BACKGROUND: There is sparse Indian data on right colon cancer. Available literature suggests that it affects the young and survival is poor. AIM: This article reviews demographics and outcomes of surgically treated right...BACKGROUND: There is sparse Indian data on right colon cancer. Available literature suggests that it affects the young and survival is poor. AIM: This article reviews demographics and outcomes of surgically treated right sided colon cancer over a nine year period in a single colorectal unit in a tertiary care teaching hospital. METHODS: A retrospective review of all patients undergoing right hemicolectomy for adenocarcinoma of the colon between January 2004 and December 2012 was undertaken. Data was collected from hospital records and telephonic interview when possible. RESULTS: Two hundred and thirteen patients were studied. Mean age was 49 years with 57.1% being 50 years or younger. Stage 1 disease was seen in 9.9%, stage 2 in 35.2%, stage 3 in 42.3%, and stage 4 in 12.7%. Follow up was available for 81.6% with a mean follow up of 35.6 months. Five year disease free survival (DFS) and overall survival (OS) was 81% and 74%. Presence of lymphovascular invasion and age >50 years were predictors of poor survival. Poor prognostic features on histopathology were not different between the young and the old. The 5 year DFS was similar in both, but the 5 year OS was better for the young (90% vs. 73%, p=0.029). CONCLUSION: Patients with right colon cancer are younger in India. They have similar histopathology when compared to the older population. Operable right colon cancer has an excellent prognosis. Five year DFS is similar in the young and the old, but OS is lower in the older population.
INRODUCTION: The etiology of gastric cancer is multifactorial. Marked differences in the incidence of gastric cancer among different ethnic groups living in the same geographical area have been observed. AIM AND METHODS:...INRODUCTION: The etiology of gastric cancer is multifactorial. Marked differences in the incidence of gastric cancer among different ethnic groups living in the same geographical area have been observed. AIM AND METHODS: This study looked at ethnic and dietary factors in patients with gastric cancer diagnosed at a tertiary referral centre in Sikkim over a period of one year. Patients of 60 years and above were included in the study and divided into four ethnic groups : Bhutias, Lepchas, Rais and other groups. RESULTS: 211 cases underwent upper GI endoscopy and 32 were diagnosed to have gastric cancer. Gastric cancer incidence was highest in Bhutia ethnic group. A trend towards higher intake of smoked meats, fermented vegetables, salt tea, and H.pylori positivity in the Bhutia ethnic group was associated with higher incidence of gastric cancer as compared to other ethnic groups. CONCLUSION: The study with a referral centre bias showed that Bhutia ethnic group had a higher incidence of gastric cancer as compared to other ethnic groups.
AIM: Cirrhosis of the liver is an important cause of morbidity and mortality in India. Currently no study exists on the disease from Himachal Pradesh, India. The purpose of this study was to evaluate epidemiological data...AIM: Cirrhosis of the liver is an important cause of morbidity and mortality in India. Currently no study exists on the disease from Himachal Pradesh, India. The purpose of this study was to evaluate epidemiological data on the etiological profile of cirrhosis of the liver in adults in a tertiary care hospital in a northern hilly state of Western Himalayas. MATERIALS AND METHODS: A hospital based, cross sectional, observational study was conducted in the department of Medicine and Gastroenterology in a tertiary care centre of Himachal Pradesh, located in northern India from 1st June, 2012 to 31st May, 2013. In total, 178 patients who were diagnosed with cirrhosis on the basis of history, physical examination, biochemistry and radiology, and of age >18 years were included in the study. Detailed history, examination and investigations were carried out in each case as per protocol. RESULTS: Alcohol was the leading cause of cirrhosis in our study (62.9%), hepatitis B was the second(10.1%), Non-Alcoholic Steatohepatitis (NASH) was the third (7.9%), and autoimmune the fourth (3.9%) most common cause for cirrhosis. Hepatitis C was present in 2.8% of patients as a cause of cirrhosis. Wilson disease and cardiac cirrhosis were present in one patient each. In 9.6% the etiology was cryptogenic. CONCLUSION: The study identified alcohol as the leading cause of cirrhosis among people in the state. Measures for taking care of preventable risk factors are desired.
BACKGROUND: Anti tuberculosis therapy agent isoniazid (INH) and rifampicin (RMP) injure hepatocytes. Heme oxygenase-1(HO-1) is a stress induced protein which seems to have some cellular protective function. We examined t...BACKGROUND: Anti tuberculosis therapy agent isoniazid (INH) and rifampicin (RMP) injure hepatocytes. Heme oxygenase-1(HO-1) is a stress induced protein which seems to have some cellular protective function. We examined the protective function of HO-1 during INH-RMP induced cell death of hepatocytes by induction of HO-1 using hemin chloride or by silencing HO-1 gene using small interfering RNA (siRNA). METHODS: The role of HO-1 induction on INH-RMP induced cell death was examined on HepG2 cells overexpressing human CYP2E1 gene (E47 cells) during short term culture. The E47 cells were treated with hemin chloride to induce HO-1 expression during INH-RMP treatment. In other set of experiments, transient knockdown of HO-1 gene using siRNA was carried out before treatment of INH-RMP. Cell viability using Trypan blue, intracellular reactive oxygen species (ROS), cell death were evaluated by FACS analysis at different time points of INH-RMP treatment. RESULTS: INH-RMP treatment to E47 cells induced expression of cytoplasmic HO-1 protein at early hours of drug treatment with minimum loss of cell viability and cell death. At later hours, failiure to express HO-1 protein resulted in loss of cell viability and increased cell death. Addition of Hemin chloride during treatment of INH-RMP induced HO-1 in E47 cells and reversed the drug induced liver injury. Silencing the HO-1 gene using siRNA potentiated INH-RMP induced cell death of the E47 cells CONCLUSION: Induction of HO-1 ameliorated INH-RMP induced cell death of hepatocytes. This may be a potential target for future therapeutic option in INH-RMP induced drug induced liver injury.
Girish BN, Rajesh G, Vaidyanathan K
… +1 more, Balakrishnan V
Trop Gastroenterol
· 2016 · PMID 29668173
BACKGROUND: The role of trace elements in the maintenance of normal pancreatic function is unclear. AIM: To estimate trace elements (zinc and copper) in chronic pancreatitis (CP) patients and study their relationship wit...BACKGROUND: The role of trace elements in the maintenance of normal pancreatic function is unclear. AIM: To estimate trace elements (zinc and copper) in chronic pancreatitis (CP) patients and study their relationship with exocrine and endocrine insufficiency. Methods: The study involved 101 CP patients and 113 healthy controls. Disease characteristics and imaging features were recorded. Erythrocyte zinc (Zn) and copper (Cu) were estimated by flame atomic absorption spectrophotometry. Fecal pancreatic elastase1 was estimated by polyclonal antibody ELISA method as a marker of pancreatic exocrine function. RESULTS: The mean erythrocyte Zn level and Zn/Cu ratio were significantly lower whereas the copper level was significantly higher in CP patients than controls. The mean Zn level and Zn/Cu ratio was significantly lower in CP patients with diabetes and those with low elastase1 as compared to non-diabetics and those with normal elastase1 respectively. Erythrocyte Cu level was significantly higher in CP patients with diabetes and with low elastase1 than those without diabetes and with normal elastase1 levels respectively. There was a significant positive correlation between elastase1 and Zn/Cu ratio (r = 0.396, p < 0.001). Receiver operating characteristic curve (ROC) analysis was performed to predict the development of exocrine insufficiency and it indicated an area under curve (AUC) of 0.838 ± 0.047 (95% CI: 0.746-0.93). The optimal cutoff value was 9.03 (sensitivity 86.5%, specificity 73.5%). When the same was performed to predict the development of diabetes, the AUC was 0.710 ± 0.05 (95% CI: 0.607-0.812). The optimal cutoff value was 7.2 (sensitivity 69.1%, specificity 69.7%). CONCLUSION: Low erythrocyte Zn/Cu ratio was found to be associated with exocrine and endocrine insufficiency in CP patients.
Acute pancreatitis (AP) is a disease of varying severity with acute necrotizing pancreatitis (ANP) being the severe form of AP. ANP needs multidisciplinary management and is associated with significant mortality and morb...Acute pancreatitis (AP) is a disease of varying severity with acute necrotizing pancreatitis (ANP) being the severe form of AP. ANP needs multidisciplinary management and is associated with significant mortality and morbidity. Local complications of ANP viz. acute necrotic collections (ANC) and walled off pancreatic necrosis (WOPN) need intervention if they are associated with symptoms, sepsis or worsening organ failure. As surgery is associated with higher morbidity and mortality, there is paradigm shift in the management of these local complications with an increased emphasis on conservative and minimally invasive treatment approach. Image-guided percutaneous drainage (PCD) is a minimally invasive intervention that helps in drainage of infected collections, temporizes sepsis and improves outcomes in these patients. The present review discusses the utility of various percutaneous interventions in management of variety of pancreatic collections occurring in ANP. The available evidence, technical details and complications and emerging innovations in the field are also summarized.