Online ISSN: 2515-8260

Keywords : endoscopy

Management of Gastroesophageal Reflux Disease – A Prospective Study

Dr. Goel Amit, Dr. Sharma Munish, Dr. Sunda Himanshu, Dr. Pandey Shruti

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 597-601

Purpose-Gastroesophageal reflux disease is the commonest gastrointestinal disease which causes reflux oesophagitis and complications like ulcerations, stricture of oesophagus. Patients present with either heartburn or reflux. Current treatment would include either lifestyle changes, pharmacological therapies, surgical fundoplications and endoscopic procedures.
Methods-Patients who have reflux would require medical therapy, endoscopic approach or surgery. The choice of therapy depends on symptoms of the patient. This article various treatment strategies for management of GERD.
Results- Fundoplication was done in 35 patients, Slippage of wrap was found in 3 patients and 4 patients persisted with postoperative dysphagia.
Conclusion- Laparoscopic fundoplication is indicated for severe gastroesophageal reflux disease, erosive esophagitis, stricture of oesophagus, hiatus hernia and is the gold standard for these conditions

Gastric Xanthelasma: Innocent impersonator

Dr.MonishaRita J, Dr.Niveditha E N, Dr.Volga Harikrishnan; Lekshmi Sudhish Nair

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 7370-7374

Gastric xanthelasma also known as gastric xanthoma is a benign asymptomatic condition that can mimic malignancy and is associated with a few other conditions of the stomach. A careful examination of the gastrointestinal tract for other co-existing conditions and histopathological confirmation of the diagnosis is needed. Gastric xanthomas are comparatively rare their incidence ranges from 0.018-0.8%, which is more frequent when compared to esophageal and duodenal xanthomas. The most common location of xanthelasmas of the gastrointestinal tract was the stomach (76%), followed by the esophagus (12%) and duodenum (12%). Here we report two patients who presented with symptoms of dyspepsia for 2 months and 3 months respectively. An endoscopy was done to find the cause of dyspepsia. Histopathological diagnosis of gastric xanthelasma was made for both patients. Gastric xanthelasma is now viewed as a warning sign of the presence of gastric malignancy. Here we report these 2 cases to emphasize that gastric xanthoma should not be overlooked when encountered endoscopically and histopathological examination is essential for diagnosis.

A Randomized Controlled trial to compare Nitroglycerine with Dexmedetomidine for Controlled Hypotension during Endoscopic resection of Juvenile Nasopharyngeal Angiofibroma

Dr. Pacharla Indira,N.Anupama Priyadarshini,Dr.W.R.Pathanjali Rao, Dr.Seema,Dr. Rajola Raghu .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5340-5348

Background:Juvenile nasopharyngeal angiofibroma(JNA) is a locally invasive benign vascular tumor. Controlled hypotension is used to facilitate endoscopic resection to reduce the blood loss and stabilize the hemodynamics. Various agents are tried till now to achieve the goal.
Objective: To compare the effectiveness of Nitroglycerine withDexmedetomidine in terms of hemodynamics and blood loss during Endoscopic resection of Juvenile Nasopharyngeal Angiofibroma
Methods: Ethics Committee has approved this Randomized Controlled trial which was conducted among 40 patients randomly divided into two groups by simple randomization using computer generated random numbers.Informed consent was taken from all the eligible participants. Group D(n=20) receivedDexmedetomidine 1µg/kg over 15 min followed by a maintenance infusion at 0.5µg/kg/hourand GroupN (n=20)received (n=20), Nitroglycerine 0.5µg/kg/min and titrated in doses 0.5-5µg/kg/min for target blood pressure respectively. Standard guidelines were followed throughout the study protocol for data collection. Data was analyzed using mean and standard deviation in two groups.
Results:Both the groups were comparable for baseline parameters. There is statistically significant difference in mean pulse rate between two groups Group D: 66.09±2.83, Group N: 86.59±4.24 (p=0.0001). Blood loss was lower in Group D: 310.71±140.58 compared to Group N: 482.61±141.42, and is statistically significant (p=0.0004). SBP,DBPand MAP were lower in Group D throughout the surgery.
Conclusions:Dexmedetomidine is a better hypotensive agent with favorablehemodynamics and less blood loss when compared to Nitroglycerine. Hence we recommend use of Dexmedetomidine over nitroglycerine in patients during Endoscopic resection of Juvenile Nasopharyngeal Angiofibroma.