in active, and 17 in severe, P
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- 2024
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3. 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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4. Endoscopic Management of Difficult Biliary Stones: An Evergreen Issue
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Magdalini Manti, Jimil Shah, Apostolis Papaefthymiou, Antonio Facciorusso, Daryl Ramai, Georgios Tziatzios, Vasilios Papadopoulos, Konstantina Paraskeva, Ioannis S. Papanikolaou, Konstantinos Triantafyllou, Marianna Arvanitakis, Livia Archibugi, Giuseppe Vanella, Marcus Hollenbach, and Paraskevas Gkolfakis
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choledocholithiasis ,ERCP ,sphincteroplasty ,mechanical lithotripsy ,cholangioscopy ,Medicine (General) ,R5-920 - Abstract
Choledocholithiasis is one of the most common indications for endoscopic retrograde cholangiopancreatography (ERCP) in daily practice. Although the majority of stones are small and can be easily removed in a single endoscopy session, approximately 10–15% of patients have complex biliary stones, requiring additional procedures for an optimum clinical outcome. A plethora of endoscopic methods is available for the removal of difficult biliary stones, including papillary large balloon dilation, mechanical lithotripsy, and electrohydraulic and laser lithotripsy. In-depth knowledge of these techniques and the emerging literature on them is required to yield the most optimal therapeutic effects. This narrative review aims to describe the definition of difficult bile duct stones based on certain characteristics and streamline their endoscopic retrieval using various modalities to achieve higher clearance rates.
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- 2024
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5. The Role of Endoscopic Ultrasound in Early Chronic Pancreatitis
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Jimil Shah, Abhirup Chatterjee, and Truptesh H. Kothari
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chronic pancreatitis ,alcohol ,SPINK1 ,abdominal pain ,Medicine (General) ,R5-920 - Abstract
Chronic pancreatitis (CP) is an irreversible and progressive inflammation of the pancreas that can involve both pancreatic parenchyma and the pancreatic duct. CP results in morphological changes in the gland in the form of fibrosis and calcification along with functional impairment in the form of exocrine and endocrine insufficiency. Studies on the natural history of CP reveal the irreversibility of the condition and the resultant plethora of complications, of which pancreatic adenocarcinoma is the most dreaded one. In Japanese population-based studies by Otsuki and Fuzino et al., CP was clearly shown to reduce lifespan among males and females by 10.5 years and 16 years, respectively. This dismal prognosis is superadded to significant morbidity due to pain and poor quality of life, creating a significant burden on health and health-related infrastructure. These factors have led researchers to conceptualize early CP, which, theoretically, is a reversible stage in the disease spectrum characterised by ongoing pancreatic injury with the presence of clinical symptoms and the absence of classical imaging features of CP. Subsequently, the disease is thought to progress through a compensated stage, a transitional stage, and to culminate in a decompensated stage, with florid evidence of the functional impairment of the gland. In this focused review, we will discuss the definition and concept of early CP, the risk factors and natural history of the development of CP, and the role of various modalities of EUS in the timely diagnosis of early CP.
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- 2024
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6. Role of Endoscopic Ultrasound in Diagnosis of Pancreatic Ductal Adenocarcinoma
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Abhirup Chatterjee and Jimil Shah
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PDAC ,EUS ,fine-needle aspiration (FNA) ,fine-needle biopsy (FNB) ,precision medicine ,pancreatic carcinoma ,Medicine (General) ,R5-920 - Abstract
Pancreatic ductal adenocarcinoma (PDAC) is the most common (90%) type of solid pancreatic neoplasm. Due to its late presentation and poor survival rate, early diagnosis and timely treatment is of utmost importance for better clinical outcomes. Endoscopic ultrasound provides high-resolution images of the pancreas and has excellent sensitivity in the diagnosis of even small (
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- 2023
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7. Prevention of Serious Complications during Endoscopic Ultrasound-Guided Biliary Drainage: A Case-Based Technical Review
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Surinder Singh Rana, Jimil Shah, Harish Bhujade, Ujjwal Gorsi, Mandeep Kang, and Rajesh Gupta
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endoscopic ultrasound ,stent ,biliary drainage ,endoscopic retrograde cholangiopancreatography ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Endoscopic ultrasound-guided biliary drainage (EUS-BD) has a potential risk of clinically significant adverse events including fatal complications. Learning from complications improves the results from interventional procedures especially the high-risk procedure like EUS-BD. The various complications that have been reported following EUS-BD include bile leak, bleeding, cholangitis, peritonitis, stent migration both internal and external as well as in the peritoneal cavity and fatal perforations. In this technical review, we discuss technical strategies to prevent serious adverse events during EUS-BD using a case based approach.
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- 2022
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8. Endoscopic Closure of Large Iatrogenic Duodenal Perforation: Right Use of Endoscopic Accessories
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Naveen Kumar, Deshidi Srinu, Rinkal Kakadiya, Kailash Chand Kurdia, Vaneet Jearth, and Jimil Shah
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conservative ,endoscopy ,ovesco ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Perforations during endoscopic retrograde cholangiopancreatography (ERCP) is a rare but dreadful complication. Type I Stapfer's perforations tend to be large and can get easily complicated by peritonitis and collections if not recognized and managed in a timely manner. With advancement in endoscopic accessories, endoscopic closure is usually attempted first, and surgical interventions are reserved only in patients with a failed endoscopic attempt. Though over the scope clips (OTSC) are used in patients with defect up to 20 to 25 mm in gastric or duodenal perforation and up to 30 mm in colonic perforations, larger defects can be also closed with the right use of adjuvant accessories. Here, we report our experience of successful closure of a large duodenal perforation during ERCP, using a single OTSC clip with help of accessories.
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- 2022
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9. Newer Stents for Unresectable Malignant Distal Biliary Obstruction: Striving for Perfection!
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Jimil Shah and Surinder Singh Rana
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stent ,pancreatic cancer ,jaundice ,endoscope ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Endoscopic biliary stenting is one of the most commonly used palliative procedure in patients with unresectable malignant distal biliary obstruction. Biliary stenting can be performed with either plastic or metallic stents. Stent occlusion and migration are important limitations of currently available stents. Variety of newer stents with varying designs and stent materials like stents with antimigratory properties, antireflux stents, drug-eluting stents, radioactive stents, and bioabsorbable stents are being developed to overcome the limitations of currently available stents. In this article, we are discussing two articles on the newer stent designs (plastic and metal stents) for biliary drainage in patients with unresectable malignant distal biliary obstruction.
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- 2021
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10. Quality of life in patients of corrosive esophageal stricture treated with endoscopic dilatation
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Naveen Anand, Akhilesh Sharma, Jimil Shah, Rakesh Kochhar, and Shubh Mohan Singh
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disability ,Patient Health Questionnare‐9 score ,World Health Organization Disability Assessment Schedule score ,WHOQoL‐BREF score ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background and Aim Caustic ingestion is associated with long‐term sequelae in the form of esophageal and/or gastric cicatrization requiring endoscopic or surgical intervention. Quality of life (QoL) and disability in patients with caustic‐induced sequelae is less explored. Methods In this prospective study, we included consecutive patients with symptomatic caustic‐induced esophageal stricture undergoing endoscopic dilatation. QoL was measured using the World Health Organization Quality of Life questionnaire (WHOQoL‐BREF). Disability was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Subjective dysphagia score was calculated by Likert scale. Results A total of 42 patients were included in the study; 25 (59.5%) patients were male. Patients had poor WHOQoL‐BREF and WHODAS scores compared to normality data in all domains of the scores among both the genders. A majority (66.7%) of patients had a current psychiatric diagnosis, with the most common being mood disorder (50%) followed by suicidality (45.2%). Males had a higher prevalence of a previous psychiatric diagnosis compared to females, while females had a higher prevalence of suicidality. Dysphagia score had strong correlation with the WHOQoL (r = −0.66; P
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- 2021
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11. Relationship between Mayo endoscopic score and histological scores in ulcerative colitis: A prospective study
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Jimil Shah, Usha Dutta, Ashim Das, Vishal Sharma, Harshal Mandavdhare, Pankaj Sharma, Dimple Kalsi, Priyanka Popli, and Rakesh Kochhar
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Geboes Index ,Mayo endoscopic score ,Nancy Index ,Robert Histological Index ,ulcerative colitis ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background The Mayo endoscopic score (MES) remains the most commonly used index in clinical practice, as well as in various clinical trials. Recently, two validated histological indices (Nancy Index [NI] and Robert Histological Index [RHI]) have been developed for ulcerative colitis (UC). We aim to study the relationship between MES with NI, RHI, and the established Geboes Index (GI) in patients with UC. Methods This was a prospective single‐center study. MES was documented from the most involved area. Biopsy was taken from the same area and reported by a single gastrointestinal histopathologist who was blinded to the endoscopic score. Histological activity was reported using GI, NI, and RHI. Statistical analysis was performed using Spearman's correlation coefficient and Cohen's kappa coefficient using SPSS version 23. Results Median age of patients with UC (n = 96) was 36 years. Seventeen patients were in endoscopic remission (MES 0/1). Correlation coefficient between MES and GI/NI/RHI was only weak to moderate (rho = 0.381/0.389/0.442, respectively; P
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- 2020
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12. Ileocecal thickening: Clinical approach to a common problem
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Roshan Agarwala, Abhi K Singh, Jimil Shah, Harshal S Mandavdhare, and Vishal Sharma
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Amebiasis ,computed tomography ,Crohn's disease ,ileocecal thickening ,intestinal tuberculosis ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Ileocecal thickening (ICT) is a common finding on radiological imaging. It can be caused by a variety of inflammatory, infectious, or neoplastic conditions, and evaluating a patient of ICT can be a challenging task. Intestinal tuberculosis (ITB), Crohn's disease (CD), and adenocarcinoma are the most common causes. Enteric bacterial infections, cytomegalovirus, histoplasmosis, amebiasis, systemic vasculitis, lymphoma, etc. should be suspected in appropriate clinical settings. However, it could often be a spurious or nonspecific finding. A thickness of more than 3 mm in a normally distended small bowel is usually considered abnormal. Detailed evaluation of imaging of the site and extent of thickening; the degree and pattern of thickening; and the associated findings, such as degree of fat stranding, fibrofatty proliferation, adjacent lymph nodes, and solid organ involvement, should be performed. Ileocolonoscopy is an important tool for diagnosing and obtaining samples for tissue diagnosis. Histopathology is usually the gold standard for diagnosis, although—not uncommonly—findings could be nonspecific, and reaching a definitive diagnosis is difficult. As such, a systematic approach with the integration of clinical, biochemical, radiological, endoscopic, histological, and other laboratory tests is the key to reaching a diagnosis. In this article, we review the causes of ICT and present a clinical approach for the management of ICT.
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- 2019
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13. Thrombotic thrombocytopenic purpura: A rare complication of acute pancreatitis
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Jimil Shah, Harshal S Mandavdhare, Chhagan Lal Birda, Usha Dutta, and Vishal Sharma
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delirium ,pancreatitis ,renal failure ,TTP ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Thrombotic Thrombocytopenic Purpura (TTP) is a poorly understood entity involving multiple organs and having grave prognosis if not treated promptly. Acute pancreatitis (AP) is a rare cause of TTP and TTP is also a rare complication of acute pancreatitis. TTP is induced in AP by poorly understood mechanism, which involves multiple pathways apart from only ADAMTS13 deficiency. Here, we report a case of a 32‐year‐old male who developed acute pancreatitis due to chronic alcoholism. He developed signs of TTP from Day 4 of his onset of pain. High clinical suspicion and prompt initiation of plasmapheresis was associated with good outcome. In this case report, we have discussed details of our case and the different mechanisms involved in pathogenesis of TTP in AP and their outcome with prompt management.
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- 2019
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14. '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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15. Gall Bladder Drainage for Acute Cholecystitis in Surgically Unfit Patients: Endoscopic Ultrasound Guided Transmural Drainage or Endoscopic Transpapillary Drainage!
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Jimil Shah and Surinder S. Rana
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gall bladder ,endosonography ,endoscopic retrograde cholangiography ,ultrasound ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Acute cholecystitis (AC) is a potentially serious condition that is associated with significant morbidity and mortality. Laparoscopic cholecystectomy is the treatment of choice of AC in surgically fit candidates. However, high-risk surgical patients with AC are a therapeutic dilemma. Various alternative treatment options available include percutaneous transhepatic cholecystostomy (PTC), endoscopic ultrasound (EUS)-guided gall bladder (GB) drainage or endoscopic transpapillary drainage of GB. Due to higher complication, unplanned hospital readmission rate, risk of tube dislodgement, and high risk of recurrent acute cholecystitis associated with PTC, endoscopic drainage GB is the preferred, minimally invasive treatment option. Both endoscopic transpapillary GB drainage as well as EUS-guided transmural drainage of GB are effective GB drainage options, but both of them have not been compared in terms of their efficacy and safety. In this news and views, we have discussed two interesting articles which have compared EUS-guided GB drainage and endoscopic transpapillary drainage.
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- 2019
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16. Needle-Based Confocal Laser Endomicroscopy: A New Promising Armamentarium for Diagnostic Endoscopic Ultrasound
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Jimil Shah and Surinder S Rana
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pancreatic cystic neoplasm ,gastric sub-epithelial lesions ,endoscopic ultrasound ,gastro-intestinal stromal tumour ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
With increasing use of cross-sectional imaging in diagnosis of various diseases, incidence of asymptomatic pancreatic cyst has increased dramatically in last decade. In management of such asymptomatic pancreatic cyst differentiation of pre-malignant cyst and benign cyst remains an utmost important parameter. Though various endoscopic ultrasound (EUS) criteria have been developed, differentiation between these two entities still remains a challenge in many patients. Confocal laser endomicroscopy (CLE) has shown promising results in diagnosis of various gastrointestinal cancers and colonic polyps. However, CLE criteria have not been prospectively validated in asymptomatic pancreatic cyst to differentiate premalignant vs benign cysts. Similarly, CLE criteria are also not defined for diagnosis of various gastric sub-epithelial lesions. In this news and views we have discussed two important articles regarding role of needle based CLE (nCLE) in these lesions. While one is a multicentric trial which prospectively validates previously defined nCLE criteria for characterizing pancreatic cystic lesion, second developed criteria for diagnosis of various gastric subepithelial lesions based on nCLE findings.
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- 2019
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17. HbA1c levels at presentation do not impact the clinical presentation or outcomes in abdominal tuberculosis
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Jimil Shah, Harshal S Mandavdhare, Naresh Sachdeva, Kaushal K Prasad, Harjeet Singh, Usha Dutta, and Vishal Sharma
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Abdominal ,diabetes ,extrapulmonary ,HbA1c ,tuberculosis ,Microbiology ,QR1-502 - Abstract
Background: The relationship between diabetes mellitus and tuberculosis (TB) has received increasing attention, and diabetes may be associated with poor outcomes in pulmonary TB. Clinical relevance of HbA1c measurement in abdominal TB is unknown. Methods: We did a retrospective study of consecutive patients diagnosed with abdominal TB and treated with antitubercular therapy for 6 months. Patients were categorized as those with normal HbA1c (
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- 2019
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18. Gastrointestinal histoplasmosis: a case series from a non-endemic region in North India
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Harshal S Mandavdhare, Jimil Shah, Kaushal K Prasad, Roshan Agarwala, Vikas Suri, Savita Kumari, Usha Dutta, and Vishal Sharma
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Medicine ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2019
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19. Lumen-Apposing Metal Stent: Not the Answer for Every Pancreatic Fluid Collection!!
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Jimil Shah and Surinder Singh Rana
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2019
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20. Thickened Gastric Folds: Approach
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Roshan Agarwala, Jimil Shah, and Usha Dutta
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large gastric folds ,menetrier’s disease ,thickened gastric folds ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Thickened gastric folds (TGF) are not an uncommon finding on radiological imaging or endoscopy. It is an enigmatic condition requiring a systematic approach with correlation between clinical, laboratory, radiological, endoscopic, and histological parameters to reach a final diagnosis. It has a varied number of differential diagnosis and reaching the final diagnosis is often challenging even to an astute clinician. Findings on endoscopy are similar and biopsy results often equivocal. Differentiating between benign and malignant conditions is challenging. Routine pinch biopsy usually does not sample deep enough to get an adequate tissue sample, and other methods of biopsy may be required. Newer modalities, such as endoscopic ultrasound (EUS) and EUS‑guided sampling, are helpful in differentiating benign from malignant causes. At times, exploratory laparotomy and full‑thickness biopsy may be required for final diagnosis. In this review, we discuss the various differentials of TGF, with special emphasis on how to approach a case of TGF.
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- 2018
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21. Tracking Wall Characteristics of Necrotic Pancreatic Fluid Collections in Acute Pancreatitis on Serial Contrast-Enhanced Computed Tomography
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Harsimran Bhatia, Joseph Johnson, Pallavi T., Pankaj Gupta, Ajay Gulati, 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 necrotizing pancreatitis ,computed tomography ,endoscopic ,necrosis ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Background Encapsulated pancreatic fluid collection (PFC) is a requisite for endoscopic drainage procedures. The 4-week threshold for defining walled-off necrosis does not capture the dynamic process of encapsulation. We aim to investigate the changes in the wall characteristics of PFC in acute necrotizing pancreatitis (ANP) by comparing baseline contrast-enhanced computed tomography (CECT) with follow-up CT scans.
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22. Drainage of pancreatic fluid collections in acute pancreatitis: A comprehensive overview
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Akash, Bansal, Pankaj, Gupta, Anupam K, Singh, Jimil, Shah, Jayanta, Samanta, Harshal S, Mandavdhare, Vishal, Sharma, Saroj Kant, Sinha, Usha, Dutta, Manavjit Singh, Sandhu, and Rakesh, Kochhar
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General Medicine - Abstract
Moderately severe and severe acute pancreatitis is characterized by local and systemic complications. Systemic complications predominate the early phase of acute pancreatitis while local complications are important in the late phase of the disease. Necrotic fluid collections represent the most important local complication. Drainage of these collections is indicated in the setting of infection, persistent or new onset organ failure, compressive or pressure symptoms, and intraabdominal hypertension. Percutaneous, endoscopic, and minimally invasive surgical drainage represents the various methods of drainage with each having its own advantages and disadvantages. These methods are often complementary. In this minireview, we discuss the indications, timing, and techniques of drainage of pancreatic fluid collections with focus on percutaneous catheter drainage. We also discuss the novel methods and techniques to improve the outcomes of percutaneous catheter drainage.
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- 2022
23. Can computed tomography-antral wall thickness predict response to endoscopic balloon dilation in patients with caustic-induced gastric outlet obstruction?
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Jimil Shah, Yalaka Rami Reddy, Pankaj Gupta, Jayanta Samanta, Naveen Kumar, Saroj K. Sinha, and Rakesh Kochhar
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Gastroenterology - Published
- 2022
24. Simultaneous determination of lactulose, sucrose, sucralose, and mannitol using high-performance liquid chromatography-refractive index to estimate intestinal permeability in patients with active ulcerative colitis
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Pooja, Sarotra, Usha, Dutta, Hina, Gupta, K P, Ravindranathan Kartha, Rakesh, Kochhar, Ajay, Prakash, Phulen, Sarma, Jimil, Shah, and Bikash, Medhi
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Refractometry ,Sucrose ,Intestinal Absorption ,Quality of Life ,Humans ,Colitis, Ulcerative ,Mannitol ,Prospective Studies ,Chromatography, High Pressure Liquid ,Lactulose ,Permeability - Abstract
The intestinal permeability (IP) of sugars and their derivatives has been widely used to assess mucosal damage in gastrointestinal diseases. Ulcerative colitis (UC) is a recurring and relapsing disease that causes inflammation of the gut. IP of sugars can be evaluated and correlated with the flare of UC.A prospective study was conducted on 91 patients with active UC at the tertiary care center in North India. Mayo grading system assessed disease activity, and IP was assessed by measuring sucrose, lactulose, mannitol, and sucralose in urine samples from UC patients. A high-performance liquid chromatography (HPLC) method to detect all of these sugars simultaneously using a refractive index detector was developed and further validated in patients with UC.The analytical recovery rate of the tested sugars ranged from 95% to 146% in the urine matrix. The limit of detection and limit of quantification were 78.838 mg/L and 262.79 mg/L for sucrose, 84.994 mg/L and 283.31 mg/L for lactulose, 74.789 mg/L and 249.30 mg/L for mannitol, and 50.908 mg/L and 169.69 mg/L for sucralose.The standardized HPLC method is sensitive and suitable for the simultaneous detection and determination of different sugar moieties in the urine sample. Patients with UC can be evaluated indirectly for the flare by estimating the recovery rate of sugars through gut permeability. The procedure is noninvasive and thus improves the quality of life of chronically ill patients.
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- 2022
25. Modified technique for deployment of a lumen-apposing metal stent during endoscopic ultrasound-guided choledochoduodenostomy in minimally dilated duct
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Jimil Shah, Anuraag Jena, Vaneet Jearth, and Anupam K. Singh
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Gastroenterology - Published
- 2023
26. Quality of life in patients of corrosive esophageal stricture treated with endoscopic dilatation
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Shubh Mohan Singh, Jimil Shah, Rakesh Kochhar, Naveen Anand, and Akhilesh Sharma
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medicine.medical_specialty ,RC799-869 ,Disability assessment ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,Patient Health Questionnare‐9 score ,Medicine ,In patient ,Prospective cohort study ,Caustic ingestion ,World Health Organization Disability Assessment Schedule score ,Hepatology ,business.industry ,Gastroenterology ,Endoscopic dilatation ,Original Articles ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,Mood ,disability ,030220 oncology & carcinogenesis ,Esophageal stricture ,Original Article ,030211 gastroenterology & hepatology ,WHOQoL‐BREF score ,business - Abstract
Background and Aim Caustic ingestion is associated with long‐term sequelae in the form of esophageal and/or gastric cicatrization requiring endoscopic or surgical intervention. Quality of life (QoL) and disability in patients with caustic‐induced sequelae is less explored. Methods In this prospective study, we included consecutive patients with symptomatic caustic‐induced esophageal stricture undergoing endoscopic dilatation. QoL was measured using the World Health Organization Quality of Life questionnaire (WHOQoL‐BREF). Disability was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Subjective dysphagia score was calculated by Likert scale. Results A total of 42 patients were included in the study; 25 (59.5%) patients were male. Patients had poor WHOQoL‐BREF and WHODAS scores compared to normality data in all domains of the scores among both the genders. A majority (66.7%) of patients had a current psychiatric diagnosis, with the most common being mood disorder (50%) followed by suicidality (45.2%). Males had a higher prevalence of a previous psychiatric diagnosis compared to females, while females had a higher prevalence of suicidality. Dysphagia score had strong correlation with the WHOQoL (r = −0.66; P, Caustic ingestion is associated with long‐term sequelae in the form of esophageal and/or gastric cicatrization requiring endoscopic or surgical intervention. We assessed quality of life, disability, and depression in a cohort of patients who ingested a caustic agent. These patients were found to have high levels of disability and depressive symptoms and poor quality of life.
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- 2021
27. Gastric secretion in patients with caustic ingestion: A prospective study
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K Rajan, Kartar Singh, C K Nain, Rakesh Kochhar, Nikhil Bush, and Jimil Shah
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Adult ,Male ,medicine.medical_specialty ,Caustics ,India ,Achlorhydria ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Burns, Chemical ,medicine ,Humans ,Prospective Studies ,Esophagus ,Prospective cohort study ,Gastrin ,Gastric Juice ,business.industry ,digestive, oral, and skin physiology ,Hepatology ,medicine.disease ,Gastrointestinal Tract ,Pentagastrin ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Esophageal stricture ,Esophageal Stenosis ,Gastric acid ,Female ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
Caustic ingestion can lead to structural changes in the upper gastrointestinal tract. However, there are limited data on the effect of caustic ingestion on gastric secretion. This study was planned to determine the changes in gastric acid output in patients with caustic ingestion. It was a prospective study done at a tertiary care center in northern India. Twenty consecutive patients in chronic phase of caustic ingestion were evaluated for the study. The gastric secretory function was estimated in the basal state and following pentagastrin stimulation. These results were compared with normal values for our laboratory. The mean age of the included patients (n = 20) was 27.35 ± 2.96 years and 14 patients were male. Sixteen (80%) patients had a history of acid ingestion. Patients with caustic ingestion had significantly lower mean gastric acid secretion (0.8 ± 0.4 mEq/h vs. 4 ± 0.4 mEq/h; p
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- 2021
28. Fatty Pancreas: Clinical Implications
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Anupam Kumar Singh, Jimil Shah, and Surinder S. Rana
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Endoscopic ultrasound ,medicine.medical_specialty ,medicine.anatomical_structure ,medicine.diagnostic_test ,business.industry ,medicine ,Computed tomography ,Magnetic resonance imaging ,Radiology ,Metabolic syndrome ,medicine.disease ,Pancreas ,business - Published
- 2021
29. Adjuvant use of combination of antibiotics in acute severe ulcerative colitis: A placebo controlled randomized trial
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Jimil Shah, Dimple Kalsi, Harjeet Singh, Usha Dutta, Arup Choudhury, Sant Ram, Harshal S Mandavdhare, Shubhra Mishra, Jayanta Samanta, Arun Sharma, Vishal Sharma, and Kaushal K Prasad
- Subjects
Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,medicine.medical_treatment ,030106 microbiology ,Azathioprine ,macromolecular substances ,Placebo ,Severity of Illness Index ,Microbiology ,Gastroenterology ,Inflammatory bowel disease ,law.invention ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,law ,Metronidazole ,Virology ,Internal medicine ,medicine ,Adjuvant therapy ,Humans ,030212 general & internal medicine ,Infusions, Intravenous ,business.industry ,Ceftriaxone ,Length of Stay ,Middle Aged ,medicine.disease ,Ulcerative colitis ,Infliximab ,Anti-Bacterial Agents ,Treatment Outcome ,Infectious Diseases ,Acute Disease ,Colitis, Ulcerative ,Female ,business ,Adjuvant ,Follow-Up Studies ,medicine.drug - Abstract
Evaluation of a combination of antibiotics as an adjuvant therapy in acute severe ulcerative colitis (ASUC). Patients with ASUC were randomized to either infusions of placebo or intravenous ceftriaxone and metronidazole in addition to standard care. Primary outcome was response on day three according to Oxford���s criteria. Secondary outcome measures included changes in partial Mayo score, CRP levels, fecal calprotectin (day three), and need for second-line therapy, hospital stay, and mortality (day 28). Fifty patients (25 in each group, median age: 33 years, 23 males) were included. The number of patients with fulminant disease in the antibiotic group were 16 (64%) as compared to 7 (28%) in the standard of care group. Complete response on day three was attained by 7 (28%) in the antibiotic and 6 (24%) standard of care group (p = 1.00). Three patients from the antibiotic group underwent colectomy and three received intravenous cyclosporine whereas four patients in the standard of care group received cyclosporine (p = 0.725). There was no significant difference in change in CRP, Partial Mayo score, and fecal calprotectin between the two groups on day three. Combination of intravenous ceftriaxone and metronidazole did not improve outcomes in ASUC. Acronym: AAASUC trial Registration Number: CTRI/2019/03/018196 and NCT03794765
- Published
- 2020
30. Colon Cancer in Ulcerative Colitis: A Mimicker of a Flare of Disease
- Author
-
Amit Yadav, Anuraag Jena, Kollabathula Arpitha, Jimil Shah, Kim Vaiphei, Usha Dutta, and Anupam Kumar Singh
- Subjects
Colon ,Colonic Neoplasms ,Gastroenterology ,Immunology and Allergy ,Humans ,Colitis, Ulcerative ,Colonoscopy - Published
- 2022
31. Role of EUS in idiopathic ulcerative colitis
- Author
-
Surinder Singh Rana, Rajesh Gupta, Ritambhra Nada, N. Kalra, Bhaskar Kante, and Jimil Shah
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Idiopathic ulcerative colitis ,Internal medicine ,Gastroenterology ,medicine ,MEDLINE ,Radiology, Nuclear Medicine and imaging ,business ,Letter to Editor - Published
- 2021
32. Complications of endoscopic ultrasound-guided transmural drainage of pancreatic fluid collections and their management
- Author
-
Jimil Shah, Rajesh Gupta, Surinder S. Rana, and Mandeep Kang
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,medicine.medical_treatment ,Perforation (oil well) ,Review Article ,Air embolism ,embolism ,Endosonography ,03 medical and health sciences ,Pseudoaneurysm ,0302 clinical medicine ,Gastrointestinal perforation ,medicine ,perforation ,Drainage ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Stent ,pseudoaneurysm ,medicine.disease ,bleeding ,Surgery ,Embolism ,stents ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business - Abstract
The development of endoscopic ultrasound (EUS)-guided drainage techniques and lumen-apposing metal stents (LAMS) has markedly reduced the complication rate of endoscopic transmural drainage of pancreatic collections and made these procedures safer and more effective. Despite its improved safety profile, various types of complications, some even life-threatening, can occur after EUS-guided drainage of pancreatic fluid collections. Stent maldeployment/migration, bleeding, gastrointestinal perforation, and air embolism are important complications of EUS-guided drainage of pancreatic collections. Delayed complications weeks after the procedure, such as bleeding and buried LAMS due to the presence of prolonged indwelling transmural stents, have also been described. Careful patient selection, with proper assessment of the size, solid necrotic content and location of the collection, as well as an in-depth understanding of various risk factors that predict complications, are important for a safer and more effective endoscopic transmural drainage. For a better clinical outcome, it is important for the endoscopist to know about various complications of EUS-guided drainage of pancreatic collections, as well as their appropriate management strategies.
- Published
- 2019
33. HbA1c levels at presentation do not impact the clinical presentation or outcomes in abdominal tuberculosis
- Author
-
Usha Dutta, Vishal Sharma, Kaushal K Prasad, Naresh Sachdeva, Harjeet Singh, Harshal S Mandavdhare, and Jimil Shah
- Subjects
Adult ,Male ,Microbiology (medical) ,medicine.medical_specialty ,Tuberculosis ,HbA1c ,Adolescent ,Antitubercular Agents ,lcsh:QR1-502 ,India ,Abdominal tuberculosis ,lcsh:Microbiology ,Diabetes Complications ,Young Adult ,Hba1c level ,Internal medicine ,Diabetes mellitus ,Abdomen ,Diabetes Mellitus ,medicine ,Humans ,Clinical significance ,Abdominal ,Retrospective Studies ,Glycated Hemoglobin ,diabetes ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.disease ,extrapulmonary ,Treatment Outcome ,Infectious Diseases ,tuberculosis ,Female ,Presentation (obstetrics) ,Pulmonary tb ,business - Abstract
Background: The relationship between diabetes mellitus and tuberculosis (TB) has received increasing attention, and diabetes may be associated with poor outcomes in pulmonary TB. Clinical relevance of HbA1c measurement in abdominal TB is unknown. Methods: We did a retrospective study of consecutive patients diagnosed with abdominal TB and treated with antitubercular therapy for 6 months. Patients were categorized as those with normal HbA1c (
- Published
- 2019
34. Thickened Gastric Folds: Approach
- Author
-
Jimil Shah, Usha Dutta, and Roshan Agarwala
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Exploratory laparotomy ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Biopsy ,medicine ,Sampling (medicine) ,lcsh:RC799-869 ,General Environmental Science ,medicine.diagnostic_test ,business.industry ,menetrier’s disease ,thickened gastric folds ,large gastric folds ,medicine.disease ,Endoscopy ,Review article ,Ménétrier's disease ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,lcsh:Diseases of the digestive system. Gastroenterology ,Radiology ,Differential diagnosis ,business - Abstract
Thickened gastric folds (TGF) are not an uncommon finding on radiological imaging or endoscopy. It is an enigmatic condition requiring a systematic approach with correlation between clinical, laboratory, radiological, endoscopic, and histological parameters to reach a final diagnosis. It has a varied number of differential diagnosis and reaching the final diagnosis is often challenging even to an astute clinician. Findings on endoscopy are similar and biopsy results often equivocal. Differentiating between benign and malignant conditions is challenging. Routine pinch biopsy usually does not sample deep enough to get an adequate tissue sample, and other methods of biopsy may be required. Newer modalities, such as endoscopic ultrasound (EUS) and EUS‑guided sampling, are helpful in differentiating benign from malignant causes. At times, exploratory laparotomy and full‑thickness biopsy may be required for final diagnosis. In this review, we discuss the various differentials of TGF, with special emphasis on how to approach a case of TGF.
- Published
- 2018
35. IDDF2020-ABS-0145 Combination of antibiotics as adjuvant therapy in acute severe ulcerative colitis: a randomized trial
- Author
-
Dimple Kalsi, Jayanta Samanta, Usha Dutta, Sant Ram, Arup Choudhury, Jimil Shah, Kaushal K Prasad, Shubhra Mishra, Harjeet Singh, Vishal Sharma, Harshal S Mandavdhare, and Arun Sharma
- Subjects
medicine.medical_specialty ,Combination therapy ,business.industry ,medicine.medical_treatment ,medicine.disease ,Placebo ,Ulcerative colitis ,Metronidazole ,Internal medicine ,medicine ,Ceftriaxone ,Adjuvant therapy ,Calprotectin ,business ,Colectomy ,medicine.drug - Abstract
Background Some studies have suggested that targeted combination therapy with antibiotics could improve response in active ulcerative colitis, but similar data is not available in acute severe UC (ASUC). Methods We randomised consecutive patients diagnosed with ASUC ( modified Truelove and Witt’s classification) to receive placebo infusions or combination antibiotics (intravenous ceftriaxone and metronidazole) groups. Response as defined by oxford criteria was used to assess response on day three. We also assessed changes in partial Mayo score, CRP levels and reduction in fecal calprotectin at day three. Also, we assessed the need for second line drug therapy, colectomy, length of hospital stay and mortality by day 28. Results Fifty patients were randomised: 25 in each arm (Median age: 33, IQR 25–45, 23(46%) males). Twenty-two patients had extensive disease, while the median disease duration was 24 months. Sixteen patients (64%)in antibiotic arm responded (complete and partial response) at day three while 18 (72%) in the placebo arm responded. Three patients from the antibiotic group underwent colectomy. Three patients in the antibiotic arm received intravenous cyclosporine, whereas four patients in the placebo group received cyclosporine (p=0.725). There was no significant difference in change in CRP, Partial Mayo and fecal calprotectin between the two groups on day three. Conclusions Combination of intravenous ceftriaxone and metronidazole in patients with ASUC neither improved the day 3 response nor reduced the need for second line therapy.
- Published
- 2020
36. Xpert MTB/RIF for diagnosis of tubercular liver abscess. A case series
- Author
-
Roshan, Agarwala, Sahajal, Dhooria, Niranjan S, Khaire, Shubhra, Mishra, Samman, Verma, Jimil, Shah, Harshal S, Mandavdhare, Savita, Kumari, Usha, Dutta, and Vishal, Sharma
- Subjects
Adult ,Male ,Bacteriological Techniques ,Liver Abscess ,Humans ,Tuberculosis ,Mycobacterium tuberculosis ,Middle Aged ,Nucleic Acid Amplification Techniques - Abstract
Hepatic involvement is an infrequent manifestation of abdominal tuberculosis and could occur in form of granulomatous hepatitis, nodular involvement or abscess formation. Tubercular liver abscess (TLA) is uncommon, and diagnosing this entity is a challenge. Xpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) assay has been widely used for diagnosing pulmonary tuberculosis (TB) and lymph nodal tuberculosis. Its utility in some forms of other extrapulmonary TB has also been studied. The role of Xpert MTB/RIF for diagnosis of tubercular liver abscess is not known. Here we present a series of four 4 cases of TLA, where the diagnosis was made on the basis of positive Xpert MTB/RIF assay tested on liver drained pus.
- Published
- 2020
37. Thrombotic thrombocytopenic purpura: A rare complication of acute pancreatitis
- Author
-
Chhagan Lal Birda, Usha Dutta, Jimil Shah, Vishal Sharma, and Harshal S Mandavdhare
- Subjects
medicine.medical_specialty ,renal failure ,TTP ,medicine.medical_treatment ,Thrombotic thrombocytopenic purpura ,pancreatitis ,Case Report ,RC799-869 ,Case Reports ,Gastroenterology ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,delirium ,Internal medicine ,hemic and lymphatic diseases ,Medicine ,heterocyclic compounds ,neoplasms ,Hepatology ,business.industry ,Diseases of the digestive system. Gastroenterology ,respiratory system ,medicine.disease ,ADAMTS13 ,030220 oncology & carcinogenesis ,Pancreatitis ,Acute pancreatitis ,Delirium ,030211 gastroenterology & hepatology ,Plasmapheresis ,medicine.symptom ,business ,Complication ,therapeutics - Abstract
Thrombotic Thrombocytopenic Purpura (TTP) is a poorly understood entity involving multiple organs and having grave prognosis if not treated promptly. Acute pancreatitis (AP) is a rare cause of TTP and TTP is also a rare complication of acute pancreatitis. TTP is induced in AP by poorly understood mechanism, which involves multiple pathways apart from only ADAMTS13 deficiency. Here, we report a case of a 32-year-old male who developed acute pancreatitis due to chronic alcoholism. He developed signs of TTP from Day 4 of his onset of pain. High clinical suspicion and prompt initiation of plasmapheresis was associated with good outcome. In this case report, we have discussed details of our case and the different mechanisms involved in pathogenesis of TTP in AP and their outcome with prompt management.
- Published
- 2019
38. Preface
- Author
-
Dr Jimil Shah and Dr Anupam K Singh
- Published
- 2021
39. Primary EUS-guided therapy of a giant visceral artery pseudoaneurysm: Expanding horizons (with video)
- Author
-
K. Hemanth Kumar, Naveen Kumar, Pankaj Gupta, Jayanta Samanta, Jimil Shah, Gaurav Muktesh, and Rakesh Kochhar
- Subjects
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
40. Acute respiratory distress syndrome in acute pancreatitis
- Author
-
Jimil Shah and Surinder Singh Rana
- Subjects
Male ,medicine.medical_specialty ,ARDS ,medicine.medical_treatment ,Lung injury ,Gastroenterology ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,medicine ,Animals ,Humans ,Mechanical ventilation ,Respiratory Distress Syndrome ,Lung ,business.industry ,Hepatology ,medicine.disease ,Prognosis ,Respiration, Artificial ,Endotoxins ,medicine.anatomical_structure ,Respiratory failure ,Pancreatitis ,030220 oncology & carcinogenesis ,Acute pancreatitis ,Cytokines ,030211 gastroenterology & hepatology ,Female ,Inflammation Mediators ,business ,Respiratory Insufficiency - Abstract
Development of organ failure is one of the major determinants of mortality in patients with acute pancreatitis (AP). Acute respiratory distress syndrome (ARDS) is an important cause of respiratory failure in AP and is associated with high mortality. Pathogenesis of ARDS in AP is incompletely understood. Release of various cytokines plays an important role in development of ARDS in AP. Increased gut permeability due to various toxins, inflammatory mediators, and pancreatic enzymes potentiates lung injury by gut-lymph-lung axis leading on to increased translocation of bacterial endotoxins. Various scoring systems, serum levels of various cytokines and lung ultrasound have been evaluated for prediction of development of ARDS in AP with varying results. Various drugs have shown encouraging results in prevention of ARDS in animal models but these encouraging results in animal models are yet to be confirmed in clinical studies. There is no specific effective treatment for ARDS. Treatment of sepsis and local complications of AP should be done according to the standard management strategies. Lung protective ventilatory strategies are of paramount importance to improve outcome of patients of AP with ARDS and therefore effective coordination between gastroenterologists and intensivists is needed for effective management of these patients.
- Published
- 2019
41. IDDF2019-ABS-0233 Long term indwelling transmural stents in patients with walled off pancreatic necrosis and disconnected pancreatic duct syndrome: safety and efficacy
- Author
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Ravi Sharma, Jimil Shah, Rajesh Gupta, and Surinder Singh Rana
- Subjects
Pancreatic duct ,medicine.medical_specialty ,Abdominal pain ,business.industry ,Colonic Fistula ,medicine.medical_treatment ,Stent ,equipment and supplies ,Asymptomatic ,Prosthesis ,Descending colon ,Surgery ,medicine.anatomical_structure ,Medicine ,medicine.symptom ,business ,Complication - Abstract
Background Long-term indwelling transmural stents in patients with walled-off pancreatic necrosis (WOPN) and disconnected pancreatic duct syndrome (DPDS) has been accepted as an effective strategy to decrease the risk of recurrence of pancreatic fluid collection (PFC). However, long term studies on the safety and efficacy of leaving permanent indwelling plastic prosthesis are lacking. Methods Retrospective analysis of the database of patients with WOPN treated with endoscopic transmural drainage over the last 8 years was done to identify patients with DPDS and permanently intended indwelling transmural stents. Patients with indwelling stents for more than 3 years were only included in this study. The follow-up database was analysed for any recurrence of symptoms or PFC or complications. Results During the last 8 years, 179 patients of WOPN were treated with endoscopic transmural drainage and 138 (77.09%) patients had DPDS. Of 138 patients, 56 patients (39 males; age range: 21–62 years) had an indwelling transmural stent/stents for >3 years (3–8 years). Amongst plastic prosthesis, 67.85% of patients had 10 Fr stents and 32.14% of patients had 7 Fr stents. Neck (n=28; 50%) was the most common site of disruption followed by proximal body (n=16; 28.57%) and distal body (n= 12; 21.43%). One patient (1.78%) developed recurrence of fluid collection 58 months later despite of in-situ stent which was successfully treated with repeat endoscopic transmural drainage. Two (3.5%) patients had asymptomatic spontaneous external migration of the transmural stent. Two (3.5%) patients developed complications 4 years later because of the indwelling stent. The transmural stent eroded into descending colon in one patient and the other patient had a recurrence of abdominal pain due to the development of pancreatic parenchymal calcification around the pigtail of the plastic stent. The transmural stent was removed in both patients and this led to the closure of colonic fistula as well cessation of abdominal pain. No other complication of long term indwelling transmural stents was observed. Conclusions Long term indwelling transmural stents in patients with WOPN and DPDS are safe as well as effective in preventing recurrence of PFC.
- Published
- 2019
42. Controversies in classification of peritoneal tuberculosis and a proposal for clinico-radiological classification
- Author
-
Pankaj Gupta, Aman Sharma, Harjeet Singh, Harshal S Mandavdhare, Usha Dutta, Jimil Shah, Roshan Agarwala, Rizwan Ahamed Z, Praveen Kumar-M, and Vishal Sharma
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Future studies ,Tuberculosis ,030106 microbiology ,Peritonitis, Tuberculous ,Microbiology ,Abdominal tuberculosis ,03 medical and health sciences ,0302 clinical medicine ,Uniform system ,Virology ,Humans ,Medicine ,In patient ,030212 general & internal medicine ,Intensive care medicine ,business.industry ,medicine.disease ,Abdominal Pain ,Radiography ,Infectious Diseases ,Radiological weapon ,business ,Peritoneal tuberculosis ,Systematic search - Abstract
Introduction: Peritoneal tuberculosis is a common type of abdominal tuberculosis. The most commonly used classification divides peritoneal tuberculosis into wet-ascitic type, dry-plastic type, and fixed-fibrotic type. Areas covered: We performed a systematic literature search on the definitions of existing classification of peritoneal tuberculosis. The literature search identified confusion in the classification of peritoneal tuberculosis. The classification system also fails to classify some patterns of peritoneal tuberculosis like an abdominal cocoon and a substantial overlap in various categories was found. The impact of the present classification on clinical management is unclear. Lack of prospective studies and the presence of heterogeneity in reporting add to the confusion. Expert opinion: We suggest that a uniform system which better classifies peritoneal tuberculosis and helps in clinical management should be used in future studies. We propose a simple, clinico-radiological classification of peritoneal tuberculosis into two types: distension-dominant and/or pain-obstruction dominant based on the clinical presentation. This approach will be relevant to clinicians as patients with the pain-obstruction dominant presentation are more likely to receive surgical interventions and may benefit from additional measures aimed to reduce fibrosis-like addition of steroids to ATT. Future studies should aim to validate the proposed clinico-radiological classification in patients with peritoneal tuberculosis.
- Published
- 2019
- Full Text
- View/download PDF
43. Relationship between Mayo endoscopic score and histological scores in ulcerative colitis: A prospective study
- Author
-
Dimple Kalsi, Priyanka Popli, Jimil Shah, Ashim Das, Rakesh Kochhar, Usha Dutta, Harshal S Mandavdhare, Vishal Sharma, and Pankaj Sharma
- Subjects
medicine.medical_specialty ,animal structures ,Nancy Index ,Robert Histological Index ,RC799-869 ,Gastroenterology ,03 medical and health sciences ,Mayo endoscopic score ,0302 clinical medicine ,Internal medicine ,Biopsy ,medicine ,In patient ,Statistical analysis ,Prospective cohort study ,Histological examination ,ulcerative colitis ,Hepatology ,medicine.diagnostic_test ,business.industry ,Geboes Index ,Original Articles ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,Ulcerative colitis ,Clinical Practice ,030220 oncology & carcinogenesis ,Mucosal healing ,030211 gastroenterology & hepatology ,Original Article ,business - Abstract
Background The Mayo endoscopic score (MES) remains the most commonly used index in clinical practice, as well as in various clinical trials. Recently, two validated histological indices (Nancy Index [NI] and Robert Histological Index [RHI]) have been developed for ulcerative colitis (UC). We aim to study the relationship between MES with NI, RHI, and the established Geboes Index (GI) in patients with UC. Methods This was a prospective single‐center study. MES was documented from the most involved area. Biopsy was taken from the same area and reported by a single gastrointestinal histopathologist who was blinded to the endoscopic score. Histological activity was reported using GI, NI, and RHI. Statistical analysis was performed using Spearman's correlation coefficient and Cohen's kappa coefficient using SPSS version 23. Results Median age of patients with UC (n = 96) was 36 years. Seventeen patients were in endoscopic remission (MES 0/1). Correlation coefficient between MES and GI/NI/RHI was only weak to moderate (rho = 0.381/0.389/0.442, respectively; P, In the era of mucosal and histological healing, it is of utmost importance to understand the relationship between endoscopic and histological scores. In our study, we have shown that the endoscopic score is only moderately correlated with histological scores. Agreement between endoscopic and histological remission is also weak. A better endoscopic scoring system is needed for defining endoscopic remission.
- Published
- 2018
44. Editorial
- Author
-
Jimil Shah
- Published
- 2018
45. Mucosal healing in inflammatory bowel disease: Expanding horizon
- Author
-
Usha Dutta, Manik Lal Thakur, and Jimil Shah
- Subjects
medicine.medical_specialty ,Gastroenterology ,Natural history of disease ,Inflammatory bowel disease ,Capsule Endoscopy ,Endoscopy, Gastrointestinal ,law.invention ,Biological Factors ,Capsule endoscopy ,law ,Internal medicine ,medicine ,Humans ,Intestinal Mucosa ,Mesalamine ,Glucocorticoids ,Wound Healing ,business.industry ,Inflammatory Bowel Diseases ,Hepatology ,Magnetic resonance enterography ,medicine.disease ,Magnetic Resonance Imaging ,Mucosal healing ,Calprotectin ,business ,Leukocyte L1 Antigen Complex ,Immunosuppressive Agents - Abstract
Management of inflammatory bowel diseases has witnessed paradigm shift from 5-aminosalicylic acid and glucocorticoids to various immunosuppressant and biological agents. Targets of therapy have also been changed drastically from symptomatic improvement to mucosal, histological healing, and recently transmural healing. Mucosal healing is associated with reduced need of steroid therapy, hospitalization, and surgery. However, whether mucosal healing alters the natural history of disease remains to be proven. Though assessment of mucosal healing is traditionally done by endoscopic examination, newer tests like fecal calprotectin, capsule endoscopy, and magnetic resonance enterography have also shown promising results. Various immunosuppressants and biologicals are the main therapy being used to achieve mucosal healing. This review focuses on the need for achieving mucosal healing, its long-term benefits, various methods and algorithm for diagnosis, and achievement of mucosal healing.
- Published
- 2018
46. Rare cause of acute abdomen–cocaine-induced small intestinal perforation with coexisting lower gastrointestinal bleed: an unusual presentation
- Author
-
Sriram Deivasigamani, Santhosh Irrinki, Jimil Shah, and Yashwant Sakaray
- Subjects
Adult ,Male ,Abdominal pain ,medicine.medical_specialty ,Lower gastrointestinal bleeding ,medicine.medical_treatment ,Perforation (oil well) ,Peritonitis ,Colonoscopy ,Case Report ,Cocaine-Related Disorders ,Young Adult ,03 medical and health sciences ,Ileostomy ,Rare Diseases ,0302 clinical medicine ,Laparotomy ,medicine ,Humans ,030212 general & internal medicine ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,Surgery ,Treatment Outcome ,Intestinal Perforation ,Acute abdomen ,030211 gastroenterology & hepatology ,medicine.symptom ,Gastrointestinal Hemorrhage ,business - Abstract
Cocaine, an alkaloid, is an addictive drug and its abuse as a recreational drug is on the increasing side with its associated complications. Gastrointestinal complications, after cocaine abuse, are less known and need to be addressed since the abuse is on the rise and the existing evidence is scarce. We report a case of a 22-year-old male patient who presented with abdominal pain following a cocaine injection. On examination, signs of peritonitis were noted and laparotomy revealed a 2×1 cm perforation in the distal ileum. The unhealthy intestinal segment was resected and taken out as a double-barrel ileostomy. The patient had an episode of severe lower gastrointestinal bleeding on postoperative day 6. CT and colonoscopy revealed signs of ischaemic bowel and tissue biopsy showed oedematous, inflamed and haemorrhagic bowel mucosa. The patient was managed conservatively and is doing well under follow-up in a de-addiction centre.
- Published
- 2021
47. Cocoon carcinomatosa: An unusual cause of intestinal obstruction
- Author
-
Roshan Agarwala, Surinder Singh Rana, Jimil Shah, Amit Kumar, Harjeet Singh, and Vishal Sharma
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Peritonitis ,Gastroenterology ,Sclerosing encapsulating peritonitis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Pharmacology (medical) ,General Pharmacology, Toxicology and Pharmaceutics ,Aged ,Sclerosis ,business.industry ,General surgery ,Continuous ambulatory peritoneal dialysis ,Intestinal loops ,General Medicine ,medicine.disease ,Connective tissue disease ,Peritoneal carcinomatosis ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,Peritoneal tuberculosis ,Intestinal Obstruction - Abstract
Abdominal cocoon, also termed sclerosing encapsulating peritonitis, is an uncommon entity associated with formation of a fibro-collagenous membrane around intestinal loops resulting in intestinal obstruction. Most reported cases are idiopathic, but many other causes have been implicated in cocoon formation, including use of continuous ambulatory peritoneal dialysis, peritoneal tuberculosis, and connective tissue disease. However, peritoneal carcinomatosis is a rarely reported entity that causes this condition. Reported here are two cases of abdominal cocoon secondary to peritoneal carcinomatosis. Both patients presented with intestinal obstruction; one underwent surgery but the other refused surgery.
- Published
- 2017
48. Sa1358 VALUE OF MEASUREMENT OF WHOLE BODY VISCERAL ADIPOSE TISSUE IN ASSESING THE RISK OF SEVERE ACUTE PANCREATITIS
- Author
-
Saurabh Dawra, Pankaj Gupta, Jimil Shah, Singh K. Anupam, Jayanta Samanta, Rakesh Kochhar, Gaurav Muktesh, and Saroj K. Sinha
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,Adipose tissue ,Acute pancreatitis ,medicine.disease ,Whole body ,business ,Value (mathematics) - Published
- 2020
49. Clinical and morphological consequences of permanent indwelling transmural plastic stents in disconnected pancreatic duct syndrome
- Author
-
Ravi Sharma, Surinder Singh Rana, Jimil Shah, and Rajesh Gupta
- Subjects
medicine.medical_specialty ,local complications ,medicine.medical_treatment ,Asymptomatic ,Descending colon ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,EUS ,Pancreatic duct ,Hepatology ,business.industry ,Gastroenterology ,Stent ,equipment and supplies ,medicine.disease ,Acute pancreatitis ,Surgery ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Pancreatitis ,Original Article ,stent ,030211 gastroenterology & hepatology ,medicine.symptom ,Pancreas ,business ,Calcification - Abstract
Background: Long-term indwelling transmural stents in patients with walled-off necrosis (WON) and disconnected pancreatic duct syndrome (DPDS) is an effective strategy to decrease risk of recurrence of pancreatic fluid collection (PFC). However, long-term studies on the safety and efficacy of this strategy are lacking. Methods: Retrospective analysis of database of patients with WON treated with endoscopic transmural drainage over the past 8 years was done to identify patients with DPDS and indwelling transmural stents for >3 years. Results: During the past 8 years, 56 patients with indwelling transmural stent for >3 years were identified and 67.85% of these patients had 10 Fr stents and 32.15% of patients had 7 Fr stents. On follow-up, 5 (8.9%) patients had pancreatic pain with one patient (1.78%) developing recurrence of PFC despite stent being in situ. Two (3.5%) patients had asymptomatic spontaneous external migration of the transmural stent. Fourteen (25%) patients developed diabetes. Two (3.5%) patients developed local complications due to indwelling stent (stent eroded into descending colon in one patient and stent-induced parenchymal calcification in the other). Forty-eight (85.7%) patients underwent EUS on follow-up and disconnected pancreas revealed ≥5 criteria for the diagnosis of chronic pancreatitis in 15 (31.25%) patients. Conclusions: Long-term indwelling transmural plastic stents in patients with WON and DPDS are safe and effective with minimal complications. Despite the presence of stents, disconnected pancreas develops morphological changes resembling chronic pancreatitis in one-third patients and clinical consequences of these changes need to be further evaluated.
- Published
- 2020
50. P844 Mucosa associated candida in ulcerative colitis: prevalence and relationship to disease severity
- Author
-
H Madhavdhare, Amitava Chakrabarti, Priyanka Popli, Phulen Sharma, Vinod Sharma, Ashim Das, Narendra Dhaka, S.M. Rudramurthy, R. Kochhar, Satyesh K. Sinha, Jimil Shah, Usha Dutta, and Radhika Srinivasan
- Subjects
medicine.medical_specialty ,Disease severity ,business.industry ,Internal medicine ,Gastroenterology ,Medicine ,General Medicine ,business ,medicine.disease ,Ulcerative colitis - Published
- 2019
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