Kanishka Uthansingh | Siksha O Anusandhan University (original) (raw)

Papers by Kanishka Uthansingh

Journal of Clinical and Experimental Hepatology

Background/aims: In view of limited data on the knowledge and awareness of hepatitis B virus (HBV... more Background/aims: In view of limited data on the knowledge and awareness of hepatitis B virus (HBV) and the available preventive strategies at the community level, it was aimed to analyse the knowledge and awareness of HBV in the community. Methods: A cross-sectional questionnaire-based survey was conducted among residents of an urban slum and a social welfare home in Bhubaneswar, Odisha, from October 2019 to April 2021. The prevalence of HBV infection was also measured by testing the serum positivity for hepatitis B surface antigen using rapid pointof-care test kits. The statistical analysis was done by using the software SPSS version 20. Results: A total of 370 individuals (mean age 38.7 ± 14.9 years, males: 55.1%) were assessed. Although 18.1% (67) had good knowledge, only 16.7% (62) had good awareness about HBV. Approximately 14.8% (55) knew that a vaccine is available in the country for HBV, and 6.2% (23) identified themselves as being vaccinated. Educational status was a significant independent predictor of knowledge and awareness such that people with education level of matriculation and above had odds of 11.05 (95% confidence interval: 5.3-22.7) and 14.7 (95% confidence interval: 6.5-33.1) for having good knowledge and awareness regarding HBV, respectively. A total of 10 participants tested positive for hepatitis B surface antigen contributing to a point prevalence rate of 2.7%. The proportion of individuals with an education status of matriculation and above was higher in the slum area when compared with the welfare home (67% vs 33%; P < 0.001), the knowledge (71.6% vs 28.4%; P < 0.001) and so was the awareness (71% vs 29%; P < 0.001) about HBV as well. Conclusion: The relatively low figures of knowledge and awareness identified in our study undermine the need for intensification of health education and promotion activities regarding the prevalence of hepatitis B infection on a large scale at the community level.

Cureus

Background and aim As a distinguished system, the cytochrome P450 (CYP) enzyme superfamily is inv... more Background and aim As a distinguished system, the cytochrome P450 (CYP) enzyme superfamily is involved in the biotransformation of several endogenous and exogenous substances including drugs, toxins, and carcinogens. Reports on the role of CYP enzyme in gastric cancer (GC) from the Eastern region of India are scarce. The present study aimed to evaluate the effect of single nucleotide polymorphisms (SNP) in cytochrome P450 family 2 subfamily C member 9 (CYP2C9*3) among cases with gastric malignancy. Material and methods The current study is a cross-sectional observational study carried out among 113 GC cases attending the

Middle East Journal of Digestive Diseases, 2021

BACKGROUND Left ventricular diastolic dysfunction (LVDD) is the earliest cardiac dysfunction note... more BACKGROUND Left ventricular diastolic dysfunction (LVDD) is the earliest cardiac dysfunction noted in patients with liver cirrhosis, which increases the morbidity and mortality in such patients. There are sparse studies from India evaluating the predictive factors of LVDD in patients with cirrhosis. Hence we undertook this prospective study with an aim to evaluate the factors predicting the development of LVDD in liver cirrhosis. METHODS 104 patients with cirrhosis were enrolled in this prospective study. A detailed cardiac evaluation was done by 2 D echocardiography with tissue Doppler imaging by an experienced senior cardiologist. The severity of liver disease was defined by Model For End-Stage Liver Disease (MELD) and Child-Pugh score. RESULTS The prevalence of LVDD was 46% in our study. Multivariate logistic regression analysis revealed that serum albumin, MELD score, and presence of ascites (OR = 0.1, 95%CI 0.03-0.3, p < 0.001; Or = 1.12, 95%CI 1.03-1.22, p < 0.001; OR = ...

Cureus, 2021

Introduction: Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder. Female p... more Introduction: Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder. Female patients with bowel disease commonly report worsening of symptoms in the menstrual cycle. However, there is a paucity of data regarding IBS presentations' variation during different phases of the menstrual cycle. The current study aimed to evaluate the same in female IBS patients. Materials and Methods: Consecutive premenopausal female patients with the diagnosis of IBS attending the outdoor (OPD)

Cureus, 2021

Background and aim Idiopathic chronic pancreatitis (ICP) is said to be present when no identifiab... more Background and aim Idiopathic chronic pancreatitis (ICP) is said to be present when no identifiable etiology can be identified. Robust evidence suggested that the serine protease inhibitor nucleus Kazol type 1 (SPINK1) N34S mutation was frequently associated with ICP. As there is a paucity of data on genetic studies in ICP cases from the coastal eastern region of India, we performed this study with an aim to evaluate the SPINK1 genetic mutations and other associated clinical correlates in ICP cases. Material and methods Consecutive ICP cases attending the department of gastroenterology, Institute of Medical Sciences (IMS) and SUM Hospital, were enrolled and evaluated for the pertinent clinical history and undergone detailed biochemical and radiological evaluations. Two ml of venous blood in ethylenediaminetetraacetic acid (EDTA) vials were collected from each case and subjected to a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) test for genetic analysis. Result In this study, the mean age of the cases at the time of the first consultation with us and the age of the first clinical presentation were 34.52±6.44 and 28.73±5.52 years, respectively. Males outnumbered females (Male:Female-2.12:1). Out of the total of 200 cases, 50% had no SPINK1 mutation, whereas 40% and 10% cases had SPINK1 N34S heterozygous and homozygous mutations, respectively. The mean age of clinical presentation, severe abdominal pain, exocrine and endocrine insufficiency, and parenchymal atrophy were significantly more common in mutants as compared to non-mutants (p-value <0.05). Conclusion In our region, 50% of ICP cases had the SPINK1 N34S mutation. The SPINK1 mutants had a relatively more severe variety of pancreatitis as compared to non-mutants.

Indian Journal of Public Health Research & Development, 2021

Background: Globally out of 200 crore population who are getting exposed to the hepatitis B virus... more Background: Globally out of 200 crore population who are getting exposed to the hepatitis B virus (HBV),about 350 million are chronically carrying it resulting in 0.5 to 1.2 million deaths each year . These mortalitiesare due to chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). Horizontal transmission in earlychildhood and parental transmission at any age are the important routes of transmission. This study wasconducted with following objectives.(a) To assess the prevalence of adherence to Hepatitis vaccination.(b) To associate this adherence with demographic factors.Methodology: After receiving approval from the Institutional Ethics Committee a record based retrospectivecohort study was conducted at Gastroenterology and Hepatology OPD of IMS and SUM Hospital,Bhubaneswar. Data regarding all the patients who have received First dose of Hepatitis Vaccine from January2019 to December 2019 were followed up till June 2020 to find out how many of them have revisited toobta...

Tropical Parasitology, 2021

Fasciolopsis is one of the rarest parasitic infestations in our locality. The usual definitive ho... more Fasciolopsis is one of the rarest parasitic infestations in our locality. The usual definitive host is the sheep; humans are accidental hosts in the life cycle of a liver fluke – Fasciola. In the chronic phage of Fasciolopsis, the patient presents with cholestasis and cholangitis. Yet, there is no proof of association of this parasite with carcinoma of the gallbladder. We here present such a case of Fasciolopsis in association with Stage IV gallbladder malignancy. Fasciola worms were extracted on endoscopic retrograde cholangiopancreatography done as a palliative measure for associated obstructive jaundice. The chronic phase of this zoonotic infection can be easily misdiagnosed as any other cause of obstructive jaundice if not properly investigated. The importance of repeated stool examination for parasitic ova and cysts should never be understated as it may help in early diagnosis of such treatable conditions as well as preventing the complications.

Journal of Pure and Applied Microbiology, 2021

Helicobacter pylorus (H. pylori) is a deadly bacterium responsible for significant worldwide Gast... more Helicobacter pylorus (H. pylori) is a deadly bacterium responsible for significant worldwide Gastric Cancer (GC) related mortality. The present study aimed to screen all the anti-microbial drugs used to eradicate H .pylori infection and to identify the most efficient drug by using computational methods through molecular docking analysis. The 3-D structure of protein chorismate synthase of H. pylori was downloaded from the Protein data bank (PDB) online browser. The x-ray crystallography structures of 13 common drugs used against H.pylori infection were also downloaded from the drug bank. We screened all 13 common drugs through molecular docking to know the most efficient binding interaction between the diverse ligand-protein complexes. The results were further compared with clinical survey data from the patients with diverse gastrointestinal H. pylori infected cases. Among the screened compounds, by in-silico approach we found that fluoroquinolone (FLRQ) and tetracycline (TET) manif...

Cureus, 2021

Introduction Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, w... more Introduction Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, with a global prevalence of 20%-40%. Approximately 40%-60% of patients with type 2 diabetes mellitus (DM2) experience NAFLD; out of which 20%-40% cases may have higher severity. Due to the scarcity of available reports from the eastern part of India, we aimed to evaluate the effects of dapagliflozin, a sodium-glucose cotransporter-2 inhibitor used in these types of cases. Material and methods The study included consecutive patients with DM2 and NAFLD, treated with dapagliflozin at 10 mg daily for six months. All patients underwent detailed anthropometric, biochemical, abdominal ultrasonography, and transient elastography studies at baseline and after therapy as well as a comparative analysis. Results In the 100 patients included in our study, the male patients outnumbered the female patients (male-tofemale ratio, 4.27:-1) and the mean age at presentation was 44.11 ± 8.24 years. The mean body mass index significantly decreased over the course of the therapy, from 27.31± 1.87 kg/m 2 at baseline to 26.21 ± 1.51 kg/m 2 after the therapy. The patients' transaminitis, dyslipidemia, and glycemic status significantly improved over the course of the therapy. We also observed significant (p < 0.05) improvement in hepatic steatosis by the end of the treatment. Although transient elastography by FibroScan-measured hepatic fibrosis score (Echosens, Paris, France) significantly decreased from 6.95 ± 1.42 to 6 ± 1.44 kPa, hepatic fibrosis did not improve significantly (p ≥ 0.05) following therapy. Conclusion Although dapagliflozin improved body mass index, transaminitis, dyslipidemia, glycemic status, and hepatic steatosis, it had a minimal effect on hepatic fibrosis.

Journal of Clinical and Experimental Hepatology, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Genes & Cancer, 2020

Backgrounds and Aims: Hepatocellular Carcinoma (HCC) is the leading cause of cancer-related morta... more Backgrounds and Aims: Hepatocellular Carcinoma (HCC) is the leading cause of cancer-related mortality across the world. Non-viral etiological factors including obesity and metabolic syndrome have now become prevalent cause of hepatocellular carcinoma. Sonic Hedgehog (SHH) pathway is activated in hepatocellular carcinoma but its role in regulation of lipogenic molecules during the hepatocarcinogenesis is not known. The aim of present study is to explore the role of SHH pathway in fatty changes associated with hepatocarcinogenesis at different stages and to further correlate the expression of SHH with lipogenic pathways. Results: Our results demonstrated significant increase in lipidosis and fibrosis in DEN+CCl4 treated animals. It was simultaneously associated with the enhanced expression level of SHH, E2F1, adiponectin, and lipogenic molecules in DEN+CCl4 treated animals. These results were also corroborated with the similar findings in higher stage patients' biospecimens. Methods: N-Nitrosodiethylamine (DEN) and Carbon TetraChloride (CCl4) induced hepatocellular acrcinoma model in male Wistar rats were established to study the expression level of SHH pathway and associated fatty changes during different stages of hepatocarcinogenesis. The expression levels of SHH, E2F1, and lipogenic molecules were checked at different stages of hepatocellular carcinoma. These results were further compared with biospecimens of hepatocellular carcinoma patients of different stages. Conclusions: Our results revealed an unknown aspect of SHH pathway in hepatocarcinogenesis via its control over lipogenesis. It gives insight into the lipogenic properties of DEN+CCl4 induced rodent hepatocarcinogenesis model and how SHH pathway operate to arbitrate this response.

Journal of Clinical and Experimental Hepatology, 2018

Background and Aim: Hepatitis B (HBV) infection had high prevalence in India. There is paucity of... more Background and Aim: Hepatitis B (HBV) infection had high prevalence in India. There is paucity of data regarding knowledge and awareness amongst the lay man. The present study was designed to evaluate the degree of awareness and knowledge regarding HBV infection transmission and outcome amongst the common public. Methods: The accompanying attendants of the patients attending the outdoor of Gastroenterology department of IMS & SUM hospital; Bhubaneswar, Odisha in between December 2017 and April 2018 were included in the study and evaluated by a set of questionnaires. Results: Consecutive 106 persons (Male: Female-3:1) were evaluated. Most (70%) of them were literate. Only 17% persons had received HBV vaccination. 77% persons were aware that HBV infection can be transmitted by sharing of the tooth brush. 88%, 71%, and 21% persons were apprehensive that HBV transmission may occur by consuming food with infected person, by coughing and shaking of hands with infected persons respectively. 75%, 90% and 63% persons were aware that HBV infection can spread by sharing of razor, may spread sexually, and by sharing of needles respectively. 52% and 35% persons were not sure regarding mother to child transmission and HBV prevention by vaccination respectively. 54% persons were not aware that liver cancer can occur due to infection. 60% persons were unaware regarding lifelong infectiveness of infected patients. 87% persons were aware that HBV infection cannot be cured. 96% persons were ashamed to suffer from HBV infection and apprehensive that they may be discriminated from their family and workplace. Only 40% showed their willingness to disclose their infective status. All the persons showed their interest to prevent HBV transmission by adopting preventive measures. Conclusions: Most of the persons from our region had insufficient knowledge regarding HBV infection and need mass awareness campaigning.

Journal of Clinical and Experimental Hepatology, 2018

Background: Cancer is the second leading cause of death in the United States, exceeded only by he... more Background: Cancer is the second leading cause of death in the United States, exceeded only by heart disease. Extant cancer survival analyses have primarily focused on individual-level factors due to limited data availability from a single data source. There is a need to integrate data from different sources to simultaneously study as much risk factors as possible. Thus, we proposed an ontology-based approach to integrate heterogeneous datasets addressing key data integration challenges. Methods: Following best practices in ontology engineering, we created the Ontology for Cancer Research Variables (OCRV) adapting existing semantic resources such as the National Cancer Institute (NCI) Thesaurus. Using the global-as-view data integration approach, we created mapping axioms to link the data elements in different sources to OCRV. Implemented upon the Ontop platform, we built a data integration pipeline to query, extract, and transform data in relational databases using semantic queries into a pooled dataset according to the downstream multi-level Integrative Data Analysis (IDA) needs. Results: Based on our use cases in the cancer survival IDA, we created tailored ontological structures in OCRV to facilitate the data integration tasks. Specifically, we created a flexible framework addressing key integration challenges: (1) using a shared, controlled vocabulary to make data understandable to both human and computers, (2) explicitly modeling the semantic relationships makes it possible to compute and reason with the data, (3) linking patients to contextual and environmental factors through geographic variables, (4) being able to document the data manipulation and integration processes clearly in the ontologies. Conclusions: Using an ontology-based data integration approach not only standardizes the definitions of data variables through a common, controlled vocabulary, but also makes the semantic relationships among variables from different sources explicit and clear to all users of the same datasets. Such an approach resolves the ambiguity in variable selection, extraction and integration processes and thus improve reproducibility of the IDA.

Journal of Clinical and Experimental Hepatology, 2018

malized ratio of 3.1. The patient was listed on priority for liver transplant with PELD value of ... more malized ratio of 3.1. The patient was listed on priority for liver transplant with PELD value of 32 and Na MELD of 30, the donor being his mother. However, within 7 days of listing the patient developed sudden onset of de-cerebrate posturing. CT scan of head showed acute frontal lobe venous infarct with midline shift. His condition deteriorated rapidly and he died on the next day likely due to cerebral herniation, despite all critical care measures. Conclusions: The above case depicts the dynamic state of "rebalanced hemostatic" in a patient with liver cirrhosis with significant coagulopathy. The risk for cerebrovascular events especially infarcts in cirrhosis has not been clearly determined. The restored balance of hemostasis afforded by concomitant reduction of procoagulant and anti coagulant factors might explain the arterial and venous thrombotic events, challenging the old dogma/paradox of increased bleeding in patients with liver cirrhosis.

Acta Scientific Gastrointestinal Disorders, 2020

Hepatocellular carcinoma (HCC) is one of the most commonly diagnosed primary liver cancer and is ... more Hepatocellular carcinoma (HCC) is one of the most commonly diagnosed primary liver cancer and is also a major cause of cancer-related mortality across the world [1]. Additionally, it is one of the cancers which is admittedly refractory to chemotherapy [2] to radiotherapy and to combination treatment [3]. The aetiology of HCC is diverse including viral factors like infection with hepatitis B or hepatitis C virus infection (HBV and HCV); non-viral factors like alcohol consumption, obesity and other metabolic syndrome; aflatoxin exposure; hereditary factor, and genetic predisposition like mutations in important signalling pathway genes [1,4]. Hepatocarcinogenesis is a multistep process, progressing from a normal hepatocyte to transformed phenotype as a result of the accumulation of aberrant genetic and epigenetic modifications and activation of various signalling pathways [5]. Two major signalling pathways found to be deregulated in HCC are Wnt and Hedgehog (Hh) pathways [6]. These two pathways play key roles in embryogenesis, morphogenesis, tissue patterning, angiogenesis, stem cell maintenance, tumorigenesis, and drug

Hepatic Oncology, 2018

Hepatocellular carcinoma (HCC) is one of the major causes of cancer-related mortality and is part... more Hepatocellular carcinoma (HCC) is one of the major causes of cancer-related mortality and is particularly refractory to the available chemotherapeutic drugs. Among various etiologies of HCC, viral etiology is the most common, and, along with alcoholic liver disease and nonalcoholic steatohepatitis, accounts for almost 90% of all HCC cases. HCC is a heterogeneous tumor associated with multiple signaling pathway alterations and its complex patho-physiology has made the treatment decision challenging. The potential curative treatment options are effective only in small group of patients, while palliative treatments are associated with improved survival and quality of life for intermediate/advanced stage HCC patients. This review article focuses on the currently available treatment strategies and hurdles encountered for HCC therapy. The curative treatment options discussed are surgical resection, liver transplantation, and local ablative therapies which are effective for early stage HCC...

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 2019

Introduction: Tuberculosis is a disease that has been affecting mankind since time immemorial and... more Introduction: Tuberculosis is a disease that has been affecting mankind since time immemorial and it still continues to be a global health concern. Objective of the study was to evaluate the burden, clinical profile, diagnosis and diagnostic difficulties and outcome of abdominal tuberculosis (AbT) in non human immunodeficiency virus (HIV) infected adults in the department of gastroenterology at a tertiary care hospital over a period of two years. Material & methods: It was an observational study and the study period was from January 2016 till January 2018. The patients who were sero positive for HIV virus were excluded from the study. Results: The number of patients hospitalized during the period of 2016-2018 with abdominal tuberculosis was 58. The burden of tuberculosis of indoor patients was 1.3 cases per every 100 patients admitted. Presenting complaint of most of these patients [61%] was abdominal pain. Constitutional symptoms like fever; weight loss and loss of appetite were present in only 40% of the patients. Ascites was the presenting sign in around 45% of the patients. Peritoneum was the most common site of involvement [27 out of 58]. Almost all of these patients [25 out of 27] presented with abdominal pain and abdominal distension. Intestine was the second most common site. Ileocaecal involvement was present in fourteen patients, while other areas of colon were involved in five patients. All the 58 patients were given anti tubercular therapy. There was complete resolution of tuberculosis in 91% of cases [53 out of 58 patients]. Six patients developed drug induced liver injury. Death occurred in two patients who had disseminated tuberculosis. Conclusion: Although the burden of the disease remains the same, availability of newer investigations has aided in its early diagnosis and availability of good drugs has reduced the mortality and morbidity.

Indian Journal of Public Health Research & Development, 2018

Indian Journal of Public Health Research & Development, 2018

Indian Journal of Public Health Research & Development, 2018

Journal of Clinical and Experimental Hepatology

Background/aims: In view of limited data on the knowledge and awareness of hepatitis B virus (HBV... more Background/aims: In view of limited data on the knowledge and awareness of hepatitis B virus (HBV) and the available preventive strategies at the community level, it was aimed to analyse the knowledge and awareness of HBV in the community. Methods: A cross-sectional questionnaire-based survey was conducted among residents of an urban slum and a social welfare home in Bhubaneswar, Odisha, from October 2019 to April 2021. The prevalence of HBV infection was also measured by testing the serum positivity for hepatitis B surface antigen using rapid pointof-care test kits. The statistical analysis was done by using the software SPSS version 20. Results: A total of 370 individuals (mean age 38.7 ± 14.9 years, males: 55.1%) were assessed. Although 18.1% (67) had good knowledge, only 16.7% (62) had good awareness about HBV. Approximately 14.8% (55) knew that a vaccine is available in the country for HBV, and 6.2% (23) identified themselves as being vaccinated. Educational status was a significant independent predictor of knowledge and awareness such that people with education level of matriculation and above had odds of 11.05 (95% confidence interval: 5.3-22.7) and 14.7 (95% confidence interval: 6.5-33.1) for having good knowledge and awareness regarding HBV, respectively. A total of 10 participants tested positive for hepatitis B surface antigen contributing to a point prevalence rate of 2.7%. The proportion of individuals with an education status of matriculation and above was higher in the slum area when compared with the welfare home (67% vs 33%; P < 0.001), the knowledge (71.6% vs 28.4%; P < 0.001) and so was the awareness (71% vs 29%; P < 0.001) about HBV as well. Conclusion: The relatively low figures of knowledge and awareness identified in our study undermine the need for intensification of health education and promotion activities regarding the prevalence of hepatitis B infection on a large scale at the community level.

Cureus

Background and aim As a distinguished system, the cytochrome P450 (CYP) enzyme superfamily is inv... more Background and aim As a distinguished system, the cytochrome P450 (CYP) enzyme superfamily is involved in the biotransformation of several endogenous and exogenous substances including drugs, toxins, and carcinogens. Reports on the role of CYP enzyme in gastric cancer (GC) from the Eastern region of India are scarce. The present study aimed to evaluate the effect of single nucleotide polymorphisms (SNP) in cytochrome P450 family 2 subfamily C member 9 (CYP2C9*3) among cases with gastric malignancy. Material and methods The current study is a cross-sectional observational study carried out among 113 GC cases attending the

Middle East Journal of Digestive Diseases, 2021

BACKGROUND Left ventricular diastolic dysfunction (LVDD) is the earliest cardiac dysfunction note... more BACKGROUND Left ventricular diastolic dysfunction (LVDD) is the earliest cardiac dysfunction noted in patients with liver cirrhosis, which increases the morbidity and mortality in such patients. There are sparse studies from India evaluating the predictive factors of LVDD in patients with cirrhosis. Hence we undertook this prospective study with an aim to evaluate the factors predicting the development of LVDD in liver cirrhosis. METHODS 104 patients with cirrhosis were enrolled in this prospective study. A detailed cardiac evaluation was done by 2 D echocardiography with tissue Doppler imaging by an experienced senior cardiologist. The severity of liver disease was defined by Model For End-Stage Liver Disease (MELD) and Child-Pugh score. RESULTS The prevalence of LVDD was 46% in our study. Multivariate logistic regression analysis revealed that serum albumin, MELD score, and presence of ascites (OR = 0.1, 95%CI 0.03-0.3, p < 0.001; Or = 1.12, 95%CI 1.03-1.22, p < 0.001; OR = ...

Cureus, 2021

Introduction: Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder. Female p... more Introduction: Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder. Female patients with bowel disease commonly report worsening of symptoms in the menstrual cycle. However, there is a paucity of data regarding IBS presentations' variation during different phases of the menstrual cycle. The current study aimed to evaluate the same in female IBS patients. Materials and Methods: Consecutive premenopausal female patients with the diagnosis of IBS attending the outdoor (OPD)

Cureus, 2021

Background and aim Idiopathic chronic pancreatitis (ICP) is said to be present when no identifiab... more Background and aim Idiopathic chronic pancreatitis (ICP) is said to be present when no identifiable etiology can be identified. Robust evidence suggested that the serine protease inhibitor nucleus Kazol type 1 (SPINK1) N34S mutation was frequently associated with ICP. As there is a paucity of data on genetic studies in ICP cases from the coastal eastern region of India, we performed this study with an aim to evaluate the SPINK1 genetic mutations and other associated clinical correlates in ICP cases. Material and methods Consecutive ICP cases attending the department of gastroenterology, Institute of Medical Sciences (IMS) and SUM Hospital, were enrolled and evaluated for the pertinent clinical history and undergone detailed biochemical and radiological evaluations. Two ml of venous blood in ethylenediaminetetraacetic acid (EDTA) vials were collected from each case and subjected to a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) test for genetic analysis. Result In this study, the mean age of the cases at the time of the first consultation with us and the age of the first clinical presentation were 34.52±6.44 and 28.73±5.52 years, respectively. Males outnumbered females (Male:Female-2.12:1). Out of the total of 200 cases, 50% had no SPINK1 mutation, whereas 40% and 10% cases had SPINK1 N34S heterozygous and homozygous mutations, respectively. The mean age of clinical presentation, severe abdominal pain, exocrine and endocrine insufficiency, and parenchymal atrophy were significantly more common in mutants as compared to non-mutants (p-value <0.05). Conclusion In our region, 50% of ICP cases had the SPINK1 N34S mutation. The SPINK1 mutants had a relatively more severe variety of pancreatitis as compared to non-mutants.

Indian Journal of Public Health Research & Development, 2021

Background: Globally out of 200 crore population who are getting exposed to the hepatitis B virus... more Background: Globally out of 200 crore population who are getting exposed to the hepatitis B virus (HBV),about 350 million are chronically carrying it resulting in 0.5 to 1.2 million deaths each year . These mortalitiesare due to chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). Horizontal transmission in earlychildhood and parental transmission at any age are the important routes of transmission. This study wasconducted with following objectives.(a) To assess the prevalence of adherence to Hepatitis vaccination.(b) To associate this adherence with demographic factors.Methodology: After receiving approval from the Institutional Ethics Committee a record based retrospectivecohort study was conducted at Gastroenterology and Hepatology OPD of IMS and SUM Hospital,Bhubaneswar. Data regarding all the patients who have received First dose of Hepatitis Vaccine from January2019 to December 2019 were followed up till June 2020 to find out how many of them have revisited toobta...

Tropical Parasitology, 2021

Fasciolopsis is one of the rarest parasitic infestations in our locality. The usual definitive ho... more Fasciolopsis is one of the rarest parasitic infestations in our locality. The usual definitive host is the sheep; humans are accidental hosts in the life cycle of a liver fluke – Fasciola. In the chronic phage of Fasciolopsis, the patient presents with cholestasis and cholangitis. Yet, there is no proof of association of this parasite with carcinoma of the gallbladder. We here present such a case of Fasciolopsis in association with Stage IV gallbladder malignancy. Fasciola worms were extracted on endoscopic retrograde cholangiopancreatography done as a palliative measure for associated obstructive jaundice. The chronic phase of this zoonotic infection can be easily misdiagnosed as any other cause of obstructive jaundice if not properly investigated. The importance of repeated stool examination for parasitic ova and cysts should never be understated as it may help in early diagnosis of such treatable conditions as well as preventing the complications.

Journal of Pure and Applied Microbiology, 2021

Helicobacter pylorus (H. pylori) is a deadly bacterium responsible for significant worldwide Gast... more Helicobacter pylorus (H. pylori) is a deadly bacterium responsible for significant worldwide Gastric Cancer (GC) related mortality. The present study aimed to screen all the anti-microbial drugs used to eradicate H .pylori infection and to identify the most efficient drug by using computational methods through molecular docking analysis. The 3-D structure of protein chorismate synthase of H. pylori was downloaded from the Protein data bank (PDB) online browser. The x-ray crystallography structures of 13 common drugs used against H.pylori infection were also downloaded from the drug bank. We screened all 13 common drugs through molecular docking to know the most efficient binding interaction between the diverse ligand-protein complexes. The results were further compared with clinical survey data from the patients with diverse gastrointestinal H. pylori infected cases. Among the screened compounds, by in-silico approach we found that fluoroquinolone (FLRQ) and tetracycline (TET) manif...

Cureus, 2021

Introduction Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, w... more Introduction Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, with a global prevalence of 20%-40%. Approximately 40%-60% of patients with type 2 diabetes mellitus (DM2) experience NAFLD; out of which 20%-40% cases may have higher severity. Due to the scarcity of available reports from the eastern part of India, we aimed to evaluate the effects of dapagliflozin, a sodium-glucose cotransporter-2 inhibitor used in these types of cases. Material and methods The study included consecutive patients with DM2 and NAFLD, treated with dapagliflozin at 10 mg daily for six months. All patients underwent detailed anthropometric, biochemical, abdominal ultrasonography, and transient elastography studies at baseline and after therapy as well as a comparative analysis. Results In the 100 patients included in our study, the male patients outnumbered the female patients (male-tofemale ratio, 4.27:-1) and the mean age at presentation was 44.11 ± 8.24 years. The mean body mass index significantly decreased over the course of the therapy, from 27.31± 1.87 kg/m 2 at baseline to 26.21 ± 1.51 kg/m 2 after the therapy. The patients' transaminitis, dyslipidemia, and glycemic status significantly improved over the course of the therapy. We also observed significant (p < 0.05) improvement in hepatic steatosis by the end of the treatment. Although transient elastography by FibroScan-measured hepatic fibrosis score (Echosens, Paris, France) significantly decreased from 6.95 ± 1.42 to 6 ± 1.44 kPa, hepatic fibrosis did not improve significantly (p ≥ 0.05) following therapy. Conclusion Although dapagliflozin improved body mass index, transaminitis, dyslipidemia, glycemic status, and hepatic steatosis, it had a minimal effect on hepatic fibrosis.

Journal of Clinical and Experimental Hepatology, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Genes & Cancer, 2020

Backgrounds and Aims: Hepatocellular Carcinoma (HCC) is the leading cause of cancer-related morta... more Backgrounds and Aims: Hepatocellular Carcinoma (HCC) is the leading cause of cancer-related mortality across the world. Non-viral etiological factors including obesity and metabolic syndrome have now become prevalent cause of hepatocellular carcinoma. Sonic Hedgehog (SHH) pathway is activated in hepatocellular carcinoma but its role in regulation of lipogenic molecules during the hepatocarcinogenesis is not known. The aim of present study is to explore the role of SHH pathway in fatty changes associated with hepatocarcinogenesis at different stages and to further correlate the expression of SHH with lipogenic pathways. Results: Our results demonstrated significant increase in lipidosis and fibrosis in DEN+CCl4 treated animals. It was simultaneously associated with the enhanced expression level of SHH, E2F1, adiponectin, and lipogenic molecules in DEN+CCl4 treated animals. These results were also corroborated with the similar findings in higher stage patients' biospecimens. Methods: N-Nitrosodiethylamine (DEN) and Carbon TetraChloride (CCl4) induced hepatocellular acrcinoma model in male Wistar rats were established to study the expression level of SHH pathway and associated fatty changes during different stages of hepatocarcinogenesis. The expression levels of SHH, E2F1, and lipogenic molecules were checked at different stages of hepatocellular carcinoma. These results were further compared with biospecimens of hepatocellular carcinoma patients of different stages. Conclusions: Our results revealed an unknown aspect of SHH pathway in hepatocarcinogenesis via its control over lipogenesis. It gives insight into the lipogenic properties of DEN+CCl4 induced rodent hepatocarcinogenesis model and how SHH pathway operate to arbitrate this response.

Journal of Clinical and Experimental Hepatology, 2018

Background and Aim: Hepatitis B (HBV) infection had high prevalence in India. There is paucity of... more Background and Aim: Hepatitis B (HBV) infection had high prevalence in India. There is paucity of data regarding knowledge and awareness amongst the lay man. The present study was designed to evaluate the degree of awareness and knowledge regarding HBV infection transmission and outcome amongst the common public. Methods: The accompanying attendants of the patients attending the outdoor of Gastroenterology department of IMS & SUM hospital; Bhubaneswar, Odisha in between December 2017 and April 2018 were included in the study and evaluated by a set of questionnaires. Results: Consecutive 106 persons (Male: Female-3:1) were evaluated. Most (70%) of them were literate. Only 17% persons had received HBV vaccination. 77% persons were aware that HBV infection can be transmitted by sharing of the tooth brush. 88%, 71%, and 21% persons were apprehensive that HBV transmission may occur by consuming food with infected person, by coughing and shaking of hands with infected persons respectively. 75%, 90% and 63% persons were aware that HBV infection can spread by sharing of razor, may spread sexually, and by sharing of needles respectively. 52% and 35% persons were not sure regarding mother to child transmission and HBV prevention by vaccination respectively. 54% persons were not aware that liver cancer can occur due to infection. 60% persons were unaware regarding lifelong infectiveness of infected patients. 87% persons were aware that HBV infection cannot be cured. 96% persons were ashamed to suffer from HBV infection and apprehensive that they may be discriminated from their family and workplace. Only 40% showed their willingness to disclose their infective status. All the persons showed their interest to prevent HBV transmission by adopting preventive measures. Conclusions: Most of the persons from our region had insufficient knowledge regarding HBV infection and need mass awareness campaigning.

Journal of Clinical and Experimental Hepatology, 2018

Background: Cancer is the second leading cause of death in the United States, exceeded only by he... more Background: Cancer is the second leading cause of death in the United States, exceeded only by heart disease. Extant cancer survival analyses have primarily focused on individual-level factors due to limited data availability from a single data source. There is a need to integrate data from different sources to simultaneously study as much risk factors as possible. Thus, we proposed an ontology-based approach to integrate heterogeneous datasets addressing key data integration challenges. Methods: Following best practices in ontology engineering, we created the Ontology for Cancer Research Variables (OCRV) adapting existing semantic resources such as the National Cancer Institute (NCI) Thesaurus. Using the global-as-view data integration approach, we created mapping axioms to link the data elements in different sources to OCRV. Implemented upon the Ontop platform, we built a data integration pipeline to query, extract, and transform data in relational databases using semantic queries into a pooled dataset according to the downstream multi-level Integrative Data Analysis (IDA) needs. Results: Based on our use cases in the cancer survival IDA, we created tailored ontological structures in OCRV to facilitate the data integration tasks. Specifically, we created a flexible framework addressing key integration challenges: (1) using a shared, controlled vocabulary to make data understandable to both human and computers, (2) explicitly modeling the semantic relationships makes it possible to compute and reason with the data, (3) linking patients to contextual and environmental factors through geographic variables, (4) being able to document the data manipulation and integration processes clearly in the ontologies. Conclusions: Using an ontology-based data integration approach not only standardizes the definitions of data variables through a common, controlled vocabulary, but also makes the semantic relationships among variables from different sources explicit and clear to all users of the same datasets. Such an approach resolves the ambiguity in variable selection, extraction and integration processes and thus improve reproducibility of the IDA.

Journal of Clinical and Experimental Hepatology, 2018

malized ratio of 3.1. The patient was listed on priority for liver transplant with PELD value of ... more malized ratio of 3.1. The patient was listed on priority for liver transplant with PELD value of 32 and Na MELD of 30, the donor being his mother. However, within 7 days of listing the patient developed sudden onset of de-cerebrate posturing. CT scan of head showed acute frontal lobe venous infarct with midline shift. His condition deteriorated rapidly and he died on the next day likely due to cerebral herniation, despite all critical care measures. Conclusions: The above case depicts the dynamic state of "rebalanced hemostatic" in a patient with liver cirrhosis with significant coagulopathy. The risk for cerebrovascular events especially infarcts in cirrhosis has not been clearly determined. The restored balance of hemostasis afforded by concomitant reduction of procoagulant and anti coagulant factors might explain the arterial and venous thrombotic events, challenging the old dogma/paradox of increased bleeding in patients with liver cirrhosis.

Acta Scientific Gastrointestinal Disorders, 2020

Hepatocellular carcinoma (HCC) is one of the most commonly diagnosed primary liver cancer and is ... more Hepatocellular carcinoma (HCC) is one of the most commonly diagnosed primary liver cancer and is also a major cause of cancer-related mortality across the world [1]. Additionally, it is one of the cancers which is admittedly refractory to chemotherapy [2] to radiotherapy and to combination treatment [3]. The aetiology of HCC is diverse including viral factors like infection with hepatitis B or hepatitis C virus infection (HBV and HCV); non-viral factors like alcohol consumption, obesity and other metabolic syndrome; aflatoxin exposure; hereditary factor, and genetic predisposition like mutations in important signalling pathway genes [1,4]. Hepatocarcinogenesis is a multistep process, progressing from a normal hepatocyte to transformed phenotype as a result of the accumulation of aberrant genetic and epigenetic modifications and activation of various signalling pathways [5]. Two major signalling pathways found to be deregulated in HCC are Wnt and Hedgehog (Hh) pathways [6]. These two pathways play key roles in embryogenesis, morphogenesis, tissue patterning, angiogenesis, stem cell maintenance, tumorigenesis, and drug

Hepatic Oncology, 2018

Hepatocellular carcinoma (HCC) is one of the major causes of cancer-related mortality and is part... more Hepatocellular carcinoma (HCC) is one of the major causes of cancer-related mortality and is particularly refractory to the available chemotherapeutic drugs. Among various etiologies of HCC, viral etiology is the most common, and, along with alcoholic liver disease and nonalcoholic steatohepatitis, accounts for almost 90% of all HCC cases. HCC is a heterogeneous tumor associated with multiple signaling pathway alterations and its complex patho-physiology has made the treatment decision challenging. The potential curative treatment options are effective only in small group of patients, while palliative treatments are associated with improved survival and quality of life for intermediate/advanced stage HCC patients. This review article focuses on the currently available treatment strategies and hurdles encountered for HCC therapy. The curative treatment options discussed are surgical resection, liver transplantation, and local ablative therapies which are effective for early stage HCC...

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 2019

Introduction: Tuberculosis is a disease that has been affecting mankind since time immemorial and... more Introduction: Tuberculosis is a disease that has been affecting mankind since time immemorial and it still continues to be a global health concern. Objective of the study was to evaluate the burden, clinical profile, diagnosis and diagnostic difficulties and outcome of abdominal tuberculosis (AbT) in non human immunodeficiency virus (HIV) infected adults in the department of gastroenterology at a tertiary care hospital over a period of two years. Material & methods: It was an observational study and the study period was from January 2016 till January 2018. The patients who were sero positive for HIV virus were excluded from the study. Results: The number of patients hospitalized during the period of 2016-2018 with abdominal tuberculosis was 58. The burden of tuberculosis of indoor patients was 1.3 cases per every 100 patients admitted. Presenting complaint of most of these patients [61%] was abdominal pain. Constitutional symptoms like fever; weight loss and loss of appetite were present in only 40% of the patients. Ascites was the presenting sign in around 45% of the patients. Peritoneum was the most common site of involvement [27 out of 58]. Almost all of these patients [25 out of 27] presented with abdominal pain and abdominal distension. Intestine was the second most common site. Ileocaecal involvement was present in fourteen patients, while other areas of colon were involved in five patients. All the 58 patients were given anti tubercular therapy. There was complete resolution of tuberculosis in 91% of cases [53 out of 58 patients]. Six patients developed drug induced liver injury. Death occurred in two patients who had disseminated tuberculosis. Conclusion: Although the burden of the disease remains the same, availability of newer investigations has aided in its early diagnosis and availability of good drugs has reduced the mortality and morbidity.

Indian Journal of Public Health Research & Development, 2018

Indian Journal of Public Health Research & Development, 2018

Indian Journal of Public Health Research & Development, 2018