92 results on '"Jimil Shah"'
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 more...
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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. more...
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- 2024
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Catalog
3. 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 more...
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- 2024
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4. 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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5. 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 more...
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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. more...
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- 2024
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6. 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. more...
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- 2024
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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. more...
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- 2022
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8. 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 ( more...
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- 2023
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9. 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. more...
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- 2022
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10. 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. more...
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- 2021
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11. 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 more...
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- 2021
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12. 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 more...
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- 2020
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13. 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. more...
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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. more...
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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. more...
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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. more...
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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 ( more...
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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. more...
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- 2018
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21. 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. more...
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- 2019
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22. Early vs. late percutaneous catheter drainage of acute necrotic collections in patients with necrotizing pancreatitis
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Harsimran Bhatia, Shameema Farook, Chaitanya Uday Bendale, Pankaj Gupta, Anupam K. Singh, Jimil Shah, Jayanta Samanta, Harshal Mandavdhare, Vishal Sharma, Saroj K. Sinha, Vikas Gupta, Thakur Deen Yadav, Usha Dutta, Manavjit Singh Sandhu, and Rakesh Kochhar more...
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Radiological and Ultrasound Technology ,Urology ,Gastroenterology ,Radiology, Nuclear Medicine and imaging - Published
- 2023
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23. Outcome of metal vs plastic stents for biliary obstruction in patients with pancreatic carcinoma undergoing neoadjuvant chemoradiotherapy: A systematic review and meta‐analysis
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Naveen Kumar, Anuraag Jena, Vishal Sharma, Siddharth Shukla, and Jimil Shah
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Hepatology ,Surgery - Abstract
Preoperative biliary drainage (PBT) may be warranted in patients with borderline resectable or locally advanced pancreatic carcinoma before neoadjuvant therapy (NAT) to relieve obstructive jaundice. However, it is unclear if the use of self-expanding metal stents (SEMS) has any benefit over plastic stents in this setting.We searched electronic databases from inception to February 11, 2022 to identify studies comparing SEMS and plastic stents for PBT in patients with pancreatic carcinoma undergoing NAT. Random effect models were used to determine pooled rates of recurrent biliary obstruction (RBO) and/or need for reintervention, stent-related complications and surgical outcome.A total of 10 studies (474 patients; metal group-37.1%) were included. Pooled risk ratio of RBO and/or need for reintervention was lower in the metal group (RR, 0.23 [95% CI: 0.11-0.45, IMetal stents are associated with reduced risk of RBO and/or need for reintervention, reduced risk of stent occlusion and cholangitis as compared to plastic stents in patients with pancreatic carcinoma undergoing NAT. more...
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- 2022
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24. 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. more...
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- 2022
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25. Abbreviated non-enhanced magnetic resonance imaging in patients with acute necrotizing pancreatitis
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Akash Bansal, Rajath Ramegowda, Pankaj Gupta, Jimil Shah, Jayanta Samanta, Harshal Mandavdhare, Vishal Sharma, Rakesh Kochhar, and Manavjit Singh Sandhu
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Adult ,Young Adult ,Radiological and Ultrasound Technology ,Pancreatitis, Acute Necrotizing ,Urology ,Abdomen ,Gastroenterology ,Humans ,Female ,Radiology, Nuclear Medicine and imaging ,Magnetic Resonance Imaging ,Retrospective Studies - Abstract
To investigate the performance of T2-weighted abbreviated magnetic resonance imaging (T2W-AMRI) protocol in evaluating patients with acute necrotizing pancreatitis (ANP).A retrospective analysis of consecutive hospitalized patients with ANP who underwent MRI (contrast-enhanced, CE or non-contrast, NC) between January 2017 and November 2020 was performed. The T2W-AMRI and complete MRI (cMRI) sequences were anonymized, and subsequently, two separate sets of data (AMRI and cMRI) were created for presentation to the radiologists involved in reading the data. The T2W-AMRI was based on a single-axial T2 half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence. The pancreatic and extrapancreatic findings were recorded and tabulated independently by two radiologists on T2W-AMRI and cMRI. In addition, the interobserver agreement and association of findings between T2W-AMRI and cMRI were analyzed.Twenty-eight patients (mean age 31.7 ± 12.2 years, 17 females) were included. Thirteen patients had CE-cMRI, while the rest underwent NC-cMRI. There was no significant difference in the identification of pancreatic necrosis on T2W-AMRI vs. cMRI (p = 1.00). However, T2W-AMRI underestimated necrosis in one patient. Collections were accurately detected in all patients on T2W-AMRI. The mean size of the collection was larger on cMRI (6.5 ± 3.7 cm) than T2W-AMRI (6 ± 3.7 cm) with p = 0.006. cMRI detected more patients with disrupted pancreatic duct (n = 9) than T2W-AMRI (n = 6). However, the difference was not statistically significant (p = 0.375). There was a good to an excellent interobserver agreement between the readers for T2W-AMRI (k = 0.62-1).T2W-AMRI may offer a suitable alternative to cMRI in ANP, especially severe disease, as it can be acquired rapidly without the need for contrast injection. more...
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- 2022
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26. 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
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27. 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. more...
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- 2022
28. 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
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29. When Endoscopy Is Needed for a 'Stone Heart'
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Anupam Kumar Singh, Pardhu Bharath Neelam, Kishore Abuji, Anuraag Jena, Jimil Shah, Yashwant Raj Sakaray, and Usha Dutta
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Hepatology ,Gastroenterology - Published
- 2022
30. IDDF2022-ABS-0257 Endoscopic dilation with bougie versus balloon dilators for caustic-induced esophageal strictures
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Anupam Kumar Singh, Yalaka Rami Reddy, Pankaj Gupta, Jimil Shah, Saroj Kant Singh, and Rakesh Kochhar
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- 2022
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31. IDDF2022-ABS-0127 Plastic versus metal stent for endoscopic ultrasound-guided transmural drainage of walled-off necrosis with significant solid debris: a randomised controlled noninferiority trial
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Rinkalben Kakadiya, Gaurav Muktesh, Jayanta Samanta, Jimil Shah, Harshal Mandavdhare, Pankaj Gupta, Vikas Gupta, and Thakur Dindayal Yadav
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- 2022
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32. Is ursodeoxycholic acid the culprit?
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Shankar Roy, Anurag Sachan, Abhirup Chatterjee, Bikkina Venkat Siddharda, Ashutosh Ishan Yadav, Gaurav Agrawal, Jimil Shah, Vaneet Jearth, and Surinder S. Rana
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Gastroenterology ,Radiology, Nuclear Medicine and imaging - Published
- 2023
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33. 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. more...
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- 2021
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34. 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 more...
- Published
- 2021
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35. 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
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36. Left gastric artery pseudoaneurysm: a rare presentation of delayed bleeding after peroral endoscopic myotomy for achalasia cardia
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Anupam Kumar Singh, Jimil Shah, Ujjwal Gorsi, Anudeep Jafra, and Harshal S. Mandavdhare
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Esophageal Achalasia ,Gastric Artery ,Gastroenterology ,Humans ,Cardia ,Hemorrhage ,Radiology, Nuclear Medicine and imaging ,Aneurysm, False ,Myotomy - Published
- 2022
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37. 'Caliper method': Simple technique for measuring gastric myotomy during peroral endoscopic myotomy
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Jimil Shah, Anupam K. Singh, and Harshal S. Mandavdhare
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Esophageal Achalasia ,Natural Orifice Endoscopic Surgery ,Treatment Outcome ,Gastroenterology ,Humans ,Radiology, Nuclear Medicine and imaging ,Esophageal Sphincter, Lower ,Myotomy - Published
- 2022
38. EUS- GUIDED RENDEZVOUS TECHNIQUE VERSUS PRECUT PAPILLOTOMY AS SALVAGE TECHNIQUE IN PATIENTS OF BENIGN BILIARY DISEASE WITH DIFFICULT BILIARY CANNULATION: A RANDOMIZED CONTROLLED TRIAL
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null arup choudhury, Jayanta Samanta, Gaurav Muktesh, Jahnvi Dhar, Antriksh Kumar, Jimil Shah, Pankaj Gupta, Vikas Gupta, Thakur Deen Yadav, and Rakesh Kochhar
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Gastroenterology ,Radiology, Nuclear Medicine and imaging - Published
- 2022
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39. 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
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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 more...
- Published
- 2020
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40. Gastroduodenal tuberculosis: a case series and a management focused systematic review
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Praveen Kumar-M, Anuraag Jena, Vishal Sharma, Jimil Shah, Pankaj Gupta, and Pranab Maity
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Adult ,Male ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,Hepatology ,business.industry ,Stomach Diseases ,Gastroenterology ,INTESTINAL TUBERCULOSIS ,medicine.disease ,Abdominal tuberculosis ,Gastrointestinal tuberculosis ,03 medical and health sciences ,0302 clinical medicine ,Tuberculosis, Gastrointestinal ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Humans ,030211 gastroenterology & hepatology ,Duodenal Diseases ,business - Abstract
Gastroduodenal tuberculosis is an uncommon form of abdominal tuberculosis.We report our experience with five cases of gastroduodenal tuberculosis and present results of a systematic review on gastroduodenal tuberculosis regarding clinical presentation, endoscopic, imaging findings, and the diagnostic and therapeutic approach.The presentation of gastroduodenal tuberculosis is diverse and may include nonspecific abdominal pain or dyspepsia like symptoms apart from gastric outlet obstruction. Endoscopy may show presence of growth, ulcer, narrowing, or fistula on endoscopy. Endoscopic biopsy, well-biopsy, or mucosal resection of an elevated lesion are helpful. On microscopy, granuloma with or without acid fast bacilli positivity can be found. For treatment, standard antitubercular therapy should be given for 6 months. In patients with tight stricture, endoscopic balloon dilatation can be helpful. Surgery is reserved for patient with diagnostic dilemma, refractory stricture, or complications like perforation or fistula. Future research should focus on improving diagnosis with use of modern microbiological techniques like PCR and Xpert MTB/RIF. more...
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- 2020
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41. Serial measurements of faecal calprotectin may discriminate intestinal tuberculosis and Crohn’s disease in patients started on antitubercular therapy
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Dimple Kalsi, Usha Dutta, Praveen Kumar-M, Arun Sharma, Harshal S Mandavdhare, Kaushal K Prasad, Vishal Sharma, Amitava Dutta, Suhang Verma, Jimil Shah, Harjeet Singh, and Shubhra Mishra
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,INTESTINAL TUBERCULOSIS ,Gastroenterology ,Feces ,Young Adult ,Crohn Disease ,Internal medicine ,medicine ,Humans ,In patient ,Prospective Studies ,Prospective cohort study ,Crohn's disease ,Hepatology ,Receiver operating characteristic ,business.industry ,Mean age ,Middle Aged ,medicine.disease ,Faecal calprotectin ,C-Reactive Protein ,Tuberculosis, Gastrointestinal ,Female ,Calprotectin ,business ,Leukocyte L1 Antigen Complex ,Biomarkers - Abstract
BACKGROUND Response to antitubercular therapy (ATT) is often used to differentiate intestinal tuberculosis (ITB) from Crohn's disease. Role of non-invasive biomarkers to predict mucosal response to ATT is unclear. MATERIALS AND METHODS A prospective study to compare faecal calprotectin and serum C-reactive protein (CRP) levels at diagnosis, 2 and 6 months of ATT in patients with suspected ITB started on ATT was done. The patients were eventually divided into two groups: ITB or alternative diagnosis (OTH). Decline of calprotectin and CRP levels was used to compute area under the receiver operating characteristic (AUROC) to predict mucosal healing at 2 months. RESULTS Thirty-seven patients (mean age: 34.95 ± 16.35 years, 23 males) were included and 28 (75.67%) were diagnosed as ITB while nine (24.32%) had alternative diagnosis (OTH). The median faecal calprotectin values of ITB and OTH groups at baseline, 2 months and 6 months were 216 and 282 µg/g (P = 0.466), 43 and 216 µg/g (P = 0.003), and 26 and 213 µg/g (P < 0.001), respectively. The median CRP values at baseline, 2 months and 6 months were 18 and 30 mg/L (P = 0.767), 4.7 and 15 mg/L (P = 0.025), and 3 and 10.85 mg/L (P = 0.068), respectively. The AUROC of percent decline in faecal calprotectin and serum CRP at 2 months for mucosal healing were 0.8287 [95% confidence inteval (CI) 0.6472-1] and 0.6018 (95% CI 0.4079-0.7957), respectively. CONCLUSION Faecal calprotectin can help in assessing response to therapy in suspected ITB patients started on empirical ATT. more...
- Published
- 2020
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42. Deep Venous Thrombosis in Acute Pancreatitis Is Associated with High Mortality: A Prospective Study
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Terence Susngi, Jimil Shah, Harish Bhujade, Vaneet Jearth, Anupam K. Singh, Harshal S. Mandavdhare, Vishal Sharma, Rajesh Gupta, Surinder Rana, and Usha Dutta
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Physiology ,Gastroenterology - Abstract
Incidence and risk factors for the development of extremity deep vein thrombosis (eDVT) in admitted patients of acute pancreatitis have been rarely explored.To identify the incidence of eDVT and to explore role of clinical scores for predicting eDVT in admitted patients of acute pancreatitis.We prospectively enrolled admitted patients of acute pancreatitis and performed a weekly eDVT screen for the duration of their admission. Well's score and Padua's score were also calculated weekly. The incidence of venous thrombosis (eDVT and splanchnic thrombosis based on contrast-enhanced CT scan abdomen) was noted, and the risk factors were determined using multivariate analysis. The correlation between Well's score, Padua's score, and development of DVT was calculated using Pearson's correlation.Of the 102 patients of acute pancreatitis enrolled, 73.5% of patients had necrotizing pancreatitis. Total of 46 patients (45.1%) developed thrombosis: 43 patients had splanchnic vein thrombosis; 5 patients had eDVT; and 1 patient had pulmonary embolism. Patients with eDVT had higher BISAP score (2.6 ± 0.9 vs 1.7 ± 0.8; p = 0.039), requirement of mechanical ventilation (60% vs 8.2%; p = 0.008), and mortality (60% vs 12.4%; p = 0.022). Well's score of ≥ 2 had sensitivity and specificity of 80% and 96.9% for prediction of eDVT and it had better correlation with the development of eDVT compared to Pauda's score.Incidence of DVT is 5% in patients with acute pancreatitis requiring admission. It is associated with higher disease severity and mortality. The Well's score is useful to predict the development of eDVT in routine clinical practice. more...
- Published
- 2022
43. Colon Cancer in Ulcerative Colitis: A Mimicker of a Flare of Disease
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Amit Yadav, Anuraag Jena, Kollabathula Arpitha, Jimil Shah, Kim Vaiphei, Usha Dutta, and Anupam Kumar Singh
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Colon ,Colonic Neoplasms ,Gastroenterology ,Immunology and Allergy ,Humans ,Colitis, Ulcerative ,Colonoscopy - Published
- 2022
44. FHP: Facial and Hair Feature Processor for Hairstyle Recommendation
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Manan Doshi, Jimil Shah, Rahul Soni, and Soni Bhambar
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- 2022
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45. MeghNA: Cloud Detection and Motion Prediction in INSAT Images
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Manan Doshi, Jimil Shah, Aumkar Gadekar, Anish Dixit, Shloka Shah, Parth Jardosh, and Dhananjay Kalbande
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- 2021
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46. Role of EUS in idiopathic ulcerative colitis
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Surinder Singh Rana, Rajesh Gupta, Ritambhra Nada, N. Kalra, Bhaskar Kante, and Jimil Shah
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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
47. Colonic mucosa‐associated candida assessed by biopsy culture is associated with disease severity in ulcerative colitis: A prospective study
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Saroj K. Sinha, Dimple Kalsi, Vishal Sharma, Usha Dutta, Srinivasan Radhika, Priyanka Popli, Pankaj Sharma, Ashim Das, Arunaloke Chakrabarti, Shivaprakash M Rudramurthy, Rakesh Kochhar, Jimil Shah, and Harshal S Mandavdhare more...
- Subjects
Adult ,Male ,medicine.medical_specialty ,beta-Glucans ,Colon ,Biopsy ,India ,Severity of Illness Index ,Gastroenterology ,Irritable Bowel Syndrome ,03 medical and health sciences ,0302 clinical medicine ,Blood serum ,Intestinal mucosa ,Internal medicine ,Humans ,Medicine ,Intestinal Mucosa ,Candida ,medicine.diagnostic_test ,biology ,business.industry ,C-reactive protein ,Colonoscopy ,Middle Aged ,medicine.disease ,Ulcerative colitis ,Case-Control Studies ,030220 oncology & carcinogenesis ,Erythrocyte sedimentation rate ,biology.protein ,Colitis, Ulcerative ,Female ,Proteoglycans ,030211 gastroenterology & hepatology ,Histopathology ,Calprotectin ,business ,Biomarkers - Abstract
Objective To evaluate the relationship of mucosa-associated candida (MAC) and disease severity in patients with ulcerative colitis (UC). Methods We prospectively investigated the presence, nature, and quantification of MAC in patients with UC and its relationship with disease severity. Consecutive patients with UC were assessed for clinical, endoscopic, histological features and serum markers of disease severity. All patients underwent mucosal brushing cytology, brushing culture, and biopsy culture for candida growth. MAC was considered present if mucosal biopsy culture grew candida. Candida spp. identification was performed by matrix-assisted laser desorption/ionization. Serum β-D-glucan was measured with a Fungitell assay. Patients with irritable bowel syndrome who had undergone similar investigations were included as controls. Results Ninety-six patients with UC showed evidence of MAC more often than the controls (n = 20) based on biopsy culture (33.3% vs 5.0%, P = 0.011), brush cytology (30.2% vs 5.0%, P = 0.019), and brush culture (36.5% vs 10.0%, P = 0.021). Patients with UC had higher candida colony counts (≥103 CFU/mL) than controls (34.4% vs 5.0%, P = 0.007). Median β-D-glucan values were higher in patients with UC than in controls (103.26 pg/mL vs 66.51 pg/mL, P = 0.011). The UC group with MAC had a higher median total Mayo score, C-reactive protein, fecal calprotectin, β-D-glucan, and histological activity than those without MAC. Conclusions Patients with UC more often show evidence of MAC and a higher candida colony count than controls. The presence of MAC is associated with high disease severity in patients with UC. more...
- Published
- 2019
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48. Complications of endoscopic ultrasound-guided transmural drainage of pancreatic fluid collections and their management
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Jimil Shah, Rajesh Gupta, Surinder S. Rana, and Mandeep Kang
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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. more...
- Published
- 2019
49. HbA1c levels at presentation do not impact the clinical presentation or outcomes in abdominal tuberculosis
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Usha Dutta, Vishal Sharma, Kaushal K Prasad, Naresh Sachdeva, Harjeet Singh, Harshal S Mandavdhare, and Jimil Shah
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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 ( more...
- Published
- 2019
50. Kairos: A Remunerative Framework for Minimum Investment Portfolio Management
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Jimil Shah, Anant V. Nimkar, and Manan Doshi
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Microeconomics ,Leverage (finance) ,Quantitative analysis (finance) ,Financial asset ,Computer science ,Kairos ,Resource management ,Portfolio optimization ,Investment (macroeconomics) ,Profit (economics) - Abstract
Quantitative analysis as a technique of rendering market conditions using an arithmetic value has been employed by several investors for identifying trading opportunities. Quantitative Trading (QT) Strategies are further aggrandized by the victorious amalgamation of finance with AI technologies. However, existing studies fail to leverage elementary finance notions for devising a portfolio optimization algorithm using rudimentary QT strategies to generate maximum profits. Such a portfolio optimization algorithm can be further optimized to require a minimum upfront investment, by exploiting the process of initially going SHORT on a financial asset, and using the generated profit to subsequently enter a LONG on another financial asset. In this paper, we propose Kairos, a computationally-inexpensive, flexible framework for exploiting LONG and SHORT QT strategies for portfolio optimization which minimizes required investment and maximizes returns. more...
- Published
- 2021
- Full Text
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