Our study indicates a similar rate of incidence of MSI in colorectal cancers in the Indian cohort compared to the West (10-15%) despite lower incidence of colorectal cancers and predominance of rectosigmoid tumors in the Indian population.

Background and AimPatients with celiac disease (CD) have a poor health‐related quality of life (HR‐QOL). We assessed the QOL in patients with CD using both generic (SF‐12) and specific (CD‐QOL) questionnaires, and the effect of gluten‐free diet (GFD) on HR‐QOL.MethodsWe conducted a prospective follow‐up study based on consecutive patients of suspected CD between June 2014 and November 2015. After taking a detailed history, all patients were subjected to laboratory investigations (including complete blood count, biochemistry, and the IgA tTG antibody), followed by endoscopy and duodenal biopsies for histopathology. The HR‐QOL was assessed using SF‐12 and CD‐QOL questionnaires. Patients who were strictly adherent to GFD were re‐assessed at the end of 6 months for laboratory parameters and QOL.ResultsSixty adult patients of CD, with mean age of 28.85 ± 12.43 years, and a M:F ratio of 1.3:1, were enrolled in the study. The mean PCS (physical health composite scale score) and MCS (mental health composite scale score) at baseline were 37.20 ± 11.09 and 41.88 ± 8.39, which showed a statistically significant improvement after GFD to 50.30 ± 9.88 and 50.22 ± 9.04, respectively. Though there was no significant difference in the total CD‐QOL score after GFD, there was a significant improvement in the dysphoria and health‐concern subscales. We also found a negative correlation of the pre‐GFD symptom score (based on number of positive symptoms) with PCS and MCS and a positive correlation with the CD‐QOL score.ConclusionThis study has shown a reduced HR‐QOL in adult CD patients, which improves significantly on GFD, and is associated with a higher symptom number.

Background: Sepsis is one of the most common causes for mortality in the intensive care unit. Several biochemical markers and clinical scoring systems have been used to assess the severity and outcome of sepsis. Objective: To correlate the extent of C-reactive protein (CRP) elevation with mortality; in addition we also try to find a correlation by combining CRP level and APACHE II score as a predictor of outcome in patients with sepsis. Methods: This prospective study included 50 patients. Serum CRP and variables to calculate the APACHE II score were collected at the time of admission .The values of CRP concentrations and APACHE II score were compared, in relation to the severity and outcome of the disease. Results: Mean CRP value in patients who recovered from the illness was 140.6 mg/dl and in patients who died was 191.1 mg/dl (p .177). CRP level of > 137 mg/dl, has sensitivity of 60% and specificity of 60% in predicting mortality in patients with sepsis and was not statistically significant (p .157). Mean APACHE II score in patients who died was 24.2, compared to the patients who recovered was 18.5 (p .002). We observed APACHE II score of >21 have sensitivity of 76% and specificity of 60% in predicting mortality in patients with sepsis, which was statistically significant (p .010). When we take both CRP level of > 137 mg/dl and APACHE II score of > 21, we observed sensitivity 48% and specificity 84% in predicting the mortality, which was statistically significant (p 0.015). Conclusion: It is better to combine both CRP and APACHE II for predicting the mortality in sepsis patients, than using either of them.

Acute limb ischemia is a serious disabling condition. The management options depend upon the patient symptoms and signs of ischemia in the affected limb. The management options include surgical thrombo-embolectomy and catheter directed thrombolysis. Catheter directed thrombolysis has now become the first line of management in symptomatic cases. Here, we discuss a case of acute left brachial artery thrombosis which was successfully managed by needle-directed pulse-spray thrombolysis.