Atypical Complications of Anti-Reflux Surgery; Post-Surgical Paraesophageal Hematoma: Two Case Reports

Background: The laparoscopic approach is the current standard for the surgical treatment of gastroesophageal reflux disease refractory to medical treatment and symptomatic hiatal hernia. Although it is a safe surgery, its potential complications are frequently underestimated. The most common postoperative complication is the dysphagia, but less common and severe complications such as pneumothorax or paraesophageal...

Major Hepatopancreatoduodenectomy for Multifocal Cholangiocarcinoma of the Intrahepatic, Proximal, and Distal Bile Duct

A 58-year-old female patient presented in the outpatient clinic with obstructive jaundice that had lasted over one month. Her past medical history includes cholelithiasis treated by sphincterotomy, lithotripsy and stone extraction followed by a laparoscopic cholecystectomy 5 months ago. Hepatic function examination revealed the following results: ALT 927 U/L, AST 722 U/L, total bilirubin 6.8 mg/dl, direct bilirubi...

Increased Activity of Alkaline Phosphatase in COVID-19: Potential Mechanisms

Clinical manifestations of Coronavirus disease 2019 (COVID-19) are multisystemic and associated with a wide range of laboratory abnormalities. Abnormalities in serum liver profile are common, however, increased serum activity of alkaline phosphatase has not been frequently reported. Two cases of PCR confirmed Sars-CoV-2 infection and high alkaline phosphatase serum activity are presented. Cholestasis from sepsis a...

Wearable Itch Monitoring System to Study Scratching Behavior

Pruritus is a perception that cannot be quantitated. To study pruritus and its behavioral manifestation, scratching activity, instruments that record it independent from gross body movement have been developed. A new version of a portable device to monitor scratching activity in patients with pruritus is described. The main feature of the device is the use of a piezo film attached to a fingernail. Vibrations of th...

A Variety of Functional Characteristics of the Probiotic Lactobacillus Plantarum Inducia Contribute to the Prevention of Clostridioides Difficile Spore Germination

Previously, we proved the possibility to prevent antimicrobial treatment-associated C. difficile infection and its recurrences by the antagonistic probiotic L. plantarum strain INDUCIA in synbiotic combination with xylitol. The strain enhances natural cellular immunity and barrier function of gut mucosa via secretion of plantaricins, induction of cytokine IL-6, production of putrescine and increases the amount of...

Sprue-Like Intestinal Disease Following Colectomy for Inflammatory Bowel Disease

After an initial index case of post-colectomy sprue-like intestinal disease or enteritis from our hospital in a patient with ulcerative colitis in 2012, a retrospective examination of over 3000 patient records with either ulcerative colitis or Crohn’s disease was done to determine if this post-colectomy sprue-like disease could be defined retrospectively in earlier patients. After review of records from a intestin...

Challenges in Detection and Sub typing of Yersinia Enterocolitica by Conventional Culture Methods

Yersinia enterocolitica is an important food borne pathogen, but the incidence of infected people is underestimated since clinical samples are not routinely tested for Yersinia. Problems emerge also from the similarities with other Enterobacteriaceae and Y. enterocolitica-like species and the heterogeneity of Y. enterocolitica as it comprises both pathogenic and non-pathogenic isolates. This review focuses on the...

Esophageal Perforation: A Rare but Life-Threatening Complication of Esophageal Dilatation

Esophageal perforation is a rare but life-threatening complication of esophageal dilatation. Based on a retrospective review of patients treated in a tertiary center for esophageal perforation, this study focused on perforation following esophageal dilatation. A review of different treatments currently available is also presented.

Thoracic Drainage

The Digital Chest Drainage (DCD) is a portable digital system that has been evaluated since 2008. Clinical evidence showed that the use of DCD leads to shorter drainage times, a shorter hospital stay, lower rates of chest drain re-insertion and higher patient satisfaction compared to conventional chest drainage when it is used in patients with pulmonary resection. One comparative study of the use of this technolog...

A Personalized Treatment Algorithm for Patient with Full-Thickness Rectal Prolapse Based on Surgical Risk and Main Aim of Treatment

Full-thickness rectal prolapse is a disabling condition, and has a significant impact on quality of life. Surgery is the only definitive treatment, and there are numerous abdominal and perineal procedures. The ideal procedures should have few complications and cure the prolapse with excellent long-term outcome. We focus on the five most common surgical procedures performed today including two perineal procedures (...

Association of High Altitude Polycythemia with an Increased Risk of Systemic Inflammatory Response Syndrome in Acute Pancreatitis

Objective: To investigate the relationship between Systemic Inflammatory Response Syndrome (SIRS) and the severity of acute pancreatitis with high altitude polycythemia (hereinafter referred to as AP+HAPC) in individuals living in a high-altitude region, to provide evidence for the treatment of SIRS and AP+HAPC. Methods: A retrospective analysis of clinical data on AP+HAPC and acute pancreatitis without high altit...

Sonographic Findings in Perforated Appendicitis

Perforated appendicitis is a common complication of acute appendicitis occurring in roughly 21% [1]. Especially in younger children, perforation occurs earlier and the rate of perforation is generally higher. Moreover, the presentation may be atypical and the right sided abdominal tenderness is often missing [1,2]. Rather than the typical ultrasonographic appearance of acute appendicitis with a swollen and dilated...

Rickets Presented with Hypocalcaemic Seizures in Infancy: Case Series

Vitamin D Deficiency (VDD) is series health issue in Sri Lanka in spite of sun exposure throughout the year. This is a case series of six infants presented with hypocalcaemic seizures diagnosed to have VDD rickets. They presented at the age of 2 to 5 months, one presented with febrile seizures and the rest had afebrile seizures, in which two had status epilepticus. None of them had clinical features of rickets. Al...

The Endoscopic Treatment in Chronic Pancreatitis: A Systematic Review

Background: In patients with chronic pancreatitis, the pain is the main symptom, sometimes really debilitating, with a negative impact on patient’s life quality. There is no etiological therapy for chronic pancreatitis. The goal of the endoscopic treatment of painful chronic pancreatitis is to drain the pancreatic duct, reduce the frequency and severity of pain and resolve local complications of the disease as bil...

Submucosal Colonic Lipoma - An Uncommon Yet Important Entity

Colonic lipomas are benign submucosal adipose tumors. Most colonic lipomas are diagnosed incidentally during radiological imaging or colonoscopy. However, large lesions greater than 4cm in size may cause non-specific abdominal symptoms or result in complications such as gastrointestinal bleeding, perforation, intussusceptions or obstruction. The development of symptoms correlates with the size of the lesion. Resec...

Hepatic Abscess with Gas by Streptococcus Pyogenes (Group A)

Background: It is reported that the pyogenic liver abscess has an annual incidence of 2.3 cases 100 000 inhabitants and has an incidence of up to 30% of all hepatic gasforming pyogenic abscesses. Clinical case: A 34-year-old man who began his condition a month ago when presenting dyspepsia data with pain in the hypogastrium and right upper quadrant. An abdominal ultrasound is performed that reports bilateral renal...

Nuance in Choosing Controls for RNA-Based Gene Fusion Test

Next Generation Sequencing (NGS) has become a widely adopted sequencing methodology in determining gene sequence changes, chromosomal structure arrangement, and even RNA transcripts alterations. Identifying the genetic variations in human cancers is especially important in determining the proper treatment regimen or disease prognosis. The quality control materials used for these NGS tests thus become increasingly...

Antimicrobial Properties of the Probiotic Strain Bacillus Subtilis 534

The effectiveness of antibiotic therapy is constantly decreasing due to the increasing spread of resistant pathogens. One alternative treatment for infections is the use of probiotics – living microorganisms that contribute to the normalization of the human microbiota. Strain Bacillus subtilis 534 is a transient probiotic, which is the basis of the drug Sporobacterin. Under submerged cultivation, the strain 534 pr...

Irritable Bowel Syndrome: A Review and Update

Relevance: Irritable bowel syndrome (IBS) is the most common GI disorder (affecting approximately 11% of the population globally) and patients with IBS are frequently seen by primary care physicians and specialists. Objectives: This article will summarize the existing evidence on epidemiology, pathophysiology, diagnosis, and treatment of IBS and to provide the best evidence in a way that can be practically utilize...

Anxiety, Irritable Bowel Syndrome, Amyotrophic Lateral Sclerosis and Intestinal Microbiota Transplantation

We report 9 cases of Anxiety, 3 Irritable Bowel Syndrome (IBS) and 1 case of Amyotrophic Lateral Sclerosis as the first diagnosis, treated with Intestinal Microbiota Transplantation (IMT). All patients presented anxiety or Irritable Bowel Syndrome as the first or second diagnosis. There were 7 women and 6 men, aged 35 to 83 years. To evaluate anxiety we consider the Hamilton scale (Hamilton M. The assessment of an...

Growth Hormone Deficiency and Related Endocrine Disorders in Children with Celiac Disease

This review focuses on the management of short stature associated with celiac disease, which is a possible expression of GH deficiency; we want also to underline the importance of diagnosis and treatment of other endocrine disorders in celiac patients. Growth failure can be a common clinical manifestation of celiac disease in children. In fact, catch-up growth is generally observed in children with Celiac Disease...

Ramadan and Peptic Ulcer Perforation: A Review

Peptic Ulcer Perforation (PUP) is a serious surgical emergency with high risks of mortality and morbidity up to 30 and 50%, respectively. The average age range of the patients with PUP differs among countries according to their socioeconomical status. While heavy smokers young adult males are typical candidates for PUP in developing world, other risk factors predominate in developed countries; advance age with mul...

Gallbladder Wall Culture Positivity and its Impact on Surgical Site Infection after Elective Laparoscopic Cholecystectomy

Cholecystectomy is one of the most common operations performed in general surgical practice. In case of cholecystectomy, inflamed gall bladder (Acute cholecystitis, empyema gall bladder or perforated gall bladder) resulting in contamination of wound increases the risk of surgical site infection. Though cholecystectomy in patients with non-inflamed gall bladder (biliary colic, flatulent dyspepsia) is considered to...

A Huge Retroperitoneal Liposarcoma with Renal Involvement

Retroperitoneal Soft Tissue Sarcomas (RPS) are rare tumors, which account for approximately 12 per cent to 15 per cent of all soft tissue sarcomas. Early diagnosis is not easy as there is an absence of specific clinical presentations. Symptoms would only be detected if the liposarcoma presses on the surrounding organs. Surgery remains the mainstay of treatment for retroperitoneal sarcomas. We report a case of a gi...

Comparative Evaluation of Alum and MPL as Adjuvants Toxicity and Related Immune Potential of Adjuvanted Rabies Vaccine

Rabies is a dangerous and preventable viral disease that is mainly transmitted through a rabid animal bite. Human rabies has been considered a problem of great concern due to high death rate that is usually associated with rabies infection. Rabies vaccine is an active immunizing agent directed to protect against infection caused by rabies virus. Current study aimed to evaluate the potentials of Alum and Monophosph...

Review: Nutrition on Chronic Liver Diseases

Nutritional problems may appear in patients with chronic liver disease and may affect both short-term and long-term clinical outcome of the disease. Especially high incidence of malnutrition, and the complications that result from malnutrition make treatments more complicated among these patients. Therefore, nutritional regulations may play a crucial role in the treatment of chronic liver disease. It is fundamenta...