Current spectrum of malabsorption syndrome in adults in India.

Aim Tropical sprue was considered to be the most important cause of malabsorption in adults in India. However, several reports indicate that celiac disease is now recognized more frequently. Methods We analyzed the clinical presentation, endoscopic and histological features of 94 consecutive patients (age >12 years) with chronic diarrhea and malabsorption syndrome. The spectrum of disease in these patients and features differentiating celiac disease and tropical sprue are reported here. Results Celiac disease (n=61, 65%) was the most common cause of malabsorption followed by tropical sprue (21, 22%). Other conditions including cyclosporiasis (3), Crohn’s disease (2), common variable immunodeficiency (2), lymphangiectasia (1), William’s syndrome (1), and idiopathic malabsorption (3) accounted for the remainder. A greater number (21, 34%) of patients with celiac disease than those with tropical sprue (4, 19%) presented with atypical manifestations. Patients with celiac disease were younger (p=0.001), more often had anemia, (p=0.001), scalloping of folds (p=0.001), moderate (p=0.02) or severe (p=0.001) villous atrophy, higher grade of intraepithelial lymphocytic infiltration (p=0.001), crypt hyperplasia (p=0.001), cuboidal (p=0.001) and pseudostratified (p=0.009) surface epithelial cells, and diffuse (p=0.001) epithelial damage. In comparison, patients with tropical sprue were older and more often had normal duodenal folds, normal villi, tall columnar epithelial cells and focal epithelial damage. Conclusions Celiac disease was the most frequent cause of malabsorption syndrome in this series of patients. There are significant clinical and histological differences between celiac disease and tropical sprue.

The science behind sacredness of TULSI (OCIMUM SANCTUM LINN.).

Medicinal properties of Tulsi (Ocimum sanctum Linn) are known for thousand years to various civilizations of the world. This medicinal herb is considered as a sacred plant by the Hindus in the Indian subcontinent. Scientific explorations of traditional belief of medicinal properties of Tulsi have got momentum mostly after the middle of the 20th century. In the present review, efforts have been made to sum up different aspects of scientific studies on this medicinal plant. Scientific evidences are available on various medicinal aspects i.e. antimicrobial, adaptogenic, antidiabetic, hepato-protective, anti-inflammatory, anti-carcinogenic, radioprotective, immunomodulatory, neuro-protective, cardio-protective, mosquito repellent etc. to name a few. Most of these evidences are based on in-vitro, experimental and a few human studies.

Mycobacterium avium-intracellulare in stool in HIV-seropositive man.

Mycobacterium tuberculosis is the predominant acid-fast bacillus causing diarrhea in HIV-seropositive patients in India. We report a 27-year-old HIV-seropositive man with diarrhea in whom M. avium-intracellulare was isolated on stool culture.

Isosporiasis in children.

The clinical, laboratory and therapeutic data of patients with diarrhea in Human immunodeficiency virus (HIV) antibody positive, immunocompromised and immunocompetent individuals were studied especially to look for prevalence of intestinal coccidiosis. During a study period of one decade, Isospora belli were identified in the stool samples of seven children with diarrhea. Diarrhea persisted for a little longer period in HIV-seropositive children compared to sero-negatives but the clinical picture did not differ significantly in either HIV infected or HIV uninfected individuals.