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Anand V Kulkarni @anandvkulkarni.bsky.social · Apr 3

With rising burden of metabolic diseases we are struggling with management of ascites in CKD. Here we try to answer them & provide an overview of approach to ascites in ESRD. @ebtapper.bsky.social @akashroyy.bsky.social

journals.lww.com/hepcomm/full...

Ascites in patients with end-stage renal disease:... : Hepatology Communications

d. However, patients with end-stage renal disease (ESRD) may also present with ascites even in the absence of cirrhosis. The literature on the management of patients with ESRD with ascites with or wit...

journals.lww.com

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Reposted by Anand V Kulkarni

Stephen Jenkins @sjenkinsmd.bsky.social · Mar 30

Patients were randomized to FIT vs colonoscopy for colon cancer screening. Participation in any form of screening was 31.8% in the colonoscopy group and 39.9% in the FIT group. 10-year colon cancer mortality risk was 0.22% in colonoscopy arm and 0.24% in FIT arm.
www.thelancet.com/journals/lan...

Effect of invitation to colonoscopy versus faecal immunochemical test screening on colorectal cancer mortality (COLONPREV): a pragmatic, randomised, controlled, non-inferiority trial

Participation in screening was higher among individuals invited to faecal immunochemical test screening than colonoscopy screening. On the basis of participation observed in this study, a faecal immun...

www.thelancet.com

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Anand V Kulkarni @anandvkulkarni.bsky.social · Mar 29

Thank you 🙏🏻

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Anand V Kulkarni @anandvkulkarni.bsky.social · Mar 28

A survey based study from AIG team and UoH on IT individuals who agreed to undergo tests
pubmed.ncbi.nlm.nih.gov/40128210/
>80% have fat in liver
20% have elevated liver enzymes
2% have fibrosis (advanced disease)
Fatty liver is curable with exercise (150 min/week) and healthy diet #Liversky

Prevalence of metabolic dysfunction-associated fatty liver disease among information technology employees in India - PubMed

The Information Technology (IT) sector is a leading industry that fuels India's economic growth. However, the work culture in this sector often promotes sedentary lifestyle, inadequate physical activi...

pubmed.ncbi.nlm.nih.gov

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Anand V Kulkarni @anandvkulkarni.bsky.social · Mar 14

Yes . No doubt 😞

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Anand V Kulkarni @anandvkulkarni.bsky.social · Mar 14

Thank you Hanna. In our settings most patients don’t agree for LT at all & we see at least 4 new AH patients per day and hardly one may fit for steroids therapy up front. We usually stabilize and then start steroids. Under supervision they do pretty well.

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Reposted by Anand V Kulkarni

Elliot Tapper @ebtapper.bsky.social · Mar 13

Phenomenal

Anand V Kulkarni @anandvkulkarni.bsky.social · Mar 13

After five decades, steroid dosing in AAH is revisited: Tapered prednisolone proves superior in reducing infections.
#STASH trial @jasmohanbajaj.bsky.social @juanpabloarab.bsky.social @ebtapper.bsky.social @tonybreu.bsky.social
@blaneymd.medsky.social
journals.lww.com/ajg/abstract... #liversky

Infections in Standard or Tapered Dose of Prednisolone for... : Official journal of the American College of Gastroenterology | ACG

mary objective was to assess the incidence of infection by day 90. The key secondary objectives were the incidence of mortality, acute kidney injury (AKI), readmissions rate and adverse events. Metho...

journals.lww.com

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Anand V Kulkarni @anandvkulkarni.bsky.social · Mar 13

Thank you Rohit

Anand V Kulkarni @anandvkulkarni.bsky.social · Mar 13

@rohitmehtani.bsky.social @hughthomas00.bsky.social @robbrierley.bsky.social @spaulliver.bsky.social @andrewmmoon.bsky.social @heykatray.bsky.social @anaostojic.bsky.social @vivekgtank.bsky.social @wongyujun.bsky.social @jonathanstinemd.bsky.social @kbibbinsdomingo.bsky.social

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Anand V Kulkarni @anandvkulkarni.bsky.social · Mar 13

After five decades, steroid dosing in AAH is revisited: Tapered prednisolone proves superior in reducing infections.
#STASH trial @jasmohanbajaj.bsky.social @juanpabloarab.bsky.social @ebtapper.bsky.social @tonybreu.bsky.social
@blaneymd.medsky.social
journals.lww.com/ajg/abstract... #liversky

Infections in Standard or Tapered Dose of Prednisolone for... : Official journal of the American College of Gastroenterology | ACG

mary objective was to assess the incidence of infection by day 90. The key secondary objectives were the incidence of mortality, acute kidney injury (AKI), readmissions rate and adverse events. Metho...

journals.lww.com

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Anand V Kulkarni @anandvkulkarni.bsky.social · Feb 22

The latest ACLF guidelines on harmonization of definition - steps from Asia. Joined by all the experts across the globe. Exhaustive recent updates and future directions.
@robbrierley.bsky.social @stevenbollipo.bsky.social @liveraim.bsky.social
link.springer.com/article/10.1...

Acute-on-chronic liver failure (ACLF): the ‘Kyoto Consensus’—steps from Asia - Hepatology International

Acute-on-chronic liver failure (ACLF) is a condition associated with high mortality in the absence of liver transplantation. There have been various definitions proposed worldwide. The first consensus...

link.springer.com

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Anand V Kulkarni @anandvkulkarni.bsky.social · Jan 5

Tips cannot prevent cirrhosis progression. Patients are okay without bleed for 3-4 years- then continue to develop complications. Having said that yes,I strongly recommend TIPS for bleeders but not for refractory ascites.Very poor outcomes! The QoL post TIPS for ascites is significantly affected.

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Reposted by Anand V Kulkarni

Vishnu Girish @liveloveliver.bsky.social · Jan 4

📢Thrilled to share our latest review article. Greatful to Prof. Rakhi Maiwall. We explore challenges of managing septic shock in cirrhosis and advocate for personalized approaches
pubmed.ncbi.nlm.nih.gov/39744868/

#liversky #Medsky #GIsky

@anandvkulkarni.bsky.social

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Reposted by Anand V Kulkarni

Elliot Tapper @ebtapper.bsky.social · Dec 12

There are *some* people whom steroids help

There is still value in trials, pragmatic trials, that refine inclusion criteria, dose, duration, and stopping rules

@anandvkulkarni.bsky.social
@juanpabloarab.bsky.social
@blaneymd.bsky.social

Elliot Tapper @ebtapper.bsky.social · Dec 12

Steroids did not help people with alcohol-associated hepatitis in this nations cohort

doi.org/10.14309/ctg...

#liversky

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Anand V Kulkarni @anandvkulkarni.bsky.social · Dec 12

Absolutely sir. Patient selection is the key!

Reposted by Anand V Kulkarni

Vinay Jahagirdar @vinayjaha.bsky.social · Nov 19

Congrats to inspiring investigators @anandvkulkarni.bsky.social @juanpabloarab.bsky.social and team, for late breaking abstract about rapid taper of steroids in AAH at #TLM24
⤵️ infections, hospitalizations with rapid taper
💫 changing practice in management of AAH
#LiverSky #AASLD

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Anand V Kulkarni @anandvkulkarni.bsky.social · Nov 19

Hey Vinay, thank you. Nice meeting you.
Best

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Reposted by Anand V Kulkarni

Rob Brierley @robbrierley.bsky.social · Nov 18

Dose tapering reduced incidence of infection and use of antibiotics. No difference noted in survival #TLM24 #LiverSky

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Reposted by Anand V Kulkarni

Rob Brierley @robbrierley.bsky.social · Nov 18

Anand Kulkarni presents data from the STASH trial of dose tapering vs fixed dose corticosteroids in patients with severe alcohol-associated hepatitis #TLM24 #LiverSky

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Anand V Kulkarni @anandvkulkarni.bsky.social · Nov 19

No difference in mortality though.

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Reposted by Anand V Kulkarni

Elliot Tapper @ebtapper.bsky.social · Nov 18

This study by challenges dogma

@anandvkulkarni.bsky.social gave a tapering dose of prednisone for alcohol hepatitis instead of 40mg for 28 days

And it paid off with fewer infections

@tonybreu.bsky.social

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Anand V Kulkarni @anandvkulkarni.bsky.social · Nov 18

Leon Schiff SOA lecture by @jasmohanbajaj.bsky.social on HE @ebtapper.bsky.social #TLM24

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Anand V Kulkarni @anandvkulkarni.bsky.social · Nov 15

Drugs for Mash cirrhosis by Prof Mazen Noureddin #TLM24

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Anand V Kulkarni @anandvkulkarni.bsky.social · Nov 13

Join to learn and discuss about Management of ACLF #Aasld #liversky

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Reposted by Anand V Kulkarni

Rob Brierley @robbrierley.bsky.social · Nov 12

I’ll be moderating a webinar tomorrow (Nov 13th) in conjunction with The Hepatitis Fund, as part of London Global Cancer Week 2024.

Join us to learn more on how liver cancer can be prevented via the elimination of viral hepatitis!

Register: us06web.zoom.us/webinar/regi...

#GastroSky #LiverSky

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