Shiran Shetty

Manipal Academy of Higher Education | MAHE · Department of Gastroenterology

Background and study aims Secondary prophylaxis with norfloxacin reduces recurrence of spontaneous bacterial peritonitis (SBP) significantly. No data available from Asia-Pacific region about recurrence of SBP in these patients. Patients and methods In a retrospective cohort study, we assessed recurrence rate of SBP in patients on norfloxacin second...

Background Primary esophageal motility disorders present with a spectrum of symptoms where manometry plays an important role. We designed this study to evaluate the utility of esophageal manometry among various symptoms Materials and Methods This is a single-center observational study conducted over 5 years in a tertiary referral center. A total o...

Helicobacter pylori (H. pylori) infection is one of the primary risk factors of peptic ulcer disease worldwide. Treatment of H. pylori with the conventional dosage form is often challenging due to the ineffective reach of the antibiotics to the inner layers of gastric mucosa, where the organism resides. This study developed an eco-friendly, stabili...

Acute kidney injury (AKI) occurs frequently in patients with end-stage liver disease and cirrhosis and is associated with increased short-term mortality. This study aims to study the prevalence and risk factors associated with AKI development and mortality in cirrhosis of liver patients. In the current prospective study, hospitalized patients with...

Liver cancer is one of the most prevalent types of cancer and a major contributor to the socioeconomic burden worldwide. The pathogenesis of hepatocellular carcinoma (HCC) is contributed by various etiological factors like virus infection, excessive alcohol consumption, exposure to toxins, or metabolic disorders. Majority of patients are diagnosed...

Helicobacter pylori (H. pylori) infection is the leading cause of chronic peptic ulcer disease worldwide. Many treatment options are available to treat H. pylori infection. However, the eradication is still a challenge due to the poor bioavailability of the currently available formulations. To improve the efficacy of therapy, novel formulations are...

Pancreatic cancer is one of the common causes of cancer-associated mortality with a dismal overall prognosis which has remained virtually unchanged over decades. In the present era, the management of patients with pancreatic cancer involves a multi-disciplinary team of radiologists, gastroenterologists, surgical oncologists, medical oncologists, ra...

Background Medications can rarely cause esophageal injury and present with acute symptoms. Multiple factors, including the type of medication, comorbidity, and method of ingestion play a role in causing drug-induced or pill esophagitis (PE). We analyzed the clinical, endoscopic, and histopathological profiles of PE cases at our gastroenterology out...

Objective We performed a systematic review to analyze the benefits of and risk factors associated with granulocyte colony stimulating factor (GCSF) in patients with liver cirrhosis. Methods PubMed, Scopus, and Embase were searched for randomized controlled trials and case–control studies that compared the use of GCSF with another treatment or cont...

Clinical Indicators of sarcopenia in chronic pancreatitis.

Peptic ulcer disease (PUD) is one of the most prevalent gastro intestinal disorder which often leads to painful sores in the stomach lining and intestinal bleeding. Untreated Helicobacter pylori (H. pylori) infection is one of the major reasons for chronic PUD which, if left untreated, may also result in gastric cancer. Treatment of H. pylori is al...

Oesophageal anastomotic leaks are serious complications with high mortality (20-50%)1 especially in the post-operative setting of malignant disease. They occur in 5-30% of cases,1 usually presenting with severe mediastinal sepsis. Revision surgery has been replaced by the use of endoscopic stents, clips, glue and vacuum therapy. The latter is the s...

Background and aim: Oesophageal candidiasis (OC) is one of the most common infections among patients with liver cirrhosis. The present study evaluates the potential predictors for OC among liver cirrhosis patients. Methodology: This retrospective study was conducted in the tertiary care centre of coastal Karnataka from January 2016 to April 2022...

Inosine monophosphate dehydrogenase (IMPDH) is a crucial enzyme involved in the de novo synthesis of purine nucleotides. IMPDH activity is used to evaluate the pharmacodynamics/pharmacokinetics of immunosuppressant drugs such as mycophenolic acid and thiopurines. These drugs are often used to prevent organ transplant rejection and as steroid-sparin...

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract. Crohn's disease (CD) and Ulcerative Colitis (UC) are the two major types affecting millions across the globe. Various Immunomodulatory drugs consisting of small molecules (thiopurines, methotrexate and tofacitinib) and biologics are used...

Background: Acute on chronic liver failure (ACLF) is a condition precipitated by acute insult in a background of cirrhosis, which has a distinct clinical prognosis. qSOFA (Sequential Organ Failure Assessment), being simple bedside scoring system has been used in sepsis patients to predict the mortality. This study aimed at comparing qSOFA with exis...

Background Clinical features are of modest benefit in determining the etiology of dyspepsia. Dyspeptic patients with alarm features are suspected to have malignancy; but the proportions of patients and true cutoff values of various quantitative parameters in predicting malignancy are explored to a lesser extent. Methods This is a prospective obser...

Background: Patients with inflammatory bowel disease (IBD) have numerous risk factors for low bone mineral density (BMD). We aimed to study the prevalence of low BMD in IBD and the factors associated with it. Methods: BMD was measured by radial quantitative ultrasound, and clinical and biochemical characteristics were compared in prospectively e...

Background Proton Pump Inhibitor (PPI) is the commonest prescribed drug in gastroenterology practice due to its proven effectiveness for a variety of indications. Long-term use contributes to adverse events. There is a large unmet need to evaluate the appropriateness of prescribing PPI therapy. Methods A cross-sectional study was conducted over th...

Background Due to increased prevalence of H. pylori antimicrobial resistance worldwide and more importantly the resistance patterns vary between different geographical regions, it is important to survey local H. pylori antibiotic resistance profile to provide physicians with more informed drug choices to better treat H. pylori infection. To our kno...

Descriptive study on esophageal motility disorders and Manometry findings.

Background Vaccination is the most cost-effective strategy in disease prevention but remains an ambiguous area in Inflammatory Bowel Disease (IBD). Most patients will require immunomodulators/biologics at some time point; hence there exists a large unmet need for vaccination. Guidelines are not strict around the world while western guidelines are n...

Background Cultural, local dietary and social factors, the frequency of malignancy in the population studied are known to affect the epedimiology of dyspepsia. Clinical features are highly unreliable in determining the aetiology of dyspepsia. Alarm features are known to help in identifying underlying malignancy in patients with dyspepsia. However,...

Introduction: Recurrent Acute Pancreatitis (RAP) and Chronic Pancreatitis (CP) are labeled as idiopathic when no identifiable factors are found. The identifications of genetic mutations associated with pancreatitis have provided opportunities for identifying patients at risk for idiopathic pancreatitis. Aim: The aim of the present study was to stud...

Background Helicobacter pylori affects almost half of the world's population and therefore is one of the most frequent and persistent bacterial infections worldwide. H. pylori is associated with chronic gastritis, ulcer disease (gastric and duodenal), mucosa-associated lymphoid tissue lymphoma, and gastric cancer. Several diagnostic methods exist t...

Background/objectives Minimal hepatic encephalopathy (MHE), though highly prevalent, is a frequently underdiagnosed complication of cirrhosis of the liver. Because lack of time is reported as the major reason for non-testing, identifying patients at high risk of MHE would help in targeting them for screening. We aimed to determine the factors assoc...

Giant-cell hepatitis (GCH) is characterized by parenchymal inflammation with formation of large multinucleated hepatocytes in response to a variety of insults to the liver. Although it is commonly described in neonates, it rarely occurs in adults. Here we report a case of GCH due to herbal medicine intake.

Biliary obstruction in chronic calcific pancreatitis (CCP) is often caused by inflammatory or fibrotic strictures of the bile duct, carcinoma of head of pancreas or less commonly by compression from pseudocysts. Pancreatic calculi causing ampullary obstruction and leading to obstructive jaundice is extremely rare. The medical records of all patient...

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder, which affects various internal organs and has a tendency for bleeding. It has a classic triad of mucocutaneous telangiectasias, recurrent hemorrhages and positive familial history of first-degree relative. Epistaxis or gastrointestinal telangiectasia can be fatal in a sm...

Context: Pancreatico-pleural fistula is rare complication of chronic or acute pancreatitis. Previous studies have reported imaging features and various management options of this condition including conservative/medical management, endoscopic treatments and surgery.This article reviews the myriad of imaging appearances of this condition in multimo...

Introduction: Prophylactic antibiotics are used frequently for acute pancreatitis (AP). Consensus guidelines do not recommend this currently, based on moderate quality evidence. In this study, we aimed to evaluate the antibiotic use pattern in AP in India and propose a risk-directed approach to antibiotic use in AP. Material and methods: This mu...

Jaundice in Grave's diseases is uncommon, but when it does occur, complication of thyrotoxicosis (heart failure/infection) or intrinsic liver disease should be considered. Grave's disease can cause asymptomatic elevation of liver enzymes, jaundice and rarely acute liver failure. It is associated with other autoimmune diseases like autoimmune hepati...

To study the IMT of the common carotid arteries and correlate with documented coronary artery disease. The study was conducted in subjects with history of coronary artery disease in the past and who presented with acute coronary syndrome. After detailed history and examination, investigations were carried out as per our protocol. The sample size wa...