Devika Dixit

GI-Hep Fellow @tulanegastro | @BIDMC_GI | @UFIMRes | @MSMEdu | @USC | Golden State Warriors

[Dr. AK 🇮🇳 @docakx]

🌟CIRRHOSIS - Pharmacotherapy

[Devika Dixit @DevikaDixit3]

Dreams came true this week. Matched my #1 for GI fellowship. Thanks to everyone who has helped me get here! Roll Green Wave! @tulanegastro

[Khushboo Bhatia @kvbhatiamd]

Just two hardworking @BIDMC_GI hepatology fellows celebrating their successful match with massages and good food in this cozy weather @DevikaDixit3

[Juan Pablo (JP) Arab, MD  @juanpabloarab]

Dr @KavishPatidar11 kicks off the meeting talking about AUD &ALD: Evolving Definitions, Diagnosis and Epidemiology:
✅ Words matter: Alcohol use disorder, not alcoholism; Alcohol-associated, not alcoholic
✅ Thresholds of alcohol consumption varies according to different experts/societies
✅ Increasing mortality in younger people and women
✅ Severe AH defined by MELD >20
✅ Moderate AH has a 12% mortality at 90 days (not benign!)
✅ Recurrent AH: correlated with poor prognosis (Protective factors: Being married and use of MAUD)
✅ Medications for AUD are underutilized
✅ Naltrexone is safe in pts with cirrhosis

[Rabih Ghazi, MD @Rabihghazi_95]

#WedGastroGuide💩

Transjugular Intrahepatic Portosystemic Shunt (TIPS)
- @AASLD 2023 Guidance

TIPS Main Indications⁉️
🔸Variceal bleed refractory to 💊or endoscopic management
🔸Ascites refractory to Na-restriction and 💊 (Spironolactone 400 mg/day + Furosemide 160 mg/day)
🔸Budd-Chiarri
🔸Others

TIPS Contraindications⁉️
🔸Absolute: congestive HF, severe TR, severe pulmonary HTN, severe uncontrolled HE, systemic infection
‼️Higher MELD score -> higher mortality with TIPS. No clear cutoff but ~18

Pre-TIPS Workup⁉️
🔸CT scan (for mapping), TTE, MELD score, and others

Hepatic venous-portal gradient (HPVG)⁉️
🔸1-5 mm Hg➡️Normal✅
🔸> 5 mm Hg ➡️ portal hypertension
🔸> 10 mm Hg ➡️clinically significant portal hypertension
🔸> 12 mm Hg ➡️increased risk of variceal bleeding🩸

TIPS for Variceal Bleeding⁉️
‼️Variceal bleeding ➡️ goal HVPG < 12 mm Hg or >50% reduction from baseline.
‼️Dilate stent starting at 8 mm and up to 10 mm to achieve gradient goals
‼️If unable to reach HVPG <12 mm Hg➡️add non-selective beta blockers

Complications⁉️
🔸Procedure-related (e.g. vessel injury)
🔸TIPS dysfunction
🔸Hepatic Encephalopathy (higher risk with lower post-TIPS HVPG)
🔸Worsening of liver function
🔸Cardiac overload

AASLD Guideline https://t.co/9tPAfJaSvv

TIPS Liver Fellow Network @LiverFellow
https://t.co/h57hqaLdka
#MedTwitter #MedEd #GITwitter #LiverTwitter

[Devika Dixit @DevikaDixit3]

LIVER LOVERS!! Come to #ACG2024 to learn about misdiagnosis of liver sarcoidosis and a new predictive score for post-LTx outcomes: MELD-Psoas! Thanks @NimyJohn ,@The__Liver for your guidance!

[Devika Dixit @DevikaDixit3]

@kvbhatiamd @AmCollegeGastro Congrats Khushboo!

[Devika Dixit @DevikaDixit3]

@umariqbalmed @UFIMRes Well-deserved!

[Devika Dixit @DevikaDixit3]

@AngeliPahim_md Congratulations Isabella!

[Wei Zhang MD PHD @Wei_Zhang_Liver]

Excited to share our latest research on the use of stigmatizing language on liver transplant center websites for Alcohol Associated Liver Disease. Our findings highlight the need for more patient-centered language to reduce stigma and improve care.

[Devika Dixit @DevikaDixit3]

@rohit8692 @BIDMC_GI @MGHMedicine @BIDMChealth Thank you Rohit!

[Devika Dixit @DevikaDixit3]

The best things happen unexpectedly.

I am happy to announce that I be starting the Advanced Hepatology Fellowship Training program at Harvard’s BIDMC! Look forward to joining @BIDMC_GI!

[Devika Dixit @DevikaDixit3]

@PrettyNerdyDoc_ @BIDMC_GI Thank you Nikki! Hope you are well!

[Devika Dixit @DevikaDixit3]

@lascano_AATD_CF @BIDMC_GI Thank you Dr. Lascano! Thank you for all your teachings in the ICU!

[Devika Dixit @DevikaDixit3]

@yasminekamal @BIDMC_GI Thanks Yasmeen!

[Devika Dixit @DevikaDixit3]

@sujaykmd @BIDMC_GI Thank you Sujay!

[Devika Dixit @DevikaDixit3]

@umariqbalmed @BIDMC_GI Thanks Umar!

[Keith Siau @drkeithsiau]

Diagnosis and management of cirrhosis - don't miss this blockbuster review by @ebtapper @NDP1001 #4KMedEd #LiverTwitter

1️⃣ Pathogenesis ⚙️
2️⃣ Natural history ⏳
3️⃣ Risk of complications ⚠️
4️⃣ Treatments 💊

(Via @QxMD in @JAMA_current)
https://t.co/dB0CxXQXfG