Indian J Gastroenterol (November 2015) 34(Suppl 1):A1–A104 DOI 10.1007/s12664-015-0600-5

ABSTRACTS

Indian Society of Gastroenterology Plenary session

PLE-2

PLE-1

Overexpressed autophagic system by activated dendritic cells in celiac disease—Is it a mere standby phenomenon

Combination of antioxidants and pregabalin in the management of pain recurrence in chronic pancreatitis after ductal clearance: A randomized, double-blinded, placebo-controlled trial

Rupjyoti Talukdar, Sundeep Lakhtakia, D Nageshwar Reddy, G Venkat Rao, Rebala Pradeep, Rupa Banerjee, Rajesh Gupta, Mohan Ramchandani, Manu Tandan, H Vivekananda Murthy Department of Medical Gastroenterology, Asian Institute of Gastroenterology 6-3-661, Somajiguda, Hyderabad 500 082, India; Wellcome-DBT Laboratory, Asian Healthcare Foundation, Hyderabad, India; Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad 500 082, India; and Department of Biost Aim: This study aimed to evaluate the effect of an antioxidantpregabalin combination in chronic pancreatitis (CP) patients with pain recurrence post-endotherapy/longitudinal pancreaticojejunostomy (LPJ). Methods: CP patients with pain recurrence post-endotherapy/LPJ were randomized to receive an antioxidant-pregabalin combination or matching placebo for 2 months, followed by open-label antioxidants to both groups for the next 4 months. Compliance, daily pain, and adverse events were captured weekly and at the end of the study. Primary outcome was pain improvement; secondary outcomes were complete pain resolution, painful days, QOL, adverse events. Tools used were the following: visual analog scale (VAS) and Izbicki scale for overall pain, pain DETECT for neuropathic pain, and EORTC-QLQ30Pan28 for QOL. Effect size was expressed as Hedges’ G (95 % CI), number needed to treat (NNT), and risk ratio (RR) (95 % CI). Analysis was intention-to-treat. Results: After sample size calculation (80 % power; 0.05 alpha; adjusted for 10 % dropout), we randomized 42 and 45 patients in the treatment and placebo arms, respectively. Five patients in the treatment arm and 3 in the placebo lost to follow up. Both arms matched for age, gender, duration between endotherapy/LPJ and enrolment, exocrine and endocrine insufficiency, type of ductal decompression, and pain scores. At 2 months, there was significantly higher reduction in VAS [−45.5 (±28.5) vs. −24.0 (±32.6); p =0.002]. 46.5 % of patients in the treatment arm had complete pain resolution (p =0.04); NNT was 5.1. Mean (SD) number of painful days was lower in treated patients [14.7 (15.2) vs. 21.8 (17.4) days; p =0.05]. At 6 months, significantly higher pain reduction persisted in the original treatment group. 23.8 % and 38.1 % of treatment arm patients experienced nausea/vomiting and drowsiness, respectively. Conclusion: The antioxidant-pregabalin combination results in significant relief in CP pain recurrence after endotherapy/LPJ.

Kim Vaiphei, Biman Saikia, Rakesh Kochhar Departments of Histopathology, Immunopathology and Gastroenterology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160 012, India Introduction: Celiac disease (CD), an immune-mediated disorder, associates with accumulation of dendritic cells (DCs) in duodenal mucosa. Besides other complementary serology markers, CD patients are positive for HLADQ. Autophagy has recently been implicated in autoantigen formation. Aim: This study aimed to analyze duodenal histology and expressions for LC3 and beclin1. Methods: Ninety IgA tissue transglutaminase-positive patients were further tested for HLA-DQ. All patients underwent endoscopic duodenal biopsies for histological assessment and immunohistochemistry (IHC) assessment of DCs and autophagic proteins using CD11c, CD86, LC3A and beclin1, and duodenal mucosal RNA extracts for quantitative analysis of LC3 and beclin1. Statistical analysis was carried out using chi-square, Fisher’s exact, and McNemar-Bowker tests with significance of p value 65 mmHg at 6 h. The tissue perfusion and hemodynamic parameters were monitored till death or 28 days follow up. Results: The patients were critically ill with the Model for End-Stage Liver Disease (MELD) (34.9±12.5 vs. 33.8±9.9, p=0.65) and Sequential

Indian J Gastroenterol (November 2015) 34(Suppl 1):A1–A104

Organ Failure Assessment (SOFA) score (13.7 ± 3.1 vs. 14.7 ± 2.6, p=0.10) in the terlipressin and noradrenaline groups, respectively. The major source of sepsis at admission was spontaneous bacterial peritonitis (SBP) followed by pneumonia. Most of the patients achieved target MAP at 6 h in both the groups (90.5 % vs. 78.6 %, p=0.13). But, terlipressin use was associated with a better maintenance of MAP with lesser shift to salvage therapy (26.2 % vs. 61.9 %, p=0.05) and also a greater discontinuation of vasopressor (33.3 % vs. 11.9 %, p

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