Role of Peroral Endoscopic Myotomy (POEM) in the Management of Esophageal Diverticula

Esophageal diverticula are uncommon; however, when present, they can cause symptoms of dysphagia, regurgitation, and chest pain. Based on location and pathophysiological characteristics, they are classified as pulsion- and traction-type diverticula. In the past, the open surgical approach was the only treatment available; however, in the past few decades, transoral incisionless approaches in the form of rigid and flexible endoscopy have gained popularity. Diverticular peroral endoscopic myotomy has emerged as an alternative treatment option. In this paper, we reviewed the role of peroral endoscopic myotomy as a treatment option for different types of esophageal diverticula. Although a safe and effective procedure, this novel submucosal tunneling technique for the treatment of esophageal diverticula requires further validation, and head-to-head comparisons between the different approaches for the treatment of esophageal diverticula are warranted.

Role of Peroral Endoscopic Myotomy (POEM) in the Management of Esophageal Diverticula

Esophageal diverticula are uncommon; however, when present, they can cause symptoms of dysphagia, regurgitation, and chest pain. Based on location and pathophysiological characteristics, they are classified as pulsion- and traction-type diverticula. In the past, the open surgical approach was the only treatment available; however, in the past few decades, transoral incisionless approaches in the form of rigid and flexible endoscopy have gained popularity. Diverticular peroral endoscopic myotomy has emerged as an alternative treatment option. In this paper, we reviewed the role of peroral endoscopic myotomy as a treatment option for different types of esophageal diverticula. Although a safe and effective procedure, this novel submucosal tunneling technique for the treatment of esophageal diverticula requires further validation, and head-to-head comparisons between the different approaches for the treatment of esophageal diverticula are warranted.

Antihyperlipidemic and anti-hyperglycemic effects of Cymbopogon jwarancusa in high-fat high-sugar diet model

Hyperlipidemia is the root cause for development of atherosclerosis, coronary heart disease, diabetes mellitus, obesity, hypertension and cerebral palsy. Cymbopogon jwarancusa is an aromatic grass [Rusha grass, khavi grass] belonging to family Poaceaea. C. jwarancusa essential oil is famous for its use in perfumery, soaps cosmetics, detergents, medicine and pharmaceuticals. The anti-pyretic, anti-fungal, antibacterial, anti-oxidant and cytotoxic activities of C. jwarancusa have been reported in literature. In the present study different doses of C. jwarancusa extract have been investigated for anti-hyperlipidemic and anti-hyperglycemic activities in high-fat high sugar diet model in rats. Hyperlipidemia and hyperglycemia were assessed by measuring body weight, serum lipid profile and fasting blood glucose levels. Administration of ethanol leaves extract of C. jwarancusa exhibited significant dose-dependent reduction in body weight, lipid parameters and blood sugar levels. Hence it may be concluded that C. jwarancusa aids in ameliorating hyperlipidemic, hyperglycemic conditions and has potential to reduce the risk of cardiovascular problems

Recent advances in transarterial embolotherapies in the treatment of hepatocellular carcinoma

Management of hepatocellular carcinoma (HCC) can be maximized with the utilization of multiple treatment modalities including transplant, surgical resection and locoregional therapies including ablative therapies and transarterial embolotherapies. Although transplant and surgical resection offer the best clinical outcomes, a limited number of patients are amenable to these surgical treatment options due to the advanced disease at presentation. Transarterial embolotherapies including conventional transarterial chemoembolization (cTACE), bland transarterial embolization (TAE), drug-eluting beads transarterial chemoembolization (DEB-TACE) and selective internal radiation therapy (SIRT) with Yttrium 90 (⁹⁰Y) have played an increasingly important role for these patients with unresectable HCC. With a better understanding of different transarterial embolotherapies, more personalized and precise treatment should be implemented for these patients with unresectable HCC. In this review, the updated evidence on the current role of each embolotherapy in the treatment of HCC is summarized.

Pediatric myelodysplastic syndrome [MDS] - case series at the childrens hospital and the institute of child health, Lahore

A study was planned to determine the pattren of FAB type distribution of myelodysplastric syndrome in childhood haematological malignancies. It was a cross sectional study carried over a twenty-month period in Haematology and Transfusion Medicine Department of Children Hospital and Institute of Child Health. All patients of age suspected of haematological malignancy were included in the study. All patients underwent a complete blood count, reticulocyte count, peripheral blood film from neonate 15 years examination, bone marrow aspiration and trephine biopsy. During a period of 20 months [from Sep 2000 to May 2002] 195 cases of haematological malignancies were diagnosed. Out of these 9 [4.6%] patients were diagnosed as cases of Paediatric MDS. There were 110 cases of acute lymphoplastic leukemia [ALL], 63 cases of acute myeloid leukemia [AML] and 13 cases of chronic myeloid leukemia [CML]. Out of the 9 MDS cases five were of MDS Type III - Refractory Anemia with Excess of Blasts-[RAEB] and four were of MDS Type I Refractory Anemia [RA]. It can be conducted that paediatric MDS represents 4.6% of all childhood haematological malignancies with nearly equal distribution of REAB and RA