Hakim Shafi

Fifteen-year follow up of endoscopic injection sclerotherapy in children with extrahepatic portal venous obstruction

Background and Aim:  Endoscopic sclerotherapy has emerged as an effective treatment for bleeding esophageal varices both in adults and children but the long‐term outcome is poorly defined in children. The authors report a 15‐year follow up of sclerotherapy in children with extrahepatic portal venous obstruction.

Pantoprazole infusion as adjuvant therapy to endoscopic treatment in patients with peptic ulcer bleeding: Prospective randomized controlled trial

Background and Aim:  Following successful endoscopic therapy in patients with peptic ulcer bleeding, rebleeding occurs in 20% of patients. Rebleeding remains the most important determinant of poor prognosis. We investigated whether or not administration of pantoprazole infusion would improve the outcome in ulcer bleeding following successful endoscopic therapy.

Endoscopic ligation vs. sclerotherapy in adults with extrahepatic portal venous obstruction : a prospective randomized study

BACKGROUND Endoscopic sclerotherapy is a well-established treatment for bleeding esophageal varices, although it has a substantial complication rate. A prospective randomized trial was conducted to determine whether endoscopic variceal ligation is safer and more effective than sclerotherapy in adults with bleeding esophageal varices because of extrahepatic portal venous obstruction. METHODS Thirty-six patients underwent sclerotherapy and 37 had band ligation. RESULTS Ligation and sclerotherapy were equally effective for achieving variceal eradication (94.6% vs. 91.7%, respectively; p=0.67). However, ligation achieved eradication with fewer endoscopic sessions (3.7 [1.2] vs. 7.7 [3.3]; p <0.0001) and within a shorter time interval (50.1 [17.7] days vs. 99 [54.8] days; p <0.0001). In the ligation group, recurrent bleeding was less frequent (2.7% vs. 19.4%; p=0.028; however, Bonferroni correction for multiple testing removes this significance) and the rate of major complications was lower (2.7% vs. 22.2%; p=0.014). Total cost per patient was significantly higher in the sclerotherapy vs. the ligation group (

CT Findings in Obturator Hernia with Meckel's Diverticulum—A Case Report

216.6 [71.8] vs.

CT findings in diffuse rectosigmoid cavernous heamangioma. A case report.

182.6 [63.4]; p=0.035). During the follow-up period after variceal eradication, no significant differences were found between the sclerotherapy and the ligation groups with respect to recurrent bleeding (3% vs. 2.9%; p=1.0), esophageal variceal recurrence (9.1% vs. 11.4%; p=1.0), and formation of new gastric varices (9.1% vs. 14.3%; p=0.51). CONCLUSIONS Variceal band ligation is superior to sclerotherapy, because it is less costly and achieves variceal eradication more quickly, with lower relative frequencies of recurrent variceal bleeding and complications.

Primary mediastinal hydatid disease leading to popliteal artery hydatid cyst embolization.

Obturator hernia is rare, constituting <2% of all abdominal hernias. Clinical diagnosis is rarely made due to vague signs and symptoms. Delayed diagnosis markedly increases postoperative morbidity and mortality especially because the affected patients are often old with other comorbid conditions. Pelvic CT is almost 100% accurate in the diagnosis of obturator hernia and should be the modality of choice in older patients presenting with intestinal obstruction of unknown etiology.

Bleeding per rectum in a patient with an amputated finger

digital examination and proctoscopy did not reveal any definite local cause of bleeding. The patient was sent to the department of radiology for computed tomography (CT) scan. CT was done on 64 multislice CT scan, which shows marked rectosigmoid wall thickening as a result of varices and vascular malformations and phleboliths of the rectosigmoid colon. The patient was subjected to abdominal surgery in which a sphincter-saving procedure was done. Postoperative course in the hospital was uneventful. J Gastrointest Surg (2009) 13:1017–1018 DOI 10.1007/s11605-008-0535-6

Primary amenorrhoea in Kashmiri adolescent females – a hospital based study

Hydatid disease is a zoonosis caused by Echinococcus granulosus . Infected dogs release eggs through their feces and the eggs infect humans through food and water. The most common locations of hydatid cysts are the liver and lungs, but primary mediastinal involvement, though rare, can be encountered. We report on a 16-year-old female with a primary mediastinal hydatid cyst leading to popliteal arterial embolization. The mediastinal lesion was treated with partial pericystectomy with removal of the germinal membrane and prophylactic albendazole. In endemic areas, it is important to consider hydatid cysts in the differential diagnosis of an acute arterial occlusion.

Primary Amenorrhea in Kashmiri Adolescent Females - A Hospital Based Study

A 42-year-old female who had her right index finger amputated 13 months back now presented to the department of gastroenterology with symptoms of abdominal pain and bleeding per rectum. On examination the patient had iron deficiency anemia and features of cachexia. Upper gastrointestinal (GI) endoscopy and colonoscopy were done but did not reveal any lesion. The patient underwent computed tomography (CT) scan on a Siemens 64-slice CT scanner, which showed multiple rounded, markedly enhancing, small gut (jejunal) lesions, along with an enteroenteric intussusception [Figures ​[Figures11–3]. A similarly enhancing lesion was also found in the left gluteus medius muscle. Figure 1 MDCT coronal image showing two markedly enhancing lesions in the jejunum Figure 3 Axial MDCT image showing enteroenteric intussusception, with an enhancing lesion as the lead point Figure 2 Axial MDCT image showing markedly enhancing lesions in the jejunum