Study of Aetiological and Endoscopic Profile of Patients with Upper Gastrointestinal Bleed in North East India - A Hospital Based Cross Sectional Study

Upper Gastro-Intestinal Bleeding (UGIB) is one of the common complaints with which patients present to casualty. It is associated with significant morbidity and mortality. The aetiological spectrum of UGIB is variable in different geographical regions. Our study aimed to analyse the aetiology, endoscopic profile, mortality, Rockall score and predictors of mortality in patients with UGIB, in North East India. METHODSThis cross-sectional study was conducted at Assam Medical College and Hospital in North East India. We enrolled patients with age 12 years and above, who were admitted between July 2019 and January 2020 with a history suggestive of UGIB. Demographic data of the patients was collected, after which they underwent clinical examination, and upper GI endoscopy. Mean ± standard deviation was used to express continuous variables. Frequency and percentage were used to express categorical variables. Test of significance for qualitative data was assessed by Chi-square test (for 2 x 2 tables). P value less than 0.05 was taken as statistically significant. RESULTSWe analysed 117 patients diagnosed with UGIB [80.34 % male, 19.60 % female], ratio of male to female of [4.08:1] was seen. The most common symptom was melena 87 patients (74.15 %), endoscopy finding showed that 48.71 % had oesophageal and / or gastric varices, 26.49 % had peptic ulcers, 17.94 % had gastric erosions / duodenal erosions / erosive gastritis, 1.7 % had Mallory-Weiss tear, 1.7 % had gastric malignancy, 1.7 % had GJ stoma bleed, 1.7 % had both oesophageal varices and peptic ulcer disease. Partial gastric outlet obstruction was observed in peptic ulcer disease in 2 patients (6.45 % of total peptic ulcer disease patients). 73.75 % patients had Rockall score < 5 and 26.49 % patients had Rockall score > 6. H. pylori infection (assessed by RUT) was an independent predictor of upper GI bleed in both variceal and non-variceal bleed [p < 0.001]. The mortality in our study was 7.69 %. Predictors of mortality in the study population were, patients with variceal bleed [p = < 0.001], Rockall score > 6 [p = 0.013], and chronic liver disease [p < 0.001]. The average duration of hospital admission of the study population is about 4.6 + / - 0.4 days. CONCLUSIONSThe study reported oesophageal varices was the most common cause of UGIB, followed by peptic ulcer in North East India. H. pylori was an independent predictor of both variceal and non-variceal bleed. Partial gastric outlet obstruction (GOO) was one of the common benign complication of peptic ulcer disease. Variceal bleed, Rockall score > 6, chronic liver disease were predictors of mortality.

Evaluation of Heavy Metals in Gills, Bones and Muscles of Fishes from Crude Oil Polluted Water of Ogoniland, Rivers State, Nigeria

This study was carried out to determine the concentrations of heavy metals (cadmium, chromium, zinc, manganese, lead and iron) in organs (gills,bone and muscle) of Iutjanus campechanusand Chrysichthys nigrodidatatusfrom Gokhana, and Khana local government areas in River State, Nigeria were investigated.This heavy metals were determined using atomic absorption spectrophotometer (AAS). The result show that Iron was significantly more abundant in the gills, bone and muscle tissue than other element with mean concentration of 144-144.58mg/kg in the gills, 18.19-39.77mg/kg in the bone and 5.47-21.50mg/kg in the muscle of both catfish and red snapper in Kaa while in bodo-city the concentration varies from189-238mg/kg in the gills, 42.16-45.39mg/kg in the bone and 11.74-43.84mg/kg in the muscle of both fishes respectively. Maximum concentration of Zinc was recorded in gills from Bodo-city for both fishes and minimum value wasrecorded in the muscle of both fish species in Kaa. High level of chromium, manganese and lead were recorded in bone of both species while the least concentration of all elements was recorded in the muscle of catfish and red snapper. It was observed that the level of metals in all organs were high except for chromium in the muscle which was lower than the permissible limits for human consumption designated by the USEPA, WHO, FAO. The result revealed that the distribution of the heavy metals follow the order Fe>Zn>Mn>Pb>Cd>Cr for Chrysichthys nigrodidatatusand Fe>Zn>Pb>Mn>Cd>Cr for Iutjanus campechanuswhile the distribution in the organs follow the other Gills>bone>muscle for both fish spices in Kaa and Bodo-City respectively. This reveal the health effect the people in the study area could be exposed to by the consumption of the muscle of catfish and red snapper which have high levels of these metals. Measures need to be taken as the level of Heavy metals detected in organs from the two site posed serious threat to the populace that feed on them

Development of EPIC-PCR Markers for Lutjanus purpureus (Lutjanidae-Perciformes) and their Potential Applicability in Population Analyses

ABSTRACT In the present study, a novel set of eight EPIC primers were developed for Lutjanus purpureus and assayed in five other marine teleosts including three lutjanids, one scianid and one anablepid. Most of the genomic regions used in this study presented genetic diversity indexes equal or greater than the intragenic regions commonly used in population genetics studies. Moreover, six out of eight markers showed cross-amplification with other taxa. Thus, the primers described here may be used to elucidate questions at the intraspecific level for a large number of taxa.

Can Lutjanus purpureus (South red snapper) be "legally" considered a red snapper (Lutjanus campechanus)?

Red snappers (Lutjanus purpureus in Brazil and Lutjanus campechanus in USA and Gulf of Mexico) are both under clear effect of overfishing. Because of their high morphological similarity it has already been suggested that they could possibly be considered as a single species. To investigate the degree of similarity and the genetic structure of red snapper populations we constructed a common dataset of partial D-loop mtDNA sequences of L. purpureus from Brazil (Amapá, Pará and Maranhão) and L. campechanus from the Atlantic coast of the USA (Florida, Louisiana and Mississippi). Phylogenetic and population genetic analyses surprisingly depicted high similarity between L. campechanus and L. purpureus, compatible with the hypothesis of a single species of red snapper for the Western Atlantic Ocean. These preliminary but very curious findings open an important discussion regarding the legislation involved on the capture of this overexploited fish resources as well as regarding their taxonomy.

A case of protein contact dermatitis / 천식및알레르기

A 24-year-old woman complained of chronic eczematous lichenified skin lesions with itching on both hands. The lesions were distributed mainly on the lateral and dorsal sides of the fingers. She had a history of atopic dermatitis and noticed itching sensation followed by erythema within minutes of contact with salmon at the respective contact sites, and subsequent formation of papules. Additionally, the ingestion of salmon resulted in swelling on her lips and throat. She had been working as a cook for 2 years and her sister had suffered from allergy to metal. Patch test with Korean standards and bakery series yielded positive to nickel and cobalt without clinical relevance. In a standardized skin prick test, strongly positive reactions to raw salmon and red snapper were observed after 20 min, but a patch test with the same substances was negative. We report a case of protein contact dermatitis due to salmon and red snapper.