ABSTRACT
Endoscopy is a competitive field in clinical practice, in which skilled endoscopists are in high demand. The learning process for Junior Gastrointestinal Endoscopists (JGEs) is difficult, quite long, and technically demanding. This directs JGEs to seek additive learning sources, including online sources. The purpose of this study was to determine the frequency, context, attitudes, perceived benefits, drawbacks, and recommendations for using YouTube videos as an educational platform among JGEs from the uses'prespective. We disseminated a cross-sectional online questionnaire from January 15th to March 17th, 2022, and recruited 166 JGE from 39 different countries. The majority of surveyed JGEs (138, 85.2%) were already using YouTube as a learning tool. The majority of JGEs (97, 59.8%) reported gaining knowledge and applying it in their clinical practice, but 56 (34.6 %) reported gaining knowledge without application in real practice. Most participants (124, 76.5 %) reported missing procedure details in YouTube endoscopy videos. The majority of JGEs (110, 80.9%) reported that YouTube videos are provided by endoscopy specialists. Only one participant, 0.6% out of the 166 JGEs surveyed, disliked video records, including YouTube as a source of learning. Based on their experience, 106 (65.4%) of participants recommended YouTube as an educational tool for the coming generation of JGEs. We consider that YouTube represents a potentially useful tool for JGEs, supplying them with both knowledge and clinical practice tricks. However, many drawbacks could make the experience misleading and time-consuming. Consequently, we encourage educational providers on YouTube and other platforms to upload well-constructed, peer-reviewed, interactive educational endoscopy videos.
Antecedentes : La endoscopia es un campo competitivo en la práctica clínica en el que los endoscopistas calificados tienen una gran demanda. El proceso de aprendizaje para los endoscopistas gastrointestinales junior (JE) es difícil, bastante largo y técnicamente exigente. Esto dirige a los JE a buscar fuentes de aprendizaje adicionales, incluidas las fuentes en línea. El propósito de este estudio fue determinar la frecuencia, el contexto, las actitudes, los beneficios percibidos, los inconvenientes y las recomendaciones para el uso de videos de YouTube como una plataforma educativa entre los JE desde la perspectiva de los usuarios. Métodos: Se aplicó un cuestionario transversal en línea difundido del 15 de enero al 17 de marzo de 2022 reclutó a 166 endoscopistas gastrointestinales junior de 39 países diferentes. Resultados : La mayoría de los JE encuestados (138, 85,2%) ya utilizaban YouTube como herramienta de aprendizaje. La mayoría de los JE (97, 59,8 %) refirieron adquirir conocimientos y aplicarlos en su práctica clínica, pero 56 (34,6 %) informaron adquirir conocimientos sin aplicación en la práctica real. La mayoría de los participantes (124, 76,5 %) informó que faltaban detalles del procedimiento en los videos de endoscopia de YouTube. La mayoría de los JE (110, 80,9%) informaron que los videos de YouTube son proporcionados por especialistas en endoscopia. Solo a un participante, el 0,6% de los 166 JE encuestados, le disgustaron los registros de video, incluyendo a YouTube como fuente de aprendizaje. Según su experiencia, 106 (65,4 %) de los participantes recomendaron YouTube como una herramienta educativa para la próxima generación de JE. Conclusión: YouTube representa una herramienta potencialmente útil para los EJ, brindándoles tanto conocimientos como trucos para la práctica clínica. Sin embargo, muchos inconvenientes podrían hacer que la experiencia sea engañosa y consuma mucho tiempo. En consecuencia, alentamos a los proveedores de educación en YouTube y otras plataformas a subir videos de endoscopia educativos interactivos, bien construidos y revisados por pares.
ABSTRACT
ABSTRACT Background: The role of dairy foods in inflammatory bowel disease (IBD) has been controversial and it is debatable if patients with IBD should avoid milk and dairy products or not, as well as the relationship between these foods and symptoms among those population. Objective: This multi centric cross-sectional study designed to evaluate if it is really necessary to deprive IBD patients from consumption of dairy foods. Methods: A multicenter study with 12 gastroenterology referral centers in four countries was designed to evaluate gastrointestinal (GI) symptoms after consumption of dairy foods from all outpatients with IBD during 6 months and to compare patients treated at the same centers without IBD (non IBD cases). Results: Overall 1888 cases included (872 IBD patients and 1016 non IBD cases). 56.6% of participants were female with average age of 40.1 years. Racially 79.8% participants were Caucasians and originally they were citizens of 10 countries. Relative prevalence of IBD was higher in Africans and Indians and the most frequent prevalence of dairy foods intolerance was seen in Asians. Among IBD patients, 571 cases diagnosed as ulcerative colitis and 189 participants as Crohn's disease. Average duration of diagnosis as IBD was 6.8 years (from 2 months to 35 years). The most prevalent GI symptoms after consumption of all the dairy foods were bloating and abdominal pain. Totally, intolerance of dairy foods and lactase deficiency was more prevalent among IBD patients in comparison with non IBD cases (65.5% vs 46.1%, P=0.0001). But the rate of GI complains among IBD patients who had not any family history of lactase deficiency, history of food sensitivity or both were 59.91%, 52.87% & 50.33% respectively and similar to non IBD cases (P=0.68, 0.98 & 0.99 respectively). Conclusion: The rate of dairy foods intolerance among IBD patients without family history of lactase deficiency or history of food sensitivity is similar to non IBD cases and probably there is no reason to deprive them from this important source of dietary calcium, vitamin D and other nutrients.
RESUMO Contexto: O papel dos alimentos lácteos na doença inflamatória intestinal (DII) tem sido controverso e é discutível se os pacientes com DII devem ou não evitar leite e laticínios, bem como a relação entre esses alimentos e sintomas nesta população. Objetivo: Estudo transversal multicêntrico foi projetado para avaliar se é realmente necessário privar os pacientes com DII do consumo desta classe de alimentos. Métodos: Um estudo multicêntrico com 12 centros de referência em gastroenterologia de quatro países foi projetado para avaliar sintomas gastrointestinais após o consumo de alimentos lácteos em todos os ambulatórios de DII durante seis meses e comparar pacientes tratados nos mesmos centros sem DII. Resultados: No total, foram incluídos 1888 casos (872 pacientes com DII e 1016 casos sem DII. 56,6% dos participantes eram do sexo feminino com idade média de 40,1 anos. 79,8% dos participantes eram caucasianos e originalmente eram cidadãos de 10 países. A prevalência relativa de DII foi maior em africanos e indianos e a prevalência mais frequente de intolerância a alimentos lácteos observada nos asiáticos. Entre os pacientes com DII, 571 casos foram diagnosticados como colite ulcerativa e 189 participantes como doença de Crohn. A duração média do diagnóstico como DII foi de 6,8 anos (de 2 meses a 35 anos). Os sintomas de gastrointestinais mais prevalentes após o consumo de todos os alimentos lácteos foram inchaço e dor abdominal. No total, a intolerância aos alimentos lácteos e a deficiência de lactase foi mais prevalente entre os pacientes com DII em comparação com os casos sem DII (65,5% vs 46,1%, P=0,0001). A taxa de queixas gastrointestinais entre os pacientes com DII que não tinham histórico familiar de deficiência de lactase, histórico de sensibilidade alimentar ou ambos foram de 59,91%, 52,87% e 50,33% respectivamente e semelhantes aos casos sem DII (P=0,68, 0,98 e 0,99, respectivamente). Conclusão: A taxa de intolerância de alimentos lácteos entre pacientes com DII sem histórico familiar de deficiência de lactase ou histórico de sensibilidade alimentar é semelhante aos casos sem DII e provavelmente não há razão para privá-los dessa importante fonte de cálcio dietético, vitamina D e outros nutrientes.
ABSTRACT
In late 2019, a novel coronavirus, now designated SARS-CoV-2, emerged and was identified as the cause of an outbreak of acute respiratory illness in Wuhan, a city in China, named as COVID-19. Since then the waves of the virus exponentially hit many countries around the globe with high rates of spread associated with variable degrees of morbidity and mortality. The WHO announced the pandemic state of the infection in March 2020 and by June 1st 2020 more than 6 million individuals and more than 370 thousands case fatalities were documented worldwide. In this article, we discussed many aspects regarding this emerged infection based on the available evidence aiming to help clinician to improve not only their knowledge but also their practices toward this infection.
Subject(s)
Indicators of Morbidity and Mortality , SARS-CoV-2 , COVID-19 , Clinical Telehealth CoordinatorABSTRACT
In late 2019, a novel coronavirus, now designated SARS-CoV-2, emerged and was identified as the cause of an outbreak of acute respiratory illness in Wuhan, a city in China, named as COVID-19. Since then the waves of the virus exponentially hit many countries around the globe with high rates of spread associated with variable degrees of morbidity and mortality. The WHO announced the pandemic state of the infection in March 2020 and by June 1st 2020 more than 6 million individuals and more than 370 thousands case fatalities were documented worldwide. In this article, we discussed many aspects regarding this emerged infection based on the available evidence aiming to help clinician to improve not only their knowledge but also their practices toward this infection.
Subject(s)
Humans , Indicators of Morbidity and Mortality , COVID-19 Nucleic Acid Testing , Phylogeny , Pneumonia , COVID-19ABSTRACT
Abstract Background and study aim: The term non-specific colitis refers to an inflammatory condition of the colon that microscopically lacks the characteristic features of any specific form of colitis and is commonly seen in pathology reports of colonoscopy biopsies. In fact, it has been questioned whether it is a separate pathological entity or it is merely an intermediate stage in the course of inflammatory bowel disease. This study was conducted to estimate the prevalence of non-specific colitis among patients with colitis and characterize its natural history over a 6 months year period. Patients and methods: Eighty adult patients presented for colonoscopy were enrolled. In the final analysis they were divided into Group A; the non-specific colitis Group and Group B; the inflammatory bowel disease Group. All patients were subjected to: full history taking, full clinical examination, laboratory investigations: which included stool analysis, CRP, ESR, complete colonoscopy and entire random colon biopsies for histopathological examination. Results: Group A included 67 patients (83.75%) while Group B included 13 (16.25%) patients. Patients with IBD had clinical and laboratory features of inflammation significantly higher than patients with non-specific colitis. Six patients (8.95%) of non-specific colitis group developed histologic features of florid inflammatory bowel disease after 6 months. There were no independent predictors of this conversion. Conclusion: Among our 80 patients with colonoscopy and biopsy 67 (83.75%) were diagnosed as non-specific colitis and out of them 6 patients (8.95%) were reexamined after 6 months and proved to have inflammtory bowel disese this change was not linked to predictive factors.
Resumo Introdução e objetivos: O termo colite inespecífica (CI) refere-se a uma condição inflamatória do cólon que microscopicamente não apresenta características de qualquer forma específica de colite; é comumente observada em relatórios patológicos de biópsias de colonoscopia. De fato, tem-se questionado se esta seria uma entidade patológica separada ou apenas um estágio intermediário no curso da DII. Este estudo foi realizado para estimar a prevalência de CI entre pacientes com colite e caracterizar seu curso durante um período de seis meses. Pacientes e métodos: O estudo incluiu 80 pacientes adultos que se apresentaram para colonoscopia. Na análise, os pacientes foram divididos em dois grupos: grupo A (CI) e grupo B (DII) Todos os pacientes foram submetidos a anamnese completa, exame clínico completo e investigações laboratoriais que incluíram análise de fezes, PCR, VHS, colonoscopia completa e biópsias aleatórias de cólon para exame histopatológico. Resultados: Do total de pacientes, 67 foram alocados no grupo A (83,75%) e 13 (16,25%) no grupo B. Os pacientes com DII apresentavam sinais clínicos e laboratoriais de inflamação significativamente maiores do que o observado em pacientes com CI. Seis pacientes (8,95%) do grupo CI desenvolveram características histológicas de DII florida após seis meses. Não foram identificados preditores independentes para essa conversão. Conclusão: Entre os 80 pacientes submetidos a colonoscopia e biópsia, o diagnóstico de CI foi feito em 67 (83,75%); destes, seis pacientes (8,95%) foram reexaminados após seis meses e apresentaram DII, sendo que essa conversão não foi associada a fatores preditivos.
Subject(s)
Humans , Male , Female , Inflammatory Bowel Diseases , Colonoscopy , Colitis/diagnosis , Colitis/epidemiology , Inflammatory Bowel Diseases/diagnosis , Colitis , Colitis/pathologyABSTRACT
Background and study aim: Liver enzymes are important markers for hepatocyte damage. Metabolic syndrome (MS) is a combination of metabolic abnormalities including high blood glucose, obesity, hypertension and dyslipidemia. The incidence of MS is believed to be increasing in Egypt. The purpose of this study is to examine the relationship between elevated liver enzymes and MS among Egyptian adults. Patients and Methods: A total 138 apparently healthy subjects were randomly included (99 females and 39 males). Demographic, clinical (blood pressure, body mass index and waist circumference) and biochemical (measurements of alanine aminotransferase (ALT), aspartate amino-transferase (AST), alkaline phosphatase (ALP), lipid profile, blood glucose and viral markers) were collected from every subject. Metabolic syndrome was defined according to a well-known criteria and subjects in the final analysis were divided into group I; metabolic syndrome and group II; non-metabolic syndrome subjects. Results: In this study, 92 persons fulfilled three of the five criteria of metabolic syndrome (group I) with prevalence of 66.7% while group II (non-metabolic syndrome) represented 33.3%. Patients with MS were older and less physically active in comparison with group II. There were an association between elevations in liver enzymes (ALT, AST, ALP) and MS. ALT, AST and ALP were elevated in 42.4%, 17.2% and 20.7% of patients with MS respectively. ALT and AST showed positive correlation with elevated blood glucose and triglycerides levels while AST/ALT ratio showed negative correlation with diastolic blood pressure, triglycerides level and waist circumference. The more items of MS the patient have the higher the level of liver enzymes. Conclusion: Among Egyptian adults elevated levels of liver enzymes were associated with MS and a correlation was noticed with its components
Subject(s)
Adult , Alkaline Phosphatase , Egypt , Enzymes , Liver , Metabolic SyndromeABSTRACT
Background and study aim: Hepatitis C virus infection is a multisystemic disease with many extrahepatic manifestations. Affection of bone matrix density is a common complication of chronic hepatitis and cirrhosis. The pathogenesis of osteoporosis in chronic liver disease is still unknown and is expected to be multifactorial. The aim of this work is to assess the frequency of osteoporosis/osteopenia in patients with chronic hepatitis C virus infection with or without cirrhosis.Patients and methods:This study was carried out on 30 patients with chronic HCV infection without cirrhosis (Group II); 30 patients with chronic HCV infection with compensated cirrhosis (Group III) and 20 age and gender matched healthy controls (Group I). All subjects of the study performed liver function tests; viral markers; liver biopsy; hormonal assay and Bone Mineral density measurement (BMD) by Dual energy X-ray absorptiometry (DEXA).Results : In patients with chronic hepatitis C (group II) the frequency of osteopenia was 11 (36.7); osteoporosis 2 (6.7); total patients with low BMD was 13 (43.3). In cirrhotic patients (group III); the frequency of osteopenia was 13 (43.3); osteoporosis was 3 (10.0); and total patients with low BMD was 16(53.3) vs 1(5.0) in the control group (group I). there was also no significant difference between patients with low BMD and patients with normal BMD as regards age; gender; common risk factors; liver function tests or hormonal levels.Conclusion : Reduced BMD is common chronic HCV-infected patients with and without cirrhosis. HCV infection is a risk factor of osteoporosis
Subject(s)
Bone Density , Egypt , Hepacivirus , Hepatitis C, Chronic , Liver Cirrhosis , OsteoporosisABSTRACT
Aims: Liver biopsy has always been represented as the standard reference for assessment of hepatic fibrosis although it has several limitations. This study aimed at evaluating the accuracy of noninvasive methods for diagnosis of hepatic fibrosis in adult Egyptian patients with chronic hepatitis C virus (HCV) infection. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted in Al-Ahrar General Hospital (local treatment centre for Hepatitis C virus), Sharkia Governorate, Egypt and the Tropical Medicine Department, Zagazig University Hospitals, Sharkia Governorate, Egypt in the period from April 2011 to March 2012. Methodology: Fifty chronic HCV patients were selected out of 255 chronic HCV patients awaiting assessment for combined pegylated interferon/ribavirin therapy according to the modified guidelines of the National Committee for Control and Prevention of viral Hepatitis C in Egypt. Diagnosis of HCV was confirmed by detection of anti-HCV antibody and positivity for HCV RNA for more than 6 months. All patients were assessed by liver biopsy and noninvasive methods namely aspartate transaminase/platelet ratio (APRI), abdominal ultrasonography measuring caudate/right lobe ratio and liver stiffness measurement. Results: The accuracy in diagnosis of liver fibrosis using different methods in comparison to liver biopsy was 60%, 84%, 88%, 90%, 92% and 84% for APRI, ultrasonography, Fibroscan, combined Fibroscan/APRI, Fibroscan/ultrasonography and APRI/ultrasonography respectively. The sensitivity was 62.5%, 87.5%, 87.5%, 90.6%, 93.8 and 87.5 for APRI, ultrasonography, Fibroscan, combined Fibroscan/APRI, Fibroscan/ultrasonography and APRI/ultrasonography respectively. The specificity was 55.6%, 77.8%, 88.9%, 88.9%, 88.9 and 77.8 for APRI, ultrasonography, Fibroscan, combined Fibroscan/APRI, Fibroscan/ultrasonography and APRI/ultrasonography respectively. Conclusion: Fibroscan appeared superior to APRI score and abdominal ultrasonography in diagnosis of liver fibrosis. Combined Fibroscan /ultrasonography performed better than other combinations for the prediction of significant hepatic fibrosis.