Association of Systemic Inflammatory and Anti-inflammatory Responses with Adverse Outcomes in Acute Pancreatitis: Preliminary Results of an Ongoing Study.

INTRODUCTION: This paper reports preliminary data of an ongoing study that evaluates the association of systemic inflammatory response (SIRS) with early severe acute pancreatitis (ESAP) and compensatory anti-inflammatory response syndrome (characterized by HLA-DR down-regulation) with infected pancreatic necrosis (IPN). METHODS: Consecutive patients presenting within 72 h of symptom onset with organ dysfunction and/or local complications were included. Following parameters were recorded: demographics, etiology, SIRS, APACHE II, creatinine, BUN. Circulating IL-8, IL-6, IL-10, TNF-alpha concentrations and expression of HLA-DR and IL-10 by qRT-PCR in PBMCs were measured. Strength of associations of cytokine concentration and HLA-DR/IL-10 expression with outcomes was expressed as Hedges' G and relative risk (95% CI). RESULTS: Twenty-eight patients (10 MSAP; 18 SAP) fulfilled inclusion criteria. Twelve patients had ESAP and eight presented with organ failure. Admission SIRS worsened in eight (28.6%) patients over 48 h. Sixteen (57.1%) patients developed primary IPN. Twenty-one (75%) patients had HLA-DR down-regulation during the first week, which persisted to the second week in 12 (42.9%) patients. IL-8, IL-6, and TNF-α progressively increased from healthy controls to MAP to MSAP to SAP. IL-6 and TNF-α was higher in the patients who developed ESAP (p = 0.01 and 0.05, respectively). Patients who died within the first week also had a significantly elevated concentration of IL-6 and TNF-α (p = 0.02 and 0.01, respectively). The relative risk (95% CI) of developing primary IPN with persistent HLA-DR down-regulation till the second week of illness was 11.3 (1.6-82.4; p = 0.01). CONCLUSIONS: Our study objectively demonstrates significant association of ESAP and early mortality with primary cytokine response, and development of IPN with persistent HLA-DR down-regulation.

Impact of treatment of gastrointestinal nemathelminths on body weight of sheep and goats.

Gastrointestinal nemathelminths affect productive as well as reproductive performance of a wide range of ruminants. To assess the impact of anthelmintic treatment on gain in body weight (b. wt.) of sheep and goat, a study was conducted using two different flocks of sheep and goats each maintained in semi intensive system. Infected animals in both the flocks were divided into three groups each. Group I and II in each flock were treated with levamisole (@7.5 mg/kg b. wt. subcutaneously) and fenbendazole (@5 mg/kg b. wt. orally), respectively. Animals of group III were kept as untreated control. Individual b. wt. and faecal egg count were recorded up to 42nd day post treatment. Results showed 100 % reduction in faecal egg count of sheep on day 7 after treatment with levamisole and on day 10 after treatment with fenbendazole. In goats, the reduction in faecal egg count was 82.60 % after treatment with levamisole and 78.87 % after treatment with fenbendazole on day 14 post treatment. The study also revealed mean increase of 29.57 and 22.67 % in b. wt. of sheep treated with levamisole and fenbendazole respectively 42nd day post treatment whereas mean b. wt. of infected untreated control groups decreased by 7.14 %. Similarly, there was an increase of 10.71 and 14.47 % in mean b. wt. of goats 42nd day post treatment with levamisole and fenbendazole, respectively whereas mean b. wt. of untreated control group decreased by 15.38 %. More weight gain was recorded in sheep as compare to goats after treatment as compared to the untreated control group, which may be due to some drug resistance in goat and required clarification by further studies in these ecological zones of Udham Singh Nagar.

Prevalence of gastrointestinal helminth infections in rodents of Tarai region of Uttarakhand.

The present work was aimed to investigate helminth biodiversity among rodents in order to evaluate the threat for helminth transmission to humans since they act as a potential source of parasitic zoonoses. In this study, faeces of 43 black rats (Rattus rattus) and 35 house mice (Mus musculus) were collected from various habitats viz. domestic places and agricultural fields of different parts of tarai region of Uttarakhand. These faecal samples were examined for the presence of parasitic eggs, adult and segments of the worms. The study revealed that the rodents were infected with 5 genera of helminth parasites, i.e. Hymenolepis nana, Hymenolepis diminuta, Syphacia muris, Capillaria hepatica, Trichuris muris and other strongyle eggs (2 species of cestodes and 4 species of nematodes). Adult Syphacia muris and segments of Hymenolepis nana were also recovered from faecal droppings. Of the 43 samples of black rat, all (100 %) and of the 35 samples of mice 9 (25.71 %) were found positive for one or more than one species of parasitic infections. Greater infection of H. diminuta 19 (44.18 %) followed by H. nana 17 (39.53 %) was seen in rat whereas mice were mostly infected with H. nana. The diversity and prevalence of various parasites reported here within domestic habitats may suggest that these can pose a high risk of helminth transmission to human population and are thus of considerable public health importance.