A Bayes Study of Bile Acid Constituents on Cholelithiasis and Carcinoma of the Gallbladder

Background: Significantly high concentration of secondary bile acids and low concentration of primary acids are reported by the surgeons in patients with gallbladder carcinoma (GBC) compared to control and cholelithiasis groups.Aim: To examine the effect of primary and secondary bile acids on the development of cholelithiasis and GBC and to investigate the association, if any, among the two groups of bile acids.Methods: The study uses two groups of patients at a time selected in accordance with some pre-fixed inclusion and exclusion criteria. Informed consent was obtained from all patients. The demographic characteristics such as mean age, sex ratio and body mass index, etc. are obtained for the selected groups of patients. The study defines dichotomous responses and the four bile acid constituents, namely cholic acid (CA), chenodeoxycholic acid (CDCA), deoxycholic acid (DCA) and lithocholic acid (LCA), as the predictors. It then assumes logistic regression model to associate the binary responses with the predictors by using probability scores. Bayes analysis is developed using Markov chain Monte Carlo (MCMC) pack in R software for the posterior simulation.Results: Twenty one cholelithiasis patients and twenty patients in each of control and GBC groups are studied. It is seen that a unit decrement in the level of CA (CDCA) increases the log (odds ratio) for cholelithiasis by an amount of 0.49 (0.14) and odds ratio by almost 1.5 (1.12). Similarly, a unit increment in the level of DCA (LCA) provides the log (odds ratio) for cholelithiasis as 0.18 (1.3) and odds ratio as 1.16 (2.95). Comparing GBC with control population, it is noted that a unit decrease in the level of CA (CDCA) in the control population increases the log (odds ratio) for GBC by an amount of 1.16(0.26) and odds ratio by almost 2.63 (1.24) times. Similarly, the log(odds ratio) for GBC increases by 0.77(1.94) and the odds ratio increases by 1.9 (5.0) for the unit increment in the level of DCA(LCA).Conclusions: The study observes relatively high variations in the primary and secondary bile acids in the cholelithiasis and GBC groups as compared with the control group. It, in turn, reflects strong association among the two categories of bile acids in gallbladder diseases

Carcinogenic herbs: a review

Herbal toxicity is a field that has rapidly grown over the last few years along with increased use of herbal products worldwide. People prefer using herbal medicines rather than allopathic because herbals are considered safe. Use of herbal medicines from ancient times does not ensure their complete safety. With the growing awareness regarding pharmacovigilance worldwide, there has been an increase in the number of reported adverse events occurring with the use of herbal products. The objective of the study is to aware the researchers about most commonly used Indian medicinal herbs inducing carcinogenicity like Aloe vera, Ginkgo biloba, Kava kava, etc.

A study to evaluate compliance in patients of diabetes mellitus in a North-Indian tertiary care hospital

Background: The objective of the study was to determine level of adherence and recognize various causative factors which can affect the compliance in the diabetic patients.Methods: This was an observational study. The study was conducted by enrolling patients of the outpatient department of Medicine of Rajindra Hospital, Government Medical College, Patiala, Punjab. To assess adherence, a questionnaire was administered to the patients - Morisky Medication Adherence Scale (MMAS) -8 item questionnaire. The various factors affecting compliance was determined by a researcher made questionnaire.Results: Out of a total of 100 subjects, age range extended from 18 years to 80 years. The mean age was 57.52±12.33years. 51% of patients were females and 49% was males. Analysis of MMAS- 8 item scores of patients showed that 52% of patients had low adherence, 29% had medium while 19% had high adherence to the treatment. Only 30% patients were compliant i.e. with HbA1C value of 7 or less while 70% patients were non-compliant i.e. with HbA1C value of more than 7.Conclusions: Compliance to medical treatment is influenced by a myriad of factors. In order to promote compliance, it is necessary to increase awareness about the disease, possible complications and treatment guidelines among patients as well as their family members.

Analysis of cost of medical therapy in patients of metabolic syndrome: an observational study

Background: The objective of the study was to analyze cost of medical therapy in patients of Metabolic syndrome.Methods: This was an observational study. The study was conducted by enrolling patients of the outpatient department of Medicine of Rajindra Hospital, Government Medical College, Patiala, Punjab. A total of 100 patients diagnosed with Metabolic syndrome were enrolled in the study. The total daily cost of the therapy was calculated by adding the direct cost of individual drugs taking in consideration the frequency of the drug. The daily cost of therapy was then extrapolated to calculate the monthly as well as annual cost of therapy.Results: The mean age of patients was 58.27±10.32 years. Out of a total of 100 patients, there were 57 female and 43 male patients, indicating a female preponderance of the disease. The average individual daily cost of medical therapy is INR 44.56 which upon extrapolation gives monthly and annual cost of INR 1336.90 and INR 16264.40 respectively. The cost of treatment in males is costlier than females (INR 50.09 in males versus INR 40.22 in females). The cost of treatment of age 31-40 years is INR 27.90 while it INR 36.97, 48.16 and 50.75 for age groups 41-50, 51-60 and 61-70 years. The various components of metabolic syndrome viz. diabetes mellitus, hypertension and dyslipidemia contribute differently to the cost of therapy. Daily cost of medical therapy for diabetes mellitus is INR 18.57 while for hypertension and dyslipidemia are INR 10.25 and INR 6.13 respectively.Conclusions: Chronic diseases like metabolic syndrome have a huge share of the healthcare budget. Given the fact that it is a lifestyle disease, its prevalence is likely to swell in the coming decades. Hence, formulation of preventive and innovative treatment guidelines is of utmost importance

Complete genome sequence of a Staphylococcus epidermidis bacteriophage isolated from the anterior nares of humans

We report here the complete genome sequence of a virulent Staphylococcus epidermidis siphophage, phage 6ec, isolated from the anterior nares of a human. This viral genome is 93,794 bp in length, with a 3' overhang cos site of 10 nucleotides, and it codes for 142 putative open reading frames

Communicable behavior of non-communicable diseases

Communicability of non- communicable diseases can be explained using the prototype of non- communicable diseases. The concept can be further extended to other non- communicable diseases. Diabetes mellitus (DM) is regarded as the prototype of non-communicable diseases. Its subtype, type 2 DM is usually associated with obesity. Obesity, in turn, can be attributed to deranged eating habits and lack of physical activity. Eating habits of a person bears a close resemblance to the parental eating habits. Other factors contributing to obesity like alcoholism can also be transmitted from parents to child. Smoking, another factor implicated in DM, can be picked as a habit from peer group as well as family. All these factors implicated directly or indirectly in the pathogenesis of DM are actually components of lifestyle. These lifestyle components can be transmitted both in an inter-generation and intra-generation fashion. And so the chances of transmission of DM (a lifestyle disease) in the same fashion cannot be ruled out

Erythrocyte membrane fatty acid profile and saturation index in gallbladder carcinogenesis: a case-control study

BACKGROUND: Gallbladder cancer is a common neoplasm of biliary tract, with an unknown etiology. PATIENTS AND METHODS: This study was carried out to evaluate the changes in the membrane fatty acid profile and saturation index in patients with gallbladder cancer. The study sample consisted of 50 newly diagnosed cases of gallbladder cancer and 50 patients undergoing cholecystectomy for cholelithiasis were recruited as controls. The fatty acid estimation was carried out by high performance liquid chromatography (HPLC). Statistical analysis was carried out by student 't' test and one-way ANOVA. Pearson's correlation coefficient was also obtained. RESULTS: A significant lowering of erythrocyte membrane stearic acid (p = 0.000), arachidonic acid (p = 0.001), and saturation index (p = 0.001) was observed in patients with gallbladder cancer compared to controls. A significant inverse relation was observed between stearic and oleic acid (r = -0.269 p = 0.007). CONCLUSION: Results of the present study suggest an increase in the delta 9 desaturation in cancer patients compared to controls however, a possible role of biliary stasis due to altered gallbladder motility or derangements of signal transduction secondary to altered membrane lipid bilayer cannot be ruled out

Assessment of Ration Scales of the Armed Forces Personnel in Meeting theNutritional Needs at Plains and High Altitudes–I

Adequate nutrition is very essential, especially for the Armed Forces, to buildup their nutritional reserveswhile deriving maximum benefits of training/peak performances in operational situations by keeping theirmorale high. The present study reviews/examines the adequacy of the existing ration scales of the ArmedForces personnel stationed under different terrain conditions of the country/recruits at various training centres.Food samples were collected from different strategic locations during different seasons of the year and analysedfor their nutrient composition like proximal constituents, vitamins A, E, B1, B2, C, and dietary fibre. Basedon the data generated, the daily nutrients/energy consumption by the soldiers/recruits, were calculated separatelyboth for personnel in plains and at high altitudes. Soldiers in plains, on an average consumed protein 124.2+ 13.0 g, fat 98.8 + 29.6 g and energy 3632+317 kcal/person/day, while their counterparts at high altitudesconsumed protein 120.4 + 11.2 g, fat 120.1 + 31.1 g, and energy 3906 + 423 kcal/person/day. The study clearlyindicate that the present ration scales for the Service personnel, both in plains and at high altitudes (9000 ftto 15000 ft) is adequate wrt their nutrient density. It is however suggested to ensure adequate supply of goodquality fresh vegetables, fruits, and meat, which inturn would not only help to keep the morale of the soldiers,high and cheerful, especially at high altitudes, but will also enable adequate micronutrient availability. Thefibre levels in the diets of these soldiers have also been found to be well within the limits (20 -35 g/ person/day) recommended for optimal health.Defence Science Journal, 2008, 58(6), pp.734-744, DOI:http://dx.doi.org/10.14429/dsj.58.170