ABSTRACT
Background/Aims@#The safety of endoscopic retrograde cholangiopancreatography (ERCP) in hepatic cirrhosis and the impact of Child-Pugh class on post-ERCP complications need to be better studied. We investigated the post-ERCP complication rates in patients with cirrhosis compared with those without cirrhosis. @*Methods@#We conducted a literature search of relevant databases to identify studies that reported post-ERCP complications in patients with hepatic cirrhosis. @*Results@#Twenty-four studies comprising 28,201 patients were included. The pooled incidence of post-ERCP complications in cirrhosis was 15.5% (95% confidence interval [CI], 11.8%–19.2%; I2=96.2%), with an individual pooled incidence of pancreatitis 5.1% (95% CI, 3.1%–7.2%; I2=91.5%), bleeding 3.6% (95% CI, 2.8%–4.5%; I2=67.5%), cholangitis 2.9% (95% CI, 1.9%–3.8%; I2=83.4%), and perforation 0.3% (95% CI, 0.1%–0.5%; I2=3.7%). Patients with cirrhosis had a greater risk of post-ERCP complications (risk ratio [RR], 1.41; 95% CI, 1.16–1.71; I2=56.3%). The risk of individual odds of adverse events between cirrhosis and non-cirrhosis was as follows: pancreatitis (RR, 1.25; 95% CI, 1.06–1.48; I2=24.8%), bleeding (RR, 1.94; 95% CI, 1.59–2.37; I2=0%), cholangitis (RR, 1.15; 95% CI, 0.77–1.70; I2=12%), and perforation (RR, 1.20; 95% CI, 0.59–2.43; I2=0%). @*Conclusions@#Cirrhosis is associated with an increased risk of post-ERCP pancreatitis, bleeding, and cholangitis.
ABSTRACT
A plethora of paraneoplastic syndromes have been reported as remote effects of colorectal carcinoma (CRC). However, there is a dearth of data pertaining to the association of this cancer with demyelinating neuropathies. Herein, we describe the case of a young woman diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with intravenous immunoglobulins and prednisone did not improve her condition, and her neurological symptoms worsened. Subsequently, she was readmitted with exertional dyspnea, lightheadedness, malaise, and black stools. Colonoscopy revealed a necrotic mass in the ascending colon, which directly invaded the second part of the duodenum. Pathologic results confirmed the diagnosis of locally advanced CRC. Upon surgical resection of the cancer, her CIDP showed dramatic resolution without any additional therapy. Patients with CRC may develop CIDP as a type of paraneoplastic syndrome. Clinicians should remain cognizant of this potential association, as it is of paramount importance for the necessary holistic clinical management.
ABSTRACT
Background: Dentist and allied professionals are undoubtedly among professional groups at risk of noise- induced hearing impairment in the workplace. There has been speculation about the relationship between hearing loss and the use of high-speed dental drills among dental professionals. In resource-poor settings, dental instruments may be old and worn out with the attendant risks of hearing impairment following their use. Aim: To report the awareness and assessment of work-related hearing impairment among dental professionals in Kano State. Methods: The study was a cross-sectional self-administered questionnaire-based survey among Dentists and dental allied staff in Kano State. Participants were given questionnaires containing detailed information about the survey to fill after consenting. Each questionnaire was examined to ensure they were properly filled and the consent form duly signed. Results: A total of 138 respondents fulfilled the inclusion criteria with a response rate of 86%. The highest respondents were Dental surgeon assistants and dental hygienist under 35 years (85.5%) of age and had worked for at least 5years. Sixty two respondents (44.9%) worked more than 8 hours / day while 76(55.1%) worked less than 8hours/day. Out of 99(71.7%) respondents who use Ultrasonic scaler about 43(43.0%) reported that the Ultrasonic scaler was at least 5 years old while out of 84 respondents who use dental turbines, 36(42.9%) of them reported that the turbines were at least 5years old. Loud power generators were an additional source of exposure to loud noise 42(31.6%) contributing to hearing impairment. Conclusion: It is recommended that periodic hearing evaluation and use of hearing protective devices and appropriate content workshops/seminar about work related noise exposure made a mandatory part of continuous professional development for dental professionals.