Clinical profile of 1208 newly diagnosed colorectal cancer patients in Tamil Nadu-A multi-centric survey.

BACKGROUND: An increasing incidence of colorectal cancer (CRC) is being reported in developing countries, including India. Most Indian studies on CRC are retrospective and single-centered. The present study is an attempt to understand the current clinical profile and stage of newly diagnosed CRCs across multiple centers in Tamil Nadu, India. METHODS: A multi-centric observational survey was conducted between September 1, 2021, and August 31, 2022, under the aegis of the Indian Society of Gastroenterology - Tamil Nadu chapter. Patients 18 years of age and older with a recent diagnosis of CRC fulfilling the inclusion criteria were prospectively recruited at the participating centers. Their demographic, clinical, biochemical, endoscopic, histopathologic, radiologic and risk factor details were systematically collected and analyzed. RESULTS: Across 23 centers in Tamil Nadu, 1208 patients were recruited. The male:female ratio was 1.49:1, while mean (SD) age was 57.7 (13.5) years. A majority (81.9%) were Tamils and 78.5% belonged to lower socioeconomic classes. The predominant symptoms were hematochezia (30.2%) and a change in bowel habits (27.5%). The most common locations were the rectum (34.3%) and rectosigmoid (15.1%). Synchronous CRCs were seen in 3.3% and synchronous colorectal polyps in 12.8%. Predisposing factors for CRC were seen in 2%. A past history of any cancer among CRC patients was obtained in 3.1% and a family history of any cancer was found in 7.6%. Patients who were either overweight or obese constituted 46.4% of the study population. At presentation, the predominant stages were stage III (44.7%) and stage IV (20.8%). CONCLUSIONS: A majority of patients with newly diagnosed CRC in Tamil Nadu belonged to the lower socioeconomic classes. About 60% had CRCs located within the reach of the flexible sigmoidoscope. Two-thirds of the patients exceeded stage II disease at presentation. TRIAL REGISTRATION: Not applicable.

Mucosa-adherent Pediococcus Pentosaceus I44 isolated from healthy human and effect of oleic acid on its probiotic properties.

With the aim of selectively isolating and understanding the cultivable lactic acid bacteria that are autochthonous to human gut, biopsy samples were collected from the terminal ileum and caecum of healthy volunteers who underwent routine colonoscopy procedure. The use of tissue samples (over stool samples) provides for a better expression of the autochthonous bacterial population of the human gut. The strains that were stable after many rounds of sub-culture were identified and studied further. One such ileal isolate, a Gram-positive, catalase-negative cocci was identified to be Pediococcus pentosaceus I44. It was studied for its gastric tolerance, bile tolerance and surface properties, and reported here. The effect of tween-80, oleic acid, extra virgin olive oil and sesame oil on the aforementioned properties of P. pentosaceus I44 was also analysed. The isolate was able to survive well in simulated gastric fluid of pH 3.0 followed by treatment in simulated intestinal fluid with a survival percentage of around 70%. It was, however, unable to withstand pH 2.0 even in the presence of supplements. It showed good tolerance to bile stress (1% w/v), and its cell surface was found to be hydrophilic. P. pentosaceus I44 showed good aggregation of 87% after 24 h, with oleic acid having a significant effect on the isolate's aggregation potential. P. pentosaceus I44 is one of the few mucosa-bound cultivable bacteria that are adapted for survival in human colon. Studying and analysing such isolates might provide useful insights into their role in metabolism and health.

Nocardia liver abscess post liver transplantation-A rare presentation.

Nocardiosis is usually a disseminated disease seen in immunocompromised individuals. We herein present a rare case of isolated Nocardia liver abscess post liver transplantation. The patient responded well to treatment and is on long-term antibiotics for Nocardia infection.

Urinary bladder diverticulum and its association with malignancy: an anatomical study on cadavers.

Present work was directed to study the prevalence and anatomical basis of diverticulum formation and its association with malignancy inside the urinary bladder on cadavers. Urinary bladder diverticulum and its complications including malignancy has been reported by different authors based on their study on radiological findings and endoscopy. Present study was undertaken on cadavers to meet the aforementioned objectives. Thirty properly embalmed cadavers (19 males and 11 females) of different ages were dissected. Sagittal section of pelvis was studied. Urinary bladder was incised to expose the interior and it was examined for the presence of diverticulum (including number and location). Detailed history of the cause of death of cadavers with diverticulum was studied to determine how many of them suffered from urinary bladder diverticular carcinoma. 23.4% cadavers (31.6% males and 9.1% females) showed presence of urinary bladder diverticulum. The location of the diverticulum in all the cadavers was on superior and lateral side of the ureteric opening on the posterior surface of the urinary bladder. Diverticulum of one male cadaver aged 74 years was complicated by malignancy. Our study observed greater prevalence of diverticulum formation as compared to previous reports. In the present work, 14.3% diverticulum of the urinary bladder showed malignant change, which is more than earlier reports in the literature. Urinary bladder diverticulum should neither be neglected nor ignored. Appropriate early treatment (including the cause) of the diverticulum should be undertaken to avoid complications like malignancy which will finally ensure longevity.