Biliary stricture complicating living donor liver transplantation (LDLT) is a relatively common complication, occurring in most transplant centres across the world. Cases of biliary strictures are more common in LDLT than in deceased donor liver transplantation. Endoscopic management is the mainstay for biliary strictures complicating LDLT and includes endoscopic retrograde cholangiography, sphincterotomy and stent placement (with or without balloon dilatation). The efficacy and safety profiles as well as outcomes of endoscopic management of biliary strictures complicating LDLT is an area that needs to be viewed in isolation, owing to its unique set of problems and attending complications; as such, it merits a tailored approach, which is yet to be well established. The diagnostic criteria applied to these strictures are not uniform and are over-reliant on imaging studies showing an anastomotic narrowing. It has to be kept in mind that in the setting of LDLT, a subjective anastomotic narrowing is present in most cases due to a mismatch in ductal diameters. However, whether this narrowing results in a functionally significant narrowing is a question that needs further study. In addition, wide variation in the endotherapy protocols practised in most centres makes it difficult to interpret the results and hampers our understanding of this topic. The outcome definition for endotherapy is also heterogenous and needs to be standardised to allow for comparison of data in this regard and establish a clinical practice guideline. There have been multiple studies in this area in the last 2 years, with novel findings that have provided solutions to some of these issues. This review endeavours to incorporate these new findings into the wider understanding of endotherapy for biliary strictures complicating LDLT, with specific emphasis on diagnosis of strictures in the LDLT setting, endotherapy protocols and outcome definitions. An attempt is made to present the best management options currently available as well as directions for future research in the area.

Sternal interventions should be avoided at the level of fourth to sixth CCJ, which is considered the danger zone. An intervention at the fourth to sixth CCJ may lead to disastrous consequences in patients who have SF.

Re-processing of primary protective equipment is the need of the hour with healthcare systems all over the world strained due to the shortage precipitated by severe acute respiratory syndrome coronavirus 2. The common methods of re-sterilization do not hold well for filtering facepiece respirators (FFRs) as they affect their structure and function. We propose the validation and eventual use of gamma irradiation, an already existing method of re-sterilization, to disinfect FFRs in bulk.

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Pancreatic duct (PD) leak leading to pancreatic ascites is a serious complication of chronic pancreatitis. Endoscopic management with endoscopic retrograde cholangiopancreatography (ERCP) has been found to be successful; however, if selective cannulation of the PD is unsuccessful, an endoscopic ultrasound–guided rendezvous procedure can help in bridging PD leaks, provided the duct is dilated. We report a successful endoscopic ultrasound–guided rendezvous procedure in a patient with PD leak, pancreatic ascites, and a nondilated duct with failed ERCP who was a poor candidate for surgery. The pancreatic ascites resolved following the procedure.

Stroke is basically a medical condition where there is low blood flow to the brain and thus results in cell death. It remains the second most common cause of death. Stroke patients also have different comorbidities on an average where they are prescribed with 6-10 medicines. This increase the chances for drug-related problems (DRPs) and adverse drug events (ADEs) or adverse drug reactions (ADRs) and the interventions found during the follow up of stroke patients. Several studies finding of interventions in stroke patients and reconciliation are ways to reduce ADRs and improve medication use safety. Interventions and medical reconciliation (MR) address a wide array of potential medication-related issues, which is carefully planned that may be done by pharmacist or doctor or professional (or) physician. Here the aim was to access the impact of interventions which includes medications reconciliation and counselling of stroke patients and also identification and categorization of DRPs. Polypharmacy causing DRPs was statistically significant in all the regions inappropriate drug selection (2.85%), and dose selection (2.85%) was the primary cause of DRPs 85% partially solved. Epidemiologically of all the three regions (GNT, VIJ, RJY) in the total study population. Males are more affected than females. Majority of comorbidities like HTN(70.05%), and DM(47.01%)were in leading role causing stroke absorbed during interventions. Leaflet & patient counselling had prominent role in conducting medical reconciliation. Other health care professionals systematically find, differentiate & report interventions like (DRPs, ADRs, and causes).