Ciplukan (Physalis angulata Linn.) is a Solanaceae family species and contains various active compounds with diverse therapeutic potential. The goal of this investigation was to see if the ethyl acetate fraction of ciplukan had an antifibrotic impact on liver fibrosis. The oral administration of 20% carbon tetrachloride (CCl 4 ) twice weekly for 8 weeks was used to cause liver fibrosis. Four weeks following fibrosis induction, ciplukan ethyl acetate fractions of 1.11 mg (CPL-1) and 2.22 mg (CPL-2) were given orally. As a positive control group, vitamin E was used. When compared to the negative control, the ethyl acetate portion of 2.22 mg (CPL-2) lowered serum alanine aminotransaminase levels (83.95 ± 27.675 vs 175.23 ± 5.641, p-value < 0.05). Microscopic histopathological changes based on the better Metavir score (CPL-2 vs. negative control = 1.25 ± 1.893 vs. 3.50 ± 0.577; p-value < 0.05) and Ishak score (CPL-2 vs. negative control = 1.50 ± 1.000 vs. 4.75 ± 0.957 p-value < 0.05) were demonstrated. Overall, in rat liver fibrosis induced by CCl 4 , these findings suggest that the ethyl acetate fraction of ciplukan has an antifibrotic effect.
Objective: The advent and utility of new endoscopic imaging modalities for predicting the histology of Barrett’s esophagus (BE) in real time with high accuracy appear promising and could potentially obviate the need to perform random biopsies where guidelines are poorly adhered to. We embarked on evaluating the performance characteristics of white-light endoscopy with magnification (WLE-z), narrow-band imaging with magnification (NBI-z) and a combination of both modalities.
Design: This was a prospective online study with 28 endoscopists from 11 countries (Asia-Pacific region) participating as assessors. In total, 35 patients with BE were assessed using 150 slides from WLE-z and NBI-z randomly arranged using a simple classification with corresponding histology. The overall Accuracy (Acc), Sensitivity (Sn), Specificity (Sp), Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of WLE-z, NBI-z and a combination of both were calculated.
Results: The overall Acc for WLE-z and NBI-z images was 87.1 % and 88.7 %, respectively. When images from the two modalities were placed side by side, the Acc increased to 90.3 %. The Sn, Sp, PPV, and NPV of WLE-z were 48 %, 92 %, 45 %, and 93 % while with NBI-z, these improved to 89 %, 89 %, 56 %, and 98 %, respectively. When both imaging modalities were viewed together, they improved further to 93 %, 90 %, 61 %, and 99 %.
Conclusion: The high NPV (99 %) when both WLE-z and NBI-z were used simultaneously indicates that areas with regular appearance that are diagnosed with confidence can effectively be left alone and not biopsied when performed at a skilled resourced center. This approach could potentially lead to a paradigm shift of how patients with BE are assessed.
Background/Aims
The coronavirus disease 2019 (COVID-19) pandemic has necessitated modifications to allow the safe practice of clinical gastroenterology and gastrointestinal endoscopy. This study aimed to investigate the characteristics of clinical gastroenterology and gastrointestinal endoscopy practices during the COVID-19 pandemic in Indonesia.
Methods
This cross-sectional study enrolled physician members of the Indonesian Society for Digestive Endoscopy. We used an online self-administered questionnaire disseminated via social media. The 32-item survey determined the baseline characteristics of the participants, characteristics of clinical gastroenterology and gastrointestinal endoscopy practices, involvement of the physicians in the management of COVID-19, and overall impact of the pandemic on practice. All collected data were analyzed using descriptive statistics.
Results
The 200 participants in this study had a median age of 50 (34–76) years. Modifications in clinical gastroenterology practice were frequently reported in the outpatient (95.5%) and inpatient (100%) settings. All participants reported changes in the gastrointestinal endoscopy practice patterns. Of the participants, 86.0% were working in high-risk zones, and several of them reported inadequate protective personal equipment (34.0%). The median overall impact score of the pandemic on practice was 9 (2–10).
Conclusions
Physicians practicing clinical gastroenterology and gastrointestinal endoscopy in Indonesia work in high-risk settings. Modifications in clinical gastroenterology and gastrointestinal endoscopy practices are prevalent during the COVID-19 pandemic.
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