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1.
Cancer Rep (Hoboken) ; 1(1): e1004, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-32729225

RESUMO

BACKGROUND: Localization and differential expression of STAT3 and survivin in cancer cells are often related to distinct cellular functions. The involvement of survivin and STAT3 in gastric cancer has been reported in separate studies but without clear understanding of their kinetics in cancer progression. METHODS: We examined intracellular distribution of STAT3 and survivin in gastric adenocarcinoma and compared it with normal and precancer tissues using immunoblotting and immunohistochemistry. RESULTS: Analysis of a total of 156 gastric samples comprising 61 histologically normal, 30 precancerous tissues (comprising intestinal metaplasia and dysplasia), and 65 adenocarcinomas, collected as endoscopic biopsies from treatment naïve study participants, revealed a significant (P < .001) increase in overall protein levels. Survivin expression was detectable in both cytoplasmic (90.8%) and nuclear (87.7%) compartments in gastric adenocarcinomas lesions. Precancerous dysplastic gastric lesions exhibited a moderate survivin expression (56.7%) localized in cytoplasmic compartment. Similarly, STAT3 and pSTAT3 expression was detected at high level in gastric cancer lesions. The levels of compartmentalized expression of survivin and STAT3/pSTAT3 correlated in precancerous and adenocarcinoma lesions. Although overexpression of these proteins was found associated with the tobacco use and alcohol consumption, their expression invariably and strongly correlated with concurrent Helicobacter pylori infection. Receiver operating characteristic analysis of nuclear survivin, STAT3, and pSTAT3 in different study groups showed acceptable positive and negative predictive values with area under the curve above 0.8 (P < .001). CONCLUSION: Overall, our results suggest that overall increase in survivin and STAT3 and their subcellular localization are key determinants of gastric cancer progression, which can be collectively used as potential disease biomarkers and therapeutic targets for gastric cancer.


Assuntos
Adenocarcinoma/diagnóstico , Infecções por Helicobacter/patologia , Fator de Transcrição STAT3/análise , Neoplasias Gástricas/diagnóstico , Survivina/análise , Adenocarcinoma/epidemiologia , Adenocarcinoma/microbiologia , Adenocarcinoma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/metabolismo , Estudos de Casos e Controles , Criança , Progressão da Doença , Feminino , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrite/diagnóstico , Gastrite/epidemiologia , Gastrite/microbiologia , Gastrite/patologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/microbiologia , Lesões Pré-Cancerosas/patologia , Fatores de Risco , Fator de Transcrição STAT3/metabolismo , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Survivina/metabolismo , Fumar Tabaco/epidemiologia , Adulto Jovem
2.
Indian J Pathol Microbiol ; 60(3): 385-389, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28937377

RESUMO

Irritable bowel syndrome (IBS) was previously considered as a psychosomatic disorder. But recent studies indicate that inflammation plays a significant role. The present study was undertaken to evaluate role of pro-inflammatory (IL 2, IL 6 and IL 8) and anti-inflammatory (IL 10) cytokines in clinically diagnosed patients of IBS. 51 patients and 29 controls were included in this study. On the basis of history of gastrointestinal infection, patients were divided into Post Infectious (PIIBS) and Non Post Infectious (NPIIBS) groups. All subsequently underwent colonoscopy and a rectosigmoid biopsy as well as measurement of levels of IL 2, 6, 8 and 10. The levels of IL 2 and IL 8 were significantly raised in IBS patients compared to controls with the mean level of IL 2,6 and 8 higher in PIIBS group than NPIIBS group but statistically significant for IL 8 only. The mean level IL-10 was reduced in patients compared to controls but statistically insignificant. Present study shows that Interleukin levels are altered in patients suffering from IBS and may have a key role in its pathogenesis.


Assuntos
Interleucinas/sangue , Síndrome do Intestino Irritável/patologia , Adulto , Biópsia , Colonoscopia , Ensaio de Imunoadsorção Enzimática , Feminino , Histocitoquímica , Humanos , Masculino , Microscopia , Pessoa de Meia-Idade
3.
J Clin Diagn Res ; 11(2): OC21-OC23, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28384910

RESUMO

INTRODUCTION: Irritable Bowel Syndrome (IBS), a common gastrointestinal (GI) disorder has been linked with asthma implying a clue to its pathophysiology as being some form of allergic response. Previous studies from other parts of the world have shown both the presence as well as an absence of an association between them. AIM: We conducted a cross-sectional study to find an association between IBS and asthma, in an Indian cohort. MATERIALS AND METHODS: Seventy patients of IBS diagnosed by exclusion and ROME III criteria with a matched control group were questioned for GI, respiratory symptoms along with their spirometry analysis. Those having reversible bronchoconstriction were categorized as asthmatic. RESULTS: The prevalence of asthma in the IBS group of 16 females and 54 males was 12 (17.14%) as compared to 14 (20%) in control group. Chi-square test revealed the Odds Ratio (OR) for prevalence of asthma in IBS as 0.828 with 95% Confidence Interval (CI) between 0.320 and 2.121 (p=0.664) which was non-significant (p>0.05). CONCLUSION: This study denies the presence of association between IBS and asthma among Indian cohorts and suggests that regional variations are present in the above association.

4.
Indian J Gastroenterol ; 36(1): 50-55, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28176238

RESUMO

BACKGROUND AND AIM: Liver diseases interfere with the production of the metabolites of vitamin D required for activation, thus resulting in abnormal calcium and bone metabolism. Previous studies show inconsistent results of vitamin D level in non-cholestatic liver diseases. Our aim was to determine the prevalence of vitamin D insufficiency in cirrhosis as compared to apparently normal relatives and its relationship with etiology and severity. METHODS: One hundred and sixty cirrhotic patients attending the Department of Gastroenterology and Hepatology, M L N Medical College, Allahabad, were enrolled, and 25-hydroxy vitamin D [25(OH)D] and calcium levels assessed. Vitamin D status was graded as insufficiency (20-30 ng/mL), deficiency (<20 ng/mL), and severe deficiency (<7 ng/mL). 25(OH)D levels of patients were compared with those of their healthy family members. RESULTS: Forty-six percent of the normal population had 25(OH)D inadequacy, whereas 51.85% of patients with cirrhosis had 25(OH)D deficiency, and 28.12% had insufficiency. Thus, 80% of patients with cirrhosis of the liver had some form of vitamin D inadequacy. 12.5% of cirrhotics had severe vitamin D deficiency. Serum calcium (Ca++) was not significantly different between the patients and control group. The etiology of cirrhosis had no relation with vitamin D levels. Prevalence of deficiency and insufficiency increased with increasing age and mean Child-Turcotte-Pugh and model for end-stage liver disease scores. CONCLUSION: Vitamin D insufficiency is highly prevalent in patients with cirrhosis irrespective of etiology and significantly more common than their healthy relatives. Measurement of 25(OH) vitamin D and replacement may be considered as part of the overall management of patients with cirrhosis of the liver as well as apparently healthy individuals.


Assuntos
Cirrose Hepática/etiologia , Cirrose Hepática/metabolismo , Vitamina D/análogos & derivados , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Índia/epidemiologia , Cirrose Hepática/diagnóstico , Cirrose Hepática/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prevalência , Vitamina D/metabolismo , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/metabolismo
5.
J Clin Diagn Res ; 10(10): EC10-EC12, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27891343

RESUMO

INTRODUCTION: Gastric cancer develops in a multistep progression and is determined by genetic and environmental factors. Over-expression of Alpha Methylacyl CoA Racemase (AMACR) is useful in diagnosis of prostate cancer. There is plenty of genetic alteration that occurs in gastric adenocarcinoma. The present study was planned to determine if AMACR can be used as a diagnostic marker in gastric adenocarcinoma similar to prostate cancer. AIM: To study the expression of AMACR in gastric adenocarcinoma and correlate its expression with density of Helicobacter pylori. MATERIALS AND METHODS: This cross-sectional, prospective study was conducted from August 2013-2015. Fifty gastric cancer biopsies were taken. Adjacent biopsy from normal/reactive mucosa was also taken from 21 cases. Samples were stained with H&E for morphological details, Loeffler's methylene blue for Helicobacter pylori and immunohistochemistry (IHC) was done to check for the expression of AMACR proteins. Statistical analysis was done using chi square test, Spearman's correlation coefficient and Fisher's exact test. The p-value ≤ 0.05 was taken as critical level of significance. RESULTS: Overexpression of AMACR was observed in 88.89% of intestinal type and 78.05% of diffuse type adenocarcinoma. AMACR expression was significantly less in adjacent reactive/dysplastic mucosa. Helicobacter pylori were seen in 8/9 (88.89%) and 35/41(85.36%) cases of intestinal adenocarcinoma and diffuse adenocarcinoma respectively. When grades of Helicobacter pylori were compared with the positivity of AMACR, no significant association and correlation was found. CONCLUSION: The expression of AMACR in neoplastic tissue was significantly higher as compared to adjacent dysplastic, reactive or normal tissue. Thus, IHC for AMACR can be used for differentiating the cases of reactive atypia from early neoplastic lesions similar to its role in prostatic tissue. Helicobacter pylori does not affect the expression of AMACR in neoplastic gastric lesions.

6.
Indian J Gastroenterol ; 35(2): 75-82, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27083430

RESUMO

Nucleotide/nucleoside analogues (antiviral therapy) are used in the therapy of HBeAg positive and HBeAg negative chronic hepatitis B. We analyzed ten selected randomized controlled with 2557 patients to estimate the effect of antiviral drugs in chronic hepatitis B with compared to placebo. Virological response, biochemical response, histological response, seroconversion of HBeAg, and loss of HBeAg were estimated as primary efficacy measures. The included studies were subjected for heterogeneity and publication bias. The heterogeneity was assessed with χ2 and I(2) statistics. Publication bias was assessed by funnel plot. Greater rates of improvement obtained in antiviral group for virological response [43.96 % vs. 3.15 %, RR = 0.57, 95 % CI = 0.54-0.61, p-value <0.00001], biochemical response [58.37 % vs. 21.87 %, RR = 0.52, 95 % CI = 0.48-0.56, p-value <0.00001], histological response [58.99 % vs. 27.13 %, RR = 0.56, 95 % CI = 0.50-0.63, p-value <0.0001], seroconversion of HBeAg [10.66 % vs. 5.56 %, RR = 0.94, 95 % CI = 0.91-0.97, p-value = 0.0005], and HBeAg loss [14.59 % vs. 9.64 %, RR = 0.92, 95 % CI = 0.88-0.96, p-value = 0.0002]. The safety analysis were carried out for adverse events such as headache [17.22 % vs. 17.34 %, OR = 1.09, 95 % CI = 0.81-1.46, p-value = 0.58], abdominal pain [16.46 % vs. 14.34 %, OR = 1.24, 95 % CI = 0.90-1.72, p-value = 0.19], and pharyngitis [22.22 % vs. 18.23 %, OR = 1.12, 95 % CI = 0.86-1.45, p-value = 0.40]. Excluding adverse events, all primary efficacy measures shown statistical significant result for chronic hepatitis treatment (p-value <0.05). Antiviral therapy provided significant benefit for the treatment of chronic hepatitis B with no measurable adverse effects.


Assuntos
Antivirais/uso terapêutico , Hepatite B Crônica/tratamento farmacológico , Nucleosídeos/uso terapêutico , Nucleotídeos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , DNA Viral , Quimioterapia Combinada , Antígenos E da Hepatite B , Vírus da Hepatite B/genética , Humanos , Estudos Prospectivos , Resultado do Tratamento
7.
Nutr Cancer ; 67(8): 1293-304, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26492225

RESUMO

Aberrantly expressed survivin and STAT3 signaling have emerged as major determinants of chemoresistance in gastric cancer. We evaluated effects of potent herbal derivatives curcumin, berberine, and quercetin on STAT3 signaling, survivin expression, and response to 5-fluorouracil (5-FU) treatment in gastric cancer cells (AGS). Cytotoxic and inhibitory effects of berberine, curcumin, and quercetin alone or in combination with 5-FU were examined by MTT assay, and their effect on survivin, STAT3, and the phosphorylated active STAT3 (pSTAT3) expression was examined by western blotting. Effect of these herbal derivatives on STAT3 DNA binding activity was measured by electrophoretic mobility shift assay. Curcumin, berberine, and quercetin effectively downregulated pSTAT3 levels, survivin expression, and gastric cancer cells viability in a dose-dependent manner (with corresponding IC50 values of 40.3µM, 29.2µM and 37.5µM, respectively). Berberine was more effective in inhibiting survivin expression as compared to other herbal agents. 5-FU in combination with berberine or curcumin showed a synergistic inhibition of survivin and STAT3 level resulting in enhanced cell death in gastric cancer cells. Overall, our data suggest use of berberine and curcumin as adjunct therapeutics to overcome chemoresistance during treatment of gastric malignancies.


Assuntos
Berberina/farmacologia , Curcumina/farmacologia , Fluoruracila/uso terapêutico , Proteínas Inibidoras de Apoptose/antagonistas & inibidores , Fator de Transcrição STAT3/antagonistas & inibidores , Neoplasias Gástricas/tratamento farmacológico , Berberina/uso terapêutico , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Curcumina/uso terapêutico , DNA/metabolismo , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Sinergismo Farmacológico , Humanos , Proteínas Inibidoras de Apoptose/efeitos dos fármacos , NF-kappa B/metabolismo , Quercetina/farmacologia , Fator de Transcrição STAT3/efeitos dos fármacos , Fator de Transcrição STAT3/metabolismo , Transdução de Sinais/efeitos dos fármacos , Survivina
8.
Indian J Gastroenterol ; 34(1): 3-22, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25772856

RESUMO

In 2012, the Indian Society of Gastroenterology's Task Force on Inflammatory Bowel Diseases undertook an exercise to produce consensus statements on Crohn's disease (CD). This consensus, produced through a modified Delphi process, reflects our current recommendations for the diagnosis and management of CD in India. The consensus statements are intended to serve as a reference point for teaching, clinical practice, and research in India.


Assuntos
Doença de Crohn , Gastroenterologia/organização & administração , Sociedades Médicas/organização & administração , Administração Oftálmica , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Azatioprina/administração & dosagem , Doença de Crohn/diagnóstico , Doença de Crohn/terapia , Glucocorticoides/administração & dosagem , Humanos , Imunossupressores/administração & dosagem , Índia , Infliximab/administração & dosagem , Quimioterapia de Manutenção , Mesalamina/administração & dosagem , Indução de Remissão
9.
Asian Pac J Cancer Prev ; 15(21): 9171-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25422197

RESUMO

AIM: P53, the most commonly mutated tumor suppressor gene in all types of human cancer, is involved in cell cycle arrest and control of apoptosis. Although p53 contains several polymorphic sites, the codon 72 polymorphism is by far more common. There are divergent reports but many studies suggest p53 pro/pro SNP may be associated with susceptibility to developing various cancers in different regions of the world. The present study aimed to find any correlation between H. pylori infection and progression of carcinogenesis, by studying apoptosis and the p53 gene in gastric biopsies from north Indian population. MATERIALS AND METHODS: A total of 921 biopsies were collected and tested for prevalence of H. pylori by rapid urease test (RUT), imprint cytology and histology. Apoptosis was studied by the TUNEL method. Analysis of p53 gene polymorphism at codon 72 was accomplished by PCR using restriction enzyme BstU1. OBSERVATION: Out of 921 samples tested 56.7% (543) were H. pylori positive by the three techniques. The mean apoptotic index (AI) in the normal group was 2.12, while gastritis had the maximum 4.24 followed by gastric ulcer 2.28, gastropathy 2.22 and duodenal ulcer 2.08. Mean AI in cases with gastric cancer (1.72) was less than the normal group. The analysis of p53 72 SNP revealed that p53 (Arg/Arg), (Pro /Arg) variant are higher (40.59% and 33.66%) as compared to p53 pro/pro variant (25.74%) in the healthy population. CONCLUSIONS: The North Indian population harbors Arg or Pro/Arg SNP that is capable of withstanding stress conditions; this may be the reason of low incidence of gastric disease in spite of high infection with H. pylori. There was no significant association with H. pylori infection and AI. However, there is increased apoptosis in gastritis which may occur independent of H. pylori or p53 polymorphism.


Assuntos
Úlcera Duodenal/etiologia , Gastrite/etiologia , Infecções por Helicobacter/complicações , Polimorfismo de Nucleotídeo Único/genética , Neoplasias Gástricas/etiologia , Úlcera Gástrica/etiologia , Proteína Supressora de Tumor p53/genética , Adulto , Apoptose , Estudos de Casos e Controles , Códon/genética , Úlcera Duodenal/patologia , Feminino , Seguimentos , Gastrite/patologia , Predisposição Genética para Doença , Genótipo , Infecções por Helicobacter/genética , Helicobacter pylori/isolamento & purificação , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prognóstico , Neoplasias Gástricas/patologia , Úlcera Gástrica/patologia , Adulto Jovem
10.
World J Gastroenterol ; 20(22): 6860-8, 2014 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-24944476

RESUMO

AIM: To investigate the low gastric cancer incidence rate relative to the highly prevalent Helicobacter pylori (H. pylori) infection; data relevant to H. pylori infection during gastric carcinogenesis in Indian patients is currently lacking. METHODS: The present study examines the prevalence of H. pylori infection in DNA derived from 156 endoscopic gastric biopsies of different disease groups that represent gastric pre-cancer [intestinal metaplasia (n = 15), dysplasia (n = 15)], cancer [diffuse adenocarcinoma (n = 44), intestinal adenocarcinoma (n = 21)], and symptomatic but histopathologically-normal controls (n = 61). This was done by generic ureC polymerase chain reaction (PCR) and cagA-specific PCR that could specifically identify the carcinogenic H. pylori strain. RESULTS: Our analysis showed the presence of H. pylori infection in 61% of symptomatic histopathologically-normal individuals, however only 34% of control tissues were harboring the cagA(+) H. pylori strain. A similar proportion of H. pylori infection (52%) and cagA (26%) positivity was observed in the tumor tissue of the gastric cancer group. In comparison, H. pylori infection (90%) and cagA positivity (73%) were the highest in gastric pre-cancer lesions. In relation to tobacco and alcohol abuse, H. pylori infection showed an association with tobacco chewing, whereas we did not observe any association between tobacco smoking or alcohol abuse with prevalence of H. pylori infection in the tissue of any of the patient groups studied. CONCLUSION: High incidence of H. pylori infection and carcinogenic cagA positive strain in pre-cancer lesions during gastric carcinogenesis may be associated with the habit of chewing tobacco.


Assuntos
Adenocarcinoma/epidemiologia , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/patogenicidade , Lesões Pré-Cancerosas/epidemiologia , Neoplasias Gástricas/epidemiologia , Estômago , Uso de Tabaco/efeitos adversos , Uso de Tabaco/epidemiologia , Adenocarcinoma/diagnóstico , Adenocarcinoma/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Biópsia , Estudos de Casos e Controles , Criança , Feminino , Genótipo , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Humanos , Incidência , Índia/epidemiologia , Masculino , Metaplasia , Pessoa de Meia-Idade , Fenótipo , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/microbiologia , Prevalência , Fatores de Risco , Estômago/microbiologia , Estômago/patologia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/microbiologia , Adulto Jovem
11.
World J Gastroenterol ; 20(6): 1503-9, 2014 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-24587625

RESUMO

Helicobacter pylori (H. pylori) is a gram negative microaerophilic bacterium which resides in the mucous linings of the stomach. It has been implicated in the causation of various gastric disorders including gastric cancer. The geographical distribution and etiology of gastric cancer differ widely in different geographical regions and H. pylori, despite being labeled as a grade I carcinogen, has not been found to be associated with gastric cancer in many areas. Studies in Asian countries such as Thailand, India, Bangladesh, Pakistan, Iran, Saudi Arabian countries, Israel and Malaysia, have reported a high frequency of H. pylori infection co-existing with a low incidence of gastric cancer. In India, a difference in the prevalence of H. pylori infection and gastric cancer has been noted even in different regions of the country leading to a puzzle when attempting to find the causes of these variations. This puzzle of H. pylori distribution and gastric cancer epidemiology is known as the Indian enigma. In this review we have attempted to explain the Indian enigma using evidence from various Indian studies and from around the globe. This review covers aspects of epidemiology, the various biological strains present in different parts of the country and within individuals, the status of different H. pylori-related diseases and the molecular pathogenesis of the bacterium.


Assuntos
Infecções por Helicobacter/epidemiologia , Helicobacter pylori/genética , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/microbiologia , Dieta , Variação Genética , Geografia , Infecções por Helicobacter/complicações , Humanos , Índia/epidemiologia , Úlcera Péptica/microbiologia , Prevalência , Fumar , Classe Social , Especificidade da Espécie , Neoplasias Gástricas/complicações
12.
Indian J Gastroenterol ; 32(6): 369-75, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23999682

RESUMO

BACKGROUND: Attempts to diagnose and subtype irritable bowel syndrome (IBS) by symptom-based criteria have limitations, as these are developed in the West and might not be applicable in other populations. OBJECTIVES: This study aimed to compare different criteria for diagnosing and subtyping of IBS in India. METHOD: Manning's and the Rome I, II, and III criteria as well as the Asian criteria were applied to 1,618 patients (from 17 centers in India) with chronic lower gastrointestinal (GI) symptoms with no alarm features and negative investigations. RESULTS: Of 1,618 patients (aged 37.5 [SD 12.6] years; 71.2% male), 1,476 (91.2%), 1,098 (67.9%), 649 (40.1%), 849 (52.5%), and 1,206 (74.5%) fulfilled Manning's, Rome I, II, and III, and the Asian criteria, respectively. The most common reason for not fulfilling the criteria was absence of the following symptoms: "more frequent stools with onset of pain," "loose stool with onset of pain," "relief of pain with passage of stool," "other abdominal discomfort/bloating," and, in a minority, not meeting the duration criterion of 3 months/12 weeks. By stool frequency, constipation-predominant IBS (<3 stools/week) was diagnosed in 319 (19.7%), diarrhea-predominant IBS (>3 stools/day) in 43 (2.7%), and unclassified in 1,256 (77.6%). By Bristol stool form, constipation, diarrhea, and unclassified were diagnosed in 655 (40.5%), 709 (43.8%), and 254 (15.7%) patients, respectively. By their own perception, 462 (28.6%), 541 (33.4%), and 452 (27.9%) patients reported constipation-predominant, diarrhea-predominant, and alternating types, respectively. CONCLUSION: By Manning's and the Asian criteria, a diagnosis of IBS was made frequently among Indian patients with chronic functional lower GI symptoms with no alarm features; the Rome II criteria gave the lowest yield. By the stool frequency criteria, a majority of patients had unclassified pattern, unlike by the stool form and patients' perception of their symptoms.


Assuntos
Síndrome do Intestino Irritável/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Índia , Síndrome do Intestino Irritável/classificação , Síndrome do Intestino Irritável/fisiopatologia , Masculino
13.
Indian J Gastroenterol ; 31(6): 307-23, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23096266

RESUMO

In 2010, the Indian Society of Gastroenterology's Task Force on Inflammatory Bowel Diseases undertook an exercise to produce consensus statements on ulcerative colitis. This consensus, produced through a modified Delphi process, reflects our current understanding of the definition, diagnostic work up, treatment and complications of ulcerative colitis. The consensus statements are intended to serve as a reference point for teaching, clinical practice, and research in India.


Assuntos
Colite Ulcerativa/diagnóstico , Colite Ulcerativa/terapia , Colite Ulcerativa/complicações , Colite Ulcerativa/epidemiologia , Técnica Delfos , Gastroenterologia , Humanos , Índia , Sociedades Médicas
15.
Indian J Gastroenterol ; 31(6): 299-306, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23073755

RESUMO

INTRODUCTION: Inflammatory bowel disease (IBD), both ulcerative colitis (UC) and Crohn's disease (CD), once thought to be uncommon, is now seen commonly in India. The Indian Society of Gastroenterology (ISG) Task Force on IBD decided to collate data on the clinical spectrum of IBD currently prevailing in India. METHODS: An open call to members of ISG was given through publication of a proforma questionnaire in the Indian Journal of Gastroenterology and the web portal of ISG. The proforma contained questions related with demographic features, family history, risk factors, clinical manifestations and characteristics, course of disease, and pattern of treatment of IBD. RESULTS: Of 1,255 filled questionnaires received, 96 were rejected and 1,159 (92.3 %) were analyzed. This comprised data on 745 (64.3 %) patients with UC, 409 (35.3 %) with CD, and 5 with indeterminate colitis. The median duration of illness was longer in patients with CD (48 months) compared to those with UC (24 months) (p = 0.002). More than one half of patients (UC 51.6 %, CD 56.9 %) had one or more extraintestinal symptoms. A definite family history of IBD was present in 2.9 % (UC 2.3 % and CD 4.6 %; p = 0.12). The extent of disease in UC was pancolitis 42.8 %, left-sided colitis 38.8 %, and proctitis alone in 18.3 %. The extent of disease involvement in CD was both small and large intestine in 39.6 %, colon alone in 31.4 % and small intestine alone in 28.9 %. Stricturing and fistulizing disease were noted in 18.8 % and 4.4 % of patients with CD respectively. Chronic continuous and intermittent disease course were present in 35.5 % and 47.2 % of UC patients respectively, and in 23.1 % and 68.8 % of CD patients. Four percent of patients with UC had undergone colectomy, while 15.2 % of patients with CD underwent surgical intervention. CONCLUSIONS: The present survey provides a reasonable picture of the demographic features and clinical manifestations of Indian patients with IBD, their risk factors, course of disease, and the treatment given to them.


Assuntos
Doenças Inflamatórias Intestinais/complicações , Fístula Intestinal/etiologia , Intestinos/patologia , Adulto , Constrição Patológica/etiologia , Feminino , Humanos , Índia , Doenças Inflamatórias Intestinais/genética , Doenças Inflamatórias Intestinais/terapia , Masculino , Índice de Gravidade de Doença
16.
J Clin Diagn Res ; 6(10): 1783-5, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23373054

RESUMO

The Budd-Chiari Syndrome is associated with hepatic venous outflow obstruction. This syndrome is rare in infants and children. As this syndrome is uncommon, especially in the paediatric age group, misdiagnoses and delays in the diagnosis are frequent. A high index of clinical suspicion along with a radiological aid and a histopathological correlation can lead to an early diagnosis and an appropriate management in such cases.This case report highlights the occurrence of this rare condition in the paediatric age group as well as it redefines the salient features of this syndrome.

17.
Indian J Gastroenterol ; 30(3): 118-27, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21792655

RESUMO

BACKGROUND: Gastroesophageal reflux disease (GERD) and its complications are thought to be infrequent in India; there are no data from India on the prevalence of and risk factors for GERD. The Indian Society of Gastroenterology formed a task force aiming to study: (a) the frequency and profile of GERD in India, (b) factors including diet associated with GERD. METHODS: In this prospective, multi-center (12 centers) study, data were obtained using a questionnaire from 3224 subjects regarding the frequency, severity and duration of heartburn, regurgitation and other symptoms of GERD. Data were also obtained regarding their dietary habits, addictions, and lifestyle, and whether any of these were related or had been altered because of symptoms. Data were analyzed using univariate and multivariate methods. RESULTS: Two hundred and forty-five (7.6%) of 3224 subjects had heartburn and/or regurgitation at least once a week. On univariate analysis, older age (OR 1.012; 95% CI 1.003-1.021), consumption of non-vegetarian and fried foods, aerated drinks, tea/coffee were associated with GERD. Frequency of smoking was similar among subjects with or without GERD. Body mass index (BMI) was similar in subjects with and without GERD. On multivariate analysis, consumption of non-vegetarian food was independently associated with GERD symptoms. Overlap with symptoms of irritable bowel syndrome was not uncommon; 21% reported difficulty in passage of stool and 9% had mucus in stools. About 25% of patients had consulted a doctor previously for their gastrointestinal symptoms. CONCLUSION: 7.6% of Indian subjects have significant GERD symptoms. Consumption of non-vegetarian foods was an independent predictor of GERD. BMI was comparable among subjects with or without GERD.


Assuntos
Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/epidemiologia , Inquéritos e Questionários , Adulto , Dieta , Feminino , Refluxo Gastroesofágico/terapia , Azia/etiologia , Humanos , Índia/epidemiologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Perfil de Impacto da Doença , Sociedades Médicas
18.
Indian J Gastroenterol ; 30(2): 66-71, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21499863

RESUMO

OBJECTIVES: To investigate the seroprevalence of hepatitis B surface antigen (HBsAg) in pregnant women and possible risk factors for perinatal hepatitis B virus (HBV) transmission. METHODS: Four thousand pregnant women were evaluated using history, examination, and test for serum HBsAg using commercial enzyme immunoassay kits. For HBsAg positive women, liver function tests and a test for hepatitis B e antigen (HBeAg) was done. HBV DNA analysis was done by polymerase chain reaction (PCR). RESULTS: Of 4,000 women studied, 37 (0.9%) tested positive for HBsAg. Of these 37 women, 6 (16%) presented with acute hepatitis and 31 (84%) were asymptomatic. The highest HBsAg positivity rate was seen in the age group of 21-25 years (1.15%) followed by 26-30 years (0.86%). Assessment of risk factors revealed history of tattooing in 29/37 (78.4%) women. HBeAg was positive in 21 of 37 (56.8%) women. Of the 16 HBeAg negative women, 5 were positive for HBV DNA and anti-HBe antibody, 6 had only anti-HBe antibody and 5 had neither HBV DNA nor anti-HBe. Vertical transmission was seen in 65% (13/20) of babies born to mothers who were positive for HBeAg and HBV DNA. In contrast, it was only 9.1% (1/11) for babies born to mothers who were negative for both HBeAg and HBV DNA. Of the 25 babies delivered vaginally, 15 (60%) developed vertical transmission. None of the four babies delivered by elective cesarean section had evidence of vertical transmission. CONCLUSIONS: Seroprevalence of HBsAg in antenatal women was found to be 0.9%. HBe-antigen and HBV DNA positivity was associated with a higher chance of vertical transmission.


Assuntos
Antígenos de Superfície da Hepatite B/sangue , Antígenos E da Hepatite B/sangue , Vírus da Hepatite B/genética , Hepatite B/transmissão , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Complicações Infecciosas na Gravidez , Adolescente , Adulto , Primers do DNA/química , DNA Viral/sangue , Feminino , Hepatite B/imunologia , Humanos , Técnicas Imunoenzimáticas , Índia/epidemiologia , Reação em Cadeia da Polimerase , Gravidez , Fatores de Risco , Estudos Soroepidemiológicos , Adulto Jovem
19.
Indian J Virol ; 22(1): 24-8, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23637498

RESUMO

The present study was designed to investigate the distribution of genotypes and its association with severity of liver disease in patients with Chronic Hepatitis B (CHB) in Uttar Pradesh, India. One hundred five HBsAg positive patients were selected for the study. The DNA was extracted by using pure viral DNA extraction kit. The genotype of Hepatitis B virus (HBV) was identified by using polymerase chain reaction- based restriction fragment length polymorphism (PCR-RFLP) method, by using AvaII and DpnII restriction enzyme to see the different patterns of cleavage that would occur at this specific site. Among 105 HBsAg positive chronic liver disease patients 58 patients were positive for HBeAg and 47 samples were HBeAg negative. Genotyping was done successfully in 91 samples. Genotype A was identified in 22% and genotype D in 78% CHB patients. Genotype A showed elevated liver enzymes much more than genotype D. The Child Pugh classification of 20 patients with genotype A was class A (n = 2), B (n = 9), C (n = 9) and of genotype D was class A (n = 13), B (n = 50) and C (n = 8). In conclusion our results showed that Genotype D was the commonest genotype in Uttar Pradesh, whereas genotype A had significantly more elevated ALT/AST levels than genotype D. (P < 0.05). Child Pugh Grade B was significantly more in patients with genotype D, whereas Child Pugh Grade C was more in genotype A.

20.
Gastrointest Endosc ; 70(2): 317-21, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19539920

RESUMO

BACKGROUND: It has been reported that the occurrence of acute cholangitis is common, especially when the self-expanding metal stent (SEMS) is placed across the main duodenal papilla. OBJECTIVE: To determine the incidence of duodenobiliary reflux and acute cholangitis after placement of SEMSs across the main duodenal papilla. DESIGN: A prospective study. SETTING: A tertiary-care teaching hospital. PATIENTS: One hundred consecutive patients with malignant bile-duct obstruction. INTERVENTIONS: A barium meal examination was performed 21 days after placement of SEMSs. Reflux of barium was monitored by using fluoroscopy. The patients were also monitored for the occurrence of fever. Serum bilirubin, alanine aminotransferase, alkaline phosphatase, and total and differential leukocyte counts were evaluated before and after the barium study. MAIN OUTCOME MEASUREMENTS: The occurrence of duodenobiliary reflux and acute cholangitis. RESULTS: Two patients developed acute cholangitis because of the failure of the function of the SEMS, and they died during the first week. Severe reflux of barium was evident in all the patients. However, none of them developed features of acute cholangitis because of reflux. After a mean (SD) follow-up of 6.4 +/- 1 months, 6 patients developed acute cholangitis because of blockage of the SEMS from ingrowth of tumor or collection of debris at the lower end of the SEMS. LIMITATIONS: Unblinded study. CONCLUSIONS: After placement of SEMSs across the main duodenal papilla, reflux of duodenal contents is a universal phenomenon. Acute cholangitis was observed only in cases with blockage of the SEMS from tumor ingrowth or debris.


Assuntos
Colangite/etiologia , Refluxo Duodenogástrico/etiologia , Neoplasias da Vesícula Biliar/cirurgia , Neoplasias Pancreáticas/cirurgia , Implantação de Prótese/efeitos adversos , Stents , Idoso , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Desenho de Prótese
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