RFP Gastroenterology International

Introduction: Oral antivirals for Hepatitis B treatment are relatively safe but rarely  complications are described. We hereby describe a case of chronic kidney disease (CKD)  with Hepatitis B infection who presented with muscle weakness due to rhabdomyolysis after  starting on Entecavir which recovered on stopping it. Case report: A 52 year old male, a patient of Diabetic Nephropathy, was initiated on dialysis  elsewhere and within few weeks developed jaundice and was screened positive for Hepatitis  B with high viral load. Entecavir was initiated, 5 days later he presented to us with leg pains  and quadriparesis. On evaluation, he had deranged liver function test (LFT),elevated LDH and  CPK levels. We stopped Entecavir as we noted reports of rhabdomyolysis with Entecavir with statin  combination. He was hydrated appropriately. Haemodialysis was continued. The patient showed gradual improvement in LFT and quadriparesis. The learning point  from this case was identifying the complication and taking action for good outcome. Conclusion: This is the first case of drug (Entecavir) induced Rhabdomyolysis in a patient  with CKD, Acute Hepatitis B, presenting with quadriparesis. Entecavir may be avoided in  CKD patients in whom Tenofovir Alafenamide may be safer.

Background: Angiodysplasia of the caecum is a common vascular abnormality that causes  gastrointestinal bleeding, especially in elderly patients. Characterized by abnormal, dilated  blood vessels, angiodysplasia can lead to intermittent or acute haemorrhage. Embolization  with Polyvinyl Alcohol (PVA) particles is a minimally invasive technique gaining popularity  for managing bleeding from caecal angiodysplasia when endoscopy fails or is not possible. Objective: To evaluate the use of PVA embolization in the treatment of caecal angiodysplasia,  focusing on its effectiveness in controlling gastrointestinal bleeding and its advantages and  risks compared to other treatment options. Results: PVA embolization has shown high success rates in controlling gastrointestinal  bleeding associated with caecal angiodysplasia. The procedure is minimally invasive, with  most patients experiencing significant improvement in symptoms and a reduction in recurrent  bleeding episodes. Conclusion: Embolization with PVA is an effective and minimally invasive treatment for  caecal angiodysplasia, particularly in patients who do not respond to or are not candidates for  endoscopic therapies.

Health is an panoramic window which presently requires the viewing at the different angles, few are curative and others are preventive. In this article we are looking for the same as the preventive task. Consider the spread and mode of transmission as faeco oral route and water borne which is considered as the maximum travel and water exposure in different types of activities. The study carried out considering the incidence and prevalence among the north India in the month of the June and July. Hepatitis A and E which has the maximum spread in the faeco oral route found in almost all the cases, HAV is most common among the pediatric age group and those who have the history of the travelling and exposure to outside water consumption such as water park, fun world, outside water consumption while travelling. Children with HAV present with sudden onset of pain abdomen, fever chills, nausea, vomiting, abdominal bloating yellowish diclouration of eyes, urine with cholestasis features.