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Oesophageal and gastric pathology: Early neoplastic lesions. Case 6. Signet ring cell intramucosal carcinoma in hereditary diffuse gastric cancer with mutated CDH1 gene
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Double spectator poles observed in a double coincidence study of the 6Li + 6Li → 2α + 2d reaction
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Design of an Alignment Tolerant Miniature Optical Subassembly Module
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핀-튜브 열교환부를 갖는 복합집열기 내 핀 형상 조건에 따른 열교환 성능에 관한 수치해석 연구
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Fundamental optimization study for open wire transmission systems
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- 저자 : Radhika Chavan (검색결과 5 건)
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Adverse events associated with third space endoscopy: Diagnosis and management
Radhika Chavan,Zaheer Nabi,Duvuur Nageshwar Reddy 소화기인터벤션의학회 2020 Gastrointestinal Intervention Vol.9 No.2
Third space endoscopy (TSE) is a ‘magnum opus’ in the field of therapeutic gastrointestinal (GI) endoscopy that has led to a paradigm shift in the management of various GI disorders. TSE or submucosal endoscopy is based on the concept of mucosal flap safety valve technique. Since, the basic principle is more or less similar for all the TSE procedures, the nature of major adverse events (AE) also shares some similarity across the spectrum of TSE procedures. These AE include insufflation related AE, bleeding, perforation, and infection. Insufflation related events are among the most commonly encountered AEs. However, majority of the insufflation related AE do not require a specific intervention and not regarded as AE in true sense. Identification of risk factors and adaptation of preventative strategies may help in reducing the incidence of AE. At the same time, early recognition and expeditious management is paramount to reduce morbidities associated with these AE. Due to heterogeneity in the reporting of AE, it is difficult to estimate the actual incidence of AE and compare the results between different studies. Therefore, universal adaptation of a standard reporting system is required to quantify the true incidence of AE for each procedure.
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Adverse events associated with third space endoscopy: Diagnosis and management
Radhika Chavan,Zaheer Nabi,Duvuur Nageshwar Reddy 소화기인터벤션의학회 2020 International journal of gastrointestinal interven Vol.9 No.2
Third space endoscopy (TSE) is a ‘magnum opus’ in the field of therapeutic gastrointestinal (GI) endoscopy that has led to a paradigm shift in the management of various GI disorders. TSE or submucosal endoscopy is based on the concept of mucosal flap safety valve technique. Since, the basic principle is more or less similar for all the TSE procedures, the nature of major adverse events (AE) also shares some similarity across the spectrum of TSE procedures. These AE include insufflation related AE, bleeding, perforation, and infection. Insufflation related events are among the most commonly encountered AEs. However, majority of the insufflation related AE do not require a specific intervention and not regarded as AE in true sense. Identification of risk factors and adaptation of preventative strategies may help in reducing the incidence of AE. At the same time, early recognition and expeditious management is paramount to reduce morbidities associated with these AE. Due to heterogeneity in the reporting of AE, it is difficult to estimate the actual incidence of AE and compare the results between different studies. Therefore, universal adaptation of a standard reporting system is required to quantify the true incidence of AE for each procedure.
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( Zaheer Nabi ),( Mohan Ramchandani ),( Mahiboob Sayyed ),( Radhika Chavan ),( Santosh Darisetty ),( Rajesh Goud ),( H V V Murthy ),( D Nageshwar Reddy ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2021 Journal of Neurogastroenterology and Motility (JNM Vol.27 No.1
Background/Aims Per-oral endoscopic myotomy (POEM) is an established treatment for achalasia. The technique of POEM is still evolving and the impact of length of esophageal myotomy on the outcomes of POEM is not known. In this study, we aim to compare the outcomes of short (3 cm) versus long (6 cm and above) esophageal myotomy in patients undergoing POEM for achalasia cardia. Methods Consecutive patients with idiopathic achalasia (type I and II) were randomized to receive short (3 cm) or long esophageal myotomy (≥ 6 cm). Both groups were compared for clinical success, operative time, adverse events, and gastroesophageal reflux disease (GERD). Results Seventy-one consecutive patients with type I and II achalasia underwent POEM with short (n = 34) or long (n = 37) esophageal myotomy techniques. Mean length of esophageal myotomy in short and long groups was 2.76 ± 0.41 and 7.97 ± 2.40, respectively (P < 0.001). Mean operative time was significantly shorter in short myotomy group (44.03 ± 13.78 minutes and 72.43 ± 27.28 minutes, P < 0.001). Clinical success was comparable in both arms at 1-year (Eckardt score 0.935 ± 0.929 vs 0.818 ± 0.983, P = 0.627). Improvement in objective parameters including integrated relaxation pressure and barium column height at 5 minutes was similar in both groups. GERD was detected in 50.88% patients with no significant difference in short and long myotomy groups (44.44% vs 56.67%, P = 0.431). Conclusions A short esophageal myotomy is non-inferior to long myotomy with regards to clinical success, adverse events, and GERD in cases with type I and II achalasia. Reduced operating duration favors short esophageal myotomy in these patients. (J Neurogastroenterol Motil 2021;27:63-70)
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Per Oral Endoscopic Myotomy in Children with Achalasia Cardia
( Zaheer Nabi ),( Mohan Ramchandani ),( D Nageshwar Reddy ),( Santosh Darisetty ),( Rama Kotla ),( Rakesh Kalapala ),( Radhika Chavan ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2016 Journal of Neurogastroenterology and Motility (JNM Vol.22 No.4
Background/Aims Achalasia cardia (AC) is a motility disorder, characterized by impaired lower esophageal sphincter relaxation and absence of esophageal peristalsis. AC is rare in children with unclear optimum management strategies. Per oral endoscopic myotomy (POEM) is a novel technique for management of achalasia with encouraging results in adult patients. The efficacy and safety of POEM is not known for pediatric AC. The aim of our study was to evaluate the safety and efficacy of POEM in children with achalasia cardia Methods The data of all children (< 18 years) who underwent POEM at our center was retrospectively analysed. Symptoms were analysed using a validated score (Eckardt score) at regular predefined intervals. Objective parameters including high-resolution manometry, timed barium swallow and esophagogastroduodenoscopy were assessed before the procedure and at 1-year follow-up. Clinical success was defined as an Eckardt score ≤ 3. Results A total of 15 children underwent POEM during the specified period. Ten out of 15 (10/15) completed 1-year follow-up. Median operative time was 100 (38-240) minutes. Mean pre and post procedure LES pressure were 36.64 ± 11.08 mmHg and 15.65 ± 5.73 mmHg, respectively (P = 0.001). Mean Eckardt score before and after the POEM was 7.32 ± 1.42 and 1.74 ± 0.67, respectively (P = 0.001). Mean percentage improvement in barium emptying at 5 minutes was 63.70 ± 4.46%. All children had complete resolution of symptoms at 1 year. Median weight gain of children at 1 year was 0.65 kg (range, 0.0-4.6). Conclusions POEM is safe and effective for children and adolescents with achalasia. Future trials with larger sample size are warranted to establish its efficacy in pediatric AC.
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