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A new technique of combined endoscopic sclerotherapy and ligation for variceal bleeding

World Journal of Gastroenterology 2003年第5期9卷 1090-1093页

作者： radha k.dhiman Yogesh k.Chawla Department of Hepatology Postgraduate Institute of Medical Education & ResearchChandigarh 160012India

AIM: To develop a technique of combined endoscopic sclerotherapy and ligation (ESL) in which both techniques of endoscopic sclerotherapy (ES) and endoscopic variceal ligation (EVL) can be optimally ***: ESL was performed in 10 patients (age 46.4±7.9;9 males, 1 female) with cirrhosis of liver using sclerotherapy needle and Speedband, Superview multiple band ligater (Boston Scientific, Microvasive, Watertown, MA). A single band was placed 5-10 cm proximal to the gastro-esophageal junction over each varix from proximal to distal margin,followed by intravariceal injection of 1.5 % ethoxysclerol (4 ml each) 2 to 3 cm proximal to the gastroesophageal junction on the ligated varices distal to deployed band. EVL was then performed at the injection site. Similarly other varices were also injected and ligated from distal to proximally. In the subsequent sessions, ES alone was performed to sclerose small varices at the gastroesophageal ***: ESL was successfully performed in all patients.A median of 3 (ESL 1, ES 2) sessions (ranged 1-4) were required to eradicate the varices in 9 (90 %) of 10 *** of varices without bleed was seen in 1 patient during a mean follow-up of 10.3 months (ranged 6-15).Two patients died of liver failure. None died of variceal bleeding. None of the patients had procedure related ***: ESL may be useful in the fast eradication of esophageal varices. However, randomised controlled trials are required to find out its relative efficacy and impact on variceal recurrence in comparison to ES or EVL.

关键词： Adult Endoscopy, Digestive System Esophageal and Gastric Varices Female Gastrointestinal Hemorrhage Humans Ligation Liver Cirrhosis Male Middle Aged Pilot Projects Sclerotherapy

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Chronic Liver Failure-Sequential Organ Failure Assessment is better than the Asia-Pacific Association for the Study of Liver criteria for defining acute-on-chronic liver failure and predicting outcome

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World Journal of Gastroenterology 2014年第40期20卷 14934-14941页

作者： radha k.dhiman Swastik Agrawal Tarana Gupta Ajay Duseja Yogesh Chawla Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh 160012 India

AIM: To compare the utility of the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) and Asia-Pacific Association for the Study of Liver (APASL) definitions of acute-on-chronic liver failure (ACLF)... 详细信息

关键词： Cirrhosis Acute decompensation Mortality Prognosis Acute on chronic liver failure

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Genetic polymorphism in CD14 gene, a co-receptor of TLR4 associated with non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2016年第42期22卷 9346-9355页

作者： Shweta kapil Ajay Duseja Bal krishan Sharma Bhupesh Singla Anuradha Chakraborti Ashim Das Pallab Ray radha k.dhiman Yogesh Chawla Department of Hepatology Postgraduate Institute of Medical Education and Research Experimental Medicine and Biotechnology Postgraduate Institute of Medical Education and Research Histopathology Postgraduate Institute of Medical Education and Research Microbiology Postgraduate Institute of Medical Education and Research

AIM To evaluate the pathogenic role of toll-like receptor(TLR) gene polymorphisms in patients with nonalcoholic fatty liver disease(NAFLD).METHODS Two hundred and fifty subjects(NAFLD = 200, healthy volunteers = 50) underwent polymerase chain reaction and restriction fragment length polymorphism to assess one polymorphism in the toll-like receptor 2(TLR2) gene(A753G), two polymorphisms in the TLR4 gene(TLR4 Asp299 Gly and Thr399 Ile allele), and two polymorphisms in the cluster of differentiation 14(CD14)(C-159 T and C-550T) gene, a co-receptor of TLR4. Association of TLR gene polymorphisms with NAFLD and its severity was evaluated by genetic models of *** On both multiplicative and recessive models of gene polymorphism association, there was significant association of CD14 C(-159) T polymorphism with NAFLD; patients with TT genotype had a 2.6 fold increased risk of developing NAFLD in comparison to CC genotype. There was no association of TLR2 Arg753 Gln, TLR4 Asp299 Gly, Thr399 Ile, and CD14 C(-550) T polymorphisms with NAFLD. None of the TLR gene polymorphisms had an association with histological severity of *** Patients with CD14 C(-159) T gene polymorphism, a co-receptor of TLR4, have an increased risk of NAFLD development.

关键词： Non-alcoholic steatohepatitis Nonalcoholic fatty liver disease Toll-like receptors Obesity Cirrhosis Insulin resistance Bacterial overgrowth

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Indian patients with nonalcoholic fatty liver disease presenting with raised transaminases are different at presentation

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World Journal of Gastroenterology 2007年第4期13卷 649-650页

作者： Ajay Duseja Ashim Das radha krishan dhiman Yogesh kumar Chawla Reena Das Sanjay Bhadada Ravinder Sialy kiran kumar Thumburu Anil Bhansali Naveen kalra Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India Department of Hematology Postgraduate Institute of Medical Education and Research Chandigarh India Department of Endocrinology Postgraduate Institute of Medical Education and Research Chandigarh India Department of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and Research Chandigarh India

We read with great interest the article, ＂Non-alcoholic fatty liver disease may not be a severe disease at presentation among Asian Indians＂ by Madan et at in the recent issue of WJG. Twenty-eight （55%） out of 51 patients with nonalcoholic fatty liver disease （NAFLD） who presented with abnormal transaminases had histological evidence of nonalcoholic steatohepatitis （NASH）. The majority of patients had grade 1 [32 （63%）] or grade 2 [16 （31%）] inflammation and either had no [23 （45%）] fibrosis or stage I [19 （37%）] fibrosis. None of the patients had cirrhosisf11. We agree with Madan et al that Asian Indians with NAFLD who present with unexplained increase in transaminases may have mild disease at presentation on the basis of similar observations made by us. NAFLD has a spectrum which includes patients with only steatosis and NASH that can progress to cirrhotic and hepatocellular carcinoma.

关键词： Gastroenterology

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