Background and Aims: Foreign-body ingestion is a common phenomenon, especially in children. In normal adults, foreign-body ingestion is usually accidental and mostly ingestion occurs with food and impaction is a result of structural abnormalities of the upper gastrointestinal tract (UGIT). However, accidental ingestion of nonfood products is unusual; especially ingestion of pins (scarf or safety pins) and needles is unknown. We come across ingestion of these unusual/sharp foreign bodies routinely from the past few years. The aim of this study was to observe, over a period of 1 year, the spectrum of nonfood or true foreign-body ingestion in our community and to see the impact of an early endoscopy on outcome or retrieval of the ingested objects. Materials and Methods: In a prospective observational study, we studied the profile of foreign-body ingestion in normal individuals of all ages and both sexes, excluding the individuals with any structural abnormalities of the gut and the people with psychiatric ailment. Results: Of total 51 patients with foreign-body ingestion, 42 (82%) were 20 or <20 years of age with females constituting 86.3% of the total and males constituting only 13.7%. Foreign bodies ingested included 38 pins (74.5%), seven coins (13.7%), four needles (7.8%), and one denture and a nail (2%) each. Overall 26 (51%) foreign bodies were seen in UGIT (within reach of retrieval) at the time of endoscopy and all of them were retrieved. Nineteen (37.3%) patients reported within 6 h of ingestion, and majority of them (16 = 84.2%) had foreign bodies within UGIT and all of them were removed. Those patients (n = 32; 62.7%) who reported beyond 6 h, only 10 (31.25%) had foreign bodies in UGIT as a result of which the success rate of removal in these patients was only 32%. Conclusion: Most of our patients were young females and the common foreign bodies ingested were sharp including scarf pins followed by coins and needles. The success rate of retrieval was high in those who reported within 6 h of ingestion of foreign body. The rate of retrieval was 100% if foreign body was found on esophagogastroduodenoscopy. Hence, we recommend an early endoscopy in these patients and some alternative to use of scarf pins. AbstractThis is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Introduction: Hepatitis C virus (HCV) infection represents a major healthcare challenge in both industrialized and developing countries. The standard treatment for hepatitis C virus (HCV) infection has been interferon-based over many years with less than satisfactory cure rate and many side-effects. Directly acting antivirals (DAAs) have promise for a treatment regimen free of interferons with much better cure rate and minimal side-effects. Aims and Objectives: To evaluate efficacy and safety of an oral interferon-free regimen, sofosbuvir plus ribavirin in the treatment in genotype 3 chronic hepatitis C patients. Materials and Methods: 200 treatment naïve chronic hepatitis C genotype 3 patients of either sex with age more than 18 years were enrolled in the study. Sofosbuvir 400 mg once daily plus Ribavarin weight-based was given to all the patients. Duration of treatment was 24 weeks and 12 weeks to cirrhotics and non-cirrhotics respectively. Data analysis was performed using the IBM SPSS version 22. Results and Observations: In this prospective study the total number of patients was two hundred (n=200). The mean age (in years) of patients was 44.2 ± 14.7. The number of male patients was 112 (56 %) and 88   (44 %) were females. The number of cirrhotic patients was 70 while 130 were non-cirrhotic. On comparison on the basis of sustained virological response at twelve weeks of the completion of treatment (SVR12) we observed that treatment naïve cirrhotic patients had  SVR 12 of  92.8 %  while in the non cirrhotic patients SVR 12= was 96.9 % . Adverse effects were insignificant and none of the patients dropped out because of side effects. Conclusion: The sofosbuvir and ribavirin based therapy showed very good rates of sustained virological response in chronic hepatitis C genotype 3 patients irrespective of the state of fibrosis. In addition it was found to be cost effective, safe and very well-tolerated. Keywords: Hepatitis C; Genotype 3; directly acting antivirals, Sofosbuvir, Sutained virologic response (SVR).

To compare the efficacy of levofloxacin based and clarithromycin based sequential therapies for eradication of Helicobacter pylori infection. Methods: From january 2017 to december 2018, 260 patients with H. pylori infection randomly received 14 d of levofloxacin-based sequential therapy (LEVO-ST group, n = 130) or clarithromycin-based sequential therapy (CLA-ST group, n = 130).H.pylori infection was defined on the basis of either histologic evidence of H. pylori by modified Giemsa staining; or a positive rapid urease test by gastric mucosal biopsy. Successful eradication therapy for H.pylori infection was defined as a negative 13-Carbon-urea breath test four weeks after the end of eradication treatment.Compliance was defined as good when drug intake was at least 90%. H. Pylori eradication rates, patient compliance with drug treatment, adverse events, and factors influencing the efficacy of eradicationtherapy were evaluated. Results: The eradication rates by intention-to-treatanalysis were 89% (116/130; 95%ci: 86.2%-95.4%)in the levo-st group and 86% (112/130; 95%ci:65.8%-77.4%) in the cla-st group (p = 0.450). Theeradication rates by per-protocol analysis were 91%(114/124) 95%ci: 89.1%-98.1%) in the LEVO-ST groupand 87% (106/122; 95%ci: 69.4%-81.8%) in the CLA-ST group (p = 0.227). Compliance was 100% in bothgroups. The adverse event rates were 17.6 % (22/125) and 28.6% (35/122) in the LEVO-ST and CLA-ST group,respectively (p = 0.038). Most of the adverse eventswere mildto-moderate in intensity; there was none serious enough to cause discontinuation of treatmentin either group. Conclusion: The 14-d levofloxacin-based sequential therapy has high efficacy for H. pylori eradication effective. Moreover, it showed excellent patient compliance and safety compared to the 14-d clarithromycin-based sequential therapy.

Introduction: Ingestion of a foreign body (FB) is a common occurrence in day to day clinical practice; however, few studies have been reported from Northern India. The aim of this study was to study the spectrum and management outcome of patients with FBs in their gastro intestinal tracts (GIT) presenting to gastroenterology unit in a tertiary care referral hospital. Material and methods: Data were collected from all consecutive patients with history of FB ingestion admitted to our endoscopy centre from January 2015 to December 2018. The demographic data, clinical presentations, and endoscopic management was reviewed and analyzed. Results: A total of 204patients with suspectedFBingestion underwent endoscopic management. 211 FBs were found in 204 patients with suspected FB.Scarf pin was most common (57.3%) followed by knitting needle in twenty-six (12.3%) cases. Most of theFBs were located in the stomach (72.6%). The majorityof patients (95.2%) were successfully removed with flexibleendoscopy with the addition of suitable accessories without any serious procedure-related complications. Conclusion: In this part of the world the pattern and types of Upper gastrointestinal tract foreign bodies is unique not seen elsewhere across the globe. Endoscopic management was found to be highly safe and efficacious.

Portal hypertensive gastropathy (PHG) encompasses the gastric mucosal changes occurring in the setting of portal hypertension,both cirrhotic and non-cirrhotic. Its significance lies in causing acute gastrointestinal bleeding and insidious chronic blood loss presenting as iron deficiency anemia. Diagnosis of PHG is straight-forward, made endoscopically often characterized by  a mosaic-like pattern resembling ‘snake-skin’, with or without red spots. Treatment of acute GI bleed is hemodynamic stabilization, vasoconstrictor therapy, antibiotic prophylaxis, non-selective beta-blockers. Endoscopic treatment like APC has a small role. In severe cases, TIPS and shunt surgery can be offered. Secondary prophylaxis of PHG bleeding with non-selective b-blockers is recommended. Keywords: Portal hypertension­, Gastrointestinal bleeding, Cirrhosis, Beta-blockers