Malnutrition is not an etiological factor in the development of tropical pancreatitis – A case-control study of Southern Indian patients.

Background and Aim: Malnutrition is implicated as an etiological factor in tropical pancreatitis (TP). The aim of the present study was to elucidate whether malnutrition is the cause or the result of TP. Methods: Consecutive recently diagnosed patients with TP were evaluated for their nutritional status and dietary patterns before and after the onset of TP. The nutritional status of patients before the onset of TP was compared with that of healthy controls to demonstrate the role of malnutrition as an etiological factor for TP. Results: Of 256 consecutive patients with chronic pancreatitis, 89 were diagnosed as TP patients with disease duration of less than 1 year (mean age 32.14 ± 14 years; 60 % males) and comprised the study group. The nutritional status before the onset of TP was comparable with that of controls (n=101) with 15% of patients and 12% of the controls being malnourished (BMI <18.5kg/m2). However, after the onset of TP, 52% (n=46) of patients lost weight and the percentage of malnourished patients increased from 15% to 38% (p=<0.001) indicating that there was significant weight loss after the disease onset. When the causes of weight loss were evaluated, it was found that low calorie intake significantly contributed to weight loss (p=0.001). Conclusion: Malnutrition is not an etiological factor of TP and weight loss occurred as a result of low calorie intake after the onset of TP.

NOTES: A review.

A few years ago a new approach to performing abdominal surgery was presented, i.e. via the natural body orifices using endoscopes. The interest and research in this approach progressed very rapidly, in spite of the initial skepticism. It was initially demonstrated in animal models, then in human beings and has now very nearly become routine practice. This article reviews the development of natural orifice transluminal endoscopic surgery (NOTES), its benefits and the hurdles we have yet to overcome.

Application of high-resolution narrow band imaging and endocytoscopy for early diagnosis of esophageal neoplasia.

The worldwide incidence of esophageal carcinoma has been rising rapidly over the past few decades. However, in only 31% of patients the carcinoma is detected early in situ. It is essential to detect the malignancy early and to determine the extent of the disease to ensure the best option for a cure. Recent advances in endoscopic technology, including high-resolution magnification endoscopy, narrow-band imaging and endocytoscopy, have increased detection rates of oesophageal microcarcinomas. We report three cases of esophageal malignancy where the use of newer diagnostic techniques ensured an early diagnosis which led to a modified course of management.