Fibrocalculous pancreatic diabetes (FCPD) is a form of diabetes secondary to chronic pancreatitis that is found in tropical countries. Most patients with FCPD are lean and many are frankly undernourished. Four patients with FCPD who were obese are reported in this paper and this is the first report of obesity in FCPD patients.

Adult↗

PubMed1989

Budd-Chiari syndrome--pathogenesis and operative repair.

Explore the source record for details and available documents.

Budd-Chiari Syndrome↗

PubMed1989

Intestinal transit in healthy southern Indian subjects and in patients with tropical sprue.

Whole gut transit was measured in a group of 21 healthy volunteers and 21 patients with tropical sprue by radio-opaque marker technique, using mean transit time single (MTTS) and single stool transit (SST) method. Mean SST in controls was 25.8 (1.4) (SE) hours, which is considerably shorter than in controls in temperate zones. Mean SST (23.7 (0.6) h) correlated significantly with average MTTS (24.9 (1.6) h) (r = 0.88; p less than 0.001) confirming that SST is a valid method to measure intestinal transit in the tropics. Patients with tropical sprue had a mean SST similar to controls (24.4 (1.1) h), in spite of significantly higher faecal weights (580 (41.2) g v 252 (17.2) g; p less than 0.001).

Adolescent↗

PubMed1989

Exocrine pancreatic function in tropical fibrocalculous pancreatic diabetes.

Exocrine pancreatic function was studied by fecal chymotrypsin test in three groups of diabetic patients seen in southern India. Exocrine pancreatic insufficiency, as shown by low fecal chymotrypsin levels, was seen in 87.5% of patients with fibrocalculous pancreatic diabetes (FCPD), in 23.5% of insulin-dependent diabetes mellitus patients, and in 4.5% of non-insulin-dependent diabetes mellitus patients. There was no correlation between fecal chymotrypsin levels and serum amylase, serum lipase, age, body mass index, duration of diabetes, fasting plasma glucose, or glycosylated hemoglobin levels. The fecal chymotrypsin test is a useful additional investigation for the diagnosis of FCPD found in tropical countries.

Adult↗

PubMed1988

Pre-operative and post-operative ultrasound evaluation of Budd Chiari syndrome due to coarctation of the inferior vena cava.

Coarctation of the inferior vena cava (IVC) is being increasingly recognised as a congenital and operable cause for chronic Budd Chiari syndrome. It is necessary to distinguish this entity from other causes of Budd Chiari syndrome because of a more favourable outcome after surgery. Early diagnosis would result in surgical intervention before irreversible liver damage and also possibly avoid the onset of hepatocellular carcinoma. Real time ultrasound has proved valuable in pre-operative diagnosis in nine patients with coarctation of the IVC. It has also been found useful to confirm patency of dorsal cavo-atrial bypass using polytetrafluoroethylene grafts in five patients and isthmusplasty of the IVC in one patient. Ultrasound is recommended for routine screening of high risk population.

Adult↗

PubMed1986

Retrohepatic cavoatrial bypass for coarctation of inferior vena cava with a polytetrafluoroethylene graft.

Eight patients with chronic Budd-Chiari syndrome resulting from coarctation of the inferior vena cava underwent operation. Transatrial dilatation was of no avail in the first case. The obstructed segment was directly visualized in the subsequent seven cases by a transthoracic, transdiaphragmatic, retroperitoneal approach. In these latter seven cases, severe hourglass constriction of the inferior vena cava was observed just above the right hepatic vein. There was no evidence of inflammation, extrinsic compression, or thrombosis. Retrohepatic cavoatrial bypass with an antibiotic-sterilized aortic homograft was unsuccessful in three patients. Five patients including one with homograft failure underwent successful retrohepatic cavoatrial bypass with a polytetrafluoroethylene graft (20 mm plain in four cases and 16 mm ringed graft in one case). These patients have been followed up for 21 months to 6 years with no recurrence of symptoms. The term coarctation of the inferior vena cava appears more appropriate than membranous obstruction of the inferior vena cava because of the operative findings in the present series.

Adult↗

PubMed1984

Humoral and cell-mediated immune responses to leptospires in different human cases.

Humoral and cell-mediated immune responses (CMI) to leptospirosis were studied in different groups of human patients. These included clinically suspected cases of leptospirosis, patients with jaundice (HBsAg negative), cases of pyrexia of unknown origin (PUC) (Widal and blood culture negative for typhoid) and healthy blood donors. Humoral immune response was evaluated with nine live strains representing different serogroups of leptospires and CMI with lysates of four strains. The study showed that the CMI appeared earlier than the humoral response which might be useful in the early detection of the disease. As in the humoral immune response, cross reactions to different leptospires were also seen in CMI response.

Antibody Formation↗

PubMed1983

Isolation of leptospires and demonstration of antibodies in human leptospirosis in Madras, India.

Among 25 clinically suspected cases of leptospirosis, organisms could be isolated from blood and urine of only 10 cases but demonstrated in 15 cases. Antibody titres at a low level were observed to one or more leptospiral antigens in all 25 cases. Nine of the repeated samples from 12 cases showed a four-fold rise in titre. The highest antibody titres were seen against autumnalis. The predominant clinical picture was of fever, myalgia, conjunctival suffusion and jaundice with renal involvement.

Antibodies, Bacterial↗

PubMedDate not supplied

Radiological appearance of pancreatic calculi in tropical versus alcoholic chronic pancreatitis.

Tropical and alcoholic forms of chronic pancreatitis differ in their clinical, aetiological and epidemiological features. We compared the radiological appearances of pancreatic calculi seen on plain roentgenogram of the abdomen of 89 patients with tropical calcific pancreatitis (TCP) and 32 patients with alcoholic calcific pancreatitis (ACP) seen in Madras, Southern India. While TCP was characterized by the frequent occurrence of large, discrete, dense calculi, patients with ACP had typically small, speckled calculi with irregular, hazy margins. The calculi in TCP resembled those described for hereditary pancreatitis. This is the first report comparing the radiological appearances of TCP and ACP patients seen at the same centre.

Adult↗

PubMedDate not supplied

Infertility, obstetric and gynaecological problems in coeliac sprue.

There is now substantial evidence that coeliac sprue is associated with infertility both in men and women. In women it can also lead to delayed menarche, amenorrhoea, early menopause, recurrent abortions, and a reduced pregnancy rate. In men it can cause hypogonadism, immature secondary sex characteristics and reduce semen quality. The real mechanism by which coeliac sprue produces these changes is unclear, but factors such as malnutrition, iron, folate and zinc deficiencies have all been implicated. In addition in men gonadal dysfunction is believed to be due to reduced conversion of testosterone to dihydrotestosterone caused by low levels of 5 alpha-reductase in coeliac sprue. This leads to derangement of the hypothalamic-pituitary axis. Hyperprolactinaemia is seen in 25% of coeliac patients, which causes impotence and loss of libido. Gluten withdrawal and correction of deficient dietary elements can lead to a return of fertility both in men and women.

Adult↗

PubMedDate not supplied

Prophylactic locking of enteral feeding tubes with pancreatic enzymes.

BACKGROUND: Obstruction of feeding tubes is a common mechanical complication associated with enteral feeding. Standard methods of flushing are not always effective. METHODS: This study was conducted with patients receiving enteral feeding via nasogastric, nasoenteral, gastrostomy, or jejunostomy tubes to determine if prophylactic use of pancreatic enzymes would maintain patency of feeding tubes. Interrupted feeding regimens were used. Control patients (n = 24) received only water for flushing. After water flushing of the tube, study patients (n = 33) received a 5-mL suspension of pancreatic enzyme containing the following enzyme activity (in Federation Internationale Pharmaceutique [FIP] units): lipase, 2000; amylase, 1500; and protease, 100. The suspension also contained 90 mg of NaHCO3 to maintain a pH of 7.5. The mean duration of observation in the control and study groups was 25 and 48 days, respectively. RESULTS: Compared with eight episodes (23.5%) of tube occlusions in the control group (n = 34), there was only one episode (2.6%) in the study group (n = 38). This difference was significant by the test of proportions (z = 2.68, p = .01). CONCLUSIONS: In addition to routine water flushing, the routine prophylactic use of pancreatic enzyme-sodium bicarbonate suspension (pH 7.5) prevents occlusion of feeding tubes.

Amylases↗

PubMedDate not supplied

Evolving a strategy for control of sexually transmitted diseases in a developing country.

Explore the source record for details and available documents.

Humans↗

PubMedDate not supplied

Comparison of polyethylene glycol versus combination of magnesium sulphate and bisacodyl for colon preparation.

Colon preparation using polyethylene glycol (PEGLEC) and combination of bisacodyl and magnesium sulphate was compared in 74 patients. Type of preparation did not influence patient discomfort. The quality of preparation was excellent with PEGLEC in 63.6% as compared to 41.6% with combination preparation. The completion rates were similar in both groups. Good preparation was linked with shorter procedure duration (p = 0.001) and greater depth of examination. No major side effects were noted with both preparations. To conclude, polyethylene glycol is recommended for screening of right colon while combination of bisacodyl and magnesium sulphate is a good and cheap preparation modality to screen the left colon.

Adult↗