50 WORLD GASTROENTEROLOGY NEWS JULY 2016 Editorial | Expert Point of View | Gastro 2016: EGHS-WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events Upper Gastrointestinal Cancer Local data from a series of 100 patients treated for esophageal cancer in Khartoum was presented. For the second part, equally important data about etiology and management of gastric cancer in a similar series treated in Khartoum Teaching Hospi-tal was presented. Celiac Disease the Tip of the Ice-berg, General Overview The speaker detailed the nature of gluten and its role in causing the disease. Many aspects of the diagnosis (including serology, endoscopy, and imaging) were discussed. The bulk of this talk was about treatment and detailing nutritional restrictions. Data from Saudi Arabia was presented. Inflammatory Bowel Disease (IBD): Outlines of Diagnosis & Manage-ment An interesting case of ulcerative colitis was presented, including both an initial assessment and, in more detail, the role of endoscopy in estab-lishing the diagnosis. Next UK epide-miology of the disease was discussed and finally management options were outlined. Diagnosis and Management of Ir-ritable Bowel Syndrome (IBS) The talk reviewed the Rome Cri-teria used to define IBS. The heart of the talk was to stress the importance of careful history taking and exami-nation to rule out organic causes of symptoms like GI malignancy, IBD, Left to Right: Dr. Mark Donnelly, Gastroen-terologist, Sheffield, UK; Dr. Soliman Hus-sein, GI Surgeon, Soba University Hospital, Sudan; Dr. ElMuhtady Said, Gastroenterolo-gist, Sheffield, UK. Left to Right: Professor Osman Khalaf-flah, Gastroenterologist, Gezira University, Sudan; Dr. Soliman S. Fedail, Gastroenter-ologist and WGO, Sudan; Dr. Atta Banaga, Gastroenterology Trainee, GI Fellowship Program, Sudan. and celiac disease, among others. Treatment modalities (including food restriction and pharmacologic op-tions) were outlined in detail. Anorectal Conditions The speaker started the talk by describing the anatomy and blood supply of the anorectal region. Next, three main anorectal conditions were discussed in detail: anal fissure, hem-orrhoids, and anal fistula. Useful tips on history talking, examination, and excluding other differential diagnosis (like IBD, malignancy, and others) were outlined. Finally, treatment options (including surgery, medica-tions, and conservative options) were explained. Thrombosis or Bleeding in Cirrho-sis: Two-sided Blade Patients with advanced acute and chronic liver diseases should not have prophylactic transfusions for prolonged INR or aPTT; if they are stable and will not undergo interven-tions with bleeding risk. They must be screened for thrombosis, and prophylaxis or treatment with low-molecular- weight heparin (LMWH) should not be withheld in appropriate indications. Focal Liver Lesions The lecture outlined the approach to focal liver lesions. It stressed the fact that this is becoming an increas-ingly recognized problem due to the widespread use of cross sectional imaging worldwide. The differential diagnosis of focal liver lesions and use of imaging techniques was explained. THE SCIENTIFIC PROGRAM HIGHLIGHTS FROM THE HEPATOLOGY SESSION Autoimmune Hepatitis (AIH) AIH is a progressive liver disease characterized by hypergamma-globulinemia, +ve autoantibodies, and response to steroids. Hepatitis B Management: An Over-view This was a comprehensive lecture that explained hepatitis B epidemiol-ogy globally as well as locally. Several local studies were explained. Patient evaluation and management was explained. Local challenges of aware-ness, screening, and availability of drugs were all addressed. Management of HBV Infection in Pregnancy In mothers with decompensated disease or acute flares, Tenofovir is the drug of choice and should be contin-ued throughout pregnancy. Lamivu-dine and Telbivudine are alternatives for short-term therapy. Prevention of perinatal transmission and universal immunization coverage should be the goal, as prevention is better than cure. Anti-viral prophylaxis with Teno-fovir being first line or during third trimester if indicated in patients with HBV high viral load, to give adequate time for lowering of viral load at the time of delivery. Postpartum monitoring of mother till at least 12 weeks should be done for early management of acute flares and decompensation. Infant should be tested at 9 – 15 months of age to document immunity development or immunoprophylaxis failure.
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