GI Endoscopy Research Articles

A Case Report on Peritoneal Tuberculosis in an Immunocompromised Patient

Background: Peritoneal tuberculosis (PTB) is one of the most challenging forms of extra pulmonary tuberculosis. Abdominal TB cases make up above 3% of all extra pulmonary TB as per the Index TB Guidelines. PTB is commonly due to reactivation of latent tuberculosis in the peritoneum. Numerous cases were still misdiagnosed due to nonspecific presentation. The golden standard for diagnosis is laparoscopic biopsy. Presenting signs and symptoms of PTB are unspecific such as ascites, abdominal pain and distension, fever, weight loss, diarrhea/constipation. Peritoneal tuberculosis is a significant cause of ascites in developing countries. The causative agent of peritoneal tuberculosis is Mycobacterium tuberculosis. Case Presentation: In this case study, a 52 year old male had complaints of progressive abdominal distension and fever for 2 weeks. Patient underwent diagnostic paracentesis, upper and lower GI endoscopy, biopsy and gene xpert to confirm peritoneal tuberculosis. Patient with peritoneal TB have gradually progressive abdominal swelling due to ascites and abdominal pain. Conclusion: Peritoneal tuberculosis should be considered in differential diagnosis. Differential diagnosis, especially in the developing countries or under developed countries. This case highlights the easy diagnosis of the condition other than the other case reports.

990 A Rare Case of Adenomyoma in Gastric Pylorus of a Young Adult Female: A Case Report

Abstract Introduction Gastric adenomyoma is a rare benign tumour which occurs 85% in antrum and 15% in pylorus. Although adenomyomas are benign, diagnosis is difficult as they are commonly found alongside with adenocarcinomas. Case report A 20-year-old previously healthy female presented with epigastric pain, gastric outflow obstruction features and weight loss for 3 months. Initial USS was followed by a CECT which, showed intramural mass lesion with necrotic centre arising from the inferior wall of the pre pyloric area of the stomach with acute inflammatory changes of the adjacent omental fat, giving differential diagnosis of GIST or gastrinoma at pyloric region. Subsequent upper GI endoscopy revealed a protruding pyloric mass without mucosal lesions. Unfortunately, the unavailability of EUS and biopsy posed a diagnostic hurdle. Intraoperatively, a mass intricately adhered to the transverse colon and omentum was discovered, leading to a surgical intervention involving distal gastrectomy, gastrojejunostomy, and jejunojejunostomy. Unexpectedly, histological analysis unveiled adenomyoma at the prepyloric area, characterized by Brunner’s glands, dilated glands, and heterotrophic small intestinal tissue. Discussion This rare manifestation of adenomyoma in the gastric pylorus, particularly in a young adult, highlights the challenges in accurate preoperative diagnosis. The favourable postoperative outcome prompts reflection on the potential role of advanced diagnostic tools, emphasizing the significance of EUS and biopsy in steering clear of extensive surgeries. Conclusions This case report underscores the crucial role of personalized diagnostic methods, especially in cases like ours where a rare adenomyoma mimicking other tumours.

Assessment of Anti-Reflux Suture in One Anastomosis Gastric Bypass for Prevention of Biliary Gastritis

Abstract Background Obesity continues to be a leading public health concern associated with many comorbidities and major hindering effect on the daily lifestyle of many people around the world. Surgical treatment for obesity has proved that it is the best and most effective, durable means of preventing the life-threatening complications and serious problems associated with morbid obesity. Objective Assessing the effect of the anti-reflux suture on the incidence and clinical consequences of bile reflux in OAGB Procedure. Patients and Methods In this prospective randomized study, 30 patients were selected in Ain Shams University hospitals between November 2021 and May 2022 for assessment of impact of Anti reflux suture on the incidence of post OAGB biliary gastritis. Results The cases presented in this study did not undergo upper GI endoscopy when they presented with symptoms of reflux or gastritis and thus it was not possible to differentiate between the presence of GERD or biliary gastritis as the source of their symptoms. Conclusion OAGB is safe and one of the leading procedures for treatment of obesity but it is still surrounded by controversy regarding its relation and effect on bile reflux gastritis. As far as this study shows, the anti-reflux suture modification alone does not seem to prevent the incidence of biliary reflux gastritis post OAGB.

Diagnostic Yield of Same Setting Oesophago-Gastro-Duodenoscopy (OGD)and Colonoscopy for Pediatric Patients with Chronic Diarrhea

Abstract Background In patients with unexplained chronic diarrhea colonoscopy and upper GI endoscopy are helpful in the diagnosis. It is the routine practice in Ain Shams University pediatric endoscopy unit to perform both procedures at same setting for patients with unexplained chronic diarrhea. Aim of the Work To find out whether doing Oesophago-gastro-duodenoscopy (OGD) and colonoscopy in patients with chronic diarrhea in one setting is essential for the diagnosis of all cases. Patients and Methods Fifty patients presenting with chronic unexplained diarrhea (>4 weeks duration) in Paediatric Gastroenterology Unit, Children’s Hospital, Ain-Shams University were enrolled. After full history taking, physical examination, both endoscopies were performed biopsy taken and histopathological recording for each sample. Results Of 50 patients with chronic diarrhea included in our study; 23 (46%) had positive endoscopic findings in the OGD. Most common findings in esophagus and stomach were inflammation and erythema. while most common findings in duodenum were edema and flattened mucosa. Colonoscopy findings were positive in 50% of patients including inflammation, nodularity, and edema mostly in the ileum. 50% of endoscopied patients reached final diagnosis based on endoscopy and histopathology. Definitive diagnosis reached through EGD alone in (12%) of cases, through colonoscopy alone in (28%) and through both techniques in (60%). There was no statistical significant agreement between endoscopy findings and predominant gastrointestinal manifestations including different types of diarrhea, fecal calprotectin with p-value =0.150, and 0.833 respectively. There was no statistical significant agreement between final diagnosis and suspected GIT part involvement on initial clinical evaluation with p- value=0.805. Conclusion Endoscopy for upper gastrointestinal tract and colonoscopy at same day may be helpful in diagnosis of cases with chronic diarrhea as we can't decide which one to perform based on clinical presentation.

ENDO 2024 - 4th World Congress of GI Endoscopy, 4-6 July 2024, COEX Convention & Exhibition Center, Seoul, Korea.

ENDO 2024 - 4th World Congress of GI Endoscopy, 4-6 July 2024, COEX Convention & Exhibition Center, Seoul, Korea.

ENDO 2024 - 4th World Congress of GI Endoscopy, 4-6 July 2024, COEX Convention & Exhibition Center, Seoul, Korea.

ENDO 2024 - 4th World Congress of GI Endoscopy, 4-6 July 2024, COEX Convention & Exhibition Center, Seoul, Korea.

ENDO 2024 - 4th World Congress of GI Endoscopy, 4-6 July 2024, COEX Convention & Exhibition Center, Seoul, Korea.

ENDO 2024 - 4th World Congress of GI Endoscopy, 4-6 July 2024, COEX Convention & Exhibition Center, Seoul, Korea.

ENDO 2024 - 4th World Congress of GI Endoscopy, 4-6 July 2024, COEX Convention & Exhibition Center, Seoul, Korea.

ENDO 2024 - 4th World Congress of GI Endoscopy, 4-6 July 2024, COEX Convention & Exhibition Center, Seoul, Korea.

HGG-01. DURABLE RESPONSE TO IMMUNOTHERAPY IN AN ADOLESCENT PATEINT WITH CONSTITUTIONAL MISMATCH REPAIR DEFICIENCY CMMRD AND SYNCHRONOUS THREE PRIMARY MALIGNANCIES

Abstract BACKGROUND Familial Cancer Syndrome FCS is of particular concern in Saudi Arabia due to the high rates of consanguinity. Constitutional mismatch repair deficiency Syndrome (CMMRD) is an autosomal recessive FCS with a wide spectrum of malignancies Caused by Biallelic germline mutations in one of 4 mismatch repair genes (MLH1, PMS2, MSH2, and MSH6). METHODS we report 13 yr. Saudi boy, previously healthy with multiple café-au-lait (CAL) macules, and Consanguineous parents with a positive family history of Malignancy. presented with progressive headache, vomiting, abdominal pain, weight loss, and microcytic anemia. MRI Brain showed a Large left hemispheric necrotic mass, MRI abdomen: Circumferential gastric body wall thickening Distal transverse colon intraluminal polypoid mass, and liver hypodense lesion. He had a Resection of the brain tumor and Upper GI endoscopy + colonoscopy with polypectomy: which showed an Ugly gastric ulcer, and multiple colonic polyps. RESULTS Brain tumor molecular pathology: Gliosarcoma WHO grade 4 with negative IHC expression in PMS2 protein, hypermutant tumor with somatic PMS2 ATRX, TP53, NFI, and PIK3R1 genes mutation. stomach biopsy confirmed invasive gastric adenocarcinoma and Colonic polyp biopsy: Tubulovillous adenoma. Genetic testing Detect pathogenic Biallelic germline PMS2 mutation. He received adjuvant focal Brain radiation therapy 59.4Gy/33 F concurrent with immunotherapy (PD-1) inhibitor Nivolumab. Follow-up Abdominal imaging showed excellent response to immunotherapy with no significant residual lesion. MRI of the brain showed surgical bed multi-cystic lesions with thick nodular enhancement suggestive either of radiation necrosis vs. progressions/pseudoprogression. repeated MRI confirmed further progression of the enhancing surgical cavity lesion which was unresectable. CTLA-4 Inhibitor ipilimumab was added to Nivolumab to optimize therapy. UpToDate our patient is clinically stable on Maintenance Nivolumab with no side effects. CONCLUSION Our case confirms immunotherapy’s efficacy for treating CMMRD-related cancers, which can improve survival while reducing toxicity from less effective conventional therapies.

Gastric Polyps in Long-Term Proton Pump Inhibitor Use: Identification of Risks and Characteristics.

Aim Estimate the prevalence of gastric polyps linked to long-term use of proton pump inhibitor (PPI), determine the various risk factors that promote this association, and identify the characteristics associated with these polyps. Methods This prospective cross-sectional study was conducted on approximately 1000 patients presenting to the Gastroenterology Endoscopic Department for upper GI endoscopy at two hospital centers in Beirut, Lebanon, over a period of 12 months from September 2021 to September 2022. The demographic and clinical data of patients who had been taking PPIs for at least one month were collected via a questionnaire. All patients with a previous Helicobacter pylori (H. pylori) infection, presence of hypergastrinemia, or a personal/family history of gastric polyps were excluded from this study. Statistical analyses were performed using SPSS 20 software. Categorical variables were compared by Fisher's exact test; p-values of less than 0.05 were considered statistically significant. Results The prevalence of gastric polyps linked to long-term PPI use was 30%. The minimum duration of daily PPI use required for the formation of polyps is around 24 months. The dosage did not play a significant role in increasing this prevalence. A significant correlation was found between chronic PPI use and factors such as sex, age range, duration, and type of PPI used. These polyps were predominantly found in females (with an OR of 2.9), increased with age, were mostly of the fundic gland type, and their size was proportionally linked to both the dosage and duration of daily PPI use. No cases of dysplasia within the fundic gland polyps (FGPs) were demonstrated in our study. Conclusion To date, there is no current data that prove an association between gastric cancer and PPI-induced FGPs. Additionally, the incidence of FGPs has increased with the widespread chronic use of PPIs. Therefore, attention should be drawn to the potential risk of dysplasia. Thus, the present study highlights the importance of limiting the prescription of PPIs to globally well-defined indications and determining the various risk factors that promote the association between gastric polyps and PPI use. This abstract was recently presented as an E-poster at the ESGE Days 2024 Congress on April 25-27, 2024, in Berlin, Germany.

Clinical and endoscopic characteristics of patients undergoing gastrointestinal endoscopic procedures in Egypt: a nationwide multicenter study

BackgroundEgypt faces a significant public health burden due to chronic liver diseases (CLD) and peptic ulcer disease. CLD, primarily caused by Hepatitis C virus (HCV) infection, affects over 2.9% of the population nationwide, with regional variations. Steatotic liver disease is rapidly emerging as a significant contributor to CLD, especially in urban areas. Acid-related disorders are another widespread condition that can significantly impact the quality of life. These factors and others significantly influence the indications and findings of gastrointestinal endoscopic procedures performed in Egypt.AimWe aimed to evaluate the clinico-demographic data, indications, and endoscopic findings in Egyptian patients undergoing gastrointestinal endoscopic procedures in various regions of Egypt.MethodsThis study employed a retrospective multicenter cross-sectional design. Data was collected from patients referred for gastrointestinal endoscopy across 15 tertiary gastrointestinal endoscopy units in various governorates throughout Egypt.Results5910 patients aged 38–63 were enrolled in the study; 75% underwent esophagogastroduodenoscopy (EGD), while 25% underwent a colonoscopy. In all studied patients, the most frequent indications for EGD were dyspepsia (19.5%), followed by hematemesis (19.06%), and melena (17.07%). The final EGD diagnoses for the recruited patients were portal hypertension-related sequelae (60.3%), followed by acid-related diseases (55%), while 10.44% of patients had a normally apparent endoscopy. Male gender, old age, and the presence of chronic liver diseases were more common in patients from upper than lower Egypt governorates. Hematochezia (38.11%) was the most reported indication for colonoscopy, followed by anemia of unknown origin (25.11%). IBD and hemorrhoids (22.34% and 21.86%, respectively) were the most prevalent diagnoses among studied patients, while normal colonoscopy findings were encountered in 18.21% of them.ConclusionThis is the largest study describing the situation of endoscopic procedures in Egypt. our study highlights the significant impact of regional variations in disease burden on the utilization and outcomes of GI endoscopy in Egypt. The high prevalence of chronic liver disease is reflected in the EGD findings, while the colonoscopy results suggest a potential need for increased awareness of colorectal diseases.

Augmented reality navigation systems in endoscopy

Navigation assistance has become part of our daily lives and its implementation in medicine has been going on for the last 3 decades. Navigation is defined as the determination of a position in space in the context of its surroundings. While routing applications used in cars highlight the street to follow, in medical applications the real-world perception of the user is enriched by digital elements that provide guidance and help the user navigate. Unlike Virtual Reality (VR) solutions, which are mainly used for training, Augmented Reality systems (AR) do not require the user to wear specific headsets/goggles, but the virtual elements are overlaid over the real image displayed on a monitor. Depending on the application and the indication, there are large differences in how much these solutions have entered clinical routine. Especially in the fields of GI endoscopy and laparoscopy, AR navigation solutions are less prominently employed in clinical practice today and still hold significant potential to elevate patient care by improved physician support. This review touches upon why AR navigation systems are currently just starting to become implemented in the GI/laparoscopic clinical routine and which applications can be expected in the GI endoscopy and laparoscopy field. By taking the practitioner’s perspective and following the intuitive navigation workflow, it gives an overview of major available and potential future AR-applications in the GI endoscopy and laparoscopy space, the respective underlying technologies, their maturity level and their potential to change clinical practice.

Cost-Effectiveness of the Baveno VI Criteria Compared With Endoscopy for High-Risk Varices in Patients With Child-Pugh A Cirrhosis

Although upper gastrointestinal endoscopy (EGD) remains the gold standard for detecting varices in cirrhosis, the Baveno VI criteria proposed a combination of transient elastography and platelet count that could rule out high-risk varices, therefore sparing the need for an endoscopy, with significant potential cost savings. We performed a cost-effectiveness analysis of the Baveno VI criteria compared with EGD in the diagnosis of high-risk varices in cirrhosis. We built an analytical decision model to estimate the cost and benefits of using the Baveno VI criteria compared with EGD in patients with Child-Pugh A cirrhosis. The analysis was performed from the UK National Health Service perspective, over 1, 5, and 20 years. A Markov model was populated with data from published evidence. Outcomes were measured in terms of quality-adjusted life years (QALYs) and avoided deaths. The analyses were repeated for Canada and Spain, using relevant cost inputs. The Baveno VI criteria were cost effective compared with endoscopy in all analyses. For 1000 patients, they produced 0.16 additional QALYs at an incremental cost of £326 ($443.41) over 5 years, resulting in an incremental cost of £2081 ($2830) per additional QALY gained. The incremental net monetary benefit of Baveno VI compared with EGD was £2808 ($3819) over 5 years per patient. Baveno VI criteria also were cost effective in Canada and Spain. Deterministic and probabilistic sensitivity analysis supported these findings. The findings demonstrate that the Baveno VI criteria are cost effective, suggesting that they should be considered for widespread implementation on the basis of safety, appropriateness, and economic grounds.

Endoscopic diagnosis and treatment of primary multiple noninvasive malignant neoplasms of the stomach: clinical case

This clinical case describes a rare combination of early stage cancer and sporadic neuroendocrine tumor in stomach. The patient 57 years old admitted to P. A. Hertsen Moscow Oncology Research Institute for diagnostics and treatment for the gastric adenoma. Upper GI endoscopy performed in P. A. Hertsen Institute, detected two tumors: a sporadic neuroendocrine tumor in the middle part of the body stomach and early cancer in the antrum. With NBI (Narrow-Band Imaging), signs of malignancy were found in both tumors. А plan for therapeutic and diagnostic endoscopic surgical interventions was implemented: two sequential endoscopic submucosal dissection (ESD). This treatment confirmed as radical, according to the results of the pathological examination.

The 2023 top 10 list of endoscopy topics in medical publishing: an annual review by the American Society for Gastrointestinal Endoscopy Editorial Board

Using a systematic literature search of original articles published during 2023 in Gastrointestinal Endoscopy (GIE) and other high-impact medical and gastroenterology journals, the GIE Editorial Board of the American Society for Gastrointestinal Endoscopy compiled a list of the top 10 most significant topic areas in general and advanced GI endoscopy during the year. Each GIE Editorial Board member was directed to consider 3 criteria in generating candidate topics-significance, novelty, and impact on global clinical practice-and subject matter consensus was facilitated by the Chair through electronic voting and a meeting of the entire GIE Editorial Board. The 10 identified areas collectively represent advances in the following endoscopic spheres: GI bleeding, endohepatology, endoscopic palliation, artificial intelligence and polyp detection, artificial intelligence beyond the colon, better polypectomy and EMR, how to make endoscopy units greener, high-quality upper endoscopy, endoscopic tissue apposition and closure devices, and endoscopic submucosal dissection. Each board member was assigned a topic area around which to summarize relevant important articles, thereby generating this overview of the "top 10" endoscopic advances of2023.

STUDY OF PHYSIOLOGICAL AND BIOCHEMICAL VARIATIONS IN POPULATION GROUPS UNDERGOING ACUTE OR CHRONIC STRESS

Objective: Stress arises from derangements of personal and professional activities. The basic reason is changes in lifestyle and psychosocial adaptations. Life becomes demanding, complicated, mechanical, and devoid of health. In today’s modern world, occupational stress has become the major factor for loss of health and peacefulness of mind. Methods: This is an observational descriptive study which was conducted in a group of 84 people between 25 and 60 years of age to study the association of acute stress on salivary amylase level and effect of chronic stress on lipid profile, glycosylated hemoglobin and certain inflammatory markers in people representing different forms of stress. Three groups of the population were studied. Group 1 (n=20) - Patients undergoing any elective surgery (abdominal/genitourinary) or an invasive diagnostic procedure (upper GI endoscopy, lymph node biopsy) Group 2 (n=32) – High/middle socio-economic male or female working for ≥8 h/day with or without stress. Group 3 (n=32) – Low socioeconomic male or female earning <100 Rs/day with or without stress. Salivary alpha-amylase and chromogranin A (CgA) levels are good markers of stress. Results: There was increased levels of cortisol (p<0.0001), alpha amylase (p<0.01), and decreased levels of CgA (p<0.001) pre-procedure period as a marker of acute stress. In the chronic stress group of low income as well as high-income status, glycosylated hemoglobin, and blood lipid profile in both males and females were significantly deranged. Plasma malondialdehyde (MDA) levels and interleukin (IL)-1 and IL-2 were significantly raised in both groups. Serum ferritin level was low in the low socioeconomic group but normal in the high socioeconomic group. Conclusion: Salivary amylase level was raised in acute stress and there is a direct correlation of chronic stress with high low-density lipoprotein/ high-density lipoprotein ratio, raised glycosylated Hemoglobin, serum MDA, IL-1, 2 levels irrespective of economic group.

Contribution of Endoscopy in the Diagnosis of Digestive Pathologies in Children in the Pediatrics Department of Gabriel TOURE Hospital

Introduction: Upper GI endoscopy is a method of visual exploration of the upper part of the digestive tract using an optical tube fitted with a lighting system called an endoscope or fiberscope. In Mali, very few data are available on digestive endoscopy in children. The aim of our study was to demonstrate the role of endoscopy in the diagnosis of digestive pathologies in the pediatric department of Gabriel Toure hospital. Material and Methods: we conducted a retrospective study from January 2017 to December 2019 of children aged 0 to 15 years who had undergone upper GI endoscopy. Results: during our study period, 52 cases of digestive endoscopy were recorded out of 24326 children hospitalized in the Department of Pediatrics at Gabriel Touré hospital, representing a frequency of occurrence of 0.21%. The sex ratio was 0.92. 40.4% of our patients underwent endoscopy before 24 hours. Lesions were located in the esophagus in 28.8% of cases. Only 11.5% of children underwent biopsy, and the death rate was 3.8%. Conclusion: Digestive endoscopy is now a routine technique in paediatric gastrology, and represents a reliable diagnostic tool, provided that it is performed by an endoscopist trained in children and that the equipment is suitable

Super-specialty Medical Teleconsultations to Remote Areas of Ladakh, India via E-Sanjeevani under Hub-and-Spoke Model: A Pilot Study

Objectives: To assess the feasibility, spectrum, outcomes and challenges of delivering super-specialty consultations to remote areas of the Union Territory (UT) of Ladakh through telemedicine. Design: Prospective, observational (descriptive), pilot study Methodology: Super-specialty medical teleconsultations were provided to healthcare providers in UT Ladakh by specialists in the Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh from October 2021 to May 2022, employing the hub-and-spoke model of the Ayushman Bharat Digital Mission. Doctor-to-doctor teleconsultations were initiated by treating doctors at healthcare facilities in UT Ladakh on the eSanjeevani™ platform. Audio-video model was used for teleconsultation and digitally signed prescriptions were shared. Setting: India – Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh (hub) and healthcare providers in UT Ladakh (spokes) Participants: Healthcare providers in UT Ladakh and specialists in the Department of Telemedicine, PGIMER, Chandigarh Interventions: Super-specialty medical consultations using telemedicine (eSanjeevani™ platform) Main Outcome Measures: Demand and spectrum of superspecialty teleconsultations, outcome of consults (whether managed successfully at teleconsultation level, or required referral for in-person visits), and technical challenges faced. Results: A total of 26 super-specialty teleconsultations were provided; 14 (54%) were for women. Patient distribution was uniform across all age groups. The super-specialty-wise distribution of consultations was - 9 from endocrinology, 9 from neurology, 3 from hepatology, 2 from cardiology, and 3 from neonatology. Reasons for seeking consultation were assistance in diagnosis (3, 12%), optimization of therapy (10, 38%), or both diagnostic evaluation and treatment optimization (13, 50%). Five cases (19%) were referred for physical visits to a higher center for advanced diagnostic testing like liver biopsy, brain biopsy, upper GI endoscopy, etc.; other cases were managed remotely. Problems with audio-visual connectivity were encountered in three patients. Conclusion: This pilot study demonstrates that complex, super-specialty medical consultations can be effectively delivered to remote areas through telemedicine. Future research should focus on assessing long-term outcomes, patient satisfaction, and cost-effectiveness to better evaluate the impact of this model.

The prevalence of functional dyspepsia using Rome IV questionnaire among chronic kidney disease patients

ABSTRACT: Background: Symptoms of dyspepsia are usually encountered by chronic kidney disease patients. Abdominal discomfort is commonly seen in CKD patients with no other causes of organic affection. Aim: to determine the prevalence of functional dyspepsia in CKD patients, and which subtype is predominant in them. Materials and patients: This observational study included 150 CKD patients. Clinical and laboratory data were recorded for every patient. All the patients were interviewed using the ROME IV questionnaire of functional dyspepsia. Patients fulfilling criteria for functional dyspepsia were exposed to upper GI endoscopy. Results: Overall, 73 (48.7%) of CKD patients were males and 77 (51.3%) were females with mean age of (45.71 ± 9.59) and mean BMI (26.58 ± 5.39). The frequency of functional dyspepsia among CKD patients was determined to be 14.7% (22 out of 150 patients). Among those affected by functional dyspepsia, the most prevalent subtype was found to be Epigastric Pain Syndrome (EPS), accounting for 59% (13 out of 22 cases). The most common predictor of FD in CKD patients was chronic HCV infection, hemodialysis, stage of CKD and eGFR as revealed by Univariate regression analysis. Conclusion: The prevalence of FD amongst CKD patients is 14.7% with EPS the predominant subtype. Male patients, HCV patients, patients with higher CKD stages and highly impaired eGFR (low eGFR) are more probable to have FD.

Peptic Ulcer Disease among Patients Undergoing Upper Gastrointestinal Endoscopy in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Peptic ulcer is a common disease of gastrointestinal tract usually present with epigastric pain and discomfort. Upper gastrointestinal endoscopy is its gold standard investigation. There has been limited study on the prevalence of peptic ulcer disease among patients undergoing upper GI endoscopy especially in Nepal. Our study aimed to find the prevalence of peptic ulcer disease among patients undergoing upper GI endoscopy at our centre. A descriptive cross-sectional study was conducted among patients undergoing upper gastrointestinal endoscopy at a tertiary care centre from October 1, 2022 to March 31, 2023. Data was retrieved from hospital records using a preformed proforma and sample size of 219 was calculated and data of 273 cases was collected using the convenience method of sampling. Among 273 patients, peptic ulcer disease was found in 29 (10.62%) of patients among which 28 (10.25%) had antral ulcer and only 1 (0.36%) had duodenal ulcer. The prevalence of peptic ulcer disease is lower in our study centre compared to other studies and further studies can be conducted on the associated risk factors and socio-demographic distribution of peptic ulcer disease.