Objective Evaluation and management of small bowel disorders have always been challenging due to the limitations of the existing technology. Motorized power spiral enteroscopy (PSE) is an innovative new technique that offers easier, faster, and more complete small bowel evaluation with the ability to perform therapeutics. We aimed to evaluate the safety and efficacy of PSE in various indications. Methods Retrospective analysis of prospectively collected data of consecutive patients, who underwent PSE at a tertiary care center. Primary outcome measures were technical success rate, pan‐enteroscopy rate, diagnostic and therapeutic yield, and the secondary outcomes measures were the depth of maximal insertion, median insertion time, and adverse events. Results Fifty‐four patients (mean age of 49.38 ± 16.26 years) underwent PSE for small bowel evaluation. Technical success rate was 95.55% (antegrade route) and 93.10% (retrograde route).  Pan‐enteroscopy rate is 46.29% and antegrade enteroscopy to the cecum was achieved in eight patients.  Overall diagnostic and therapeutic yields were 85.18% and 30.76%, respectively. The most common findings were ulcero‐stricturing lesions (51.92%) followed by vascular lesions (9.61%). The most common histopathologic diagnosis was Crohn's disease in 29.62%. Median depth of maximal insertion was 400 cm (range 150–550 cm; antegrade route) and 180 cm (range 50–350 cm; retrograde route). The median insertion time to depth of maximal insertion was 70 min (range 30–110 min; antegrade route) and 45 min (range 20–70 min; retrograde route).  PSE‐associated major adverse events occurred in one patient and minor adverse events were seen in 48.14%. Conclusion PSE is a safe and effective modality for the evaluation of small bowel disorders with a high diagnostic yield.

No abstract

No abstract

No abstract

2,4-D (2,4-dichlorphenoxyacetic acid) is a chlorphenoxy group pesticide. Its relative safety and broad leaf selectivity makes it a favourite herbicide of many home gardeners and agricultural workers. Severe systemic toxicity requiring hospital admission and intensive care usually occurs following intentional oral ingestion. 2,4-D poisoning is an under-recognised cause of a potentially lethal toxic syndrome, especially in low- and middle-income countries, where such compounds are widely used in farming and readily available in households. It warrants close monitoring and high-quality supportive care along with plasma alkalinisation or extracorporeal removal of the toxin.  We present a short review on 2,4-D poisoning and describe two illustrative cases with significant oral ingestion resulted in early and rapidly developing systemic toxicity. Both patients were admitted to the intensive care unit; one patient was managed with alkaline diuresis and other case required three sessions of haemodialysis.