Open Journal of Gastroenterology

Journal Information
ISSN / EISSN : 2163-9450 / 2163-9469
Published by: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 410
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Mamadou Diakité, Amadou Koné, Akoun Fabrice Aké, Kouassi Olivier Claver Koffi, Anassi Jean Baptiste Okon, Kadidiatou Diallo
Open Journal of Gastroenterology, Volume 12, pp 27-35; https://doi.org/10.4236/ojgas.2022.122003

Abstract:
Objective: The objective is to determine the prevalence of Helicobacter pylori (Hp) infection and highlight the determinants of the infection as well as the gastric histopathological lesions associated with this infection. Methods: This is a retrospective study carried out from August 01, 2015 to December 31, 2020 in Bouaké. It included all patients with gastric and/or duodenal lesion on upper gastrointestinal endoscopy in whom gastric biopsies and histopathology results are available. Results: The study involved 510 patients (301 men and 209 women). The prevalence of Hp was 66.47% (339/510 patients). The presence of Hp was not significantly related to age and gender. Epigastralgia was the most common indication with no significant difference between the positive and negative Hp groups (65.37% vs 34.63%, p = 0.35). A significant difference was only observed for duodenal ulcers (84.31% Hp+ vs 15.69% Hp-, p = 0.004). Regarding histological lesions: Chronic and active gastritis was strongly related to the presence of Hp (p Hp. These precursor lesions of gastric cancer (metaplasia and atrophy) were, however, significantly related to chronic gastric disease with p = 0.02 and p Conclusion: The prevalence of Hp is high in Bouaké. Our study confirms the link between Hp infection and chronic and active gastritis.
Hakima Abid, Maryam Khayari, Hajar Cherkaoui, Maria Lahlali, Nada Lahmidani, Mounia Elyousfi, Nourdin Aqodad, Sidi Adil Ibrahimi, Mohamed El Abkari
Open Journal of Gastroenterology, Volume 12, pp 55-63; https://doi.org/10.4236/ojgas.2022.123006

Abstract:
For a long time, a combination of interferon and ribavirin has been used to treat viral hepatitis C, but the sustained virological response was only achieved in 45% of cases and side effects were serious [1]. Direct acting antivirals (DAA) have provided a cure for almost everyone with hepatitis C, with few side effects. The Purpose of Our Work is to compare the results of treatment for viral hepatitis C before and after DAA. Patients and Methods: This is a retrospective study, bringing together all patients with chronic viral hepatitis C treated between January 2009 and March 2020 at the University Hospital Hassan II in Fez, Morocco. The epidemiological, clinical, biological, virological characteristics of the included patients were collected from the two groups: A, treated with interferon and ribavirin or by triple therapy and B, treated with DAA. Results: 162 patients were included, the average age was 55 y/o, with 90 women and 72 men. 88 patients (54.3%) were already cirrhotic, of which 61 were compensated and 27 were decompensated. Genotype 1 was dominant with a frequency of 71.6%, 107 patients (66%) initially treated with old HCV treatments and 55 (34%) treated with DAA. Sustained viral response was obtained in 59 cases (55.14%) in group A versus 54 cases (98.18%) in group B with a very significant difference (p i.e. 2% in group B (p = 0.019). 14 patients relapsed in group A (13.1%) versus 0 patient in group B (p = 0.003). The tolerance of the treatment was excellent in group B as a whole with only five patients (9%) reported side effects which were minor, not leading to the discontinuation of treatment while the side effects were major in 49 patients (45.7%) in group A with led to the permanent discontinuation of treatment in 6 patients. The difference in side effects between the two groups was very significant with (p Conclusion: Our study has shown the superiority of DAA in terms of efficacy and tolerance compared to the old treatments for chronic hepatitis C. In addition, these treatments allow almost systematic viral elimination and therefore consequently a reduction in the risk of complications hepatic with a short time of treatment.
Reza Ahmad, Anjuman Sultana, Mohammad Haroon Or-Rashid, Tarik Alam Ony, Marzina Faruq, Mahbubul Islam, Ashfeka Gini, Kaniz Farhana, Golam Mahmud Rayhan
Open Journal of Gastroenterology, Volume 12, pp 44-54; https://doi.org/10.4236/ojgas.2022.123005

Abstract:
Background: Fast track surgery is an evidence-based multidisciplinary approach. The underlying principle is to enable patients to recover from surgery and leave the hospital sooner by minimizing the stress responses on the body during surgery. Our aim was to compare the outcome of fast-track protocol and conventional methods in colorectal surgery. Method: It was an observational cross-sectional study carried out at the Department of Surgery in different tertiary level hospitals, Dhaka Bangladesh during the period January 2014 to December 2017. Among this population, 50 patients were placed in the fast-track program (Group A) from January 2014 to December 2015 and 50 patients were in the conventional method (Group B), from January 2016 to December 2017. The fast-track patients were selected after receiving ethical approval from the Bangladesh College of Physician & Surgeons. Data analysis was done using the statistical package for social science (SPSS) for windows version 20. Results: The average age of the patients was 45.24 ± 16.65 years (range: 11 - 70 years) in the fast track group (Group A) and 43.24 ± 17.76 years in the conventional method (Group B). The majority were female between two groups, with 56% in group A and 52% in group B. General and surgical complications occurred in 9 (18%) patients and 11 (22%) patients respectively in group A. On the other hand in group B general and surgical complications occurred in 10 (20%) patients and 13 (26%) patients respectively. The average hospital stay was 9.24 ± 5.99 days in group A and the average hospital stay was 10.10 ± 6.04 days in group B. Conclusion: Making the decision to adopt fast-track surgery will challenge current traditional practice for all members of the multidisciplinary team across the whole local health community.
Jean-Paul Mayimona Kimpiatu, Aliocha Natuhoyila Nkodila, Antoine Wola Yaba Tshimpi, Charles Nlombi Mbendi, Thérèse Ndarabu, Jean Jacques Matimbo, Youyou Paka, Patrick De Jésus Ngoma, Blaise Batumona, Trésor Monsere, et al.
Open Journal of Gastroenterology, Volume 12, pp 107-118; https://doi.org/10.4236/ojgas.2022.124011

Abstract:
Background and Objective: HIV infection is often associated with HBV and HCV infection, together leading to high morbidity and mortality in developing countries. The objective of this study is to describe the clinical, biological, immunological and therapeutic profile of patients co-infected with HIV-HBV and/or HCV. Methods: A cross-sectional and descriptive study including 180 people living with HIV (PLWHIV) in the city of Kinshasa province was conducted. Socio-demographic, clinical, biological and serological characteristics were analyzed. Results: The frequency of HIV-HBV/HCV co-infection was 23.9%. The distribution of age and sex of patients did not differ significantly according to co-infection status. The notion of pedicure and manicure was significantly more observed in patients free from viral hepatitis (51.1% versus 32.6%, p = 0.034). The median duration of knowledge of the HIV status which was longer in the co-infected (4 years versus 2 years, p = 0.022). A lower median level of GPT was observed in co-infected compared to other patients (14 IU/L versus 20 IU/L, p = 0.041). Serum albumin (3.1 g/L versus 3.3 g/L, p = 0.034) and prothrombin (58.3% versus 65.6%, p = 0.045) were lower in HIV co-infected-VHB and/or VHC. The median INR was higher in co-infected than in other patients (1.6 versus 1.4; p = 0.009). Patients without therapy Antiretroviral (TARV) medication were more numerous in co-infected (20.9% versus 8.0%, p = 0.025). Conclusions: The profile of PLWHIV was dominated by the presence of pedicures and manicures with high transaminases and without anti-viral treatment.
SalamatA Diallo, Alioune Badara Fall, Mamadou Lamine Gueye, Marie Louise Bassene, Marieme Polele Fall, Mame Aissé Thioubou, Alsine Yauck
Open Journal of Gastroenterology, Volume 12, pp 64-70; https://doi.org/10.4236/ojgas.2022.123007

Abstract:
Hepatic artery aneurysm (HAA) is a rare disease. HAA is generally asymptomatic disease when symptomatic, they usually present with abdominal pain, upper gastrointestinal (GI) bleeding and/or jaundice, hypovolaemia secondary to rupture or GI bleeding with normal GI endoscopy. Surgical repair and endovascular treatment are the two therapeutic options available at present. Case report: A 49-year-old male presented at the emergency department with high gastrointestinal bleeding, abdominal pain and jaundice. Gastroscopy showed an ulcer with flat pigmented haematin on ulcer base (Forrest IIc) that was controlled by medical treatment. CT angiography was done and showed aneurysm of the proper hepatic artery almost totally thrombosed measuring 100 × 59 mm associated with signs of contained rupture. Emergency surgery was indicated. The laparotomy objectified a rupture of the aneurysm in the biliary tree in per operative excision of aneurysm and ligation of the hepatic pedicle was carried out. After surgery, the evolution was favorable with a follow-up of 8 months. Conclusion: HAA rupture is a rare cause of upper GI bleeding. The mortality rate after rupture is relatively high. CT angiography or MRI can diagnose a ruptured of HAA. Urgent surgery should be the first choice in patients with a ruptured HAA with active hemorrhage causing hemorrhagic shock.
Lin Li, Lin Niu, Na Guo, Luyang Cheng, Tengfei Hao, Ying Xu, Xiangling Li, Qian Xu, Lei Liu, Songhe Yang
Open Journal of Gastroenterology, Volume 12, pp 1-18; https://doi.org/10.4236/ojgas.2022.121001

Abstract:
Background: This study is aimed towards an exploration of mutant genes in primary liver cancer (PLC) patients by using bioinformatics and data mining techniques. Methods: Peripheral blood or paraffin-embedded tissues from 8 patients with PLC were analyzed using a 551 cancer-related gene panel on an Illumina NextSeq500 Sequencer (Illumina). Meanwhile, the data of 396 PLC cases were downloaded from The Cancer Genome Atlas (TCGA) database. The common mutated genes were obtained after integrating the mutation information of the above two cohorts, followed by functional enrichment and protein-protein interaction (PPI) analyses. Three well-known databases, including Vogelstein’s list, the Network of Cancer Gene (NCG), and the Catalog of Somatic Mutations in Cancer (COSMIC) database were used to screen driver genes. Furthermore, the Chi-square and logistic analysis were performed to analyze the correlation between the driver genes and clinicopathological characteristics, and Kaplan-Meier (KM) method and multivariate Cox analysis were conducted to evaluate the overall survival outcome. Results: In total, 84 mutation genes were obtained after 8 PLC patients undergoing gene mutation detection with next-generation sequencing (NGS). The top 100 most mutate gene data from PLC patients in TCGA database were downloaded. After integrating the above two cohorts, 17 common mutated genes were identified. Next, 11 driver genes were screened out by analyzing the intersection of the 17 mutation genes and the genes in the three well-known databases. Among them, RB1, TP53, and KRAS gene mutations were connected with clinicopathological characteristics, while all the 11 gene mutations had no relationship with overall survival. Conclusion: This study investigated the mutant genes with significant clinical implications in PLC patients, which may improve the knowledge of gene mutations in PLC molecular pathogenesis.
SalamatA Diallo, Alioune Badara Fall, Marie Louise Bassène, Mamadou Ngoné Gueye, Marieme Polele Fall, Mame Aissé Thioubou, Alsine Yauck, Abdoul Aziz Atteib Fall, Atoumane Faye
Open Journal of Gastroenterology, Volume 12, pp 89-97; https://doi.org/10.4236/ojgas.2022.124009

Abstract:
Introduction: As of February 2022, coronavirus disease 2019 (COVID-19) has caused a pandemic affecting all countries, with a total of 399 million patients and 5 million deaths. The lungs are the major organs involved in COVID-19. COVID-19 infection is not limited to the respiratory system but can affect multiple organs including the gastrointestinal tract. The aim of our study was to assess the prevalence of gastrointestinal (GI) symptoms on admission in patients with COVID-19 and their association with adverse outcomes, including mortality. Methods: In a retrospective study, we examined medical record data from patients with SARS-CoV-2 infection admitted to epidemic treatment center of hospital Aristide Le Dantec, Dakar (Senegal) between May 1, 2020, and June 31, 2021. SARS-CoV-2 infection was diagnosed by real-time polymerase chain reaction on nasopharyngeal and throat swabs. We included all patients with SARS-CoV-2 infection and GI symptoms. Result: The study identified 472 hospitalized patients with confirmed SARS-CoV-2 infection during the study period. We recruited 222 patients with gastrointestinal symptoms. The mean age of patients with GI symptoms was 56 years [17 - 90 years], and 54.9% were male. Patients with GI symptoms had comorbidities in 66.2% of cases. Hypertension, diabetes mellitus and chronic kidney disease were the most common comorbidities at 29.3%, 23.9%, and 6.7%, respectively. Patients with GI had cough in 69.4%, shortness of breath in 61.7%, ageusia in 57.6%, and fever in 53.1%. At presentation among patients with GI symptoms, 32.4% had mild disease, 27.5% had moderate disease, and 40.1% had severe disease. The prevalence of digestive manifestations was 47%, and the main digestive manifestations were nausea (27%), diarrhea (17.1%), abdominal pain (17.1%) and vomiting (14.4%). GI symptoms such as abdominal pain, diarrhea, and vomiting were more common in those with hypertension (45%) and those with diabetes (43%). Conclusion: Gastrointestinal symptoms are common in patients with COVID-19. During a pandemic, patients with GI symptoms should be considered for SARS-CoV-2 infection.
SalamatA Diallo, Mariéme Polele Fall, Marie Louise Bassène, Mamadou Ngoné Gueye, Mame Aissé Thioubou, Cheikh Ahmadou Bamba Cissé, Alioune Badara Fall, Abdoul Aziz Atteib Fall, Alsine Yauck
Open Journal of Gastroenterology, Volume 12, pp 98-106; https://doi.org/10.4236/ojgas.2022.124010

Abstract:
Viral hepatitis C is a major public health problem. The aim of our work was to determine the epidemiological, diagnostic and treatment profiles of patients with HCV in Dakar (Senegal). We conducted a retrospective, descriptive, multicentre study between January 1, 2010, and December 31, 2019. We included 26 patients. The mean age of the patients was 53.5 years [28 - 70 years] and 46.2% were males. Of the 26 patients included, 7 (26.9%) were Senegalese, and the majority were from other African countries. Risk factors for contamination found were surgery in 11 patients (42.3%) and blood transfusion in 1 patient (3.8%). The mean viral load was 6.47 log IU/ml [4.26 - 7.26 log IU/ml]. Ten patients were infected by genotype 4. No patients were co-infected with HIV or HBV. Six patients (23.1% of patients) had significant fibrosis, of which five (19.2% of patients) were in the stage of cirrhosis. Twelve patients (46.2%) started treatment. Eleven were treatment-naïve and 1 did not respond to ribavirin-pegylated interferon-based therapy after 48 weeks. Ten cases of antiviral therapy were based on DAA and ribavirin-pegylated interferon in 2 patients. For the patients treated with peginterferon and ribavirin, a rapid virologic response was observed at 12 weeks in one patient, and the other patient was lost to follow-up. Among DAA-treated patients, 7 had sustained virologic responses at 12 weeks, 2 persisted, and 1 was lost to follow-up. Moderate thrombocytopenia and weight loss were observed in one patient receiving peginterferon and ribavirin. In our study, no patient died on treatment and no patients developed de novo HCC during or after DAA therapy. Conclusion: Viral hepatitis C is rare in Senegal. Despite the progress made in the therapeutic management of viral hepatitis C, it remains a challenge in Senegal. Indeed, DAAs are expensive and are not marketed, which makes them inaccessible to most patients.
Antoine Tshimpi, Patrick De Jésus Ngoma-Kisoko, Aurore Beia, Tressy Kalenga-Ngomba, Jacqueline Nkondi, Fabrice Bokabanja, Heritier Mawalala, Trésor Monsere, Pitshou Kengibe, Mireille Nganga Nkanga, et al.
Open Journal of Gastroenterology, Volume 12, pp 71-87; https://doi.org/10.4236/ojgas.2022.123008

Abstract:
Introduction: Helicobacter pylori (Hp) infection is a worldwide public health problem. Unfortunately, its management poses a problem because of resistance to antibiotics. However, there are codified treatment protocols covering sequential and concomitant quadritherapy with regard to first-line probabilistic treatment. The objective of this study was to assess the therapeutic efficacy of these 2 treatment regimens in the management of Hp infection at Kinshasa. Methods: This was a mixed study, with documentary, descriptive and interventional approaches, carried out between September 1, 2018 and April 30, 2020. Results: Sixty-four patients were collected, including 36 men against 28 women with a sex ratio of 1H:1F; the mean age was 54 ± 16.5 years. There was an over-representation of senior patients (n = 29); an intermediate number of adult patients (n = 22) and a lower number of young patients (n = 13). 34 and 30 were respectively treated according to the concomitant and sequential regimens. Concomitant quadruple therapy offered an eradication rate of 91.2% compared to 56.7% for sequential quadruple therapy; concomitant treatment, advancing age and absence of risky behavior more quickly predicted the occurrence of eradication success. Conclusion: The present study showed superiority of concomitant quadruple therapy over sequential quadruple therapy in first-line treatment. Alcohol with active smoking had a negative influence, while concomitant quadruple therapy, advancement in age had a positive influence on the success of the eradication of Hp infection.
Nsenga Djapa Guy Roger, Fogang Fogoum Yannick, Ndjitoyap Ndam Antonin Wilson, Kowo Pierre Mathurin, Ankouane Andoulo Firmin, Choukem Simon Pierre
Open Journal of Gastroenterology, Volume 12, pp 129-135; https://doi.org/10.4236/ojgas.2022.125013

Abstract:
Background: Biermer disease is a megaloblastic disease caused by vitamin B12 deficiency. It is a rare clinical entity especially in subsahara Africa. Case presentation: We report the case of a 45 years old female patient who consulted for a one month history of generalised muscle cramps, weakness and numbness of all four limbs. Physical examination was relevant for a poor gait, poor coordination of both upper and lower limbs, a positive Romberg sign, normal muscle tone in all four limbs, reduced pallesthesia and deep tendon reflexes, abolished plantar reflexes. Paraclinical investigations revealed macrocytosis without anemia, a low cyanocobalamin (vitamin B12) level with a normal folic acid level, an atrophic corporeofundic mucosa which upon pathological analysis revealed a chronic atrophic gastritis with no Helicobacter pylori infection. Anti-intrinsic factor antibodies were positive while anti parietal cells antibodies were negative. The diagnosis of Biermer disease was considered and the patient did well on vitamin B12 supplementation. Conclusion: Though a rare disease, Biermer disease should be considered in a patient who consults for polyneuropathy even in the absence of anemia.
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