Gastroenterology practice in the COVID-19 era: Ghana Association for the Study of Liver and Digestive Diseases (GASLIDD) position statement

The COVID-19 pandemic has impacted healthcare negatively across the globe. The practice of gastroenterology has been affected especially gastrointestinal (GI) endoscopy which is considered high risk for transmission of the virus. As a community of practitioners there is the need to share information and make evidence-based statements to guide GI practice in Ghana. This GASLIDD position statement based on the growing and rapidly evolving body of knowledge is to provide up to date information on the COVID-19 disease and guidance for the practice of gastroenterology in Ghana and beyond. It is to help the GI community of practice to maintain the highest level of health delivery and safety for our patients, staff, community and GI practitioners

Percutaneous microwave ablation versus partial splenic embolization for treatment of hypersplenism in patients with liver cirrhosis

Background and study aim: In patients suffering from portal hypertension as result of liver cirrhosis, hypersplenism was ranged from 11 to 55%. The aim of our work was to compare between percutaneous microwave ablation (MWA) and partial splenic artery embolization (PSE) in the management of hypersplenism in patients with liver cirrhosis as regard efficacy and safety. Patients and Methods: Sixty patients with liver cirrhosis complicated with splenomegaly and hypersplenism were divided randomly into three groups; Group (1): Twenty patients were underwent one session of MW ablation of splenic parenchyma with target ablation volume about 20%, Group (2): Twenty patients were underwent two sessions of MW ablation of splenic parenchyma with 1 week interval with target ablation up to 40%, Group (3): Twenty patients were underwent PSE. Results: There was an improvement in the hemoglobin, platelet and leucocyte levels in three groups, which was 9.47± 2.14 gm/dl, 42.75 ± 15.4 x103/ mm3 and 2.6±0.5 x103/mm3 before the procedure respectively and become 9.95 ± 2.29 gm/dl, 313.5±99.6 x103/mm3 and 6.88± 1.89 x103/mm3 after one month as regard PSE group. As regard one session of MWA was 9.73±2.02 gm/dl, 45.57±11.2 x103/mm3 and 2.8±0.85 x103/mm3 and become 11.83±0.74 gm/dl, 152±26.43 x103/mm3 and 5.85±1.01 x103/mm3 after one month. As regard two sessions of MWA group; was 9.2±2.15 gm/dl, 40.6± 11.5 x103/mm3 and 2.4±0.55 x103/mm3 and become 12.74±1.2 gm/dl, 183.4± 26.43 x103/mm3 and 6.29±1.17 x103/mm3 after one month. PSE was significantly more effective in the elevation of platelets and leucocytes than other two groups (p=0.00), and two sessions of MWA more than one session of MWA. The two sessions MWA group was significantly higher than other two groups while one session of MWA group was more than PSE group in the elevation of hemoglobin (p=0.00). No mortality occurred in the three groups, but PSE was associated with more serious complications than the other two groups. Conclusion: MWA and PSE were effective in treatment of hypersplenism in patients with liver cirrhosis, while percutaneous MWA has less serious complications than PSE

Fellowship in India - Gastroenterology Foundation

An opportunity was afforded me to consolidate the technical and theoretical knowledge, learning and experience garnered during my two-year Witwatersrand University HPB Fellowship by being awarded an International Travel Fellowship by the courtesy of the sponsorship of the Oscar Norwich Foundation, together with the unwavering support and encouragement of the Gastro Foundation South Africa, organisations to whom I am profoundly grateful. The Travelling Fellowship enabled me to spend a period of 10 weeks in Mumbai, India at the Global Hospitals Mumbai and the Tata Memorial Hospital from October to December 2018

Celebrating 10 years of gastro foundation fellows meetings - gastroenterology foundation

On the 1st of February, a pristine day at Spier in the Cape ushered in the 10th annual Gastro Foundation Fellows meeting. The preceding meetings promised and delivered not only invaluable academic preparation for fellows sitting for the exit exams in various fields of gastroenterology, but the opportunity to network and form enduring friendships. This meeting would prove no different

Hereditary Angioedema : a gastroenterology perspective

In 1888, Sir William Osler first described a case of recurrent episodes of painless, non-pruritic swellings that occurred in a 24 year old female. These swellings typically lasted between one and four days and affected various parts of her body ­ hands, fingers, knees, elbows, face and lips. Whilst most episodes affected the face and limbs, other more severe episodes resulted in abdominal colic, nausea and vomiting. He noted that these episodes would often occur spontaneously, with no specific triggers identified. Osler then obtained a comprehensive family history, which revealed that these symptoms had been present in twenty-eight other family members in the preceding five generations. He then went on to make the following conclusions: 1. "The occurrence of local swellings in various parts of the body, face, hands, arms, legs, genitals, buttocks, and throat. In one instance, possibly in two, death resulted from a sudden Oedema Glottidis. 2. Associated with oedema, there is almost invariably gastro-intestinal disturbance: colic, nausea, vomiting and sometimes diarrhoea. 3. A strongly marked hereditary disposition, the disease having affected members of the family in five generations. "

Complete pathological response in rectal cancer after neoadjuvant therapy - case report

A fifty-four year old woman underwent colonoscopy due to symptoms of altered bowel habit and weight loss. There was a malignant looking lesion at her rectosigmoid junction [Fig. 1a] which was confirmed histologically to be a moderately differentiated adenocarcinoma. Although the blood results were normal, her CT scan and MRI [Fig 2a] showed an apple core lesion at rectosigmoid junction which was deemed to be Stage IIIC (T4aN2aM0)

The treatment of metastatic colorectal cancer : an overview - review

Over the last 25 years there have been systematic improvements in the overall survival of patients with metastatic colorectal cancer (mCRC), the median overall survival of patients has gone from 6 months to approximately 36 months.1 While 5 Flurouracil has remained at the core of treatment protocols newer chemotherapy and targeted agents and combination protocols have resulted in incremental improvements. The sequencing of the various protocols is the current challenge which still needs to be fully defined