Tropical Gastroenterology 

About: Tropical Gastroenterology is an academic journal. The journal publishes majorly in the area(s): Medicine & Pancreatitis. It has an ISSN identifier of 0250-626X. Over the lifetime, 125 publications have been published receiving 279 citations.

Chronic hepatitis B in Nepal: an Asian country with low prevalence of HBV infection.

Abstract: Sandwiched between China, a country with high prevalence of hepatitis B surface antigen (HBsAg) and 30% of the world's HBsAg carriers, and India which has intermediate HBsAg prevalence and 10% of the world's carriers, Nepal has the lowest prevalence of hepatitis B virus (HBV) infection in Asia, with an HBsAg carrier rate of 0.9%. This treatise discusses the probable causes of this low prevalence based on published literature on the subject. The HBsAg prevalence among pregnant women in Nepal is low (0.5%) and none of those examined were HBeAg positive. The highest prevalence of HBsAg was found in the 6-15 years age group. The low prevalence of this infection in the country was due to an absence of significant vertical transmission and its predominant spread by horizontal transmission among the adolescent age group.

Treatment of chronic hepatitis C in end stage renal disease: experience at a tertiary care centre.

Abstract: INTRODUCTION Treatment of patients with chronic hepatitis C (CHC) is difficult in the setting of end stage renal disease (ESRD). The present study aimed to analyze the treatment outcome in patients with CHC and ESRD, being evaluated for kidney transplantation. METHODS Data of 65 patients of ESRD with CHC (males: 53, mean age: 39.2 +/- 14.4 years) was analysed retrospectively. Patients were treated with either pegylated or conventional interferon (IFN) without ribavirin. Treatment response was assessed for rapid virological response (RVR), early virological response (EVR), end of treatment response (ETR) and sustained virological response (SVR). RESULTS All patients were receiving hemodialysis (duration 1-60 months). Sixteen patients (25%) (genotype 1: 11, genotype 3: 4, genotype 2: 1) agreed for treatment (13 pegylated IFN and 3 conventional IFN). RVR was achieved in 7 patients (44%) and out of 11 patients (69%) who achieved EVR, ETR was achieved in 7 (44%) patients. Seven patients (44%) dropped out during treatment (2 because of side effects). SVR could be demonstrated in one of 7 patients who achieved ETR (6 patients were lost to follow up after ETR). CONCLUSIONS In our experience, dropouts before, during and after treatment are a major problem in patients with CHC and ESRD. Of those who complete treatment, around half of them are able to achieve the end of treatment response.

Major hemobilia--experience from a specialist unit in a developing country.

Abstract: Background and Aim: Hemobilia is a rare but potentially life threatening problem, which can be difficult to diagnose and treat. In the last few decades there has been a change in the etiologic spectrum and management of this problem in the West. The aim of this study was to analyze the etiology, clinical features, management and outcome of major hemobilia in a tertiary referral centre from western India. Methods: A retrospective analysis was undertaken on 22 patients (16 males, 6 females; mean age 39 years, range 13 to 74) who presented with major hemobilia over a 5-year period. Results: The etiology was iatrogenic in 13 patients (percutaneous transhepatic biliary drainage 8, post laparoscopic cholecystectomy 3, endoscopic retrograde cholangiopancreatography 1, and liver biopsy 1), liver trauma in 6 and liver tumors in 3 patients. Twenty patients presented with gastrointestinal bleeding (melena 20 patients, hemetemesis with melena 8 patients), 5 with jaundice and 8 had fever. Abdominal angiography was performed in 20 patients. Angiography revealed pseudoaneurysm of the right hepatic artery or its branches in 14 patients, left hepatic artery in 2, an arterio-biliary fistula in 1, tumor blush in 1 and the source could not be located in 2 patients. Seventeen of the 22 patients were treated with radiological intervention, 3 required surgery (liver resection for tumors 2, laparotomy for venous collateral bleeding of portal cavernoma 1) and two were managed conservatively. Radiological intervention involved embolisation with coils and/or glue in 16, and chemoembolisation in 1 patient. Sixteen of 17 patients responded to embolisation. Overall there were two deaths. Conclusion: The spectrum of hemobilia seen in India is now similar to that in the developed world with iatrogenic causes being the commonest. Interventional radiology can treat a majority of patients reducing the need and morbidity associated with surgery.

Serogroup distribution of Shigella in Ile-Ife, southwest Nigeria.

Abstract: Background: Shigellosis is endemic throughout the world and Shigella spp. is among the most common pathogens responsible for bacterial diarrhoeal diseases. Death attributed to shigellosis is common in developing countries, where affected populations are immunologically compromised due to poor nutrition and background infections. Aim: To investigate the serogroup distribution of Shigella spp. recovered from clinically diagnosed cases of gastroenteritis and acute diarrhoea among children (0–5 years) in Ile-Ife, southwest Nigeria between September 2003 and September 2006. Methods: The isolates were identified and characterized biochemically and serologically. Results: Out of 102 Shigella isolates identified, 45 (44%) were S. flexneri, 26 (25%) were S. dysenteriae, 19 (19%) were S. boydii, 6 (6%) were S. sonnei and 6 (6%) were untypable strains. Conclusions: We conclude that Shigella serogroups can be considered an important aetiological agent of acute diarrhoea and mortality among children in Ile-Ife, southwest Nigeria.