The Utility of Capsule Endoscopy in Patients under 50 Years of Age with Recurrent Iron Deficiency Anaemia: Is the Juice Worth the Squeeze?

Background and Aims. The role of capsule endoscopy (CE) in the <50 years of age patients with iron deficiency anaemia (IDA) remains unclear. We aim to assess its utility in this cohort. Methods. All patients referred for CE for recurrent IDA were included retrospectively. Patients were divided into Group 1 (<50 years) and Group 2 (≥50 years). Results. There were 971 patients with recurrent IDA and 28% belonged to Group 1. The mean age was 40 years in this group with a DY of 28% (). Significant diagnoses included erosions and ulcers (26%; ), small bowel (SB) angioectasia (AE) (10%; ), SB tumours (3%; ), Crohn’s disease (3%; ), SB bowel strictures (1%; ), and SB varices (1%; ). On logistic regression, the presence of diabetes () and the use of warfarin () was associated with increased DY. The DY in Group 2 was 38% which was significantly higher than in Group 1 (). While SB tumours were equally common in both groups, AE was commoner in Group 2 (). Conclusion. A significant proportion of patients <50 years are referred for CE. Although the DY is lower compared to those ≥50 years, significant pathology is found in this age group. CE is advisable in patients <50 years old with recurrent IDA and negative bidirectional endoscopies

Taxonomic studies on subgenus Pseudomegachile Friese under genus Megachile Latreille (Hymenoptera) from Sutlej basin plains (India)

Genus Megachile forms an integral part of the ecosystem as its members are important pollinators of both wild and cultivated flora. Surveying on a large scale helps in gathering a lot of information about their spatial and temporal data. This also helps in studying their biodiversity and taxonomy. Three species of solitary bees under subgenus Pseudomegachile Friese of the genus Megachile Latreille collected from Sutlej basin plains of India have been studied and described taxonomically. Megachile (Pseudomegachile) creusa (Bingham), M. (P.) ramakrishnae Cockerell and M. (P.) elfrona (Cameron) with 21 examples are described including their morphological characters, taxonomically important characters, zoogeographic records, floral associations along with genitalic and sternal plates. Since most of the areas included in the study have been surveyed first time for Megachile study, these are new records for the studied area

Taxonomic studies on species belonging to subgenus Eutricharaea Thomson of the genus Megachile (Hymenoptera: Megachilidae)

Solitary bees belonging to genus Megachile are important pollinators very crucial for the wellbeing of the ecosystem. Large scale surveying will return a wealth of spatio-temporal species data which is critical for systematics, taxonomy and conservation of biodiversity. Detailed taxonomic characterization of solitary bee species belonging to subgenus Eutricharaea collected from the Sutlej basin of Indian northern plains is being described. A total of four species viz. Megachile hera Bingham, M. femorata Smith, M. vera Cameron and M. argentata Cameron belonging to subgenus Eutricharaea with 18 examples were studied. Detailed morphological descriptions, zoogeographic records, specimen examined, floral associations with illustrations and morphological measurements have been provided. Various areas finalised from different parts of Sutlej basin of northern plains were surveyed for the first time for the documentation of Megachile fauna. Hence, all these four species are first records for the studied area

Fluoride release and uptake in enhanced bioactivity glass ionomer cement (“glass carbomer™”) compared with conventional and resin-modified glass ionomer cements

Objectives: To study the fluoride uptake and release properties of glass carbomer dental cements and compare them with those of conventional and resin-modified glass ionomers. Materials and Methods: Three materials were used, as follows: glass carbomer (Glass Fill), conventional glass ionomer (Chemfil Rock) and resin-modified glass ionomer (Fuji II LC). For all materials, specimens (sets of six) were matured at room temperature for time intervals of 10 minutes, 1 hour and 6 weeks, then exposed to either deionized water or sodium fluoride solution (1000 ppm in fluoride) for 24 hours. Following this, all specimens were placed in deionized water for additional 24 hours and fluoride release was measured. Results: Storage in water led to increase in mass in all cases due to water uptake, with uptake varying with maturing time and material type. Storage in aqueous NaF led to variable results. Glass carbomer showed mass losses at all maturing times, whereas the conventional glass ionomer gained mass for some maturing times, and the resin-modified glass ionomer gained mass for all maturing times. All materials released fluoride into deionized water, with glass carbomer showing the highest release. For both types of glass ionomer, uptake of fluoride led to enhanced fluoride release into deionized water. In contrast, uptake by glass carbomer did not lead to increased fluoride release, although it was substantially higher than the uptake by both types of glass ionomer. Conclusions: Glass carbomer resembles glass ionomer cements in its fluoride uptake behavior but differs when considering that its fluoride uptake does not lead to increased fluoride release

Near simultaneous measurements of NO2 and NO3 over tropics by ground-based absorption spectroscopy

The present study concentrates on measurements of NO2 and NO3. NO2 has been measured during twilight period using zenith sky absorption spectrometric technique in the 436 to 448 nm region. NO3 has been measured during night time using direct moon as a source of light in the 655 to 667 nm region. These measurements have been taken at low latitude station, Ahmedabad (23 deg N, 76 deg E), India for the past two years

Towards the probabilistic analysis of small bowel capsule endoscopy features to predict severity of duodenal histology in patients with villous atrophy

Small bowel capsule endoscopy (SBCE) can be complementary to histological assessment of celiac disease (CD) and serology negative villous atrophy (SNVA). Determining the severity of disease on SBCE using statistical machine learning methods can be useful in the follow up of patients. SBCE can play an additional role in differentiating between CD and SNVA. De-identified SBCEs of patients with CD and SNVA were included. Probabilistic analysis of features on SBCE were used to predict severity of duodenal histology and to distinguish between CD and SNVA. Patients with higher Marsh scores were more likely to have a positive SBCE and a continuous distribution of macroscopic features of disease than those with lower Marsh scores. The same pattern was also true for patients with CD when compared to patients with SNVA. The validation accuracy when predicting the severity of Marsh scores and when distinguishing between CD and SNVA was 69.1% in both cases. When the proportions of each SBCE class group within the dataset were included in the classification model, to distinguish between the two pathologies, the validation accuracy increased to 75.3%. The findings of this work suggest that by using features of CD and SNVA on SBCE, predictions can be made of the type of pathology and the severity of disease

Does magnetically assisted capsule endoscopy improve small bowel capsule endoscopy completion rate? A randomised controlled trial.

Background and study aims: Delayed gastric emptying is a significant factor in incomplete small bowel capsule examinations. Gastric transit could be hastened by external magnetic control of the capsule. We studied the feasibility of this approach to improve capsule endoscopy completion rates. Patients and methods: Prospective, single-center, randomized controlled trial involving 122 patients attending for small bowel capsule endoscopy using MiroCam Navi. Patients were randomized to either the control group (mobilisation for 30 minutes after capsule ingestion, followed by intramuscular metoclopramide 10 mg if the capsule failed to enter the small bowel) or the intervention group (1000 mL of water prior to capsule ingestion, followed by positional change and magnetic steering). Outcome measures were capsule endoscopy completion rate, gastric clarity and distention, relationship of body habitus to capsule endoscopy completion rate (CECR), and patient comfort scores. Results: 122 patients were recruited (61 each to the control and intervention groups: mean age 49 years [range 21 – 85], 61 females). There was no significant difference in CECR between the two groups (P = 0.39). Time to first pyloric image was significantly shorter in the intervention group (P = 0.03) but there was no difference in gastric transit times (P = 0.12), suggesting that magnetic control hastens capsular transit to the gastric antrum but does not influence duodenal passage. Gastric clarity and distention were significantly better in the intervention group (P < 0.0001 and P < 0.0001 respectively). Conclusions: Magnetic steering of a small bowel capsule is unable to overcome pyloric contractions to enhance gastric emptying and improve capsule endoscope completion rate. Excellent mucosal visualisation within the gastric cavity suggests this technique could be harnessed for capsule examination of the stomach