Devika Dixit

🌟CIRRHOSIS - Pharmacotherapy

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

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

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

#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 journals.lww.com/hep/fulltext/2… TIPS Liver Fellow Network @LiverFellow aasld.org/liver-fellow-n… #MedTwitter #MedEd #GITwitter #LiverTwitter

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!

@kvbhatiamd @AmCollegeGastro Congrats Khushboo!

Just got my abstracts accepted to #ACG2024 to brighten my Friday! Who's coming to Philly? Let's connect🙋‍♀️ @AmCollegeGastro #GITwitter #LiverTwitter

@umariqbalmed @UFIMRes Well-deserved!

Could not have imagined it to be any better Received the Troy Linn Award, heart of the ethos @UFIMRes With the most beautiful citation ever written : “To acknowledge a fundamental respect for life, thirst for knowledge, compassion, and dedication to the practice of medicine”

@AngeliPahim_md Congratulations Isabella!

I’M GOING TO BE A SURGEON!!! I MATCHED INTO GENERAL SURGERY CATEGORICAL AS AN IMG!!! #GenSurgMatch2024 #Match2024

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.

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

@DevikaDixit3 @BIDMC_GI Congratulations! See you soon the Harvard ecosystem @MGHMedicine @BIDMChealth

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!

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

@DevikaDixit3 @BIDMC_GI Congratulations Devika!!!

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

@DevikaDixit3 @BIDMC_GI Amazing!!! I knew it!!! You are the best!!!

@yasminekamal @BIDMC_GI Thanks Yasmeen!

@DevikaDixit3 @BIDMC_GI Congratulations 🥳 that’s exciting

@sujaykmd @BIDMC_GI Thank you Sujay!

@DevikaDixit3 @BIDMC_GI Massive Congrats!!!

@umariqbalmed @BIDMC_GI Thanks Umar!

@DevikaDixit3 @BIDMC_GI Congratulations 🎊🍾🎉

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) jamanetwork.com/journals/jama/…