Open Journal of Gastroenterology and Hepatology


Liver cirrhosis with high IgG4 in a patient with, diabetes mellitus, ulcerative colitis with papillary thyroid cancer, is it all related ? which one to blame& is it time to raise awareness about IGG4 and hepatobiliary diseases

Research Article of Open Journal of Gastroenterology and Hepatology Liver cirrhosis with high IgG4 in a patient with, diabetes mellitus, ulcerative colitis with papillary thyroid cancer, is it all related ? which one to blame& is it time to raise awareness about IGG4 and hepatobiliary diseases Makki H.Fayadh MRCP UK,FRCP Ed,FRCP London*, Salim Awadh MRCP UK,FRCP London, Tarek Mohamed Badawy, Mahmoud Bahram MD, Ayman Salah Moussa MD, Loai Elkewisny MD, Diaa Eldeeb MD Advanced center for day care surgery Abu Dhabi UAE Back ground: There is possible etiological relation between high IgG4 in a patient with liver cirrhosis, ulcerative colitis, diabetes mellitus , prostatitis ,venous thrombosis and thyroid cancers and the use of immunosuppressive & biologic agents. Method: a study of patient with multiple organ involvement with persistently elevated IgG4. A 56 years old male with persistently elevated IgG4 over 2.5 times normal level, diabetic on insulin, ulcerative colitis on azathioprin & adalimumab developed deep skin pigmentation and liver enzymes elevation with portal hypertension and liver cirrhosis, azathioprine & adalimumab were stopped and golimumab started, after 3 infusions of golimumab papillary thyroid cancer developed .Total thyroidectomy followed by radio iodine after which severe sialo adenitis developed which responded to steroids. His ulcerative colitis was treated with vedolizumab with good response. liver cirrhosis progressed with bleeding varices and portal vein thrombosis with factor Leiden V mutation. Results and conclusions: High IgG4 can be related to many organs including pancreas,liver,thyroid ,small and large bowel,parotid glands ,in this patients all these were affected resulting in colitis,diabetes,liver cirrhosis and thyroid cancer and sialo adenitis. Awareness is needed on the associations with high IgG4. Conclusion: A patient with elevated IgG4 , liver cirrhosis , diabetes mellitus, ulcerative colitis developed skin pigmentation, and papillary thyroid cancer associated with persistently elevated IgG4. Keywords: IgG4 related, liver cirrhosis ...

Domination of Gastric Complications Among Diabetic Patients

Review Article of Open Journal of Gastroenterology and Hepatology Domination of Gastric Complications Among Diabetic Patients Abdul Kader Mohiuddin Department of Pharmacy, World University of Bangladesh, 151/8, Green Road, Dhanmondi, Dhaka – 1205, Bangladesh This article covers the epidemiology, pathophysiology/complications and management of diabetic gastroparesis (DGP), and more broadly diabetic gastroenteropathy, which encompasses all the gastrointestinal manifestations of diabetes mellitus (DM). Hyperglycemia, autonomic neuropathy, and enteric neuromuscular inflammation and injury are implicated in the pathogenesis of delayed gastric emptying (GE). Initial options include dietary modifications, supplemental oral nutrition, and antiemetic and prokinetic medications. Patients with more severe symptoms may require a venting gastrostomy or jejunostomy and/or gastric electrical stimulation (GES). To date, few population-based studies have estimated the true prevalence and incidence of gastroparesis. Nonetheless, its prevalence appears to be rising, as does its incidence among minority populations, documented via hospitalizations, which can impose significant economic burdens on patients. Keywords: gastroparesis; pyloric dysfunction; diabetes; delayed gastric emptying; dyspepsia; gastric electrical stimulation ...

Electronic Procedural Reporting for Colonoscopy; Challenges (Discrepancies) in Data Entry and Report Generation

Research Article of Open Journal of Gastroenterology and Hepatology Electronic Procedural Reporting for Colonoscopy; Challenges (Discrepancies) in Data Entry and Report Generation Tahseen Rahman, David Armstrong, Khurram J. Khan McMaster University, Hamilton, ON Aims: Computerized reporting systems that generate standardized endoscopy reports are available and facilitate easy retrieval of data for quality assurance review. We aim to compare the accuracy of extracted database fields in our reporting system (endoPRO) for key measures of quality to the final edited endoscopy report for colonoscopy procedures. Methods: In a retrospective analysis, we compared data retrieved from endoPRO to the final colonoscopy reports at Hamilton Health Sciences (HHS). The data included demographics, indications for procedures, bowel prep quality, findings, extent of exam, and recommendations. Discrepancies, changes or missing information pertaining to key quality indicators for colonoscopies were recorded. Results: In total, 1843 colonoscopy procedures were done at HHS from January to March 2010, and reports for 592 colonoscopies, randomly selected, were analyzed for this study. Discrepancies were seen in: Indication - 34 cases (5.7%), Assistants present during colonoscopy - 94 cases (15.9%), Quality of bowel preparation - 35 cases (5.9%), Findings & impressions - 38 cases (6.4%) including polyps, inflammation, diverticulosis and haemorrhoids. Conclusions: Our study demonstrates the variability between data found in patients’ final colonoscopy reports and data retrieved from the endoscopy databases. Structured endoscopy reporting and the use of databases facilitate quality assurance but editing of procedure reports after structured data entry compromises accuracy of the data in key quality measures. Inaccurate or incomplete data recording will compromise the enhancements in quality assurance that would accrue otherwise from regular audit processes. Keywords: Endoscopy reporting, Quality Assurance, Colonoscopy ...

A Skipping Breakfast Everyday Keeps Well-being Away

Review Article of Open Journal of Gastroenterology and Hepatology A Skipping Breakfast Everyday Keeps Well-being Away AK Mohiuddin Department of Pharmacy, World University of Bangladesh, Bangladesh Breakfast, the first meal of the day, is considered the most important meal throughout the day. As nutritionist Adelle Davis famously put it back in the 1960s: “Eat breakfast like a king, lunch like a prince and dinner like a pauper”. Breakfast is most commonly skipped meal more than lunch and dinner specifically in the young adult in the university study period and those who wake up late. Lack of time is the main reason behind skipping meals, in general, lack of appetite, inability to cook, fasting/religion, and not being hungry. Many people are used to be in a hurry for job, business, children’s’ school in the morning where a filled stomach may prevent them to walk a long way. It is obvious that the irregular omission of breakfast may be effective in energy intake reduction over the next 24 hours and in this day, exercise performance may be compromised. There is no evidence that breakfast skipping reduces overeating or prevent weight gain. Some people argue that breakfast and good health is a marketing strategy by breakfast companies. Abbreviations: Body Mass Index (BMI); Cardiovascular Disease (CVD); Coronary Artery Disease (CAD); Coronary heart disease (CHD); European Prospective Investigation into Cancer and Nutrition (EPIC); Fasting Blood Glucose (FBG); Glucagon-Like Peptide (GLP); Helicobacter pylori (HP); Irritable Bowel Syndrome (IBS); Institutional Review Board (IRB); Type 2 Diabetes Mellitus (T2DM); Waist Circumference (WC) Keywords: Breakfast; Meal; Appetite; Omission; Energy; Metabolism; Time; Fasting; Skipping meal ...

Dr. Mohammed Naeem
Chair, Patient Safety Reporting/Consultant Pediatric Intensivist/ Head PICU (A)/ Assistant Professor, Dept. of Pediatrics. Ministry National Guard Health Affairs Riyadh, Saudi Arabia

Dr Toru Ishikawa
Gastroenterology, Saiseikai Niigata Daini Hospital

Dr. George Paraskevas
Associate Professor of Anatomy Orthopedic Surgeon, Department of AnatomyMedical School, Aristotle University of Thessaloniki, Post Box: 300, Post Code: 54124, Thessaloniki, Greece

Dr. Mahaboob Vali Shaik
Assistant Professor/Senior Scientist, Department of Genetics & stem cell Research, Narayana Medical College & Hospitals

Dr. Ifeadike Chigozie Ozoemena
Associate Professor, Department of Community Medicine, Faculty of Medicine, Nnamdi Azikiwe University

Dr. Eduardo de Moura GH
Professor, niversity of São Paulo School of Medicine, São Paulo, Brazil

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1.Gomes, K.K.L; Lima, A.A.F. Living Style of Diabetic Patients Type.Open Journal of Gastroenterology and Hepatology, 2018, 1:5. DOI:10.28933/ojgh-2018-05-1005

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Open Journal of Gastroenterology and Hepatology is a peer reviewed open access journal publishing research manuscripts, review articles, editorials, letters to the editor in Gastroenterology and Hepatology  (Indexing information).

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Open Journal of Gastroenterology and Hepatology

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