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Comparison of Endoscopic Injection Sclerotherapeutic Agents in Nonvariceal Upper GI Bleeding: A Retrospective Study
By Dr. Rifat Jahan , Dr. Ibrahim Masoodi , Dr. G N Yattoo , Dr. Abdul R Shah , Dr. S A Zargar , Dr. Gul Javid , Dr. Charanjit Singh , Dr. Mushta Chalkoo
Submited on: 29 Aug 2011 02:41:20 PM GMT
Published on: 30 Aug 2011 01:52:20 PM GMT
 
Injection sclerotherapy improves outcomes in nonvariceal upper GI bleeding
Posted by Dr. Sashidhar Sagi on 12 Dec 2011 06:33:55 PM GMT

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    The title of the article is misleading - No comparison between sclerotherapeutic agents is made in the study and epinephrine by itself is not a sclerosing agent

    Patients who were treated with epinephrine alone were included as cases

    This is a case control study and to determine if sclerotherapy(+/-epinephrine) made a difference the control group has to be better defined - matching for epinephrine use

    There is no power calculation listed in the methodology

    The number of controls in the paper and abstract dont match 52 vs 51

    The sample size is overall small to draw any meaningful conclusions

     

     

     

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I do clinical work in this area.

  • How to cite:  Sagi S .Injection sclerotherapy improves outcomes in nonvariceal upper GI bleeding[Review of the article 'Comparison of Endoscopic Injection Sclerotherapeutic Agents in Nonvariceal Upper GI Bleeding: A Retrospective Study ' by Chalkoo M].WebmedCentral 2011;2(12):WMCRW001234
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More evidence on treating bleeding ulcers...
Posted by Prof. Alejandro Piscoya on 30 Oct 2011 03:56:05 PM GMT

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? No
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    This is a case control study but there is no sample size calculation nor calculation of power after the study was made. There are some important confounders that are not commented as the condition of the cases, smoking or another diseases. Confidence intervals are lacking and are important because the small sample size may make these results unreliable.

     

     

     

     

  • Competing interests:
    None to declare
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:
    Espinoza Ríos J, Huerta-Mercado Tenorio J, Huerta-Mercado Tenorio J, Lindo Ricce M, García Encinas C, Rios Matteucci S, Vila Gutierrez S, Pinto Valdivia J, De Los Rios Senmache R, Piscoya Rivera A, Bussalleu Rivera A. [Prospective validation of the Rockall Scoring System in patients with upper gastrointestinal bleeding in Cayetano Heredia Hospital Lima- Peru]. Rev Gastroenterol Peru. 2009 Apr-Jun;29(2):111-7. Spanish. Piscoya A. Missed opportunities in the trial on proton-pump inhibitor therapy in bleeding peptic ulcers. Ann Intern Med. 2009 Oct 20;151(8):589-90; author reply 590. No abstract available. Bravo Paredes E, Guzmán Rojas P, Gallegos López R, Corzo Maldonado M, Zegarra Chang A, Surco Ochoa Y, Piscoya Rivera A, Huerta-Mercado Tenorio J, Prochazka Zárate R, De Los Ríos Senmache R, Pinto Valdivia J. [Utility of urease rapid test for detection of Helicobacter pylori in patients with upper gastrointestinal bleeding from peptic ulcer]. Rev Gastroenterol Peru. 2011 Jan-Mar;31(1):17-20. Spanish.
  • Experience and credentials in the specific area of science:

    This is my area of work

  • How to cite:  Piscoya A .More evidence on treating bleeding ulcers...[Review of the article 'Comparison of Endoscopic Injection Sclerotherapeutic Agents in Nonvariceal Upper GI Bleeding: A Retrospective Study ' by Chalkoo M].WebmedCentral 2011;2(10):WMCRW001077
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A further support to the use of sclerotherapeutic injection in non-variceal upper gastrointestinal bleeding
Posted by Dr. Yeong Y Lee on 01 Sep 2011 09:34:01 PM GMT

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? Yes
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    Overall: The current study has its merit and deserves attention. However the design of study was confusing and misleading at times. While there is no novel information being reported here, the centre experience appears to support what others have reported. There is much room for improvement and a major revision will push the paper forward.

     

    Abstract: All abbreviations eg UGI should be spell out in full first before abbreviated.  Omeprazole was mentioned as being given in both study group and control group in abstract but pantoprazole was mentioned instead in the methodology section.  Please clarify.  The percentage sign (%) was missing for 43.13 in the results section.

     

    Methodology: retrospective design itself is a limitation. Investigator did not comment on power of study.  The overall design of study was confusing and misleading – study group vs. control or comparing the interventions within study group? Age and gender matched in the study group? Again abbreviations used were not explained eg APD disease.  While it appears that many parameters were included in the study, most were not included in the analysis.

     

    Results:  Data analysis mainly descriptive.  No novel information from the study. While intervention in study group showed a clear difference from controls but comparison between the three types of intervention did not reach a difference. Could this be due to power of study? Also can location of bleed and stigmata of recent hemorrhage influence the outcome of intervention? Mortality outcome – in-hospital mortality or 30 days mortality? This would need clarification. Also how accurate the information from mortality register?

     

    Discussion:  Overall discussion was pretty general. Study limitations should be discussed. 

     

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    My area of interest

  • How to cite:  Lee Y .A further support to the use of sclerotherapeutic injection in non-variceal upper gastrointestinal bleeding[Review of the article 'Comparison of Endoscopic Injection Sclerotherapeutic Agents in Nonvariceal Upper GI Bleeding: A Retrospective Study ' by Chalkoo M].WebmedCentral 2011;2(9):WMCRW00915
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