Evaluation of changes in serum lipid profile and fasting blood glucose levels in patients with gall stone disease before and after cholecystectomy

Background: There is paucity of information regarding the effects of cholecystectomy on serum lipid profile parameters and blood glucose levels in the patients of cholelithiasis. Therefore, this study was undertaken to compare some serum lipid parameters and blood glucose levels in patients of cholelithiasis and effect of cholecystectomy on the same.Methods: The study was conducted on 50 patients of cholelithiasis who were admitted in Surgery department, MLN Medical College over a period of one year and were planned for cholecystectomy. Complete lipid profile (which included total cholesterol, triglycerides, high density lipoproteins (HDL) cholesterol, low density lipoproteins (LDL), very low density lipoproteins (VLDL) and atherogenic index) and fasting blood glucose was evaluated pre-operatively and post-operatively on the 3rd, 7th and further after 1 month of cholecystectomy. Results: Out of 50 patients, maximum of 38% were in their 4th decade with females constituting 82% of total. There was significant elevation in fasting blood glucose and HDL cholesterol on 3rd, 7th and 30th day post-cholecystectomy as compared to pre-operative values (p value<0.0001). Triglyceride and VLDL cholesterol elevated on 3rd and 7th day but it significantly decreased one-month post-cholecystectomy as compared to pre-operative levels (p value<0.0001). However, LDL, total cholesterol and atherogenic index significantly decreased on 3rd ,7th and 30th day post-cholecystectomy.Conclusions: Cholelithiasis is an important cause associated with significant pathological changes in many lipid profile parameters, which will return towards normal after cholecystectomy. This normalization will be a time dependent phenomenon with long term beneficial effects.

Aneurysmal Bone Cyst of Mandible: A Case Report.

Aneurysmal bone cysts are rare benign lesions of bone tissue, infrequent in the craniofacial skeleton about other structures like long bones or the spine. The rare jaw lesions encountered in the mandible and maxilla. On the other side, it is at the same time very exciting in terms of its differential diagnosis with other types of mandibular or maxillary bone lesions. We present the case of a 45-year-old female patient with an aneurysmatic cyst located at the left angle of the mandible describing the treatment for the same i.e. surgical excision and hemi mandibulectomy with reconstruction. We have focused on the differential diagnosis, mainly with the malignancies, which can be found at this location, along with therapeutic options classically described for these kinds of pathologies. In our patient, the surgical excision and hemi mandibulectomy allowed a complete removal of the lesion and recon plate was placed for rehabilitation.

Evaluation of a novel decorporation approach to prevent radioactivity uptake by using acidosis in experimental animals.

With an aim to devise a prophylactic and/or therapeutic approach for preventing internalization of radiothallium (201Tl), and more importantly by implication, its chemical analogue radiocesium (137Cs) during any nuclear emergency, different ex vivo and in vivo animal models were created to determine the role of pH in absorption of 201Tl across jejunum/muscle tissue and whole body retention of 201Tl respectively. Movement of Tl+ under simulated pH conditions proved that pH had direct influence on its absorption. Oral intake of acidified water or parenteral administration of lactic acid was able to reduce the body burden of 201Tl by up to 12 and 50% respectively. The results indicate that acidification of gut, within physiological range may be used as an option for decorporation/inhibition of incorporation of radiothallium and radiocesium, particularly in cases of mass casualty.

Transient cell function disruption by low dose acute exposure of ionizing radiation.

Incubation of BMG-1 cells with thallium chloride (201Tl) in the range of diagnostic dose did not show a smooth uptake curve and appeared to have an unsuspected deviation in initial phase. In the present study this unexpected phenomenon was explored, using commonly used radionuclides (viz., 201Tl and 131I). Comparison was made with technetium-99m pertechnetate (99mTcO4-) and technetium-99m labeled methoxyisobutylisonitrile (99mTc-MIBI) that are known to show conventional 2 phase graph representing inflow and outflow segments. Serial in vitro, ex-vivo and in vivo gamma scintigraphy as well as NMR spectroscopy experiments were conducted to corroborate the results. BMG-1 cells demonstrated a four-phase uptake pattern with 201Tl as compared to a conventional biphasic pattern with 99mTc-MIBI. Flow cytometry data however did not reveal any 201Tl induced cell injury. Further, mice tissue extracts injected with 201Tl also showed a transient depression in its uptake. Scintigraphy experiments in rabbits administered with diagnostic dose of 201Tl and 131I confirmed the in vitro and ex vivo findings. Further, proton NMR spectroscopy showed decrease in the level of choline at 3 h and 24 h in 201Tl treated animals as compared to control. Phosphoethanolamine peak firstly decreased at 3 h but reached normal level at 24 h time point. No significant change was observed in the level of betaine. This transient reduction in internalization of 201Tl and 131I may represent a hitherto unknown acute effect of low dose radiation, i.e., transient depression in Na+-K+ ATPase pump activity without any apparent evidence of cell damage, representing a transient cell membrane dysfunction. The phenomenon may present a mechanistical explanation of ‘thyroid stunning’ at cellular level and suggest that it may be more universal in nature than suspected till now.

Epilepsy with myoclonic absences.

Epilepsy with myoclonic absences is a rare seizure disorder with intellectual impairment and resistance to conventional anti-convulsants. It is essential to diagnose epilepsy with myoclonic absences earlier for a better outcome. The authors present a case report to highlight this fact.

Impact of hypercholesterolemia on in vitro toxicity of N-nitrosodiethylamine: effect on lipidperoxidation of blood and tissue.

In vitro treatment of erythrocytes of normal and hypercholesterolemic rats with N-nitrosodiethylamine (NDEA), an important carcinogen frequently present in human environment and food chain resulted in a marginal increase in osmotic fragility of erythrocytes without affecting their antioxygenic potential as evidenced by insignificant effect on lipid peroxidation (LPO). However, (LPO) of all the tissues (heart, lung, liver, kidney and spleen) increased significantly on in vitro treatment with NDEA. The effects were different in different tissues under different dietary conditions