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| 1 | Diagnosis of Crohn's disease in India where tuberculosis is widely prevalent显示文摘AIM:To define the parameters that positively predict diagnosis of Crohn's disease (CD) and differentiate it from gastrointestinal tuberculosis (GITB). METHODS:This prospective study over 3 years was carried out in the consecutive Indian patients with definite diagnosis of CD and equal numbers of patients with definite diagnosis of GITB. Demographic, clinical, laboratory, morphological and histological features were noted in all the patients. Serological tests such as p-ANCA, c-ANCA, IgA ASCA and IgG ASCA, were performed. Endoscopic biopsy and/or surgical tissue specimens were subjected to smear and culture for acid-fast bacilli (AFB) and tissue polymerase chain reaction for tuberculosis (TB PCR). Diagnosis of CD and GITB was based on the standard criteria. Data were analyzed using univariate Chi-square test and multiple logistic regression (MLR). RESULTS:The study is comprised of 26 patients with CD (age 36.6 ± 8.6 year, male:female, 16:10) and 26 patients with GITB (age 37.2 ± 9.6 year, male:female, 15:11). The following clinical variables between the two groups (CD vs TB) were significant in univariate analysis:duration of symptoms (58.1 ± 9.8 vs 7.2 ± 3.4 mo), diarrhoea (69.2% vs 34.6%), bleeding per rectum (30.7% vs 3.8%), fever (23.1% vs 69.2%), ascites (7.7% vs 34.6%) and extra-intestinal manifestations of inflammatory bowel disease (61.5% vs 23.1%). Of these, all except ascites and extra-colonic manifestations were found statistically significant by MLR. Accuracy of predicting CD was 84.62% based on the fever, bleeding P/R, diarrhoea and duration of symptoms while it was 63.4% when histology was reported as inflammatory bowel disease and 42.3% when there was recurrence of disease after surgery. Accuracy of predicting GITB was 73.1% when there was co-existing pulmonary lesions and/or abdominal lymphadenopathy;75% when tuberculosis was reported in histology;63.4% when granuloma was found in histology;82.6% when TB PCR was positive;and 61.5% when smear and/ or culture was positive for AFB. Serological test was not useful in differentiation of CD from GITB. Positivity rates for CD and GITB were:p-ANCA-3.8% and 3.8%, c-ANCA-3.8% and 0%, IgA ASCA-38.4% and 23.1%, and IgG ASCA-38.4% and 42.3%, respectively. CONCLUSION:Simple clinical parameters like fever, bleeding P/R, diarrhoea and duration of symptoms have the highest accuracy in differentiating CD from GITB. | Deepak N Amarapurkar Nikhil D Patel Priyamvada S Rane | 2008 | World Journal of Gastroenterology2008，14，5： | 24 |
| 2 | Changing spectrum of Budd-Chiari syndrome in India with special reference to non-surgical treatment显示文摘AIM: To evaluate patterns of obstruction, etiological spectrum and non-surgical treatment in patients with Budd-Chiari syndrome in India.METHODS: Forty-nine consecutive cases of Budd-Chiari syndrome (BCS) were prospectively evaluated. All patients with refractory ascites or deteriorating liver function were, depending on morphology of inferior vena cava (IVC) and/or hepatic vein (HV) obstruction, triaged for radiological intervention, in addition to anticoagulation therapy. Asymptomatic patients, patients with diuretic-responsive ascites and stable liver function, and patients unwilling for surgical intervention were treated symptomatically with anticoagulation.RESULTS: Mean duration of symptoms was 41.5 ± 11.2 (range = 1-240) mo. HV thrombosis (HVT) was present in 29 (59.1%), IVC thrombosis in eight (16.3%), membranous obstruction of IVC in two (4%) and both IVC-HV thrombosis in 10 (20.4%) cases. Of 35 cases tested for hypercoagulability, 27 (77.1%) were positive for one or more hypercoagulable states. Radiological intervention was technically successful in 37/38 (97.3%): IVC stenting in seven (18.9%), IVC balloon angioplasty in two (5.4%), combined IVC-HV stenting in two (5.4%), HV stenting in 11 (29.7%), transjugular intrahepatic portosystemic shunt (TIPS) in 13 (35.1%) and combined TIPS-IVC stenting in two (5.4%). Complications encountered in follow-up: death in five, re-stenosis of the stent in five (17.1%), hepatic encephalopathy in two and hepatocellular carcinoma in one patient. Of nine patients treated medically, two showed complete resolution of HVT.CONCLUSION: In our series, HVT was the predominant cause of BCS. In the last five years with the availability of sophisticated tests for hypercoagulability, etiologies weredefined in 85.7% of cases. Non-surgical management was successful in most cases. | Deepak N Amarapurkar Sundeep J Punamiya Nikhil D Patel | 2008 | World Journal of Gastroenterology2008，14，2： | 9 |
| 3 | Thymosin alpha in the treatment of chronic hepatitis B:an uncontrolled open-label trial 显示文摘 | AMARAPURKAR D DAS HS | 2002 | Indian J Gastroenterol2002，21，2： | 1 |
| 4 | Asian Pacific Association for the Study of the Liver consensus statements on the diagnosis management and treatment of hepatitis C virus infection显示文摘 | McCaughan GW Omata M Amarapurkar D | 2007 | J Gastroenterol Hepatol2007，22，： | 1 |
| 5 | Non-alcoholic steatohepatitis in type 2 diabetes mellitus显示文摘 | Gupte P Amarapurkar D Agal S | 2004 | J Gastroenterol Hepatol2004，19，8： | 1 |
| 6 | Non-alcoholic steatohepatitis in type 2 diabetes mellitus显示文摘 | Gupte P Amarapurkar D Agal S | 2004 | J Gastroenterol Hepatol2004，19，： | 1 |
| 7 | Asian pacific association for the study of the liver consensus statements on the diagnosis,management and treatment of hepatitis C virus infection显示文摘 | McCANGHAN GW OMATA M AMARAPURKAR D | 2007 | J Gastroenterol Hepatol2007，22，5： | 1 |
| 8 | Natural history of hepatitis C virus infection显示文摘 | Amarapurkar D | 2000 | J Gastroenterol Hepatol2000，，： | 1 |
| 9 | Non-alcoholic steatohepatitis in type 2 diabetes mellitus 显示文摘 | Gupte P Amarapurkar D Agal S | 2004 | J Gastroenterol Hepatol2004，19，8： | 1 |
| 10 | Asian Pacific Association for the Study of the Liver consensus statements on the diagnosis, management and treatment of hepatitis C virus infection显示文摘 | McCanghan GW Omata M Amarapurkar D | 2007 | J Gastroenterol Hepatol2007，22，5： | 1 |
| 11 | Non - alcoholic steatohepatitis in type 2 diabetes rnellitus 显示文摘 | Gupte P Amarapurkar D Agal S | 2004 | J Gastroenteml Hepatol2004，19，： | 1 |
| 12 | Asian Pacific Association for the Study of the Liver consensus statements on the diagnosis,management and treatment of hepatitis C virus infection显示文摘 | McCaughan GW Omata M Amarapurkar D | 2007 | J Gastroenterol Hepatol2007，22，5： | 1 |
| 13 | Diagnostic laparoscopy in the era of modem imaging--retrospective analysis from a single center 显示文摘 | Amarapurkar D Bhatt N Patel N | 2013 | Indian J Gastroenterol2013，32，5： | 1 |
| 14 | Asian PacificAssociation for the Study of the Liver consensus statements on thediagnosis,management and treatment of hepatitis C virus infection显示文摘 | McCaughan GW Omata M Amarapurkar D | 2007 | J Gastroenterol Hepatol2007，22，5： | 1 |
| 15 | Primary biliary cirrhosis and autoimmune hepatitis switch over:report of 2 cases显示文摘 | Patei N Amarapurkar D Amarapurkar A | 2005 | Trop Gastroenterol2005，26，： | 1 |
| 16 | Non - alcoholic steato- hepatitis in type 2 diabetes mellitus 显示文摘 | Gupte P Amarapurkar D Agal S | 2004 | J Gastroenterol Hepatol2004，19，8： | 1 |
| 17 | Thymosin alpha in the treatment of chronic hepatitis B:an uncontrolled open-label trial显示文摘 | AMARAPURKAR D DAS H S | 2002 | Indian J Gastroenterol2002，21，2： | 1 |
| 18 | Consensus recommendations and review by an international Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC)显示文摘 | Park JW Amarapurkar D Chao Y | 2013 | Liver Int2013，33，： | 1 |
| 19 | Asian Pacific Association for the Study of the Liver consensus statements on the diagnosis,management and treatment of hepatitis C virus infection 显示文摘 | McCaughan G W Omata M Amarapurkar D | 2007 | J Gastroenterol Hepatol2007，22，5： | 1 |
| 20 | Risk of develop- ment of hepatocellular carcinoma in patients with NASH-related cirrhosis 显示文摘 | Amarapurkar D N Dharod M Gautam S | 2013 | Trop Gastroenterol2013，34，3： | 1 |
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