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Background/Aims@#Patients with Barrett’s esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapies aim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injection to create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis to evaluate the safety and efficacy of hybrid-APC. @*Methods@#We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplastic and non-dysplastic Barrett’s esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures included complete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessary to achieve CR-IM. @*Results@#Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872–0.939; I2=0%). Pooled stricture rate was 2.0% (95% CI, 0.005–0.042; I2=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007–0.055; I2=0%). @*Conclusions@#Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safety profile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlled trials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparable to the current standards of care.
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Trophoblastic differentiation of endometrial carcinoma is extremely rare, till date 18 cases reports are there in the literature. A 68-year-old postmenopausal female presented with abnormal vaginal bleeding. Histopathologically, there were areas of serous carcinoma with trophoblastic differentiation (~90%). On immunohistochemistry, the trophoblastic component was positive for ?-human chorionic gonadotropin (hCG), HPL and EMA. IHC confirmed the diagnosis of serous carcinoma with trophoblastic differentiation. The clinicopathological features of 18 previously reported cases of trophoblastic differentiation in the uterine tumor were analyzed in addition to the present case.
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Background: To analyze the prescribing patterns of statins a hypolipidemic agents by using HMIS database in outdoor patients at tertiary care teaching hospital of central India.Methods: In this retrospective study Using HMIS database, 1000 prescriptions were analyzed for statin use for various WHO prescription indicators using ATC code of statins, the ratio of prescribed daily dose (PDD) and defined daily dose (DDD) was calculated.Results: Atorvastatin was the only statin which was prescribed as monotherapy (61.1%), whereas as combination with aspirin (38.9%). While analyzing the prescriptions, it was found that patients having abnormal lipid profiles (51.8%) and normal lipid profiles (48.2%) were prescribed atorvastatin. Hypertension with diabetes (37%) was the most common disease followed by hypertension (21.2%) and diabetes mellitus (21%) for which atorvastatin was prescribed. The average number of drugs per prescription were 3.8±1.65.Conclusions: This study depicts the use of atorvastatin in various disease conditions, both as primary and secondary preventive measures. There was no polypharmacy. Such studies should be done to educate the physicians on good prescribing practices and to rationalize use of hypolipidemic drugs.