68 research outputs found
Submucosal tunneling endoscopic resection of upper gastrointestinal tract tumors arising from muscularis propria
No full textClostridium septicum aortitis with synchronous ascending colon and rectal adenocarcinoma
No full textPreoperative elective transjugular intrahepatic portosystemic shunt for cirrhotic patients undergoing abdominal surgery
No full textEndoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures
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Transoral Incisionless Fundoplication for Refractory Gastroesophageal Reflux Disease: Where Do We Stand?
No full textGastroesophageal reflux disease (GERD) is a chronic, progressive, and costly medical condition affecting a substantial proportion of the world population, predominantly the Western population. The available treatment options for patients with refractory GERD symptoms are limited to either laparoscopic surgery with significant sequelae or potentially lifelong, high-dose proton pump inhibitor therapy. The restoration of the antireflux competence of the gastroesophageal junction at the anatomic and physiologic levels is critical for the effective long-term treatment of GERD. Transoral incisionless fundoplication (TIF) surgery is a safe, well-tolerated, and effective treatment that has yielded significant symptomatic improvement in patients with medically refractory GERD symptoms. In this review article, we have summarized case series and reports describing the role of TIF for patients with gastroesophageal reflux symptoms. The reported indications, techniques, complications, and success rates are also discussed
Esophageal Stricture Prevention after Endoscopic Submucosal Dissection
No full textAdvances in diagnostic modalities and improvement in surveillance programs for Barrett esophagus has resulted in an increase in the incidence of superficial esophageal cancers (SECs). SEC, due to their limited metastatic potential, are amenable to non-invasive treatment modalities. Endoscopic ultrasound, endoscopic mucosal resection, and endoscopic submucosal dissection (ESD) are some of the new modalities that gastroenterologists have used over the last decade to diagnose and treat SEC. However, esophageal stricture (ES) is a very common complication and a major cause of morbidity post-ESD. In the past few years, there has been a tremendous effort to reduce the incidence of ES among patients undergoing ESD. Steroids have shown the most consistent results over time with minimal complications although the preferred mode of delivery is debatable, with both systemic and local therapy having pros and cons for specific subgroups of patients. Newer modalities such as esophageal stents, autologous cell sheet transplantation, polyglycolic acid, and tranilast have shown promising results but the depth of experience with these methods is still limited. We have summarized case reports, prospective single center studies, and randomized controlled trials describing the various methods intended to reduce the incidence of ES after ESD. Indications, techniques, outcomes, limitations, and reported complications are discussed
Mess is More: Iterating Dwelling Design Processes For The Urban Poor In New Delhi, India
No full textThe architectural discipline has always maintained a safe distance from the ‘informal’ settlements by positioning itself as objective outsiders. However, in the case of India’s capital city of Delhi with 73% of its population living in these settlements, the discipline has been forced to re-position itself. Forming outside the claims of regulation and planning, the sheer existence of these settlements challenges the city’s aspiration to become a ‘world city’. Resultant, is a love-hate dynamic where a high-modernist design propaganda seeks to evict the urban poor’s position in the city to a ‘safe’ distance where they are out of sight but in the appropriate range to aid the city function.I base my study in ‘Anand Parbat’,a deplorable resettlement transit neighbourhood developed 4 miles from the city core to re-house slum dwellers evicted from inner city areas. Envisioned as a transition camp, it is home to more than 2000 families. The design of the ‘camp’, involved a process of ‘formalizing’ the informal and invited disciplinarian aid, which by the virtue of ‘always being outside the system’ was exceedingly limited in the understanding and translational of the emergent qualities of a user-generated informal dwelling. With rigid dwelling typologies, unregulated open/shared space structure and an incoherent application of ‘incrementality’, Anand Parbat is an architectural mess.This thesis attempts an iteration to existing approaches by offering an alternative housing scheme. It learns from the contextual informality and rationalises the learnings for a disciplinarian application. It uses infrastructure as invisible layers as the backbone of the dwelling layout and reimagines domestic space for rendering progressive and high-spirited families. By the means of economics, proactive policies and careful design decisions it lays out an itertive and nuanced masterplan scheme that beneath its surface offers various spatial characteristics of an informal settlement from Delhi. The project peaks at building and surface material innovation where to make the dwellings cost effective a brick is modelled out of kitchen waste found commonly in Indian urban poor kitchens. A large variety of colors and sizes are innovated to give the settlement an aesthetical character. Various cost effective techniques are used to involve inhabitants into small-scale buidling processes.The project is rationalised for a widespread application in New Delhi, fully capable to absorb and embody contextual characters - geographic, cultural and economical. The project is also visualised for projective iterations and scenarios that would be cast by its inhabitants to highlight the performance of the design decisions in time.Architecture, Urbanism and Building Sciences | Explorela
Impact of Video Aid on Quality of Bowel Preparation Among Patients Undergoing Outpatient Screening Colonoscopy
No full textAim: To investigate the effect of video aid on quality of bowel preparation. Study: A retrospective study was done on patients undergoing outpatient screening colonoscopy. All subjects received educational video prior to colonoscopy in addition to the standard counseling. Patient charts were reviewed to collect data regarding quality of bowel preparation (adequate or inadequate). The study population was stratified into four groups according to viewing status: Group I 0% (control group), Group II 50% to <75%, and Group IV watched ⩾75% of the video. Results: A total of 338 patients with an average age of 59.1 years and 60.3% females were included in the final study cohort. Of the patients in Groups I, II, III, and IV, 94.3%, 90.9%, 100%, and 91.7%, respectively, had adequate preparation ( P value = .827). Adenoma detection rate (ADR) for Groups I, II, III, and IV was 28.8%, 50%, 50%, and 22.6%, respectively ( P value = .305). The mean cecal intubation time was 20.7, 16.4, 16.57, and 17 minutes for Groups I, II, III, and IV, respectively ( P value = .041). Conclusions: Video aid use for patients undergoing screening colonoscopy lacked a statistically significant impact on the quality of bowel preparation, ADR, and advanced adenoma detection rate when compared with standard practice
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