Helicobacter pylori infection in non-ulcer dyspepsia: A cross-sectional study.

Background: Helicobacter pylori infection has been known to be associated with dyspepsia for more than two decades; however, studies on this topic in India are limited. This study was carried out to estimate the Helicobacter pylori infection rates in non-ulcer dyspepsia. Methods: Helicobacter pylori infection rates detected by rapid urease test (RUT) positivity were analyzed in 235 patients presenting to a tertiary care center with dyspepsia having no evidence of peptic ulcer disease on esophagogastroduodenoscopy. Results: In this study, the prevalence of Helicobacter pylori infection diagnosed by the RUT was found to be 40.85%. Gender-based prevalence was found to be 40.14% and 41.93% for men and women, respectively. The highest prevalence was found in the age group of 30-39 years. The most common area of involvement was the isolated antrum of the stomach as seen in 93 patients. Conclusion: This study shows a modest RUT positivity rate for Helicobacter pylori infection with the commonest site of involvement being the antrum of the stomach. Further studies will be needed to assess the prevalence of Helicobacter pylori in the community to analyze the extent of infection.

Occult metabolic bone disease in chronic pancreatitis.

BACKGROUND: Chronic pancreatitis (CP) leads to malabsorption and metabolic bone disease (MBD). Alcoholic CP (ACP) and tropical CP (TCP) are the two common types of CP. OBJECTIVE: We investigated the presence of occult MBD in patients with CP and compared the same between ACP and TCP. MATERIALS AND METHODS: In this cross-sectional, observational study, we included serial patients of CP in different stages and are grouped as ACP (Group 1; n = 67) and TCP (Group 2; n = 35). We determined serum calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D (25OHD), and intact parathyroid hormone (PTH) levels. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry in the neck of the left femur. MBD was defined by the presence of either low bone mass (Z-score Results: The study participants (85 males; 17 females) had a mean age of 40.8 ± 12.6 years, CP duration of 3.7 ± 4.7 years, and Body Mass Index of 22.5 ± 3.2 kg/m2. A total of 37 (36%) patients had MBD (osteomalacia in 31 and low bone mass in 6). The frequency of MBD was same in the TCP (16/35) and ACP (21/65) groups (P = 0.1940). Elevated PTH (>70 pg/mL) was seen in 14 patients with 25OHD deficiency and low calcium (<8.5 mg/dL) in 29 patients. BMD did not show a significant correlation with the duration of CP. CONCLUSION: Occult MBD is seen in a third of patients with CP and is similar irrespective of the etiology. The disease is silent and mandates active screening in all susceptible individuals.

Acute cortical necrosis in Falciparum malaria: an unusual manifestation.

The spectrum of acute renal failure in Falciparum malaria varies from mild urinary abnormalities to acute renal failure. Acute tubular necrosis has been reported in 1% patients, and acute cortical necrosis has rarely been reported. We present a case of acute cortical necrosis in a young patient with Falciparum malaria who had a prolonged oligo-anuric course followed by partial recovery of renal function.

Successful medical treatment of emphysematous pyelonephritis in a renal allograft recipient.

Emphysematous pyelonephritis in renal allograft recipients is a rare but serious complication. The management of this entity is a subject of controversy in live related donor programs where the absence of a second donor is a key factor influencing surgical removal of the graft. We present a case of emphysematous pyelonephritis in a renal allograft recipient managed successfully with medical therapy alone.