Endoscopic Ultrasound-Guided Gastroenterostomy for Malignant Gastric Outlet Obstruction: A Minimally Invasive Alternative to Palliative Surgical Bypass.

Gastric outlet obstruction is a mechanical obstruction to the flow of gastric contents to the intestines. The most common causes of malignant gastric outlet obstruction (MGOO) are pancreatic and gastric cancers. MGOO is associated with reduced quality of life and poor prognosis due to malnourishment from the inability to tolerate oral intake. Surgical gastrojejunostomy and endoscopic placement of enteral stents are palliative options with different advantages and disadvantages. We present a case of MGOO treated with endoscopic ultrasound-guided gastroenterostomy, a minimally invasive alternative to palliative surgical bypass.

Arterial Pseudoaneurysm Mimicking a Mural Nodule Within a Pancreatic Cyst.

Pancreatic cysts with high-risk characteristics are at increased risk of harboring high-grade dysplasia or pancreatic cancer. Endoscopic ultrasound may clarify the nature of the cystic lesion and its malignant potential. A mural nodule found through endoscopic ultrasound within a cyst may represent malignancy and require fine-needle aspiration. Pancreatic pseudocysts are benign walled-off fluid collections that form in the setting of pancreatitis and may be difficult to differentiate from neoplastic cysts. Pseudoaneurysms form when pancreatitis inflammation damages vessel walls and can cause fatal hemorrhage. We present a pancreatic pseudocyst with pseudoaneurysm mimicking a neoplastic cyst with a mural nodule.

Assessment of diabetes risk profile in a rural population of northern India using the Indian Diabetes Risk Score - A community-based study.

Background: Diabetes is one of the leading killers among noncommunicable diseases of the present time and poses a considerable burden to the society in terms of public health. The Indian Diabetes Risk Score (IDRS) can be used as a risk assessment tool to estimate the population at risk and plan appropriate interventions. The present study was conducted to assess the diabetes risk profile of a rural population of Punjab by using IDRS. Materials and Methods: This was a cross-sectional study conducted in two phases after obtaining approval from the Institutional Ethics Committee. Phase 1 was done in Rural Health Training Center (RHTC), Pohir, where every fifth patient attending the outpatient department was included in the study. Phase 2 was conducted in village Gopalpur, which is one of the villages in the field practice area of Department of Community Medicine, where participants were enrolled by conducting house to house survey after taking their informed consent. Sociodemographic characteristics, risk factor profile, and the IDRS of the participants were noted. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0 to calculate the percentages. Pearson's Chi-square test was used for qualitative variables, and mean, standard deviation and analysis of variance (ANOVA) were used for quantitative variables. A P value of less than 0.05 was considered significant. Results: A total of 252 subjects (99 male and 153 female) from RHTC and 213 subjects (71 male and 142 female) from village Gopalpur participated in the study, with their mean IDRS being 44.8 ± 15.7 and 46.6 ± 21.1, respectively. On calculating the IDRS of participants enrolled in RHTC, it was found that 15.5% had low, 56% had moderate, and 28.5% had high risk, whereas from village Gopalpur, 19.2% had low, 57.3% had moderate, and 23.5% had high risk for developing diabetes mellitus. The risk for developing diabetes was found to be higher among females, subjects living in joint families, and subjects with high body mass index (BMI). The mean systolic and diastolic blood pressure showed an increasing trend with increase in IDRS score of the participants. Conclusion: The present study showed that even in rural areas, nearly one-fourth of the adult population was at high risk, whereas more than half of the population was at moderate risk of developing diabetes mellitus. This corroborates the World Health Organization's (WHO's) stand to declare diabetes as a public health emergency and to devise ways to urgently mitigate this problem. Therefore, awareness and health education campaigns should be implemented in rural areas for early identification of risks, which will help in prevention and hence decreasing the burden of the disease.