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Tracheoesophageal fistula (TOF) can be congenital or acquired. Acquired TOF can be caused by iatrogenic or traumatic or due to malignancy with pulmonary infection or aspiration being the presenting symptom. Management of TOF is associated with high mortality and morbidity and remains an interdisciplinary challenge. In general, depending on the size and location of the tracheal aspect of the fistula, surgical therapy involves primary repair of the fistula and, if necessary, resection and reconstruction of the trachea. We present two cases of iatrogenic TOF following surgery successfully closed using over‑the‑scope clips. This report also compares both the Ovesco and Padlock clip devices.

Taeniasis caused by Taenia solium-the pork tapeworm-or Taenia saginata-the beef tapeworm, and is endemic in Southeast Asia. In a study by Wani et al.[1], the prevalence of T. saginata asiatica was reported to be 7.69 % in rural Kashmir which was secondary to ingestion of measly beef. Most cases of taeniasis are asymptomatic and usually complain of passage of proglottids with stools. However, others present with pruritus ani (77 %), nausea (46 %), abdominal pain (43 %), dizziness (42 %), increased appetite (30 %), and other mild gastrointestinal symptoms [2]. The diagnosis is generally established by identifying eggs or proglottids in the stool. Single dose of 5-10 mg/kg of oral praziquantel is the treatment of choice. Taeniasis is rarely detected on endoscopy. We present an incidental endoscopic removal and detection of T. saginata asiatica in a case of carcinoma of distal esophagus (Fig. 1). He was asymptomatic and in retrospect he revealed episodic passage of white strings/proglottids in stools and was a beef eater. It is essential to improve the protocol detection of parasitism in meat industries.

Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease. Ultrasound-based transient elastography (TE) or TE of the liver is a noninvasive tool for effectively evaluating liver stiffness and fibrosis. The study aimed to compare the accuracy of TE as assessed by Fibroscan with liver biopsy in staging fibrosis in patients with NAFLD. Consecutive NAFLD patients (N = 72) were prospectively enrolled. TE evaluation was performed with Fibroscan and compared with liver biopsy, which is a reference standard. Fibrosis was staged according to the METAVIR scoring system (Meta-analysis of Histological Data in Viral Hepatitis). TE scores and biopsy-related fibrosis stages were correlated. Diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) of TE was evaluated. Data were analyzed using software R v3.6.3. Liver biopsy showed that 36.11% of patients did not exhibit fibrosis, whereas 25, 16.67, 15.28, and 6.94% of patients had stage F1 (por-tal/mild fibrosis), F2 (periportal/moderate fibrosis), F3 (bridging/severe fibrosis), and F4 (cirrhosis/advanced fibrosis), respectively. TE showed that 50% of patients had cirrhosis, whereas 20.83,15.28, and 13.86% of patients had mild, moderate, and severe fibrosis, respectively. TE had 71% accuracy, 89% sensitivity, and 38% specificity in diagnosing the severity of fibrosis. Hence, it can be implemented as a noninvasive alternative diagnostic tool for understanding the severity of fibrosis in patients with NAFLD. Moreover, it can also be used for quick early diagnosis of NAFLD, reliable staging of fibrosis, and understanding the need for liver transplantation in patients with NAFLD.

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