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1.
Intestinal Research ; : 162-171, 2024.
Article in English | WPRIM | ID: wpr-1043104

ABSTRACT

Background/Aims@#Association of sarcopenia with disease severity in ulcerative colitis (UC) is not clearly defined. We planned to estimate the prevalence of sarcopenia in patients with UC as per the revised definition and its relation with the disease severity. @*Methods@#A cross-sectional assessment of sarcopenia in patients with UC was performed. Disease activity was graded according to complete Mayo score. Hand grip strength was assessed with Jamar hand dynamometer, muscle mass using a dual energy X-ray absorptiometry scan, and physical performance with 4-m walk test. Sarcopenia was defined as a reduction of both muscle mass and strength. Severe sarcopenia was defined as reduced gait speed in presence of sarcopenia. @*Results@#Of 114 patients (62 males, mean age: 36.49±12.41 years), 32 (28%) were in remission, 46 (40.4%) had mild-moderate activity, and 36 (31.6%) had severe UC. Forty-three patients (37.7%) had probable sarcopenia, 25 (21.9%) had sarcopenia, and 14 (12.2%) had severe sarcopenia. Prevalence of sarcopenia was higher in active disease (2 in remission, 6 in active, and 17 in severe, P<0.001). Of 14 with severe sarcopenia, 13 had severe UC while 1 had moderate UC. On multivariate analysis, lower body mass index and higher Mayo score were associated with sarcopenia. Of 37 patients with acute severe colitis, 16 had sarcopenia. Requirement of second-line therapy was similar between patients with and without sarcopenia. On follow-up (median: 18 months), there was a non-significant higher rate of major adverse events in those with sarcopenia (47.4% vs. 33.8%, P=0.273). @*Conclusions@#Sarcopenia and severe sarcopenia in UC correlate with the disease activity.

2.
Arq. gastroenterol ; Arq. gastroenterol;59(4): 478-482, Out,-Dec. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1420213

ABSTRACT

ABSTRACT Background: Advanced achalasia cardia (AC) represents the end stage in the natural history of AC. Role of per oral endoscopic myotomy (POEM) in this technically difficult subset is emerging. Methods: Retrospective review of the patients who had undergone POEM for advanced AC with sigmoid esophagus. We assessed the technical success, clinical success and adverse event rate. Pre and post POEM Eckardt score (ES), integrated relaxation pressure-4sec (IRP-4), lower oesophageal sphincter pressure (LESP) and height and width of barium column at 5 minutes were noted. Results: Of the 85 patients who underwent POEM for AC, 10 patients had advanced AC with sigmoid esophagus of which eight were sigmoid and two were advanced sigmoid. The clinical and technical success was 100% with significant reduction of ES, IRP-4, LESP and height and width of barium column at 5 minutes. One patient had a minor adverse event in the form of mucosal injury that was closed with hemoclips. At a median follow up of 17 months there was no recurrence. Conclusion: Our study demonstrates POEM to be a safe and effective modality of treatment in this technically difficult subset of AC with sigmoid morphology.


RESUMO Contexto: Acalasia cárdia avançada representa o estágio final na história natural do megaesôfago. Está emergindo o papel da miotomia endoscópica peroral (POEM) neste subconjunto tecnicamente difícil. Métodos: Foi realizada uma revisão retrospectiva dos pacientes submetidos a POEM para tratamento do megaesôfago avançado. Avaliamos o sucesso técnico, o sucesso clínico e a taxa de eventos adversos. O escore de Eckardt, pré e pós POEM, a pressão integral de relaxamento de 4 seg (IRP-4), a pressão do esfíncter inferior do esôfago e a altura e largura da coluna de bário em 5 minutos, foram anotadas. Resultados: Dos 85 pacientes submetidos a POEM para acalasia cárdia, 10 pacientes apresentaram acalasia cárdia avançado com esôfago com aspecto sigmoide, dos quais dois eram muito avançados. O sucesso clínico e técnico foi de 100% com redução significativa do escore de Eckardt, do IRP-4, da pressão do esfíncter inferior do esôfago e da altura e largura da coluna bário em 5 minutos. Um paciente teve um pequeno evento adverso na forma de lesão mucosa que foi fechada com hemoclipes. Em um seguimento mediano de 17 meses não houve recorrência. Conclusão: Nosso estudo demonstra que a POEM é uma modalidade segura e eficaz de tratamento neste subconjunto tecnicamente difícil de megaesôfago com morfologia sigmoide.

3.
Arq. gastroenterol ; Arq. gastroenterol;59(2): 198-203, Apr.-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1383854

ABSTRACT

ABSTRACT Background: The role of ascitic and serum levels of various tumour biomarkers in the discrimination of cause of ascites is not well established. Objective: To evaluate the role of serum and ascitic levels of tumor biomarkers (CA 72-4, CA 19-9, CEA and CA 125) in discrimination of cause of ascites. Methods: A prospective study was conducted in consecutive patients presenting with ascites. Serum and ascitic levels of CA 19-9, CA 125, CA 72-4 and carcinoembryonic antigen (CEA) were determined at the presentation. The patients with cirrhotic ascites, tuberculous peritonitis (TBP) and peritoneal carcinomatosis (PC) were eventually included in analysis. Results: Of the 93 patients (58 males, mean age 47 years) included, the underlying cause was cirrhosis in 31, PC in 42 and peritoneal tuberculosis in 20. The best cutoff for discriminating benign and malignant ascites for serum CEA, CA 19-9 and CA 72-4 were 6.7 ng/mL, 108 IU/mL and 8.9 IU/mL, respectively. The best cutoff for discriminating benign and malignant ascites for ascitic CA 125, CEA, CA 19-9 and CA 72-4 were 623 IU/mL, 8.7 ng/mL, 33.2 IU/mL and 7 IU/mL, respectively. Conclusion: The performance of single biomarker for the prediction of underlying PC is low but a combination of serum CA 19-9 and CA 72-4 best predicted the presence of peritoneal carcinomatosis.


RESUMO Contexto: O papel dos níveis ascíticos e séricos de vários biomarcadores de tumores na discriminação da causa das ascites não está bem estabelecido. Objetivo: Avaliar o papel dos níveis séricos e ascíticos de biomarcadores tumorais (CA 72-4, CA 19-9, CEA e CA 125) na discriminação da causa das ascites. Métodos: Estudo prospectivo foi realizado em pacientes consecutivos que apresentaram ascite. Foram determinados níveis do soro e ascítico de CA 19-9, CA 125, CA 72-4 e antígeno carcinoembrínico (CEA). Os pacientes com ascites cirróticas, peritonite tuberculosa e carcinomatose peritoneal (CP) foram eventualmente incluídos na análise. Resultados: Dos 93 pacientes (58 homens, média de idade 47 anos) incluídos, a causa básica foi cirrose em 31, CP em 42 e tuberculose peritoneal em 20. O melhor corte para discriminação de ascites benignas e malignas para soro CEA, CA 19-9 e CA 72-4 foram 6,7 ng/mL, 108 UI/mL e 8,9 UI/mL, respectivamente. O melhor corte para discriminação de ascites benignas e malignas para CA 125 ascitico, CEA, CA 19-9 e CA 72-4 foram 623 UI/mL, 8,7 ng/mL, 33,2 UI/mL e 7 UI/mL, respectivamente. Conclusão: O desempenho do biomarcador único para a previsão do CP subjacente é baixo, mas uma combinação de soro CA 19-9 e CA 72-4 melhor previu a presença de carcinomatose peritoneal.

4.
Article | IMSEAR | ID: sea-209447

ABSTRACT

Background: Instillation of intraperitoneal lignocaine, bupivacaine, levobupivacaine, and ropivacaine has been used followinglaparoscopic gynecological and general surgical procedures to reduce post-operative pain through randomized trials formany years. Hence, the present study was undertaken for assessing and comparing the efficacy of intraperitoneal instillationof levobupivacaine (0.25%) and ropivacaine (0.25%) for post-operative analgesia in patients undergoing laparoscopiccholecystectomy (LC).Materials and Methods: Ninety patients were enrolled and were randomly divided into three groups of 30 each. Group L:Patients were given 20 ml of 0.5% levobupivacaine plus dexmedetomidine at 1 μg per kg body weight and making total volume40 ml by adding normal saline (NS), intraperitoneally after gallbladder removal. Group R: Patients were given 20 ml of 0.5%ropivacaine plus dexmedetomidine at 1 μg per kg body weight and making total volume 40ml by adding NS, intraperitoneallyafter gallbladder removal. Group C: Patients were given 40 ml of NS. Postoperatively, the patients were assessed for painutilizing visual analog scale (VAS). The results were statistically analyzed using latest software.Results: The mean VAS score reading was lower in Group L and Group R in comparison to Group C at all the time intervals. Thenumber of patients requiring rescue analgesia was significantly higher in Group C in comparison to other study groups. Amongthe L group and R group, the number of patients requiring rescue analgesia was lower in Group L in comparison to Group R.Conclusion: Intraperitoneal instillation of local anesthetic solution in LC provided effective post-operative analgesia, butanalgesia provided by levobupivacaine plus dexmedetomidine was significantly better than ropivacaine plus dexmedetomidine

6.
Article | IMSEAR | ID: sea-193968

ABSTRACT

Background: Obesity is associated with an increased risk of atherosclerosis, which can be mediated by an increase in angiogenesis and inflammation. The objective of the present study was to explore the relationship between BMI and levels of VEGF, a circulating biomarker of angiogenesis.Methods: 225 healthy volunteers in the age group of >18 years formed the subjects of the study. Individuals with any acute or chronic illness including history of HT, DM, and smoking, alcohol or drug abuse or on any long term medication were excluded from the study. Anthropometric measurements were taken, and BMI calculated. Blood samples were taken, and serum levels of VEGF were estimated using commercially available ELISA kits. Student’s ‘t’ test was done for comparison and correlation was assessed using Pearson’s method.Results: A statistically significant difference in the levels of VEGF was found in subjects with BMI < 25 kg/m2 as compared to subjects with BMI > 25 kg/m2 (p<0.001). A significant positive correlation was found between the levels of VEGF and BMI in both males and female subjects of the study group (r=0.68 and 0.73 respectively).Conclusions: The positive correlation of levels of VEGF with BMI in the healthy subjects of the study group may be related to the expansion of adipose tissue and to the concomitant formation of new vessels to support tissue deposition. These factors may predispose an individual to an increased risk of atherosclerotic damage later in life. VEGF may therefore, have a potential as a biomarker for the prediction of cardiovascular risk and estimation may allow intervening with lifestyle modifications and nutritional changes before the disease is manifested and pharmacotherapy is required.

7.
Article in English | IMSEAR | ID: sea-154581

ABSTRACT

Background: Identification is the establishment of identity of an individual. The basis of dental identification is based on the observation that no two individuals can have same dentition. Palatal rugae are irregular, asymmetric ridges of the mucous membrane extending laterally from the incisive papilla and the anterior part of the palatal raphe. The location of palatal rugae inside the oral cavity confers them with stability even when exposed to high temperatures or trauma. Their resistance to trauma and their apparent unique appearance has suggested their use as a tool for forensic identification. Aims: To record the biometric characteristics of shape, size, direction, number and position of palatal rugae and analyze whether palatal rugoscopy can be used as a tool for personal identification and for sex determination. Settings and Design: A cross‑sectional study. Materials and Methods: The sample consisted of 100 subjects (50 males, 50 females) between 18 and 25 years. Maxillary impressions were made with elastomeric impression material and dental stone was used to make models. The palatal rugae patterns were traced and analyzed with a magnifying hand lens. The biometric characteristics of number, size, shape, and direction were analyzed using Thomaz and Kotz classification (1983). The casts were coded to blind the examiners about the identity of the subjects. Statistical Analysis Used: Unpaired t‑test and one‑way ANOVA using SPSS 19.0 statistical program for Windows. Results: The average number of rugae was slightly more in females. Wavy (44.9%) and curved (41.8%) shapes were more prevalent. Maximum number of rugae was found in E quadrant (40.73%). The average size was 9.221 mm. Most rugae were forwardly directed in both groups. Conclusion: This study concluded that rugae pattern are highly individualistic and can be used as a supplementary method for personal identification and sex determination. Further inter‑observer and intra‑observer variability were not found to be significant, which further validates the use of rugoscopy as a forensic tool.


Subject(s)
Adolescent , Adult , Biometric Identification , Cross-Sectional Studies , Ethnicity , Female , Forensic Dentistry , Humans , Male , India , Palate, Hard/anatomy & histology
8.
Article in English | IMSEAR | ID: sea-163727

ABSTRACT

Seven bis-ligands of carbamides were synthesized and characterized on the basis of elemental analysis, Infrared spectroscopy, 1H NMR, mass spectra and UV-Visible studies. These bis-ligands were synthesized by condensation method, of acidic dichloride with 4-methoxyphenylcarbamide (4-MPC) in stoichiometric ratio of 1:2 respectively. It were found that, the behaviour of bis-ligands acting as chelating agents (chelators), therefore these were comparatively interpreted on the basis of physicochemical properties such as viscosity, surface tension, conductivity, pH and solubility. The antimicrobial activities of chelating ligands also have been studied. The results were revealing that, the activities of newly synthesized chelating ligands were found to be higher than its parent’s compound. The aromatic chelating compounds shows more activity in all physicochemical properties as compare to aliphatic chelators. The nanoparticle sizes of chelating ligands were significantly identified by scanning electron microscopy (SEM) and morphological result of each chelating compound were found totally different.

10.
Article in English | IMSEAR | ID: sea-163695

ABSTRACT

2-Aryl/heteryl-3-aryloxy/heteryloxy-4H-chromones 5 have been synthesized through a series of reactions starting from phenols under microwave irradiation. This process is an effective alternative to the traditional thermal heating method. The yields are excellent and the reaction time is in a few minutes. These compounds have been characterized on the basis of IR, 1H NMR, 13C NMR and Mass spectrometry and evaluated for antibacterial activity.

11.
IJPR-Iranian Journal of Pharmaceutical Research. 2012; 11 (2): 433-445
in English | IMEMR | ID: emr-131753

ABSTRACT

The solubility enhancement of poorly soluble compounds is an important task in pharmaceutical technology as it leads to better bioavailability and a more efficient application. Fused dispersions [FDs] of simvastatin [SIM] using PEO-PPO block copolymer were prepared which paved the way for the formation of an amorphous product with enhanced dissolution and bioavailability. The accumulative solubility of simvastatin [SIM] from PEO-PPO block copolymer [Lutrol NF 127 prill surfactant] was found to be superior to the drug alone which may be due to the increased oxyethylene content that played the major role in solubility enhancement. A 3[2] full factorial approach was used for optimization wherein the temperature to which the melt-drug mixture cooled [X[1]] and the drug-to-polymer ratio [X[2]] were selected as the independent variables and the time required for 90% drug dissolution [t[90%]] was selected as the dependent variable. A low level of X[1] and a high level of X[2] were suitable for obtaining higher dissolution of SIM from SIM FDs. On increasing melt to cool drug temperature, t[90%] increased thus improving dissolution rate of FD[2] batch with the maximum drug release [99.63%] in 120 min. The optimized FDs were characterized by saturation solubility study, drug content, in-vitro dissolution, fourier transform infrared spectroscopy, scanning electron microscopy, differential scanning calorimetry, x-ray diffraction, [1]HNMR spectroscopy and pharmacodynamic evaluation. Capsules containing optimized FDs were prepared and compared with marketed brand [SIMVOTIN[registered]]. Finally, it can be concluded that the optimized FDs of SIM ameliorate the solubility and dissolution of drug with improved pharmacodynamic activity

12.
Clinics ; Clinics;66(4): 635-639, 2011. graf
Article in English | LILACS | ID: lil-588916

ABSTRACT

OBJECTIVE: The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function. METHODS: Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja'afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique. RESULTS: There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution), the fracture displacement (21 mm or more), shortening (15 mm or more) and the fracture union (malunion). CONCLUSION: This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes.


Subject(s)
Adult , Humans , Clavicle/injuries , Fractures, Comminuted/therapy , Fractures, Malunited/therapy , Orthotic Devices/adverse effects , Range of Motion, Articular/physiology , Shoulder/physiopathology , Chi-Square Distribution , Clavicle , Fractures, Comminuted/physiopathology , Fractures, Malunited/physiopathology , Malaysia , Muscle Strength/physiology , Prospective Studies , Shoulder , Treatment Outcome
14.
Article in English | WPRIM | ID: wpr-628236

ABSTRACT

This study was conducted to evaluate the efficacy of intraarticular injection of hyaluronic acid for the treatment of knee osteoarthritis. Patients with knee osteoarthritis were followed for a period of six months to assess the efficacy of intra articular injection of hyaluronic acid given three times in three consecutive weeks. Fifty patients were reviewed at two, eight and 24 weeks post injection. The average age was 60.9 years and female to male ratio was 3:1. Patients were assessed using the Lequesne Algofunctional Index for function, and the visual analogue score for pain and side effects. We found that the knee pain reduced and the function improved in most patients and these beneficial effects maintain till the last follow up. The only side effect noted was one case of acute non septic joint effusion after the 3rd injection. We concluded that intra articular injection of hyaluronic acid can produce pain relief and functional improvement for up to 6 months.

15.
Article in English | WPRIM | ID: wpr-151021

ABSTRACT

Malaria parasites adapt to the oxidative stress during their erythrocytic stages with the help of vital thioredoxin redox system and glutathione redox system. Glutathione reductase and thioredoxin reductase are important enzymes of these redox systems that help parasites to maintain an adequate intracellular redox environment. In the present study, activities of glutathione reductase and thioredoxin reductase were investigated in normal and Plasmodium berghei-infected mice red blood cells and their fractions. Activities of glutathione reductase and thioredoxin reductase in P. berghei-infected host erythrocytes were found to be higher than those in normal host cells. These enzymes were mainly confined to the cytosolic part of cell-free P. berghei. Full characterization and understanding of these enzymes may promise advances in chemotherapy of malaria.


Subject(s)
Animals , Mice , Antioxidants/isolation & purification , Cell Fractionation , Cytosol/enzymology , Erythrocytes/parasitology , Glutathione Reductase/isolation & purification , Plasmodium berghei/enzymology , Thioredoxin-Disulfide Reductase/isolation & purification
16.
Article in English | IMSEAR | ID: sea-24118

ABSTRACT

BACKGROUND & OBJECTIVE: The suitability of pig as an animal model for research in coronary artery disease is well established. As coronary arteries (CAs) of the pig are reportedly closely resemble those of man. We investigated the CAs of the pig (Sus scrofa) and study differences between the two, if any. METHODS: The origin and pattern of the coronary arteries were studied in the hearts of 30 fully grown pigs obtained from a slaughter house in Chandigarh (India). The openings of the CAs were identified at the commencement of the ascending aorta. The arteries were washed with acetone by introducing appropriate sized cannulae in their ostia. A 20 per cent solution of cellulose acetate butyrate (CAB), a plastic material, dissolved in acetone was injected in the CAs. The hearts were fixed in 10 per cent formalin solution for three to four days after which the CAs and their branches were dissected. RESULTS: Both coronary arteries arose from the aortic sinuses below the supravalvular ridge in all the cases. Sinuatrial nodal artery (SAN) arose from the RCA in 70 per cent and from the circumflex artery (CX) in 30 per cent of instances. There was RCA dominance in all hearts of the pig. The atrioventricular nodal artery (AVN) and the posterior interventricular artery (PIV) were branches of RCA. The coronary arterial circulation in the pig was found to be similar to that in human. INTERPRETATION & CONCLUSION: By and large the coronary arterial pattern of the pig was similar in that of the humans. We can conclude that the heart of a pig can be used for experiments but differences have to be kept in mind.


Subject(s)
Animals , Coronary Vessels/anatomy & histology , Heart/anatomy & histology , Humans , Models, Animal , Species Specificity , Sus scrofa/anatomy & histology
18.
Article in English | IMSEAR | ID: sea-46728

ABSTRACT

The variable origin of muscles is not uncommon though the complete or partial absence of the clavicular head of pectoralis major muscle is rare. This paper deals with bilateral partial absence of clavicular head of pectoralis major muscle. The clavicular head was arising only in the middle of medial half of the clavicle and was separated from sternocostal head by a gap of 2.5cm and laterally from the origin of deltoid from clavicle by a gap of 2.5cm. Nerve supply of this muscle was from lateral and medial pectoral nerves as usual. The partial absence of the clavicular head of pectoralis major muscle becomes important in cases of reconstructive surgery as this head is required to cover the lateral acromioclavicular defect and in cases of established facial paralysis.


Subject(s)
Adult , Cadaver , Diagnosis , Humans , Male , Pectoralis Muscles/abnormalities
19.
Article in English | IMSEAR | ID: sea-46861

ABSTRACT

Posterior cord (PC) is formed by the union of posterior divisions of upper, middle and lower trunks. During routine dissection variations in the formation and distribution of PC and its branches were observed on both the sides. These variations were: i) prefixed brachial plexus on left side ii) PC on both the sides was formed by the union of posterior divisions of only the upper (C5, 6) and middle (C7) trunks while the posterior division of lower (C8, T1) trunk joined the radial nerve directly and also gave contribution by two roots to left thoracodorsal nerve iii) length of PC varied on both the sides; on right side it was 4cm while on left side it was 1.5cm long. iv) upper subscapular nerve on right side arose from PC far proximal to other branches and on its course communicated with lower subscapular nerve before distributing to subscapularis while on left side it arose from posterior division of the upper trunk (C5, 6) only. v) on left side nerve to teres minor arose directly from axillary nerve trunk instead of arising from its posterior branch. The axillary nerve on both the sides divided into terminal branches before entering the quadrangular space of arm instead after traversing the quadrangular space. vi) the branches of radial nerve, which normally arise in the radial groove, arose in the axilla on both the sides. So in cases of trauma or injury of arm some of these branches may be spared.


Subject(s)
Axilla/abnormalities , Brachial Plexus/abnormalities , Cadaver , Humans , Pilot Projects , Radial Nerve/abnormalities
20.
Article in English | IMSEAR | ID: sea-46917

ABSTRACT

The sternalis muscle on the manubrium sterni and its communication with sternocleidomastoid has been reported by many workers as unilateral or bilateral in both the sexes. The present report deals with bilateral sternales below the angle of sternum in a male cadaver during routine dissection. The proximal attachment of the muscle was from the manubriosternal joint on either side, right being broader than left and was found to be overlapping the lateral part of sternum and adjoining pectoralis major muscle. The muscle was running downwards and laterally and was attached on the cartilage of 6th and 7th ribs appearing to be continuous with rectus abdominis muscle. The muscle was found to be innervated by branches of the corresponding intercostal nerves of these spaces. The sternalis if present could be used for reconstructive surgical operations on the breast.


Subject(s)
Cadaver , Humans , Male , Muscle, Skeletal/abnormalities , Sternum
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