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Cost saving by reloading the multiband ligator in endoscopic esophageal variceal ligation: A proposal for developing countries

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World Journal of Gastroenterology 2008年第14期14卷 2222-2225页

作者： Zaigham Abbas lubna rizvi Umair Syed Ahmed Khalid Mumtaz Wasim Jafri Department of Medicine The Aga Khan University Hospital Karachi 74800 Pakistan

AIM:To assess the cost savings of reloading the multiband ligator in endoscopic esophageal variceal ligation (EVL) used on the same patient for subsequent sessions. METHODS:This single centre retrospective descriptive study analysed patients undergoing variceal ligation at a tertiary care centre between 1st January, 2003 and 30th June, 2006. The multiband ligator was reloaded with six hemorrhoidal bands using hemorrhoidal ligator for the second and subsequent sessions. Analysis of cost saving was done for the number of follow-up sessions for the variceal eradication. RESULTS:A total of 261 patients underwent at least one session of endoscopic esophageal variceal ligation between January 2003 and June 2006. Out of 261, 108 patients (males 67) agreed to follow the eradication program and underwent repeated sessions. A total of 304 sessions was performed with 2.81 sessions per patient on average. Thirty-two patients could not complete the programm. In 76 patients (70%), variceal obliteration was achieved. The ratio of the costs for the session with reloaded ligator versus a session with a new ligator was 1:2.37. Among the patients who completed esophageal varices eradication, cost saving with reloaded ligator was 58%. CONCLUSION:EVL using reloaded multiband ligators for the follow-up sessions on patients undergoing variceal eradication is a cost saving procedure. Reloading the ligator thus is recommended especially for developing countries where most of the patients are not health insured.

关键词： Esophageal varices Reloading Multiband ligator Eradication Cost saving

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Giardiasis in patients with dyspeptic symptoms

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World Journal of Gastroenterology 2005年第42期11卷 6667-6670页

作者： Javed Yakoob Wasim Jafri Shahab Abid Nadim Jafri Saeed Hamid Hasnain Ali Shah lubna rizvi Muhammad Islam Hizbullah Shaikh Section of Gastroenterology Department of Medicine Aga Khan University Hospital Karachi 74800 Sindh Pakistan Department of Pathology Aga Khan University Hospital Karachi 74800 Sindh Pakistan

AIM： To investigate the prevalence of giardiasis in patients with dyspeptic symptoms. METHODS＂ Clinical records of consecutive patients who attended Gastroenterology Department at Aga Khan University Hospital from January 2000 to June 2003 and had esophagogastroduodenoscopy （EGD） with duodenal biopsies and international classification of diseases 9th revision with clinical modifications （ICD-9-CM） coded with giardiasis were studied. RESULTS： Two hundred and twenty patients fulfilled the above criteria. There were 44% （96/220） patients who were giardiasis positive, 72% （69/96） of them were males and 28% （27196） of them were females. There were 65% （81/124） males and 35% （43/124） females who were giardiasis negative. The mean age of patients with giardiasis was 28±17 years, while that of giardiasis negative patients was 40±18 years （P〈0.001）. In patients with giardiasis, abdominal pain was present in 71% （68/96） of patients （P = 0.02） and diarrhea in 29% （28/96）（P = 0.005）; duodenitis in 25% （24/96） on EGD （P = 0.006） and in 68% （65/96） on histopathology （P = 0.002）. CONCLUSION： Giardiasis occurs significantly in young people with abdominal pain, while endoscopic duodenitis is seen in only 25% of giardiasis positive cases, which supports routine duodenal biopsy.

关键词： Abdominal pain Giardiasis Stool examination EGD Duodenal biopsy

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