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OBJECTIVE: The aim of the study was to find out the etiology of obstructive jaundice and its correlation with the ethnic population of Sikkim. MATERIAL AND METHOD: The data of patients with obstructive jaundice admitted under the Department of Gastroenterology was collected retrospectively from March 2019 till February 2020. There were a total of 73 patients of obstructive jaundice patients, the benign etiology was found to be more common than malignant etiology. RESULTS: The male-to-female ratio in our study was 0.35:1. The most common etiology of benign cause of obstructive jaundice was choledocholithiasis (95.83%) followed by common bile duct stricture (3.07%), Mirizzi syndrome (1.53%). The most common causes of malignant obstructive jaundice were carcinoma of gall bladder (62.5%) followed by carcinoma of periampullary region (12.5%), cholangiocarcinoma (12.5%), carcinoma of head of pancreas (12.5%). CONCLUSIONS: The most common etiology of obstructive jaundice in this study was choledocholithiasis. There was no any correlation of obstructive jaundice with ethnic population of Sikkim.
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Upper gastrointestinal bleeding is one of the most commonly encountered emergencies in day-to-day practice. In the present retrospective study, the various causes of acute nonvariceal upper gastrointestinal bleeding (NVUGIB), its management modalities, and the final outcome of patients were studied. METHODS: A retrospective study of etiology of upper gastrointestinal (UGI) bleeding for a period of 13 months, January 2015 to February 2016 in Department of Gastroenterology, Central Referral Hospital, Gangtok, was conducted. There were a total of 127 upper gastrointestinal bleeding patients, out of which 70 patients were excluded due to endoscopically proven variceal bleeding. Of the 57 patients, the various causes were determined by investigations and were treated accordingly. CONCLUSION: Hematemesis was the most common presentation and duodenal ulcers the most common etiology among the acute nonvariceal upper gastrointestinal bleed. The cause of bleeding was not identified in one patient. Majority (34 patients, 59.64%) of the patients was treated conservatively, some needed endoscopic interventions (23 patients, 40.35%) and there was no any mortality.
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Upper gastrointestinal (UGI) endoscopy is a routine procedure done in field of gastroenterology. It is a safe procedure which can be done with or without sedation with rare post procedure complications. Our case illustrates that parotid gland swelling is a uncommon event post upper g.i endoscopy and it a benign event which resolves on its own.
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AIM: To assess the clinical profile of 80 chronic hepatitis C patients in a tertiary health care center in Northern India and also to study the efficacy and tolerability of pegylated interferon (Peg-IFN) α 2b and ribavirin therapy in a cohort of chronic hepatitis C patients. METHODS: Thirty subjects with chronic hepatitis C (CH-C) with genotypes 2 and 3 received Peg-IFN α 2b 1.5 µg/kg subcutaneously weekly plus daily ribavirin 800 mg for 24 weeks .Subjects with genotype 1 infection received therapy for 48 weeks with ribavirin 1000 mg/day and Peg-IFN α 2b dose remained the same. The primary end point was the sustained viral response (SVR). Drug dosage was modified or temporarily discontinued if anemia or bone marrow suppression developed. RESULTS: The clinical profile of chronic hepatitis C infected patients showed decompensated cirrhosis in the more elderly patients. Genotype 3 was the commonest genotype and was seen in 21 (70%) patients. The mean baseline HCV RNA was high. SVR was achieved less commonly with genotype 1 than with genotype 2/3. Patients who became negative for HCV RNA at 4-weeks (rapid virological response or RVR) and 12 weeks (early virological response or EVR) of treatment showed significantly higher sustained virological response (SVR) rates. Similarly, patients who showed normalization of ALT level at 4-weeks and 12-weeks of treatment showed significant high rate of SVR. Overall treatment was well tolerated. CONCLUSION: In our region, CHC subjects have high viral load and genotype 3 being the most common. Treatment with Peg-IFN α 2b and ribavirin is effective and well tolerated. Genotype 1 was more resistant to the treatment. Patients who achieved RVR and EVR are more likely to achieve SVR. Although the numbers of patients in this study was small, considering the paucity of data of treatment from India, the data is relevant.
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BACKGROUND: The relationship between age and serum HBV DNA levels with histological activity in chronic hepatitis B inactive carriers is still unclear. We evaluated the correlation between age and hepatitis B viral DNA levels with Metavir score in inactive chronic HBV carriers. METHODS: 50 patients (30 males and 20 females) were enrolled in the study after informed consent. Their blood samples were taken for routine investigations and specific tests for the study. Serum HBV DNA levels were quantified by real-time PCR. Metavir score was used for histologic grading. RESULTS: A1F0, A1F1, A1F2, A2F2 and A2F3 metavir scores were found in 41 (82%), 4 (8%), 1 (2%), 3 (6%), and 1 (2%) patients, respectively. There was significant correlation between age > 40 years and Metavir scores (p < 0.001). However there was no significant correlation between HBV DNA level with Metavir score (p = 0.074). CONCLUSION: Inactive carriers of 40 years of age or more should undergo liver biopsy to look for presence of significant histological findings despite having low HBV DNA level and normal SGPT level.