Vishnu Dev

Associate Consultant at @Sarvodaya_Care
DM Gastroenterology, MMC Chennai.
MD Medicine (AIIMS).

[Vishnu Dev @drvdevMD]

SHARP Trial , no more upfront minor papillotomy? ✂️🛑

[Indiana University Gastroenterology and Hepatology @IUGastro]

✂️ Minor papillotomy, major question.

Is this standard treatment effective for recurrent acute #pancreatitis with pancreas divisum?

Evan Fogel, MD, shares SHARP trial findings in @JAMA_current. #ManuscriptMonday

📑https://t.co/XGdA5y24py

#SHARPTrial #GITwitter

[Vishnu Dev @drvdevMD]

@Bealoquebea @fgomollon @DCharabaty @JosephHabibi_MD @geteccu @IBDimmunology @BattatMD4IBD @ibd_pal @KaazanPatricia @ShomronH @Y_ECCO_IBD Wonderful compendium 👍🏻👍🏻

[Vishnu Dev @drvdevMD]

Landmark ✌🏻

[NEJM @NEJM]

Presented at #EASL:

In two phase 3 trials, 19% of patients with chronic hepatitis B infection had a functional cure with the antisense oligonucleotide bepirovirsen, 24 weeks after stopping all HBV treatment; functional cure was not seen with placebo. Full results of the B-Well 1 and B-Well 2 trials: https://t.co/jcwJDIT5XR

Editorial: A Major Step toward a Cure for Hepatitis B Infection https://t.co/WzYWLC6lFU]

@EASLnews

[Elliot Tapper @ebtapper]

Hepatology papers
#livertwitter, someone had to do it

[Kevin Whelan @ProfWhelan]

First ever guidelines for #diet in #constipation

▶️59 recommendations
▶️4 systematic reviews
▶️Included 75 RCTs
▶️6 years of work
▶️Endorsed by @BDA_Dietitians @PCSGastro

Led by @EiriniDimidi

@JHND_Official👉
https://t.co/HNJusoYTwT

@NGMJournal👉
https://t.co/P0ezgAgnuM

[Vishnu Dev @drvdevMD]

Our study in ACG Summit.
The Enigma of Cholestasis in Hereditary Spherocytosis : Official journal of the American College of Gastroenterology | ACG https://t.co/ZueiUKvwqh

[Klaus Mönkemüller, MD, PhD @KMonkemuller]

✅ Biopsies in suspected microscopic colitis

👉🏻 In this article Virine et al convincingly show that a diagnosis of microscopic colitis is always reached when evaluating biopsies of the ascending AND descending colon.
https://t.co/8WA73O5uFX
showPdf?
pii=S1542-3565%2820%2930206-8

[George Ioannou @gnioannou]

If AFP level was 1-3 the last few times it was measured, & then "jumps" to 9, this should be a *POSITIVE* screening test for HCC (even if 9 is not above threshold):

👉Serial AFPs improve HCC screening sensitivity compared to fixed threshold

https://t.co/WHnKGGQC6i

[Carl Kay, MD @CarlKayMD]

🚨 New ACG Crohn’s Guidelines (2025)

▪️Scope at 6–12 mo post-op
▪️Early advanced therapy = key
▪️Anti-TNF, IL-23, JAKi > mesalamine
▪️High-risk = smoking, prior surgery, penetrating dz
▪️Surgery for abscess >2cm or strictures

🔗 https://t.co/PfEj2Rvnke

[Vishnu Dev @drvdevMD]

Yes..finally!

[Nadeem Tehami @helpatologist]

Thrilled to see this international consensus work on EUS PPG presented today #DDW2025

29 advanced endoscopists and 18 hepatologists participated, led by the brilliant Dr. Thomas J. Wang 👏

All 22 statements reached consensus by Round 2

[Vishnu Dev @drvdevMD]

@Hiba_Chagla @LorenLaine2 @PaulMoayyedi This debate, a relevant one especially with the whole new armamentarium of PCABS coming up

[Klaus Mönkemüller, MD, PhD @KMonkemuller]

✅ This is a 🔝 development

🧰 Large working channel scope allows for more suction and of course, better instrumentation (can aspirate while having accessories inside the working channel) 👍🏻

[Sebastian Marciano @sebas_marciano]

#TLM2024

ALD & MetALD debrief by @juanpabloarab

➡️ Steroid tapering trial in alcohol-hepatitis ⬇️ infections vs standard approach

➡️ Many ALD pts are MetALD

➡️ In ALD, men and private insurance favors LT

➡️ Larsucosterol trial for alcohol-hepatitis

@AASLDtweets @alehlatam

[Vishnu Dev @drvdevMD]

Types of hunger

[Keith Siau @drkeithsiau]

Today I learnt that there are 3 different types of hunger

📸: https://t.co/a1fLJl9Egh

[Vishnu Dev @drvdevMD]

@DouglasAdlerMD @asge @bostonsci @EUSandEndoscopy @NEndoscopy Sir, the collection was secondarily due to acute pancreatitis?

[Vishnu Dev @drvdevMD]

Highly useful..

[Carl Kay, MD @CarlKayMD]

Choosing Advanced Therapies for UC Based on Concomitant Immune Conditions & Extra-Intestinal Manifestations

▪️Plaque psoriasis ➡️ IL-23 & TNFi
▪️Psoriatic arthritis ➡️ IL-23, TNFi, JAKi
▪️Spondyloarthropathy ➡️ TNFi & JAKi
▪️Atopic dermatitis ➡️ JAKi
▪️Uveitis ➡️ TNFi

#ACG2024

[Neena S Abraham MD MACG FASGE AGAF @NeenaSAbrahamMD]

👉🏽 Did you know curcumin mixed with black pepper & green tea extract pills (used for weight loss) are some of the most toxic OTC supplements for the liver?

👉🏽 @nagachalasani @AmJGastro lecture on Drug Induced Liver Disease #ACG2024

@JasmohanBajaj
@MLongMD

[Vishnu Dev @drvdevMD]

@SahajRathi @Nature Fact sir. And the predatory publishing houses have successfully blocked sci-hub through their collective greed.

[Walter Chan, MD, MPH @WalterChanMD]

Lots of clinical pearls & practical tips from the colon & anorectal cases panel, including approach to #IBS, defecation & pelvic floor dysfunction, transition from pediatric to adult care, and dietary, psychological and pharmacologic therapy.

#HarvardMotility2024

[Vishnu Dev @drvdevMD]

But always rule out
❗local and ❗systemic risk factors.

Note:
❗PVT is not equal to EHPVO.

❗PVT with the young without demonstrable risk factors might be EHPVO.

❗❗❗If older age (>30 years) with new onset PVT, find out risk factors for the same.
#gitwitter #livertwitter

[Vishnu Dev @drvdevMD]

⚠️ Tests to do in non tumoral, non cirrhotic PVT. ⚠️

1. Protein C, S, ATIII Deficiency

2. Factor V Leiden Mutation

3. Prothombin 20210A gene mutation

4. JAK2 mutation

5. PNH workup

6. Serum Homocysteine,

7. APLA profile

8. If fitting, ANA

1/3
#gitwitter #livertwitter

[Vishnu Dev @drvdevMD]

Below ones might b expensive, but worth to do:
- activated Protein C resistance,
- genotyping of Factor V to search for G1691A mutation,
- Factor VIII assay,
- occult MPD by endogenous erythroid colony assessment
- bone marrow (helps in 30% EHPVO/PVT)

2/3
#gitwitter