Jaber Al-Ali

Publications (2)2.41 Total impact

• Article: Endoscopic management of gastric variceal bleeding with cyanoacrylate glue injection: safety and efficacy in a Canadian population.

  Jaber Al-Ali, Monika Pawlowska, Alan Coss, Sigrid Svarta, Michael Byrne, Robert Enns
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  ABSTRACT: Gastric variceal bleeding (GVB) is a major cause of morbidity and mortality among patients with portal hypertension. Endoscopic band ligation and standard sclerotherapy have been used but have significant limitations. Decompression through transjugular intrahepatic portosystemic shunt insertion has been shown to be effective. Gastric variceal injection therapy with a commercially available cyanoacrylate glue is less invasive than transjugular intrahepatic portosystemic shunt insertion and has recently been shown to be effective for acute hemostasis. To assess the immediate and long-term outcomes of cyanoacrylate glue injection therapy for GVB. A retrospective chart review was conducted to identify patients treated with cyanoacrylate injection for GVB at two tertiary care hospitals over a period of six years. The outcomes assessed included complications, acute hemostasis, rebleeding rate and all-cause mortality. Thirty-seven patients (60% men) underwent cyanoacrylate glue injections for GVB. The median follow-up period was 14 months and included 29 patients (eight were lost to follow-up). Initial hemostasis was achieved in 35 patients (95%). No significant complications from cyanoacrylate injection were observed. Early rebleeding was rare (8%) and late rebleeding occurred in only 28% of patients. The all-cause mortality rate was 28.6% during the median follow-up period. The data suggest that cyanoacrylate injection therapy is safe and effective for the prevention of short- and long-term bleeding from gastric varices. Furthermore, although these patients had significant comorbid disease, survival in the follow-up time period was greater than 70%.
  Canadian journal of gastroenterology = Journal canadien de gastroenterologie 10/2010; 24(10):593-6. · 1.21 Impact Factor
• Article: Diagnostic performance of gastric imprint smear for determination of Helicobacter pylori infection.

  Jaber Al-Ali, Fahad Al-Asfar, Rita Dhar, Piyaray M Dhar, Kapila Kusum
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  ABSTRACT: Despite the availability of several methods (invasive and noninvasive) for the diagnosis of Helicobacter pylori infection, no test is considered to be the 'gold standard'. Endoscopy-based tests are regarded as the reference method in most studies. To evaluate the diagnostic performance of imprint cytology smears of antral biopsies compared with Gram-stained smears, the rapid urease test and culture methods, separately and in combination. Antral biopsies were obtained from consecutive patients undergoing upper gastrointestinal endoscopy at a single centre. The biopsies were examined for the presence of H pylori by Gram-stained smear, the rapid urease test, culture methods and imprint cytology smear. A total of 273 biopsies were studied. All tests were positive in 36% of the patients. Of 252 biopsies tested, 73% were positive using the imprint cytology technique. Using Gram-stained smear, the rapid urease test and culture methods individually, the sensitivity and specificity of imprint cytology smears for the detection of H pylori were found to be 92.7% and 50%; 92.7% and 49%; and 92.4% and 38.5%, respectively. Combining the three microbiological methods resulted in a sensitivity of 92.1%, a specificity of 51.0% and an efficiency of 71.7% for imprint cytology smears. Endoscopic examination provides useful clinical information. Imprint gastric cytology can be used as a rapid test to establish the diagnosis of H pylori infection at the time endoscopy is performed, enabling the endoscopist to start treatment with immediate effect.
  Canadian journal of gastroenterology = Journal canadien de gastroenterologie 10/2010; 24(10):603-6. · 1.21 Impact Factor