Colitis and Crohn's Foundation (India): a first nationwide inflammatory bowel disease registry.

BACKGROUND/AIMS: The national registry for inflammatory bowel disease (IBD) was designed to study epidemiology and prescribing pattern of treatment of IBD in India. METHODS: A multicenter, cross-sectional, prospective registry was established across four geographical zones of India. Adult patients with ulcerative colitis (UC) or Crohn's disease (CD) were enrolled between January 2014 and December 2015. Information related to demographics; disease features; complications; and treatment history were collected and analyzed. RESULTS: A total of 3,863 patients (mean age, 36.7 ± 13.6 years; 3,232 UC [83.7%] and 631 CD [16.3%]) were enrolled. The majority of patients with UC (n = 1,870, 57.9%) were from north, CD was more common in south (n = 348, 55.5%). The UC:CD ratio was 5.1:1. There was a male predominance (male:female = 1.6:1). The commonest presentation of UC was moderately severe (n = 1,939, 60%) and E2 disease (n = 1,895, 58.6%). Patients with CD most commonly presented with ileocolonic (n = 229, 36.3%) inflammatory (n = 504, 79.9%) disease. Extraintestinal manifestations were recorded among 13% and 20% of patients in UC and CD respectively. Less than 1% patients from both cohorts developed colon cancer (n = 26, 0.7%). The commonly used drugs were 5-aminosalicylates (99%) in both UC and CD followed by azathioprine (34.4%). Biologics were used in only 1.5% of patients; more commonly for UC in north and CD in south. CONCLUSIONS: The national IBD registry brings out diversities in the 4 geographical zones of India. This will help in aiding research on IBD and improving quality of patient care.

Plasma ghrelin levels after laparoscopic sleeve gastrectomy in obese individuals.

Background & objectives: Ghrelin is an orexigenic gut hormone expressed by the gastric fundus. Laparoscopic sleeve gastrectomy (LSG) procedure involves resection of the gastric fundus leading to a decreased appetite and weight loss. This study was undertaken to determine the levels of plasma ghrelin after sleeve gastrectomy in obese patients. Methods: The study was conducted on 90 morbidly obese patients [body mass index (BMI) >40 kg/m[2]] and severely obese patients (BMI >35/kg/m[2]) who underwent sleeve gastrectomy. The patients were followed up for six months. Weight loss parameters and plasma ghrelin levels were assessed pre- and postoperatively. Results: A significant weight loss and decrease in BMI were observed at three and six months postoperatively. A significant decrease in plasma ghrelin levels over six months of follow up postoperatively was also seen. Interpretation & conclusions: These preliminary findings indicated inhibition of ghrelin production after LSG leading to a decrease in the plasma ghrelin levels within a few days of surgery and sustainable weight loss in obese patients.

Gender bias in cardiovascular healthcare of a tertiary care centre of North India.

OBJECTIVES: To analyse the gender bias in paediatric patients referred for free cardiac treatment as part of School Health Programme at a tertiary care centre in North India. METHODS: A total of 537 children were referred for further management of congenital heart disease or rheumatic heart disease. Of these, 519 underwent cardiac intervention, and the data from their records were analysed retrospectively to determine any gender disparity in the utilisation of cardiac surgery. RESULTS: Of the 519 children studied, only 195 (37.6%) were girls, while the remaining 324 (62.4%) were boys (male-to-female ratio of 1.66:1, p<0.0001), indicating a large gender divide. Gender bias was found to be prevalent across all the age groups irrespective of the type of cardiac ailment. Moreover, no statistically significant difference was found between the urban and rural populations (male-to-female ratio of 1.64:1 in rural and 1.71:1 in urban populations; p=0.823) in terms of gender disparity. CONCLUSIONS: Significant gender discrepancies exist in healthcare-seeking behaviour of patients in North India despite the provision of free cardiac treatment. An equal prevalence of gender bias in urban and rural communities points towards deep-rooted social norms beyond just the economic constraints. Healthcare policies ensuring equal treatment of male and female children should be promulgated to ensure a complete eradication of this social evil.

Clinical and angiographic profile of patients presenting with first acute myocardial infarction in a tertiary care center in northern India.

OBJECTIVE: Acute myocardial infarction (AMI) is one of the presentation of coronary artery disease (CAD) and is thought to occur in younger age group in this region. The objective of this study was to evaluate clinical, biochemical and angiographic profile of patients with first acute myocardial infarction. METHODS: Eight hundred and forty-six consecutive patients who underwent coronary angiography within 4 weeks of MI were included. RESULTS: Males (n = 705, 83.3%) outnumbered females (n = 141, 16.7%) in each age group. Mean age of presentation was lower in females (58.25 +/- 9.69: 55.74 +/- 10.63). Three hundred and forty-two (40.8%) patients were thrombolyzed. Most common type of MI was anterior wall MI (n = 485, 57.32%). Three hundred and forty (40.4%) were diabetic with females outnumbering males proportionately (females = 63, 44.68%: males = 277, 39.29%). More females were hypertensive (females = 81, 57.45%: males = 306, 43.40%). Prevalence of smoking was quite low (n = 140, 16.50%) and mean age of smokers was less by 7 years than non-smokers. One hundred and forty-two (16.7%) were obese with mean age of presentation less by 7 years than non-obese. Single vessel disease (SVD) was more prevalent (361/846; 42.67%) and was more common in younger, non-diabetics and smokers. Diabetics were more likely to have triple vessel disease (TVD) (n = 112, 32.95%). CONCLUSIONS: The study reveals that age of first AMI was comparable to that in western world. Females tend to be more hypertensive and diabetics. Younger, non-diabetics and smokers tend to have single-vessel disease. Diabetics and older population were more likely to have diffuse disease (TVD).