Notes

Irisin takes away obesity-related spermatogenesis problems through damaging the AMPKα signalling process.
This easy-to-follow standardized protocol will help streamline the initial management of this complex disorder in the Middle East region and even globally.How to cite this article Rashed Ul Islam SM, Shahera U, Jahan M, et al. Prevalent HBeAg-negative HBV DNA-positive Chronic Hepatitis B Individuals in Bangladesh. Euroasian J Hepato-Gastroenterol 2021;11(1)49-50.Mucinous cystic neoplasm (MCN) of the pancreas is a rare neoplasm affecting the elderly women. They vary in their clinical presentation and biological behavior. Spontaneous rupture of MCN is very rare and only eight cases have been reported so far in the English literature. We report a case of a young woman presenting with abdominal pain following spontaneous contained rupture of MCN managed with surgical resection. How to cite this article Krishnamurthy G, Ganesan S, Ramas J, et al. Ruptured Mucinous Cystadenoma Pancreas A Case Report and Review of Literature. Euroasian J Hepato-Gastroenterol 2021;11(1)45-48.Endoscopic papillectomy has become the mainstay treatment in early papillary neoplasia. However, local recurrence remains the Achilles heel of the procedure due to the complex anatomy and limited ductal involvement unappreciated on endoscopic ultrasound (EUS) and/or endoscopic retrograde cholangiopancreatography (ERCP). While re-do papillectomy is, in general, technically feasible and widely accepted to treat recurrent adenoma, re-redo procedures to this end have rarely been reported. Likewise, utilization of cold snare technology is rarely considered in papillectomy and has, in fact, only once been reported in the literature before. We present a unique clinical case with a highly atypical growth pattern with a bonnet-like pedunculated lesion with a small insertion point just at the pancreatic duct orifice treated by re-redo cold snare papillectomy. How to cite this article Zimmer V, Emrich K. Cold Snare Papillectomy for Re-redo Endoscopic Resection of a Defiant Adenoma Recurrence with a Unique Growth Pattern. Euroasian J Hepato-Gastroenterol 2021;11(1)43-44.Right hepatic artery (RHA) syndrome is a well-recognized, though an uncommon cause of benign bile duct stricture, potentially simulating malignancy. Albeit the latter was not the case in this unique clinical report after cholangitis resolution and clearance of biliary sludge and debris, high-quality direct cholangioscopy (DC) illustration of the RHA overriding the proximal common bile duct with well visible arterial pulsation has not yet been reported before. Beyond its potential visual informativeness, this uncommon cholangioscopic documentation may provide key didactic advances in terms of intraductal visualization of the anatomy of the biliary tree. How to cite this article Zimmer V. Dynamic Intraductal Endoscopic Visualization of Right Hepatic Artery Pulsation Underlying Minor Vascular Impression of the Proximal Bile Duct. Euroasian J Hepato-Gastroenterol 2021;11(1)41-42.
Globally, the incidence, as well as mortality, related to hepatocellular carcinoma (HCC) is on the rise, owing to relatively few curative options. Underlying cirrhosis is the most common etiology leading to HCC, but risk factors of cirrhosis show great regional variability. Over the years, there has been a steady development in the diagnostic and therapeutic modalities of HCC, including the availability of a wide range of systemic chemotherapeutic agents. We aim to review the recent advancements in the diagnostic and therapeutic strategies for HCC.

The literature search was done using databases PubMed, Cochrane, and Science Direct, and the latest relevant articles were reviewed.

Screening of HCC is a pivotal step in the early diagnosis of the disease. Current guidelines recommend using ultrasound and alfa fetoprotein but various new biomarkers are under active research that might aid in diagnosing very small tumors, not picked up by the current screening methods. Treatment options are decided based uponzkan H, et al. Updates on the Diagnosis and Management of Hepatocellular Carcinoma. Euroasian J Hepato-Gastroenterol 2021;11(1)32-40.The coronavirus 2019 (COVID-19) pandemic has resulted in 168 million cases and about 3.5 million deaths (as of May 26, 2021) during the last 18 months. These 18 months of the COVID-19 pandemic have been characterized by phases or waves of new cases, the emergence of new variants of the deadly virus, and several new complications. After providing emergency approval to several drugs and adherence to several public health measures with frequent full and partial lockdowns, the incidence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could not be contained till now on a global basis. Although prophylactic vaccines have inspired optimism, the scarcity of vaccines and several vaccine-related regulations indicate that the vaccine's benefit would not be reaching the people of developing countries anytime soon. In the course of our clinical practice, we used pegylated interferon (Peg-IFN) in 35 patients with chronic liver diseases (CLD), and we found that only two of them were infected with SARS-CoIFN for pre- or postexposure prophylaxis in the acquisition of SARS-CoV-2 infection and influencing the natural course of COVID-19 remains to be clarified.
Akbar SMF, Mahtab MA, Aguilar JC,
Role of Pegylated Interferon in Patients with Chronic Liver Diseases in the Context of SARS-CoV-2 Infection. Euroasian J Hepato-Gastroenterol 2021;11(1)27-31.
Akbar SMF, Mahtab MA, Aguilar JC, et al. Role of Pegylated Interferon in Patients with Chronic Liver Diseases in the Context of SARS-CoV-2 Infection. Euroasian J Hepato-Gastroenterol 2021;11(1)27-31.
Exchange transfusion in newborns is recommended as emergency management of hyperbilirubinemia to prevent bilirubin encephalopathy and kernicterus.

This study aimed to determine the frequency and document common side effects of exchange transfusion and outcomes of newborns requiring exchange transfusion.

This prospective study was done in the Neonatal Intensive Care Unit (NICU) of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from January 2016 to December 2019. Information was obtained regarding maternal details, newborn demographics, and clinical status. Blood grouping and Rh typing were done for both mothers and newborns. In all newborns, pre-exchange complete blood count, peripheral blood film, Coombs test, reticulocyte count, serum bilirubin and post-exchange serum bilirubin, hemoglobin, random blood sugar, serum electrolyte, and calcium were done. G6PD level was done wherever suspected. Frequency, maternal and neonatal factors, indications, and outcomes were analyzed.

Among 839 tion was Rh incompatibility (80.5%). Overall outcome after exchange transfusion was favorable.

Dey SK, Jahan S, Jahan I,
Exchange Transfusion for Hyperbilirubinemia among Term and Near Term in NICU of a Tertiary Care Hospital of Bangladesh Findings from a Prospective Study. Euroasian J Hepato-Gastroenterol 2021;11(1)21-26.
Dey SK, Jahan S, Jahan I, et al. Exchange Transfusion for Hyperbilirubinemia among Term and Near Term in NICU of a Tertiary Care Hospital of Bangladesh Findings from a Prospective Study. Euroasian J Hepato-Gastroenterol 2021;11(1)21-26.
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is currently a significant public health concern and causing a pandemic in the world. Despite immense attention to the coronavirus disease 2019 (COVID-19), very little attention has been given to the kinetics of disease progression in infected patients. Therefore, in this study, we present a 14-day clinical observation of hospital-admitted COVID-19 patients.

After recording the demography of 42 COVID-19 patients on day 1, we observed the clinical progression for 14 days by investigating the hematological and biochemical responses of patients' blood and serum, respectively.

Approximately, 62% of the hospital-admitted COVID-19 patients presented cough, followed by fever (∼52%). The top comorbidities of these patients were hypertension (30%) and diabetes mellitus (19%). The average blood hemoglobin (Hb) level was slightly low among the patients in the early days of infection and went up to the normal level on the later days. A substantial increase in the level of ALT or SGPT [up to 106 IU/L; standard error of the mean (SEM) 12.64] and AST or SGOT (up to 64.35 IU/L; SEM 5.013) in COVID-19 patients was observed, which may suggest that infection with coronavirus is associated with the functionality of other organs of COVID-19 patients.

This 14-day observational study may help clinicians to decide the choice of treatment for COVID-19 patients.

Shaha M, Islam MA, Huq F,
Clinical Manifestations of Hospitalized COVID-19 Patients in Bangladesh A 14-day Observational Study. Euroasian J Hepato-Gastroenterol 2021;11(1)14-20.
Shaha M, Islam MA, Huq F, et al. Clinical Manifestations of Hospitalized COVID-19 Patients in Bangladesh A 14-day Observational Study. Euroasian J Hepato-Gastroenterol 2021;11(1)14-20.
A preferred treatment for cholelithiasis with choledocholithiasis is endoscopic retrograde cholangiopancreaticography (ERCP) followed by laparoscopic cholecystectomy (LC), which can be performed early (within 72 hours) or can be delayed for 6 to 8 weeks. This study is conducted to compare and analyze the outcome of early versus late LC following common bile duct (CBD) clearance by ERCP and determine the optimum timing for performing LC post-ERCP.

This comparative analysis was conducted at St Joseph Hospital, Ghaziabad, from September 2019 to March 2021 on 89 cases of cholelithiasis with choledocholithiasis. Patients were divided into two groups. Group I (
= 45) patients underwent early LC within 72 hours post-ERCP and group II (
= 44) patients underwent late LC after an interval of 8 weeks. Various preoperative, perioperative, and postoperative clinical parameters like operative difficulty, complications, surgery duration, hospital stay, and conversion to open cholecystectomy were analyzed.

There waepato-Gastroenterol 2021;11(1)11-13.
The present study aimed to investigate the effect of the presence of polyposis in sporadic early-onset colorectal cancer (EOCRC) on clinicopathological and oncological outcomes.

The retrospective study included patients with sporadic colorectal cancer aged 16 to 50 years who underwent curative resection at the general surgery clinics in two healthcare centers between 2013 and 2019. Patients were divided into two groups polyposis and nonpolyposis. Vorinostat Clinicopathological characteristics and oncological outcomes were compared between the two groups.

A total of 127 patients were included, of whom 60.6% were men. There were 25 (19.68%) patients in the polyposis group and 102 (80.31%) patients in the nonpolyposis group. Seventy-one (69.6%) of the nonpolyposis group and 23 (92.0%) of the polyposis group had adenocarcinoma histological types. The total number of patients with mucinous tumor and signet ring cell carcinoma in the nonpolyposis and polyposis groups was 31 (30.4%) and 2 (8.0%), respectively (
= 0.04210.
Aday U, Kafadar MT, Oğuz A, et al. Polyposis and Oncologic Outcomes in Young-onset Sporadic Colorectal Cancer. Euroasian J Hepato-Gastroenterol 2021;11(1)6-10.
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