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RISS 인기검색어
- 검색키워드
- 저자 : ( Ujjwal Sonika ) (검색결과 3 건)
- 무료
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Predictive factors for malignancy in undiagnosed isolated small bowel strictures
( Ujjwal Sonika ),( Sujeet Saha ),( Saurabh Kedia ),( Nihar Ranjan Dash ),( Sujoy Pal ),( Prasenjit Das ),( Vineet Ahuja ),( Peush Sahni ) 대한장연구학회 2017 Intestinal Research Vol.15 No.4
Background/Aims: Patients with small bowel strictures have varied etiologies, including malignancy. Little data are avail able on the demographic profiles and etiologies of small bowel strictures in patients who undergo surgery because of intestinal obstruction but do not have a definitive pre-operative diagnosis. Methods: Retrospective data were analyzed for all patients operated between January 2000 and October 2014 for small bowel strictures without mass lesions and a definite diagnosis after imaging and endoscopic examinations. Demographic parameters, imaging, endoscopic, and histological data were extracted from the medical records. Univariate and multivariate analyses were conducted to identify factors that could differentiate be tween intestinal tuberculosis (ITB) and Crohn’s disease (CD) and between malignant and benign strictures. Results: Of the 7,425 reviewed medical records, 89 met the inclusion criteria. The most common site of strictures was the proximal small intes tine (41.5%). The most common histological diagnoses in patients with small bowel strictures were ITB (26.9%), CD (23.5%), non-specific strictures (20.2%), malignancy (15.5%), ischemia (10.1%), and other complications (3.4%). Patients with malignant strictures were older than patients with benign etiologies (47.6±15.9 years vs. 37.4±16.4 years, P=0.03) and age >50 years had a specificity for malignant etiology of 80%. Only 7.1% of the patients with malignant strictures had more than 1 stricture and 64% had proximally located strictures. Diarrhea was the only factor that predicted the diagnosis of CD 6.5 (95% confidence interval, 1.10-38.25; P=0.038) compared with the diagnosis of ITB. Conclusions: Malignancy was the cause of small bowel strictures in approximately 16% patients, especially among older patients with a single stricture in the proximal location. Empirical therapy should be avoided and the threshold for surgical resection is low in these patients. (Intest Res 2017;15:518-523)
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COVID-19 Rapid Antigen Test: Role in Screening Prior to Gastrointestinal Endoscopy
Ashok Dalal,Ujjwal Sonika,Manish Kumar,Roshan George,Ajay Kumar,Siddharth Srivastava,Sanjeev Sachdeva,Barjesh Chander Sharma 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4
Background/Aims: The severe acute respiratory syndrome coronavirus 2 pandemic has affected the gastrointestinal (GI) endoscopyunits globally owing to the risk of transmission. We present our data on the use of rapid antigen test (RAT) as a screening tool priorto endoscopy to prevent the transmission of coronavirus disease (COVID-19). Methods: This study was a retrospective analysis of patients who underwent any GI endoscopic procedure from July 2020 to October2020 at a tertiary referral center in New Delhi, India. All patients underwent screening for COVID-19 using RAT, and endoscopywas performed only when the RAT was negative. The data are presented as numbers and percentages. Results: A total of 3,002 endoscopic procedures were performed during the study period. Only one endoscopic procedure wasperformed in a COVID-19 positive patient. A total of 53 healthcare workers were involved in conducting these procedures. Only2 healthcare workers (3.8%) were diagnosed COVID-19 positive, presumably due to community-acquired infection, during thisperiod. Conclusions: The COVID-19 RAT is easily usable as a simple screening tool prior to GI endoscopy during the COVID-19 pandemic.
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RWON Study: The Real-World Walled-off Necrosis Study
Ankush Pawar,Ujjwal Sonika,Manish Kumar,Sundeep Saluja,Siddharth Srivastava 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.6
Background/Aims: The management of walled-off necrosis (WON) has undergone a paradigm shift from surgical to nonsurgicalmodalities. Real-world data on the management of symptomatic WON are scarce. Methods: Prospectively collected data of symptomatic WON cases were retrospectively evaluated. The treatment modalities usedwere medical management alone, percutaneous catheter drainage (PCD) or endoscopic drainage (ED), or a combination of PCD andED. We compared clinical outcome among these modalities. Results: A total of 264 patients were evaluated. The most common indications for drainage were pain and fever. Of the patients,28% was treated with medical therapy alone, 31% with ED, 37% with PCD, and 4% with a combined approach. Technical successand clinical success were achieved in 93% and 91% of patients in the endoscopic arm and in 90% and 81% patients in the PCD arm,respectively (p=0.0004 for clinical success). Lower rates of complications (7% vs. 22%, p=0.005), readmission (20% vs. 34%, p=0.04),and mortality (4% vs. 19%, p=0.0012), and shorter hospital stay (13 days vs. 19 days, p=0.0018) were observed in the endoscopicgroup than in the PCD group. Conclusions: ED of WON is better than PCD and is associated with lower mortality, fewer complications, and shorter hospitalization.
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