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Rohit Singhania, Donald P KotlerDepartment of Medicine, St Luke's-Roosevelt Hospital Center, New York, NY, USAAbstract: HIV-associated lipodystrophy is a term used to describe a constellation of body composition (lipoatrophy and lipohypertrophy) and metabolic (dyslipidemia and insulin resistance) alterations that accompany highly active antiretroviral therapy. These changes, which resemble metabolic syndrome, have been associated with a variety of adverse outcomes including accelerated cardiovascular disease. The body composition and metabolic changes appear to cluster in HIV infection, although they are distinct alterations and do not necessarily coexist. Epidemiological studies have demonstrated multiple pathogenic influences associated with host, disease, and treatment-related factors. The adverse treatment effects were more prominent in early regimens; continued drug development has led to the application of metabolically safer regimens with equal or greater potency than the regimens being replaced. Disease-related factors include HIV infection as well as inflammation, immune activation, and immune depletion. The body composition changes promote anxiety and depression in patients and may affect treatment adherence. Treatment of dyslipidemia and alterations in glucose metabolism is the same as in non-HIV-infected individuals. Lipoatrophy is managed by strategic choice of antivirals or by antiviral switching, and in some cases by plastic/reconstructive surgery. Lipohypertrophy has been managed mainly by lifestyle modification, ie, a hypocaloric diet and increased exercise. A growth hormone releasing factor, which reduces central fat, has recently become available for clinical use.Keywords: lipoatrophy, lipohypertrophy, body composition, dyslipidemia, insulin resistance

Autistic spectrum disorders is a complex developmental disorder with social and communication dysfunction at its core. It has a wide clinical spectrum with a common triad of impairments -- social communication, social interaction and social imagination. Even mild or subtle difficulties can have a profound and devastating impact on the child. To be able to provide suitable treatments and interventions the distinctive way of thinking and learning of autistic children has to be understood. The core areas of social, emotional, communication and language deficits have to be addressed at all levels of functioning. The important goals of assessment include a categorical diagnosis of autism that looks at differential diagnosis, a refined precise documentation of the child's functioning in various developmental domains and ascertaining presence of co-morbid conditions. The interventions have to be adapted to the individual's chronological age, developmental phase and level of functioning. The strategies of curriculum delivery and teaching the child with autism is distinctive and includes presence of structure to increase predictability and strategies to reduce arousal of anxiety. [ABSTRACT FROM AUTHOR]

The motor and cognitive development of a visually handicapped child is delayed due to various constraints placed on learning by the handicap. The child requires a functional visual assessment, and assessment of mental & motor development. Based on these findings a total remediation programme needs to be worked out. This is individualised, integrated & includes stimulation of residual vision, optional use of residual vision and special measures to promote general development. [ABSTRACT FROM AUTHOR]

Cordycepin (3' deoxyadenosine) has been widely researched as a potential cancer therapy, but many diverse mechanisms of action have been proposed. Here, we confirm that cordycepin triphosphate is likely to be the active metabolite of cordycepin and that it consistently represses growth factor-induced gene expression. Bioinformatic analysis, quantitative PCR and western blotting confirmed that cordycepin blocks the PI3K/AKT/mTOR and/or MEK/ERK pathways in six cell lines and that AMPK activation is not required. The effects of cordycepin on translation through mTOR pathway repression were detectable within 30 min, indicating a rapid process. These data therefore indicate that cordycepin has a universal mechanism of action, acting as cordycepin triphosphate on an as yet unknown target molecule involved in growth factor signalling., (© 2024 The Author(s). FEBS Letters published by John Wiley & Sons Ltd on behalf of Federation of European Biochemical Societies.)

Introduction: The modified OXIS (O - open contact, X - point contact, I - straight contact, S - curved contact) classification provides a useful framework for assessing interproximal contacts in primary canines and predicting caries risk. The study aimed to assess the incidence of modified OXIS classification of canine interproximal contacts in six-to-nine-year-old children from the Delhi National Capital Region (NCR) population., Methods: A cross-sectional study was conducted to assess the interproximal contact areas between primary canine and first molar among six-to-nine-year-old children (n=400) according to the modified OXIS classification using the die stone study model. A single calibrated examiner performed a type III examination to assess a total of 1,536 contact areas from the occlusal aspect. The prevalence of each type was reported in terms of both numbers and percentages using the Chi-square test to find the prevalence, Fisher's exact test to compare the inter- and intra-arch occurrence of the different contact types, and Kruskal-Wallis test to find its correlation with age., Results: The Chi-square test showed that the most common contact type was I at 46.55% (715), followed by S1 at 28.06% (431), X at 18.56% (285), O at 6.19% (95), and S2 at 0.65% (10). The p-value of 0.000 indicated a statistically significant difference among the groups. The Kruskal-Wallis test found no statistically significant differences in patient ages. Additionally, Fisher's exact test demonstrated a statistically significant prevalence of types O, I, and S1 when comparing them across arches., Conclusion: Based on the current study, the most common contact type observed was type I, followed by type S1, according to the modified OXIS criteria. The findings indicate a higher prevalence of closed-type contacts in this population, suggesting that the occurrence of such contacts increases as permanent teeth erupt. This tool may be useful for assessing caries risk in this age group., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee of Manav Rachna Dental College, Faculty of Dental Sciences, Manav Rachna International Institute of Research and Studies issued approval MRIIRS/MRDC/SDS/IEC/2024/127. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Srivastava et al.)

Objectives: The tobacco epidemic is more than just a health concern. It is a socioeconomic one with far-reaching effects. Smoking being the most common mode of tobacco use worldwide, has an impact on human life and well-being. Hence, this study aimed to seek the knowledge and awareness of adolescents about e-cigarettes and spread awareness about the harmful effects of vapig so as to reduce the ongoing rise in cigarette consumption among these individuals., Methods: A questionnaire-based cross-sectional survey was conducted among 100 teenage children of urban schools in Delhi NCR of age group 14-17 years which collected information on teenage vaping practices, views about vaping, and their accessibility to vaping items. The data were analyzed using the Statistical Program for Social Sciences - SPSS version 25 through frequency and percent, graphs, Bar chart and Chi-squared test., Results: A total 100 participants took part in the survey out of which of 59 were males and 41 were females. A significant proportion of the participants (94 %) possessed knowledge of e-cigarettes, and 14 % had actually used them at some point. Most of the participants were aware of the disposable variety of e-cigarettes and most of them thought that e-cigarettes were less addictive., Conclusions: A significant portion of educated young adults who have never vaped are susceptible to using e-cigarettes in the future. It is also discovered that e-cigarettes are still available and being promoted in spite of the restrictions. In addition to good health education for minors, more stringent enforcement of current rules and monitoring could help prevent larger uptake in the future., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Vitamin D deficiency in expectant mothers is very common in India. As a consequence, the possibility of hypoplasia of teeth and resultant propensity for faster progression of early childhood caries (ECC) is expected to be higher in Indian children., Aim: This study aimed to determine the relationship between prenatal vitamin D intake of mothers and dental caries experience in their preschool children, and whether vitamin D deficiency in mothers could be a risk factor for tooth decay in their children., Design: This cross-sectional study included 120 mothers of children aged up to 71 months with dental caries attending the Department of Pediatric Dentistry in India. Mothers were surveyed about their prenatal vitamin D intake and their practices regarding vitamin D and sunlight exposure. Children were clinically examined, and their caries status was recorded using the decayed, extracted, filled teeth (deft) index., Results: Data were analyzed descriptively and correlated using an independent t -test. Binary logistic regression was employed to predict the effects of the duration of sun exposure and vitamin D deficiency on dental decay. The correlation of mothers' prenatal vitamin D intake was significantly associated weekly with children's caries experience. Their sun exposure ( p = 0.002) and practices adopted ( p = 0.0001) regarding vitamin D levels were statistically significant for children's caries status. Improper brushing frequency was also significantly associated with higher deft scores., Conclusion: The association between mothers' prenatal vitamin D intake and health practices related to vitamin D with dental caries was not confirmed. Subjects with vitamin D deficiency and their children had significantly higher odds of developing dental decay. However, our findings suggest that 25-hydroxyvitamin D insufficiency may be a risk factor for developing dental caries in children., How to Cite This Article: Kalra G, Kumar Y, Langpoklakpam C, et al. Relationship between Maternal Prenatal Vitamin D Status and Early Childhood Caries in Their Children: A Cross-sectional Survey. Int J Clin Pediatr Dent 2024;17(8):860-863., Competing Interests: Source of support: Nil Conflict of interest: NoneConflict of interest: None, (Copyright © 2024; The Author(s).)

Photo nanocatalyst have shownpromise in a variety of fields, including biohydrogen production where their catalytic efficiency is related to size, surface-to-volume ratio, and increasing the number of atoms on the surface. They can harvest solar light to create electron-hole pairs which is the key mechanism to define its catalytic efficiency, thus requiring suitable excitation wavelength, band energy, and crystal imperfections. In this review, a discussion on the role of photo nanocatalysts to catalyze biohydrogen production has been carried out. Photo nanocatalysts feature a large bandgap, andhigh defect concentration, thus having the ability to be tuned for their characteristics. Customization of the photo nanocatalyst has been addressed. Mechanism of the photo nanocatalysts in catalyzing biohydrogen has been discussed. Limiting factors of photo nanocatalysts were highlighted and several recommendations have been made to enhance the effective utilization of these photo nanocatalysts to enhance photo-fermentative biohydrogen production from biomass wastes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Background: Attention deficit hyperactivity disorder (ADHD) and Substance dependence are often thought to be linked as they are found to co-exist in many individuals. ADHD is estimated to be an essential indicator for the development of substance use disorder. Aim and Objective: To explore the relationship between different substance dependence and ADHD., Methods and Materials: This cross-sectional single-interview study was done at a tertiary care hospital in which a total of 153 Cases presenting to the Psychiatry OPD in a period of 03 months were selected serially based on inclusion and exclusion criteria. The diagnosis of substance dependence was made as per ICD-10 criteria. These subjects were then evaluated for the presence of ADHD and physical and psychological symptoms using the Adult ADHD self-rating scale and Maudsley's Addiction Profile., Results: The majority of our study subjects were aged between 24-29 years (45%) and were predominantly males (98.7%). Most of our subjects were dependent on smack (adulterated heroin) (38.5%) followed by cannabis (27.4%) and alcohol (18.3%). When evaluated for ADHD using the ADHD self-rating scale, we found that almost one-third of the study population had ADHD (33%). Prevalence of ADHD was maximum in the subjects with cannabis dependence (47.6%) followed by tobacco/smoking (38.8%), cocaine (33%), and alcohol (21.5%). This association was statistically significant for cannabis (p = 0.035). The standard mean of both the physical as well as psychological symptoms experienced by subjects was higher in the ADHD group compared to the non-ADHD group which was statistically significant (p < 0.05)., Conclusion: While managing patients with substance dependence we need to target both underlying ADHD and any co-morbid physical and psychological illness if present for holistic recovery of the patient., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Industrial Psychiatry Journal.)

Large-scale protein regulatory networks, such as signal transduction systems, contain small-scale modules ('motifs') that carry out specific dynamical functions. Systematic characterization of the properties of small network motifs is therefore of great interest to molecular systems biologists. We simulate a generic model of three-node motifs in search of near-perfect adaptation, the property that a system responds transiently to a change in an environmental signal and then returns near-perfectly to its pre-signal state (even in the continued presence of the signal). Using an evolutionary algorithm, we search the parameter space of these generic motifs for network topologies that score well on a pre-defined measure of near-perfect adaptation. We find many high-scoring parameter sets across a variety of three-node topologies. Of all possibilities, the highest scoring topologies contain incoherent feed-forward loops (IFFLs), and these topologies are evolutionarily stable in the sense that, under 'macro-mutations' that alter the topology of a network, the IFFL motif is consistently maintained. Topologies that rely on negative feedback loops with buffering (NFLBs) are also high-scoring; however, they are not evolutionarily stable in the sense that, under macro-mutations, they tend to evolve an IFFL motif and may-or may not-lose the NFLB motif.

The tumor microenvironment is necessary for recapitulating the intratumoral heterogeneity and cell state plasticity found in human primary glioblastoma (GBM). Conventional models do not accurately recapitulate the spectrum of GBM cellular states, hindering elucidation of the underlying transcriptional regulation of these states. Using our glioblastoma cerebral organoid model, we profiled the chromatin accessibility of 28,040 single cells in five patient-derived glioma stem cell lines. Integration of paired epigenomes and transcriptomes within the context of tumor-normal host cell interactions was used to probe the gene-regulatory networks underlying individual GBM cellular states in a way not readily possible in other in vitro models. These analyses identified the epigenetic underpinnings of GBM cellular states and characterized dynamic chromatin changes reminiscent of early neural development that underlie GBM cell state transitions. Despite large differences between tumors, a shared cellular compartment made up of neural progenitor-like cells and outer radial glia-like cells was observed. Together, these results shed light on the transcriptional regulation program in GBM and offer novel therapeutic targets across a broad range of genetically heterogenous GBMs., Significance: Single-cell analyses elucidate the chromatin landscape and transcriptional regulation of glioblastoma cellular states and identify a radial glia-like population, providing potential targets to disrupt cell states and improve therapeutic efficacy., (©2023 American Association for Cancer Research.)

Recent breakthroughs in human stem cell technologies have enabled the generation of 3D brain organoid platforms for modeling human neurodevelopment and disease. Here, we review advances in brain organoid development, approaches for generating whole-brain or cerebral organoids and region-specific brain organoids, and their applications in disease modeling. We present a comprehensive overview of various brain organoid generation protocols, including culture steps, media, timelines, and technical considerations associated with each protocol, and highlight the advantages and disadvantages of each protocol. We also discuss the current limitations as well as increasing sophistication of brain organoid technology, and future directions for the field. These insights provide a valuable assessment of multiple commonly used brain organoid models and main considerations for investigators who are considering implementing brain organoid technologies in their laboratories., Competing Interests: Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Recently, the world is experiencing a shift from petroleum refineries to biorefineries due to fossil fuel depletion and environmental concerns. To achieve sustainable development of biorefineries and other components of the biofuel production process, eco-friendly and cost-effective approaches are necessary. Therefore, lignocellulosic biomass (LCB) must be exploited in biorefineries for the generation of a broad spectrum of products. The complex structure of LCB prevents its direct saccharification by enzymatic means, so pretreatment is necessary. There are several pretreatment technologies for disrupting the lignocellulosic structure, but hydrothermal pretreatment is the leading pretreatment technology for recovering hemicellulose fraction with a low number of inhibitors and an increased amount of cellulose. The severity of hydrothermal pretreatment plays a principal role in affecting cellulose, hemicellulose, and lignin structure. A detailed account of microwave-assisted hydrothermal pretreatment technologies and the cost-effectiveness, eco-friendliness, and upcoming challenges of this technology for commercialization with the probable solution is presented., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Biohydrogen (bio-H 2 ) is regarded as a clean, non-toxic, energy carrier and has enormous potential for transforming fossil fuel-based economy. The development of a continuous high-rate H 2 production with low-cost economics following an environmentally friendly approach should be admired for technology demonstration. Thus, the current review discusses the biotechnological and thermochemical pathways for H 2 production. Thermochemical conversion involves pyrolysis and gasification routes, while biotechnological involves light-dependent processes (e.g., direct and indirect photolysis, photo/ dark fermentation strategies). Moreover, environmentally friendly technologies can be created while utilizing renewable energy sources including lignocellulosic, wastewater, sludge, microalgae, and others, which are still being developed. Lifecycle assessment (LCA) evaluates and integrates the economic, environmental, and social performance of H 2 production from biomass, microalgae, and biochar. Moreover, system boundaries evaluation, i.e., global warming potential, acidification, eutrophication, and sensitivity analysis could lead in development of sustainable bioenergy transition with high economic and environmental benefits., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

In this study, the brown algae Sargassum Hemiphyllum was used as a carbon source for synthesis of magnetic porous biochar via pyrolyzing at high temperature and and doping iron oxide particles (Fe-BAB). Cu (II) species were removed from aqueous solutions using Fe-BAB under various conditions. Fe-BAB demonstrated superior Cu (II) adsorption (105.3 mg g -1 ) compared to other biochars. On the surface of Fe-BAB, there are several oxygen-containing functional groups, such as -COOH and -OH, which are likely responsible for the excellent heavy metal removal performance. By utilizing magnet, the Fe-BAB can be conveniently separated from the solution and ready for further usage. Multi-adsorption mechanisms were responsible for Cu adsorption on Fe-BAB. Using the magnetic algal biochar for heavy metal removal is feasible due to its high adsorption efficiency and simplicity of separation., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

In a moving bed-biofilm reactor (MBBR), the fluidization efficiency, immobilization of microbial cells, and treatment efficiency are directly influenced by the shape and pores of biofilm carriers. Moreover, the efficacy of bioremediation mainly depends on their interaction interface with microbes and substrate. This review aims to comprehend the role of different carrier properties such as material shapes, pores, and surface area on bioremediation productivity. A porous biofilm carrier with surface ridges containing spherical pores sizes > 1 mm can be ideal for maximum efficacy. It provides diverse environments for cell cultures, develops uneven biofilms, and retains various cell sizes and biomass. Moreover, the thickness of biofilm and controlled scaling shows a significant impact on MBBR performance. Therefore, the effect of these parameters in MBBR is discussed detailed in this review, through which existing literature and technical strategies that focus on the surface area as the primary factor can be critically assessed., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The goal of this research was to study the role of excess charges in regulating biohydrogen production from Paulownia. The excess charges were generated through charge compensation in SnO 2 nanocatalysts by Zn doping. The maximum hydrogen yield of 335 mL was observed at 8%Zn doping with a concentration of 150 mg/L, 47% higher as compared to standard sample. It was observed that the hydrogen production rate increased with Zn doping and the highest value (77 mL/h) was observed for 8%Zn at 24 h. The decrease in the total amount of byproducts (2.52 g/L from 4.28 g/L) at 8% Zn indicates an increase in bacterial metabolism. The lowest value of oxidation-reduction potential (-525 mV) at 24 h for 8%Zn confirms that Zn doping provides excessive electrons to the fermentative medium which helps the bacteria to transfer electrons faster during the redox reaction, hence, enhancing the enzymatic process and eventually hydrogen production., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Ustekinumab (UST) is a monoclonal antibody against the p40 subunit of IL-12/23. It is approved for the treatment of moderate to severe Crohn's disease (CD) and Ulcerative Colitis. We performed a retrospective study to demonstrate the efficacy and outcomes of UST in CD patients who received prior anti-TNF therapies., Methods: We collected a list of all patients who received UST until May 2021. In addition, the list was screened for patients who were on anti-TNFs for treatment of CD in the past. Data was collected for patient demographics, disease characteristics, comorbidities, disease phenotype, age of initiation of UST, prior biologic therapy, time since last biologic therapy, concomitant use of steroids or immunomodulator, inflammatory markers, induction of remission, deep remission. Chi-square tests were used for statistical analysis., Results: We identified 34 patients (59% females) with CD on UST who failed at least one anti-TNFs before induction with UST. Clinical remission was documented in 70.5% of patients. 29 percent of patients who achieved clinical remission were on concomitant steroids or immunomodulators at the time of induction of remission along with UST. Fifty percent of patients had a fistulizing disease, of which 70% achieved clinical remission with UST. C-reactive protein (CRP) was reported in 70 percent of patients. Mean CRP prior to initiation of UST was 2.4. CRP trended down to 1.98 (p = 0.079, 95% CI: -0.064-1.08). Eighteen percent of patients had fecal calprotectin reported. Mean fecal calprotectin before initiation of UST was 386, and it trended down 175 while on UST (p = 0.148, 95% CI: -106.25-528.46)., Conclusion: Our study demonstrates that remission rates in CD patients who have failed prior anti-TNF therapy are high, including for patients with perianal disease. In patients with fistulizing CD, we suggest using UST for higher rates of remission after induction. We also found that for fecal calprotectin, although an excellent surrogate of colon inflammation, compliance amongst patients remains low., (Copyright © 2021 by The American College of Gastroenterology.)

Freshwater demand is rising worldwide due to largely increasing population and industrialization. Latest focus is to explore the Ocean and saline effluent from industries to produce freshwater in a sustainable way via algal desalination. Current physicochemical desalination technology is not only an energy-intensive and expensive process but also gives severe environmental impact from brine and GHGs emissions. Therefore, it is neither environmentally-friendly nor feasible to countries with limited resources. Biodesalination could be an attractive technology with recent breakthroughs in algal bioprocess with fast growth rate under highly saline conditions to effectively remove salts optimally 50-67% from saline water. Algal desalination mainly occurs through biosorption and bioaccumulation which governs by biotic and abiotic factors e.g., strain, temperature, pH, light and nutrients etc. This review provides a current scenario of this novel technology by an in-depth assessment of technological advancement, social impact, possible risks and scope for policy implications., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Waste biomass of Lactobacillus brevis obtained from in vivo γ-aminobutyric acid (GABA) production was used for value-addition. This study aims to extract glutamate decarboxylase (GAD) and characterize it for in vitro GABA production. Extracted GAD showed an excellent activity for in vitro GABA production. 52 W ultrasonic output was best in crude GAD extraction which was purified by Q HP anion-exchange column followed by Superdex-200 colloid separation column. The molecular weight of the purified GAD was determined to be ~53 kDa, and the K m value for L-glutamic acid was calculated ~7.65 mM. Pyridoxal 5'-phosphate (PLP) acted as the best cofactor for GAD. Optimum temperature and PLP dosing were deferring for crude and purified enzyme forms which respectively exhibited at 45°C, 55°C, 200 µmol and 20 µmol whereas optimum pH was the same at 4.5. GAD finds applications in food industries hence its detailed characterization would be promising for commercial exploitations., (Copyright © 2021. Published by Elsevier Ltd.)

Lytic polysaccharide monooxygenases (LPMOs) emerged a decade ago and have been described as biomass deconstruction boosters as they play an extremely important role in unravelling the enzymatic biomass hydrolysis scheme. These are oxidative enzymes requiring partners to donate electrons during catalytic action on cellulose backbone. Commercial cellulase preparations are mostly from the robust fungal sources, hence LPMOs from fungi (AA9) have been discussed. Characterisation of LPMOs suffers due to multiple complications which has been discussed and challenges in detection of LPMOs in secretomes has also been highlighted. This review focuses on the significance of LPMOs on biomass hydrolysis due to which it has become a key component of cellulolytic cocktail available commercially for biomass deconstruction and its routine analysis challenge has also been discussed. It has also outlined a few key points that help in expressing catalytic active recombinant AA9 LPMOs., (Copyright © 2021. Published by Elsevier Ltd.)

Emphysematous gastritis [EG] is a rare condition associated with a high mortality rate which involves the invasion of gas-forming organisms into the gastric mucosa. Risk factors include mucosal defects such as gastric ulceration as well as systemic illnesses such as diabetes. Clinical presentation includes abdominal pain as well as signs of sepsis. Air in the gastric wall and portal venous system on abdominal imaging are characteristic radiographic findings. The ideal treatment of the condition is unclear, given its rarity. Cases have typically involved either surgical options or conservative management with bowel rest and intravenous antibiotics. We report on two patients treated successfully at our institution with conservative management and a review of the current knowledge in this area. Recent case literature shows a trend towards conservative management for emphysematous gastritis with several successfully managed cases, suggesting that patients can avoid surgery in the majority of cases., (© 2021. Japanese Society of Gastroenterology.)

Background: We compared real-world practice of dyspepsia management to the new American College of Gastroenterology (ACG)/Canadian Association of Gastroenterology (CAG) guidelines 2017., Methods: We conducted a retrospective, observational study using administrative data to include patients undergoing esophagogastroduodenoscopy (EGD) for dyspepsia., Results: Out of 122 EGDs, only 30 (24.5%) were deemed appropriate per guidelines. Only 13 (14.1%) patients had undergone both Helicobacter pylori ( H. pylori ) test and treat and adequate proton pump inhibitor (PPI) before undergoing endoscopy. Nineteen (15.5%) patients had alarm symptoms (weight loss, melena and early satiety). Positivity rate of H. pylori was 36.3%, but only half completed treatment. Twenty-six patients (21.3%) had abnormalities on endoscopy, most commonly gastritis. There were no cases of gastric/esophageal cancer., Conclusions: The rate of inappropriate upper gastrointestinal endoscopy is higher than the existing literature, likely because of the stricter use of EGD in patients < 60 years. Only one in eight patients underwent the recommended workup before undergoing endoscopy., Competing Interests: None to declare., (Copyright 2021, Gupta et al.)