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Veena Tiwari, Saurabh Kedia, Sushil Kumar Garg, Ritika Rampal, V Pratap Mouli, Anuja Purwar, D K Mitra, Prasenjit Das, S Dattagupta, Govind Makharia, S K Acharya, Vineet Ahuja
BACKGROUND: Distinguishing between Crohn's Disease (CD) and Intestinal Tuberculosis (ITB) has been a challenging task for clinicians due to their similar presentation. CD4+FOXP3+ T regulatory cells (Tregs) have been reported to be increased in patients with pulmonary tuberculosis. However, there is no such data available in ITB. The aim of this study was to investigate the differential expression of FOXP3+ T cells in patients with ITB and CD and its utility as a biomarker. METHODS: The study prospectively recruited 124 patients with CD, ITB and controls: ulcerative colitis (UC) and patients with only haemorrhoidal bleed...
2018: PloS One
Inês Pita, Pedro Bastos, Mário Dinis-Ribeiro
Chronic radiation proctopathy is a frequent complication after both pelvic external radiation therapy and brachytherapy and most commonly presents as rectal bleeding. Deep rectal ulcers and fistulae are much rarer and more clinically challenging consequences. We present the case of a 72-year-old male with a history of prostate adenocarcinoma treated with brachytherapy, who was referred to our institution due to a deep painful rectal ulcer refractory to medical treatment. The ulcer presented shortly after a haemorrhoid elastic band ligation and progressed to rectourethral fistulisation despite both faecal and urinary diversion...
January 2018: GE Portuguese Journal of Gastroenterology
Abualbishr Alshreef, Allan J Wailoo, Steven R Brown, James P Tiernan, Angus J M Watson, Katie Biggs, Mike Bradburn, Daniel Hind
AIM: Haemorrhoids are a common condition, with nearly 30,000 procedures carried out in England in 2014/15, and result in a significant quality-of-life burden to patients and a financial burden to the healthcare system. This study examined the cost effectiveness of haemorrhoidal artery ligation (HAL) compared with rubber band ligation (RBL) in the treatment of grade II-III haemorrhoids. METHOD: This analyses used data from the HubBLe study, a multicentre, open-label, parallel group, randomised controlled trial conducted in 17 acute UK hospitals between September 2012 and August 2015...
September 2017: PharmacoEconomics Open
Eugénia Matos-Pires, David Pina-Trincão, Susana Brás, Lurdes Lobo
No abstract text is available yet for this article.
February 2018: Contact Dermatitis
Abdullah Albassam, Abdelmoneim Awad
OBJECTIVES: This study was designed to identify the services provided by community pharmacists in Kuwait and their views regarding self-care in pregnancy and lactation. In addition, it determined the pharmacists' recommendations for treatment of pregnancy-related and breast feeding-related ailments. DESIGN: Cross-sectional questionnaire-based survey. SETTING: Community pharmacies in Kuwait. PARTICIPANTS: 207 pharmacies were randomly selected from the Ministry of Health database...
January 5, 2018: BMJ Open
Qurat Ul Ain, Yasir Bashir, Emmanuel Eguare
INTRODUCTION: With high incidence of haemorrhoidal disease and significant complication rates of traditional haemorrhoidectomy procedures, transanal haemorrhoidal artery ligation and mucopexy (THD) emerges as a minimally invasive procedure with superior results. However, it is crucial that effectiveness of results and patient satisfaction be gauged based on post-operative experience, symptomology and recurrence. AIM: Our aim is to provide a long-term analysis of efficacy and patient's satisfaction for the procedure, for the largest patient population, in correlation to presenting symptoms and degree of haemorrhoids...
December 6, 2017: Irish Journal of Medical Science
Angus Jm Watson, Jonathan Cook, Jemma Hudson, Mary Kilonzo, Jessica Wood, Hanne Bruhn, Steven Brown, Brian Buckley, Finlay Curran, David Jayne, Malcolm Loudon, Ramesh Rajagopal, Alison McDonald, John Norrie
BACKGROUND: Haemorrhoids are a benign anorectal condition and are highly prevalent in the UK population. Treatments involve clinic-based procedures and surgery. The surgical procedures available include stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH), and over 25,000 operations are performed for haemorrhoids annually in the UK. The disease is therefore important both to patients and to health service commissioners. Debate remains as to which of these surgical procedures is the most clinically effective and cost-effective...
November 2017: Health Technology Assessment: HTA
Guido Weyand, Claudia Susanne Theis, Aboubacar Nzambi Fofana, Felix Rüdiger, Thomas Gehrke
Background Laser haemorrhoidoplasty (LHP) with the 1470 nm diode laser in minimally invasive surgery for advanced haemorrhoid disease has been studied with respect to clinical variables, such as pain and complications, and intraoperative characteristics such as mucopexia, number of treated knots and energy consumed per patient. The study also included patient satisfaction, symptom relevance and cost effectiveness. Patients and Methods Between November 2010 and November 2016, 497 patients (age 55 ± 14 years) were submitted to laser haemorrhoidoplasty with a 1470 nm diode laser in the centre for minimally invasive proctology in Siegen District Hospital...
November 29, 2017: Zentralblatt Für Chirurgie
O Cano-Valderrama, A Sánchez-Pernaute, M A Rubio, P Talavera, E Martín-Antona, A J Torres
New-onset benign anal disorders (NBADs) represent a potential complication following bariatric surgery, although their incidence in this population is not well studied. The preoperative characteristics, weight loss, bowel habits and NBADs data of 196 patients with bariatric surgery were collected by telephone interviews and medical records review and evaluated retrospectively. Ninety-nine patients had undergone gastric bypass (GBP) and 97 had a modified biliopancreatic diversion (MBPD). Fifty-nine patients were excluded...
November 7, 2017: Clinical Obesity
Dasel W M Kaindi, Wambui Kogi-Makau, Godfrey N Lule, Bernd Kreikemeyer, Pierre Renault, Bassirou Bonfoh, Esther Schelling, Jakob Zinsstag, Christophe Lacroix, Leo Meile, Christoph Jans, Jan Hattendorf
Consumption of traditional fermented dairy products (tFDP) in Africa leads to the ingestion of up to 108 Streptococcus infantarius subspecies infantarius (Sii) per millilitre of spontaneously fermented milk. Sii is a member of the Streptococcus bovis/Streptococcus equinus complex (SBSEC) for which some members are associated particularly with colorectal cancer or endocarditis. The extent of health risks to tFDP consumers is largely unknown. A hospital-based unmatched case-control study was conducted at Kenyatta National Hospital, Nairobi (Kenya) on 80 cases and 193 controls that were selected exhaustively from patients attending colonoscopy at the hospital...
February 2018: Acta Tropica
Attique-Ur-Rehman Jehangiri, Rahid Gul, Rania Hadayat, Adil Naseer Khan, Zabiullah, Liaqat Khursheed
BACKGROUND: Bleeding from anus is usually referred as rectal bleeding but actually rectal bleeding is defined as bleeding from lower colon or rectum, which means bleeding from a place distal to ligament of Treitz. This study was conducted to determine the frequency of different causes of rectal bleeding in patients at Ayub Teaching Hospital, Abbottabad. METHODS: One hundred and seventy-five patients with evidence of rectal bleed, without gender discrimination were selected by non-probability convenient sampling from the out-patient department and general medical wards...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
J P Taylor, S Gearhart
We present a case of a chronic recurrent rectovaginal fistula that initially arose from complications of haemorrhoid surgery and had failed multiple prior surgical repairs. The fistula was successfully managed using viable cryopreserved placental tissue.
November 2017: Annals of the Royal College of Surgeons of England
Steven R Brown
Haemorrhoids are common, affecting up to one quarter of all adults according to some estimates. Numerous interventions exist for their management, ranging from topical and medical therapies to outpatient treatments and surgical interventions that aim to fix or excise. Given the polysymptomatic nature of the disease, it is difficult to effectively judge which treatment option is best. Recently introduced novel haemorrhoid management techniques, such as stapled haemorrhoidopexy, Ligasure™ excision and haemorrhoidal artery ligation, aim to reduce harm whilst maintaining or improving on outcome...
October 2017: Therapeutic Advances in Chronic Disease
D Surridge
BACKGROUND: The stapled haemorrhoidopexy has been used for 20 years. A rare but serious complication is stenosis, occurring in 1-2% of cases. The mechanism for this stenosis has never been described. METHOD: The cadavers of five pigs previously euthanised underwent the procedure for prolapse and haemorrhoids (PPH). Four deliberate mistakes were tested: 1) doubling the circular suture back on itself for part of the circumference at the same depth; 2) placing the circular suture at varying depths; 3) placing one bite of the suture deeper and on the opposite wall of the rectum; and 4) firing the stapler with the anvil positioned proximal to the circular suture but with the suture secured tightly to the shaft of the device...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Haytham Abudeeb, Ajogwu Ugwu, Jamshid Darabnia, Ahmed Hammad, Khurram Khan, Min Maung, Elizabeth McNulty, Abdul Latif Khan, Arijit Mukherjee
AIMS: Transanal haemorrhoidal dearterialisation and mucopexy has evolved in recent years as a popular minimally invasive non-excisional surgery for symptomatic prolapsing haemorrhoids. The long-term outcome of this procedure however, remains to be established. We aim to analyse the long-term outcome of THD-mucopexy in the management of prolapsing haemorrhoids based on the evidence of a prospective data from a single institution. METHODS: A prospective data was collected on 100 consecutive cases of grade 3 and 4 symptomatic haemorrhoids between the period 03/2010 and 06/2015 who underwent the procedure as a day case under general anaesthetic...
September 2017: Annals of Medicine and Surgery
Eduardo Alvarez-Sarrado, Salvador Pous-Serrano, Omar Carreño Saenz, Jose Pamies-Gilabert
Cystic retrorectal tumours are a very rare entity that pose a problem in differential diagnosis between congenital cyst and other lesions. We present a 49-year-old female patient presenting a perineal bulge which was discovered simulating a vaginal birth associated with prolapsed haemorrhoids grade IV. The interest of this case resides in the surgical indication of a big presacral cyst demonstrated via CT causing acute intense pain due to pelvic organ compression, as no emergent surgery management has been reported up to date...
June 19, 2017: BMJ Case Reports
N J R Lyons, J B Cornille, S Pathak, P Charters, I R Daniels, N J Smart
AIM: Conventional haemorrhoidectomy is still considered the reference standard for the management of severe or recurrent haemorrhoids. Pain is reported by patients to be the most common postoperative complication. Although the literature lacks a consensus on its effectiveness, metronidazole is often used to reduce postoperative pain. We have performed a meta-analysis of all randomized controlled trials (RCTs) that investigated the use of metronidazole for pain relief after haemorrhoidectomy...
September 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Ervin Toth, Diana E Yung, Artur Nemeth, Gabriele Wurm Johansson, Henrik Thorlacius, Anastasios Koulaouzidis
BACKGROUND: Colon capsule endoscopy (CCE) offers direct mucosal visualisation without sedation or gas insufflation required in conventional colonoscopy (CC). However, evidence for the role of CCE as an adjunct or alternative to CC remains equivocal. In this observational cohort study, we report our experience of using CCE to investigate patients with suspected colon pathology at a tertiary referral centre. METHODS: From 2007-2015, consecutive patients requiring colonoscopy were recruited from a tertiary care centre in Malmo, Sweden...
May 2017: Annals of Translational Medicine
S Greensmith, B Ip, Z Vujovic
Haemorrhoidal artery ligation has now been established as a treatment modality for symptomatic haemorrhoids. We report a case of a fit 44-year-old male who underwent the procedure as a day case, who subsequently developed pelvic sepsis due to rectal perforation. This case is the first report of a potentially life-threatening complication resulting from this procedure, which has a previously excellent safety profile.
May 2017: Annals of the Royal College of Surgeons of England
Anicet Puigdollers
No abstract text is available yet for this article.
April 27, 2017: Cirugía Española
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