Biomedical subjects
Publications and source records attributed to K Singh.
Presentation of abdominal tuberculosis with portal hypertension is rare. We report a 25-year-old man with portal hypertension due to compression of the portal vein by tuberculous lymph nodes at the hepatic hilum. After antitubercular therapy, features of portal hypertension disappeared as the nodes regressed.
The study was conducted to detect the effect of giardiasis on human disaccharidase levels. Forty patients attending the medical outpatient department of PGIMER, Chandigarh were enrolled. Twenty patients, positive for Giardia lamblia comprised the study group while 20 patients negative for Giardia lamblia were taken as controls. Upper gastrointestinal endoscopy was performed in all patients. Estimation of lactase, sucrase, maltase and trehalase was done in biopsies. Histopathological investigation was carried out in all biopsy specimens after Haematoxylin and Eosin staining. Complaints of pain abdomen and bloating occurred commonly in giardiasis. Four biopsy samples in study group showed mild increase in lymphomononuclear infiltrate. Giardia lamblia was detected in 7 biopsies. Lactase levels were decreased significantly (p < 0.05) in giardiasis. Rest of the enzymes were comparable to the controls. No differences in the enzyme activities were observed between males and females in either group and with the duration of symptoms.
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OBJECTIVE: To study the effect of rotavirus infection on lipid composition and glucose uptake in small intestine of infant mice. METHODS: Thirty six 7-day old balb/c mice were given 50 mL (100 ID50) rotavirus suspension orally; 36 control animals received only normal saline. Body weight of animals was recorded. Six animals in each group were sacrificed on days 0, 1, 3, 5, 7 and 10 post-inoculation (pi). Intestines were removed, everted and homogenized in ice-cold saline. Cholesterol and phospholipid content, glucose uptake and alkaline phosphatase in the jejunum and ileum were determined. RESULTS: Rotavirus infection led to a significant decrease in body weight with on days 3 and 5 pi as compared to controls, and to an increase in cholesterol and phospholipid content of the intestine. Uptake of glucose also increased significantly. Alkaline phosphatase activity was significantly reduced on days 3 and 5 pi as compared to controls. CONCLUSION: This study provides characterization of the lipid composition and uptake of glucose in infant mice small intestinal segments during rotavirus infection.
OBJECTIVE: To assess the effect of smoking on activity of intestinal disaccharidases. METHODS: The study was conducted on patients with non-ulcer dyspepsia who were smokers (n=20) or non-smokers (n=20). Smokers were classified according to smoking index into mild, moderate and heavy smokers. Biopsy specimens were taken from the second part of the duodenum at endoscopy and examined histologically, and for disaccharidase (lactase, sucrase, maltase and trehalase) activities. RESULTS: Mean duration of symptoms was more in smokers than in non-smokers. None of the smokers had endoscopic evidence of duodenal inflammation. Lactase and trehalase levels were significantly decreased in smokers. There was no difference in enzyme levels between mild smokers and non-smokers. Decreased lactase, maltase and trehalase activities were observed in moderate smokers compared to mild smokers. Duration of symptoms had no relation to enzyme activities. CONCLUSIONS: Intestinal disaccharidase levels are diminished by smoking.
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Primary neuroendocrine carcinoma of the gall bladder is rare. We report a 70-year-old woman with a gall bladder mass and liver metastases; fine-needle aspiration cytology from these revealed neuroendocrine carcinoma. There was no evidence of any other primary site. The patient was treated symptomatically; she died within a month of discharge from hospital.
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Rapid methods for detection of Escherichia coli O157: H7 diarrhoea are preferred to limit differential diagnostic evaluation including invasive procedures. Fifty stool samples from children and adult patients having diarrhoea and ten control samples from volunteers without diarrhoea were collected. Each sample was inoculated into two tubes containing peptone water and one containing MacConkey broth. They were incubated for 5 hours or longer till growth occurred. The first tube of peptone water with growth was tested for production of indole. All samples were tested for enzyme beta-glucuronidase in the pellet of the second peptone water growth. The MacConkey broth growth was tested with latex beads sensitized separately with antisera to E. coli O157 and E. coli H7. All indole positive and beta glucuronidase negative samples with positive agglutination with E. coli O157 and H7 coated latex beads were taken as E. coli O157: H7 positive samples. Three out of 50 diarrhoeic samples were found to be positive for E. coli O157:H7. Confirmation of the results of our rapid assay was done by parallel conventional culture of faecal specimens on sorbitol MacConkey agar. Our rapid assay required only 7-10 hours compared to the conventional technique where the report is available only on the third day. It can therefore be used routinely for initial screening of faecal specimens for E. coli O157: H7.
AIMS: This study was conducted to compare the duodenal and jejunal disaccharidase levels in the same individual with duodenal ulcer or non ulcer dyspepsia. METHODS: Thirty seven patients (duodenal ulcer--11, non-ulcer dyspepsia--26) were included in the study. Endoscopic biopsy samples were obtained from jejunum and duodenum using pediatric colonofibroscope. RESULTS: Levels of jejunal disaccharidases were significantly higher than the duodenal disaccharidases. CONCLUSIONS: An estimate of jejunal disaccharidases can be had by multiplication of duodenal disaccharidased by a factor 1.48 for lactase, 1.50 for sucrase and 1.56 for maltase.
BACKGROUND: Twenty-five patients of irritable bowel syndrome (IBS) and 25 normal healthy individuals serving as controls, were studied for lactose intolerance. METHODS: Hydrogen breath test was used as an investigation after giving 50 g of oral lactose. Clinically, the patients were classified into 3 types of IBS. RESULTS: Eleven (44%) out of 25 patients belonged to diarrhoeal type of IBS, 7 (28%) of 25 patients to spastic and rest 7 (28%) of 25 patients had features of both types of symptoms. Lactose hydrogen breath test was abnormal in 9 cases (82%) of 11 diarrhoeal type of IBS which was significantly higher (p < 0.02) than controls. However, the difference of abnormal hydrogen breath test between spastic type of IBS and patients with features of both types was not significant as compared to controls. CONCLUSIONS: These results suggest that patients with diarrhoeal type of IBS have a higher incidence of lactose intolerance as compared to spastic type as well as patients with features of both types.
OBJECTIVE: To study the effects of soybean trypsin inhibitor (TI) on glycine uptake, glutathione (GSH) levels and morphological changes of intestine in rotavirus (RV) infected infant mice. METHODS: A total of 144 infant mice (7/8 days old) were divided in 3 groups (i.e. control, RV and RV + inhibitor). Infant mice were orally inoculated with the EB strain of RV and Trypsin protease inhibitor (TI) and 8 animals each were sacrificed on days 0,1,3,5,7 and 10 post infection (p.i). Glycine uptake (in vitro), GSH levels and histological changes were assessed in the jejunum, ileum and colon. RESULTS: Glycine uptake and GSH levels were significantly reduced on days 3 and 5 p.i in jejunum and ileum of RV inoculated animals, compared to the controls. Glycine uptake and GSH levels were maintained as in controls in the RV + TI inoculated animals on days 3 and 5 p.i in jejunum and colon but not in ileum where lesser values were recorded. Histology showed vacuolar degeneration in ileum towards the apical portion whereas normal morphology was observed in jejunum, similar to controls. No histological changes were observed in colon in any of the groups. Electron microscopic study confirmed the viral infection. CONCLUSION: Administration of Trypsin protease inhibitor along with RV reverted the effects of RV infection on amino acid uptake and GSH levels completely in the jejunum and partially in the ileum.
BACKGROUND: Helicobacter pylori is a leading cause of gastritis. Some of the histological changes revert after eradication of H. pylori. There is paucity of reports from India. AIM: To study the effect of H. pylori eradication on the histopathological changes. METHODS: Endoscopically obtained antral biopsies from 164 consecutive H. pylori positive cases of dyspepsia were analysed before and 4 weeks after completion of treatment. RESULTS: Treatment for H. pylori resulted in eradication of the organism as confirmed histologically in 123 out of 164 (76.22%) cases. Analysis of histopathological changes in pre and post treatment biopsies from the same patient revealed a significant reduction in neutrophils, eosinophils, chronic inflammatory cells, acute epithelial changes and regenerative foveolar hyperplasia (p < 0.001) There was no difference in these findings in cases where H. pylori eradication failed when compared with their pre-treatment biopsies (p > 0.05). Similarly the pre and post treatment biopsies revealed, no difference in frequency of intestinal metaplasia and gastric atrophy in cases where H. pylori was eradicated or persisted after treatment. CONCLUSION: There was significant reduction in neutrophils, eosinophils, chronic inflammatory cells, acute epithelial changes and regenerative foveolar hyperplasia, following eradication of H. pylori.
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Gastrointestinal infections are known to occur due to bacterial contamination of dairy products. A total of 141 dairy products viz. kulfi, ice cream and softy samples were investigated bacteriologically. Staphylococcus was the predominant organism isolated followed by Klebsiella pneumoniae, Escherichia coli and Campylobacter. Two of the samples also yielded Yersinia. The total bacterial counts obtained ranged from 2 x 10(1) to 5.2 x 10(11) colony forming units per ml (CFU/ml) for kulfi, 4 x 10(1) to 9 x 10(9) CFU/ml for ice cream and 2 x 10(1) to 2 x 10(10) CFU/ml for softy samples. The high degree of bacterial contamination seen indicates poor hygienic conditions and faults in manufacturing/handling of dairy products during and after processing and production.
A patient with typical features of idiopathic ulcerative colitis, in remission, developed an attack of severe colitis. Sigmoidoscopy showed submucosal black nodules in the sigmoid colon. Mucosal biopsies from the involved areas showed evidence of acute on chronic colitis with cytomegalic cells and intra-nuclear inclusions suggestive of cytomegalovirus (CMV) disease. The patient attained remission following subtotal colectomy and intravenous ganciclovir therapy for 3 weeks. The patient had another relapse five months later. The colonic biopsies during this relapse showed evidence only of idiopathic ulcerative colitis, with no CMV infection. The patient responded well to steroid therapy.
A 65-year lady presented with diarrhea and weight loss of six months duration. Initial evaluation suggested that malabsorption was the possible underlying mechanism for the diarrhea. Work up for the common etiologies of malabsorption was non-contributory. Presence of pneumobilia raised the suspicion of a bilio-enteric fistula, which was subsequently confirmed on barium enema and endoscopic cholangio-pancreaticography to be a cholecystocolic fistula. At surgery, a fistulous tract from the fundus of the gallbladder was found to be communicating with the hepatic flexure. Fistulectomy with cholecystectomy resulted in prompt relief of symptoms. Cholecystocolic fistula (CCF) is a rare biliary fistula with diverse presentation.