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Ghoshal UC, Sachdeva S, Pratap N, Verma A, Karyampudi A, Misra A, Abraham P, Bhatia SJ, Bhat N, Chandra A, Chakravartty K, Chaudhuri S, Chandrasekar TS, Gupta A, Goenka M, Goyal O, Makharia G, Mohan Prasad VG, Anupama NK, Paliwal M, Ramakrishna BS, Reddy DN, Ray G, Shukla A, Sainani R, Sadasivan S, Singh SP, Upadhyay R, Venkataraman J. Indian consensus on chronic constipation in adults: A joint position statement of the Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology. Indian J Gastroenterol 2018; 37:526-544. [PMID: 30617919 PMCID: PMC6339668 DOI: 10.1007/s12664-018-0894-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/18/2018] [Indexed: 02/06/2023]
Abstract
The Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology developed this evidence-based practice guideline for management of chronic constipation. A modified Delphi process was used to develop this consensus containing 29 statements, which were generated by electronic voting iteration as well as face to face meeting and review of the supporting literature primarily from India. These statements include 9 on epidemiology, clinical presentation, and diagnostic criteria; 8 on pathophysiology; and the remaining 12 on investigations and treatment. When the proportion of those who voted either to accept completely or with minor reservation was 80% or higher, the statement was regarded as accepted. The members of the consensus team believe that this would be useful for teaching, clinical practice, and research on chronic constipation in India and in other countries with similar spectrum of the disorders.
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Affiliation(s)
- Uday C. Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014 India
| | | | | | - Abhai Verma
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014 India
| | - Arun Karyampudi
- Asian Institute of Gastroenterology, Hyderabad, 500 082 India
| | - Asha Misra
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014 India
| | - Philip Abraham
- P D Hinduja Hospital and MRC, and Hinduja Heathcare Surgical, Mumbai, 400 016 India
| | | | - Naresh Bhat
- Aster CMI Hospital, Bangalore, 560 092 India
| | | | | | - Sujit Chaudhuri
- Advanced Medicare Research Institute, Salt Lake, Kolkata, 700 091 India
| | - T. S. Chandrasekar
- Department of Gastroenterology, Medindia Hospitals, Nungambakkam, Chennai, 600 034 India
| | - Ashok Gupta
- Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014 India
| | - Mahesh Goenka
- Appollo Gleneagles Hospitals, Kolkata, 700 054 India
| | - Omesh Goyal
- Dayanand Medical College, Ludhiana, 141 001 India
| | - Govind Makharia
- All India Institute of Medical Sciences, New Delhi, 110 029 India
| | | | | | | | | | - D. N. Reddy
- Asian Institute of Gastroenterology, Hyderabad, 500 082 India
| | - Gautam Ray
- B R Singh Railway Hospital, Kolkata, 700 014 India
| | - Akash Shukla
- Lokmanya Tilak Municipal General Hospital and Medical College, Sion, Mumbai, 400 022 India
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Gowda SL, Bhandiwad A, Anupama NK. Litigations in Obstetric and Gynecological Practice: Can it be prevented? A Probability to Possibility. J Obstet Gynaecol India 2016; 66:541-7. [PMID: 27651659 PMCID: PMC5016466 DOI: 10.1007/s13224-016-0881-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 03/19/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Litigation in medical practice is becoming a global problem. So it is necessary to know what constitutes negligence and what is required to prove it and how far it is preventable. OBJECTIVES To analyze the prevalence and reasons for litigations in Obstetrics and Gynaecology for medical negligence and deficiency in service. To analyze on what grounds negligence was proved and to know whether it was preventable. MATERIALS AND METHODS It is a retrospective analysis of the judgments obtained from all the District Consumer Courts of South India and was specifically analyzed for reasons in filing the case, nature of settlement, and factors considered in deciding negligence especially in the field of obstetrics and gynecology. RESULTS Totally 1317 cases were found on medical negligence and deficiency in service, with 347 (26.34 %) cases on Obstetrics and Gynecology (OBG) topping the list. Out of 347 cases on OBG 312 (89.91 %) cases were settled in the Courts. Negligence was proved in 98 (31.41 %) cases and 214 (68.59 %) cases were dismissed without compensation. 77 (24.68 %) cases on gynecology were filed with common reasons for litigation being Post-op complications, intraop complications (11.68 %), extension of surgery beyond consent (2.6 %) and out of 235 (75.32 %) cases on Obstetrics, tubectomy failure (23.82 %), birth asphyxia (10.21 %), traumatic injury to new born (5.96 %) were the common reasons for litigations. Inadequate documentation and improper consent were the main factors considered in deciding negligence on part of the doctors. CONCLUSION With reasonable skill and care in diagnosis and treatment, proper documentation and legally valid consent it is not probable but possible to prevent litigations.
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Affiliation(s)
- Surakshith L. Gowda
- Department of OBG, JSS Medical College and Hospital, JSS University, #140/4, 2nd Cross, Shankarmutt Road, Fort Mohalla, Mysore, Karnataka 570004 India
| | - Ambarisha Bhandiwad
- Department of OBG, JSS Medical College and Hospital, JSS University, #140/4, 2nd Cross, Shankarmutt Road, Fort Mohalla, Mysore, Karnataka 570004 India
| | - N. K. Anupama
- Department of OBG, JSS Medical College and Hospital, JSS University, #140/4, 2nd Cross, Shankarmutt Road, Fort Mohalla, Mysore, Karnataka 570004 India
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Abstract
Chronic diarrhea is a common clinical problem in gastroenterology practice and often difficult to diagnose the cause. Presence of villous atrophy in these subjects is not specific as differential diagnosis can be broad. Drug-induced diarrhea is often overlooked during the evaluation. We report a short series of such challenging small bowel diarrhea secondary to olmesartan-related sprue-like enteropathy.
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Affiliation(s)
- Naresh Bhat
- Department of Gastroenterology, Columbia Asia Referral Hospital, 26/1, Brigade Gateway, Malleswaram West, Yeshwanthpur, Bangalore, 560 055, India,
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Dubale N, Anupama NK, Tandon M, Pradeep R, Reddy D, Rao G. Anomalous biliary duct mistaken as hilar stricture. A case report. J Interv Gastroenterol 2011; 1:34-36. [PMID: 21686112 DOI: 10.4161/jig.1.1.14600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 07/11/2010] [Accepted: 07/16/2010] [Indexed: 11/19/2022]
Abstract
Anomalous biliary anatomy is frequently encountered by surgeons during cholecystectomy. Importance of its recognition lies in avoiding serious biliary injuries. One such anomaly is cholecystohepatic duct. We describe rare clinical situation wherein agenesis of CHD along with cholecystohepatic duct was mistaken for hilar stricture.
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