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Cholestatic liver diseases:An era of emerging therapies 认领 引用 被引量：7
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作者 Hrishikesh Samant Wuttiporn Manatsathit +4 位作者 David Dies Hosein Shokouh-Amiri Gazi Zibari Moheb Boktor Jonathan Steve Alexander 《World Journal of Clinical Cases》 SCIE 2019年第13期1571-1581,共11页
Recently the field of cholestasis has expanded enormously reflecting an improved understanding of the molecular mechanisms underlying bile secretion and its perturbation in chronic cholestatic disease.Novel anti-chole... Recently the field of cholestasis has expanded enormously reflecting an improved understanding of the molecular mechanisms underlying bile secretion and its perturbation in chronic cholestatic disease.Novel anti-cholestatic therapeutic options have been developed for patients not favorably responding to ursodeoxycholic acid(UDCA),the current standard treatment for cholestatic liver disease.Important novel treatment targets now also include nuclear receptors involved in bile acid(BA)homoeostasis like farnesoid X receptor and G proteincoupled receptors e.g.,the G-protein-coupled BA receptor“transmembrane G coupled receptor 5”.Fibroblast growth factor-19 and enterohepatic BA transporters also deserve attention as additional drug targets as does the potential treatment agent norUDCA.In this review,we discuss recent and future promising therapeutic agents and their potential molecular mechanisms in cholestatic liver disorders. 展开更多
关键词 Bile acids Drug therapy Cholestatic liver disease Nuclear receptor agonists
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Breccia-cored columnar rosettes in a rubbly pahoehoe lava flow,Elephanta Island,Deccan Traps,and a model for their origin 认领 引用
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作者 Hetu Sheth Ishita Pal +2 位作者 Vanit Patel Hrishikesh Samant Joseph D'Souza 《Geoscience Frontiers》 SCIE CAS CSCD 2017年第6期1299-1309,共11页
Rubbly pahoehoe lava flows are abundant in many continental flood basalts including the Deccan Traps.However,structures with radial joint columns surrounding cores of flow-top breccia(FTB),reported from some Deccan ru... Rubbly pahoehoe lava flows are abundant in many continental flood basalts including the Deccan Traps.However,structures with radial joint columns surrounding cores of flow-top breccia(FTB),reported from some Deccan rubbly pahoehoe flows,are yet unknown from other basaltic provinces.A previous study of these Deccan "breccia-cored columnar rosettes" ruled out explanations such as volcanic vents and lava tubes,and showed that the radial joint columns had grown outwards from cold FTB inclusions incorporated into the hot molten interiors.How the highly vesicular(thus low-density)FTB blocks might have sunk into the flow interiors has remained a puzzle.Here we describe a new example of a Deccan rubbly pahoehoe flow with FTB-cored rosettes,from Elephanta Island in the Mumbai harbor.Noting that(1)thick rubbly pahoehoe flows probably form by rapid inflation(involving many lava injections into a largely molten advancing flow),and(2)such flows are transitional to 'a'a flows(which continuously shed their top clinker in front of them as they advance),we propose a model for the FTB-cored rosettes.We suggest that the Deccan flows under study were shedding some of their FTB in front of them as they advanced and,with high-eruption rate lava injection and inflation,frontal breakouts would incorporate this FTB rubble,with thickening of the flow carrying the rubble into the flow interior.This implies that,far from sinking into the molten interior,the FTB blocks may have been rising,until lava supply and inflation stopped,the flow began solidifying,and joint columns developed outward from each cold FTB inclusion as already inferred,forming the FTB-cored rosettes.Those rubbly pahoehoe flows which began recycling most of their FTB became the 'a'a flows of the Deccan. 展开更多
关键词 Rubbly pahoehoe Columnar jointing Flow-top breccia Volcanism Flood basalt Deccan Traps
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Comparison of split-dosing vs non-split(morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy 认领 引用 被引量：11
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作者 Hardik Shah Devendra Desai +4 位作者 Hrishikesh Samant Sandeep Davavala Anand Joshi Tarun Gupta Philip Abraham 《World Journal of Gastrointestinal Endoscopy》 2014年第12期606-611,共6页
AIM: To compare(using the Ottawa Bowel Preparation Scale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the ... AIM: To compare(using the Ottawa Bowel Preparation Scale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the optimal preparation-to-colonoscopy interval.METHODS: Single-centre, prospective, randomized, investigator-blind stud in an academic tertiarycare centre. Two hundred patients requiring elective colonoscopy were assigned to receive one of the two preparation regimens(split vs morning) prior to colonoscopy. Main outcome measurements were bowel preparation quality and patient tolerability.RESULTS: Split-dose regimen resulted in better bowel preparation compared to morning regimen [Ottawascore mean 5.52(SD 1.23) vs 6.02(1.34); P = 0.017]. On subgroup analysis, for afternoon procedures, both the preparations were equally effective(P = 0.756). There was no difference in tolerability and compliance between the two regimens.CONCLUSION: Overall, previous evening- same morning split-dosing regimen results in better bowel cleansing for colonoscopy compared to morning preparation. For afternoon procedures, both schedules are equally effective; morning preparation may be more convenient to the patient. 展开更多
关键词 Bowel preparation Colonoscopy Morning preparation Split dose preparation Preparation to colonoscopy interval
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Efficacy and safety of standard and anti-reflux self-expanding metal stent:A systematic review and meta-analysis of randomized controlled trials 认领 引用 被引量：5
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作者 Sudha Pandit Hrishikesh Samant +1 位作者 James Morris Steven J Alexander 《World Journal of Gastrointestinal Endoscopy》 2019年第4期271-280,共10页
BACKGROUND Self-expanding metal stents are the main palliative treatment modality for unresectable esophageal cancer.Gastroesophageal reflux is a common adverse outcome after placement of esophageal stent for cancer i... BACKGROUND Self-expanding metal stents are the main palliative treatment modality for unresectable esophageal cancer.Gastroesophageal reflux is a common adverse outcome after placement of esophageal stent for cancer involving the gastroesophageal junction and the gastric cardia.Anti-reflux stents with valve have been designed to prevent the acid reflux.The superiority of anti-reflux stent over standard stent in preventing gastroesophageal reflux has not been established well.This study compares the anti-reflux stent and the standard stent in terms of their efficacy to prevent acid reflux.AIM To compare the standard and the anti-reflux stents in terms of their efficacy,safety,and complications.METHODS The meta-analysis included 8 randomized clinical trials(RCTs)to compare pooled outcomes of total 395 patients.Primary outcomes include improvement in reflux symptoms and dysphagia score.Secondary outcomes include complications of stent migration,occlusion,and bleeding.RESULTS A total of eight RCTs were included in the meta-analysis.Compared to the standard stent,the anti-reflux stent showed a trend towards reduction in the dysphagia score without reaching a statistical significance[Standardized mean difference(SMD):-0.33(-0.71,0.05);P=0.09,I2:37%].There was no statistical difference in the gastrointestinal reflux(GER)scores between the two types of stents[SMD:-0.17(-0.78,0.45);P=0.008,I2:74%].Compared to standard stent,anti-reflux stent showed no difference in the risk of stent migration[OR:1.37(0.66,2.83);P=0.40,I2:0%],bleeding[OR:1.43(0.40,5.13);P=0.59,I2:0%],and obstruction[OR:1.66(0.60,4.60);P=0.33,I2:0%].CONCLUSION Traditional self-expanding standard esophageal stent and anti-reflux stent with valve are similar in terms of outcomes and complications. 展开更多
关键词 Self expanding metal stent Anti-reflux stent Randomized controlled trial Esophageal stent Meta-analysis
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