Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver

Background/Aims@#Gluten-free diet has an excess of fats and simple sugars and puts patients with celiac disease at risk of metabolic complications including metabolic syndrome and fatty liver. We assessed prevalence of metabolic syndrome and fatty liver in two cohorts of celiac disease. @*Methods@#Study was done in 2 groups. In group 1, 54 treatment naïve patients with celiac disease were recruited. Of them, 44 returned after 1-year of gluten-free diet and were reassessed. In group 2, 130 celiac disease patients on gluten-free diet for ≥1 year were recruited. All patients were assessed for anthropometric and metabolic parameters and fatty liver. Metabolic syndrome was defined as per consensus definition for Asian Indians. Fatty liver was defined as controlled attenuation parameter value >263 decibels by FibroScan. @*Results@#In group 1, of 44 treatment naïve patients with celiac disease, metabolic syndrome was present in 5 patients (11.4%) at baseline and 9 (18.2%) after 1 year of gluten-free diet. Patients having fatty liver increased from 6 patients (14.3%) at baseline to 13 (29.5%) after 1year of gluten-free diet (P=0.002). In group 2, of 130 patients with celiac disease on gluten-free diet for a median duration of 4 years, 30 out of 114 (26.3%) and 30 out of 130 patients (23%) had metabolic syndrome and fatty liver, respectively. @*Conclusions@#Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver, which increases further with gluten-free diet. These patients should be assessed for nutritional and metabolic features and counseled about balanced diet and physical activity regularly.

Neuroprotective Activity of Protocatechuic Acid (3,4-Dihydroxybenzoic Acid) to Treat Parkinson s Disease

The present study was designed to explore the possible neuroprotective role of protocatechuic acid (3,4-dihydroxybenzoic acid) against rotenone induced locomotor, oxidative and mitochondrial dysfunction in mice. We also wanted to evaluate its ability to prevent neuronal degeneration in rotenone intoxicated mice. MethodsThirty mice, Albino strain, between 20 – 25 g, were included in the study. Group 1 is control group. It received sunflower oil 0.1 mL subcutaneously for two weeks. Group 2 received rotenone (1 mg / Kg) S.C. Group 3 also received rotenone (1 mg / Kg / day) S.C. in sunflower oil alternatively and Protocatechuic acid 10 mg / Kg B.W. P.O. for 2 weeks. Group 4 and 5 received rotenone as same in group 2 and Protocatechuic acid (25 mg / Kg) and (50 mg / Kg) B.W. P.O. After the finish of trial, open field test, stride length measurement, catalepsy, forced swim test, sucrose preference test and elevated plus maze test were conducted. ResultsExposure to Rotenone in mice led to reduction in peripheral and central movements. Pre-treatment with protocatechuic acid prior to rotenone exposure was able to maintain the both motor and non-motor symptoms of PD. However, protocatechuic acid was effective in the maintenance of dopaminergic and nondopaminergic pathways. ConclusionsThis study strengthens the fact that the protocatechuic acid in rotenone-affected areas might offer neuroprotection.

Clinical Study on Lesions Causing Cavernous Sinus Syndrome

Background: The naming of cavernous sinus was in the year1732 due to its resemblance to the corpus cavernosum. Thepresent study was conducted with the aim to determine theetiologies of cavernous sinus thrombosis.Materials and Methods: The present retrospective crosssectional study was performed in the Department of Medicine,SP Medical College, Bikaner, Rajasthan (India) andDepartment of Eye, Government District Hospital, Bikaner,Rajasthan (India). The type of management received was alsotaken into consideration. Patients with incomplete records werenot enrolled in the study. Subjects belonging to ASA grade 4,patients with significant co morbidities were excluded from thestudy. All the data thus obtained was arranged in a tabulatedform and analysed using SPSS software. Data was expressedin percentage.Results: The mean age of the subjects was 41.73+/- 3.56years. The most common cause was tumour followed bytrauma. Least number of cases was of diabetes (3.3%). Therewere 13.3% cases of inflammation. Surgery was attributed in10.7% cases. There were 6 and 6.7% cases of infection andaneurysm respectively.Conclusion: The most frequent cause of cavernous sinusthrombosis in our study was trauma.

Analysis of Prevalence and Prognosis in Bell’s Palsy

Background: A facial expression is due to the contraction andcoordination of the facial musculatures, and this is mainlysupplied by the facial nerve. When its function is disturbed,significant alterations may be observed, with impairment offacial expression. The prevalence of the five major causes inthe USA are as follows: Bell’s palsy (25 cases per 100000yearly), infection (7.7 cases per 100000 yearly), neoplasticaetiologies (6.8 cases per 100000 yearly), neurologic causeslike cerebrovascular accidents (6.8 cases per 100000 yearly)and traumatic reasons (4.1 cases per 100000 yearly). Thepresent study was conducted to determine the prevalence andetiology of bell’s palsy.Materials and Methods: The complete demographic detailslike age, gender and socioeconomic status was noted amongstall the subjects. The type of treatment received, the risk factorsassociated were also recorded in a tabulated form. All the datathus obtained was arranged in a tabulated form and analysedusing SPSS software. Data was expressed in percentage.Results: There were 33.3% males (n=200) and 66.7% females(n=400). The recovery rate after treatment was 100% amongstall the patients.Conclusion: Females were more commonly affected ascompared to males and a 100% recovery rate was observed inour study. The most common age group affected was 21-40years.

Minimally Invasive Microscope-Assisted Stand-Alone Transarticular Screw Fixation without Gallie Supplementation in the Management of Mobile Atlantoaxial Instability

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the clinico-radiological efficacy of stand-alone minimally invasive transarticular screw (MIS-TAS) fixation without supplemental Gallie fixation in the management of mobile C1–C2 instability. OVERVIEW OF LITERATURE: Data evaluating the efficacy and feasibility of MIS-TAS in the literature is scanty. METHODS: Patients with mobile atlantoaxial instability and >2 years follow-up were included and managed by stand-alone TAS fixation using the Magerl technique and morselized allograft without additional fixation. Patient demographics and intra-operative parameters were noted. Clinical parameters (Visual Analog Scale [VAS] and Oswestry Disability Index [ODI]), neurology (modified Japanese Orthopaedic Association [mJOA]), and radiological factors (anterior atlanto-dens interval and space available for cord) were evaluated pre and postoperatively. Computed tomography (CT) was performed in patients who did not show interspinous fusion on X-ray at 1 year, to verify intra-articular fusion. Statistical analysis was performed using IBM SPSS ver. 20.0 (IBM Corp., Armonk, NY, USA); the Student t-test and analysis of variance were used to assess statistical significance (p <0.05). RESULTS: A total of 82 consecutive cases (three males, one female; mean age, 36.26±5.78 years) were evaluated. In total, 163 TASs were placed. Significant improvement was noticed in clinical (mean preoperative VAS=7.2±2.19, postoperative VAS=3.3±1.12; mean preoperative ODI=78.3±4.83, postoperative ODI=34.05±3.26) and neurological features (mean preoperative mJOA=14.73±2.68, postoperative mJOA=17.5±2.21). Radiological evidence of fusion was noted in 97.5% cases at final follow-up. Seventeen patients were found to have no interspinous fusions upon X-rays, but CT revealed facet fusion in all patients except in two. Inadvertent vertebral artery injury was noted in three cases. CONCLUSIONS: Stand-alone TAS fixation with morselized allograft provides excellent radiological and clinical outcomes. The addition of a supplementary tension band and structural graft are not essential. This provides the opportunity to avoid the complications associated with graft harvesting and wiring.

Comparing the Efficacy of Latanoprost (0.005%), Bimatoprost (0.03%), Travoprost (0.004%), and Timolol (0.5%) in the Treatment of Primary Open Angle Glaucoma

PURPOSE: To compare the efficacy and safety of latanoprost, bimatoprost, travoprost and timolol in reducing intraocular pressure (IOP) in patients with primary open angle glaucoma. METHODS: This was a prospective study conducted at a tertiary-care centre. One hundred and forty patients with newly diagnosed primary open angle glaucoma were randomly assigned to treatment with latanoprost (0.005%), bimatoprost (0.03%), travoprost (0.004%) or timolol gel (0.5%); 35 patients were assigned to each group. All patients were followed for 2, 6, and 12 weeks. The main outcome measure studied was the change in IOP at week 12 from the baseline values. Safety measures included recording of adverse events. RESULTS: The mean IOP reduction from baseline at week 12 was significantly more with bimatoprost (8.8 mmHg, 35.9%) than with latanoprost (7.3 mmHg, 29.9%), travoprost (7.6 mmHg, 30.8%) or timolol (6.7 mmHg, 26.6%) (ANOVA and Student's t-tests, p < 0.001). Among the prostaglandins studied, bimatoprost produced a maximum reduction in IOP (-2.71; 95% confidence interval [CI], -2.25 to -3.18) followed by travoprost (-1.27; 95% CI, -0.81 to -1.27) and latanoprost (-1.25; 95% CI, -0.79 to -1.71); these values were significant when compared to timolol at week 12 (Bonferroni test, p < 0.001). Latanoprost and travoprost were comparable in their ability to reduce IOP at each patient visit. Ocular adverse-events were found in almost equal proportion in patients treated with bimatoprost (41.3%) and travoprost (41.9%), with a higher incidence of conjunctival hyperemia (24.1%) seen in the bimatoprost group. Timolol produced a significant drop in heart rate (p < 0.001) at week 12 when compared to the baseline measurements. CONCLUSIONS: Bimatoprost showed greater efficacy when compared to the other prostaglandins, and timolol was the most efficacious at lowering the IOP. Conjunctional hyperemia was mainly seen with bimatoprost. However, the drug was tolerated well and found to be safe.

Diet and functional foods in treatment and maintenance therapy of colon disorders.

Dietary habits have been associated with variations in the risk of colon disorders, either its increase or decrease. Colon-specific approaches showed their potential to target and treat colon cancers and inflammatory diseases, but they vary in success rates for local recurrence, disease-free survival, and overall survival. Also, chemotherapies and radiotherapies have been applied as the surgical adjuvant treatments. The significant role of exogenously administered Lactobacilli in reducing toxin-producing bacteria in the gut and increases the longevity of the host, led to the coining of the term ‘probiotics’. The evidence on the effects of inulin and oligofructose on colonization, translocation of pathogens and the prevention of intestinal diseases make them suitable candidates to treat colon disorders. Among potentially protective foods, growing attention has been dedicated to functional foods comprising probiotics, such as Lactobacilli or Bifidobacteria, and prebiotics such as fructooligosaccharides or fructans, as their consumption may treat inflammatory bowel diseases, like ulcerative colitis, crohn’s disease as well as experimentally induced colon cancer in mammals. The readily apparent synergy of concomitantly using beneficial microorganisms and nutritive materials that support their growth led to the term “synbiotics” to describe foods or supplements that combine both probiotics and prebiotics. Various potential mechanisms are addressed in the present paper. This article discusses the real value of dietary components, which offers practical information to help patients as well as health professionals. Furthermore, article has focused on the possible value of probiotics, prebiotics and synbiotics in treatment and maintenance therapy of colonic ailments.