Subject(s)
Celiac Disease/epidemiology , Celiac Disease/genetics , Adolescent , Child , Enzyme-Linked Immunosorbent Assay , Female , Humans , India/epidemiology , Male , Prevalence , SiblingsABSTRACT
Malignant disease of oropharynx, esophagus and small intestine occurs in patients of celiac disease frequently. The role of gluten-free diet in prevention of malignancy is unclear. We report a case of postcricoid carcinoma occurring in the patient of celiac disease.
Subject(s)
Carcinoma, Squamous Cell/pathology , Celiac Disease/complications , Hypopharyngeal Neoplasms/pathology , Lymph Nodes/pathology , Adult , Carcinoma, Squamous Cell/diagnosis , Celiac Disease/physiopathology , Humans , Hypopharyngeal Neoplasms/diagnosis , MaleSubject(s)
Device Removal/methods , Esophagoscopy , Esophagus , Foreign Bodies/surgery , Adult , Catheterization , Humans , Ligation/instrumentation , MaleSubject(s)
C-Reactive Protein/analysis , Colitis, Ulcerative/pathology , Adult , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Severity of Illness IndexABSTRACT
Esophageal variceal bleed in children is treated with endoscopic sclerotherapy (EST), which is associated with significant complications. Endoscopic variceal ligation (EVL) was found to be more effective and safe in adults. Use of EVL in children has not been studied much. Thirteen consecutive children (mean age 9.4 years) with variceal bleed were subjected to EVL by multi band ligator. Varices were eradicated in 2.8 sessions (range 2-4) and one patient had bleed during procedure. No other complications were noted. EVL could not be performed in 2 children less than 3 years of age.
Subject(s)
Esophageal and Gastric Varices/surgery , Adolescent , Child , Child, Preschool , Endoscopy , Female , Humans , Ligation/instrumentation , Male , Treatment OutcomeABSTRACT
OBJECTIVE: To determine the frequency of extraintestinal manifestations in patients with idiopathic ulcerative colitis. METHODS: 46 patients underwent detailed clinical, biochemical and radiological evaluation. RESULTS: One patient (2%) had peripheral arthritis and two patients (4%) had ocular involvement in the form of anterior uveitis. No patient had mucocutaneous, vascular, or hepatobiliary manifestations, or sacroiliitis. CONCLUSIONS: The frequency of extraintestinal manifestations in patients with IUC in northwestern India is low.
Subject(s)
Colitis, Ulcerative/epidemiology , Colitis, Ulcerative/physiopathology , Joint Diseases/etiology , Adolescent , Adult , Colitis, Ulcerative/complications , Female , Humans , India/epidemiology , Male , Middle Aged , PrevalenceABSTRACT
BACKGROUND: According to the WHO, signs of hepatic dysfunction are unusual, and hepatic encephalopathy is never seen in malaria. However, in recent years, isolated cases have been reported from different parts of world. AIM: To identify the evidence for hepatocyte dysfunction and/or encephalopathy in jaundiced patients with falciparum malaria. DESIGN: Prospective observational study. METHODS: We studied 86 adult patients of both sexes who had malaria with jaundice (serum bilirubin > 3 mg%). The main outcome measures were: flapping tremor, deranged psychometric test, level of consciousness, serum bilirubin level, serum aspartate transaminase (AST) and alanine transaminase (ALT) levels, blood ammonia level, viral markers for hepatitis, ultrasonography of liver and gall bladder and electroencephalography (EEG). RESULTS: The range of serum bilirubin was 3-48.2 mg% (mean +/- SD 10.44 +/- 8.71 mg%). The ranges of AST and ALT levels were 40-1120 IU/l (294.47 +/- 250.67 IU/l) and 40-1245 IU/l (371.12 +/- 296.76 IU/l), respectively. Evidence of hepatic encephalopathy was seen in 15 patients. Asterexis was observed in 9 patients, impaired psychometric tests in 12 and altered mental state in 13. Arterial blood ammonia level was 120-427 meq/l (310 +/- 98.39 meq/l). EEG findings included presence of large bilateral synchronous slow waves, pseudo burst suppression and triphasic waves. Four patients died due to multiple organ dysfunction; the others made rapid recoveries. DISCUSSION: There is strong evidence of hepatocyte dysfunction and hepatic encephalopathy in some of these patients, with no obvious non-malarial explanation. Current guidelines may need to be revised.
Subject(s)
Hepatic Encephalopathy/parasitology , Hepatocytes/parasitology , Liver Diseases, Parasitic/complications , Malaria, Falciparum/complications , Adult , Alanine Transaminase/blood , Antimalarials/therapeutic use , Aspartate Aminotransferases/blood , Bilirubin/blood , Biomarkers/blood , Female , Hepatic Encephalopathy/drug therapy , Humans , Jaundice/drug therapy , Jaundice/parasitology , Liver Diseases, Parasitic/diagnosis , Liver Diseases, Parasitic/drug therapy , Malaria, Falciparum/drug therapy , Male , Prospective Studies , Quinine/therapeutic use , Treatment OutcomeABSTRACT
A 31 year old female patient presented with a one and a half year history of pain in the upper abdomen. The pain was mild, constant, dull aching, and increased with change in posture or sudden movements. There was no definite relation to meals. She also had a lump in the right upper quadrant, which had been gradually increasing in size over three months. She had mild anorexia and reported a 5 kg weight loss over one year. She had no history of intake of oral contraceptive drugs, exposure to vinyl chloride, thorotrast or any other industrial toxin. Ultrasonography of the abdomen revealed multiple space occupying lesions of altered echotexture in both lobes of the liver. The portal venous system and hepatic vascular system were normal. Computed tomography of the abdomen confirmed the ultrasound findings. Histopathology was diagnostic for primary epithelioid haemangioendothelioma; the first such case reported from India. The patient has been put on a waiting list for a liver transplant.
