- Neonatal Hyperbilirubinemia in a Marginalized Population on the Thai-Myanmar Border: a study protocol. [Journal Article]
- BPedBMC Pediatr 2017 Jan 21; 17(1):32
- CONCLUSIONS: The strength of this study is the prospective cohort design. It will allow us to collect information about the pregnancy and detect all infants with neonatal hyperbilirubinemia, to observe their clinical response under treatment and to compare their neurodevelopment with infants who did not develop neonatal hyperbilirubinemia. Our study design has some limitations in particular the generalizability of our findings will be limited to infants born after the gestational age of 28 weeks onwards and neurodevelopment to the end of the first year of life.
- Autoimmune hepatitis and eosinophilic granulomatosis with polyangiitis: a rare association. [Journal Article]
- BCBMJ Case Rep 2017 Jan 20; 2017
- We describe a case of 40-year-old woman who presented to our hospital with symptoms of non-radiating epigastric pain for 4-5 days associated with nausea and vomiting. Her history was significant for ...
We describe a case of 40-year-old woman who presented to our hospital with symptoms of non-radiating epigastric pain for 4-5 days associated with nausea and vomiting. Her history was significant for asthma with recurrent exacerbations, polyneuropathy and recurrent sinus infections. Liver function tests revealed cholestasis. Antinuclear antibody and antismooth muscle cell antibody were positive. Liver biopsy revealed active chronic hepatitis with cholestasis. A diagnosis of autoimmune hepatitis was made. All other causes of cholestatic jaundice were ruled out. Her history of recurrent asthma exacerbations, eosinophilia, recurrent sinus infections and positive myeloperoxidase antibodies was suggestive of eosinophilic granulomatosis with polyangiitis. She was found to have combination of autoimmune hepatitis and eosinophilic granulomatosis with polyangiitis, a rarely reported association in the medical literature. She was started on prednisone for her autoimmune hepatitis. On follow-up with her gastroenterologist, her transaminases were trending down and she was symptomatically better.
- Early Posthepatoportoenterostomy Predictors of Native Liver Survival in Biliary Atresia. [Journal Article]
- JPJ Pediatr Gastroenterol Nutr 2017; 64(2):203-209
- CONCLUSIONS: Serum TB and albumin levels 3 months post-HPE independently predicted native liver survival in BA when controlling for center. Serum albumin level <35 g/L in infants with BA who were no longer jaundiced at 3 months post-HPE was a poor prognostic indicator. Poorer linear growth and absence of significant coagulopathy suggest a role for early aggressive nutritional therapy in this group.
- Experience in clinical diagnosis and treatment of duodenal tumors. [Journal Article]
- MCMol Clin Oncol 2016; 5(6):731-739
- Small bowel tumors are rare tumors. Duodenal tumors occur more commonly compared with other small intestinal tumors. To summarize the clinicopathological features of duodenal tumors, in the present s...
Small bowel tumors are rare tumors. Duodenal tumors occur more commonly compared with other small intestinal tumors. To summarize the clinicopathological features of duodenal tumors, in the present study 44 cases of duodenal tumors were collected, and the comparative clinicopathological characteristics between tumors of the ampulla and non-ampulla, the choice of treatment, and differences in the prognosis, were analyzed. The pathological type identified was predominantly adenocarcinoma; periampullary duodenal tumors were almost classifiable as adenocarcinoma in terms of their type. Non-ampulla duodenal tumors also included rare pathological types, such as stromal tumor and large B-cell lymphoma. The symptoms of duodenal tumors were non-specific, therefore rendering early diagnosis and treatment difficult. Due to jaundice, periampullary duodenal tumors were diagnosed earlier than non-ampulla duodenal tumors. Endoscopy and computed tomography (CT) examinations were valuable in terms of diagnosis, and were used as a means of screening. Carcinoembryonic antigen (CEA) and cancer antigen 199 (CA199) were revealed to be important as biomarkers. Radical surgery was the most effective treatment. Pancreaticoduodenectomy was revealed to be applicable in all cases of duodenal tumors. For non-ampulla duodenal tumors, partial duodenum resection and subtotal gastrectomy were appropriate for selection as methods of treatment. No survival benefits were identified for adjuvant chemotherapy. Duodenal tumors were shown to be a rare neoplasm with atypical symptoms; they should be diagnosed and treated as early as possible; CT and gastroscopy may be used for screening, radical surgery offers the best treatment; pancreatoduodenectomy is not the only surgery option available; and chemotherapy did not result in any survival benefits.
- Unusual Case of an Alcoholic with Liver Injury from Sulfasalazine Use. [Journal Article]
- JBJ Basic Clin Pharm 2016; 8(1):38-39
- A 57-year-old male with a history of alcoholism presented to the emergency room with abdominal pain, jaundice, transaminitis, and hyperbilirubinemia. Due to the history of alcoholism, it was initiall...
A 57-year-old male with a history of alcoholism presented to the emergency room with abdominal pain, jaundice, transaminitis, and hyperbilirubinemia. Due to the history of alcoholism, it was initially presumed that the patient had alcoholic hepatitis but further investigation revealed that he was recently started on sulfasalazine for the treatment of rheumatoid arthritis. Upon cessation of the drug, the patient's liver function tests significantly improved over a few days and eventually normalized within weeks. This case was interesting as the patient's history of alcoholism disguised the actual diagnosis. Furthermore, the late presentation of sulfasalazine-induced liver injury is uncommon as it commonly presents 2-4 weeks after initiation of therapy.
- A Man with Pancreatic Head Mass Lesion on Endoscopic Ultrasound and Granuloma on Cytopathology. [Journal Article]
- CRCase Rep Gastroenterol 2016 Sep-Dec; 10(3):760-768
- Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic a...
Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic adenocarcinoma. Here we present an Iranian case of primary pancreatic lymphoma in a 47-year-old male suffering from jaundice and 20% weight loss. Endoscopic ultrasound revealed a mixed echoic mass lesion at the head of pancreas. The patient underwent endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass and histopathologic diagnosis revealed granuloma. Computed tomography-guided core needle biopsy was performed and eventually histological examination showed granuloma that was coherent with the diagnosis of primary pancreatic lymphoma. Primary pancreatic lymphoma is a rare entity presenting with nonspecific symptoms, laboratory and radiological findings. Computed tomography results in combination with clinical and radiological studies generally provide guidance for appropriate investigation.
- [Repeated yellowing of the skin and sclera for 2 years]. [Journal Article]
- ZDZhongguo Dang Dai Er Ke Za Zhi 2017; 19(1):77-80
- A two-year-old girl was admitted due to repeated yellowing of the skin and sclera for 2 years and had no other specific symptoms or signs. The use of phenobarbital could relieve the symptoms of jaund...
A two-year-old girl was admitted due to repeated yellowing of the skin and sclera for 2 years and had no other specific symptoms or signs. The use of phenobarbital could relieve the symptoms of jaundice. Multiple examinations showed increased indirect bilirubin levels, and the results of aminotransferases and liver imaging were normal. There was no evidence of hemolysis. The analysis of UGT1A1 gene in her family found that this child had double homozygous mutation of c.211G>A(G71R) and c.1456T>G(Y486D), which had been reported as the pathogenic mutation for Gilbert syndrome. Her parents carried double heterozygous mutation of G71R and Y486D and had no symptom of jaundice. The child was diagnosed as having Gilbert syndrome. It is concluded that as for patients with unconjugated hyperbilirubinemia which cannot be explained by liver damage and hemolysis, their family history should be investigated in detail and gene analysis should be performed as early as possible, in order to identify congenital bilirubin metabolic disorders.
- Antioxidant and hepatoprotective potential of Lawsonia inermis L. leaves against 2-acetylaminofluorene induced hepatic damage in male Wistar rats. [Journal Article]
- BCBMC Complement Altern Med 2017 Jan 18; 17(1):56
- CONCLUSIONS: The present experimental findings revealed that phytoconstituents of Lawsonia inermis L. possess potential to effectively protect rats from the 2-AAF induced hepatic damage in vivo possibly by inhibition of reactive oxygen species and lipid peroxidation.
- Association between timing of elective cesarean delivery and adverse outcomes among women with at least two previous cesareans. [Journal Article]
- IJInt J Gynaecol Obstet 2016 Dec 26
- CONCLUSIONS: Among women with multiple cesareans, delivery at 37 weeks was associated with increased risk of neonatal respiratory morbidity and decreased risk of neonatal jaundice, but not with a reduction in maternal complications, as compared with delivery at 38 weeks or later.
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- Laparoscopic pancreaticoduodenectomy in A-92-older Chinese patient for cancer of head of the pancreas: A Case report. [Journal Article]
- MMedicine (Baltimore) 2017; 96(3):e5962
- CONCLUSIONS: LPD can be performed safely in patients of any age who are fit for surgery in specialist centers.