Dietary fiber assessment of patients with irritable bowel syndrome from Northern India.

BACKGROUND: Data on the absolute fiber intake and the source of dietary fiber intake in patients with irritable bowel syndrome (IBS) have been lacking in northern Indians. OBJECTIVE: To find out the absolute fiber intake from different sources of food items in patients with IBS and healthy subjects from northern India. METHODS: Using the 72-hour recall method, dietary intake of macronutrients and fiber was determined in 33 consecutive adult patients with IBS and 33 age- and gender-matched healthy controls. RESULTS: The patients consumed lower amounts of macronutrients (protein 60.4 g vs 79.3 g, fat 47.7 g vs 65.7 g, and carbohydrates 294.6 g vs 339.8 g) and dietary fiber (8.1 g vs 15.7 g) than the control subjects. Though the patients consumed similar amount of pulses as the controls (46.6 [25.0] vs 46 [19.6] g/day), their fiber intake from pulses was lower (0.8 [0.7] vs 1.4 [0.9] g/day). The intake of fiber from vegetables and fruits was also significantly lower in patients (2.1 and 0.5 g/day, respectively) than in control subjects (5.8 and 3.9 g/day, respectively; p< 0.001 each). CONCLUSION: Total dietary fiber intake and intake of fiber from vegetables, fruits and pulses are lower in patients with IBS from northern India than in control subjects.

The rates of false-positive lumbar discography in select patients without low back symptoms.

STUDY DESIGN: Experimental disc injections in subjects with no history of low back symptoms. OBJECTIVE: To determine in an experimental setting the relative pain response and pain-related behavior in selected subjects without a history of low back pain undergoing lumbar discography. This study aimed to select a study population that more closely represented patients undergoing discography in clinical practice. SUMMARY OF BACKGROUND DATA: Previous work has shown that in young, healthy men with little degenerative disc disease and no history of low back problems, discographic injections usually did not cause significant pain. This group differed from the patients who usually undergo discographic evaluation in clinical practice. Most clinical patients are older, have significant degenerative disc disease, have behavioral changes associated with chronic pain, and often have confounding psychosocial troubles. The authors undertook to study discography in subjects without low back pain but with clinical profiles similar to patients undergoing discography in clinical practice. METHODS: Twenty-six individuals, mean age 43 years, with no history of low back pain had lumber discography according to the strict protocol of Walsh et al. Of these, 10 were pain-free; 10 had chronic neck and arm pain, but no low back symptoms; and 6 had primary somatization disorders without low back symptoms.- RESULTS: Significant positive pain response and pain-related behavior with discography were found in 10% of the pain-free group, in 40% of the chronic cervical pain group, and in 83% of the somatization disorder group completing the injections. Twenty-four subjects had negative control discs. Discs with annular disruption were more likely to be painful on injection, particularly in those individuals with ongoing compensation issues, chronic pain, or abnormal psychological testing.- CONCLUSION: If strict criteria are applied, the rate of false-positive discography may be low in subjects with normal psychometric profiles and without chronic pain. Significantly painful injections were very common in subjects with annular disruption and chronic pain or abnormal psychometric testing.

Assessment of the modified internal gas generator system for isolation of Campylobacter.

The modified internal gas generator system (MIGGS) to create microaerophilic conditions for the isolation of Campylobacter was compared with two conventional methods viz., the Gaspak and the hydrogen and carbon dioxide gas mixture from gas cylinders. Ten reference strains of C. jejuni, C. coli and C. laridis were grown on Butzler's medium at optimum temperature under microaerophilic conditions. The MIGGS and Gaspak gave identical results which were better than with the compressed gas mixture. As the chemicals required for MIGGS are commonly available in the market, it works out to be less expensive than the commercial Gaspak. Further, investigations with MIGGS revealed Campylobacter in the faecal samples of 1.9 per cent (50 out of 2661) patients of diarrhoea visiting a Teaching Hospital in Ludhiana (Punjab). None of the 105 healthy volunteers excreted Campylobacter in their faeces. In the 50 positive patients, highest (22%) occurrence was observed in April followed by 16 per cent in May. High prevalence of Campylobacter diarrhoea was observed among infants and children up to 10 yr. Male patients were found to be more susceptible to infection than females (1.9:1). All strains were sensitive to the common antimicrobial agents tested.