Diverticular per oral endoscopic myotomy (DPOEM) for esophageal diverticular disease: a systematic review and meta-analysis

The traditional way to tackle Zenker’s diverticulum (ZD) has been flexible endoscopic septum division (FESD). Recently, the concept of per oral endoscopic myotomy has been found useful for managing diverticular diseases of the esophagus and has been termed DPOEM. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of D-POEM in diverticular disease of the esophagus and to compare it with FESD. We systematically searched PubMed and Embase, for studies reporting clinical success, technical success and adverse events in D-POEM alone or D-POEM comparing with FESD. We computed pooled prevalence for D-POEM alone and risk ratio for D-POEM vs FESD using random effect method with inverse variance approach. Subgroup analysis for ZD, non-ZD and mixed diverticulum was conducted. Totally 19 studies including 341 patients were identified reporting on D-POEM. The pooled clinical, technical success and adverse event rates for D-POEM were 87.07%, 95.19% and 10.22%, respectively. The clinical success was significantly better than FESD while the technical success, adverse event rate, procedure time and length of hospital stay were comparable with FESD. The recurrence rate was negligible for D-POEM compared to FESD. On subgroup analysis by dividing into three groups of ZD, non-ZD and mixed, there was no difference between clinical, technical success and adverse event rate among the three groups. D-POEM is an effective and safe technique among both ZD and non-ZD patients and has better clinical success than FESD.

     

Analyzing Indian general public’s perspective on anxiety,stress and trauma during Covid-19 - A machine learning study of 840,000 tweets

Background and aimsEver since COVID-19 was declared a pandemic by WHO in late March 2020, more and more people began to share their opinions online about the anxiety, stress, and trauma they suffered because of the pandemic. However, very few studies were conducted to analyze the general public’s perception of what causes stress, anxiety, and trauma during COVID-19. This study focuses particularly on understanding Indian citizens.MethodsBy using Machine learning techniques, particularly Natural language processing, this study focuses on understanding the attitude of Indian citizens while discussing the anxiety, stress, and trauma created because of COVID-19 and the major reasons that cause it. We used Tweets as data for this study. We have used 840,000 tweets for this study.ResultsOur sentiment analysis study revealed the interesting fact that, even while discussing about the stress, anxiety, and trauma caused by COVID-19, most of the tweets were in neutral sentiments. Death and Lockdown caused by the COVID-19 were the two most important aspects that cause stress, anxiety, and Trauma among Indian citizens.ConclusionIt is important for policymakers and health professionals to understand common citizen’s perspectives of what causes them stress, anxiety, and trauma to formulate policies and treat the patients. Our study shows that Indian citizens use social media to share their opinions about COVID-19 and as a coping mechanism in unprecedented time.     

Total Phenolics,Tannins and Antioxidant Activity in Twenty Different Apple Cultivars Growing in West Himalaya,India

The present study evaluated phenolics and antioxidant activities in fully ripened fruits of 20 different apple cultivars e.g., Royal Delicious, Fanny, Gale Gala, Esopus Spitzenburg, King David, Winter Banana, Buckinghum, Super Chief, Breven, Red Fuji, Organ Spur, Tompking County, Red Gold, Golden Spur, Vance Delicious, Red Delicious, Macintosh, Rymer, Bhura Delicious, and Richa Red growing at different locations/elevations of Uttarakhand, West Himalaya, India. Total phenolics and tannins varied significantly among cultivars and the maximum content was recorded in Bhura Delicious (phenolics—3.77 mg GAE/g fw; tannins—16.47 mg TAE/g fw) as compared to others. Antioxidant activity using different in vitro assays showed highest activity in Bhura Delicious and lowest in Esopus Spitzenburg. A significant (p < 0.001) positive relationship was found between total phenolics and ABTS (r = 0.816), FRAP (r = 0.797) and DPPH (r = 0.862) assays. Phenolics and antioxidant activity exhibited significantly (p < 0.05) higher content in the peel as compared to whole fruit and flesh portion. Based on the results, it is concluded that Bhura Delicious is one of the promising sources of phenolics and antioxidant activity and, therefore, recommended for large scale plantation to harness its potential.

     

Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatment

The Asian Pacific Association for the Study of the Liver (APASL) Working Party on Portal Hypertension has developed consensus guidelines on the disease profile, diagnosis, and management of noncirrhotic portal fibrosis and idiopathic portal hypertension. The consensus statements, prepared and deliberated at length by the experts in this field, were presented at the annual meeting of the APASL at Kyoto in March 2007. This article includes the statements approved by the APASL along with brief backgrounds of various aspects of the disease.     

Successful Aortic Valve Replacement Surgery in a Patient with Severe Haemophilia a with Low Titre Inhibitor

Acute leukemia, secondary myelodysplasia and paroxysmal nocturnal hemoglobinuria evolving from severe aplastic anemia (AA) following immunosuppressive therapy are well recognized. However, severe AA occurring after complete remission of acute promyelocytic leukemia (APL) has been documented only once in 2009. We report a case of 30-year-old male diagnosed with APL who achieved complete cytogenetic remission with all-trans retinoic acid based induction regimen and developed severe AA few months later during maintenance therapy.