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- Volume 13, Issue 2, 2015
South African Gastroenterology Review - Volume 13, Issue 2, 2015
Volume 13, Issue 2, 2015
Author D. Nageshwar ReddySource: South African Gastroenterology Review 13, pp 7 –9 (2015)More Less
Evolution of pancreato-biliary endoscopy over last decade has revolutionized the management of many pancreato-biliary diseases. ERCP is now done only with therapeutic intent and EUS is transforming gradually from a predominant diagnostic to a therapeutic modality. In the following section I will brief up some of the recent advances in pancreato-biliary endoscopy.
Asymptomatic cholelithiasis in diabetes mellitus - to operate or not to operate, that is the question : reviewSource: South African Gastroenterology Review 13, pp 13 –16 (2015)More Less
The management of gallstones in diabetic patients has traditionally been considered problematic. Autopsy findings and uncontrolled studies have documented a higher prevalence of cholelithiasis in diabetes, and early reports have showed dramatically increased perioperative morbidity and mortality for the treatment of diabetics with acute cholecystitis. As a result, some authorities have recommended prophylactic cholecystectomy for diabetic patients with asymptomatic cholelithiasis, which is in contrast to recommendations for non-diabetics. More recent investigations have shown a comparable natural history, and operative morbidity and mortality for biliary surgery in diabetics when compared to a nondiabetics. Decision tree analyses have shown that prophylactic cholecystectomy confers no benefit and should not be routinely performed for diabetics with asymptomatic cholelithiasis. Cholecystectomy is indicated as is the case in the general population when symptoms develop.
Asymptomatic gallstones are increasingly diagnosed today due to widespread use of abdominal ultrasonography for the evaluation of patients with foregut symptoms. Asymptomatic cholelithiasis, as defined by the Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO), is when gallstones are detected in the absence of gallstone-related symptoms, such as history of biliary pain (pain in the epigastrium or right upper abdominal quadrant that may radiate to the patient's back or the right scapula), or gallstone-related complications such as acute cholecystitis, cholangitis, or pancreatitis. Other nonspecific symptoms such as epigastric discomfort, dyspepsia, flatulence, nausea, abdominal gurgling noises, or abdominal pain at other sites, cannot be considered as symptomatic cholelithiasis and can be attributed to other gastrointestinal diseases such as peptic ulcer disease, and irritable bowel syndrome.
Source: South African Gastroenterology Review 13, pp 19 –22 (2015)More Less
The aim of his article is to provide insight to the interpretation of the "mystery tracings" of High Resolution Manometry Pressure Topography (HRMPT) as it is currently applied to esophageal motility disorders. Esophageal motility disorders are classified by the Chicago Classification using HRMPT and standardized metrics. This classification is the result of recurring deliberations of the Pharyngeal and Esophageal motility disorders and the Gastro-Esophageal reflux disease steering committees of the International Working Group for Gastrointestinal Motility and Function. This is an umbrella organization for academics and clinicians with an active interest in the clinical application of these technologies. They have modified the classification in 2009 in San Diego, 2011 in Ascona, and 2014 in Chicago. In future they plan to update the classification on a three-year cycle. HRM interpretation is facilitated by esophageal pressure topography plots, known as Clouse plots in honor of Ray E. Clouse (1951-2007), their key innovator. The HRM concepts were developed in the late 1980's. The first clinical water perfused HRM system studies were introduced in the mid 1990's and the first solid-state studies in 2002-2003. The first major version of the Chicago Classification was published in 2009 after a meeting of the International HRM working group. Their aim was to standardize HRM metrics and thereby categorize the esophageal motility disorders in patients with non-obstructive dysphagia and/or chest pain. The Chicago Classification is applied to results analyzing each individual swallow using HRM pressure topography and the protocol of giving ten 5 ml boluses of water to the patient in a supine position with 20-30 seconds between each swallow. The Chicago Classification was determined using the Sierra system. Cutoffs defining abnormal metrics, especially IRP, are technology-specific.
Source: South African Gastroenterology Review 13, pp 25 –28 (2015)More Less
Traditionally, colorectal cancer has been regarded as rare among black South Africans and common among white South Africans. Over the years, this perception spawned studies searching for either the protective factors among black South Africans or predisposing factors among their white counterparts. However, the distribution of the underlying risk drivers in the population has been gradually changing, with many black South Africans gradually adopting diets and lifestyles that can be considered aetiological. Thus with the potential of a growing burden of disease it is opportune to review the available data on the epidemiology of colorectal cancer in South Africa and provide a baseline for monitoring future trends.
Source: South African Gastroenterology Review 13, pp 30 –32 (2015)More Less
A 50-year-old woman with background of hypertension on perindopril had a myocardial infarction in May 2014 requiring placement of a drug eluting stent in her left anterior descending artery. As part of her management she started on aspirin, clopidogrel and simvastatin.
Author Stephen GroblerSource: South African Gastroenterology Review 13, pp 34 –35 (2015)More Less
Author Olusegun OjoSource: South African Gastroenterology Review 13 (2015)More Less
The Africa-Middle East Association of Gastroenterology is one of the four regional affiliate bodies that make up the World Gastroenterology Organization (WGO). The three other affiliates are the Asia-Pacific Association of Gastroenterology (APAGE), The United European National Societies of Gastroenterology (UEG) and the Pan-American Gastroenterological Society (OPGE). As an organ of the WGO, AMAGE coordinates the activities of the National Gastroenterology Societies in the countries of Africa and the Middle East. This makes it a fact that AMAGE potentially covers the largest swathe of the gastroenterology world as things stand today.
Source: South African Gastroenterology Review 13 (2015)More Less
Colonoscopy up-skilling has been identified as an area that needs to be developed in South Africa. Following a Train the Trainers in Wolverhampton in June 2014 we felt that the time was right to attempt to develop capacity to run an up-skilling course in South Africa. Surgical Innovations was approached to help fund a course which would enable us to run similar up-skilling courses in South Africa. From the outset Surgical Innovations embraced the project and very generously, in partnership with Olympus UK, offered to sponsor the costs of the course.
Author Bilal BobatSource: South African Gastroenterology Review 13 (2015)More Less
"Tell me and I forget. Teach me and I learn. Involve me and I remember."This was the opening statement of the Train the Trainers (TTT) Workshop organised by the World Gastroenterology Association and hosted by the Gastroenterology Society of Taiwan which was held in April 2015 in the city of Taoyaun.
Author Olufunmilayo LesiSource: South African Gastroenterology Review 13 (2015)More Less
The World Gastroenterology Organization has established endoscopy-training centers in Egypt, South Africa and various countries across the globe. It was with great pride that the Lagos Center was inaugurated as the 17th WGO training center worldwide (the first in West Africa) on April 18, 2015. This center is a collaboration of the WGO, Society for Gastroenterology and Hepatology in Nigeria (SOGHIN) and the Lagos University Teaching Hospital (LUTH) established to enhance and deepen the skill of digestive endoscopy in Nigeria and the sub-region.
Second South African doctor awarded Discovery Foundation grant for further study at Massachusetts General Hospital : Discovery FoundationSource: South African Gastroenterology Review 13 (2015)More Less
At a ceremony in Sandton, the Discovery Foundation announced the second recipient of the Discovery Foundation MGH Fellowship Award. This grant of R2.1 million is awarded to top South African academic doctors to do clinical research and study at Massachusetts General Hospital (MGH) in Boston, USA.