Background: Acute mesenteric ischemia accounts for around 0.1% of all hospital admission and less than 1% of emergency admissions. However, the presentation is varied, and diagnosis is obscure. The diagnosis of intestinal ischemia demands a high index of suspicion. The overall mortality associated with mesenteric ischemia is between 60% and 93% but rises acutely once bowel wall infarction has occurred. Early diagnosis of ischemia remains the key to reduce morbidity and mortality. I-FABP is a cytosolic protein present in epithelial cells of intestines and released upon ischemia or necrosis of bowel. Author estimated the levels of I-FABP in serum and established it as a marker for acute intestinal ischemia.Methods: 40 patients admitted to JSS Hospital with suspected acute intestinal ischemia were included in the study. Plasma concentrations were quantified using ELISA for fatty acid binding protein 2. Statistical methods were applied and sensitivity and specificity of serum I-FABP were determined. Confirmation of ischemia was by histopathological analysis of the resected bowel specimen.Results: 23 patients out of the 40 were diagnosed to have intestinal ischemia. Mean values of serum IFABP levels were significantly higher in patients diagnosed with intestinal ischemia (65.94pg/ml in the non-ischemic group vs 673.53pg/ml in the ischemic group P=0.0002). Cut off chosen in diagnosing intestinal ischemia in this study was 187.59pg/ml. Sensitivity was 95.7% and specificity 88%.Conclusions: Serum I-FABP can be used for the diagnosis for intestinal ischemia. It is specific and sensitive marker to detect early bowel ischemia.
Background:Cancer constitutes an enormous burden on society in more and less economically developed countries alike. The incidence of gastric cancer is found to increase in the developing countries like India due to change in the life style like having smoked food containing nitrates, smoking , alcoholism and consumption of large amount of red chillies. The objective of this study was to measure the serum pepsinogen I and pepsinogen II levels and its ratio in gastric cancer patients admitted in JSS hospital and Bharath Cancer Centre during the period October 2012 to October 2014 and to compare with controls.Methods: 80 patients - 40 patients with gastric cancer and 40 patients control were studied. Serum pepsinogen I (PG I) and pepsinogen II (PG II) levels were measured using ELISA.Results:The mean PG I levels for cancer patients and controls were 93.98μg/dl and 82.156μg/dl respectively, the mean PG II levels were 42.67 μg/dl and 18.79 μg/dl respectively. The PG I/II ratio in cancer patients is 2.75 and 5.73 in controls, the ratio was significantly lower in cancer patients (P value significant).Conclusions:The ultimate aim in the management of carcinoma stomach is the early detection of the disease. At present endoscopy and biopsy is the gold standard of diagnosis. Different screening tools are under development for the diagnosis of the disease. Our study evaluates a test which can be recommended as an alternative to the diagnosis of gastric carcinoma at an early stage.
Background: Benign breast diseases are common pathological entities with which women in her early reproductive age present to OPD with fear of malignancy and significant morbidity. Except for surgery and use of non-selective estrogen receptor blockers, there are no other treatment options, and these have lot side effects. Ormeloxifene a newer drug has shown promising results with minimal side effects and used as the first line of treatment reducing the morbidity of surgery and subjecting the patient to less hormonal side effects.Methods: Diagnosis of benign breast diseases was made by baseline investigation which included measurement of size of fibroadenoma using Vernier caliper and USG, fibroadenosis,ie nodularity measured using Lucknow-Cardiff scale and VAS score was used for pain assessment of mastalgia after which patients will be given the drug and placebo and the response for the drug and its side effects are noted.Results: 61.9% (44) were diagnosed with fibroadenoma, 16.9% (12) with fibroadenosis and 21.1% (15) with mastalgia. Lucknow Cardiff score for fibroadenosis exhibited 50% had smooth breasts with no nodularity at the end of six months, in fibroadenoma group 52% showed decrease in size and 31% showed complete disappearance of the lump and in the mastalgia group 40% had no pain (VAS score of 0). 16(22.5%) of had menstrual abnormality as the major side effect.Conclusions: Ormeloxifene can be used as the first line of treatment in patients with fibroadenosis and mastalgia and used as an alternative to surgery for fibroadenoma.
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